Why AVN supposedly quit Facebook

goodbye-facebook

On a rather recent January 13th the Australian Vaccination-risks Network announced its partial departure from Facebook. Only weekly videos of Meryl Dorey’s Under The Wire show and Facebook-live videos will continue.

By member email, and more fittingly by Facebook post, distraught followers and amused critics were confronted with this graphic and informed;

The AVN Committee has made the decision not to remain on Facebook where we are already shadow-banned and suppressed for sharing factual, referenced information on the harms and ineffectiveness inherent in our one-size-fits-all vaccination program. We cannot support a platform that is so blatant about silencing us and so many others.

Yes. There is a lot of wrong packed into that short paragraph. Perhaps the mid-section is the most compelling. This blog is one of many that counter so-called “factual, referenced information” from the AVN and the contention that vaccination programmes are harmful and ineffective. The “one-size-fits-all” anti-vaccine mantra has become standard in recent years, finding a place amongst CBS News’ 10 deadly myths about childhood vaccines. The US site Vaxopedia comprehensively addresses this claim.

This was pushed by Judy Wilyman in her 2015 PhD thesis. The term features on four pages and receives much attention as supposed support for her claim that genetic diversity renders immunisation programmes ineffective and dangerous. It also features on her website. This towering failure to grasp immunology rests upon her exploitation of a 70 year old quote from Sir Frank Macfarlane Burnet. I touched on this in 2012 and in the previous post referred to Wilyman’s most recent publication which again presents this contention. Australia’s National Immunisation Programme is not “one size fits all”. It is a diverse programme targetting specific needs.

Back to the paragraph of wrong. It finishes by stating the AVN can’t “support” Facebook because it is so blatant about “silencing” them and others. This is all very dramatic and as I will explore part of an attempt by the AVN to big-note themselves as a radical right wing threat to social media. One must remember that at no time in their history of “supporting” Facebook has the AVN page been temporarily suspended. It’s fascinating timing that whilst writing today I scrolled to a video announcing that Dorey has been suspended from the AVN Facebook page for 30 days. I’m unaware as to why and her most recent Under The Wire (UTW) videos remain on the page.

♦︎ Update 4 Feb. 2021 – see below.

AVN founder Meryl Dorey and president Aneeta Hafemeister have constantly peddled the line that they may be deplatformed at any time due to warnings from Facebook. In fact in a 31 May 2020 Facebook live video Hafemeister observed that Facebook got “snarky” because they had “shared about the [anti 5G] picnics”. So radical was this that she didn’t know if they’d get any more warnings. You may grab the MP3 here [300KB] or listen below.

Aneeta Hafemeister tells listeners AVN could be banned from Facebook, 7 1/2 months before they voluntarily leave… somewhat.

So this leaves us with the claim they were already “shadow banned and suppressed”. We can dispense with the claim of suppression immediately. The AVN has had nothing more than fact-checked posts to deal with. These are greyed out and state False Information: checked by independent fact-checkers, giving the reader pause before proceeding. The AVN once observed that such censoring revealed the importance of the information. Shadow banning involves quietly blocking posts or comments such that members aren’t aware of the ban. This hasn’t happened either. Although the claim being made seemed to be about notifications of posts. They claimed followers could not find them or see notifications.

I’m not sure how this was determined as some commenters confirmed they had the page marked and missed nothing. None agreed they were suddenly not being notified. The lie, as it turned out to be, was revealed the following Saturday when Dorey’s show attracted a larger than normal audience. To date there have been over 800 shares and over 500 comments. The next show managed 470 comments. A recent video by Hafemeister managed 300 shares and 424 comments. To top it off she talked about the spike in numbers visiting the AVN page. Topping that off is that live videos will include interviews from the Vaxxed II bus which can number several per day.

So. Why the pretence? Both Dorey and Hafemeister are unashamed conspiracy theorists and seemingly seek the attention presently given to right wing extremists. Having retained US citizenship, Dorey is a Trump devotee and proudly voted for him. I will stress they are not active extremists but do crave an anti-authoritarian image. In today’s social media environment that means wandering into areas of the far right. They are anti-government mainly in thought, sticking to large, safe gatherings and protesting against soft, even meaningless and imagined “suppression”. Like all anti-vaxxers COVID-19, 5G, lockdowns and then the COVID vaccines gave them the chance to play rebel and increase their following without facing up to the reality that they in turn were a means for others and not a solution.

They have both revelled in the thrill of being taken seriously whilst ignoring the inescapable adage that nothing is forever. From Hafemeister gushing about “We are not government property” painted on the Vaxxed II bus to Dorey’s frenetic rants about fascist dictators that I posted in The Hill We Die On, they have laid a rebellious veneer over the anti-vaccine reality. The opening slug of that post quoted Dorey as follows;

When the police were in Ballina and they were telling us we had to move… I called Aneeta who’s the president of the AVN and I explained to her what the situation was… and she said ‘this is the hill we die on’. And that’s what I think too. We can’t be pushed any further, we just can’t. [..] I did not move here to live in a dictatorship… I will live in a free country or I will die.

The audio of Dorey in the post contains far more intense pseudo-revolutionary, anti-government ranting than the above. Hafemeister’s live videos are filled with “we the people” rhetoric mocking government health policy. A rhetoric that consistently pushes the fallacy of a vaccine injury epidemic that the AVN works against “the system” to solve. In truth both these women are secure white upper middle class individuals with very comfortable, entitled, privileged lives. It’s this very privilege and comfort that allows them to invent and internalise huge problems that don’t exist. Their present lives are spent in elaborate role play.

This was confirmed a number of times during last year’s Vaxxed II bus tour. Despite promises to metaphorically storm the Bastille, and literally die or be free Dorey and Hafemeister meekly complied with requests to move their elaborate show elsewhere. Without exception. Without as much as a shaken fist. The promised revolution shrivelled to behind keyboard attacks on Lord Mayors, councillors and business owners who had dared “suppress” them. AVN members were and are constantly exploited in these endeavours. They are fed contact details of targets and often provided with a template response. Abusive tweets and sabotage of Facebook pages is the norm. Accepting that these responses are excessive is not something the AVN does.

All of this rhetoric, posturing and role playing helps us grasp why the AVN announced its departure from Facebook at the time they did and in the way they did. It was just over a week since the riot and breach of the US Capitol [Wikipedia]. Significant changes had occurred on Twitter and Facebook with Trump’s accounts being permanently suspended and his violent followers being banned. The right wing extremist and fascist hosting platform Parler had been dumped from app stores and deleted from Amazon. It has not yet returned. Much to their frustration the AVN was left happily unmolested. Even Dorey’s very pro Trump “they-stole-the-election” Twitter feed was untouched. When it comes to anti-authoritarianism they just ‘aint bad enough to be Zucked permanently. If they weren’t going to be pushed they could always jump. So they did.

It was the ideal time to leave. They could seize upon the energy following the banning of dangerous accounts and important identities. For bad ass anti-vax revolutionaries it isn’t just what you leave but where you go that matters. The AVN announcement offered a list of alternatives where they would set up shop. These were Telegram, Parler, Gab, MeWe, Brighteon Social and Twitter with videos being posted at YouTube, Brighteon, Bitchute and Rumble. Most of these groups will permit unchallenged falsehoods to be published as “news” and “fact” under the guise of “freedom of speech”. Compare this rubbish from AVN’s Gab page (vaccine kills 24) with the actual reports (COVID kills 24). One can plainly see why fact checking and mainstream media don’t fit their plans.

The AVN also mentioned in their email that Telegram was under threat of being deplatformed, but omitted the reason. Following Parler’s ban the encrypted messaging app had become the default platform for radical nationalists. Telegram channels had long been used by potentially violent elements. Telegram was under pressure to act and finally removed Neo-Nazi and extremist channels. The move was a no-brainer for Telegram which was gaining tens of millions of new users thanks to the confusion over WhatsApp’s upcoming changes to its privacy policy.

One wonders at the wisdom of six different social media platforms and four video sites. It’s excessive but these platforms offer the AVN more exposure, potentially more recruits and thus more members. They seem to be settling in to Telegram and Gab (using their past name Australian Vaccination Network), the latter accomodating large numbers of Trump supporters. Gab is similar to Parler in that it is a haven for right wing extremism and hate speech. It was dumped by GoDaddy in late October 2018 after a member was involved in a synagogue shooting. The domain was then registered by Epik. It has been reported that Gab now rents server hardware.

The AVN’s Twitter and Parler accounts are unique to the group whilst Meryl Dorey also has Parler, Twitter and Facebook accounts. These accounts provide insight into how genuine the move from Facebook may be. On 25 September 2020 on what is the AVN Twitter account they announced;

The AVN has just set up a page on [Brighteon]. If you can join us there, it means that we can actually leave Facebook and its censorship, far, far behind! Please share this link as widely as you can too. Show Zuckerberg hs is very replaceable! [Screenshot]

Dorey leaving Facebook for Parler

Then on 5 December 2020 Dorey announced (left) she was leaving her personal Facebook account for Parler. She was tired of “the censorship, the abuse from FaceBook itself and the constant fact-less checks”.

Meryl would no longer be posting or responding to anything on Facebook. However she was back in four weeks by 1 January 2021 – before Parler was deplatformed. Indeed a quick check confirms she was “responding” to another commenter on her page earlier today. The post to the left has been deleted.

Meryl Dorey is still the face of AVN and wears whatever colours seem to get the attention she desires. COVID-19 is a hoax, a ‘scamdemic’ perpetrated by governments to enable control of the population. Yet she is an adamant supporter of hydroxychloroquine as a treatment for COVID-19 and those right wing commentators who claim it is being suppressed. Her Twitter profile (@nocompulsoryvac) features a photo of Donald Trump and she tweets and retweets in support of the notion the US election was stolen. She supports COVID conspiracist, Dr. Simone Gold and posts common themes of COVID misinformation. Some of her tweets are in the slide show below. The same themes featured in Parler in December 2020 and continue on the AVN’s current Twitter account and Dorey’s personal Facebook page. The image from Gab would have been promptly fact-checked on Facebook.

  • covid misinformation
  • avn tweet brighteon
  • avn post on gab

By quitting Facebook with as much fanfare as possible the AVN can associate itself with genuine anti-government forces on social media. Aneeta Hafemeister and particularly Meryl Dorey can envelope themselves in a controversy that is not of their making and has zero to do with them. In time their narrative can bend to accomodate claims that they, and many others, were forced to leave Facebook at the time of the US Capitol riots. In the case of the AVN they will now claim they were forced to make the choice.

The reality is that the COVID-19 pandemic drew unforeseen attention and numbers to the anti-vax cause. Anti-vaccine media coverage increased by 900% from March to May 2020. It is highly unlikely anything like this will be repeated although it is also a wave with ongoing energy. The COVID-19 vaccine rollout, the Trump election fiasco and the US Capitol riot have continued to motivate a disparate conspiracy-loving demographic. Nonetheless the AVN had begun to witness a decrease in Facebook attendance which they blamed on supposed censorship.

Both Hafemeister and Dorey have easily embraced unrelated dynamics to fit their role play. The impetus for the changes in social media were unmistakably due to events that occurred in Washington D.C. and had the specific aim of restricting organised and potentially violent episodes on behalf of Donald Trump and his claim of election fraud. For Meryl Dorey however the issue was the need to be a source of vaccine and medical information. For both, it’s an opportunity to exploit AVN members and perhaps turn the events to their own profit.

In the audio outtakes below from UTW 16 January 2021 we hear Dorey open by telling viewers that;

Here in our bunker we are on a war footing and that is only a slight overstatement because actually the entire world of social media, most governments and certainly the medical community and the media are at war with the truth. So we are your home at the present time, while we’re allowed to be, for the truth about vaccines and medical practices that you need to be aware of.

Yes, indeed.

Nonetheless, it’s now time to say goodbye from the bunker. You can download the MP3 here [1.5MB] or listen below to farewell AVN’s Facebook days… sort of.

An unedited 5 1/2 min from the opening is available here [4.6MB] for those interested in the unblemished truth from which the outtakes above are taken. It does offer insight into how Meryl tries to convince members to cancel any Amazon subscriptions, as she did, because she can’t abide censorship. She’s not going to tell them what to do but if they’re Amazon subscribers they might want to consider doing the same sort of thing. Subtle.

One awaits further AVN social media developments with interest.

♦︎ 8:00 PM 4 February 2021: AVN publish newsletter stating the 30 day ban was due to the most recent UTW episode of 30 January 2021 which is still available on the Facebook page.


Latest update: 9 Feb. 2021

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AstraZeneca problems don’t confirm anti-vax theories

Last week AstraZeneca announced demonstrated varying efficacy in two different dosing regimens of its candidate COVID-19 vaccine, AZD1222 (ChAdOx1 nCOV-19).

In a November 23rd press release [PDF] the company announced efficacy of 90% when AZD1222 was given as a half dose and followed by a full dose at least one month later. This sample group had 2,741 subjects. Vaccine efficacy of 62% was evident when two full doses of AZD1222 were given at least one month apart. This was observed in a sample group of 8,895. They also announced a “combined efficacy” averaging 70% in a sample of 11,636.

Problems emerge

Whilst this sounded like a positive outcome it soon became apparent that the Oxford-AstraZeneca team still had hurdles to clear. It emerged later that the dose regimen yielding efficacy of 90% was given by mistake. This wasn’t made clear in the press release. The first dose should have been a full dose but due to a “manufacturing issue” only half of the expected dose was given. Regulators were told at the time and agreed the trial could continue with the immunisation of more volunteers. It is problematic that the trial wasn’t designed to test this regimen and less than 3,000 subjects aged 55 or less were involved. In order to validate the results another study examining the efficacy of the regimen will take place.

The other problem was the notion of “combined efficacy”. These data come from two different trials with different dosing regimens. One trial arm in the UK began in May. The Brazilian trial arm began in late June. So this information has not come from a single large Phase III trial as was the case with Pfizer and Moderna. Averaging efficacy from two different trials to yield “combined efficacy” of 70% is not acceptable. This doesn’t provide a sound assessment of what level of efficacy, or regimen, the public can expect. So again, further trials are needed. Also press release is not the vehicle to present scientific information and the AstraZeneca issue is an example of how problematic this can be. Study specifics that have been peer reviewed carry far more weight.

Media coverage

Which raises a point made by Norman Swan on today’s Coronacast that rumours are circulating, apparently with very little confirmation, that suggest Oxford-AstraZeneca are rushing to publish. He referred to a Financial times article which reported on Saturday;

Regulators and the rest of the world will soon have the full data. The Oxford academics who developed the vaccine have submitted a paper setting out their full Phase 3 results to The Lancet medical journal. They will be working over the weekend to answer questions from the journal and its referees and the article could be published as early as Thursday [UK time].

Concern and criticism about transparency and trust has been raised, particularly in the USA. Natalie E. Dean, assistant professor of biostatistics at the University of Florida posted a series of tweets on November 25th. Apart from transparency, concern about scientific rigour was raised. Her tweets included;

AstraZeneca/Oxford get a poor grade for transparency and rigor when it comes to the vaccine trial results they have reported. This is not like Pfizer or Moderna where we had the protocols in advance and a pre-specified primary analysis was reported.

The point about protocols in advance, along with the fact that AstraZeneca was one of nine vaccine makers to sign a scientific rigour pledge in September was raised in a highly critical article by Hilda Bastian writing in Wired. The article goes into the Phase III trial arms in depth and the manner in which Oxford-AstraZeneca has deviated from their trial protocol. Comparisons are made to the BioNTech-Pfizer vaccine at 90% efficacy and the Moderna vaccine at almost 95% efficacy. Bastian certainly casts them in a positive light. These two companies use messenger-RNA as the vector in their COVID-19 vaccines. Oxford-AstraZeneca use an adenovirus vector in their vaccine. How variously each approach effects COVID-19 vaccine efficacy is presently unknown. The Moderna and Pfizer vaccine results were also made public by press release. 

It’s important to note that the FDA has argued a vaccine must be at least 50% effective to be useful in combating the pandemic. Whilst concern has been raised about the AstraZeneca situation it is over efficacy and not safety. The fact that regulators will accept an efficacy of at least 50% was noted by Mene Pangalos, AstraZeneca’s executive vice president for research, who dismissed concerns. AstraZeneca also want to alter the specifics of the US trial under the auspices of Operation Warp Speed. The aim is to change the two full dose regimen to a half dose, full dose regimen.

Certainly further successful trials are well within AstraZenecas grasp. The BMJ recently published COVID-19 vaccines: where are the data? The article examines the position of the three recent candidate vaccines and what is expected through peer-reviewed publication. The UK government has asked the Medicines and Healthcare products Regulatory Agency to evaluate authorising supply of the Oxford-AstraZeneca vaccine.

The cold chain needs of each vaccine vary. The Pfizer candidate requires storage at -70 degrees Celsius. This alone provides a challenge difficult to meet in developed nations and impossible in nations without significant infrastructure. Moderna’s candidate vaccine can be stored at -20 degrees Celsius meeting most pharmacy and hospital freezer temperatures but providing transport challenges for developing nations.  Moderna claims that after thawing the vaccine will remain stable for up to 30 days at 2 – 8 degrees Celsius. AstraZenecas candidate can be stored in a normal refrigerator at 2 – 8 degrees Celsius and thus meets conditions in present healthcare settings and realistic options in developing nations. A successful outcome for Oxford-AstraZeneca is significant for the management of a global pandemic.

Back to Norman Swan of Coronacast;

And remember, this is a vaccine that they promised not to make profits out of, that is cheap and they are committed to giving very large doses, I think something enormous like a third of the world’s doses of vaccines are relying on AstraZeneca. So there’s a lot riding on this vaccine.

Anti-vaccination lobby

The anti-vaccination community have taken the challenges faced by AstraZeneca as more evidence Big Pharma is always up to no good. A recent AVN Facebook post observed that maybe it wasn’t a good idea to let drug companies release their own study information without independent oversight.

AVN on AstraZeneca

So again we might consult the press release. It includes (para 3);

An independent Data Safety Monitoring Board determined that the analysis met its primary endpoint showing protection from COVID-19 occurring 14 days or more after receiving two doses of the vaccine. No serious safety events related to the vaccine have been confirmed. AZD1222 was well tolerated across both dosing regimens.

Reading information on the AstraZeneca board we see;

Our Directors are collectively responsible for the success of AstraZeneca. In addition, the Non-Executive Directors are responsible for exercising independent and objective judgement and for scrutinising and challenging management.

Quickly scattering the seeds of disinformation in this manner is what the AVN always do. One expects this manipulation of their members. What I’m more interested in is the inability of the group to acknowledge that the focus on COVID-19 vaccine development has revealed a number of long standing claims to be false. In September I posted on how the Oxford-AstraZeneca trial pause alone refuted long standing anti-vaccine claims. Namely transparent mainstream media coverage and the documented process of Phase III trials. Despite the ample criticism of AstraZeneca’s handling of data the AVN are even further from defending their claims than they were in September.

As a quick reminder it is the claim that vaccine manufacturers do not assess the safety or efficacy of vaccines. Ever. Added to this is the strange insistence that a placebo must always be inert. Let’s revisit quotes promoting these errors. Given that the COVID-19 candidates are new vaccines the following quote published in a response to a journalist is particularly relevant. See Proposition 4;

…there have never been double-blind, placebo-controlled prospective studies done on either the safety or efficacy of vaccines, not even when a new vaccine is introduced. 

This piece on HPV is highly misleading. Yet it’s the claim in the second paragraph under Safety In Question I find compelling;

By definition, a placebo must be a totally inert substance which will never provoke a response.

That definition might be fine for the “sugar pill” placebo. As in when we think of the “placebo effect”. Yet in vaccine trials it is more important to sustain the double blind nature of the trial. Simply put a subject must not know what group they are in. The AVN are anti-HPV vaccination. Gardasil trials have used the amorphous aluminium hydroxyphosphate sulphate adjuvant, or AAHS as placebo. This, unlike saline, produces an injection site effect like a genuine vaccine. Thus members of the placebo group and those administering the dose are unaware they have received or given the placebo. The randomised double blind nature of the trial is preserved.

Double blind randomised control trials are what Meryl Dorey, founder of the AVN calls “the gold standard” insisting they are ignored in vaccine research. The claim is part of the AVN Did You Know? leaflet. In this case demanding only inert placebos be used helps to both refute the value of trials and contend a heavy metal neurological injury is potentially caused by adjuvant placebos. The impact of this rhetoric can be seen below in an image of an interviewee on the Vaxxed II bus (27 Nov. 2020). Her T-Shirt has the words “gold standard science” and “inert saline placebos” amongst others written on it in Texta.

Finally as discussed in this article, by contending that no vaccine trials using saline placebos have ever been conducted the insistence that vaccines are primed to harm persists. It’s a simple no true Scotsman anti-vaccine fallacy. Also when saline is used as the placebo in an HPV vaccine trial, there really is nowhere to hide. Vaccine studies using saline placebos abound. Period.

t-shirt with anti-vax wording

AVN devotee wearing T-shirt demanding ‘inert saline placebo’ trials

As it happens saline has been used in the USA arm of the AstraZeneca Phase III trials. In other groups a meningococcal vaccine is given as placebo. This won’t only create an injection site effect but a general feeling in line with being vaccinated. Not being aware they are receiving a placebo ensures subjects don’t introduce an unexpected variable to the trial. This fact, and the ethical nature of the approach is discussed in a well written article here. Finally in establishing the safety of vaccines a more convincing and in depth picture is gained through the application of more than just placebo controlled studies.

Conclusion

The more we see of Phase III trials for COVID-19 candidates, whether they be immediately accepted or controversial, the greater the refutation of the above anti-vaccine tropes. Senior members of the AVN are reading material that describes Phase III trials and their testing of both safety and efficacy. The above claim that double blind, placebo controlled trials don’t exist, “even when a new vaccine is introduced” still exists on the AVN website and in discussion. In the bright light of facts this is a true measure of the group.

The Oxford-AstraZeneca AZD1222 results have been met, understandably, with specific criticism. This relates to efficacy only. Safety is not being questioned. Some media reports have hinted that AstraZeneca will have difficulty getting the vaccine regulated for emergency use in the USA based on present data. Further, larger studies are needed to establish the veracity of the 90% efficacy finding in the smaller sample given a half dose followed by a full dose. This is entirely within reach of AstraZeneca.

Given the unscientific notion of a “combined efficacy” of 70% it is within AstraZeneca’s interests to pursue further research. Indeed everything being equal one may hope that the “combined efficacy” rate is not reinforced with further research. As STAT reported;

If it’s 70%, then we’ve got a dilemma,” said Fauci. “Because what are you going to do with the 70% when you’ve got two [vaccines] that are 95%? Who are you going to give a vaccine like that to?

AstraZeneca’s AZD1222 vaccine has enormous potential. The low cost, cold chain specifics and the company’s offer to not profit from the vaccine meets a global imperative for pandemic recovery. What the scientific community and the public need to see is a large robust Phase III trial that reproduces efficacy in the region of 90%. 

 


References:

COVID-19 vaccines: where are the data? – BMJ

After admitting mistake AstraZeneca faces difficult questions about its vaccine – NYT

Oxford COVID vaccine: regulator asked to assess jab – BBC

Australia’s Oxford-AstraZeneca COVID-19 vaccine choice questioned as experts highlight ‘shaky’ science – ABC

Pfizer vaccine: what an efficacy rate above 90% really means – The Conversation

Moderna’s trial data shows its COVID-19 vaccine nears 95% efficacy – ABC

Placebo use in vaccine trials: Recommendations of a WHO expert panel – NCBI

There are no vaccines with saline placebo? – Vaccines Work blog

Last Update: 1 Dec. 2020

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In 2015 Bill Gates advised on the need to prepare for a global pandemic

In 2015 Bill Gates gave a TED Talk on the importance of preparedness for a global pandemic caused by “a highly infectious virus”.

An Ebola epidemic that began in December 2013, and continued until 2016, had by that time killed around 10,000 people in West Africa. Gates cites three reasons as to why there weren’t more deaths. 1.) The selfless work by front line health workers including locating infected persons and preventing further spread (see Contact Tracing below). 2.) Ebola is not an airborne virus and by the time those who are infected become contagious, most are so ill as to be bedridden. 3.) The virus did not reach many urban areas and this directly kept the number of cases lower than had Ebola spread throughout urban communities.

Yet he also refers to what he calls “a global failure”. Noting the slowness of response. The failure to study treatment approaches, diagnostics and the application of epidemiological and medical tools.

In what has been shown to be an uncomfortably prescient statement Gates notes;

So next time, we might not be so lucky. You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market.

Gates uses the Spanish Flu of 1918 to demonstrate how quickly an airborne virus can spread. He observes that the World Bank have estimated that a global flu epidemic will cause a drop in global wealth of “over three trillion dollars” and there would be “millions and millions of deaths”.

It’s important to note that the present reality with COVID-19 is not absolutely reflected in Gates’ TED Talk. Trends of global financial impact have not yet played out. Total fatalities will be disturbing and many may lose friends and loved ones, yet the prediction of “millions and millions” of deaths is not a current reality.

Nonetheless the reason that the capacity to reduce morbidity and mortality – to flatten the curve – is in our hands is indeed touched on by Gates. Just after the five minute mark he speaks of our ability to use certain tools to create an effective response system. Science and technology. The use of cell phones to inform the public. Satellite maps to inform on the movement of people. Advances in biology and research that will support rapid turnaround of drugs and vaccines to fit the pathogen responsible for the pandemic.

As I touched on above another factor discussed but not labelled as such by Gates, that is presently more robustly employed to reduce the spread of COVID-19 is Contact Tracing. Gates talks about locating infected persons and preventing further spread. In May 2017 African Health Sciences published a review of contact tracing in containing the 2014 Ebola outbreak. However with an airborne coronavirus this has proven, as expected, to be enormously more complicated.

At the time of writing there exists a spectrum of tactics in various countries, with some considered invasive to privacy. Israel has passed emergency laws to allow its security agency, Shin Bet to tap peoples phones without a warrant.

According to the Computational Privacy Group in the case of Singapore (using TraceTogether), Taiwan and South Korea this involves using cell phones and dedicated software in the;

…recording [of] close proximity between people using Bluetooth, WiFi, or GPS data, [which] could help efficiently notify people that they have earlier been in contact with someone now diagnosed with coronavirus and should self-isolate

The CPG have published Can we fight COVID-19 without resorting to mass surveillance? which looks at both location data and contact tracing in different regions, and the technology used.

Reports in Australia have suggested that tracking the public through their phones has been considered and that the federal government is “looking to Singapore” and the TraceTogether app. Victoria’s Department of Health and Human Services has expanded contact tracing to include use of the messaging platform Whispir.

IT News reports;

The department will begin using the cloud-based platform from Thursday to regularly interact with those that have come into close contact with someone who has contracted COVID-19.

The platform, which will automate interactions between the department and select individuals, will also be used to enforce self-isolation for Victorians who have confirmed cases of the virus.

Gates was more than reasonably accurate in predicting our response. Presented without exact figures from the epidemiology and pathology of the infectious agent Gates’ description of how we could and would respond deserves high marks.

Presently we are witnessing the application of the tools at our disposal to flatten the curve of morbidity and mortality. We know that only an effective vaccine can break the back of the pandemic as it now exists. Drugs that target specific symptoms and slow or prevent the impact on COVID-19 comorbidity are greatly needed. The use of cell phone apps to both inform and trace the public is well underway.

Most importantly we have accepted that staying at home, social distancing and increasingly reducing the number of people together in public, together with effective hand washing and smothering of coughs or sneezes are vitally effective measures. Some of these measures should be employed every flu season and it’s hoped we will continue to do just that.

One imagines we will be better prepared in future for the emergence of another pandemic. Gates was right in that we needed to prepare. We see that clearly now in the need for hospital beds, ventilators and other medical equipment. He also noted the necessity of strong health systems in poor countries and presently the need for increased funding in developing nations is a reality. [AlJazeera news video]

To finish off perhaps we should focus on what Gates observed at the end of his talk;

So I think this should absolutely be a priority. There’s no need to panic. We don’t have to hoard cans of spaghetti or go down into the basement. But we need to get going, because time is not on our side.

In fact, if there’s one positive thing that can come out of the Ebola epidemic, it’s that it can serve as an early warning, a wake-up call, to get ready. If we start now, we can be ready for the next epidemic.

Of course we were not utterly unprepared for a pandemic. Far from it. There are global and national agencies throughout the world that focus on both the risk of a viral pandemic and how we can best prepare. Developing nations are closely monitored by organisations such as the WHO and the UN. Still the lack of any treatment or vaccine to prevent COVID-19 has proven to be an enormous hurdle.

Developed nations are in a better position to fund and respond to recommendations. Australia has a Health Management Plan for Pandemic Influenza, last updated in August 2019. The UK has its Pandemic Contingency/Major Infectious Diseases Outbreak Plan. Similar plans exist around the world.

An interesting dynamic in the USA at present is whilst President Trump has criticised the CDC for its response to coronavirus, he had from 2018 cut their budget for global disease management and closed government units dedicated to preventing pandemics.

Trump’s administration has also cut similar funding for the National Security Council (NSC), Department of Homeland Security (DHS), and Health and Human Services (HHS). Other cuts to CDC funding used to manage chronic disease are scheduled for 2021 and as yet have not been approved by Congress. Perhaps justifiably Trump has come under scorn for his approach to the coronavirus outbreak.

Funding for the prevention of pandemics is an essential part of a solid public health budget. Without a doubt these budgets should be designed with input from scientists. By shirking reason and evidence in their pursuit of “alternative facts” and a post truth world, the Trump administration had maneuvered itself into an increasingly perilous position.

One hopes that as we move toward the future and find ourselves past the COVID-19 pandemic that we aim to listen to the evidence, learn from the past and prepare for pandemics we cannot yet predict.


 

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TRANSCRIPT

00:17
When I was a kid, the disaster we worried about most was a nuclear war. That’s why we had a barrel like this down in our basement, filled with cans of food and water. When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel.

00:37
Today the greatest risk of global catastrophe doesn’t look like this. Instead, it looks like this. If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes. Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents. But we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.

01:20
Let’s look at Ebola. I’m sure all of you read about it in the newspaper, lots of tough challenges. I followed it carefully through the case analysis tools we use to track polio eradication. And as you look at what went on, the problem wasn’t that there was a system that didn’t work well enough, the problem was that we didn’t have a system at all. In fact, there’s some pretty obvious key missing pieces.

01:51
We didn’t have a group of epidemiologists ready to go, who would have gone, seen what the disease was, seen how far it had spread. The case reports came in on paper. It was very delayed before they were put online and they were extremely inaccurate. We didn’t have a medical team ready to go. We didn’t have a way of preparing people. Now, Médecins Sans Frontières did a great job orchestrating volunteers. But even so, we were far slower than we should have been getting the thousands of workers into these countries. And a large epidemic would require us to have hundreds of thousands of workers. There was no one there to look at treatment approaches. No one to look at the diagnostics. No one to figure out what tools should be used. As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them. But that was never tried.

02:53
So there was a lot that was missing. And these things are really a global failure. The WHO is funded to monitor epidemics, but not to do these things I talked about. Now, in the movies it’s quite different. There’s a group of handsome epidemiologists ready to go, they move in, they save the day, but that’s just pure Hollywood.

03:22
The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola. Let’s look at the progression of Ebola over this year. About 10,000 people died, and nearly all were in the three West African countries. There’s three reasons why it didn’t spread more. The first is that there was a lot of heroic work by the health workers. They found the people and they prevented more infections. The second is the nature of the virus. Ebola does not spread through the air. And by the time you’re contagious, most people are so sick that they’re bedridden. Third, it didn’t get into many urban areas. And that was just luck. If it had gotten into a lot more urban areas, the case numbers would have been much larger.

04:17
So next time, we might not be so lucky. You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market. The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism. So there are things that would literally make things a thousand times worse.

04:39
In fact, let’s look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So here’s what would happen: It would spread throughout the world very, very quickly. And you can see over 30 million people died from that epidemic. So this is a serious problem. We should be concerned.

05:04
But in fact, we can build a really good response system. We have the benefits of all the science and technology that we talk about here. We’ve got cell phones to get information from the public and get information out to them. We have satellite maps where we can see where people are and where they’re moving. We have advances in biology that should dramatically change the turnaround time to look at a pathogen and be able to make drugs and vaccines that fit for that pathogen. So we can have tools, but those tools need to be put into an overall global health system. And we need preparedness.

05:41

The best lessons, I think, on how to get prepared are again, what we do for war. For soldiers, we have full-time, waiting to go. We have reserves that can scale us up to large numbers. NATO has a mobile unit that can deploy very rapidly. NATO does a lot of war games to check, are people well trained? Do they understand about fuel and logistics and the same radio frequencies? So they are absolutely ready to go. So those are the kinds of things we need to deal with an epidemic.

06:13
What are the key pieces? First, we need strong health systems in poor countries. That’s where mothers can give birth safely, kids can get all their vaccines. But, also where we’ll see the outbreak very early on. We need a medical reserve corps: lots of people who’ve got the training and background who are ready to go, with the expertise. And then we need to pair those medical people with the military. Taking advantage of the military’s ability to move fast, do logistics and secure areas. We need to do simulations, germ games, not war games, so that we see where the holes are. The last time a germ game was done in the United States was back in 2001, and it didn’t go so well. So far the score is germs: 1, people: 0. Finally, we need lots of advanced R&D in areas of vaccines and diagnostics. There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly.

07:21
Now I don’t have an exact budget for what this would cost, but I’m quite sure it’s very modest compared to the potential harm. The World Bank estimates that if we have a worldwide flu epidemic, global wealth will go down by over three trillion dollars and we’d have millions and millions of deaths. These investments offer significant benefits beyond just being ready for the epidemic. The primary healthcare, the R&D, those things would reduce global health equity and make the world more just as well as more safe.

07:55
So I think this should absolutely be a priority. There’s no need to panic. We don’t have to hoard cans of spaghetti or go down into the basement. But we need to get going, because time is not on our side.

08:09
In fact, if there’s one positive thing that can come out of the Ebola epidemic, it’s that it can serve as an early warning, a wake-up call, to get ready. If we start now, we can be ready for the next epidemic.

08:26
Thank you.

No reason to not vaccinate but anti-vaxxers continue to resist sound health policy

On April 17th last year Paul Offit was interviewed by Christiane Amanpour of CNN on the fact that there is “no legitimate reason” for not vaccinating.

This video very recently accompanied a February 21st article by U.S. pediatrician Dr. Edith Brancho-Sanchez, entitled Several vaccines at once might be too much for parents, but kids are just fine. The article reinforced the fact that the misinformation regarding the safety and efficacy of vaccines causes variations of anxiety in parents who take their children to be vaccinated.

It was reported that a 2014 USA National Immunization Surveillance Survey indicated that;

… over a third of parents of children ages 19 to 35 months followed delayed immunization schedules. Of the parents surveyed, 23% followed an alternate schedule that either limited the number of shots per visit or skipped at least one vaccine series altogether. Another 14% followed an unknown or unclassifiable schedule that did not follow a pattern and was not in line with national recommendations. Children who followed an alternate pattern were four times as likely not to be up to date on their vaccines and those who followed an unclassifiable pattern were over twice as likely not to be up to date.

Regrettably pediatricians are in a Catch 22 situation. They need to build parental trust. A 2015 study published in Pediatrics indicated that 93% of 534 pediatricians had been asked by parents of children under 2 to spread out vaccines. 82% believed complying with the parent’s request would build trust, whilst 80% thought if they declined, this may lead to parents leaving their practice.

In Connecticut, USA state lawmakers “narrowly advanced a bill” this week that seeks to ban religious vaccine exemptions for children. Despite reports of a 25% increase in religious exemptions from last year anti-vaccine opposition to the bill was fierce including protests in Connecticut’s Legislative Office Building. One Democrat representative, who seemed to have abandoned any pretense of basing his decision on evidence, referred to vaccination as “injecting a witches brew of chemicals”.

Here in Australia the leading anti-vaccine disinformation group The Australian Vaccination-risks Network has called on members and fellow anti-vaxxers to heed another infamous Action Alert. They are targetting Victoria and South Australia. In Victoria the Health Services Amendment Bill 2020 seeks to provide for mandatory vaccination of healthcare and ambulance workers with specific immunisations. Ten days ago the Victorian Minister for Health published this media release outlining the logic behind the decision.

The vaccines included are the flu vaccine, whooping cough, measles, chicken pox and hepatitis B. It is astonishing, as we witness the evolving impact of COVID-19 in the absence of a vaccine, that groups such as the AVN seek to multiply these negative effects. They have teamed up with the anti-science, anti-medicine group, Health Freedom Victoria helping to disseminate their “generic letter” for anti-vaxxers to mail to “all Victorian politicians including your local member”. Of course one may pen ones own. Be sure to stress you “vehemently oppose this draconian overreach of the Andrews’ government”.

They also advise to follow up with phone calls. Following that, they basically suggest harassing Martin Foley who is Minister for Mental Health, Minister for Equality and Minister for Creative Industries. Martin Foley’s mental health portfolio sees him quite active in reducing discrimination for Victorians living with mental health challenges. Health Freedom Victoria want anti-vaxxers working in the health sector to email and call Mr. Foley to;

Tell him you are appalled that he would change the Discrimination Act to get away with forcing you to take an untested and unwanted medical procedure in order to keep your job

In the material they have disseminated to encourage targetting Martin Foley, Health Freedom Victoria refer to him as, “the Minister for amongst other things, Mental Health and Discrimination”.

South Australia introduced No Jab No Play legislation on September 30th 2019. Again there is a “generic letter” ready to go. In both cases the AVN seek to motivate loyal anti-vaccine followers to engage in pestering letter and/or email writing campaigns, asking those involved to follow up with a phone call, in this case “within half an hour but at least by the end of the day”. This is to confirm they have received your email and will be sending a Decision Regulatory Impact Statement (RIS). Of course one should inform the person you’ll call back in two weeks to chase up that RIS. And why?

In the words of the AVN themselves;

Phone calls increase their workload, so they’re more likely to do their job to avoid getting repeat calls.

Yep, you read that right. Wasting the time of your local members already busy and hard working staff is ensuring they “do their job”.

Now, it’s over to Paul Offit…

 

Immunisation: Why we do it and how ‘herd immunity’ works

Denial of community immunity or herd immunity is a common feature of antivaccinationists.

In fact groups that spread harmful disinformation, such as the Australian based Australian Vaccination-risks Network (AVN), have for years been refining the denial of this evidence based fact. Notably they misrepresent what herd immunity is, primarily by referencing an aspect of herd immunity or an expected result of herd immunity.

The Australian Government Department of Health offer this definition;

If enough people in a community are immunised against an infectious disease, there is less of the disease in the community, which makes it harder for the disease to spread.

Immunisation protects both people who are vaccinated and also helps the entire community. It helps protect those who are too young to be vaccinated and those who can’t be vaccinated for medical reasons. This is known as community (herd) immunity.

Claiming that the “laws” of No Jab No Pay and No Jab No Play “are based on herd immunity”, Meryl Dorey of the AVN contends;

The theory claims that the unvaccinated are more likely to contract and transmit diseases than their vaccinated peers.

Travel to a largely unvaccinated country, get shots and you’re apparently in a protected bubble. Back home and they’d have us believe we need a 95 per cent plus vaccination rate to be protected and that a lone unvaccinated individual can be responsible for an epidemic.

Indeed rather than “claim” that unvaccinated community members will contract and transmit disease, herd immunity provides greater protection for the unvaccinated. Nonetheless herd immunity cannot protect any particular unvaccinated individual and is very important with respect to protection from measles infection.

This is why individuals who cannot be vaccinated for specific reasons or those with weakened immune systems will be better protected in a community that has a vaccination level of 95% or above. In certain communities where vaccination levels are low, herd immunity and the cluster of immune individuals doesn’t exist. In this instance measles can easily spread from an infected individual to unvaccinated individuals.

If not for herd immunity providing protection to those who refuse vaccination and deny their children the protection of vaccine induced immunity, many of the false beliefs held by antivaccinationists could not persist. The success of so-called natural remedies, homeoprophylaxis and so on persist simply due to the protection of herd immunity.

  • The video below was produced by the BBC and provides an accurate summary of vaccination and herd immunity.

Immunisation: Why we do it and how ‘herd immunity’ works – © BBC News

Discredited anti-vaccine conspiracy theorist Judy Wilyman has even used denial of herd immunity in her ongoing attacks on Australia’s successful vaccination policy. Wilyman wrongly contends that only public health reforms such as sanitation led to the control of vaccine preventable diseases.

Vaccines did not create herd immunity to control infectious diseases, is an open letter on her website. The monumental flaw in her fallacious claim begins with her use of only mortality, and no morbidity data.

Also, Wilyman refers to changes in public health occurring before 1950. This ignores more modern vaccines such as that for Haemophilus influenzae type b (Hib) used in Australia from 1993 and later in Kenya from 1999.

Only vaccination can explain the control of Hib and the emerging success of the HPV vaccine.