[K] Conclusion

The current international situation for the Sars-Cov-2 pandemic remains grossly uncertain. Yet it is clear that inoculant/vaccine efficacy wanes after 6 months, and that the treatment does not meaningfully prevent transmission of Sars-Cov-2. It remains striking that the literature clearly articulates that the most the mRNA vaccines can do, is reduce symptoms. In submitting for approval for boosters, even the manufacturer acknowledges that alleviation of symptoms is the signature benefit of this new technology. Current policy appears structured around increasing controls, including mandates that are based on a hypothetical sterile vaccine. Public health measures can shift towards more evidence based measures that reflect the increasing rate of natural immunity in the population and the recognition that onerous and coervice measures often impact low-income populations the hardest. Page 10 contains a list of evidence-based recommendations. [i]

Groups that are calling for vaccination for all to stamp out COVID-19 are yet to address the current uncertainty relating to vaccine efficacy and risk of waning, as well as the risk of breakthrough variants. Modelling has excluded these factors, and ignored the fact that healthy young people and children are at less risk of harm from Sars-Cov-2 than they are from normal risks that are navigated in daily life. The evidence for national policy requiring compulsory vaccination, and the likelihood that this would require a 3^rd booster, is extremely weak, resting on extremely precarious ground. There has been a failure to acknowledge natural immunity, and the questionable efficacy of current vaccines in relation to new variants, which extend beyond variant D. In addition, there are substantial ethical and moral concerns about vaccinating healthy children and young adults, for whom the risk of Sars-Cov-2 is negligible. There are causes for concern relating to adverse effects, and children and young adults should not be engaged instrumentally to prevent the spread, when there is little evidence, they are at harm.

In this environment any action, emergency or otherwise, by parliament, Cabinet or the Ministry of Health to impose so-called vaccine passports, mandates, or take other measures to restrict the rights of New Zealand citizens is unjustified and contrary to the public interest. The current response, which includes tightening rules towards mandatory vaccination and requiring a registry of school children is unjustified. As of writing, the proposed COVID-19 Public Health Response Amendment Bill (No 2) which strengthens powers and increases infringement penalties is pecuniary, draconian and will impact low-income groups, including Māori and Pasifika, the hardest.

The Health Act states that ‘all government measures must be ‘proportionate to the public health risk sought to be prevented, minimised, or managed’ and not be made or taken in an arbitrary manner. [ii]

Current state recommendations for treatments are rudimentary and unsupportable. It is evident that the highest risk populations are those who are older, and groups with obesity and associated metabolic disease. The elderly and those with chronic and metabolic diseases can benefit from vaccination, however as these groups are often immunosuppressed, they may also be at greater risk of vaccines waning, and more at risk from breakthrough infections than the general population. These populations are substantial. Due to the absence of certainty, all effort must be made to ensure treatments and therapies are made available that can both prevent extreme harm from, and lessen the symptoms should these groups become infected with Covid-19. Ongoing nutritional therapies may also reduce the potential for long-Covid.

On October 31, an International Alliance of Physicians and Medical Scientists reconvened to produce an Updated Physicians Declaration II. The statement noted that ‘considering the risks vs. benefits of major policy decisions, thousands of physicians and medical scientists worldwide have reached consensus on three foundational principles’. These principles, as primary resolutions resolved[iii] that:

Healthy children should not be subject to forced vaccination
Naturally immune persons recovered from Sars-Cov-2 shall not be subject to any restrictions or vaccine mandates;
All health agencies shall cease interfering with physicians treating individual patients.

In times of crisis, it can be difficult to judge evidence. Medical authorities, governments and pharmaceutical funding agencies insist on specific trials for individual treatments that are directly showing efficacy for the treatment of Covid-19. However, it can be argued that these institutions have a public obligation to recognise the body of knowledge that arises from long term research on a therapy or treatment that produces a ‘weight of evidence’[iv] for symptom treatment, such as the potential for vitamin D to lessen inflammation and prevent lower respiratory tract infections and the data supporting the safety and clinical efficacy of Ivermectin.

As with any area of expertise, medicine has always involved educated guesswork, because human bodies respond differently when exposed to environmental stressors. Globally, conservative doctors are testifying that low-risk multi-target therapies prevent and alleviate the critical symptoms observed in COVID-19 patients at low cost. For those infected with Sars-Cov-2 and its variants, vitamin D can never be the only therapy. However, there is clear evidence that it is an important co-factor in preventing an adverse outcome. However, if vitamin D is considered controversial, it is no surprise that even more ‘controversial’ low cost and low risk therapies cannot be transparently debated, including repurposed drugs[v] [vi] zinc[vii] [viii] and vitamin C.[ix] [x] These treatments reduce risk of severe outcome or death without substantial risk of side-effect or adverse drug-drug interaction. They prevent hospitalisation and they enable the individual to maintain autonomy in health care and health management. COVID-19 impacts people differently, medical treatment impacts people differently, and a public health approach must be responsive to these facts.

It remains unaddressed as to why the Health Act, with its principle of proportionality, and its recognition of the role of the individual, has been so profoundly side-lined by a raft of hyper-speed legislation that appears to be unable to reflexively respond to the scientific knowledge.

There appears little authoritative contestation to demand why state modelling does not include the many ‘uncomfortable knowledges’ articulated in this paper that help to articulate why the mRNA vaccine/inoculant/injection cannot be the silver bullet that both the state and its citizens would wish it to be.

In such an environment, it is worryingly inevitable, that absent such relevant considerations, absent political courage and a publicly legitimated political platform in which to articulate such concerns, it is not surprising that our healthy young adults, our healthy children, who are predominantly not at risk of Sars-Cov-2; - who would instead stand to gain from natural immunity - will inevitably – and unethically - become coerced, and bound into, a novel treatment that increasingly appears to carry with it -a risk profile that appears greater than their risk of COVID-19 following infection. In such an environment, those families and groups who particularly struggle with low incomes, high house costs and rudimentary diets, would be disproportionately represented in hospitals. Our sincere concern is that in a political environment that disinhibits physician autonomy, where only a rudimentary narrow spectrum of treatment modalities are ‘authorised by the state’ that good doctors will have their hands tied, they will be unable to respond to their pathologies of the disease that manifests as COVID-19 in such a way that is both protective of health and promotes health equity.

NEXT: October 2021: Submission to the COVID-19 Public Health Response Amendment Bill (No 2) - Including oral hearing with Members of Parliament.

REFERENCES

[i] Halperin et al. Revisiting COVID-19 policies: 10 evidence-based recommendations for where to go from here. BMC Public Health (2021) 21:2084 https://doi.org/10.1186/s12889-021-12082-z

[ii] Health Act 1956. 92F Principle of proportionality https://www.legislation.govt.nz/act/public/1956/0065/latest/whole.html#whole

[iii] Physicians Declaration II – Updated Global Covid Summit. International Alliance of Physicians and Medical Scientists October 29, 2021. https://doctorsandscientistsdeclaration.org/

[iv] Fedak et al 2015. Applying the Bradford Hill criteria in the 21st century: how data integration has changed causal inference in molecular epidemiology. Emerg Themes Epidemiol. 2015; 12: 14.

[v] Ngo et al 2021. The time to offer treatments for COVID-19. Expert Opinion on Investigational Drugs, 30:5, 505-518, DOI:

10.1080/13543784.2021.1901883

[vi] Marik et al 2021. A scoping review of the pathophysiology of COVID-19. International Journal of Immunopathology and Pharmacology. (2021) 35:1-16.

[vii] Pal et al 2020. Zinc and COVID-19: Basis of Current Clinical Trials. Biological Trace Element Research 199:2882–2892

[viii] Anuk et al 2020. The Relation Between Trace Element Status (Zinc, Copper, Magnesium) and Clinical Outcomes in COVID-19 Infection During Pregnancy. Biological Trace Element Research 199;3608–3617

[ix] Coelho-Ravagnani 2021. Dietary Recommendations During the COVID-19 Pandemic: an Extract. Komp Nutr Diet 2021;1:3–7 DOI: 10.1159/000513449

[x] Ho et al 2021. Perspective Adjunctive Therapies for COVID-19:Beyond Antiviral Therapy. Int. J Med Sciences.18:2;314-324.

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