Introduction

The emergence of COVID-19 has led to a proliferation of disputes and disagreements over COVID-related knowledge and policy (Liester 2022), including the origin of the SARS-CoV-2 virus (van Helden et al. 2021), restrictive measures taken by most governments such as social-distancing, lockdowns, contact-tracing and mask requirements (Biana and Joaquin 2020), the use of certain treatments of the disease and the exclusion of others (Mucchielli 2020), the safety and efficacy of vaccines against COVID-19, and the implementation of “vaccine passes” in many countries (Palmer 2021). Harambam (2020) has referred to these disputes as the “Corona Truth Wars.”

Since the beginning of the pandemic, while governments and health authorities argued that restrictive lockdown policies were necessary to deal with the pandemic and prevent deaths, many scientists and medical practitioners questioned the ethics and morality of such tactics, including Nobel laureates and leading physicians and scholars (e.g., AIER 2020; Abbasi 2020; Bavli et al. 2020; Brown 2020; Ioannidis 2020a; Lenzer 2020; Levitt 2020). Furthermore, from early 2020, increasing numbers of scientists and doctors argued that the pandemic, as well as morbidity and mortality figures, were being inflated and exaggerated (Ioannidis 2020; Brown 2020); that the extreme policies and restrictions violated fundamental rights (Biana and Joaquin 2020; Stolow et al. 2020); and that governments were using fear campaigns based on speculative assumptions and unreliable predictive models (Brown 2020; Dodsworth 2021). Some scholars, medical practitioners and lawyers have pointed to biases, concealment and distortions of vital information regarding COVID-19 morbidity and mortality rates that misled policymakers and the public (AAPS 2021; Abbasi 2020; AIER, 2020; Fuellmich 2020; King 2020).

It has been argued that much of the discussion around the COVID-19 pandemic has been politicized (Bavli et al. 2020), and that science and scientists are being suppressed due to political and economic interests (Bavli et al. 2020; King 2020; Mucchielli 2020). This criticism has grown, especially following the start of the COVID-19 vaccine campaign. Criticism was made regarding the hastiness with which the mRNA vaccines were granted Emergency Use Authorization by the FDA even for children; the quality of the clinical trials that led to the authorization of the vaccines (including violations of research protocols and evidence of fraud); the lack of transparency regarding the process and data that led to the authorization; the inflation of efficacy estimates; and the minimization or ignoring of adverse events (Doshi 2020, 2021; Fraiman et al. 2022; Thacker 2021).

Critics have argued that the scientific and policy discourse surrounding COVID-19 has not been carried out on a level playing field due to censorship and suppression of views contrary to those supported by medical and government authorities (Cáceres 2022; Cadegiani 2022; Liester, 2022; Mucchielli 2020). Some governments and tech corporations, such as Facebook, Google, Twitter and LinkedIn, have taken measures to censor contrary viewpoints, arguing that views challenging government policies are dangerous misinformation, and therefore censorship is justified to protect public health (Martin 2021).

The present study explores the phenomenon of censorship of dissent from the point of view of well-known scientists and doctors who were censored for their heterodox views on COVID-19, in order to learn about the range of tactics that have been used to censor and silence them, as well as the counter-tactics they have used to resist these attempts.

Censorship of COVID-19 Heterodoxy

To describe a view or position on COVID-19 as heterodox implies the existence of an orthodox position, which here refers to the dominant position supported by most major governmental and intergovernmental health agencies. Liester (2022) provides a list comparing what he refers to as the dominant versus dissenting views with respect to COVID-19, which includes the origin of SARS CoV-2 (zoonotic vs. laboratory), mask mandates (will prevent spread vs. will not prevent spread), early treatment with drugs such as hydroxychloroquine and ivermectin (ineffective and dangerous vs. effective and safe), the usefulness of lockdown measures and other restrictions (effective and beneficial vs. ineffective and harmful), COVID-19 vaccines (safe and effective vs. unsafe and dangerous), and COVID-19 vaccine mandates and passports (necessary and ethical vs. harmful and unethical). While it may be true that none of these dominant positions have been universally adopted by all governments worldwide to the same degree or down to every last detail, nevertheless a dominant or orthodox position on all of these issues can be identified on a country-by-country basis with strong similarities across national borders.

It is worth noting that orthodox positions can change. For example, by mid-Spring 2020, discussion of the laboratory origins of SARS-CoV-2 was forbidden on certain social media sites, like Twitter and Facebook (Jacobs 2021). More recently the lab-leak theory has since gained more legitimacy, especially following articles in the Proceedings of the National Academy of Sciences (Harrison and Sachs 2022), Frontiers in Virology (Ambati 2022) and Vanity Fair (Eban 2022) as well as a statement by WHO director-general Ghebreyesus, who commented on an interim report by the Scientific Advisory Group for the Origins of Novel Pathogens, saying that all hypotheses need to be considered and criticizing the report for inadequate assessment of the lab-leak hypothesis (WHO 2022). Another example relates to the necessity of mask wearing: US officials such as the director of the National Institute of Allergic and Infectious Diseases (NIAID), Anthony Fauci, are on record recommending against universal mask wearing in March 2020, only to change their position in April to recommend universal mask wearing and mandates (Roche 2021).

Since early 2020, there has been an upsurge of complaints about censorship by individuals and groups presenting heterodox COVID-related viewpoints and information, with even more complaints in 2021 following COVID-19 vaccine rollouts. Many instances involve social media censorship, including the removal of accounts (“deplatforming”) or blocking the visibility of a user’s content without informing them (“shadow banning”) (Martin 2021).

While complaints regarding scientific censorship and suppression preceded the pandemic (Elisha et al. 2021, 2022; Martin 2015), a new feature of the COVID era is the prominent role played by information technology companies such as Facebook and Google (Martin 2021). One prominent example was the down ranking of the Great Barrington Declaration’s website by Google (Myers 2020). The Declaration, spearheaded by three epidemiologists at Harvard, Stanford and Oxford universities, was released in October 2020 (Kulldorff et al. 2020) and signed by many notable scientists and doctors, including the Nobel Prize laureate Michael Levitt. It argued against universal lockdowns in favor of focusing on protecting vulnerable groups. However, to reduce exposure, Google altered its search algorithm (Myers 2020). In February 2021, Facebook deleted a page set up by a group of scientists involved with the declaration (Rankovic 2021). In April 2021, YouTube removed a recording of an official public hearing on the pandemic that featured Florida governor Ron DeSantis and the authors of the Great Barrington Declaration. One of them, Prof. Kulldorff, who is one of the most cited epidemiologists and infectious disease experts in the world, was himself censored by Twitter in March 2021 (Sarkissian 2021). Though his tweet saying that not everyone needs the COVID-19 vaccine was not taken down, he was warned, and users have been prevented from liking or retweeting the post (Tucker 2021).

Similar cases abound. For example, the research-networking site ResearchGate removed physicist Denis Rancourt’s article about masks (Rancourt 2020), and in 2021, it banned him entirely (Jones 2021). In July 2021, LinkedIn suspended the account operated by Dr. Robert Malone, an internationally recognized virologist and immunologist, an action repeated by Twitter in December 2021 (Pandolfo 2021).

These are just some of the many examples of censorship related to COVID-19. Beyond the large scale of the censorship phenomenon, and the wide involvement of tech companies in it, another unique characteristic of COVID-related censorship is its targets. Many of the doctors and researchers being censored by the world’s biggest technology companies are not fringe figures. As in the examples above, these are mainstream scientists, many of them leading experts working in prestigious universities and/or hospitals, some of whom have authored books and published dozens or even hundreds of papers and whose studies have been widely cited. Some of them are editors of scientific/medical journals and some are heads of medical wards or clinics.

This heavy censorship was done with the encouragement of governments (Bose 2021; O’Neill 2021), which cooperated with tech companies such as Facebook, Twitter, and Google. For example, on March 7, 2022, US Surgeon General Vivek Murthy called on tech companies to report “health misinformation” to the federal government and to step up their efforts to remove it (Pavlich 2022). Subsequently, e-mails released from legal proceedings have documented the ways in which government officials directly coordinated with tech companies like Twitter and Facebook to censor doctors, scientists and journalists (Lungariello and Chamberlain 2022; Ramaswamy and Rubenfeld 2022). In December 2021, an e-mail from the fall of 2020 was released via a Freedom of Information Act (FOIA) request. It revealed a behind-the-scenes effort by Francis Collins, then head of the National Institutes of Health (NIH), to his colleague, Anthony Fauci, head of NIAID, to discredit the Great Barrington Declaration and disparage its authors. In the email, Collins told Fauci that “this proposal from the three fringe epidemiologists … seems to be getting a lot of attention,” adding that “there needs to be a quick and devastating published takedown of its premises. I don’t see anything like that online yet—is it underway?” (Wall Street Journal 2021).

Practices of censorship have also been used by the Israeli Ministry of Health (IMOH) and media against doctors and researchers whose views run counter to institutional orthodoxy. One such example is the Israeli Public Emergency Council for the Covid19 Crisis. The organization, which consists of leading doctors and scientists, was targeted by the IMOH and the media numerous times, including attacks on individual members of the organization (Reisfeld 2021).

Censorship, the Backfire Effect and Public Outrage

COVID-19 censorship is, in part, an exclusion of the views of dissident experts as well as citizens who question the standard position. This type of censorship has been a feature of many other controversial areas in science and medicine, such as AIDS, environmental studies, fluoridation, and vaccination (Delborne 2016; Elisha et al. 2021, 2022; Kuehn 2004; Martin 1991, 1999; Vernon 2017). In fact, censorship has a long history, and its purpose is to suppress free speech, publications and other forms of expression of unwanted ideas and positions that may be perceived as a threat to powerful bodies such as governments and corporations.

Censorship of opposing or alternative opinions and views can be harmful to the public (Elisha et al. 2022), especially during crisis situations such as epidemics, which are characterized by great uncertainties, since it may lead to important views, information and scientific evidence being disregarded. Furthermore, the denial or silencing of contrary views can elicit public mistrust (Gesser-Edelsburg and Shir-Raz 2016; Wynne 2001). Studies have indicated that in situations of risk, especially risk that involves uncertainty, the public prefers full transparency of information, including different views, and that providing it does not raise negative reactions in terms of behaviour, but rather, helps reduce negative feelings and increases the public’s respect for the risk-assessing agency (De Vocht et al. 2014; Lofstedt 2006; Slovic 1994). As Wynne (2001) warns, institutional science’s attempts to exaggerate its intellectual control and use knowledge as justification for policy commitments, while ignoring its limits, only alienates the public and increases mistrust.

Moreover, censorship can be counterproductive, in essence backfiring, because it can lead to greater attention being paid to the censored information, foster sympathy for those being censored and promote public distrust of the actors and agencies engaged in censorship (Jansen and Martin 2003, 2004, 2015). This is especially evident in the internet age. While information technology companies such as Google and Facebook play a prominent role in the attempts of governments and authorities to censor dissenting positions on COVID-19 (Martin 2021), it is a serious challenge to achieve this completely. Their visibility in the mainstream media and in web search results can be curtailed, but there are too many alternative communication options to prevent dissenters from communicating their positions (Cialdini 2016). Therefore, attempts to silence and censor critics can sometimes backfire.

Considering the extent of censorship reported during the COVID-19 era, and in particular the number of accomplished doctors and scientists censored and silenced, as well as the extensive involvement of tech companies, on the one hand, and governments, on the other, it is worthwhile investigating this phenomenon. The present study is designed to explore the subjective perceptions of well-credentialed, highly accomplished mainstream doctors and scientists who have experienced censorship and/or suppression after expressing non-orthodox positions regarding the handling of the COVID-19 pandemic, and how they dealt with it. Through interviews, we examine censorship tactics used by the medical establishment and the media (both mainstream and social media), and the counter-tactics employed by their targets.

Method

The study is a qualitative one (Aspers 2004), which aims to identify internal perceptions from the point of view of those who have experienced the phenomenon under question.

Participants

Study participants include 13 established doctors and scientists (12 men and 1 woman), from different countries around the world (viz., Australia, Canada, the Czech Republic, Germany, Israel, UK and US). Of these, 11 have formal medical training from a variety of fields (e.g., epidemiology, radiology, oncology, cardiology, paediatrics, gynecology, emergency room management) and two are research scientists without medical degrees (in the areas of risk management and psychology). All participants hold either an MD or PhD degree, and four hold both. Most of them are well known in their fields, with a proven research background that includes many academic publications. We used a purposeful sampling method, i.e., a non-probabilistic sampling according to which a deliberate selection is made of individuals who could teach us about the phenomenon under study (Creswell 2012). To preserve the respondents’ anonymity, details that might lead to their identification are omitted.

Research Tool and Procedure

The study is based on in-depth interviews using a semi-structured interview guide. The questions focused on the respondents’ stance towards COVID-19 that was seen as controversial, events they experienced due to their stance, the implications of these events for their professional and personal lives, and their responses to these events.

Recruitment was done in several ways. First, through a Google search we located the contact details of doctors and researchers known for their critical stances toward COVID-19 pandemic measures and policies. Second, we used the “snowball” method to reach other respondents. The initial contact with the respondents was by email, in which we explained the purpose of the study and asked for their consent to be interviewed anonymously. The interviews were conducted via Skype, Zoom or telephone, and lasted about an hour and a half on average. Each respondent was asked to sign an informed consent form. The interviews were recorded and transcribed.

Data analysis and coding were based on identifying the key issues that emerged from the interviews, while classifying and grouping them into meaningful categories. We assured the reliability and validity of the study by applying different methods. The analysis of the data was discussed by all of us as an expert peer group, and different sources of data served as triangulation of the data (e.g., documents and correspondence provided to us by the interviewees). Quotes in the text are provided for illustrative purposes (Creswell 2012).

Findings

Study participants reported being subject to a wide variety of censorship and suppression tactics used against them by both the medical establishment and the media, due to their critical and unorthodox positions on COVID-19. They also described the counter-tactics they used to resist. We divide the findings into two sections, the first describing censorship and suppression tactics and the second describing the counter-tactics used by our participants.

Silencing Dissent: Censoring and Suppressing Tactics

Tactics of censorship and suppression described by our respondents include exclusion, derogatory labelling, hostile comments and threatening statements by the media, both mainstream and social; dismissal by the respondents’ employers; official inquiries; revocation of medical licenses; lawsuits; and retraction of scientific papers after publication.

Exclusion

Respondents reported how, at a very early stage of the epidemic, when they just began to express criticism or their different position, they were surprised to discover that the mainstream media, which until then had seen them as desirable interviewees, stopped interviewing them and accepting opinion pieces from them:

Neither X nor Y [two central newspapers in the respondent’s country] wanted to publish my articles. Without a proper explanation. Just stopped receiving articles. It was quite blatant, that they stopped accepting articles expressing a different opinion from that of the ministry of health (MOH). The number of journalists who can really be talked to, who are willing to listen to another opinion, to publish, has been greatly reduced, and most health reporters today are very biased towards the MOH (#10).

Denigration

Respondents reported that exclusion was only the first step: shortly after that they started being subjected to defamation by the media, and disparaged as “anti-vaxxers,” “Covid deniers,” “dis/misinformation spreaders” and/or “conspiracy theorists”:

After that report came out…, I was front page of the Sunday Times… it said… X [the respondent name], a professor in A [the institution this respondent works in] is co-author of anti vax report… I was now, yeah…, I was told I was anti-vaccine (#9).

I have been vilified.… I’ve been called a quack…, an anti-vaxxer and a COVID denier, a conspiracy theorist (#13).

Recruiting “Third Parties” to Assist in Discrediting

One prominent tactic our respondents claim was used by the media to discredit them was the use of seemingly independent “third party sources,” such as other doctors, to undermine them, for example by writing defamatory articles:

I was shocked at what came out the next day in The Wall Street Journal… So here we had three of the most senior doctors with hundreds and hundreds of publications and scientific credibility to our resumes and …a major media outlet allowed a junior doctor to publish who has no academic standing or track record…[and] have him publish a defamatory piece (#6).

Another “third party” source used by the media, according to our respondents, was “fact-checking” organizations, a practice that is ostensibly meant to verify published information to promote the veracity of reporting. However, some respondents alleged that the fact-checking groups were recruited and operated by corporate or other stakeholders to discredit them and try to discredit the information they presented:

…the fact checkers are a source of misinformation, so though it may review something and say, Dr. X said something, but… they make a counterclaim. The counter claims are never cited in the data… they all trace back to the vaccine manufacturers or the vaccine stakeholders (#6).

you get the fact checkers… They tried to discredit S, but also, because I was a co-author, they were picking on me…, and all this sort of stuff and… discredit by association… (#4).

As seen in the second example above, some of the participants said that those “fact-checking” groups were used to discredit and defame not only the researcher or doctor who presented a contrarian opinion or information, but also others who were associated with them.

Some respondents said that the media persecuted them to the point of blackening their name at their workplace, resulting in their dismissal, or that they were forced to resign:

I lost my job…, I was working for the last 20 years in X [the institution’s name]… And so, the media started coming to X… there was a concerted effort to… ruin my reputation, even though, this is unbelievable, they had the lowest death rate basically in the world, and the doctor who brought it to them, gets vilified and slandered. So, I left on my own… My reputation was slandered. I mean the level of treatment that I didn’t expect and abuse I would say (#1).

Online Censorship

Some respondents reported being censored on social media networks (e.g., Facebook, Twitter, TikTok, YouTube, Google, LinkedIn), and said some of their posts, tweets, videos or even accounts were taken down by the networks.

My YouTube videos were being taken down. Facebook put me in jail, “Facebook Jail.” And I found that I was being de-platformed everywhere (#1).

I’ve always had videos, just my teaching material I’ve been putting up on YouTube…, but I also started to put up materials around this just sort of talking through some of the research… looking at the vaccine efficacy data… YouTube started taking it down. And so now …, I cannot post, I can’t even mention vaccines, because within seconds, as soon as I’m actually trying to upload the video, YouTube will say this video goes against our guidelines… (#3).

I got terminated from TikTok… All of a sudden, I was permanently banned because presumably I had a community violation (#2).

I’m currently on my sixth twitter account…the last one was shut down supposedly for a tweet about X’s lab [the name of the lab], but it was coming. I ruffled too many feathers (#2).

As can be seen in the above examples, respondents noted that the removal of their materials from social networks was accompanied by a notice claiming they had violated the “community rules.” They emphasized that these were academic materials, backed up scientifically:

I became aware that an academic YouTube video that I had put together regarding the paper in the XXX journal … was pulled down by YouTube, and I received a notice that it had violated terms of the YouTube community… without ever having any terms of use from YouTube that would explain what types of terms would be applied to a four PowerPoint slide scientific video…(#6).

One of the respondents reported on censorship even in Google Docs, which means that even private communications are being censored:

Google Docs started restricting and censoring my ability to share documents… This is not Twitter throwing me off like they did. This is an organization telling me that I cannot send a private communication to a colleague or to a friend, or to a family member… (#1).