Wally of the Week – Richard Madeley

1. Send his daughter Down Under!!!!!!!!!!!!! She’s a nice bit of crumpet!!!!!!!!!!! I’ll sort her out!!!!!!!!!!!!! And knock the whacko out of her!!!!!!!!!!!!!!!!!!!!!!! Do not send Judy though —- she’s as a bag of spanners short of a Diane Abbott!!!!!!!!!!!!!!!!!!!!!!!

2. Whilst I’m not a particular follower of this pair (by that I mean never watched them), it’s disingenuous to critique an opinion based on an absence of medically or otherwise personal qualifications, like that’s even relevant.
   Most people and by most, I mean all, get their information by listening to or reading about the work done by others. Even virologists form opinions on the work that other virologists have done and assess and evaluate them using former experience, sometimes, and just take their word for it at others.
   Most (again all) of us do not form views based upon our own clinically relevant experiments. We look to others, and when a selection of others present information which fits with former knowledge and understanding we tend to give it credit and use it to formulate or modify existing opinion. That is, of course, if you are not on ‘the left’ whose dogma can remain totally unmoved by contrary factual information.
   So, presuming that most here aren’t on the rabid left, let’s see if there is anything to support the comments of Richard Madely.
   Johan Giesecke, an epidemiologist with a spectacular CV, recently appointed as vice-chair of the WHO,s Strategic and Technical Advisory Group on Infectious Hazards and the architect of Sweden’s largely successful (streets ahead of the UK anyway) Covid-19 strategy, would seem to agree with our Richard. He says: ‘that “everyone will be exposed” to the virus at some point and that “most people will become infected”—but many will have weak or mild symptoms. “There is very little we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear. I expect that when we count the number of deaths from COVID-19 in each country in one year from now, the figures will be similar, regardless of measures taken.’
   We then might take a look at logic and ask a question, one that I asked at the beginning of this extraordinary period, which is: ‘Why do pandemics end’.
   They all do, in that the pathogen may remain, but its affect on serious illness or mortality virtually disappears. Scarlet Fever, by way of example, from 1830 – 1890 was the biggest killer of all, far exceeding smallpox and all the childhood diseases and is still prevalent in schoolchildren yet causes low mortality and has effectively disappeared, the effective treatment being antibiotics. Surprisingly, for many, there was never a vaccine for it, (almost all illnesses no longer seen and whose demise has been wrongly attributed to inoculation did so long before a vaccine became available).
   It’s a humdinger of a question, because once one has the answer the strategy would be to do just that. However, the answer isn’t clear cut. Existing immunity is one factor and acquired immunity may be another. Do viruses become less virulent over time, perhaps not, so why do pandemics end as they all do!
   Whilst the exact nature of pandemics and what stops them from killing everybody is not absolutely clear, there are a number of actions that, bearing in mind the virulence of a highly infectious pathogen, that could not possibly have any beneficial effect at all. The biggest and probably the most useless action is lockdown as it achieves nothing. Unless you imagine that the virus would get tired of waiting for us to emerge from quarantine and go on holiday instead, shutting people away cannot possibly have any effect on transmission. As Johan Giesecke rightly surmises, it’ll still be waiting when you emerge.
   Second on this rather long list of pointless actions would be masks, followed by social distancing, followed by they absence of contact, because regardless of their effectiveness against transmission at a particular time none of these actions independently or collectively answer the fundamental question raised earlier, ‘why do pandemics end’?
   The answer, of course, is that pandemics end when the circumstances for them to do so obtain.
   Of all these actions, only handwashing has evidence to support clinical efficacy but even that doesn’t address the fundamental question and is still a mechanism to postpone rather than eliminate.
   There was, and can still be, a better way.
   Covid-19 is likely caused by the Sars-Cov-2 virus (there is insufficient data yet to submit this suspected causation to Koch’s postulates for affirmation). It is interesting in that it is only dangerous to quite specific demographics. We all know they are older people, those with co-morbidities, many of whom would succumb to serious flu or other respiratory infection, because their lives are naturally coming to an end.
   The commonality between the demographic which is susceptible and those who aren’t is the relative effectiveness and resilience of the immune system. Covid-19, may be the initiator of severe pulmonary distress but the killer blow is landed by the immune system itself. Part of the immune response is to produce cytokines to combat the infection. In a severely compromised immune system, of the sort deliberately caused by chemotherapy drugs in particular and old age in general, the immune system isn’t up to the job and goes into panic mode. Cytokines are still produced, but to excess which damages the alveoli and increases the respiratory distress. Cytokine production to this extent is called a Cytokine storm. Just by way of information, this is usually the point where patients were put onto ventilators (no more, you’ll notice) which killed them. The point being that these little oxygen sacs (alveoli) are already filling with fluid leaving less space and higher pressures inside. The increased pressure causes damage to the walls of the alveoli, so you can see that pumping more pressure in with the aid of a machine is only going to have one outcome.
   For those with a fully functional immune system Covid-19 ranges from totally unnoticeable to a bit of a cold. Those with weakened immune systems will suffer more. The action that should have been taken is blindingly obvious. Weak immune systems = nasty infection, so strengthen immune systems. For those with severely compromised immune systems, perhaps keep them away from trouble, but as this infection began with one person and spread around the world, one is likely to bump into it sometime, in the same way as one has a chance of being run over by a bus. However, shouldn’t that be the decision of the individual anyway?
   The logic is inescapable. Find the cause of the problem (the problem not being infections, but the consequences of infection), and address it. What could be clearer?
   Fortunately, to do this is mind numbingly simple. The critical elements aren’t vaccines, or drugs, but vitamins. Vitamin C is additionally the best treatment for severe respiratory distress caused by Covid-19. Vitamin A provides cellular protection to inhibit vital transgress and Vitamin D inhibits replication. In fact, all the things that Hydroxycloroquine does, but without the side effects and even cheaper. A national campaign on immune system education would have been a much more effective strategy.
   So, it would seem that Richard Madely was right. Maybe he’s been listening to someone sensible?

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