July 2, 2020 - 1:52pm
Some good news: the Oxford vaccine trial is showing promising early results. I’m pleased, because I’m now part of the trial.
I recently went along to the Royal London Hospital for Integrated Medicine, in Great Ormond Street, to join in. The RLHIM used, to my gentle amusement, to be the old Royal Homeopathic Hospital and now offers “evidence-based” alternative medicine, which reminds me of the old Tim Minchin gag: “You know what they call alternative medicine that’s been proved to work? Medicine.”
Anyway, it’s not a homeopathic vaccine, it’s an adenovirus vaccine — a weakened form of a virus that causes colds in chimps, genetically modified to be unable to replicate in humans. The protein spike (the sticky-out bit of the coronavirus) has been altered to be the same as SARS-Cov-2, so it should prime my immune system to respond to that protein — and therefore the virus — when it encounters it for real.
That is, of course, if I have been given the real vaccine. The trial will include around 10,000 people, and about 5,000 of them will be given the real vaccine, and the rest a placebo; neither the subjects nor the doctors and nurses know who got which. If we did, we might change our behaviour and skew the results.
For the same reason, the placebo is also a vaccine, for meningococcal meningitis. That’s because vaccines can cause minor side-effects, such as fever; if the placebo was a saline solution, and I’d got those side-effects, I could have worked out that I had the real thing. They even told me to take paracetamol as soon as I got home, I think partly so that I wouldn’t try to work out which I’d had from my symptoms (“headache? Must be the meningitis!”).
It turns out that I’m going to have to stick a swab up my nose every Friday for the next year, or until the trial is over; not something I’m looking forward to, since I heard someone on More or Less do it and then audibly retch. Those swabs will be immediately posted for testing; if they return a positive result, I have to tell the trial immediately (and self-isolate). And I’ll be tested for antibodies after one month, three months, six months and 12 months, again assuming the trial isn’t ended (either because it’s shown to work or shown not to) before then.
There is a significant risk that, because the virus is now so rare in the UK, the study won’t get enough positive results to get good statistical information about the difference between the placebo arm and the intervention arm; for that reason, simultaneous trials are going on. One is in UK health workers, who should be at higher risk of exposure; others are in parts of the world, such as Brazil, where the virus is still more prevalent.
Each week I’ll also have to fill out a questionnaire, asking what I’ve been up to that week; have I spent time in contact with people, have I been exercising or going to the pub. The hope is that as well as providing info on the vaccine, the trial can tell us a bit about how the virus spreads. If it turns out that everyone who ticks “I went to the pub” immediately gets sick, for instance, then that will be informative, as well as disappointing.
The good news, of course, is that whether or not I got the real vaccine, I will get it as soon as the trial is over (assuming it’s shown to work). So by this time next year I should be invincible, and can return to licking the flush handles in public toilets as tradition dictates.
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SubscribeI have felt from the very beginning of this that a humoral/epitope-focused vaccination approach is quite likely to be relatively unsuccessful, based simply upon what was already known about CoVs (including original SARS) before the pandemic got going.
I don’t understand why everyone is bulldozing ahead nevertheless. The facts have not changed — they have only been reinforced by study of SARS-CoV-2 it seems.
Consider the following preprint:
https://www.biorxiv.org/con…
It appears to me that governments all over the world are doing exactly the wrong thing in every respect, almost invariably. Lockdowns of healthy and invulnerable majorities of active people is insane, and can only be justified by overwhelm of hospitals (which should be, or have been, a short-term issue in wealthier countries) or a strategy of 100% reliance upon a vaccine solution, trading off an enormity of much larger social and health costs against this relatively weak pathogen without any evaluation.
People are naive and infantilized, including the so-called “leaders”. The proper comparison is the 1918 flu, which was also novel but much more virulent. Comparison of seasonal flu’s for which there is a century of natural immunity built up, as well as widesprerad seasonal vaccination, is grossly inappropropriate and misleading.
Attempting to “hold back” contagion amongst anything but the known vulnerable may extend economic hardship and all of its sequelae for many years. The Spanish flu required several years to stamp out, and flu spreads faster than this virus does — anyone who doubts this should look up the research done so far on the “serial interval”. I have found not a single study not estimating a longer SI for this virus than for any flu. It could take half a decade or more at the rate lockdown societies have been going so far before sufficient herd immunity stamps this virus out.
The US should be shooting for at least a half million infections daily, which it now appears to be doing. That is a good thing, not bad. At that rate, sustained, maybe half of the population will have developed endogenous immunity within a year. That is more than long enough to wait. Anything longer is absurd.
Except we don’t actually know that having had the disease confers immunity.
I’ll revisit your positive endorsement of:
Fairly soon the health systems of Texas and Florida will be overwhelmed. That will be a very painful moment for a nation with the resources that the US has available. I’m afraid allowing the virus to spread without check should not be an option.
Widespread testing, except in a narrowly focused effort to keep the virus out of nursing/care homes and medical facilities, seems completely useless to me. People are obsessing over data that they have no understanding of how to interpret usefully, generating nothing but irrational fear.
Indeed, testing in the beginning was useful to track where things where headed and where they were coming from. At this point, it’s just spending Big Pharma money.
It should hopefully go without saying by now that this virus cannot be stamped out except by achievement of herd immunity, with or without the assistance of vaccination. Vaccination is certainly not necessary, and may or may not be worth costs of associated efforts.
Mr Chivers : well done for volunteering .
Excellent.