The Wry Observer’s Covid-19 update (228): The End

“The time has come”, the Walrus said “To talk of many things”… This is my last Covid blog. For nearly four years I have tried to examine the pandemic was an unjaundiced eye, made numerous mistakes along the way, admitted when I was wrong and tried all the time to keep a positive and helpful attitude. I have probably read more articles, blogs and books than was good for me. I have submitted protocols to government but my advice was ignored. I have submitted evidence to the Hallett Inquiry but in light of the treatment there of Professor Carl Heneghan I suspect I shall not be called to give oral evidence as I requested. I have developed a profoundly different approach to pandemic management than that put forward by non-clinicians and modelling fantasists – in summary, that you do not have to devise draconian protection strategies if the infective organism doesn’t kill people. You simply protect those at risk and treat those who get seriously ill.

SARS-CoV-2 made many people very ill at the beginning, and many died, largely because the complication called Covid-19 was not recognised as a hyperimmune state, akin to that described as a result of other infective organisms, drugs, genetic makeup and more. And it was wrongly treated. Latterly the global strain has mutated to a less virulent form and the emergency treatment I recommended has been established, albeit after a long and unnecessary delay. SARS-CoV-2 is little more of a risk than influenza viruses or even the common cold. The virus was well-established worldwide long before any protective measures were put in place, and those were necessarily incomplete so would not have worked. Testing was fatally flawed. There was no robust evidence that masking was effective. Models exaggerated the risk at least in public perception but were flawed – indeed those using them had an excellent track record of prophesy failure. Vaccines have risks that have been understated; trials of them were flawed and data was manipulated. When criticisms have been raised, and conclusions questioned or branded as wrong, not once have any of the establishment provided a rebuttal of those criticisms. I venture to suggest that it is because they cannot.

Against this background we have the unpleasant spectacle of a Galileo-like Professor of evidence-based medicine being aggressively attacked by the Hallett Inquiry counsel with revelations that senior government medical advisers behaved in a most unprofessional way by calling him a fuckwit, and disparaging his advice, honestly offered and backed by good evidence, because by training he is “only a GP”. The Inquiry appears to have ignored his long written submission entirely. Frankly those advisers should be held to account by the General Medical Council for unprofessional conduct. I doubt that they will be; they have been fawned over by the Inquiry instead and praised for their valiant efforts, never mind that to a clinician versed in the management of immunological disease (me) they were and indeed are barking up the wrong tree and have made a grave error in not listening to proper clinicians who do actually know what they are talking about.

In that context I quote, via Norman Fenton’s “Trust the Evidence”, the listing by counsel of the qualifications of Jeremy Farrar:

“You trained, I believe, in medicine, with postgraduate training in London, Chichester, Edinburgh, Melbourne, Oxford and San Francisco. You have a DPhil PhD from the University of Oxford. You were a director of the Oxford University Clinical Research Institute at the Hospital for Tropical Diseases in Ho Chi Minh City in Vietnam from 1996 to 2013. From 2013 you were Director of the Wellcome Trust, and from May 2023 have you been the Chief Scientist at the World Health Organisation? Have you throughout your professional career served as a chair on a multitude of advisory bodies, for governments and global organisations? Have you received a plethora of honours from a number of governments, institutes and entities?”

So?

If I was there I would add a few supplementaries:

Have you examined the historical context of pandemic management, and thus understood that each pandemic has been at some point mismanaged for the last 100 years? (Ref: Mark Honigsbaum’s “The Pandemic Century”)
Have you ever managed a patient seriously ill with septicaemia?
Have you ever looked after severely disabled patients who are prone to develop sudden septicaemia?
Are you aware of the entity known as a cytokine storm, or hyperimmune state?
Do you understand the correct treatment for such a condition?
Have you read the textbook “Cytokine Storm Syndrome” by Cron and Behrens?
Do you therefore understand that Covid-19 is, in all its manifestations, a hyperimmune state?
Do you believe that all your illustrious appointments qualify you to take clinical decisions?
Do my 86 published letters in “The Times” refute the possibility that I could be a fuckwit? (Note – you can find one of them in the little anthology “Sir” on page 178)

Of course were I to appear before the Inquiry I would also ask the same questions of the inquisitor, even if he was to try and undermine my evidence by suggesting that I was not an epidemiologist, pulmonologist or intensivist and further that I was so long retired as to be bordering on senility. To which I would then respond that it is quite reasonable to make diagnoses on paper patients (there’s a quiz each week in the BMJ), that being an epidemiologist is irrelevant to clinical management, that I did part of my training at the world-renowned Brompton Hospital in London, that I have managed seriously ill patients in intensive care and that, by way of an analogy, once you have learned to ride a bicycle, or swim, you do not forget how to do it. I have saved lives by giving septicaemic patients high-dose steroids, counter-intuitive as it may seem. Sitting on fancy committees does not necessarily fit you to manage seriously ill patients in an emergency. I would then repeat: if an infection does not make you seriously ill it doesn’t signify (example – we don’t test for common colds and then isolate anyone who gets one). If it makes you seriously ill you need to focus on how and why and then administer the correct treatment. If you are going to apply epidemiologically-based restrictions to an entire population when only 2% of them get seriously ill you are wasting resources.

I might also mischievously ask how many letters he has had published in “The Times”.

I have written many tens of thousands of words in the public domain. I have written to government, government health advisers, the media, the medical press. I have never had a formal response. I doubt my own submission to the Hallett Inquiry will be taken seriously; after all, I am “only a rheumatologist”, and a retired one at that. I have observed the self-serving evidence of the Chairman of the British Medical Association whose main aim appeared to be to protect doctors and who has not listened to clinical advice. If one is to be consistent one could argue that he hasn’t a clue because he’s not versed in epidemiology, he’s “only a gynaecologist”.

Professor Heneghan asked in his latest blog whether he should bother to go on with his Covid analyses. I don’t think he should. However others have disagreed, and he is going to persevere. When I expressed my own doubts about continuing to blog some while ago I had a number of readers asking me to go on. I am grateful to them for their confidence, but there comes a time to stop banging one’s head against a brick wall, and for me that time has come. I shall continue to watch this space but comment rarely. The Hallett Inquiry, unless there is some dramatic change, will be a useless whitewash and as four years of my attempts to help have been spurned, and I expect to be unable to put my views in person, the time has come to talk of other things – or, given the other horrors in the world, bury my head in the sand and hope it will all go away.

PS I hope my diary will become a book. I might revisit in a few years when the Inquiry is complete. Regular readers might like to look at my book “Mad Medicine” (available on Amazon) and thereafter understand oxymoronic medicine and deja vu. I might blog on other “many things” but two novels call.