Critical thinking about medicine or any topic requires weighing multiple sources against one another and distinguishing between degrees of certainty, not ruling out all sources of evidence but one and equating “unproven” with “false.” The approach to health information increasingly taken by public officials, reporters, and social media—under which any statement is “unproven” and must be assumed harmful, barring some definitive pronouncement by public health authorities to the contrary—is thus not only authoritarian but also damaging to public health and science as a whole.

Imperial County, California, a poor, largely Hispanic agricultural region in the southeastern corner of the state, has been hit hard by Covid-19. By the end of January, according to the New York Times’s Covid-19 database, Imperial County had suffered 845 Covid deaths, or 4.7 per thousand inhabitants—a rate almost 80 percent higher than the U.S. average. The case fatality rate in Imperial County is 1.44 percent, the second-highest in California—and was significantly higher, 2.10 percent, at the end of October 2021 before the Omicron wave.
Two doctors in Imperial County, though—George Fareed and Brian Tyson, who run the All Valley Urgent Care network of medical centers—claim to have done far better with their Covid-19 patients. In fact, they claim near-perfect success: in a book that they published last January, they claim to have seen more than 7,000 patients and had only three deaths, all among patients who began treatment in later disease stages. A statistical analysis of part of their results by the statistician Mathew Crawford, included in their book, counts only seven hospitalizations and three deaths among 4,376 patients seen up through March 13, 2021—a reduction in hospitalization risk of well over 90 percent from the county average, even after (admittedly imperfect) statistical adjustments for differences in age between Fareed and Tyson’s patients and the general population.
According to prevailing medical views, Fareed and Tyson’s claimed results should be impossible. The doctors’ first protocol was based around hydroxychloroquine (HCQ), a repurposed anti-malarial drug, with other drugs such as ivermectin as more recent additions. Received opinion on the drugs is that ivermectin is at best unproven in treating Covid-19 (the Food and Drug Administration maintains an official webpage warning against using it as a treatment for the virus), and that HCQ has been actively disproved: early optimism from laboratory experiments and small clinical studies did not hold up in larger, more rigorous trials.
Such opinions have influenced not just news coverage but also the moderation policies of social media platforms, which have imposed ever-stricter rules against “misinformation” (meaning, in practice, contradicting American public health authorities). After Fareed and Tyson spoke by invitation at a meeting of the Imperial County Board of Supervisors, the Los Angeles Times ran an article noting that the Imperial County Medical Society “had urged supervisors to ‘not contribute to the dissemination of false or misleading information by legitimizing unproven treatments.’” The paper also quoted an executive at an Imperial County hospital, saying, “We need to stick with what we know is approved by the FDA for COVID-19 treatments. . . . Misinformation itself ought to be stopped.” In December, Twitter also suspended Tyson’s account for breaking its policies against Covid misinformation.
The dismissal of hydroxychloroquine as a possible Covid-19 treatment, however, was never based on solid science. The Los Angeles Times article reveals a fundamentally authoritarian worldview: medical claims are “unproven,” and dangerous for the public to discuss, until some official body endorses them—an approach that threatens public health and science alike.
Interest in hydroxychloroquine as a coronavirus treatment stretches back at least to 2005, when an in vitro study showed that chloroquine, a very similar compound, might protect against SARS infection. Based on laboratory studies and small clinical trials, medical authorities in China and South Korea recommended chloroquine as a Covid-19 treatment in February 2020.
Some doctors outside East Asia followed. Vladimir Zelenko, a doctor in a Hasidic community in New York, advocated a combination of HCQ, azithromycin (an antibiotic to guard against secondary infections), and a zinc supplement: HCQ increases the uptake of zinc ions into cells, a property that Zelenko surmised might provide antiviral effects. In an open letter in April 2020, Zelenko claimed to have treated about 1,450 patients, including 405 that he judged “high risk,” with only two deaths. Luigi Cavanna, a doctor in Piacenza, Italy, also claimed about the same time that thanks to an HCQ treatment protocol, none of his patients had died and only 5 percent were hospitalized—one-sixth the contemporaneous Italian hospitalization rate of over 30 percent. Many more systematic “observational” studies of HCQ—comparing patients in a hospital or elsewhere who received a drug (because of their own or a doctor’s choice) with those who did not—returned good results both as a treatment of Covid-19 cases (including one large study from the Henry Ford Health System in metropolitan Detroit) and for prevention of Covid-19 in individuals at high exposure risk. One especially striking example of the latter is a set of 11 “case-control” studies from India, where medical authorities recommended but did not mandate a weekly prophylactic dose of HCQ for medical workers. Most of these studies found that workers who took HCQ had reduced odds of testing positive for SARS-CoV-2 antibodies, with especially marked reductions for those who took six or more doses of the protocol.
Medical researchers tend to discount doctors’ reports and observational studies—which, granted, have many potential biases that can’t always be spotted or corrected. For instance, observational studies can underestimate the efficacy of a treatment that’s given more often to sicker patients—or overestimate it, if health-conscious patients are more likely to demand experimental treatments, or if doctors who give ineffective experimental drugs are also more likely to give effective experimental drugs (this latter point was a common and valid criticism of the Henry Ford study). So doctors generally consider randomized trials, which avoid these classes of bias, to be more reliable—though they have drawbacks, too, such as considerably greater expense and, therefore, typically smaller sample sizes.
And most analyses of randomized trials of HCQ—on the basis of which mainstream medical opinion decided that it doesn’t work for Covid-19—do draw negative conclusions. For instance, a February 2021 review by Cochrane, an organization that produces comprehensive reviews of randomized trials, concludes, “HCQ for people infected with COVID‐19 has little or no effect on the risk of death and probably no effect on progression to mechanical ventilation.” Another meta-analysis in Nature by Cathrine Axfors et al. estimates an 11 percent increase in risk of death on the basis of 26 randomized trials.
The results of both meta-analyses were essentially determined by two large, similar trials: the Solidarity trial run by the World Health Organization and the Recovery trial at the University of Oxford. These trials accounted together for over 97 percent of the statistical weight in Cochrane’s main analysis, and both claimed to rule out more than a tiny benefit of HCQ for hospitalized Covid-19 patients.
But neither trial disproves claims such as Fareed and Tyson’s. First and most importantly, both trials were on hospitalized patients and are not necessarily applicable to “outpatients” earlier in the disease course. Antiviral treatments work better earlier: for instance, oseltamivir (also known as Tamiflu), an antiviral influenza treatment, works well if started within two days of symptom onset, but not later. In Covid-19, viral load peaks soon after symptom onset, and viral replication has already ceased in most hospitalized patients, guaranteeing that antiviral treatments will have limited effect. One review in The Lancet found that dozens of studies consistently find that viral load in Covid-19 peaks in the first week of symptoms and that “No study detected live virus beyond day 9 of illness.”
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A theology that traces promise across the contours of human history and misery, sees that its trajectory ends in a genuine hope which is of greater gravity and density than any merely topical words of comfort. Biblical theology arms the pastor, sitting by a death bed, sitting in the ruins of relational betrayal, occupying the hinterland of doubt and complexity, with the one Story whose ending is joyous without being artificial.

If a theology is true and good it will live well outside of the textbook and the classroom. If a body of scholarship fairly represents the word of God and the God of the word, then its impact will be felt beyond the pulpit and the more obvious didactic activities of the local church. A theology which has the Incarnation at its heart but that fails to land in everyday life is an inadequate and anaemic parody of divine revelation. Not all theology is experiential in content but it must be experiential in impact, the truths the theologian handles are not lifeless pinned butterflies but live specimens whose beauty and benefit should be seen and felt in the world, with the weight of God about them.
The work of a local church pastor is one of the most obvious interfaces for theology and practice, for doctrine and experience. Taking Biblical Theology as my starting point (I hope to write on Systematics at a later stage) in this post I want to share three ways in which this discipline has helped me in the caring aspect of my work as a local church pastor:
1. The Big Story gives me a book that travels well.
One of the things that can mark out a pastoral visit to a home from those made by other members is that such contact provides an informal opportunity for word ministry. This is the ‘house to house’ element of Christian service that Paul was keen to highlight to the elders in Ephesus (Acts 20:20), the ministerial priority that Richard Baxter so heavily emphasised in The Reformed Pastor, and an unseen work that forms the backbone of individual and family discipleship within the local church. Whether it is to the hospital ward, a care facility, or a home, bringing the Bible with me and leaving a word from it behind me is one of the rich privileges of being engaged in Christian service.
In this forum Biblical Theology comes into its own. Many (but by no means all) of the people whom a pastor visits are suffering from ill health, or have faced other setbacks in their Christian walk. This means that many of the texts shared in this environment are Bible promises: the consolation of the Psalms, the tender ministrations of the major and minor prophets, the pastoral heart of Jesus, or the loving counsel of the apostles. The dynamic of a broken heart or stricken health coming into contact with the living word of God can be an electrifying experience. This is often where the real conversation begins, with the word softening the reader’s and hearers’ hearts and opening a door for the mercy and goodness of God to be ministered. The danger of this, however, is that texts can be atomised or psychologised, and the insistence on context that garrisons the pulpit on a Sunday can be lost in the side ward or living room during the week.
This is where the Big Story of Biblical Theology is so beneficial. It has become common to sneer at Jeremiah 29:11 as the anthem of a therapeutic Christianity, but its counsel can be shared with those in crisis merely by disclosing something of the movement of redemptive history that gave dimension and pathos to the prophet’s words. Sections of the Psalter can be ripped away from their moorings, but Biblical Theology insists that the setting is what allows a gem to show its lustre. Having the imprint of the drama of redemption, the sweep and line and arc of what God was doing when this text was written, allows the pastor to speak hope that is real and tangible, textual and contextual. Where appropriate, and where the capacities of those visited allows it, brief context can be given to what is being read, opening up the conversation to be a teaching moment rather than a textual extraction/abstraction. It is hard not to believe that the Holy Spirit can honour the word of God when shared in this way.
2. Small stories are where the Big Story happens.
Aside from direct teaching of Scripture, Biblical Theology helps with pastoral visitation because of its esteem for history and narrative as the channel through which we come to know the mind and ways of God.
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Written by Aaron M. Renn |
Thursday, May 9, 2024
There’s a copious amount of discussion about family structures in this book, but Todd adds to that an overlay of religion. He sees Protestantism, rather than the market, industry, or technology as the heart of the modern West. Its most critical impact was a drive for universal literacy, so that all the people could read the Bible in their own language. It also created the famed Protestant work ethic. An educated, industrious populous led to the takeoff of economic growth in Protestant countries. Indeed, Protestant countries were the most advanced industrial economies in Europe and basically remain the leaders. (Todd believes France benefitted from being adjacent to a band of Protestant nations).

French historian and demographer Emmanuel Todd was the first person to have predicted the fall of the Soviet Union. He noted that, unusually, its infant mortality rate was rising, and that they had even ceased publishing that statistic. Based on this and other data, he concluded that the Soviet Union had entered “the final fall.”
In something of a parallel to that work, his new book, La défaite de l’Occident (The Defeat of the West), published in January, says that the West is on track to lose the conflict in Ukraine. Unsurprisingly, this was received poorly by critics who accused him of repeating Kremlin propaganda.
What caught my attention was that Todd blames the fall of Protestantism for unleashing a crisis in the heart of the West itself. And that this rather than Russia’s invasion of Ukraine was the true source of our problems. He writes, “The real problem facing the world today is not Russian will to power, which is very limited. It’s decadence at its American center, which is unlimited.” (You can see why people hated this). I read the book for myself to see what he had to say about Protestantism.
My earliest readers will know that that I’ve been learning French. I’ve mastered enough to essay Todd’s book, but am still sub-fluent. So you should validate the translations I provide here before relying on them, as they are a mixture of Google Translate and my own work.
Much of Todd’s research work has focused on the influence of historic family structures on ideologies. For example, he argues that the Russian family structure created a social state that was amenable to communism. Russian families were strongly patriarchal, and all of the sons lived with their father. This created an ideal of, simultaneously, authoritarianism (of the father) and equality (between the brothers). Communism was, in a sense, an embodiment of this type of social order.
There’s a copious amount of discussion about family structures in this book, but Todd adds to that an overlay of religion. He sees Protestantism, rather than the market, industry, or technology as the heart of the modern West. Its most critical impact was a drive for universal literacy, so that all the people could read the Bible in their own language. It also created the famed Protestant work ethic. An educated, industrious populous led to the takeoff of economic growth in Protestant countries. Indeed, Protestant countries were the most advanced industrial economies in Europe and basically remain the leaders. (Todd believes France benefitted from being adjacent to a band of Protestant nations).
If Protestantism brought positives to Europe, it also introduced the idea of inequality in a profound way, through its idea of the elect and the damned. Hence Protestant countries also created the worst forms of racism (as in the United States) and antisemitism (as in Germany). He cites the fact that Protestant areas of Germany were more supportive of the Nazis than Catholic ones.
The root of the nation state is also in Protestantism, not in the French Revolution or anything of that nature. He writes, “With Protestantism, there appeared peoples who, by too much Bible reading [in their vernacular], believed themselves chosen by God.”
In this analysis, he seems to basically be recapitulating Max Weber, of whom Todd describes himself as a student.
Protestantism Active, Zombie, and Zero
If Protestantism lies at the heart of the West, then the disappearance of Protestantism is a crisis for the West.
Todd divides religions in modern societies into three states: the active state, the zombie state, and the zero state.
In an active state, people attend church regularly. They have families on the Christian model, and they do not cremate their dead. (Christianity has always frowned on cremation as denying the hope of the resurrection of the body).
In a zombie state, people no longer attend church regularly, but still turn to the church for baptisms, weddings, and funerals. Critically, in a zombie state, people still hold to the habits and values of the old religion. So in a Protestant zombie state, people would still have the Protestant work ethic, place a value on literacy (education), etc. They largely retain Protestant practices around family and avoiding cremation. Especially they retain “the ability for collective action.”
In a zero state, people no longer even have church weddings or funerals. They don’t have their children baptized. In the zero state, the habits and values of the old religion have disappeared. People embrace cremation. And they abandon the Christian family structure. Todd sees the arrival of “marriage for all” as marking the definitive point of arrival at a religious zero state.
I did not note exactly when he said the United States entered a Protestant zombie state, but it encompassed the first part of the twentieth century up until about 1965. Todd notes that the zombie Protestant era was very good for America, with an extended period of triumph from FDR to Eisenhower. But that does not mean a zombie state always produces good outcomes. He also sees Nazism as arising out of a Protestant zombie state in Germany.
Around 1965, America entered a transition phase towards a zero state. In his treatment of the UK, Todd illustrates the loss of the habits and values of Protestantism by pointing to a softening of the culture of the English public schools (which, confusingly to Americans, are actually their most elite private schools). The same phenomenon occurred to a lesser extent here at elite prep schools and colleges. We see the transition in a few phenomena. One has been steady grade inflation over time. Todd cites figure showing that students spend significantly less time studying today than they used to as well. Another is the loss of the ethic of public service and self sacrifice. Many of the graduates of those schools fought, and even died in World War II. Rather than go directly to college, George H. W. Bush joined the Navy right after graduating from Phillips Andover to fight as an aviator in the Pacific theater. By Vietnam this became the exception. A recent newsletter from Matthew Yglesias on why colleges students need to study more covers similar territory here.
But just as the positive qualities of Protestantism began to unravel, so did the negative. In particular, Todd see the civil rights movement and the entire subsequent efforts toward full social and economic integration of blacks into mainstream society as a product of Protestant decay. To him, racism and discrimination against blacks were not just regrettable byproducts of a Protestant belief in inequality, but played a core function in structuring American society. Putting blacks into the role of “the damned” in society was what allowed there to be equality among whites themselves.
With the Obergefell decision in 2015, the transition phase ended and America definitively arrived at a Protestant zero state.
I’m more going to present Todd’s theories than attempt to rigorously analyze them, but it is worth noting that there are things one could critique here. For example, while there may have been a base level racial equality among whites, all whites were certainly not viewed as equal, as prewar Catholics and Jews could attest.
Also, the 1950s are supposedly part of the Protestant zombie era, and yet that was the high water mark of church attendance in the United States. Todd pooh-poohs the idea that America has been that distinct from Europe on that front. He says research shows people inflate their church attendance levels in surveys. But no one disputes that the 1950s were an era of high church attendance.
Todd also brutally dismisses the evangelical movement, seeing it as heretical and not really Protestant at all. But the only source he cites for that take is Ross Douthat’s book Bad Religion, which does not suggest he has a sophisticated understanding of American evangelicalism.
That brings up one of the key weaknesses of Todd’s analysis of America. His analysis of contemporary America leans heavily on writers like Douthat, names that are known and are legitimate, but are in an important sense dissident or peripheral. Others in this vein that he refers to are Joel Kotkin and John Mearsheimer. This will weaken the credibility of his arguments with many American readers who defer to mainstream consensus authorities – although those reading here definitely cast a wider net that includes dissident sources. American evangelicals, of course, are likely to discount critiques coming from Catholic commentators like Douthat.
I was particularly struck that Todd’s framework aligns quite well with my own three worlds model. The transition from zombie Protestantism starting circa 1965 is also when I say the status of Christianity (especially Protestantism) starts to go into decline in America. That transition phase covers my Positive and Neutral Worlds.
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