Two months ago, on 29th November 2022, I wrote a Rapid Response to an opinion piece at the British Medical Journal entitled "Understanding and neutralising covid-19 misinformation and disinformation". My reply was longer than the article and the editors chose not to run it (quite possibly for reasons other than length, though). I include it here, unedited, since the points it makes are salient. You do not need to read the original opinion piece for context - it will all be quite clear from my response.
Dear Editors,
This is surely a timely topic, with California having recently passed the controversial legislation Assembly Bill 2098 that the authors refer to in passing. This is a law that allows doctors who express views that depart from 'consensus' to be struck off, and prevented from practicing as doctors. The authors' argument revolves around the claim that that since misinformation and disinformation are by definition a harmful distortion of the facts, such laws are desirable and ought to be pursued. Yet as scientists, we are obligated to remain open to new evidence as to what the facts might be - otherwise, we foreclose investigation and can no longer claim to be acting as scientists.
To a great degree, the authors conclusions rest on a series of presumptions that are not well-supported by any of their chosen citations. For example, it is apparent from the text that the authors have reached the following conclusions about non-pharmaceutical interventions:
a) That 'lockdowns' and other disruption of assembly measures are effective at halting transmission of respiratory viruses and/or SARS-CoV-2 specifically
b) That community masking is effective at halting transmission of respiratory viruses and/or SARS-CoV-2 specifically
The authors do not provide any evidence in support of these assumptions. Instead, they provide a link to evidence that "long covid has risen substantially in children and young people". This is a tangential question, and one that is also a matter of ongoing scientific research and debate. The decision not to provide evidence in support of the implicit claim that non-pharmaceutical interventions are effective constitutes a substantial flaw in this text. Having followed the research on these topics closely for two years, I would personally judge that the balance of evidence was currently against both of these hypotheses, but as a scientist I am always open to hearing new evidence, and would readily acknowledge that the scientific discussion is far from being concluded in these matters.
Because the success of non-pharmaceutical interventions is assumed, and not evidenced, the authors' discussion of mis- and disinformation takes an odd turn. The authors imply UsForThem, HART, UK Medical Freedom Alliance and Children's Health Defence are propagating mis- and disinformation about these and other interventions. Are the authors correct? It's not possible to tell this from their text and its citations. Perhaps more importantly: how could we possibly know if they are correct while these matters are still live research topics...?
It is worth noting that the organisations named are of very different kinds. Conflating a parental activist group (UsForThem) with a research coalition (HART) is a dubious proposition, although it can be acknowledged that there is some political commonality in the groups mentioned, just as there is a political commonality between the authors of this paper and the sponsors of Assembly Bill 2098. This political dimension may be considerably more important than the authors allow.
In the implied denouncement of the previously mentioned organisations, the first two articles cited by the authors are from the Byline Times. One of these pieces claims HART is "a COVID-19 disinformation group which harbours a range of conspiratorial views about the pandemic." This claim is unsubstantiated in this citation and appears quite implausible on the basis of a brief review of HARTs published commentaries. The Byline Times' view is one that could only be reached by pre-supposing the outcome of ongoing scientific research topics. The same article later terms the Great Barrington Declaration (a statement reinforcing what was the standard view on pandemic response up to 2019) a "pandemic disinformation network" - which is an odd and implausible claim, although one that goes beyond the scope of this rapid response to explore. The inclusion of these Byline Times articles as cited evidence significantly weakens the authors claims to speak in a scientific register, as this cited article is a deeply politicised perspective with negligible scientific relevance.
Their third citation is a BBC article that itself contains a factual error: it claims that all the groups mentioned by the authors are engaged in putting out a message 'against vaccines'. But the matter being discussed in the article cited is specifically the mRNA vaccinations for use in the context of SARS-CoV-2, and even then in the specific context of administering these to children. As new drugs, and treatments that received approximately 90 days of safety testing (versus, say, 5 or 10 years of assessment as was expected prior to 2020), conflating doubts about these specific new medical treatments with opposition to vaccination in general (as both the authors and the cited-BBC article engage in) is questionable and misleading. It might even qualify as misinformation - or even, if either party purposefully intends to mislead on this matter, disinformation.
I certainly condemn those who mislead parents by falsifying an NHS Consent Checklist and circulating it, as the BBC article reports. This is certainly not the action of a reputable scientist. But the BBC article does not provide any prima facie evidence against any of the groups the authors mention. Instead, it expressly admits the difficulty in drawing such a connection. Rather, the BBC article assumes that because certain scientists are questioning the mRNA treatments, all such individuals can be grouped together in the vilified category of mis- and dis-information. As scientists, we must take much greater care on these issues, especially given the fact that - as the BMJ reported in November 2021, Pfizer's trial for their mRNA treatment entailed serious data integrity issues.
It is noteworthy that the BBC did not report this story, a point I will return to below.
I would venture to suggest it is implausible to assume any scientific misconduct on behalf of HART et al with respect to what is, after all, a treatment with incomplete safety and efficacy data. It is far from clear to me, frankly, that "contrarian messages" (as the authors put it) are where our concerns regarding mis- and disinformation ought to lie, especially since the engine of scientific discovery is precisely the engagement of contrarian interpretations with our prior assumptions. To be opposed to contrarian messages is to be opposed to the very possibility of new scientific discoveries.
However, the authors are surely correct to draw a parallel with the way that alcohol and tobacco industries distorted the research and media landscape in connection with the health risks of their products. It is plausible to assume that similar interference has occurred in connection with the mRNA treatments, especially given the tremendous advertising expenditure provided by Pfizer and Moderna in the United States via all major television news services, which have played a substantial role in framing debate around these issues.
As BMJ editor Peter Doshi has repeatedly stressed, what is required at this point to restore trust is for Pfizer to release anonymised data of its original trial in order to see where it's "95% effective" figure came from. It is now quite clear from the data on the ground that these treatments were not in any way 95% effective, and it is apparent from the BMJ's whistle-blower story that fraud is one possible explanation for how the now-falsified figure was obtained. In the question of mRNA vaccines and mis- and dis-information, this aspect of the situation ought to be a far more significant area of investigation than "the extent to which groups promoting contrarian messages were able to influence policy" that the authors judge of particular importance.
In this regard, it is worth noting that on 10th December 2020, the BBC announced an alliance dubbed 'the Trusted News Initiative', which included AP, AFP; BBC, CBC/Radio-Canada, European Broadcasting Union (EBU), Facebook, Financial Times, First Draft, Google/YouTube, The Hindu, Microsoft, Reuters, Reuters Institute for the Study of Journalism, Twitter, and the Washington Post. The stated purpose of this media group was to:
...ensure legitimate concerns about future vaccinations are heard whilst harmful disinformation myths are stopped in their tracks.
The implication was that this group would report all factual issues about vaccines. Yet as far as I can ascertain, not one of these sources reported the whistle-blower story covered by the BMJ, which certainly constituted "legitimate concerns". As such, we have reasons to doubt that this media group was able to follow-through on its original commitment, with the inevitable implication that its attempt to prevent mis- and disinformation might ironically have ended up operating as a source of mis- or disinformation in at least some cases.
When we act as scientists, our duty is towards the patient assembling of the truth. This is not something that happens quickly or easily. Prior to 2019, we spent five to ten years establishing the safety of vaccinations before green lighting them for population-level distribution. As such, the earliest we could realistically expect to be able to make assessments of mis- or disinformation with respect to these new mRNA vaccines would be in the 2030s, when there has been sufficient data gathered, and time for adequate debate. Unless that time has passed and that discussion has occurred, it is impossible to ascertain with any certainty whether groups like HART will have their concerns vindicated or disproven. Certainly, it is premature to assume on the basis of a single BBC article that HART is a greater risk of mis- and disinformation that, say, Pfizer, for whom the BMJ has already confirmed malfeasance.
Ultimately, the authors suggestion that the inquiries into the response to SARS-CoV-2 ought to be widened to examine the extent to which "groups promoting contrarian messages" feels terribly misguided, even on the logic of their own discussion. If it were reasonable to expand the inquiry into such areas, the priority ought to be establishing the extent to which news organisations such as those who joined the 'Trusted News Initiative' were unduly influenced by pharmaceutical companies in a manner parallel to the author's references to alcohol and tobacco companies. The question of importance here ought to be the degree to which scientific investigations have been disrupted by pre-empting the dissemination of facts and the withdrawal of support for open debate in public channels on the topics of both non-pharmaceutical interventions and mRNA vaccines.
It is hard to avoid the conclusion that what should be topics of open scientific enquiry and debate have become politicised, and therefore distorted. If we are acting as scientists, this concern ought to be of far graver importance than attempting to police singular interpretations of the facts by smearing alternative interpretations as mis- or disinformation. The authors consider Assembly Bill 2098 in California an "appropriate course of action". Contrary to this opinion, I would call it a shameful betrayal of the ideals of scientific discourse, and a potentially unlawful attempt to supress both free speech and open scientific enquiry.
If we are scientists, our first duty is to the truth, no matter how elusive it may be. When we pre-empt the ongoing search for that truth, as every attempt to assert the categories of mis- and disinformation on an active research topic must necessarily entail, we are no longer acting as scientists. We have let our political beliefs blind us, and we have betrayed the very ideals upon which scientific investigation rests.
Dr Chris Bateman