Tag Archives: matt hancock

Oxford obfuscation<<< updated on 31.12.20

It is the view of Grumpy that there has been significant intervention by the government to subvert medical opinions in the interests of avoiding political embarrassment. In response to the decision to have a 3 month gap between the first and second doses, Pfizer have issued a statement, as follows

“Data from the phase 3 study demonstrated that, although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95%. There are no data to demonstrate that protection after the first dose is sustained after 21 days”

In other words, Matt Hancock is ignoring data from the inventor of the Pfizer vaccine that underlines there is NO evidence that a 3 month gap will provide any protection for the majority of that period. as set out below, this is driven by the vaccine delivery schedule and the need for political points. This has all the makings of a future scandal.

(Initial post as follows) Matt Hancock announced this morning (30.12.20) that the Oxford vaccine had been approved for use in the UK. Seemingly good news, but it very soon became apparent that the implementation plan was almost wholly driven by political considerations rather than a well planned strategy to reduce COVID. Further, given vaccination is planned to start in January, their are many outstanding questions about more or less every aspect of its use.

Dosage : It is as yet unclear as to whether the dosage regime will be a half dose (‘LD’) followed by a full dose (‘SD), or whether it will be two full doses. This is of more than academic relevance, since the SD+SD regime is only about 60% effective, which is way, way worse (although cheaper – perhaps a factor) than the competing Pfizer and Moderna vaccine alternatives. The alternative LD+SD option was stated to be up to 90% effective, but as it was not tested on anyone over 55, whether it will work at all for the most vulnerable 60+ years cohort of the population is just not known, as admitted by all parties. (See http://grumpy.eastover.org.uk/oxford-vaccine/ )

Protocol : All the tests submitted as a basis for approval for the vaccine to the UK regulator, the MHRA, were based on two doses 28 days apart. It has now been decided that the doses will be separated by 3 months. Grumpy can find no evidence of whether this regime, plucked from mid air, is as effective or not. Note how the LD / SD variation had a huge impact on effectiveness, so it is baffling how the MHRA approved a plan which had simply no material testing evidence to support not only its efficacy, but whether it was safe or would even work as assumed – and it is assumption. Previous documentation on the dosing has stated (as late as the date of this entry) that “two doses of vaccine, four weeks apart, are needed to to offer best protection”; when did this change, and why? The answer lies, Grumpy believes, in the fact that the government’s own numbers on vaccine delivery schedules and the rate of vaccination simply do not add up, and this is a fudge to avoid Hancock embarrassment over yet another failure.

Numbers : Hancock spoke on the BBC Today program on 30.12 and stated that 1m vaccinations per week would be done from January 4th. This implies that by February 4th, 4m people will have been vaccinated. However, bulk deliveries of vaccine (40m doses) will not be available for 2-3 months (according to AstraZeneca), so these numbers simply don’t add up, as the first delivery of 4m units does not have sufficient doses. The inevitable fudge comes from the sudden change in plan to separate the doses by 3 months, thus doubling the number of first shots available. The delivery schedule had already slipped back by many weeks, so Grumpy thinks that pulling back from the 1m per week target is all but inevitable – testing/tracking all over again. The switch to a 3 month gap for no stated medical reason is thus driven entirely by political motives, and Hancock sought to bury this the fanfare resulting from approval.

Timing : Pascal Soriot, CEO of AstraZeneca, stated on the Today program on 30.12 that the Company could deliver “up to” 2m doses per week. The population of the UK is 67m, so (assuming the 2m doses included both first and second jabs) the population would be vaccinated at best by April 2022. Allowing for the 30m Pfizer doses ordered (but not yet fully delivered) , that would bring completion forward somewhat, with the caveat that neither company has a record of delivering on time. That timing is far short of Matt Hancock’s less than credible statement on Radio 4 ‘s Today program that the UK would be “out of this by the spring.” This is surely a statement he will come to regret, but as Grumpy has pointed out before he has a habit of offering unnecessary hostages to fortune. (See http://grumpy.eastover.org.uk/foot-shooting/ )

Europe : The EMA (EU regulator) has not approved the Oxford vaccine, stating that there is no basis for granting even a conditional licence. Are the standards less demanding in the UK ? Does the European regulator know something the UK regulator does not, or is discounting?

New mutation : As of 30.12, AstraZeneca informed Reuters that its Covid-19 vaccine is potentially effective against the new coronavirus variant, with studies underway to fully analyse the impact of the mutation. Studies underway ? They don’t know yet whether it will work on a variant pushing daily cases over 50,000 or not? Is this one more element of evidence pointing to the the UK regulator being premature, which raises the issue of government pressure and interference to get it approved ?

So, in summary, here are the questions to ask

  • Will the dosing regime be LD+SD or SD+SD ? This has a huge impact on how the individual should plan his/her lifestyle post vaccination
  • If the dosing is LD+SD, will more tests be done to confirm its effectiveness (or otherwise) before rolling it out to the 60+ cohort, or do the government plan to use the next batch of 70+ citizens as test mice?
  • Why was the gap between doses suddenly changed to 3 months, when all tests were done on 28 days ? Is there any quantitative evidence (certainly none is published) that this would be an effective protocol, or even work ?
  • How can the conflict between stated delivery schedules of Oxford vaccine and the claimed rate of vaccination be explained ?
  • Given the CEO of AstraZeneca’s statement on the ceiling on dose deliveries, how does the implied time to complete UK vaccination reconcile with Hancock’s optimism on being “out of it by the spring” (whatever that might mean) ?

Foot shooting

Grumpy’s father had a litany of expressions with which he would precede some view of life or the world. One favourite started “what I don’t understand, and never will”… This expression came to mind recently when Grumpy was contemplating the tendency of government ministers to make pronouncements that were self-evidently hostages to (inevitable) fortune. The part that Grumpy doesn’t understand and never will is that any possible benefit from the proclamation was totally opaque; there was no rational reason to having taken the risk.

Grumpy got more than halfway through his rather mundane career before he learned the value of ‘shutting up’ in a business environment. People generally don’t like silence and they feel a strong compulsion to fill it by saying – well, something.

This is greatly amplified in politicians. Firstly, they tend to like to be the one talking and not listening (see Trump here as a perfect example); messages need to be got across. Secondly, they try to generate ‘soundbite’ or two, simple enough for even readers of the Daily Mail. Thirdly, they fear (quite wrongly) minimalism in communication will be equated with a vacancy of ideas by the electorate and press.

The issue is that normally they fall in to the trap of seeking to quantify the unquantifiable; of using numbers in their statements about outcomes when there is in fact not only huge uncertainty about same, but where they are mostly outwith their control.

David Cameron once made the rash statement that immigration would be limited to the “tens of thousands”. No doubt he had in his mind that 99,000 was within that limit and he had some leeway (wrong), but the opposition was no doubt sharpening their knives for anything remotely approaching that (‘tens’ is not ‘almost 100’). Although at least it should have been technically in his control, two factors did for him, namely the EU and lack of competent management.

However, Matt Hancock had absolutely no good reason for forecasting how many COVID tests would be done by what date ,or how many gowns would be delivered by when. There was a perfectly good and defensible “Sir Humphrey” statement that “an adequate number of tests / gowns would be available to prevent any shortages”. Instead he kept on quantifying that over which he had no control and each iteration of unknowable numbers was yet another target on his chest

Worse, it hard to imagine what drove Boris to declare all would be normal by Christmas. It’s a pure case wanting to hear himself say something positive, filling a silent gap, and looking for a soundbite.

The outcome is pretty near inevitable. It is extremely likely that things will not only not be back to normal at Christmas, they may be worse than the current state by virtue of winter flu. He must surely realise that this adds up to bad headlines and a ‘PM’s Question Time’ thrashing.

Why do they do it ? The impulse to shoot oneself in the foot like this is something that Grumpy doesn’t understand and never will.