BMJ

It’s cold, grey and wet. We’re sheltering behind closed curtains and in front of a fire, either working on spreadsheets, working on school stuff or reading sobering, cautionary correspondence about how we, as the human race, are going to deal with the SARS-CoV-2 virus.

The widespread opinion has been that we’re in this sticky situation until we can get a vaccine sorted, rolled out and administered to as many people as possible. And that’s the goal.

But there are signs that it’s not going to be quite as simple as Design Vaccine, Mass Produce Vaccine, Immunise World Population. Never mind the clear difficulties inherent in steps 2 and 3: number 1 seems to be proving more problematic than we had hoped.

This BMJ editorial from various UK academics spells out (some of?) the potential problems with any vaccine (and other immunological therapies) for Covid-19

Worldwide, many covid-19 vaccines are at various phases of development…
Understandably, there is great public expectation that these efforts will be successful, but caution is necessary with respect to both vaccines and passive immunity.

Vaccine being poking you with stuff that will make your body produce antibodies against Covid-19, and passive immunity being short-term protection by poking you with ready-made antibodies taken from someone who has had Covid-19.

Both are good ways to prevent people getting any given disease, but there are no guarantees that either of them will be successful against Covid-19.

There are many reasons why they might not work, or why they might not work as well as we would like or need them to:
Vaccines don’t work as well in older people: Covid-19 disproportionately affects older people. So can we make it work in the people that need it most?
The bit of the virus that we are hoping to target with the vaccine might mutate – meaning that even if we make a working vaccine, it might not work for very long.
We’ve never managed to make a vaccine against SARS or MERS – both very similar viruses to this nasty bugger – despite years of trying.

And – it’s complicated – but giving antibodies to patients might not be the best plan either. It’s worked well before with other diseases (even Ebola!), but this isn’t other diseases. In fact, there’s even the risk that – because of the way some cases of Covid-19 progress – giving convalescent serum (the antibodies) to a patient might even make them sicker.

Finding the solutions to these problems isn’t something that you or I can influence, but I just felt that it was worth putting it out there that you should probably abandon those foregone conclusions that science will have this all sorted out by Christmas (or whenever).

Sorry about that.

This is great. While I’ve been out of the rhythm of writing blog posts and everyone else has been out of the rhythm of reading them, suggestions for blog posts have been coming in by email, facetube and twitter. It’s almost like you guys actually want me to write some stuff.

Do ya miss me? Huh? Do ya?

One such suggestion came from the UK, from an anaesthesiologist (I think that’s what she does, anyway?) and involved a retrospective cohort study, conducted in Australia, asking – after Amy Winehouse’s untimely but not entirely unexpected death and the fuss over the “27 Club” – whether 27 was really a dangerous age for famous musicians.

Of course, this isn’t the first time that Australian scientists have pondered important questions in the BMJ using cohort studies. Who could forget the seminal research of Lim et al at an Australia research institute back in 2005, investigating the disappearance of teaspoons from er… an Australian research institute?

This 2011 paper on the 27 Club (or, as it appears, the lack of it), comes from Adrian Barnett and others from Queensland University of Technology and uses complex statisical methods to analyse the mortality rate of musicians who had number 1 hits (albums) in the UK between 1956 and 2007 and compare them to the mortality rate amongst the general UK population. During this period 71 (7%) of the musicians died.

The sample included crooners, death metal stars, rock ‘n’ rollers and even Muppets (the actors, not the puppets). The total follow-up time was 21,750 musician years.
The authors used mathematical analysis to determine the significance of age 27. They found no peak in the risk of death at this age, however musicians in their 20s and 30s were two to three times more likely to die prematurely than the general UK population.
The research team found some evidence of a cluster of deaths in those aged 20 to 40 in the 1970s and early 1980s. Interestingly, there were no deaths in this age group in the late 1980s and the authors speculate that this could be due to better treatments for heroin overdose, or the change in the music scene from the hard rock 1970s to the pop dominated 1980s.
The authors conclude that the “27 club” is based on myth, but warn that musicians have a generally increased risk of dying throughout their 20s and 30s. They say: “This finding should be of international concern, as musicians contribute greatly to populations’ quality of life, so there is immense value in keeping them alive (and working) as long as possible.”

Their frame of reference begins with Frank Sinatra’s Songs for Swingin’ Lovers! on 28 July 1956 (dead), and continues through to Leona Lewis’ Spirit on 18 November 2007 (sadly still with us). However, as with any research, it has its limitations:

Our sampling scheme only captured three of the seven most famous 27 club members), as one fell outside our time period (Robert Johnson, who died in 1938), and three did not have a number one UK album (Jimi Hendrix, Janis Joplin, and Jim Morrison).
Although we only captured three of the seven famous 27 club members, we did capture seven Muppets.

I can hardly wait to see what Australian statistical research provides us with in December 2017.

Thanks Lynn.

Tag: BMJ

Day 106 – No definite answer

Blogging by other people