22nd February - Roadmap out of the pandemic, lifting of restrictions.

[initiation]

How on earth can we have another 10 weeks before we can have a pint inside or meet friends in a house.

Zoe survey showing that infections are where they were at the start of June last year.

But remember it is about data not dates apparently...

 

[yorkie]

Latest Daily UK COVID-19 Data: Vaccines, Cases, Trends | ZOE

COVID infection & vaccination rates in the UK today, based on public data and reports from millions of users of the ZOE Health Study app

covid.joinzoe.com

120,508​

people are currently predicted to have symptomatic COVID in the UK​

Daily new cases of COVID​

Total numbers of new daily cases across the UK​

6,242​

The Government are going to find it increasingly difficult to toe the line of "The vaccines work; get vaccinated!" / "The vaccines don't work; we need to keep locking down!" contradictory messaging, if these trends continue...

 

[brad465]

A sign of things improving: the NHS plan to close the Nightingale Hospitals from April (yes many were PR facilities so to speak but their closure still seems to be positive):

Covid-19: Nightingale hospitals to close from April

The temporary hospitals, which were largely unused, are being shut as patient numbers fall.

www.bbc.co.uk

The network of emergency Nightingale hospitals set up to cope with a surge of Covid-19 cases is to close from April, the NHS has said.

Established last spring amid fears that the NHS might be overwhelmed, the temporary hospitals in England were largely not needed.

Some were used as rehab centres and the sites in London and Sunderland will stay open for vaccinations.

The NHS said they had been the "ultimate insurance policy".

Seven Nightingale hospitals were built in England, starting in April 2020 with the 4,000-bed facility at London's ExCel centre. Another was set up in Belfast, while Scotland and Wales had their own temporary hospitals.

But they were never used on a large scale, because the NHS did not have enough trained staff to fill the Nightingales as well as the permanent hospitals.

During the winter surge in coronavirus cases, Chris Hopson of NHS Providers, which represents hospital trusts, said they had been built to avoid a situation like that seen in northern Italy in spring last year. But he said it would be a "success" if they were not used.

Yorkshire's 500-bed hospital, opened by Capt Sir Tom Moore, will close next month without treating a single patient. It will operate as a testing centre until then.

It does though beg the question about if the situation is going to be much better next month that these hospitals will close, why don't they lift almost all, if not all restrictions then? I expect the SAGE pessimists are the answer, but this sort of questioning needs hounding at them, especially as we could well have completed first doses for 5-9 groups around the same time the Nightingales appear to be closing.

 

[Crossover]

A sign of things improving: the NHS plan to close the Nightingale Hospitals from April (yes many were PR facilities so to speak but their closure still seems to be positive):

I think it some way it is a bit of a landmark time. For me (and some of my family) the very ‘building’ of them was something of a sobering thought, particularly the one at the NEC, a place I’ve visited many times both as a visitor and an exhibitor, whereby it felt like a sign of how serious things were. (Notwithstanding the later epiphany that were actually as much use as a chocolate fireguard due to the lack of staff for them)

It’s certainly good to hear that we are in a position that they are to be dismantled - it does probably herald another step towards the normal

 

[Mugby]

Does anyone know how much money has been wasted spent on the Nightingale hospitals?

 

[TT-ONR-NRN]

Does anyone know how much money has been wasted spent on the Nightingale hospitals?

I think the correct word is invested. Money would have been saved if we had not built it, as they were not needed - but think how awful it’d have been if they were needed!

 

[HSTEd]

Ultimately an irrelevant sum of money.

It's all peanuts next to furlough and the economic disruptions.
Having extemporised hospice wards available could have been useful had things worked out a bit differently.

(If the kent variant had been marginally more infectious , making the lockdown ineffective against it, for example)

 

[yorksrob]

A sign of things improving: the NHS plan to close the Nightingale Hospitals from April (yes many were PR facilities so to speak but their closure still seems to be positive):

Covid-19: Nightingale hospitals to close from April

The temporary hospitals, which were largely unused, are being shut as patient numbers fall.

www.bbc.co.uk

It does though beg the question about if the situation is going to be much better next month that these hospitals will close, why don't they lift almost all, if not all restrictions then? I expect the SAGE pessimists are the answer, but this sort of questioning needs hounding at them, especially as we could well have completed first doses for 5-9 groups around the same time the Nightingales appear to be closing.

I must admit, whilst SAGE are still bleating that there might be another "hard winter" I'm not convinced that now would be the time to de-commission the Nightingales.

It sounds like them lazily falling back on their default position of being happy to impose restrictions on the public, rather than providing a working health service.

 

[duncanp]

I must admit, whilst SAGE are still bleating that there might be another "hard winter" I'm not convinced that now would be the time to de-commission the Nightingales.

It sounds like them lazily falling back on their default position of being happy to impose restrictions on the public, rather than providing a working health service.

By the time next winter comes around, the vast majority of adults in the UK will have had both doses of the vaccine.

Therefore there will be a large degree of immunity in the population, so that COVID-19 can be managed in the same way as flu is.

Face coverings may be advised in certain cirucmstances, but I cannot see them being made mandatory again.

Nor do I envisage another lockdown. It would be largely ignored, and the economy cannot take any more punishment, as we shall see in the autumn budget.

The Nightingale hospitals were largely symbolic, and were opened so that the government could be seen to be doing something.

Closing them will have little effect on future NHS capacity.

 

[Bantamzen]

I must admit, whilst SAGE are still bleating that there might be another "hard winter" I'm not convinced that now would be the time to de-commission the Nightingales.

It sounds like them lazily falling back on their default position of being happy to impose restrictions on the public, rather than providing a working health service.

The Nightingales were barely used, and probably more of drain of resources than any kind of help. Added to the fact that hospitalisations should be significantly lower from here on in, there seems little point throwing more money at them.

 

[Class 33]

All this talk of a possible lockdown next winter from MPs, the cabinet, and others, I really really don't get. What an earth are they on about??? The whole country would have been vaccinated by then! And there won't be a surge of thousands of hospital admissions and deaths like there has been before! Those days are over! When we come out of this lockdown, this will be the last ever lockdown.

 

[nlogax]

this will be the last ever lockdown

I'd hope so, but please don't jinx it

Save yourself some woe and step back a little from the headlines. There are a thousand talking heads on media / social media, each with their own opinion of Covid's future in this country and where things are headed. Grim news-topping predictions aren't hard to find amongst the noise, but the vaccination program is doing what it needs to do to fade this thing out and return our lives to us. Gotta have some faith..

 

[35B]

I must admit, whilst SAGE are still bleating that there might be another "hard winter" I'm not convinced that now would be the time to de-commission the Nightingales.

It sounds like them lazily falling back on their default position of being happy to impose restrictions on the public, rather than providing a working health service.

I read it differently - a signal to the events industry that their venues are going to be able to be used for events.

 

[Class 33]

I'd hope so, but please don't jinx it

Save yourself some woe and step back a little from the headlines. There are a thousand talking heads on media / social media, each with their own opinion of Covid's future in this country and where things are headed. Grim news-topping predictions aren't hard to find amongst the noise, but the vaccination program is doing what it needs to do to fade this thing out and return our lives to us. Gotta have some faith..

Yes, although I have a look at the news websites every day, I don't bother clicking in to read any of the ridiculous doom mongering that's still going on. One of the most ridiculous headlines I saw recently was something like "If restrictions are eased too quickly there will be 50,000 deaths this summer, expert warns". Absolutely ridiculous some of the claptrap these people come up with, and that the press and media gives them airtime.

 

[yorksrob]

I read it differently - a signal to the events industry that their venues are going to be able to be used for events.

I suppose that's the "glass half full" interpretation.

I just don't want them to have any excuses to put in restrictions again.

 

[YorkshireBear]

I don't know about others but Chris Witty's tone today seems to be much more in line with there will be deaths and we have to accept it rather than saying we need more restrictions to stop these deaths. I.e. warning us it will continue to kill people no matter what.

It's subtle but for me it represents a change of tone.

 

[chris11256]

I don't know about others but Chris Witty's tone today seems to be much more in line with there will be deaths and we have to accept it rather than saying we need more restrictions to stop these deaths. I.e. warning us it will continue to kill people no matter what.

It's subtle but for me it represents a change of tone.

It's a welcoming change of tone but I fear the damage has been done. For 12 months now people have been conditioned to think that any covid case/death is bad news and we must lock down. It's going to be very hard to turn people back to normality without the restrictions of social distancing, capacity limits, masks and such.

 

[island]

It's a welcoming change of tone but I fear the damage has been done. For 12 months now people have been conditioned to think that any covid case/death is bad news and we must lock down. It's going to be very hard to turn people back to normality without the restrictions of social distancing, capacity limits, masks and such.

I have tried in other fora pointing out that in under-50s deaths with COVID are comparable to road deaths, and nobody’s suggesting banning cars. Sadly, I did not get much buyin.

 

[brad465]

Registered deaths are now only just above the excess line, and more Covid deaths are not excess than are:

Deaths registered weekly in England and Wales, provisional - Office for National Statistics

Provisional counts of the number of deaths registered in England and Wales, including deaths involving the coronavirus (COVID-19) pandemic, by age, sex and region.

www.ons.gov.uk

Selling restrictions will be a challenge if/when deaths soon are below excess, combined with hospital levels plummeting as well.

 

[yorksrob]

I don't know about others but Chris Witty's tone today seems to be much more in line with there will be deaths and we have to accept it rather than saying we need more restrictions to stop these deaths. I.e. warning us it will continue to kill people no matter what.

It's subtle but for me it represents a change of tone.

It is, but given he's conceded that there will be some vulnerable people who don't receive the vaccine, or for whom it doesn't work, I still don't see what is to be achieved by dragging out the reopening process.

Supposing in five weeks time, the numbers aren't looking as good as they'd hoped. What are they going to do. Postpone the next stage ? What will that achieve exactly, because if you've vaccinated everyone vulnerable who's going to be vaccinated, there isn't anything more that can be done.

 

[cuccir]

Supposing in five weeks time, the numbers aren't looking as good as they'd hoped. What are they going to do. Postpone the next stage ? What will that achieve exactly, because if you've vaccinated everyone vulnerable who's going to be vaccinated, there isn't anything more that can be done.

Let's suppose that in mid-April (at the point of the 'phase 2' reopening) the virus is starting to circulate at higher levels, or is growing with R >1. A fourth wave starting at that point could still be fairly deadly: I'd guess about half the population will be unvaccinated (FT projection is to start under-40s in mid-April), the 12 million over 65s will mostly not have had their second shot ie they'll have something like 80% protection against severe illness. But that still means the possibility of 2,500,000 vulnerable people getting a severe illness: of course not that many would, but still potential for a number of deaths albeit you'd hope at a lower level than the third wave.

Groups 1-4 should have all had their second shots by mid-May and all over 65s should have their second shots by mid-June. All adults should have had their first shot by the end of May or first week of June. And then add two weeks to all those dates to allow for immunity to actually develop.

So in terms of delaying, yes, I can see that IF (and that's a big IF) the reopening in March has started to push numbers up, there is merit in postponing reopenings, or staggering them out a bit more, probably until we are in mid-July. And during that period, every week you delay means more partially vaccinated people and more fully vaccinated people, so even putting everything back by just a little bit could make a huge difference. If phases 2 and 3 were delayed or staggered perhaps the gap between phases 3 and 4 (ie to full reopening) could be shortened to try and make up for lost time a bit as you'd be doing those when more or less everyone is are vaccinated.

That's all a "let's suppose".... so far the vaccination programme has been effective at the levels of the most optimistic expectations so let's hope it keeps that way!

 

[yorksrob]

Let's suppose that in mid-April (at the point of the 'phase 2' reopening) the virus is starting to circulate at higher levels, or is growing with R >1. A fourth wave starting at that point could still be fairly deadly: I'd guess about half the population will be unvaccinated (FT projection is to start under-40s in mid-April), the 12 million over 65s will mostly not have had their second shot ie they'll have something like 80% protection against severe illness. But that still means the possibility of 2,500,000 vulnerable people getting a severe illness: of course not that many would, but still potential for a number of deaths albeit you'd hope at a lower level than the third wave.

Groups 1-4 should have all had their second shots by mid-May and all over 65s should have their second shots by mid-June. All adults should have had their first shot by the end of May or first week of June. And then add two weeks to all those dates to allow for immunity to actually develop.

So in terms of delaying, yes, I can see that IF (and that's a big IF) the reopening in March has started to push numbers up, there is merit in postponing reopenings, or staggering them out a bit more, probably until we are in mid-July. And during that period, every week you delay means more partially vaccinated people and more fully vaccinated people, so even putting everything back by just a little bit could make a huge difference. If phases 2 and 3 were delayed or staggered perhaps the gap between phases 3 and 4 (ie to full reopening) could be shortened to try and make up for lost time a bit as you'd be doing those when more or less everyone is are vaccinated.

That's all a "let's suppose".... so far the vaccination programme has been effective at the levels of the most optimistic expectations so let's hope it keeps that way!

But at that stage, the over 50's will have been vaccinated which will mean that the risk to the NHS will have been neutralised.

Surely by then it should be up to individuals to decide how much risk they're willing to take.

 

[DB]

Let's suppose that in mid-April (at the point of the 'phase 2' reopening) the virus is starting to circulate at higher levels, or is growing with R >1. A fourth wave starting at that point could still be fairly deadly:

It really wouldn't! Pretty much all of those at risk would already have a high level of protection even with only the first injection. The younger age group who won't have had it at all are mostly at very low risk in any case.

Plus you aren't taking seasonality into account - the respiratory virus season will end within the next month or so.

 

[takno]

Let's suppose that in mid-April (at the point of the 'phase 2' reopening) the virus is starting to circulate at higher levels, or is growing with R >1. A fourth wave starting at that point could still be fairly deadly: I'd guess about half the population will be unvaccinated (FT projection is to start under-40s in mid-April), the 12 million over 65s will mostly not have had their second shot ie they'll have something like 80% protection against severe illness. But that still means the possibility of 2,500,000 vulnerable people getting a severe illness: of course not that many would, but still potential for a number of deaths albeit you'd hope at a lower level than the third wave.

Groups 1-4 should have all had their second shots by mid-May and all over 65s should have their second shots by mid-June. All adults should have had their first shot by the end of May or first week of June. And then add two weeks to all those dates to allow for immunity to actually develop.

So in terms of delaying, yes, I can see that IF (and that's a big IF) the reopening in March has started to push numbers up, there is merit in postponing reopenings, or staggering them out a bit more, probably until we are in mid-July. And during that period, every week you delay means more partially vaccinated people and more fully vaccinated people, so even putting everything back by just a little bit could make a huge difference. If phases 2 and 3 were delayed or staggered perhaps the gap between phases 3 and 4 (ie to full reopening) could be shortened to try and make up for lost time a bit as you'd be doing those when more or less everyone is are vaccinated.

That's all a "let's suppose".... so far the vaccination programme has been effective at the levels of the most optimistic expectations so let's hope it keeps that way!

The trouble is that the second shot looks like it's only pushing complete protection from 80% to 86%, which doesn't materially move very much at all. Under 50 the disease is just not serious enough to justify any systematic reaction to it - in a society without any over 50s it probably wouldn't even be worth doing any testing of people who weren't seriously ill. By mid-April we should be pretty close to as-good-as-it's-going-to-get.

The cost from the loss of jobs and businesses we will suffer as a result of a casual months or two extra restrictions would be devastating. You might save a couple of hundred people from having Covid on their death certificate, but at that point you'd almost certainly be losing more through suicides.

 

[DustyBin]

The trouble is that the second shot looks like it's only pushing complete protection from 80% to 86%, which doesn't materially move very much at all. Under 50 the disease is just not serious enough to justify any systematic reaction to it - in a society without any over 50s it probably wouldn't even be worth doing any testing of people who weren't seriously ill. By mid-April we should be pretty close to as-good-as-it's-going-to-get.

The cost from the loss of jobs and businesses we will suffer as a result of a casual months or two extra restrictions would be devastating. You might save a couple of hundred people from having Covid on their death certificate, but at that point you'd almost certainly be losing more through suicides.

I totally agree, and the government can't afford to simply pour yet more money into keeping businesses afloat at this stage either.

 

[Eyersey468]

The trouble is that the second shot looks like it's only pushing complete protection from 80% to 86%, which doesn't materially move very much at all. Under 50 the disease is just not serious enough to justify any systematic reaction to it - in a society without any over 50s it probably wouldn't even be worth doing any testing of people who weren't seriously ill. By mid-April we should be pretty close to as-good-as-it's-going-to-get.

The cost from the loss of jobs and businesses we will suffer as a result of a casual months or two extra restrictions would be devastating. You might save a couple of hundred people from having Covid on their death certificate, but at that point you'd almost certainly be losing more through suicides.

I also agree. A lot of businesses are hanging by a thread as it is and pushing their reopening dates back may well send them under with the consequential loss of jobs, which the country can't afford

 

[cuccir]

But at that stage, the over 50's will have been vaccinated which will mean that the risk to the NHS will have been neutralised.

It really wouldn't! Pretty much all of those at risk would already have a high level of protection even with only the first injection. The younger age group who won't have had it at all are mostly at very low risk in any case. Under 50 the disease is just not serious enough to justify any systematic reaction to it - in a society without any over 50s it probably wouldn't even be worth doing any testing of people who weren't seriously ill. By mid-April we should be pretty close to as-good-as-it's-going-to-get.

The trouble is that the second shot looks like it's only pushing complete protection from 80% to 86%, which doesn't materially move very much at all.

I should say I'm really not predicting this particularly, but I'm arguing against the view that delaying would make no difference in the spread of the disease IF R shot up again after schools reopening and increased social mixing in March.

The difference in how a disease can spread in a population with 40-50% of people vaccinated as it will be by mid-April, compared to 85% or whatever we end up reaching by late June, is significant. In that window between early April and early June you have a period where the disease could still spread pretty quickly because lots of people won't be vaccinated, but in which protection amongst the vulnerable is not complete. We'd see much less of a wave than we've just seen in Jan-Feb of course but still to a high level. And these are vaccinated people - after the first shot, 20% of the people would have got the severe version of the disease without vaccination will still get it. My understanding is that against the most common variants in the UK, protection with the second shot against severe disease is >95% for the current vaccines, so it does make a big difference.

And it's not like you'd have to push things right back in that period - every week brings an extra 3-4 million shots of the vaccine so every week delayed would improve the situation somewhat. Or you could look at staggering a bit more, in the way that phase 1 has been staggered in March.

Plus you aren't taking seasonality into account - the respiratory virus season will end within the next month or so.

In April it is very much weather dependent. My daughter was born on April 25th and on the day we took her home from hospital it was snowing! So yes in a warm April the winter season can be snuffed out nicely quite early on, but in a colder year it can persist to mid-May. A mild Easter could make a huge difference this year.

I also agree. A lot of businesses are hanging by a thread as it is and pushing their reopening dates back may well send them under with the consequential loss of jobs, which the country can't afford

I'd hope that if we did have to delay or stagger stages 2 and 3 of reopening, we could squeeze the time between stages 3 and 4 because at this point vaccination levels would be higher, so you could significantly mitigate any economic loss from doing that. But yes, we should only delay if cases were really shooting up and right now there's no evidence to suggest they will - so far, every step of the vaccination programme has been at the highest level of expected effectiveness.

 

[joncombe]

I must admit, whilst SAGE are still bleating that there might be another "hard winter" I'm not convinced that now would be the time to de-commission the Nightingales.

It sounds like them lazily falling back on their default position of being happy to impose restrictions on the public, rather than providing a working health service.

Yes though ironically there was a report on the BBC news yesterday that much of the worry is there will be much less immunity in the population next winter due to little to no exposure to flu this winter due to lockdown.

 

[yorksrob]

We'd see much less of a wave than we've just seen in Jan-Feb of course but still to a high level. And these are vaccinated people - after the first shot, 20% of the people would have got the severe version of the disease without vaccination will still get it. My understanding is that against the most common variants in the UK, protection with the second shot against severe disease is >95% for the current vaccines, so it does make a big difference.

If it's much less of a wave than Jan - Feb, then the NHS won't be overwhelmed, which to my mind means that lockdown measures simply are not appropriate. Perhaps other measures might be appropriate for a time to mitigate spread, however lockdown could only ever be appropriate (if at all) in an emergency situation. A much smaller, less deadlier wave where the NHS isn't at risk of being overwhelmed, is not an emergency situation.

Yes though ironically there was a report on the BBC news yesterday that much of the worry is there will be much less immunity in the population next winter due to little to no exposure to flu this winter due to lockdown.

Just one of the many problems and bad outcomes caused/exacerbated by lockdown, along with vitamin D deficiency, other conditions going un-diagnosed etc.

 

[Watershed]

In that window between early April and early June you have a period where the disease could still spread pretty quickly because lots of people won't be vaccinated, but in which protection amongst the vulnerable is not complete.

All in the 'vulnerable 1-4' group were offered a vaccine by the government deadline of 15 February. By virtue of the 12 week rule, all will have been offered their second vaccination by 10 May.

The programme is currently working on group 8 (over 55s), and it seems likely all in the 'vulnerable 1-9' group will have been offered a vaccine before the end of this month.

Protection amongst those making up 90% of deaths ('vulnerable 1-4' group) is already 90% as good as it is ever going to get, and we have made significant inroads into those making up the next 9% or so of deaths.

If that isn't enough to reopen - what is?! Don't forget that there are murmurs about vaccine-induced immunity only lasting for 6 months. You really have to hope we're not going to be sitting in the same boat in 6 months' time...