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Vaccine Progress, Approval, and Deployment

Darandio

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What safeguards have been removed/bypassed?

The reason that most vaccines take so long to develop is that they take time finding funding for each phase of development and testing and then at each stage of testing with people or takes time to get people to volunteer, both those add years and years to the process, something which hasn't been an issue for Covid-19.

Whilst the delivery method is new, in the case of the Oxford vaccine is been in development for a few years now and it's just programming of it to be for Covid that is new.

That post wasn't in reference to the Oxford vaccine though, that hasn't been approved. What has been approved is very much experimental.
 
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The Ham

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It will still need a fair amount of logistical planning, you don't want to risk losing lots of it because planning wasn't in place. So it will likely be invitation only for this one at least for those away from places that can store it in deep freeze.

Most urban areas, and for that matter quite a few rural areas, would be within an hour's drive of a key hospital (in fact in my rural village of 9,000 I can list at least 6 hospitals which would be within an hour's drive, most of which could be done so during rush hour).

Now that would allow significant numbers of people to be vaccinated without the need for even all of those hospitals to be able to keep the vaccines at very low temperatures.

Anyway if your concerted you work out how many per day of vaccines you have (let's say you've got 500 over 5 days) you then offer 120 people to have their vaccine on day one to four if you're below the 100 target on day one you start to offer some on day five with the understanding that they may need to come back a few days later, and then ramp up those offers if you're still behind on day two. What should happen is that 500 are vaccinated in the first 4 days, but chances are some won't turn up, so with the ability to offer more on day 5 you shouldn't then need to waste (ideally) any, although I'd you do it should be fairly small numbers.
 

MikeWM

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What safeguards have been removed/bypassed?

The reason that most vaccines take so long to develop is that they take time finding funding for each phase of development and testing and then at each stage of testing with people or takes time to get people to volunteer, both those add years and years to the process, something which hasn't been an issue for Covid-19.

I have no issue in this case with the usual 'Phases', and the gaps between them, being abbreviated.

However, there is no mechanism for assessing medium or long-term effects or side-effects *without actually waiting to see what happens*!

Whilst the delivery method is new, in the case of the Oxford vaccine is been in development for a few years now and it's just programming of it to be for Covid that is new.

That is true, and why if you held a gun to my head and forced me to take one of the vaccine candidates today, I'd pick the Oxford one over these new mRNA ones.
 

hwl

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That's the timeline I've been working to in my own head. Easter should see the most vulnerable in terms of age/health (or both!) inoculated which should allow a significant easing of restrictions as we go into summer and begin to rollout to other less vulnerable groups. Obviously I hope that some restrictions can be eased prior to Easter but I'm banking on significant changes around Easter.

Agreed, the problems is that lots of people have been setting their hopes on the vaccine having a quick impact, the reality is the impact won't be that quick.

It is worth noting that Boris stopped using back to "normal" last week and swapped to "near normal" which suggests the penny has dropped that vaccines won't solve everything.
 

The Ham

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I have no issue in this case with the usual 'Phases', and the gaps between them, being abbreviated.

However, there is no mechanism for assessing medium or long-term effects or side-effects *without actually waiting to see what happens*!



That is true, and why if you held a gun to my head and forced me to take one of the vaccine candidates today, I'd pick the Oxford one over these new mRNA ones.

Most of the side effects of vaccines are things like flu like symptoms, a pain in the arm and other fairly short term issues.

One thing which is worth noting is that the flu vaccine is "new" each year and few have an issue with having that. I say "new" in that the delivery method is the same is just the generic material which changes to suit the flu strains expected (which is a significant reason why it's not always that good at protecting against flu if the strains aren't guessed correctly).

Whilst of prefer the Oxford vaccine myself (partly due to the cost, potentially meaning savings for the NHS to use on other things) I wouldn't be overly concerned whichever I was offered (when my time finally comes as I'm in the we'll work out when you'll get done later group).

Although being down the pecking order possibly has an impact on that, in that others will have had it for a good few months, plus those on the trail having had it for a few months prior to that.

These timescales look over optimistic to put it mildly.

Flu vaccines have been administered since September this year but aged 64 I have been given a mid-December date for mine and no doubt many will be later than this.

That is three months plus just to look after the over 50s!

Subject to supply and capacity to administer they might just about reach the over 70s by the end of January, and remember everyone needs two doses.

However with the flu vaccine you have to remember that children are also being done (all three of mine have now had it) and there's quite a few who will have had it privately (as myself and my wife have had, both back in October).

That's a lot of people taking up capacity/supply which wouldn't be the case with Covid vaccines.

As such I wouldn't read too much into the time taken to get your flu vaccine when trying to work out how fast Covid vaccines could be rolled out.

Yes it does sound very optimistic, however I would also highlight that those dates are likely to be when those next groups will be offered it, that doesn't mean that everyone from the previous group will be done and there could still be 80+ year olds getting their first dose in February. It's just that as the next group gets their invites the numbers of the previous group would likely be starting to slow down a bit and so you don't get wasted capacity the invites would continue to be sent out.
 
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MikeWM

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Most of the side effects of vaccines are things like flu like symptoms, a pain in the arm and other fairly short term issues.

But there are also more serious things that happen - they are rare with 'established' methods of vaccination, but we shouldn't pretend they don't happen. Those who got narcolepsy from the swine flu vaccine in 2009, for example

https://www.narcolepsy.org.uk/resources/pandemrix-narcolepsy

or the issues in 1976 in the USA (a BBC article!) where people got Guillain-Barre syndrome

https://www.bbc.com/future/article/20200918-the-fiasco-of-the-us-swine-flu-affair-of-1976


The 'new' mRNA vaccines may actually be better and avoid these potential issues. Alternatively they may have a whole host of new issues. The problem is that it is far too soon to tell.
 

hwl

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I don't want to be a Cassandra here, but given previous conversations I'm surprised that I appear to be the only one. This should ring very large alarm bells in anyone looking at this objectively.

This vaccine uses a totally new, never-before-tried mechanism. We can have no idea at this point of whether there are any long-term effects or consequences. We also don't know if there is risk of antibody-dependent amplification in specific segments of the population - a particular issue that has arisen before in attempts to make a coronavirus vaccine.

Under no other circumstances would this have been approved on such a timescale or study size.

Maybe all will be fine. But with so many safeguards having been removed and bypassed, I fear we may look back at this in the way we look back now at Thalidomide or DDT, or potentially even worse. If I were responsible for the healthcare of someone elderly or vulnerable, personally I'd strongly try to persuade them to stay away, at least *for a while*.
I was steering clear of any safety related issues as that is a whole discussion thread in itself. The key point is that "long term" doesn't exist for mRNA vaccines (in humans) yet. The Oxford/AZ approach (also being used by some others) has at least been around a bit longer.

My main point was that many people will expect a 90+% reduction in hospitalisations and fairly quickly, in reality the reduction is going to be smaller and take quite a while to work through. The government will have to make sure this message comes out. Ultimately a reasonable effectiveness at reducing transmissions (Prof Sahin of BioNTech guessed at 50% as no data) and vaccinating the 16/18 to 50 age group as well will be needed to reduce infections and hence potential hospitalisations (to allow the NHS to function near normally) in the group with at least 5m where the vaccines hasn't "worked" or those that can't be vaccinated (ignoring those who chose not to).

The vaccination effectiveness data includes the effect of masks, distancing, working from home and other risk mitigation measures hence Pfizer and everyone else have no idea what the effectiveness might be when those change or if there is a difference between summer and winter (i.e. is that difference in viral load between some contacts in summer and winter).

The vaccines will be transformative but we don't know the detail yet so should expect a few hiccups along the road.
 

The Ham

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But there are also more serious things that happen - they are rare with 'established' methods of vaccination, but we shouldn't pretend they don't happen. Those who got narcolepsy from the swine flu vaccine in 2009, for example

https://www.narcolepsy.org.uk/resources/pandemrix-narcolepsy

or the issues in 1976 in the USA (a BBC article!) where people got Guillain-Barre syndrome

https://www.bbc.com/future/article/20200918-the-fiasco-of-the-us-swine-flu-affair-of-1976


The 'new' mRNA vaccines may actually be better and avoid these potential issues. Alternatively they may have a whole host of new issues. The problem is that it is far too soon to tell.

Both of those have fairly small risks and interestingly the BBC article highlights that there's also a risk of getting Guillain-Barre Syndrome is higher from the Flu than from the Flu Vaccine.

In the case of 2009 vaccine the risk is 1:55,000. Compare that with a 1:4,300 chance of catch Covid on a short haul flight, or about the same of rolling 6 on 6 dice back to back (1:50,000). It's also not much lower than dying from a wasp/bee sting (1:54,000). However compared to other things which many are fearful of dying from, such as a motor crash (1:100), motorcycle crash (1:900), cycling (1:4,000).

That's not too say that we shouldn't be careful, however with the Pfizer vaccine trail having 44,000 people being tested and the Oxford testing up to 30,000 people then there's a good chance that most risks would be picked up.

However at large scale, 66 million people, you're always going to see a number of people impacted. At 1:55,000 that would be 1,200 (so probably 900 to 1,500) people impacted, however how does that compare with the impact of (say) Long Covid?

I'd imagine that given that it's been made such a big thing, that Long Covid is likely to have already impacted many more than 1,500 people and deaths from Covid-19 has already exceeded that by more than a factor of 30 that for many the risk from a vaccine would be much lower.
 

Bantamzen

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Most urban areas, and for that matter quite a few rural areas, would be within an hour's drive of a key hospital (in fact in my rural village of 9,000 I can list at least 6 hospitals which would be within an hour's drive, most of which could be done so during rush hour).

Now that would allow significant numbers of people to be vaccinated without the need for even all of those hospitals to be able to keep the vaccines at very low temperatures.
Hospitals probably won't be the primary source for widespread vaccination, the last thing they need is hundreds more people descending on them every day for months. And in the initial phases their absolute priority would be towards in-patients and staff.

Anyway if your concerted you work out how many per day of vaccines you have (let's say you've got 500 over 5 days) you then offer 120 people to have their vaccine on day one to four if you're below the 100 target on day one you start to offer some on day five with the understanding that they may need to come back a few days later, and then ramp up those offers if you're still behind on day two. What should happen is that 500 are vaccinated in the first 4 days, but chances are some won't turn up, so with the ability to offer more on day 5 you shouldn't then need to waste (ideally) any, although I'd you do it should be fairly small numbers.
Its still going to be a very complicated process to ensure that a) everyone invited gets an appointment(s) that suit, and that they know how to cancel should circumstances require. For this first vaccine there is little to no chance of a walk-up service, & probably little chance of last-minute slot-ins due to two being needed 3-4 weeks apart. That doesn't necessarily mean its going to be massively difficult, but it does need a fair bit of planning.
 

Yew

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The vaccination effectiveness data includes the effect of masks, distancing, working from home and other risk mitigation measures hence Pfizer and everyone else have no idea what the effectiveness might be when those change or if there is a difference between summer and winter (i.e. is that difference in viral load between some contacts in summer and winter).
Those effects are accounted for in the control group, this is the exact reason we have them.
 

packermac

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But there are also more serious things that happen - they are rare with 'established' methods of vaccination, but we shouldn't pretend they don't happen. Those who got narcolepsy from the swine flu vaccine in 2009, for example

https://www.narcolepsy.org.uk/resources/pandemrix-narcolepsy

or the issues in 1976 in the USA (a BBC article!) where people got Guillain-Barre syndrome

https://www.bbc.com/future/article/20200918-the-fiasco-of-the-us-swine-flu-affair-of-1976


The 'new' mRNA vaccines may actually be better and avoid these potential issues. Alternatively they may have a whole host of new issues. The problem is that it is far too soon to tell.
But bearing in mind a few posters on here have suggested just letting old people die from Covid and not waste the NHS resource and have the economic impact of lockdowns would a few vaccination deaths be any different?
Oh I forgot I suppose it would be young people at risk this time!
 

Dent

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But bearing in mind a few posters on here have suggested just letting old people die from Covid and not waste the NHS resource and have the economic impact of lockdowns would a few vaccination deaths be any different?

Has anyone really suggested that, or are you making a strawman?

I haven't seen anyone making such a suggestion, but I have seen multiple examples of people being falsely accused of making such suggestions in an attempt to stifle rational discussion.
 

ainsworth74

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Looks like there's new guidance out from the Joint Committee on Vaccination and Immunisation which can found here and replaces the previous guidance from September. The bit I suspect everyone will want to know is around the priority groups. They seem to be pretty much the same but there is now a 'Phase One' which is detailed below:

Phase 1 – direct prevention of mortality and supporting the NHS and social care system

JCVI advises that the first priorities for the COVID-19 vaccination programme should be the prevention of mortality and the maintenance of the health and social care systems. As the risk of mortality from COVID-19 increases with age, prioritisation is primarily based on age. The order of priority for each group in the population corresponds with data on the number of individuals who would need to be vaccinated to prevent one death, estimated from UK data obtained from March to June 2020.

1 Residents in a care home for older adults and their carers
2 All those 80 years of age and over Frontline health and social care workers
3 All those 75 years of age and over
4 All those 70 years of age and over Clinically extremely vulnerable individuals*
5 All those 65 years of age and over
6 All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7 All those 60 years of age and over
8 All those 55 years of age and over
9 All those 50 years of age and over

* Clinically extremely vulnerable individuals are described here. This advice on vaccination does not include pregnant women and those under the age of 16 years (see above)

It is estimated that taken together, these groups represent around 99% of preventable mortality from COVID-19.

JCVI advises that implementation of the COVID-19 vaccine programme should aim to achieve high vaccine uptake. An age-based programme will likely result in faster delivery and better uptake in those at the highest risk. Implementation should also involve flexibility in vaccine deployment at a local level with due attention to:

• mitigating health inequalities, such as might occur in relation to access to healthcare and ethnicity;
• vaccine product storage, transport and administration constraints;
• exceptional individualised circumstances; and
• availability of suitable approved vaccines e.g. for specific age cohorts.

JCVI appreciates that operational considerations, such as minimising wastage, may require a flexible approach, where decisions are taken in consultation with national or local public health experts. To be assured that outcome is maximised however, JCVI would like to see early and regular comprehensive vaccine coverage data so that the Committee can respond if high priority risk groups are unable to access vaccination in a reasonable time frame.

There is not as yet much detail on further phases but they do have this to say:

The next phase – further reduction in hospitalisation and targeted vaccination of those at high risk of exposure and/or those delivering key public services

As the first phase of the programme is rolled out in the UK, additional data will become available on the safety and effectiveness of COVID-19 vaccines. These data will provide the basis for consideration of vaccination in groups that are at lower risk of mortality from COVID-19. The Committee is currently of the view that the key focus for the second phase of vaccination could be on further preventing hospitalisation.

Vaccination of those at increased risk of exposure to SARS-CoV-2 due to their occupation could also be a priority in the next phase. This could include first responders, the military, those involved in the justice system, teachers, transport workers, and public servants essential to the 10 pandemic response. Priority occupations for vaccination are considered an issue of policy, rather than for JCVI to advise on. JCVI asks that the Department of Health and Social Care consider occupational vaccination in collaboration with other Government departments.

Wider use of COVID-19 vaccines will provide a better understanding of whether they can prevent infection and onward transmission in the population. Data on vaccine impact on transmission, along with data on vaccine safety and effectiveness, will potentially allow for consideration of vaccination across the rest of the population.

As trials in children and pregnant women are completed, we will also gain a better understanding of the safety and effectiveness of the vaccines in these persons.

Hopefully this will be of interest!

Edit: Now with added link to document :oops:
 

hwl

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Those effects are accounted for in the control group, this is the exact reason we have them.
I think you fail to understand.

Pfizer didn't monitor mask wearing or any other mitigation measures unless the person had a positive test at which point they got a questionnaire.
There is the assumption that the control group does exactly the same as the vaccinated group but they don't really know as they didn't bother collecting the data for the majority in the trial to check, but restrictions + advice also changed over time during the trial so we don't know the effect of changing mitigation measures on the vaccine effectiveness as this wasn't kept constant during the trial. Control groups only take account of certain things not everything. So on a basic level they are taken account of but we have no data for the scenario where risk mitigation measures weren't taken as there was no parallel set of trials for people taking no risk mitigation measures and a control group doesn't take this into account.

There is no trial data for a return to "normal" or "near normal" life on the vaccine effectiveness as the trial was not designed to test that, we will however effectively get this data later in 2021 after mass vaccination. We also don't have any data on vaccine effectiveness in the medium and long term and how it decreases over time.

While the 94% effectiveness number (preventing 17 out of 18 potential cases vs the control group levels) is a useful starting point for modelling work, this needs to be monitored over time including real infection rates under different conditions that prevail at the time.
 

packermac

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Has anyone really suggested that, or are you making a strawman?

I haven't seen anyone making such a suggestion, but I have seen multiple examples of people being falsely accused of making such suggestions in an attempt to stifle rational discussion.
I would suggest that this paragraph #9 on the Welsh thread does that, but it is not the only one in recent months just the easiest to find from a couple of days ago.

"The idea of saving thousands of lives being lost with an average age of 80+ due to one cause, but in exchange causing massive long-term damage to many younger people, is totally wrong in my opinion. There needs to be an acceptance, by those who propose, advocate, and support, lockdowns that lockdowns are a means of passing the burden from wealthier or older people down to poorer or younger people."
 

Dent

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I would suggest that this paragraph #9 on the Welsh thread does that, but it is not the only one in recent months just the easiest to find from a couple of days ago.

"The idea of saving thousands of lives being lost with an average age of 80+ due to one cause, but in exchange causing massive long-term damage to many younger people, is totally wrong in my opinion. There needs to be an acceptance, by those who propose, advocate, and support, lockdowns that lockdowns are a means of passing the burden from wealthier or older people down to poorer or younger people."

That's not really suggesting "just letting old people die from Covid", confirming that your claim is indeed a strawman.

There needs to be rational consideration about the balance between potential lives saved by a current course of actions vs the damage (which also includes lives lost) caused by that course of action. Attempts to stifle rational discussion with logical fallacies are really not helpful.
 

Yew

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I think you fail to understand.

Pfizer didn't monitor mask wearing or any other mitigation measures unless the person had a positive test at which point they got a questionnaire.
There is the assumption that the control group does exactly the same as the vaccinated group but they don't really know as they didn't bother collecting the data for the majority in the trial to check, but restrictions + advice also changed over time during the trial so we don't know the effect of changing mitigation measures on the vaccine effectiveness as this wasn't kept constant during the trial. Control groups only take account of certain things not everything. So on a basic level they are taken account of but we have no data for the scenario where risk mitigation measures weren't taken as there was no parallel set of trials for people taking no risk mitigation measures and a control group doesn't take this into account.

There is no trial data for a return to "normal" or "near normal" life on the vaccine effectiveness as the trial was not designed to test that, we will however effectively get this data later in 2021 after mass vaccination. We also don't have any data on vaccine effectiveness in the medium and long term and how it decreases over time.

While the 94% effectiveness number (preventing 17 out of 18 potential cases vs the control group levels) is a useful starting point for modelling work, this needs to be monitored over time including real infection rates under different conditions that prevail at the time.
Yes, this is why the treatment group and the control group are selected randomly, and both groups are ran concurrently, there may be slight differences, but statistically they either average out or effect both groups roughly equally.

Your point about a trial to see if about near normal makes no sense; are you suggesting that we can't be certain that the vaccine will work without restrictions?

At this stage, long term effectiveness isn't really relevant, if we need a booster every year, then it's no different to the flu jab.

Finally, who cares about if infection rates if it's not serious, we don't care if people get a cough, we care if they're hospitalised, and that's the endpoint that has been measured.

Search for the word 'die' in this forum.
You make it sound like people are advocating replacing ventilators with guillotines, rather than just ensuring that the benefits outweigh the harms of various strategies.
 

nlogax

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You make it sound like people are advocating replacing ventilators with guillotines, rather than just ensuring that the benefits outweigh the harms of various strategies.

Pointing people to the search function is advocating replacing ventilators with guillotines? Right. I'll leave you to reflect on how daft that sounds.
 

hwl

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Yes, this is why the treatment group and the control group are selected randomly, and both groups are ran concurrently, there may be slight differences, but statistically they either average out or effect both groups roughly equally.

Your point about a trial to see if about near normal makes no sense; are you suggesting that we can't be certain that the vaccine will work without restrictions?
It should still be very effective we just don't know precisely how effective, hence we should be slightly cautious and not just assume the 94.x% number will always hold...
Research (using long standing approved vaccines) has shown vaccination in the morning is more results in greater effectiveness than vaccination in the afternoon. If we now start running a mass vaccination campaign for 15-16 hours a day (like some testing locations) including evening vaccinations we may the average effectiveness of the vaccine declines compared to the trial.
At this stage, long term effectiveness isn't really relevant, if we need a booster every year, then it's no different to the flu jab.
The Flu jab isn't a booster it changes to cover the 3 or 4 strains that they think will be post prevalent that year. The protection against a strain normally lasts for decades, there are lots of strains.
We should just about be able to vaccinate all adults before we start needing to give boosters but if it lasts 2+ years that is better news.
Finally, who cares about if infection rates if it's not serious, we don't care if people get a cough, we care if they're hospitalised, and that's the endpoint that has been measured.
Reducing asymptomatic infections is key to a Covid vaccine being effective at reducing transmission. The more effective the transmission reduction the more effective 16-50 age group vaccinations will be. The biggest effect overall in reducing transmission is the speed a which a return to(near) normality can be achieved.

The majority of hospitalisations are from those with other underlying medical issues, a group that were excluded from the trials hence we don't have clear idea what the actual reduction in hospitalisations is likely to be.

It is worth noting the cautious words from WHO and the PM today on overoptimism around the effectiveness and speed of impact.
 

brad465

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Agreed, the problems is that lots of people have been setting their hopes on the vaccine having a quick impact, the reality is the impact won't be that quick.

It is worth noting that Boris stopped using back to "normal" last week and swapped to "near normal" which suggests the penny has dropped that vaccines won't solve everything.
We're going to have to go back to normal at some point (I.e. have no restrictions related to Covid), whether the vaccine allows this or not. You said yourself in an earlier post about summer seeing less respiratory virus prevalence, this will be an opportunity to lift everything without serious worry, while rolling out more vaccinations ahead of the next winter and perhaps further drug treatments, which combined with vaccines will help.

So much of the population has been told "no normality until a vaccine is deployed", or some other equivalent phrase, that if restrictions are still in place/needed after all the vulnerable people at least have been vaccinated, serious questions are going to be asked.
 

hwl

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We're going to have to go back to normal at some point (I.e. have no restrictions related to Covid), whether the vaccine allows this or not. You said yourself in an earlier post about summer seeing less respiratory virus prevalence, this will be an opportunity to lift everything without serious worry, while rolling out more vaccinations ahead of the next winter and perhaps further drug treatments, which combined with vaccines will help.

So much of the population has been told "no normality until a vaccine is deployed", or some other equivalent phrase, that if restrictions are still in place/needed after all the vulnerable people at least have been vaccinated, serious questions are going to be asked.
I think there are many definitions of normal which is going to cause issues!
Employers will still have to worry about HaSaW (1974), hospital and carehomes about improved hygiene levels.

I suspect we will see a lot (but not all) of restrictions removed before the warmer months hence BJ's "near normal" but that removing the remainder (some of which many people may not even notice) might need substantial progress on the 16-50 healthy adults category (see #73 above) they are already looking at strategies for prioritising within that group e.g. starting with key workers, high contact number individuals.

The vaccine has been sold by some (politicians) as the solution rather than the largest part of it and they are now busy trying to shift to the later!
 

philosopher

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I think there are many definitions of normal which is going to cause issues!
Employers will still have to worry about HaSaW (1974), hospital and carehomes about improved hygiene levels.

I suspect we will see a lot (but not all) of restrictions removed before the warmer months hence BJ's "near normal" but that removing the remainder (some of which many people may not even notice) might need substantial progress on the 16-50 healthy adults category (see #73 above) they are already looking at strategies for prioritising within that group e.g. starting with key workers, high contact number individuals.

The vaccine has been sold by some (politicians) as the solution rather than the largest part of it and they are now busy trying to shift to the later!
I think professor Van-Tam in the press conference today said that the first phase of vaccination will protect those who make up 99% of hospital admissions. Now obviously the vaccine is not 100% effective and not all offered will take the vaccine, however I think it is reasonable to assume the first phase of vaccination will prevent the vast majority of hospitalisations and deaths (perhaps 70% to 80%).

So I think by April, the vaccination of the most vulnerable plus the impact of the warmer weather should have meant the threat of an overwhelmed NHS is no longer an issue. So I think by that point we should be at a point where the vast majority of restrictions can be removed and it left to individuals to decide how much risk they want to take. If say in April a forty year old who is good health is still worried about Covid they themselves can take measures to minimise getting infected.
 

3141

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I think professor Van-Tam in the press conference today said that the first phase of vaccination will protect those who make up 99% of hospital admissions. Now obviously the vaccine is not 100% effective and not all offered will take the vaccine, however I think it is reasonable to assume the first phase of vaccination will prevent the vast majority of hospitalisations and deaths (perhaps 70% to 80%).

So I think by April, the vaccination of the most vulnerable plus the impact of the warmer weather should have meant the threat of an overwhelmed NHS is no longer an issue. So I think by that point we should be at a point where the vast majority of restrictions can be removed and it left to individuals to decide how much risk they want to take. If say in April a forty year old who is good health is still worried about Covid they themselves can take measures to minimise getting infected.

I think your first paragraph is broadly right. If a high proportion of those most likely to suffer seriously from Covid 19, or die from it, have been vaccinated then hospital admissions should be down.

But thereafter it's not just a matter of other people deciding how much risk they want to take. When they take such a risk they are also risking passing the infection to others. Among those others are people aged up to 50-ish whose response to Covid, if they get it, will be a lot more serious than the majority. They can't all voluntarily shield themselves until they get their turn to be vaccinated, and some won't know till too late that they are more susceptible.
 
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hwl

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I think your first paragraph is broadly right. If a high proportion of those most likely to suffer seriously from Covid 19, or die from it, have been vaccinated then hospital admissions should be down.

But thereafter it's not just a matter of other people deciding how much risk they want to take. When they take such a risk they are also risking passing the infection to others. Among those others are people aged up to 50-ish whose response to Covid, if they get it, will be a lot more serious than the majority. They can't all voluntarily shield themselves until they get their turn to be vaccinated, and some won't know till too late that they are more susceptible.
Completely agreed.

At some point in the first half of 2021 when the deaths and hospitalisations have fallen significantly people will start to look at the impact of long covid and the cost of people having time off (increases in the number of annual sick days as it becomes endemic) and there will probably be lots of encouragement to get the 16-50 group vaccinated as well.
The hospital need to be pretty clear to get the waiting lists down.

I think professor Van-Tam in the press conference today said that the first phase of vaccination will protect those who make up 99% of hospital admissions. Now obviously the vaccine is not 100% effective and not all offered will take the vaccine, however I think it is reasonable to assume the first phase of vaccination will prevent the vast majority of hospitalisations and deaths (perhaps 70% to 80%).

So I think by April, the vaccination of the most vulnerable plus the impact of the warmer weather should have meant the threat of an overwhelmed NHS is no longer an issue. So I think by that point we should be at a point where the vast majority of restrictions can be removed and it left to individuals to decide how much risk they want to take. If say in April a forty year old who is good health is still worried about Covid they themselves can take measures to minimise getting infected.
along the lines "of will target those who make up ..."The effect of the partial lockdown over the last month has been to reduce infections by 60% vs the do nothing case, hence half that level by going to 80% reduction could still see some big numbers of serious cases.
 
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DB

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along the lines "of will target those who make up ..."The effect of the partial lockdown over the last month has been to reduce infections by 60% vs the do nothing case, hence half that level by going to 80% reduction could still see some big numbers of serious cases.

Cases were already falling before the lockdown started. Correlation does not automatically equal causation, and the most likely places for infection, schools and workplaces, have remained open, while the shops still open have been busier.

So while the lockdown may have had some effect, it will be nothing close to a 60% reduction.
 

bramling

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I think professor Van-Tam in the press conference today said that the first phase of vaccination will protect those who make up 99% of hospital admissions. Now obviously the vaccine is not 100% effective and not all offered will take the vaccine, however I think it is reasonable to assume the first phase of vaccination will prevent the vast majority of hospitalisations and deaths (perhaps 70% to 80%).

So I think by April, the vaccination of the most vulnerable plus the impact of the warmer weather should have meant the threat of an overwhelmed NHS is no longer an issue. So I think by that point we should be at a point where the vast majority of restrictions can be removed and it left to individuals to decide how much risk they want to take. If say in April a forty year old who is good health is still worried about Covid they themselves can take measures to minimise getting infected.

On the latter point, it should perhaps be added that if such people wish to take measures off their own back, they should not expect to be carried by the taxpayer if such people choose to impose a financial burden upon themselves. Likewise they should not expect others to adapt their behaviour to suit, in particular in relation to masks.
 

brad465

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Today the likes of Hancock and Rees-Mogg have got in trouble for lying about how not being in the EU anymore sped up approval of this vaccine. British exceptionalism and all its consequences will one day be the death of us (not literally hopefully).
 

hwl

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Cases were already falling before the lockdown started. Correlation does not automatically equal causation, and the most likely places for infection, schools and workplaces, have remained open, while the shops still open have been busier.

So while the lockdown may have had some effect, it will be nothing close to a 60% reduction.
You appear to have got your wires slightly crossed. As I said "the effect of the partial lockdown over the last month has been to reduce infections by 60% vs the do nothing case"
The tiers etc an other restrictions in place before then were not "do nothing", so I'm wondering why you have chosen to confuse things by comparing partial lock down vs tier rather than partial lock down vs do nothing / return to normality.
The case rate during the later part of partial lock down lockdown was about 60-65% of the no restriction back to normal rate due to all the prevention measures in place. The Tiers and other restrictions were already achieving a reduction of 55-60% vs of the no restriction back to normal rate due to all the prevention measures in place.

On the latter point, it should perhaps be added that if such people wish to take measures off their own back, they should not expect to be carried by the taxpayer if such people choose to impose a financial burden upon themselves. Likewise they should not expect others to adapt their behaviour to suit, in particular in relation to masks.
On your latter point unless the government exempts covid infections from Health and Safety law (which they haven't so far) then organisations will still need to take reasonable mitigation measures to reduce the risk to their employees and customers hence their customers might have to adapt their behaviours.

Australia reduced Flu by 90-95% as a by product to this years strict covid restrictions, even a 20% reduction in the UK in the future would save the NHS huge amounts and result in a more functional healthcare system in winter as well as reduced lost working time etc. for employers in general.
 
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birchesgreen

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Today the likes of Hancock and Rees-Mogg have got in trouble for lying about how not being in the EU anymore sped up approval of this vaccine. British exceptionalism and all its consequences will one day be the death of us (not literally hopefully).

The vaccine nationalism was petty and childish.
 

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