Thousands of scientists and medical professionals have now signed a letter published in the Lancet against ending lockdown. It’s been well received outside of the UK but, for some odd reason, it’s been largely ignored by the UK government. Following on from the health secretaries statement in the commons yesterday, the team heading up the challenge have decided to hold another press conference.
Dr Deepti Gurdasani, Clinical Epidemiologist and Senior Lecturer in Machine Learning at Queen Mary University started proceedings by challenging the government’s “if not now, then when” argument by explaining that we’ve still only vaccinated 51% of the population so clearly ‘now’ is not the right time and ‘when’ would be after we’ve achieved a much higher rate of double vaccinations. She also questions why there has been no consideration given to the rate of people getting long-Covid or the subsequent consequences on patient health, front line NHS workers and on routine care. Dr Gurdasani urges us to question why the government is acting against the public interest, given that polls suggest that “public sentiment is ‘not’ in favour of what the government is doing”
Professor Christina Pagel, Director of the Clinical Operational Research Unit at UCL and a member of Independent SAGE, revealed that the latest SAGE models have just been released and they’re predicting that “at peak you could have 1000 to 2000 (hospital) admissions per day” and there don’t appear to be any contingency plans for when the NHS gets overwhelmed. She also picked up on an interesting point in that the government have inadvertently admitted that schools are not a safe place for children because now they’re arguing that the summer holidays is a good time to end lockdown when children will be off school. Prof Pagel also points out that there’s been no mention of how they intend to protect children when they return to school in September and she reminds us that school safety has been part of the government’s argument for not vaccinating school children. Prof. Pagel appears genuinely flabbergasted at the government’s rhetoric. She challenges their argument that opening up is inevitable and that we have no choices. She goes on to explain that dealing with an infectious disease, or “a pandemic, requires collective responsibility not individual responsibility… we can choose to support our vaccination program with better contact tracing, with support for isolation, with support for businesses, with better ventilation… All of that we can choose to do and ‘they’re’ not choosing to do it”
Dr Richard Horton, the Editor in Chief of the Lancet, exclaimed his shock at witnessing the Secretary of State for Health, in the Commons today, endorsing the lifting of all restrictions at a time “when you’re seeing a doubling of the infections every 11 days, hospitalisations going up almost 50% in the past week, Covid-19 dedicated intensive care units being recreated, warnings from NHS providers and the NHS confederation about pressure on the NHS.” Dr Horton also points out that the government is choosing to be highly selective in the data they reference. For example, the government are currently quoting a rate of infection of 301 cases per 100,000 (6th July) when, in actual fact the infection rate is very different around the country… “in the north east its 706, per 100,000, in the north west its 434 per 100,000… in particular sub-regions it’s even higher, south Tyneside – 1,308 per 100,000, in north Tynside its 726 per 100,000, Newcastle its 837, Gateshead its 876.” Dr Horton explains that the government is “allowing this unconstrained pandemic to course through our communities… rapidly deepening the existing inequalities that already put people at risk.” Dr Horton then adds that he “found it extraordinary that the government’s Chief Medical Officer, Professor Chris Whitty, suggested and emphasized that there was widespread agreement across the scientific community, whereas, in fact, there is profound disagreement.. he mentioned the letter form the Academy of Royal Colleges, he did ‘not’ mention the letter that many of you have signed and that we have published and I’m afraid I have to conclude that the Chief Medical Officer is wilfully misrepresenting scientific opinion across the country and that is extraordinary to observe”
Dr Helen Salisbury, a GP and educator at Nuffield department of primary care health sciences, explained that in her area she’s seen a large number of cases, mostly in the younger age groups, many that have had one vaccination and a few that have even had two vaccinations (including one of her colleagues). She explains that people who are unvaccinated and those who have a weak immune system (i.e. older people in general) and cannot mount a response to the virus, feel like they’re being “thrown to the wolves.” Dr Salisbury thinks the government is being “completely irresponsible” in their actions as they are effectively allowing the UK to become a petri dish for the development of new mutant strains that will make us all less safe and she points out that no other country in the world has taken this approach. Everyone else is effectively still working hard to reduce the case numbers and stop the spread. She’s also struggling to understand the logic in telling NHS frontline workers that they won’t need to isolate if they’ve been double vaccinated, despite being pinged by the track & trace system. The fact is, you can still get infected even if you’re double vaccinated and you can then become an asymptomatic carrier and pass it on to all your patients.
Trish Greenhalgh, Professor of Primary Care Health Sciences / Medical Sciences division at the University of Cambridge, talked about the insanity of the government’s decision to remove the legal mandate for wearing a mask and keeping a safe distance. She explains that it only takes one unmasked carrier in a train carriage to contaminate the air for all the other passengers. Masks, she says, should be seen as a symbol of freedom.
Dr Zubaida Haque, former Interim Director for the Runnymede Trust and a commissioner on the Hamilton Commission, explains how the 19th July will not be “freedom day” for the clinically vulnerable nor for the children or the carers of the clinically vulnerable, as “their freedoms will be substantially restricted!” She believes it’s fair to ask the government whether or not any “equality impact assessments were carried out on the impact of opening up, on the impact of abandoning ‘all’ public health measures or all legal restrictions around public health measures on disabled groups… and clinically vulnerable” Professor Christina Pagel further added that “it also affects ethnic minorities and more disadvantaged communities who we know are already more exposed to catching Covid through their living and working conditions.” These communities also have significantly lower rates of vaccinations and are more prone to getting long-Covid, so she points out that by dropping all restrictions, the government is “allowing infections to rip through disadvantaged and ethnic minority communities disproportionately”
Professor Martin McKee, a professor of European Public Health, LSHTM and also a member of Independent SAGE, explains that vaccine take up is not yet wide spread enough. In fact, vaccine take up has dropped significantly and we certainly have not “broken the link” between cases and hospitalisations. He also explains that the government road map came in months before we registered the first cases of the Delta variant and yet the map still hasn’t changed to accommodate this fact.
Professor Aris Katzourakis, Professor of Evolution and Genomics at the University of Oxford, talked about the evolution of new variants and explained that “the public health measures that we take have direct evolutionary consequences and we saw this both with the alpha and the delta variants… the alpha was facilitated by the relaxation in December 2020, while the Delta variant was imported, in very grave numbers, due to a failure in having an appropriate border control policy.” Relaxing our guard now effectively risks further viral evolution and spread in a partially vaccinated population. Prof. Katzourakis explains that opening up now means a much more significant risk of viral evolution (mutant variants) than if we’d waited for greater proportion of the population to have been vaccinated first.
In the Q&A section there was an interesting question about whether or not clinically vulnerable children should be attending school, given that restrictions will have been lifted and the government hasn’t put in any mitigating measures to ensure their safety. Dr Deepti Gurdasani, made an excellent point… “the only thing they can do is not attend school.. we’ve created this situation in the name of ‘personal responsibility’ where children can do nothing to protect themselves apart from get out if education.” She explains that lots of parents have been forced to de-register their children as a result.
Another interesting question put to the panel was whether the government might be forced to u-turn if the case numbers rose steeply after a number of super-spreader events, like the Euros’ appear to have been. A number of the panel seemed to be convinced that the government is now pursuing a herd immunity through infection strategy and super-spreader events would only serve this agenda. Dr Zubaida Haque goes on to describe the government’s strategy as a “mass infection experiment” designed to see what happens when you let a virus rip through 48% of a population (i.e. people who have either only had one dose or haven’t yet received a single dose of the vaccine).
The panel then discussed the modelling that the Chief Medical officer had been referring to, in his earlier statement, in respect of scenarios for opening up over the summer, compared to opening up over the winter months and a number of the panel pointed out that the modelling is very limited because it only looks at cases and deaths. It doesn’t take into consideration the number of people who might get, and have to live with, long-Covid for example.
A number of the panel also pointed out that the government’s thinking is deeply flawed when it comes to pursuing herd immunity through some final wave of infections because, as we’ve seen elsewhere, even countries who put in stricter restrictions, stronger border control measures and who managed to vaccinate a larger percentage of their population, still had another wave of infections because another more transmissible variant took hold and because vaccine immunity is not an indefinite state as you do eventually need to have boosters. The irony is that despite the fact that the UK has a huge rise of cases at the moment the government is pushing to relax border controls.
It seems the panel are largely in agreement that the government are now pursuing a strategy of herd immunity by infection. Concluding the session, Dr Salisbury remarked on the distinctions between achieving herd immunity through vaccination compared to allowing infections to rip through the population.. “if you do it by infection, loads of people get ill and lots of people get really ill and stay really ill. If you do it by vaccination, you’re in control, you don’t pass it on and everybody stays well.” In her view, pursuing herd immunity through infection is “criminal.” Seems to me, there might be other distinctions as well. For example, herd immunity through infection would facilitate further mutations and allow new variants to develop. This could potentially have a devastating impact on the UK population, not to mention the rest of the world.
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