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Vaccine Progress, Approval, and Deployment

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Dent

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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.
How do you know this "no restrictions back to normal rate"?

That is an unknowable quantity, so what is the basis of your comparison?
 
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DustyBin

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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).

Funnily enough I was just thinking about how many people criticise British exceptionalism, yet don’t question how/why we’ve approved a vaccine potentially months ahead of anyone else! Or am I missing something (genuine question)?
 
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notlob.divad

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Lockdowns only work when they are applied indefinitely. I can't believe that anyone who has seen cases rise post-lockdown in so many countries can still believe they are effective. All they do is delay, and in some case accelerate infection rates.
There is an assumption you have made in that statement that the aim of 'Lockdowns' is to eliminate the virus. I have never seen a epidemilogical scientist or anyone with significant medical knowledge claim that this would be the aim. You say all they do is delay or accelerate (I have seen no evidence of the latter). Well from my observations, they have therefore done exactly what they were designed to do. Flatten the peak, bring the accelerating case rate back to a manageable level so that health services, morgues, undertakers, can actually cope with the numbers of patients and deaths that are occuring.
 

DB

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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 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.

But you have no idea what the 'do nothing' outcome would have been, so the 60% is pure fantasy. If you are relying on the government's modelling, in cases where that can be measured it's been consistently completely wrong...

As regards Covid infections and H&S, you have it the wrong way round - there has never been any expectation that employers try to prevent viruses from spreading in the workplace, so unless the H&S legislation is amended (and it's primary legislation) there will be no expectation that employers need to do anything once the specific Coronavirus restrictions expire.
 

Bantamzen

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There is an assumption you have made in that statement that the aim of 'Lockdowns' is to eliminate the virus. I have never seen a epidemilogical scientist or anyone with significant medical knowledge claim that this would be the aim. You say all they do is delay or accelerate (I have seen no evidence of the latter). Well from my observations, they have therefore done exactly what they were designed to do. Flatten the peak, bring the accelerating case rate back to a manageable level so that health services, morgues, undertakers, can actually cope with the numbers of patients and deaths that are occuring.
Lockdowns are a political solution, and unless you've had your head in the sand for the last 9 months you'll be aware that many countries have tried for an elimination strategy using them.

As for acceleration of spread post-lockdowns, the data tell all.
 

DB

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There is an assumption you have made in that statement that the aim of 'Lockdowns' is to eliminate the virus. I have never seen a epidemilogical scientist or anyone with significant medical knowledge claim that this would be the aim. You say all they do is delay or accelerate (I have seen no evidence of the latter). Well from my observations, they have therefore done exactly what they were designed to do. Flatten the peak, bring the accelerating case rate back to a manageable level so that health services, morgues, undertakers, can actually cope with the numbers of patients and deaths that are occuring.

Yet again, can you please explain why Sweden, with no lockdowns, did not have a continuous exponential increase until it reached herd immunity? Also, the first lockdown here occurred when respiratory viruses were declining anyway as winter had ended - this is likely to be significant.

There seems to be a lack of willingness in many to accept that there are rises and declines in infection rates naturally for respiratory viruses.
 

notlob.divad

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You are again unquestioningly assuming that correlation equals causation, and assuming that without these measures there would have been continuous exponential increase. This is not a reliable assumption - Sweden, with its much less draconian measures, has not experienced what we are constantly threatened with.
Have you actually read anythign about what is happening on the ground in Sweden? Even the lead Epidemiologist who has been acclaimed by the libertarians, has basically admitted he doesn't know what is going on and why his strategy hasn't worked.

https://theprint.in/health/herd-immunity-is-a-mystery-swedens-top-epidemiologist-says/556127/

Yes Sweden's healthcare system has not as yet been overrun, but Wuhan, Lombardy, Madrid, New York and other major population centres have been.
 

Bantamzen

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Have you actually read anythign about what is happening on the ground in Sweden? Even the lead Epidemiologist who has been acclaimed by the libertarians, has basically admitted he doesn't know what is going on and why his strategy hasn't worked.

https://theprint.in/health/herd-immunity-is-a-mystery-swedens-top-epidemiologist-says/556127/

Yes Sweden's healthcare system has not as yet been overrun, but Wuhan, Lombardy, Madrid, New York and other major population centres have been.
Perhaps that says more about the healthcare systems in those countries?
 

notlob.divad

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Yet again, can you please explain why Sweden, with no lockdowns, did not have a continuous exponential increase until it reached herd immunity? Also, the first lockdown here occurred when respiratory viruses were declining anyway as winter had ended - this is likely to be significant.

There seems to be a lack of willingness in many to accept that there are rises and declines in infection rates naturally for respiratory viruses.
Because Sweden's no lockdown did actually consist of a significant amount of social distancing, they just didn't have to enforce it by law.

Because Sweden's housing stock, lower density living arrangements, lower levels of social interactions, and basic social environment creates a lower base R rate without the need for draconian measures.

The Swedish people's love of nature means they spend more time outdoors seeking the peace and solitude of nature rather than crowding into small dingy pubs to watch the match and get leathered.

I agree that the timing of the first lockdown coinciding with the Spring, means that British people were more likely to head outdoors and to other environments where transmission of the virus is less common. I am perfectly willing to accept that there are what you refer to as 'natural' changes in the rate for respiratory viruses, but these are linked to differing human behaviours with respect to their environment, rather than being directly corrolated with the changing seasons, which seems to be your implication.
 

DB

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Because Sweden's no lockdown did actually consist of a significant amount of social distancing, they just didn't have to enforce it by law.

Because Sweden's housing stock, lower density living arrangements, lower levels of social interactions, and basic social environment creates a lower base R rate without the need for draconian measures.

The Swedish people's love of nature means they spend more time outdoors seeking the peace and solitude of nature rather than crowding into small dingy pubs to watch the match and get leathered.

I agree that the timing of the first lockdown coinciding with the Spring, means that British people were more likely to head outdoors and to other environments where transmission of the virus is less common. I am perfectly willing to accept that there are what you refer to as 'natural' changes in the rate for respiratory viruses, but these are linked to differing human behaviours with respect to their environment, rather than being directly corrolated with the changing seasons, which seems to be your implication.

Several members of this forum (Yorkie was one) visited Sweden recently, and thoroughly debunked these alleged differences between Sweden and the UK...
 

notlob.divad

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Perhaps that says more about the healthcare systems in those countries?
It probably does. The problem is the state of the UKs health serve is far closer to that of Wuhan, Lombardy, Madrid, & New York than it is to Sweden's, and the only way it was in anyway 'able to cope' during the first wave of infection was by stopping all elective procedures. Many other places were able to keep their base health system running whilst providing Covid support on top. But in the UK the health service ha been sut to the bare bones, where to provide anything 'extra' something else first has to give.

Several members of this forum (Yorkie was one) visited Sweden recently, and thoroughly debunked these alleged differences between Sweden and the UK...
I have also visited Sweden this year, I also have an old friend who I am regularly in touch with who lives there. I am very happy to stand by what I have written from both first and second hand sources.
 

DB

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It probably does. The problem is the state of the UKs health serve is far closer to that of Wuhan, Lombardy, Madrid, & New York than it is to Sweden's, and the only way it was in anyway 'able to cope' during the first wave of infection was by stopping all elective procedures. Many other places were able to keep their base health system running whilst providing Covid support on top. But in the UK the health service ha been sut to the bare bones, where to provide anything 'extra' something else first has to give.

Sweden's per capita infection rate has been lower than this country, so medical capacity is not the main issue here.

And as regards having to stop all elective procedures, this doesn't fit with the fact that the Nightingale hospitals with barely or not at all used, and retired medics who had offered to assist were not called on.
 

Cdd89

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Yes Sweden's healthcare system has not as yet been overrun, but Wuhan, Lombardy, Madrid, New York and other major population centres have been.

I agree there are examples of the virus overwhelming healthcare and if that is going to happen then I am reluctantly in favour of restrictions.

However, note that your examples are all from very early in the first wave. In other words, places caught out by the virus before there was widespread awareness and people changed their behaviour.

There is nowhere where behavioural patterns haven’t changed and that change has been mostly voluntary. For example there is no law about social distancing, and yet people are very good at spreading out on trains and public transport. There are obviously some people who refuse to believe the virus is real and act irresponsibly, but they are probably balanced out by the people who have themselves in their bedrooms for 9 months.

I would like (that’s the wrong word!) to see evidence of other countries having their healthcare services overloaded despite widespread public awareness of the virus - in other words, later than April 2020 - before accepting that lockdowns are the only option.
 

MikeWM

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Simple things like handwashing aren't going to be a problem, although there needs to be a programme of reinstating public amenities to aid with this. I am not so convinced long term, widespread use of sanitisers I'm not so sure is a good idea especially for the environment.

Or indeed for increasing antibiotic resistance, which concerns me a lot more than Covid.

See https://phys.org/news/2020-04-heavy-sanitizer-boosts-antimicrobial-resistance.html, for example.

I think it is downright irresponsible for our chief medical officers to be encouraging regular long-term use in the way they are.

People staying at home when ill should be encouraged, but again needs work to ensure that people don't lose wages, get unfairly disciplined or even lose their jobs as a result.

Exactly, the pendulum may have swung on this one for now, but I can easily see it swinging back when employers think employees are taking too many 'sickies'.
 

notlob.divad

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I agree there are examples of the virus overwhelming healthcare and if that is going to happen then I am reluctantly in favour of restrictions.

However, note that your examples are all from very early in the first wave. In other words, places caught out by the virus before there was widespread awareness and people changed their behaviour.

There is nowhere where behavioural patterns haven’t changed and that change has been mostly voluntary. For example there is no law about social distancing, and yet people are very good at spreading out on trains and public transport. There are obviously some people who refuse to believe the virus is real and act irresponsibly, but they are probably balanced out by the people who have themselves in their bedrooms for 9 months.

I would like (that’s the wrong word!) to see evidence of other countries having their healthcare services overloaded despite widespread public awareness of the virus - in other words, later than April 2020 - before accepting that lockdowns are the only option.
I think the problem with the way you frame the question is that what people are willing to call a 'lockdown' has mutated since we saw the first one in Wuhan.

Wuhan's lock down saw entire families locked into their own homes in some cases.
In Madrid's children were pretty much confined to their homes with no adequate reason to go out.

However now, people are talking about the UK having just emerged from lockdown 2. However it was very different from the first, this time children were still in school, construction sites and factories remained open. The country was not in the same situation as when key workers were the only ones leaving the house for more than a jog around the block or a trip to the supermarket.

So the nature of lockdown has changed. People have learnt from the past when the health services were overloaded and stepped up and down the restrictions as deemed nessesary to prevent it happening. I am not sure you would get the evidence you are looking for because which government would evidentally want to be seen to allow this to get so out of control again that the systems they are in charge of are unable to cope.
 

Cdd89

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I do take the argument that countries that haven't locked down for second waves are (not coincidentally) the countries that have for whatever reason been lucky enough not to have had out-of-control spread. So yes, those of us making the case against lockdowns based on other examples may be falling into a fallacy here.

The problem is that it's impossible to prove this either way, which is why the discussion tends to go around in circles :) - also such discussions don't factor in that as the perceived risk gets higher, more people decide to voluntarily limit their exposure. The week leading up to the first lockdown saw more movement restriction - entirely voluntary - than any time I've seen since from about early May onwards.

I would need to see evidence that voluntary measures are insufficient before supporting legal interventions. It's not enough in my opinion to say "we should lockdown and not take the risk", as the risks of lockdowns are known and significant. The risks of not lockign down feel more speculative.
 

The Ham

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Simple things like handwashing aren't going to be a problem, although there needs to be a programme of reinstating public amenities to aid with this. I am not so convinced long term, widespread use of sanitisers I'm not so sure is a good idea especially for the environment.


People staying at home when ill should be encouraged, but again needs work to ensure that people don't lose wages, get unfairly disciplined or even lose their jobs as a restaken.
Indeed there would need to be measures to ensure that people weren't unfairly disciplined, etc.

However I was talking about people continuing to work, just at home rather than in the office where that was an option. As such there shouldn't be any reason why they would be out of pocket by doing so.

Obviously not all jobs would be able to be done from home. Likewise if staff were taking the micky (e.g. being ill for a few days every time their season ticket was up for renewal so as to save money, or every time that their football team were playing an evening match so that they were able to watch the whole game) then there would need to be appropriate and measured steps taken. However, even then, several employers would be inclined to let it slide if the work was being done (let's say that the person watching the match started work at 8 rather than 9 so as to be sure to have finished at 4:45 rather than 5:30 to then go to the match and checked their emails and replied to them until the end of the working day) and the person was generally a good employee. Clearly it would be better if everyone was able to be open and honest, with the ability to enable such flexible working above board.
 

yorksrob

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Agreed, but the point is to illustrate the that vaccines aren't a magic bullet that will solve everything (or quickly either) and was a comparison for an earlier poster comments discussions the effects of a vaccine substituting for restrictions/risk mitigation measures not being purely additive to the effects of those measures.

No, the vaccine can't be addative to measures to anything like the extent we have become used. Once the most vulnerable have been vaccinated, everything but the least onerous measures must go.

I think the problem with the way you frame the question is that what people are willing to call a 'lockdown' has mutated since we saw the first one in Wuhan.

Wuhan's lock down saw entire families locked into their own homes in some cases.
In Madrid's children were pretty much confined to their homes with no adequate reason to go out.

However now, people are talking about the UK having just emerged from lockdown 2. However it was very different from the first, this time children were still in school, construction sites and factories remained open. The country was not in the same situation as when key workers were the only ones leaving the house for more than a jog around the block or a trip to the supermarket.

So the nature of lockdown has changed. People have learnt from the past when the health services were overloaded and stepped up and down the restrictions as deemed nessesary to prevent it happening. I am not sure you would get the evidence you are looking for because which government would evidentally want to be seen to allow this to get so out of control again that the systems they are in charge of are unable to cope.

Ah yes, the locckdown where you're allowed to work yourself to the bone, but everything making life remotely bearable is banned.

No, that type of lockdown needs to be finished with also I'm afraid.
 

hwl

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No, the vaccine can't be additive to measures to anything like the extent we have become used. Once the most vulnerable have been vaccinated, everything but the least onerous measures must go.
Precisely - which means (serious) case numbers will be rather higher than many of those who are more optimistic about the vaccine impact expect which will need a more general 16-50 vaccination programme (assuming at least a limited transmission rate reduction with vaccines) will also need to be well underway to remove some of the last restrictions that remain at that point.

The government is effectively saying that it will be very difficult to get the Pfizer vaccine to care home residents so it looks like it will be a case of wait till the Oxford/AZ approval.
 

yorksrob

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Precisely - which means (serious) case numbers will be rather higher than many of those who are more optimistic about the vaccine impact expect which will need a more general 16-50 vaccination programme (assuming at least a limited transmission rate reduction with vaccines) will also need to be well underway to remove some of the last restrictions that remain at that point.

The government is effectively saying that it will be very difficult to get the Pfizer vaccine to care home residents so it looks like it will be a case of wait till the Oxford/AZ approval.

Great. I'm all for it, but we can't hang around for months on end in lockdown or quasi-lockdown waiting for it.
 

hwl

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Great. I'm all for it, but we can't hang around for months on end in lockdown or quasi-lockdown waiting for it.
The problems is it will take months, (see the Lancet article in the other thread) the quoted vaccine effectiveness is 2 weeks post second dose so 5 week minimum if the minimum spacing 3weeks between doses (realistically the gap is likely to be slightly longer) and the 50+ target needs more doses than is available of the Pfizer vaccine in the near term, they won't even have enough for the over 65s for a long while.
We have no data about effectiveness in those with underlying conditions who have been the majority of serious cases so far.
 

yorksrob

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The problems is it will take months, (see the Lancet article in the other thread) the quoted vaccine effectiveness is 2 weeks post second dose so 5 week minimum if the minimum spacing 3weeks between doses (realistically the gap is likely to be slightly longer) and the 50+ target needs more doses than is available of the Pfizer vaccine in the near term, they won't even have enough for the over 65s for a long while.
We have no data about effectiveness in those with underlying conditions who have been the majority of serious cases so far.

Then they'll have to find a better way to manage things than lockdown. In the interim, a suite of sustainable measures as we had working perfectly well before everyone suddenly descended on school and University at the same time is the only sensible way of managing things. Give those in the older, but not near the front of the queue for a vaccine category, the means to take a backseat from work for a few months.
 

nlogax

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After Williamson's comments about Belgium (where the Pfizer vaccine is produced) today, the vaccine order should be cancelled.

No it shouldn't. Gavin Williamson is an idiot who loves to tout the warped logic of British exceptionalism but we shouldn't let one numpty get in the way of the vaccination effort.
 

MikeWM

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I see they've decided not to do NHS staff first anymore. I wonder if that is anything to do with the survey I saw last week that 40% of doctors wouldn't take one at this point?

(Link is behind a registration wall, but the first two lines should be sufficient to make the point)
https://www.medscape.com/viewarticle/941492
A Medscape UK reader poll of 308 UK doctors found 4 in 10 would not have a COVID-19 vaccine as soon as one is approved by the MHRA.
 

duncanp

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And now there are reports that being vaccinated won't free you from the need to self isolate if you come into contact with someone who has COVID-19.

This is because scientists don't yet know the effect of the vaccine on transmission. ie. After being vaccinated, you won't get COVID-19 yourself, but you could still pass it on to someone else.

But I suppose that once the most vulnerable people have been vaccinated, it won't matter as much if there is an increase in cases, as younger people are statistically less likely to be hospitalised.

And once a significant proportion of the population have been vaccinated, we will be approaching herd immunity.


People who receive the coronavirus vaccine will not be exempted from self-isolation if they are contacted by NHS Test and Trace, it has emerged.
Although the vaccine will give recipients immunity from the virus, scientists do not yet know whether it will stop them being carriers.
Government sources said it was likely to be months before there was any prospect of the vaccine negating the need for self-isolation.
It means that even if someone has been vaccinated, they will still have to remain at home for 14 days if they come into contact with someone who has the virus.
A Government source said: “People who get vaccinated will have to stick to the same rules as everyone else because we don’t know if it stops people being carriers and passing the virus on to others.
“It will take a long time to work out what effect on transmission the vaccine will have.
“We will have to be at a point where a sizeable portion of the population has been vaccinated before we have that evidence.”

The news will be a blow to workers in the NHS, care homes and elsewhere who had hoped that once they had received the vaccine they would be able to work without the risk of having to self-isolate.
It will increase the pressure on the Government to speed up the rollout of mass testing to replace the need for self-isolation.
A pilot scheme which is being trialled in Liverpool allows contacts of people who have tested positive for the virus to have tests every day instead of going into self-isolation.
If they test negative seven days in a row they are given the all-clear.
The Government’s intention is to roll out the scheme nationwide in January if the pilot is deemed to be a success, meaning it will be mass testing, not vaccination, that will hold the key to ending the need for self-isolation.

It will depend, however, on the availability of many millions of lateral flow tests, which give results from a swab in less than 30 minutes. Mr Johnson hopes that more than 500 million of the tests will be available by mid-January.
Any other vaccine that might be approved by regulators, such as the one being developed by Oxford University, will also be subject to the same lengthy process of discovering whether it prevents people being “silent” carriers of the virus.
Jonathan Van-Tam, the deputy chief medical officer, said on Wednesday: “We don't know if this vaccine will prevent transmission, or any of [the vaccines].
“We have to wait for the science to tell us if it will prevent transmission, though we are very hopeful on that point.
“We also have to be patient to see the real live effects on transmission and hospitalisations and deaths, and until we see that as scientists, we can't then scope what the likely impact is going to be on bringing this pandemic to an early end.”
 

Richard Scott

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And now there are reports that being vaccinated won't free you from the need to self isolate if you come into contact with someone who has COVID-19.
I hope this isn't true. It seems whatever happens some people want to keep restrictions in place as something might happen. You really would think this is the most deadly virus ever.
 

duncanp

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Jonathan Van Tam was saying on the TV news tonight that if we vaccinate the most vulnerable people, he thinks we could get rid of 99% of the hospitalisations and deaths from COVID-19.

Even if it doesn't turn out to be 99%, then a large decrease in hospitalisations and death will mean that COVID-19 is no worse than seasonal flu, and something approaching a normal life can then resume.

I think the requirement to continue self isolating after vaccination is only until the scientists understand the effect of vaccination on transmission of the virus, or until sufficiently large numbers of people have been vaccinated.
 
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