Coronavirus in the UK - news, lockdown and discussion

[elbows]

Neither of you read the foot note or noticed the alternative figure 2? It's because the original figure contained data that might be used to identify individuals.

By the way I know that with previous modelling you werent very impressed with the vaccine effectiveness percentages they used. So I'd be keen to hear what you think of the figures the different universities have used this time, when trying to take account of the Delta variant.

 

[elbows]

Since I've started to read the new SAGE documents about the modelling, I will pluck out a few bits to quote here in the coming hours.

This exponential growth in cases will accelerate as people have more social contact (including more riskier contacts), particularly if Step 4 is taken on 21st June. This increase will continue to quicken until either a) behaviours spontaneously change in response to the resurgence, b) policy changes or c) a build-up in immunity (acquired either through vaccination or by infection) means the epidemic starts to grow more slowly and eventually shrink.

The delta variant is highly transmissible. Whilst the precise herd immunity threshold cannot be calculated, an R0 of 7 would require over 80% of all people (not just adults) to be immune for herd immunity to be reached and for the epidemic to begin to shrink without further measures. Younger adults play a disproportionately large role in transmission but have not yet been vaccinated.

Whilst highly effective, vaccines do not provide perfect protection against infection and so more than 80% of the population need to be either vaccinated or infected to prevent ongoing long chains of transmission. Despite the success of the vaccine rollout, without behavioural change, the growth in cases will increase for many more weeks.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/993510/S1287_SPI-M-O_Summary_Roadmap_step_4.pdf

 

[Monkeygrinder's Organ]

Vaccines to be available to all adults from later this week apparently.

 

[elbows]

Neither of you read the foot note or noticed the alternative figure 2? It's because the original figure contained data that might be used to identify individuals.

OK I've read that document now, I see that unlike what I said earlier, the redacted thing relates to data concerning what has already happened, not future projections.

I'll tell you exactly why I think it was redacted and it involves 3 letters. JBC. The Joint Biosecurity Centre has been extremely secretive so far, I dont think I've ever seen and detailed output from it made public in the pandemic so far. It is way less open than SAGE etc. I would have ranted more about this but its hard to know what sort of info they've been sitting on during their existence so far since its relatively rare for their name to even come up and the press havent gotten stuck into this.

 

[elbows]

My conclusion from reading that document giving a summary of recent modelling is that right now they are stuck in the same sort of position as me. There is great uncertainty about level of hospitalisations and deaths, they dont know if the peak is going to be better or worse than the last waves peak.

Figure 4 shows the results of the groups’ central scenarios7. In all instances, the confidence intervals indicate that under these particular sets of assumptions, a peak in hospital admissions that is either higher or lower than that of January 2021 is plausible.

This shows that, while there is a significant resurgence in admissions in all scenarios, the scale of that resurgence is highly uncertain and ranges from considerably smaller than January 2021 to considerably higher. The difference between the optimistic and cautious effectiveness assumptions leads to a factor of three difference in the peak height; between 20% additional and 20% less transmission advantage leads to a factor of five difference.

As results are so sensitive to these assumptions, SPI-M-O cannot determine with confidence whether taking Step 4 of the Roadmap on 21st June would result in a peak that might put unsustainable pressure on the NHS.

School summer holidays get a mention:

Models assume that transmission will be significantly reduced during the school summer holidays and so a delay of four weeks that moves further relaxations into this time period has a particularly large effect.

My attempt to insert the relevant charts may end up a bit large so I'm sticking it in a spoiler tag.

Spoiler

 

[platinumsage]

By the way I know that with previous modelling you werent very impressed with the vaccine effectiveness percentages they used. So I'd be keen to hear what you think of the figures the different universities have used this time, when trying to take account of the Delta variant.

Again all three models used hospitalisation assumptions much lower than the 92%/96% figures published yesterday.

 

[elbows]

Again all three models used hospitalisation assumptions much lower than the 92%/96% figures published yesterday.

I've got information overload at the moment, where are the 92%/96% figures to be found? Cheers.

 

[elbows]

 

[strung out]

You still in Bristol?
Mine is 26th July, pfizer, I’m 45. Don’t want to risk rebooking. It’s already changed twice, not at my behest.

Yeah, rebooked at Ashton Gate for 14th July. I hadn't actually booked a second appointment, so I didn't need to cancel it to bring mine forward.

 

[elbows]

OK I've read that document now, I see that unlike what I said earlier, the redacted thing relates to data concerning what has already happened, not future projections.

I'll tell you exactly why I think it was redacted and it involves 3 letters. JBC. The Joint Biosecurity Centre has been extremely secretive so far, I dont think I've ever seen and detailed output from it made public in the pandemic so far. It is way less open than SAGE etc. I would have ranted more about this but its hard to know what sort of info they've been sitting on during their existence so far since its relatively rare for their name to even come up and the press havent gotten stuck into this.

An example of a reply on twitter to Christinas redaction question.

 

[platinumsage]

I've got information overload at the moment, where are the 92%/96% figures to be found? Cheers.

Vaccines highly effective against hospitalisation from Delta variant

New analysis by PHE shows for the first time that 2 doses of COVID-19 vaccines are highly effective against hospitalisation from the Delta (B.1.617.2) variant.

www.gov.uk

 

[platinumsage]

I haven’t seen any rationale for the hospitalisation rates used in models, or any reasoning as to why they should always be lower than what I would consider a reasonable assumption to be at the time of preparing the model.

Certainly if I was a modeller I’d want my output to predict a range of scenarios from “we don’t need to do anything” through to “we need to take serious measures to protect the NHS”. That way, I wouldn’t be able to be wrong. If I picked a protection from hospitalisation rate that was too high, and all my scenarios were consequently unalarming, I’d be worried about the blame if things turned out worse.

 

[elbows]

Thanks very much for the info.

Regarding timing and which estimates they use, I note that SAGE discussed those modelling results on 9th June and although I havent read the individual models papers yet, they were tending to use real data up to dates like 1st June and 4th June. The hospitalisation estimates you helpfully pointed me to were ony published yesterday, and I dont know exactly when that analysis was completed or how much advanced sight of those estimates the modellers had, if any. Although I do note that the data used for that also went up to June 4th.

I note that the ranges their vaccine hospitalisation estimates involved are really still quite large. So its more stuff where a 'wait for more data' approach is required in order to increase my confidence that the estimates remain valid. eg 2nd dose Pfizer range of 86-99% and 2nd dose AZ range of 75-97%.

A couple of tables from the main analysis document and the supplimental document. I'll stick them in spoiler tags again due to potential size of these images (as I'm having some hi res display issues when taking screenshots)

Spoiler

From the two documents at Effectiveness of COVID-19 vaccines against hospital admission with the Delta variant - Public library - PHE national - Knowledge Hub

 

[thismoment]

Thanks for this - just got mine brought forward to mid-June.

Am 37 years old with Pfizer if that makes any difference.

I had Moderna end of May and have the second one in August. Really want to move it forward but I’m worried that if I cancel I’ll end up rebooking for even later.

 

[thismoment]

That's why I didn't chance it, and just stayed with the appt I had. Sorry to hear that.

That’s put me off changing mine too. Oh well, I’ll just be grateful that I have a second appointment booked

 

[strung out]

If you're already 11 or 12 weeks between jabs, the system won't let you book one any later than that.

 

[elbows]

I probably dont need to say much more about the modelling given the high degree of uncertainty. Will just have to wait for more real data to become avaiable int he coming weeks. I'll take the opportunity to have a break when I can, I wont be reporting on daily data every day, just when I can say something new about it.

An additional reason for me not going on about the detail of the modeeling too much at the moment:

The modelling does not reflect preliminary estimates from PHE and PHS of a higher rate of hospitalisation of cases for the delta variant compared with the alpha variant, which are still highly uncertain.

Thats from the minutes for SAGE meeting 92 of June 9th. https://assets.publishing.service.g...nt_data/file/993387/S1284_SAGE_92_minutes.pdf

Also in that part of the minutes, they discuss how a delay will allow more data to accrue, which should reduce uncertainties they have about the effects of proceeding with step 4. Then they make a brief reference to reimposing measures:

Reducing uncertainty about whether there may be unsustainable pressure on the NHS also reduces the risk of needing to consider reimposing measures. Although there is a risk of unsustainable pressures even with a delay, it is much lower.

 

[elbows]

The previous SAGE meeting, of June 3rd makes mention of mitigation measures required to deal with the Delta variant and the rise in cases, including hospital infection control:

The rising prevalence of the delta variant will increase the importance of mitigation measures. If the infectious dose were lower for this variant, this might increase the relative importance of measures to reduce the risk of airborne transmission, in particular (e.g., ventilation). Measures to reduce the risk of nosocomial transmission are crucial and will become increasingly important as COVID-19 hospital admissions increase. Updated guidance has recently been published on this and now needs to be implemented within the NHS.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/993106/S1266_SAGE_91_Minutes.pdf

 

[elbows]

 

[elbows]

Although I look at various vaccination stats I dont attempt to do my own sums about supply and rates needed to meet announced targets. This guy does and he reckons the targets they laid out yesterday involve a quite pathetic rate of vaccination compared to what we've been able to deliver previously. I lack the means to check his sums.





There are other tweets of his that go into more detail and I think he does vaccination weekly figure projections on there too.

 

[LDC]

I worked at a vaccine clinic today as have been for a 5 months or so. Was doing 2 clinics a week for ages, last 2 months they've been fortnightly, and today's was the penultimate one, with the last one in 2 weeks.

I asked how this was the case when more people are going to need jabbing, especially now it's been opened up to over-18s and plenty still need second doses. Was told they're going to the local large NHS hub as GPs can't manage it anymore. Except have also been told that the local large NHS hub is mostly closing as it's being used for sporting stuff (as it's a football stadium). Plus boosters are not far off I expect...

 

[Supine]

 

[Supine]

Great thread on how the next wave is looking

 

[elbows]

I worked at a vaccine clinic today as have been for a 5 months or so. Was doing 2 clinics a week for ages, last 2 months they've been fortnightly, and today's was the penultimate one, with the last one in 2 weeks.

I asked how this was the case when more people are going to need jabbing, especially now it's been opened up to over-18s and plenty still need second doses. Was told they're going to the local large NHS hub as GPs can't manage it anymore. Except have also been told that the local large NHS hub is mostly closing as it's being used for sporting stuff (as it's a football stadium). Plus boosters are not far off I expect...

Thanks for the examples on this side of things. I did find myself writing on another thread recently about some of the vaccination centres in my town that are on reduced hours or have/will soon be shutting up as some of the venues return to normal use. I much preferred the couple of times I got to write about pop up vaccination centres that were active on a handful of days some weeks ago now, when this was one of the places undergoing durge testing for the Delta variant. Both because they were popular and were reaching some people the main system didnt, and because more choice and capacity is obviously more pleasurable to talk about than reductions at a crucial time.

 

[LDC]

Thanks for the examples on this side of things. I did find myself writing on another thread recently about some of the vaccination centres in my town that are on reduced hours or have/will soon be shutting up as some of the venues return to normal use. I much preferred the couple of times I got to write about pop up vaccination centres that were active on a handful of days some weeks ago now, when this was one of the places undergoing durge testing for the Delta variant. Both because they were popular and were reaching some people the main system didnt, and because more choice and capacity is obviously more pleasurable to talk about than reductions at a crucial time.

Yeah, sometimes a view 'on the ground' (as it were) is short sighted or too focused on the job in hand with no decent overview, and I'm more than happy for that to be the case here with what I posted above, but nobody I have come across seems to be able to answer what the medium and long term vaccination plan is for getting millions more people done.

Hopefully someone clever in an office somewhere has a national overview and it's all in hand...

 

[BillRiver]

I worked at a vaccine clinic today as have been for a 5 months or so. Was doing 2 clinics a week for ages, last 2 months they've been fortnightly, and today's was the penultimate one, with the last one in 2 weeks.

I asked how this was the case when more people are going to need jabbing, especially now it's been opened up to over-18s and plenty still need second doses. Was told they're going to the local large NHS hub as GPs can't manage it anymore. Except have also been told that the local large NHS hub is mostly closing as it's being used for sporting stuff (as it's a football stadium). Plus boosters are not far off I expect...

Whereabouts is your vaccine clinic?

 

[LDC]

Whereabouts is your vaccine clinic?

Northern England city, PCN clinic (so run by a number of GP surgeries).

 

[BillRiver]

Northern England city, PCN clinic (so run by a number of GP surgeries).

Interesting, thanks. I work at one in Hackney, also organised and funded by a group of GP's (I think they call it a consortium).

 

[miss direct]

Yeah I'm having to go to the big arena right across the city for jab 2 rather than the medical centre up the road.

 

[Boudicca]

Our vaccine hub is closing for 3 weeks for a cheerleading competition.

Except that I wonder whether that is going ahead now that unlocking has been delayed.