Skip to main content

Visit or invasion?

It is encouraging to read about vaccines making their way successfully through the early stages of testing. I have been tracking some of the discussion about the SARS-CoV-2 virus in some of the scientific literature. But have to confess that while I can follow the flow of the academic arguments, I find that details ain't sticking in my memory.

I will hardly be alone in having to defer to people with decades of training and experience. However, I have at other stages of my life, seen people benefit from inoculation or vaccination.

More critically, I knew of a family where the parents decided not to allow either of the Salk or Sabin vaccinations against polio to be administered to any of their children. All three caught polio. Although long term there seems to have been no effects, there were many years of misery for the children concerned.

Albert Sabin and Jonas Salk share the glory of all but eradicating polio. But their vaccinations were radically different. Sabin's arrived first to market and was a "dead" virus injected to create immunity. Salk's live-virus oral vaccine shortly followed it.

I think I had the jab. But I certainly remember that a box of sugar cubes became part of the contents of my father's medical bag. Salk's oral vaccine was dripped onto sugar and (almost) every kid took it without question. The small number of dissenters got theirs on a small piece of bread.

I understand that Sabin's jab was considered superior, docs love the needle?, but the ease of administration of a sugar cube won out.

We may be, if we are fortunate, about to see a repeat of the polio vaccine battle. A number of successful vaccines which create the desired antibody creation using a variety of different routes. If successful, that will be good, because a minority for whom a particular vaccine is not appropriate, may have another option.

For the NHS, having a choice of vaccines, if of equal efficacy, should keep the price down as companies compete to get their variant into service.

So for politicians, the challenge will be to avoid dropping options from support when they still look viable. Because in the rush to head off the spread of this virus, the temptation to look for short-cuts is always there.

The traditional "Dr Finlay" approach to community medicine had much to commend it even if a good portion of its success depended on the character of the personal rather than clinical support provided by a trusted local GP. The range of interventions available to them when I was a youngster in the 1940s and 50s was extremely limited by comparison with today.

I remember the excitement of new vaccines and new antibiotics. On one occasion, I had an attack of impetigo, a highly infectious skin condition, which affected my upper lip. This disease killed almost no one and went away of its own accord in about ten days. But I remember my father's excitement at the almost magical effect of Aureomycin, a member of a new class of antibiotics called tetracyclines. Their "trick" was to inhibit the multiplication of bacteria rather than as penicillin which directly attacked them.

As an ointment, it was perfect for my impetigo. It's "magic" effect was, of course, magnified by its using gold as one of its constituents. Hence the "Aureo" prefix. Or so I remember from dinner table discussions. The fact that it was an expensive remedy only seemed to magnify its powers.

Those were simpler days. There wasn't much evidence that GPs spent time extending their skills and knowledge. In today's much more complex world, with a vastly wider range of pharmacological options available, a much greater understanding of the adverse side effects, and the need to consider the interactions of multiple medicines prescribed for more than a single condition in a patient, it's so much more complex.

There was really only one publication that came into the household that gained much consideration. That was MIMS - The Monthly Index of Medical Specialities. It was simply a list of the drugs available for prescription. There were three alphabetical indexes, by drug name, by British Pharmacopoeia name, by disease or condition. And it little bit of commentary at the start about this month's amendments. I suspect this was the only thing father read to keep up to date with what was changing in the medical world. I very rarely saw either the British Medical Journal or the Lancet in his hand. We kids read Pulse, a freebie newspaper for GPs.

MIMS was of some use to the rest of the family too. On a daily basis, packets would be delivered by the postie from drug companies. These samples got slung into a big chest of drawers against the idea that they might prove useful at some future date. Their value seemed to be mostly for self-medication by my siblings and me.

If we thought we were unwell or experiencing a treatable condition, we would consult MIMS. And then rummage around to see if there was a sample that matched our problem. If yes, it was upstairs to consult father. Generally, we would say something like, "Double dose to start and then TID?" (TID - Ter in Die, three times a day - father still prescribed in Latin for names and Greek symbols for quantities). After a brief examination of the medicine, not the patient, he would peer over his specs and generally respond with, "Won't do you any harm".

Today we have central bodies to advise doctors on prescribing. And active monitoring of outcomes.

Choosing from multiple vaccines, as seems not unlikely, will be yet another decision the docs will have to make. But at least there are likely to be solutions available.

I wrote earlier in my diary about our failure to find a vaccine to control the virus clan that causes the common cold even after decades of research. And hung my pessimism about the prospects for a successful SARS-CoV-2 vaccine out to view.

Perhaps today's a day when I should crank up my optimism a notch or two. Although my autumn flu etcetera jabs may require more arms to be punctured in future years. I suspect we shall need at least an annual kick up the rear for our immune systems to continue to be safe from this rotten bug.

As if my cup cannot be already filled up by my pharma-led lifting of mood, my political world will experience a boost today as well.

Boris Johnson is here to help the Independence campaign by reminding us that "London knows best".

Seems he may be visiting the military, as I predicted to my spouse a few days ago, on a visit to Moray.

But then maybe not as he has not done the courtesy of telling the Scottish Government anything about his plans for the day.

Business as usual.

Comments

Popular posts from this blog

Advice to the new MSPs

A contribution made to Portland PR 's weekly briefing on Holyrood A new job is a time to look in the mirror and undertake a self-assessment about what one can contribute in a new role. And what weaknesses one may have that could inhibit success. Being elected an MSP is no different in that respect. But very different in many others. One has become public property and every action, or action thought to be by you, will be open to public comment, often unfairly. Silence is often your best response. When one comments on criticism one lengthens the “war” and widens the knowledge of it. Set your own agenda rather than respond to that of others. Who can you trust among your fellow Parliamentarians? Make contact with as many as you can as quickly as you can. And make it a priority to interact with political opponents. The first substantive decision in the new Parliament is the election of a new Presiding Officer and it will be a secret ballot. Understanding the dynamic of other partie

End of an Era 2016-2021

Written for  Holyrood magazine's "The End of an era 2016-2021"  published 07 April 2021.    Neil Findlay is the man who loves you to hate him. As he rises from his habitual place in a distant corner of the Parliamentary Chamber, a snarl as firmly attached to his face as he is disconnected to any symbol of middle-class values such as a tie, tension flows as he selects his target for the day. Is it dapper John Scott? The record-holder for the shortest time between his being sworn in and making his first speech in Parliament; a mere twenty hours. Does Willie Rennie attract his ire? Confession; we went to the same school. Almost anything liberal is bound to attract this Labour very-back-bencher’s contumely. Greens rarely attract his attention but he should remember that John Finnie, another member of this year’s escape committee, can efficiently direct a canine arrest. Now of course, I have sought to avoid any engagement with the fellow. I never, just never, even acknow

Clutter

When big things go wrong, and one feels powerless to do much about them, small things in one's life can become surrogates for one's anger. And there are quite a few big things around at the moment; COVID-19, No-Deal Brexit; A US Presidential Election where the incumbent leads with racist statements. As the end of the current session rushes towards us, many of my colleagues are concluding that they will not be putting themselves forward at the forthcoming election. A couple of our younger colleagues are placing their families first. But most are looking at being in their eighth decade, as I already am, at the end of the next session. When the two leading candidates for the US President are both older than I am - seventy-four in five week's time - it may seem surprising that retirement may be beckoning for me and others a lustrum younger than I am. But it illustrates the profound differences between being a back-bencher in our Parliament and the political life of a US Senator