Part #2: An open letter to Discovery founder and CEO Adrian Gore
Adrian Gore has mandated thousands of people get specific medical treatment. That demands a bulletproof justification. I want to challenge him on that. I argue that his “six-point rationale” is flawed.
Many will follow his ruling because of his formal source of power as leader of Discovery. Many will follow it because of the high esteem they justifiably hold him in.
In a series of pieces, I will press Gore on many of his premises. My goal is a healthy debate. This is important for its precedent and the impact a vaccine mandate will have on lives. I heartily invite your response and a good-spirited debate.
You say, “The individual health imperative is clear, given the unequivocal data that COVID-19 vaccines are effective and safe.”
Unequivocal? No. Especially on transmission.
The word “unequivocal” sets off hazard lights for me. At the sight of it, one needs to test it. Data can be unequivocal but rarely is. In pursuits like mathematics, there are proofs. I have no qualm with “unequivocal” here.
Public Health England covers vaccine effectiveness comprehensively in their “Covid-10 vaccine surveillance report” – I’ll refer to Week 36 here.
There is meaningful variation in quality data sources on safety and effectiveness. Sources I have seen do tend to show good but not perfect safety – everything has a cost.
Effectiveness is a different story. Effectiveness at preventing infection is the kicker.
As per the table below, this is highly equivocal. Between ages 40 and 79, a higher proportion of fully vaccinated people (two doses) than unvaccinated people caught the virus during weeks 32 and 35 of 2021. That time window is 9 May to 5 September. See table below.
I’ll repeat this in the words of Public Health England: “In individuals aged 40 to 79, the rate of a positive COVID-19 test is higher in vaccinated individuals compared to unvaccinated.”
Their terse attempt at explaining this is woeful: “This is likely to be due to a variety of reasons, including differences in the population of vaccinated and unvaccinated people as well as differences in testing patterns.” I’m all ears if that explanation holds more water than it appears to me.
Here’s more on effectiveness at preventing passing the virus on. Anthony Fauci has conceded equivocality, if not ineffectiveness. In an interview regarding the Delta variant, he says, “when you look at the level of virus in the nasopharynx of people who are vaccinated who get breakthrough infections, it’s quite high and equivalent to the level of virus in the nasopharynx of unvaccinated people who get infected”. He concludes, “So we know now that vaccinated people who get breakthrough infections can spread the virus to other people”.
I’d suggest even “breakthrough infection” is a misleading term in this light. It suggests that vaccinated people who get the virus are outliers.
From another study, “Taken together, the study findings indicate that the delta variant of SARS-CoV-2 is capable of inducing infection even in fully vaccinated individuals and that a significant proportion of vaccinated individuals with breakthrough infections are capable of transmitting the virus to others” and from the original study: “Furthermore, individuals with vaccine breakthrough infections frequently test positive with viral loads consistent with the ability to shed infectious viruses.”
So, your staff all have the choice to take the vaccine, significantly reducing their chances of severe symptoms, hospitalisation and death if they do catch the virus. Vaccination does not unequivocally (or, I’d argue, perhaps at all) limit the chances of getting the virus. What is the point of demanding vaccines? It would follow from these two premises that it is only to demand people apply your risk/reward standards to their own healthcare.
Time matters too. Safety and effectiveness data necessarily do not exist for the long term. Your premise suggests that safety and effectiveness are unequivocally established without reference to time. I submit you cannot back that up.
I ask only for precision, completeness and suitably cautious use of “unequivocal”.
Your lack of contextualisation of percentages is troubling. 80% sounds fantastic. Is it 80% of 0.05%? Or are we talking 80% of 92%? Only providing the 80% is not strictly incorrect. But the two ways of portraying the data tell different stories. That matters.
Do you agree that the data with additional context is a more reliable story? And that both ways of showing data should be provided in this critical decision?
I hit this pedantic thing hard mainly because it has consequences on public perceptions. These are distorted in many ways and directions.
Public perceptions – Wonky at best
People have a disfigured view of the risks Covid poses to them. Consider these findings from a Franklin Templeton survey, July 2020.
- Americans, on average, reckon Covid deaths among people 24 and younger make up 8% of the total. It is more like 0.1%-0.2%.
- More broadly, as per the chart below, people overestimate how many young people die from Covid; and underestimate how many older adults die from Covid. In short, they think the young die vastly more than they do. The dividing line is around 65 – the approximate retirement age for many. That is, people believe far more working-age people die from Covid.
- Political leanings have a role to play. 41% of Republicans think flu has caused more deaths than Covid-19, compared to 13% of Democrats. Interestingly, both groups display the age-based bias shown above.
- Asked, “What percentage of people who have been infected by the coronavirus needed to be hospitalised?”, 34% of adults say that at least half of infected people need hospitalisation. The actual number seems to vary between about 1% and 5%.
- “For people aged 18–24, the share of those worried about serious health consequences is 400 times higher than the share of total COVID deaths; for those age 25–34, it is 90 times higher.” See the chart below. Note again that retirement age is a watershed moment in the data.
The misunderstanding cuts both ways. Here are results out of King’s College London regarding the British population. “One in seven (15%) still think people are more likely to die from seasonal flu than coronavirus, while the large majority of scientific estimates suggest that the latter is more deadly.”
This is all to implore you to be relentlessly open with your framing of the data. To be as precise as possible. Avoid only presenting figures in the format that most accentuates their potential to be read favourably towards your argument.
Your internal data is valuable. Here I only query you on methodology. When you tell us, for example, “80% of X”, several questions leap to mind.
- On what population and sample?
- How did the results vary by age and comorbidity?
- How were data points verified? For example, Public Health England counts a Covid death as any death within 28 days of a positive test. That could be a motorcycle accident.
- What was the time period of the collection?
- Has anyone outside your organisation reviewed the data or tried to replicate your findings?
Will you make this available to us?
Next: Faulty Fiat #2
My energy hasn’t run out. Next, I’ll do my thing on part #3 of your rationale.
Here’s my recommended read for this edition. John Ioannidis is Professor of Medicine and Professor of Epidemiology and Population Health, and Professor (by courtesy) of Biomedical Science and Statistics at Stanford University. He argues regarding the response to Covid-19, “Even the best peer-reviewed journals often presented results with bias and spin. Broader public and media dissemination of scientific discoveries was largely focused on what could be exaggerated about the research, rather than the rigour of its methods and the inherent uncertainty of the results.”
If you are mandating thousands of people get a specific medical treatment, your argument should be bulletproof. In my analysis, yours has significant faults that deserve fuller consideration before the rule affects many lives.
Adrian, I would hugely appreciate your engagement on this. Despite my firm conviction, one way, I endeavour to be open-minded and ready to change my mind if persuaded. Despite your decision, and I imagine an equally potent yet polar conviction to mine, I do hope you’ll do the same.