Canadian public health officials are reeling following the publication of an investigation in the BMJ criticising Canada’s response to the Covid pandemic. While the report cites some positives, they are eclipsed by the criticisms. Positives include “the involvement of women in decision making”. Negatives include the fact that an “overall impression of adequacy masks important inequalities by region, setting and demography”. Damning indeed. The report cites the lack of “an independent, federal inquiry” which has allowed “others to step into the frame”. Is this a critique of Canada’s Public Health response or a thinly-veiled attack on what the authors refer to as “the so-called National Citizens’ Inquiry?”
The report, published this week, is entitled ‘The World Expected More of Canada‘. It notes that “Canada is among the healthiest and most diverse nations in the world”, that multiculturalism is “protected in national law” and that “amongst a population of 40 million people about a quarter are foreign-born”.
Many will remember Canada chiefly for its totalitarian response to Covid, the fightback from truckers and the state’s attempts to suppress this ‘rebellion’ through the closure of bank accounts. The Trudeau administration no doubt wants to be remembered for competently handling the situation with tough but difficult decisions being taken. This is how many people who wear dark blue suits and white shirts like to see themselves.
The BMJ report suggests that, beneath the veneer of competence, there was a shambolic approach which exacerbated existing health inequalities. The report claims that the failures hit immigrant and indigenous populations particularly badly and that “what saved Canada was a largely willing and conforming populace that withstood stringent public health measures and achieved among the world’s highest levels of vaccination coverage”. As a statistician, I was pleased to note a reference to problems to do with the attribution of deaths “complicated by definitions of death ‘with’ versus death ‘from’ COVID-19 across time and jurisdiction”. I covered this in a talk I gave at a rally in Hyde Park back in July 2020.
Reporting on the article, Canada’s National Post may have hit the nail on the head when it quotes from the report:
According to the BMJ editorial the National Citizens Inquiry (a citizen-led inquiry originally launched by former Reform Party leader Preston Manning) “appears fuelled by vaccine safety misinformation and ideological concerns” about stringent Covid measures. The BMJ goes on to say it “is far from the full, national and public inquiry led by independent experts that Canada’s pandemic performance deserves”.
Is the BMJ article a genuine critique of the Canadian authorities or an attempt to swing the pendulum back towards the official narrative, namely, that Covid was a highly deadly disease which was only fought off through exceptional measures, heroic sacrifices and the work of experts?
Comments on the National Post article seem mostly critical of the Canadian Government and the public health response and suggest that anyone in the ‘official narrative’ camp should have cause for concern:
“Our government sucks. Big league.”
“The Convoy demonstrated that the Federal Government was not following science, but was more interested in autocracy and bullying tactics that saw civil liberties suspended, even though science did not warrant such.”
“The unvaccinated deserve a huge apology from everyone.”
While the idea that ‘citizens’ might have their say may have ruffled a few international experts’ feathers, we clearly do need open and robust debate on these issues. So, how is ‘The Science’ doing?
On a separate front, the Retraction Watch website now lists 346 scientific papers about Covid that have been withdrawn from publication. These range from ‘5G Technology and induction of coronavirus in skin cells’ (first published July 16th 2020, retracted July 24th 2020) to ‘Willingness to Accept COVID-19 Vaccine and Associated Factors Among Adult Household Members in Dire Dawa City Administration, East Ethiopia’ (number 346, published on November 1st 2022 retracted on February 8th 2023). Just think how much fun we could have had if they were still available to read.
It is pretty clear that a significant amount of what might have been considered as ‘The Science’ has turned out to be junk. Retractions work in a variety of ways, the most concerning being those which are the result of concerted campaigns to get something removed by nit-picking or minor ‘administrative’ criticisms. Others may be genuine errors; some are removed because they are duplicates.
There is clearly an attempt to ‘manage’ the science and we need journals such as the BMJ to navigate these challenges successfully and independently. These challenges are clearly very serious. In November 2022, in one of the last acts of outgoing BMJ Editor Fiona Godlee, the BMJ “urged” Facebook to “act over incompetent ‘fact check’ of BMJ investigation”. Having met a fact checker and worked with the BMJ, I’d say the BMJ’s integrity factor is somewhat higher than the ‘fact checkers’.
As well as publishing journals, the BMJ runs events. One of these is the International Forum on Quality and Safety in Healthcare. A joint venture with the Institute for Healthcare Improvement, the Forum has run in Europe for many years and launched events in Asia prior to the pandemic. I have followed the trajectory of this event over the past few years and was pleased that the June 2022 event went ahead in Gothenburg Sweden. For many, a highlight was no doubt a Northern Lights disco attended by healthcare professionals from across the world. This large scale conference must have taken some guts and planning from the organisers at that still Covid-jittery time.
Events like these provide an important means of practical international exchange outside of the environs of the World Health Organisation (WHO) and similar bodies. Its list of speakers provides an indication of the geographical spread of international experts. Alongside speakers from Europe and the USA, the last pre-pandemic Asian event (held in September 2019) had speakers from Australia, Hong Kong, Japan, Malaysia, Singapore Thailand and Taiwan. There was a distinct lack of representation from mainland China. While it may not have helped that the event was held in Taipei, my understanding is that China was not seen as a centre of excellence in healthcare prior to the pandemic. Sixty-one of the 346 retracted Covid articles were Chinese (based on the authors affiliations); none were from the main BMJ journal.
The BMJ was one of many publishers and organisations to provide free access to Covid-related materials during the pandemic. Others included the Financial Times and the Royal Society of Medicine (RSM). This was important. The work of these outlets forms part of an information eco-structure which should be independent of bodies such as the World Health Organisation, which seems worryingly set on world domination. When the RSM hosted a debate on the WHO’s pandemic treaty, I was able to ask: “Can we trust the WHO?” The convenor responded by saying, “Good question.”
So, what do we make of the BMJ’s call for an ‘expert’ inquiry in Canada? Last year, I took part in three of four Covid ‘Evidence Sessions’ run by the Royal Statistical Society. The overwhelming conclusion seemed to be that, while lessons can be learned, most experts had done their particular job to the best of their ability at the time. None questioned the overall picture. A highlight was ‘Hancock’s half hour’, when the former Health Secretary appeared and presented his case. He took two questions at the end and was then chased down the street by his main interlocutor Dr. Heiko Khoo who’d asked him about the veracity of Ferguson’s half a million deaths projection (Khoo is an academic, not a medical professional). The former Health Secretary cockily answered “we locked down”. Official narrative confirmed. At the final session I was able to present my ‘alternative hypothesis’ that the response to Covid “did more harm than good” (or put simply, there was a bit of an over-reaction). In that respect my own COVID-19 inquiry had reached its central conclusion swiftly and with little expense. The more difficult questions are: why did it happen and how do we prevent the next over-reaction?
Nigel Jacklin is a statistician and market researcher. His company, Accord.me.uk, runs the national Medical Media Surveys whose clients include many medical publishers including BMJ.