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Feature Christmas 2021: Time Warp

The end of the pandemic will not be televised

BMJ 2021; 375 doi: https://doi.org/10.1136/bmj-2021-068094 (Published 14 December 2021) Cite this as: BMJ 2021;375:e068094

Rapid Response:

Ending the pandemic: will it require a subversive act?

Dear Editor,

David Robertson and Peter Doshi say this: “Deactivating or disconnecting ourselves from the dashboards may be the single most powerful action towards ending the pandemic.” (BMJ 2021;375:e068094, December 14) I wondered if they were pulling our legs, until I remembered the questions they and many others have been asking since the WHO declared the pandemic on March 11, 2020, and even before: What is a pandemic? How do we count the number of cases? If there is a vaccine is it safe and effective? These are subversive questions, and in the present situation the answers are not self-evident.

1) What is a pandemic? Doshi asked the question in in a 2009 essay titled “How should we plan for pandemics?” (BMJ 2009;339:603) It was occasioned by controversy over whether WHO revised its definition when it declared the influenza A/H1N1 pandemic. Doshi’s essay was also aroused by concern that the tendency for public health agencies to assume worst case scenarios carried the risk of doing more harm than they prevent. He and six colleagues later published a round table discussion titled “The elusive definition of pandemic influenza.” (Bull World Health Organ 2011;89:532) They concluded that there had been no revision because WHO had never formally defined pandemic influenza in the first place…. Carl Heneghan and Tom Jefferson have concluded that Covid-19 was not a pandemic because the age structure of those most affected did not fit the evidence from previous pandemics. (“COVID-19 deaths compared with ‘Swine Flu’”--Centre for Evidence-Based Medicine, 9 April 2020)….Greene and Vargha observed that pandemics end when “…in the attention of the general public and in the judgment of certain media and political elites who shape that attention, the disease ceases to be newsworthy.” https://bostonreview.net/science-nature/jeremy-greene-dora-vargha-how-ep...

2) The absence of strict clinical and laboratory criteria in documenting and counting cases of Covid-19 has called into question the numbers in the dashboards and in the headlines (e.g. “COVID HAS KILLED ONE IN EVERY 100 OLDER AMERICANS. Death Toll nears 800,000 Overall” New York Times, December 13, 2021) (https://www.bmj.com/content/375/bmj.n2558/rr) For this and other reasons John Ioannidis has questioned the number of deaths attributed to Covid-19. (Eur J Clin Invest 2020;e13423)….Spencer and colleagues have asked “When is Covid, Covid?” and concluded, “Only when an international standard is agreed upon will we be able to make comparisons and answer the question (of what really constitutes a case of Covid).” (Centre for Evidence-Based Medicine, 11 September 2020)

3) In the US the push for universal Covid-19 vaccination is absolutely relentless, including attempts to impose rigid mandates. However, outside officialdom here and in the UK there is much dissent and grave concern about vaccine safety and effectiveness. The lack of transparency of Covid-19 vaccine trials, ‘decisions without data’, is a particular source of concern. (Tanveer et al, BMJ Evidence-Based Medicine online 9 August 2021. doi:10.1136/bmjebm-2021-111735)…Here I paraphrase part of a recent response to The BMJ: “There is considerable uncertainty about the effectiveness of Covid vaccines, some serious short-term complications and a lack of data on long-term harms. Randomized controlled trials are the only means of providing robust data on safety and effectiveness, yet the randomized trials of Covid vaccines lasted for a very short time. For young individuals the harms of the vaccines are almost certain to outweigh the benefits.” (https://www.bmj.com/content/375/bmj.n2957/rr-1)

Are Robertson and Doshi being subversive? Perhaps, but it is widely acknowledged that the Covid pandemic has become heavily politicized, so subversive acts to end it may be essential. Many, many lives and livelihoods are at stake.

ALLAN S. CUNNINGHAM 22 December 2021

Competing interests: No competing interests

22 December 2021
Allan S. Cunningham
Retired pediatrician
Cooperstown NY 13326 USA <crabarbicus62@gmail.com