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This is what we do about anti-vaxxers: No job. No entry. No NHS access

What shall we do about the anti-vaxxers? A presumptuous question, I know, because they’re human beings, same as the majority of the population who choose to take the Covid-19 vaccines, and we’re all entitled to do what we will or won’t with our own bodies.

But the time has come when the hard choices are looming closer. If we don’t want this Covid crisis to last forever, we need some new simple, guidelines: No jab, no job; no jab, no access to NHS healthcare; no jab, no state education for your kids. No jab, no access to pubs, restaurants, theatres, cinemas, stadiums. No jab, no entry to the UK, and much else.

Who wants their grandma looked after by someone with coronavirus, or teaching in a school full of kids sneezing the Indian variant everywhere, or to watch a football game with someone coughing their viral load all over you? That’s not my idea of freedom. 

Society always needs to balance rights against obligations, and, with rare exceptions (on problem health grounds) those refusing a vaccine need to accept what everyone else does, or face the consequences. 

It is a critical moment, a point where we can either win the war with the virus, and keep it down to endemic but minimal levels, or lose the struggle forever. So we either get the vaccination programme done, to borrow a phrase, or risk many more lives lost, and never-ending stop-go, on-off lockdowns every time some new variant appears and starts to “spread like wildfire”, as the health secretary graphically puts it. 

Herd immunity cannot work unless the great majority of a population is inoculated. In the earlier stages of the programme, it didn’t matter so much that there were some who were reluctant, for whatever reason. Now, with the appearance of the more infective Indian variant, and with the willing soon to be vaccinated, the tougher, stricter choices have to be taken.

They need to be taken by those individuals who need convincing about the safety of the vaccine – and millions of successful jabs should prove that point – but decisions have also to be taken by the community as a whole.

Fortunately, no one’s fundamental human rights need to be violated. No one should ever make vaccination compulsory, for that very reason. It would be a violation of their human rights. But those who decline to accept their societal obligations, as is their right, cannot expect life to be just the same as it ever was and they can just go around spreading the virus to other people, vulnerable or not. The rest of us have rights too, including the right to life. 

We have to protect the wider population from ill-health, death and the lingering social impact of a fractured economy, stuttering month-to-month in and out of tiers and restrictions. Who wants that to go on forever? Of course, we could try to “learn to live with” the virus and the succession of more vicious variants, but it would cost many lives, and tear society apart and break the NHS – full-on waves of the plague, like in the old days.

As the Tory MP Mark Harper tweeted recently: “Concerning to hear Govt is entertaining the delay of the 21 June unlocking – causing massive problems for many people’s livelihoods – because some people won’t have a jab. Wider society’s fate can’t be sealed by the actions of a small group of people, whatever their reasoning.”

Quite right, which is why the doubtful need to be persuaded and encouraged to do the right thing. There should be far more mobile, drop-in vaccine centres, door-to-door outreach, public information, debunking campaigns, choice of types of vaccines and so on to reach individuals and communities who have missed out on this life-saving jab.

But, if they really are so insistent that the vaccine is dangerous or an instrument of mind control or whatever, then they are free to go vaccine-free, but not to go around infecting, hurting and maybe killing their fellow citizens with impunity. It is discriminatory, certainly, but it is fair discrimination, just as we only allow qualified drivers to be employed as train drivers. 

If we discourage irresponsible people from drink-driving, as Andrew Lloyd-Webber argues, or from smoking indoors, or polluting the environment, then surely we can discourage them from spreading a potentially deadly disease? As I say, with rare exceptions of genuine medical justification, everyone who refuses a vaccine could be a killer on the loose, and should be judged accordingly. 

Reference: Independent: Sean O'Grady  

Vaccine diplomacy: inside Biden’s decision on Covid patents

US president faced down pharma lobby and some in his administration

Before becoming president, Joe Biden pledged to upend the US government’s approach to the pharmaceutical industry by backing a move to end companies’ rights to enforce their intellectual property on Covid vaccines. “This is the only humane thing in the world to do,” he said during a campaign event in July 2020. But until the moment the decision was announced this week, many in government and the industry doubted that the US president was going to follow through on his campaign promise. Not only did several high-ranking members of his administration have doubts, but few pharma executives believed that a US government would really take a position so vociferously against the industry’s powerful lobby.

“Nobody really thought Biden was going to take on the pharmaceutical lobby, [they thought] that he would be too scared,” said Brandon Barford, a partner at the Washington-based consultancy Beacon Policy Advisers. “But before the financial crisis [of 2008], everybody thought the financial services industry was untouchable, then that changed. This week showed that pharma companies are the new banks.” When India and South Africa first approached the World Trade Organization in October last year with a proposal to suspend intellectual property rights for all Covid-related drugs and technology, it was quickly shot down. Not only did the US and EU oppose waiving the Trips intellectual property agreement for Covid medicines, they blocked any discussion of it at all.

Biden’s comments on the campaign trail opened up the possibility of a change in US policy. However, even when Katherine Tai, the top US trade envoy, began a multi-departmental consultation on the issue last month, most officials thought the US would maintain the position adopted by Donald Trump’s administration. “There is pressure to do this from Democratic members of Congress,” a senior pharma industry lobbyist told the Financial Times last month. “But the White House is never going to back this.”

Over the course of the next three weeks, Tai met people who had an interest in the issue, from trade union leaders to the chief executives of the vaccine makers. Many who attended those meetings said it was difficult to tell what Tai was planning, but people on both sides of the debate came away from the talks believing she supported their arguments. Asia Russell was part of a virtual meeting with Tai on April 13 in her capacity as executive director of Health Gap, an organisation dedicated to improving access to HIV drugs worldwide.  “I do not think she had made her mind up when she met us,” said Russell, a prominent campaigner for the waiver. “But she did tell us that the response of the government to the Covid crisis could not be business as usual, which we found very encouraging.

” Two weeks later, Tai held virtual meetings with senior executives at each of the companies that have had Covid vaccines authorised in the US or are close to doing so: Pfizer, Moderna, Johnson & Johnson, Novavax and AstraZeneca. They told her supporting a Trips waiver would undermine the US vaccine rollout by increasing competition for scarce vaccine-making supplies, while also allowing Russia and China to access America’s technological breakthroughs. “We made a powerful case and she definitely seemed to be listening,” said one pharmaceutical industry figure involved in the talks.

Those who have dealt with Tai say her inscrutability is one of her greatest assets. “[Tai] is not a person you would ever want at your poker game, because she’s going to kick your ass,” said a person who participated in the consultations. “She’s got the best poker face.”

Meanwhile, high-ranking members of the Biden administration were voicing their concerns at backing a waiver. Gina Raimondo, the commerce secretary, was the most forthright, according to several people involved in the discussions, with her department’s US Patent and Trademark Office particularly concerned about the long-term effect on American intellectual property rights.  Several people also said David Kessler, the head of Operation Warp Speed, the government programme which helped to develop the vaccines, was against the waiver.

A person involved in the consultations said Kessler had described it as the “third rail” for the pharmaceutical industry — so highly-charged it was not to be touched. A spokesperson for Kessler did not respond to a request to comment. One of the most high-profile figures to voice concern was Anthony Fauci, the president’s chief medical adviser and one of America’s best-known public health experts. Just two days before the decision was announced, Fauci told the Financial Times he was “agnostic” on the issue, but was worried it could end up tangling the US in lengthy litigation from the pharma companies. Fauci’s comments triggered a backlash from progressive campaigners, who accused the administration of bowing to the pharmaceutical lobby.

But people within the administration say the progressives’ anger was not what won the day. Instead, Tai and Jake Sullivan, the national security adviser, both argued this was a low-risk way to secure a diplomatic victory for the Biden administration, which had come under fire for not exporting more vaccines and failing to respond quickly enough to the unfolding Covid crisis in India. Litigation was a distant threat given how long WTO negotiations would take and might not happen at all if others including the UK and EU continued to oppose the move.

A day after Fauci made his comments, Tai presented her conclusion to Biden in a meeting in the Oval Office. Also in attendance were Ron Klain, the president’s chief of staff, Bruce Reed, Klain’s deputy, Sullivan and Jeff Zients, the head of the White House Covid task force. None of the prominent opponents of the idea attended; Raimondo was in Connecticut at the time, according to her department. The president and his advisers were particularly persuaded by the diplomatic reasons to back a waiver, said those briefed on the meeting. “This is not the measure to end the pandemic,” said one person within the administration.

“But it does make sense politically.” Campaigners for the waiver say they will now monitor discussions at the WTO to make sure they do not get dragged out to the point where it ceases to be useful. Angela Merkel, Germany’s chancellor, has already said she opposes the measure. Recommended Covid-19 vaccines Covid-19 vaccine tracker: the global race to vaccinate But those in Washington say that whatever the outcome of the WTO talks, the US pharmaceutical industry has now lost its sheen of untouchability.

That could have major consequences for future policy debates such as how to lower US drug costs, because patent protections are the bedrock that allow pharma companies to charge premium prices for a period of time without fear of competition from cheaper generic rivals. “There is now a broad consensus in the Democratic party that something needs to be done about drug prices,” Barford said. “What the president has just done is show it can be done.” 

Indian Covid-19 variant found in 44 countries around world, says WHO

The World Health Organization said Wednesday that a variant of Covid-19 behind the acceleration of India's explosive outbreak has been found in dozens of countries all over the world.

The UN health agency said the B.1.617 variant of Covid-19, first found in India in October, had been detected in more than 4,500 samples uploaded to an open-access database "from 44 countries in all six WHO regions".

"And WHO has received reports of detections from five additional countries," it said in its weekly epidemiological update on the pandemic.

Outside of India, it said that Britain had reported the largest number of Covid cases caused by the variant.

Earlier this week, the WHO declared B.1.617 -- which counts three so-called sub-lineages with slightly different mutations and characteristics -- as a "variant of concern".

It was therefore added to the list containing three other variants of Covid-19 -- those first detected in Britain, Brazil and South Africa.

The variants are seen as more dangerous than the original version of the virus because they are either being more transmissible, deadly or able to get past some vaccine protections.  

The WHO explained Wednesday that B.1.617 was added to the list because it appears to be transmitting more easily than the original virus, pointing to the "rapid increases in prevalence in multiple countries".

WHO also pointed to "preliminary evidence" that the variant was more resistant to treatment with the monoclonal antibody Bamlanivimab, and also highlighted early lab studies indicating "limited reduction in neutralisation by antibodies".

It stressed, though, that "real-world impacts" on the effectiveness of vaccines against the variant for instance "may be limited".

WHO said the spread of B.1.617, alongside other more transmittable variants, appeared to be one of several factors fuelling India's dramatic surge in new cases and deaths.

India -- a country of 1.3 billion people -- is the world's second-most infected after the United States with nearly 23 million Covid-19 cases, and is currently recording more than 300,000 new cases and close to 4,000 deaths each day.

The new surge in cases has ravaged major cities, including the capital New Delhi and financial hub Mumbai, pushing hospitals to breaking point and leading to severe shortages in oxygen and beds.

"WHO found that resurgence and acceleration of Covid-19 transmission in India had several potential contributing factors, including increase in the proportion of cases of SARS-CoV-2 variants with potentially increased transmissibility," it said.

It also pointed to "several religious and political mass gathering events which increased social mixing; and, under-use of and reduced adherence to public health and social measures".

"The exact contributions of each of these factors on increased transmission in India are not well understood."

WHO stressed that so far, only 0.1 percent of positive Covid tests in India had been genetically sequenced and uploaded to the GISAID database to identify the variant in question.

By the end of April, B.1.617.1 and B.1.617.2 accounted for 21 and seven percent respectively of all sequenced samples from India, it said.

In addition, other more contagious variants are also spreading in the country, including B.1.1.7, which was first detected in Britain. 

Reference 24: NEWS WIRES  6 hrs ago

Have scientists found the key to beating prostate cancer?

Scientists have discovered that a key protein may be the secret to treating prostate cancer patients with ‘miracle’ immunotherapy drugs.

Clinical trials have now begun – with the goal of unleashing cancer-killing white blood cells to attack the tumour.

Immunotherapies have had stunning results against some types of the disease.

But, so far, they have failed to work against prostate cancer and scientists have not been able to work out why.

Now, researchers at the Institute of Cancer Research (ICR) and the Royal Marsden Hospital in London say they have got the answer – and it is a protein called CD38.

The cancer hijacks white blood cells called B-cells and manipulates them to make CD38.

Research suggests it then deprives other cancer-killing white blood cells of the energy they need to attack the tumour.

This means that drugs that target CD38 could unleash the power of the immune system on the cancer cells.

Crucially, such medicines already exist and trials are underway.

Given to 24 men with advanced prostate cancer, isatuximab – an immunotherapy used to treat blood cancer – re-energised the cancer-killing white blood cells, a conference heard last month.   

Researcher Professor Johann de Bono said: ‘There’s a lot of evidence that prostate cancer causes what we call immune tolerance – that the cancer suppresses the body from attacking it with its immune cells.

‘Our findings suggest that we can target immune cells displaying CD38 proteins to awaken the immune system.’

Samples from more than 200 men with advanced prostate cancer revealed that those whose tumours had a lot of CD38 protein were twice as likely to die in the next ten to 15 years.

The research, published in the journal European Urology, also found that the cancer became harder to treat as levels of the protein rose.

Prostate cancer is the most common cancer in men – with 48,500 cases a year and almost 12,000 needless deaths. The Daily Mail has long campaigned for greater awareness, treatment and diagnosis of the disease.

Professor Paul Workman, of the ICR, said: ‘Studies like this are critical in helping us understand how prostate cancer interacts with the body’s immune defences and could help pave the way for more effective treatments.’

Reference: Fiona Macrae for the Daily Mail  4 days ago