The Denigration of Science in The United States
Why ousting the whistleblower Dr Rick Bright, former director of BARDA, is Bad for us All
In the early morning hours a sweaty, blue, and suffocating COVID-19 patient arrived unannounced and lay waiting outside my ER, spending precious life saving moments on the cold concrete as my team and I hurriedly donned our personal protective equipment.
In the days before COVID-19, he would have been rushed into a room and within thirty seconds had cardiac monitors placed, oxygen delivered, and two IVs coursing through his veins. But now, because of the danger he posed to everyone in my ER, and even to my family members awaiting me at home, and because we don’t yet have adequate treatments for COVID-19, he had to wait until the department was ready to see him. Sadly, he wasn’t the only sick and suffocating patient that day.
Just like everyone in America and across the world, those of us on the front lines long to be jolted like heavy turbulence out of this never ending medical and economic nightmare. But the more we learn, the more we realize that sick and dying COVID-19 patients arriving unannounced at ERs across the country will remain the new normal until a vaccination arrives, that like smallpox or polio, eliminates or drastically reduces the global prevalence of SARS-CoV-2.
There is much talk about slowly obtaining herd immunity and “immune passports” to protect our communities, but it is a false haven, as the closely related benign human coronaviruses that cause roughly one third of common colds are able to reinfect patients multiple times — despite having antibodies present. Additionally, those who had SARS in 2003, the most similar virus to this current pandemic, only maintained antibodies for an average of two years.
Even Middle Eastern Respiratory Syndrome, or MERS, a far more fatal coronavirus transferred by dromedary camels that emerged in 2012, which continues to bubble in mostly Saudi Arabia, does not convey antibodies in 100% of those infected. Studies in South Korea are showing SARS-CoV-2 antibodies produced after being infected can be protective, but we don’t know for how long, and the WHO recently released a scientific brief cautioning against relying on antibodies as protection. Ultimately, it’s unknown how our immune systems will react to SARS-CoV-2 in the coming months and years, so we need a vaccine to instruct our bodies what to do, and we need it ASAP.
Our best hope for long term immunity, and banishing this virus off the face of the earth, is a vaccination that activates not just the humoral or antibody arm of our immune system, but conveys long term immune system memory, as well as triggering cellular immune responses from the soldier like T-lymphocyte and Macrophage cells that destroy anything recognized as foreign. One of the key governmental agencies coordinating these vaccination efforts in the United States, and therefore a leading contender for all of humanity simply because of its economic might, is BARDA, or the Biomedical Advanced Research and Development Authority, a perhaps purposely obscure wing of the United States Health and Human Services Department (HHS).
BARDA is a new department in our government, only established in 2006 by the Pandemic and All Hazards Preparedness Act (PAHPA), after SARS and H5N1 influenza emerged out of Asia in the early 2000s. It is the only federal agency dedicated to the advanced development of medical products for public health emergencies intended for civilian use; think of it like a civilian DARPA (Defense Advanced Research Projects Agency).
BARDA’s main directives are the procurement and development of medical countermeasures against bioterrorism, chemical and nuclear threats, pandemic influenza and emergency diseases, as well as maintaining stockpiles of medical equipment. They direct heavy governmental investment into the most promising vaccinations, therapeutic medications, and many of the rapid diagnostic tests soon to be deployed throughout our country.
BARDA’s programs come from both the private sector, but they also serve as a developmental transition partner for the NIAID (National institute of Allergy and Infectious Disease), and the DoD (Department of Defense). Most people have heard of the NIAID, headed by the venerable Dr Anthony Fauci, who’s broad responsibility includes conducting and funding the groundwork stage 1 studies that many of these promising medications and therapeutics are built on. However, it’s up to BARDA to lead a federal task force that includes representatives from the NIAID, CDC, VA, USDA, and FDA, especially in the midst of a pandemic or emerging biomedical threat, to determine which contenders have the highest chance of efficacy, and according to recently ousted Director Dr Rick Bright, “bring them home to success”.
Bright, a self described “farm grown Kansas boy”, has been devoted to vaccinations since his days in a grad school laboratory that had ample funding for HIV research, but when asked to study influenza was told “nobody cares about it”. After much pleading, he was given a small fund to investigate a universal influenza vaccination. During his time researching the 1918 Spanish flu, named not because of origin in the Iberian peninsula, but because Spain is where it was first widely reported, Bright came across a leading hypothesis: that the deadly flu may have arisen from his home state of Kansas. Ultimately we don’t know exactly where the “Spanish Flu” originated from, but one thought kept motivating Bright; “Wouldn’t it be something if a farm grown boy from Kansas was responsible for ending influenza?” Since then, Bright has been immersed in the world of influenza vaccine research and other viruses demanding pandemic preparedness.
Brights experience is substantial, after obtaining his PHD in Immunology and Molecular Pathogenesis from Emory University, he continued his influenza research at the CDC, then worked with the global public health non profit PATH in 2008, eventually becoming the director of the Influenza division of BARDA in 2010. In 2016, he became the director general of BARDA, overseeing its large portfolio and budget. To put it simply, Dr Bright and BARDA are responsible for ratcheting up our most promising biomedical weapons against a pandemic virus, which is key to our swift response to COVID-19.
In 2019 BARDA’s annual budget was 1.27 Billion, much smaller than NIAID’s annual repository of 5.89 billion, but BARDAs responsibilities are much more precise. When looking at BARDA’s COVID-19 portfolio, which is easily found on it’s website, you can see exactly which horses they have thrown into this race, and according to an HHS spokesperson, is a strategy to “have a diverse portfolio of candidate technologies since it is unknown which technology will lead to a safe and effective vaccine.” In just the first quarter of 2020, they have funded 1.27 Billion towards COVID-19 countermeasures alone. For comparison, the Bill and Melinda Gates Foundation has committed 250million towards COVID-19 countermeasures in 2020 thus far.
Of the 1.27 billion, 917 million has gone to three vaccine research companies, each using very different methods. They include a genetically modified and culled adenovirus platform with specific SARS-CoV-2 proteins inserted, and two vaccines targeting the spike protein that gives all coronaviruses their crown-like appearance, using either mRNA or recombinant protein technologies. BARDA also maintains a stockpile of hundreds of millions of eggs peppered across an undisclosed number of poultry farms in the United States, awaiting emergency dispersal for when a candidate vaccination succeeds and heads into mass production.
BARDA has also allocated 25million towards fifteen different rapid diagnosis tests, and 324 million towards fifteen different therapeutic companies researching new medicines like convalescent plasma, cytokine messenger antibodies, and antivirals. This funding includes a company who is racing through a library of existing medicines to see which may have antiviral activity towards SARS-CoV-2, as repurposing of existing medications towards COVID-19 has a real chance of temporizing this pandemic. However, here is what all physicians on the front line have known from day one — the data behind chloroquine and hydroxychloroquine in COVID-19 was never conclusive — yet Donald Trump and his administration continued to tout it, despite its risks.
I am baffled as an ER physician that sees the destruction to human lives this virus causes daily, that in a time when we need our best and most experienced minds to direct and concentrate our most promising therapeutics, diagnostic tests, vaccinations, and funding, that Dr Rick Bright can allegedly according to his whistleblower statement, be removed for speaking the truth against the use of hydroxychloroquine. The truth is this; the data on Hydroxychloroquine and Chloroquine efficacy in COVID-19 was never convincing, its high rate of arrhythmias place it in the “one pill can kill” club if accidentally ingested by children, making it a very dangerous medication to give to anybody and have in any household. It has led the FDA to caution against its use for COVID-19 outside of any hospital.
We cannot tolerate the denigration of science in the United States any longer, which in addition to touting unsafe and unproven medications like hydroxychloroquine, includes the dangerous suggestion of ingesting UV lights and household cleaners. As an ER physician who sees toxic ingestions regularly, similar to the Arizona couple who overdosed on chloroquine containing fish-food in an attempt to protect themselves from COVID-19, people will try anything — which is precisely what happened in the 18 hours following Trump’s claim in New York city according to the cities poison control center. Even prior to this pandemic, I’ve cared for many sane but worried patients who attempted to rid their bodies of lice, scabies, or bed bugs by ingesting or anally suppositing insecticides and disinfectants. It is human nature that when scared or uncertain, people will try anything, especially as this pandemic continues.
As we approach the several month mark of COVID-19’s grip on America, the initial adrenaline of our country’s front line workers is fading, and we are left with the memory of thousands of dead at our feet. But now that some states are rightly clamoring for the economic relief and gradual reopening of the American way of life, we are bracing for even more suffering and the very plausible reality of secondary curves.
In a time when we need wind beneath our sails, when we need solid, ratified, and vetted scientific guidance in this global “2 minute drill”, we just pulled one of our starting quarterbacks, for allegedly speaking up on what every doctor I know supports.
We on the front lines will continue to stand firm, but we need our leaders to make rational decisions. We need our leaders to support science and those with proven experience, which Dr Rick Bright has, because unless there was an extremely legitimate reason to remove him, a reason in which he displayed negligence or poor performance, he is our most experienced person to be at the helm of BARDA, and should not be removed during a crucial time of this biotechnological fight. Our World depends upon it.
