Summary — while the vaccinated still appear to have some protection against severe symptomatic covid and death, it appears that they’re less likely to make it into ICU if they get seriously ill.
"....ICU staff are professionals interested in saving lives, and would be unlikely to want to cooperate in any Machiavellian schemes...."
I don't know what social and peer pressures are like in the US, but in Europe and the UK there has been a considerable rise in employment by multi-national companies or government bureaucracy.
A feature of work in a large hierarchy is that you have little individual autonomy and are required to function as a cog in the mechanism. You do not get to chose whose lives you will save, or even what treatment they are to be given - there are all pre-defined by the system.
People at the higher levels of the system have invested much of their life in gaining their position. And if more senior figures want to see data which supports high-level policy, it is so easy just to tweak a few directives and allocate resources differently to provide what your masters want. Conversely, if you are seen as unwilling to do this, the position you worked so hard to obtain is suddenly in jeopardy.
So do not be surprised if non-optimal policies are introduced and forced through, in spite of data showing that they may be killing people unnecessarily. There is nothing Machiavellian about this - it's simply how bureaucracies work....
In one classic comedy series in the UK, 'Yes Minister', the politician, elected on a ticket of cutting administration costs, demands that the staff numbers in his department are lowered. They duly are. Later he finds out that he is employing more staff than ever before, and that the civil servants have interpreted his requirement to lower the numbers by re-defining many posts in such a way as to take them out of the staff count.
Nowadays, I fear that we need to be particularly cautious about any statistics coming from government. Undoubtedly these figures are considered politically before release, and what you are seeing may simply be an artefact of some re-jigging to create a better result in some unconnected area...
I think you may be missing something important. Characteristics of the unvaccinated vs. vaccinated groups differ, yes, in that they have had the vaccine, but also in that the vaccinated group almost exclusively contains the extremely clinically vulnerable people (something like 99.9% of this group received the jab), as compared to the unvaccinated group. These extremely clinically vulnerable people (of all ages) are more likely to die from or with covid. I am speculating, but I imagine these people may deteriorate more quickly also, and thus could explain why fewer vaccinated who die make it into ICU. There may be other important related factors also, such as end of life pathway protocols. Their condition (which may be the primary cause of death, and not covid) may not warrant them being admitted to ICU.
We cannot interpret these observational data as though they are a randomised treatment and control group data, with the two groups having similar characteristics and only differing by vaccine status. That simply isn't the case.
Much of what is seen in vaccinated vs unvaccinated might be down to behaviours and intrinsic qualities. This might explain other things, such as the apparent negative vaccine efficiency suggested by the UKHSA cases data (in the vaccine surveillance reports).
OTOH, I'd note the post vaccination 'deaths from anything other than covid' data, which suggests that the unvaccinated are much more likely to die of 'not covid' than the vaccinated, which then suggests that perhaps it is the unvaccinated are the more vulnerable group.
As a group perhaps, but that doesn't mean that the small proportion of the most highly vulnerable (nearly 100% of them) couldn't be driving the covid deaths.
This is why the govt really needs to release all data. And why proper RCTs with proper follow ups should have been conducted on the vaccines. We can't conclude much from analysing the observational data like these. We'd need far more information, so that we could control for lots of variables in a multivariable analysis. Then we could infer more.
And Dr. Will Jones on Daily Sceptic has written a few articles about this.
"We cannot interpret these observational data as though they are a randomised treatment and control group data, with the two groups having similar characteristics and only differing by vaccine status"
- The people who are most at risk of Covid are people with multiple comorbidities and/or are obese. It's quite disgraceful the UK government isn't being completely transparent with the data, since they definitely have it.
Thanks so much - I'll take a look. I agree - it's disgraceful. I've never known anything quite like this, and it's so worrying. I'm the last, I've found our govt to be transparent and publish proper reports, so that people could understand what's going on. It seems those days are truly over now.
OTOH, the extremely extremely clinically vulnerable were likely in the unvaccinated group, as they couldn't cope with and get the jab, see also Norway on that.
Certainly for May-July numbers, likely diminishing over time though, of course.
Yes -- you see exactly this effect in non-covid deaths by vaccination status, including the the 'diminishing in time' part. You also see the same effect for dose 2 -- as though there are very frail individuals that were judged shouldn't take another jab. For details of the supporting data, see https://bartram.substack.com/p/on-the-impact-of-the-vaccines-on
No, I specifically remember that something like 99.9% of the most vulnerable group were vaccinated (here in the UK). Vaccine uptake went down when it got to less vulnerable groups.
There is overlap there actually. The most highly vulnerable patients (eg. those with terminal disease) are also vulnerable to covid. And this group could be driving those statistics. And in the absence of a multivariate analysis controlling for such factors, the most simple explanation is that one.
Bartram, do you have any thoughts on Pfizer trial results of serious disease 9/162 = 5% for unvaccinated and 1/8 =12% for vaxxed. I’ve never seen this difference discussed in detail. Could it impact your analysis here? Best wishes, Kimberley
May to July was predominately low spread so “cases” and “deaths” would be mostly false positives via Bayesian voodoo math, which disfavors the vaccines. ICU admission after a positive test is a more selective criteria than “happening to die for any reason after a positive test,” so it’s less prone to false positives during low spread, that’s all.
Because efficacy cannot be demonstrated if “equal false positive rates.” Though, it’s not truly equal per-cap false positive rates until “infection efficacy” drops, since “infection efficacy” reduces “half false positives” (dying with, but not of SC2) among the vaxxed, but on a whole population scale you’ll still catch a few of those as well as a few “full false positives” (PCR error). Since loads of people die naturally.
Either way the observer needs to jack up selectivity if looking at reality outside of a wave. The trials build this in, by not including test results absent of symptoms, for better or worse. It isn’t surprising that ICU admission is more selective than death.
"....ICU staff are professionals interested in saving lives, and would be unlikely to want to cooperate in any Machiavellian schemes...."
I don't know what social and peer pressures are like in the US, but in Europe and the UK there has been a considerable rise in employment by multi-national companies or government bureaucracy.
A feature of work in a large hierarchy is that you have little individual autonomy and are required to function as a cog in the mechanism. You do not get to chose whose lives you will save, or even what treatment they are to be given - there are all pre-defined by the system.
People at the higher levels of the system have invested much of their life in gaining their position. And if more senior figures want to see data which supports high-level policy, it is so easy just to tweak a few directives and allocate resources differently to provide what your masters want. Conversely, if you are seen as unwilling to do this, the position you worked so hard to obtain is suddenly in jeopardy.
So do not be surprised if non-optimal policies are introduced and forced through, in spite of data showing that they may be killing people unnecessarily. There is nothing Machiavellian about this - it's simply how bureaucracies work....
That's a possible reason, yes. It would require that the hospitals would have to favour putting the unvaccinated into ICU, though.
Trying to work out how humans behave is complex.
In one classic comedy series in the UK, 'Yes Minister', the politician, elected on a ticket of cutting administration costs, demands that the staff numbers in his department are lowered. They duly are. Later he finds out that he is employing more staff than ever before, and that the civil servants have interpreted his requirement to lower the numbers by re-defining many posts in such a way as to take them out of the staff count.
Nowadays, I fear that we need to be particularly cautious about any statistics coming from government. Undoubtedly these figures are considered politically before release, and what you are seeing may simply be an artefact of some re-jigging to create a better result in some unconnected area...
I think you may be missing something important. Characteristics of the unvaccinated vs. vaccinated groups differ, yes, in that they have had the vaccine, but also in that the vaccinated group almost exclusively contains the extremely clinically vulnerable people (something like 99.9% of this group received the jab), as compared to the unvaccinated group. These extremely clinically vulnerable people (of all ages) are more likely to die from or with covid. I am speculating, but I imagine these people may deteriorate more quickly also, and thus could explain why fewer vaccinated who die make it into ICU. There may be other important related factors also, such as end of life pathway protocols. Their condition (which may be the primary cause of death, and not covid) may not warrant them being admitted to ICU.
We cannot interpret these observational data as though they are a randomised treatment and control group data, with the two groups having similar characteristics and only differing by vaccine status. That simply isn't the case.
You're quite right, of course.
Much of what is seen in vaccinated vs unvaccinated might be down to behaviours and intrinsic qualities. This might explain other things, such as the apparent negative vaccine efficiency suggested by the UKHSA cases data (in the vaccine surveillance reports).
OTOH, I'd note the post vaccination 'deaths from anything other than covid' data, which suggests that the unvaccinated are much more likely to die of 'not covid' than the vaccinated, which then suggests that perhaps it is the unvaccinated are the more vulnerable group.
As a group perhaps, but that doesn't mean that the small proportion of the most highly vulnerable (nearly 100% of them) couldn't be driving the covid deaths.
This is why the govt really needs to release all data. And why proper RCTs with proper follow ups should have been conducted on the vaccines. We can't conclude much from analysing the observational data like these. We'd need far more information, so that we could control for lots of variables in a multivariable analysis. Then we could infer more.
Keep asking questions, your work is appreciated!
Sorry I had to delete my original comment.. full of typos and one or two things not clearly expressed.
Berenson's post from earlier today was interesting:
https://alexberenson.substack.com/p/the-english-data-on-vaccines-and/comments
And Dr. Will Jones on Daily Sceptic has written a few articles about this.
"We cannot interpret these observational data as though they are a randomised treatment and control group data, with the two groups having similar characteristics and only differing by vaccine status"
- The people who are most at risk of Covid are people with multiple comorbidities and/or are obese. It's quite disgraceful the UK government isn't being completely transparent with the data, since they definitely have it.
Thanks so much - I'll take a look. I agree - it's disgraceful. I've never known anything quite like this, and it's so worrying. I'm the last, I've found our govt to be transparent and publish proper reports, so that people could understand what's going on. It seems those days are truly over now.
Unfortunately they are and you can't blame the "cock up factor", there is an obvious and frightening agenda in play.
Sorry I was being a bit lazy in my last post, here is Dr. Will's latest:
https://dailysceptic.org/2021/11/28/nhs-chief-stephen-powis-claims-the-overwhelming-majority-of-covid-icu-patients-are-unvaccinated-but-is-he-using-out-of-date-data-from-july/
Thanks. Have you read this thought-provoking piece? https://www.hughwillbourn.com/post/23-cock-up-conspiracy-or-murmuration
*in the past
There really needs to be an edit option...
OTOH, the extremely extremely clinically vulnerable were likely in the unvaccinated group, as they couldn't cope with and get the jab, see also Norway on that.
Certainly for May-July numbers, likely diminishing over time though, of course.
Yes -- you see exactly this effect in non-covid deaths by vaccination status, including the the 'diminishing in time' part. You also see the same effect for dose 2 -- as though there are very frail individuals that were judged shouldn't take another jab. For details of the supporting data, see https://bartram.substack.com/p/on-the-impact-of-the-vaccines-on
No, I specifically remember that something like 99.9% of the most vulnerable group were vaccinated (here in the UK). Vaccine uptake went down when it got to less vulnerable groups.
That was 'vulnerable to covid' not 'vulnerable as is so frail that they could die any day'.
There is overlap there actually. The most highly vulnerable patients (eg. those with terminal disease) are also vulnerable to covid. And this group could be driving those statistics. And in the absence of a multivariate analysis controlling for such factors, the most simple explanation is that one.
Bartram, do you have any thoughts on Pfizer trial results of serious disease 9/162 = 5% for unvaccinated and 1/8 =12% for vaxxed. I’ve never seen this difference discussed in detail. Could it impact your analysis here? Best wishes, Kimberley
May to July was predominately low spread so “cases” and “deaths” would be mostly false positives via Bayesian voodoo math, which disfavors the vaccines. ICU admission after a positive test is a more selective criteria than “happening to die for any reason after a positive test,” so it’s less prone to false positives during low spread, that’s all.
The same biases affect both vaccinated and unvaccinated. It isn't clear why you'd think that this would disfavour the vaccines.
Because efficacy cannot be demonstrated if “equal false positive rates.” Though, it’s not truly equal per-cap false positive rates until “infection efficacy” drops, since “infection efficacy” reduces “half false positives” (dying with, but not of SC2) among the vaxxed, but on a whole population scale you’ll still catch a few of those as well as a few “full false positives” (PCR error). Since loads of people die naturally.
Either way the observer needs to jack up selectivity if looking at reality outside of a wave. The trials build this in, by not including test results absent of symptoms, for better or worse. It isn’t surprising that ICU admission is more selective than death.
Excellent as always, thank you.