Some of my readers may be aware that Nelson lawyer Sue Grey is taking a case to the NZ High Court in an attempt to stop the roll-out of the Pfizer vaccine. I don’t agree with her stance, but she has every right to do this.
However, I was more than a little surprised to see that one of the academics promoting “Plan B” as an alternative to the government’s current means of controlling the spread of SARS-Cov-2 in this country has provided an affidavit supporting this action. You can find this document on the public kti.org.nz website; (I used a ‘read-only’ plugin to access it as my antiviral software didn’t like the page. I found this … amusing.)
Dr Thornley’s PhD research was into the statistical prediction of cardiovascular disease, and many of his recent publications look at issues relating to diet and obesity; very few relate to the epidemiology of infectious respiratory disease. However, since the advent of SARS-Cov-2 and covid-19 he has produced a number of publications on this subject (in addition to forming the lobby group Plan BA and writing for its blog). More recently, not only has he given support to Voices for Freedom (an antivaccine group with a strong conspiracy bent and – claims to the contrary notwithstanding – a certain reluctance to really engage with the science), but also provided that affidavit supporting Grey’s case against the rollout of the Pfizer vaccineB. This is truly perplexing, given that he works in the field of public health.
After discussing his expertise, Dr Thornley mentions the swine flu (H1N1 influenza virus) epidemic, which caused illnesses & deaths in NZ in 2009. He states that it was later found to be “ubiquitous” in this country; a seroprevalence study from 2010 found that the “overall community seroprevalence was 26.7% for the study population.” It’s worth noting that seroprevalence varied by age (highest in the 5-19 age group) & ethnicity: much higher in Pacific Island peoples and Māori. Both those groups were also hospitalised, and admitted to ICU care, at a much higher rate than other ethnicities. The H1N1 epidemic faded away relatively quickly, but it’s a false equivalence for him to imply that the same would be true for SARS-Cov-2, which is a different type of virus and, as the news from India shows, is not going anywhere soon.
Plan B has been “Questioning the evidence for the use of masks to prevent Covid-19 infection, based on randomised trial evidence” – this refers to this Danish study. This study had a number of limitationsC – identified by the authors – but still showed some indication of a reduction in the risk of infection for those wearing masks. It was hardly evidence that masks definitively don’t work. In addition, there is plenty of evidence, published in similarly good-quality journals, showing the positive impact of mask use to reduce the spread of the virus from infected individuals. For example, research from Germany, published in the Proceedings of the National Academy of Sciences, found a roughly 45% reduction in infections following the introduction of a mask mandate. Another paper in the same journal found that “mask wearing reduces transmissibility per contact by reducing transmission of infected respiratory particles in both laboratory and clinical contexts.”
Dr Thornley also repeats the statement – made frequently by others claiming the virus isn’t that bad – that “many of those deaths were ‘with’ covid-19 not ‘from’ covid-19”. It’s worth sharing this commentary from the BMJ that addresses such claims directly, and which includes this statement:
In 90% of certificates where covid-19 is recorded, it does so in part 1 [of the death certificate] as the cause contributing directly to death.
That is, for those patients covid-19 was the direct cause of death. Had they not acquired the infection, they might not have died. This Reuters article makes exactly the same point, as do the doctors quoted here.
The citation for his claim that SARS-Cov-2 infections were “widespread” in Italy in September 2019 is to a blog post on the Plan B webpageD, which in turn is based on this article, which discusses the results of antibody tests for the spike protein. (This paper, describing the findings of wastewater surveillance, provides evidence that the virus was present in northern Italy in December 2019). It does seem unusual that there was apparently no uptick in unusual pneumonia cases along with those positive antibody tests in September. After all, in the case of Spain over the 2020 summer considerably less than 10% of the population had returned a positive antibody test, even though the country had recorded 28,000 deaths from covid-19 by then.
Italy locked down northern parts of the country in February 2020 (the first deaths there were on Feb 22), with a nationwide lockdown starting in early March. By then excess mortality had already reached its first peak in Italy, which doesn’t seem to match the suggestion that policy measures (eg lockdowns) rather than the virus caused many of the deaths.
There’s a comment that “The age distribution of death from covid-19 is no different from the age distribution of background death, indicating that the virus is not especially virulent or deadly.” It would be interesting to see his take on that in light of the global excess mortality in 2020.
From there, the affidavit moves on to setting out reasons to halt the vaccine rollout in New Zealand.
One is his perception that the roll-out of the mRNA vaccines is “rushed”. This is something I addressed in an earlier post. As I said there, animal testing & Phase I, II, & III trials were all completed, and the results published. The delivery mechanism (the lipid “bubbles”) had already been developed; once the viral genome had been published, developing the vaccine took very little time. And, “while it’s true that most clinical trials last several years, much of this time is actually occupied in finding funding for each phase, and in enrolling participants – it can take a couple of years just to enlist enough volunteers to obtain statistically reliable data. Neither of those posed a problem this time round: the RCT enrolled those 43,000 people in a matter of a few months.”
Another is the “very low fatality rate of covid-19 in people under the age of 65 years.” Yet this paper in the Lancet gives an approximately 1% infection-fatality risk for those aged 45-64 (see also the Our World in Data webpage). That’s one in a hundred. And here are the risk ratios for infection, hospitalisation, & death, updated in February this year, from the CDC. The majority of those who died had one or more underlying conditions, but that should not be used to dismiss the deaths. In fact, in the NZ context, it’s worth remembering that a reasonably large number of Kiwis have comorbidities that put them at risk from covid-19, and not only in those older age groupsE. There are also marked ethnic disparities, with “substantial disparities for Māori and Pacific peoples … for the vast majority of commonly-diagnosed comorbidities”; in addition, prevalence of those conditions shows up at earlier ages for those two groups. (The quote is from the linked paper.) Thus vaccinating all those who wish to be vaccinated, regardless of age group, can protect a large number of others.
Thus, because of those ethnic & demographic features, it’s not really helpful to look at Iceland & extrapolate to New Zealand (as the affidavit does). And to say that “only” 5% of those infected were hospitalised there, and “only” 1% required ICU care, is to trivialise what that translates to across the population.
The risk of antibody-dependent enhancement in relation to the Pfizer vaccine has been raised by a number of those opposed to the vaccination program. But those designing the vaccines took a lot of care to minimise this risk, and with hundreds of millions of doses administered to date, we still have no evidence that this is actually a concern.
The clinical trials for the vaccine did not begin only “late last year”, as Dr Thornley states in his affidavit. Phase III trials (large-scale trials that involved 43,000 volunteers) began on July 27 2020, early in the second half of the year. Phase III concluded in mid-November of that year, with all individual participants having been closely monitored for 42 days from the date of first vaccination (pretty much a standard time-frame for vaccine studies). And the Phase III results were published in late December in the New England Journal of Medicine.
Similarly the effects of this vaccine on hospitalisation & death from covid-19 have been reported multiple times: from Israel, where more than 53% of the population is now fully vaccinated; from the US (here, & here, for example); and the UK (note that the last one is a preprint only at this point). Both the Israeli & UK data show high efficacy (in terms of reduced risk of hospitalisation, ICU admission, & death for the especially-vulnerable older age groups).
Yes, hospital fatality rates are falling in some parts of the world, as the disease and its treatment become better-understood. But since we also know that the outcomes from this virus are not a simple died/fully-recovered dichotomy (see here, and here, and this very recent paper. for example), that is also no good reason to oppose vaccination.
As for advocating for ivermectin & vitamin D supplementation… While several studies have found that vitamin D was depleted in patients hospitalised with covid-19 infection, the nature of that relationship is unclear. We know, for example, that vitamin levels are depleted by illness. So, was the deficit a cause, or a result? While supplementation has been recommended in some patients (see here as an example), we have yet to see the results of properly randomised, blinded, controlled trials. And the US National Institutes of Health recently had this to say about ivermectin.
A Voices claim to be about choice when it comes to vaccines. However, while they have always had a choice, their activities seem designed to prevent others also having one, as does Grey’s High Court case.
B Plan B’s post on “vaccine spin” begins thus: “We are usually supporters of vaccines, and our children are all immunized. Yet…” When I blogged about it a week or so back, I decided not to include the observation that those who say something like “we support vaccines, but…” often turn out to be opposed. Perhaps I should have done so anyway.
C Among those limitations were problems with participants’ adherence to the recommendation (not requirement) to wear a mask when outside the home.
D It’s noticeable that many of the citations in the affidavit are to his own papers, and content on the Plan B blog.
E Plan B has repeatedly called for “focused protection” for this older demographic (see also the Great Barrington Declaration), without really explaining what that would look like in practice, and apparently ignoring the economic & social impact of removing a large cohort from active participation in society.