Hospitals are Censoring Doctors. That Endangers the Rest of Us.

This post was originally published on here by staff writer Chandra Bozelko.

An emergency physician in Bellingham, Wash., Ming Lin used his personal Facebook account to claim that patients and staff lacked the necessary personal protective equipment (PPE) in his hospital. Having made public his grievances with his employer’s handling of the covid-19 pandemic, he was fired soon after.

Lin’s case is an ominous example. We cannot punish doctors for speaking out during this pandemic. They have a perspective that we need badly now — bringing back first-person knowledge of the worst extremes of a still-building crisis.

Until recently, it was difficult for physicians to share their experiences in newspapers and other publications, unless they could contort their own perspectives into the confines of a constantly mutating news cycle. As it did to so many facets of life, the coronavirus pandemic changed that. Suddenly, news outlets are actively seeking input from physicians and nurses. It should be an ideal time for these fellows to publish and lead. And it would be, if only their employers weren’t getting in the way.

On the day that Lin said he was fired, I sent a group of doctors that I work with in my capacity as a facilitator for the OpED Project a link to a CNN form that asked clinicians to share their experiences. In less than 10 minutes, my email was met with another from a hospital administrator, saying “[The hospital] is asking that you NOT share your stories with the media per an email that went out yesterday.”

Soon after, a message arrived from the hospital’s media office explaining the prohibition: “The format that these kinds of submissions would take inherently make things look more chaotic than they actually are,” it read, adding, “We wouldn’t want to create the impression that we are detracting from patient care in order to shoot these.”

On March 11, another physician connected with my program posted an innocuous mention of a lack of tests and a picture of herself at work; the post was shared more than 1,800 times. She messaged me later saying “turned down interviews w ABC nightly news and Good morning America” because her posts had angered “some important people.” She didn’t say exactly what irked them, but the only part of her post that would have had anything to do with her employer was the fact that it didn’t have enough supplies, which aligned with Lin’s complaints.

Similar issues seem to be playing out elsewhere. Fortune magazine and Bloomberg News have both reported that NYU Langone Medical Center in New York has forbidden staff from contacting the media without permission under threat of termination. A number of physicians have complained that they can’t speak to the media for fear of being fired.

Protecting patient privacy is a must. So is treating patients; health-care providers shouldn’t prioritize media appearances over medical appointments. But after working with health-care professionals during this crisis to facilitate their inclusion in the news, I don’t think there’s much risk to privacy or patients themselves. From what I’ve witnessed in working with them, my fellows are committed professionals, and they know that, in this unprecedented crisis, patient care includes public advocacy, minus the personal details.

We need to confront what this media management is really about. Esther Choo, an emergency physician at Oregon Health and Science University, said on CNN this past weekend that much of this is simply hospitals “not wanting to be upfront about how things aren’t going well inside their walls.” That sounds a lot like an attempt at self-preservation by corporate entities.

That’s not to say that all hospitals have something to hide. Indeed, a shortage of PPE isn’t an oversight on the facility’s part; they are victims to failed leadership by the federal government. And it is true, of course, that we need clinicians doing on clinical duty, not getting ready for their close-up, though all the doctors I know put their professional responsibilities first.

But as the virus spreads, so do health-care providers’ job descriptions; they’re being asked to fill out clinical rosters in specialties they’re not used to. It’s not always clear whether this added media responsibility is one of whistleblower or citizen journalist but I don’t think that matters. All that matters is that they be allowed to do it without fear of repercussions.

I’m an ER doctor. The coronavirus is already overwhelming us.

For safety and privacy reasons, journalists can’t embed themselves in emergency department bays. The reporting of physicians and nurses is essential. In fact, it might be what saves us. That one Facebook post written by the doctor who declined all of those invitations to speak on national news shows convinced a local politician to activate state agencies in Massachusetts. Another published an op-ed in which he drew on his clinical experience in the hospital to explain how the United States could avoid becoming like Italy. Manufacturers and experts contacted him, inquiring how they could help. I suspect that his employer will eventually tout him as one of the heroes who helped solve the ventilator shortage, as will those of Lin and all the other physicians in the news — if they allow their employees to speak.

Not every doctor or nurse who’s had a media appearance has been quieted or threatened. But I fear that many of those who’ve been allowed to speak have been encouraged to do so out of an interest in branding, rather than from a desire to provide real information.

Some may argue that these physicians should take their lumps if they don’t follow their employers’ orders. And there’s some truth to that: When your job and health insurance are in play, sometimes it’s wise to walk a safe path. But this is not one of those times — and they shouldn’t have to put themselves in professional jeopardy to help inform us when they’re already in the line of fire. And that means it’s on their employers to let them speak up. Rendering clinicians inconsequential during a worldwide pandemic is the worst thing they can do.

How Authoritarians are Exploiting the COVID-19 Crisis to Grab Power

This post was originally published on here by staff writer Kenneth Roth.

For authoritarian-minded leaders, the coronavirus crisis is offering a convenient pretext to silence critics and consolidate power. Censorship in China and elsewhere has fed the pandemic, helping to turn a potentially containable threat into a global calamity. The health crisis will inevitably subside, but autocratic governments’ dangerous expansion of power may be one of the pandemic’s most enduring legacies.

In times of crisis, people’s health depends at minimum on free access to timely, accurate information. The Chinese government illustrated the disastrous consequence of ignoring that reality. When doctors in Wuhan tried to sound the alarm in December about the new coronavirus, authorities silenced and reprimanded them. The failure to heed their warnings gave COVID-19 a devastating three-week head start. As millions of travelers left or passed through Wuhan, the virus spread across China and around the world.

Even now, the Chinese government is placing its political goals above public health. It claims that the coronavirus has been tamed but won’t allow independent verification. It is expelling journalists from several leading US publications, including those that have produced incisive reporting, and has detained independent Chinese reporters who venture to Wuhan. Meanwhile, Beijing is pushing wild conspiracy theories about the origin of the virus, hoping to deflect attention from the tragic results of its early cover-up.

Others are following China’s example. In Thailand, Cambodia, Venezuela, Bangladesh, and Turkey, governments are detaining journalists, opposition activists, healthcare workers, and anyone else who dares to criticize the official response to the coronavirus. Needless to say, ignorance-is-bliss is not an effective public health strategy.

When independent media is silenced, governments are able to promote self-serving propaganda rather than facts. Egypt’s President Abdel Fattah el-Sisi, for example, downplayed the coronavirus threat for weeks, apparently wanting to avoid harming Egypt’s tourist industry. His government expelled a Guardian correspondent and “warned” a New York Times journalist after their articles questioned government figures on the number of coronavirus cases.

The government of Turkey’s President Recep Tayyip Erdogan implausibly denies that there are any COVID-19 cases in its prisons, and a prosecutor is investigating a member of parliament—himself a doctor—who says that a seventy-year-old inmate and a member of the prison staff have tested positive. Thailand’s Prime Minister Gen Prayut Chan-ocha warned journalists to report on government press conferences only and not to interview medical personnel in the field.

Of course, a free media is not a certain antidote. Responsible government is also needed. US President Donald Trump initially called the coronavirus a “hoax.” Brazilian President Jair Bolsonaro called the virus a “fantasy” and preventive measures “hysterical.” Before belatedly telling people to stay home, Mexican President Andrés Manuel López Obrador ostentatiously held rallies, and hugged, kissed, and shook hands with supporters. But at least a free media can highlight such irresponsibility; a silenced media allows it to proceed unchallenged.

Recognizing that the public is more willing to accept government power grabs in times of crisis, some leaders see the coronavirus as an opportunity not only to censor criticism but also to undermine checks and balances on their power. Much as the “war on terrorism” was used to justify certain long-lasting restrictions on civil liberties, so the fight against the coronavirus threatens longer-term damage to democratic rule.

Although Hungary has reported Covid-19 infections only in the hundreds to date, Prime Minister Viktor Orbán used his party’s parliamentary majority to secure an indefinite state of emergency that enables him to rule by decree and imprison for up to five years any journalist who disseminates news that is deemed “false.” Philippines President Rodrigo Duterte has also awarded himself emergency powers to silence “fake” news.

As Israeli Prime Minister Benjamin Netanyahu faces corruption charges, his justice minister cited the coronavirus to suspend courts for most cases, as did a close parliamentary ally as he attempted to prevent the opposition’s new majority from ousting him as Knesset speaker—a move that the Israeli Supreme Court said “undermin[ed] the foundations of the democratic process.” The Trump administration has cited the coronavirus to discourage requests under the Freedom of Information Act, suddenly insisting they be made by only traditional mail, in spite of the greater public health safety of electronic communication.

Some governments are breathing a sigh of relief that the coronavirus has provided a convenient reason to limit political demonstrations. The Algerian government has halted regular protests seeking genuine democratic reform that have been under way for more than a year. The Russian government has stopped even single-person protests against Vladimir Putin’s plans to rip up term limits on his presidency. The Indian government’s recently announced three-week lockdown conveniently ends the running protests against Prime Minister Narendra Modi’s anti-Muslim citizenship policies. It remains to be seen whether such restrictions outlive the coronavirus threat.

Other governments are using the coronavirus to intensify digital surveillance. China has deepened and extended the surveillance state that is most developed in Xinjiang, where it was used to identify some of the one million Uyghur and other Turkic Muslims for detention and forced indoctrination. South Korea has broadcast detailed and highly revealing information about people’s movements to anyone who might have had contact with them. Israel’s government has cited the coronavirus to authorize its Shin Bet internal security agency to use vast amounts of location-tracking data from the cellphones of ordinary Israelis. In Moscow, Russia is installing one of the world’s largest surveillance camera systems equipped with facial recognition technology. As occurred after September 11, 2001, it may be difficult to put the surveillance genie back in the bottle after the crisis fades.

There is no question these are extraordinary times. International human rights law permits restrictions on liberty in times of national emergency that are necessary and proportionate. But we should be very wary of leaders who exploit this crisis to serve their political ends. They are jeopardizing both democracy and our health.

Truth Distancing? Whistleblowing as Remedy to Censorship During COVID-19

This post was originally published by NCBI here.


In the COVID-19 pandemic, whistleblowers have become the essential watchdogs disrupting suppression and control of information. Many governments have intentionally not disclosed information or failed to do so in a timely manner, misled the public or even promoted false beliefs. Fierce public interest defenders are pushing back against this censorship. Dr Fen and Dr Wenliang were the first whistleblowers in China to report that a new pandemic was possibly underway, and ever since, numerous other whistleblowers around the world have been reporting on the spread of the virus, the lack of medical equipment and other information of public interest. This paper maps the relevant whistleblowing cases in China, the USA and Europe and shows that many whistleblowers are initially censored and face disciplinary measures or even dismissals. At the same time, whistleblowing during the COVID-19 pandemic has drawn public attention to the shortcomings of institutional reporting systems and a wider appreciation of whistleblowers as uniquely placed to expose risk at early stages. Ultimately, whistleblowing as a means of transparency is not only becoming ever less controversial, but during COVID-19 it has become the “remedy” to censorship.

I. A pandemic in a post-factual world

How do governments deal with a pandemic in a “post-factual” world? Far too many have not disclosed information or failed to do so in a timely manner, misled the public or even promoted false beliefs. Transparency has been particularly underserved by those leaders who generally tend to be dismissive of truth and facts. More than error or miscalculation, censorship of information is at the core of how some governments and authorities manage this pandemic as they seek to control the narrative over its eruption and spread.

Whistleblowers have played a crucial role in exposing facts during the COVID-19 pandemic, starting with Dr Li Wenliang and Dr Ai Fen in China and numerous other (medical) workers around the world. Whistleblowers have disclosed information relevant for the spread of the virus, the lack of medical equipment and other information of public interest. Such information has been reported to the press, in social media as well as internally at their workplaces or through hotline calls to organisations working on the protection of whistleblowers.

This paper traces the main whistleblowing cases in China, the USA and Europe. In mapping these cases, this paper relies on data drawn from interviews with stakeholders and experts, news reports and reports by organisations working with whistleblowers, and, where possible, on official government documents. At the time of writing, we are still in the midst of the COVID-19 crisis and therefore we are yet to receive further official reports and analysis. In this respect, this paper offers an initial tentative analysis of the current developments, with the aim of discerning some broader patterns from the available material.

The paper observes that many whistleblowers are initially censored and face disciplinary measures or even dismissals, although there are important differences between China and the USA/Europe on the level of censorship and information control. Whilst backlash against whistleblowers is not news, whistleblowing during the COVID-19 pandemic is impacting the public opinion on the acceptability of whistleblowers and has mobilised civil society to increase cooperation globally in acting as a critical watchdog on government censorship of whistleblowers. The paper concludes that censorship is challenged by many fierce public interest defenders who confront information control and expose relevant facts about the COVID-19 pandemic.

II. “Truth and rumour”: censorship and Chinese whistleblowing law

“I regret that back then I didn’t keep screaming out at the top of my voice.” – Dr Ai Fen, Wuhan Central Hospital

In December 2019, Dr Li Wenliang posted a message to a social media chat group, which included other medical doctors, about some patients showing signs of a new illness similar to severe acute respiratory syndrome (SARS). His communication with his colleagues soon reached the local authorities. On 3 January 2020, Dr Wenliang was detained for “spreading false rumours” and was forced to sign a police document admitting that he had “seriously disrupted social order”.3 Article 41 of the Chinese Constitution foresees the “right to criticize and make suggestions to any state organ or functionary” and to raise complaints and charges against, or exposures of, any state organ or functionary for violation of the law or negligence of duty. However, “fabrication or distortion of facts for the purpose of libel or frame-up” is prohibited. Therefore, during the reporting process, it is essential to assess whether a report may be categorised as a “rumour”. Chinese law does not define the meaning of a “rumour”, although many regulations foresee penalties for “spreading rumours”.

Quite contrary to disrupting social order, Dr Wenliang’s attempts to alert his colleagues and later the public were crucial to disrupting information suppression and control. This kind of “disruption” is essential for generating public knowledge, and such disclosure of information by insiders is necessary for the purposes of accountability. Dr Wenliang blew the whistle that a new pandemic was possibly underway, and he was not alone in raising the alert. It is reported that on the same day as Dr Wenliang’s post in the chat group, another medical doctor, Dr Ai Fen, had reported to a hospital’s public health department and infection department that she had seen a test sheet mentioning symptoms of SARS. Hospitals, however, may defer to local health authorities about reporting infections, apparently to avoid surprising and embarrassing local leaders. The mayor of Wuhan publically admitted that the news about the virus should have been made known earlier and acknowledged that, in his role as mayor, he could only release information upon receiving authorisation from the relevant authorities.

COVID-19 has brought the discussion on whistleblower protection to the fore in China, and a wider public debate has ensued as to the value of whistleblowers. The censorship of information about this pandemic and the responses of authorities bear a similarity to the case of Shuping Wang, who blew the whistle in the 1990s exposing the handling of HIV and hepatitis epidemics in China. Yet unlike before, public opinion is shifting in terms of the role of the whistleblower. Legally, a whistleblower in China is viewed as an enforcer of government regulation. Current Chinese law on whistleblowing offers protection in bits and pieces with provisions in the criminal law procedure, labour law, work safety, foods and drugs, product quality, securities and financial fields. A Chinese legal expert explains that “the focus of the policy is to encourage and protect insiders who have real inside information to come forward to assist the government in performing its regulatory functions”.

For the Chinese government, whistleblowing is viewed as a social control mechanism, especially for controlling corruption of officials.14 The COVID-19 whistleblowers in China, however, do not fit this narrow view of a whistleblower as an agent who enforces regulation on behalf of the government. Rather, they are pointing to a role of a whistleblower who raises an alarm in the public interest, even when the government seeks to supress such information or control its distribution. Dr Wenliang’s case illustrates this point. When he died from COVID-19 in February 2020, it sparked widespread public anger, with many citizens openly expressing calls for freedom of speech in social media (leading to nearly two million views) that were later censored, and the phrase “#Wuhan government owes Dr Li Wenliang an apology” received tens of thousands of views before it was removed. Hence, in Chinese public opinion, Dr Wenliang is seen as a whistleblower who sought to raise an alarm in the public interest and whose voice was being silenced rather than supported by the government. This in turn highlights that the interest of the people to know can be in tension with the government’s efforts to withhold that information. The COVID-19 pandemic has drawn public attention in China to the role of whistleblowers as voices of public interest and to whistleblowing as a form of freedom of expression. Whether such a view will be sustained or even transposed into law remains to be seen.

III. Censorship and silencing whistleblowers in the USA and Europe

Whilst the effects of supressing and controlling information in China are severe, workers around the globe, especially medical workers at the frontline of fighting COVID-19, have faced pressure from governments and authorities to remain silent. As The New York Times reported:

In New York City, the epicenter of the crisis in the United States, every major private hospital system has sent memos in recent weeks ordering workers not to speak with the media, as have some public hospitals.

In addition to constraining their freedom to speak out on the COVID-19 pandemic, workers have also experienced disciplinary measures and even dismissals in instances where they have expressed concerns about their working conditions. In the USA, the Government Accountability Project, a whistleblower protection and advocacy organisation based in Washington, DC, has reported numerous cases of whistleblowers being fired for speaking out. For example, in Seattle, an emergency room physician was fired after giving an interview to a newspaper about inadequate protective equipment and testing, as was a nurse in Chicago for asking for better equipment in emails with her colleagues.

On the other side of the Atlantic, the situation has been similar. In the UK, medical professionals of the National Health Service have been put under pressure not to speak out, and media report that tactics for silencing workers include “threatening emails, the possibility of disciplinary action, and some people even being sent home from work”.

In European Union (EU) countries where the rule of law had deteriorated even prior to COVID-19, even harsher pressures have been reported. For example, upon using social media to alert on missing masks and equipment, a healthcare professional in Poland was fired by their hospital director. This situation led to a reaction by Poland’s Ombudsman to the Ministry of Health, asking that the decision to fire the health worker be revoked and reminding the Ministry of the constitutional freedoms and rights for freedom of expression in Poland. The issue is not isolated to one doctor, but seems to have become a growing practice, with medical staff being asked to consult with management and forbidding doctors to discuss their work or matters pertaining to COVID-19 directly with journalists. Hungary can be seen as an even more extreme case, since blowing the whistle is not even a possibility due to measures limiting freedom of expression that are directly targeted at journalists, including a prison term of five years for “fake” reporting.

Pressures on whistleblowers and freedom of speech have also been reported in Serbia, an EU candidate state. For example, a whistleblower sought to reveal that the union of workers is charging for masks that medical staff should use, or in another case a local TV crew staffer was arrested after investigating a tip from a whistleblower under the alleged accusation that the reporter did not respect the precautionary health measures for COVID-19 when he entered the city hall.

Against this background of pressure and dismissals of whistleblowers and even possible imprisonment of journalists who help bring these facts to the public, more than 95 civil organisations across Europe and globally have come together to issue a statement calling for the protection of whistleblowers and making it clear that they, as a civil society, will continue to monitor and expose the censorship of whistleblowers. Organisations such as Protect in the UK offer specific advice lines for COVID-19 whistleblowers and information for workers as well as members of vulnerable groups. Transparency International Ireland has also published new guidance on whistleblowing for workers and guidance for employers during the COVID-19 pandemic. The guidance includes advice on reporting COVID-19-related concerns to employers, regulators or the media, as well as measures employers can take to respond to concerns effectively. In addition to the hands-on work with guiding and helping whistleblowers, civil society is also focused on advocating for turning these solutions into a coherent policy. As explained by Anna Myers, the Executive Director of Whistleblowing International Network (WIN), a crisis like the COVID-19 pandemic reveals that: “Everyone, not just the appointed decision-makers, but everyone, everywhere needs information in order to make informed decisions”.

This aspect of COVID-19 whistleblowing is having an impact on public opinion about who may be a whistleblower, why it is important to protect individuals who speak out as well as why whistleblowing can be a unique tool for channelling information to the public. Trying to make use of this favourable public opinion on whistleblowing, civil organisations are connecting and mobilising globally and monitoring how governments and businesses are responding and whether they are trying to stop or punish those who are blowing the whistle. For example, WIN is gathering this information to set up a COVID-19 Whistleblowing Information Hub that would be used for current work on protecting whistleblowers, but also for future advocacy for advancing protections. In other words, the appreciation for information sharing during this pandemic has opened up new ground for showing the value of whistleblowing and possibly transposing that public support into a longer-lasting effect by establishing and expanding legal protections or, where they exist, to ensuring that they are being adequately implemented.

IV. COVID-19 watchdogs

Whistleblowers as watchdogs during the COVID-19 pandemic have put in full display the shortcomings of institutional reporting systems, as well as the distinct value of whistleblowing in exposing risk at early stages. Lack of transparency and information-sharing failures have been systematic and global during the COVID-19 pandemic. Censorship of information by governments and authorities indicates an inclination to put reputational interests ahead of solving serious problems such as shortages of medical equipment and the work safety of workers, particularly medical professionals. Censorship only enables governments to control the narrative and public opinion in the short term. When dealing with a crisis such as COVID-19, sustaining transparency is not only a checklist item for good governance; it can actually save lives. Whistleblowers are filling this transparency gap and have become an essential watchdog for keeping governments in check in terms of how they manage this pandemic. The cases discussed in this paper show that the purpose of these whistleblowers has been to expose serious errors or the lack of resources in the health system in order to ensure that errors are rectified as soon as possible. At the same time, these whistleblowers have been pressured to remain silent and disciplined or dismissed in cases when they have spoken out. In extreme cases, the journalists who sought to expose their stories have faced threats of imprisonment. Such efforts to curtail freedom of speech have invigorated civil society to mobilise globally in advancing long-term policy solutions and protections for whistleblowers. Ultimately, whistleblowing as a means of transparency is not only becoming ever less controversial, but during COVID-19, it has become the “remedy” to censorship.

A Federal Coronavirus Vaccine Contract Released at Last, but Redactions Obscure Terms

This post was originally published on here by staff writer Sydney Lupkin.

Even as the companies enlisted by the government’s Operation Warp Speed project to develop COVID-19 vaccines say they’re making quick progress, details of their lucrative federal contracts have been slow to emerge.

But late Friday, the Department of Health and Human Services released its August contract with Moderna. When announcing the deal, HHS said it was worth $1.5 billion and would secure the first 100 million doses of the company’s vaccine and the option to buy up to 400 million more.

Overall, there is a lack of disclosure around the terms of the federal contracts with companies involved in the crash program to make COVID-19 vaccines. Most of the contracts haven’t been released.

While the publicly posted Moderna contract includes previously unknown details, extensive redactions leave the public in the dark about some of the company’s obligations as well as the extent of protections for taxpayers.

It’s 53 pages long, but only 14 of them are free of redactions.

Some of the redactions obscure information that has already been disclosed. The value of the contract, for example, is blacked out with a note that it isn’t disclosable under public records law because it is a trade secret.

However, the $1.5 billion value of the deal was trumpeted by HHS in its August announcement, and Moderna, a front-runner in the vaccine program, included the news in a financial filing the same day.

“There’s no question that that is not confidential,” says Kathryn Ardizzone, a lawyer at Knowledge Ecology International, a nonprofit public interest group that focuses on intellectual property. “HHS was less transparent than Moderna.”

An HHS spokesperson emailed the following statement about the release to NPR:

“The documents that were posted were reviewed by both the government and the company, as is general practice. Based on this process, as well as the applicable law, the posted document includes the information we determined as properly releasable at this time. Operation Warp Speed is committed to being as transparent as possible. The government will continue to monitor what is releasable over time as part of this commitment to transparency.”

Moderna spokesman Ray Jordan says that the company will be discussing details of the contract during its quarterly earnings call this Thursday, but he had no additional comment regarding the intellectual property or data rights provisions in the contract when he spoke to NPR on Saturday. He later said that contract details may be disclosed after the earnings call instead of during it.

Moderna will get an extra $300 million if it receives approval or an emergency use authorization from the Food and Drug Administration “on or before January 31, 2021,” according to a company disclosure about this contract. But the speed bonus is one of many things that has been redacted from the contract that HHS released.

The newly released Moderna contract does reveal a clause that is standard in drug development that receives funding from the federal government. It allows the government to “march in” and take control of a drug or vaccine if a manufacturer that received federal financial support engages in price gouging, for example.

That clause is a relief, says James Love, director of Knowledge Ecology International. Of the Operation Warp Speed contracts that have been made public, not all of them include this safeguard.

But the process under these so-called Bayh-Dole protections is often lengthy, requiring a series of administrative and court proceedings and an appeal process. “In the case of COVID-19, that’s not an ideal situation,” Love says.

Given the pandemic, Love says he thinks the government should have included an exceptional-circumstances authority to this part of the Moderna contract, which could potentially allow the U.S. government to own the vaccine patents.

“We thought the COVID pandemic completely fit the bill for exceptional circumstances,” Love says, adding that KEI wrote a letter to the agency and House Speaker Nancy Pelosi about this. “They would have much more leverage over the people receiving the money on any policy they wanted to connect to the right to use the patent.”

Although the Moderna contract is heavily redacted, it includes a list of contracting regulations that, if expanded, would include dozens or hundreds of pages of taxpayer protections, says attorney Franklin Turner, a partner at McCarter & English who specializes in government contracting. If the government doesn’t think Moderna is complying with the contract, for example, it has the right to terminate the contract and go after the company for damages.

“Are taxpayers being adequately protected as a matter of regulation? My answer is yes,” he says. The government “impose[s] extensive obligations on the contractor to govern the procurement.”

Turner says it isn’t typical to see such broad redactions in the work requirement section of the contract because that’s something the government sets and it shouldn’t include trade secrets. However, he says he believes “there’s nothing nefarious here.”

Data rights, which would govern disclosure and sharing of key studies, cell lines and the know-how to make a product, are less clear in the Moderna contract because they’ve been heavily redacted. “The fact that the government is not open-sourcing the know-how to make vaccines in this pandemic when it’s paying for the building of factories and clinical trials and soup to nuts on a lot of these vaccines is a massive policy failure,” Love says.

The government released three other contracts at the same time it released Moderna’s. One contract is with Ology Bioservices, a manufacturer of biological products, for vaccine and antibody drug production. The other two contracts — one to Becton, Dickinson & Co. and another to Retractable Technologies Inc. — cover syringes and needles for administering vaccines. The patent and data rights included in these contracts are inconsistent.

Members of Congress, advocacy groups and journalists had been asking for Operation Warp Speed’s procurement contracts for months. At least two nonprofits, KEI and Public Citizen, sued when their public records requests went unanswered. KEI has obtained some contracts through public records requests, and it discovered that important clauses were missing or redacted.

None of the vaccine contracts that have been made public so far include those that NPR first reported went through a third party called Advanced Technology International. NPR is still trying to obtain those contracts, which have a combined value of more than $6 billion.

An Important Part of Science is Admitting When We’re Wrong

This post was originally published on here by staff writer Mary Beth Griggs.

This week started with a whole lot of people getting very angry about someone being wrong on the internet. This time, it was computer scientist Steven Salzberg, who wrote a blog post on Forbes arguing that people should start vaccinating now — phase 3 clinical trials had just started. They seemed to be going well. Why not start passing out doses to willing, informed volunteers?

Well, a whole bunch of reasons, most of which boil down to some variation of that’s what the trials are there for. The evidence that’s needed to move something into the third level of human testing is pretty high — but not high enough to justify use on the broader population, as biostatistician Natalie Dean pointed out in a New York Times rebuttal of the Forbes post.

“It’s just fundamentally wrong to think that because there’s an emergency, that we should somehow throw out aspects of scientific research,” Alex John London, director of the Center for Ethics and Policy at Carnegie Mellon University told Verge reporter Nicole Wetsman this week.

In fact, Wetsman writes, sticking to the process, gathering the evidence, and making sure the vaccine actually works is what makes the vaccines we have today so safe. There are some things we can speed up, but widely distributing untested vaccines would be reckless.

Hundreds of people showed up online to point out the error of Salzberg’s ways. But instead of this dissolving into drama, or fading into the background of new Twitter fights and controversies, something very different happened.

“I was wrong,” Salzberg wrote in a new Forbes post. “After reading many of the responses to my article, some of them outlining the risks in greater detail, I have concluded that (1) the risks are greater than I presented them, and (2) the benefits are not as great as I had thought.”

It’s always a better feeling to be right on the first try. Doing background research first and challenging your own biases can avoid screw-ups before they happen. But having the flexibility to admit that we were wrong, like Salzberg did, will serve us well as we head through the next phase of the pandemic.

Many of the things we thought at the start of the pandemic were wrong. Asymptomatic and pre-symptomatic people can transmit the virus. The virus probably does spread through the air. There’s a whole lot more that we just don’t know yet. Everyone is learning about this new, world-altering virus in real time, and that means that sometimes we get lost, or head down dead ends, or want to speed ahead, if only to make the suffering stop.

Rigorous examination of evidence and beliefs is part of what makes the entire process of science work, and it’s what brings us back toward the truth, even when we veer away from it. There’s only so much we can do to speed up science — but by working together, we might be able to keep ourselves on the right track.

Big Pharma is Not Willing to Help us Defeat COVID-19

This post was originally published on here by staff writer Nick Dearden.

For months, experts have repeatedly told us that no one is safe from coronavirus until we are all safe. If that is true, we should be going all out to ensure the world’s resources are used to bring treatments and vaccines to the whole world as soon as possible.

Several initiatives have attempted just that, but efforts have been stymied by the self-interest of big business, and by the leaders of rich countries who are terrified of undermining rules designed to keep their countries at the top of the pecking order.

A recent ground-breaking proposal by India and South Africa could change all that. Those governments have lodged a proposal at the World Trade Organization (WTO) to suspend international patent laws for an extended period, allowing countries to share technology and produce their own versions of patented medicines, treatments and protective equipment without being held to ransom by the corporations which own those patents. It is a game-changer, which challenges one of the most shameful aspects of modern trade rules.

Intellectual property – essentially patents and copyright – first became a trade issue in the mid-1990s when the Agreement on Trade-Related Aspects of Intellectual Property Rights, or TRIPS, was negotiated at the WTO. TRIPS extended Western-style patent protections across the whole world, allowing the business to sit on patents for a minimum of 20 years, during which time they are able to dictate who can use their creations and at what price.

At a stroke, it meant that one of the main benefits of trade for developing countries – the ability to learn from and copy technologies developed in richer countries – was lost. Just as bad, corporations started worrying more about extending these patents, for instance making tiny changes to products that were of no benefit to the consumer, than they did developing new and useful products.

Nowhere did this have a more devastating impact than in the development of medicines. TRIPS was concluded as the HIV/AIDS crisis reached epidemic proportions in Southern Africa. While drugs had been developed that could lengthen life, reduce suffering and help prevent the transmission of HIV, most people in the world could not afford those medicines, and the new trade rules prevented countries from simply taking the technology and producing the drugs themselves. Millions died unnecessarily in one of the most obscene examples of corporate profits trumping the right to life.

Today, Big Pharma, as these corporations are collectively known, is a dysfunctional industry. While modern medicine risks collapsing because of antibiotic resistance, these companies spend more resources inflating their stock price than developing new medicines. What useful medicines are produced depend on massive injections of cash from the public sector, which normally comes without any conditions constraining the prices these megacorporations can charge for the final drugs produced.

Little wonder then that India and South Africa are sceptical about the ability of Big Pharma to help us deal with coronavirus. In fact, there have already been attempts to design a system which can help the world provide coronavirus medicines which would be available to all on a fair basis. Costa Rica proposed allowing countries and researchers to share their technologies, collaborate on research and produce patent-free medicines back in the spring.

Despite gaining broad support from around the world, Big Pharma howled in protest. Pfizer called it “nonsense”. British companies working on coronavirus treatments, AstraZeneca and GlaxoSmithKlein, refused to participate, backed by the British government which tried to water down the proposals. When asked whether he would attend the launch of the Costa Rican scheme, the director of a prominent Big Pharma lobbying group, said he was “too busy”.

The scheme is up and running, but its voluntary nature means that its impact will be limited. And while there are global programmes to support “fair distribution” of medicines across the world, these schemes are all based on Big Pharma keeping its patents intact. The fact that rich countries are spending billions of dollars buying as many potential vaccines as possible suggests they do not have much faith in these schemes. They are, it seems, just for poor countries who have no better choice.

It is true that some companies have promised to produce medicines “without profit” during the pandemic, but even here we have every reason to be sceptical, with companies themselves left to define when the pandemic is “over” and near-total secrecy surrounding their pricing. What we do know is that one company, Gilead, which produces Donald Trump’s favourite drug remdesivir, tried to get special patent protection on the basis that their medicine had a limited potential market; an astonishing claim in a drug you hope will help in a pandemic.

Another company, Moderna, released suspiciously early test findings on its contender for a vaccine, in a move suspected of helping its executives cash in on rising share prices rather than get its medicine out to as many people as possible. And British company Astra-Zeneca made a deal with Oxford University, which has trumped Oxford’s initial promise to make their research available without patents. All of these drugs have received significant amounts of public money.

But perhaps this behaviour is not surprising. After all, what else can be expected of a system which hands no-strings public funds over to the some of the richest corporations in the world, and allows them to charge whatever the market will bear for life-saving medicines for at least 20 years? It is the model itself which is broken, and the Indian-South African proposal aims to change this.

There are already exemptions within TRIPS, hard-fought-for by campaigners in the 1990s, under which countries can override patents in certain circumstances. Indeed, a number of countries in recent months from Germany to Ecuador, Chile to Israel, have said they will use this option if forced to. But there are huge limitations to these exemptions, most notably that they leave individual countries to fight over every individual drug that they need to get hold of, against the full might of Big Pharma and their Western government backers. Far better, given how fundamentally broken the system is, to use this opportunity to do things differently.

If coronavirus has shown us anything, it is how reliant we are on each other, and on public services. Many of us in the West enjoy a health system which is protected from the whims of the market. If this applies to our hospitals, why should it not also apply to the medicines we are given when we are in hospital? And if it is good enough for the rich world, it is surely even more important in countries where so many die every year simply because Big Pharma does not find it sufficiently profitable to research the medicines that could save those lives, or to charge a low enough price that those in need could afford them. It is time for a transformation. The Indian-South African proposal must be supported as a vital first step.

Elon Musk Again Calls for COVID-19 Lockdowns to End in Great Barrington Declaration Discussion

This post was originally published on here by staff writer Aatif Sulleyman.

lon Musk has once again called for an end to lockdown measures intended to slow the spread of COVID-19. The Tesla CEO has been one of the most high-profile critics of lockdown and has repeatedly downplayed the pandemic over the past several months.

His latest comments were made as part of a Twitter discussion started by right-wing journalist Toby Young, who once argued for what he described as “progressive eugenics.”

Young was claiming that the website of the Great Barrington Declaration, a petition that says that anybody who is not vulnerable to the virus “should immediately be allowed to resume life as normal,” does not appear in Google’s search results.

The Great Barrington Declaration calls for nursing to only “use staff with acquired immunity” and for retired people to “have groceries and other essentials delivered to their home” and “meet family members outside rather than inside.”

A spokesperson for Google has confirmed to Newsweek that it “did not take any action to impact how this site appeared in Google.”

“It can take a little time for our automated systems to learn enough about new pages like this for them to rank better for relevant terms,” Danny Sullivan, Google’s public liaison for search, explained on the Google Search forums.

“This delay can vary by country. This page is and was ranking in the first page in the US, has risen elsewhere & likely will continue automatically.

“For example, the official Joe Biden website took some time to appear in the first page for searches seeking it, after it launched. As with that case, this case or any case, we’ll look to see how we can improve freshness for such navigational queries.

“Do keep in mind that rankings can change often. With a new page especially, you might see fluctuations as we continue to learn more about it.”

In the example referenced by Sullivan, a parody site mocking Joe Biden was given greater prominence than the official Joe Biden campaign site in Google.

Responding to a tweet from Tesla fan Pranay Pathole, who calls for countries around the world to “learn from Sweden’s” response to COVID-19, Musk wrote: “Yes. We also have to consider population life-months lost from lockdowns & other restrictions vs life-months lost from any given disease.”

Elon Musk leaves after giving a statement to the press as he arrives to have a look at the construction site of the new Tesla Gigafactory near Berlin on September 03, 2020 near Gruenheide, Germany. The Tesla CEO has repeatedly downplayed the pandemic and called for lockdown measures to be lifted.

Sweden has taken a softer approach to the pandemic than most countries, choosing not to impose a national lockdown, but to encourage personal responsibility instead.

It opted not to close businesses and schools, or to make the use of face masks mandatory. It did, however, place a ban on gatherings of 50 people, asked people to observe and respect physical distancing, and told vulnerable people to self-isolate.

In May, Sweden recorded the most deaths from COVID-19 per capita in Europe, but in August, Mike Ryan, the executive director of the World Health Organization’s Health Emergencies Program, praised the country following a considerable drop in outbreak statistics reported over the summer.

Cases there are now on the rise again and Swedish health officials are considering new protocols to slow the spread of the virus.

“The right thing to do would be to not have done a lockdown for the whole country but to have, I think, anyone who’s at risk should be quarantined until the storm passes,” Musk said on Sway, the New York Times’ podcast, last month.

He added that he and his family do not plan to get vaccinated against COVID-19 if and when a vaccine becomes available, and refused to reveal whether he would pay a worker if they refused to go to work because of COVID-19 fears.

Musk has also referred to the panic during the early stages of the virus as “dumb” and predicted that there would be “close to zero new cases in US … by end of April.”

Contact Tracing Apps Have a Major Design Flaw

This post was originally published on here by staff writer Allison Gardner.

During the first wave of COVID-19, researchers at Oxford University built a computer model that suggested if 56% of the U.K. downloaded and used a contact-tracing app (alongside other control measures) it could end the epidemic in the country.

With the English app only available since September, it’s too early to tell how the system is actually doing. But even based on other countries whose apps have been available much longer, there’s still very little evidence that they can make a real difference to fighting COVID-19—or that they can’t.

While this doesn’t mean we should write off contact-tracing apps altogether, the lack of evidence is a concern given the focus and money devoted to these apps and the policy decisions made around them. This kind of “tech solutionism” could be a distraction from developing proven manual contact-tracing systems. Indeed, the Council of Europe has raised the question of whether, given the lack of evidence, the promises made about these apps are “worth the predictable societal and legal risks.”

Despite predictions that between 67.5% and 85.5% of potential app users would download apps, worldwide download rates of contact-tracing apps have so far been low, running approximately at 20%. In Germany it has been around 21%, in Italy 14%, in France just 3%. Iceland and Singapore, which was one of the first to launch an app, have the highest download rates to date at 40%.

Download rates matter because you need lots of other people to have the app on their phone to increase the chance that if you come into contact with someone who has the virus the system will be able to alert you of that fact.

In broad terms, if you have 20% of the population as active app users then there is only a 4% chance of coming into contact with another app user (the math is explained here). Increase the download rate to 40% and you have a 16% chance of meeting another active app user. This also works on the assumption that users have the same app or different ones that can work together.

Apps may not need high download rates to have some impact. A second report from the Oxford researchers suggested that a well-staffed contact-tracing system that included digital as well as manual notifications could reduce infections by 4%-12% and deaths by 2%-15% if just 15% of the population used the app.

Singapore’s Ministry of Health claims that where it used to take contact-tracing teams four days to identify and quarantine a close contact, the app can enable them to do so in within two days.

But in the real world, downloading the app isn’t the same as using it or, most importantly, responding to warnings to self-isolate if the app tells you you’ve been in contact with an infected person. A U.K.-government commissioned study of more than 30,000 people showed that just 18% of people agreed to self-isolate when someone working for the country’s manual contact-tracing system actually called them and explained why. The numbers for an automated message on your people’s phones are likely to be even lower.


So why haven’t contact-tracing apps had more demonstrable success? First, there appears to be a lack of public trust in the technology and its use of personal data.

Earlier in the year, there was much discussion about whether the apps should upload data to a central database or store it on users’ phones in order to preserve their privacy. Most countries eventually opted for the latter, although France went with the former, less private system (and has reported very low take-up).

England also initially experimented with centralized model but after much criticism and reported difficulties switched to decentralized. However, the loud public debate may have left a permanent negative impression of the efficacy and inherent privacy concerns of government-developed tracking apps.

Indeed there is good reason to be skeptical of the apps’ effectiveness. Most countries (with the exception of Iceland) have also opted to use Bluetooth to record when app users come into contact rather than using GPS to track their specific location, again to protect privacy. But Bluetooth has a number of weaknesses that mean it can record contacts that never happened and miss others that did.

For example, the app might record you coming into contact with someone even if they are the other side of a partition wall. But if you keep your phone in your back pocket it may not connect with another held by someone standing in front of you.

One study, which took place on a tram and compared the Italian, Swiss and German apps, concluded that the technology was very inaccurate, no better than “randomly selecting” people to notify, regardless of proximity. The resulting false alerts have likely added to public confusion and lack of confidence in the tracer apps.


Another problem is, of course, that only smartphone owners can use the apps. Given that, in the U.K., 61% of over-65s don’t have access to a mobile internet device, this means that the largest at-risk group is much less likely to be able to benefit from contact-tracing apps.

One solution to this problem might be to use alternative technology to register people’s contacts. Singapore has introduced a token that can be carried on a lanyard or in the pocket or bag, and that contains technology to enable it to fulfill the same function as a tracing app. New Zealand has also considered a similar “covid card” to circumvent the smartphone issue.

But ultimately, if any of this technology is to have an effect, the only evidence we have suggests it must be part of an effective test and trace system that includes manual contact tracing—something few countries have yet managed to establish. A tech solution is not always the answer.

70% of News Advertising Now Belongs to Big Pharma

This post was originally published on here by staff writer Christina Morales.

Nicholas Christakis says that “clamping down on people who are speaking is a kind of idiocy of the highest order.”

If you watch television for any amount of time, you’re probably going to see a drug commercial that tugs on your heart strings, promises to heal your worst medical conditions, and then a voiceover will quickly gloss over the multitude of side effects in a too-quick-to-understand string of monotone words. Prescription medications are are multi-BILLION dollar industry that’s making not only the pharmaceutical companies tons of money, but also the network television stations. How is this influencing public opinion AND health?

As we casually watch TV, we usually don’t think twice about these drug ads, but let’s take a glimpse behind the screen. Did you know that pharmaceutical advertising has soared 62 percent since 2012 and is projected to cost $610 billion by 2021? Worse yet, nine out of the 10 largest revenue-generating pharmaceutical companies spend more on advertising than they do on research and development (it appears that they care more about selling drugs than making sure that they are safe and effective). Equally concerning is that pharmaceutical advertising is banned in just about every country except the United States and New Zealand. And consider this: the average American watches 16 hours of pharmaceutical commercials each year which is more time than they spend with their primary physician. One-third of these people ask their doctors about a drug advertisement and most request a prescription.

Clearly this type of advertising in generating a huge response from the public, but it also is having an impact that consumers rarely think about: if these companies are paying television networks billions of dollars to advertise their drugs, would their news stations risk losing big money accounts by reporting negative information about the company? Public figure and activist Robert F. Kennedy Jr. once shared that, “I ate breakfast last week with the president of a network news division and he told me that during non-election years, 70% of the advertising revenues for his news division come from pharmaceutical ads. And if you go on TV any night and watch the network news, you’ll see they become just a vehicle for selling pharmaceuticals. He also told me that he would fire a host who brought onto his station a guest who lost him a pharmaceutical account.”

I had a history professor say that products were made much better in the 1940’s and 50’s. For example, you could buy a toaster once and you’d never have to buy another one because it was made so well. The problem was that these quality products actually hurt revenue since it was a one time purchase. Nowadays, you buy a toaster, it breaks a few years later, and then you go back and buy another one. This same philosophy can be said for big pharma.

“Thanks to government protections [big pharma is] able to make their products more addicting and less effective so they can create return customers and extend their profits,” explains investigative journalist John Vibes. “If a medication is effective in curing a patient then they won’t continually use and purchase that drug because they will have no need to do so. However, if the drug is mediocre and has addictive properties then it will become a regular part of the patient’s monthly budget.”

Mass advertising is clearly one way to start this cycle of addiction. Furthering this point, just this month opioid manufacturer Purdue Pharma announced that they are giving a $3.4 million grant to a non-profit company to help develop low-cost naloxone nasal spray, an antidote for those who overdose on opioids. So let’s get this straight: instead of creating preventative measures to reduce opioid usage and address the true underlying problems, they’re creating a drug to try and solve a major drug epidemic. Anyone else see the flaw in this thinking?

Every drug has its benefits and risks, and it’s time that we, as consumers, educate ourselves to make the best choices for our health. We need to read up on prospective medications, really talk to our doctors, and maybe, just maybe, turn the channel when that drug commercial comes on.

Big Pharma Spends Nearly 68% of its $30 Billion Annual Ad Dollars to Persuade Doctors and Others to Prescribe Their Drugs to Patients. Could this Explain Why More Doctors Prescribe Remdesivir Instead of Hydroxychloroquine?

This post was originally published on here by staff writer Nickie Louise.

Big Pharma is a term commonly used for the world’s largest publicly traded pharmaceutical companies. The Big Pharma is one of the most powerful industries in the world. The global revenue for Big Pharma was over $1 trillion in 2014, according to a report from DrugWatch website. To put that into a perspective, the US spends $3.3 trillion, or 17.8 percent of the GDP on healthcare in 2016.

Nowhere else in the world do the drug and medical device industries have as much power and make as much money as in the United States. Today, Six of the top 10 pharmaceutical companies have their headquarters in the U.S. These companies include Johnson & Johnson, Pfizer, Merck, Gilead, Amgen and AbbVie.

In 2015 alone, Americans spent an all-time high of $457 billion on prescription drugs, and drug prices continue to rise. So, how does the Big Pharma spend its money? According to BMJ, for every $1 spent on “basic research,” Big Pharma spends $19 on promotions and advertising.

According to a study conducted by JAMA also confirmed by Arstechnica, Big Pharma also spends nearly $30 billion that health companies now spend on medical marketing each year. What’s surprising about the spending is that around 68 percent (or about $20 billion) goes to persuading doctors and other medical professionals—not consumers—of the benefits of prescription drugs. In other words, the Big Pharma shells out $20 billion each year to schmooze doctors and $6 billion on drug ads.

According to many drug analysts, charming doctors isn’t surprising and not a new occurrence. Big Pharma traditionally spends most of its marketing dollars on schmoozing doctors “by sending sales representatives to doctors’ offices for face-to-face visits, providing free drug samples and other swag, offering payments for speeches, food and beverages, travel, and hosting disease ‘education.’”

However, what is new and appears to be more “shadier situation—is the explosion of direct-to-consumer (DTC) marketing that couples with those efforts for a one-two marketing punch.” The Big Pharma’s influence is not limited to doctors and other medical professionals. The Big Pharma has also wields over media outlets.

For example, in 2018, an estimated 70% of all news advertising in the US came from pharmaceutical companies. I have written elsewhere about how “reporting” on medical issues can be difficult to distinguish from outright marketing for drug companies.

With the ongoing coronavirus pandemic, the question everyone is asking is, could this explain why more doctors are prescribing remdesivir instead hydroxychloroquine? Remdesivir is a broad-spectrum antiviral medication developed by the biopharmaceutical company Gilead Sciences, one of the 7 Big Pharma we mentioned above.

Dr. James Todaro, a graduate of Columbia University, also made similar observation in Twitter post earlier today. Dr. Todaro said:

“The influence that the pharmaceutical industry wields over media outlets is no secret…An estimated 70% of all news advertising in the US came from pharmaceutical companies.” I guess it’s no surprise why mainstream media loves Remdesivir and hates HCQ.

We’ll let you decide and draw your own conclusion.