A recent article published in the Canadian Medical Association Journal titled “Impact of population mixing between vaccinated and unvaccinated subpopulations on infectious disease dynamics: implications for SARS-CoV-2 transmission” has garnered much medical and societal attention.
The article uses unproven and subjective mathematical models in an attempt to simulate one’s COVID-19 infection risk across various patterns of interactions with both vaccinated and vaccine-free individuals. The author concludes that individuals who avoid vaccination contribute to negative health consequences for others.
“The risk of infection [is] markedly higher among unvaccinated people than among vaccinated people under all [population interaction] assumptions.”
Such an assertion is incorrect and blatantly bias as I will demonstrate.
This article is fraught with egregious misassumptions and glaring omissions. This deceptive study:
• Uses problematic mathematical modelling as a surrogate for real-world data
• Overestimates vaccine effectiveness against symptomatic infection
• Overestimates the risk of transmission (secondary attack rate)
• Underestimates the percentage of the unvaccinated population with effective and robust natural immunity
• Does not account for the waning immunity provided by vaccines
• Is published by a lead author who’s conflicts of interest are multiple and significant as it pertains to COVID-19 vaccines.
First, inaccurate mathematical modelling (aka computer modelling) has been frequently used throughout the COVID-19 response in order to justify lockdown measures while promoting unscientific public health edicts. I have yet to observe any real accuracy nor public health benefit to the multiple computer modelled declarations or the policies they generate to date.
Next, the authors have used the fictitious range of vaccine effectiveness against symptomatic infection of 40-80%. This represents the upper bound limit of 80% as seen in some Delta variant data and a lower bound limit of 40%, the rate presumed months prior to any real-world early Omicron variant data.
These assumptions are not consistent with the current data available to the medical community. The vaccine effectiveness against Omicron symptomatic infection ranges from 0% to 75% which represents a range independently associated with one’s vaccine type, duration since primary series, and duration since booster(s).
Regarding transmission, the author overstates the ability of vaccines to reduce the risk of transmission of the SARS-CoV-2 virus by a remarkable amount. The most current information available from the publication United Kingdom COVID-19 Vaccine Surveillance Report Week 16 (April 21, 2022) confirms a vaccine effectiveness of 0-25% in reducing SARS-CoV-2 transmission at all time periods since a booster dose. Current data supports the fact that COVID-19 vaccines do a poor job at reducing one’s risk of transmission of disease.
Thus, the authors’ models grossly overestimate vaccine effectiveness against both symptomatic infection and transmission. Moreover, the model proposed fails to account for the single-handedly most important reason for the ongoing and relentless Omicron waves, namely waning vaccine immunity.
Countless studies and real-world data demonstrate rapid waning immunity in the fully vaccinated population. Vaccines do not currently protect the vaccinated. Why can’t we all just admit this reality?
Furthermore, the authors assume a baseline previously infected rate of 20% in the unvaccinated population. Since the Omicron BA.1 and BA.2 waves, it is now estimated that 50-80% of Canadians have been infected and thus have achieved natural immunity, with that number continuing to rise daily.
The longevity of protection from natural immunity against symptomatic infection has been repeatedly proven superior to vaccination alone, meaning that the underestimation of those with natural immunity further skews the model from being anything remotely resembling what we are witnessing in reality.
Since the beginning of the SARS-CoV-2 pandemic, the level of academic rigor, integrity, and quality used to support mandates, restrictions, and Public Health guidance has drastically diminished. We are forced to adhere to observational data and models, which would fail scrutiny in any first-year medical epidemiology course as the gold standards for determining efficacy and effectiveness. Appallingly, this same evidence is being used to guide and dictate policies, which have caused irreversible damage to adolescents, families, careers, and our healthcare system. Randomized control trials are compromised and left unfinished leading to a discreet lack of data that should cause any clinician worth their degree cause for concern.
Finally, I must address the footnote provided in the study. Dr. Fisman admits he accepts direct compensation from multiple COVID-19 vaccine agencies including Pfizer and AstraZeneca. When it comes to subjective societal models, how can we trust a researcher who has direct financial ties to the vaccine industry to be objective about a matter of utmost financial importance to the companies to which he pledges allegiance? Cui bono?
Evidence-based medicine has lost its aptitude amidst a time where academics like Dr. Fisman financially benefit by producing poor quality studies that the media, the provincial government and their enablers, including the provincial heath officer deem as gospel.
(B.C. Premier) John Horgan recently posed the question “[Do] you want a headline, or do you want action?”. True academics would like quality evidence from independent researchers who have no conflicts of interest. Unfortunately, the true nature of our current reality leads us to a realm that includes unproven mathematical models, a misunderstanding about the importance of the variables at hand, an underrepresentation of the natural immunity we all share, and most importantly the intentional misleading of the public when it comes to public health matters nation-wide.
Promotion of poorly constructed research such as this can only lead to further stigmatization and division in our once tolerant society. We challenge the CMAJ to retract this “study” and similarly challenge all media outlets who carried this story to issue a correction in their next publication.
Dr. Ralph Behrens is a medical doctor located in Fruitvale, B.C.
MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.
There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.
The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.
Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.
Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.
Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.
“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.
Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.
But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.
That includes his own teenage daughter.
“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.
It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.
“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”
___
AP data journalist Kasturi Pananjady contributed to this report.
___
The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
How a sperm and egg fuse together has long been a mystery.
New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.
“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.
The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.
Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.
It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.
Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.
Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.
The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.
The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.
The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.
The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.
The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.
“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.
When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.
“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.
“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.
The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.
Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.
The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.
“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.
They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.
“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”
This report by The Canadian Press was first published Oct. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
