Sunday Supplement – 26/12/2021

Dec 26, 2021


Welcome to supplement 52 of 2021…..and at the risk of the broken record, after the amount of feedback I got last week, I’ve tried to complete the job I started without making it too heavy for boxing day! Dreams of a light-hearted, motto-filled supplement full of japery were dashed almost as soon as I finished writing last week’s effort – because I knew there was more that would be needed to try and add to the “to jab or not to jab” numbers.

There’s one thing I’m absolutely delighted about that’s come about from last week’s effort, and a couple of mini-update posts that I’ve done since. That is the number of people that have engaged that are on the sceptical side – and some are even brave enough to reveal that they haven’t been vaccinated.

I can already hear some readers shouting. “Brave?” – yes. Deliberate choice of words. For the avoidance of any doubt, I’ve had 3 shots – May, June, December. I feel I’ve been well researched before having them all, and am very much at peace with my personal choice. However, I’m also (as discussed last week) deeply concerned about the civil liberty side of this debate, and throughout have stated just how disturbed I will be if mandatory vaccinations are introduced. I’ve also stated that I have the belief in the social fabric of the UK to believe this won’t be the case.

Some will cry “a-ha, but it has already happened!”. Well, no it hasn’t. They’ve pushed the boundaries. Passage to every other country in the world isn’t necessarily possible or welcomed – but that depends on that country’s domestic policy, which under any sensible values framework is up to them. I don’t agree with every country’s stance on human rights, on foreign policy, on other religions other than their own – etc. etc. – I don’t spend time getting concerned with them.

The mandatory vaccinations in the care sector also (and impending in the NHS). This is even closer. 61 Tory MPs were against this (the more libertarian side of the party) when it was passed in law. Only 39 from other parties stood against it. The way I would frame this is “we think you are stupid to not be vaccinated and so we will force you to, under the guise of your job, to be vaccinated”. Of course, they are operating under some data (which is a moveable feast – from variant to variant aside from anything else) – around transmission. I discussed last week the data around double-AZ jabbed people who are as likely to transmit Omicron as the unvaccinated, and credited those “fringe” doctors who have pointed this out as a possible outcome all along – although I still don’t like the incompleteness of the overall debate, I also feel that no-one is really trying to have it.

So – the message for me is simple. Tony Blair is a great example of doing the wrong thing here. His approach (if you missed it) – everyone who “refuses” the vaccine who is eligible is an “idiot”. This is the same way that he, and many on the remain (or if you prefer, project fear) side of the debate, approached the Brexit referendum. Dominic Cummings engineered a campaign that spoke to other fears, but actually “spoke” to floating voters. It contained some lies (as did both sides) but, crucially, it didn’t insult people. I don’t think insulting anyone ever did any good at all in a similar situation.

I’ve quite a few friends who are not vaccinated. I’ve quite a few more I suspect are not vaccinated, but I’m not the Gestapo or going around trying to bang the drum to get vaccinated. I know there are people reading this who are not vaccinated. I’d suggest I’m more likely to get one of them to change their mind than Tony Blair is by calling people idiots en masse.

After all, I drink alcohol on occasion (as an example). Alcohol in the grand scheme of things has limited health benefits (if you believe that side of the alcohol lobby) and is more likely to do me more harm than good. Under the Blair framework, I’m an idiot? Does that make me more or less likely to “toe the line”? Less likely, I’d argue.

My friends referred to above are not stupid people. Quite a few of them are quite the opposite – it is their penchant to ask questions that has made them entrepreneurial people, forging their own paths and careers. They aren’t happy with the constant messaging, the fearmongering which I believe will have damaged so many lives in the past 22 months, and what they consider to be the propaganda (and I don’t blame them – I caused some fuss last week by having to rework some data from the ONS to come to a more realistic conclusion – its important to say that I don’t think the source data was wrong, but the methodology for their conclusion was so weak that it should never have been approached like that in the first place).

This pushes them into a place. Nearly 90% of the population above 12 have had 1 jab. As discussed, some are slower getting their second jab. Will all of those who had 1, have 2? (well, no, mathematically some will not make it to their second jab and sadly pass away, as c. 500,000+ people in the UK do every single year). Will some have had a bad reaction to jab 1 and decide against jab 2? Of course. 1 in 10 people isn’t a small number not to be jabbed – 6 million + (as we are limiting ourselves to those over 12).

Language is BIG here, as it always is. The media (or parts of it, in fairness) have chosen to adopt the word “refusenik”. More stupidity (on the pro-vaccination side). The definition is: a person who refuses to follow orders or obey the law, especially as a protest.

Not as bad as it sounds. But many won’t get to the definition – instead, they will spit the word with venom. The word has been carefully chosen. After all, it has made us choose sides, and for whatever reasons (and there are many, deep-seated psychological ones) we adore choosing sides as human beings – to be part of the collective. We are red, you are blue – let’s fight! Why? How many “refuseniks”, since being called that, have decided “yep, the abuse/disrespect will sure make me get the jab now”. Again, none in my view.

So, the void that I’m trying to fill is the public debate side – not to actually have it, or moderate it (although I’d be very happy to do that, I’m not a podcaster etc. or someone with a suitable platform to do that). But to inform those, who I know are intelligent people, with the data to allow themselves to make a decision. I know that I’ve fallen into the classic trap at a whole variety of points in the past 22 months and started to believe things that “make sense” rather than dispassionately picking apart the data at every stage. It seems likely to me that others will have done the same, and are holding onto different conclusions from a place of not having seen all of the data.

Also – some people are no doubt scared of the jab. Fear, as we are often taught in personal development circles, is rarely rational. However, it is understandable to be scared. Some will have genuine phobias. They will need stronger arguments to step forward and put their arm out – not just commands from the state/former premiers/well-meaning family and friends.

So – those are some ground rules that I believe the debate would be enriched by. The whole thing is a scale. If we, as a society, want participation in the vaccine up from here, we need to work very hard to achieve it in order to preserve our hard-fought-for civil liberties, in my view.

There’s also a network effect that’s interesting. The classic network effect example was the fax machine. Bloody useless unless other people have fax machines, but every other fax machine sold makes my fax machine better. This has implications in vaccination too, in two ways. Firstly, IF vaccination does help contain the spread of the disease, then I’m better off if you are vaccinated (figures already referred to have, of late, caused this one to be called into question – not to debunk it, completely, but to call it into question). Secondly, if by being unvaccinated you are much more likely (comparatively, not absolutely) to go into hospital and/or the ICU if you catch covid, I don’t want that. Not because I care about you – whether I do or not – but because there are finite resources and I don’t want the NHS spending £50,000, £250,000, or millions of taxpayers money on keeping you in hospital/alive if by having the vaccine could have minimized this.

So, I’m not just the “thinking person’s sceptic” or just a concerned citizen. Network effects are a part of what’s driving me too. However, there’s another analogy we need to consider here.

This is a bit like insurance, specifically fire insurance. There is a very small probability of a bad outcome. If that outcome happens, the bad outcome could lead to death when it otherwise didn’t need to. That insurance is “bad value” from a technical, expected value point of view. If you have one house, it is very sensible to insure against fire. If you have 1000 houses, it isn’t so sensible but might still be a condition of your financing (your premiums for the year might allow for one full rebuild, and a large fire is more than a 1000-1 shot in a single year). If the insurance wasn’t “bad value”, insurance companies would go bust.

Some people are generally risk averse and will just always insure, without getting into the debate. I dare say those people are fully vaccinated, right now.

However, I choose my words carefully. It is a “bit” like fire insurance. But it is harder – because we have a situation here where there is a new malaise in the world. That’s made the world less safe for all of us – despite our incredible hard work to make the world safer for us every year. That’s why it has disturbed us all so much. We don’t have a straightforward decision to make, or a simple set of probabilities. We have a worsened outcome, whether we vaccinate or not. This is the stage that I’ve seen some refuse in their minds to get past – and until we accept this premise, it is much harder to have a debate.

At the more “Piers Corbyn” end of the spectrum, some people’s psychological coping mechanism has made them deny all existence of covid-19. This enables them to keep living their life as per “the old days” – it is similar to the bias that lets us reflect on things with rose-tinted spectacles – “It was so much better in the 70s (or insert other favourite decade here)”. Of course, demonstrably, it really wasn’t. I can’t really speak to those people, since they can just deny fact and move on in a Trumpian fashion. “Fake news, Fake news”. Ok mate.

So – what might my sceptical friends want to see beyond last week’s analysis – well, we need to have an open debate about side-effects from a vaccine. Remember – we are starting from a place where the world isn’t as safe, or as good, as it was in 2019. And the enemy is invisible, and that’s the hardest enemy of all to understand, respect, battle and defeat – and historically, these things are not defeated – they are managed.

I’ve been quite proud of the level of transparency that is out there in the UK data. The interpretation of it, as always, has left much to be desired – to achieve manipulative political ends. To sell more vaccines, from the producers who are doing this for profit. However, to pretend this hasn’t happened on the sceptical side would be absolute folly. Those agendas are often harder to see, and not everyone on the sceptical side operating as “lone wolves” even necessarily has an agenda. Some pursue this with zeal beyond that that I’ve observed in Jehovah’s witnesses over the years – they are SO convinced they know the right answers that you must listen, you really must (again, they are seeking the network effect of converting others into their club, their values and beliefs system, perhaps so they don’t feel as lonely in there as they currently do?)/

So, we go to the data. To start us off, here’s a throwaway statement, missing context, that I’ve heard repeated as an anti-vaccine argument. “There have been more bad reactions to this vaccine than any other vaccine in history”. A few problems – i) the vaccine adverse effect reporting systems are at a far better place than they have been in the past ii) (the big one) there are so many more jabs being administered, just counting the bad outcomes is not the right approach – the right approach is to convert them into percentages and iii) which bad outcomes should we be focusing on? Presumably, death and life-changing injuries (as that’s what we would be focusing on on the covid side of the debate, too? So it is consistent).

Let’s also be clear. Once a week, the government in the UK publish an update on the yellow card reporting system that we use. The data is transparent within those reports, they are quite long and boring. And, rarely in government, they are also proactive in their approach – for example the fairly swift way in which they acted to only offer AZ to over-40s due to observing more negative side effects in AZ in the young than in Pfizer. Please don’t take those numbers out of context either – this is about difference in probability. The chances of a bad outcome from either were incredibly low – but it is about saying if there’s a 1 in 50,000 chance here and a 1 in 100,000 chance here, what’s the upside in taking the 1 in 50,000 chance instead? Nothing – so don’t do it.

What ARE the side effects? The most reported severe ones (and I’m deliberately going to simplify here, because the terminology just gets so technical to a level that won’t help this debate) have been blood clots, and myocarditis (inflammation of the heart). This is this week’s graphic – and some points around it:

We are looking at cases per million doses. Quite an incredible idea – so the very most at risk category is people from 18-28 having a reaction to their second dose of the Moderna vaccine. That chance is 70 in a million, or 0.007% (or, framed another way, 99.993% don’t have that reaction)

Moderna is a bit more risky, eh? Should I be scared of Moderna? Well, based on 1 – no. But based on my logic in the text above, why take a bigger risk – or why is it a bigger risk (even though it is still a very, very small risk indeed). Well, because Moderna’s approach (basically) is to give the highest dose possible to get the most protection. Pfizer’s approach (basically) is to give the lowest dose possible to minimize the adverse reactions and still provide protection. Both are, of course, justifiable. One sounds more commercial to me than the other, perhaps leading to more jabs being needed in the long run (already being borne out) but there you go.

Myocarditis is a side-effect/long run effect of covid-19 itself. This is the critical one. This refers back to what I was saying earlier – that desire to believe nothing has changed. Sorry folks – but I always give it to you straight – it has. The data shows that there is a higher risk of myocarditis remaining unvaccinated than the risk of getting it as a vaccine side effect. This has been captured incredibly well by a far greater analyst than I – Tomas Pueyo – and I will include the link to the relevant article in the comments (it’s a bit heavy, but then again, you could say the same about this…..) – he also has some interesting comments about the JCVI which I’ve not gone into as yet in the detail that I want to, but they sound very disappointing but also very congruent with my ongoing point about the medical side being excellent, but the mathematical/statistical side being far weaker than it should be……

If I project myself into a position where I am reading this, and still unvaccinated, at this point I would still have several bullets left in the chamber. Some of those I can’t second guess – but I would appreciate those brave enough to share them and will try and answer them at some point over the coming week. One that springs to mind is “if there’s such a small chance of a bad reaction, why all this fuss?” And at an individual level, that’s really easy to understand. As a 40-year-old, let’s say, no comorbidities, the chance of a bad reaction from catching covid is minimal. You can use the QCovid calculator I linked to, last week, so see that probability. The move from very unlikely to very very unlikely, and the actions to take, might not be compelling enough.

I get that. The governmental/societal problem is at a different level because we get into the law of large numbers. Here’s my anecdotal bit to bridge that gap. I’ve 5000 Facebook friends and 7000 LinkedIn contacts. Not everyone I know is connected to me on those platforms, so let’s settle at about 12,500 people. I “know” half a dozen dead from covid, a couple of dozen with long-term effects (how serious, only the longer-term can tell), one with a really bad vaccine outcome, and one who has been in ICU and come out (who is unvaccinated). None of the dead were vaccinated, but all died before they had a chance to vaccinate anyway (so that part is moot). The couple of dozen with long covid, I don’t know about their vaccination status. This is why anecdotal is often rubbish! But, still quite a large sample size. There will be those within that 12,500 that have had effects that I’m not aware of, of course, as well.

So to the governmental problem. Is it OK to have 30-50 year olds (to pick on a slice of the population – I pick them because they likely pay the most income taxes, so are “government assets” to a degree) walking around, with a 98.9% chance of not having a bad covid outcome (that figure comes from a mesh of data on death and long covid) but a 99.997% chance (using the table) of a bad vaccine outcome? Not really. The chances are really small at the individual level but at the governmental level, if you’ve got to roll that dice 20 million times, the differences are absolutely huge. So you can understand their problem, a bit, but of course we only look at solving our own problem (and the problem of our nearest and dearest).

I hope that is somewhat illuminating, and of interest. The numbers in the above will change, over time, of course. It is a moveable feast. If you take the 1% number (roughly) across the globe, 78 million people are/were at risk of death or very bad outcome, pre-vaccine – so that again offers some context as to why it has all been worth getting quite so worked up about. Note, that is not a defence of the way that the UK, or any other country, has handled it. Those who’ve handled it well versus those who’ve handled it badly was very predictable, early on, but I truly believe that some westernized liberal democracies have totally and utterly lost their way with positions on mandatory vaccination, vaccine passports and the likes. The overall impact has been a bad and negative one, even though for some (many in the western world) financially it has not been a terrible burden. We have that ongoing choice between what’s bad and what’s worse – and this encapsulates the “new normal”. Not gigantically different to the old one – but not better. We need to make great decisions from hereon in, at the individual level – the level at which we can control, and to an extent, influence – to make it a better new normal rather than an inferior one. I hope we can achieve that in 2022. Let’s see what restrictions we wake up to (hopefully none, because figures for severity of Omicron look promising).

All the best to those who have slogged through that until the end – gold stars and merit badges all round – and if you have further questions, or other things you’d like to see – next week we go squarely back to property with 2022 macro predictions and pricing, markets, what might be hot or not, and where to be focusing your attention – find that quiet time, set your goals, and then commit to them – and then make yourself accountable. It is a winning formula……Happy New Year to all!