Misinformation on Covid-19 vaccines really is prevalent! We read, over the weekend, an analysis by one Dr Joseph Mercola, claiming that vaccines do not work because in the UK and Israel, the majority of those currently hospitalised are fully vaccinated. He very cleverly argues his case using carefully curated data, including from reliable sources such as Public Health England (see Chart 1). This is the chart that is being shared widely on social media. It is frightening, isn’t it, that vaccines are apparently failing to protect people?
As we have written before, Covid-19 is a very emotional subject for most. We think this is why even very intelligent people looking at this chart are quick to jump to conclusions and believe in the worst, without taking pause to think it through.
The New York Times calls Mercola, “The Most Influential Spreader of Coronavirus Misinformation Online”. Why are we writing about this? The report is definitely crafted to mislead, yes, but we are compelled to rebut the claims because they are extremely dangerous — he is actively trying to convince people to say no to any and all future vaccine shots, thus endangering both lives and livelihoods.
We are not going to dispute the accuracy of the figures in Chart 1. On the contrary, this very result is a mathematical certainty. And we will prove this to you with simple mathematics (see Table 1). Furthermore, we will corroborate this with actual real-world data. We must, again, emphasise that statistics need to be looked at in totality, not by being selective. Data can very easily be manipulated and managed to suit the agenda.
Let us assume a hypothetical country with a population of one million. In scenario A, Covid-19 was introduced into a wholly unvaccinated population. At an infectivity rate of 1%, there will be 10,000 positive cases. Obviously, 100% of these 10,000 people must be unvaccinated; in other words, 0% of the infected are vaccinated (since no one is vaccinated).
In scenario B, 20% of the population have now been vaccinated. Assuming a breakthrough rate of 20%, the total number of cases = (800,000 unvaccinated people x 1% infectivity rate) + (200,000 vaccinated people x 20% breakthrough rate x 1% infectivity rate) or equivalent to 8,400. The percentage of cases who are vaccinated = 400/8,400 or 5%. Note that this percentage is higher than in scenario A (which is zero).
In scenarios C and D, more of the people are vaccinated, 50% and 80% respectively. Using the same formula, vaccinated people now account for an even higher 17% and 44% respectively of the total case numbers.
Finally, in scenario E, 100% of the population are fully vaccinated. Anyone who is subsequently infected MUST be vaccinated simply because no one remains unvaccinated. Mathematically, 100% of the infected must therefore be fully vaccinated.
In short, the higher the percentage of the population vaccinated, the higher the percentage of vaccinated people who will make up the total cases. This is statistical truism. The point is, the aim of misdirecting attention to just one figure — the percentage of cases/hospitalised/deaths who are fully vaccinated — is to distract you from seeing the whole picture. The most important data is the falling total number of cases, hospital admissions and deaths — naturally, not shown in the report — as the vaccination rate rises. We will most certainly show this a little later in the article.
There will still be positive cases because breakthroughs happen. No vaccine is ever, or claims to be, 100% effective, especially with the highly contagious Delta variant. But clearly, scenario E (100% population vaccinated) with only 2,000 cases is far, far better than scenario A (100% unvaccinated), where 10,000 people are infected.
Let us look at real-world numbers in Malaysia. Fully vaccinated people (defined as 14 days after second dose) accounted for 12.8% of total new cases on Aug 14, when only 20.9% of the total population had been fully vaccinated. Since then, Malaysia has ramped up its vaccination rate. As at Sept 5, some 40.1% of the total population were fully vaccinated. Accordingly, the percentage of those fully vaccinated making up total cases also rose in tandem, to 33.7% (see Chart 2).
But this higher percentage is nothing to fear. As we said, it is mathematically inevitable, as more and more people are inoculated. Notably, of the 20,396 confirmed positive cases (on Sept 5), 98.4% fell into Category 1 (no symptoms) and Category 2 (mild symptoms). Put another way, the percentage of those fully vaccinated falling into Categories 3 to 5 was disproportionately lower (see Chart 3).
The results are the same in Sarawak, which reported a record high of 3,747 cases on Sept 5, of which 99.7% were in Categories 1 and 2. Only 10 of the 3,747 cases were in Categories 3 to 5. Sarawak is one of the highest vaccinated states in Malaysia — 63.6% of the total population (87.7% of adults) have received two doses.
Similarly, in Singapore, fully vaccinated people accounted for 76% of total new cases in the past 28 days (see Chart 4). But the percentage of these people falling severely ill is far lower than for the unvaccinated, at only 0.9%.
The UK (where 72.3% of the population have at least one dose) and Israel (66.4%) are among the world’s most vaccinated nations. Hence, it is not at all surprising that a higher percentage of the infected are also fully vaccinated (as argued in the report). The most critical goal of vaccines is to protect against severe illness and deaths. Charts 5 to 8 prove just that — despite rising infections, cases and, more importantly, deaths in both the UK and Israel remain well below previous peaks.
Mobility for the UK and Israel has returned to pre-pandemic levels. Israel lifted almost all Covid-19 restrictions on June 1 while the UK ended all restrictions including mask mandates on July 19. Increased social and economic interactions among the people will translate into higher case numbers. The fact that cases are NOT exponentially higher now (with no restrictions) than at previous peaks (when there were stringent movement restrictions), and given the highly contagious Delta variant, is evidence that vaccines work! Importantly, hospitalisations and deaths in both countries remain well below previous peaks.
The proof is even starker when compared against countries with low vaccination rates that are now seeing a Delta-driven surge in cases, across Asean and including countries that had very successfully contained the outbreak earlier such as Vietnam and Australia (see Charts 9 and 10).
That said, the outbreak in Israel does appear to be worsening compared with the UK. The higher level of breakthrough cases is attributed to the waning efficacy of the Pfizer vaccine (according to its government’s data). Israel was one of the first countries to very quickly ramp up vaccination, faster than the UK. It is currently giving a third booster shot to all those who have received their second dose, with a five-month gap.
We still do not fully understand the virus, which is constantly evolving. But it seems quite clear now that the Covid-19 pandemic will not end anytime soon. Facing Covid-19 as an endemic disease (that we have to live with) will require a change in mindset for people. We need to be self-disciplined and vigilant in following the standard operating procedures (for the foreseeable future), including mandatory face masking, personal hygiene and regular self-testing. But at the same time, we must also break away from the crisis mode, the pervasive fear and anxiety that we have been in for the past 19 months. Life must move forward and all social and economic activities must resume, as closely as possible, to the way they were.
We must accept the fact that everyone will most likely be infected (and reinfected) at some point in their lives. The key is that those vaccinated will probably be asymptomatic or have mild symptoms. It will be similar to catching the flu, in which case you stay home until it blows over. This will not tax the healthcare system. Some rare cases may require hospitalisation and in very, very rare instances, they may be fatal. It is not a sign that vaccines do not work — as all the above evidence shows, vaccines remain highly protective against severe illness. The option of continued lockdowns for extended periods of time is not without costs, including to lives, not just livelihoods. This is the reality of life’s choices.
The Global Portfolio gained 0.2% for the week ended Sept 8. Alibaba Group Holding (+3.5%), Home Depot (+2.5%) and Apple (+1.7%) were the top gainers while the notable losers include Singapore Airlines (-2.3%), Johnson & Johnson (-1.1%) and Alphabet.com (-1%). Last week’s gains lifted total portfolio returns to 65.8% since inception. The portfolio is still outperforming the MSCI World Net Return Index, which is up 59.7% over the same period.
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Photo: Bloomberg
