Aseem Malhotra curing the pandemic of misinformation
A little snip bit from Aseem Malhotras curing the the pandemic of misinformation papers. I have them all so I may post a bit every day if I see any interest in them. 😊
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Aseem Malhotra is world-renowned. He was on the BBC pushing the vaccines because he was misinformed. He was also the first to be double-jabbed. Now he's found out the truth and written this paper things have changed. I doubt he'll get back on the TV.
A pandemic of misinformation
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 evidencebased 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: [M]ost clinical trial results may be misleading or not useful for patients. Most guidelines (which many clinicians rely on to guide treatment decisions) do not fully acknowledge the poor quality of data on which they are based. Most medical stories in mass media do not meet criteria for accuracy, and many stories exaggerate benefit and minimise the harms.
1 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.
2 Has the UKs Chief Medical Officer Professor Chris Whitty critically appraised the evidence? Recently, he publicly shared a letter outlining the importance of healthcare staff to become vaccinated against COVID-19, which was neither comprehensive nor consistent with the totality of the evidence:
3 The COVID-19 vaccines are safe and effective. It would have been more accurate to state that ‘the vaccine is not completely safe and not anywhere close to being as effective as we’d hoped for. Not even in the same ball park when compared to the efficacy and safety of traditional vaccines’. Professor Chris Witty stated: Our professional responsibility is to get the covid vaccines as recommended to protect our patients’.
4 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 his company’s COVID-19 injection ‘offers very limited protection, if any’.
5 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;
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’
1 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 BMJ and JAMA Internal Medicine) have launched campaigns to reduce the harms of too much medical intervention. According to the cofounder of the Cochrane Collaboration, Peter Gøtzsche, prescribed medications are the third most common cause of death globally after heart disease and cancer.
This is not surprising when one understands that most published research is misleading specifically where benefits from drug trials are exaggerated, and harms downplayed (Box 18). If a doctor is making clinical decisions on biased information, it will lead (at best) to suboptimal outcomes and (more concerningly) harm to patients. Shortcomings of the medical profession.
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. Similarly, only 37% of the public trust medical research compared to 65% who trust the experience of their friends and family.
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. Failure of regulation and research misconduct 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: The whole problem with Pfizer is the indemnity bond. Why should we sign it? If something happens, a patient dies, we will not be able to question them [Pfizer]. If somebody challenges in a court of law, the central government will be responsible for everything, not the company.
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 EvidenceBased 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. It is this very industry that has been found guilty of the most egregious corporate crimes: between 2003 and 2016 the top 11 pharmaceutical companies paid $28.8 billion in fines just within the United States (US), much of it for criminal activity such as the illegal marketing of drugs, manipulation of results and hiding data on harms. As pointed out in the BMJ, since then no systemic changes have been made to mitigate these harms.
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.25 An egregious documented case of research misconduct involved a prominent Dutch physician whose work influenced the European Society of Cardiology guidelines on the use of beta blocker drugs in non-cardiac surgery. He was dismissed from Erasmus University for ‘violations in academic integrity’, including using ‘fictitious data’ in research. It’s estimated that these guidelines increased patient mortality by 27% resulting in 800000 excess deaths across Europe over an 8-year period.26 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 Box 227). His solution, which I agree with, would be to ensure that serious forms of research misconduct are made into criminal offences with meaningful sanctions and that allegations of such activity should be investigated by an independent body with legal powers.
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. 28 After I had alluded to this on GB News, the whistle-blower informed me that non-disclosure agreement letters were sent to all members of the team involved in this particular area of research. Evidence-based medicine and COVID-19 vaccine roll-out 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.29 The raw data from clinical trials comprise thousands of pages that have yet to be released for independent scrutiny. This is important because historically when independent researchers have on occasion gained access to this data then it can completely overturn the conclusions of the published trials: A case in point is Tamiflu.30 Getting access to clinical case reports for Tamiflu ultimately revealed that the drug was no more effective than paracetamol for influenza and also came with small but significant harms. The UK government had spent half a billion dollars stockpiling a drug that in effect proved to be useless despite claims by the manufacturers (Roche, Basil, Switzerland) that it shortened the duration and severity of the illness. The independent researchers who were able to analyse the data concluded that all industry-sponsored research should be considered marketing until proven otherwise. 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.31 The FDA wanted a US Federal court judge to allow the agency 55 years to release this data.32 Why would the FDA – ‘which is responsible for the oversight of more than $2.7 trillion in consumption of food, medical products, and tobacco’33 – do this? Secrecy should never surround any public health intervention. The lawyer acting on behalf of the plaintiff Aaron Siri reported that: [T]he government also sought to delay full release of the data it relied upon to license this product until almost every American alive today is dead. That form of governance is destructive to liberty and antithetical to the openness required in a democratic society. 31 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.
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