you're most welcome to today's talk
wednesday the 12th of may
a little bit of a focus on the uh the uk
a little bit on europe and the united
states today
and it has to be said some interesting
uh or somewhat strange information
coming out of the centers for disease
control but more on that in a minute
now here's the coverage symptom study
data
and we can see this nice downward trend
but the last few days there has been a
very slight increase in prevalence 14857
up slightly overall according to the
coverage symptom tracker
data 17 381
now as you know what i'm concerned about
is the the new variance particularly the
india variant so we're gonna have to
keep a bit of an eye on that and see
what happens
so these are the numbers in the uk just
over two thousand two and a half
thousand new cases
per day officially diagnosed four deaths
twenty deaths yesterday four deaths a
day before 127
000 deaths within 28 days of a diagnosis
that's the death certificate figure 151
000 cases now here we have the uh
this is kind of the official slides that
uh
are used on the downing street briefing
chris whittie goes through these
first one's pretty straightforward it
shows the increase in number of people
vaccinated the blue line one vaccine
the the great brownish area is it there
is uh people have had two vaccines and
the numbers going up in millions so
that's all
pretty good then he showed this slide
which is the evidence of efficacy
in vaccinated people so here we have a
symptomatic disease
hospitalizations deaths now chris whitty
did not explain the difference between
the dark brown and the light brown
in these reductions uh he seemed to skip
over that i think he might have got a
bit confused
and it's not in the official government
explanations either but i think it's
first dose
and second dose i think that's what it
is so after two doses you get this
greater reduction
but this is basically the thing the
reason it's confusing is they actually
say after the first dose here
after one dose but i think that's what
this brown bit means as far as i can
tell
um so reduction in symptomatic disease
55 to 70 after one dose reduction in
hospitalization 75 to 80
after one dose and reduction in death 75
to 80
after one dose and as the darker brown i
believe shows
a greater reduction after after
two doses of vaccine good graphic but we
could have done with a bit more
explanation there from uh
from the government sources and from
chris whitley when he gave the
presentation
uh now this this is really quite
important so here we are we're
vaccinating over 40s
now this is deaths here so of course
it's going to prevent the vast majority
of deaths
still a few deaths there it has to be
said not insignificant
but it's going to prevent the vast
majority of deaths but this here
is infection so it's going to prevent
these infections as we've seen
at least to a degree but these ones it's
not
so people under the age of 39
can still get infected because they have
no vaccine protection at all
of course on the 17th of may we've got
quite a lot of opening up coming up in
the uk
so that means we will see an increase in
infections
in the under 39s or the under 40s after
the 17th of may that is unfortunately
is inevitable now i'm not expecting it
to feed through into deaths because
there's a small number of deaths in that
age group
but it doesn't alter the fact we are
going to see an increase in cases
that is uh that's inevitable i'm afraid
um number of people in hospital with
covered 90 in the uk
again we see a nice fairly fairly
dramatic and sustained
reduction and let's hope that covered
symptom tracker data that was showing a
slighter
increase in cases over the past few days
is just
uh is just an anomaly now the other
useful
slide they didn't show on the press
briefing but i've got it here it's quite
useful
um summary of evidence on vaccine
effectiveness against different outcomes
now the green means that we're sure
the amber means that we've got medium
confidence and uh
low confidence in the uh the light pink
color is it
so um and of course this is the way the
data's coming in so
uh first dose symptomatic disease
fifty-five to seventy percent protection
with the pfizer bioentech exactly the
same as with the oxford
hospitalization protection after the
first dose 75 to
85 exactly the same as with the oxford
but of course the data is not yet in for
the oxford astrozenica because we
started doing the pfizer before
and we do see these gratifyingly high
figures although the data for that is
not
firmed up yet it will soon
but i mean that that slide there is
clear evidence of
the uh of the efficacy of the
vaccination program so that is
that that's looking pretty good um now
moving on the vaccination figures we
know they're pretty good now in in the
uk
uh these figures are for those over
18. whereas i prefer the method of the
united way than the united states does
it actually their figures are for the
whole population
but these are just over 18s in the uk
and likewise for the second dose over
18's the adult population
now just looking at europe generally
things are getting better in europe but
france
now france do not have it has to be said
particularly good genomic monitoring for
a sophisticated country that genomic
analysis is relatively
weak but nevertheless they've detected
um 20 cases of the india variant
five clusters and that's a few days ago
uh health minister reopening bars
restaurants and outdoor service on the
19th of may
vaccines in france while 26.6
of the population have had one dose
compared to the uk where
67 so
vaccination programs picking up in
europe
but still pretty slow obviously we know
that cases have been going down in
france therefore there's less poorly
people
so as of last saturday just over 5000
people in intensive care overall
occupancy
sunday down to 4971 first drop below
5000 since
march so
it's going down it's going down but uh
of course there's this tale of
poorly people unfortunately a tale of
death as cases go down but we're still
concerned about the india variant with
the opening up and the low vaccination
numbers
we've got three factors there that make
a bit of an unknown situation in france
and indeed in other
european countries now moving on to the
united states the numbers are going
down in the states albeit slowly so
deaths are going down
and cases are going down but fairly
slowly um
i won't put the latest figures up but
they're all there now the u.s food and
drug administration expanded emergency
use authorization of the fisa bioentec
vaccine from 12
to 15 year olds now this is the first
country in the world to do so
so adolescence now eligible for the fisa
vaccine
and as time goes on i would expect them
to become eligible for the moderna
and the janssen johnson johnson vaccine
as well it's just this is where their
data is at the moment
it's not saying there's an intrinsic uh
benefit with the fisa vaccine or an
intrinsic deficit
with the others it's just where the data
is up to the same as those
efficacy figures we've just looked at
for the uk
janet woodcock i think she's acting
director of the fda
memory service allows for a younger
population to be protected bringing up
bring us closer to return to a sense of
normal normalcy ending the pandemic
now this is somewhat important for the
individuals but it's also very important
for herd immunity
but uh fda do want to point out that
between
first of march 2023 to april 2021
one and a half million cases have
covered 19 and 11 to 17 year olds so
these people are by no means
immune so they get two doses three weeks
apart the same as the adult
pfizer regime now i must say i'm a
little bit surprised about this
the way i understand the immunology is i
would have thought you'd get a better
overall immune response with a longer
gap
but this is the way it stayed since the
clinical trials all the way through
by the fda the thing is you make the
antibodies quite quickly but things like
the t
cells and and the b cells and the memory
cells take a bit longer to make
but that's the way it's done in the
states i don't quite understand their
immunological rationale the position in
the uk does seem
more scientifically uh reasonable to me
but
um that they they probably got
sophisticated reasons that i'm not privy
to
now the fda are saying that the
potential benefits of this vaccine in
individuals 12 years of age
and older outweigh the known and
potential risks so what they're saying
here as i read this
is the risk of the having the disease
for someone 12 to 12 to 17 11 to 17 or
adolescence basically
now that that one's um yeah it's 12 to
15 the latest data isn't it
that they're saying that the individual
has a greater risk if they got covered
19 than if they have the vaccine
so they're accepting the herd immunity
of course
but they're saying that it's protected
for the individual
as well which is is good so
that seems to be the rationale there
predicating that decision on so that
rollout should have started
now and uh of course it'll be
interesting to uh to follow that up
now i can't pretend this isn't a bit
curious
centers for disease control and
prevention scientific brief
uh 7th of may just a few days ago
uh read it for yourself sars coronavis 2
is transmitted by exposure to infectious
respiratory fluids
people release respiratory fluids uh
infection depends on concentration of
viral particles well
they've released this on the 17th of may
but
the rest of us have known this for about
a year or more now
so it does seem a bit strange that
they're releasing this
now are they seeking to clarify
um have they just caught up i can't
believe they've just caught up
maybe they're seeking to clarify i don't
know three principal ways of
transmission inhalation mucous membrane
deposition
and touching uh mucous membranes with
contaminated hands so
that's like a dirty surface with a virus
on up to the mucous membranes
so inhalation into the airways and
droplets landing on the mucous membranes
so that would be droplets getting in the
nose the eyes and the mouth
now they now say that these two are the
primarily that this is the most
important virtually all the infections
are caused by this
so this is still there they're saying
that's there but it is third
so it looks like hand washing is still
important
disinfecting surfaces is still important
but way
way less important than these two
so no one's going to say stop washing
your hands but it is less important than
the inhalation
and deposition of viral particles on
mucous membrane root
now i don't think there's anything we
didn't know that but so we'll accept the
clarification let's not be cynical about
it
the clarification is good uh factors in
inoculum now inoculum is the number of
viruses that someone is
someone is infected with and that
determines whether they're going to get
the infection or not
and what no one has said definitively
yet it depends it also probably
is going to influence how severe an
illness someone gets or no one seems to
have written that down
but the idea that you get a few hundred
particles and get a mild illness so you
get a few billion particles and get a
more severe illness
it's probably true um but it's not
it's never been published yet anyway
talking about the
the the dose of particles it depends on
the airstream
thermal layering of course the hot air
can rise and initial jetting of
exhalations that's how
much you spit it out when so we said
back in january coughs and sneezes
spread diseases
but for example we know that people
talking quietly will
have less momentum in their droplets
therefore the virus those droplets can
contain
whereas people are shouting it's it's
much more
much much more they talk about enclosed
spaces
uh increased exhalation and prolonged
exposure so increased exhalation could
be singing for example
and the amount of time people are
exposed for now
we have been worried about a lot of
outdoor activities i remember we were
worried about um
the the protests that were in the united
states that there could be
outdoor transmission but there doesn't
seem to have been hardly any outdoor
transmission the vast majority of
transmission has been indoors
in close spaces and as we now know from
other data it doesn't say this but the
virus can be suspended in the air
aerosolized for three hours
and of course we've been talking about
this for a year i get well a year about
we've been talking about increasing
ventilation but now it's become official
so
quite i suppose they just felt the need
to clarify this i don't really pretend
to understand why they are
so apparently behind the times on this
um
world health organization of the same i
remember i can't remember the day
you might you might remember do let me
know if you remember it but remember
remember dr tedros was saying in one of
his briefings way back in early first
part of last year i'm sure
he said this virus is airborne and then
it was actually quite comical
you could see mike ryan sitting next to
him writing him a note and sticking a
note to him
then the next time it was dr ted ross's
turn to speak he said when i say
airborne i don't mean airborne as in
paratroopers.
so he was actually saying it's not
airborne it's not suspended an error
sliced particles there but it is
he was wrong he was right the first time
so was that freudian slip the first time
where he actually said what he knew to
be true and
you know it gets a bit confusing it was
a bit it was a bit comical actually it
was a bit like a farce
so mike ryan sent him this notion he
corrected himself not funny of course
because people's lives are at stake
no accountability for the world health
organization of course
uh senior people that have made big
errors are still in
post unfortunately
um progressive loss of viral viability
and infectiousness
temperature and again we've known this
for ages that the optimum temperature
for viral survival is about five degrees
centigrade
much lower at 20 degrees centigrade much
lower 40 degrees centigrade
we talked about this must have been
about last february march we talked
about this
humidity we talked about that as well in
lower humidity the
larger droplets with the virus in will
dry out
become smaller droplets and suspended in
the air for longer ultraviolet radiation
of course kills the virus
therefore infection still possible more
than six feet away
because it can diffuse and again we
talked about this a long long time ago
so indoor poorly ventilated settings are
where this virus has been spreading
and we've been ranting about ventilation
for
for years it's just so well not for
years for over a year
you know it's just so obvious and yet
they just seem to be making this
official now
passing through a space an infected
person has left
so for example if someone's at home sick
and the paramedics or something come to
pick them up or indeed if a person has
died and the undertaker's come to pick
them up
need to ventilate the area because the
viruses can hang in the air for three
hours
and this seems to be the cdc just
acknowledging this
practically physical distancing well
fitting mass adequate ventilation they
are now stressing
avoiding of crowded indoor spaces
they're now stressing so
i don't pretend to understand why
they're doing this so late why they're
so late to the party
but i did look at history so cdc advised
wearing mass on the 19th of um
april world health organization
advised wearing mass on the 17th of june
now i thought masks would be beneficial
right back in january february but the
reason i didn't say it loud and clear
was because we had senior doctors
telling us that masks were no good
or that mass were actually harmful so
this was like the official
guidance but i actually went against i
remember that i remember the date well
because i remember for some reason it
stuck in my mind 17th of
17th of march on this channel we said
masks are going to be a lot more useful
than not wearing masks and that was
based on
data from the united states research
from the united states on the physical
properties of aerosolized particles
and droplets cdc took another month
world health organization of course
came to the party last of all 5th of
june
incredible but
true you know you look at every picture
from the 1918-19 pandemic and everyone's
wearing masks
and yet we had our senior doctors and
advisory bodilys
for january february march
um into april to the 19th of april for
the cdc and up to the
5th of june for the who saying saying
must do more harm than good
um just incredible why didn't they learn
anything from history
these are the people that are supposed
to be our guardians it's um
and i i i feel bad about coming to the
party as late as the 17th of march
um maybe i let myself be over distracted
by the official guidelines
but of course i can't really i can give
counter argument to the official
guidelines but of course i can't go
against them because the government
guidelines are essentially statutory
items now last thing today um this i'm
reluctant to do this but i'm going to do
it anyway
just an article from the guardian in the
uk uh astrozenica vaccine
20 manufacturing partners around the
world brilliant
uh with which it has shared covered 19
vaccine technology and
know-how so this is well shared this has
allowed the india cm institute in pune
to supply 300 million doses so far 265
countries
because of this sharing of technology
and uh know-how from
astrazeneca i don't have shares in
astrazeneca i've no interest in this i'm
just reporting it
i'm aware it's on the edge of my
competence level because it goes into
economics
but everything i've written here is
factual as i understand it from this
from from this article 90 of india's
vaccine so far
has come from the indian serum institute
which of course
is uh no no what sorry what this means
is 90
of india's vaccine so far have been the
oxford astrazeneca style based on their
technology and know-how sharing
and they've supplied so far 98 of the
supply to kovacs
and i think i think the i think it's
three dollars a dose for the oxford
astrazeneca maybe slightly less
the pledge for non-profit basis for the
duration now i'm not saying astrazeneca
is perfect i'm just
this is what this article is saying
astrazeneca lost money for the first few
months
pfizer and modern are on course to make
45 billion dollars 32 billion pounds
collectively from their current advice
vaccine this year
so um that's a direct quote from the
article so
it is interesting and of course we we
hope that
money that people are making from
vaccines and potentially other
medication has no influence on
any other any other policies
so i'm going to leave that there to
those of you that are better at economic
matters than me but
there does seem to be you know quite
quite a big quite a big difference there
um and i believe the the johnson johnson
johnson vaccine is ten dollars a dose as
well so that one's quite cheap
as well um and it just seems uh
that the a lot of the adverse publicity
has been about the uh
the less expensive uh vaccines
so we'll leave that there but it's
interesting and food for thought
and interesting that why has the cdc
just published this so late if you know
it from the states let me know i might
be something missing something
completely utterly obvious about this
so to summarize case is going down in
the uk starting to go down in europe
a bit concerned about a resurgence in
the uk after the 17th of uh
may there will be one because of the
unvaccinated younger people who will
spread the infection to some extent
uh countries like france and other
european countries relatively poor
genomic monitoring
risk of new variants come along release
of lockdown
low vaccination low vaccination levels
could be a bad
could be a potentially bad triple whammy
there so
basically we've got quite a bit of
things that we don't know about the next
few months
in the in what we might call the west
the western world
and of course things are carrying on at
a great pace in uh
in other parts of the world which is now
the
india for example is the current
epicenter of the pandemic which we
looked at in some detail
yesterday okay that'll do for today
otherwise i'll just
prattle on too long so thank you for
watching