Thursday 7 January 2021

There's no vaccine against ineptitude

In April 2020, I wrote an article accusing political leaders in Europe and USA of prioritising ideology over epidemiology – of callously sacrificing lives not just to Covid-19 but, needlessly, to the Moloch of partisan dogma.

What happened since then can be adequately described with just one word: ineptitude.

On the positive side -- one societal engine did fire up: science delivered a solution – it did so assuredly, in just a few short months.  It developed vaccines, tested them on tens of thousands of people and found them to work better than anticipated.  All our esteemed leaders have to do now is make sure those vaccines are manufactured, distributed and administered with rocket speed, as befits a once-in-a-century emergency.

For once, money is no object: in the UK, each day of lockdown costs nearly £2 billion.  That’s 10% of the entire annual NHS budget, gone to the drain every goddam week!  And that’s before one factors in the long term and indirect effects of the economic slump…  Oh, and there’s also the small detail of 1,000 people currently dying of Covid every day.  So any conceivable expenditure needed to shorten the ordeal is, almost by definition, justified – not just financially, but in moral terms, too!

And yet, in more than 3 weeks of ‘vaccination drive’ (i.e., by 6 January 2021), the UK managed to give the first jab (i.e. to ‘half-vaccinate’) to a paltry 1.3 million people; that’s just 10% of what the government itself defined as the ‘top priority’ group – those over 70, people with severe clinical vulnerabilities, as well as frontline health and social care staff.  It is just 2% of the population.

On average, just over 56,000 vaccines were given every day in the UK – the world’s fifth-largest economy, boasting almost 7,000 GP surgeries, staffed by circa 45,000 doctors and 16,000 nurses. 

In Israel (the world’s 30th-largest economy, where vaccinations started a week later than in the UK), circa 1.5 million people already got the first jab.  That’s 50% of those over 60 (plus most clinically vulnerable, as well as frontline health and social care staff ) and almost 17% of the entire population.  The country’s GP surgeries are staffed by c. 5,000 doctors

The European Union is performing even more poorly: just 250,000 jabs in Germany and 150,000 in Italy – two countries with strong healthcare assets and capable pharmaceutical industry.  As for France (population 67 million), it is yet to achieve 500 jabs.  No, this is not a typo: I mean 500; not 500,000!

So what’s the problem?  Well, the problem is that… nobody seems to know what the problem is.  Our ‘leaders’ are unable or unwilling to deliver plans and time schedules – beyond ‘targets’ for mid-February and (at a stretch) March.  What’s more, the media seems utterly unable to extract or surmise such information.

The Nature Magazine blames the shortage on vaccine production capacity.  The BBC cites three hindrances:

·        “a global shortage of glass vials to package up the vaccines

·        long waits for safety checks

·        the process of ensuring there are enough vaccinators”

A “global shortage of glass vials”?  Really??  For those who don’t know, glass is manufactured starting from that very rare, precious raw material: sand.

Seriously: which of those “hindrances” came (or should have come) as a surprise?  From the beginning of this pandemic, we were told that vaccines are being developed; that they would be the ultimate key to regaining our freedom, our wellbeing, our normality.  It is in the nature of vaccines that they need to be manufactured, packaged in glass vials, tested and administered by injection.  Why, then, was additional manufacturing and testing capacity not built?  How long does it take to make and install a glass vial line?  9 months is usually enough time to bring to the world a new life; surely it should have been enough to build additional production capacity, to expand batch testing facilities; and to train an army of ‘vaccinators’ (most people who can drive a car can also be trained to administer a jab).  Surely, given the huge stakes, this could and should have been accomplished by now – irrespective of effort and expense?

As for “ensuring there are enough vaccinators”: we certainly could train Amazon delivery drivers to give jabs; but fortunately we may not have to.  Thousands of recently retired doctors and nurses have volunteered to act as vaccinators.  Unfortunately, as the BBC informs us in a surreally casual article, they were told that they cannot… unless and until they take a few refresher courses on such essential topics like ‘Conflict resolution, Level 1’, ‘Preventing radicalisation, Level 1’, ‘Equality, Diversity and Human rights, Level 1’, ‘Data security awareness, Level 1’ and ‘Fire safety, Level 1’.  Children aren’t being vaccinated – but that does not absolve the would-be vaccinators from the strict requirement to study ‘Safeguarding children, Level 2’.  Fortunately, courses like ‘Astronomy for dummies’ or ‘Advanced rocket-building’ are not required.  Yet!

If you think this takes stupidity to new records, wait – this isn’t all; it’s not even the most mind-boggling blunder.

There are, we know, two vaccines approved by the US Food and Drug Administration – a serious, reliable institution – as well as by its EU counterpart.  I am talking about the Pfizer/BioNTech and Moderna products: both tested on tens of thousands of people; both exhibiting efficacies around 95%.

Granted, neither is available in sufficient quantities for the entire UK population.  But, hey: this isn’t ‘business as usual’, right?  It’s war!  So the UK government should buy, rent, steal or requisition all available vaccine production capacity it can get its hands on; it should urgently seek a licence agreement with Pfizer and/or Moderna, enabling the requisitioned facilities to manufacture those companies’ approved, efficacious products.

Instead, the government is idiotically backing and betting on the Oxford/AstraZeneca vaccine – which has so far only been approved in the UK and India.  Why only in the UK and India?  Because it’s safe, but…err… not very good.

The information on the efficacy of this vaccine has been manipulated and dressed up in pompous media articles.  So some of you, dear readers, may be confused.  Let me clarify, using published, peer reviewed scientific data: in clinical trials, the Oxford/AstraZeneca vaccine was administered to c. 12,000 individuals (a similar number received a dummy shot, a placebo).  Circa 9,000 of those 12,000 received two identical doses of vaccine, 28 days apart.  Let’s call this the I (identical) cohort.  But, due to a mistake (!!!), 2,741 individuals were given only half of the first dose, followed by the full second dose 28 days later.  Let’s call this the D (‘different’) cohort.  The vaccine efficacy in the I cohort was just 62%; in the D cohort, the efficacy was calculated (and published) as 90%.  However, this is utterly unreliable, deceptive data: the D cohort was too small and did not include enough old and vulnerable people – so in reality the ‘90%’ is just a number with no scientific relevance, published by the company merely for commercial purposes, to muddy the waters and hide an unpleasant truth: that their product is considerably poorer than those of the competitors’.  In fact, because the D cohort was so inadequate, the British and Indian regulators have only approved the I regimen, the one with 62% efficacy.

So, merely because the AstraZeneca product was ‘invented here’, the UK government will condemn most of us to receive a vaccine that is just 62% efficacious, rather than one with 94% or 95% efficacy.  This means that more of us will needlessly catch the disease – even after being vaccinated.  Some of us might be left suffering of various complications – the so-called ‘long Covid’; some of us might even unnecessarily die – we simply don’t know.

But that’s not all!  There isn’t enough production capacity for the AstraZeneca vaccine, either.  It’s only manufactured… you guessed it: in the UK and India.  So, in order to ‘spread’ the paltry inventory as thinly as possible, the government now decided to ‘invent’ a new vaccine regimen: to give the second jab up to 12 weeks after the first – triple the interval recommended by the manufacturer and assessed in the clinical trials.  Since this regimen has never been tested (not on 9,000 people, not on 2,700, not even on one individual!) it is impossible to know – beyond the level of ‘educated guess’ – what its efficacy will be.  Logically, however, it should be lower – if nothing else, because the virus will have 3 times longer to attack people in-between the two doses.

Let’s be clear here: had a doctor decided to give one individual the two doses 30 (rather than 28 ) days apart, that doctor would have been severely sanctioned.  S/he would have been suspended and may have been unable to ever practice again.  But, through a decision supported by… err… theoretical assumptions, most of us will be subjected to what amounts to a mass ‘medical’ experiment – to a vaccine regimen never tried before.

And it’s not just the government and the few not-very-successful scientists turned ‘advisers’.  The opposition, while valiantly nitpicking at details, completely ignores the big picture.  According to the BBC, Leader of the Labour Party Keir Starmer

“says the government needs to ensure vaccination centres and GP surgeries have better information about how much vaccine they will be given for the rollout of the Oxford-AstraZeneca jabs to go smoothly.”

As for the devolved administrations, they are more concerned with petty, childish manifestations of ‘autonomy’ from Westminster (the Welsh lockdown was called a ‘firebreak’, which obviously is something utterly different from the English ‘circuit breaker’!) than with ensuring the welfare of their nations.

In consequence, the most fateful decisions have never been properly scrutinised (let alone challenged) in Parliament.  As for the legal system… none of those passionate activists who were so keen to attack Brexit-related decisions ever bothered to take this one to court; proving once and for all that ideology matters to them more than the lives of their countrymen.

And then there’s the stupid, sheep-like media.  They will ask the Prime Ministers ‘harsh’ questions like ‘why did you announce the school closures only on Wednesday, when you knew about the problem on Tuesday?’  They’ll swoop like blood-thirsty vultures on some political adviser that broke lockdown rules.  But they seem idiotically oblivious to the things that really matter.

Yes, I blame the government.  But no, it’s not just the executive.  What we are experiencing is a complete failure of the British political system – lock, stock and gossipy tabloids.

But… let us face it: We The People are also to blame.  No, I’m not calling anyone to ‘take the Westminster’; but we should be protesting – peacefully but determinedly – and demanding a reckoning.  If we don’t do that, then we deserve what we’ll be getting: a shoddy vaccination programme – delivered slowly, ineptly and expensively by a subpar ‘leadership’.

No comments:

Post a Comment