The Lancet

New Lancet Study From Sweden Shows Vaccine Effectiveness Against Infection Dropping to Zero and Sharp Decline Against Severe Disease As Well

To judge from recent scientific and media output, there appear to be two parallel realities currently existing side-by-side in Covid world. In one, the vaccines are highly effective at preventing infection and transmission, and any data that suggests otherwise is being misrepresented or is biased or contains some kind of basic error. In the other – the one that bears a much closer resemblance to the one we actually live in – vaccine effectiveness against infection has been declining significantly and after six months is basically zero. At some point, one of these realities is going to have to give way because they can’t both be true. I know which one my money’s on.

An example of the first appeared in New Scientist this week, headlined: “How much less likely are you to spread COVID-19 if you’re vaccinated?” The answer: at least 63%, according to a new population-based pre-print study from the Netherlands.

A recent study found that vaccinated people infected with the Delta variant are 63% less likely to infect people who are unvaccinated.

This is only slightly lower than with the Alpha variant, says Brechje de Gier at the National Institute for Public Health and the Environment in the Netherlands, who led the study. Her team had previously found that vaccinated people infected with Alpha were 73% less likely to infect unvaccinated people.

What is important to realise, de Gier says, is that the full effect of vaccines on reducing transmission is even higher than 63%, because most vaccinated people don’t become infected in the first place.

De Gier and her team used data from the Netherlands’ contact tracing system to work out the so-called secondary attack rate – the proportion of contacts infected by positive cases. They then worked out how much this was reduced by vaccination, adjusting for factors such as age.

The data comes from August and September 2021, when Delta was dominant in the Netherlands. The key table, breaking the figures down by whether the index case and contacts were vaccinated, is below.

New Lancet Study Confirms Plummeting Vaccine Effectiveness

A study appeared in the Lancet this week confirming that vaccine effectiveness against infection is fading fast.

The study involved 3,436,957 people over the age of 12 who are members of the healthcare organisation Kaiser Permanente Southern California. It sought to assess the effectiveness of the Pfizer vaccine against SARS-CoV-2 infections and COVID-19-related hospital admissions for up to six months, with a study period covering December 14th, 2020, to August 8th, 2021.

Comparing fully vaccinated to unvaccinated, and controlling for confounders such as prior infection, the researchers found that effectiveness against infection plummeted from 88% (95% confidence interval 86-89%) during the first month after double-vaccination to 47% (43-51%) after five months. The variation by age (depicted above) was largely within the margins of error.

Among sequenced infections, the researchers found vaccine effectiveness against Delta infection was 93% (85-97%) during the first month after double-vaccination but dropped to 53% (39-65%) after four months. Effectiveness against infection from other variants the first month after double-vaccination was 97% (95-99%), but declined to 67% (45-80%) at 4-5 months.

Pfizer vaccine effectiveness by Covid variant

Lancet’s Panel Investigating Covid Origins Disbanded Because of Ties to Peter Daszak

The Chairman of a Lancet-affiliated panel of scientists looking into the origins of Covid says he has disbanded the commission because of its ties to Peter Daszak, the President of EcoHealth Alliance who proposed in 2018 to use U.S. money to fund gain-of-function research on bat coronaviruses at the Wuhan Institute of Virology. MailOnline has the story.

Columbia University Professor Jeffrey Sachs told the Wall Street Journal on Saturday that he was concerned with the links to Daszak, who led the task force until recusing himself from that role in June.

Daszak, who lives in New York, devoted his career to championing so-called ‘gain of function’ research to engineer coronavirus to be more deadly to humans, arguing that it was the best chance to detect and prevent a global pandemic.

Shocking documents released this week revealed his 2018 proposal to help the Wuhan Institute of Virology engineer bat coronaviruses to be more deadly, by inserting genetic features that are similar to those found in SARS-CoV-2.

There is still no conclusive proof as to whether Covid, a coronavirus linked to bats, first jumped to humans from a wild animal or in a lab setting.

But from the early days of the pandemic, Daszak has made every effort to paint the lab origin hypothesis as a “conspiracy theory”, including masterminding a letter in the Lancet that established a veneer of scientific consensus that natural origin was the only possibility. …

Several members of the disbanded Lancet task force have collaborated with Daszak or EcoHealth Alliance on projects in the past.

“I just didn’t want a task force that was so clearly involved with one of the main issues of this whole search for the origins, which was EcoHealth Alliance,” Dr. Sachs told the journal.

Sachs said a new Lancet Covid Commission would continue studying the origins for a report to be published in mid-2022, but broaden its scope to include input from other experts on biosafety concerns, including risky laboratory research.

It comes just days after the release of bombshell documents showing Daszak’s 2018 funding request to the U.S. Defense Advanced Research Projects Agency (DARPA) seeking $14.2 million to fund gain-of-function research on bat coronaviruses at the Wuhan lab.

The proposal, titled Project DEFUSE, was leaked to independent researchers with the DRASTIC research team.

In it Daszak requests funding for an elaborate project to genetically enhance coronaviruses and inoculate bats in Yunnan, China in the hopes of stopping new viruses jumping from bats to humans.

The funding request was denied by DARPA, but the proposal reveals a shocking line of research that could have conceivably been carried out independently by Chinese members of Daszak’s team, who included the infamous ‘bat woman’ Shi Zhengli.

Worth reading in full.

Stop Press: In a further blow to its reputation, the latest issue of the Lancet has a bizarre cover describing women as “bodies with vaginas”. Apparently, editor Richard Horton thought this would endear him to female scientists. MailOnline has more.

The Lancet was accused of sexism and dehumanising women after it editors used the term, which was written in an article titled ‘Periods on Display’, on the journal’s front cover in an attempt to be inclusive to trans people.

The article, which was published on September 1st, examines an exhibition exploring the taboos and history of periods at the Vagina Museum in London and sees the writer use the word “women” but also use the term “bodies with vaginas”.

The quote, which was then used on the journal’s front page, read: “Historically, the anatomy and physiology of bodies with vaginas have been neglected.”

However the move to display the quote on the journal’s front cover has been met with criticism, with some academics calling it “insulting and abusive” and a “misguided pursuit of woke points”.

Meanwhile others said they had cancelled their subscriptions with the peer-reviewed medical journal – which was founded in 1823.

It comes just months after critics lambasted Brighton and Sussex University Hospitals NHS Trust after it told staff to use terms like “birthing parents” and “human milk” rather than referring to “mothers” and “breast milk”.

Worth reading in full.

The Lancet Changes Mind on Lab Leak Theory – Calls for “Objective, Open and Transparent Debate”

The Lancet appears to have had a change of heart on the lab leak theory, having published an article calling for an “objective, open and transparent debate” on Covid’s origins – a whole 19 months after writers “strongly condemn[ed] conspiracy theories suggesting that Covid does not have a natural origin“. The idea that the evidence points away from the lab leak theory and towards a natural origin “could [now] literally be reversed”, say the authors of the new article. “There is no direct support for the natural origin of SARS-CoV-2, and a laboratory-related accident is plausible.” The Mail on Sunday has more.

It was revealed earlier this year that Peter Daszak – a British scientist with long-standing links to the Wuhan Institute of Virology – had secretly orchestrated a landmark statement in the Lancet in February 2020 which attacked “conspiracy theories suggesting that Covid does not have a natural origin”.

The now-infamous letter, signed by 27 leading public health experts, said they stood together to “strongly condemn” the theories which they said “do nothing but create fear, rumours, and prejudice”.

They also lavished praise on Chinese scientists who they said had “worked diligently and effectively to rapidly identify the pathogen behind this outbreak… and share their results transparently with the global health community”.

Now, the Lancet has agreed to publish an alternative commentary which discusses the possibility that laboratory research might have played a role in the emergence of the SARS-CoV-2 virus.

It also directly confronts the efforts of science journals to stifle debate by labelling such theories as “misinformation”. …

[The authors say] the February 2020 statement “imparted a silencing effect on the wider scientific debate”.

And they say scientists, “need to evaluate all hypotheses on a rational basis, and to weigh their likelihood based on facts and evidence, devoid of speculation concerning possible political impacts”.

Science itself, they go on, should “embrace alternative hypotheses, contradictory arguments, verification, refutability, and controversy” and rather than congratulating China on its supposed “transparency”, they call on the secretive superpower to open up.

Worth reading in full.

A Doctor Writes: Predictions of Doom Have Not Been Borne Out

We’re publishing an update this morning from the Daily Sceptic’s in-house doctor in which he analyses the latest NHS hospital data. Conclusion: no need to panic.

I have been a bit quiet lately, partly due to being on holiday and partly due to waiting a while to examine what trends are emerging from the hospital admissions data over the later summer.

On looking at the latest figures and associated media commentary I have been reminded of an old Russian aphorism from the Soviet era: “The future is certain, but the past keeps changing.”

For example, on February 3rd, 2020, Boris Johnson, warned of the danger that “new diseases such as coronavirus will trigger a panic”, leading to measures that “go beyond what is medically rational, to the point of doing real and unnecessary economic damage”.

I didn’t catch any reference to that (very reasonable) remark this week when the Prime Minister imposed further taxation on the working-age population and the companies that employ them. Before returning to the airbrushing of recent history, I will consider the hospital level data over the last month to discern trends and discuss what reasonable inferences we can draw from the numbers. I confess that some of the information doesn’t quite make sense to me – I will elaborate on this point later.

The first and most glaringly obvious fact is that the catastrophic tsunami of hospitalisations confidently predicted by all the experts who have assumed the governance of the U.K. has failed to arrive. How annoying that must be for Richard Horton, Editor in Chief of the Lancet, who described the relaxing of restrictions in July as “driven by libertarian ideology” rather than the data. Or Trish Greenhalgh, Professor of Primary Care Health Sciences at Oxford University, who said that “the Government policy seems designed to increase cases” and predicted there will be hundreds of ‘superspreader’ events in the coming weeks. The Lancet published a letter signed by 122 self-identifying experts which suggested that the Government was conducting a “dangerous and unethical experiment” in removing societal restrictions on July 19th.

Have 1,200 Experts Ever Been Proved Wrong So Quickly?

Guido Fawkes reminds us today that over 1,200 so-called experts signed ‘the Declaration’ – cooked up by the same people behind the John Snow Memorandum – warning of the terrible effect easing coronavirus restrictions on July 19th would have. The Declaration originally took the form of a letter in the Lancet, published on July 7th, in which 120 self-described ‘scientists’, many of them members of Independent SAGE, described ‘Freedom Day’ as “dangerous and premature”. They cited the SAGE modelling showing there would be 100,000 new Covid cases a day if the Government went ahead with its plans and set out the dire consequences for Britain and the rest of the world. “We believe the Government is embarking on a dangerous and unethical experiment, and we call on it to pause plans to abandon mitigations on July 19th, 2021,” they wrote.

Two weeks on from ‘Freedom Day’, their predictions aren’t holding up terribly well.

According to Public Health England, the number of new daily cases fell to 21,691 today, another five-week low. So the 1,200 signatories of the Declaration exaggerated the number of daily cases that would follow ‘Freedom Day’ by 500%.

The Lancet letter also predicted that hospital admissions would soar as a result of Boris’s recklessness:

The link between cases and hospital admissions has not been broken, and rising case numbers will inevitably lead to increased hospital admissions, applying further pressure at a time when millions of people are waiting for medical procedures and routine care.

Perhaps they should have thought twice before inserting that word “inevitably” because the latest data shows hospital admissions falling. “Another 731 admissions were recorded by officials on July 30th, the latest date available – down 15% on the week before,” reports MailOnline.

And it wasn’t just these 1,200 ‘experts’ who were sounding the alarm. Let’s not forget that Keir Starmer also described Boris’s plan to ease restrictions as “reckless”.

And, of course, our old friend Neil Ferguson said on July 18th that it was “almost inevitable” that daily cases would climb to 100,000 a day if Boris went ahead with the unlocking the following day and added that “the real question” was whether they would reach 200,000 a day or more and warned of a “significant burden on the healthcare system”. Out by 1000% – which is actually pretty modest by Ferguson’s standards.

As Guido Fawkes says: “Guido can’t remember a time 1,200 so-called experts were proven so wrong in one fell swoop…”

Boris’s decision to go ahead with ‘Freedom Day’ is the first time I can think of in the past 16 months when he’s stuck to his guns in the face of wildly apocalyptic claims from various ‘experts’ about the consequences of “letting it rip” (their phrase for giving us our freedoms back). On every previous occasion, because he’s done exactly as these gloomsters have asked, they haven’t been proved wrong. Admittedly, locking down three times hasn’t stopped the U.K. from having one of the worst Covid death tolls in Europe, and Sweden’s excess deaths in 2020 were lower than ours in spite of not locking down. But the crystal ball gazers have always been able to argue that things would have been so much worse if we hadn’t locked down. Yet this time – finally – Boris ignored their doom-mongering and, as a result, they have been proved spectacularly – and humiliatingly – wrong.

Will this experience stiffen Boris’s backbone the next time he’s prevailed upon by the Government’s scientific advisers, sundry public health experts and the chin-wobblers in the Cabinet to lock down again, which really is inevitable? We can but hope.

Lancet Paper Over-Estimates Number of Complications Associated with COVID-19 Hospital Patients

Last week, a paper was published in the Lancet that drew some alarming conclusions about the number of complications associated with COVID-19 hospital patients, generating a predictable number of alarming headlines. However, our in-house doctor has cast his eye over it and has spotted a number of flaws. Here is an extract:

My main criticism of this paper lies in the conclusions drawn from the data. The majority of the discussion section concentrates on the incidence of complications from acute Covid in hospitalised younger patients – defined as under 50 years of age. Yet only 12.6% of the sample size were under 50 years of age. Very little discussion is made of the other 87.4% of patients in the older age groups, who actually had the worst outcomes.

Major emphasis is laid on the incidence of renal complications seen in the younger subgroup and what implications that might have for the future health of the patients. Inference is drawn that such acute kidney injury may lead to higher risks of subsequent renal failure and heart disease in later life.

Yet the authors extrapolate those conclusions based on citations of other papers which do not reflect the subgroup of younger patients referred to in their own figures. In my view it is not reasonable to compare a group of patients under 50 experiencing transient acute kidney injury in the context of another acute disease with a cohort of much older patients having AKI after recent heart attacks (as in one of their citations). Equating the long-term outcomes from these two distinct groups is likely to be a flawed assumption.

I note with interest that the incidence of acute kidney injury as a proportion of overall complications in each age group decile up to the over 90s was remarkably consistent at between 32% and 35%. No distinction was made in the analysis between people requiring renal replacement with dialysis or filtration and those experiencing transient biochemical renal dysfunction that was correctable with intravenous fluid replacement and other simple interventions. This observation supports my suspicion that the parameters of ‘renal injury’ have been set too wide to distinguish between mild dysfunction of no long-term consequence and serious renal damage.

Worth reading in full.

Editor-in-Chief of The BMJ Says Lab Leak Is “Plausible and Worthy of Serious Inquiry”

The two most famous British medical journals are The Lancet (founded in 1823) and The BMJ (founded in 1840). The Lancet – which is arguably the more famous of the two – has come under criticism in recent months for publishing a letter that dismissed the lab leak as a “conspiracy theory”.

Now the Editor-in-Chief of The BMJ has written a surprisingly bold editorial, which is titled ‘Covid 19: We need a full open independent investigation into its origins’. Referencing a longer BMJ article by the science journalist Paul Thacker, she notes that “suppression of the lab leak theory was not based on any clear evaluation of the science.”

She goes on to say, “We don’t know which theory is right, but a lab leak is plausible and worthy of serious inquiry.” And she concludes by calling for a “a full, open, and independent investigation.”

Thacker’s article, which is much longer, examines the role that scientific journals and journalists played in shaping the now-punctured narrative that COVID-19 couldn’t possibly have leaked from a lab in Wuhan.

The story begins with the aforementioned Lancet letter, published in February of last year. That letter, it subsequently transpired, had been organised by Peter Daszak – president of EcoHealth Alliance – who has funded controversial gain-of-function research at the Wuhan Institute of Virology.

Daszak’s letter helped to stifle debate on COVID origins for more than a year. As the molecular biologist Richard Ebright told Thacker, ‘conspiracy theory’ is a “useful term for defaming an idea you disagree with”. Ebright, incidentally, blames not only The Lancet, but also Nature and Science – the world’s two preeminent scientific journals – for suppressing the lab leak theory.

As an aside, Nature’s role in suppressing the lab leak has been covered extensively by the journalist Ian Birrell. As he notes, “Allegations swirl that it was not down to editorial misjudgement, but something more sinister: a desire to appease China for commercial reasons.”

Returning to Thacker’s article, he suggests two main reasons for the “U turn”, whereby the lab leak went from “conspiracy theory” to plausible hypothesis. The first is that Trump lost the election. Because Trump had endorsed the lab leak theory, Thacker argues, “Daszak and others used him as a convenient foil to attack their critics”. (So much for guilt-by-association being a logical fallacy.)

The second factor is that the WHO investigation into COVID origins, which had gone looking for evidence of zoonotic spillover, came back pretty much empty handed. “More worryingly,” Thacker notes, “members were allowed only a few hours of supervised access to the Wuhan Institute of Virology.”

In the final part of the article, Thacker documents the various media outlets and “fact-checking” organisations that have scrambled to retroactively cover their anatomy. For example, Vox added a correction noting, “Since this piece was originally published in March 2020, scientific consensus has shifted.”

Thacker’s article offers a case study in what happens when scientific journals and journalists neglect their duty of independence, and instead become purveyors of an official narrative. It is worth reading in full.

Authors of Lancet Letter Welcome Investigation Into COVID-19 Origins, but Don’t Apologise for Calling Lab Leak a “Conspiracy Theory”

In February of 2020, 27 scientists wrote a letter to The Lancet, claiming studies “overwhelmingly conclude that this coronavirus originated in wildlife”. The authors stated, “We stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin.”

Fast forward to May of 2020. 18 other scientists – including some of the biggest names in the field – wrote a letter to Science stating, “Theories of accidental release from a lab and zoonotic spillover both remain viable” and we must “take hypotheses about both natural and laboratory spillovers seriously until we have sufficient data”.

Now some of the authors of the Lancet letter have penned a new letter for that journal. As several commentators have noted, it’s a rather shameless piece of writing. This is particularly true given that the authors were already criticised for not declaring conflicts of interest.

They begin by describing the context of their original missive: “Unsubstantiated allegations were being raised about the source of the COVID-19 outbreak and the integrity of our peers who were diligently working to learn more about the newly recognised virus.”

Given the location of the first outbreak, and other circumstantial evidence, suggesting the virus might have leaked from a lab was perfectly reasonable. Yet the authors still refer to such suggestions as “unsubstantial allegations”, even though their own theory is just as “unsubstantiated”.

They claim that their peers – by whom they presumably mean scientists at the Wuhan Institute – were “diligently working to learn more about the newly recognised virus”. The implication here is that it was unfair for people to suggest they might have dropped the ball on lab security.

However, these scientists weren’t “diligent” enough to mention that a virus in their database whose genome is 96.2% similar to SARS-CoV-2 was identical to one that had been implicated in an unexplained 2012 outbreak of pneumonia. Nor have they been “diligent” enough to share their lab records with other scientists. Ironically, the authors later mention the importance of “transparent sharing of data”.

They go on to say: “We believe the strongest clue from new, credible, and peer-reviewed evidence in the scientific literature is that the virus evolved in nature, while suggestions of a laboratory-leak source of the pandemic remain without scientifically validated evidence that directly supports it in peer-reviewed scientific journals.”

Lancet Paper Claims Zero Covid Is a Sensible Strategy, but It’s Not Very Convincing

Yesterday, a short paper titled “SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties” was published in The Lancet. The authors claim, “Countries that consistently aim for elimination – i.e., maximum action to control SARS-CoV-2 and stop community transmission as quickly as possible – have generally fared better than countries that opt for mitigation – i.e., action increased in a stepwise, targeted way to reduce cases so as not to overwhelm health-care systems.”

This claim is supported by three charts, each comparing “OECD countries opting for elimination” with “OECD countries opting for mitigation” (see below). The first chart shows that “OECD countries opting for elimination” had fewer deaths per million; the second shows that they had smaller declines in GDP; and the third shows that they had less restrictive lockdowns.

The authors note, “With the proliferation of new SARS-CoV-2 variants of concern, many scientists are calling for a coordinated international strategy to eliminate SARS-CoV-2.” They also note, “Countries that opt to live with the virus will likely pose a threat to other countries” whereas those “opting for elimination are likely to return to near normal”.

One might be tempted to conclude that “elimination” (or “Zero Covid” as it’s sometimes termed) is a sensible strategy going forward. However, I don’t find the authors’ analysis very convincing.

First, they don’t explain how they classified countries as either “opting for elimination” or “opting for mitigation”. For example, did they simply look at outcomes (which would be circular), or did they examine statements by politicians from the spring of last year? (E.g., “This Government will pursue an elimination strategy.”) It’s not clear.

Only five countries were classified as “opting for elimination”: Australia, Iceland, Japan, New Zealand, and South Korea. All other OECD countries were classified as “opting for mitigation”. It may have occurred to you that the five “eliminationist” countries are not exactly representative. Four are islands and one is a peninsula (with a fairly impenetrable border to the north). Two are East Asian. And in fact, these two – Japan and South Korea – are the only East Asian countries in the OECD.

As I argued in a piece for Quillette, all the Western countries that have kept their death rates low are geographically peripheral countries that imposed strict border controls at the start (Norway and Finland, plus a few islands). Their geographic circumstances not only made border controls practical, but also gave them a head start in responding to the pandemic.

It’s very unlikely that large, highly connected countries like France, Italy or the US would have been able to contain the virus during the deadly first wave. And although Britain is an island, we probably wouldn’t have been able to either. The epidemic was already more advanced in London and other international hubs by the time most Western countries introduced lockdowns and social distancing.

In other words, “elimination” was probably never a realistic option for Britain and other large Western countries – even if it could have a passed a cost-benefit test. But what about Japan and South Korea?

Although South Korea did use a combination of early lockdowns and strict border controls to contain the virus, the same cannot be said for Japan. According to the Oxford Blavatnik School’s COVID-19 Government Response Tracker, Japan has had only two days of mandatory business closures and zero days of mandatory stay-at-home orders since the pandemic began. (And the two days of mandatory business closures were the 25th and 26th of April this year.)

Japan did introduce border controls quite early, which may have protected it during the first wave. However, these were not sufficient to prevent an epidemic from burgeoning in the winter of 2020–21. (By early February, the number of daily deaths was in the 90s.) Yet this epidemic retreated without any real lockdown measures being imposed, which suggests that some other cultural or biological factor accounts for Japan’s success.

Second, even if you believe an “elimination” strategy was feasible for Britain and other large Western countries in the early weeks of the pandemic, that ship has arguably sailed. This is particularly true for Britain, where almost 70% of adults now have COVID antibodies. In other words: while it might have been sensible to “eliminate” the virus last spring (assuming that was possible), the costs of doing so now would almost certainly outweigh the benefits.

Overall, the Lancet study does not provide a strong case for “elimination” of COVID-19. And in fact, a survey by Nature of 119 experts found that 89% believe it is “likely” or “very likely” that SARS-CoV-2 will become an endemic virus. As Michael Osterholm – an American epidemiologist – noted, “Eradicating this virus right now from the world is a lot like trying to plan the construction of a stepping-stone pathway to the Moon. It’s unrealistic.”