The Wry Observer’s Covid-19 update (225)

An interesting link… I didn’t listen to the podcast but read the transcript of “Dismantling The Covid Pandemic & mRNA “Vaccine” Narratives” at https://wherearethenumbers.substack.com/p/dismantling-the-covid-pandemic-and?utm_campaign=reaction&utm_medium=email&utm_source=substack&utm_content=post and responded as follows:

I agree that the virus origin is irrelevant, though the politics of it are interesting. Two things you missed out. First, ventilation contributed to deaths. The lung pathology in severe Covid is alveolar leakage and no amount of ventilating will beat that – indeed, it will make things worse. Pierre Kory has written an elegant exposition of this (https://pierrekory.substack.com/p/the-premature-use-of-mechanical-ventilation). Second, the underlying mechanism of the severe systemic effects is a cytokine storm (which, as it happens, can be provoked by other viruses) probably generated by the original version’s spike protein. The huge peak in deaths was due to ventilator misuse on the one hand, and failure to deploy treatment for the cytokine storm on the other. Once this was done using steroids and tocilizumab, pari passu with the spike protein mutation resulting in a much decreased risk of CSS, the fatality rate plummeted. My experience of attempting to bring the second point to the attention of the UK authorities underlines the resistance of those authorities to any hypothesis that challenged the “Settled Science” view; the refusal of said authorities to admit their mistakes; and the virtual impossibility of a retired physician (me) to get my points across. I would argue further that by the time any infection is at risk of being identified as a pandemic it is too late to stop spread; if most people don’t get sick it doesn’t matter, and if a few do get sick then the proper treatment must be instigated immediately. I outlined an investigation and treatment protocol in the UK in May 2020. Bits of it were adopted by January 2021. How many deaths might have been prevented had there not been an 8 month delay?

Last week we went to see the play “Dr Semmelweis” starring Mark Rylance. A remarkable performance. Apart from being brilliant some of the dialogue describes attitudes of those in authority identical to those of today, with failure to be critical of old ideas and listen to new ones. The one big difference is that today’s Semmelweis’s are somewhat less confrontational than the original, though not a lot of good does that do us! The Simon and Garfunkel song “The Boxer” expresses it well… “a man hears what he wants to hear, and disregards the rest”, which I referenced in September 2020. Why does this persist despite all the evidence that it is foolish and wrong? At least as yet I have not gone mad, unlike poor Ignaz Semmelweis. Neither (so far as I know) have any of the other dissidents who have been rather more publicly cancelled than me – Carl Heneghan, Norman Fenton, Jay Bhattarcharya, Sunetra Gupta, John Campbell and Pierre Kory among others – although some of our offerings have perhaps become a little more intemperate as frustration has built up.

An editorial in the BMJ caught my eye; “Where now in the danse macabre of covid-19 and misinformation?” (BMJ 2023; 382 : p1884; https://www.bmj.com/content/382/bmj.p1884). I responded:

“You ask a few questions but let’s be clear about terminology before we conclude that Covid-19 is on the rise again. I have said before that Covid-19 is a subset of those infected with SARS-CoV-2 – a subset that develops a systemic hyperimmune reaction or cytokine storm. So while SARS-CoV-2 infections may be rising, what evidence is there that these new infections are causing those infected to be hospitalised? The new variants appear to have a spike protein mutation that is far less immunogenic, so if Covid-19 admissions are not rising there is no need to panic.

Your questions, and my answers:

 What are now the right policies for protecting vulnerable people and limiting transmission in healthcare settings?

We cannot protect anyone from acquiring the infection, either by lockdowns or vaccination, as the data over the last two years has clearly demonstrated. There is no good evidence that masks work, , as the last Cochrane review indicated. What we can do is identify at-risk groups and ensure that they are rapidly investigated, and treated, at the first signs of infection translating to a hyperimmune state (incidentally there has been little reaction to the studies suggesting that patients with rheumatoid arthritis on biologics have a lower risk of developing Covid-19 following SARS-CoV-2 infection, implying that immune suppression may actually be beneficial) (1-3).

Does anything need to be done to prevent transmission among the general population?

On the basis that the vast majority of the population who are infected do not become seriously ill – no.

Why, when accountability on behalf of those most affected must be paramount, is the UK’s Covid inquiry failing to be responsive to bereaved families?

I disagree that bereaved families are not receiving a response from the Inquiry. They have already been given ample opportunity to present their stories. But I cannot see how this will help us either to decide what these stories add to either the issue of what was done wrong, or how they will inform future preventive measures. They are tragic, sad and irrelevant.

What was done wrong in the initial stages was to fail to listen to those who understood quite early the mechanism of why people got seriously ill, and the failure to administer in a timely fashion the treatment that might have saved many of them – treatment that required no trial, because it was already identified.

1. Favalli EG, Monti S, Ingegnoli F, et al. Incidence of COVID-19 in patients with rheumatic diseases treated with targeted immunosuppressive drugs: what can we learn from observational data? Arthritis Rheum. 2020;72(10):1600–1606.

2. Ddf N, Leon L, Mucientes A, et al. Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis. 2020;79(11):1393–1399.

3. Murray K, Quinn S, Turk M, et al. COVID-19 and rheumatic musculoskeletal disease patients: infection rates, attitudes and medication adherence in an Irish population. Rheumatology. 2020. cited 2020 Dec 30. Available from: https://doi.org/10.1093/rheumatology/keaa694

Arvind Joshi from Mumbai asked:

“If I understood what Dr Andrew Bamji has said, it means:

1) Masks, Lockdowns, Vaccines are not able to protect people from getting CoVID-19.

2) Immunosupprssants mitigate manifestations of CoVID-19.

Shall/should this be taken as gospel truth?

Do we need a consensus statement?

Since CoVID-19 cases have already risen 80% according to a recent statement by WHO, there is good scope for trials aimed at verifying Dr Andrew Bamji’s views. Should such trials be undertaken at the earliest and in earnest?

This is not to doubt Dr Andrew Bamji’s views, but to put these views to use if found correct.”

And I replied:

“Dr Joshi asks whether masks, lockdowns and vaccinations protect against SARS-CoV-2 acquisition.

The most recent Cochrane review of masks found that there is no clear evidence of benefit from mask-wearing. That is not to say that they don’t work, merely that the evidence does not prove it, but if one considers the likelihood that a flimsy paper or cloth mask can filter out viral particles, plus the evidence for transmission by touch, it is theoretically unlikely.

Lockdowns cannot work because they can never be complete. In the UK the number of exemptions for critical workers (not just in the health service but also in public transport and logistics) provide ample opportunity both to catch and spread any infective agent. Furthermore if those exempted bring it home to a closed environment the likelihood that they will give it to their cohabitees is extremely high.

It now appears generally accepted that vaccination cannot interfere with spread, not least because so many vaccinated people acquired the virus (myself included). Whether the risks (such as induction of myocarditis and coagulopathy) outweigh any benefit (such as reduction in severity) remains unproven, not least as there are confounders such as the reduced risk of developing Covid-19 from newer mutant strains whose spike proteins are less immunogenic.

As for immune suppression, I highly recommend the textbook on cytokine storm syndrome by Cron and Behrens (Springer, 2019), which gives the rationale for using steroids and immunological agents such as IL-1 and IL-6 antagonists. Dexamethasone was trialled in Covid-19 and proved to be effective, and this together with tocilizumab are currently recommended in those developing a cytokine storm syndrome from SARS-CoV-2. Never mind that Cron and Behrens describe their use in cytokine storms caused by other things (including other viruses) which in my view rendered any trial in Covid-19 unnecessary. It is not hard to believe that pre-existing treatment with these might have modified the risk of developing Covid-19.”

Dr Joshi’s further response suggests he is happy with my analysis. There are no critical or debunking ones, which suggests either few people read the responses, or there is not a lot wrong with my argument. Misinformation? I think not and certainly hope not.

The Wry Observer’s Covid-19 update (224)

Various bits of news require an update for completeness.

The release of correspondence casts more doubt on The Lancet article that firmly denied the possibility of a lab leak in Wuhan. Although it appears that some of the senior players had their doubts, the party line seems to have been toed out of political expediency. Such interference bodes ill for the future of scientific and medical research, although we are (mostly) only too aware of the bias introduced by the suppression of publication of drug trials that fail to show benefit.

The problem of post-vaccination myocarditis is explained in an article/blog which turned up in my inbox yesterday (although it appears to be a year old). See https://wmcresearch.substack.com/p/spike-protein-induced-cardiotoxicity?utm_source=cross-post&publication_id=770713&post_id=135784167&isFreemail=true&utm_campaign=516896&utm_medium=email

Note the role of TNF and IL-1. I have suggested that anyone with symptoms or signs of trouble should have steroids as soon as possible. Apropos immune mediators it’s also interesting to see the early apparent success of biologics administered intrathecally to reduce amyloid formation in Alzheimer patients. It’s over 12 years ago that the Professor of Rheumatology at Guy’s Hospital, Gabriel Panayi, noted the disappearance of renal amyloid in patients with rheumatoid arthritis treated with TNF blockade, and I suggested back then that they should be tried in Alzheimer’s. Ahead of the game again…

There are rumblings about a new Covid wave that will be caused by a subtly different variant of Omicron. This has caused an Omigod reaction with loud screams in the media. Yet increasing analysis of historic data leads one to think – what fatal wave? It’s time to stop panicking. Not only should one not cross one’s bridges until you come to them, but you should not worry about crossing those bridges until you are sure that there are bridges. There’s enough unnecessary panic about. Don’t start me on climate change (I have kept that out of this blog, but if you want my sceptical views you can find them in my Substack blog at https://drandrewbamji.substack.com/); just to add that the latest evidence for why global temperature has risen this year is because of the massive release of water vapour into the stratosphere following the Tonga eruption. Fossil fuel use pales into insignificance. If Nobel prizewinners in Physics don’t believe the climate change mantras then neither will I. I mention this because there is a common thread; climate change prophesy is based on computer modelling just as pandemic death risk is. GIGO (or for the acronym virgins, garbage in, garbage out).

All quiet on the Inquiry front.

The Wry Observer’s Covid-19 update (223)

The Heneghan/Jefferson dialogue on their “Trust the Evidence” blog underlines the disappearance of the Hallett Inquiry from the news now that the Big Beasts have given their evidence, which wasn’t worth much anyway. Having trawled through the module list again I looked at the core participants and was perhaps unsurprised to find that they were almost without exception people who could have had no insight into the pathological mechanisms of Covid-19. As for the module remits there is but one sentence in the Vaccines and Therapeutics module that gets to the heart of the matter – when people get very sick with Covid-19, how should they have been treated. I am somewhat concerned that they are going to spend time analysing trials, which I have stated many times were unnecessary.

When will the clinicians (hello, here I am!) get their chance to explain things? I am still waiting to be called… never mind that I am retired, medicine in many ways is like swimming or riding a bicycle, you never forget how to do it. A single case will, if significant enough, stick in the mind forever. Significance can take many shapes; amusing, challenging, upsetting, revelational, oxymoronic among others. There are many examples in my book “Mad Medicine” (https://www.amazon.co.uk/Mad-Medicine-maxims-National-Service/dp/1688011897) which any student of medicine or the NHS would do well to read, not least so they don’t fall into the traps that I did or underestimate the importance of institutional memory.

(Written 13th July)