What’s in a baseline? We now have all cause mortality data for the first quarter of 2021 for England and Wales, and so it is time to add this data to one of the many charts Dr No has squirreled away in his covid dossiers. This chart shows quarterly standardised mortality ratios (SMRs) from Q1 2000 to Q1 2021, the last two decades. They are calculated using the indirect method, using all 2000 mortality data as the standard. Each point represents that quarter’s SMR compared to all 2000 all cause mortality, adjusted for population size and age distribution, with values above 100 meaning observed mortality was higher than expected using the 2000 baseline, and values below 100 meaning it was less than expected. Quarters 1 to 4 are identified by the colours shown in the key. What do we see?
Early on in the pandemic, Dr No coined the phrase hot stiff bias to describe the habit of doctors of the covid tendency to attribute any death that might, however vaguely, be due to covid, as being definitely due to covid. It is a covid specific form of the more general hot stuff bias, in which doctors tend to attribute illness and deaths to ‘hot’ diseases, the ones that are currently ‘hot’ topics. It is a practical expression of there’s a lot of it about, the old medical standby for when one doesn’t have a clue, but wants to sound as if one does. An easy concept to understand, hot stiff bias is typically hard to quantify, but the latest ONS data does gives us a clue. It seems that as the weather warms up, covid hot stiff bias cools off.
The vexed question of domestic covid immunity passports remains in the balance. The general tone and drift of the government is that they are going to happen. Yesterday’s ID card munching journalist is today’s prime minister, ordering passport trials to go ahead. A recent Roadmap Review published by the government noted that covid immunity passports are ‘likely to become a feature of our lives until the threat from the pandemic recedes’, and that they ‘could have an important role to play…as a temporary measure’. At the same time, retailers and the hospitality sector have recoiled against the idea, even though the majority of their customers want them. Rather late in the day, the Equality and Human Rights Commission has come out with a mealy mouthed ‘can have a role, but important to strike the right balance’ type statement that merely adds more mud to the already turbid waters. A while back, the Royal Society produced a similar sitting on the fence report. On twitter, covid immunity passport nuts queue up to post ‘TBH, I don’t really want to eat in the same places as anti vaccine loons’ and ‘the only people refusing [vaccines] are idiots, if two-tier society means less idiots around me I’m fine with that’. Truly, we are already a nation divided — and about to be ruled.
Isn’t it curious how describing deaths brought forward by a short interval by covid as dry tinder garners disapproval, while the MHRA’s breezy description of Yellow Card deaths associated with covid vaccination as spontaneous combustion — most likely would have died anyway, dear boy — goes quite un-remarked. Be that as it may, Dr No has taken a look at the MHRA’s Yellow Card Scheme for reporting adverse drug reactions, after some discussion in a recent post about a BMJ Rapid Response which suggested significant underreporting of covid vaccination side-effects. What can the Yellow Card Scheme tell us about adverse reactions to the covid vaccines? Is there any evidence for or against significant under-reporting of adverse reactions?
“Model individuals will be commended in accordance with regulations, and extensive publicity will be conducted through the news media to create a trustworthy and glorious public opinion atmosphere.”State Council of the People’s Republic of China (2014)Heartening as it is to hear some political opposition to covid passports, even if some of the opponents are a mixed bag of chancers and free-loaders, it still seems — assuming the polls are right — the majority of the Britons favour the introduction of covid passports for a wide range of broadly defined social activities. Expressed opposition, on the other hand, is low, never more than one in four of those polled. If the public gets what it wants, which seems likely, given the Tories’ penchant for policy that pushes on open doors, then Franklin’s ‘Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety’ will have finally achieved in full its true modern meaning.