Boston University’s National Emerging Infectious Diseases Laboratory (NEIDL) has been conducting research on infectious diseases for over a decade, and studying COVID specifically pretty much since the pandemic began. But on Oct. 14, when the lab released a preprint detailing results of their work reengineering the Omicron spike protein, their research suddenly became a lightning rod for panic and speculation. 

News outlets were quick to sound the alarm. “This is playing with fire—it could spark a lab-generated pandemic,” one Daily Mail headline warned. “Boston University researchers claim to have developed new, more lethal COVID strain in lab,” Fox News announced. The articles really highlighted two things: Scientists were making their own versions of the virus, and that  it killed 80 percent of the mice in the study.

The fear is understandable. The pandemic has killed millions of people worldwide and left others permanently debilitated. The idea that scientists could have created a more deadly version of the virus is scary and feeds into theories about a possible artificial origin for COVID-19—something that is being investigated but for which nobody has found concrete evidence. It’s also not entirely true. 

The study is a preprint, meaning it hasn’t been peer-reviewed or accepted by a scientific journal. But that doesn’t mean there weren’t any guidelines or approvals before it was submitted. According to a lab press release responding to fearmongering over the study, the study was approved by the Institutional Biosafety Committee, and the Boston Public Health Commission, and was conducted in the lab’s biosafety-level 3 facilities. Although the work was not cleared by the National Institutes of Health (NIH), as a STAT article explains, this was not necessary because the team wasn’t using funding from the agency. 

In terms of the actual methods of the research, contrary to what outlets reported, the virus was not engineered to be more dangerous. Rather, it was trying to compare different strains of the SARS-CoV-2 virus to give us a better idea of how we could eventually combat it. This is the purpose of most work that occurs in these facilities.

“This research is not gain-of-function research, meaning it did not amplify the Washington state SARS-CoV-2 virus strain or make it more dangerous,” NEIDL Director Ronald B. Corley said in a press release. “In fact, this research made the virus replicate less dangerous.”

In the BU study, researchers were actually just comparing how the Omicron variant compared to the original Wuhan strain. They created a hybrid version of the virus that contained genetic information for both the Omicron and the ancestral strain. They started in a tissue culture and eventually moved on to an animal model, but never humans. Working with mice, they found that the recombinant version killed 80 percent of the lab mice, which—and this is key—made it more deadly than the Omicron strain but still weaker than the original strain. 

“The animal model that was used was a particular type of mouse that is highly susceptible, and 80 to 100 percent of the infected mice succumb to disease from the original strain, the so-called Washington strain,” Corley said. “Whereas Omicron causes a very mild disease in these animals.”

Mohsan Saaed, one of the lead researchers on the study, also emphasized that this research is similar to that of other organizations, including the Food and Drug Administration (FDA).

“Consistent with studies published by others, this work shows that it is not the spike protein that drives Omicron pathogenicity, but instead other viral proteins,” Saeed said in a press release. “Determination of those proteins will lead to better diagnostics and disease management strategies.”

It makes sense why people were quick to freak out over this given that some believe the SARS-CoV-2 originated in a lab in Wuhan, China. This COVID lab-leak theory often feeds into many misunderstandings about the nature of scientific research. So-called gain-of-function research—wherein scientists make viruses more capable and deadly—is controversial. In fact, from 2014-2017, there was a moratorium on research that was attempting to create novel pathogens. However, the NIH lifted this moratorium in December 2017, deeming gain-of-function research important in “helping us identify, understand, and develop strategies and effective countermeasures against rapidly evolving pathogens that pose a threat to public health.” 

But, as previously mentioned, the Boston University study was not gain-of-function research. As virologist Florian Kramer points out in a Twitter thread, this research is normal. 

“Of note, other labs have legally made such viruses and used them for serology assays [tests for immune responses] without any problem,” he wrote, citing a study published in Nature earlier this year. He also points out that the FDA did similar experiments, published in September. 

Altogether, the headlines were completely sensationalized and misrepresented the purpose of the study. This incident highlights how work on dangerous viruses can get spun into a conspiracy theory that doesn't resemble reality. 

Have you ever had that weird feeling of letting your mind wander on a car trip, then not remembering anything about your drive when you arrive at your destination? Or perhaps you’ve struggled to fall asleep as your brain cycles endlessly through intrusive thoughts? Do you ever get “in the zone” while deeply engaged in an activity, like playing music or sports?

These are some of the common experiences that have inspired a team of scientists to dramatically reimagine the evolution of consciousness, which is a state of awareness that humans (and perhaps some other animals) possess about their minds and the world. Led by Andrew Budson, a professor of neurology at Boston University and Alzheimer’s Disease Center, the researches propose that “consciousness is, at its core, a memory system,” and that other functions that we associate with consciousness like problem-solving “developed later in evolutionary history,” according to a study published this month in the journal Cognitive and Behavioral Neurology.

One important consequence of this hypothesis is that our decisions and actions are first performed unconsciously, and then remembered consciously about a half-second later. In this way, our brains fool us into thinking we are making conscious actions in the present, when we are only experiencing delayed memories of events. For example, the authors note, previous studies found that it took about 500 milliseconds for subjects to consciously register stimulation.

”We would argue, in fact, that we do not consciously perceive events directly in real time,” the authors state. “We perceive the world as a memory. In other words, technically, we are not consciously perceiving anything directly; we are actually experiencing a memory of a perception.”

Key to this theory is the idea that we call consciousness initially developed to facilitate episodic memory—the brain combining sensory inputs to form a recollection of events to infer the future. Memory and consciousness are inextricable because they evolved as part of the same system.

“Our theory of consciousness rejects the idea that consciousness initially evolved in order to allow us to make sense of the world and act accordingly, and then, at some later point, episodic memory developed to store such conscious representations,” Budson and his colleagues said in the study. “Our theory is that consciousness developed with the evolution of episodic memory simply—and powerfully—to enable the phenomena of remembering.” 

According to the researchers, the origins of consciousness in memory and its continued existence as the most advanced part of the brain’s memory system explains all sorts of observed phenomena. For example, they note that athletes take split-second actions unconsciously first, with the conscious awareness (or memory) of those actions only arriving later.  

“We posit further that consciousness was subsequently co-opted to produce other functions that are not directly relevant to memory per se, such as problem-solving, abstract thinking, and language,” the team noted. “We suggest that this theory is compatible with many phenomena, such as the slow speed and the after-the-fact order of consciousness, that cannot be explained well by other theories. We believe that our theory may have profound implications for understanding intentional action and consciousness in general.” 

Scholars have debated the origin and function of consciousness for thousands of years, and the subject now touches a variety of fields that include neuroscience, evolutionary biology, philosophy, and ethics. Some researchers have suggested that consciousness evolved as a mechanism to mediate and control our attention, and others have proposed that it is related to language and culture. 

Budson and his colleagues note that many previous studies have hinted at the key role of episodic memory in consciousness, but they take this hypothesis to the next level by suggesting that the process of remembering episodes in our life is the foundation of our conscious minds. This would explain, they say, our frequent inability to control our thoughts and our capacity to unconsciously complete complex tasks, such as driving or making music. 

“Our central claim is that consciousness is essentially and originally part of explicit memory. We experience the world progressing serially because our conscious memory system creates a linear, coherent stream of experiences from our unconscious, parallel brain processes,” the team concluded. “We believe that our memory theory of consciousness is useful (and perhaps correct) because it helps explain phenomena that have been recognized as long-standing puzzles for previous theories” and also “helps us understand clinical syndromes, experimental studies, and everyday experiences.”

Of course, this is all just a theory—it may well be disproven, or another theory may prevail. The authors note that past experiments that may indicate unconscious memory at work complicate their idea, but they add that there may be alternative explanations for the observed results. Regardless, it’s a fascinating hypothesis. 

In September of 2021, the Ohio Medical Board automatically renewed the license of osteopathic physician Sherri Tenpenny, surprising just about everyone, seemingly including Tenpenny herself. She issued a statement on Telegram thanking her supporters for standing behind her. “Especially now,” she wrote, “as we navigate through some of the most harrowing times we will most likely ever witness!” 

Months later, public records show, Tenpenny was being investigated by the same medical board, an investigation which is ongoing; she faces consequences ranging from a reprimand to the potential loss of her medical license. While the details of why she’s being investigated aren’t public, it seems safe to presume it has something to do with Tenpenny’s extensive, well-documented, and frequently outrageous anti-vaccine statements. (A spokesperson for the medical board told Motherboard, “Under Ohio law, complaints and/or investigative materials, including the number of complaints or investigations, are confidential. However, if a licensee is disciplined by the board, the action is public record.”) 

Osteopaths often fill the same roles as MDs, but also focus on the musculoskeletal system; the osteopathic philosophy holds that many health issues are due to misalignment of the bones, joints, or muscular system. (Osteopaths are sometimes accused of employing dubious theories or pseudoscientific practices in their work, though that is not always the case.) For years, though, Tenpenny has put her focus instead on the supposed harms of vaccines. During the pandemic, she’s made ever-more extreme and occasionally comical claims about COVID vaccines in particular. Shortly before her license was renewed, for instance, Tenpenny claimed that COVID vaccines make their recipients magnetic. “‘They can put a key on their forehead. It sticks,” she declared, falsely, in testimony before the Ohio House Health Committee that quickly went viral. 

Nor are vaccines, by any measure, a new preoccupation for her: During remarks made aboard a 2016 cruise for conspiracy theorists, which I attended, Tenpenny downplayed the risks of measles—a disease that can be deadly—to young children while advocating against MMR vaccines. She also told her audience that, in general, they shouldn’t need to be vaccinated as long as they avoided “filth countries,” a phrase that has lodged immovably in my memory. 

As Tenpenny faces down Ohio’s medical board, a similar drama is playing out in Maine, where a hospital internist named Meryl Nass has had her medical license suspended since January of this year. Nass, who describes herself as an expert on anthrax and vaccine injury, has actively spread COVID misinformation on Twitter and on her blog; she’s also involved with Children’s Health Defense (CHD), Robert F. Kennedy Jr.’s prominent anti-vaccine organization. She’s made conspiratorial claims that COVID is part of a large conspiracy on the part of “the cabal,” as she calls it, writing on Substack in June that “the cabal” is “seriously pulling lots of levers now, and that money pox [sic], artificial shortages of oil, fertilizer, railway cars and baby formula are part of their plan to create economic havoc worldwide, and probably famine in the poorer regions of the world.” 

The medical board began investigating her after she prescribed hydroxychloroquine and ivermectin to a COVID-positive family of three – two parents and their adult son– charging that she failed to follow proper standards of care. All three people ultimately ended up in the hospital; a concerned doctor who treated one of them made a report to the medical board. Separately, a midwife reported Nass’ conduct to the board in December, saying that earlier in the year, one of her pregnant clients tested positive for COVID and said she was prescribed hydroxychloroquine by Nass. A progress note that Nass wrote on September 21 for the patient contained, according to the board, “no patient history, no physical examination, no medical decision-making, no patient informed consent, no coordination of care, and no recommended follow-up.” 

At a hearing this week, Nass called other COVID-and-vaccine denying pseudocelebrities to testify on her behalf, including Robert Malone, who falsely claimed that people were getting COVID vaccines due to “mass formation psychosis,” and Pierre Kory, one of the ivermectin guys.

Nass and CHD have made it clear that they view the case against her as a momentous one. CHD livestreamed two October hearings against her and crowed when the board dropped some of the misinformation charges against her. (The board did not return a request for comment from Motherboard about why it chose to do so.) The Epoch Times, the Falun Gong-backed newspaper which has become an enormous pipeline for far-right misinformation and for which Nass has written columns on COVID, also aired a livestream of the hearings. In a lengthy opening statement, Nass’ attorney, Gene Libby, denied any wrongdoing on her part or failure to properly care for her patients, and said she had been “caught in a web of government lies to the public.”

The anti-vaccine world seems to see Nass’ situation as a test case in how to combat charges of misinformation, as well as a chance to loudly promote what they call “early treatment”—that is, the use of long-discredited COVID treatments like ivermectin and hydroxychloroquine. 

“Once I realized I was being used as a poster child in a national fear campaign designed to purge doctors who think independently, I decided to fight back,” Nass wrote in a recent blog on Substack. “Fortunately, Children's Health Defense is helping with my legal expenses, which is what allows me to mount a strong defense against the bulldozing of free speech, patient autonomy and choice, and the doctor-patient relationship. There is a lot riding on the outcome.”

In one sense, Nass is correct: What’s happening to her and Tenpenny is part of a much larger trend, and a brewing, culture-wide showdown. State medical boards and certification bodies face growing pressure to take action against crank doctors, and more and more often, they’re heeding that call. This summer, Kory and Peter McCullough, who have both loudly advocated for discredited COVID treatments, said they were at risk of losing their board certification from the American Board of Internal Medicine. California governor Gavin Newsom recently signed a new law that will make doctors subject to professional discipline if they repeat “false or misleading” medical information to their patients. And the Federation of State Medical Boards recently issued a strongly worded statement and a position paper on the problem of physicians spreading medical misinformation, and the consequences they should face. 

Anti-vaccine organizations and public figures have proclaimed that they’re outraged by these actions, saying they infringe on free speech and the privacy of the doctor-patient relationship. But they also quite clearly see an opportunity, taking this moment as a chance to grandstand, promote more COVID misinformation, turn the reprimanded doctors into martyrs for free speech, and, above all, fundraise. 

And they have powerful allies, like Wisconsin senator Ron Johnson, who recently told an anti-vaccine audience he’s in a “guerilla war” against the medical establishment and what he called “woke doctors.” (Johnson complained those doctors “will not question authority, don't have the courage and compassion to practice medicine. They just follow orders.”)  

There are also clear signs that medical boards trying to sanction crank doctors is becoming the next major culture war fight. In several states, legislation has been introduced that is aimed at limiting medical board power or explicitly allowing “off-label” treatments—that is, things like ivermectin and hydroxychloroquine— for COVID. (The prescription of drugs outside their intended use, it should be noted, is incredibly common. It’s difficult to imagine what a regulatory regime that would still permit it while barring discredited COVID treatments would look like.)

Meanwhile, some medical experts say what medical bodies are doing to respond to the problem of crank doctors isn’t enough. 

“At this point, I’m disappointed and I'm just pissed,” Nick Sawyer told Motherboard. He’s a co-founder of No License for Disinformation, which was founded to respond to the problem of doctors promoting COVID and vaccine misinformation. 

The medical establishment response, Sawyer, argues, has been utterly inadequate, the definition of too little too late. 

“There are so many people who have the authority, the platform and the finances to stop this,” he said recently. “But they’re not standing up for science, the truth, and they’re not standing up for patients.” 

Even before COVID, a small subsection of doctors promoted medical misinformation: bogus cancer cures, fake and politicized science drawing false linkages between vaccines and autism, or between abortion and subsequent breast cancer. Naturally, then, COVID misinformation began as soon as the pandemic did, and doctors were never immune to its lure. People like Nass, Kory, and Malone, who weren’t particularly prominent before the pandemic, have become famous in the alternate, COVID-skeptical universe, even as they face some amount of mainstream opprobrium or professional consequences. Joe Rogan has played a particularly large role in increasing some of these people’s public platform, hosting Kory, Malone, McCullough and former New York Times journalist and current full-time COVID troll Alex Berenson, among numerous other guests who have made false or misleading claims about COVID and vaccines.  

Not every doctor has suffered professional consequences for promoting COVID misinformation: Joseph Ladapo, for instance, a UCLA researcher who appeared with the quack group America’s Frontline Doctors, has become Florida’s surgeon general, a position he immediately used to fearmonger about COVID vaccines. Ladapo recommended that younger men not get those vaccines, leading to immediate and widespread condemnation from other medical experts.

It’s also not common for doctors to be suspended or stripped of their licenses solely for promoting misinformation or for promoting their own bizarre brands of COVID denial. (One doctor in San Francisco who promoted bogus COVID treatments did relinquish his medical license voluntarily last year to become an unlicensed “health coach.”) Most of the charges against Nass are about her failure to create a coherent treatment plan or refer her patients to an emergency department when it became clear they needed one, and for lying to a pharmacist, claiming that one of the patients had Lyme disease,in order to get them a hydroxychloroquine prescription. (Nass acknowledged lying in a statement to the medical board.) There won’t be a quick resolution to her case, either; the next day of hearings is not scheduled until January, giving CHD and other similar organizations plenty of time to make her a poster child for their movement. 

Sherri Tenpenny, meanwhile, currently faces a possible reprimand for not participating in the administrative process set up by Ohio’s medical board. Records from the board show that state investigators have tried to make contact with Tenpenny since July of 2021, before her license was automatically renewed. Their last attempt, according to a letter they sent to her and her attorney, was in mid-June 2022, when they asked her to attend an “investigative office conference” the following month. Tenpenny informed them in a return letter that she did not believe the board “has a lawful basis for the investigative office conference” and said she wouldn’t participate in it. (Tenpenny’s attorney, Thomas Renz, who’s busily tried to make a name for himself by aligning with the anti-vaccine movement, did not respond to a request for comment from Motherboard.) 

In both cases, the doctors are setting up clear challenges to the medical board’s authority, their ability to oversee what doctors do and set basic safety and competency standards. 

“These doctors are violating state law,” said Sawyer of No License for Disinformation, referring generally to doctors who promote medical and COVID misinformation. “It’s not like this is a matter of opinion. Each state has a medical practice act that specifically defines the boundaries around acceptable professional behavior.” He’s watched as the same group of doctors and anti-vaccine groups put out statements and shoddily-designed studies, all aimed at questioning the realities of COVID and the vaccines against it, what he calls a “brute force disinformation campaign.” 

This new campaign takes it a step further, Sawyer added; by questioning a state medical board’s authority to oversee them, and the science underpinning the practice of medicine, “these people are questioning reality itself. And that’s incredibly dangerous.” 

This is, of course, of a piece with the politics of the moment: The states trying to legalize or formalize the use of drugs like ivermectin are largely conservative-leaning ones, where denying the reality that Donald Trump lost the last election brings political advantage. If Republican politicians get the sense that standing up for quackery and against the basic processes of the administrative state is a useful wedge issue, there’s no reason to think more of them won’t join in. And in the meantime, the ivermectin and hydroxychloroquine discourse is leading to increasingly weird, bizarre and and worrying real-world encounters. Last December, the president of the California medical board said she was followed and harassed by people belonging to America’s Frontline Doctors, four of whom confronted her in a dark parking garage and followed her to her home. (The incident ended without physical violence.) 

There’s a strong reason to think that all of this is just beginning, and that the endgame here is not just to question reality, but to bend it into a shape more favorable to the COVID deniers and the broader pseudomedical universe they’re part of. Part of the strategy for getting there is to force loud, public showdowns between these two versions of the world. Medical boards records show that after Nass prescribed hydroxychloroquine to her COVID patient and lied to a pharmacist to get it, she reported what she’d done herself. 

“I wrote a letter to the board of medicine telling them they had forced me to miss inform [sic] a pharmacy today in order to get a life-saving medicine to a patient,” Nass wrote in a text to the patient’s spouse. “Let’s see what they do with that.”