This is not my field of expertise, but I trained as a scientist (two chemistry degrees), worked professionally in IT, and understand the importance of testing.
The "hope" that @krishgm mentions is forlorn, in this case.
A thread in which I prove (using ONLY published Pfizer trial data) that the UK CMOs and JCVI have not so much ignored the science, as left it bleeding at the roadside.
Intrigued?
Read
The trial data said that after a single dose of the Pfizer vaccine coverage was 52%. Six days after the second dose that rose to nearly 91%. The new policy to delay 2nd dose is based on the idea that the 91% was in fact due to the first dose. We must hope that is true.
— Krishnan Guru-Murthy (@krishgm) December 30, 2020
This is not my field of expertise, but I trained as a scientist (two chemistry degrees), worked professionally in IT, and understand the importance of testing.
As vaccines go, it's "new tech", the first mRNA vaccine and the results are stunning.
Perhaps one should be cautious about deviating from a clinical trial procedure, at least until there is greater experience of mRNA vaccines?
At best, the 12 weeks strategy was based on one critical assumption, namely that the 2nd dose has NO effect on efficacy in the first 7 days after it is given.
And if it did?
https://t.co/wAiMlgrRvn
My head almost exploded. @bmj_latest said the figure was 52%, where did this figure come from? Had it been said by mistake?🤷🏻♂️
I sent a query to @patrickharvie who kindly replied with this:
https://t.co/DZe1pOlItY
Hmmm, OK? 🤔
It was clearly time to read the Pfizer (Phase 3 trial) paper.
https://t.co/WlkBSoOX1C
I asked the CMO this question today. The 52% figure comes from looking at the level of protection as soon as the vaccine is administered, ie includes everything from day 0. The higher figure is the level of protection achieved, but which takes time to develop.
— Patrick Harvie \U0001f1ea\U0001f1fa\U0001f308 (@patrickharvie) January 4, 2021
However, I do have three published scientific papers to my name and know how to read them, as long as they are written in something resembling plain English.
High energy physics? Pass.
Vaccine efficacy? Good to go!👍🏻
The 90% efficacy figure is drawn from the 7 day period AFTER dose 2 has been given.
1. It has no effect
2. It has some effect
3. It is the dominant effect
An assumption has been made by the 4 UK CMOs and JCVI that the first is true.
Why?
That's one hell of an assumption.
If only there was some data to offer clues?
Gee, there is! 🤓
He is concerned about the @joebiden plan to deploy all vaccine doses (rather than holding back enough to ensure 2nd doses can be given on time).
https://t.co/AMiwNisRF4
Phase 1 studies? Well, let's look at that paper.
Obviously, the CMOs and the JCVI must have had a look at it, right? 🤔
The UK policy on a 12 week gap between Pfizer doses, is a Damoclean sword, suspended by an assumption that the 2nd dose has no effect for the first 7 days after it is given.
100% incorrect. 😲
https://t.co/AaQGc6EnU2
Heh.
The Pfizer (Phase 1/2 trials) paper, shows clearly that in this instance, the science is being ripped into tiny pieces, those tiny pieces are then set on fire, and the flames are extinguished by being urinated on. 🤦🏻♂️
Phase 1/2 clinical trials are more about working out the right dose and checking safety.
Pfizer used three separate doses at this stage.
10 μg
30 μg
100 μg
Crucially, for 100 μg, only 1 dose was given.
Two measurements were taken at baseline, at 7 and 21 days after the first dose, at 7 days (day 28) and 14 days (day 35) after the second dose.
Essentially they are related to the strength of the antibody serum levels and receptor binding thingys...or something along those lines. 🤷🏻♂️
The larger the numbers, the better. 👍🏻
10 μg dose
Baseline 0.8
Day 7 0.9
Day 21 534 (2nd dose given))
Day 28 4,813
Day 35 5,880
30 μg dose
Baseline 0.9
Day 7 0.8
Day 21 1,536 (2nd dose given)
Day 28 27,872
Day 35 16,166
7 days after the 2nd 30 μg dose has been given, the binding value becomes 18 times larger.
Clearly something dramatic is happening in the 7 days AFTER the 2nd dose has been given. 🤔
Fortunately, this can actually be confirmed by looking at the data for the 100 μg dose, where NO second dose was given.
It's obvious, right?
These guys are experts, right? 🤔
Still, let's check!
Baseline 0.9
Day 7 1.2
Day 21 1,778 (NO 2nd dose given)
Day 28 1,260
Day 35
So, as predicted you can see WITHOUT adding a 2nd dose, the value soars by...um...it FALLS, by 30%?
It's almost as if the 2nd dose is significant? 🤔
I mean the CMOs and JCVI did read the Phase 1/2 Trials paper, right?
Still, this isn't my field, so maybe it's the other measurement that is the important one?
That's probably the one that shows the 2nd dose has no effect in the first 7 days?
Let's check!
The second set of values doesn't include any beyond Day 21 (for the 100 μg dose) , because the first set of values have already determined that to be the peak, for that dose.
Gosh, that's kinda awkward.
Here's the data.
The UK is giving doses of the Pfizer vaccine 12 weeks apart (as opposed to the recommended 3 weeks), in the belief that this delivers 90% efficacy, which only increases to 95% efficacy after the 2nd dose.
However, when one looks at the Phase 1/2 Trials data, it clearly shows that the 2nd dose has an immediate turbocharge effect.
In the first 7 days after Day 21, if no second dose is given, the efficacy goes down.
Two doses of 10 μg given 3 weeks apart, produces a binding thingy value (BTV) of 4,813 at Day 28, while one dose of 100 μg has a BTV of 1,260 at Day 28.
Far from increasing between Day 21 and Day 28, the efficacy of a single dose declines significantly.
We have been told that the first Pfizer dose is the cake (90% efficacy), and the second dose is the icing on top of the cake (95%).
The 1st dose is like the cake base and the 2nd dose is the cake.
Oh, and if you don't add the cake after 3 weeks, the cake base starts to disintegrate.
Not having one's cake and not eating it.
Yummy...NOT! 😬
For the Pfizer vaccine:
1. The 2nd dose has a vastly greater effect than the 1st dose on its own.
2. The optimum time to give the 2nd dose is 3 weeks.
In the worst case, by the time you give a 2nd dose at 12 weeks, it may be like a new 1st dose, of limited efficacy and decline quickly.
Can one imagine that might lead to behavioural changes which could increase their risk of getting infected?
"I'm fine...been vaccinated...90% protected!”
As well as making people feel they are wearing a suit of vaccine armour, while the reality is they are in a papier-mâché vaccine ensemble, you're kinda wasting two doses of Pfizer vaccine.
Not ideal, is it?
As mass vaccination programs go, this is the Titanic Maiden Voyage Special Edition.
Could there be a more ill-conceived strategy? 😱
Q. Your country is in crisis in the middle of a pandemic. Suddenly, you are given a 95% effective vaccine. Do you:
A. Follow the instructions and improve the situation?
or
B. Use in the least effective way possible, resulting in more deaths?
😫
“We live in a society exquisitely dependent on science and technology, in which hardly anyone knows anything about science and technology."
Therein lies a problem.
There are professionals for whom this stuff is their day job.
Literally, this is matter of life and death.
What the hell have they been doing? 🤷🏻♂️
Granted, I then spent a couple of hours making sure I was 100% correct.
So what have the CMOs, the National Clinical Directors and the JCVI been playing at?
This IS their day job.
If they DID read it, it's absolutely inconceivable that they didn't understand its significance.
So what's left? Providing cover to justify a political decision?
Those words are:
"Untenable position.”
and
“Resign!"
If I hear the phrase, "That's a clinical decision, I can't overturn it." (or words to that effect) once more, I will scream.
Medicine is a branch of science (last time I checked!)
The scientific method is ALL about challenging.
However, leaving aside his "mortality challenged" life status, the paper would be judged on its merits and the quality of the ideas it contained.
The peer review process is essentially a form of intellectual kicking.
The quality of your data and ideas will be challenged.
It's nothing personal.
It IS a trial by ordeal.
If you're trying to add to the Tree of Human Knowledge, it's better to avoid adding diseased branches, for all of us.
OK, so be it.
If ministers have signed off on bad advice, without even challenging it, because it's "a clinical decision", they are equally culpable.
I can think of some obvious questions.
2. What assumptions have you made and why do you believe they are justified?
3. If you're wrong, what's the worst case scenario?
Oh...and maybe pick up the phone to Pfizer for a chat, as well? 🤔
Who's left in this epic catalogue of failure?
Ah yes, the Fourth Estate.
Since I read the Pfizer Phase 3 trials paper, I've been waiting for a journalist to ask a question, which indicated they had.
Still waiting.
However, it's also a science story.
Having said that, I'm not sure how many journalists who cover science, actually have a science background?
“Science is a way of thinking, much more than it is a body of knowledge.”
Indeed, it is.
Once you have that training, it will usually point you in the right direction in terms of questions to ask, even in areas that are new to you.
#CarlSaganRocks
In particular, my thanks are due to Dr. Anthony Fauci, @drsanjaygupta, @DrPaulOffit, @ChrisCuomo, @andersoncooper, @jaketapper and @wolfblitzer
This thread wouldn't exist without them.
My bulwark against the latter feeling has always been, "I agree with Dr. Fauci."
Phew!
The new Biden plan is to deploy all vaccines held in reserve and ramp up manufacturing to be able to give 2nd doses on time.
That's risky.
However, when I listen to the UK CMOs, it's far from obvious that they have looked at the Pfizer Phase 1/2 trials data. 🤔
So, if I only know what many others already know, what can I bring to this (socially distanced) virtual party?
However, I'm also a photographer and think in terms of images.
In my career, I was generally regarded as having skills in communicating technical matters in a way that was understandable to business people.
Like every profession, they have their own code in terms of language.
A phrase like, "There's no data to support that.", might (in a certain context) actually translate as:
"Are you utterly forking insane?”
"We take full responsibility for the disastrous Pfizer vaccine rollout, but we sincerely believed..."
Essentially, Blair after Iraq.🙄
It was impossible to prove the non-existence of that which didn't exist.
In the case of the Pfizer vaccine, we have VERY clear and understandable published research.
Just RTFM!
I'm shattered.
For 9 nights, I've had trouble sleeping (and I normally sleep VERY soundly).
My Science-sense was tingling from the moment the 12 weeks gap between doses was announced.
This has taken a lot of energy and determination, but I had the best motivation in the world.
I want to keep my Mum safe.
Oh wait, that line doesn't have the greatest history, does it? 😜
I've tried to make my case as clearly as I can, because I am certain lives depend upon it being understood.
More from Society
1/ A thread of comments & observations about the death of the cackling vampire Rush Limbaugh.
My first observations in the main thread are here, but this offshoot is needed because there's been so many wise & witty things I've
2/ First, re: those who in their wayward moral obtuseness feel we "can't speak ill of the dead." I've said that this is what abuse enablers say, but I hear that some religious traditions preach this. Oy.
So there's this: https://t.co/7Ky4RA3nkZ &
3/ Drucker is another great wit, and this carries the proper mood
4/ There's definitely a Jewish Tradition angle for how to treat evil people who die: the only respect is to justice, right & wrong, and above all compassion's existence necessitates condemning cruelty
5/ We're coming up on #Purim, and that's all about how to remember evil. There may be a reason, then, that I share the attitude of many other people committed to righting
My first observations in the main thread are here, but this offshoot is needed because there's been so many wise & witty things I've
37.90/ Limbaugh was a cruel hate-machine who made a fortune off hurting people. To say "don't speak ill of the dead" is the attitude of abuse enablers.
— Joshua Cypess (@JoshuaCypess) February 18, 2021
If you can't condemn a ghoul who dedicated his life to destroying society, you're part of the problem! https://t.co/ijvG2zDACH
2/ First, re: those who in their wayward moral obtuseness feel we "can't speak ill of the dead." I've said that this is what abuse enablers say, but I hear that some religious traditions preach this. Oy.
So there's this: https://t.co/7Ky4RA3nkZ &
This is how Rush's death should be honored. Let's not speak ill of the dead, let's quote Rush speaking ill of the dead.
— Sane English (@SaneEnglish) February 17, 2021
3/ Drucker is another great wit, and this carries the proper mood
It's easy to make fun of Rush Limbaugh right now, but it's important to remember that he also brought a lot of people a lot of joy by dying
— Mike Drucker (@MikeDrucker) February 17, 2021
4/ There's definitely a Jewish Tradition angle for how to treat evil people who die: the only respect is to justice, right & wrong, and above all compassion's existence necessitates condemning cruelty
It\u2019s ok\u2014essential, even\u2014to speak the truth about people who caused great harm.
— Rabbi Danya Ruttenberg (@TheRaDR) February 17, 2021
Even after their death.
5/ We're coming up on #Purim, and that's all about how to remember evil. There may be a reason, then, that I share the attitude of many other people committed to righting
today i said Jewish culture requires dancing on the graves of those who have wronged us and i picked up like 300 followers LMAO
— Erin Biba (@erinbiba) February 18, 2021
people love Jewish vengeance \U0001f923\U0001f923
wait till they hear about Purim
It is simply not correct to point fingers at wind & solar energy as we try to understand the situation in TX. The system (almost) had a plan for weather (almost) like this. 1/x
It relied on very little wind energy - that was the plan. It relied on a lot of natural gas - that was the plan. It relied on all of its nuclear energy - that was the plan. 2/x
There was enough natural gas, coal and nuclear capacity installed to survive this event - it was NOT "forced out" by the wind energy expansion. It was there. 3/x
Wind, natural gas, coal and nuclear plants all failed to deliver on their expectations for long periods of time. The biggest gap was in natural gas! The generators were there, but they were not able to deliver. 4/x
It may be fair to ask why there is so much wind energy in ERCOT if we do NOT expect it to deliver during weather events like this, but that is an entirely different question - and one with a lot of great answers!! 5/x
Conservatives are using the Texas power chaos to argue against climate policy even as fossil-generated power outages dwarf the amount of renewables knocked offline during the historic deep freeze. President Biden and progressives have been slow to respond.https://t.co/UajKhptEAU
— E&E News (@EENewsUpdates) February 17, 2021
It relied on very little wind energy - that was the plan. It relied on a lot of natural gas - that was the plan. It relied on all of its nuclear energy - that was the plan. 2/x
There was enough natural gas, coal and nuclear capacity installed to survive this event - it was NOT "forced out" by the wind energy expansion. It was there. 3/x
Wind, natural gas, coal and nuclear plants all failed to deliver on their expectations for long periods of time. The biggest gap was in natural gas! The generators were there, but they were not able to deliver. 4/x
It may be fair to ask why there is so much wind energy in ERCOT if we do NOT expect it to deliver during weather events like this, but that is an entirely different question - and one with a lot of great answers!! 5/x
