Thread by @ProfDFrancis

Tony Blair is (for once) right that the most efficient use of the limited vaccine supplies would be to give everyone (who wants it) one dose, and once that is all done, and more vaccine is available, go back for 2nd doses.

HOWEVER, much as I love to kick the government, I can see fully why they are NOT doing this.

If I was the head of my village in Outer Francisia, and I had only n vaccine doses for my n people, I would give them all 1 each. (If I had less, I would give to the most at-risk)

... based on this startling graph

Source: sci-hub.se/10.1056/NEJMoa…

But that is because I force my tribe's members to be educated in reasoning and calculation.

We may not have the wheel, or indeed fire, but we do have inspirion, and all tribe members are all-gold on it.

tweetorials.inspirion.org/h2/c48ed511bc7…

So when out of the tens of thousands of tribe members who get one dose, the odd one or two still die of coronavirus, their relatives will understand why the resources were used in that way: to _minimise spread_.

They won't sue me. (And anyway I am the Village Judge too.)

However the actual UK government faces a population in whom they have actively promoted ignorance and fanned the flames of anti-intellectualism, so it is much safer for them to follow the manufacturer's instructions to the letter.

That doesn't give the country the optimal health outcome, but it does protect the decisionmakers from having to defend themselves against a tirade of ill-thought-through, but vocal, opposition from the very constituency of foolish people on whom they depend.

Good question from ELoyal!

https://twitter.com/eduleal/status/1341742134928371713?s=20

Well ELoyal, if I made you the locum Tribe Chief of my 10,000 person village, and 10,000 vaccine doses, today, what would you do?

No lawyers, no newspapers.

Just 10,000 people whom you love and don't want to die. They love you too and will take your paternalistic advice.

Now, instead of being the Village Chief of 10,000 people whom you have instilled the virtue of reason, imagine you are a regulator.

Your actual job title is no longer "Trade off benefits and harms to achieve the best for your people".

NOW your job title is "People come to you with drugs. You check to see if the evidence is valid. Then you issue the licence. If you license a think which turns out to be invalid, you are fired and can never work again."

Which course of treatment would you license?

And now you are the government, faced with the result of the regulator, that

* Only the 2-jab course is licensed *

What would you do?

Remember, you have already f*cked up the country by promising voters a made-up £350m per week to tell our neighbours to p*ss off.

And at the time your xenophobic plan to "take back control of UK's borders" (from the hotbed of Terrorism that is France) was to come to fruition, France has ironically taken back control by locking and bolting their side of the door.

So we do have control to open or close our side, but only to see or not see another door bolted from the other side.

You are relying on the fools that voted for your daft plan to vote for you again.

They are easily swayed by simplistic stories - as you have proven.

Do you go against the regulators, the lawyers, and the manufacturers, with a 1-stop-shop plan?

And risk the families of one-stop recipients who still died, crucifying you in the press?

Remember, it will be no defence that since more rapid herd immunity extinguished the pandemic sooner, "there are many more people alive today, than would have been with the 2-jab policy".

Because you have trained the electorate to be thick.

What would YOU do if you were BJ?

Really interesting question here from @C8Luna

https://twitter.com/C8Luna/status/1341747736765472770?s=20

Some people think that scientists don't guess. This is completely false.

In fact it the guesses of scientists that I value above all others.

There are lots of things we don't KNOW, but we do guess, based on scientific experience.

"We have been told effectiveness of reduction of transmission was not studied. So shouldn’t act as if so."

This is where science comes in.

What proportion of the general public survive infection from coronavirus?

How do they do that?

The moment your first SARS COV2 virus particle arrives in your body, your body has no idea what it is. The virus busies itself replicating (which is what it does for a living).

If your body did nothing, you would die.

In reality, the body gradually builds up an immune response to the millions (billions? zillions? I've no idea) of virus particles floating around your body.

The immune response has to wipe out the virus particles AND kill or neutralise ALL your infected cells. From a standing start with no warning.

Indeed from a starting point of only realising when almost overwhelmed already.

_Still_ 99.5% of human bodies succeed.

Indeed 50% of bodies to it so efficiently that the person doesn't even know anything unusual is happening.

So how do you think the vaccine works?

In the olden days, virus vaccines were mashed-up bits of virus (which you HOPED weren't infective), or special versions of the virus which you cultured that would cause an infection but not cause you harm.

These modern vaccines are far cleverer. They contain the code for a surface protein of a virus particle.

The body uses the instruction in the vaccine to make this surface protein, and learns to recognise it.

This gives the body a head start.

It's like faxing ahead a photo of a criminal so that people can be on the lookout, even though they have never seen him before.

Suppose you had a trial that proved that when you sent out to banks 2 copies of a wanted poster, 2 weeks apart, it virtually completely ended robberies by this person.

In fact the robberies pretty much stopped just before the 2nd mailout.

You don't KNOW that both mailouts are needed.

If you have far too few copies to mail out to cover all banks nationwide, what would you do (assume you can't just make more copies!)

Thank you @JackAidley - I didn't know this

https://twitter.com/JackAidley/status/1341753125384892417?s=20

However, I think for politicians the fear is not of legal repercussions, but of public relations shaming, which has a lower standard of proof.

No amount of law-making can undo a front page headline

"Politician X killed my mum by giving her 2nd jab to a refugee/criminal etc."

Good point Guy!

I actually know nothing about vaccines. The last I knew was what I learned in Medical School about Salk and Sabin etc. Good solid vaccines, made of proper stuff, like God intended!

So this RNA vaccine concept is all new to me.

https://twitter.com/gadboit/status/1341755244053745664?s=20

Good followup question:

https://twitter.com/eduleal/status/1341774709831163906?s=20

Remember the vaccine doesn't have any direct disease-reducing effect on the body. It isn't an anti-viral or an anti-inflammatory (indeed the opposite!)

All it is, is an advance warning to the body of what the virus looks like.

The ONLY way it works is that the body's immune defences are prepared for the virus, rather than having to learn about the virus while the virus is running rampant.

Therefore our scientific expectation is that, if a vaccine works against any endpoint (e.g. infection), it will work against all endpoints (e.g. peak viral load, infectivity, transmission, hospitalization, death).

It's a guess, but I am happy to listen to guesses from scientists, i.e. people who are skilled in guessing about the behaviour of the natural world.

Aha! Thank you @barttels2 for so quickly highlighting this story.

Source (no paywall, but subscribe if you want to encourage the newspaper)
theguardian.com/world/2020/dec…

What Prof Barclay is saying is the regulator viewpoint.

There is no TRIALS basis for recommending 1-stop-shop.

She can't actually say anything else, can she?

But let's not argue too much. Let's focus on getting the damn thing into as many people as we can funnel in over the next few weeks.

New vaccines are coming out too and I am sure there will soon be plenty for all wealthy countries to have everyone vaccinated (except for the usual flat-earth nutters).

Not sure what point this person is making. Of course we don't know the long term consequences of ANYTHING, even eating a banana or watching an episode of the Simpsons, until ... the long term. Hence the name, "long term".

https://twitter.com/VAReadjuster89/status/1341781300336799745?s=20

A key benefit of education is how to order things in order of priority to worry about.

There is a strange cohort of people that like to publically worry about things that have no particular resolution nor useful intervention.

Asteroid strike.

Loch Thames monster.

Etc.

Look around you at the highly successful and effective people that you know.

Do they spend time worrying about things that are unknown and which they have no influence over?

Let's be like the latter.

Get the vaccine into people as quickly as it can be made. (It's speeding up week-by-week).

Think about how to make it available to poor countries.

Learn that we are part of a world community, next time someone tells us that our country is special.

And get back to doing what we were doing in 2019.

(If anyone can remember what that was.)