Monday, 22 March 2021

Opinion: Between statistical and personal side effects

Logs out of my eyes

A good deal of my job involves the gathering, analysis, and interpretation of activity and error logs. As I am not on site to observe with my own eyes the environment, situation, or circumstances that create issues, I am left with deducing from the jumble of logs, the what’s, the how’s, and the why’s of things.

Sifting through and parsing data in the language and the numbers to determine patterns to follow; the logic or sequence of events almost becomes second nature. You can scarily come to some conclusions with such certainty, you might begin to doubt if you have read the situation right, even if you are usually right.

Then, how do you account for bias or possible error when assessing data presented from other environments outside your professional purview? Clarity is essential and, in the presentation,, you need to see what is clearly known, what is definitely unknown, what is still in dispute, open to debate and inconclusive, and the direction of travel towards tying up the loose ends.

Making sense of what’s out there

Nowhere is this more pertinent than in studying the recent developments around the COVID - SARS-Cov-2 vaccine, in particular the Oxford/AstraZeneca vaccine. That it has courted so much controversy started with the bungling of the test profile first with the dosing and then leaving the over 65s out of the cohort.

Since then, there have been reports of blood clot incidents post-vaccine which have not yet been proven just as it has not been conclusively disproven that the vaccine is the cause that might have resulted in 9 fatalities. [EMA - COVID-19 Vaccine AstraZeneca: benefits still outweigh the risks despite possible link to rare blood clots with low blood platelets]

A personal experience of side effects

Whilst a cost-benefit analysis would lead experts to suggest the benefits outweigh the risks, that is a statistical thing that works for the majority but not for the individual that presents the cases of serious concern. I remember being put on Triumeq a few years ago, it was to replace my Atripla regimen.

I was to detach a card from the Triumeq package, one of the side effects was instant death, that was scary enough. However, I did not tolerate it that well, the side effects diminished my quality of life, I recorded in a diary 42 days of insomnia, nerve-tingling, unexplained sudden joint pain, nausea, diarrhoea, it was hellish that I asked to be put back on Atripla without considering any other options.

Now, whilst I have been on Atripla since May 2010, I had a few neurological and cognitive issues, vivid dreams, simulated psycho-activity as if I was on psychedelic drugs and insomnia, but over time, I had developed coping mechanisms for toleration and satisfaction with it. Other people have psychological and psychiatric issues evoking suicidal thoughts, depression and worse.

Report side effects always

Statistically, both drugs are amazingly effective at controlling the Human Immuno-deficiency Virus (HIV), the side effects are generally tolerable, however, to the individual that is more than just a statistic to accommodate the percentile for drug approval, the issues cannot be ignored. That is why we are invited to participate in the Yellow Card Scheme for reporting adverse drug reactions, medical device adverse incidents, defective medicines, and counterfeit or fake medicines.

On the vaccine, I took the first dose of the Pfizer/BioNTech vaccine just under 4 weeks ago, I am glad it was available, and it offers me some protection including taking consideration for my frequent visits to South Africa. I had to check the side effects and possible drug interactions with my current medication with the view to raise concerns if necessary.

Praise and accountability matter

The success of getting the vaccine to most adults in the UK is commendable and it puts us well ahead of Europe. It was a gamble that paid off, being first movers that presented UK patients as Guinea pigs with a recalibration to allow for a higher proportion of first jabs to full inoculation. That being said, there must be accountability for the rotten debacle of the loss of lives at over 126,000 people and the exorbitant Test and Trace regime that did little to contain or control the virus when it really mattered.

We can in the dearth of good news run away with the slither of good fortune at the expense of other things or adopt a more pragmatic approach, being able to see the bigger picture, giving praise where it is due and excoriation where it is deserved. No one issue is mutually exclusive of the other, they are all part of the narrative where you see the rose, the thorns, or the whole bush.

References

[EMA - COVID-19 Vaccine AstraZeneca: benefits still outweigh the risks despite possible link to rare blood clots with low blood platelets]

[The New York Times: AstraZeneca’s Covid-19 Vaccine Is Found to Be 79% Effective in U.S. Study]

[BBC News: Covid vaccine: US trial of AstraZeneca jab confirms safety]

[MHRA: Yellow Card scheme]

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