The Wrong Question

At UnHerd Tom Chivers asks a serious question: how many lives has bioethics cost?

In April, the US Centres for Disease Control paused the use of the Johnson & Johnson vaccine. They had noticed that among the 6.8 million people who had been given the J&J jab, six people had suffered a rare blood clot known as a “cerebral venous sinus thrombosis” (CVST). They said in a statement that they were recommending that healthcare providers stop using it, until the FDA had reviewed the evidence, and that they were doing so “out of an abundance of caution”.

Caution is a strange word to use. On the day they released the statement, about 70,000 new cases of Covid were confirmed in the United States, and about 1,000 people died of it. Is it “cautious” to stop using a vaccine which would almost certainly reduce those numbers, because of an uncertain chance that it might have negative effects in a tiny cohort?

But caution, in this sense, has been rife during the pandemic. The governments of various European countries stopped the use of the AstraZeneca vaccine over similar concerns. Germany, the Guardian reported in March, “was the first country to refuse to allow people over the age of 65 to have the AstraZeneca vaccine because of the absence of evidence of how well it worked in older people, indicating a more cautious approach than most”.

Over the last two years, again and again, the fears of some possible risk caused by something we might do have outweighed the fears of a thoroughly real, utterly obvious risk which was killing people at the time. And it has, I think, been a failure of the field, or at least the practice, of bioethics.

I think he’s pointing his finger in the wrong direction and, indeed, asking the wrong question. There have been multiple failures in two different political administrations with one thing in common: medical bureaucracies and it isn’t just one. Early in the pandemic the Centers for Disease Control fumbled in developing a test for COVID-19. Right now the Food and Drug Administration is delaying approval of Paxlovid in a wild sort of Catch-22. It has not been proven effective enough to approve but it is too effective to continue testing. To my eye the problem is not politics or bioethics or physicians. It’s bureaucracy.

Bureaucracies live and die by process and they are the outcome of largeness. When an organization grows beyond a certain, small size it will be governed by a bureaucracy. We know of no other alternative. Solve that problem and you’ll have solved one of the greatest curses of the modern world, afflicting both liberal democracies and autocracies.

12 comments… add one
  • Jan Link

    https://tfiglobalnews.com/2021/11/08/japan-crushes-big-pharma-with-a-small-yet-effective-move/

    ”Ivermectin was discarded unceremoniously till now, but Japan has demonstrated that the drug can be used as a more effective cure and a permanent substitute for the Coronavirus vaccines produced by big pharmaceutical companies.

    …

    The Pandemic in Japan was going out of control, yet the Japanese government was smart enough to look beyond vaccines in its COVID-19 containment efforts.

    In September, Japan deployed Ivermectin and legalising the use of the anti-parasitic drug has helped people recover from COVID-19 with more durable and long-lasting immunity. Caseloads have come down rapidly without the need for booster vaccination doses. In Tokyo, there were around 6,000 cases in the middle of August, but the number has now dropped down to below one hundred.

    Japan is now overcoming the Coronavirus, with the number of COVID tests dropping from 25% in the fag end of August to just 1% mid-October.

    Ivermectin use is thus helping Japan permanently beat the COVID-19 Pandemic. If and when vaccine efficacy wanes, Japan will have a choice- using an anti-parasitic medicine as a permanent cure to ensure speedy recovery of infected patients with durable immunity. Japan has thus crushed Big Pharma with a small move- deploying the use of Ivermectin.”

    Japan now has a death rate of almost zero – far better than what the U.S. is experiencing. I don’t know whether the powers that be – our political and medical bureaucracies – have been deliberately blind sighted by big pharmaceuticals, such as Pfizer, or if they are simply stuck-on-stupid in disallowing the distribution of legal drugs to be repurposed when they indicate a reduction in COVID hospitalizations and deaths in other counties. When reading the above Global News piece, note the contractual obligations made by Pfizer with some countries, dealing with it’s distribution practices.

  • Jan Link

    Excerpted from the Global Times article Pfizer’s contractual arm twist:

    ”However, information security expert Ehden Biber had recently alleged, “If you were wondering why Ivermectin was suppressed, it is because the agreement that countries had with Pfizer does not allow them to escape their contract, which states that even if a drug will be found to treat COVID-19, the contract cannot be voided”

    Everything tied to these vaccines seem to be under a “do it or else” kind of enforcement. First fear, then humiliation, then bribery, and now punishments are being doled out to manifest for world leaders the desire to universally jab everyone – whether the efficacy of these vaccinations holds or not.

  • Drew Link
  • steve Link

    No one knows if Japan is using any Ivermectin or how much. We do know that they had several covid surges after the first time the Japanese official suggested using Ivermectin.

    https://gidmk.medium.com/ivermectin-didnt-save-japan-from-covid-19-afd64641ee4d

    Steve

  • Jan Link

    https://verumetinventa.wordpress.com/2021/08/26/japan-moderna-vax-is-out-ivermectin-treatment-is-in/

    The internet is like a menu. A person can find almost anything that will satisfy their opinion taste buds. Fact checkers, though, are meaningless because of their bias. And government stats are not far behind, in their selective reporting to line up behind a government-approved narrative. I know this sounds cynical, but the untruths and half truths, propagated under a growing authoritarian world order, only makes one question more what is really going on.

    As for Japan’s protocols, they are not mandating vaccines, allowing people to be treated with antivirals. The results of this freedom to chose how to protect themselves from Covid has resulted in fewer hospitalizations and deaths, per capita, than here in the U.S. I only wish we were allowed such grace and freedom.

  • steve Link

    Note the first comment in your link. The doc who suggested Ivermectin in February. Since then Japan has had several covid surges including their largest ones. Also note that you still have no evidence that anyone is actually using Ivermectin in Japan and if they are how much. All you have have are two instances of the same guy suggesting the use of Ivermectin and that somehow means they are using it in Japan and that it works. It actually doesnt surprise me that you think this is proof it works but I think everyone should know how people like you reach your conclusions.

    Steve

  • steve Link

    On topic, bioethics may have cost some lives. We could just force prisoners, as one example, to be our guinea pigs for experimental drugs or procedures. We could do away with informed consents for the same when using “volunteers”. We could do away with requiring that physicians, medical executives, etc do away with conflict disclosures. However, I think that a lot of those things would cost lives. Not sure how you would do the calculations.

    Steve

  • Jan Link

    Countries like India, Mexico, S. America are reported to have resorted to antiviral protocols that have been successful in curtailing the more lethal aspects of COVID. You can reach whatever conclusion you want about the quantity of ivermectin used in Japan. However, the positive move by Japan is that they allowed people to use something other than a vaccine to treat the lethality of this virus, without force or punitive measures.

    Furthermore, I don’t understand why the medical establishment finds it ok to use brute force implementing universal vaccination via a vaccine doing little to limit it’s transmission, and whose efficacy is now waning without mandating further injections. On top of these jabs wearing out within months, there continue to be medical personnel who annotate experiences in ICUs, ERs, COVID wards that starkly contradict government stats, legacy media, and a medical community too cowed to speak freely about how many vaccine abuse cases are coming in for treatment. The past couple of days I’ve been listening to groups of RNs, paramedics etc., relaying the fear being propagated to report vaccine-related issues (blood clots, myocarditis, heart attacks, strokes, neurological problems, abnormally high reactivation of cancers) and deaths. Hospital staff is summarily intimidated or fired for going against their administration’s edict to not talk about such negative side effects. This atmosphere of deception, IMO, is criminal. But, nonetheless, fear of reprisals has successfully cocooned many people from speaking out and/ or recording these abuses on VAERS, indicating the figures there are woefully underreported. However, over and above people’s reticence to talk about the vaccine abuses they see, is how time-consuming and complex paperwork is to fill out, along with how few people even knew about this site until the debut of these vaccines.

    Finally, Fauci-followers make predictions how many more lives would have been lost should these vaccines not have been implemented. There are many more physicians, here and around the world, who talk about the thousands of lives already lost due to the discouragement of early treatment protocols and the use of inexpensive, readily available, fully approved antivirals. Drs Risch (Yale), Malone (9 patents on the mRNA technology), McCullough, Tyson, Fareed, Kulldorff (Harvard), Kory, Yeadon;(former VP of Pfizer) are but a sampling of distinguished doctors/scientists who vocally have cautioned using these vaccines, putting their reputations and livelihoods on the line to do so. It’s incredible how the powers that be are able to excoriate and silence such voices of reason.

  • Drew Link

    They are making it up on the fly.

    There are accusations that Fauci and the CDC have reduced quarantine periods from 10 days to 5 to accommodate industry and to keep entire companies from shutting down.

    Almost as if what is claimed to be “The Science” is in fact a hodge-podge of political decisions being made by bureaucrats and their political counterparts, like Ron Klain.

    But then, this has been going on since the start of the covid panic. Fauci lied about mask being ineffectual, because he didn’t want lowly civilians buying them up and shorting them for medical professionals. (Surprise! He had it right the first time — they are almost entirely ineffectual, but he didn’t know that when he claimed it.)

    He then played game with what would constitute “herd immunity” — 70%? 75%? 85% 90% — and admitted he just made up numbers according to what he believed the public was “ready to hear” or what they would tolerate. When he felt they were “ready to hear” higher numbers, an would tolerate higher numbers, he shifted his target for herd immunity upward.

    He admitted this — he admitted that what he claimed to be “The Science” was in fact just a grab-bag of psychological gambits and tactical deceptions intended for maximum manipulative impact on the public.

    And yet when you pointed this out, he contacted his pals at the social media companies to censor you.

    “Experts” wonder why people don’t believe a god-damned word coming from their lying mouths, and want to know why.

    Why? When they talk about “The Science,” they are really just hustling them to get them to comply with our policy and political preferences by labeling it “The Science”?

    Well, maybe they should look at the huge repulsive mass of lies they’ve vomited at us for two years for a clue.

  • steve Link

    ” On top of these jabs wearing out within months, there continue to be medical personnel who annotate experiences in ICUs, ERs, COVID wards that starkly contradict government stats, legacy media, and a medical community too cowed to speak freely about how many vaccine abuse cases are coming in for treatment.”

    Its not showing up in any data. You are choosing to believe a few anecdotal reports which must be correct and all fo the other doctors and nurses in the world, not just the US are lying and deliberately killing millions of people.

    I am not choosing to believe anything about Japan. I am telling you what happened using the data sources you chose. I am then giving you the opportunity to show to me how many people are actually using Ivermectin in Japan and how well it is working. I know this is unfair since the data does not exist but prove me wrong.

    India, Mexico and S America should publish their results and share them with us if they are having success. It is really a shame that they are hiding them and letting the rest of the world suffer. South America in particular has very bad per capita death rates from Covid with most of their countries among the 30 worst. Peru is worst by far and Brazil makes the top 10. I for one would not want to copy that kind of success but maybe you can explain why we should follow that example.

    https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/

    Steve

  • Jan Link

    Steve, I have followed the various testimonies of medical personnel, involving the aftermath effects of the vaccines, for some time. Maybe it’s because I have an RN license and used to see hospital practices that didn’t necessarily live up to having the highest and best interests of the patient. After all, hospital administrators are personally removed from a patient’s daily life in a hospital. It is Nurses, like me, who have bedside familiarity with patients, who confide in us their fears and concerns more than they do even with impersonal MDs whisking around making hasty rounds. Nurses, like me, also become attached to patients, taking it hard when avoidable medical issues and/or deaths occur on their watch. Consequently, when I hear nurses discuss deaths or injuries created after taking these vaccines, I feel for their anguished recollections and believe their stories. To me their perspectives and opinions, on how these vaccines are negatively effecting patients, are not irrelevant and should be taken seriously, rather than being passed off as nothing to look into and purely “anecdotal.”

  • steve Link

    I started out as a corpsman, meaning I did all of the direct pt care and nurses carried around clipboards. I have repeatedly said that we should not ignore what these nurses say but rather that it should lead to a study or investigation of some sort. That is being done as there are lots of ongoing studies and lots have been done. They dont bear out the claims of these nurses. I think there are several reasons for this.

    First, not that many people really understand statistics. If something happens on average once a week that doesnt mean it really happens once a week. It may happen 3 times one week and then not happen at all for 4 weeks, then twice in one week, etc. In a country with 330 million people you are gong to have a couple of places that have seemingly high rates of a problem but then you will also have a lot of places that will offset that by seeing nothing.

    Second, nurses learn more from each other and are much less likely to directly read the medical literature. I am not trying to demean nurses but after working for them them with them for 50 years it is just what I have seen. So a lot of times nurses dont fully understand what they are seeing. Its why 95% (probably more now) of docs are vaccinated but many fewer nurses get vaccinated. We directly read the literature.

    There is a lot of whispering down the lane. The more hierarchical a system the more you have gossip. Had a lot in the military also. So one case with a complication quickly turns into dozens. I have had to deal with that dozens, maybe hundreds of times as a department chair. Its usually over something minor like “that doctor yells at all of us” which turns out to be one doctor yelled at one nurse who was also yelling at him. They were both inappropriate but not the case that he was yelling at everyone. This sounds very much like the same phenomenon.

    Last, nurses are people too. A lot have been caught up in their tribal affiliations so they see what they want to see. They get lots of attention when they make their claims. Notice that the large, large majority of nurses dont see what these few nurses claim. Also note that you dont seem to read the nurses who are talking about the fact that most of their patients are unvaccinated. That they are being verbally abused by the anti-vaxxers including abuse at their homes. That pt families are treating staff with hostility and refusal to take meds or even accept their diagnosis.

    So because we all have our human failures you really need studies/data to find if what you think you are seeing is correct. We call this the evidence based practice of medicine.

    Steve

    As an aside, I am part of the team that has lead us in our takeover of a bunch of failing hospitals and turning them around. There are a lot of crappy administrators and doctors at these places and a primary part of the task is to get rid of the bad ones quickly. There are also a bunch of crappy nurses at these places. I am lucky enough to work with mostly really awesome nurses but there are lots of them who try to do as little as possible during their 8 hours and lots who care more about their breaks than patient care. I am way past that old trope from the 80s-90s that nurses are all angels of mercy and doctors dont care. You should let go of that too.

    Steve

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