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Pandemics Bookended Our Careers

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(An Essay Written for Graduates in Medicine, University of Sydney, Class of 1965)

There have been five pandemics inflicted on Australia. 

Protected through the 19th century by a moat that took months to cross, the Bubonic Plague of 1900 broke the back of pretension that Australia was shielded by its geographic isolation, courtesy of sea-going rats. Plague in Sydney established a pattern with which over the last two years we have become familiar: confusion and bureaucratic bungling followed by some clarity and a more logical approach to management.

The remarkable Ashburton Thompson, President of the NSW Board of Health, changed the course of pandemic management by developing the “test and isolate” principle. This involved each year culturing blood from 40-50,000 rats caught along the shoreline of Darling Harbour (as Thompson proved that disease in man followed breakout epizootic disease in rats). This innovation in public health was followed by an 80 percent reduction in both clinical infections and costs to the community.

Similar scientific contributions followed the three influenza pandemics in the 20th century. After the Spanish flu in 1918/19, Macfarlane Burnet established a world-leading influenza research center. The subsequent Asian and Hong Kong influenza pandemics in mid-century stimulated viral research culminating in a Nobel Prize to Peter Doherty.

The world mortality from the pandemics of plague and Spanish flu of, respectively, 15 and 50-100 million, puts Covid-19 into perspective. Covid world mortality sits at 6 million. Mortality rates in Australia for plague at 25 percent and Spanish flu at 2.5 percent compared with a death rate from Covid at little more than 0.1%. Not too different from observations in a bad flu season. 

Have you ever thought that we bookended our medical careers with pandemics: the 1968 Hong Kong H3N2 influenza pandemic, and in 2020, Covid-19? Interestingly the metrics of both are not too different, yet no one remembers the Hong Kong pandemic with the passion we associate with “our” Covid-19 experience.

Why is that? This essay attempts to find an answer.

Certain general similarities between the “Australian Pandemics” exist despite obvious differences in pathogenesis and outcomes. 

First, a pandemic phase of 2-3 years was followed by years of endemic disease: bubonic plague continued in Australia for over 20 years, H1N1 flu (1918) was the dominant seasonal isolate until the 1950s (and recurred post-2000), while the H3N2 Hong Kong isolate (a “shift” due to recombination from the 1956 H2N2 variant) continues to dominate seasonal outbreaks. Covid has already stamped its role in creating long-term sequelae with Long Covid in 20 percent of those recovering from the infection. The extent of the impact of Long Covid and endemic disease is a question for the future.

Second, quirky and controversial vaccines dominated medical thinking in all pandemics. Remarkably all claimed about 50 percent protection against death. Waldemar Mordecai Haffkine from the Pasteur Institute developed a killed bacterial vaccine five years after Alexandre Yersin had identified the causal bacteria in 1894; a polybacterial vaccine was used in the UK and Australia in the Spanish flu (claiming reduction in death in young adults from staphylococcal pneumonia); in 1968 a novel split antigen H3N2 vaccine was available within five months of the onset of the Hong Kong influenza pandemic. In our current Covid-19 pandemic a novel experimental genetic “vaccine” for Covid-19 was developed 12 months after the virus was identified which became the central plank of pandemic management. 

Comments on Covid-19

The surprise was not the pandemic, but its cause. Coronaviruses were part of life with regular mild airways infections. Perhaps we should have been more alert, given SARS and MERS were mutated coronaviruses. 

We expected—even trained for—the next flu pandemic. A respiratory tract virus causes a pandemic when mutations enable it to escape from the bronchus into the alveolar space. In the bronchus, a virus is contained by the non-inflammatory mucosal compartment immune system. However, the alveolar space is protected by the systemic immune apparatus, which by its nature is pro-inflammatory as the aim is, and must be, to create sterilizing immunity.

In Covid infection virus can flood the alveolar space, initiating a vigorous inflammatory response, and manifest clinically as viral pneumonia. The Spike protein of the virus which attaches to the ACE-2 receptors in the lung tissue adds to damage through its intrinsic toxicity.

Injected vaccines, be they classic antigen vaccines as used in influenza protection, or the genetic vaccines used for protection against Covid-19, stimulate only IgG antibody which is restricted to the systemic compartment. This protects against alveolar space damage but has no effect on mucosal infection. Exactly what is found clinically: protection against severe disease with less admission to hospital and deaths, but little to no effect on getting infected, local disease or transmission of disease to others. 

Where did the Covid-19 virus come from? The balance of evidence favors laboratory manipulation to enhance pathogenicity rather than “escape” from a non-human host in the Wuhan wet markets. Genetic sequencing identified a “jump” unexpected for staged evolution, and base sequences characteristic of artificial insertion have been identified. 

Perhaps we will never know the truth.

Waves of infection correlate with antigenic drift, as seen with other RNA viruses. To date evolved clades are characterized by high infectivity, with progressively less pathogenicity. The genetic identity of the current variants is as different from each other as they are from the parent Wuhan isolate. This accounts in part for progressive vaccine failure which is not surprising given experience with influenza.

Comments on Pandemic Management

How have we handled the pandemic? The answer is that we could have done better. Much better.

First, the classic pattern seen in pandemics of confusion, bureaucratic bungling and economic cost are there for all to see. We are closing on three years with no end in sight for the pandemic, nor for the misinformation. Previous pandemics lasted about two years before settling into a low-level endemic phase. With 5,500 cases per day currently at a mortality of 0.2%, the pandemic thrives in Australia (though down from 110,000 cases per day in January 2022, with a similar mortality).

Are waves of antigen-specific clades selected by vaccines of limited capacity? Protracted symptoms of “Long Covid” in about 20 percent of those recovering from the infection, little affected by vaccination, paint a bleak long-term picture for many. Failure of vaccination to bring the pandemic to a close, and the appearance of more infections, more deaths and more protracted disease in multi-immunized subjects, has led some to call Covid a “pandemic of the triple-vaccinated.”

The “pulse” of the pandemic has been vaccination. The promise of sterilizing and herd immunity could never be achieved—that is not the way of vaccines used for control of mucosal infections. Infected subjects continue to spread virus, irrespective of vaccination—indeed those with boosters secrete more virus for longer periods. Repeated vaccination over short periods gives progressively less benefit, and for shorter periods, due to stimulation of T reg (suppressor) cells. Suppression of unregulated response to the myriad antigens bathing mucosal surfaces is the defining characteristic of mucosal immunology. Experience with injected “desensitization” therapy for allergic disease to inhaled antigens (an exact parallel to repeated boosters for inhaled virus infections) indicates net suppression can persist for years (Covid vaccines’ Biomechanics and Efficiency. Quantum 20.3.2022)

Second, the outcomes claimed by the pharmaceutical industry, and the suppression of effective, cheap, safe and available therapies, were driven by a “narrative” developed by those making vaccines (and $100 billion per year). The promise of the narrative caught the imagination of regulatory bodies and politicians. Its intent was to focus only on vaccines, excluding all hurdles that might slow their community uptake.

Third, control by industry and bureaucrats was possible because the structure of medicine no longer supported or controlled the practice of medicine. The laws of science in medicine and of the doctor-patient relationship—foundation stones of practice—were at risk of compromise.

Fourth, the “narrative” controlling Covid management was flawed in science. Covid is an infection of the mucosal compartment and thus controlled by the local immune response. The dominant characteristic of mucosal immunity is the potent suppression of immunity, which is discussed above. 

Fifth, the dangers of mRNA vaccines. mRNA is widely distributed within the body. It can be detected in blood for weeks while Spike protein locates in blood vessels associated with “autoimmune” T-cell infiltrates in post-mortems following unexpected deaths. It is also a feature in endocardial biopsies of subjects with post-vaccine myocarditis. Unprecedented reports of severe adverse events in all Western official registers, including deaths, go without comment. VAERS is the official US reporting body. Between December 14, 2020 and August 8, 2022, there have been more than 250,000 serious adverse events reported, with over 30,000 deaths. A “signal” of concern. These figures dwarf cumulative reports combined for all other vaccines over more than 20 years.

A 15 percent increase in “unexpected deaths” timed to vaccine programs across the world, attracts no official interest. Official UK data released on July 6, 2022 is representative of the scary concerns now being faced: mortality rate ratios (standardized per 100,000 person years for the period February 2021 to May 2022), all cause deaths for “Vaccinated/not Vaccinated” was 6.37 (P<0.0001); for non-Covid deaths 7.25 (P<0.0001); and for deaths from Covid 2.06 (NS). Analysis of Pfizer’s Phase 3 data showing all-cause mortality was higher in the vaccinated compared to controls, which should have fired a warning shot. 

Post-vaccine myocarditis in adolescent males is recorded as 1 in 5-10,000 vaccinated: yet a prospective study in Thailand measuring troponin levels and using ultrasound diagnosed 2-3% of vaccinated high school boys with myocarditis.

Where is All This Going?

We are locked into a narrative with no apparent way out. Abuse, rhetoric and deregistration are tools used to control doctors challenging poorly spaced booster programs, or who express concern over damage caused by genetic vaccines. Or even those who dare to support cheap, safe and effective drug treatment that could shorten the pandemic. The scariest thing is that doctors most at risk are those who insist on ensuring patients give informed consent after consideration of vaccine risks. This is a basic requirement of the doctor-patient relationship, and paradoxically insisted on by the same authorities who cancel registration for doing the same!

Covid has laid bare a medical profession no longer with input into health policy. Financial interest influences decisions enacted by bureaucrats, driven by the pharmaceutical industry, and woven into political agendas. A cultural blindness to objectivity begins with medical journals failing to publish any article outside of the narrative.

The New England Journal of Medicine and Lancet were both forced to retract corrupt articles containing “false news” aimed at discrediting cheap, safe and effective drugs. Government authorities, professional organizations and universities deny freedom of speech as they trumpet misinformation. All under the protective umbrella of the “Trusted News Initiative,” the internationally coordinated process whereby only “the narrative” is promoted in the mainline press.

Our current experience can be summarized in the following question:

Are we witnessing the confused approach characteristic of every pandemic since the Black Death in 1347 including those experienced in 20th century Australia, or is the international response to Covid more dystopian—even Orwellian—in moving toward a totalitarian state of global proportions?”

Note “the Great Reset” plan for post-Covid world economic recovery, with the WHO centrally controlling future pandemic health challenges. The very WHO that emerged from the Covid pandemic scarred and corrupted through the influence of governments, industry and powerful individuals.

This snapshot picture of pandemics in Australia over 120 years shows both similarities and differences. The essential difference between the five pandemics affecting Australia through this time relates to the balance between narrative and science. 

For pandemics prior to Covid, science eventually won with strong professional leadership, internationally significant research contributions and stronger public health and government institutions.

Covid is not following that course—power structures outside of the traditional medical hierarchy control a self-seeking narrative that has failed to control the pandemic. Decisions fail to respect science. The outcomes include emergence of mutant virus and a protracted pandemic, a restriction on effective cheap treatments that could terminate the pandemic, a failure to interrogate mRNA adverse events, and a failure to respect a medical profession faced with the management of Covid patients.

The family doctor could only say “If you can’t breathe go to hospital” (or, recently add “We have for a minority, some questionable drugs that will cost the government (i.e. you) over $1,000”). At a community level, Mirko Bagaric, Dean of Law at Swinburne University, contributes a powerful argument with respect to control of the freedoms we take for granted. He describes the behavior of government through the pandemic as “the worst abuse of criminal law in a democracy in recent memory,” noting as an example “more than 50,000 law-abiding Victorians subject to criminal sanctions.”

What can we do? Understanding the meme state of cognitive dissonance that has overwhelmed many in our profession in accepting without argument, the “Covid narrative” of pharma/politics, is too hard for me. In practice, we must take back control of our profession and regain roles we once had to influence our patient’s health, based on science not narrative. 

If the medical profession fails to restore a competent transparent evidence-based system, our grandchildren choosing a career in medicine face a dystopian future run by bureaucrats for global interests driven by greed. Health decisions will become further removed from best practice principles we have taken for granted.

If it has taken a Covid pandemic to shine light on a process that had been below the radar, recognition of its concerning nature and any opportunity to counter its impact may be the positive outcome for Covid that we have come to expect from pandemics in Australia, over the last 120 years.

Author

  • Robert Clancy

    Robert Clancy is Emeritus Professor of University of Newcastle School of Medicine and Public Health. He is a Clinical Immunologist, Foundation Professor Pathology, University of Newcastle and past Head of the Newcastle Mucosal Immunology Group.


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