Federal Doctor Says He Was Removed For Resisting Unproven Coronavirus

AI Thread Summary
The discussion centers on the intersection of medical policy and politics, particularly in the context of vaccine development during the Coronavirus crisis. A federal doctor claims he was removed from his position for advocating for scientifically vetted solutions rather than unproven treatments. Participants express concern about the implications of political interference in medical decisions, emphasizing that politicians without medical backgrounds should not dictate medical advice. The conversation also touches on the challenges of discussing these issues without veering into political territory, as well as the need for substantial funding for vaccine research. There is a consensus that the management of the health crisis has been poorly handled, leading to a call for more scientific freedom and less political influence in public health matters. The discussion highlights the complexities of balancing scientific integrity with political realities, particularly in times of crisis.
  • #51
russ_watters said:
Really? It's nice to say that in principle, but in reality that isn't anywhere close to true. Money spent on disease treatment research is not at all well correlated with scientific concerns. Why is breast cancer so much better funded than other forms of cancer? Because it kills a lot of people? No (it doesn't), because it's a convenient and attractive cause for women and people who want to sell things to women. And maybe because breasts are more attractive than colons.
I think it's perfectly fine for policy to direct priorities to different areas, but that is also not at issue with this case. Bright claims he was dismissed from his position for resisting efforts to fund research into chloroquine and hydroxychloroquine and for limiting the agency from recommending the broad use of the drugs. Typically, when government funds a particular area of research, they leave it to scientists working for the government to decide what particular projects in that area of research merit funding (i.e. merit is decided through a system of peer review run by the NIH, NSF or other agency). Similarly, political figures typically do not interfere with decisions to approve individual drugs, and instead leave these decisions to experts at the FDA (that said, the Obama administration was the first to engage in such interference). The circumstances of Bright's firing seem more akin to these situations than deciding to fund breast cancer research at a higher level than other cancers.

Minor point:
Breast cancer has the highest incidence of all cancer types in the US accounting for ~ 15% of all new cancer cases (however, it responsible for the third most deaths behind lung cancer and colorectal cancer at 7.0% of cancer deaths). The National Cancer institute spends ~17% of its budget on breast cancer research (the most of any cancer type), which is fairly commensurate with the incidence of the disease (though not the mortality as you point out). If you want a better example of where incidence and funding are out of line, leukemia represents ~3.3% of new cancer cases and 3.8% of deaths but ~8.0% of NCI funding (third behind breast and lung cancer). (This is not to criticize funding of leukemia, however, as there are scientific reasons to justify the funding).
 
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  • #52
BillTre said:
Well, it just another example of the extremely poor management of this whole mess by those who do the administrating nationally in this country, reagrdless of its consequences for the health and safety of its citizens.
I can hardly wait until they’re in charge of all of our healthcare!

How are we supposed to even consider the validity of his claim when by design we are only permitted to hear his side? You think his boss is going to disclose the reasons he was moved to another position. That’s illegal!

By the way, this guy wasn’t working on a vaccine although he has a history in that field. He’s (was) the head of procurement at BARDA!

What BARDA does.
 
  • #53
Ygggdrasil said:
I think it's perfectly fine for policy to direct priorities to different areas, but that is also not at issue with this case. Bright claims he was dismissed from his position for resisting efforts to fund research into chloroquine and hydroxychloroquine and for limiting the agency from recommending the broad use of the drugs. Typically, when government funds a particular area of research, they leave it to scientists working for the government to decide what particular projects in that area of research merit funding (i.e. merit is decided through a system of peer review run by the NIH, NSF or other agency).
So you would be interested to discover what his job actually was. At least what the law said it was...
Research and Development of Qualified Medical Countermeasures –
Section 2 of the PBS Act enacted Section 319F-1 of the PHS Act (42 U.S.C. 247d-6a), authorizing the use of a variety of streamlined procedures in awarding grants, contracts, and cooperative agreements relating to the research and development of qualified countermeasures. Reporting is required on the use of limited competition, expedited peer review, and increased simplified acquisition thresh- olds.
And a “qualified countermeasure” is:
(A)Qualified countermeasure
The term “qualified countermeasure” means a drug (as that term is defined by section 321(g)(1) of title 21), biological product (as that term is defined by section 262(i) of this title), or device (as that term is defined by section 321(h) of title 21), that the Secretary determines to be a priority (consistent with sections 182(2) and 184(a) of title 6)—
(i)
to diagnose, mitigate, prevent, or treat harm from any biological agent (including organisms that cause an infectious disease) or toxin, chemical, radiological, or nuclear agent that may cause a public health emergency affecting national security;
(ii)
to diagnose, mitigate, prevent, or treat harm from a condition that may result in adverse health consequences or death and may be caused by administering a drug, biological product, or device that is used as described in this subparagraph; or
(iii)
is a product or technology intended to enhance the use or effect of a drug, biological product, or device described in clause (i) or (ii).[/

https://www.law.cornell.edu/uscode/text/42/247d-6a

Sounds like he (Bright) thought that he was the boss. Sounds like a typical disgruntled employee trashing his boss.

[Mentor’s note: this post has been edited to remove an off-topic comment about an unrelated legal issue]
 
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  • #54
https://www.thoracic.org/covid/covid-19-guidance.pdf (April 3rd, 2020)
"For hospitalized patients with COVID‐19 who have evidence of pneumonia, we suggest hydroxychloroquine (or chloroquine) on a case‐by‐case basis. Requirements include all of the following: a) shared decision‐making in which the patient is informed about the possible benefits and potential side effects, b) collection of data in a manner that enables studies that use valid methods for causal inference and control of confounders for the purpose of interim assessment, c) the patient’s clinical condition is sufficiently severe to warrant investigational therapy, and d) there is not a shortage of drug supply."

PLease see also post #20 for possible dangers,
 
  • #55
chemisttree said:
I can hardly wait until they’re in charge of all of our healthcare!
It is important to separate the incompetence of a particular administration from the more general question of the efficacy of government. Polling suggests that Americans with government-run healthcare plans (e.g. veterans and people on medicare or medicaid) are more satisfied with the healthcare system than people with private insurance (from unions, employers or purchased on the market).

chemisttree said:
Sounds like he (Bright) thought that he was the boss. Sounds like a typical disgruntled employee trashing his boss.

Bright is certainly a disgruntled employee trashing his boss, and his comments should be taken with a grain of salt. However, he does bring up many important criticisms of how the federal government has been addressing the pandemic, and many of these criticism are consistent with information from other news reports. In particular, his criticisms reflect other reporting that the administration has consistently been ignoring warnings from scientists and other experts, and instead focused much too heavily on political concerns surrounding the upcoming election.

Ultimately, I think the administration's alleged plans to distribute millions of doses of hydroxychloroquine despite warnings of risks and no solid evidence of efficacy were wrong, and therefore see the firing of Bright as reflective of a managerial culture that overly values the opinion of the president over the opinion of experts. Reasonable people could disagree on this point, however (for example, the hydroxychloroquine plan did not go into effect and the US government officially recommends against hydroxychloroquine + azithromycin and states there is no evidence for the effectiveness of hydroxychloroqine or chloroquine, so the recommendation of scientific experts did win out in the end).
 
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  • #56
Ygggdrasil said:
It is important to separate the incompetence of a particular administration from the more general efficacy of government. Polling suggests that Americans with government-run healthcare plans (e.g. veterans and people on medicare or medicaid) are more satisfied with the healthcare system than people with private insurance (from unions, employers or purchased on the market).

I don't know a single veteran who is more happy with the medical service they get from the VA compared with the medical service my family gets from our private plan. They may be satisfied overall, because the fact that it is FREE outweighs the abysmal actual service.

The only dissatisfying feature of my family's private plan is the COST. But I wouldn't trade my family's private plan for the FREE VA plan based on numerous discussions with veterans I know who are using the plan. FREE is the only thing they like about it.
 
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  • #57
NPR published a correction four days ago: "An earlier version of this story described Richard Bright as a doctor, implying that he is a physician. He has a Ph.D. in immunology." Should the OP and/or the thread title be similarly corrected?
 
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  • #58
chemisttree said:
Sounds like he (Bright) thought that he was the boss. Sounds like a typical disgruntled employee trashing his boss.

Look.
Speaking inconvenient truth to power is, and always has been, a risky enterprise. That is inherent in any power structure. It does all "emanate from the barrel of a gun"
The question on the table is whether there has been an abuse of power. This is not a question legal authority but of moral authority
The President of the United States has the legal authority to launch a 3 megaton warhead on Pyongyang as I write this. Or Bejing.
Of course the captain can be relieved command. Of course guy who correctly evaluates projects can be terminated.
The question is on the morality of the act.
 
  • #59
hutchphd said:
Look.
Speaking inconvenient truth to power is, and always has been, a risky enterprise. That is inherent in any power structure. It does all "emanate from the barrel of a gun"

But it seems the fact here is that the PhD who was fired went beyond speaking the inconvenient truth to power - he went public with his complaint contrary to the rules of his employment.

One thing I loved about the Air Force Academy was the open door atmosphere. I could walk in and speak with anyone in the chain of command and politely voice my observations, views, and recommendations.

Airing dirty laundry in public is a much different thing than discretely speaking truth to power. It's trying to manipulate a preferred outcome by going public with one's views. Firing employees for such deliberate manipulative tactics is not usually an abuse of power, it is necessary for the efficient management of large organizations. Anything less is giving every employee permission to cause a PR hassle for the institution any time they have a burr in their saddle and can find co-conspirators in the media to give them their 15 minutes of fame.
 
  • #60
Dr. Courtney said:
But it seems the fact here is that the PhD who was fired went beyond speaking the inconvenient truth to power - he went public with his complaint contrary to the rules of his employment.

Unless I am misreading the news reports, he was not removed from his position for going public with his criticisms. He released his complains to the media only after he was removed as director of BARDA.

In a statement Wednesday that was released by his attorneys, Richard Bright specifically cited his pushback against unproven potential treatments that President Trump has repeatedly advocated for during White House briefings and on Twitter.

Bright was director of the Biomedical Advanced Research and Development Authority and a deputy assistant secretary with the Department of Health and Human Services until, he says, he was removed on Tuesday. Bright said he has been transferred to "a more limited and less impactful position" at the National Institutes of Health.
https://www.npr.org/sections/corona...for-resisting-unproven-coronavirus-treatments
 
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  • #61
Dr. Courtney said:
I don't know a single veteran who is more happy with the medical service they get from the VA compared with the medical service my family gets from our private plan. They may be satisfied overall, because the fact that it is FREE outweighs the abysmal actual service.

The only dissatisfying feature of my family's private plan is the COST. But I wouldn't trade my family's private plan for the FREE VA plan based on numerous discussions with veterans I know who are using the plan. FREE is the only thing they like about it.
While I generally agree with this post, there are many levels of veterans. I left the USAF after eight years service following several injuries on duty. Only after President Clinton intervened was I allowed to use VA medical benefits but I pay premiums and co-pays similar to Medicare. Nothing is free. No thing.

I could try to obtain service-connected free care but as I was able to graduate from uni while working in computer science, I figure to pay into the system to help veterans with more serious disabilities and utter hardship.

Medical care jitters between cruel through joking; hopefully with some happy mediums. For example, I presented for 12+ years with massive heart murmur, chest pain and bicuspid aortic valve also damaged in accidents at radar sites. My PCP refused to provide care and overrode Cardiology even after confirmatory stress EKG tests.

Forced to use a Medicare pain clinic, my anesthesiologist caught the murmur and insisted on cardiac cauterization at the local hospital. After devising a surgical treatment plan, I was able to obtain surgery 600 miles away in Palo Alto, California, VA.

Troubles, difficulties, 'accidents*' and politics beset every effort to remain alive against the apparent efforts of the VA. Even with subsidies, surviving completely depleted my retirement funds. Individual doctors and nurses might care, dragged down by the hacks and hateful failures clogging the weird system. Most VN vets agree the VA mission is to kill us.

*my ICU bed and later a chair collapsed waiting to be replaced. Wham! Dumped to floor. Incorrect blood was infused (came close to the Forum in the Sky that time!). A patient in surgical-ICU screamed en Espanol non-stop and ran around attacking sedated patients at night. An IV drip was jammed deep in my muscle tissue instead of blood vessel; then massive doses of amiodarone injected until a nursing student changed my IV for cleaning next day. Ruined my hand, blocked right eye and caused massive cardiac problems. Post-surgical exercise recovery was supervised back home by a devote "R" supporter who only spoke to same. My case was considered A+ treatment with positive outcome. Luckily I exercise like a maniac and have low BP.
 
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  • #62
Klystron said:
While I generally agree with this post, there are many levels of veterans. I left the USAF after eight years service following several injuries on duty. Only after President Clinton intervened was I allowed to use VA medical benefits but I pay premiums and co-pays similar to Medicare. Nothing is free. No thing.

I could try to obtain service-connected free care but as I was able to graduate from uni while working in computer science, I figure to pay into the system to help veterans with more serious disabilities and utter hardship.

Medical care jitters between cruel through joking; hopefully with some happy mediums. For example, I presented for 12+ years with massive heart murmur, chest pain and bicuspid aortic valve also damaged in accidents at radar sites. My PCP refused to provide care and overrode Cardiology even after confirmatory stress EKG tests.

Forced to use a Medicare pain clinic, my anesthesiologist caught the murmur and insisted on cardiac cauterization at the local hospital. After devising a surgical treatment plan, I was able to obtain surgery 600 miles away in Palo Alto, California, VA.

Troubles, difficulties, 'accidents*' and politics beset every effort to remain alive against the apparent efforts of the VA. Even with subsidies, surviving completely depleted my retirement funds. Individual doctors and nurses might care, dragged down by the hacks and hateful failures clogging the weird system. Most VN vets agree the VA mission is to kill us.

Anyone who has been part of the system knows this. When my Dad had his heart attack, the attending cardiologist couldn’t figure out why. The blockage was apparently a transient thing. He tried strong-arming a man too weak to walk to the bathroom to let him put my Dad on the operating table so they could stop his heart again and “study” how it behaved and recovered. Dr. Cardiologist was heading a study and needed participants.

I will NEVER support government provided healthcare. Too many years a military brat and I’ve seen it up close and personal.

Studies say? Live it for awhile and get back to me.
 
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  • #63
Ygggdrasil said:
Unless I am misreading the news reports, he was not removed from his position for going public with his criticisms. He released his complains to the media only after he was removed as director of BARDA.

Everything he has been procuring is unproven unless you know of a scientifically proven treatment that Bright wanted instead. All treatments are being given on a compassionate use basis and none of them are scientifically proven yet... even Remdesivir!

I wonder why Bright singled out HC + AZ? Sounds like politics to me. What was the reason for his pushback? Safety concerns? Prove that! Show me the studies and the numbers. HC has been around since the fifties. Millions of doses given. Show ONE QT elongation related death attributed to HC. There should be LOTS of data to support such a vociferous protest against it! Millions of doses already given for HC.

Show me the data.
 
  • #66
Oh, OK.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760572/

see esp. the Discussion section of above for more references

Again, being out of my main field, I didn't go through the whole article. Hopefully someone more attuned to the life sciences can do a reasonable evaluation.

Cheers,
Tom
 
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  • #68
chemisttree said:
I wonder why Bright singled out HC + AZ? Sounds like politics to me.

Internal documents from the White House show that the administration was planning a massive campaign to make hydroxychloroquine widely available (perhaps even outside of hospital settings), which contradicted recommendations from HHS to only makie it available through controlled clinical trials:
In an internal consensus statement, a medical countermeasures group within Health and Human Services recommended that chloroquine-based COVID-19 treatments should be studied only in controlled, hospital-based clinical trials, as their safety and efficacy was “not supported by data from reliable clinical trials or from non-human primates” and carried “potential risks.” The medicines—which are used to treat malaria as well as autoimmune conditions such as lupus—can have serious side effects, including heart arrhythmias.

And yet, just hours after that April 4 press conference, White House officials pushed ahead with a massive behind-the-scenes pressure campaign on the government’s top health officials to deliver huge amounts of chloroquine drugs to just about anyone who wanted them, according to documents reviewed by Vanity Fair. That night, Brett Giroir, the assistant secretary for health in the Department of Health and Human Services, sent an email with the subject line “Hydroxychloroquine” to a group including FEMA administrator Pete Gaynor, HHS assistant secretary for preparedness and response Robert Kadlec, and Navy Rear Admiral John Polowczyk, who leads a supply-chain task force at FEMA.

The email read:

WH call. Really want to flood Ny and NJ with treatment courses. Hospitals have it. Sick out patients don’t. And can’t get. So go through distribution channels as we discussed. If we have 29 million perhaps send a few million ASAP? WH wants follow up in AM.

We can get a lot more of this. Right Bob? Millions per week?

The emails indicate that the administration’s top health officials were closely involved in a frenzied effort to make unproven chloroquine treatments widely available, even though the FDA’s new emergency rule limited distribution of the drug as a COVID-19 treatment to hospitalized patients. One hour after the first email, Gaynor replied to Kadlec, Giroir, and Polowczyk, seeming to suggest that FDA commissioner Stephen Hahn was on board with expanding COVID-19 patients’ access to the drug: “Hahn asked to distribute to hospitals and the drug stores.”
https://www.vanityfair.com/news/202...ts-reveal-team-trumps-chloroquine-master-plan

Bright was not pushing back against the compassionate use of the drug; he was pushing back against plans to widely distribute the drug and make it available for use outside of hospital settings.

In the statement related to his firing, Rick Bright seemed to refer to that authorization when he wrote, “I rightly resisted efforts to provide an unproven drug on demand to the American public. I insisted that these drugs be provided only to hospitalized patients with confirmed COVID-19 while under the supervision of a physician.”

But top officials were not satisfied with the more restrictive approach and kept pushing for more widespread distribution of the drug. In an email that appears to have been addressed to Gaynor at some point after the emergency use authorization was issued, Brett Giroir argued strongly against limiting the drugs to hospitals. “NOPE. Needs to go to pharmacies as well,” he wrote. “The EUA matters not. The drug is approved [and] therefore can be prescribed as per doctor’s orders That is a FINAL ANSWER.”

In the context of these plans, it makes complete sense to Bright to push back specifically on hydroxychloroquine. Had similar recommendations been made for remdesvir, I would hope that he would have had similar push-back.
 
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  • #69
Yesterday, Dr. Bright filed a whistler blower complaint alleging:

"I was pressured to let politics and cronyism drive decisions over the opinions of the best scientists we have in government," Bright said on a call with reporters after filing his complaint. Bright said in the complaint he raised urgent concerns about shortages of critical supplies, including masks, to his superiors in the Trump administration but was met with skepticism and surprise.
...

In his whistleblower complaint, Bright says he raised concerns about US preparedness for Coronavirus starting in January but was met with "indifference which then developed into hostility" by leaders at the Department of Health and Human Services

Later, he says he pushed back on HHS's leadership when they sought to make "potentially harmful drugs" available for treating Covid-19, including hydroxychloroquine, which had been repeatedly touted by Trump as a potential cure despite a lack of robust testing.
"His efforts to prioritize science and safety over political expediency and to expose practices that posed a substantial risk to public health and safety, especially as it applied to chloroquine and hydroxychloroquine, rankled those in the Administration who wished to continue to push this false narrative," the complaint reads.
 
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