How can you save someone’s life by taking the vaccine? And which vaccine did the video mean? At the time the video came out, there were two vaccines being used in the UK, from Pfizer and AstraZeneca. At the time of releasing this video it would not be possible to definitively prove that the vaccines interrupt transmission, which would help others. Therefore this was an unsubstantiated claim as well as emotionally manipulative. It was reported on 24 January that Israel had seen a 60% reduction in hospitalisations in over 60-year-olds,10 but firstly this was not proof of interruption of transmission, and secondly it could not have been factored into the video, which was released on 25 January. I asked the NHS, Public Health England, the MHRA and the Department of Health and Social Care if this claim is accurate, but they didn’t reply. I have a feeling that if I had asked the various press offices about a video which was negative about vaccines they would have been much more responsive.
I was surprised by the claim that there have been ‘no cases of significant side-effects’. There are always side-effects with vaccines and it’s essential to be honest about risks for ethical informed consent. For example, according to Pfizer’s patient information safety leaflet, the vaccine may cause ‘temporary one-sided facial drooping’ (Bell’s palsy) in up to one in 1,000, and ‘events of anaphylaxis have been reported’.
The MHRA’s Yellow Card reporting system provides data on adverse effects. When I contacted the MHRA for their comment about the claim made in the film, the press team responded: ‘The general safety profiles of the COVID-19 vaccines authorised in the UK are similar to other types of routinely used vaccines. As previously stated, the MHRA will publish details of all suspected reactions reported in association with available COVID-19 vaccines, along with our assessment of the data on a regular basis. We will inform you as soon as this has been published.’ This was opaque, but of course they cannot say ‘there are no significant side-effects among the millions of people who have received this vaccine therefore the claim in this video is wrong’, without risking the credibility of the video and disrupting trust in the vaccine. The first month of Yellow Card data11 for both vaccines showed there were some significant side-effects, even if they occurred in relatively small numbers, just as you would expect, including anaphylaxis, Bell’s palsy, and many more.
I would have felt more comfortable fact-checking all of these claims through the NHS, the government or the MHRA; I wish they had responded to me. Another of the claims that niggled at me was ‘the vaccine does not include pork or any material of foetal or animal origin.’ Well, again, which vaccine? And what does the video mean by ‘include’? According to fact-checking website Fullfact, the AstraZeneca Covid-19 vaccine was developed using cells which have been replicated from the kidney cells of an aborted foetus called HEK 293. Put simply, ‘While human-derived cells are used to manufacture the vaccine, they are filtered out of the final product.’12 So, the vaccine does not include foetal material, but was developed using it. Don’t people of faith deserve the complete truth for informed consent? The British Medical Islamic Association does cover this in its own Q&A on the AstraZeneca vaccine:
‘While the key recombinant protein is made in cells descended from human embryonic cells, the original and descended cells are not present in the final vaccine.’ Faith groups don’t advise against the AstraZeneca vaccine, although it is a very controversial area and I suggest individuals should be fully informed in order to make up their own minds.
I interviewed Calvin Robinson, educationalist, political advisor and commentator on race issues, about the video for a sanity-check and a different perspective. Broadly speaking, he was sanguine about the aims and benefits: ‘As much as I hate propaganda, I think things like this are necessary. I’ve seen a lot of anti-vax content shared on social media. I have concerns about lockdown and civil liberties but I’m not an anti-vaxxer. If this video is going to help encourage people to trust the vaccine, then I am for it.’
I explained my concerns about the unsubstantiated and bold claims made in the video, and he agreed that ‘individual statements in the video are worrying, and I don’t think we should combat misinformation with misinformation. I don’t like the idea of manipulation.’
One reason I wanted Calvin’s perspective is that as well as being known for his incisiveness, he is from an ethnic minority. I asked him if he could imagine this video being made by white people for white people. He laughed and said he couldn’t. I said I thought that despite its obviously good intentions, it felt infantilising and racist. He agreed.
On 18 February a re-shot version was aired on ITV, Channel 4, Channel 5 and Sky. Boris Johnson and the Prince of Wales tweeted the film on 19 February. This is a phenomenal level of support.
I couldn’t quite get to the bottom of how the film was made, but the reluctance of everyone to answer my questions was in itself suspicious. I offered the right to reply numerous times to Samir Ahmed and the Cabinet Office. Eventually I eked sparse responses from the Cabinet Office which seemed designed to close down the questions rather than deny involvement.
I asked the Cabinet Office some specific questions:
•Samir Ahmed at Media Hive told me he knew I had been in touch with the Cabinet Office. As you are communicating with each other, please can you tell me more about the level of collaboration between the Cabinet Office (or a different government department) and the creators of the video?
•Did the UK government, a government unit, or an agency employed by the government collaborate on the video in terms of conception, script, direction, public relations?
•Was the UK government involved in fact-checking the video to ensure accuracy about the vaccine?
•The video states: ‘Soon we will be reunited with our friends and family provided we do one simple thing. Take the vaccine’ and ‘Not only will you be saving your life, but you will be saving other lives too.’ Would you agree that this statement, alongside a few similar ones in the video, could be seen as emotional manipulation? And do you think this could interfere with someone’s ability to make a decision based on informed consent?
•The video states: ‘How can you save someone’s life? Take the vaccine.’ How will you be saving someone else’s life by taking the vaccine?
•The video states: ‘There are no cases of significant side-effects among the millions of people who have received this vaccine. ‘The video does not make it clear which vaccine it is talking about. Is the statement correct?’
The Cabinet Office press officer replied that ‘the video by Adil Ray is not part of a Government campaign and was made independently.’ I pointed out that ‘made independently’ could refer simply to the recording (as the end screen of the video stated), but allowed room for collaboration between government and the agency and Adil Ray over inception, scripting, fact-checking and publicity, for example. There had obviously been some collaboration as Samir Ahmed at Media Hive knew I had been in touch with the Cabinet Office. I pressed again for answers to my specific questions. The reply was: ‘We have nothing further to add to the below.’
The unwillingness of government departments to comment on the accuracy of the vaccine claims, the media support, the dovetailing of the film with SPI-B’s recommendations and other resulting actions, the fact that the Cabinet Office and agency were communicating behind the scenes, and social media support from the PM and Prince of Wales do suggest a level of collaboration.
I asked Lucy Easthope about the video. She said: ‘In disaster and recovery planning we make “safe” lists of people who can deliver the messages for us, act as ‘interpreters’ for us. One of my concerns was sitting in meetings where psychologists come up with the lists of celebrities who will best sell messages to different communities. I’m afraid I can see how this would have been done. It’s a reductionist approach to use people for their ethnicity.’ On one hand, it’s understandable to use ‘community champions’. But on the other hand it feels grossly offensive to recruit people based on their ethnicity. A
ccording to Easthope, she has been told by ethnic minorities that they are aware of being racially targeted which leads to cynicism. She cited an example of black youths laughing with her about videos that targeted them being set in ‘chicken shops’.
An article13 in the BMJ summed up the issues of informed consent around the Covid vaccine: ‘it is important to ensure that information communicated to the public be truthful, transparent and accurate. This is best communicated by experienced professionals. Risk should be disclosed in terms of both known risks, including common side-effects, and potentially unknown risk.’
It looks like the government is using all the behavioural insights techniques at its disposal to encourage people to take the vaccine. Many will think the ends justify the means if the vaccine ends lockdown. Stephen Reicher, SPI-B advisor, commented to MPs, ‘I used to say until we get a vaccine, all the things we can do to contain an epidemic are behavioural. I was completely wrong, the vaccine itself raises many issues. The vaccine solves nothing, it’s people getting vaccinated that solves things.’ But are covert tactics and emotional manipulation ethical?
Sometimes celebrities are used more obviously than this. Earlier in the year, TV celebrity Amanda Holden tweeted, ‘I’ve downloaded the #NHSCOVID19app to help protect my family, who are my everything. ad. #HaveYouDownloaded covid19. nhs.uk’ . The word ‘ad’ should have had a hashtag before it, but its use indicated that this was a paid promotion. I wonder how paid promotions like this helped the app? Personally, I see it and I think, hang on, if it’s so good, why did you need to be paid to promote it? Richard Shotton told me that ‘having a celebrity associated with your product can be seen as “costly signalling”. People rate products as better quality if the manufacturer sponsors a major TV programme. Celebrities can have a flatter effect. People who like the celebrity may rate a product better, but people who don’t like the celebrity might like the product less.’ A risky strategy then?
A company called Main Street One in the US contacted celebrities, offering to pay them to promote vaccines: ‘I’m reaching out to share a paid partnership opportunity to share your voice about what the COVID vaccine means to you… Can you use a personal story to explain why you’re blocking out misinformation around the COVID vaccine and prioritising the health of your community? Why are you confident that vaccines are both safe AND effective?’
I don’t know if companies would pay people to promote vaccines in the UK. Again, it is ethically dubious. (I don’t for a moment think the people involved with Ray’s video were paid, by the way, they were clearly involved in good faith.) The Main Street One pitch is an insight into the origins of the kinds of messages we see endorsed on global social media. As Main Street One says, they are about ‘messages people are ready to believe, delivered by messengers they already trust.’
Breakthrough Media, which works with RICU, is now rebranded as Zinc Network. This is how they describe their mission on their website: ‘At the centre of our work are people and communities. To reach and influence them, we work with a network of grassroots partners – those closest to the issues we tackle. We design behavioural science informed interventions that change attitudes and actions for the better.’ They are more upfront now about ‘countering extremism and radicalisation’ and working with government. As well as radicalisation they also focus on ‘preventing online harms’.
On 19 November 2020 there was a coordinated campaign of over 300 tweets, comprised of accounts which looked genuine and some which appeared to be bots, to promote the Online Harms Bill. The tweet said: ‘More and more people are scared of getting #vaccinated after reading anti-vax #fakenews online. We finally need a law to rein in the #socialmedia giants @BorisJohnson #onlineharms’.
The tweet campaign was initiated by SumOfUs, but the use of obvious bots indicated that it was being amplified beyond their own dedicated followers. I wondered who initiated the campaign and who deployed these accounts to push for online censorship? I spoke to Silkie Carlo, who had also noticed the campaign. She told me that campaigns run by her organisation Big Brother Watch had also been artificially boosted in the past, and you could never get to the bottom of who did it and why. We agreed it made Twitter a deceptive and toxic environment for most unwitting users on the platform.
Also on 19 November, MP Damian Collins took part in a debate about online harms in the House of Commons, pushing for a strong bill. (Interestingly, Collins is the co-founder of Infotagian, a Covid fact-checking service.) Furthermore, Met Police Assistant Commissioner Neil Basu called for a debate on 19 November on the introduction of new laws to punish people who spread anti-vaccination conspiracy theories. So, 19 November was a day when there were different types of public calls for an online harms bill – was this coordinated?
I approached SumOfUs and exchanged emails with an employee. She said she was not aware of how their campaign had been co-opted and she said they hadn’t worked with the government. I also approached Zinc Network to see if they were involved or had suggestions but did not receive a reply.
Twitter abounds with shady tweet campaigns. The potential deliberate amplification of the SumOfUs campaign is one of many. At the end of January there was a series of tweets all proclaiming ‘Boris we love you and stand by you, your [sic] doing a great job, keep working hard and doing as your [sic] doing! My prime minister [heart emoji]’ As the tweets were identical, I’m afraid it can’t be a natural and spontaneous outpouring of love for Boris Johnson. Paid ‘promotion’? If so, it was very, very badly done. People playing a prank? The opposition? It’s hard to second guess such a clumsy campaign.
Another facet to Twitter propaganda is the use of troll accounts to discredit people. You will notice that a common retort to trolls in the UK is that they are ‘77th’ – operatives in the UK army’s 77th Brigade. It is impossible to know if these individuals are genuine people, or paid trolls, or who employs them, let alone whether they are part of the 77th Brigade, but this does reveal the suspicion raised by nasty tweets and the sense of ‘organisation’ behind it. It also reveals a sizeable contingent of people who don’t trust their own government. I spoke to former footballer and sports commentator Matt le Tissier, who has come under fire for being outspoken against lockdown, and he showed me reams of examples of trolls he’d had to block. They can be characterised by names with numbers, ‘egg’ profiles, and taking a ‘one note’ approach to certain issues. These trolls en masse create a sense of disapproval which the individual experiences on their timeline, as well as sending a signal to the rest of the world. The intention is clearly to discredit the individual, which can have real-world implications for their mental health, participation in social media and also for careers with public profiles.
If we’re talking about online harms, what about the harm caused by shady actors buying Twitter campaigns for covert purposes? Who amplifies tweet campaigns that coordinate with political debates and why? A transparent investigation is needed.
DAVE, HOSPITAL DOCTOR
I want to share three examples that illustrate the breadth of the impacts of our country’s response to Covid.
We treated a young man who had advanced cancer. He was scared to access healthcare last spring. When he did try and get help, he wasn’t able to see someone in person and he had a video appointment. He felt they didn’t take him as seriously as maybe they should have done. By the time we saw him, it was inoperable. We gave him palliative surgery and intervention. Might he have been saved? Almost certainly. He had a wife and a family. He is almost certainly now deceased.
We are treating a woman at the moment. She is younger than me and has children. She has made a very serious suicide attempt. Her life is still in the balance and she’s suffered irreversible brain damage. She had no previous history of mental ill-health and self-harm, but she is in financial ruin and couldn’t see a way out. She’s not the only one. We’ve seen many others. There is no way of recording this, no way of coding data that someone suffered extreme mental harm as a result
of lockdown. It is intuitive the restrictions have caused harms, but how will this be measured?
A woman in her late 60s had been gradually deteriorating and suffering chest pains over many months. She didn’t want to make a fuss and overwhelm the health system, and she was scared of catching Covid in hospital. Eventually, she presented with end-stage heart failure. Had she not been fearful and gone to her GP, she could have had treatment and continued to care for her children.
9. COERCION
‘Those who consciously justify torture, and are not candid enough to state that they use it to defend their own power and privilege, rely essentially on the philosophic argument of a lesser evil for a greater good. They reinforce this with an appeal to the doctrine of necessity – the existential situation forces them to make a choice between two evils.’
From Report on Torture, Amnesty International, 1973
Social psychologist Albert Biderman investigated and reported on how Chinese and Korean interrogators ‘brainwashed’ prisoners of war in the 1956 paper Communist attempts to elicit false confessions from Air Force prisoners of war. His studies resulted in a framework, Biderman’s Chart of Coercion, which has since been used in other contexts, such as domestic abuse, to understand coercive techniques. While not as extreme, lockdown and social distancing measures bear more than a passing resemblance to the tactics featured in Biderman’s Chart of Coercion.
Dr Harrie Bunker-Smith, a psychologist, also compared some of the government’s tactics to psychological abuse. She told me that ‘there is a parallel with an abusive relationship, which I noticed because I am trained in domestic abuse. The phrases were the same. A few months in we saw that mistakes had been made. A paper came out that said lockdowns cause more harm than good in the summer. And fair enough, mistakes happen. But they kept on happening. Like people working in care homes could go in and out, but family couldn’t visit their loved ones. Social isolation can kill people, it’s a serious risk to be considered alongside infection with Covid. Abusers will say they won’t do something again but then they keep doing it. Abuse is not constant, it’s not bad all the time, you have periods of extreme abuse followed by the honeymoon period, where you get flowers and apologies and promises and then things deteriorate again.’
A State of Fear: How the UK government weaponised fear during the Covid-19 pandemic Page 15
