Thread by @cv_cev

🚨Dame Kate Bingham🚨
Dubbed the "hero in a pink jacket 💕"

On Evusheld:
"I felt very strongly [.]. We were following a very clear 2 tier strategy where the CV immunocompromised were being deprioritised [.] I felt that was *manifestly* wrong both ethically and morally [.]"
1/🧵

The above video was taken out of sequence. The below should give more context...

KB "So actually, the first goal was around protecting the UK population."

CTI [Hugo Keith KC]
"Do you think you succeeded on securing or making available those monoclonal antibodies?"

KB "No!"
2/

Kate goes on to make the argument that by not protecting this population, we were also promoting viral mutation and the evolution of variants.

3/

On funding, clinical trials, and onshore manufacturing. We need long-term planning and strategy.

KB "We don't have that level of capability or long-term thinking in government."

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On the inclusion of therapeutics within the remit of the Vaccine Taskforce:

KB "It was quite clear that there was 'open warfare' between BEIS [Department for Business, Energy & Industrial Strategy] and the Department for Health"

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CTI "If you had brought [.] therapeutics within the remit of the VTF, you might have ended up dividing your attention [.] You would have been less able to focus ruthlessly on the question of identifying, procuring, and making available vaccines [.]"

KB "Correct"
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KB "I felt strongly that we should have governance over the neutralising antibodies because there are a portion on people in the UK who are immunocompromised."

"It was part of our original mandate."

"to protect all those people *including* the immunocompromised."

7/

She goes on to explain the difference between the antibodies and how Evusheld was designed to last longer to dose every 6m minimum. Other antibodies, designed as treatments, only last around 1 month.

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If the VTF had taken on antivirals, Kate believes that they could have made treatments available more rapidly, and they might have been more effective. However, she would have required a larger team.

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CTI "Did you ever get the impression during your time in the VTF that the issue of prophylactic development was being left behind, being made to be a second-class citizen?"

KB " I absolutely felt that, yes. From late October 2020."

10/

The JCVI identified *30 MILLION* people who were deemed to be Clinically Vulnerable (at that time):

💙All adults over 50
💜Those under 50 with severe underlying disease

Kate described it as an "enhanced 'flu cohort"

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"Immediately" in May 2020, the VTF were aware of the development of Evusheld.

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KB "We initially signed a [.] letter of intent, but non-binding for a million doses of their long acting antibody cocktail [.] expected to have a 6m effect."

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1 million doses of Evusheld =

2 doses spread over 1 year
OR
1 dose per winter for 2 winters

"The numbers of immunocompromised people [500k] were data that had come from the Department of Health."

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AZ couldn't supply this order, as they had 2.5M doses for the world.

They then asked what was the minimum order to protect the immunocompromised population.

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The CMOs suggested no more than 50,000 if there was a political will.

Ultimately, no prophylactic treatment has *ever* been purchased to protect this, our most vulnerable, population.

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KB "I felt very strongly [.]. We were following a very clear 2 tier strategy where the CV immunocompromised were being deprioritised [.] 1 felt that was *manifestly* wrong both ethically and morally [.]"

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KB " It did not follow the goal that we had been set, which was to protect the entire population."

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Important comparison between the attitude to procuring vaccines vs. prophylactic treatments for people who are not sufficiently protected by vaccines.

19/

CTI suggests that the cost of Evusheld was not the reason for the decision against.

Kate quotes JVT, "I consider cost, including cost effectiveness and practicality considerations to be entirely rational factors when making decisions on neutralising Ab procurement."

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🧨💥

Thank you 💕 @katebingham2 💕

"The fact that the vaccine rollout had been effective doesn't stop people without an immune system getting infected."

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The decision about purchasing Evusheld was ultimately with ministers.

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Kate Bingham on that lack of purchase of Evusheld:

"I just think that it was the wrong decision."

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