BMJ Blogs

I can understand why people feel this way, and in the UK this is also somewhat prevalent. In part, it stems from the poor messaging on COVID risks (at the individual and population level) and control measures we have available. In short, the UK media are somewhat pushing "COVID is over" at the same time as "the only tool is lockdown, and we can't do that again". These two factors, I suspect, mean that people are encouraged by the vaccination-heavy strategy we're pursuing.

Children are one group for whom this strategy may be problematic, and is a more significant issue in the UK than US right now given that only 12+ are eligible. This review discusses some of the arguments around this topic: https://adc.bmj.com/content/early/2021/11/01/archdischild-2021-323040

We also have CEV and elderly groups for whom the vaccine still leaves a reasonable degree of risk. Here's an opinion piece that cites research into CEV & vaccine protection: https://blogs.bmj.com/bmj/2021/03/30/vaccinated-yet-still-clinically-extremely-vulnerable/

In addition to the health risk/benefit to the individual, there is also the societal cost to lost productivity. This is where keeping low COVID prevalence may be worth pursuing on a solely economic basis through low-invasiveness NPIs.

Of course, there's also the risk of escape variants, and that's just simple maths. As vaccine-only strategies do not keep R(eff) < 1, there is reasonable potential for escape variants like Omicron to surface. Though I am not…

From Wikipedia, on the Great Barrington Declaration:

The World Health Organization (WHO) and numerous academic and public-health bodies have stated that the proposed strategy is dangerous and lacks a sound scientific basis.[8][9] They say that it would be challenging to shield all those who are medically vulnerable, leading to a large number of avoidable deaths among both older people and younger people with pre-existing health conditions,[10][11] and they warn that the long-term effects of COVID-19 are still not fully understood.[9][12] Moreover, the WHO says that the herd immunity component of the proposed strategy is undermined by the limited duration of post-infection immunity.[9][12] They say the more likely outcome would be recurrent epidemics, as was the case with numerous infectious diseases before the advent of vaccination.[11] The American Public Health Association and 13 other public-health groups in the United States warned in a joint open letter that the Great Barrington Declaration "ignores sound public health expertise" despite public health experts agreeing "better balance must be found between protecting public health and helping the economy."[8]

The Great Barrington Declaration was sponsored by the American Institute for Economic Research, a libertarian free market think tank associated with climate change denial.[13][14][15]

More on the AIER:

Prominent AIER fellows have run afoul of social media for opposing such measures. For example, Naomi Wolf, the…

Another similar story recently was a bug found in analysis software used in many 'brain scan' papers. Then there are a continuous stream of scientific retractions going on (see retractionwatch.com).

We do science as follows: data is collected, run through some analytic and/or statistical method, and then the results are published. Then those results get cited by other papers. It's a dependency graph. If some flaw is found in the data or the analysis it would be natural to invalidate this paper and automatically flag all downstream dependencies in the chain of inference. Unfortunately the publishing model does not allow this.

I think if we'd developed the internet and software engineering practises before we'd developed scientific publishing, what scientists produce would look less like papers and more like Git repositories. Under this fantasy scenario, we'd have metadata that included statistical methods and software for all analyses. The raw, open data in the repositories could be re-analyzed by anyone else at any time. If there were doubt thrown on a method, or if some data were fraudulent, we could instantly assess the impact on all of current knowledge.

I wonder if these recurring problems in curating and re-assessing knowledge will eventually lead to a restructuring of science. Researchers are starting to take the idea of a 'post journal world' seriously (http://blogs.bmj.com/bmj/2016/06/15/richard-smith-what-will-the-post-journal-world-look-like/)

Some quick points about this.

The British Medical Journal and Royal Society of medicine have published a number of concerns about this vaccine.

"Will covid-19 vaccines save lives? Current trials aren’t designed to tell us"
https://www.bmj.com/content/371/bmj.m4037

"All these data for the different vaccines are potentially very promising, but none of the phase III trials have been published in peer reviewed journals or analysed by age group, gender and case description...

As public health professionals, we believe that the results of clinical trials, whether interim or final, should be subject to an appropriate systematic process, and then published in peer-reviewed professional journals. Reporting the covid-19 vaccine trial results in press releases before publication in journals is neither good scientific practice nor does it help to build public trust in vaccines"
https://blogs.bmj.com/bmj/2020/11/27/covid-19-vaccines-where-are-the-data/

"When good science is suppressed by the medical-political complex, people die

Politicians and governments are suppressing science. They do so in the public interest, they say, to accelerate availability of diagnostics and treatments. They do so to support innovation, to bring products to market at unprecedented speed. Both of these reasons are partly plausible; the greatest deceptions are founded in a grain of truth. But the underlying behaviour is troubling."
https://www.bmj.com/content/371/bmj.m4425

In the UK: The doctors come up with a plan. The parents disagree. The doctors need to go to court to get a ruling.

In the US: The doctors come up with a plan. The parents disagree. It is the parents who need to go to the courts to get a ruling.

Charlie Gard's case has absolutely nothing to do with cost. In the UK children are humans and humans have rights, and those rights are protected by the courts. Parents do not get to own children as possessions. The courts will focus on the child's best interests, because of the Paramountcy Principle which flows from Article 3(3) of the EU Treaty and Article 24 of the Charter of Fundamental Rights of the European Union, which flows from the UNCRC article 3(1). Charlie Gard's case is about someone who cannot make a choice for themself, and the courts focussing on that person's best interests, not on the interests of that person's relatives.

Charlie Gard had RRM2B MDS. This has fewer than 50 cases worldwide. There is no cure. There is no treatment. The discussion is whether to allow him to die with pain relief, or allow medical experimentation that has no hope of success but which will cause pain. Unsurprisingly the courts decided it was in his best interests to be allowed to die with pain relief.

http://blogs.bmj.com/medical-ethics/2017/07/07/never-let-an-ill-child-go-to-waste/

You may wish to read the judgments, because almost everything written by the US press was…

Well, about that ...

https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-research-is-fraudulent-until-proved-otherwise/

"Richard Smith was ... for many years the chair of the Cochrane Library Oversight Committee, and a member of the board of the UK Research Integrity Office."

"Stephen Lock, my predecessor as editor of The BMJ, became worried about research fraud in the 1980s, but people thought his concerns eccentric. Research authorities insisted that fraud was rare, didn’t matter because science was self-correcting, and that no patients had suffered because of scientific fraud. All those reasons for not taking research fraud seriously have proved to be false, and, 40 years on from Lock’s concerns, we are realising that the problem is huge, the system encourages fraud, and we have no adequate way to respond. It may be time to move from assuming that research has been honestly conducted and reported to assuming it to be untrustworthy until there is some evidence to the contrary."

So a former Chair of the Cochrane Library Oversight Committee thinks medical research is filled with fraud. How reliable can it be really?