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Lack of transparency during the COVID-19 pandemic: Nurturing a future and more devastating crisis

Published online by Cambridge University Press:  03 June 2020

Alain Braillon*
Affiliation:
Retired
*
Author for correspondence: Alain Braillon, E-mail: braillon.alain@gmail.com
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Abstract

Type
Letter to the Editor
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

“Collaboration is a key part of the success of any organization, executed through a clearly defined vision and mission and based on transparency and constant communication.” Dinesh Paliwal. (https://en.wikipedia.org/wiki/Dinesh_Paliwal)

To the Editor—The editor must be commended for having provided to Rahimi et alReference Rahimi1 the opportunity to pledge transparency during the COVID-19 crisis, a major issue that has been overlooked in scholarly journals. This issue has two aspects, most concrete.

First, healthcare professionals have faced bullying when speaking out in the media about their real-life experiences of the COVID-19 crisis as they faced basic resources shortage or bureaucratic barriers precluding adequate care or even protecting themselves. In The New York Times, Scheiber and Rosenthal reported that nurses and doctors were bullied for speaking out.Reference Scheiber and Rosenthal2 Similarly, in the United Kingdom, hospital professionals were gagged for voicing concerns about shortages of equipment to protect against coronavirus.Reference Campbell3 This occurrence is most frightening because in the United Kingdom the culture of transparency is an old one and has even been strengthened by a comprehensive framework of legal protections: the Employment Rights Act 1996, amended as Public Interest Disclosure Act 1998, and the Defamation Act of 2013. In other European countries, no protections exist for whistleblowers, and the motto seems to be “Silence is golden”!

This issue also extends to scientific committees advising governments. In Great Britain, the government deliberately kept secret the list of participants in its committee of scientific experts.Reference Stewart4 In France, the Haut Conseil de la Santé Publique (High Council of Public Health), the expert body of the Ministry of Health for the French government, issued 4 dozen reports about COVID-19. As a member, when recruited, I had to sign a form swearing I would respect the “duty of reserve” regarding the content of meetings. This issue is not a theoretical one: I was forced to resign (October 3, 2018) from Public Health France’s scientific committee after a written threat of being sued for such a breach if I refused to resign because whistleblowing by a civil servant is a specific criminal offense in France (Law 83-634, Article 26). This situation contrasts with that the United States where the Lloyd-La Follette Act of 1912 protects civil servants who criticize superiors from official retribution.

In 1998, Söderlund summarized the challenges faced by healthcare systems “protecting against catastrophic illness events,” “improving allocative efficiency and equity of access to services,” and “combating cost escalation,” among many key issues.Reference Söderlund5 Setting transparent and fair rules is a mandatory prerequisite for confidence and effectiveness. Old democracies are deliberately breaching their most basic principle. The crisis is before us.

Acknowledgments

Financial support

No financial support was provided relevant to this article.

Conflicts of interest

The author reports that he is an unpaid member of the Haut Conseil de la Santé Publique (High Council of Public Health), the expert body of the Ministry of Health for the French government.

References

Rahimi, F, Talebi Bezmin Abadi A. Transparency and information sharing could help abate the COVID-19 pandemic. Infect Control Hosp Epidemiol 2020 Apr 22 [Epub ahead of print]. doi: 10.1017/ice.2020.174.Google Scholar
Scheiber, N, Rosenthal, BM. Nurses and doctors speaking out on safety now risk their job. New York Times website. https://www.nytimes.com/2020/04/09/business/coronavirus-health-workers-speak-out.html. Published April 9, 2020. Accessed May 16, 2020.Google Scholar
Campbell, D. NHS staff “gagged” over coronavirus shortages. The Guardian website. https://www.theguardian.com/society/2020/mar/31/nhs-staff-gagged-over-coronavirusprotective-equipment-shortages. Published March 31, 2020. Accessed May 16, 2020.Google Scholar
Stewart, H. We will not publish who is on scientific advisory group, says Raab. The Guardian website. https://www.theguardian.com/world/2020/apr/26/raab-warns-britons-of-risk-of-second-spike-in-coronavirus-outbreak Published April 26, 2020. Accessed May 16, 2020.Google Scholar
Söderlund, N. Possible objectives and resulting entitlements of essential healthcare packages. Health Policy 1998;45:195208.CrossRefGoogle Scholar