Wordsmith-ing and rhetoric in scientific literature
“Impact of population mixing between vaccinated and unvaccinated subpopulations on infectious diseasedynamics: implications for SARS-CoV-2 transmission” Fisman etal CMAJ publication
Communication is the complex set of tools we use to convey a whole host of information and reciprocally receive to understand information ourselves. Effective communication requires responsible and careful use of appropriate language, words, symbols and non-verbal expressions. For the purposes of this article, I will focus on the use of language and symbols only as a means of communicating meaning as derived from this dataset publication. Effectively communicating also requires a genuine understanding of the power of words and their associations together. Perception of what is truthful and factual is heavily derived from language as meaning purveyor. And, as such, it highlights the responsibility each of us has to understanding the quality of information we are receiving and disseminating and its impact on others. Most often this process inspires significant inquiry. Naturally, a series of questions arise in critical thinkers: who wrote or said this, what affiliations or conflicts do they have? What is the goal or end points of this information? What is the quality of this information? How does this fit with previous knowledge? Is there any perceived bias in the information and or the language/rhetoric selected? If so, is anyone harmed by the information/statements? Basically, in order to most fully understand the information presented to you, an essential requirement is to be aware of and appreciate the who, what, when, where, why and how of each element of the information puzzle. My goal is to critically analyze a recent study publication put out by the CMAJ entitled “Impact of population mixing between vaccinated and unvaccinated subpopulations on infectious disease dynamics: implications for SARS-CoV-2 transmission” from a communication/language and meaning perspective. Public independent rigorous appraisal for quality of the study methods and data has begun. Dr. Bridle, the OCLA, Dr. Jessica Rose, Dr. Denis Rancourt and others have put out their critical assessments of this piece. I fully endorse their extremely concerning sentiments and echo these independent experts’ demand for retraction of this publication. My perspective inevitably builds upon others’ analyses, but will address a more critical appraisal of the type and quality of communication and language/rhetoric used in their study write up as this can and does directly influence the conclusions the public draws when receiving this new “peer reviewed data”. If we wish to be responsible global citizens, we are then required to attempt to most fully understand the information presented before accepting the presented conclusions. Switching the lens through which we explore to take a closer and more comprehensive look from multiple perspectives is imperative then.
Titles of scientific research publications and news media headlines alike carry increasingly important roles, given that the majority of people, roughly 6/10, read only this little bit of information and use it in a broad generalized understanding of complex problems. We have all done it, but seemingly we have culminated at a point now that most people “do not invest additional time into following the news more in depth” and that this has become the acceptable standard for arriving at conclusions. We, by and large, do not seek a deeper understanding of information, its quality, structure, contents, function, or its overall conclusions and meaning in the complex interconnections of social living. Our social fabrics all around the world have been altered and tangled with the onset of the SARS-CoV-2 pandemic and response. As such, we must search deeper for meaning and truth as titles can be deceiving.
When reading the title of this study, “Impact of population mixing between vaccinated and unvaccinated subpopulations on infectious disease dynamics: implications for SARS-CoV-2 transmission” the language choice is important to closely examine. Fisman etal. start off by immediately and categorically painting all unvaccinated people into one team and all vaccinated people into another. Remember, this is a model or simulation and not a study that involved a real group of diverse human beings. Through these word pairings, the authors create and perpetuate division between these two groups of human beings in a widespread generalization. An “us vs them” messaging is disseminated that is congruent with political messaging over the past year. Logical fallacies can be manifested from here, and many people will likely believe that all unvaccinated people pose the same increased risk to all vaccinated people. It is dangerous as it can lead many people to a belief that the author’s conclusions are factual rather than based in assumptions as they are. The space that exists between an author’s conclusions and public perception of meaning is an important one and can function as a place of scrutiny or ignorance depending on the reader. Their statement continues with a clear choice of language that not only implicates unvaccinated people as “others” but also incites ill will in this same group of people by the vaccinated due to their study’s constructed findings, which Dr. Jessica Rose, Dr. Byram Bridle and Dr. Denis Rancourt outline explicitly. Fisman et al’s use of the term “population mixing” is concerning for suggestions that this is somehow dangerous or wrong to be doing as human beings. Social psychology clearly outlines the inextricable link between the human need for maintaining social bond within a group and decision making. Inherent in their suggestion is impressions of superiority, inferiority, discrimination and the potential ‘need’ for separation or segregation. By what we know regarding headlines and people’s overall interest in looking deeper into the information for a more comprehensive understanding, we can see how challenging this title becomes as a meaning purveyor within the public realm. We need to also realize just how quickly this messaging was spread and by whom and for what purpose. The legacy state-funded media is an enormous source for information gathering for much of the population. At least 13 different mainstream media corporations latched onto this with almost central command-like orders and spread this title as quickly as possible to reach as many people quickly. As you can see (below), many media outlets who hastily and simultaneously (without scrutiny or verification) splashed this study and its ‘conclusions’ into the mainstream news medium. If you are to just read the titles splashed across your screen, that are derivatives of the study title, it might seem that its clear, the unvaccinated people put others at risk. However, repeating inaccurate and misleading information does not make it truthful no matter how many times it is propagated. In fact, the inverse is true. This is highly dangerous and why anyone would want to push to prove this narrative or believe this as any sort of real world conclusion is beyond me. I digress.
Moving to the Abstract and the Background sections of this piece, Fisman, Amoako and Tuite declare the “speed of vaccine development has been a singular achievement during the COVID-19 pandemic…”. Increased speed of new medical treatment development is generally and historically cause for some concern, and indicates a dramatic deviation from the standard time acceptable for its completion. However, today the authors praise this “achievement” as a supreme accolade. Here, Fisman etal offer up a suggestion of speedy science as being intimately connected to technology and, thus, is progressive and good. Science, in its truest form does not and, in fact, cannot sacrifice either safety nor time. When safety is negated or dismissed, and Big Pharma are rushing vaccine development, errors inevitably occur. Yet, there is no mention or discussion on the limitations or risks of these injections. Next, we must consider this position from the authors. Fisman etal goes on, “Vaccine opponents often frame their opposition in terms of the rights of the unvaccinated”. Evidently, as per the authors, “vaccine opponents” include all people who have legitimate questions or concerns about a new rushed medical product, despite the individuals’ acceptance or views on all other vaccines, are now ideologically aligned with “anti-vaccination”. There is also an air of derogation for anyone who endorses such views, creating further solidification of the division and inequality the title ascribes. In these words, the authors take their own perceived authority to mean they can label human beings as they see fit, including on the grand world stage, to purvey overall meaning. Effectively, they are removing human agency from each and every one of the people who have unanswered questions or concerns about this novel injection. Fisman etal have stolen the authority from others and placed themselves at the helm of appropriating groups of people. Here we can see overt paternalism at play that science and medicine has worked diligently and progressively to remove. Claiming these ‘anti-vaxxers’ “frame their opposition in terms of the rights of the unvaccinated” presupposes that this is a self-centred and selfish act. Such a broad sweeping generalization of concerned citizens and experts signals serious red flags. Human rights abuses of the past are nothing to dismiss, yet this choice of language offers the reader that concern for the egregious violations of everyone’s (not just unvaccinated) individual inalienable human rights is dismissible at the authority’s whim. Inherently, the authors suggest that being stripped of one’s bodily autonomy/ free will - ie. “my body my choice” - is a justified standard, is necessary, and results in ‘greater good’. From my lens, any process involving the dismissal of the importance of individual human rights and free will is headed for further abuse, denial and potentially worse. Given the gravity of this, a pause is essential. Consider, is anyone being harmed by these statements? If so, who? Such questions are required by responsible global citizens working together for “the greater good”.
U of T is a highly respected University and Scientific/Medical establishment. CMAJ is considered a trusted source of peer reviewed medical and scientific literature. The peer review process historically requires rigorous scrutiny. Dr. Fisman and team are exquisitely deemed ‘experts’ by those hiring them and promoting their work. Fisman is on advisory boards of multiple covid-19 vaccine producing pharmaceutical companies, and was even selected to be on the Ontario Science Table. He also provides his recommendations to powerful unions, such as the Teacher’s Union. Funding for this study came from a government grant. Having backing from such seemingly esteemed sources for info, surely there cannot be anything afoul here. Yet, with a different lens we can see different details. ‘The devil is in the details’, though, and to be responsible global citizens, we each must look a whole lot deeper to ensure the highest quality of data to draw the best informed conclusions. For all who look closely at this study with objective criticism can see immediately Fisman’s egregious conflicts of interest, state funding for these results, and extreme bias in the authors perspectives. State and corporate establishment interests benefit from the results of this study and we must be acutely aware of this fact when taking away messages and meaning from its conclusions and recommendations.
Evaluating the Methods for conducting such a study, we can immediately find serious concerns. “We constructed the simple susceptible-infectious-recovered compartmental model …”. Here, the authors indicate the entire basis of this study is a MODEL. While mathematical modelling has important uses (see Dr. Jessica Rose’s recent substack article found here:
it cannot and should not be utilized as the sole driver of broad sweeping absolute conclusions. Especially, not in instances such as this where the gravity and seriousness of accusing certain human beings of causing harm to others and suggesting public policy isolates or segregates them. All limitations of this type of information and data really need to be deeply considered and evaluated for validity. Fisman etal goes on to include the term “transmission” and, as such, directly connects the likelihood of spread of SARS-CoV-2 as coming from unvaccinated populations. Given what we now know, none of these novel inoculations actually have any evidence for reduction in infectious transmission, whatsoever. Vast demonstrable evidence exists that these injections do not positively alter the transmission of SARS-CoV-2. Now, let’s reconsider that his study is a simulation, and not an investigation amongst real people. A model he and his team created and deliberately chose which parts to show the readers and which values to plug in to their equations, in attempting to inform the public that one group of people should avoid the other. Importantly, as Dr. Rose and Dr. Bridle outline so nicely, there is one particular data piece, or symbol, that their conclusions draw heavily on. Baseline immunity in unvaccinated subgroup was decided exclusively on assumptions and not factual data, which exist currently as peer reviewed evidence and could have been used. As Dr. Rose points out “Perhaps the most important point I would like to make is this: if one single parameter value is altered, the entire result of the model changes in turn.” These experts provide us with valuable insights into understanding the modelling approach, and that the authors’ choice to arbitrarily and intentionally use a specific factor of 0.2 as the “percentage of people assumed by the authors to be immune in the ‘unvaccinated’ population” absolutely alters the conclusions in favour of their expectation! It begs the question, why would the authors reduce the effect of natural immunity so extremely despite current literature on a more accurate value of 0.9 from recent peer reviewed studies. This invalidates the entire results of this study. Had the author’s chose a more modest value to represent the natural immunity amongst unvaccinated people, as Dr. Bridle outlines, the results, and thus meaning of their conclusions, would be entirely different, and potentially more valuable contribution. To gain understanding, we must now tie the choices of language to their decision to use such an extreme and inaccurate value for such an imperative parameter in the study.
In terms of the language and rhetoric utilized throughout their Methodologies section, I’ll point to the authors stated population: “with two connected subpopulations: people who were vaccinated and those who were unvaccinated”. Fisman etal presuppose that the human beings in one “sub population” differ so greatly in ‘protection’ by being vaccinated and in ‘risk’ by being unvaccinated. They denote perceived superiority in the vaccinated group in more ways than just one throughout the entire publication. Elevating one group of human beings over another fosters inequality and divisiveness and destroys social cohesiveness. Such statements have no place in objective science, or in the practice of ethical compassionate medicine. They tells us “we simulated a spectrum of patterns…”, again revealing their overt creation or imitation of selected patterns to achieve their results. Fisman etal, who constructed the results based on bias and inaccurate assumptions, also turn and use it as a weapon against unvaccinated people. “Vaccinated people were, as expected, at markedly lower risk of SARS-COV-2 infection during the [simulation], however, when random mixing with unvaccinated people occurred, they decreased attack rates in the unvaccinated people by serving as a buffer…”. Here is clear evidence of bias and selection in the authors’ chosen language, in outlining their constructed results of what they expected to see. If the authors created the equation to obtain such results, of course it would be expected. Degrading the scientific process in this way is a justifiable reason for anyone to mistrust ‘experts’ and the health system entirely. The individual and societal harms that messaging, such as this, is causing cannot be overstated. Many unvaccinated people refuse to seek out essential health care in fear of maltreatment and discriminatory care. Such abuses are a true reality occurring and emerging in our communities and thoughtful consideration to this is required immediately. Using assumptions to manipulate conclusions, paired with rhetoric that persuades the human mind toward a specific impression of a targeted group of human beings is further disenfranchising innocent people. In seeing how the use of assumptions helps deliver whatever desired results of the authors, we must also consider how these same assumptions were used in their interpretation of such ready made results to draw real life conclusions. As a physician and a human being, this concerns me greatly.
Interpretation and Results sections of Fisman etal’s piece are particularly ripe with concerning language, phrases, and rhetoric. As a function to persuade readers toward their conclusions, which are demonstrably inaccurate, we cannot help but consider the impact of such actions on the affected individuals and the entire social fabric of our population. Throughout their interpretations, the authors persuade the reader with phrases like “simple deterministic model…” when it is anything but simple as Dr. Jessica Rose and others outline. “Deterministic” is an absolute term, which presupposes conclusiveness of their model and results. Conclusions cannot be drawn from this poor quality assumption based simulation study, let alone elevating it to being a vehicle for which public policies can be derived from. Readers are guided toward deceptive generalizations by the authors in their reasons as to why vaccinated people are continuing to become increasingly affected by, ill, and hospitalized with SARS-COV-2. The authors state “Notwithstanding the model’s simplicity, it provides graphical representation of the expectation that even with highly effective vaccines, and in the face of high vaccine coverage, a substantial proportion of new cases can be expected to occur in vaccinated people…”. Here, the authors are imposing even more assumptions into their simulation, with the effectiveness (VE) value they assign to the vaccinated group. Real examples exist all over the world of only fully vaccinated populations aboard cruise ships or in universities and hospitals, that have worse rates of infection than ever before. Waning vaccine immunity is a fact also demonstrated in real time by the increasing boosters required to be considered “protected” or “fully vaccinated”. What purpose does this serve to be relaying constructs that are known to be inaccurate while we are experiencing the opposite reality occurring all around us? Well, it could be that knowing this conflict exists, it induces a degree of mistrust in our own self knowledge of real world observations as it veers far from the perpetual official messaging. When we do not trust ourselves, we look to other external figures (experts) to provide that validation for us. I must highlight the very nature of the authors’ suggestion and imposition are disempowering for human beings.
Fisman and team go on to admit reduced protection against infection by Omicron in vaccinated, but continue in their narrow misguided interpretations of vaccinations’ effectiveness on specific outcomes, including hospitalization and death. They claim in absolute terms, as evidenced by their choice of language, “this means that acceptance of vaccination is a means of ensuring that greater health care capacity is available for those with other illness”. However, many more subtle assumptions become apparent. Such as, this claim assumes that our Ontario hospitals have, at some point, required any additional surge capacity above and beyond what existed. Current Ontario data from multiple hospitals in many regions, as obtained via a Freedom Of Information Act requests, outline that hospitals operated well below or, at times, up to its capacity at every level in 2020 and 2021 compared to previous years. The authors also assume that by cancelling all the elective surgeries for other already diagnosed serious health issues, like cancer, was not going to ever be enough to improve capacity. Fisman etal overestimate the role of the vaccines in contributing to overall hospitalizations, as real world evidence shows there is no effective change in admission rates year to year. So much confusion arises from relying on assumptions as our conclusions. It must stop. See below for the obtained FOIA requests to better understand hospital use and access compared to many previous years. Shout out to Adam Thompson for his extensive and diligent work on this.
https://bodyisorganic.wordpress.com/2021/10/27/owen-sound-hospital-operation-data-covid-19/
As for making explicit claims like “anti vaccine sentiment, fuelled in part by organized disinformation efforts has resulted in suboptimal uptake …” and “by contributing to these backlogs, unvaccinated people are creating a risk that those around them may not be able to obtain the care they need and, consequently, the risk they create cannot be considered self-regarding”… Subtle use of repetitive catchphrases and words, such as those bolded, are paternalistic and absolutist in nature, which needs to draw a sounding alarm in the reader. Blaming, shaming and categorizing human beings and arrogantly deciding for large swaths of people what has lead to their concerns is overtly abusive. Additionally, these very same people who make claims of “organized disinformation” are in fact the spreaders of disinformation themselves. Dismissing and negating the realtime erosion of trust that a growing part of our population has in the public health response is not a result of a targeted group of civilians, but rather is a direct result of the incessant and pernicious dishonesty, lack of transparency, and failed policies from those in charge and those working to help shape such poor policies. An assumed risk that does not exist in reality we have come to learn, and an assumed risk in hospital capacity that have always had space are utilized as vehicles for continuing discrimination and abusive policies for unvaccinated people. Processes used for creating perception of accuracy in a reader requires more than assumptions. Science and the peer review process are required to limit assumptions as much as possible. Without more clarity, this study is accusatory in the most vile way. Attempting to invite the public to believe that a specific group of concerned people are the cause of infectious risk to vulnerable people in need of acute medical care is emotionally vampirical. Many vaccinated people have avoided medical care due to the fearful messaging from our government and public health leadership, hospital administration, ‘experts’ and legacy media. This is but one example of many reasons for delayed care from the pandemic response. Inciting additional fear by pitting human beings against one another is a terrorizing and abusive act, and has no place in scientific literature, health care or leadership.
The last bit of literary treasure within this publication I will draw attention to is the authors’ conclusions. Specifically, the description of “the choice of some individuals to refuse vaccination is likely to affect the health and safety of vaccinated people in a manner disproprtionate to the fraction of unvaccinated people in the population.” Why are vaccinated people at such high risk from a disproportionately small subset of the population, particularly when transmission is essentially the same in both groups? Is this subgroup not highly protected? And “considerations around equity and justice for people who do choose to be vaccinated, as well as those tho choose not to be, need to be considered in the formulation of vaccination policy.” Here the authors position of equity and justice, similarly defined as “the quality of being fair and impartial” ought to be part of policy development, which is likely the only agreement I can make with them. However, their own entire study, its function, its fatally flawed assumed results, and its use of rhetoric as meaning purveyor is in absolute contradiction to these essential principles. Firman et al continue on, “It is unlikely that SARS-CoV-2 will be eliminated…” and “Our findings will likely be relevant to future …emerging variants”. Is it the author’s view, then, that this “mixing” of unvaccinated people with the vaccinated should never be allowed again? Life on earth is simply too dangerous because of a microscopic germ that we cannot resume normal human behaviour ever again? Is it equitable and just that certain human beings will be forced to indefinitely be kept from “mixing” freely amongst others when policies emerge from their results? This suggestion is esoterically planted within the meaning derived from specific manipulation of language by the authors.
Where are the checks and balances?
Fisman et al included a brief paragraph outlining their limitations. When you compare this to the Competing Interests proclamation, it’s almost the same size. I will only comment to say that their insights into their limitations is … well, limited and full of assumptions. Why wouldn’t it be, the rest of the publication is. At least they’re consistent. Sigh.
One of the most frightening revelations from this piece is that we are left to reconcile that Fisman and team either deliberately created and distributed disinformation, or they were so unaware of their own confounding assumptions, limitations, and bias; yet, this was not picked up via the peer review process. How was this simulation approved as it lacks the ability to stand up to public and professional scutiny? The levels of irresponsibility are astounding for any sort of definition of “quality” scientific study. We are called now to further question the integrity and intentions of the authors, our medical peer review process and the journals themselves also. Who is actually creating mistrust or hesitancy? Given that such a disservice has occurred in this paper where the quality is so poor to be of limited to no societal benefit whatsoever, how many other seminal peer reviewed papers over the past 2 years that shaped policies have this same disregard happened? This is an important moment in which we are experiencing the active development of public mistrust in science, medicine, formidable institutions, and health policies. The low quality of science here is being ushered forth as a vehicle to justify current pandemic measures, such as the travel ban, and to inform future public policy it seems. The Truduea government TODAY (may 2/22) referenced this study for its travel bans!!! This is a terrifying reality and prospect. Link to hear for yourself below.
Conclusions
Skewed or disingenuous models/studies equals skewed outcomes and invalid conclusions. Garbage in = garbage out. Using a simulation model based on extreme assumptions as exclusive evidence that unvaccinated people impose a greater risk for those who are vaccinated is a profound deviation from acceptable standards of medical research and it’s possible conclusions. Their use of definitive, provocative and persuasive language about these false results is pernicious. Fisman etal’s claims are serious with vast potential for harm and stigmatization to millions of people. Unvaccinated people are already suffering from heavily biased and unscientific policies that affect them disproportionately. When examining closely the chosen language, we clearly see the divisive and derogatory sentiments targeted at a specific minority population. Many instances of the authors’ rhetoric serve to ‘other’ a large group of our population, which is a paternalistic, colonialistic, and dehumanizing. Adding insult to injury by pejorative wordsmithing is unethical, and is fundamentally eroding the integrity of medicine, science, literature and our very social values and norms. We already know of the many egregious conflicts of interest Fisman has; which, ought to trigger some alarm for concern or at the very least provoke an awareness of the possible influence of that on his study methods and results. In directing the reader to believe their claims at face value we see many different types of fallacies. For a thought experiment, I invite readers to find the reference below to see how many fallacies you can find within their publication. Rigorous scrutiny of all scientific and medical publications, especially when suggesting the results should inform discriminatory public policy that will inevitably harm the targeted minority group these authors are attacking.
It seems the authors of this study, the editor of CMAJ, and those who peer reviewed and approved its contents need to answer in response for the inadequacies, assumptions, bias, and rhetoric used to inform the public in the name of transparency, accountability, and trust in our formidable experts and institutions. Otherwise, immediate retraction is required to reduce harm and restore public trust.
References:
Dr. Jessica Rose’s article above
Dr. Bridle’s critical assessment below
https://ocla.ca/ocla-statement-on-cmaj-fisman-et-al/
https://thebestschools.org/magazine/15-logical-fallacies-know/