Rampant Fraud and Misconduct Reinforced COVID-19 Fear

Traditional Image of Healthcare Professionals

Many people continue to have great respect for medical researchers, doctors, and public health officials. Competence, compassion, integrity, honesty, and trustworthiness are some of the distinguishing qualities associated with traditional images of these professionals.

Many people, however, have no idea about how much fraudulent medical research gets put into widespread practice, or how this subpar research is enabled by considerable conflicts of interest.  The current extent of this fraud significantly damages the reputation of the health care industry and renders unquestioning faith in health care professionals unfounded. 

One of the best examples of the problem was the swine flu pandemic of 2009.

Swine Flu Fraud

Calling a person or thing a "fraud" means that the person or thing is an impostor, a fake,  or a pretender. A fraudulent person or thing deceives people, typically by unjustifiably presenting qualities or circumstances that do not actually exist. The 2009 swine flu pandemic had every appearance of this.

For evidence, consider the two references that follow.

1. Cohen, D., & Carter, P. (2010). WHO and the Pandemic Flu "Conspiracies". BMJ: British Medical Journal (Online). 

Here, the authors point out:

Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. These conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A/H1N1 pandemic as “conspiracy theories.” 

... WHO’s handling of the pandemic has led to an unprecedented number of reviews and inquiries by organisations including the Council of Europe, European Parliament, and WHO itself, following allegations of industry influence.

2. Paul Flynn (rapporteur) (2010). The Handling of the H1N1 Pandemic: More Transparency Needed, Parliamentary Assembly of the Council of Europe: Social, Health and Family Affairs Committee. 

The word, transparency, in the above title, means visibility or accessibility of readily understood information, free from pretense or deceit, especially concerning business practices.

Failing to honor any sense of transparency, on June 11 2009, WHO declared an H1N1 influenza pandemic (i.e., swine flu) that kicked off an immediate, extensive international vaccination campaign, despite evidence that the H1N1 virus overall presented relatively mild clinical symptoms. While WHO insisted on maintaining the pandemic at level 6 against all evidence, many stakeholders and the public at large increasingly doubted its credibility.

The way WHO interpreted scientific and empirical evidence for an illness that still remained moderately severe one year after its outbreak came under serious questioning. Did WHO overstate the threat posed by the virus, ignoring practical evidence that the pandemic seemed to be of moderate severity from its very start? Did WHO fail to consider that, in many countries, no clear distinction had been made between patients dying with swine flu and patients dying from swine flu? These questions and more needed answers, which greater transparency on the part of WHO would have provided. 

There was also the issue of changed definitions. Even though WHO denied that any definition had been changed, the undeniable fact is that WHO did, in fact, change the definition of a pandemic by lowering the threshold for its declaration, thereby enabling the launch of the swine flu pandemic on June 11, 2009. WHO, thus, was untruthful in its claim of not changing definitions. WHO refused to face the truth of its own actions, which is the same as telling a lie — the hallmark of a fraud.

In general, a clear pattern of misrepresentation appeared to develop within a cooperative network that included the WHO, the pharmaceutical industry, regulatory agencies, news media, and health practitioners themselves.

Incredibly, 2009 was not the first time that health officials and their associates seemingly staged a swine flu pandemic. The year 1976 saw a similar unfolding of events, as explained in the CBS investigative news program, 60 Minutes, aired Sunday, November 4, 1979 [see video below].

The Magnitude of Corruption is Great and Seemingly Unrestrained

The problem I am presenting here has been known about for quite some time. I am not conveying a conspiracy theory or offering a wild, unsupported opinion. I am telling the truth as it is supported by qualified experts and real-world facts.

The most reputable sources of medical information have acknowledged the problem. Various oversight bodies supposedly have taken steps to address the problem. But my research indicates that the problem continues. The effects of the problem, moreover, have only gotten worse, as evidenced by the highly questionable declaration of the 2019 coronavirus (SARS-CoV-2) pandemic. 

Popular news media will not reveal this information. My evidence, on the other hand, comes from professional literature that includes the following titles:

3. New England Journal of Medicine  

4. PLOS Medicine (Public Library of Science)

5. Publication Bias in Meta-Analysis – Prevention, Assessment and Adjustments (Book)

6. International Journal of Surgery

7. Indian Journal of Medicine 

8. BMJ (British Medical Journal)

9. Perspectives in Clinical Research

10. Journal of Education and Ethics in Dentistry

11. The Lancet 

12. JAMA (Journal of the American Medical Association)

13. International Journal for Educational Integrity

14. Voices in Bioethics 

Below, I cite each of the above sources in detail, along with key quotes [italicized]. I have also placed links to copies of the sources in my Dropbox [accessed by clicking underlined, blue-colored text].

3. K. A. Schulman, D. M. Seils, J. W. Timbie, J. Sugarman, L. A. Dame, K. P. Weinfurt,   D. B. Mark, & M. Robert (2002). A National Survey of Provisions in Clinical-trial Agreements between Medical Schools and Industry Sponsors. New England Journal of Medicine, 347(17) 1335-1341.

Academic institutions routinely engage in research that fails to adhere to ICMJE (International Committee of Medical Journal Editors) guidelines for trial design, access to data, and publication rights. Our findings suggest that a reevaluation of the process of contracting for clinical research is urgently needed.

4. John P. A. Ioannidis (2005). Why Most Published Research Findings Are False. PLOS Medicine, 2(8): e124. https://doi.org/10.1371/journal.pmed.0020124

 ... even in the most stringent research designs, bias seems to be a major problem.

For example, there is strong evidence that selective outcome reporting, with manipulation of the outcomes and analyses reported, is a common problem even for randomized trails.

Conflicts of interest are very common in biomedical research, and typically they are inadequately and sparsely reported.

Prestigious investigators may suppress via the peer review process the appearance and dissemination of findings that refute their findings, thus condemning their field to perpetuate false dogma.

While the main claim in the title of Ioannidis' 2005 paper met with vigorous criticism, Ioannidis answered his critics with detailed counter arguments. I would add that important points from his paper (noted above) have applied more strongly than ever to the COVID-19 crisis. I would further suggest to his critics that, if not outright false, then most research findings pertaining to COVID-19 in particular have been of low scientific quality.

5. H. R. Rothstein, A. J. Sutton and M. Borenstein (Editors) (2005). Chapter 1: Publication Bias in Meta-Analysis, Publication Bias in Meta-Analysis—Prevention, Assessment and Adjustments, John Wiley & Sons, Ltd.

Although publication bias has likely been around for as long as research has been conducted and reported, it has come to prominence in recent years largely with the introduction and widespread adoption of the use of systematic review and meta-analytic methods to summarize research.

... evidence that publication bias has had an impact on meta-analyses has been firmly established by several lines of research. 

... there are numerous potential information suppression mechanisms that go well beyond the simple definition given above, including: language bias (selective inclusion of studies published in English); availability bias (selective inclusion of studies that are easily accessible to the researcher); cost bias (selective inclusion of studies that are available free or at low cost); familiarity bias (selective inclusion of studies only from one’s own discipline), and outcome bias (selective reporting by the author of a primary study of some outcomes but not others, depending on the direction and statistical significance of the results). 

... it is safe to say that publication bias will remain a problem in many disciplines for the foreseeable future.

In cases where publication bias analyses suggest that severe bias may exist, this can serve as a warning to researchers and practitioners to regard the initial results cautiously, and to avoid potentially serious mistakes such as recommending an intervention or policy that could be useless or even harmful. 

The editors of this book present an optimistic view that the problems they feature are not so widespread as to cause great worry, but, given my reading of expert opinions over the past two or more years (2019 - 2022), widespread bias appears obvious in research surrounding COVID-19, especially in regard to vaccine development and promotion. Accordingly, the final quote (above) applies to an extreme degree for the current era.

6. Usman Jaffer and Alan E. P. Cameron (2006). Deceit and Fraud in Medical Research, International Journal of Surgery, 4(2):122-126. 

Deceit and fraud in medical research is a serious problem for the credibility of published literature. Although estimating its prevalence is difficult, reported incidences are alarming. The spectrum of the problem ranges from what may seem as rather innocuous gift authorship to wholesale fabrication of data.

Potential factors which may have promoted fraud and deceit include financial gain, personal fame, the competitive scientific environment and scientific hubris. Fraud and deceit are difficult to detect and are generally brought to the fore by whistleblowers. 

This evidence fairly convincingly debunks the idea that fraud or deceit in medical research is a relatively minor and isolated activity. It is indeed widespread.

Jaffer and Cameron echo precisely what censored experts have been trying to convey about the COVID-19 crisis.

Little has changed since 2006. If anything, the situation has gotten worse.

7. Subrata Chattopadhyay (2013). Corruption in Healthcare and Medicine, Indian Journal of Medical Ethics (IJME), 10(3):153-159.

Undermining the moral vision—and nobility—of the art of healing, corruption is arguably the most serious ethical crisis in medicine today. 

Corruption is pervasive across cultures and endemic in countries, be they small or large, poor or rich, capitalist or socialist or in the North or South.

As is obvious, researchers were still pointing out the problem, seven years after Jaffer and Cameron.

8-a. Peter Doshi (2013). Influenza: Marketing Vaccine by Marketing Disease, BMJ (British Medical Journal), 346:f3037.

Doshi is an editor at BMJ.  The following are his words:

Closer examination of influenza vaccine policies shows that although proponents employ the rhetoric of science, the studies underlying the policy are often of low quality, and do not substantiate officials’ claims. The vaccine might be less beneficial and less safe than has been claimed, and the threat of influenza appears overstated.

Healthy user bias threatens to render the observational studies, on which officials’ scientific case rests, not credible.

If the observational studies cannot be trusted, what evidence is there that influenza vaccines reduce deaths of older people—the reason the policy was originally created? Virtually none.

This means that influenza vaccines are approved for use in older people despite any clinical trials demonstrating a reduction in serious outcomes. Approval is instead tied to a demonstrated ability of the vaccine to induce antibody production, without any evidence that those antibodies translate into reductions in illness.

Drug companies have long known that to sell some products, you would have to first sell people on the disease. 

Marketing influenza vaccines thus involves marketing influenza as a threat of great proportions. 

 ... recorded deaths from influenza declined sharply over the middle of the 20th century, at least in the United States, all before the great expansion of vaccination campaigns in the 2000s, and despite three so-called “pandemics” (1957, 1968, 2009).

... most “flu” appears to have nothing to do with influenza. 

All influenza is “flu,” but only one in six “flus” might be influenza. It’s no wonder so many people feel that “flu shots” don’t work; for most flus, they can’t.

8-b. Richard Smith (2021). Time to Assume that Health Research is Fraudulent Until Proven Otherwise?, The BMJ Opinion.

Richard Smith is a former editor of BMJ (British Medical Journal). Eight years after Peter Doshi (the other editor of BMJ quoted above) made his comments (in 2013), Smith had this to say (in 2021):

We have long known that peer review is ineffective at detecting fraud, especially if the reviewers start, as most have until now, by assuming that the research is honestly reported.

We have now reached a point where those doing systematic reviews must start by assuming that a study is fraudulent until they can have some evidence to the contrary.

Researchers progress by publishing research, and because the publication system is built on trust and peer review, is not designed to detect fraud -- it is easy to publish fraudulent research. 

Regulators often lack the legal standing and the resources to respond to what is clearly extensive fraud, recognising that proving a study to be fraudulent (as opposed to suspecting it of being fraudulent) is a skilled, complex, and time-consuming process.

In his analysis, Smith makes reference to the following BMJ article from six years earlier:

8-c. Ian Roberts, Katharine Ker, Phil Edwards, Deirdre Beecher, Daniela Manno & Emma Sydenham (2015). The Knowledge System Underpinning Healthcare is Not Fit for Purpose and Must Change, The BMJ 350:h2463.

The literature is awash with low quality, underpowered, single centre trials and the trend is upwards. As Altman recognised over 20 years ago “much poor research arises because researchers feel compelled for career reasons to carry out research that they are ill equipped to perform, and nobody stops them.

Most journal editors and systematic reviewers take trial reports at face value with little or no effort to confirm whether a particular trial even took place.

Meta-analyses with sparse data can miss modest but clinically important treatment effects, and the potential for random error to result in false positive conclusions is considerable. Repeated statistical testing as trials accumulate increases this potential. Statistical analyses that account for multiple testing show that as many as two thirds of apparently conclusive findings in Cochrane reviews could be falsely positive.

One of the most important contributions of The Cochrane Collaboration was to show the world that the knowledge base for healthcare decision making is inadequate. Thousands of articles have been published about publication bias. However, the challenge is not to describe the flaws in the current system but to create a better one, where decisions about healthcare are informed by valid and reliable evidence.

All authors of this analysis were listed as members of the Cochrane Injuries Group, described as one of the 53 Cochrane Review Groups that are part of Cochrane, an international not-for-profit and independent organization, dedicated to preparing up-to-date, accurate information about the effects of healthcare worldwide.

9. Ashwaria Gupta (2013). Fraud and Misconduct in Clinical Research: A Concern, Perspectives in Clinical Research, 4(2):144-147.

Fraud and misconduct in clinical research are widespread. 

Good clinical practice is a guideline adopted internationally as standard operating procedure for conduct of clinical research. Despite these guidelines being available, unavailability of internationally harmonized framework for managing research fraud and misconduct makes clinical research a highly vulnerable area to commit fraud. 

The most common types of misconduct in clinical research are: Failure to follow an investigational plan; inadequate and inaccurate records; inadequate drug accountability; inadequate completion of informed consent forms; failure to report adverse drug reactions; failure to obtain and/or document subject consent; failure to notify an Institutional Review Board (IRB)/Ethics Committee (EC) of changes/progress reports; failure to obtain or document IRB approval. 

10. T. Padmapriya (2014). Ethical Misconduct and Corruption in Medical Research, Journal of Education and Ethics in Dentistry, 4(2):74-6.   

The cases of fraud and misconduct prevail at an alarmingly increasing rate in the medical research, the cause of which seem multi-factorial like procuring sponsorship from pharmaceutical companies, personal greed of some scientific professionals, etc.

An underlying desire to be successful in science and fear of failure also cause researchers to resort to misconduct. Pharmaceutical companies securing grants and finances for drug research, professional careerism are also reasons causing the research misconduct.

Research and development of drugs are primarily governed by pharmaceutical industries that sponsor them. Hence there is a high risk of bias that can be involved in clinical trials of drugs sponsored by them, so that newer such drugs can be approved and marketed for their benefit.

The random clinical trial despite being the best available method to check the efficacy and safety of new drugs has many flaws inherently prevalent in the design of its methodologies.

There have been instances of adverse reactions kept undeclared in reports for approval and marketing of some drugs which can actually be more harmful than of use.

11. Richard Horton (2015). Offline: What is Medicine's 5 Sigma?, The Lancet, 385(9976):1380. 

The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue.

Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness. 

Can bad scientific practices be fixed? Part of the problem is that no-one is incentivised to be right.

The bad news is that nobody is ready to take the first step to clean up the system.

Richard Horton is editor-in-chief of The Lancet, yet another prestigious journal editor conveying the troubling truth that too many people do not know about, especially people empowered to make life-changing policy decisions.

12-a. R. Dal-Ré, A. S. Kesselheim, F.T. Bourgeois (2020). Increasing Access to FDA Inspection Reports on Irregularities and Misconduct in Clinical Trials. JAMA (Journal of the American Medical Association), 323(19):1903–1904. 

Despite their importance, FDA inspection reports are not proactively disclosed. 

... most reports are extensively redacted to remove information on the investigational product and details of the clinical trial, making it difficult to link the FDA inspections to specific drugs or published trial reports. As a result, the frequency with which research irregularities are uncovered is not known.

FDA trial inspection reports have been largely hidden from public view, but access to information on the integrity and quality of clinical trials that underpin a product’s assessment is critical, particularly when irregularities or misconductare identified. Public availability of these reports is required to meet current standards for clinical trial transparency and uphold the integrity of the scientific evidence base.

The authors of this article make reference to the following, more extensive article, published in JAMA, five years earlier (2015), which indicates the persistence of the problem into the present day:

12-b. Charles Seife (2015). Research Misconduct Identified by the US Food and Drug Administration: Out of Sight, Out of Mind, Out of the Peer-Reviewed Literature, JAMA Internal Medicine, 175(4):567–577.

This investigation has found numerous studies for which the FDA determined there was significant evidence of fraudulent or otherwise problematic data. Such issues raise questions about the integrity of a clinical trial, and mention of these problems is missing from the relevant peer reviewed literature.

The FDA does not typically notify journals when a site participating in a published clinical trial receives an OAI [Official Action Indicated] inspection, nor does it generally make any announcement intended to alert the public about the research misconduct that it finds. The documents the agency discloses tend to be heavily redacted. As a result, it is usually very difficult, or even impossible, to determine which published clinical trials are implicated by the FDA’s allegations of research misconduct.

An FDA inspection classified as OAI (Official Action Indicated) is the most severe, reserved for cases where the inspection uncovered objectionable conditions or practices poor enough to warrant regulatory action.

13. S. D. Sivasubramaniam, M. Cosentino, L. Ribeiro, & F. Marino (2021). Unethical Practices Within Medical Research and Publication – An Exploratory Study, International Journal for Educational Integrity, 17(7).      

Despite the measures taken by several research councils, unethical research, publishing and/or reviewing behaviours still take place. 

Some of these practices are mainly influenced either by the undue institutional expectations of research esteem or by changes in the journal review process. 

... the number of misconduct and/or QRP’s [Questionable Research Practices] are on the rise. 

14.  Frideriki Poutoglidou, Marios Stavrakas, Nikolaos Tsetsos, Alexandros Poutoglidis, Aikaterini Tsentemeidou, Georgios Fyrmpas, & Petros D. Karkos (2022). Fraud and Deceit in Medical Research: Insights and Current Perspectives, Voices in Bioethics, 8.    

The number of scientific articles published per year has been steadily increasing; so have the instances of misconduct in medical research. 

The growing number of scientific articles published per year has practically overwhelmed the peer-review system. Manuscript submissions are often reviewed superficially or assigned to inexperienced reviewers; therefore, misconduct cases may go unnoticed.

Scientists often manipulate their data to fit their initial hypothesis or change their hypothesis to fit their results, leading to outcome-reporting bias.

Researchers with financial ties to a pharmaceutical company funding their research are more likely to report results that favor the sponsor, which eventually undermines the integrity of research.

Common forms of fabrication include concealing negative results, changing the results to fit the initial hypothesis, or selective reporting of the outcomes. Falsification is the manipulation of experimental data that leads to inaccurate presentation of the research results. Falsified data includes deliberately manipulating images, omitting, or adding data points, and removing outliers in a dataset for the sake of manipulating the outcome. 

Falsification and fabrication are dangerous to the public as they can result in people giving and receiving incorrect medical advice. Relying on falsified data can lead to death or injury or lead patients to take a drug, treatment, or use a medical device that is less effective than perceived. Thus, some members of the scientific community support the criminalization of this type of misconduct.

Fraud in medical research damages science by creating data that other researchers will be urged to follow or reproduce that wastes time, effort, and funds. ...  Meanwhile, fraud in medical trials may lead to the release of ineffective or unsafe drugs or processes that could potentially harm individuals.

Despite the increasing efforts of regulatory organizations, scientific misconduct remains a major issue.

... the pressures from the pharmaceutical industry and academic competition pose significant threats to the trustworthiness of science.

COVID-19 Was the High Point of Decades-Long Corruption

Given what professional medical literature of the past twenty or more years has documented (as demonstrated above), current leaders were acting unreasonably and irresponsibly to dismiss what highly qualified (yet vilified) experts repeatedly tried to convey about the level of fraud encompassing COVID-19. 

In 2012, Nurit Kalderon, a Ph.D. attempted doing research and development using grants from the U. S. National Institutes of Health (NIH), but eventually compiled an extensive report of her alleged experience of fraud at NIH:

15. Nurit Kalderon, Ph.D. (2012). Whistleblowing, Misconduct, Fraud and Corruption at the NIH.

My objective here is to expose and bring into the public court a specific group of corrupt NIH grant dispensing administrators that operates within the Grant Management Branch (GMB) at the National Institute of Neurological Disorders and Stroke (NINDS). Instead of advancing the NIH mission, these administrators divert the NIH grant funds to support personal projects unauthorized by law.

In 2022, over 17,000 physicians and scientists worldwide expressed similar concerns, particularly in reference to the COVID-19 crisis:

16. International Alliance of Physicians and Medical Scientists (2022).

We, the physicians and medical scientists of the world, united through our loyalty to the Hippocratic Oath, recognize that the disastrous COVID-19 public health policies imposed on doctors and our patients are the culmination of a corrupt medical alliance of pharmaceutical, insurance, and healthcare institutions, along with the financial trusts which control them. They have infiltrated our medical system at every level and are protected and supported by a parallel alliance of big tech, media, academics and government agencies who profited from this orchestrated catastrophe.

Could an Entire Field of Medicine be Fraudulent?

Given what Doshi (Reference 8-a) has reported about vaccines, a rational person would be wise to consider the history of vaccines. 

A summary of this history is in the following document:

17. Let the EVIDENCE speak: Did Vaccines Save Us? (2022).

 Two charts from this document are as follows:

As the above chart [Figure 1] illustrates, from 1900 to 1963, the number of deaths from measles in the United States decreased astronomically, before a measles vaccine was ever introduced. The question one has to ask, then, is: 

Was the continuing, small decrease in measles deaths after 1963 caused by vaccination, or was the continuing decrease in measles deaths a natural progression linked to further advances in life quality?

This chart [Figure 2 above] shows that deaths from whooping cough in England and Wales decreased astronomically, from 1838 to the 1950s, again before widespread use of a vaccine ever took hold.

Other diseases followed similar trends. Why do more people not know about this? How has this information been kept out of common view? The fact that it has raises suspicions. 

Reports of widespread fraud in medical research have accumulated from too many different directions to be considered an unfounded conspiracy theory. And too many people have raised questions about the COVID-19 vaccines, in particular, for leaders to ignore their messages.

Something is not right, and it started to go wrong long before COVID-19. 

2019 seems to have been a pinnacle year that marked such severe divergence from good reasoning that people who question the logic (ill logic?) of that era have increased dramatically. Clear divisions have occurred between people who really know what was going on and people in power who have no clue, because either they are held captive by degraded standards, or they are complicit in cultivating degraded standards.

END

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