In a recent review, my colleague Ben Pantrey argues Richard Kearney’s Touch is itself out of touch with the ‘maddeningly Baroque … meme-ified soup of internet discourse.’ Given the Boston-based Irish philosopher is from an older generation, a relative lack of insight is perhaps unsurprising, but in dismissing the work in at times caustic terms, the reviewer perhaps missed its central thrust.
Touch provides a compelling narrative on an intimate connection between healing and touch, pointing to a dominant tendency in Western medicine – writ large during the Covid-19 pandemic – to disregard the role of the healer, in favour of what Kearney calls a ‘model of outmanoeuvring and overcoming illness.(p.68)’
That this view now appears risqué – in the face of coercive public health – demonstrates how the argument for the type of healing that Kearney points to is being lost.
The flag of the World Health Organization, with a rod of Asclepius.
Hippocratic v. Asklepion
Kearney identifies two paradigmatic schools of medicine originating in Ancient Greece, one emanating from Chiron who taught his disciple Asclepius ‘the art of healing through touch’; and another from Hippocrates, ‘followed the way of Zeus, Chiron’s brother, who dwelt on Mount Olympus and promoted a method of optocentric supervision. (p.66)’
Following a Hippocratic approach, the patient is viewed from a distance – objectified – before the prescribed remedy, or prophylactic, is applied to an undifferentiated ‘case.’
In contrast:
Chiron comes from the word kheir, meaning hand, or, more precisely, one skilled with the hands. The related term kheirourgos means surgeon. As healer, he accompanied the art of touch – often portrayed as laying on of hands and bodily massage – with medicinal plants from the earth, music, and sleep potions. (p.66)
Asklepion healing is a two-way process that includes: ‘tactile acts of bathing, ritual massage, and the ingestion of curative herbs. (p.68)’ This sounds similar to so-called ‘alternative’ medicinal practices – dismissed as ‘unscientific’ by some doctors – and also encompasses much of the fading role of the general practitioner, where a physical presence before each distinct patient is generally considered important.
This form of healing, however, is severely compromised by exhortations – backed up by unprecedented draconian laws – to ‘socially’ distance – which is surely an oxymoron.
Kearney’s work points to profound damage that occurs when physical contact is lost, heightening a pre-existing epidemic of loneliness, which a report in 2014 found to have even worse effects on our health than obesity. The psychiatrist Iain McGilchrist goes so far as to argue that all medicine should be viewed ‘as a branch of psychiatry, and psychiatry as a branch of philosophy.’[i]
Indeed, recognising a psychological origin to physical symptoms might explain our current impasse: transfixed by the challenge of a particular virus, seemingly to the exclusion of all else. This collective hysteria suggests widespread trauma, which may be the legacy of diminished physical contact in a digitally mediated age, accelerated by what Naomi Klein described as a ‘Screen New Deal,’ rolled out under cover of lockdown.
It begs the question: what happens to society when we shrink in fear from the flesh, blood and microbes of one another? ‘Touch’, Kearney says, ‘serves as the indispensable agency of intercorporality – and by moral extension, empathy. (p.47)’
The School of Athens by Raphael.
Aristotelian Touchstone
According to Kearney, Plato’s Academy held sight to be ‘the highest sense because it was deemed the most distant and mediated.’ In contrast, according to Kearney, Aristotle, ‘makes the startling claim that human perfection is the perfection of touch, (p.35)’ writing in Metaphysics (chapter 10, 105ib, 23-25):
The being to whom logos has been given as his share is a tactile being, endowed with the finest tact.
Kearney argues convincingly that in Western medicine the Aristotlean approach, drawing on Asklepion wisdom, has been drowned out by a Platonic, ‘heroic-Hippocratic model’, which ‘only tells half the story. (p.68-69)’
In support of this thesis, in his history of the origins of the scientific discipline from the late eighteenth century, Richard Holmes has drawn attention to a delusional optimism wherein there emerged, ‘the dazzling idea of the solitary scientific ‘genius’, thirsting and reckless for knowledge, for its own sake and perhaps at any cost.’ This was the idea of a ‘Eureka’ moment: ‘the intuitive inspired instant of invention or discovery, for which no amount of preparation or preliminary analysis can really compare.’[ii]
Arguably, blind faith in dazzling scientific genius distorted public health priorities in the era of COVID-19. Lockdowns were aimed at keeping the population ‘safe’ before the invention of a ‘miraculous’ vaccine. Many seemed to assume this would act as a panacea, allowing us to awaken from the nightmare of ongoing restrictions. But a cycle of anxiety endures with the arrival of each new variant, however mild the symptoms it produces, suggesting an underlying anxiety is itself the problem.
in pursuit of a single-minded, Hippocratic “model of outmanoeuvring and overcoming illness”, morbidity and mortality from COVID-19 was inadequately weighed against the health impacts of lockdowns. According to Ari R. Joffe, the response of Western nations threatens to make ‘and likely has already made, several Sustainable Development Goals for the most vulnerable among us in low-income countries out of reach.’ The same paper also argues the ‘destabilizing effects may lead to chaotic events (e.g., riots, wars, revolutions).’
A van set on fire during the riots in Rotterdam on 26 January 2021.
Merleau-Ponty
Another philosopher Kearney cites is Maurice Merleau-Ponty who ‘took the novel step of applying the phenomenology of touch to the question of healing. (p.49)’ In response to increasing dependence on ‘optocentric’ remote diagnostics, it is worth revisiting passages Kearney quotes.
Merleau-Ponty emphasises the importance of tactility in the treatment of psychiatric illness in particular:
In treating (certain illnesses) psychological medicine does not act on the patient by making him know the origin of his illness: sometimes a touch of the hand puts a stop to the spasms and restores to the patient his speech.
Moreover,
The patient does not accept the meaning of his disturbance as revealed to him without the personal relationship formed with the doctor, or without the confidence and friendship felt towards him, and the change of existence resulting from this friendship. Neither symptom nor cure is worked out at the level of objective or positing consciousness, but below that level.
He concludes with a revolutionary idea in the context of this pandemic, where the patient-doctor relationship is side-lined in favour of generalised prescriptions, addressing one particular disease:
What this implies is that human symptoms cannot be explained by either biochemistry or intellectual volition alone – though both have their role. Ultimate healing involves an existential conversion of one body-subject in tactful communion with another. (p.49)
Moreover, Kearney adds that ‘untimely withdrawal of touch may do worse psychic damage than outright hostility or anger. (p.102)’ He refers to the findings of the Austrian doctor René Spitz in 1945, concerning an orphanage, which prevented contact between children in order to reduce a risk of them being exposed to contagious diseases, while giving them excellent nutrition and medical care. Startling, thirty-seven percent of the infants died before reaching the age of two.
Kearney also draws attention to epigenetic research demonstrating ‘key alterations in our bodies are made not just by toxins and biochemical stimulants but by the way we resonate with our fellow beings. (p.104)’
Image: Daniele Idini (c)
Responding to Covid
Given Kearney completed the book just as the COVID-19 pandemic began, his observations are of a provisional nature.
Nonetheless he makes a far-reaching claim that ‘In the first half of 2020, the virus went viral. Homo sapiens became Homo cybernens. (p.136)’ He assumes, however, an upbeat tone that now seems misplaced, saying ‘what we lost on the roundabout we won the swings’, recalling, how friends had received ‘unexpected messages from old friends and old flames (the “ex-factor”) wishing to “reconnect” at a time when physical travel and tactile contact was suddenly suspended. (p.134)’
Almost two years into the pandemic another philosopher, Byung-Chul Han has a far less rosy assessment. Writing for The Nation he describes what he calls ‘The Tiredness Virus’ in the pandemic’s wake. A triumph of sight over touch has generated what Han describes as ‘Zoom narcissism’ such that a ‘digital mirror’ encourages ‘dysmorphia’ (an exaggerated concern with supposed flaws in one’s physical appearance).
‘Digital communication is a very one-sided, attenuated affair’ Han argues, ‘There is no gaze, no body. It lacks the physical presence of the other.’ Moreover, he fears this this form of communication will become the norm, recalling all that we have lost:
The rituals we have been missing out on during the pandemic also imply physical experience. They represent forms of physical communication that create community and therefore bring happiness. Most of all, they lead us away from our egos … A physical aspect is also inherent in community as such. Digitalization weakens community cohesion insofar as it has a disembodying effect. The virus alienates us from the body.
Prolonging Covid?
Could an enforced absence of touch be linked to outright pathology in the context of COVID-19?
In response, Professor Robert Dingwell criticised ‘this very strong message which has effectively terrorised the population into believing that this is a disease that is going to kill you.’
Is it possible that widespread conviction that a disease “is going to kill you” had unforeseen consequences in terms of adding to the burden of ‘Long Covid,’ or Covid ‘Long Haulers’ as it is referred to in the U.S.?
Long Covid is a condition fitting within the general category of a post-viral syndrome, or post-viral fatigue, which is ‘a sense of tiredness and weakness that lingers after a person has fought off a viral infection.’ which ‘can arise even after common infections, such as the flu.’ Notably, prior to the pandemic there were up to 150,000 who were already affected by ‘extreme and disabling exhaustion,’ with no apparent origin in the U.K.. Yet virtually no attention was given to this condition until the pandemic.
Moreover, in October, 2020 a leading advocates for sufferers, Professor Trish Greenhalgh clarified that Long Covid is only very rarely a long-term affliction: ‘The reviews we’ve done seem to suggest that whilst a tiny minority of people, perhaps one per cent of everyone who gets Covid-19, are still ill six months later, and whilst about a third of people aren’t better at three weeks, most people whose condition drags on are going to get better, slowly but steadily, between three weeks and three months.’
Ordinarily, one would expect public health officials to downplay such a condition, given broad acceptance that psychological stress – including a lack of touch or loneliness – is a factor in the subjective evolution or pathogenesis of most diseases. Instead, Long Covid has been widely highlighted in the media, often as a warning to young people, who might otherwise be insufficiently scared of a virus highly unlikely to kill a person under the age of fifty.
Frequent, graphic accounts, espeically via social media, may have had unintended consequences. Curiously, an informal survey of 450 people by Survivor Corps, a patient advocacy group for people with Long Covid, found that 171 said their condition improved after vaccination. That a vaccine would alleviate a post-viral syndrome is surely grounds for suspicion, hinting at a psychological origin to objective pain and suffering.
Adam Gaffney, an assistant professor in medicine at Harvard Medical School, has argued for a more critical appraisal of Long Covid. Having expressed scepticism around a condition characterised by symptoms such as ‘brain fog’, he recalls being contacted by a journalist who said: ‘I’m asking as much as a person as a journalist because I’m more terrified of this syndrome than I am of death.’
Gaffney acknowledges ‘myriad long-term effects, including physical and cognitive impairments, reduced lung function, mental health problems, and poorer quality of life’ from severe bouts of COVID-19, but cites a survey showing two-thirds of ‘long haulers’ had negative coronavirus antibody tests, and another, organised by self-identifying Long Covid patients indicating around two-thirds of those surveyed who had undergone blood testing reported negative results.
He asserted: ‘it’s highly probable that some or many long-haulers who were never diagnosed using PCR testing in the acute phase and who also have negative antibody tests are “true negatives.” In other words, for many this may be a disease with a psychological origin, which Gaffney attributes to ‘skyrocketing levels of social anguish and mental emotional distress,’ referencing a paper showing that about half of people with depression also had unexplained physical symptoms.
Getting Back in Touch
Recovery from the trauma of the pandemic should lead to a reappraisal of public health priorities. It is apparent by now that no “miracle” cure is available, decisively “outmanoeuvring and overcoming” COVID-19, and that lockdown measures, including pysch-ops instilling fear, have left deep wounds.
Works such as Kearney’s remind us of the importance of healing touch, inspired by Asclepius, which should be accorded equal importance to the Hippocratic inheritance. Now, with an ever-increasing burden of morbidity in society, particularly a veritable epidemic of mental ill-health, a paradigm shift is required.
However, Bessel Van Der Kolk describes in a recent work quoted by Kearney how mainstream medicine ‘is firmly committed to a better life through chemistry, and the fact that we can actually change our own physiology and inner equilibrium by means other than drugs, [that is] by such basic activities as breathing moving and touching … is rarely considered.’[iii]
This issue could become one of the most important political questions of our time, and may lead to political realignments in the wake of a pandemic that has changed our lives.
Featured Image: A member of the Peruvian Army with a police dog enforcing curfew on 31 March 2020.
[i] Iain McGilchrist, The Master and His Emissary: The Divided Brain and the Making of the Western World, Yale University Press, New Haven/
[ii] Richard Holmes, The Age of Wonder: How the Romantic Generation Discovered the Beauty and Terror of Science (London, 2008) p. xvii
[iii] Bessel Van Der Kolk, The Body Keeps the Score, New York, Penguin, 2015, p.38.
Surveying the demise of the Celtic Tiger, Fintan O’Toole devoted an opening essay ‘‘Do you know what a republic is?’ The Adventure and Misadventure of an Idea’ in Up the Republic! Towards a New Ireland (2012) to assessing the health of the Irish Republic. He considered its vitality based on the presence, or otherwise, of three indicators: Non-Domination; Mixed Government and tolerance of Obstreperous Citizens.
These features of a healthy republic, he wrote, diverge from a narrow form of republicanism associated with Rousseau ‘which argues for the notion of a single, sovereign popular will: ‘the People’ effectively taking the place of the king in a monarchy.’ Up to that point in Ireland, O’Toole argued, this latter, narrow version had predominated, which he associated ‘in vulgar terms’ with appeals being made to ‘pull on the green jersey’’; and where ‘an idea of accountability implicit in mixed government is ditched.’
‘For most of the history of the state’, O’Toole concluded that the state ‘failed miserably in the basic task of ensuring citizens were free from subjection to the arbitrary will of others.’[i]
Now, as Ireland slowly unwinds from an interminable lockdown that tendency of Irish governments to pull on the green jersey, avoid accountability, reject obstreperousness and a conspicuous failure to ensure that citizens are free from the subjection to the arbitrary will of others, is evident once again. This regression has arrived especially through what O’Toole himself described on April 28th, 2020 as the ‘top-down, command-and-control approach’ of the National Public Health Emergency Team (NPHET), which the elected government has deferred to throughout most of the pandemic.
The COVID-19 pandemic is likely to reshape the Irish political landscape, eroding foundational certainties of left and right. When the dust settles new formations may crawl from the debris, with democracy itself in peril, as the coalition government chooses to extend emergency powers until November, while other countries such as Denmark aim for a swift return to normality.
In terms of the pandemic’s wide-ranging impact, there are parallels with the outbreak of a global war. As Hannah Arendtput it: ‘The days before and the days after the first World War are separated not like the end of the an old and the beginning of a new period, but like the day before and the day after an explosion.’[ii]
Placing billions under lockdown around the world had a shuddering effect on daily routines, altering intimate exchanges and gestures, besides radically reducing the ambit of daily peregrinations. It’s a very modern form of trench warfare that confined most of us to within 5km of barracks – spilling out invective on (anti-)social media.
In Ireland, with the advent of bigger government, there is a confidence among some on the left that their time has arrived, and that a relatively youthful population will vanquish age-old privileges of wealth and caste through a permanently enlarged state.
However, as Eric Hobsbawm records, one reason Engels (and even the late Marx) ‘began to turn away from calculations that the international war might be an instrument of revolution was the discovery that it would lead to ‘the recrudescence of chauvinism in all countries’ which would serve the ruling classes.’[iii]
Similarly, nationalism chauvinism – ‘excessive or prejudiced support for one’s own cause, group, or sex’ – has been witnessed throughout the pandemic in Ireland. This is perhaps unsurprising as, historically, infectious diseases have given rise to, and fed, plagues of prejudice and outright racism; the diseased ‘other’ at the gates of the city is a recurring theme. Ruling classes have often put forward strongman rulers to harness this xenophobic sentiment.
Since March 2020 we have poured over spreadsheets of daily deaths, infections, testing rates and vaccine roll outs to determine how ‘we’ are doing relative to ‘them.’ In Ireland we tend to measure achievements and failures against the noisy neighbour next door, whose boorish leader has somehow managed to transform one of the world’s highest death tolls per capita from Covid-19 into a great British victory pageant, through a rapid vaccine rollout. Boris now looks unassailable, notwithstanding Brexit storm clouds, Dominic’s revenge, Indian variants; and just the suspicion that the vaccine may not prove quite the panacea it seems now in winter 2022. Time will tell.
Indeed, the narrative arc of Boris Johnson’s response to the pandemic should serve as a warning to the Irish left that ruling classes can easily steal their best clothes. In this respect, Johnson operated with far greater flexibility than Donald Trump, shifting from a ‘take on the chin’ herd immunity approach in March, 2020 to championing what he would have previously decried as a ‘nanny state’ lockdown. He and his chumocracy used the pandemic as a pretext for introducing draconian legislation againstprotest and civil disobedience, apparently aimed at movements such as Extinction Rebellion.
The End of American Leadership by Christopher Parkison FDR said there was nothing to fear but fear itself, while JFK asked what you can do for your country; now Donald Trump resorts to blaming foreigners.#FDR#JFK#Trump#TrumpMeltdownhttps://t.co/JrJupSJhKI@broadsheet_ie
Similarly, though less dramatically, Leo Varadkar resuscitated his political career after Fine Gael’s disastrous performance in General Election 2020, donning proverbial scrubs for the initial phase of the pandemic. Having identified himself with “early-rising” middle class voters Varadkar was smart enough to realise that his preferred Thatcherite policy of reliance on an Invisible Hand of market forces could lead to a public health disaster during a pandemic.
Since entering the coalition, Fine Gael Ministers have emphasised a law and order approach – Simon ‘TikTok’ Harris was quick off the blocks denouncing as ‘disgusting, grotesque and obscene’ a comparatively unobstreperous anti-lockdown protest in Dublin by European standards. Fine Gael have also allowed Fianna Fail to act as a mudguard for a failing system of public health: Ireland’s health expenditure is the third highest in the EU, yet we have only 5 ICU beds per 100,000, compared to 35 in Germany and 28 in Austria.
Fine Gael represents itself as a centrist party, placing emphasis on its belated support for marriage equality and abortion referendums, which obscures from a failure in government to address structural inequalities and ongoing environmental damage. Replacing James Reilly as Minister for Health in 2015 Leo Varadkarpromptly abandoned universal health insurance (UHI).
After becoming leader of Fine Gael and Taoiseach, Leo Varadkar claimed he would represent thrusting early risers – tantamount to saying he would not alter structural inequalities that are most apparent in access to housing. In combination with Fianna Fail, Fine Gael has represented the dominant interest of large property owners, indifferent to whether their wealth is maintained via independent corporate entities, the state, or as in Ireland’s case increasingly, a corporate-state nexus.
Simple distinctions of left and right are often misleading. Thus, when considering the virtues, or otherwise, of big government it should be clear that administrative levers and patronage may drive inequality; most obviously through mind-boggling salaries, such as the €420k paid to the Director General of a dysfunctional HSE, Paul Reid – ironically a former Workers’ Party activist. Reid has no medical or scientific qualifications, and previously acted as chief executive of Fingal County Council.
Moreover, left-wing politicians and their supporters are often drawn from higher income groups; a tendency that within Fine Gael circles used to be referred to as noblesse oblige – accompanied by the obligatory glass of fine Cognac – of which the Just Society was the apotheosis. But a left-wing identity may be superficial, as the distribution of state largesse, or patronage, apart from being expressed in high public sector salaries, often benefits established professional elites of lawyers, academics and indeed doctors.
Big government patronage motors along fine in Ireland for all concerned as long as the tech and pharma sectors do the heavy economic lifting. This is the ‘Leprechaun Economics’ that Paul Krugman referred to dismissively. But now the Biden administration’s taxation proposed changes to the global tax system may make the current Irish model unworkable. The ECB is also likely to desist eventually from quantitative easing, with inflation looming.
Renewed fiscal rectitude and the prospect of multinationals leaving a perpetually unaffordable capital city for workers, will place increasing reliance on those indigenous SMEs that have endured the Crash of 2008, and the unprecedented challenges of the pandemic. Yet whole sectors have been furloughed for over a year, with some such as events and tourism wondering whether they have a future at all. The Central Bank has warned that one in four firms could fail when pandemic payments cease.
It should be unsurprising, therefore, for a small businessperson living from transaction to transaction to be wary of parties promising higher taxation on the left, and instead be attracted to politicians on the right, or even far-right, that are acquainted with the language of commerce, however superficial this may be, in the case of Leo Varadkar at least, whose concern for SMEs has disappeared after his supportive comments proved unpopular last October.
'None of those people would have faced being on #PUP, none of them have to tell someone they are losing their job, none of them will have to shutter a business for the last time' – Tánaiste Leo Varadkar on #NPHET#cblivepic.twitter.com/ZAw7sDxGLo
An objective for a progressive left should be to attract support from an increasingly marginalised mercantile class, emphasising that a favourable environment for entrepreneurship, as in Scandinavia, is enabled by efficient public service, including a one-tier, functioning health system. The left can argue that leaving healthcare to market forces – as in the U.S. – is not only deeply unfair, but also, crucially, leads to greater costs than a functioning one tier public system which also – as in most European countries – delivers better outcomes overall.
The inherent danger of Ireland’s two-tier model, where health care provision is subject to market forces is epitomised by a question recently posed by a Goldman Sachs executive: “Is curing patients a sustainable business model?” In an age of profound health insecurities – which are amplified through subtle advertising cues – market forces will continue to distort public health priorities.
It was the father of economics Adam Smith who warned: ‘People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices.’ However, while resisting a buccaneering tendency in the delivery of a vital government service such as healthcare, the left cannot afford to dismiss the dynamism of entrepreneurship in society at large. Just imagine the food you would be served if the government was running all the restaurants.
Following Public Health Guidance
While there are a range of financial supports available to SMEs, the world-beating length of Ireland’s lockdown has made trade impossible for many businesses, some of which may never recover. The failure of the two centre-right parties in government to represent their concerns arguably, lies at the heart of Ireland’s deeply flawed response to the pandemic.
From March to June, 2020, 96% of additional deaths related to COVID-19 in Europe occurred in patients aged older than 70 years. Yet, despite having the youngest population in the Union, according to a Reuters by February Ireland had endured 163 days of workday closures. This was the highest, by some measure, of all the European countries surveyed at that point. By contrast, Denmark had lost just fifteen days, having experienced a death toll almost half that of Ireland’s per capita.
The uncritical attitude of mainstream Irish left wing parties towards public health officials should also be reconsidered. Recall the major mistakes in particular by Chief Medical Officer Tony Holohan, who saw nothing wrong with fans going to Cheltenham in early March, 2020, ordered care homes to re-open to visitors that same month, and then transferred 4,500 untested patients back into care homes – surely contributing to the second highest level of care home mortality in the world during the first wave. Yet Irish left wing politicians have consistently complained about the government failing ‘to follow public health advice,’ despite Holohan’s long history of cock-ups and cover-ups.
Even before Christmas NPHET – a body composed primarily of career civil servants and notably short on scientific expertise – seemed to have been all on board for the ’meaningful Christmas’ of Micheal Martin’s imagination. The only significant deviation between the government’s approach and NPHET’s advice was that the latter preferred to permit household gatherings rather than opening the hospitality sector. Cue raucous Christmas house parties, as opposed to what were mainly orderly affairs in pubs and restaurants.
In fact, Ireland’s ‘third’ wave, which coincided with the more transmissible B.119 variant (although apparently not more lethal as was widely reported) actually commenced in week 48 of 2020 (22/11/2020), while the country was still under Level 5 Lockdown restrictions, according to a report by the HSPC.
Sadly, public health obscurantism has also brought denial of their own data, which said outdoor transmission of Covid-19 is about as frequent as curlew sightings.
The latest embarrassment over NPHET refusing to acknowledge the benefits of antigen testing, underlines that if left-wing politicians are slavishly going ‘to follow the public health advice,’ and whatever Yes Minister civil servant advises then we won’t see radical reforms in Ireland any time soon.
Frank O’Connor
Guests of the Nation
Over the course of the pandemic Irish attitudes have hardened against the free movement of people in and out of the country, culminating in the introduction of mandatory hotel quarantines for some foreign, including EU, arrivals at the end of February.
Contemporary Irish attitudes to hardworking foreigners resident in Ireland recall Frank O’Connor’s classic 1931 short story ‘Guests of the Nation.’ Set during the War of Independence 1919-21 it portrays a bond of friendship that grows up between two IRA men, Bonaparte (the narrator), and Noble, who are detailed to guard two captured English soldiers Belcher and ‘Awkins who have a natural affinity with the country:
I couldn’t at the time see the point of me and Noble being with Belcher and ‘Awkins at all, for it was and is my fixed belief you could have planted that pair in any untended spot from this to Claregalway and they’d have stayed put and flourished like a native weed.
Ultimately ‘Awkins and Belcher are sacrificed at the altar of of a narrow nationalism, just as a today the Populist appeal to ‘protect our own people’ has ordained that the rights of immigrants in Ireland, and abroad, to see their families was disregarded.
"We need to protect our own people. We have a duty to protect our own people to the maximum. This legislation fails to do that"✖️
That's why we have proposed an amendment to make hotel quarantine mandatory for everyone travelling here with the exception of essential travel 🛬 pic.twitter.com/wwaFueUbvz
This appears to stem from a widespread notion that ‘we,’ like faraway New Zealand and Australia, can eliminate the disease from ‘our’ shores altogether – devolving into the juvenile #wecanbezeros hashtag adopted by some politicians on the left. The problem is that ‘we’ are a society with lots of ‘them’ immigrants living here, and an enormous diaspora of ‘us’ beyond the shores of an island divided into two jurisdictions, highly dependent on international trade in goods arriving on trucks (with drivers).
Moreover, apart from the extreme geographic isolation and sparse populations of Australia and New Zealand, ‘we’ in Ireland have legal obligations to preserve freedom of movement under European treaties and the Good Friday Agreement, enshrining a porous open land border. Apart from committing economic hari-kari, pursuit of ZeroCovid appears legally impossible, unless of course we want to pursue an Irexit and build a wall along the Northern border.
Nonetheless, egged on by febrile – ‘if it bleeds it leads’ – coverage in a national media increasingly reliant on government advertising, a prevailing view is that all deaths from Covid are essentially preventable; emanating from the failing of the state, or the reviled Covidiot, rather than being the tragic consequence of a pandemic, the death toll from which has been systematically exaggerated.
Moreover, intercepted correspondence within the ZeroCovid ISAG group of independent scientists – who have taken on the Opus Dei role to the Catholic hierarchy of NPHET – reveals, among other disturbing insights, that they were looking ‘for ways to increase insecurity, anxiety and uncertainty.’ As these revelations first appeared in right-wing Gript, however, the left-wing echo chamber refuses to acknowledge it is being played.
Are you right there Michael?
Nonetheless, a number of politicians have come forward representing an anti-authoritarian left, concerned by the harms of lockdown and favouring a targeted approach – protecting the elderly – and building up ICU capacity. In a recent blistering Twitter attack the independent (and former Labour) TD for Clare, barrister Michael McNamara – who as chair of the Oireachtas Committee on Covid-19 Response became as well acquainted as any Irish politician with diverging epidemiological assessments of the pandemic – identified a recurring Irish deference to vested authority.
In response to a Fintan O’Toole article critiquing the DUP McNamara wrote: ‘Instead of criticising unionism, let’s look at the complete mess we’ve made of Irish nationalism and nationhood. We’re ruled by a junta of medics, just as we were Rome Ruled for 7 decades. The Orthodoxy changes but the crawthumping remains the same.’
He continued: ‘If it wasn’t for Unionism, we’d be like Hoxha’s Albania now. There’d be no way off this island. But there is a beacon. Belfast Airport and Larne are beyond the reach of NPHET, just as surely as the rule of the Archbishop’s palace in Drumcondra didn’t pass the bridge in Portadown.’
He added more controversially:
‘We can’t blame the medics for their experimental therapy, any more than we could blame the clergy for their zeal. Successive governments have abdicated their democratic responsibility throughout this State’s short history. So why would Unionists want to be “governed” by Dublin?’
Instead of criticising unionism, let's look at the complete mess we've made of Irish nationalism and nationhood. We're ruled by a junta of medics, just as we were Rome Ruled for 7 decades. The Orthodoxy changes but the crawthumping remains the same. https://t.co/05VbBmHnSI
It was a fair question, when one considers the North is reopening far sooner than the Republic. Although this has arrived after a rapid vaccine rollout, the experimental nature of which McNamara raises problems with.
Facing Up to Errors
Here we come to the crux of an unhelpful cultural division between left and right that the ruling parties will use to divide and conquer. This is the new identity politics arising out of the pandemic, epitomised by attitudes towards face masks.
For too many on the left the science on this issue is proven as opposed to followed. Wearing a face mask now appears to have become an article of faith. Yet a recent report by the European Centre for Disease Control and Prevention entitled ‘Using face masks in the community: first update – Effectiveness in reducing transmission of COVID-19’ stated:
The evidence regarding the effectiveness of medical face masks for the prevention of COVID-19 in the community is compatible with a small to moderate protective effect, but there are still significant uncertainties about the size of this effect. Evidence for the effectiveness of non-medical face masks, face shields/visors and respirators in the community is scarce and of very low certainty.
Additional high-quality studies are needed to assess the relevance of the use of medical face masks in the COVID-19 pandemic.
Moreover, the Irish left should consider our dependence on pharmaceutical behemoths that jealously guard intellectual properties, notwithstanding huge state aid grants, and indemnification against adverse reactions. It is akin to the dependence of small farmers in developing countries on genetically modified seed, under a model of Philanthrocapitalism overseen by Bill Gates, who according to a recent article by Alexander Zaitchik has shown “a lifelong ideological commitment to knowledge monopolies,” and devotes hundreds of millions of dollars each year to whitewashing his reputation through “charitable” media grants.
Moreover, all too often, media debates around Covid-19 fail to acknowledge the link between pre-existing morbidities – ‘underlying conditions’ – and morbidity and mortality from Covid-19. Thus, US Studies have shown that having a BMI over 30—the threshold that defines obesity—increases the risk of being admitted to hospital with covid-19 by 113%, of being admitted to intensive care by 74%, and of dying by 48%, making it almost as relevant a consideration as having been vaccinated.
In Ireland, moreover, Mayo coroner Patrick O’Connor recently questioned the attribution of deaths to Covid-19, saying: ‘In reality, a lot of people have terminal cancer or multiple other serious co-morbidities. People can die from Covid and or with Covid. I think numbers that are recorded as Covid deaths may be inaccurate and do not have a scientific basis.’
Furthermore, by embracing ZeroCovid Utopianism many on the Irish left failed to focus on the failings of a decrepit Irish health system. This epitomises a tendency among politicians to dance to the tune of a corporate media that has placed relentless focus on the disease itself, regularly interviewing mendacious ISAG figures, while generally ignoring underlying social and environmental factors that drive morbidity and mortality.
The canard that Ireland could simply shut its borders and reach ZeroCovid perhaps points to the need for reform of an Irish secondary educational system, which according to the a rather unkind assessment from the OECD’s Andreas Schleicher is designed to produce ‘second-class robots.’ Perhaps too many of us are lacking the requisite critical faculties to look beyond news headlines.
In fact a radically different, defiantly left-wing approach to the pandemic been put forward by, among others, Harvard epidemiologists Katherine Yih and Martin Kuldorff in The Jacobin. They pointed out:
Elites have seen their stock portfolios balloon in value, and many professionals have been able to keep their jobs by working from home. It is the country’s poor and working-class households, particularly those with children, who have borne a disproportionate share of the burden. Lower-income Americans were much more likely to be forced to work in unsafe conditions, to have lost their livelihoods due to business and school shutdowns, or to be unable to learn remotely.
Beyond ZeroCovid, the Irish left should emphasis the harms of Ireland’s reliance on lockdowns, and harness the malcontents of the poorest, including small business owners. Otherwise they court irrelevance as the traditional ruling parties have already taken on the role of ‘caring’ for the people, while retaining the power to ease restrictions in the face of opposition from the left.
Science and Technology are not Neutral
Also, as opposed to running in fear from being labelled anti-vaxxers by a cheerleading corporate media, the left might at least consider the wisdom of foisting vaccines that have been granted under emergency use conditions on all age groups. Indeed, many on the left in Ireland seem unwilling to question dominant institutional narratives, a tendency recently criticized by the Greek socialist Panagiotis Sotiris in The Jacobin, who said: ‘What is missing here is something that used to be one of the main traits of the radical left, namely, an insistence that science and technology are not neutral.’
It remains unclear whether universal immunization will bring about long-term ‘herd’ immunity; while in the absence of long-term safety data the benefits to young, healthy subjects of vaccination may not outweigh the cost in terms of adverse events from treatments granted under emergency use licences. Sober assessment seems to have given way to an ideological and, at times, a coercive approach.
In terms of the efficacy of the Pfizer vaccine, writing in the British Medical Journal, Peter Doshi, pointed to how in the media ‘a relative risk reduction is being reported, not absolute risk reduction, which appears to be less than 1%’ for severe disease.’ Ollario et al in The Lancet referred to absolute risk reductions of ‘1·3% for the AstraZeneca–Oxford, 1·2% for the Moderna–NIH, 1·2% for the J&J, 0·93% for the Gamaleya, and 0·84% for the Pfizer–BioNTech vaccines.’ The authors also pointed to how ‘considerations on efficacy and effectiveness are based on studies measuring prevention of mild to moderate COVID-19 infection; they were not designed to conclude on prevention of hospitalisation, severe disease, or death, or on prevention of infection and transmission potential.’
Doshi has also objected to the undermining of ‘the scientific integrity of the double-blinded clinical trial the company—and other companies—have been conducting, before statistically valid information can be gathered on how effectively the vaccines prevent hospitalizations, intensive care admissions or deaths.’ This came after Pfizer pleaded an ‘ethical responsibility’ to unblind its trial and offer those who received a placebo the opportunity to receive its vaccine.
Doshi argued that ‘there was another way to make an unapproved vaccine available to those who need it without undermining a trial. It’s called “expanded access.” Expanded access enables any clinician to apply on behalf of their patient to the FDA for a drug or vaccine not yet approved. The FDA almost always approves it quickly.’
An alternative policy would be to reserve vaccines for those most susceptible to severe symptoms – the old and the obese – along with healthcare workers and others unavoidably working around the world in congested environments. Devoting scarce resources to increasing ICU provision to bring us into line with European averages might be a better approach than relying exclusively on the quick fix of the vaccine.
The Irish left should now desist from identity politics around vaccine uptake that the centre-right is relishing. ‘Tiktok’ Harris previously stoked tensions with talk of mandatory vaccines and promoting vaccine passports. The left should resist vaccine apartheid, nationally and globally, while demanding the release of patents earned through state supports.
On the Horizon
Ireland can expect significant social problems to emerge out of our world-beating lockdown strategy that recalls a prior devotion to austerity; a mental health pandemic and mass youth unemployment are upon us already. Moreover, the young are currently denied the safety valve of an easy hop to another English-speaking country for work. This may be a recipe for radicalism, but unfortunately genuinely dark forces on the far-right are ready to pounce on malcontents.
It is surely vital that we maintain our European connections, thereby scrapping Mandatory Health Quarantine that is an insult to immigrant groups in Ireland, as well as the diaspora. 90% of scientists believe that Covid-19 will be with us forever, so it seems there will always be ‘variants of concern’ to contend with, just as there are with influenza.
As a country Ireland has serious work to get on with in terms of addressing a housing crisis and improving our environment. A narrow focus on the pandemic should not be allowed to derail these efforts. This may be like a war but it is not a war. Even prior to vaccines, this is a virus with an infection fatality rate of less than 0.2% in most locations. Moreover, up to 86% of those infected may not have symptoms, such as cough, fever, or loss of taste or smell, according to a UK study from October. We require better provision of public health and an adequate plan to address the ongoing obesity pandemic.
We also need to start thinking more critically — and speaking more cautiously — about Long Covid, considering ‘at least some people who identify themselves as having Long Covid appear never to have been infected with the SARS-CoV-2 virus.’
The pandemic calls for a new social contract to be negotiated in Ireland that acknowledges republican values of Non-Domination; Mixed Government and tolerance of Obstreperous Citizens. The French COVID-19 Scientific Council led the way in a paper for The Lancet:
it is time to abandon fear-based approaches based on seemingly haphazard stop-start generalised confinement as the main response to the pandemic; approaches which expect citizens to wait patiently until intensive care units are re-enforced, full vaccination is achieved, and herd immunity is reached.
They continue:
Crucially, the new approach should be based on a social contract that is clear and transparent, rooted in available data, and applied with precision to its range of generational targets. Under this social contract, younger generations could accept the constraint of prevention measures (eg, masks, physical distancing) on the condition that the older and more vulnerable groups adopt not only these measures, but also more specific steps (eg, voluntary self-isolation according to vulnerability criteria) to reduce their risk of infection. Measures to encourage adherence of vulnerable groups to specific measures must be promoted consistently and enforced fairly. Implementation of such an approach must be done sensitively and in conjunction with the deployment of vaccination across the various population targets, including all generations of society.
They argue against reliance on lockdowns:
Using stop-start general confinement as the main response to the COVID-19 pandemic is no longer feasible. Though attractive to many scientists, and a default measure for political leaders fearing legal liability for slow or indecisive national responses, its use must be revisited, only to be used as a last resort.
To date, many on the Irish left appear to have had their heads in the sand promoting a Utopian ZeroCovid solution. This should give way to a more balanced appraisal that considers the interests of all of Irish society. With the youngest population in Europe, and as one of the richest countries, the Irish government could have preserved a far higher standard of living for the population during the pandemic. We now need to draw up a social contract that takes a more balanced approach.
Featured Image: Daniele Idini
[i] O’Toole, Fintan (editor), Up The Republic: Towards a New Ireland. Faber and Faber, London, 2012, p.1-52.
[ii] Arendt, Hannah, The Origins of Totalitarianism, Penguin, London, 1966, p.22
[iii] Eric Hobsbawm, How to Change the World, Tales of Marx and Marxism, Little, Brown, London, 2011, p.79
Editor’s Note: Having previously published Vaccination: A Matter of Trust with Caveats, we now anticipate objections from some readers to an article that may provoke vaccine hesitancy, at a point when rapid rollout to the entire adult population is widely touted as the only path out of interminable lockdowns. The author of this article, Dr. Marcus de Brun, however, is a medical doctor, and prior to his resignation last year– in protest against the government’s handling of the pandemic – a member of the Irish Medical Council. He also holds a first class degree in microbiology from TCD. Thus, we believe it is incumbent on Cassandra Voices as ‘a home for independent voices to inspire new thinking’ to provide this platform for him to articulate fully a public stance that he would not vaccinate a healthy person with any of the four vaccines currently on offer in Ireland. All the more so in a period of crisis, we maintain it is vital to give space to informed arguments that go against the grain. We invite comment and/or rebuttal, and ask if you appreciate this article that you offer a contribution to this publication, either through signing up with us on Patreon or through a single donation Buy Me A Coffee.
Having recently stated publicly that I would ‘not administer a genetic-vaccine to a healthy animal, never mind a ‘healthy human being,’ I have been asked by friends (and foes) to clarify this statement, and will attempt to do so here.
Speaking as a qualified Microbiologist, l would NOT administer an mRNA vaccine to a healthy animal, never mind a healthy human being.
At present, vaccines produced by four companies (Pfizer, Moderna, Astra Zeneca and Johnson & Johnson) are available on the European market. All four are ‘genetic vaccines’ in that they are composed of synthetic DNA or RNA that is contained within a membrane or shell. In construction and appearance the vaccine is very similar to the SARS-CoV-2 virus responsible for the coronavirus disease known as Covid-19. The vaccine gains entry to human cells by a process that is almost identical to the manner by which a virus generally gains access to host cells. This process is called ‘transfection’.
Each of these vaccines work by introducing either DNA or RNA into host cells. The genetic material then instructs host cells to make a piece of the coronavirus (the spike protein) that is then released into the blood stream or tissues. There, the spike protein will trigger an immune response. Following this immune response, the vaccinated individual will retain some immunity; they will have antibodies and white cells that can now recognise Covid-19 and attack it before it has a chance to cause a serious infection.
The AstraZeneca and Johnson & Johnson vaccines are DNA vaccines,[i] which transfect DNA into the Nucleus of host cells. The Pfizer and Moderna Vaccines are RNA vaccines, these transfect their RNA into the cytoplasm of host cells. The difference will be explained later; however, the initial process is the same: human cells take up synthetic viral genes, those genes then direct those cells to begin manufacturing the spike-protein of Covid-19. The cells will then release the nascent spike-protein into the bloodstream or tissues, where it will then function as a ‘traditional vaccine.’
In essence, the distinction between genetic-vaccines and ‘traditional vaccines’ is that the latter would involve a person being injected with killed or inactive virus or spike-protein, which would then cause our immune systems to mount a response. Each of these novel genetic-vaccines however, insert genetic material into human cells. These synthetic genes then ‘hijack’ those cells or ‘convert’ them to manufacture and release the spike-protein. With a genetic vaccine, pharma does not make the vaccine, our own cells are programmed to do the work instead, a process entirely different from that of a ‘traditional vaccine’.
Out with the Old…
For the first time in my medical career of some twenty years, I am presented with the apparent necessity of vaccinating young healthy people with experimental vaccines, against a disease for which they have little or no risk of suffering life-threatening,[ii] or even serious long-term[iii] illness. The vast majority of ‘vulnerable’ people to whom they might pass Covid-19 have already been either vaccinated or been exposed to the virus.[iv]
I have an article today in @statnews making the case that we need to start thinking more critically, and speaking more cautiously, about “Long COVID.” https://t.co/WCGxyxKe37
In Ireland according to our Central Statistics Office, during the past 12 months up to the end of January 2021; amongst the entire population of 1-24yr olds, there have been 55,565 PCR confirmed cases of Covid-19. Out of those cases, there has not been a single death recorded; from, by, or associated with Covid-19.[v] It has been reported that a single Covid-related death in this cohort (1-24yrs) did occur in February of this year. However, this has yet to appear in the figures published by the CSO.
Young nurses, medical staff, care workers, are being pressured into taking a vaccine they probably don’t need themselves, despite residents under their care having been almost all vaccinated already. Now Covid-19 genetic-vaccines are being tested upon children as young as six months old.[vi]
We are where we are today because of the GREATEST Political and Scientific Blunders in History!
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A Scarcity of Serious Questions? Or a Scarcity of Serious Media?
The justification for many, if not most, policies during this crisis has largely been based on ‘mortality data’. In contrast, Swedish authorities have enforced relatively few restrictions, nor made masks mandatory. In Ireland, the CSO indicate that 92% of all Covid-related deaths have occurred in those over 65 years of age.[vii]
In Sweden that cohort of their population is 3.17 times greater Ireland’s. Thus, if we roughly compare the Swedish mortality total (at the time of writing) of 13,262, to the Irish total of 4588, and if we then multiply the Irish mortality total by 3.17, we arrive at a figure of 14,544, which is significantly higher than the comparable Swedish total.
We are crudely, but reasonably, comparing ‘like with like’ to reveal glaring potential problems with our own relatively draconian Covid policies. When compared with Sweden, our own version of lockdown seems to have had no benefit in terms of preventing mortality. It might not be unreasonable to assert that our stricter policies may have contributed to a relatively higher mortality. Yet, perhaps the biggest question here is: why are there so few questions being posed in the media in respect of the efficacy of masks, lockdowns or vaccination policies?
On the rare occasion questions are raised in our national media, it as if an ‘anti-vaxxer’, ‘right-wing loon’, or political extremist is trying to gate crash what might otherwise be a rather sedate and respectable party.
Pro-Vaxxer
In the good old days before Covid, in Ireland, and around the world, we only vaccinated those who were vulnerable to, or at risk from a specific disease. We still vaccinate children against an array of illnesses that adults have not been, and are not routinely vaccinated against; Rotavirus and Meningitis B are but two obvious examples. Adults are equally susceptible to infection by either, but they are not as vulnerable to serious illness, and so are not vaccinated. Previously, we only ever vaccinated the vulnerable and those at risk; recently, however, that good science and common sense has been turned on its head.
It is suggested that we should vaccinate young healthy people who have little if anything to fear from Covid-19. A paediatric genetic-vaccine is expected to be available later this year. It is argued that even though children are generally not susceptible to serious disease, they should be vaccinated in order to protect the vulnerable and achieve ‘herd-immunity.’ In the meantime, the vulnerable have in large part already been either been vaccinated already, exposed or sadly passed away.
If getting the disease does not give immunity, how do you think that a vaccine that makes the same spike protein as the virus makes will give immunity?
If getting the disease does not give immunity, how do you think that a vaccine that makes the same spike protein as the virus makes will give immunity? https://t.co/UGlSeE8LhW
Between March and June, 2020, 96% of additional deaths related to COVID-19 in Europe occurred in patients aged older than 70 years[ix] We have clearly lost sight of whom we are trying to protect, and what we are trying to protect them from. Presently we have a national obsession with conformity, and an ostensible adherence to guidelines. Despite empirical truths, and substantial contrary evidence, we are being corralled into what increasingly appears to be a specific belief-system surrounding Covid-19, and its threat to the entire population.
Those who have read George Orwell’s Animal Farm (1945) will be familiar with the threats issued to the hapless animals: ‘Jones the farmer will return, and destroy all of your good work!’ In contemporary parlance, he will return with ‘Long Covid,’[x] and frightening ‘New Variants’ with him.
Politicians have applied policies that are in keeping with this notion of ‘universal severity’ in response to a virus where 86% of those infected did not have virus symptoms, such as cough, fever, and loss of taste or smell., according to a UK study from October.[xi] Many of our Covid policies arrive with the benefit of preserving established governments from demonstrations and assemblies calling for policy revisions and or enquiries.
My own calls for a public enquiry into nursing home deaths, or my pleas on behalf of common sense and natural science, are at best ignored by media. As are those of colleagues who feel and believe as I do, including Limerick GP Dr. Pat Morrissey, and Wexford GP Dr Gerry Waters, who was recently suspended by the Medical Council for refusing to adhere to and promote current public health guidance. Others who have openly spoken out against current policies have been subjected to investigation by the Medical Council, and ongoing vilification by many of our peers. Speaking out returns precious few short term dividends.
Throughout much of Europe since the outset of the crisis, governments, like our own, are presently controlled by proxy scientific-panels or unelected expert committees. Governments claim to be simply ‘following their scientists advice,’ whilst the scientists insist that they are merely informing the government and not directing government policy. In this apparently blameless political ‘no man’s land’, the stage is perfectly set for blameless political atrocities.
War of the Words: ‘Genetic vs ‘Traditional’
Many scientists and physicians prefer to describe most Covid-19 vaccines as ‘gene therapy’. It is a phrase that no doubt serves as much to antagonise proponents, as it does to inform them. However, it is as good a place as anywhere to start.
Genetic vaccines are certainly not ‘traditional’ vaccines. The licence for their use against Covid-19 throughout Europe was granted under emergency legislation that permits manufacturers to skip phase 4 safety trials that would have otherwise delayed their distribution. Advocates insist that skipping this final phase was absolutely necessary to resolve the current crisis.
There is much to this argument, and we will not dive into it here. However, one point should be made. There are at least two off-patent (cheap and safe) drugs, Hydroxychloroquine and Ivermectin, that may be effective in treating Covid-19. These drugs are not, however, licensed for use in treating Covid in many Western countries, (particularly the wealthier ones who can afford the novel vaccines).
If either, or both, drugs had been licensed, this might have proved an obstacle to the granting of emergency use licences for Covid-19 vaccines. The reason for this is that grounds for emergency licensing of genetic-vaccines are substantially reinforced, as long as there are no other pharmacological treatments available at the time.
Edward Jenner (1749-1823)
A Traditional ‘Vaccine’
In China the practice of inoculation against diseases such as smallpox was established as far back as 200 BC.[xii] It is likely that traditional medicine, tribesmen and ancient civilisations used, or at least inadvertently ‘knew’ something of the benefits of limited exposure to a disease, in order to establish some degree of immunity.
Our own modern era of the ‘traditional’ vaccine begins when Edward Jenner (1749-1823) noticed that milkmaids appeared to be relatively immune to smallpox, a viral illness that was, in Jenner’s day, responsible for widespread suffering and death.
Jenner observed that something was being transmitted from the cows to the milkmaids, effectively protecting them against smallpox. Cows contract cowpox. It’s not the same disease as smallpox, but as the respective viruses are so similar, whenever the hands of a milkmaid came into contact with a blister or pox on the udder of a cow infected with cow-pox; the milkmaid would be exposed to this very similar virus.
In these instances the cowpox virus or ‘pieces’ of it, would enter the milkmaid’s blood stream through a cut or minor abrasion on her hands. The virus would be identified by her immune system as a ‘pathogen’ or disease-causing agent. White cells would attack the cowpox virus, causing it to break apart. Those same white cells would manufacture antibodies; little Y-shaped proteins that will stick to surface-proteins on the virus, and cause it to be directly destroyed, or recognised by other white cells that will mobilise to destroy it.
All of this complex immunology would of course be occurring within the milkmaid’s blood, whilst she happily milked her cows. She might notice a slight blister, a little pus, or minor swelling around one of the abrasions on her overworked hands. The slight redness might be ignored, and would inevitably fade away. However this localised reaction would have heralded exposure to cowpox. The cowpox antibodies would then persist in her blood, remaining attached to the surface of many of her circulating white blood cells; protecting her or “vaccinating” her against small-pox.
If the milkmaid should later come into contact with smallpox, those newly formed cowpox antibodies would be ready to mount an early and more efficient immune response. Her antibodies to the cowpox virus could attach to the smallpox virus, recruit other white cells – killer t-cells etc – onto the scene, and mount a pre-emptive response. This would be fast enough to eradicate the smallpox infection before it had an opportunity to spread and cause severe illness or death. It was Jenner’s genius that ultimately brought this reality to light.
Jenner collected some of the pus that oozed from the udders of cows infected with cowpox. He swirled it about in a drop of water, placed it in a glass vial and then offered it to the world as the prevention for small-pox. Half a century later Louis Pasteur coined the phrase ‘vaccination’ after vacca, the Latin for cow. The paradigm in respect of human medicine and public health had shifted forever.
Louis Pasteur.
Perhaps the real hero of the vaccination story was an eight-year-old boy by the name of James Phipps, the son of Jenner’s gardener. On May 14th 1796, Jenner made a small incision into James’s arm, and rubbed in a drop of his magical ‘pus-paste’, making little James the first to be given a vaccine in the modern sense.
Thankfully, little James proved immune to the various small-pox ‘exposures’ and challenges that Jenner then came up with. At the time small-pox was responsible for almost 10% of annual deaths in England. Jenner sent his results in a paper to the Royal Society for publication, but his paper was ignored.
Having had the audacity to suggest pus from an infected cow’s udder, as a cure for smallpox, Jenner was at first dismissed as an eccentric by his peers. Yet, rather than disappearing into obscurity, he persisted. He vaccinated a further twenty-three people, and having seen little James survive, he even included his own eleven-month old son Robert, in this first ever vaccine trial.
At that stage the medical establishment found it impossible to ignore his findings, which soon attracted widespread interest amongst the medical fraternity. However, it was not until 1840, some forty-four-years after his first attempt to publish his results, that the British Government began offering Jenner’s vaccination, free of charge, to the general public.
The same but different
Since Jenner’s day, ‘traditional vaccines’ have functioned in precisely the same way. Pharmaceutical companies take a virus or bacterium, they break it up, kill it, or leave it intact but render it weaker or ineffective ‘the same but different.’ They then take the bug (or pieces of the bug), swish them around in a little drop of water, add in a few elements that act as preservatives and immune-stimulants; then we doctors inject those pieces into people, thereby preventing many from succumbing to various infective diseases. The vaccination exposes us to a bug or pieces of a bug causing our immune system to generate antibodies and white blood cells that will persist in our circulation and be ready to launch a pre-emptive strike against the bug or a similar bug if it is encountered again: we have, in essence, become immune.
So what is different about genetic-vaccines? Well here’s where the story becomes a little nuanced. Let’s try to put it in terms we might relate to.
To begin with we must remind ourselves that: all living things are composed of cells, which is perhaps the most basic tenet of biology.
Image of a recreated 1918 influenza virus.
Viruses are not considered ‘living things’, because they are not ‘cells’ and neither are they made up of cells. They are formally referred to as ‘obligate intracellular parasites.’ They only become ‘alive;’ and can only replicate, after entering host cells, at which point they replicate or multiply within host cells. Once inside a cell the virus hijacks the cell’s own processes for making things that the cell needs for itself. The infected cell then becomes a virus factory, it swells with new virus particles, until it bursts, dies, and releases its payload of new virions into the bloodstream, or fluid outside of the cell membrane.
It is only when a virus is outside the cell, within the blood stream or tissues, that it might be recognised by white cells or antibodies, and become the subject of an immune response. When a virus is inside one of our cells, there are some discrete ways this cell can let other cells know that it has become infected; there are means by which the immune system detects that one of our own cells has a virus inside it. However, these are comparatively slow, indefinite and uncertain processes and will not be discussed here. The major and most important way the immune system clears viruses is by getting at them before they get inside our cells.
Once a virus is inside a cell, for the most part, it is hidden from the immune system. This point will be crucial to understanding the distinction between a genetic vaccine, and a traditional vaccine.
All Cells Look a Little, or a Lot, Like a Fried Egg:
Under a microscope, all cells appear a little like fried eggs. Almost all of them have the same basic plan, the yellow yolk being the nucleus; the white of the egg, the ‘cytoplasm;’ and the outer margin of the fried egg (the crispy brown edge) being the ‘cell membrane’ or wall surrounding the cell. To learn the basics of how genetic vaccines work, we need only refer to this analogy, but we must understand our ‘egg’ a little better before we put the toast on.
The yellow yolk, or nucleus, contains all of our DNA. To understand what DNA looks like, imagine your fly, not the one buzzing at the window, but the zip on your trousers. It is composed of two sides or strands that are linked together when your zipper is up, and separated when your zipper is down.
DNA is like an extremely long length of closed zip. Imagine this super long ‘zip’ coiled into individual space-saving packages, like neat balls of wool. Each of these little packages is called a chromosome and (with the exception of sperm cells and egg cells) the nucleus of each of our cells contains forty-six of these little balls of wool; twenty-three from mum, and twenty-three from dad.
All forty-six are packed into the nucleus, the yellow yolk of our analogous egg. When we, or one of our cells, needs something; a protein, a hormone, a replacement part etc., the information to make what the cell needs (the recipe for all of life’s necessities) is coded for in that length of closed zip, our DNA.
Each of the ‘teeth’ along the length of the zip strands, represent a single letter of the genetic code. An entire message may contain many letters, or teeth, along a specific length or piece of the zip. The lengths of zip that contain messages (or recipes) are called our ‘genes.’
The ‘message’ within a gene is like a recipe in a cookbook. It contains a coded instruction for how to make the protein, enzyme etc., or whatever it is that the cell wants or needs. The DNA code is in the nucleus, and the basic ingredients are located in the cytoplasm, and it is in the cytoplasm (the egg-white) where the item required is assembled and manufactured. The raw materials for manufacture get into the cytoplasm, when they are absorbed across the cell membrane (the crispy brown bit at the edge of our fried egg). These raw materials are the amino-acids, sugars and vitamins etc., that we receive in our diet.
To kick off the process, when a cell needs to make something, a signal is sent from the white of the egg (the cytoplasm) into the nucleus. That signal makes its way to the ball of wool or chromosome that contains the particular recipe, or code for the ingredients that will make up whatever is needed by the cell. When the signal reaches the chromosome containing the particular recipe or gene, the ball of wool is loosened slightly, and a relatively small length of closed zip (or DNA containing that recipe), is unzipped. One side of the opened zip is then copied into a piece of mRNA.
That copy of one side of the unzipped zip is called messenger RNA. In most textbooks it (the mRNA) looks exactly as I have described it: a single side of a zip. This messenger RNA then exits through pores in the nucleus. It enters the white of the egg, where this mRNA ‘recipe’ is then read or translated, and whatever it is the cell needs can now be manufactured within the cytoplasm or the white of the egg.
The Ribosome
When the strand of messenger RNA leaves the nucleus and enters the cytoplasm it is immediately found by a fascinating little cytoplasmic protein called a ‘ribosome’. The ribosome attaches to the mRNA. It then slides along this single strand of zip, and as it does so, ‘reads’ the code, and then makes a little strand, like a bead of pearls (a polypeptide). That strand of polypeptide then curls and folds itself into a little ball or blob; and this little blob of protein, is the very thing that the cell was looking for in the first place.
It might be a structural protein, an enzyme, a building block, a replacement part, or whatever. When the ribosome slides along the piece of mRNA it makes this new little string that will ultimately fold upon itself to become the required product. This wonderful orchestral process is as ancient as life itself and is called ‘translation.’
It is one of the rare occasions when jargon makes sense, for the little piece of mRNA, has indeed been ‘translated’ into a protein or ‘final product’ by the ribosome. The cell has now manufactured the thing that it needs, and after a few translations, the mRNA then degrades. No more ribosomes can attach to it, and no further product can be manufactured from it. If the cell wants another product it must send another message into the nucleus and call for another mRNA copy to be made in the nucleus and sent into the cytoplasm. It is a beautifully organised process, integral not simply to human life but to all life on the planet.
How Does a Genetic-Vaccine Work?
If you got all of that, you have grasped some of the fundamentals of cell biology and we are now able to ask: how does a genetic vaccine work?
Most of us have seen an image or an artist’s impression of what a coronavirus looks like. A little ball, covered in spikes, like a medieval weapon swung from the end of a chain. Inside this little ball are the virus’s own genes. These genes are in the form of strands of RNA; the same type of RNA that is made in the nucleus of our cells, and sent into the cytoplasm for the manufacture of all ‘things’ that the cell needs.
SARS-CoV-2
The main difference between the RNA strands within a coronavirus, and those that naturally emerge from the nucleus of our own cells, is that coronavirus RNA does not code for ‘things’ that our cells might need. On the contrary, it codes for pieces that make up the coronavirus itself.
When a coronavirus binds to the outside of one of the cells in our respiratory tract, it releases its RNA into those cells – into the white of the egg – and there, instead of making proteins that are needed by our cells, our ribosomes attach to their viral RNA and begin to manufacture (or translate) proteins that make up the physical structure of the virus. The host cell has now becomes a virus-making factory; the cytoplasm swells with viral particles; the cell bursts, and thousands of new viruses (virions) are released into the bloodstream, or the fluid that lies outside of the cell membrane.
A genetic vaccine looks like, and functions, in almost exactly the same manner as the coronavirus itself. If a genetic vaccine could be visualised, it would look like a little sphere that encapsulates a piece of viral RNA or DNA (depending on which of the four vaccines we are considering). The role of the sphere is to protect the RNA or DNA inside the vaccine, and, most importantly, to bind it to human cells in a manner that will allow the piece of RNA or DNA to enter host cells at the site where the ‘vaccine’ is injected.
For an RNA containing vaccine (Pfizer & Moderna) once the vaccine RNA gets inside our cells, our ribosomes attach and translate the RNA into a piece of the virus (one of the spike proteins). The host cell will then swell with spike proteins, and release them into the blood stream or body fluids outside the cell. There, the spike-protein will trigger the same immune response that Jenner and the traditional vaccines make use of.
For DNA vaccines (Johnson & Johnson, AstraZeneca) the vaccine-DNA makes its way into the nucleus of our cells where it begins working (and is treated the same as our own DNA). It is copied into a piece of mRNA that will then travel into the cytoplasm and be translated by ribosomes into spike-proteins. Because genetic vaccines cannot infect cells, the process whereby a genetic-vaccine enters host cells is referred to as ‘transfection’.
It is only after the transfected host cell releases spike-protein into the blood stream that our genetic-vaccine begins working in the ‘traditional’ way. In reality, it is the cellular process for the manufacture of things which has been hijacked, and the ‘traditional vaccine’ is being made inside one’s own cells. The ‘vaccine’ is released into our blood stream in the same way that a cell infected with a virus releases new virus into the blood stream or tissues.
The final result might be the same, however, where a genetic-vaccine is different is in its mechanism it operates inside cells at a level of intimacy that Jenner could never have imagined. Because DNA vaccines enter the nucleus of our cells, and are treated as our own DNA, they come with a risk of damaging our own DNA, causing mutations, including, potentially, cancer. The potential is indeed an established fact. It is no less established than the fact that there is a link between smoking and cancer.
Consider when a piece of synthetic DNA comes within intimate proximity of a relatively enormous coiled ball of DNA that is dynamically unwinding and unravelling in response to the daily activities of the cell. Is there a chance that this relatively small piece of synthetic DNA might become incorporated into or interfere with the normal function of our own DNA? Before Covid, the answer was an emphatic yes. However of late, the mere suggestion will undoubtedly be treated as something of a ‘conspiracy theory’.
It is for this and other reasons that genetic-vaccines have not been previously licensed for use in humans prior to the current crisis. Thus, a 2013 paper[xiii]published in Germs, the respected Journal of Infectious Diseases lists the established disadvantages of DNA vaccines.
Of the 4 Genetic Vaccines currently available, 2 are RNA based (Pfizer/Moderna), & 2 are DNA based (AstraZen/J&J). Here's what non-bias (pre-covid) Science, states about the disadvantages of DNA Vaccines:
Very limited forms of gene therapy are available in the treatment of terminal cancers. However, pharmaceutical companies have not been able to market this form of medicine, outside of the laboratory, on human populations.[xiv] A cynic might reasonably argue that companies are exploiting the current crisis in order to expedite safety trials and open the market for ‘gene-therapy’.
There is nothing new here, this type of therapy, whereby patients are administered the gene for a missing or desired product, has been in development for several decades. The major difficulty for pharmaceutical companies has been how to get it out of the laboratory and past the paralysis of safety trials. It is certainly easy to see that if our cells are programmed to make and release spike-proteins, they can also be programmed to release other kinds of proteins, drugs and potential therapies directly into the human blood stream or tissues.[xv] Getting this type of therapy past regulators, and avoiding meaningful debate, has, (for better or worse), clearly been accomplished within the context of the current crisis.
From a simple economic perspective, if human cells can be programmed to take on the role of manufacturing the ‘drug’, numerous difficulties in respect of production, costs, delivery, and even safety trials, are relatively easily overcome. The paradigm shift that resulted from Jenner’s development of vaccination could pale into insignificance compared to the potential game changer of genetic-vaccine.
If, indeed, these vaccines are going to protect people from Covid-19, and they come with the added benefit of paving the way for novel therapies, why are people like me getting our proverbial knickers in a twist?
Again the answer is not that complicated. The cellular process of ‘translation’ that is being ‘hijacked’ by the relevant pharmaceutical companies, does not belong to them, to our respiratory cells, or even human cells. As mentioned already, it is a process that belongs to ALL cells, in ALL species. In essence it ‘belongs’ to all living things in Nature.
If anything happens to go wrong, the consequences are not limited to human beings, as the process being ‘hijacked’ is not exclusive to us. It ‘belongs’ to all life on Earth. The consequence of error, may extend further than a little nausea or swelling at the injection site.[xvi] Potential consequences extend to all cells that utilize the same process, and come in contact with the manufactured DNA or RNA.
DNA or RNA? Red or White?
Whilst the potential for either of the two available DNA vaccines to integrate into, or damage, human DNA is well established; there is an argument being made that this cannot possibly occur with the two available RNA vaccines.
Generally speaking within our cells once RNA is copied or made in the nucleus it moves into the cytoplasm. It does not travel backwards. RNA does not move back inside the nucleus and incorporate into our DNA. However, the key words here are: ‘generally speaking.’
Nature (generally speaking) blocks this possibility because the copied RNA that exits the nucleus, is different to DNA. It is an RNA copy of the DNA, the RNA cannot bind or interact with DNA. In the first instance RNA is a single stranded copy of one side of the zip. In the second instance the ‘teeth’ on the newly copied RNA are slightly different. They are tweaked with a sugar molecule called ribose, they are ‘ribosylated’ and therefore cannot readily recombine with DNA. (The ‘R’ in RNA simply means Ribosylated Nucleic Acid.)
The RNA does indeed code for the same message that is contained within the DNA, but the teeth, or the letters of the RNA code, are slightly different. RNA does not travel backwards and interfere with DNA. Generally speaking they are incompatible, and cannot interfere with each other. Therefore, when the vaccine makers insist that the pieces of RNA that they have transfected into our cells do not interact with our DNA; well, they aren’t spoofing. It doesn’t normally happen that RNA interferes with DNA.
So that’s what it says on the tin. However, there are two points that must be considered before we take this claim at face value. The first is a question of ‘precedence’ and the second is a question of scale.
Does it happen in humans and in Nature that RNA can travel backwards into the nucleus and interfere with or incorporate into DNA? The simple answer to this question is a definite yes! RNA can and does travel backwards to incorporate itself into our DNA. This retrograde move, (where RNA sequences become incorporated into DNA) is called reverse-transcription. The reason for the use of ‘retro’ in the word retrovirus, is because retroviruses, and many other viruses, make use of reverse-transcription, converting RNA into DNA that will then integrate into our own DNA.
HIV and HTLV (a human virus that causes t-cell leukaemia) are examples of viral infections, where RNA is converted backwards into DNA which then ‘interferes’ with our own DNA inside the nucleus of our cells. These viruses contain RNA, and they also carry an enzyme called ‘reverse transcriptase’. This enzyme converts RNA backwards into DNA. Retroviruses and other viruses (such as Hepatitis B) introduce the reverse-transcriptase enzyme into our cells when they infect them.[xvii] Furthermore, our own cells normally produce and use this enzyme (reverse transcriptase) inside the nucleus, where it has some ‘house-keeping’ roles in maintaining our own DNA.[xviii]
Perhaps even more interesting is the fact that within the human genome some 8% of our DNA is composed of DNA that was originally viral RNA. Infections with RNA viruses whose genes have since become permanently incorporated into our own DNA. These sequences are called ‘Human Endogenous Retroviral Sequences’ or HERVS.[xix] Many of them persist within our genome because they may code for proteins or things that are likely to be of some benefit to us; genes brought into our genome from outside the cell, via the natural, dynamic interaction between viruses, retroviruses and human DNA.
Many more of these endogenous retroviral (originally RNA) sequences are mysteriously redundant, and science is yet to learn of their function in sickness or in health. The fact remains that they are present; been present for countless millennia; may be integral to our evolution as a species; and are certainly with us ‘until death do us part.’ They should serve to remind us that there is a long established history of communication between viral and human genetics; an interaction that we should attempt to understand before it is blindly manipulated.
Interconnectedness
Too often viruses are portrayed as static structures, distinct from our own genetic material and distinct from one another. This is quite simply a rather primitive concept, the same kind of thinking that removes human beings and the consequence of our actions from Nature. It is part of the reason we remain largely incapable of seeing and appreciating the vast web of interconnectedness that dependently joins us to whales, rain forests, and even viruses.
We depend upon viruses for our genetics, as we depend upon yeast for our beer. Often viruses depend upon each other to cause infection. In certain instances, if a particular virus is missing something, a part or component (without which it is defective or deficient), the missing part is supplied by another helper-virus. There are helper-viruses, and there is an entire family of viruses (dependoviruses) that are entirely dependent upon assistance from helper-viruses. For example, in Humans, Hepatitis D virus is activated, only in the presence of Hepatitis B virus. Essentially, in order to function, the D-virus ‘borrows’ some missing parts from the B virus.
In short, viruses are not ‘monogamous recluses’: interacting with each other; helping each other; interacting with our genetic material within the cytoplasm and within the nucleus. It does not matters if that genetic material has come from the nucleus of our own cells, or been synthesized in the labs at Johnson and Johnson.[xx]
A Question of Scale
There is no such thing as a ‘perfect process’. Do something for the first time and you might do it right, do it right enough times, and you will eventually do it wrong.
When vaccine RNA or DNA hijacks a natural cellular processes and transforms the cell to vaccine or spike-protein production; how many times does this ‘event’ occur in the tissue of the person who has thus been vaccinated? Thousands, or several thousands of times? How many times has it occurred when several billion people are vaccinated? I don’t know the answer to this question. However, when a process is repeated billions of times, mistakes are no longer ‘possible’, they are inevitable. Such mistakes or mutations are not only inevitable but are essential, lying at the heart of evolution itself.
The End is Nigh?
There is certainly a mountain of spin and delusion on either side of the ‘genetic-vaccine’ or ‘gene-therapy’ debate, and we must keep matters in perspective. Genetic modification is here to stay, for better or for worse. The argument in respect of unforeseen genetic consequence to ourselves and/or other species is an old one. It began with ‘Dolly’ the sheep, and has raged for some time around the desirability of genetically modified foods.
Ironically, the introduction of synthetic genes into vegetables, created something of an international furore, yet the transfection of synthetic genes into millions of regular human beings has created far less controversy. Debate or discussion on the subject of genetic modification or therapy, its necessity, utility, or potential harm, is long overdue; although perhaps it might be a case of too little, too late.
Today, many of the foods we eat have been genetically modified to some degree. Genetically modified food is, however, met with and processed by the acid and digestive enzymes in our guts. The synthetic genes in GM products do not (as far as we know) enter our cells, they do not attempt to manipulate our own cellular or genetic processes.
There is clearly an urgent need to revisit this debate in light of these new vaccines. The battle may have been lost in respect of GM crops, but there is a reasonable argument to be advanced this time round as ‘human genetic processes’ are being tampered with, rather than sheep, beetroot or soya beans.
The Right Hashtag?
In recent years discourse and protest have become strangely predictable, organised around or stimulated by whatever happens to be trending on social media. It seems the right hashtag hasn’t been developed for ‘debate’ in respect of current pandemic policy, even as that policy extends into the function of our own cells.
How many people in Ireland, or around the world, know how a Covid vaccine work? How many clinicians are aware for that matter? When debate does erupt in relatively small pockets around the country it is hijacked by extremists or dismissed as being organised and attended by extremists. Social media appears to be moderating our behaviour to a greater degree than even genetics.
The health of our society depends far more on constructing a more honest and happier version of ourselves. We need to re-evaluate materialism, define happiness, reduce consumption, eat less (or no) meat, take plastics out of our food chain and ecosystems, restore and preserve habitats, protect and understand a biodiversity upon which we are entirely dependent. All of this, and more, is not contingent on genetic modification, no more than it is dependent on us getting to Mars.
Therefore, for the reasons I have outlined, I would not inject a healthy animal with an experimental genetic-vaccine, never mind a healthy human being.
[i] Jonathan Corum and Carl Zimmer, ‘How the Oxford-AstraZeneca Vaccine Works,’ New York Times, March 22nd, 2020, https://www.nytimes.com/interactive/2020/health/oxford-astrazeneca-covid-19-vaccine.html
[ii] Smriti Mallapaty, ‘The coronavirus is most deadly if you are older and male — new data reveal the risks’ August 28th, 2020, https://www.nature.com/articles/d41586-020-02483-2
[iii] Adam W. Gaffney, ‘We need to start thinking more critically — and speaking more cautiously — about long Covid’ Statnews, March 22nd, 2021, https://www.statnews.com/2021/03/22/we-need-to-start-thinking-more-critically-speaking-cautiously-long-covid/
[iv] Conor Pope, Vivienne Clarke, ‘Vaccination rollout in nursing homes almost complete, HSE says,’ February 12th, 2020, Irish Times, https://www.irishtimes.com/news/health/vaccination-rollout-in-nursing-homes-almost-complete-hse-says-1.4483250
[vi] Moderna Announces First Participants Dosed in Phase 2/3 Study of COVID-19 Vaccine Candidate in Pediatric Population https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-first-participants-dosed-phase-23-study-0
[ix] ‘Immune evasion means we need a new COVID-19 social contract’, The Lancet, February 18th, 2021, https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00036-0/fulltext
[x] Jeremy Divine, ‘The Dubious Origins of Long Covid’, Wall Street Journal, March 22nd, 2021, https://www.wsj.com/articles/the-dubious-origins-of-long-covid-11616452583
[xi] Angela Betsaida B. Laguipo, ‘86 percent of the UK’s COVID-19 patients have no symptoms,’ News Medical Life Sciences, October 9th, 2020, https://www.news-medical.net/news/20201009/86-percent-of-the-UKs-COVID-19-patients-have-no-symptoms.aspx
[xii] The History of Vaccines, Chinese Smallpox Inoculation, https://www.historyofvaccines.org/content/early-chinese-inoculation
[xiv] Kristina Fiore, ‘Want to Know More About mRNA Before Your COVID Jab?’ Medpage Today, December 3rd, 2020, https://www.medpagetoday.com/infectiousdisease/covid19/89998
[xv] Nature Reviews Drug Discovery volume 17, pages261–279(2018)
[xvi] Nicola Davis, ‘Covid vaccine side-effects: what are they, who gets them and why?’ The Guardian, March 18th, 2021, https://www.theguardian.com/world/2021/mar/18/covid-vaccine-side-effects-what-are-they-who-gets-them-and-why
[xvii] Medical Microbiology. 4th edition (Chapter 62).Galveston (TX): University of Texas Medical Branch at Galveston; 1996.
[xviii] Proc Natl Acad Sci U S A. 1986 Apr; 83(8): 2531–2535.
doi: 10.1073/pnas.83.8.2531, https://www.nature.com/articles/1205081
[xix] PMCID: PMC7139688 PMID: 32155827 Human Endogenous Retroviruses (HERVs): Shaping the Innate Immune Response in Cancers.
[xx] Knipe, David M.; Howley, Peter M. (2007). Fields Virology (5th ed.). Lippincott Williams & Wilkins. pp. 126–7.
In August of last year I wrote an article pointing to the impending consequence of the Irish government’s rolling lockdown policy, ‘The Perfect Storm’[i] gathering on the horizon over the country. By that I meant a significant second wave of Covid-19 – to hit this winter. I made that prediction based on the following factors:
An elevated number of potential viral hosts, which is a consequence of suppression of natural-immunity.
Increased life of the virus in the external environment due to decreased daylight
Raised levels of social anxiety and subsequent susceptibility to illness/infection
Continued persistence of the virus at low levels within Irish society
The ‘storm’ made landfall at the start of January, leading to the imposition of an extreme lockdown for the third time – with children denied their constitutional right to an education – amid renewed fears the hospital system would be overwhelmed, as many elderly in care homes passed away once again.
Sadly, this ‘third’ wave actually commenced in week 48 of 2020 (22/11/2020), while the country was still under Level 5 Lockdown restrictions, according to a report by the HSPC.[ii]
Could additional deaths have been averted if the Taoiseach had not sought ‘a meaningful Christmas’; or if NEPHT’s advice had been followed to the letter – permitting house visits rather than opening restaurants and gastropubs[iii] at the start of December? Based on the HSPC report that seems doubtful. And I would question whether most Irish people would have willingly foregone sociability throughout the depths of winter – there was certainly no political clamour to cancel Christmas – having endured near-constant lockdown since March. But you never know.
Furthermore, without a Christmas spending spree many indigenous retailers and restaurateurs might have been forced out of business – to the unrestrained joy of Jeff Bezos, Tescos and the rest.
But in Ireland, as ever, we desperately need someone to blame third time round; anyone other than NPHET that has managed to preserve a reputation for scientific insight despite the damage it is doing to the country. So, instead of questioning the government’s response, youngsters – who may have availed of a brief chink of light to socialize – are scapegoated.
Other than that we find talk of selfish immigrants returning home over Christmas to see loved ones. And now attacks on those who escaped the overwhelming doom and gloom for a post-Christmas break. Yet, whatever one’s thoughts on the sustainability of flying, it is notable that just 1% of cases since the pandemic began have been traced to travel abroad.
Lockdown Policy
In the midst of any crisis scientific arguments compete to establish the best way forward. In the case of Covid-19 in Ireland ‘the argument’ has been remarkably one-sided. Discussions in the media are generally over the severity of lockdowns to be employed – this hitherto unheard of public health intervention with enormous collateral damage, which has somehow been normalised.
From the outset I have been convinced that the Irish government at the prompting of the WHO – along with most other Western governments – adopted an erroneous approach, based on a flawed epidemiological assessment, which led Leo Varadkar to suggest there could be a staggering 85,000 deaths[iv] in Ireland.
Virtually alone in Europe, the Swedish health authorities (relatively free of political interference) stood apart, refusing to lockdown in March, 2020. I would argue that this softer approach has been to the benefit of the vast majority of people living there – and may even lead to a lower death toll in the end – compared to the trauma of lockdowns experienced by citizens in most other European countries.
Notably, during the first wave almost 92% of confirmed deaths from Covid-19 in Ireland were among over sixty-five-year-olds,[v] and when this Irish cohort is compared to Sweden’s considerably older population a very different picture emerges; in contrast to the usual truck of ‘deaths per capita’ and ‘deaths per million.’
Hats off to the impressively organised states of Norway and Finland, where Covid-19 mortality has remained very low indeed, but vigorous track and trace strategy operating in these countries have proved ineffective elsewhere; even Germany is floundering this winter, having been locked down for months.
Revealingly, in March 2020 the Director-General of the Norwegian Institute for Public Health Camilla Stoltenberg[vi] recommended that her government should keep schools open – as in Sweden – and was advocating last June for a softer approach in the likely event of a second wave.
Now, as the death toll from Covid-19 in Ireland steadily converges with Sweden’s – especially when adjusted for the relative age of each population – it remains to be seen whether much-vaunted, but still experimental, vaccines will significantly alter the respective death tolls.
I maintain that a policy of keeping the Irish population under rolling lockdowns until the whole population is vaccinated will have a worse impact on the nation’s long-term health than any mortality or morbidity that may be avoided.
Zero Covid Utopianism
The frankly bizarre ‘option’ of Zero Covid-19 that has been grasped by some on the left, and the right, in Ireland is a form of Utopianism. It ignores the virtual impossibility of eradicating an aerosol, sub-microscopic pathogen such as Covid-19 from Ireland. Moreover, we remain one of the most globalized societies in the world with over half-a-million foreign born resident in the country[vii] and an Irish-born diaspora of three million;[viii] rely on international trade for most commodities; besides having a porous border to the North.
Moreover, New Zealand and Australia are currently enjoying summer, when respiratory viruses retreat. This seasonal effect is enhanced by a depleted ozone layer over the Southern Hemisphere – causing the world’s highest rate of skin cancers[ix] – which elevates the level of UV light that destroys viruses. Both countries are also insulated from the rest of the world by vast oceans and an uninhabited landmass. Even still, outbreaks occurred in New Zealand and Melbourne last winter, prompting draconian responses.
Notably, however, the maximum number of cases that Melbourne – with a population almost the size of Ireland’s – experienced in a single day was just seven hundred, and it required an extreme 112-day lockdown[x] – and/or the arrival of spring before an apparent elimination. In contrast, case numbers in Ireland have exceeded eight thousand in a single day.
Covid-19: Southern Dreaming
A Zero-Covid approach assumes the island of Ireland is sealed hermetically. Good luck with telling the DUP that they have to follow the rules of the South! And ‘success’ would presumably give way to a permanent state of siege against the viral dangers posed by the outside world.
At this point even New Zealand’s Prime Minister Jacinda Arden has had enough, acknowledging the long-term impossibility of pursuing Zero Covid she recently said: ‘Our goal has to be though, to get the management of Covid-19 to a similar place as we do seasonally, with the flu. It won’t be a disease that we will see simply disappear after one round of vaccine.’[xi]
Comparing Ireland to East Asian countries may also be inappropriate as, Wuhan apart, no single country in that region has experienced a significant outbreak. Notably, Japan, which has avoided locking down throughout the crisis experienced forty times as many flu and pneumonia deaths during that period. This suggests other factors – East Asia has been the geographic origin of several modern coronavirus epidemics – may be inhibiting the spread of Covid-19 there.[xii]
‘Zero Covid’ is as much a vote-winner, as a zero tolerance for crime or any other virtuous objective, but it’s political claptrap from an taxidermized left and a neoconservative right, furnished by scientists that seemingly have no conception of biological realities.
“The only thing that brings this deadly virus to our shores is human bodies.“
It is sobering what dark emotions the pandemic unleashed. I can only hope that in a year, to most, this statement will sound the way it would have sounded a year ago. https://t.co/GVRYtlVw1P
The success of any institution might be summed up by the notion that it is only as good as its ability to predict the future. Throughout human history we have had two powerful methods of prediction: science and religion. If not religion, we might define this in terms of ‘faith,’ or an ‘unscientific’ belief system of some kind or other.
If the Romans, the Egyptians, the Spartans, or the Native Americans, had done a ‘better’ job predicting the future, the world would be a different place. Thus, the success or persistence of any individual, nation, or civilisation, is based on an ability to reliably predict the future. Our faith in science is strengthened solely by this condition, and undermined when predictions go awry.
Galileo Galilei, 1636 portrait by Justus Sustermans.
Galileo’s prognostications in respect of the Earth and the Sun led him into conflict with the dominant powers of his day. The accuracy of his predictions disturbed the established cosmic order, as any heresy does. The predictions of Einstein had a similar effect on Newtonian Physics, and now Quantum Mechanics has become the sacred cow. Final judgements on the success or otherwise of policies are, of course, made through the prism of hindsight.
Two Schools of Thought
At present around the world there are two broad scientific schools[xiv] of thought in respect of how to respond to Covid-19. On one side there is a dominant view: that we are in the midst of a once-in-a-lifetime crisis, where humanity is dealing with a virus that will kill, and perhaps permanently incapacitate, many millions more than it has already done; and that the correct response for any government should be to impose a lockdown and mandate masks until the ‘scientific cavalry’ arrive, carrying their novel genetic vaccinations as shields to save the day.
On the other side there are the conspiracy theorists, Covid-deniers, and a minority of scientists who consider most most masks in use to be ineffective, and who argue that restrictions and lockdowns cause more harm than good. These scientists have advocated protecting the vulnerable and permitting an equilibrium of natural immunity to emerge within the non-vulnerable majority as the least harmful way forward.
The question for ordinary people and politicians, then, is where does the truth lie? Or, more accurately, who is correctly predicting the future?
When the dust settles in a few years, perhaps we’ll see that the truth lies somewhere in the middle. An appreciation of a middle way, or synthesis, is evident in Sweden’s chief epidemiologist Anders Tegnell’s acknowledgement in June that mistakes were made in the first wave.[xv] Such concessions to human fallibility seem to be the preserve of Scandinavian leaders. This may explain why increased restrictions have been introduced in Sweden during their second wave, though its government has refrained from imposing a lockdown, and the emphasis is still on personal responsibility.
Last April I resigned my position on the Irish Medical Council to the shock of family, friends and former colleagues. I did so because I believed a catastrophe was immanent, and that hundreds of nursing home residents would die as a consequence of political ineptitude and mass hysteria. As it transpired, 62% of deaths in Ireland occurred in this setting during the first wave of the pandemic, the second highest proportion in the world.[xix]
A prominent doctor has resigned from the Medical Council over the government's handling of #COVID19 in nursing homes.
Dr Marcus de Brun said residents have been treated as "an afterthough".
I take no comfort that my fears were realised, and have since also resigned as a contracted employee of the HSE. I could no longer, in good conscience, enforce guidelines upon staff and patients I do not consider either efficacious or ethical.
I would argue that a failure to conduct a proper inquiry into the decision-making that led to this carnage has led to avoidable mortality in this second wave in the care home setting. Any enquiry would surely have highlighted the inadequacy of safety protocols in these settings, and the absence of real expertise on NPHET.
Before my small Covid-19 rebellion, in March 2020, I circulated a paper on the response to Covid called The Mismanagement of Covid-19 in Ireland. Its premise was (and remains) quite simple: that Covid-19 is a viral illness with a mortality confined to a relatively small and manageable subset of our population.[xx]
I argued that Ireland’s gross demographic – the youngest population in Europe – is (and was) the key to navigating a safe path through the crisis. With a relatively low population of over sixty-fives – approximately 650,000 – this amounted to a manageable population of those truly vulnerable.
I also noted how, unlike during influenza pandemics of the past, children and young adults were not dying of this disease, and that the vast majority of adults without serious underlying conditions were also relatively (if not entirely) immune to significant consequence.
Long Covid
A current cause for concern with Covid-19, which may be deterring our governments from permitting younger people from resuming their lives is so-called ‘Long Covid,’ or Covid ‘Long Haulers’ as this is referred to in the U.S..
This is a condition that appears to fit within the category of a post-viral syndrome, or post-viral fatigue;[xxi] which is ‘a sense of tiredness and weakness that lingers after a person has fought off a viral infection. It can arise even after common infections, such as the flu.’
In October one of the leading advocates for Long Covid patients, and a firm advocate of draconian policies, Oxford University’s Professor Trish Greenhalgh clarified that Long Covid is only very rarely a long-term affliction:
The reviews we’ve done seem to suggest that whilst a tiny minority of people, perhaps one per cent of everyone who gets Covid-19, are still ill six months later, and whilst about a third of people aren’t better at three weeks, most people whose condition drags on are going to get better, slowly but steadily, between three weeks and three months.[xxii]
Fatigue is a symptom of a number of diseases—anaemia, depression, chronic infection, cancer, autoimmune disorders and thyroid disorders among them. But no apparent cause can be found for a state of extreme and disabling exhaustion that has acquired a number of names, the most generally accepted worldwide being chronic fatigue syndrome (CFS). In the UK, where it is (often incorrectly) known as ME (myalgic encephalomyelitis), 150 000 people are said to be affected. Other terms used for the condition are postviral fatigue syndrome (PVFS) and chronic fatigue and immune dysfunction syndrome (CFIDS).[xxiii]
So, we can conclude that Long Covid is hardly a new phenomenon, and while the pandemic is likely to create an additional burden on health services, the extent of the problem needs to be put in context: perhapsone percent of sufferers are still ill after six months.
Moreover, the impact of Covid-19 is significant heightened by environmental factors such as air quality[xxiv] and poor nutrition. I would argue, therefore, that the threat of Long Covid is insufficient grounds for closing universities and denying young people the chance of a social life beyond walking the block.
In my March paper I also observed that Covid-19 is a member of the coronavirus family responsible for many common colds,[xxvii] and that such viruses are seasonal, in that they are eliminated especially by increasing UV light (and the population’s tendency to retreat indoors). These were hardly earth-shattering revelations, and have been noted by many other doctors and scientists around the globe.
Globally, Covid cases peaked on Jan 7th and have declined 28% in three weeks.
This also appears to be a global decline, with cases falling from recent peaks on all continents: pic.twitter.com/c7vNfYZPlU
I also compared the population of over sixty-five-year-olds in Ireland, to the equivalent cohort in the U.K., noting there are roughly twenty-times the number of over sixty-five in the UK (while the overall population is less than ten times that number); so I assumed U.K. mortality would be in the region of twenty times that of Ireland’s.
In this respect, Ireland has performed significantly better than the U.K., but other factors such as population density and an elevated risk of severe disease among BAME groups[xxviii], may account for the higher relative death toll there. It should also be emphasised that the U.K. has almost the highest rate of mortality in the world.
Like many other doctors and scientists, I argued that in the absence of a proven cure or vaccine at that time for Covid-19, humanity is (or was) very much operating at the whim of nature. Thus, without a cure we were (and to a certain extent still are) subjected to natural forces, as I assumed this virus would spread widely through the population. All we could do, then, was ‘flatten the curve,’ protect the vulnerable, and await a safe vaccine.
At the outset of the crisis that was the mantra behind which the public united. Flattening the curve would reduce the rate at which the vulnerable would present for treatments in hospitals. This would protect the system form being overwhelmed, bringing an increased chance of survival for those badly afflicted.
‘Protect the NHS’ from collapse was a similar cry across the water. That made sense at the outset of the crisis. The reiteration of these ‘priorities’ might now illicit a yawn, as our national health authorities did not use the flattened time and space to increase ICU capacity substantially, which brings the ‘necessity’ of recurring lockdowns.
Hysteria
Since March of last year events have taken a strange turn. With fear and hysteria at the helm politicians lost their nerves. The mantra shifted from ‘flatten the curve’, to ‘protect everyone from this deadly disease,’ despite it becoming clear that the infection fatality rate (IFR) is considerably lower than the 0.9% assumed initially. Now a paper on the WHO website states that the infection fatality rate for the disease is less than 0.2% ‘in most locations.’[xxix]
Perversely, children have become the focus of inordinate efforts; locked indoors, locked out of school and forced into wearing masks. We have insisted upon protecting them from a disease that has not caused a single child death in Ireland throughout the entire crisis.[xxx]
Troublingly, when Covid-19 panic gripped the nation, politicians and mainstream media listened only to the scientific ‘authorities’ that fed the hysteria and justified everything from political incompetence to profligate expenditure. Hospitals were emptied in preparation for an approaching ‘tsunami’ of illness, as tens of thousands of deaths were incorrectly predicted by politicians and esteemed professors, all of whom continue to profess, and have even grown in esteem.
Covid patients were dumped from hospitals into Nursing Homes, and tests were withheld from residents lest they run short for the healthy-hysterical. The vulnerable were not only abandoned, but too many of them were crushed in the stampede.
Thus, there is the shocking case of a resident in a Meath care home discovered to have had a maggot-infested a wound.[xxxi] What began as a campaign to protect the vulnerable, had turned into nothing short of a manslaughter machine.
At the End of the Day
The natural endpoint for viral infection in respect of many viral pathogens is of course ‘herd immunity.’ This is the point where a sufficient proportion of a population have been exposed to and develop full or partial immunity to a particular pathogen, such that its rate of reproduction is below 1 most of the time.
With insufficient hosts, a virus can no longer spread easily. This is not full elimination but an endemic equilibrium within the population, with a certain annual death toll tolerated – such as is the case with influenza, which kills up to a thousand people a year in Ireland, despite the availability of a vaccine.
This natural evolution, or pathogenesis, is also helped along by the seasonal shift from spring to summer. Increasing daylight reduces the level of viral particles, and people spend more time out of doors, or ventilate their living spaces in warmer conditions. This is how nature brings an end to seasonal colds and flus. Yet curiously this basic piece of natural science was largely ignored in March. Talk of UV light became highly politicised and thence poisoned.
The Swedes
Sweden provided a template for a country acting within the bounds of common sense and science. From the outset health authorities there endeavoured to protect a vulnerable aged cohort, leading to a natural-immunity developing within the population. In permitting this to occur they also took the precaution of doubling ICU capacity[xxxii] which, like Ireland’s, had been among the lowest in Europe when the pandemic began.
Comparison between Sweden and Ireland cannot be made on a like-for-like basis, any more than the Irish can be compared to any other national group; however, some relevant comparisons can be drawn in respect of population demographics.
Sweden has twice Ireland’s population, but 3.2 times the number of over sixty-five-years-olds. Ireland has not quite experienced just over a third of Sweden’s mortality (11,815 v 3,418); but while Ireland’s death rate from Covid-19 has been steadily increasing over the month of January, Sweden’s has flattened to point where, according to the WHO, Sweden’s death toll has been in single figures since the start of February, while Ireland has been experiencing daily deaths over one hundred.
There may be a further uptick in Covid deaths in Sweden once schools reopen – and even a third wave – but the hopeful signs are that the country is now reaching a herd immunity threshold – one that has brought less suffering overall when compared to other jurisdictions.
A similar comparison can be drawn between Sweden and most other European states, implying, in most situations, that mortality is not significantly reduced by lockdown policies. Yet invariably whenever one reads about Sweden in mainstream Irish media[xxxiii] comparisons are only drawn with best-in-class Scandinavian neighbours, where lockdowns have also been, for the most part, avoided.
Lockdowns are likely to increase mortality through missed cancer screenings, dysfunctional health services, serious mental health impacts, besides the ‘shadow-pandemic’ of domestic violence that has occurred under lockdown.
The writing on the wall?
What of the good people on the opposite side of the Swedish argument? It is fair to say that lockdowns can flatten the curve. This is apparent if we compare mortality graphs on the Euromomo website that tracks excess deaths across Europe. It shows that Sweden did not see the same kind of spike on their graph of mortality during the first wave as in other countries that locked down, but experienced a steady decline, which in July led the New York Times to state prematurely that ‘Sweden Has Become the World’s Cautionary Tale’[xxxiv]
The question is whether the short-term benefits of lockdowns in terms of averted-deaths are worth the cost? Or, were lockdowns necessary, and will they ultimately translate into lives being saved rather than simply deferring deaths? Perhaps the truth lies in the middle of these arguments but I know which side I lean.
Lockdowns do not prevent deaths, but slow the rate of infection and mortality. They can only ease the burden on hospital or tertiary care services. The purpose of lockdown should be to insure that the sick can access the best treatment available, and should not be ‘a primary means of controlling the virus’[xxxv] according to leading authorities in the WHO, as we are experiencing in Ireland.
Although the mortality figures in Ireland still lag behind Sweden’s I suspect this is deferred mortality and does not represent patients who have been cured or saved. The curve has been flattened. Thus far, lockdown policies have had the beneficial effect of decreasing mortality by less than 20% compared to Sweden’s when adjusted for our respective age profiles. In my view, however, what may simply be deferred mortality, cannot justify the burden of lockdowns on the wider population.
Only when the crisis has passed, and with the benefit of hindsight, will it be possible to determine if the Swedes broadly got things right. Although, it is more appropriate in the context of a disease that has killed thousands of people – and caused suffering to most of the rest of the population – to state that some countries will have managed it better than others. For sure, no one will have got everything ‘right’.
Assuming vaccines do not represent a panacea, if it transpires that most Irish mortality is confined to the nursing home sector, and that all lockdowns accomplish is to preserve a larger number of potential hosts for successive seasonal resurgences then the pandemic will have been a more painful and long-running saga in Ireland than it might otherwise have been.
[i] Marcus de Brun, ‘The Perfect Storm’, Cassandra Voices, August 19th, 2020, https://cassandravoices.com/science-environment/covid-19-the-perfect-storm/
[ii] Epidemiology of COVID-19Outbreaks/Clustersin IrelandWeekly Report Prepared by HPSC on25thJanuary 2021, https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/covid-19outbreaksclustersinireland/COVID-19%20Weekly%20Outbreak%20Report_Week032021_25012021_WebVersion_final.pdf
[iii] Digital Desk Staff, ‘Opening hospitality will mean limiting Christmas gatherings, Nphet warns’, November 26th, 2020, Extra.ie, https://www.breakingnews.ie/ireland/nphet-strongly-opposed-to-parts-of-governments-lockdown-exit-plan-1042387.html
[iv] ‘Up to 85,000 Irish people could die from coronavirus in worst-case scenario, Taoiseach indicates, as three more diagnosed’ John Downing, Eilish O’Regan and Gabija Gataveckaite, Irish Independent, March 9th, 2020, https://www.independent.ie/world-news/coronavirus/up-to-85000-irish-people-could-die-from-coronavirus-in-worst-case-scenario-taoiseach-indicates-as-three-more-diagnosed-39029363.html
[v] COVID-19 Deaths and Cases, Central Statistics Office, https://www.cso.ie/en/releasesandpublications/br/b-cdc/covid-19deathsandcases/
[vi] ‘Norwegian health chief: we advised against closing schools’, 10 June, 2020, Unherd, https://unherd.com/thepost/norwegian-health-chief-we-advised-against-closing-schools/
[vii] ‘Census of Population 2016 – Profile 7 Migration and Diversity’, https://www.cso.ie/en/releasesandpublications/ep/p-cp7md/p7md/p7anii/
[viii] Ciara Kenny, ‘ The global Irish: Where do they live?’, February 4th, 2015, Irish Times, https://www.irishtimes.com/life-and-style/generation-emigration/the-global-irish-where-do-they-live-1.2089347?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Flife-and-style%2Fgeneration-emigration%2Fthe-global-irish-where-do-they-live-1.2089347
[ix] American Institute of Cancer Research, Skin cancer statistics, https://www.wcrf.org/dietandcancer/cancer-trends/skin-cancer-statistics
[x] Phil Mercer, ‘Covid: Melbourne’s hard-won success after a marathon lockdown’, 26th of October, BBC, https://www.bbc.com/news/world-australia-54654646
[xi] Luke Malpass, ‘Jacinda Ardern declares 2021 ‘the year of the vaccine’’, January 21st, 2021, Stuff, https://www.stuff.co.nz/national/politics/124012148/jacinda-ardern-declares-2021-the-year-of-the-vaccine
[xii] Ramesh Thakur, ‘The West should envy Japan’s COVID-19 response’ January 10th, 2021, Japan Times, https://www.japantimes.co.jp/opinion/2021/01/10/commentary/japan-commentary/west-japan-coronavirus-response/
[xiii] Gabriel Scally: It is essential Ireland tightens borders in fight against Covid-19, January 30th, 2020, Irish Times, https://www.irishtimes.com/opinion/gabriel-scally-it-is-essential-ireland-tightens-borders-in-fight-against-covid-19-1.4471283
[xiv] Sarah Bosley, ‘Covid UK: scientists at loggerheads over approach to new restrictions’, September 22nd, 2020, The Guardian, https://www.theguardian.com/science/2020/sep/22/scientists-disagree-over-targeted-versus-nationwide-measures-to-tackle-covid
[xvi] Sebastian Rushworth M.D., ‘Here’s a graph they don’t want you to see’, 25th of January, 2021, https://sebastianrushworth.com/2021/01/25/heres-a-graph-they-dont-want-you-to-see/
[xvii] Sheena Cruickshank ‘A new study suggests coronavirus antibodies fade over time – but how concerned should we be?’ October 27th, 2020, The Conversation, https://theconversation.com/a-new-study-suggests-coronavirus-antibodies-fade-over-time-but-how-concerned-should-we-be-148957
[xviii] Amy Kazmin, ‘India’s tumbling Covid cases raises question: Is the pandemic burning itself out?’ February 1st, 2021, Irish Times, https://www.irishtimes.com/news/world/asia-pacific/india-s-tumbling-covid-cases-raises-question-is-the-pandemic-burning-itself-out-1.4472406?mode=amp
[xix] Fergal Bowers, ‘High percentage of virus deaths in Ireland’s care homes highlighted in comparison report
[xx] Mismanagement of Covid in Ireland’ May 27th, RTE, https://www.rte.ie/news/coronavirus/2020/0527/1143036-covid-deaths-ireland/
[xxi] ‘What to know about post-viral syndrome’ Medical News Today, https://www.medicalnewstoday.com/articles/326619
[xxii] Jennifer Rigby, ‘Why long Covid can be really grim, but is rarer than you think’, October 3rd, 2020 The Telegraph, https://www.telegraph.co.uk/global-health/science-and-disease/long-covid-can-really-grim-rarer-think/
[xxiv] Matt Cole et al, ‘Air pollution exposure linked to higher COVID-19 cases and deaths – new study’, July 13th, 2020, The Conversation, https://theconversation.com/air-pollution-exposure-linked-to-higher-covid-19-cases-and-deaths-new-study-141620
[xxv] Meredith Wadman, ‘Why COVID-19 is more deadly in people with obesity—even if they’re young’, September 8th, 2020, https://www.sciencemag.org/news/2020/09/why-covid-19-more-deadly-people-obesity-even-if-theyre-young
[xxvi] Shauna Bowers, ‘Irish policies to tackle obesity ‘fall behind international best practice’ – report’, November 9th, 2020, Irish Times, https://www.irishtimes.com/news/health/irish-policies-to-tackle-obesity-fall-behind-international-best-practice-report-1.4403921?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fnews%2Fhealth%2Firish-policies-to-tackle-obesity-fall-behind-international-best-practice-report-1.4403921
[xxvii] Anthony King, ‘Coronavirus family now a prime suspect in previous pandemics,’ February 4th, 2020, Irish Times, https://www.irishtimes.com/news/science/coronavirus-family-now-a-prime-suspect-in-previous-pandemics-1.4463053
[xxviii] Tom Kirby, ‘Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities’, The Lancet, May 8th, 2020, https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30228-9/fulltext
[xxix] Infection fatality rate of COVID-19 inferred from seroprevalence data
John P A Ioannidis, WHO, September 13th, 2020, https://www.who.int/bulletin/volumes/99/1/20-265892/en/
[xxx] (According to the CSO there have been 20,402 confirmed cases of Covid amongst the age group 0-24yrs, during the period from Feb 2020 to December 2020 and not a single recorded death in Ireland. https://www.cso.ie/en/releasesandpublications/br/b-cdc/covid-19deathsandcasesseries18/
[xxxi] Simon Carswell, ‘Widow ‘outraged’ by footage of husband’s facial wound’, August 26th, 2020, Irish Times, https://www.irishtimes.com/news/health/widow-outraged-by-footage-of-husband-s-facial-wound-1.4338831?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fnews%2Fhealth%2Fwidow-outraged-by-footage-of-husband-s-facial-wound-1.4338831
[xxxii] Emma Lofgren, ‘’The biggest challenge of our time’: How Sweden doubled intensive care capacity amid Covid-19 pandemic’, June 23rd, 2020, The Local, https://www.thelocal.com/20200623/how-sweden-doubled-intensive-care-capacity-to-treat-coronavirus-patients
[xxxiii] Suzanne Cahill, ‘Coronavirus lockdowns are still a step too far for Sweden’, February 3rd, 2021, Irish Times, https://www.irishtimes.com/opinion/coronavirus-lockdowns-are-still-a-step-too-far-for-sweden-1.4473119?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fopinion%2Fcoronavirus-lockdowns-are-still-a-step-too-far-for-sweden-1.4473119
[xxxv] Michelle Doyle, ‘WHO doctor says lockdowns should not be main coronavirus defence’, October 12th, 2020, ABC, https://www.abc.net.au/news/2020-10-12/world-health-organization-coronavirus-lockdown-advice/12753688
