14 October 2022: Tedder - C

Questions from core participants:

On his Lancet article about haemophilia patients who had tested positive for HTLV-III and whether the information was fed back to the supplying Haemophilia Centres (and the patients); he said it would be dreadful if had not been fed back to the Centres who in effect owned the information from which the study was based. He would also expect and hope that the information was also fed back to the patients. It could not be done by his team, but the Centres since the information also belonged to the patients. (This writer would normally have assumed there was a specific protocol to pass on information to patients which was discovered through research, not least when it included the fact of the patient having a serious life-limiting viral infection which could be passed on to others. However, such an otherwise normal, fair, and logical assumption is tainted by knowledge of systemic non-disclosure arising from the Inquiry, time and time again.)

On Hepatitis B and its prevalence during key dates; he said he did not know, but thought it was low.

On the concept of “know your donor” and effective exclusion criteria for those potential donors who posed a significant risk; he quickly listed a couple of ways.

On Treloar College, and if he was involved with that infection situation in the way he was with the Edinburgh cohort; he said he had no recollection of having done that.

On the evaluation of screening tests and if haemophiliacs blood was involved in that; he said he could not say.

On the actual long-term sustainability of a HCV “sustained viral response” (effectively told they had “cleared the virus”) after cancer treatment; he said that if the SVR equates to virus clearance from the liver then it should not be possible for it to reactivate. However, if the SVR is sustaining a period of suppression of detectable viraemia with the assumption being that the patient is then cured of the infection then that infection could re-establish if the patient host is subjected to immuno-suppression. He said you can think you have gotten rid of a virus infection, but later something is done to them and if there is any residual virus, it may reactivate. On the whole if it is said somebody is cured, then the assumption, or belief is that there is no virus left so it would not re-activate. (This writer, for one, was not completely reassured by this response.)

The Chair had one topic to explore, that of surrogate testing. He asked a few preliminary questions for context and clarity, which led to a dialogue involving hypothetical scenarios to get into the detail and underlying rationale for testing and using test results. It is clearly not an exacting science. Maybe that is why so many doctors are still “practicing” (… on their patients).

Counsel gave a clarification on an earlier reference to the current blood supply issues in the media. It was explained how it was not down to a lack of donors, but to staff shortages. However, this did not quench the admirable free-will response of more people turning up to donate blood.

The witness wanted to point out that he was not just a virologist, but he had a deep sadness over how “well-meaning” treatments had led to such terrible harms to people some who were in attendance and many more beyond. He hoped such a thing would not happen again, though he referenced the Covid situation as an indicator that more work was required.

The Chair noted how the witnesses’ last comment was a matter for a different Public Inquiry. He also recognised the latter-day learning from Prof Tedder that it might have been useful for expert witnesses to have access to a whiteboard while giving their evidence. He thanked the witness for his help with understanding the complex information about viruses.

Counsel then made an announcement about the forthcoming November oral hearings.

It might have seemed like the heat was off for a few weeks, but with the prospect of final submissions there will be certain infected and affected souls with the campaigner or patient representative label firmly stuck to their chest who will not yet be in the running for respite. Any recovery from so-called Inquiry fatigue for them/us will have to wait a bit longer.

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