Authorities and sections of the medical profession have supported unethical, coercive, and misinformed policies such as vaccine mandates and vaccine passports, undermining the principles of ethical evidence-based medical practice and informed consent. These regrettable actions are a symptom of the ‘medical information mess’: The tip of a mortality iceberg where prescribed medications are estimated to be the third most common cause of death globally after heart disease and cancer.
To identify the major root causes of these public health failures.
A narrative review of both current and historical driving factors that underpin the pandemic of medical misinformation.
Underlying causes for this failure include regulatory capture – guardians that are supposed to protect the public are in fact funded by the corporations that stand to gain from the sale of those medications. A failure of public health messaging has also resulted in wanton waste of resources and a missed opportunity to help individuals lead healthier lives with relatively simple – and low cost – lifestyle changes.
There is a strong scientific, ethical and moral case to be made that the current COVID vaccine administration must stop until all the raw data has been subjected to fully independent scrutiny. Looking to the future the medical and public health professions must recognise these failings and eschew the tainted dollar of the medical-industrial complex. It will take a lot of time and effort to rebuild trust in these institutions, but the health – of both humanity and the medical profession – depends on it.
This article highlights the importance of addressing metabolic health to reduce chronic disease and that insulin resistance is also a major risk factor for poor outcomes from COVID-19.
What has become clear with regard to the coronavirus disease 2019 (COVID-19) vaccines is that we have a pandemic of misinformed doctors and a misinformed and unwittingly harmed public. Coercively mandating these COVID-19 vaccinations (most certainly not an evidence-based policy) has been a particularly egregious mis-step, especially in the light of clear indicators suggesting that the use of these pharmaceutical interventions – especially in younger age groups – should have been suspended. Such policies continue to undermine the principles of ethical evidence-based medical practice and informed consent, to the detriment of optimising patient outcomes.
In his 2017 paper, ‘How to survive the medical misinformation mess’, Professor John Ioannidis and colleagues highlight that:
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A senior doctor in regular contact with the United Kingdom’s (UKs) Chief Medical Officer Professor Chris Whitty recently expressed concerns to me that he felt most of his colleagues in leadership positions influencing health policy may not be critically appraising the evidence and instead are relying on media stories on COVID-19 and the vaccine. This is consistent with the admission of Rochelle Walensky, the former chair of the Centers of Disease Control (CDC), whose optimism in the efficacy of Pfizer’s COVID-19 vaccine came from reading a CNN news story, which was an almost verbatim reproduction of Pfizer’s own press release.
Has the UKs Chief Medical Officer Professor Chris Whitty critically appraised the evidence? Recently, he publicly shared a letter
Professor Chirs Witty stated:
Our professional responsibility is to get the covid vaccines as recommended to protect our patients’.
He should have said as far as omicron is concerned, ‘the vaccine offers little to no protection against infection. Data on the delta variant also revealed that once infected there is no significant difference in transmission rates between the vaccinated and unvaccinated individuals.
Professor Whitty’s statements are especially surprising given that the CEO of Pfizer has stated that in realtion to omicron ‘We know that the two doses of a vaccine offer very limited pretection, if any’.
Could it be that Professor Whitty is also a victim of the medical misinformation mess?
There are four key drivers and seven sins that are at the root of the medical misinformation mess:
Drivers:
Much published medical research is not reliable or is of uncertain reliability, offers no benefit to patients or is not useful for decision makers; Most healthcare professionals are not aware of this problem; Even if they are aware of this problem, most healthcare professionals lack the skills necessary to evaluate the reliability and usefulness of medical evidence; and Patients and families frequently lack relevant, accurate medical evidence and skilled guidance at the time of medical decision making.
Sins:
Biased funding of research (that’s research that’s funded because it’s likely to be profitable, not beneficial for patients) Biased reporting in medical journals Biased reporting in the media Biased patient pamphlets Commercial conflicts of interest Defensive medicine An inability of doctors to understand and communicate health statistics.
Ioannidis and colleagues highlight that:
‘Ignorance of this problem, even at the highest levels of academic and clinical leadership, is profound’
Compounded over several decades, these upstream and downstream risk factors for misinformation have had a devastating effect in the healthcare environment we find ourselves in today. Over-prescription of drugs is considered such a public health threat that two leading medical journals in the past 10 years (the
Major limitations in the interpretation, external validity and usefulness of drug industry-sponsored clinical trials.
Trials are conducted of a study drug against a treatment known to be inferior
Use multiple endpoints in the trial and select for publication those that give favourable results
Do multicentre trials and select for publication results from centres that are favourable
Conduct subgroup analyses and select for publication those that are favourable
Present results that exaggerate the benefit – for example, use of relative risks as opposed to absolute risks
Conduct trials on subjects that are unrepresentative of the patient population
Conflate primary and secondary endpoints in the published report
Conceal unblinded patients and include them in efficacy analyses for publication
Exclude placebo responders in the wash-out phase of the trial
Delay publication of negative trial results until positive trial results are published
Conceal negative trial results whilst publishing only positive trial results
Conceal serious adverse events
Fail to distinguish clinical from statistical significance
If a doctor is making clinical decisions on biased information, it will lead (at best) to suboptimal outcomes and (more concerningly) harm to patients.
According to Professor Carl Heneghan and urgent care General Practitioner, the director of the University of Oxford’s Centre of Evidence-Based Medicine: ‘with every intervention you do as a doctor you must ask yourself two questions: how much difference does it make? How do I know this?’
Building on the Academy of Medical Royal Colleges Choosing Wisely campaign,
There are six components essential to informed decision making: (1) description of the nature of the decision; (2) discussion of alternatives; (3) discussion of risks and benefits (in absolute terms); (4) discussion of related uncertainties; (5) assessment of the patient’s understanding; and (6) elicitation of the patient’s preference.
If the administration of the vaccine did not adhere to these principles (which is likely widespread, consistent with historical evidence
It is instructive to note that the greater the financial interests in a given field, the less likely the research findings are to be true.
Institutional corruption is defined as an institution’s deviation from a baseline of integrity.
Prior to 2020 there already existed gross shortcomings in the medical–industrial complex – there has been too much pharmaceutical industry influence on clinical decision making. This has not gone unnoticed, resulting in a growing crisis of trust in medical research: a report by the Academy of Medical Sciences in 2017 revealed that 82% of GPs and 63% of the public did not believe the results of pharmaceutical industry-sponsored research to be unbiased.
This growing lack of trust – most recently exacerbated by coercion, vaccine passports and little mainstream media coverage of an unprecedented scale of reported vaccine harms in the population – has been most recently exemplified by 8 million people in the UK refusing to take the COVID-19 booster shot. In addition, with all the attention on COVID-19 (which poses almost zero risk to children in its current omicron form), diverts attention away from, and even worse raises the suspicion of, more efficacious and safe interventions such as the measles, mumps, rubella (MMR) vaccine. Indeed, in the UK MMR vaccination rates have hit their lowest for 10 years.
Authorities want the public to ‘trust the science’, but vaccine manufacturers have successfully negotiated deals with several major governments globally that indemnify them against any financial liability in the event of vaccine-related harm. Interestingly, India, the world’s largest democracy, refused to grant Pfizer indemnity from harms for its vaccine. An Indian government source told Reuters that:
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Pfizer walked away from the Indian market rather than undertake a local safety and immunogenicity study.
It is important to first understand that drug companies have a fiduciary obligation to deliver profits to their shareholders, not any legal responsibility to provide you with the best treatment. At a talk at the Centre of Evidence-Based Medicine in Oxford in 2014, Peter Wilmshurst said the real scandal is that many of those with a responsibility to patients and scientific integrity (doctors, academic institutions and medical journals) often collude with industry for financial gain.
In an international survey of respondents from higher education institutions, 14% admitted to knowing a colleague who fabricated, falsified and modified data, and 34% of scientists report questionable research practices that included selective reporting of clinical outcomes in published research and concealing conflicts of interest.
In evidence submitted to the UK parliamentary science and technology review into research integrity committee in 2017 (Chaired by Sir Norman Lamb), Dr Peter Wilmshurst lists a number of risk factors that drive research misconduct in British institutions (see
Written evidence from Dr Peter Wilmshurst to UK Parliamentary Science and Technology Research Integrity Committee (June 2018).
Academic institutions bear responsibility for the pressure to publish for career advancement that can result in research misconduct.
A record of prominent publication is likely to attract future funding, which institutions demand, and good publicity, which institutions desire.
Other pressures for misconduct come from the association of academic institution with industry, such as when investigators or their institutions hold patents or shares, or they receive payments from industry, so that there is financial pressure to publish research that will be profitable for the company and to suppress ‘negative’ findings.
Some publications are simply organised criminal activities, which may be at the behest of sponsors, when prominent academics are paid large sums of money to publish false data by industry, or a sponsor may be one of the victims, when payments for conducting research are made to ‘investigators’, who simply fabricate data.
Medical journals have financial pressures to publish positive findings of research on drugs and medical devices, because their manufacturers buy reprints of the papers for distribution to doctors and they pay for advertisements linked to articles favourable to their product.
Academic institutions and journals depend on the public belief in the integrity of science, so they are unwilling to admit the seriousness and frequency of research misconduct.
To protect their reputations academic institutions conceal research misconduct, destroy evidence and silence whistle-blowers.
Journals are reluctant to admit that they published flawed research, so they commonly refuse to publish failures to replicate.
Fear of a libel action contributes to the failure to expose research misconduct.
Investigation of research misconduct may be difficult because there may be international collaboration between investigators, many of whom do not see the full data, and the resulting publications may be in journals that are published in countries where none of the investigators work.
The bodies that investigate research misconduct in the UK (such as the GMC and UKRIO) are hampered by a desire to play down the problem, by lack of proper forensic skills when investigating, by inconsistent interpretation of rules and by inadequate powers to compel the cooperation of academic institutions and journals.
Because lenient sanctions are imposed, institutions believe that the misconduct is not very serious, and potential research fraudsters are not deterred.
GMC, General Medical Council; UKRIO, United Kingdom Research Integrity Office.
One researcher at a prestigious UK institution contacted me to inform me that in his cardiology department a group of academics were deliberately suppressing research that revealed that the mRNA vaccine was shown to significantly increase coronary risk as determined by cardiac imaging as compared to the unvaccinated. The chair of the group expressed concerns that publishing the data may result in loss of funding from the pharmaceutical industry.
Neither the drug regulators nor the vaccine manufacturers have yet to share all the raw data from the pivotal trials for the COVID-19 vaccines.
It is against this backdrop that transparency advocates sued the Food and Drug Administration (FDA) to gain access to the data upon which the Pfizer (BNT162b2) vaccine was granted emergency use authorisation.
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Instead, the judge ordered the FDA to release the data over a period of eight months after all commercially sensitive information has been redacted.
A major risk factor for failure to protect the public from such harms is lack of independence of the regulator. The FDA’s Centre for Drug Evaluation Research (CDER) receives 65% of its funding from the pharmaceutical industry (mainly in the form of user fees).
Separate analyses have revealed the overwhelming majority of new drugs that have been approved by the FDA in the past few decades have later been shown to be just copies of old ones, which is not surprising when one understands that drug companies spend 19 times more on marketing than they do on researching new molecular entities, which all contributes to considerable waste. Between 2000 and 2008 of the 667 drugs approved by the FDA, only 11% were found to be truly innovative. In the US it’s estimated that 30% – 50% of healthcare activity brings no benefit to patients. Extraordinarily, a survey of FDA scientists revealed 70% of them did not feel the FDA had the resources to perform effectively in its mission in ‘protecting public health … and helping the public get accurate science-based information to use medicines and foods to improve their health’.
An analysis of every new drug product approved in France between 2002 and 2011 revealed only 8% offered some advantages and double that amount – at 15.6% – were found to be more harmful than beneficial with the majority of other new drugs being essentially copies of old ones contributing to a colossal waste of public money.
Irrespective of the merits of inoculating higher risk groups where a small but significant benefit may exist against the original Wuhan strain, vaccinating lower risk children in the name of preventing asymptomatic transmission has no strong scientific validity and therefore exposes them to possible harm.
In the UK the Office for National Statistics has revealed an as yet unexplained significant increase in deaths over the 5-year average in 15- to 19-year-old children since May 2021. Given what we now know of potential harms especially in relation to myocarditis, myocardial infarction and sudden cardiac death (even in 16- to 39-year-olds) has the COVID-19 vaccine been excluded as a possible cause?
In September 2021, the Joint Committee on Vaccination and Immunisation (JCVI) made a controversial recommendation that the Pfizer/BioNTech vaccine is marginally beneficial for 12- to 15-year-old children.
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Is this in keeping with the totality of the evidence?
Award winning investigative science journalist Maryanne Demasi published the harrowing story of one of those trial participants, 12-year-old Maddie De Garay. After experiencing severe abdominal pain followed by seizures she was admitted to hospital and is now left permanently disabled, wheelchair bound and fed through a nasogastric tube. In Pfizer’s trial they reported her adverse effect as mild: stomach upset.
It is important to emphasise that the risk of death from COVID-19 in a 12- to 15-year-old is close to zero at 1 in 76 000. In keeping with the principles of ethical evidence-based medical practice through shared decision making, parents need to be told that there is no high-quality data in children that the vaccine will prevent infection, transmission, serious illness or death but may come with serious side effects of myocarditis – particularly in young males where it occurs in up to 1 in 2700
On its website the MHRA declares that the majority of its funding comes from the pharmaceutical industry and £3 million (UK pounds) from the Bill and Melinda Gates Foundation (BMGF). Are policymakers and the public aware that the foundation’s corporate stock endowment is heavily invested in food (including McDonald’s and Coca-Cola) and pharmaceutical companies, directly and indirectly? As pointed out in a 2009
Obesity researcher Dr Zoe Harcombe has also investigated the financial ties that could potentially be biasing the view of the joint committee for vaccines and immunisation and discovered that the subcommittee members work for organisations that receive in total $1bn from the BMGF.
The commercial determinants of health are best defined by ‘strategies and approaches adopted by the private sector to promote products and choices that are detrimental to health’.
Diagram of dimensions, vehicles, practices and outcomes of power.
Corporations are able to shape preferences and frame the dominant narratives on the determinants of health, through unchecked invisible power. One pathway is through the ownership of mass media. The global media market is dominated by seven corporations and chains that own 80% of the newspapers in the US.
The BBC, though seemingly not directly influenced by industry interests, has traditionally been seen by some as the UK’s most trusted media source. Its coverage of issues surrounding COVID-19 has in my view (possibly through additional government pressure) been extremely poor and – specifically on issues surrounding the vaccine – grossly negligent. During a recent report on tennis player Novak Djokovic explaining his decision to not take the vaccine until he has more information on its benefits and harms, a reporter asked the question ‘how much more information does he need?’. The reporter failed to mention the fact that Djokovic has had COVID-19 and that evidence suggests that natural immunity offers
In the US, Senator Ron Johnson, who conducted hearings with healthcare professionals who were presenting data on clear, substantial and very common adverse effects from the mRNA jabs, which deserved widespread public attention, said ‘the mainstream media are co-conspirators in this political dirty trick. Will they be held accountable for their role in this deception’?
Social media platforms continue to be guilty of spreading misinformation. Their business model that focusses on increasing engagement at any cost makes society increasingly lose access to the truth and worsens our capacity for empathy as individuals, sowing even greater division and hostility. The so-called ‘fact checkers’ have censored anything that challenges the prevailing mainstream narrative (the establishment is trustworthy, and the vaccines are completely safe). They even labelled the
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It has also come to light that Facebook has partnered with drug company Merck in deciding what content should be censored on its platform in relation to COVID-19 and the vaccine.
Failure of public health messaging and policies to help individuals to improve their lifestyles during the pandemic represents a missed opportunity to mitigate harms from respiratory diseases such as COVID-19. After age, the biggest risk factor for worse COVID-19 outcomes has been obesity and conditions related to excess body fat. More than 90% of the deaths from COVID-19 occurred in countries where more than 50% of the population is overweight or obese. The United Kingdom’s biobank data during the first wave revealed a more than fourfold higher risk in hospitalisation from COVID-19 depending on lifestyle factors. For example, a non-smoking adult in their mid-fifties with a normal body mass index (BMI) and obtaining adequate physical activity levels had a 1 in 1521 chance of being admitted to hospital after contracting COVID-19, whereas an obese, smoking, sedentary person’s risk was 1 in 327.
Postulated pathophysiological mechanisms of risk and complications from infection include an array of markers that have insulin resistance and chronic inflammation at the root.
Even a single high blood glucose reading in non-diabetics (a marker of insulin resistance) admitted to hospital has been shown to be associated with worse outcomes.
Markers of metabolic health.
The government and medical authorities should have made it a priority to emphasise the importance of eliminating ultra-processed foods and low-quality carbohydrates to reduce risk. They could have made the public aware that reversal of metabolic syndrome has been shown to occur in up to 50% of patients – independent of weight loss – within four weeks of dietary changes alone.
The coronavirus disease 2019 was a momentary crisis that exploited a slow pandemic of poor metabolic health (see
Optimising metabolic health would not just improve immune resilience but also reduce the burden of heart disease, type 2 diabetes, cancer and dementia. Learning lessons from tobacco control, policy changes that target the availability, acceptability and affordability of ultra-processed food and drink and low-quality carbohydrates would significantly reduce the burden of obesity, related metabolic diseases and likely optimise immune resilience in populations within a few years (see
Policies to curb obesity and lifestyle-related disease.
Taxation of all ultra-processed foods and drinks needs to be enforced with the money gained going directly to subsidise whole and minimally processed foods such as fruit and vegetables
All medical students and doctors need to have adequate training in nutrition and lifestyle medicine
Every doctor should be measuring the metabolic health of their patients and making lifestyle prescriptions specifically linked to diet, physical activity and stress reduction to improve those health markers as their first-line intervention before the use of medication
Compulsory nutrition education and cooking skills introduced into all school curriculums
All hospital chief executives need to be made accountable for allowing the sale of ultra-processed food on hospital grounds, as it continues to harm the health of staff and patients and legitimises the acceptability of such food consumption to the wider public
A ban on advertising of all ultra-processed food and drink on television and online demand services
A public education campaign is needed to help consumers understand what ultra-processed food is and the harm it causes
A complete ban and dissociation of ultra-processed food and drink sponsorship of sports teams and sporting events
Local authorities should encourage active travel and protect and increase green spaces in urban areas to make the healthy option the easy option
Medical staff, including doctors, nurses and dietitians, should themselves be assessed on their metabolic health and encouraged and helped to improve it, not just to set an example to patients but to optimise their own health and performance.
There was never any evidence justifying any COVID-19 vaccine mandates, passports or any of the other coercive measures adopted by various governments worldwide. Every patient who was offered any COVID-19 vaccine should have been made aware of what their risk from COVID-19 is according to age and risk factors. In keeping with ethical medical practice, doctors should have informed patients of their absolute risk reduction for infection from previous more lethal variant being approximately 0.84% or 1 in 119 (based on non-transparent data) and that this level of protection only lasts for a few months. They should also have provided more precise and robust data on what the actual absolute individual risk reduction of COVID-19 death from the vaccine is, what the true rates of serious adverse events (such as permanent disability, hospitalisation or death) are. It is only when doctors and patients have all this information that they can then be empowered to have frank decision making conversations on whether any treatment – including this vaccine – is right for them.
The profession must explain that optimising metabolic health will give patients the best chance for ensuring they are not just resilient to infection but reducing their risk of chronic disease including heart disease, cancer and dementia.
The time has come to stop misleading evidence flowing downstream into media reporting and clinical decision making and resulting in unethical and unscientific policy decisions. It’s time for real evidence-based medicine (
Defining real evidence-based medicine and actions to deliver it.
Is the application of individual clinical expertise with best available evidence and taking into consideration patient preferences and values in order to improve patient outcomes (relieve suffering and pain, treat illness and address risks to health)
Makes the ethical care of the patient it’s top priority
Demands individualised evidence in a format that clinicians and patients can understand
Is characterised by expert judgement rather than mechanical rule following
Shares decisions with patients through meaningful conversations
Builds on a strong clinician–patient relationship and the human aspect of care
Applies these principles at community level for evidence-based public health
Although the pharmaceutical industry plays an important role in developing new drugs, they should play no role in testing them
All results of all trials that involve humans must be made publicly available
Regulators such as the FDA and MHRA must be publicly funded, and not receive any money from the pharmaceutical industry
Independent researchers must increasingly shape the production, synthesis and dissemination of high-quality clinical and public health evidence
Medical education should not be funded or sponsored by the pharmaceutical industry
Patients must demand better evidence, better presented (using absolute and not relative risk), better explained and applied in a more personalised way
There is also a strong scientific, ethical and moral case to be made that the current mRNA vaccine administration must stop until Pfizer releases all the raw data for independent scrutiny.
Given all the recent well-documented aforementioned shortcomings in medical research integrity (including that possibly half the published medical literature ‘may simply be untrue’), the editor of the
We must use this as an opportunity to transform the system to produce better doctors, better decision making, healthier patients and restore trust in medicine and public health. Until all the raw data on the mRNA COVID-19 vaccines have been independently analysed, any claims purporting that they confer a net benefit to humankind cannot be considered to be evidence-based.
I thank Dr Clare Craig for edits and data analysis, and Alex Starling for comments and suggestions. The author is also grateful for the assistance of a scientist who wishes to remain anonymous due to career pressure.
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
A.M. is the sole author of this article.
This article followed all ethical standards for research without direct contact with human or animal subjects.
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Data sharing is not applicable to this article as no new data were created or analysed in this study.
The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of any affiliated agency of the author.