Dr David Livermore

On Being Shanghaied

China has locked down its largest city, Shanghai, and quarantined in camps the 20,000 who've tested positive, but claims only 300 are symptomatic. Are the rest false positives, now confined with the infectious?

A Curate’s Egg of a Public Inquiry

by David Livermore The U.K. Government has published Draft Terms of Reference for its Inquiry into the COVID-19 pandemic. Final Terms will be published once the chair, Baroness Hallett, has "consulted with the public, including with bereaved families and other affected groups". Baroness Hallett is a retired Court of Appeal judge and crossbench peer. She acted as coroner for the victims of the 7/7 bombings, and the BBC once claimed she was the "eighth most powerful woman in England". When her role was announced she was quoted as saying: The pandemic has affected us all, some much worse than others. I am acutely conscious of the suffering it has caused to so many. I shall do my utmost to ensure the Inquiry answers as many questions as possible about the U.K.'s response to the pandemic, so that we can all learn lessons for the future. I hope I can add some constructive suggestions. For, like the proverbial curate’s egg, I find the Draft Terms ‘Good in Parts’. And the bad bits are mostly gaps, not incipient putrefaction. We’re promised that the Inquiry will: Examine the COVID-19 response and the impact of the pandemic… and produce a factual narrative account. Including:• In relation to central, devolved and local public health decision-making and its consequences .• preparedness and resilience;• how decisions were...

The Futility and Hazards of Boosterism

by Professor David Livermore The Government’s answer to Omicron is boosters, boosters and more boosters. Everyone over 18 is eligible. Early queues exceeded five hours; December 18th saw 904,000 boosted. Israel is doling out fourth shots to the over-60s and Germany plans to follow suit. Please don’t lump me with the anti-vaxxers as I roll my eyes. The present vaccines are invaluable for preventing severe COVID-19 – probably via a T-cell mechanism – in anyone of late middle age or above, or with vulnerabilities. But those of us who broadly support vaccination must be honest: Spring’s fond notion that we could mass vaccinate our way out of the pandemic, as with measles or polio, is a busted flush. The dash for boosters only underscores the point. The core problem is that the vaccines give only brief protection against infection. Moreover, they are ‘leaky’, and SARS-CoV2 can outflank them. Clinical trials suggested that the doubly vaccinated initially enjoyed 90% protection against infection. But, with ageing vaccination and circulating Delta, this eroded by summer’s end. Omicron is even more evasive. At a December party in Oslo, where 98% of 117 guests had been double vaccinated, 74% caught COVID. Boosters restore protection to 71-76%, but this doesn’t last long. Early UKHSA evidence is that it’s down by 15-25% within 10 weeks. Worse, by...

We Should Ask the Modellers to Prove Their Models Can Accurately Predict the Future Before Following Their Advice Again

by Dr. David Livermore I headed PHE’s Antibiotic Resistance Monitoring and Reference Lab from 1998 to 2011. NHS hospital labs would send unusually-resistant bacteria to us for investigation. We’d confirm or refute the claimed resistance, investigate its mechanism, advise on treatment and assess any emerging public health threat. Over 13 years my lab documented the rise of MRSA, of super-resistant gonorrhoea, and of ‘opportunist gram-negative bacteria with a particularly nasty antibiotic-destroying enzyme dubbed ‘New Delhi Metallo' (NDM) because many early cases were in folks recently hospitalised in the Indian sub-continent. When a new resistance problem was expanding sharply, I’d be summonsed to brief the Agency’s higher management. I could then guarantee that someone would suggest mathematical modelling. So, I’d meet with the modellers and outline the variables. NDM enzymes, for example, are carried by loops of DNA, called plasmids. These can transfer among bacteria, spreading the resistance. Within species NDM reached multiple strains, some more spreadable than others, and some good at living innocuously in the gut before finding their way to the urinary tract or, following surgery, to the abdominal cavity, where they’d cause difficult-to-treat infection. After a while, the modellers and I would agree that the problem wasn’t tractable to modelling and I, together with epidemiology colleagues, would go back to tracking its actual progress. This was impossible...

Vaccine Passports are Dead – Long Live Vaccine Passports!

by David Livermore Vaccine passports or certificates – an idea we thought dead – have, regrettably, just been sleeping. With no little sense of irony, the Government is busy resurrecting them in time for “Freedom Day”. To be clear, I won’t be too put out if an immigration officer demands a SARS-CoV-2 vaccination certificate in future, especially if I’m travelling to a low-Covid country, like Taiwan. I doubt it will protect them in the long term, but I’m happy to be vaccinated and it doesn’t upset me any more than having to obtain a yellow fever vaccine and certificate. The issue is with using vaccine passports internally, to restrict access to large events and maybe even pubs and restaurants. Certificates will be used to discriminate against the unvaccinated, not all of whom belong to the awkward squad. They include the young, not yet offered vaccination, as well as those who can’t be vaccinated. But, set aside the ethical. Others have written extensively. What concerns me is the practical. Certificates are touted on the basis that ‘They will make concert-goers feel safe.’ Really? Perhaps the concert-goers should while away one of Wagner’s tedious half hours counting the odds. Suppose a concert is attended by 1,000 people, 900 vaccinated and 100 unvaccinated, which is about the current split. Assume also that vaccines...

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December 2022
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