Dr Alan Mordue

by Dr Alan Mordue MB ChB, FFPH (Ret) During this Covid pandemic I have heard much in the media from 'public health experts' and 'public health officials', but rarely from colleagues in my own specialty – Public Health! This is very surprising since the specialty, which I practised for 28 years as a Consultant in England and Scotland before my retirement in 2016, usually leads the management of all outbreaks of infectious diseases in the U.K., and also has had the responsibility for leading the production of pandemic plans in the U.K. But is there any difference between a Public Health (PH) official, expert and specialist? Certainly you wouldn't think so listening to most broadcast media. Here are my definitions: So these three groups are very different. Only one group has undertaken an in-depth specialist training and has theoretical and practical experience in outbreak control and management (as well as other areas of PH specialist practice).  When a PH 'expert' expresses views in the media about the management of the Covid pandemic it is therefore essential to know a little about their background training and experience. Even if they have an exalted title like 'professor', their chair may be in anthropology or their main experience in nutrition or dentistry. This is not to dismiss the contributions of diverse disciplines – given the...

by Dr. Alan Mordue During this Covid pandemic I have often wondered about how two key principles central to medicine and public health have been used. The first is the Hippocratic oath “primum non nocere” or “first do no harm”, which all doctors used to swear to abide by on graduation. The second is the precautionary principle, used in public health, particularly where there is uncertainty about the health effects of a proposed intervention or exposure to a potential harmful agent. They often seem to have been applied selectively and even ignored, particularly in relation to illnesses other than COVID-19. The press conference on April 7th chaired by Deputy CMO Jonathan Van-Tam with representatives from the MHRA and the JCVI about clotting side effects of the Oxford Astra-Zeneca vaccine was a case in point. During the press conference charts showing potential benefits in preventing ICU admission compared to potential serious harms of the AZ vaccine were presented by age group and for three levels of population incidence of SARS-CoV-2 (2, 6 and 20 per 10,000): Chart 1 – Low Exposure Chart 2– Medium Exposure Chart 3 – High Exposure The conclusions of the press conference were that these blood clots were extremely rare, that the benefits of the AZ vaccine outweigh the risks, and that an alternative vaccine should be...