Another doctor who's been banging on since March and been right every time, ex-colleague of one of our duo of public govt scaremongerers and ex CEO of Pfizer. Dr Michael Yeadon.
For others, impacts are substantial. Failures of businesses small & large are unavoidable despite Govt assistance & poverty is an inevitable consequence. The interruption to normal social lives represent, for some, the severing of crucial contacts without which their lives are lonely & without meaning. But the effects of the restrictions are most evident on people’s health. The NHS is harder to access than before, resulting in missed maternity reviews, lowered rates of childhood vaccinations & checks on development milestones in babies. There has been a catastrophic fall in the rates of routine screening for diseases which, if detected early, have a high chance of good outcomes, like tests for cancers. GPs normally urgently refer a small fraction of their patients for investigation of worrisome signs & symptoms. This everyday, lifesaving practise is reduced alarmingly. There is no question that a large number of people have already suffered & died avoidable deaths as a direct effect of ‘measures’ who’s stated intent is to preserve life.
Many children & young adults at schools and universities are being deprived of important educational opportunities which will be permanently lost. These young people will bear the scars of the unfocused measures for the rest of their lives. Depression & anxiety across the country has greatly increased and is going innly one direction. Who among us can say the price being paid in livelihoods, suffering & deaths of tens of thousands of our fellow citizens is a price worth paying?
The ghastly irony is anyway clear. These measures aren’t even effective in preventing transmission of respiratory viruses. We can already see the increases in seasonal viral illnesses, from colds to ‘flu. Speaking of ‘flu, the Declaration asks us to do no more than we do, as individuals & as a society, in relation to risks from ‘flu. Despite ‘flu vaccines, and care in relation to elderly or unwell relatives & friends, we’re generally mindful not to spread illness when we are symptomatic. Most are mature enough to recognise that ‘flu fatalities are a consequence of shared existence and in many cases is the final illness is the old & infirm.
The vast majority of deaths from covid19 are in the elderly. Median age of those perishing of or with this virus is over 80. The risk of imminent demise of those of advanced years is well understood & even successfully avoided in the case of covid19 for some people, others of the many endemic or seasonal viruses will instead be that final illness. Importantly, we are now appreciating that the magnitude of the threat to life & health of covid19 is, mercifully, not close to the levels we initially thought, from way back in the early spring. It has lways been the case that estimates of the lethality of new infectious disease outbreaks are greater during the event than calculated in the cold light of day. This is mostly because we greatly underestimate the numbers of people who’ve been infected yet had mild or no ymptoms. It is already clear that, far from being an unusually virulent & lethal virus, improving estimates of the morbidity & mortality associated with covid19 show it to be rather ordinary. I’m confident that in retrospect, we will see covid19, from a medical perspective, as akin to seasonal influenza, killing around 1 in 1000 people it infects. In matters affecting the whole population, it’s important to be dispassionate. The general public doesn’t routinely need to know that every year, just under 1% of us won’t make our next birthday. Viewed against that, which represents around 620,000 deaths annually, the approximately 0.06% who have died from or with covid19 is, as you can see, from an actuarial perspective, not even a leading cause of death.
So here we are, engaged in a battle to prevent the spread of a single, not particularly remarkable respiratory virus, using methods that simply don’t work, while seemingly willing to accept, as a price worth paying, the indirect & avoidable deaths of tens of thousands of our families, friends & neighbours. On top of this, the impacts on the economy of the measures have had & will continue to wreak devastation on the lives of millions of the most vulnerable people. I have never accepted this ‘lethal calculus’, and I don’t believe you should either. That said, I’m not defeatist at all about how better to handle the threats that covid19 represents. We’re so much more able to save more lives of those made deeply ill by it than we were in spring. We know now only rarely to ventilate, for this is not a disease of airways obstruction but of impaired gas exchange, so we offer oxygen masks. Often this alone both relieves extreme distress but is sufficient for the patient to bridge a few days & move onto a path of healing. We’re now alert to clotting disorders, so carefully monitor parameters of coagulation & where needed, we’ve a medicine chest f anti-coagulants ancient & modern on which to rely. And we also now know that overwhelming inflammation can be part of the course of disease in some, and know how to safely use powerful anti-inflammatory corticosteroids (most familiar you us through their beneficial effects on asthma). We don’t yet have a vaccine, that much is true. But do note, a vaccine isn’t going to be a panacea. I think it’s most important to recognise that in the very old & already unwell, vaccines are often simply not very effective.
You require a well unctioning immune system in order to benefit from a vaccine. I do think we’ve lost our way completely on all this. Many people may think the measures imposed on us will at least end triumphantly as medical science vanquishes this virus. I don’t wish to be overly negative but we don’t even know if vaccines will much reduce the death rate from covid19. It may surprise you to learn that this endpoint, deaths, is not something even being studied in clinical trials. The main objective is to understand the durability of an immune response to the vaccines in development. I believe there may be some “challenge studies” yet to be conducted. So we actually don’t even know for such to what extent vaccines will reduce illness, either. Now, I do expect they will reduce the severity of illness in some. I’m open-minded to the possibility it will only have a marginal impact on deaths. It’s also the case that only a minority of population have any need whatsoever for a vaccine against covid19. That’s because most of us are not made ill by it & most who are, do not require hospitalisation. In his regard, it’s very like ‘flu. We offer ‘flu vaccination to people over 60, some others who are more vulnerable as a consequence of an ongoing illness & to some children (‘flu can kill children, though it is an extremely rare event). Others talk of ‘long Covid’. While of course we must remain vigilant to prolonged consequences of a severe illness from this virus, it’s important that you know that this syndrome is not at all new. The way it’s discussed, you’d be forgiven for thinking it’s a new observation. It also occurs after other viral illnesses, including ‘flu. The data are yet young, but good reviews have appeared & so far, there’s no sign that ‘long’ occurs more often or with greater severity after covid19 than after ‘flu. Turning to the immune system, it’s vital to appreciate some important points.
Firstly, ‘flu mutates at a high rate & so despite perhaps having ‘flu last year does not, sadly, mean you can’t get it this year. The vaccines that are made available are the best guess of the likely dominant strain by the time it reaches us. The effectiveness of ‘flu vaccines is quite limited & in some years, almost nothing at all. But we don’t restrict society for months on end. If we were to chase around the country, testing the population for the presence of partial genetic sequences of ‘flu, we’d be shocked. A very large number of people will be infected by ‘flu from now until spring 2021. But few will be made very ill by it and some - we’ve no idea how many - people will die from it given that there isn’t any meaningful immunity in the population to each new strain of ‘flu......