Cassandra Voices

Tag: science

  • COVID-19 in Ireland: Lives Lost

    Irish Times health correspondent Paul Cullens reported on February 13, 2023 that a disturbing 1,300 patients had ‘died over the winter as a result of delays in hospital admission from emergency departments, according to an analysis of Health Service Executive data.’

    This followed a longer article by Cullen the previous Saturday exploring what is driving the deeply concerning excess death figures recorded over the previous year in Ireland and elsewhere – ‘among worst in 50 years’ according to the BBC.

    Importantly, Cullen acknowledges that COVID-19 itself ‘can only explain a fraction of the additional number of people dying.’

    Given this is a global issue, attributing additional mortality primarily to the parlous state of emergency medicine in Ireland is a difficult argument to sustain. It could be a contributory factor, but conditions in 2022 were no different to the preceding years. For example, prior to the onset of the pandemic, in January, 2020 Cullen reported that ‘[t]he first week of the new year has been the worst ever for hospital overcrowding, according to figures from the Irish Nurses and Midwives Organisation.’

    The first of Cullen’s recent articles, in particular, appears to have been written in response to high mortality being ‘attributed by some online to Covid vaccines.’ He summarises his arguments to the effect that ‘[t]his limited data does not appear to support claims of a vaccine-related rise in deaths in this age cohort.’

    He then reveals,

    While the vast majority of medical specialists we asked in recent months about claims of vaccine-induced harm say they have no cause of concern, it is fair to say a small number of doctors do, though for now they are reluctant to speak publicly.

    This reluctance among members of the Irish medical profession “to speak publicly” about adverse reactions to the vaccines should be setting off alarm bells, but what is really striking about the current coverage of elevated mortality is the detached, clinical tone.

    This contrasts starkly with the emotive way in which death, and illness, attributed to COVID-19 was reported during the period of the emergency powers (March 2020 – January 2022).

    Stalin (in)famously said the death of one man is a tragedy but the death of a million is a statistic. In Ireland during that period a single death from COVID-19 was treated as a tragedy, whereas today thousands of additional deaths only seem to be eliciting comment when vaccines are implicated.

    A Calamity?

    Over the course of the pandemic the mean age of death from COVID-19 (as of 09/08/2021) in Ireland was eighty years or older, just two years younger than the average age of death. Four in five deaths from COVID-19 had at least three medical conditions. Revealingly, CSO mortality figures through the years 2018-2020 (2018: 31,116; 2019: 31,134; 2020: 31,765) show little difference between the first year of the pandemic and preceding years.

    There remain also serious question marks over how deaths are attributed to COVID-19. The Central Statistics Office (CSO) adopted WHO guidance listing COVID-19 as the underlying cause of death when:

    confirmed by laboratory testing irrespective of severity of clinical signs or symptoms.

    diagnosed clinically or epidemiologically but laboratory testing is inconclusive or not available.

    Chief Medical Officer Tony Holohan acknowledged a remarkably low threshold in April, 2020: ‘Clinically, the “index of suspicion” for the disease would be “a good deal higher” than would normally be the case for flu.’

    Even allowing for a high mortality from COVID-19 in the early part of 2021, the death toll of 33,055 for that year – after vaccines had arrived – is striking. The full set of figures for 2022 are not yet available, but the CSO say that in Quarter 2 (Q2) of 2022 there were 2,626 more deaths (39.2%) when compared with the same period in 2021. Assuming that pattern is evident throughout 2022 and beyond then perhaps we should be describing this is as a calamity.

    There is now compelling evidence of under-reporting of serious adverse harms from vaccines. However, by January, 2021 the FDA had allowed Pfizer ‘to undermine the scientific integrity of the double-blinded clinical trial’. This means we cannot easily attribute additional deaths to the vaccines. But nor can we rule out the possibility that a significant proportion of excess deaths are an unintended consequence of a treatment that is still being promoted in Ireland for infants as young as six-months-old.

    This article, however, proposes another determining cause, which is that heightened stress levels generated by lockdowns and other non-pharmaceutical interventions designed to instil fear of contracting COVID-19, and actively promoted by emanations of the state and mainstream media, are the primary cause of excess deaths in Ireland and beyond.

    Summer, 2020

    Even after case numbers and deaths had plummeted by early summer 2020, legacy Irish media remained fixated on COVID-19. Writing for the Irish Times on May 23 clinical psychologist and author Maureen Gaffney reckoned that ‘Covid-19 has scored a direct hit on our most basic psychological drives.’ She seemed oblivious to how statements such as her own that ‘the consequences of the coronavirus pandemic may have changed life more permanently’ might be further stressing out her readers.

    Yet the first wave of COVID-19 afflicted few Irish people directly. An “omni-shambolic” testing infrastructure meant it was impossible for most people to determine whether symptoms synonymous with the common cold were COVID-19 or not. Despite early evidence of the unreliability of PCR testing, almost seven hundred million euro would be spent in Ireland on testing over the course of the pandemic.

    However, so-called ‘confirmed’ cases (via PCR) appear to have served a purpose beyond diagnostics. Speaking on RTÉ in November, 2021, Dr Deirdre Robertson of the ESRI’s Behavioural Research Unit said one ‘of the biggest predictors’ of social activity has been the level of worry over the virus: ‘As cases have gone up, worry has gone up and that has changed behaviour.’

    The authorities seem to have identified a correlation between case numbers and “worry over the virus” which influenced “behaviours”. By maintaining case numbers at a sufficient level through mass testing, worries could thus be maintained.

    This perhaps explains NPHET’s almost comical resistance to antigen testing. The availability of these cheap, over-the-counter kits would eventually allow people to self-diagnose, but the results could not be used to induce fear.

    It might also be noted that after leaving his post of Chief Medical Officer, Tony Holohan took up a role with Enfer, one of the primary testing provider to the state, which earned €122.4 million in 2020.

    Irish people were subjected to unprecedented social atomisation during a first lockdown that extended into the summer of 2020 – beyond most other European countries. Public figures such as then Minister for Health Simon Harris sent out subtly misleading messages, cultivating the idea that the virus was far more deadly than it was in reality.

    Later in 2020, Fianna Fail TD Cathal Crowe referred to ‘a fatality rate at the moment in this country of 6.2% of those who contract Covid.’

    However, research by Professor John Ioannidas reveals a far lower pre-vaccination infection fatality rate, especially among non-elderly populations, than previously assumed. This is as low as 0.03% for under sixties. Notwithstanding this easily accessible information, the Irish public were reminded ad nauseum of the ‘deadly’ coronavirus by mainstream media.

    Thus, in the summer of 2020 a public address called on bathers to ‘socially’ distance at Seapoint beach in Dublin. Reinforcing the dystopian atmosphere, in July a national mask mandate was introduced, despite a longstanding consensus, confirmed in a recent meta-analysis, that these do not block the transmission of respiratory pathogens.

    This generated a distinctively modern Irish form of hysteria – often vented on social media platforms – which found fullest expression in the enraged response to Golfgate at the end of August, 2020.

    In hindsight the breaches by politicians were relatively mild. It was the hypocrisy that stung, as people recalled being denied a last visit to a loved one on their death bed. Suppressing a natural human inclination to socialise was putting people in a semi-permanent state of repressed anger.

    A nation of obsessive smart phone users was confronted by an unprecedented onslaught of information tailored to stress them out. The only ‘sensible’ opposition to the lockdown policy presented by the mainstream media came in the form of a delusional ZeroCovid movement that promised an end to lockowns by locking down more strictly.

    Best in Class

    From the outset, Irish journalists and other public figures adopted a best-in-class superiority, contrasting the chaos in Britain under Boris with the virtuous restraint of Irish people. After early prevarication, clean-cut (caretaker) Taoiseach Leo Varadkar struck the right note of gravity as he heroically re-registered as a doctor, having warned of a death toll of 85,000 in a worst-case scenario. Headline writers were uninterested in the best-case scenario.

    Mainstream Irish media hardly raised a murmur at an unconstitutional power grab by NPHET. The millions of euros poured by the government into advertising seems to have had a chilling effect, while a pliant national broadcaster was quietly bailed out by the government.

    Anyone calling for moderation was subjected to ridicule or attack; guilt by association with Qanon followers calling it a hoax, and who immediately mounted a challenge in the courts to the unprecedented restraints on liberty. Thereafter, anyone calling for moderation was branded far-right.

    Independent TD Michael McNamara bravely articulated a sceptical middle ground after chairing the Oireachtas Special Committee on the Covid Response, but to little avail. Despite their unreliability, opinion polls were often taken to represent the will of the people.

    Care Home Deaths

    While the virus had little direct effect on Europe’s youngest population, Ireland did witness the second highest proportion of care home deaths in the world during the first wave. To some extent this was a product of an understandable failure to recognise that the virus seems to have been circulating for over a year. Thus, CMO Tony Holohan ordered private care homes to re-open to visitors in early March, 2020.

    Less forgivably, testing was withdrawn at the height of the surge, and many older people were removed from hospitals, to create space for an expected onslaught of younger people that never arrived.

    The scale of care home deaths revealed longstanding neglect of older people in those setting. A Pandemic Doctor wrote despairingly:

    The airwaves and print media are bursting with opinion, analysis and occasional outrage as the crisis unfolds and consumes the institutionalised elderly. The great and the good understand and discuss, sounding wise and all-knowing. But week after week we are alone. Where is the calvary? Where are the boots on the ground? Who is going to help?

    Difficulties were exacerbated by staff shortages caused by outbreaks among workers living in crowded accommodation. One resident of a county Meath nursing home – fittingly called Kilbrew – died two weeks after being admitted to hospital with an infestation of maggots in a facial wound.

    Lost Lives

    Never before in the history of Irish media and politics had there been such unrelenting emphasis on a particular disease, generating what Maureen Gaffney described as ‘our version of the spirit of the Blitz.’ But it was fear rather than resilience that were to the fore.

    In June, 2020 RTÉ Investigates ran a two-part documentary called Inside Ireland’s Covid Battle. This stretched the war time metaphor to its limit, bringing the spectre of patients gasping for breath into living rooms around the country, to devastating effect.

    You could cut through the paranoia on streets festooned with two-metre markers and yellow-coloured public health notices. Pedestrians would take refuge on to the road to avoid a close shave with another living human being. Joggers became hate figures.

    Later in the summer of 2020, the Irish Times launched an emotive Lives Lost Series. It reads: ‘Those who have died in Ireland and among the diaspora led full and cherished lives’; the series was ‘designed to tell the stories behind the numbers.’

    These included Richard Brady, an ‘Avid Dubs fan who loved his family dearly’; Ann Hyland, who ‘wrote a children’s book, climbed the Great Wall of China, rode a camel in Morocco, jet-skied in Barbados’; and Vincent Fahy who ‘began his career with ESB ‘putting the light’ into rural areas.

    These are touching tributes to ordinary people among a generation that built Ireland as we know it, but these lives were only cherished after their deaths. It begs the question: why are additional people now dying being treated as numbers? Where are the TV cameras to witness them gasping for breath?

    The name chosen for the series ‘Lives Lost’ is also instructive. Lost Lives: The Stories of the Men, Women and Children who Died as a Result of the Northern Ireland Troubles is a well-know book containing short biographies of the victims of the Northern Ireland Troubles. It was adapted into a film by the same name in 2019.

    The linkage between Lives Lost and Lost Lives is surely deliberate. It conveys the impression that any death from COVID-19 was not really by natural causes, but caused by the terrifying virus.

    Over the course of the summer of 2020, the Irish public also became acquainted – via social media – with the phenomenon of Long Covid, or ‘long haulers’, through social media. This too seems to have been used to sustain worry, once many had discovered the low infection fatality rate for COVID-19. Thereafter, mainstream media, including the Irish Times and RTÉ, ran a series of articles emphasising the struggles of previously healthy individuals suffering from Long Covid.

    It is notable that no hue and cry was raised by the mainstream media when the Mater Hospital lost its fight to maintain a Long Covid clinic in late 2022.

    https://vimeo.com/426871719

    ‘We Need a Reckoning’

    Considering the calamitous excess deaths we are now witnessing, Irish society ought to be reflecting on the efficacy, and morality, of adopting the lockdown-to-vaccination policy promoted by the WHO. What Maureen Gaffney referred to as ‘Our version of the spirit of the Blitz’ may come to be regarded as the most damaging public health intervention in history – the military equivalent of turning guns on ourselves.

    In a powerful video message called ‘We Need a Reckoning’, the Indian writer Arundhati Roy describes the infliction of a two month lockdown on her country as a Crime Against Humanity causing untold suffering to millions of impoverished workers in particular. Ireland needs a reckoning too.

    In his article on excess deaths, Paul Cullen at least acknowledges that ‘many non-Covid deaths arose from the pandemic and its impact on our wider physical and mental health.’

    We are not alone. According to Eurostat in September, 2022:

    Excess mortality in the EU climbed to +16% in July 2022 from +7% in both June and May. This was the highest value on record so far in 2022, amounting to around 53 000 additional deaths in July this year compared with the monthly averages for 2016-2019.

    Throughout 2022, EuroMOMO pooled estimates of all-cause mortality for the participating European countries showed elevated excess mortality. Most shockingly there has been a clear uptick in deaths among young people, especially children under the age of fourteen.

    Source: https://www.euromomo.eu/

    Since April 2022, according to the economist Dan O’Brien, Ireland’s excess deaths have been well above the average – 15% higher than the average pre-pandemic level (circa 2,500 people over 7 months).

    That this unusual pattern of mortality should be occurring in the wake of a respiratory pandemic is particularly alarming, given these generate excess deaths. A wave of illness afflicting almost everybody at least once ought to have accelerated the deaths of a substantial proportion of those with underlying illnesses between 2020 (or earlier) and 2021, leaving behind a healthier population overall.

    Last October, ex-Taoiseach Micheal Martin told a Fianna Fáil meeting that medical experts had warned him of ‘dramatically increasing cancers because of delayed diagnoses’ linked to the impact of COVID-19 on the health service. But we know from the UK that people missed appointments out of fear of contracting the virus, not because of insufficient capacity. Moreover, there is no evidence of an increase in mortality from cancer between 2019, 2020 and 2021.

    Stress

    One indicator that the stress of lockdowns and other non-pharmaceutical interventions bear primary responsibility comes from the case of Sweden, where health authorities famously took a softer approach, declining to lockdown in March, 2020. Notably, vaccination rates are above average compared to the rest of Europe.

    Among a list of countries studied by the Organisation for Economic Co-operation and Development, the Scandinavian nation ranked lowest for overall cumulative excess deaths from 2020-22 at 6.8 per cent, compared to Australia (18 per cent), the UK (24.5 per cent) and the US (54.1 per cent). In Ireland and elsewhere, we may be witnessing the delayed impact of stress generated by repressive policies and fear messaging.

    In his recent book, the Myth of Normal: Trauma, Illness, & Healing in a Toxic Culture (2022), Gabor Maté cites illuminating research into the biopsychosocial determinants of many illnesses, including cancer, auto-immune conditions and heart disease. ‘Stress’, he says, ‘plays its incendiary role: for example through the release of inflammatory proteins into the circulation’. This inflammation is ‘a fertilizer for the development of disease.(p.94)’

    He also alerts readers to what Dr Lydia Ternoshock has described as a type C[ancer] personality. She interviewed 150 patients with melanoma and found them to be ‘excessively nice, pleasant to a fault, uncomplaining and unassertive.(p.99)’

    Maté argues that ‘repression disarms one’s ability to protect oneself from stress’, explaining:

    If you go through life being stressed while not knowing you are stressed, there is little you can do to protect yourself from the long-term physiological consequences.(p.100)

    It is also possible that near-constant stress generated by a prevailing belief that COVID-19 was going to kill or do serious harm to you played a part in the prevalence of ‘Long Covid’.

    Adam Gaffney, an assistant professor in medicine at Harvard Medical School argued for a more critical appraisal of Long Covid in 2021. Having expressed scepticism around a condition characterised by symptoms such as ‘brain fog’, he recalls being contacted by a journalist who said: ‘I’m asking as much as a person as a journalist because I’m more terrified of this syndrome than I am of death.’

    Gaffney acknowledges ‘myriad long-term effects, including physical and cognitive impairments, reduced lung function, mental health problems, and poorer quality of life’ from severe bouts of COVID-19, but cites a survey showing two-thirds of ‘long haulers’ had negative coronavirus antibody tests, and another, organised by self-identifying Long Covid patients indicating around two-thirds of those surveyed who had undergone blood testing reported negative results.

    He asserted: ‘it’s highly probable that some or many long-haulers who were never diagnosed using PCR testing in the acute phase and who also have negative antibody tests are “true negatives.”

    In other words, Gaffney argues that for many Long Covid is a disease with a strong psychological component, which Gaffney attributes to ‘skyrocketing levels of social anguish and mental emotional distress,’ referencing a paper showing that about half of people with depression also had unexplained physical symptoms.

    During COVID-19, a trusting Irish public were habituated to low intensity stress driven by constant reminders of the presence of “the virus” across media and in their day-to-day lives. Any form of rebellion against this state of affairs made one a social pariah, leading most to repress this impulse. This could have provided an ideal “fertilizer for the development of disease.”

    It now appears that both lockdowns and much vaunted vaccines had only marginal effects on preventing mortality from COVID-19. It is unsurprising, therefore, that mainstream media in Ireland is giving scant attention to the collateral damage of policies that were, with few exceptions, uncritically accepted over the course of the pandemic.

    Feature Image: Daniele Idini

  • The Big House: Censorship of the Medical Profession in Ireland

    ’From my experience of my patients on the front line since March 2020, I estimate that between 1% and 10% of the Irish population have suffered from a serious traumatic stress disorder, depression and suicidal ideation as a direct result of the government instigated media propaganda and lockdown, which works out at between 48 000 and 480 000 people of this country. This must be seen as a national tragedy, if not a massive crime against the Irish people, perhaps the worst since the great famine..’
    Dr Gerry Waters submission to the High Court, prior to his suspension from the medical register, April 2021 as quoted in the British Medical Journal.

    Looking out upon a ‘snot-green’ sea, I wonder how our ancestors explained the emergence of the craggy rocks and pools. Today we might smile at the idea that the ebb and flow of the tide being the work of ‘spirits’ or gods of sand and stone. Yet perhaps there is a ‘spirit’ of our time? The zeitgeist; a shared belief-system that interprets our world and is the ultimate arbiter of truth itself?  Perhaps it is this ‘spirit’ that future generations might equally recognise as a thing that is drenched in myth and fallacy?

    Lately it seems that truth, like the tide, is constantly shifting. Our mute and collective response to Covid-19 policies suggests we have indeed entered a ‘Post-Truth’ era, where truth has gone the way of video and record stores, to become almost entirely subscription based.

    I was once of the belief that science served to shape and guide public opinion. I have lately come to feel that when science does not align itself with public opinion, it is dismissed as the ramblings of a madman.

    In recent years the most basic scientific principles, even the simple notion of ‘cause and effect’ have been temporarily suspended. Presently, science is in the service of the zeitgeist. It no longer informs public opinion, instead it is used as a drunk might see a lamp post; more for support than illumination.

    Newton’s Third Law…

    During and prior to Covid, Europe and Ireland, enjoyed several years of what economists call ‘quantitative easing’. In layman’s terms this means printing lots of money in order to keep people content, or at least to keep them spending.

    The world is apparently a better place when we are all spending freely. Economists call this ‘economic growth.’ Strangely the cause and effect of this simple expedient is entirely lost on most people. The countless billions that have been pumped into European economies in recent years, now means that money is worth less, which is generally referred to as inflation.

    At home, in addition to inflation, our Covid-related crises: deaths in nursing homes, suicides, mental health, missed cancer diagnoses, along with enormous political blunders, were all effectively obscured by a bonfire of some fifty billion euro.

    The light of that conflagration was bright enough to relegate our home-grown crises into the shadows of relative obscurity.

    The idea that we are experiencing inflation as a consequence of two years of fiscal dissipation is, either roundly ignored or blamed upon other crises.  One does not hear such a strange assertion on RTÉ, which itself received a significant share of that fiscal dissipation for its ‘public service’ broadcasting.

    We hear nothing about the government’s responsibility for social destruction and economic waste. Vladimir Putin’s invasion of Ukraine must have come as a relief. Now the priority is that ‘Putin must go’, an idea seemingly oblivious to the fact that much of the world might have to go down with him.

    All in this together?

    As Minister for Health for the initial phase of our Covid crisis, Simon Harris stated notoriously: “Remember this is coronavirus Covid-19 – that means there have been 18 other coronaviruses and I don’t think they have actually successfully found a vaccine for any.” Less comically, both he and members of NPHET are still protected from any review into nursing home deaths.

    Nor are the main opposition parties, including Sinn Fein, blameless in respect of the temporary madness. I suspect that when they inevitably get hold of the piggy bank they are unlikely to call for any kind of revision to the narrative. We were ‘all in this together’ after all.

    Nonetheless, as inflation continues and war escalates, the appetite for truth will surely grow, albeit at a remove from the big glasshouse on Nutley Lane.

    When it is safe to speak and ask honest questions, and once the capacity for relating cause and effect returns, calls for a review of the past two years of policy might yet begin in earnest.

    Any colour as long as its black..

    Some truths seem to persist for longer than others. Scientific truths endure not because they are more precious than myth, but simply because they are (or they remain) largely inescapable.

    During the Covid years, scientific truths succumbed to a form of relativism. Thus, one could have any scientific ‘truth’, as long as it was consistent with the fear-frenzy and the dominant narrative that Covid was the only challenge our government ought to address.

    In contrast, unpopular truths became the subject of a formal and informal censorship. Science has become strangely ‘right wing’ in its obedience to pharmaceutical companies and its lack of tolerance for essential questions and contrary facts. Yet Karl Popper once argued; ‘the demand for scientific objectivity makes it inevitable that every scientific statement must remain tentative for ever.’

    In the presence of industry-led censorship, neither science nor democracy functions properly. Yet many people still believe that the scientific discourse is free. Sadly, unscientific views on masks, lockdowns and administering genetic vaccinations to children and pregnant women are (for the moment at least) considered to accord perfectly with the scientific evidence.

    Entire national policies were based upon a flawed epidemiology of Covid. That epidemiology was described almost everywhere in the context of ‘deaths per million’, despite Covid being from its inception a disease with a cohort-specific mortality.

    Indeed, mortality itself was defined in the context of deaths ‘with’ Covid-19 as opposed to ‘from’ Covid-19. PCR testing remains the gold standard in determining a ‘Covid case’ as opposed to detecting traces of virus in an asymptomatic individual who has recently been exposed to the virus.

    In response to Covid-19, foundational principles of science and epidemiology were turned on their heads to satiate a politically profitable narrative. Such contortions are unsustainable in the long term.

    The majority desperately feared Covid, and so an aggressive cold virus – dangerous to the elderly and infirm – became a disease almost entirely inflated by a politically inflated fear.

    Science was annexed to supply an array of ‘facts’ to substantiate this fear and pursue the enormous wave of Covid ‘research’ funding from a strange marriage between Big Pharma and the State. Fearmongers were given seemingly unlimited time on TV and radio. In contrast, ‘contrarians’ were issued with legal threats and ongoing investigations.

    Latter Day Inquisition

    It is worth bearing in mind that science has generally co-existed with unscientific ideas. Thus, religion and science have jousted for centuries. However, when governments depend upon science to justify draconian laws and unprecedented spending; to question ‘the science’ becomes a direct challenge to the government itself.

    When governments depended on the Church for legitimacy, for anyone to question its religious tenets was a dangerous heresy, rooted out by Inquisition if necessary.

    In respect of the medical profession the government has a powerful tool to silence doctors, which is the Irish Medical Council (IMC). The Medical Regulator acts as ‘Grand Inquisitor’, answerable only to the Minister for Health.

    During the Covid crisis, anyone in my profession who openly criticised the Science associated with policy, was immediately condemned as a ‘conspiracy theorist’.

    These ‘misinformed medics’ represented, (and in most cases still represent) a ‘clear and present danger’ to public health. They were heretics were to be rooted out; removed from society like a cancerous prostate gland.

    The danger we pose is not towards public health, but rather towards the public’s understanding of the issue. The social operation is ongoing, and the IMC remains its enthusiastic surgeon.

    Enemies of the People

    It is not an easy thing for a doctor who spends the best part of his or her working life trying to solve people’s immediate problems, to be suddenly turned into a kind of pathology, and confined to the world of the anti-vaxxer and right-wing conspiracy theorist.

    Yet that is the fate of any doctor who voiced criticism of Covid-policy. We remain under formal investigations, heading towards the end-game of sanctions and potential strike-offs. The personal struggles behind these investigations are given no public attention.

    The necessity of belonging, to a society, to a fraternity of peers, even continuing to belong to one’s own family, all become tenuous when one is considered a pariah. For some, including myself, the isolation has led to a breakdown of sorts. My own ‘crash’ came in the form of simply running out of gas: facing up to the fact that my ‘gas’ is considered as a form of flatulence by most of my colleagues.

    I have worked hard at keeping my family together, and that has been as much as I can handle, finding solace in bee keeping and a polytunnel. For other colleagues and their families, the consequences have been far more devastating.

    In the mid-nineteenth century the Hungarian physician Ignaz Semmelweis suggested that surgeons were spreading disease by not washing their hands between operations. He was ostracised for his conspiratorial assertion. Ridiculed and vilified, he ended his days in a lunatic asylum.

    Irish communities draw their strengths from being close knit, but this can lead to a damaging conformity, as our history with the Catholic Church readily demonstrates. Neighbours and friends soon learn who the ‘anti-vax’ doctor is. A whisper at the school gate or a snub in the supermarket may not qualify as an assault, yet it can be just as hurtful to the spouse or daughter of a ‘dangerous’ doctor.

    There are, and were, many Irish doctors who publicly and privately rejected much of our conflicting and often, frankly, comical Covid policies. Too many to list here.

    However, the pressures brought to bear from without, and the enormous financial incentives for the majority of GPs, were sufficient to ensure that serious questions, or even discussion, in respect of policies, was cancelled from the outset. Some GPs have their bicycle clubs sponsored by Pfizer and were most keen not to bite the hand that feeds.

    https://twitter.com/theRiverField/status/1254488307054120960

    Whistleblower

    I occupy a rather unpleasant space as one of the first to speak out against ‘scientific’ polices that led to upwards of a thousand deaths in Irish nursing homes over a period of a few months in early 2020.

    I stood at bedside and watched my patients die, whilst a spouse or loved one sat crying in the car park or staring through the window outside. I struggled to obtain medicines, oxygen and PPE.  Many, if not most, deaths were the consequence of a policy of dumping untested hospital patients into nursing homes to make way for a Covid-19 ‘tsunami’ that ultimately manifested in empty makeshift hospitals and tic-toc videos of dancing medics.

    An enduring myth in respect of those who died in the nursing homes is that that the ‘tragedy’ occurred everywhere equally. Yet throughout Europe, during the first wave, the highest per capita death toll in care homes occurred in Ireland. We hold the dubious record of being second highest in the world after Canada.

    Those who complained about these deaths to the regulator, became the subject of investigation by the regulator, while those responsible are feted as heroes.

    In March of 2020, I attempted to ‘whistle blow’ on the unfolding catastrophe of incompetence, and deprivation within the nursing homes. I resigned my Ministerial appointment in the hope that the Medical Council might investigate what might be considered as criminal manslaughter.

    Yet they chose to ignore the dead and investigated me instead. In the media I found myself being dismissed as a ‘far right’, ‘conspiracy theorist’ and ‘anti-vaxxer’.

    Far right is funny, as I am proudly left and liberal in my thinking. Anti-vaxxer is even funnier, as I have given more vaccines than I have had hot dinners. But ‘funny’ is perhaps the wrong word because it conceals some of the hurt endured by own family.

    In one article in the Independent I was described as among those doctors giving ‘horse de-wormer’ to Covid patients.

    Propaganda is a powerful tool. The wild accusations came late in the pandemic and seemed designed to highlight the ‘ridiculous’ things going on outside of the general medical adherence to ‘official guidelines’.

    Dr Gerry Waters

    Other Doctors who went much further than I could have gone have suffered more than insult and isolation. They and their loved ones are more courageous, and deserving of a voice that will be heard as soon as science is liberated from the shackles of dominant interests.

    One such man is Dr Gerry Waters who adamantly refused to administer Covid-19 vaccinations to his non-vulnerable patients, and refused to refer patients for farcical PCR testing. From the start of the pandemic, he fully comprehended, who is, and who is not at risk from Covid-19.

    He recognised that masking and injecting children was ethically and scientifically wrong, and fully understood that the essential impartiality of science had been hijacked by politics and media. In a partial validation of Dr Waters’ fears, the Irish public have smelled a rat, and to date, less than 25% of eligible children have taken the vaccine. Our rather expensive over-stock (some 4 million doses) is presently being donated to Mexico and elsewhere. A mere €25 million to be added to the bonfire.

    Dr Waters stayed true to his conviction that, beyond protecting the elderly, Covid lockdown policy was socially destructive and itself seriously pathogenic.

    Doubtless, he was of the same view as a friend of mine, a former dean of medical studies at RCSI, who told me: ‘we would have been far better off, had we done nothing at all.’ Imagine what could have been done to improve the country with the billions that were wasted?

    Some Doctors in Ireland remain convinced that many people, old and young, could be alive today were it not for the inept response and draconian measures. Effectively, what began as a rallying cry to ‘protect the vulnerable’, culminated in policies that effectively threw them under the bus. Instructively, suicide statistics and missed diagnoses, for the Covid period have yet to be released.

    After speaking the truth as he saw it, Dr Waters was rapidly investigated, tried, and subsequently suspended from the medical register; deprived of a livelihood and compelled (it would seem) to live out the remainder of his days in ignominy.

    https://twitter.com/BillyRalph/status/1458052402372923392

    Resigning from my Practice

    I am somewhat pleased that I managed to avoid administering this genetic vaccine. I contend to this day that many or most GPs in Ireland haven’t the faintest clue as to what a genetic vaccine actually is, never mind how they work and what are the potential risks involved. Unlike Dr Waters I took the less courageous step of simply resigning my post, before vaccinations became part of public policy.

    For a time, I had been able to separate my practice of medicine from my convictions. Indeed, I have been doing that for years. I suspect most doctors operate with this contradiction most days, at least when we write prescriptions for medicines that many people don’t require.

    At the start of the pandemic in 2020 I could work within the guidelines; refer for testing; visit my nursing home; wear a silly mask in the supermarket. As long as I showed that I was formally participating in the farce, I was relatively safe from the regulator.

    However soon after resigning, they placed me under investigation, although they could find nothing to hang me with; except my opinion, contradicting NPHET and Professor Luke O’Neill, and a vocal stance in respect of the nursing home dead.

    A lot of people, including many of my former patients were unhappy to see me closing the practice. Yet, regardless of my practical adherence to policy, my position as an advocate of only vaccinating the vulnerable, became untenable.

    Every week I would hear from nurses, teachers, students and employees who were being threatened with dismissal unless they received the vaccine. I have never witnessed such a blatant assault on human rights. I shudder to this day when I recall how so many people were coerced and intimidated by the government, and by members of my profession.

    Formal resignation from the HSE was my only option, as long as I wished to continue working as a GP. Private GPs are not contractually obligated to vaccinate anyone. I could manage by doing private work for a friend, and out of hours work at an on-call centre.

    Formal Censorship

    To state that the IMC was satisfied with silencing whistle-blowers or making an example of Dr Waters would be a gross understatement. Almost every doctor in Ireland who refuted policy and did not resign from their post, was either fired or placed under investigation.

    Thus, Martin Feely a respected surgeon and clinical director of the Dublin Midlands Hospital Group, was forced to resign; Dr Pat Morrisey a principled and dedicated GP in Adare was both fired from the board of Shannon Doc, and placed under ongoing investigation by the Medical Council.

    Offending doctors received written warnings from the then President of the Council, and others were placed under investigation for failing in their new duty to: ‘promote public health guidelines.’

    One legacy of our colonial administration is a very efficient tax system, another is the efficient censorship of heretical opinions.

    After two years as a member of the IMC I am entirely convinced that it is neither fit for purpose, nor does it have a practical leg to stand on when it comes to regulation. For the most part it makes its own work as it presides over a ‘General Register’ with little or no regulation at all.

    Thus, untrained specialists are invited to come to Ireland from almost anywhere in Europe, and practice wherever and however they see fit, without specialist training; a situation that supplies regional and rural hospitals with ‘affordable’ specialists.

    The public must suck up the consequences and the IMC keeps itself busy with the inevitable mistakes and complaints. For unqualified and untrained specialists, the back door into Ireland is through the front door of the IMC.

    How to burn a heretic..

    The most difficult consequence for a doctor who is placed under investigation by the IMC is without a doubt the process of investigation itself. I recognise this as a ‘gamekeeper who has turned poacher’.  Much of my time at the IMC was spent on the Council’s Preliminary Complaints Committee, tasked with conducting the initial investigation into complaints against doctors.

    Once entangled in the Kafkaesque web of a formal inquiry, there is no escape until the investigation is completed. In many cases this takes several years. Formal letters are sent back and forth, requesting clarifications and further information, which must be formally replied to.

    One cannot leave the country to work or volunteer abroad. One cannot easily change job, as any new or prospective employers must be informed that an investigation is ongoing. One’s professional life is essentially frozen beneath a question-mark.

    Doctors who were openly critical of the Covid response, have been under investigation for over two years now. The IMC has chosen (with the notable exception of Dr Waters) to prolong these dissections for as long as possible.

    It seems that what is important for both the government and the Council is that doctors critical of policy should remain under investigation for as long as possible. Anything he or she might say or do, any comment made whilst under investigation, can readily become part of the investigation itself.

    Moreover, to refuse to engage fully with an investigation, to refuse to reply to the regular formal correspondence, is itself grounds for an immediate suspension.

    The absurd basis of the investigation into me, is that I made an appearance at a public demonstration in 2020 and ‘may not have sanitised my hands between hand-shakes.’

    To my knowledge, all of the GPs under investigation are locked into the process based on equally frivolous grounds. The pretext for investigation is unimportant, the investigations are sufficiently punitive and sufficiently censorious, hence their protracted duration.

    Heads Above the Parapet

    Perhaps the main reason for my now coming out of ‘hiding’, to tap impotently upon my keyboard, has been recent correspondence from the IMC. Some doctors have recently been informed that the investigations will now proceed to the next level of ‘formal hearings.’

    After the IMC has finished its investigation process, it can then decide either to close the case, or proceed to a full Fitness to Practice Hearing. In this instance the doctor in question must appear before the Council’s court room, and plead a case for their continued right to earn a living. As these cases relate to a doctor’s opinion rather than any clinical practice, medical insurers have declined to pay for legal representation, and the doctor must pay for his own legal counsel.

    There is a rich irony here, in that most if not all of the doctors under investigation, have themselves lodged formal complaints with the IMC in respect of registered doctors on NPHET, for ‘unscientific policies’ or financial conflicts of interest.

    For example, several Doctors have lodged complaints against the President of the Irish College of General Practitioners in respect of his openly encouraging medical discrimination against non-vaccinated patients.

    Also, at the height of the pandemic, Leo Varadkar re-registered as a doctor, helping to ‘man the phones’ and visit halting sites to test the Travelling Community. It was all a rather vulgar PR stunt lapped up by the media with a relish normally reserved for freshly baked cake.

    However, when Dr Varadkar re-registered he became open to complaints to the IMC, along with Dr Holohan, and several other key policymakers. Without exception, not one of these complaints have been investigated. Instead, it is the doctors who lodged them who find themselves under ongoing investigations.

    At a point when Leo Varadkar was found to have been leaking sensitive and lucrative contract details to a friend in General Practice, the then President of the Medical Council was busy issuing written warnings to fellow GPs that they had an ethical duty ‘promote government policy’.

    Call for Caution

    Some doctors in Ireland felt a moral and scientific obligation to understand how Covid vaccines work prior to administering them. Many advocated caution, particularly in respect of pregnancy and young healthy children.

    My friend in Wexford is one example. A respected GP, a man of science and integrity, he vaccinated all of his elderly and vulnerable patients in keeping with HSE guidelines, but when it came to pregnant women and healthy young children he called for caution.

    He reminded colleagues of their ethical obligation to ‘first do no harm’, and made no secret of his concerns and fears. In doing so he stepped outside of the public health policy, and into the crosshairs of the IMC.

    Each IMC investigation and each insulting article in the media, along with the invective and scorn that is heaped on contrarians from within the profession itself, comes at a cost. In his case, a deep personal cost.

    The most painful barbs are the ones that are cast into one’s private life. Spouses and children are no less attached to a doctor than they are attached to any husband or wife. Even with the best will in the world no doctor can keep the ramifications of an investigation from creeping into the most intimate spaces.

    Those who objected to Covid policies are treated to daily realities that are small thorns: a neighbour looking at you with scorn; former friends crossing to the other side of the street; wives or children being subjected to insult or abuse simply because they are related to the newly christened ‘right-wing’ or ‘anti-vaxx’ doctor.

    My friend in Wexford tried hard to toe the line whilst preserving his integrity and an uncompromising commitment to the welfare of his patients. He has a family and bills to pay. Full resignation from the HSE is not a financial option for all. He tried to work within the guidelines, whilst at the same time urging caution. He continued to work, for the sake of his patients, his family, to pay his mortgage, and help his daughters get through college.

    Were he on his own and without dependants he (and probably me) might have stood tall and offered the Medical Council the two fingered salute, as Gerry Waters had courageously done.

    He (like me), tried desperately for a time to justify his position to our profession, to our colleagues, with articles, references, papers from the most esteemed of Medical Journals etc. He pointed to the lack of safety data on the vaccine during pregnancy and in children. It was to no avail. His position was akin to a lamb trying to convince a pack of wolves of the virtues of vegetarianism.

    Nonetheless, he defended his position upon an internet forum exclusive to GPs; and despite my words of caution, they tore him to pieces.

    A couple of months ago, my brave friend found himself parked in a lonely spot in Wexford. When the authorities located him, he had taken enough pills to silence the wolves forever.

    After two weeks in intensive care and a return from near death, he returned home to count his blessings, recover from his ordeal, and begin a life-long process of recovery.

    Absolute Power

    As a member of the IMC I was always intrigued at the efficacy and authority that a wealthy quango can wield. There is a sense of limitless power within the inner circle – reminiscent of a well-funded Big House – with a special relationship with the Minister.

    At the IMC there is a department devoted to briefing and monitoring the press for issues that relate to the medical profession. Before each Council meeting a member of this office addresses the Council with a summary of what is happening in the media. It runs a little bit like “…and now what it says in the papers.”

    I mention this to highlight that my friend, the Wexford GP, his near death, and the harrowing experience of his family and many of his patients, was highlighted in the national papers and the local press. Having gone missing for some days, news of his disappearance was reported in the national media.

    There can be no doubt that the Medical Council was well-briefed about his ordeal. Yet within a week or two of his discharge from hospital he (and by proxy his family) received his letter from the IMC, informing him that he has been placed under formal investigation for his failure to promote Covid vaccination policy. He now faces an impending fitness to practice hearing, whereupon it will be decided if he too will be deprived of an ability to earn a living.

    In its role as Grand Inquisitor, the Medical Council has destroyed the professional lives of many doctors, before, during and after Covid.

    In my view, Irish Medicine is as rotten as any pathology it might pretend to address. This is a rot reflecting a wider rot in our political system. Perhaps it extends deep into the zeitgeist itself.

    There is much to address in Irish medicine including inter alia our current mental health crisis, polypharmacy, corruption within the medical schools, defective specialist training schemes, deaths in nursing homes, relationship between pharmaceutical companies and research institutions, tensions between the public and private health sectors, and a general lack of regulation, but none of these seem to be of any concern to the IMC.

    When the dust settled at the end of our last national crisis, the banking regulator was ultimately recognised as being guilty of catastrophic failures in respect of its duties and obligations. I suspect that if science is ever liberated from special interests, and media is free from a particular type of agenda, history will be seen to have repeated itself yet again.

    Our teetering or collapsing system of medical care in Ireland is equally the consequence of an incompetent, and morally bankrupt, regulator.  As usual, there is no one to ‘police the police’, only a fickle public opinion, and a Minister who is as much dependent on the regulator as they are answerable to him.

    As a post-colonial society, and in the ‘spirit’ of our times, we tip the cap, with the same deference as ever to the ‘Big House’.

  • Psychedelic Eucharist

    In October 2018, I wrote an article for the Irish Medical Times entitled: ‘Acid Test-are hallucinogens finally shaking off their taboo?’ The impetus came from reading Michael Pollan’s How to Change your Mind (New York, 2018), Michael A.Lee’s Acid Dreams The Complete Social History of LSD: the CIA, the Sixties, and Beyond (New York, 1985) and James Fadiman’s The Psychedelic Explorer’s Guide (Maine, 2011), all of which explore the history, myths and indisputable facts around what has been, over many decades, a highly contentious subject.

    I was surprised that the Irish Medical Times deigned to publish it. After all, these are schedule 1 substances, i.e. ‘dangerous substances with no medical or scientific value’ according to the Misuse of Drugs Act 1977.

    In hindsight, I consider my 2018 article naïve and anachronistic, leading the reader to believe that these substances are, for the most part, recent cultural adjuncts.

    Psychedelic Therapy – “Love is the Glue”

    The Immortality Key

    A recent award-winning book by Brian C. Murareska, The Immortality Key The Secret History of the Religion with No Name (New York, 2020) on the use of ‘mind-manifesting’ (psychedelics) or ‘god-inspiring’ (entheogens) and their use in human cultures for millennia prompts this revisionist take.

    The book explores such practices as the use of kykeon, a plant-infused wine used during the infamous, but little understood, Eleusinian Mysteries; the Vedic traditions of India in which a similar psychedelic substance called soma was consumed; and the cultures of south and central America where ayahuasca, peyote or psilocybin are still used in their religious ceremonies.

    The human desire to ‘turn on, tune in and drop out’ long predates Harvard Universities notorious Professor Timothy O’Leary, once labelled ‘America’s most dangerous man’. Although, this latter titled was supposedly bestowed on him by a President who vowed to bomb an agrarian society ‘back to the stone age’ in the name of democracy.

    What can explain a near universal desire, traversing cultures and millennia, for psychedelics? And why has its practice been vilified, persecuted and legislated against, pushing it into the underworld of crime, rather than exalting and exhibiting it as a means to transcendence and spiritual enlightenment?

    Drug use in the 1960s was portrayed by the media – with help from the CIA – as posing a threat to respectable society – middle class, consumerist values hypocritically portrayed as love of family, country and God. What it really represented was a genuine threat to production of drones for the corporate, industrial and military establishments.

    Evidence of the health benefits of these substances, if used in controlled and supervised environments, were clear, even in the 1960s. By then a thousand research papers were in print demonstrating dramatic therapeutic effects for conditions such as chronic depression, alcohol dependence and anxiety in cancer patients.

    Canadian psychiatrist Humphry Osmond obtained abstinence in 45% of his alcohol dependent patients at one year post treatment. There are no products today in the field of addiction medicine that can produce such impressive results.

    Then all studies were stopped, the substances were deemed dangerous and subsequently made illegal, even in research settings; this despite their non-addictive nature. In fact, repeated dosing has less and less of an effect.

    Yet these are drugs with an excellent safety profile, as it is almost impossible to overdose. They have clear health benefits and provide spiritual insights. Nonetheless, for over thirty years no further research was allowed to be carried out.

    Finally, in early 2000 Professor Roland Griffiths at St. John’s Hopkins University, Baltimore carried out the first of the latest wave of research using psilocybin (the active ingredient in several species of fungi, P.semilanceata, or Liberty cap mushrooms – that can be found here in Ireland).

    Now Imperial College, London and even Tallaght University Hospital have carried out research using these substances.

    What We Learn On Psychedelics

    Caveats

    Before going any further in extolling the virtues of psychoactive plants from historical, cultural or medicinal standpoints it is worth highlighting serious caveats.

    Psychoactive substances, and that includes alcohol, should not be used by those with immature brains, i.e. those under twenty-five years-of-age. Before this age the prefrontal cortex – that bit of the brain that makes you do the right thing when the right thing is the hard thing to do, according to Robert Sapolsky’s Behave: the Biology of Humans at Our Best and Worst (New York, 2017) – is not fully developed.

    Clearly, as witnessed in our world at large, this maturation process is not inevitable. Two essential conditions for the safe use of these substances are usually absent when young people ‘drop a tab’ washed down with a bottle of vodka on an all-night bender, with equally immature and vulnerable friends.

    These are the set (the mindset) and the setting (an appropriately supervised environment). These substances were never meant to be abused in this way. Indeed, there are so many things in our society that were never meant to be abused – love, trust, community, friendship etc.

    If we broaden out the list of psychoactives, beyond the schedule 1 substances, we do encounter substances as harmless as nutmeg, nausea-inducing fly agaric (the iconic red and white fungus of children’s storybooks), the lethal mandrake (of witch folklore) and Deadly Nightshade. Apart from shamans in Lapland drinking fly agaric laced reindeer urine, who even knows about these substances?

    So why the paternalistic need to protect society? To my mind it is part of a sinister power play between the perceived powers of good, i.e. Church and State and evil i.e. the ungovernable, the anarchistic psychonaut.

    This is of course a nonsense, fairytale for adult consumption. Those who have used and currently use psychadelics responsibly are looking for shortcuts to enlightenment by transcending the world of the everyday perceived consciousness, in order to experience the numinous.

    Anarchy

    Such aspirations are equated with anarchic ideas questioning the need for the boundaries of laws and earthly rules if one experiences transcendence.

    The question may be asked: what need is there to fritter one’s life away in meaningless work to earn valueless money to spend on vacuous consumer goods if one can experience Nirvana?

    And what need would there be for the religious authorities of the world, if one achieves direct access to the heavenly realm whilst still on earth, or if one can die before one dies?

    These very concepts bring us to the main theme of Brian C. Muraresku’s The Immortality Key, exploring various ancient traditions, over three thousand years, in which psychedelic substances were used to achieve these transcendent states.

    These were traditions and practices guided and controlled mainly by women, and they continued up until their brutal eradication by the many Inquisitions of the Catholic Church.

    These psychedelic ceremonies were disruptive because of their use of drugs by women to bypass manmade barriers to transcendence. Muraresku’s research supports The Pagan Continuity Hypothesis that implies that much of Christian and indeed Western culture has borrowed more than it wants to admit from ancient ‘barbarian’ cultures.

    Depiction of the Aztec goddess Itzpapalotl from the Codex Borgia.

    Role of Women

    The role of women as holders of sacred knowledge was systematically undermined from the eleventh to the seventeenth centuries, especially by the Papacy during the many Inquisitions, and also by the early Protestant churches. Tens of thousands of women were tortured and murdered because of male fears of their sacred, potentially subversive knowledge, and not because they were ‘witches’, wreaking havoc on innocent communities.

    The Church has always feared woman. Mary Magdalen should have become the first Pope ahead of Peter, and spread the word of Jesus, which required no institutions to disseminate, and no male power to dominate.

    Fyodor Dostoyevsky wrote lucidly about the Catholic Church’s dilemma in The Brothers Karamazov. ‘The Grand Inquisitor’ a Jesuit, clearly explains to the returning Jesus why his potentially disruptive presence is unwelcome – and that his religion of personal responsibility on the path to enlightenment could negate the role of all-powerful Church.

    Today our society reflects this loss of spiritual responsibility. Those practising formal religions may read the holy books but generally take them too literally, and often live lives devoid of profound contemplation.

    Many of the flock consume religion like they consume capitalist goods, failing to question the meaning of the texts as they fail to explore the source of their cheap consumer goods surrounding them.

    Similarly, we consume products that are allegedly food, but don’t nourish us; information from media companies that doesn’t inform us; and pharmaceutical products that promise health, but perpetuate illness. All are profiting from a sick society.

    Preparation of Ayahuasca, Province of Pastaza, Ecuador.

    Full Circle

    What effect would widespread use of psychadelics achieve today? Perhaps a reduction in the level of fear in society; and less social atomisation as we move away from an increasingly locked-in and isolated world of gadgets and home deliveries.

    It could perhaps lead to greater rejection of hierarchical authority, one often based on arbitrary rules and which offer only self-serving explanations about why society should be moulded in one way as opposed to another, more intuitive, way. Psychedelics might even lead to greater self-reliance, and a more human-centred form of socialism.

    The wisdom our ancestors knew, and cherished, which, for the most part, we have arrogantly disregarded in favour of materialist theories in science, offers great insights.

    Perhaps we are coming full circle, as Bernardo Kastrup discusses in his series of essays Science Ideated: the fall of matter and the contours of the next mainstream scientific worldview (New York, 2021).

    Traditionally, science has mistakenly assumed mind and consciousness to be epiphenomena of materialism. However, having reached an impasse, especially in the science of consciousness, we require a revaluation, and perhaps greater humility towards the wisdom of Hinduism, Buddhism and the Sufi tradition of Islam, as we consider what these have to say about mind and consciousness.

    The awakening of an interest in psychedelics, both in academia and in society at large, perhaps reflects an intuitive desire to know more than science can explain, and learn more than fundamentalist religious teachings can reveal, instead validating a felt experience at a deep spiritual level.

  • Covid-19 Absurdities

    Foremost among Utopian absurdities, we had the false promise of ZeroCovid. This continues to inflict untold damage on millions of lives and livelihoods that have been lost along the mystical path to salvation.

    Although the ZeroCovid leaders identified themselves with logic and rationality, the fanciful idea of every country excluding an influenza-like virus appears to have been a hangover from Judeo-Christian eschatology, which purports to save human beings from themselves.

    Other Utopian modern ideologies including Communism, Nazism and even neoconservatism, adopt a similar schema, wherein a vanguard elite guides the flock to safety.

    The nonsense started before the ZeroCovid concept grew legs, as China, the source of our slave-produced consumer goods, provided carefully choreographed footage demonstrating how instantaneous death ensued after infection with the deadly pox. All dutifully conveyed by compromised media.

    That China also runs concentration camps for the Uyghur Muslim minority, and harvests organs for transplantation from healthy executed prisoners was ignored. The West adopted a lockdown policy that represented the onset of another, dystopian Cultural Revolution.

    The WHO advised the West that lockdowns were essential. This advice arrived despite the 2019 WHO pandemic preparedness document containing no such recommendation. China then supplied genetic sequences they happened to have lying around to dodgy German academics to create the PCR test, which is a research tool not a diagnostic test.

    Weren’t we so lucky that the Wuhan Institute of virology is located near the alleged ground zero? It just so happened to be doing gain of function research on bat corona viruses in conjunction with the Americans.

    Herd Immunity

    Initially there were sensible discussions – including from the U.K.’s chief scientific officer Patrick Vallance – around herd immunity, the limited lethality of corona viruses in general, and the potentially disastrous effects of shutting down entire societies.

    Sweden, then a bastion of social democracy, held on to its rational faculties. Sadly, the government of no other major Western democracy seriously weighed up the effects on society of its public health policy. In an atmosphere of acute hysteria some governments acted against the advice of their health authorities.

    Resistance to drastic measures broke down once the Italians began singing to the world from their balconies, and army trucks were filmed removing dozens of bodies from hospital morgues. Strange how film crews always seem to know when to turn up to capture such footage.

    In what was the final twist of the thumb screw, our old friend Professor Reliable Data from Imperial College pulled scary figures from a dark orifice and waved it in the face of sceptics. Bear in mind, the same guy had predicted in 2005 that up to one hundred and fifty million people could die from bird flu. In the end, only 282 people died worldwide from the disease between 2003 and 2009.

    Despite the reasoned arguments of Nobel laureate Professor Michael Levitt, which few were able to read or hear, the British and others opted for the doom-laden scenario.

    T-Shock

    Meanwhile, on our own benighted little island of Ireland, beloved of Big Pharma and Big Tech, T-Shock Varadkar took to the podium to address the nation in our solemn hour, as the spectre of a common cold virus loomed on the horizon. Paraphrasing Winston Churchill’s World War II speech, he told the nation ‘this is the calm before the storm…’ before opining that there could be up to 85,000 deaths.

    Severe limits were placed on our freedom to roam freely and meet one another, as if we faced the impending Blitzkreig. He asked us to perform the unlikely feat of ‘coming together as a nation by staying apart.’

    Ironically, the wellbeing of the nation had become the central focus for a right-wing government, as individual needs and desires were cast aside, apparently for the common good. A country that had racked up vast personal and household debt worshipping at the altar of Mammon was expected to do a U-turn and become altruistic. But beneath the surface snouts were in the trough.

    For the first time in the history of infectious diseases the entire global population, healthy and infirm, would now be forced to quarantine, as apparently we could be asymptomatically-ill, or healthy-sick.

    Staying apart from each other meant no visits to elderly relatives, because grandchildren might kill their grannies. Children might even infect one another with a disease less likely to kill than being struck by a fork of lightning.

    Naturally outdoor sports and music events would have to be prohibited too. After all, they wouldn’t want people to be discussing the bullshit over a few pints. And finally, most small and medium sized businesses were to be closed down, regardless of the long-term effects.

    Well not all small businesses. Off licences, fast food outlets and supermarkets would still be open. These however are usually staffed by low skilled, low-wage earners. Young and expendable in other words.

    The propertied middle class would stay at home, protected from the menace of infection behind computer screens, home deliveries and A-rated houses. These were the civil servants, tech workers, teachers, and professional classes.

    This ‘Zoomocracy’ would ‘stay safe’, while boosting the profits of Messrs Bezos, Gates, Dorsey, Zuckerberg et al. Somehow the top ten wealthiest men in the world managed to double their wealth in the midst of the biggest international crisis since World War II. It would make you wonder who was really in control.

    Garda Checks

    We were treated to the daily sight of embarrassed members of the Gardai stopping ordinary citizens on their way to shops enquiring as to the purpose of their journeys.

    Other brave fellows formed road blocks at entry points to beaches or mountain trails. A particularly bizarre incident took place one Sunday near the tiny Cavan village of Mullahoran, when the only four roads leading to the Catholic church were blocked by garda cars preventing parishioners accessing their place of worship.

    The terror was augmented by the obscene nightly roll call of death and pestilence, which had the desired effect on the majority. Those who didn’t succumb to the fear were subjected to ridicule, or simply starved of the oxygen of publicity. Dissenters were forced to resign from their jobs.

    Throughout, we were repeatedly assured as to its deadliness, yet the median age of death was eighty-two years of age. The true figures for the numbers who died of (not with!) this virus will never be known.

    Paradoxically, despite the elevated risk of those over eighty years of age dying from COVID-19, their family doctors were advised that they didn’t need to see their patients.

    There were simply no treatments available. This despite Professor Didier Raoult from Marseille, Professor Paul Marek from Virginia and Professor Peter McCullough from Texas successfully repurposing drugs. The advice for the Irish patient was to take two paracetamol and at the first tinge of blue call an ambulance. Primum non nocere, my arse.

    https://twitter.com/BillyRalph/status/1458052402372923392

    Psychological Torture

    Fear, like any stimulus exhausts itself, so using the support and advice from various purveyors of psychological tortures, such as Susan Michie, governments introduced curveballs to confuse the population even further. We couldn’t have people waking up and smelling the bullshit when they reflected on how many in their social circles had actually died of this deadly virus, relative to an average influenza season.

    ‘The New Normal’ was a term coined by very shady unelected people and repeated ad nauseum by some equally shady elected individuals.

    Once measures designed to ‘open up’ society were introduced we were treated to the infamous €9-45 minute meal and a pint. No meal, no pint. Then we had the restricted purchasing within supermarkets – crisps and condoms, but no socks or Nerf guns.

    Then came the masks, for almost every setting, including eventually, primary schools. Lone occupants of cars and swimmers at the Forty Foot and even people out picking blackberries in the remotest parts of Ireland weren’t excused.

    All of this imported from totalitarian China! And woe betide anyone not wearing their badge of allegiance. These untermensch were jostled by shopping centre security guards, refused access to medical care and even arrested, regardless of their age. And in the final entry in this sorry list, jailed.

    Having endured the relentless propaganda, lockdowns, masks, social isolation, endless hours of Netflix, nourished on the finest delicacies from Dominoes and McDonalds, the vast majority of the country’s wage slaves were simply dying to become commuters and patrons of the country’s pubs, cafes and restaurants once again.

    Safety First…

    So, when the experimental mRNA gene therapy, also known as the Covid vaccine, became available the population had been primed. Primed by the most successful advertising campaign in history, a global conformity Edward Bernays and his admirer Joseph Goebbels could have only dreamed of achieving.

    That ‘vaccine’ is the gift that keeps on giving – to its manufacturers. If Bill Gates’s wish comes true all seven billion humans on the planet will receive it.

    It is so safe that one manufacturer persuaded a court that its supporting data should be hidden away from prying eyes for seventy-five years. Nonetheless, the post-mortem in the peer reviewed literature is revealing serious adverse reactions.

    We heard from many sources including our own resident expert Professor Luke O’Neill that the vaccine was a game changer, while potential conflicts of interest were never disclosed or discussed during the extended time he spent on air.

    Other worthies such as dear old Joe Biden advised that you would not catch the virus, it would stop the transmission of the virus, and even stop hospitalisations and deaths.

    Fast forward a few months and you can catch the virus, you can transmit it, you can end up in hospital and die despite two, three or even four shots of this miracle medicine.

    Worst of all, we now can’t have an open scientific debate because the truth might get in the way of the vast profit potential for the manufacturers how inept our so-called experts really are, and how venal politicians in so-called democracies became as they made light of civil liberties.

    Medical Profession

    Today in Ireland, most of the medical profession are reluctant to acknowledge the damage inflicted on societies by their gullible and myopic approach of shutting down society, and they most certainly do not want to kill the golden goose, especially in general practice.

    No heed is taken of the CDC-VAERS data, Eudravigilance, WHO’s own reporting, the Yellow Card system in the UK, the up to 40% rise in life insurance pay outs in some European countries; resistance to exposing drug trial data to public scrutiny.

    A company that previously paid out the largest health care fraud settlement and the largest criminal fine is now making billions in profits.

    No heed is taken of the meteoric rise in the careers of so-called celebrity scientists and doctors whose integrity and ethics were dispensed with at the first whiff of the profits on show.

    Contrast this with some real academics and scientists whose careers have been badly damaged by retaining their integrity; for example Professor Sunetra Gupta of Oxford University, Professor Martin Kuldorff of Harvard, Professor Jay Bhattacharya and Professor John Ioannidis of Stanford, and Professor Peter McCullough of Texas A&M.

    This latter group called for the availability of early treatments, focused protection of the vulnerable, but for society to function as normal to limit unintended damage. They also advocated for judicious not widespread use of an experimental product, avoiding children and pregnant women in particular, and most importantly preserving scientific debate.

    Instead, we got lockdowns and restrictions on civil liberties, no early treatments, and a coercive vaccination campaign straight form the CCP playbook.

    Feature Image is a still from RTE’s Claire Byrne Live of Professor Luke O’Neil trying ‘Zorbing’.

  • COVID-19: Torches of Freedom

    ‘Harold Evans used to say that an investigation only really began to count once the readers – and even the journalists – were bored with it’
    Alan Rusbridger: who broke the news?

    In New York city on Easter Sunday 1929, in a premeditated move, a group of women brought the annual parade to a halt and proceeded to light up cigarettes. In a choreographed response, the tobacco industry, guided by the legendary Edward Bernays, re-branded cigarettes ‘Torches of Freedom’.

    This manipulated scandal had the desired effect of connecting smoking cigarettes with female empowerment. Within a few years, a woman’s ‘right’ to smoke had largely been conceded. Effectively doubling its market, the tobacco industry laughed all the way to the bank.

    Such an apparently spontaneous public spectacle is arguably the gold standard in advertising, wherein an avant-garde movement is associated with a product or service – all while the consumer is blissfully unaware. Importantly, radical or even rebellious social groups often inform mainstream taste, as with the popularity of so-called ‘ghetto styles’.

    This article explores how the pharmaceutical industry, in league with technology corporations and so-called stakeholder capitalism – which entails giving corporations more power over society and democratic institutions less – successfully associated global support for universal vaccine uptake against COVID-19 with a ‘left-wing’ political outlook, infused with youthful idealism.

    In particular, global Black Lives Matter demonstrations appear to have been harnessed – without the consent of organisers – to popularise the use of face masks, which became the enduring global symbol of the pandemic. The fretful atmosphere these inculcated offered a chilling reminder that COVID-19 was constantly in our midst.

    This arrived despite an article in the New England Journal of Medicine in April, 2020 dismissing calls for widespread masking as ‘a reflexive reaction to anxiety over the pandemic’. That same month the Oxford Centre for Evidence Based Medicine referred to 14 trials on the use of masks vs. no masks, saying these ‘showed no effect in either healthcare workers or in community settings’. Thereafter, even experts who questioned their efficacy were censored on social media.

    Masks were supposed to play an equivalent role to the assumed purpose of vaccines: protecting others. They were made – and in some cases remain – compulsory in many settings in numerous states, foreshadowing similar laws enforcing vaccine compliance. In essence, the vaccine would set us free from an obligation to wear masks.

    Summer, 2020

    By the summer of 2020, with case numbers plummeting, many were wondering whether COVID-19 had become an endemic, seasonal respiratory infection. We learnt that France’s first known case was in December, 2019. Later, it was discovered to have been circulating in Italy from September, 2019 and in Spain from as far back as March, 2019, apparently without overwhelming medical systems.

    But a whole industry had been waiting for a pandemic to occur, with the incentive of producing a vaccine for global use and, seemingly, an architecture of surveillance that had been publicly discussed from the outset. In contrast to the Swine Flu debacle, this opportunity would not be lost.

    Moreover, it was being reported that PCR testing was inflating case counts (and thus mortality statistics) through false positive results. Publicity stunts that generated a wave of global hysteria were by then appearing increasingly absurd. Meanwhile, extraordinary predictions for mortality, suggesting we were contending with a challenge equivalent to the Spanish Influenza Pandemic of 1919 were proving seriously wide of the mark.

    Spanish Influenza caused approximately 75 million deaths, whereas COVID-19 may have been responsible for a global death toll of 6 million, the vast majority of whom were beyond average life expectancy, at a time when the global population was about five times that of 1919.

    Indeed, the early spike in deaths from (or with) COVID-19 in some countries can be attributed to hospitals transferring sick older patients into care homes, where outbreaks followed and only basic medical care was available.

    The ‘Scientific’ Advice Changes…

    After a period of social isolation brought about by unprecedented stay-at-home orders and lockdowns, there were no significant outbreaks of COVID-19 in the wake of large and often disorderly Black Lives Matters demonstrations triggered by the brutal murder of George Floyd on May 25.

    In response, some outlets claimed protestors’ use of face masks had prevented outbreaks. However, most of those in evidence were cotton fabric, which health agencies now acknowledge to be next to useless. Furthermore, masks had been worn as a defence against tear gas, or in order to preserve anonymity prior to COVID-19, as the feature image for this article from 2014 demonstrates.

    Whatever the purpose, an impression was created of ‘caring’ mask-clad protestors demanding racial justice around the world. Subsequently, Joe Biden’s own lawyers helped Whole Food workers mount a legal challenge to allow them to wear Black Lives Matters-branded facemasks while on the job. More revolutionary aspirations – including to disband the police – were conveniently ignored by lockdown-enthusiasts who craved enforcement.

    Circumstantial evidence suggests that demonstrations were seized on by an alliance of vested interests that exert control over a swathe of media, new and old.

    The role of the Bill and Melinda Gates Foundation appears pivotal. The Foundation is the second-largest contributor to the WHO budget, and put over $10 billion into universities in 2020 as well as at least $250 million into journalism in the first half of 2020 alone.

    Unprompted by the publication of any scientific study, the WHO changed its advice on wearing masks on June 5, 2020 shortly after the Black Lives Matters demonstrations. Most national health agencies – long subject to regulatory capture – followed suit, although a few countries declined to alter long-standing advice.

    In the U.S., NIAID director Dr Anthony Fauci claimed he had previously told a white lie to the effect that wearing a mask offered no protection in order to prevent a run on stocks. But emails obtained through a Freedom of Information Act request reveal he was giving the same advice in private — against mask use.

    Manipulation of mortality statistics can also be traced to a WHO document from April, 2020 entitled ‘International Guidelines for Certification and Classification (Coding) of COVID-19 as Cause of Death’. This set out strict new rules for the registration of COVID-19 deaths that differed fundamentally from registration for other causes.

    The guidelines define a COVID-19 mortality as ‘a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma).’

    The achievement of universal vaccine uptake – no matter how limited its usefulness – offered dizzying possibilities to the super-rich intent on engineering a new world order, which was openly being referred to as the Great Reset.

    Political Identification

    There was also a direct political purpose for stoking fears around COVID-19, which goes some way towards explaining the involvement of actors beyond the pharmaceutical sector. Application of ‘the science’ against COVID-19 would undermine right-wing Populist movements around the world, which had been to the fore in challenging globalisation – alongside chauvinistically asserting national and religious identities.

    The political quiescence of the radical left in a period of authoritarian lockdowns led by rapacious global corporations arrived following the defeats of Bernie Sanders in the U.S. and Jeremy Corbyn in the U.K., and a concomitant decline in investigative journalism. Fresh from seriously undermining Corbyn with bogus charges of antisemitism, the once-progressive Guardian became a leading conduit for fearmongering coverage of COVID-19. It now provides fawning interviews with Bill Gates, whose Foundation subsidises the newspaper.

    Nonetheless, in the era of the internet political allegiances retain a tribal dimension that can be exploited. Thus, at the outset of the pandemic when lockdowns were first mooted many identifying as left-wing assumed that in ‘following the science’ and/or ‘listening to the experts’ they would be preventing the medical system from collapsing.

    But as the Greek socialist Panagiotis Sotiris put it: ‘What is missing here is something that used to be one of the main traits of the radical left, namely, an insistence that science and technology are not neutral.’

    In fact, from the outset there were huge divisions, and arguments, in the scientific community over the efficacy of lockdowns, masks and vaccine passports. But these debates were largely concealed from public view through online censorship of authoritative academic sources.

    2020 was also the year of the U.S. Presidential election during which the Democrats used the pandemic as a weapon against incumbent Populist President Donald Trump, who actively antagonised those identifying as left-wing.

    In order to defeat Trump, the Democrat establishment seems to have entered a Faustian Pact with Big Tech, ‘stakeholder capitalism’ and Big Pharma.

    One still hears partisan support for vaccines against COVID-19 being expressed by those identifying as left-wing. Most seem oblivious to the world’s ten richest men doubling their fortunes during the period, while the incomes of 99 percent of humanity fell; besides the enrichment of pharmaceutical companies.

    It is axiomatic that young people are drawn to idealistic ‘left-wing’ ideas – any man who is not a socialist at age twenty has no heart. Any man who is still a socialist at age forty has no head. This was also the cohort that would be most difficult to persuade to take a vaccine.

    Therefore, apart from allaying individual health concerns, taking a COVID-19 vaccine was sold as an exercise in civic virtue. Hold outs were decried as selfish and put other people’s lives at risk, even unAmerican, while ‘anti-vaxxers’ were portrayed by a prominent (however hypocritical) left-wing ideologue Fintan O’Toole as a motley crew of ‘egoists, paranoiacs and fascists.’

    Generally ignored in this coverage is in that in the U.S. vaccination rates lagged among people of colour, and that leaders of the Black Lives Matters movement were steadfastly opposed to vaccine passports.

    ‘We Realised We Could’

    In a revealing interview with The Times Professor Neil Ferguson of Imperial College, whose unpeer-reviewed paper in March, 2020 proved pivotal – ‘due to the professor’s WHO ties’ – to the introduction of lockdowns in the U.K. and elsewhere, revealed amazement at the influence he wielded. After the British government followed Chinese policy in introducing a lockdown he observed: ‘It’s a communist, one-party state, we said. We couldn’t get away with it in Europe, we thought. And then Italy did it. And we realised we could.’

    “Getting away” with imposing lockdowns – that appear to be causing ongoing excess deaths – was predicated on the assumption that a vaccine, or vaccines, against COVID-19 would be invented within eighteen months or longer.

    A subsidised vaccine against COVID-19 would be all the more lucrative if it was not simply a one-off treatment, and as long as states were offering a captive market, through coercion if necessary.

    It also represented a unique opportunity to trial new technologies. Unsurprising, the industry, and their supporters, were highly resistant to any suggestion of a safe, off-patent treatment being used instead.

    Since the nineteenth century, the pharmaceutical industry has been implicated in a host of scandals, including the recent opioid epidemic. Oliver Wendell Holmes, dean of Harvard Medical School concluded in 1860 that ‘if the whole materia medica, as now used, could be sunk to the bottom of the seas, it would be all the better for mankind – and the worse for the fishes.’

    Moreover, in a history charting advances in longevity, The Changing Body (2012), Floud et al argue that ‘it would be easy to exaggerate the importance of scientific medicine when one considers that much of the decline in the mortality associated with infectious diseases predated the introduction of effective medical measures to deal with it.’

    Of course medications such as antibiotics continue to save many lives, but as David Healy put it ‘we are living off scientific capital accumulated in an earlier age.’

    Peter C. Gøtzsche of the Nordic Cochrane Centre has argued that the industry’s conduct today closely resembles organized crime syndicates. He wrote perceptively: ‘Drugs always cause harm. If they didn’t, they would be inert and therefore unable to give any benefit.’

    A recently published work entitled The Illusion of Evidence-Based Medicine: Exposing the crisis of credibility in clinical research (2020) by Jon Jureidini and Leemon B. McHenry argues:

    Pharmaceutical spin doctors are the contemporary counterparts of the sophists of fifth century Greece. The essence of sophistry is to shape public opinion by skilful mastery of persuasive speaking without regard for any considerations of truth. Pharmaceutical marketing is a form of sophistry, whereby the serious attempt to discover efficacy or safety in medicine is subjugated to the goal of promotion. Medical rhetoric has usurped medical science – an embarrassment in an age allegedly devoted to evidence-based medicine (p.126).

    Qualitatively Different

    Attitudes to the COVID-19 vaccines were also scaffolded on tried and tested paediatric vaccines against common infectious diseases such as measles. Parents are encouraged to vaccinate their kids not just for their own sake, but for the sake of all children.

    The COVID-19 vaccines were, however, from the outset qualitatively different to most traditional vaccines, which generally produce a herd immunity that diminishes childhood morbidity – and even mortality – from infectious diseases, notwithstanding at times spurious claims of adverse reactions.

    All COVID-19 ‘vaccines’ produced so far are qualitatively different to most – with rare exceptions – traditional vaccines that are designed to prevent an infection from occurring.

    At the very least, one would have expected the trials to determine whether a COVID-19 vaccine would seriously diminish illness; yet as British Medical Journal associate editor Peter Doshi observed in October, 2020: ‘The world has bet the farm on vaccines as the solution to the pandemic, but the trials are not focused on answering the questions many might assume they are.’

    He continued:

    None of the trials currently under way are designed to detect a reduction in any serious outcome such as hospital admissions, use of intensive care, or deaths. Nor are the vaccines being studied to determine whether they can interrupt transmission of the virus.

    Moreover, the companies were busy covering their tracks, meaning efficacy, and long-term safety data, would be difficult to determine. In January, 2021, Peter Doshi and Donald Light in the Scientific American objected to the undermining of ‘the scientific integrity of the double-blinded clinical trial the company—and other companies—have been conducting, before statistically valid information can be gathered on how effectively the vaccines prevent hospitalizations, intensive care admissions or deaths.’

    This came after Pfizer pleaded an ‘ethical responsibility’ to unblind its trial and offer the vaccine to those who received a placebo. Yet Doshi and Light argue that ‘there was another way to make an unapproved vaccine available to those who need it without undermining a trial. It’s called “expanded access.” Expanded access enables any clinician to apply on behalf of their patient to the FDA for a drug or vaccine not yet approved. The FDA almost always approves it quickly.’

    The information in the public domain was easily manipulated by servile media. In April, 2021 a Lancet article by Ollario et al referred to the ‘elephant (not) in the room’, wherein vaccine efficacy was being reported overwhelmingly in terms of a relative risk reduction. This gives percentages of around 95% efficacy, whereas the absolute risk reduction of developing a serious illness was in the region of just 1%.

    Importantly, relative risk reduction only considers ‘participants who could benefit from the vaccine, the absolute risk reduction (ARR), which is the difference between attack rates with and without a vaccine, considers the whole population.’

    Peter Doshi has since publicly argued these ‘products which everyone calls MRNA vaccines are qualitatively different from standard vaccines.’

    Whistleblower

    In November, 2021, Paul D. Thacker in the British Medical Journal brought to light a whistleblower’s account of poor practices at a contract research company carrying out Pfizer’s trials. Brook Jackson raised questions about data integrity and regulatory oversight which, once again, gained little or no traction in mainstream ‘progressive’ media.

    The real scandal is that often coercive attempts to persuade the entire adult – and in many cases child – population was not based on a cost-benefit analysis.

    Recently, a peer reviewed article in Vaccine – the premier journal for vaccine research – found the Pfizer and Moderna mRNA COVID-19 vaccines were associated with a 16% higher risk of serious adverse events.

    The study was limited to an analysis of trial data the companies had submitted to the FDA and did not evaluate the vaccines’ overall harm-benefit. The authors argue that

    The excess risk of serious adverse events found in our study points to the need for formal harm-benefit analyses, particularly those that are stratified according to risk of serious COVID-19 outcomes. These analyses will require public release of participant level datasets.

    A young, healthy person faces a vanishing risk of hospitalisation from COVID-19.

    However, throughout the pandemic industry-aligned ‘fact checking’ initiatives served to undermine scientific integrity. The tactic of so-called fact checkers is to highlight absurd claims from random sources that serve to undermine informed criticism of the lockdown-mask-vaccine policy.

    Apart from its political ramification, the vaccine was, and is, a cash cow. It is instructive that the AstraZeneca vaccine, which in an apparent appeal to left wing sentiment was to be sold ‘at cost’, never received U.S. authorisation, and the manufacturers have since announced that it will be sold for a profit.

    The failure to interrogate vested interests reflects a serious decline in contemporary journalism, especially from publications previously associated with progressive viewpoints, many of which now depend on philanthro-capitalist handouts. We have reached an absurd juncture where a centibillionaire such as Bill Gates is attacked for being ‘left-wing’.

    Sell to Anyone

    The COVID-19 pandemic realised former Merck CEO’s Henry Gadsden dream of making drugs for healthy people, which Merck would be able to ‘sell to anyone’, as he candidly revealed to Fortune magazine in the 1970s.

    This could not have been achieved without the active collaboration of technology corporations and stakeholder capitalism in an era of surveillance capitalism. The censorship and disinformation used to bring the world to a halt in 2020, and beyond, represents a unique attack on democracy and worked to the benefit of a global financial elite.

    As Jon Jureidini and Leemon B. McHenry anticipated ‘the ideal of an open, democratic society is threatened by an oligarchy of corporations’ (p.23).

    However, at least much of the evidence that was used to permit coercion is slowly being decoded by investigative journalists such as Paul D. Thacker and research scientists of the calibre of Peter Doshi. We can remain optimistic that the truth will eventually out, at least on the margins, despite continued social media censorship.

    Nonetheless, the willing dissemination of disinformation in once-reputable publications has been increasingly normalised. Thus, the first and enduring casualty of the war in Ukraine has been the truth.

    On September 10, 2022 the Guardian reported that ‘the much-publicised Ukrainian southern offensive was a disinformation campaign to distract Russia from the real one being prepared in the Kharkiv region, Ukraine’s special forces have said.’ Strikingly, the authors do not refer to the Guardian previously publicising that disinformation.

    COVID-19 generated a conveyor belt of disinformation that has cast doubt over the reliability of contemporary journalism, and revealed how medico-scientific discourse can be captured by vested interests. It is vital for the future of humanity, as we confront environmental challenges, warfare and crushing poverty that scientific rigour, coupled with values that can be traced to Aristotle, are reasserted.

    Feature Image: Black Lives Matter demonstration in Oakland, California, December 2014.

  • Spina Bifida Parents Demand Treatment

    The HSE, and health care access more generally in Ireland, has never been under such scrutiny as has been the case in recent times. From the handling of the pandemic to the chaos witnessed during last year’s cyber attack, we now face recent revelations about utter confusion in the handling of funds and a recruitment crisis, exposed in leaked tapes published by the Business Post.

    HSE CEO Paul Reid also admitted in a recent News Talk interview how, particularly recruitment issues, were “not going to be solved in one year.”

    It is reasonable to assume that addressing structural dysfunctions in health services will take time, but we often forget the real impacts, and often irreversible damages on our most vulnerable members of society, caused merely by the passage of time. This applies especially to the treatment of complex conditions requiring a multi-disciplinary approach.

    A most striking example is the effects on those children awaiting treatment for Spina Bifida/Hydrocephalus, and their parents.

    We recently spoke to Amanda Coughlan Santry, the co-founder of the parent-led advocacy group Spina Bifida & Hydrocephalus Paediatric Advocacy Group, which has been active since 2017. It raises awareness around the lack of access to care for children affected by the condition, and actively engages with the institutions to address what seems one of the worst failings by the State in contemporary Ireland.

    Amanda, along with other parents Una Keightley, Stefania Opinto, and Orlaith Maher Lalor, joined us for an in-depth interview which we hope can draw further attention to the current situation.

    The group have recently launched a website www.sbhpag.com in which sixty-nine children’s stories are presented. Here one can discover the scale of the challenges surrounding their access to treatment.

    We heard of children being left on waiting lists for surgeries for over a year for treatments, which in other European countries are urgently attended to. There have been years of complaints, which went for the most the most part unanswered and, most distressingly, in the last few months, parents of children in pain, have felt compelled to refuse to leave A&Es for days on end until their children were treated.

    Daniele: Can you tell us more about this condition?

    Amanda: Spina Bifida is described as one of the most complex conditions compatible with life; a baby’s spine and spinal cord does not develop properly in the womb, causing a gap in the spine. Spina bifida is a type of neural tube defect. The neural tube is the structure that eventually develops into the baby’s brain and spinal cord.

    Most people with spina bifida can have surgery to close the opening in the spine. But the nervous system will usually already have been damaged, which can lead to problems such as weakness or total paralysis of the legs, Urological, Bowel and Renal issues.

    Many babies will be born with or develop hydrocephalus which is a build-up of fluid on the brain. This requires a V.P or a shunt to drain the excess fluid from the brain into the abdomen or the heart.

    There are about approximately 550 children under 18 living with Sb/Hydro in Ireland. Ireland has one of the highest rates of neural tube/SB birth rates in the developed world.

    Daniele: Can I ask you for a little bit of context to give an idea of the extent of the services needed?. What are the types of care that your children need?

    Amanda: Our children need proactive care and what they are receiving is often reactive care via emergency intervention. This is often too late and results in long term damage and loss of function. These children need timely access to care particularly in relation to Orthopaedics, Urology, Ophthalmology, Neuropsychology and Neurosurgery.

    Daniele: How are these types of care being delivered in Ireland and is the capacity in the health service enough to address the scale of the problem in Ireland?

    Amanda: Currently the care in Ireland is sporadic, chaotic, under-funded & under-resourced. Some children have access to a Multidisciplinary Spina Bifida Clinic, others do not. There is no clear pathway of care for children living with Hydrocephalus alone. An annual MDT SB clinic is international best practice. We estimate 85% of SB children are not receiving this and the percentage is higher in children born prior to 2009.

    Daniele: I gather that the waiting times are causing actual daily pain and suffering. If someone breaks a bone or a dislocation, he gets treated in a fairly short time. How’s that different from the pain that your children suffer? And what happens if you go to the A&E?

    Amanda: I know of a child that received her surgery last month because the mother took the drastic measure of taking her daughter to accident and emergency and refusing to leave. She dug her heels in the A&E in Temple Street, until she was admitted. And once she was admitted sat for two and a half weeks before the child had her surgery.

    In that process, the CEO of the National Children’s Hospital Group, Joe Gannon, subsequently wrote to one of the politicians in government who had been trying to fight for this child’s case, and told the politician that she was currently an inpatient and that she was going to have her surgery on the 17th of January.

    He made it sound that it was a planned admission and that she had been given a date and they had come in.

    Actually what happened is that the mother refused to leave until her daughter’s medical needs were met and also the child did not have her surgery until a week later. The mother is very grateful to all the doctors involved as they all told her that she was doing the right thing not to leave and were very supportive. She was supported in that sense by us as well but she should have never had to take such a drastic step.

    We’ve had another number of families that have had to do this since last September.

    Another mother went in on a Saturday with her son, who had dislocated hips for four years, the child is six, and she refused to leave until they were admitted. And once they were admitted, they couldn’t see the surgeon because he wasn’t there. They refused to leave and sat there for 10 days until their child had the surgery. 

    Daniele: How did your organisation come into being?

    Amanda: We’re all parents of children with spina bifida or hydrocephalus that came together to advocate for better services for children, under the age of 18, living with Spina Bifida/Hydrocephalus in Ireland.

    Our group was formed in 2017 and have been trying to work in a proactive and collaborative manner with all relevant stakeholders since then.

    My own son was one of the children failed, he sat on a waiting list from 2014 to 2016, and by the time he’d seen a spinal surgeon in 2016, we were told it’s too late.

    So my son lives with inoperable scoliosis and he cannot be helped by this campaign or anything else but I wanted to do something to stop this from happening to other children. Una Keightley was one of the very first to come on board when we formally launched the paediatric advocacy group.

    Daniele: Una Keightley, what pushed you to take a more proactive role in dealing with the issue?

    Una: I suppose it did become quite apparent that no matter how many letters you wrote, like what Amanda had said, the situation didn’t improved. She wrote to everyone, she had highlighted it. And it just really concerned me. And I’m a health care professional. I’m a radiation therapist and it was just unbelievable to me that this was going on. And I suppose at that stage my child was younger when we came together. Once we talked to more and more parents we realized that people were actually lodging complains but they were going nowhere.

    So we started to proactively inform the powers that be and Children Health Ireland asking them to do something about it.

    Amanda: There is a cohort of children born prior to 2009 who had no access at all to this to the Spina Bifida team in Temple Street Hospital because there was no urologist on that team. So it was decided it was safer to leave the children in Crumlin Hospital and move them at a later stage. A urologist didn’t come onto the team at Temple Street until 2014, and the children were never moved. So a lot of our children were receiving inadequate services are no service at all.

    We highlighted this problem in 2018 with the CHI board. In that meeting, they asked us, our advocacy group, to go back to the families and identify whether they felt that they weren’t receiving a timely access to services or any services at all. So we did, which was a big job being undertaken because we’re volunteers.

    There was also a cohort of families who thought that their children were being treated but many other that did not.

    Una: In the beginning of 2019, we gave Children’s Health Ireland a list of 133 families and children who felt that they weren’t receiving a proper service. There was then so many e-mails back and forth between Amanda and CHI. We asked them: When can we meet? What are we going to do about this? And the answers were like: “We’re verifying the list.” “We are analysing the list.”

    We have screen shots of these emails.

    That one way communication continued for probably 18 months until, after March 2020 they just ignored us.

    Entering 2021 we felt we had to do something but, on top of that, I need to say that I suppose a lot of parents were fearful. If they talk out, maybe the care standard that would be provided to their child would be diminished. Now, I wouldn’t have that fear, and I don’t think any of us would.

    It was especially after Professor McCormack and Prof Connor Green had presented before the Oireachtas health committee in November 2021 that things were very desperate, that it became blatantly obvious that it was a systemic failure for our children.

    It was then when we decided to publish online our children stories. Which is something that distressed us greatly but we felt we were left with no choice.

    We had requested to meet the Minister ever since he took up office. He wouldn’t meet us. The Minister for Children wouldn’t meet us. The Minister for Disability wouldn’t meet us. Nobody would take up and highlight what was happening to these children. So the parents as a group decided that we were going to have to do something fairly drastic to get their attention. So that’s what we did.

    Daniele: I have noticed an increase in media attention to the issue in 2021, also thanks to your campaigning. Are you hopeful that increased scrutiny could move things in the right direction?

    Amanda: Yes, people now view our children as the vibrant individuals they are as opposed to a number on a list or a medically complex child that is unrelatable. The support received initially from media, County Councils, and local representatives across all 26 counties has been immense. This has stemmed from the proactive and

    drastic measures taken by the Paediatric Advocacy Group and the families to highlight the failures in care for their beloved children.

    People have been shocked by the current state of medical neglect that has

    been inflicted by the Irish state on our children. They are not willing to allow a further generation of children to be failed and to turn a blind eye to the historical neglect that has been allowed to happen.

    Daniele: After years of campaigning, countless letters to TDs and local councillors, you have finally met with Minister Donnelly along with Spina Bifida Hydrocephalus Ireland and other stake holders last February in relation to the abnormal waiting times that are now in place for paediatric orthopaedic treatments. Plans have been presented and funding – as much €19 million that the HSE made available to CHI –, albeit with little information on the specific break down. The Minister also set some clear goals, including to limit the waiting time to four months at first with the aim for this to be reduced to zero, and to provide a number of additional treatments. What’s the reaction from you and your organization to these pledges?

    Amanda: There aren’t many details released yet, and there is still a draft in formation. What they told us is that they have ring fenced €19 million for children with spina bifida, but also to children with scoliosis.

    They have also said that clinically no child should wait for more than four months for surgery. So that is very ambitious and while we’re glad about these pledges, we’re not blindly trusting. There’ve been promises made before not only to us, but to the scoliosis advocacy groups as well. So yes, the funding is great, but we need to see that the funding is going to make a real difference in these children’s lives.

    One of the government target is to “treat an additional 107 Spina Bifida cases” but we don’t know how they come up with that particular number. There is no database within CHI of how many children are living with the condition. So how do you come up with a number if you don’t know how many children you’re treating, do you know? So we’re a little bit dubious about it and we don’t want to be tied to that number. What we want is to fund and to reach as many children as possible.

    Daniele: Did the Minister agree to regularly update your organisation while they endeavour to deliver these pledges?

    Amanda: We do have a commitment from Stephen Donnelly and Children Health Ireland, to regularly engage with us and we do now have a contact with one of the Minister’s special advisers. So if an issue comes up or we want to speak to Donnelly, all I have to do is give the special adviser a ring and he will relay any information and if need be  we speak to the Minister directly. So that’s the promise we have. So we are we’re optimistic and he seemed very genuine when we spoke to him. But don’t intend to take the pressure off until this gets sorted. We intend to stay very, very focused.

    Daniele: Are there any kind of league tables or other international comparisons that can be drawn on?

    Una: It would be difficult because we have such a high rate compared to a lot of the world. What we do know is that in Ireland it is not the expertise that is missing but proper funding and organization. Cases are picked up in pregnancy here more than they are in other countries, probably because the stenographers are looking for them due to the high incidence.

    Daniele: What kind of challenges are you dealing with as mothers and what are the support needed for families at large?

    Stefania: My daughter’s name is Aurora and she’s just turned three. From her birth in February 2019 until August 2019 she was in hospital as she was born with Hydrocephalus.

    I found out about that on my 26 week scan here in Ireland and to be honest with you I didn’t know what it  meant so I had to do my own research. They didn’t explain to me exactly what it was. So I had to go back to Italy, and I went to the hospital in Genoa to try to get different opinions.

    Once she was born, here in Ireland, she needed to go straight for surgery because there was too much pressure on the brain because of these fluids. And so we got transferred first to Temple Street, and after two weeks to Crumlin.

    I just want to clarify that doctors and nurses were fantastic to me, to my husband and to Aurora. She wouldn’t be here if the surgery hadn’t been successful.

    Having said that there definitely gaps in the communication between the two hospitals. They were relying on the parents to get the information, which is not ideal because I’m not a doctor and that created frustrations and fears.

    When our daughter was released from hospital we were pretty much left to  our own devices. She had just one appointment in Temple Street during  her first year. And after that, I’ve been told that I needed to wait another year. Initially I thought that such a long time between visits was just because she’s doing well but It’s not the case. There was lots of information that I had to get elsewhere, and not from the professionals. In terms of psychological support for parents, we were very much left on our own. So you either cope and become resilient or probably you’re not going to make it mentally. I’m grateful I found this group and that these  ladies became my source of knowledge.

    Una: In terms of the financial support as well, like. Many of us received no financial support because our husbands or partners were too high earning So although your child has very high medical care needs – you could have a child who’s on oxygen 24 hours a day – you won’t get one penny from the government.

    Orlaith: In my case, my daughter is 20. We were under a multi-disciplinary team but with only three consultants in it. And after 2008, Crumlin finished up its spina bifida clinic. We then ended up being spread over four hospitals which don’t share files. So as Silvana said earlier, it is up to the parent to bridge the gap.

    When she was born she was very ill for the first four and a half months. We lived in the hospital paying for parental accommodation.

    I had my dream job. I worked in the Irish Times and I was part of the first team to ever bring in supplements into a broadsheet newspaper. I went on carer’s leave and eventually ended up leaving my job.

    There was no support for children with hydrocephalus. It’s not considered an intellectual disability. So, you know, you’re very much left on your own. My husband had a good job. I’ve never received Carer’s allowance after the first four or five months that we spent in hospital with her.

    When my daughter was seven they took away her medical card. In this country, when the medical card is taken away, your medical hardship scheme is directly attached. So a lot of the equipment you need you have to pay for it yourself.

    At nine she had three failed shunts, and two brain bleeds ending up spending nearly four months in Beaumont Hospital. I had to pay for my parking every day, for my accommodation and my food. Thousands of euros. I can’t claim back anything on that. And we still had to pay our bills and our mortgage.

    There’s a lot of stress around dealing with the child that’s sick and sure, you’re not failing your special child as you’re doing the best you can. On top of that, you’re fighting for everything. You’re fighting for therapy, you’re fighting for access to care, you’re fighting for basic things like my daughter’s incontinence and the allocation of nappies. It compounds into a heavy psychological weight. It’s not the disability alone, it’s the lack of support; the lack of access to timely care and that constant heavy worry all the time. They need help. I can’t get them help. I can’t force my appointments. I can’t force the consultant to do this or that. My daughter has now aged out of paediatrics and there’s no transition pathway. So now my job is going to my GP all the time. She had her first orthopaedic appointment in five years two weeks ago, and that took 16 adult consultants to refuse her before we got that orthopaedic consultant. So there’s lots of stress on you all the time.

    Here in Ireland, we have great nurses, we have great doctors, and I wouldn’t made it without them, but they’re not resourced and there doesn’t seem to be a willingness to accept we have such a high rate of these cases and that it needs to be invested in.

    Amanda: In the space of 18 months, my son went from needing care to becoming completely inoperable. For the first couple of years. He had a lot of appointments. Then it that stopped.

    My relationship with my partner deteriorated and broke down, very early on due  to the stress and the strain of trying to care for a very medically vulnerable child. I suddenly became a single working mother with two children, one with massive medical need and not financially supported by the state. I worked full time, paid a huge amount of rent. I’ve subsequently remarried and have gone on to have other children. Thankfully, my husband came into this with an open eyes.

    We wouldn’t change our children, what we would do and what we want to do is to change the services for them. They can become independent within their capabilities, and live their lives to the fullest without the need to be in pain or to have their parents struggling and fighting for services.

    https://twitter.com/BillyRalph/status/1458052402372923392

    Daniele: Over the last two years of pandemic, and with the HSE coming under cyberattack, your stress levels must have been almost unbearable. Having said that it is quite evident that these dysfunctions were there prior to these. How have you coped?

    Amanda: I’ve spoken to numerous families about this and we acknowledge that the pandemic and the cyber-attack happened, It was very scary and nobody had to protect our children more than we did.

    But what happened in the pandemic? The small amount of services and extra curriculum activities that our children were receiving stopped.

    Physiotherapists, occupational therapists were all redirected to COVID services and we understand the need for that. But there was also a huge recruitment drive by the HSE up thousands of health care professionals, like myself were ready to help but weren’t called up.

    We know now that during the pandemic, orthopaedics accident where less frequent so why weren’t our children’s needs met within this timeframe when obviously there was the space to meet them given the cessation of extracurricular activities?

    As parents,  we would call the pandemic and the cyberattack, the new great excuse for not giving us an appointment.

    Our children didn’t just freeze their conditions for two years or three years. You know, they continue to deteriorate.

    Stefania: My daughter Aurora, she has malformation of her ribs and she has never seen an orthopaedic surgeon in the last 3 years.

    It’s not that the doctors aren’t aware. Her Cardiologist took her case to his heart and did his best to advocate within Crumlin Children Hospital and he really fought for me but it’s not his job to organize a better multidisciplinary care structure.

    Daniele: That would be the job of the administration I presume. To conclude, how do you think Irish society perceives disability and how can awareness be promoted?

    Amanda: Irish people generally would be viewed as very laid back and positive.

    Therefore, there is an element that “disability cannot happen to me!”. It is only with an ageing population, inaccessible public transport, inaccessible housing, and educational facilities that the message is relayed to the ordinary person about how vast the inequality is between the non-disabled & disabled communities in Ireland.

    Over the last few decades Ireland has become a more diverse nation. Our children are exposed to more languages, ethnicity and religions than has ever been present on this island.

    These are the children of a new and inclusive Éire and as such, they do not have the same prejudices and intolerances as those who have gone before them. Our children living with disabilities are accepted by their peers and integrated more within society.

    It is deeply distressing for us that the relevant stakeholders within government and the Irish health care system, have not adopted the same attitude and continue to treat our children like second class citizens.

  • The “Strawman” Conspiracy Theorist

    In two hundred years doctors will rule the world. Science reigns already. It reigns in the shade maybe – but it reigns. And all science must culminate in the science of healing – not the weak, but the strong. Mankind wants to live… to live.
    Joseph Conrad, The Secret Agent (1907), p.263

    This article charts the origins and development of what often appears to be a strawman conspiracy theorist over the course of the COVID-19 pandemic, especially through “fact checker” initiatives operating at the behest philanthrocapitalism. This appears to have insulated regulatory agencies long prone to capture from adequate journalistic scrutiny, leading to a groupthink amidst an effective censorship of alternative, and scientifically valid, assessments of the danger posed by COVID-19, and the optimal humanitarian response.

    Losing Our Grip?

    In May, 2020, veteran Guardian journalist John Naughton explored the origins of Plandemic a “documentary” video ‘featuring Dr Judy Mikovits, a former research scientist and inveterate conspiracy theorist who blames the coronavirus outbreak on big pharma, Bill Gates and the World Health Organization.’ Naughton relates how the video migrated from mainstream social media into the dark recesses of the Internet.

    As he put it: ‘The cognitive pathogen had escaped into the wild and was spreading virally.’ Ultimately, the New York Times ‘traced it back to a Facebook page dedicated to QAnon, a rightwing conspiracy theory, which has 25,000 members.’ All this Naughton said: ‘confirms something we’ve known since at least 2016, namely that conspiracy theory sites are the most powerful engines of disinformation around. And when they have a medical conspiracy theory to work with, then they are really in business.’

    In May, 2020 The Atlantic’s Jeff Goldburg announced that conspiracy theorists were winning, and that America was ‘losing its grip on Enlightenment values and reality itself.’ Thus a 2014 study estimated that half the American public ‘consistently endorses at least one conspiracy theory,’ a proportion that had risen to 61% by 2019, suggesting the Internet was accelerating the trend. Another survey indicated that 60% of Britons were wedded to a ‘false’ narrative.

    Adjudicating on the falseness, or otherwise, of a narrative is not always, however, a straightforward exercise. Indeed, it will be argued that justifiable concerns around recent impugning of expertise have been weaponised to create another layer of disinformation over the course of the COVID-19 pandemic.

    The “wild-eyed” conspiracy theorist – often referred to as “members of the tin foil hat brigade” – has become a widely derided figure. This appears to be a belated response to so-called “post-truth” accounts, associated with supporters of Donald Trump in the U.S. and proponents of Brexit in the U.K., dismissive of expertise. This challenged a board consensus around such issues as the importance of mitigating climate change. But in confronting genuine disinformation it appears that many on the left, in particular, failed to interrogate vested interests during the pandemic.

    “Totalizing Discourse”

    Charles Eisenstein defines conspiracy myths as ‘a totalizing discourse that casts every event into its terms.’ He traces these overarching explanations – relying on observed phenomena only insofar as these fit with a preordained pattern – to the first century Gnostics, who believed that ‘an evil demiurge created the material world out of a pre-existingdivine essence.’

    The “totalizing” nature of such an approach has previously been dismissed by Karl Popper since ‘nothing ever comes off exactly as intended.’[i] Oliver and Wood (2014) identify three facets to an approach that has traditionally pointed to Freemasonry –an “illuminati” – Jews and Jesuits, and, in more recent times, intelligence agencies such as the CIA, KGB, MI5 or Mossad:

    First, they locate the source of unusual social and political phenomena in unseen, intentional, and malevolent forces. Second, they typically interpret political events in terms of a Manichean struggle between good and evil … Finally, most conspiracy theories suggest that mainstream accounts of political events are a ruse or an attempt to distract the public from a hidden source of power (Fenster 2008)

    In her seminal 1951 text The Origins of Totalitarianism, Hannah Arendt identifies such a tendency as a precursor to mob rule, describing how a conspiracy theorist ‘is inclined to seek the real forces of political life in those movements and influences which are hidden from view and work behind the scenes.’[ii]

    Yet certain conspiracy theories in our time, such as suggestions the U.S. invaded Iraq in 2003 in order to plunder oil resources rather than decommission weapons of mass destruction, or that the fossil fuel industry deliberately sowed confusion over climate change, remain plausible, even if we lack clear documentary proof.

    A problem lies in how individuals with minimal academic attainment treat conspiracies as objective truths rather than conjectures based on circumstantial evidence. The likelihood of a conspiracy is often portrayed as “beyond reasonable doubt”, as opposed to “on the balance of probabilities.” A formally educated observer may be repelled by an insistent approach that does not allow for reasonable doubt.

    The intuition relied on by confirmed conspiracy theorists thus generally fails to acknowledge uncertainty, and lacks scientific or historical rigour. Yet these accounts may still occasionally yield insights when empirical methods fall short. After all, suspicions raised by conspiracy theories are often vindicated. Rather than dismissing out of hand such ‘magical thinking’, it is useful to consider these as unproven hypotheses, and not necessarily untrue, simply because an individual is overstating a case.

    For example, over the course of the COVID-19 pandemic increasingly persuasive evidence has emerged of a laboratory leak – perhaps from so-called ‘gain of function’ research – giving rise to the pandemic. But in February, 2020 The Lancet published a letter from a number of prominent scientists who ‘strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin.’ This had a chilling effect on the scientific debate during the early stages of the pandemic.

    Notably also, the ‘father of economics’ Adam Smith opined that ‘People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices.’[iii] Smith’s portrayal of commercial calumnies is reflected in a question posed at a medical conference in 2018 by a Goldman Sachs executive: ‘Is curing patients a sustainable business model?’

    Previously, a succession of pharmaceutical scandals led Ben Goldacre MBE to take a sympathetic view of so-called “anti-vaxxers”, who are now consistently conflated with “conspiracy theorists”: ‘I think it’s fair to say that anti-vaccine conspiracy theories are a kind of poetic response to regulatory failure in medicine and in the pharmaceutical industry. People know that there is something a little bit wrong here.’

    Similarly, Tom Jefferson – editor of the Cochrane Collaboration’s acute respiratory infections – in an interview with Der Spiegel in 2009 in the wake of the Swine Flu pandemic-that-never-was pointed to shadowy pharmaceutical forces: ‘Sometimes you get the feeling that there is a whole industry almost waiting for a pandemic to occur.’

    UNESCO’s World Trends Report 2018.

    Journalism Under Threat

    An assumption of malevolent or self-serving – cui bono? – motivations (particularly concerning a Big Pharma industry with a shameful record of distortion and manipulation) is almost a prerequisite for being an investigative reporter. Stories don’t drop out of the air. Unless a journalist assumes wrongdoing – in essence a conspiracy theory – there would be no reason to begin digging.

    The key distinction between genuine journalism and conspiracy theorising is that proponents of the latter tend to blurt out their “findings” without marshalling supporting evidence, with the Internet providing anonymity as required. This, however, makes such accounts easy to ridicule to the detriment of journalism with an evidential basis.

    Journalists have long been deflected from investigating large corporations. In a recent memoir the great American journalist Seymour Hersh fumes at how in the late 1970s The New York Times shut down his attempt to investigate corporate America ’when confronted by a gaggle of corporate conmen.’[iv]

    This challenge has increased significantly in the wake of the Internet. After the “Original Sin” of free online publication, the number of American journalists fell from 60,000 in 1992 to 40,000 in 2009, a pattern seen across the world. As revenues diminished, workloads increased. Cardiff University researchers recently conducted an analysis of 2,000 U.K. news stories, discovering the average Fleet Street journalist was filing three times as much as in 1985. To put it another way, journalists now have only one-third of the time to do the same job.[v]”

    “Fact Checkers”

    Over the course of the pandemic a strawman conspiracy theorist appears to have been consciously developed to deter valid journalistic interrogation, in particular, through so-called “fact checking” initiatives. It has reached a point where, as Charles Eisenstein observes: ‘“Conspiracy theory” has become ‘a term of political invective, used to disparage any view that diverges from mainstream beliefs. Basically, any critique of dominant institutions can be smeared as conspiracy theory’

    In the absence of adequate journalistic scrutiny during the pandemic corruption has been rife. The executive director of The British Medical Journal Kamran Abbasi described ‘state corruption on a grand scale’ that is ‘harmful to public health’ Abbasi observes how the pandemic ‘has revealed how the medical-political complex can be manipulated in an emergency—a time when it is even more important to safeguard science.’

    This also occurred in the context of unregulated social media, where companies set their own rules. In March, 2020, having previously styled itself ‘the free speech-wing of the free-speech party’, Twitter moved to address concerns around conspiracy theories. In future it would be: ‘Broadening our definition of harm to address content that goes directly against guidance from authoritative sources of global and local public health information.’

    Nonetheless, free reign was given to “click-bait” alarmists such as Eric Feigle-Ding on Twitter, who saw his following mushroom from just two thousand to almost a quarter of a million. Angela Rasmussen, a Columbia University virologist, identified a pattern: ‘He tweets something sensational and out of context, buries any caveats further down-thread, and watches the clicks and [retweets] roll in.’

    Twitter did not act alone in upholding an apparent orthodoxy that often lapsed into an extremism that deterred legitimate questioning. Google took unprecedented steps to erase material violating ‘Community Guidelines’: ‘including content that explicitly disputes the efficacy of global or local health authority recommended guidance on social distancing that may lead others to act against that guidance.’

    Initially at least, Facebook adopted a more laissez faire approach, although users who had read, watched or shared ‘false’ coronavirus content received a pop-up alert urging them to go the World Health Organisation’s website. In November, 2021, however, the editors of the British Medical Journal sent an open letter to Facebook in response to “fact checkers” undermining their investigative report into ‘a host of poor clinical trial research practices’ at Pfizer’s original vaccine trial.

    Thus, the approach of the social media giants was bolstered by an unprecedented journalistic effort to “factually” repudiate conspiracy theories during the pandemic; notwithstanding how ‘uncontested facts—things that are ascertainable, reproducible, transferable and predictable—tend to be elusive.’

    Preparations for the “fact-checking” initiative began in January, 2020 when a global #CoronaVirusFacts Alliance, comprising more than one hundred “factcheckers” around the world, described as ‘the largest collaborative factchecking project ever,’ was launched by the Poynter Institute, ‘when the spread of the virus was restricted to China but already causing rampant misinformation globally.’ It said that the WHO had classified the issue as ‘an infodemic — and the Alliance is on the front lines in the fight against it.’

    From March 2020, with the support of these “fact checkers”, outlets such as Reuters responded to an anticipated wave of conspiracy theories, taking particular care to address allegations against Bill Gates. He has been described as ‘the world’s most powerful doctor’ despite not having earned a medical degree due to the Gates Foundations being the second largest funder of the WHO, after China. This included allegations that he had apparently planned the pandemic, and wanted to commit genocide through vaccines.

    For example, on May 30, 2020 a BBC article purported to defuse claims the pandemic was ‘a cover for a plan to implant trackable microchips and that the Microsoft co-founder Bill Gates is behind it’; although it acknowledged Gates had said that ‘eventually “we will have some digital certificates” which would be used to show who’d recovered, been tested and ultimately who received a vaccine,’ and also referenced ‘a study, funded by the Gates Foundation, into a technology that could store someone’s vaccine records in a special ink administered at the same time as an injection.’

    Front building of the Bill and Melinda Gates Foundation in Seattle.

    Gates Foundation

    When it came to outlandish conspiracy theories around COVID-19 all roads led to Bill Gates and his $47 billion philanthropic Bill and Melinda Gates Foundation – besides a personal fortune of $115 billion, and growing, as of October 2020.

    For many of world’s population under stay-at-home orders the pandemic was viewed through a digital prism – often at a remove from morbidity or mortality itself. At that stage, Gates’s 2014 Ted Talk ‘The Next Outbreak. We’re not ready’ seemed almost prophetic.

    He opined: ‘If anything kills over ten million people in the next few decades it is most likely to be a highly infectious virus rather than a war.’ The failure of Western governments to prepare for such an eventuality seemed to have been laid bare – in particular the Presidential administration of Donald Trump, who according to a Cornell University study ‘was likely th\\e largest driver of the COVID-19 misinformation “infodemic.”’

    Gates’s Ted Talk, however, failed to discuss the false alarm of the Swine Flu Pandemic, when the WHO estimated that between 2.0 and 7.4 million could die, assuming the outbreak was relatively mild. This proved a wild exaggeration as less than 300,000 were estimated to have died globally, with Western governments stockpiling millions of dollars’ worth of GlaxoSmithKlein’s Pandemrix vaccine, which  brought an elevated risk of narcolepsy.

    Gates’s main reference point appears to have been the Spanish Influenza (H1N1) outbreak of 1918 – the Ur-pandemic of modern times  – that led to up to fifty million deaths, many of them young men in their prime, at a point when the global population was approximately two billion. In contrast, the infectivity and severity of SARS-CoV-2 ‘are well within the range described by respiratory viral pandemics of the last few centuries (where the 1918–20 influenza is the clear outlier).’

    Neil Ferguson

    “Scientific Groupthink”

    In March, 2020, Imperial College’s Neil Ferguson told the New York Times the ‘best case outcome’ for the U.S. was a death toll of 1.1 million, rising to 2.2 million in a worst case scenario, a projection that has proved wildly inaccurate. Yet, alternative, and scientifically valid, assessments of the danger posed by COVID-19, and the optimal humanitarian response to the challenge were virtually ignored in legacy media at the time. Thus, an Oxford University paper, which included Sunetra Gupta as an author, countered what the New York Times described as the ‘gold standard’ Imperial modelling underestimated immunity from prior coronavirus infections and posited a far lower infection fatality rate.

    But in March, 2020, the Financial Times warned that Gupta’s group’s modelling was ‘controversial and its assumptions have been contested by other scientists.’ Implicitly, the Financial Times was accepting the “gold standard” Imperial paper.

    Moreover, in November, 2020 an article in the Scientific American describes how Stefan Baral, an epidemiologist and associate professor at Johns Hopkins Center for Global Health, wrote a letter about the potential harms of lockdowns which was rejected from more than ten scientific journals (and six newspapers) in April, 2020. Baral recalls, ‘it was the first time in my career that I could not get a piece placed anywhere.’

    The article also recalled that, ‘highly anticipated results of the only randomized controlled trial of mask wearing and COVID-19 infection went unpublished for months.’ The authors concluded that the ‘net effect of academic bullying and ad hominem attacks has been the creation and maintenance of “groupthink”—a problem that carries its own deadly consequences.’

    In the absence of access to authoritative, diverging scientific accounts, opposition to lockdowns could easily be dismissed as being the preserve of conspiracy theorist cranks associated with “anti-vaxxers” and even a “far-right” fringe.

    “Screen New Deal”

    Apart from offering pharmaceutical companies the huge financial incentive – grasped within open arms – of developing a vaccine for universal application, lockdowns and social distancing measures also brought soaring profits for major technology corporations. Moreover, restrictions provided a testing ground for the Gates Foundation’s long advocacy of technological approaches in education.

    In May, 2020 Naomi Klein identified collusion between state and Big Tech interests in what she described as ‘A Screen New Deal.’ She referred to New York Governor Mario Cuomo’s courting of Google and the Gates Foundation: ‘Calling Gates a “visionary,” Cuomo said the pandemic has created “a moment in history when we can actually incorporate and advance [Gates’s] ideas … all these buildings, all these physical classrooms — why with all the technology you have?” he asked, apparently rhetorically.’

    Remote learning technology permitted extended school closures around the world, despite the chance of death from COVID-19 being ‘incredibly rare’ among children. Research now suggests many students made little or no progress while learning from home, and that learning loss was most pronounced among disadvantaged students. As a consequence, up to 20,000 children in the U.K. went missing from school rolls during the pandemic. Nor is it apparent that teachers faced any greater risk compared to the wider population in fulfilling classroom teaching.

    Media Funding

    Popular consent on a global scale for lockdowns, particularly from those identifying on the left, seems to have been manufactured through vast ‘philanthropic’ funding of journalism, in particular of publications associated with progressive outlooks.

    By June 2020, the Gates Foundation contributed $250 million to journalism, which according to Tim Schwab in The Columbia Journalism Review, ‘appears to have helped foster an increasingly friendly media environment for the world’s most visible charity.’

    A theme of ‘we are in this together’ inhibited criticism and enquiry. This quiescence has been criticized by the Greek socialist Panagiotis Sotiris who wrote: ‘What is missing here is something that used to be one of the main traits of the radical left, namely, an insistence that science and technology are not neutral.’

    Tim Schwab calculates that $250 million had been devoted to journalism by the Gates Foundation for the six months up to June, 2020,. Recipients included BBC, NBC, Al-Jazeera, ProPublica, National Journal, The Guardian, Univision, Medium, The Financial Times, The Atlantic, The Texas Tribune, Gannett, Washington Monthly, Le Monde, and the Center for Investigative Reporting, as well as the BBC’s Media Action and The New York Times’ Neediest Cases Fund.

    Schwab adds: ‘In some cases, recipients say they distributed part of the funding as subgrants to other journalistic organizations—which makes it difficult to see the full picture of Gates’s funding into the fourth estate.’

    As a result, he says:

    During the pandemic, news outlets have widely looked to Bill Gates as a public health expert on covid—even though Gates has no medical training and is not a public official. PolitiFact and USA Today (run by the Poynter Institute and Gannett, respectively—both of which have received funds from the Gates Foundation) have even used their fact-checking platforms to defend Gates from “false conspiracy theories” and “misinformation,” like the idea that the foundation has financial investments in companies developing covid vaccines and therapies. In fact, the foundation’s website and most recent tax forms clearly show investments in such companies, including Gilead and CureVac.

    ‘Undermining Scientific Creativity’

    The Gates Foundation’s pivotal role in funding global health has long raised concerns. In 2008, Dr. Arata Kochi, the former head of WHO’s malaria programme argued the Gates Foundation was undermining scientific creativity in a way that ‘could have implicitly dangerous consequences on the policymaking process in world health.’ He worried that Gates-funded institutions – including Imperial College London (MRC Centre for Global Infectious Disease Analysis) – were adopting ‘a uniform framework approved by the Foundation,’ leading to homogeneity of thinking: ‘Gates has created a ‘cartel,’ with research leaders linked so closely that each has a vested interest to safeguard the work of others. The result is that obtaining an independent review of scientific evidence (…) is becoming increasingly difficult.’

    GAVI, the Vaccine Alliance, is the most obvious example of the Gates Foundation’s engagement. GAVI has successfully immunized large numbers of children, but been criticized by other NGOs for inadequate funding of health system strengthening.

    One of GAVI’s senior representatives reported that Bill Gates often told him in private conversations ‘that he is vehemently ‘against’ health systems (…) he basically said it is a complete waste of money, that there is no evidence that it works, so I will not see a dollar or cent of my money go to the strengthening of health systems.’

    As of 2017 only 10.6 percent (US$862.5 million) of GAVI’s total commitments between 2000 and 2013 had been dedicated to health system strengthening, whereas more than 78.6 percent (US$6,405.4 million) have been used for vaccine support. Doctors Without Borders (MSF) states that, while GAVI has helped to lower prices of new and underused vaccines for eligible countries, the cost to fully immunize a child was 68-times more expensive in 2014 than it was in 2001.

    According to long-time Gates critic James Love, Gates ‘uses his philanthropy to advance a pro-patent agenda on pharmaceutical drugs, even in countries that are really poor.’

    Safe Treatment?

    This article makes no bold claims regarding the efficacy of any treatments, but the overwhelmingly negative reaction of legacy media to research pointing to the efficacy of the off-patent drug Ivermectin suggests that vested pharmaceutical interests wished to undermine public confidence in any scientific arguments regarding its efficacy.

    In June, 2020, a laboratory study demonstrated it was ‘an inhibitor of the causative virus’ (Caly, 2020). Later, a Systematic Review, Meta-analysis that included twenty-four randomized controlled trials said: ‘Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin.’

    In a predictable example of “fact-checking” where an outlandish claim is used to discredit a compelling hypothesis, the Poynter Institute quoted a social media post ‘rating’ the claim that Ivermectin basically ‘basically obliterates’ as ‘false.’

    The Guardian’s dedication to discrediting the meta-analysis also suggested vested interests were at work, and contrasts with a failure to report on the British Medical Journal’s account of a whistle blower alleging serious data integrity issues during Pfizer’s vaccine trial.

    It should hardly be controversial – let alone dismissed as a conspiracy theory – to argue that the weight of evidence points to a ‘Gates-Approach’ lying behind ongoing adoption by most Western governments of unprecedented suppression measures in support of universal vaccination – notwithstanding potential treatment alternatives – leading to the introduction of vaccine passports, as Gates “predicted” in April, 2020. This also occurred alongside a familiar ‘rhetoric supportive of ‘holistic’ health systems.’

    It is now clear that consent for lockdowns, especially in the Anglophone world, was manufactured through wildly inaccurate epidemiological assessments of an infection fatality rate of 0.9% in the notorious Imperial College paper. This estimate has since been adjusted to 0.2% (available on the WHO website), a figure which Joffe argues is likely ‘a large over-estimate.’

    It is also clear that globally mortality statistics for COVID-19 have been systematically exaggerated. This manipulation can be traced to a WHO document from April, 2020 entitled ‘International Guidelines for Certification and Classification (Coding) of COVID-19 as Cause of Death’. It set out strict rules for the registration of COVID-19 deaths, which differ fundamentally from registration for other causes. The guidelines define a COVID-19 mortality as ‘a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma).’

    It is revealingly that in a country such as Ireland since the pandemic began the mean age of death from COVID-19 has been eighty years of age (eight-two being the median age), just two years younger than the average age of death, and that level of mortality through the years 2018-2020 (2018: 31,116; 2019: 31,134; 2020: 31,765) show little difference.[vi]

    For most people COVID-19 is a virus that poses little danger. Prior to the arrival of a vaccine, a U.K. study from October, 2020 found 76.5% of a random sample who tested positive reported no symptoms, and 86.1% reported none specific to COVID-19. Moreover, an article from Peter Doshi in the British Medical Journal in September, 2020, stated: ‘At least six studies have reported T cell reactivity against SARS-CoV-2 in 20% to 50% of people with no known exposure to the virus’; apparently vindicating Sunetra Gupta’s “controversial” paper, over which the Financial Times cast doubt.

    It should not be controversial to argue that morbidity and mortality from COVID-19 ought to have been weighed against the global impact of lockdowns. On that score, a new paper jointly by authored by researchers from Johns Hopkins University in the US, Lund University, in Sweden and the Centre for Political Studies, in Denmark concluded that lockdowns in Europe and the US decreased COVID-19 mortality by a measly 0.2% on average.

    Conclusions

    A “totalizing” discourse of a COVID-19 conspiracy theory identifies a preordained plan being set in motion by malicious actors, wherein the pandemic culminates in a dangerous vaccine being foisted on a brainwashed population. This might lead to an assumption that such vaccines invariably give rise to severe adverse reactions that are systematically covered up. Such an account does not demand evidence as events are simply unfolding “as planned.”

    In reality, however, events rarely follow a preordained pattern, and even in circumstances of regulatory capture state agencies are never entirely bereft of integrity. Moreover, such accounts divert attention from probing interrogation of the efficacy of vaccines and the desirability of universal uptake of a medication that does not block transmission, especially one rushed to the market, and which may cause unforeseen adverse reactions.

    It is also apparent that public perception of the efficacy of vaccines has been distorted by the media’s reporting of relative risk reduction, as opposed to absolute risk reduction, which is just 0·84% for the Pfizer–BioNTech vaccines.

    Moreover, importantly, in January, 2021, Peter Doshi and Donald Light in the Scientific American objected to the undermining of ‘the scientific integrity of the double-blinded clinical trial the company—and other companies—have been conducting, before statistically valid information can be gathered on how effectively the vaccines prevent hospitalizations, intensive care admissions or deaths.’

    This came after Pfizer pleaded an “ethical responsibility” to unblind its trial and offer the vaccine to those who received a placebo. The authors argue that ‘there was another way to make an unapproved vaccine available to those who need it without undermining a trial. It’s called “expanded access.” Expanded access enables any clinician to apply on behalf of their patient to the FDA for a drug or vaccine not yet approved. The FDA almost always approves it quickly.’

    In terms of any actual conspiracy or contrivance to raise prices along the lines of tendencies that Adam Smith pointed to among gentlemen of commerce, the role played by Bill Gates has been, doubtless, more complex than many conspiracy theorists allow for. However, in circumstances where a billionaire with a history of monopolistic aspirations promotes an agenda aligning with his financial interests it should come as no surprise that colourful theories abound; especially with many journalists seemingly inhibited from enquiring into his Foundation’s activities.

    Indeed, ironically, the aforementioned Guardian journalist John Naughton recently described Gates while Microsoft CEO as having acted like ‘a mogul who is incredulous that the government would dare to obstruct his route to world domination.’ Does such a leopard ever change his spots?

    Sadly, the amplification of the outlandish claims of conspiracy theorists by so-called “fact checkers” could be causing reputational damage to genuine expertise, and allow demagogues reliant on angry mobs to say: “I told you so.” The propagandist role of “fact checkers” has undermined genuine investigative reporting, much of which already occurs on the margins.

    In the early stages of the pandemic especially, difficulties in reporting were compounded by deficits in scientific understanding among overworked journalists in precarious employment, who were encouraged to justify unprecedented lockdowns as a form of social solidarity. The assumption that by “following the science” a journalist is adequately performing his or her role is a dangerous fallacy, which does not take account of how diverging scientific arguments may be concealed.

    In the absence of sufficient independent journalism, and amidst censorship of alternative scientific opinion, troubling questions remain unanswered as the pandemic draws to a close. Perhaps we will never know the full story. Nonetheless, it is vital that adequate cost-benefit analyses (including with access to full trial data) are conducted on all pharmaceutical and non-pharmaceutical interventions in future.

    Feature Image (c) Daniele Idini: The Burning of “the Witch of Winter” in Cardano al Campo, Lombardy, Italy.

    We are an independent media platform dependent on readers’ support. You can make a one-off contribution via Buy Me a Coffee or better still on an ongoing basis through Patreon. Any amount you can afford is really appreciated.

    [i][i] Karl Popper (1972). Conjectures and Refutations, 4th ed. London: Routledge Kegan Paul. pp. 123–125.

    [ii] Hannah Arendt (1951) The Origins of Totalitarianism, 1951, p.140

    [iii] Adam Smith, The Wealth of Nations, book 1, chapter 10, par. 2).

    [iv] Seymour Hersh, Reporter, 2018, p.247.

    [v] Rusbridger, Alan, The Remaking of Journalism and Why it Matters, 2018, p.163-181

    [vi] Worldometre attributes 1,736 deaths to COVID-19 by December 31st, 2020.

  • Vaccine Passports “Inherently Illiberal”

    On October 5th of this year, Minister for Health Stephen Donnelly spoke before the Dáil during a debate to extend the legal framework for restrictions in the State – the sunset clause of the Health Amendments (Covid-19) Act 2021 – for three months. He stated that there was no intention to extend the restrictions beyond October 22nd, but that they wished to keep the legal framework in place in case of the need for further restrictions or lockdowns.

    This was clearly a lie, or ignorance on an unforgiveable scale. It cannot be both.

    In the interim, hospitalisations related to COVID-19 have steadily climbed, and the wheel of fear and dread has begun to turn again, quickly gathering pace.

    Thankfully, the government are attempting to turn the tide by extending the need for the Covid certification pass to theatre and cinemagoers, as well as banning nativity plays and playdates, thus surely halting the inevitable pressure that is being mounted on our health system.

    Inherently Illiberal

    I must state from the outset that I am vehemently against the concept of a vaccine passport or vaccine mandates. I believe them to be inherently illiberal and it pains me to see the willingness with which we have adopted them into our society.

    I acknowledge that when an issue produces such a visceral response, there is an increased likelihood that my reasoning may be faulty. Having read Daniel Kahnemann’s Thinking, Fast and Slow , I recognise that instinct and emotion can often cloud clear judgement. Hence, I have attempted to examine the principal arguments for and against vaccine passports in the context of the coronavirus pandemic to see if I can or will come to a different conclusion.

    I take COVID-19 extremely seriously and witness the impact of the pandemic on the patients that I meet every day. This relates not just to actual illness but to the myriad other issues, both medical and non-medical that the past twenty-two months have created for them.

    I support vaccination but not forced inoculation in the same way that I support appropriate medical treatment, not forced care. I worry that unnecessary interventions will create long-term sequalae that cannot be predicted, in the same way that inappropriate prescribing of medications does.

    Preventing the Spread?

    The most obvious argument in favour of vaccine certification is that it should prevent the spread of disease in an enclosed area. The certificate will work to protect both vaccinated and unvaccinated from contracting and spreading the disease and reducing the burden on the hospital system.

    Unfortunately, there is absolutely no evidence that this is the case. Vaccinated citizens have been readily demonstrated to be able to contract and transmit the virus in the exact same manner as an unvaccinated person.

    A recent Lancet study demonstrated that vaccination reduced the risk of Delta variant infection and accelerated viral clearance. This is great news, demonstrating that vaccines are effective. However, fully vaccinated individuals with breakthrough infections had peak viral load similar to unvaccinated cases, and could efficiently transmit infection in household settings, including to fully vaccinated contacts.[i]

    If vaccinated and unvaccinated persons are equally capable of transmitting a virus, why do we insist on segregation and marginalisation of a significant minority of our population?

    Pandemic of the Unvaccinated?

    The second argument commonly encountered is that it is the segment of the population who are unvaccinated by choice who are creating the ICU and hospital bed capacity issues.

    As of November 17th 52% of patients are unvaccinated, with a significant percentage of this population also immunocompromised. According to Minister Donnelly, 98% of the vaccinated ICU patients are immunocompromised. On this basis, there is a strong likelihood that a significant proportion of the unvaccinated cohort are not unvaccinated by choice but because they are too unwell to receive the vaccine.

    This is speculative on my part but is worth considering, and requires refutation.

    Another argument advanced is that full participation in society is not free and requires solidarity on the part of the individual citizen: Thus, “Play your part. Protect yourself. Protect others” is a common slogan.

    David Robert Grimes wrote an essay recently for The Guardian, comparing smallpox vaccine mandates in the early 1900’s to today’s issues. Of course, he neglected to mention that there was no vaccine passports in use at the time for participating in normal life, and provides no justification for them other than that they represent a mark of ‘solidarity.’

    He also states that participation in society is not free, and that freedom comes at a cost, which is somewhat paradoxical. There is an expectation of brotherhood in society. However, if brotherhood is coerced against someone’s will, it is difficult to define it so.

    I have not seen any evidence that prominent politicians during the smallpox era demanded that unvaccinated people should be banned from supermarkets and public transport. Does this evoke the spirit of fraternité?

    Finally, although never explicitly stated in Ireland, vaccine certification is certainly an effective measure to improve uptake of a vaccine.

    Whether one defines this as a nudge, gentle encouragement or coercion is a different argument. When I asked the Irish College of General Practitioners their position on the implementation of this system, they replied that ‘these people (the unvaccinated) may particularly benefit from national interventions to promote vaccination and limit the spread of COVID-19’.

    This statement is certainly open to interpretation. Undoubtedly, it has been effective in ensuring increased take-up of the vaccine in young adults – young people who may not have bothered otherwise with brother- and sisterhood.

    In a Machiavellian sense, this is the only true and potentially justifiable reason for a vaccine passport to be introduced in a civilised society. I cannot see another. Unfortunately, even 100% vaccination uptake, as in Gibraltar, has not resulted in the resolution of pandemic issues, with rising case numbers among the vaccinated causing all large Christmas activities to be cancelled.

    At this point in the pandemic, the above justification in Ireland no longer holds water. Ireland has one of the highest vaccination rates in the world, with 93% of the eligible adult population fully vaccinated.

    One should therefore assume that the remaining 7% of the ‘non-cooperating’ population are much more likely to consider a certification system coercive and will exacerbate their own fears of over-intervention by the State and unwelcome intrusion into their private lives.

    Someone who argues that this is for the benefit of the unvaccinated in protecting them from society does not do so in good faith. If someone does not wish to be inoculated at this point, there is more than a strong possibility that they do not wish to take up the kind offer of a jab.

    A certification system hence is more likely to have the inverse effect of its presumed benign intention. It is more likely to convince them further that the State wishes to harm and to segregate them against their wishes from a society that has already, by and large, shunned them.

    State of Distrust

    There has been no attempt to understand any of the multiple reasons why people do not wish to receive this vaccine. Distrust of the State, distrust of the pharmaceutical industry, distrust of the healthcare industry, anecdotal reports of adverse effects and concerns regarding under-reporting, the list is varied. The consistent link between all these issues/concerns is that of distrust.

    Many papers have been written on the subject of discussing vaccine hesitancy as a doctor with a patient. All suggest addressing hesitancy with compassion and understanding as decision-making around vaccination entails a complex mix of cultural, psychosocial, spiritual, political, and cognitive factors.[ii]

    Reasons for vaccine hesitancy fit into three categories: lack of confidence (in effectiveness, safety, the system, or policy makers), complacency (perceived low risk of acquiring VPDs), and lack of convenience (in the availability, accessibility, and appeal of immunization services, including time, place, language, and cultural contexts).

    All suggest addressing the patient’s concerns carefully, discussing with openness and honesty any potential side-effects as well as advocating the benefits, such as they are.

    Has any of this been done at any point during the pandemic with the vaccine hesitant? Vaccine passports are not a tool to advocate for immunisation in a humane and empathic manner and it is equally certain that the most effective way of fomenting further distrust is to patronise people for their ‘stupidity’ in doubting the effectiveness of a medical intervention, while downplaying the potential for any side-effects and then to mandate the intervention as a necessity for full participation in normal society, such as it is.

    Scapegoating

    Instead of focusing on and congratulating the 94% of the eligible adult population who have been vaccinated, we have decided to scapegoat and segregate the dirty few who have not complied with government directives.

    As a reminder, segregation has never been an attractive or effective feature of a functioning society. I make no lazy comparison to Nazi Germany, but rather suggest that people consider the State’s recent attitudes to same-sex relationships.

    It should not be forgotten that homosexuality was only decriminalised in Ireland in 1993. That was a horrible and unjust law, horridly intruding into the lives of normal people. Same-sex marriage was legalised six short years ago in 2015.

    Can any sane person reasonably make the case that it was legitimate or more importantly, healthy for a society to deny that two private citizens who love each other should be allowed to spend their lives together in a loving, equal relationship? That it was reasonable that same-sex marriage was such a danger to society that it had to remain illegal in the twenty-first century?

    By this logic, are the unvaccinated so lethally unclean that it is worth intentionally re-dividing society? That it is worth every citizen who wishes to eat in a restaurant having to demonstrate by law a private medical decision to a waiter that has no interest and no business in knowing same?

    The State is not a benign entity and is capable of dreadful, discriminatory decisions that have long-lasting impacts of the fabric of the country that we live in. Our long history of governmental corruption, cronyism and cover-ups at the cost to its people did not magically disappeared at the onset of a pandemic to be replaced by a wonderful, altruistic body guided by love and the rights of the individual.

    Marginalisation

    We should also consider the demographics of some of the people who do not wish to be vaccinated. People with lower levels of household income and those living in disadvantaged areas are demonstrably associated with increased likelihood of vaccine resistance and hesitancy.

    A recent survey also demonstrated that BAME people are a minimum of 25% less likely to take up the offer of the Covid vaccine.

    It is regularly reported that lockdowns and prolonged periods of state-imposed restrictions have had the most demonstrably negative effects on the exact population groups who are also hesitant to receive the vaccine.

    Therefore, we have managed to punish and further marginalise the very people who have suffered the most throughout this pandemic and will likely suffer the most in the years of anticipated turmoil ahead.

    This is not to denigrate the many wonderful, intelligent people who quite rightly question the manner in which they feel their country is being governed and directed but to highlight the unnecessary dual suffering that many people will encounter in the months and years ahead.

    In any other time, scepticism and resistance to dictates targeting minorities would be celebrated, not scorned. We should hold our leaders to a high standard at all times, not allow them easy opportunities for deflection from their own failings and label almost everything that does not agree with State narrative as “misinformation.”

    Again, instead of trying to understand why people do not wish to be injected with a treatment that they consider dangerous and unproven, and to try to convince in a humane and empathic manner, we have instead chosen to demonise and make them the culprits for the current issues that the hospital system faces in Ireland.

    Do we wish to follow the example of Singapore and begin charging patients who become ill and are unvaccinated by choice? Do we wish to follow the lead of Australia and send our citizens to quarantine camps against their wishes? Do we wish to follow the lead of Austria and lockdown the unvaccinated, and now mandate vaccines for the whole population?

    Why are these questions not being asked and answer by the opposition political parties in Ireland? Liberalism is defined as a political and social philosophy that promotes individual rights, civil liberties, democracy, and free enterprise and is supposed to be the cornerstone of left-wing politics.

    The presumed left, including Sinn Fein, Labour, the Social Democrats, People before Profit, have been pathetic in their lack of any attempt to hold the State to account. A strong opposition is the cornerstone of democracy, and it is not present currently in Ireland.

    Image (c) Daniele Idini.

    Public Health Department

    I have discussed vaccine certification with the local public health department in relation to the management of this pandemic. The doctor that I spoke to readily admitted that there is no medical indication for the use of vaccine certification and was shocked at the extension of the recent legislation in October.

    Hence, my surprise at the recent declarations by Colm Henry and Ina Kelly, president of the IMO, that the public should walk out of pubs or restaurants that are not asking for Covid 19 digital certificates.

    There remains no evidence whatsoever that vaccine certification has made any improvement to the management of the COVID-19 pandemic in any country that it has been used.

    An Israeli paper examining the effects of their ‘Green Pass’ concluded that apart from the coercive effects of increasing vaccine uptake[iii], there is no evidence that the use of a passport system reduces morbidity loads on a population.

    To repeat, there is no public health evidence for the intentional segregation of society. None. Zero. Nada. Zilch.

    Anyone who argues that there is should be immediately dismissed as a fool. However, if you wish to look at the data, the HSPC have kindly provided information on COVID-19 outbreaks in the Republic of Ireland.

    In May of 2021, there had been a grand total of two outbreaks attributed to hairdressers/personal grooming services. By November, there are now twenty-two recorded. In May, there were ten outbreaks attributed to public houses. By November, there have been forty more.

    Does anyone truly believe that presenting a piece of paper at the door achieves anything when the holder continues to have the potential to be highly infectious? There is no evidence that it improves either your safety or the safety of others.

    Image (c) Daniele Idini

    Misdirected Indication

    There has also been a recent effort to blame the unvaccinated for various sad occurrences that have occurred because of the lack of capacity in the HSE. Thus, it was reported that a transplant operation was cancelled because unvaccinated patients occupied ICU beds and the procedure was unable to go ahead.

    Blaming the unvaccinated for this is completely disingenuous and abdicates responsibility for decades of poor management. The reader should know that Ireland does not have a good reputation in the transplant world. We are currently 18th out of 24 countries in Europe, below Lithuania and Estonia in terms of organ transplantation per million people.

    In 2015, Dr David Hickey, the transplant surgeon described in the Irish Independent that he was the only pancreatic transplant surgeon in the State. Despite multiple offers to the HSE to mentor two people to take over his role, nothing was done. The pancreatic transplant program was then moved to another hospital setting, against advice and without consultation. At the time, no transplants, despite their life-saving nature, took place over a nine-month period.

    To consider that the people ‘clogging up the ICU’s’ are responsible for historically well-recognised governmental and state body failures is malicious.

    The 2019 Euro Health Consumer Index places Ireland in last position, below Albania, North Macedonia, Latvia and Romania, countries all with their own issues, in terms of outpatient hospital waiting lists.

    Ireland has the lowest rate of hospital consultants in the EU18, a fact heavily bemoaned by the Irish Medical Organisation. Shortages of GPs, shortages of nursing and allied health professionals, overcrowded emergency departments and public health failures have been reliable sources of outrage and headlines over the course of the past twenty years.

    Fortunately, there is now a perfect fall guy in the shape of an unvaccinated person to take the ire of the populace.

    The unvaccinated are at fault for five-year orthopaedic waiting lists, the unvaccinated are responsible for spiralling chronic diseases in an increasingly obese and unhealthy society. The unvaccinated are responsible for the lack of clinical staff living and working in this country.

    It would be laughable were it not for the real human cost of such misdirected indignation and hatred.

    If we are to blame the individual for the failings of the system, we should apply this logic to the others who place a heavier burden on the health system. The obese, the alcoholics, the smokers, the poor should all feel our wrath at the impact they place upon our hospitals. Perhaps an obesity cert would be an incentive for them to lose weight or keep them out of restaurants? That can only have positive results.

    Chaotic Interference

    Continuing along this path of chaotic interference in people’s lives will have iatrogenic consequences. Professor Helen Townsend, director of the Self-Harm Research Group in the University of Nottingham, has described the likely severe long-term consequences of lockdowns and that these have never been accounted for in policy making19.

    Has any consideration been given to the societal impacts of intentionally separating the ‘dirty dissenters’ from the rest of the country? If there is no public health evidence for overwhelming benefit, how can we justify such an enormous departure from normality?

    The ethical implications of these decisions have clearly not been fully considered, if at all. It should be noted that the National Public Health Emergency Team does not have any bioethical or legal representation, an amazing fact considering the enormous decisions that have been made on the basis of their recommendations over the course of the past twenty months.

    The Irish Council for Civil Liberties has repeatedly requested that such a representative should join NPHET, but this has been ignored. The ICCL, for what it is worth, has also stated their strong opposition to a domestic vaccine passport, stating that the system is discriminatory and has been developed without any meaningful consideration of human rights.

    And yet still we persist and tolerate further encroachment into both our and our children’s lives. 50,000 people can go to a football match in the Aviva stadium, the CEO of the HSE can drink and rub shoulders with sporting royalty indoors without a mask, yet we think it is appropriate that nine-year-old children should be masked and instructed not to attend nativity plays.

    190,000 children are currently living in poverty in Ireland, yet this is not a crisis worth addressing in the mainstream media. Instead, it is recommended to avoid playdates and sleepovers while Gary Barlow croons to thousands in the 3 Arena. It is preposterous and the antithesis of public health. It causes me great shame as a doctor that these measures are being carried out in the name of my profession.

    I am unable to convince myself that a system of vaccine certification is a reasonable or ethical idea in an essentially fully vaccinated adult population for a virus that is transmissible regardless of your vaccination status.

    Image (c) Daniele Idini.

    A Thought Experiment

    If you remain convinced that it is, I would like to propose a final thought experiment. Consider a politician or government that you dislike or fear. Consider your reaction if they were to have introduced a vaccine passport over the course of the past six months.

    Would you agree with segregation of society if Donal Trump suggested it? Would you clap wholeheartedly if Vladimir Putin encouraged marginalisation of a minority of people who have not broken any laws? Would you dismiss civil rights concerns if Bolsanaro was championing minority-blaming and hatred?

    If you would agree to all these questions, I would congratulate you on your single-minded conviction and realise that I will never convince you – as is assumed to be the case with all ‘anti-vaxxers’, a derogatory term that I despise.

    Coercion and essentially forced vaccination signifies a complete failure of scientific and public health messaging. My sympathies lie with the people who are not currently welcome to participate in society on the basis of one personal decision which has not broken any law.

    They have been stripped of their constitutional rights without seemingly without any recourse to due process. That should give anyone reason to pause and reflect. Without acknowledging it, we have become a country that has slipped, almost overnight, into an enduring state of fear and intolerance. I worry for the future and the country that my children will inhabit.

    [i] Anika Singanayagam, PhD et al, ‘Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study’, The Lancet, October 29, 2021,  https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00648-4/fulltext

    [ii] Shixin (Cindy) Shen and Vinita Dubey, ‘Addressing vaccine hesitancy: Clinical guidance for primary care physicians working with parents’, The College of Family Physicians of Canada, 2019 Mar; 65(3): 175–181. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515949/

    [iii] Ruth Waitzburg, ‘The Israeli Experience with the “Green Pass” Policy Highlights Issues to Be Considered by Policymakers in Other Countries,’ November 2021, International Journal of Environmental Research and Public Health, 18(21):11212. https://www.researchgate.net/publication/355819969_The_Israeli_Experience_with_the_Green_Pass_Policy_Highlights_Issues_to_Be_Considered_by_Policymakers_in_Other_Countries

  • Chay Bowes: HSE Perpetuating Dysfunction

    In the controversy surrounding the leaking of a confidential document by then Taoiseach Leo Varadkar last year, a key point has been missed regarding whistleblower Chay Bowes’s motivations. As an insider and former head of the VHI Homecare division Bowes gained significant insights into the operation of the Irish health system, especially the HSE. This interview probes into the obstacles he faced in attempting to deliver an effective model of community care away from overcrowded hospitals. He argues the HSE perpetuates dysfunction to the benefit of the private system.

    Innovator

    Chay Bowes first interfaced with medicine through the Irish Army Medical Corps in 1988. This stoked a passion for healthcare which led him to take up a job as a phlebotomist, where he encountered an older generation of hospitals, such as St James’s, where he worked with elderly patients in the country’s public health system.

    This experience coloured his view of the health system as it evolved to become, as he puts it, ‘more focused on financial outcome rather than patient outcome,’ and led him to set up his own company, focused on clinical work in people’s homes.

    He had found that general hospitals tended to be ‘Victorian constructs, where we put all the sick people who are susceptible to infections, so that they can mix with other sick people.’ He concluded ‘that much of what happens in the hospitals doesn’t really need to happen there, and a huge volume of those patients could be treated at home in a cheaper and safer holistic fashion.’

    After the dismantling of small, community hospitals Bowes observed ‘pressure building on the larger general hospitals to become the catchall for all kinds of diseases and complexities,’ and that this ‘contributed to the ongoing perpetual dysfunction which is today what we call the HSE.’

    Taking out a bank loan, he purchased a van to move around the nursing homes, taking blood samples. By that stage he had observed thousands of elderly arriving into hospital in taxis and ambulances for routine blood samples. There they were catching flus and colds, so he said to himself: “why don’t I develop a system to treat those people out in the community?” This was back in 2004-2005, but he was told that’s not how things are done.

    Undeterred, he decided to take an extended leave of absence from the hospital to set up a service doing these blood tests in the community, which proved very successful. The only limitation was that he was working alone.

    At that point, he expanded his service to give vaccinations in the community too and took on a few employees. The first company evolved into another, leading to a contract with the HSE in 2007 worth €14 million. That business was focused on patients with chronic obstructive pulmonary disease and chest diseases. Its rationale was to keep various types of patients in the community, who were repeatedly being admitted to hospital with lung diseases.

    ‘So, they didn’t go into a hospital, where people tend to get sicker, particularly those with lung diseases. It also helped these patients,’ he says, ‘that their social networks were intact.’ Soon there were two hundred working for the company.

    Resuscitation room bed after a trauma intervention.

    Tara Healthcare

    At that point he brought Dr. Gerry McElvaney on board, ‘a really patient focused guy,’ he says, ‘who was highly intelligent and super-committed to doing things differently.’

    Together, they pushed forward with what became Tara Healthcare. When patients were surveyed, he says, ‘ninety-eight percent preferred to remain in the community under our scheme rather than go into hospital: all the data was saying that this was a much safer.’ It was also cheaper to deliver, and the patients’ families were delighted to remain with their loved ones.’

    He argues that they had created a perfect example of how a community-based scheme could be delivered cheaper with better patient outcomes, and where staff were really happy too, as they could get out of the acute hospitals.

    However, he encountered, ‘an incredible level of scepticism around innovation in Irish healthcare.’ In one case, he says, there was a hospital in Dublin, which ‘wouldn’t send patients to this new service, because they didn’t like our medical director because he came from another hospital group. Professional rivalry is rife in Irish Medicine, sometimes to the detriment of patients.’

    HSE Logic

    Time and again he was met with the perverse HSE logic of ‘it’s doing really well, so let’s shut it down and send all these patients back into the hospital.’

    The HSE’s reaction to the Financial Crisis of 2008 was just like its dysfunctional approach to COVID-19 he argues. They closed his operation down because hospitals ‘which were in perpetual crisis wanted us to move this service into their area.’ A senior HSE figure told him directly that ‘“what you’ve done in Dublin is almost too good. Everyone’s going to want it. They’re going to want it in Galway. They’re going to want it in Limerick” So, they wouldn’t fund it because they were already funding the dysfunction.’

    Acute beds per capita in Ireland, March, 2020. Source: https://twitter.com/kevcunningham/status/1245060194356379648/photo/1

    Essentially, Bowes argues:

    The agency funds the dysfunction to a certain level of service with tens of billions of euros. And when something outside of the system comes along and demonstrates efficacy, financial viability, and good patient outcomes, that’s irrelevant because they still have to fund the dysfunction. It’s like trying to repair an airliner in mid-air – you don’t want to land because it could expose the rottenness of the system.

    So, we sent the patients back to hospital, further highlighting the dysfunction of the HSE at the time. They had to pay us a penalty for terminating the contract prematurely, which cost them more than running it for the subsequent two years.

    Working for the HSE he found innovation was met with suspicion: ‘the hospitals want to hold onto patients because without patients occupying beds, they can’t justify their budgets.’

    And because budgets are pinned to occupancy and the size of the facility, hospitals seemed slow to manage overcrowding at the cost of lesser funding.

    Fair Deal?

    He argues that we should ‘evolve to a place where we simply don’t treat people with certain uncomplicated infections in hospitals, like in Canada and Australia.’

    Now, he says, the only fast track for vulnerable patients is into a state or private nursing home, which is excessively expensive, ‘or their home is taken from them in what the government very cynically calls a Fair Deal:

    someone works all their life, pays taxes, builds a home for their family, and contributes to the state and to society. But when they get ill, go into a nursing home or require dignified care the state wants to take their home from them to pay for that care.

    Moreover, despite earning huge praise from patients, peers and when he presented the scheme to the NHS in the UK, he found the HSE ‘were always finding fault with what we were doing.’

    ‘I became used to that,’ he says ‘and very quickly realized the only thing the Irish public system does very well is perpetual dysfunction. It manages to procure massive budgets from the State, and despite this consistently overspends,’ despite ‘terrible outcomes for patients.’

    He suggests that it takes ‘a concerted effort to continually do health as badly as we do in Ireland’, a system of public health, ‘with such huge budgets for such a small population.’

    He says it is important to question why, given a very small and young population, ‘half of that population pays out of pocket expenses, approaching €2 billion, for private health insurance.’ He reckons this is ‘to protect ourselves from the dysfunction of the public system.’

    Knock, Knock

    ‘It’s a very simple problem,’ he says, ‘too many of the same actors are involved in the public and private systems.’ The analogy he uses is of two separate doorways in a clinic: the public and the private:

    You knock on the public door, and say, “Look, doc, I’ve got a terrible hip. It’s really hurting me. And he goes: “Yeah, you need a relatively simple, hip replacement, but it’s going to be probably three, three and-a-half years, because the system is overloaded.”

    But the doctor adds unless of course you’ve got health insurance. So you say, “OK, I’ll go and get health insurance.” But by this stage you are too old to avail of this. But what are you going to do now, as your hip is only going to get worse?

    You’ve been to the first door, where you met the doctor in the public system about the hip, who we’ll refer to as Dr Jim. Then you go ten feet down the corridor and knock on the door. “Who’s there? Why it’s Dr Jim again!’” And you say “Hey, Dr Jim, you just told me that you couldn’t fix my hip for three years.” and he responds: “not exactly. I can fix it if you pay me via your insurer.”

    In a country of five million people, we have almost one million people waiting for care of one sort or another in a public system, which is one of the best funded systems in the developed world.

    And, Bowes says, ‘it just so happens that the man running the show, Paul Reid, has no specific health care experience, for example. The UK’s NHS employs around 1.4 million people to serve a population of nearly 67 million. Its CEO Simon Stevens is paid €210,000 a year, while Ireland’s HSE employs around 102,000 people with a population of only 4.9 million, Reid is astoundingly paid over €426,000 a year.’

    We have hundreds of people who work for the agency on long term sick leave. The dysfunction runs into every fractional part, IT, training, resourcing, recruitment, and services. The dysfunction is almost at a cellular level. But again, we are consistently told that we can’t land the jumbo jet to fix it, because if we do that, what will happen?

    COVID-19

    When COVID-19 landed, Bowes says, ‘with the stroke of a pen, we bought up every single private bed in the State. This occurred despite people saying since the foundation of the State, “Oh, you know, you can’t publicize the private, it would never work, but it was done overnight because the will existed.’

    Health policy in Ireland, he says, reflects:

    the laissez faire attitude of a class of people who are running the medical system, advising the agency and the legal system. They of course all have health insurance. I don’t know anybody who served on the board of the VHI or any doctor working in the system who doesn’t have private healthcare. I myself have to admit that I took out private health insurance purely because I know how difficult it is to access care via the public system. It’s sad but true and I am lucky enough to be able to pay, unlike more than 50% of the most needy In our society who cannot.

    ‘Irish People’ he says are dying ‘for the lack of basic diagnostic care.

    Bowes muses on how: ‘The further up the pyramid you go around a health product in Ireland, the less you hear about the patients. And when you get to the board level, patient outcomes are in some way superfluous to the real issues, which are profit and the market.’ He argues that there ‘isn’t a single private provider in the country here’ which ‘isn’t preoccupied with profit.’

    He says:

    We’re happy to ostensibly starve a public system and propagate a private system which is absolutely predatory on the dysfunction in the public system. And in many, many cases, the people providing the care in the public system also have been or currently are providing care in the private system.

    That’s our medieval, dysfunction and immoral system. It’s actually, and I don’t use this term lightly, an apartheid system. We have a segregated, apartheid system in health care. It simply isn’t based on needs of the patients. Ok, obviously, if someone’s at death’s door, they’re going to get seen, but I’m talking about this grinding dysfunction, where both sides are nodding to each other as they pass each other in the night, knowing that it’s so wrong. It’s so wrong. There are super doctors out there, super surgeons, super nurses and staff operating in the health system. It’s definitely a case of lions being led by donkeys.

    Staffing

    Bowes muses ‘I have no problem with doctors wanting to make a decent living. You’ve got to pay people appropriately. But now we’re flooding the system with locums from overseas who are often poorly trained and have poor English and patient interaction skills .’

    And points to another ‘incredible dysfunction, which is again, state sponsored.’

    We train more doctors than any other country of our size in the world, but we export them to Australia, New Zealand and the UK. It costs the state a significant amount to train these guys, and then they can just catch a plane to Bondi Beach. Of course, we can’t force people to work here – no more that we can force a health care worker to take a vaccine – but there are ways to incentivize the system, and develop better methods of training doctors, because we still use the archaic Leaving Cert as the basis for deciding who we train as doctors.

    He also wonders:

    How is it that while we train more doctors than anyone else that we are importing more doctors and nurses than anyone else? Countries like the Philippines, India and others are being bled of their precious nursing and medical staff to come to Ireland to look after our sick. There’s something wrong, right? But in the Irish system nothing changes. No wants to take on the vested interests. No one wants to take on the big personalities in health care and medicine. The political nexus between medicine, law and politics in Ireland is so tight because of insular practices and local allegiances trumping national welfare with some of the biggest political donors and influencers being waist deep in the sector.

    He wonders ‘Who’s going to challenge the vested interests and speak out for vulnerable patients? The CEO of the HSE? Absolutely not. The past CEOs of the HSE seem to be only good at one thing, which is saying, “We’re trying…” But they walk out at the end of the end of their contracts with a big pension and usually into guess where? Yes, you guessed it, the private sector.’

    He reveals how ‘a former CEO of the agency said to my face that he was the most powerless man in the health system.’

    Image (c) Daniele Idini

    Dysfunction Funds Profit

    Bowes wonders:

    How can you operate a business with a hundred and twenty thousand employees and seem to be powerless to sack people for not delivering, or in many cases simply doing their job wrong? Where’s the accountability in that system?

    And looking back on the foundation of the HSE in 2005 he wonders:

    How can you amalgamate numerous health boards which are operating as satellites into a single “dynamic entity” and nobody loses their job? Not one manager is made redundant. Not one of them is even sanctioned.

    How can a health system pay out tens and tens of millions in malpractice claims for egregious malpractice and incompetence in both governance and clinical care? For essentially killing women who are pregnant by denying them an abortion? By condemning young women to terrible life ending illness by failing to diagnose their cancers? How can you pay out these tens and tens of millions again and again, year after year, and nobody is sanctioned for it? How does that work?

    It works because the dysfunction funds profit, and that profit is harvested by vulture funds, by private hospitals and private investors, by their legal advisors, some of whom don’t even pay taxes in this country, and who pays the price? The citizens that languish on public waiting lists accruing ill-health because they can’t pay for treatment. The man with the simple requirement for treatment, he’s invisible to the system, he is superfluous to the profit motive.

    The poor he says have no bargaining power because:

    the bargaining power is money and influence, and the people who have the influence to change the system are receiving huge salaries to manage and essentially perpetuate dysfunction. Again, the private system predates on the mismanagement of the public system. If it functioned there would be no need for a private system, right? Therefore, you have to wonder, who does the current dysfunction benefit? It’s an easy one: the private providers. But nobody who is of the machine is working against it. No one in Leinster House is saying to the CEO of the HSE: “What are you doing for your four hundred grand? We’ve got less intensive care beds per capita than Lithuania or Latvia. Two years into a pandemic, we still don’t have a dedicated COVID hospital which is just insane.

    Apparatchiks of a state system who’ve worked, like Paul Reid in state jobs are seen as a safe bet. They’re nominated in as managers, managers of dysfunction, gatekeepers for their political sponsors and marked for future cushy roles on the private side of the wall.

    Image (c) Daniele Idini.

    Perpetual Crisis

    He adds that ‘things like this mysterious and much vaunted “Cyber Attack”, which apparently “destroyed the abilities of the system” seem to be a perfect excuse to deflect from the internal failures of HSE management and external incompetence of its political masters.’

    Bowes says: ’what I know, and anyone that has worked in the system knows, is that there was and is no viable system to attack.’ The HSE have ruminated for decades on the implantation of an electronic patient record: they have spent millions evaluating, re-evaluating, procrastinating, and failing to implement a viable solution.

    Months after this “Attack”, you’re still running Windows 1998. Somebody needs to be held accountable.

    But, he says: ‘the Minister doesn’t talk to the to the HSE, the relationships between the “Three Masters” of Health are utterly flawed, the Department of Health is cumbersome and cautious, the HSE is a lumbering leviathan with no real direction other than self-preservation, and the Minister is preoccupied with surviving a potentially career ending stint in the mire of the Irish Health system.’

    Consider this, with such a huge annual Health budget and such poor outcomes for patients alongside such terrible value for money, the dysfunction and paying for it becomes central to the rational of the organisation. They actually need this dysfunction. Without the dysfunction, they’d be screwed because there would be an open accounting of what we’re doing in a system which is delivering horrendous results.

    He also criticises Stephen Donnelly’s policy of giving more money to the National Treatment Purchase Fund, which sends public patient overseas for treatment, arguing that ‘this is not the same as a really equitable national health system where everybody gets treated on the basis of need.’

    He says that people could argue that in a free-market economy if someone wants to purchase health insurance it’s up to them: ‘However, that’s different to paying almost half a million a year to a CEO to perpetuate a dysfunctional system.’

    He says the HSE is only interested in crises, ‘in things like COVID’ and saying ‘but COVID is why the system is screwed, or we’re dealing with the cyber attack, which has caused this perpetual dysfunction, which is, you know, all entirely untrue.’

    His conclusion is ‘the managers, architects and political apologists for the segregated and morally bankrupt system have done an exceptional job of screwing the Irish people out of their tax dollar and their rights to health and dignity. I’m not sure they are capable of doing anything else. It’s time to demolish and rebuild.’

    Featured Image by Gareth Curtis

  • Is General Practice a Victim of Pandemic?

    I loved working for the NHS (National Health Service), especially as it was configured in Bradford, West Yorkshire. Bradford was a health action zone, and probably still is due to its high level of social deprivation. This meant it got more funding for health and social initiatives.

    Darndale, Dublin or Moyross, Limerick would be areas with similar issues. The practices in Bradford were large and covered virtually everything except performing major surgeries and delivering babies, meaning there was an eclectic mix of health professionals, all under the same roof. This was referred to as a ‘primary care team’. A team?

    After completing my undergraduate training in Dublin I arrived under the impression that being a GP was essentially a solo effort, a bit like being a snooker player.

    In his own eyes the GP is the hero, even if in Ireland he is a failed consultant in other people’s view. Not so in the NHS, and certainly not in Bradford, where GPs were part of a multidisciplinary team approach to the provision of health services. Each person was a cog in wheel that contained management, administration, nursing, occupational therapy, physiotherapy and community pharmacy services. They even held meetings, spoke to each other civilly and advice flowed in various directions. How radical!

    On a wider scale, local practices provided many of the out-patient services traditionally provided by hospitals including cardiology, neurology, rheumatology and chronic disease management; they even carried out minor surgery and endoscopies. GPs were encouraged to upskill to become what they called ‘GPs with special interests’ or GPSI (pronounced Gypsy). All of this occurred in close proximity to their patients and in familiar surroundings. These practices were based in large urban centres, although I would imagine it would have been difficult to replicate this model in rural areas with widely dispersed populations.

    Unemployed outside a workhouse in London in 1930.

    Beveridge Report

    The NHS emerged in a society with a different history to Ireland’s. The 1942 Beveridge report highlighted that urban poverty was widespread in the U.K., as George Orwell’s account in The Road to Wigan Pier bears testament. One can get all misty-eyed about Beveridge’s recognition of the plight of the working class; the reality was a fear that workers’ poor health would impact on profits, and might turn revolutionary.

    Nevertheless, the post-War drive to correct some of these deficits lay behind the birth of the Welfare State, including the establishment of the NHS in 1948. This was strenuously resisted by the medical profession, much as the profession in Ireland, along with the Catholic Church, were resistant to Noel Browne’s Mother and Child Scheme. More latterly the mere mention of ‘Sláintecare’ induces apoplectic rage among certain members of the ‘caring’ profession.

    This may seem naïve, but I fail to see what’s wrong with a universal health service, ’free at the point of entry from the cradle to the grave’, paid for out of taxation revenue and borrowings; this is a service that encourages the utilisation of all health-related services in a country, public and private, for all citizens, based not on ability to pay, but need. But apparently this isn’t a good idea.

    I have come across many ideas that were thought not to be good ideas in my twenty-seven years of practice, but few had credible reasons for their outright rejections. Chronic disease management, i.e. diabetes, heart failure, COPD or renal failure should be undertaken by a person known to the patient – i.e. a GP – living in close proximity to where they live.

    ‘Too Busy’

    This has been the bread and butter work of GPs in the U.K. since the 1990s, but apparently in Ireland during the 2000s this wasn’t a good idea, because we were ‘too busy’. Doing what I wonder?

    Integrated services would allow GPs to order investigations directly. In Ireland at present, if, for example, a chap without health insurance injures his knee playing Sunday football and his GP thinks it could be a torn cartilage, he will have to wait up to two years to see an orthopaedic surgeon. He is then put on a waiting list for perhaps another year, until finally he has his MRI scan and discovers he has a torn cartilage.

    By that time, however, he is no longer playing football and is twenty kilos overweight, having spiralled into an unhealthy lifestyle. To add insult to injury he will receive a letter from the hospital asking if he wishes to remain on the waiting list for his knee operation, by which stage he might as well get in the queue for a knee replacement.

    Big Pharma

    Nowadays, it’s not a good idea to refuse to meet pharmaceutical reps when they call to the practice. Having trained in Bradford – where none of the practices or the training scheme’s educational events gave access to reps – I thought that it was reasonable to turn them away. We didn’t meet reps selling toilet rolls or coffee, so why meet representatives of multibillion dollar pharmaceutical corporations? Such companies spend more on advertising and marketing than research because they know how it works.

    Alas, we dopey doctors assume they are sharing their scientific data with us whilst buying us lunch, giving us pens (with names of drugs emblazoned on them), stationary, wall clocks, mugs etc. So, they do share ’their’ science, the bits of their research that shows their product in a good light, not the science or the research warts, or heart attacks, and all.

    After all, we G.P.s are trained professionals and would never be influenced by such inducements. Forget about the science demonstrating a correlation between drug prescribing and frequency of pharmaceutical rep visits.

    Cosy World

    A cosy world of Irish general practice featuring golf, rugby and tweed had been frozen in time until 2008. The GMS contract which began in 1970s paid well, but we still had our ‘privates’. In other parts of the English-speaking world ‘privates’ usually refers to one’s genitalia, but in an Irish GP setting this refers to the paying customer.

    In some practices private patients are given preferential access to appointments. Invariably, this will involve nothing more than prescribing an antibiotic for a cold. Such patients usually have their own cardiologist or several oncologists they refer to using their first names. However, from 2008 onwards when the International Monetary Fund invaded Ireland and took control of the purse strings, the government of the day unilaterally took 35% off the GMS contract payments. Then the privates became more important, but these patients were increasingly hard up too with the world’s economy in a mess.

    The next few years for me remain a blur. My recollections arrives through the haze of mental illness and stress brought on by a Celtic Tiger mortgage, business partnership shenanigans, and yo-yoing emigration-immigration, amongst other adventures.

    Image (c) Daniele Idini

    Pandemic

    Fast forward to 2020 and the unknown quantity that was the Sars-CoV2 escape from Wuhan’s virology research centre – known as the Wuhan Wet Market dose to some, depending on your trust in media, governments and power elites.

    Then the WHO advised GPs via august bodies such as the Irish College of General Practitioners to do nothing, as there were no treatments despite it being a deadly pandemic. Furthermore, we didn’t even need to see patients. We locked our doors, sat by the phone, ‘stayed safe by staying apart,’ among a litany of other trite statements.

    It was heartening to note on some well-known GP websites that some practitioners were one step ahead of WHO/HIQA/NPHET insofar as they immediately sensed a threat to ‘the privates’. Not as an unwanted symptom of a Sars-CoV2 infection, but as a result of the hatches being battened down. How could the privates access their GPs and more importantly pay them?

    The unelected and widely disrespected government with its GP-trained Taoiseach knew instinctively what to do. More accurately Leo Varadkar knew what to do. He found the answer to this most perplexing question and saved the day. Make everyone private. GMS patients ringing up resulted in a fee, privates ringing up resulted in a fee from the government.

    So the gravy train sloshed its merry way through the pandemic. An entire profession was bought, and continues to be bought by vast sums of money for examining patients that one is already being paid for, vaccinating all and sundry against influenza, Sars-CoV2-twice or is it three times, who knows, who cares, the money spigot is stuck on maximum flow.

    Money that was not available up to 2020 is now flowing like goodies from the proverbial cornucopia. This has bought compliance with ways of treating people that run counter to the codes of practice of any good doctor.

    Practices are now treating patients like lepers, creating nonsensical plastic barriers, one way passes through surgeries, discouraging unvaccinated patients, disrespecting patient autonomy, and offering a paternalism reminiscent of the Victorian era. But worst of all is a refusal to treat patients in the early stages of Sars-CoV2, regardless of how medically vulnerable they may be because of ignorance and hubris.

    This is what buying a profession produces.

    Image: Daniele Idini.

    Eau de BS

    Born and reared in a working class Dublin area with a healthy disrespect for all authority, I have always been a contrarian. That disrespect has served me well. So, when I hear people in authority asking citizens to pull together or to do deeds for the good of the nation I instinctively smell eau de BS.

    Supposedly for the good of the nation, we are creating a society that is comfortable with meaningless segregation based on vaccination status that is supported by the medical profession. We even have the prospect of hospitals taking young people off transplant lists and families being refused access to a dying loved one in a care home. Now we are witnessing a clamour for a dubiously effective pharmaceutical product to be inflicted on children as young as five.

    The medical profession has allowed one of the highest levels of trust to be stolen by greedy fools who use it to ensure people think that their products can also be trusted. The medical profession has become avaricious, self-serving, vindictive, patient-averse, opinionated and authoritarian, and is failing to foster the doctor-patient relationship.

    I fear that relationship which is the bedrock of general practice has been irrevocably damaged. What need then will there be for GPs if artificial intelligence can deliver the information in an up-to-date, rational, non-judgemental and timely fashion in the comfort of anyone’s home?

    It seems that when this older generation pass into retirement, a tech savvy generation will not want what they never really had: a genuine doctor-patient relationship.

    Featured Image: Aneurin Bevan talking to a patient at Park Hospital, Manchester, the day the NHS came into being in 1948.