El Andalous - Considerations

 

Sahl Hasheesh at Night

I’m writing a blog on my thoughts on the pandemic this week, because I’ve been spending a lot of time brooding about it and researching as I try to determine what it is that I believe (I’m not sure I’ve got there yet!). I don’t want to prescribe to people what they should do, but I would be more comfortable if I thought people chose their actions (by the way, Idette, this is not pointed at you - I've been brooding for ages, and I know you thought long and hard, so I'm happy that you made a choice).

I’m going to do my best to keep this as objective as I can and then add some personal thoughts at the end.

On the UK Yellow Card reporting site, it states what is pretty much repeated worldwide:

Vaccination is the single most effective way to reduce deaths and severe illness from COVID-19.

A lot of money has been thrown at the vaccination program.

However, the evidence in favour of the use of ivermectin is persuasive. There are, of course, many ways to cook the data, but just looking at the 30 randomized clinical trials of ivermectin use for covid-19 gives a combined 67% improvement when used as early treatment, 29% improvement in late treatment, and meta-analyses on mortality have shown 62-81% reduced risk of mortality. Ivermectin is generic, cheap, and comes in tablet form. Its long-term safety profile is well understood. Hurrah. Yet WHO will permit its use only in clinical trials. This decision causes loss of life. Incidentally, if WHO had approved ivermectin, they would not have been allowed to approve the vaccines for emergency use.

Why are there no early treatment guidelines / suggestions to reduce the number of hospitalisations and deaths? Early treatment options do exist. Again, vitamin D or ivermectin could be suggested here. Yet the overriding message is simply to isolate, which does not help the infected person to heal. WHO's clinical trial is focused on those who are already hospitalised rather than on treating early when it would be easier to prevent hospitalisation and death.

When assessing your personal risk profile for a vaccine, remember to compare like with like. It does not make sense, for example, to balance a 95% relative reduction for death (ie, relative to the risk for death without the intervention) with a 0.01% increased risk of blood clots by taking a vaccine (figures are fictional and for illustration only). If your risk of death from covid is 2%, a 95% relative risk reduction translates to an absolute risk reduction of 1.9% and a remaining risk of 0.1%, so that's what you need to balance again the risk of various vaccine side effects along with the unknown possibility of side effects that may only become apparent after several years (eg, cancer). Your answer will depend on your own risk profile (do you have underlying conditions making your initial risk of death from covid higher than average, for example), your faith in the information provided about the vaccine safety profile, and your personal stick-a-finger-in-the-air estimate of likelihood of future side effects (which can range from nil risk to certain death, according to who you are! At this stage, it’s entirely subjective).

If you want actual figures for absolute risk reduction of the various vaccines (and a less simplistic explanation of absolute risk reduction), read this article.

Bear in mind that authorisation of emergency use is not an experiment (in the sense of formal clinical trial). In a clinical trial, all adverse events would have to be reported regardless of presumed etiology (since adverse events can be surprising, such as suicide, which was originally not consistently monitored in clinical trials until it was revealed to be an actual possible adverse event). Adverse events are notoriously underreported in real life use. From the UK Yellow Card reporting site, page 10 of the report of July 7^th:

The overall reporting rate is in the order of 3 to 7 Yellow Cards per 1,000 doses administered for the Pfizer/BioNTech vaccine, COVID-19 Vaccine AstraZeneca and COVID-19 Vaccine Moderna. It is known from the clinical trials that the more common side effects for both vaccines can occur at a rate of more than one in 10 doses (for example, local reactions or symptoms resembling transient flu-like symptoms).

That is, the reporting rate is 0.7 reports per 100 doses vs known common side effects occurring in more than 10 per 100 doses. My point is that without trial data, it’s difficult to assess a vaccine’s safety profile. Nevertheless, the Yellow Card figures are thought to vindicate the use of vaccines, despite numerous claims that the Yellow Card (or other database) data cannot be used for analysis (and thus conclusions, presumably).

It’s unclear to me at what point a reported event becomes a safety signal (ie, a danger signal). For instance, there were over 1000 deaths reported as suspected associated with the drug but were deemed, after analysis, to be not related as many were in aged patients or people with underlying illness. However, thromboembolic events were a safety signal with 405 cases (presumably due to the excess in the young, which may have just been more frequently reported) and they are investigating 22,981 menstrual disorders but are downplaying it by saying that these are common in general practice. Remember, these numbers are likely under reported. As above, it ends up being a personal assessment about whether the adverse events are likely or not.

My concern is the trend towards making vaccines mandatory and the rising number of people who are vaccinating because they want to be able to travel, or go to events. To me, this latter is close to coercion. This is not how health practice is meant to be. And my personal view is that the vaccines were pushed forward without any emphasis on implementing, trying out, or assessing early treatment options to resolve disease before hospitalisation and death enter the equation.

I am happy to live in Egypt where President Sisi stated outright he did not want to create fear in the population regarding the coronavirus. I switched off the news fairly early on in the pandemic, so I’m coming from a perspective where I haven’t been exposed to a lot of the messaging. I am not necessarily anti-corona vax, but I am pro-choice. I also don’t think using new vaccines whose long-term safety profile (or long-term efficacy) is not yet known with the aim of obtaining herd immunity is an achievable or ethical goal. The lack of interest in cheap options where there’s no profit to be made smells to me like a society that’s corrupt. Maybe I shouldn’t be so surprised. And maybe I’m wrong. But that’s where my view is tending.

If there’s no blog next week, you’ll know I’ve been banned!