Just suppose that in some future trade war or Brexit scenario, there was a problem acquiring vaccinations. Just suppose. The effect could be devastating, we could have epidemics of for instance measles where lots of young children died. In this blog piece we want to unpick some of the culpability in such a scenario: it is not at all straightforward.
We want also to use the Andrew Wakefield debacle where he linked MMR vaccinations with the development of autism, in a way subsequently understood to be completely fraudulent, but touching on a subject that parents around the world are only too keen to believe. It is a subject where the tin god syndrome amongst medical professionals is only too apparent.
And the link of things that lots of people want to believe even when they are not true takes us to another angle on Brexit, where populist politicians among whom Farage is now infamous can pander to things that people want to believe that are simply untrue at any level. An older guy in Wigan is reported this morning as saying things were better before we joined the EU in 1970: the corollary that they would be better again in some way that related to 1970s Wigan if we left is at least difficult to sustain in any reasoned way.
Tusk says Brexit “a vaccine” on continent against populists. FT 29/05/19
Autism and the gut
In Andrew Wakefield’s original research, there was a dimension of leaky gut syndrome, something I have a close interest in. When the gut lining’s active action is damaged, large molecules that are not supposed to pass into the blood can do so, and in the developing infant these can have a damaging effect on the brain. What seems better established now than it was in 1998, the date of Wakefield’s paper, is that if you sample the gut microbiome of autistic children and the gut biome of children who show no signs of autism, then they are distinct: very different in a systematic way.
Let me be clear that this is an association. There is no implied causation in either direction. However, because gut microbiome research is in its infancy, the questions it raises about early development are unanswered to the best of my knowledge. We also know that everyone’s gut microbiome is damaged to the extent that we do not know what a primally healthy one looks like. We know that there is more diversity in the genetic material of microbiota that make up our working immune system that exists in human DNA.
So I think it is fair to say alongside Andrew Wakefield being a disgraced fraud, that we still do not know the effects of MMR vaccines on developing infants at the level that we need to if we are to be able to say they are safe. Statistically there are (low) risks and we do not know how to judge which infants might be at more risk than others. Further, this has become such a minefield that few researchers would dare go there.
Just suppose for a moment that we found that glyphosate, known to cause leaky gut, was found to be a significant risk factor in the administration of MMR vaccines. How would that play out?
Complexity and herd immunity
The arguments for vaccination involve the notion of herd immunity. If enough of a population, herd, are immune to a disease then the spread of that disease is inhibited. There are simply not enough people in contact with a particular case of the illness who are able to contract and therefore spread it. But we are reluctant to see ourselves as one of a herd, no matter how strong the evidence is. The notion that I must vaccinate my unique child to improve the level of protection for your child who you might chose not to have immunised is fraught.
Indeed, in most areas of public policy we go the other direction. If one child has an accident in a playground, all playgrounds are made too safe for children to learn to take risks in. If one school trip is badly run, so much bureaucratic risk management is added that other trips are spoiled or never happen at all.
This subject of the herd is a classic systems complexity issue. We need to be able to think at the level of the individual and the family and at the level of a community and a society and the issues are not at all the same. We typically try to reconcile the different perspectives before we have understood them separately. And this is where populist politicians and fraudulent doctors play: they put forward the view that your own individual prejudices and illusions are also herd priorities.
In my local opticians, there is a poster sponsored by some purveyor of posh spectacles with a number of optical illusions to play with while you are waiting. Typically there is a process required: focus on this then focus on that and you will see things that confuse your system of sight. What we see depends on what we pay attention to. There are multi-lens cameras where what we choose to focus on and to bring out clearly in a photograph can be deferred until after the picture has been taken. We desperately need this sense of different fields of vision where there are several valid different images of the same scene.
I was taught this lesson very early in my career. As a seismic geophysicist I produced images of the rock strata beneath southern England for professional interpreters at Shell to look for potential oil and gas reservoirs. I had a playful approach to producing images and insisted on showing how different the images could be under different assumptions. A guy in his fifties in tears was brought to me to say that he just needed to know what the right answer was.
Donald Tusk in the quote above clearly thinks populists are a problem. Populists by definition say things that people want to hear. In the recent EU elections in the UK, Nigel Farage came top of the poll without having a party or any policies, all the while stinking of illegal funding. But he was clearly saying things that people wanted to hear.
What links Nigel Farage and Andrew Wakefield is precisely their politician’s ear for what people want them to say. People want an excuse not to have their children vaccinated, and they want to give establishment politicians a kicking. Just give them a chance and they will do so. And it doesn’t matter how illegal the arrangements are and how many lies are told on the way because the point is to express something quite other.
If we describe it like that we can get at the complexity questions a little more easily.
The vaccination question is not open and shut. What successful vaccination programmes do is to develop a level of immunity in the herd that means that there will be no natural outbreaks of the disease. If there are no outbreaks then there will be no natural immunity: the herd will rely absolutely and completely on the vaccination programme.
So when the vaccination programme begins to falter, the herd is exposed to much worse epidemics than would have occurred if there had been no programme in the first place. Remember that the populations in various place in the Americas were reduced by 90% by the diseases brought by colonisers. Which is far from saying that vaccination does not save lives or that it is not a good idea, just that it belongs to a certain rather bureaucratic and patriarchal view of the world.
So we must see populism as a disease for which our current politics has made us vulnerable. We have epidemics of populism that can lead to the deaths of many people, far more people than in we had had a politics that actually dealt with the issues that confronted it in a properly consensual manner. Brexit as a manifestation of populism merely shows that real politics has been profoundly undemocratic and has allowed an establishment to lie and cheat and defraud people without their having any way to address the abuse.
Of course the effects of the protest vote are desperately counter-productive. The protest is choreographed by much darker forces than the current politicians. It is another turn of the screw that produces abject subjection and an even more complete absence of political redress for abuses of power. The UK seems to be simply a sandbox in which these forces can practice their dark arts, and of course the tragedy is that people think they are winning their freedom.
Andrew Wakefield and his successors are similarly exploitative. The message that vaccinations can cause autism delivers people into the hands of epidemics but also the hands of quacks of many kinds, all out to make big bucks out of people’s fears and miseries. People do not learn that they have been duped, they become serially vulnerable, just as the people duped by populists become subject to ever tighter and more vicious manipulation.
How to escape the vortex
The only ways to escape the vortex are the sorts of arguments that were have explored many times in these blogs. We need to be able to see the system at different levels: at least two levels and probably more. There is a profound difference between what seems to be a good idea locally and the individual level and what that same idea might look like, how it might play out, at a herd level. They are not, and cannot be, the same thing. This is the populist trap in one: your white supremacist stance may make you feel powerful but it delivers you into profound powerlessness. It sets in train forces that will destroy you in due course.
Things are not what they seem, like the optical illusions on the poster. If you are persuaded to believe that what you see now is the only truth then you have no way of seeing how you are being manipulated. You don’t need to believe in conspiracy theories to read recent history in terms of how we were sold cigarettes, how we were sold an oil-based economy, how we were sold processed food, how we were sold wars. Each time there was political support for something that was profoundly not in the interest of the people who supported it. Each time the skills gained by the manipulators were honed for the next challenge in painting black as white.
It is also true that this is always gun-boat diplomacy. Read David Graeber about the Occupy Movement and how swathes of people came to understand that law enforcement works for the 1% and only for the 1%. The gun-boats are always there to persuade people of where their best interests lie. And the brave souls who stand up for simple truth, perhaps Tim Noakes showing people how to recover their health through eating fewer carbohydrates, are put on trial and persecuted by their “colleagues”. We have to fight for our ability to see what is being done in our name.
What does it take to see Andrew Wakefield back then and Nigel Farage right now as utter frauds who would sell your grandmother? I think we need to focus away from their weaselly personalities to ask about the forces that they channel. Where Farage’s funding comes from is really the only question worth asking. Whose fool is he? The people who say Boris Johnson must be defeated at the ballot box not in the courts are both right and wrong. People must be able to form political judgements based on whose bidding Boris is doing. Ultimately Boris is not the issue because if he goes under a lying bus then there will be another Boris or Doris to take his place.
All in all these characters are straight out of Smith’s First Law, which says that FIFA needs football far more than football needs FIFA. We will be exploring that in next week’s blog.
 Nassim Taleb writes a fair bit about the difference between individuals and the herd, and how probabilities play out differently whether you’re talking about a population or a series of experienced events. Not at all intuitive, even to people who think that they do rigorously statistically valid science.
 Not just the two-lens systems that appear in modern phones, but also light field (plenoptic) cameras like the now-defunct Lytro that also capture information about the direction that light rays were travelling.
 i.e. decimated in the modern sense of the word, rather than the classical sense of a punitory 10%