Flip-Flopping and Turning Coats on an Evidence-Free Stage

Well, it now looks as if the grandees are turning against each other. Rishi Sunak, as we reminded our readers, stated to the Spectator that not even Cabinet Ministers were aware of the rationale for the toxic cocktail of evidence-free restrictions imposed on the nation.

Now, Sir Patrick Vallance, the Government’s Chief Scientific Adviser during Covid, is accusing politicians of cherry-picking the science. Apparently, the diary he kept will be produced at the Hallett Enquiry. So, whom do you believe? Sir Patrick used some pretty strong words to describe the former Prime Minister, and incidentally, a registered medical practitioner should not use words such as ‘bipolar’ as an insult. Mental illness is no joke, especially for those whose conditions were caused or triggered by the three Ronnies’s restrictions. So why was Sir Patrick always standing up like a stalwart at the three Ronnies’ show every night? Why did he not resign if the Government was running amok with the advice? Two metres, rule of six, night curfews, see granny in the garden and Christmas parties on balconies and all.

We think the restrictions narrative is now fast unfolding. Unlike the decks of the Titanic, it’s everyone for themselves – I got my damehood/knighthood, my pension, time to move on with my trusted Kevlar armour around me.

One of the reasons why the narrative is unfolding is that SARS-CoV-2 is going up and down regardless of whatever idiocy the Government, the media and the so-called experts dreamed of, which brings us to our thread on the outputs of the UKHSA. On Tuesday we pointed out that the UKHSA has produced a map of what it calls available evidence on the use of what it classifies as non-pharmaceutical interventions – NPIs (the ‘Evidence Gap Map’). Here’s the main screen again:

As we explained, you can click the arrows in the top row and inspect the list of different interventions.

So the map tells us there is a massive dump of models of all kinds, a few other bits and pieces, but nothing strong enough to justify granny in the garden having a conversation through the window or ‘closing the Welsh borders’.

But we are curious, you know us: we ask questions the whole time. So, we have downloaded references numbers 24 to 123, which are the 100 models which form the backbone of the UKHSA dataset (100 out of 151; 66% to be precise).

We have downloaded them, and now we are reading them and asking four straightforward questions about each published or quasi-published model included in the map:

What is the NPI being assessed (e.g. is it an NPI, and is it defined and described?) and in what setting? (e.g. community, hospital, homes etc.)
What is the source for the effect estimate? (to model its effects, you need a source of data, i.e., what does it do?).
What is the size of the effect? (such as risk reduction of SARS-CoV-2 infection)
What is the case definition? (how did they define a case of COVID-19?)

Once we have answered these questions, we will grade the model using the ROBINS I tool. Remember the UKHSA did not assess the risk of bias, it just mapped.

We will then synthesise our findings and reflect on the advisability of relying on the mapped models for introducing restrictions.

To remind readers, we have done a similar exercise with a previous review produced by the UKHSA:

The UK Health Security Agency Review – our Trust the Evidence Critical Appraisal

Bear with us as we do this work and present the results. TTE resources are finite: it’s just Tom and Carl.

Dr. Carl Heneghan is the Oxford Professor of Evidence Based Medicine and Dr. Tom Jefferson is an epidemiologist based in Rome who works with Professor Heneghan on the Cochrane Collaboration. This article was first published on their Substack, Trust The Evidence, which you can subscribe to here.