U-turn on mandatory Covid vaccinations for NHS and social care workers

[WineGetsMeThroughIt]

Apparently this will be announced tomorrow. Thank god there's some sense coming back into this world

www.telegraph.co.uk/politics/2022/01/30/front-line-health-staff-no-longer-need-covid-vaccines/

if you think of all the people that already lost their jobs or quit, all the staff involved in this shit show and the checks,paperwork ,meetings etc it's an absolute fucking disgrace and waste of money and staff

Well yes, but then wasting things is what they're good at ... some might say all they're good at

This is untrue. There is currently no strong rationale for pushing funding into campaigning/prescribing vitamin D, given there is no robust evidence for efficacy, and therefore it could be better spent elsewhere..

And there we have it. This was my point, wasn’t it. That without the big pharma companies spotting a potential way to make £££ and taking a punt on good trial outcomes, to bust research into vit d just isn’t going to happen. Because, trials conducting by non-profit-making bodies are so limited in number.

Being open minded means conducting well powered, well designed RCTs, rather than pushing vitamin D based on insufficient evidence. This is exactly what is happening. Predictably, various groups are making spurious claims about vit D (and why it means no one needs to be vaccinated), exactly as they did with ivermectin and HCQ.

Ah, I hadn’t realised you were fearful of people taking evidence of vit d being useful as a rationale for not become vaccinated. I was viewing it as a useful add-on rather than a sole preventative.

I think it would be a pity if we deprived people of a means to improve their health because of fears that a small minority might make hay with any positive trial results.

I also hope this isn’t standing in the way of further research.

I don’t dismiss your point about trial data, but I do think we need to weigh up the risks of a therapy before dismissing it out of hand when it could help with a major problem where we don’t have time to wait and the risks from said therapy are extremely small and if’s cheap.

What would be the risk to the average Brit if supplementing with a modest dose of Vid D? Let’s face it, they’d be tiny. The cost would be minimal too.

@Tealightsandd

I expect that the medical negligence solicitors will be gearing up for a busy period.

They will presumably be taking enquiries from bereaved families - who lose a loved one after being in the 'care' of an unvaccinated HCP.

Also very mixed messaging being sent out by the (UK) government. One minute launching a campaign urging pregnant women to get vaccinated...but then saying well vaccines aren't so important afterall...

You couldn't make it up really. HCP working in science and medicine...who don't trust science and medicine

What about medical negligence due to understaffing? Or as long as it's not covid then no one gives a shit?

Ah, I hadn’t realised you were fearful of people taking evidence of vit d being useful as a rationale for not become vaccinated.

I'm not fearful of anything, I'm just pointing out it makes no sense to pour money into pushing treatments for which there is no evidence for efficacy.

I pointed out the fact that various anti-vaccine groups use this argument for multiple drugs that don't work (HCQ, vit D, ivermectin) claiming because they are miracle cures no-one needs to be vaccinated.

@leafyygreens

Ah, I hadn’t realised you were fearful of people taking evidence of vit d being useful as a rationale for not become vaccinated.

I'm not fearful of anything, I'm just pointing out it makes no sense to pour money into pushing treatments for which there is no evidence for efficacy.

I pointed out the fact that various anti-vaccine groups use this argument for multiple drugs that don't work (HCQ, vit D, ivermectin) claiming because they are miracle cures no-one needs to be vaccinated.

The thing with Vitamin D is it would be so cheap, it wouldn’t be about ‘pushing’ something really costly.

It’d be great if trials were sped up, but I’m guessing there’s no money for this as no big profit for big pharma and very limited public funding for other trials. This leaves a big hole in the middle where good treatments for all sorts of illnesses may be being missed.

I asked an ex nursing colleague out of the blue today how she was getting on today - she has chosen not to be vaccinated for her own reasons.

She said that maybe everyone who is adamant they didn’t want care from someone unvaccinated should wear some sort of badge or medical bracket stating that.

Just incase she saw someone needing CPR like she did a few years ago so she could walk on by instead of keeping them alive until the ambulance arrived. Because she wouldn’t want them being treated by someone who they didn’t want to be.

It’d be great if trials were sped up, but I’m guessing there’s no money for this as no big profit for big pharma and very limited public funding for other trials.

Again, this makes no sense.

I have previously linked to you the scores of trials that were set up and are currently ongoing to quickly test the efficacy of various candidate off-patent drugs that could be repurposed to treat or prevent COVID. There is no profit in this either for "big pharma".

The thing with Vitamin D is it would be so cheap, it wouldn’t be about ‘pushing’ something really costly.
I don't think you understand - it's not about the cost of the drug, it's about the cost of campaigning, raising awareness etc of whatever demographic you want to take it. This is not justified when there is no evidence for efficacy and we already have recommendations in place regarding vit D.

Viruses love vitamins too 🤷‍♀️

And delighted to hear this (tho not front page headlines as it should be).

But also 'amused' as pretty much everyone on here who thinks it's terrible (that NHS staff can no longer be coerced into vaccination) post at best a 4-6 word sentence in defence of their pro vax sentiment.

Reminds me of the sound bites of Brexit, actually.

[quote leafyygreens]Taken as a body, however, there’s a fair suggestion that adequate vitamin D could be protective. We definitely need more but it looks reasonably promising overall.

This is untrue. There is currently no strong rationale for pushing funding into campaigning/prescribing vitamin D, given there is no robust evidence for efficacy, and therefore it could be better spent elsewhere.

hence it becomes easy to dismiss interest in vit d as ‘the new Ivermectin’ rather than be open minded.
Being open minded means conducting well powered, well designed RCTs, rather than pushing vitamin D based on insufficient evidence. This is exactly what is happening. Predictably, various groups are making spurious claims about vit D (and why it means no one needs to be vaccinated), exactly as they did with ivermectin and HCQ.

See Cochrane for a systematic review of the lit, with appropriate risk of bias assessments:
www.cochrane.org/CD015043/HAEMATOL_vitamin-d-effective-and-safe-treatment-covid-19[/quote]
We'll have to disagree, I think as far as what we have, vitamin d looks promising. And as mentioned by a pp, it is something people should do anyway.

Similarly, whicle obesity is not easy to address, (though it hasn't been addressed in the most useful ways before, especially with kids) what's more to the point is that covid measures have actually made it worse. Little effort seems to have gone into thinking about how these measures impacted other areas of health. Even simple, free things like getting out and being active were effectively discouraged.

And if we want to talk about evidence base, we could look at the evidence base for travel restrictions, or vaccination mandates, or trying to pressure hesitant people into vaccinations through their jobs. All of which either have no real evidence base or worse, are known to create problems.

If true, this is great news! And also a kick in the teeth for the care workers who have already lost their jobs, and the NHS staff who jumped before they were pushed. Not to mention the anxiety all of this will have caused.
Thank you to the tens of thousands of NHS staff who stood up to it all, and said no. First it was care workers, then NHS... it will not have stopped there.

I'd also point out that while RCT are the "gold standard" they are never what you get first and in many cases they are even impossible. If we only used those in terms of medical practice, medical practice would look a lot different than it does now.

The thing with Vitamin D is it would be so cheap, it wouldn’t be about ‘pushing’ something really costly.
I don't think you understand - it's not about the cost of the drug, it's about the cost of campaigning, raising awareness etc of whatever demographic you want to take it. This is not justified when there is no evidence for efficacy and we already have recommendations in place regarding vit D.

I don’t think you’re quite getting my point regarding the chicken and egg nature of the evidence gathering, here. Saying we’re not going to trial something because there’s no good evidence it works because we haven’t done the trials is rather circular! On that basis, we won’t conduct trials to find evidence for anything!

For awareness there would be some cost, but it would be small compared to what we’ve spent on the pandemic generally.

Personally, I’d rather take a vitamin than a medicine, as medicines always have side effects (and yes, I know there could be side effects from vit d if taken to excess, but not at the level we’re talking about).

Agree with this

And if we want to talk about evidence base, we could look at the evidence base for travel restrictions, or vaccination mandates, or trying to pressure hesitant people into vaccinations through their jobs. All of which either have no real evidence base or worse, are known to create problems.

I don't see how this is relevant to the incorrect claims that vitamin is effective?

The solution to bad science is not more bad science.

There simply isn't the evidence to justify diverting funding into encouarging people to take vitamin D to prevent or treat COVID. We have the recommendations regarding supplementation already, people can buy OTC. I just don't understand this obsession with the idea that information is somehow being buried because it won't profit "big pharma".

That was re SantaClawsServiette post

Saying we’re not going to trial something because there’s no good evidence it works because we haven’t done the trials is rather circular! On that basis, we won’t conduct trials to find evidence for anything!

Eh I didn't say anything of the sort? There are currently RCTs ongoing for vitamin D. I'm not sure what you're trying to say @TotalRhubarb

@SantaClawsServiette

I'd also point out that while RCT are the "gold standard" they are never what you get first and in many cases they are even impossible. If we only used those in terms of medical practice, medical practice would look a lot different than it does now.

Yes, this is very relevant. I always feel a bit uneasy about this when I see promising early data and then we wait years for an RCT before patients can be offered a treatment. Meanwhile people are suffering and dying in some cases.

What I'm struggling to understand is the apparent one way 'freedom'.

Why is it ok to say as I've seen some anti vaxxers say (not necessarily on this thread) - that CV patients concerned about unvaxxed HCP need to just lump it or go elsewhere for healthcare...

...but not ok to suggest that a HCP who doesn't believe in science and medicine seeks alternative employment in a non science and medicine based environment?

@leafyygreens

Saying we’re not going to trial something because there’s no good evidence it works because we haven’t done the trials is rather circular! On that basis, we won’t conduct trials to find evidence for anything!

Eh I didn't say anything of the sort? There are currently RCTs ongoing for vitamin D. I'm not sure what you're trying to say @TotalRhubarb

Based on this confusion alone I don't think you have a very good idea of the current body of evidence regarding vitamin D & prevention/treatment of COVID.

I linked the cochrane review to you a couple of posts ago.

Yes, this is very relevant. I always feel a bit uneasy about this when I see promising early data and then we wait years for an RCT before patients can be offered a treatment. Meanwhile people are suffering and dying in some cases

RCTs have been conducted for vit D. We have not found any strong evidence it is effective.

RCTs are not the be all and end all, and there are alternative study designs which can be helpful (not observational) and have been conducted for vit D, which have also found no evidence for efficacy.

There are further trials ongoing. As I said, the review linked is a good place to start.

Also again. What message is the government putting out?

On the one hand, launching campaigns urging pregnant women to get vaccinated - 'because the vaccine is important and works'... But at the same time suggesting that, actually, vaccines aren't so important and/or don't work after all.

What are vulnerable patients (including pregnant women) expected to make of it?

@leafyygreens

Saying we’re not going to trial something because there’s no good evidence it works because we haven’t done the trials is rather circular! On that basis, we won’t conduct trials to find evidence for anything!

Eh I didn't say anything of the sort? There are currently RCTs ongoing for vitamin D. I'm not sure what you're trying to say @TotalRhubarb

So you’re saying we need to hold off recommending it until the trial data comes in, whenever that might be.

Obviously that’s what we usually do outside of emergency situations like a pandemic.

When there are very few risks to at least informing the public that it could be useful, it’s a pity to wait, I feel, though I understand what you’re saying. In the context of other treatments with potential grave side effects, I would agree with you. This is so low risk and cheap, though.

@Tealightsandd

Also again. What message is the government putting out?

On the one hand, launching campaigns urging pregnant women to get vaccinated - 'because the vaccine is important and works'... But at the same time suggesting that, actually, vaccines aren't so important and/or don't work after all.

What are vulnerable patients (including pregnant women) expected to make of it?

But this isn’t about saying the vaccines aren’t important. It’s about recognising the logistical impossibility of sacking that many staff if we want a functioning NHS.

I’d like to think the government had recognised the importance of autonomy, but I wouldn’t credit them with that amount of respect for principles.

No, it’s purely to avoid the NHS collapsing in April and the Tories being blamed for that.

If that sends unhelpful messages I’m not sure Boris et al will be too bothered. They weren’t bothered about what message it sent when they threw all those parties, did they?!

@TotalRhubarb

So you’re saying we need to hold off recommending it until the trial data comes in, whenever that might be.Obviously that’s what we usually do outside of emergency situations like a pandemic.

When there are very few risks to at least informing the public that it could be useful, it’s a pity to wait, I feel, though I understand what you’re saying. In the context of other treatments with potential grave side effects, I would agree with you. This is so low risk and cheap, though.

There is no evidence it is effective. We have null RCTs. We have null findings from other types of study design such as genetic instrumental variable analysis.

It is completely unethical to recommend a treatment that has no evidence base, or to invest money in encouraging it's use.

We already have recommendations regarding vitamin D in general, and people can buy it over the counter or get a prescription from their GP.