Coronavirus in the UK - news, lockdown and discussion

[bimble]

This is awful, you can feel the real despair in it, a thread where a doctor is pleading with the government to be allowed to show the public images from inside hospitals, to convince the deniers that covid is real and the nhs is not coping.

 

[platinumsage]

I agree. It would have been much cleaner if they started this for people having the first dose rather than changing plans for people expecting the 2nd.

It would have been, but perhaps they didn't have the necessary information to make the decision back then. For every elderly or vulnerbale person worried about a rescheduled appointment, there will be another elderly or vulnerable person getting their first jab sooner.

 

[brogdale]

This is awful, you can feel the real despair in it, a thread where a doctor is pleading with the government to be allowed to show the public images from inside hospitals, to convince the deniers that covid is real and the nhs is not coping.

So many clinicians are at their wits end, aren't they?
Things are spiralling out of control.

 

[andysays]

I'm genuinely confused about the timeline here, so this is what I understand has happened, but maybe someone can correct me if I've got it wrong.

1. At some point during the development of the vaccine, it was discovered that one jab didn't give full immunity, but two did (or at least near enough to full for us to call it full immunity).
2. The vaccine was approved for use.
3. A schedule of priority was announced, on the basis of two jabs being needed.
4. The vaccination programme was started, with the plan being that people would get the second jab a few weeks after the first.
5. Tony Blair (and possibly others, though he got the most publicity) made his intervention, with the suggestion that vaccinating more people once would be better than following the original plan (and the makers' recommendations and how the vaccine was intended to be used when it was approved) of giving two vaccinations.
6. The government have now announced that rather than following the original plan, people who have had the first jab will now have to wait 12 weeks for the second.

Have there been any new medical discoveries about the effectiveness of a single jab, or is this new decision based on no medical changes and therefore on purely administrative and/or political grounds?

 

[brogdale]

It would have been, but perhaps they didn't have the necessary information to make the decision back then. For every elderly or vulnerbale person worried about a rescheduled appointment, there will be another elderly or vulnerable person getting their first jab sooner.

Creating two old folk with no confidence that their single jab will have given them the protection they were told would accrue from the double dosing.

 

[brogdale]

I'm genuinely confused about the timeline here, so this is what I understand has happened, but maybe someone can correct me if I've got it wrong.

1. At some point during the development of the vaccine, it was discovered that one jab didn't give full immunity, but two did (or at least near enough to full for us to call it full immunity).
2. The vaccine was approved for use.
3. A schedule of priority was announced, on the basis of two jabs being needed.
4. The vaccination programme was started, with the plan being that people would get the second jab a few weeks after the first.
5. Tony Blair (and possibly others, though he got the most publicity) made his intervention, with the suggestion that vaccinating more people once would be better than following the original plan (and the makers' recommendations and how the vaccine was intended to be used when it was approved) of giving two vaccinations.
6. The government have now announced that rather than following the original plan, people who have had the first jab will now have to wait 12 weeks for the second.

Have there been any new medical discoveries about the effectiveness of a single jab, or is this new decision based on no medical changes and therefore on purely administrative and/or political grounds?

It's political, not clinical/scientific.

 

[platinumsage]

Creating two old folk with no confidence that their single jab will have given them the protection they were told would accrue from the double dosing.

What matters is their actual risk of dying or becoming seriously ill, and the medical advice they receive on that matter. That's far more important than the impression they get from reading the news.

 

[LDC]

Creating two old folk with no confidence that their single jab will have given them the protection they were told would accrue from the double dosing.

That's a bit patronising tbh. Plenty of 'old folk' will be able to understand why this has happened and make their own mind up as to whether it is OK.

 

[andysays]

It would have been, but perhaps they didn't have the necessary information to make the decision back then. For every elderly or vulnerbale person worried about a rescheduled appointment, there will be another elderly or vulnerable person getting their first jab sooner.

I'd want a bit more than "perhaps" tbh, especially if I was expecting my 2nd jab in the next couple of weeks.

 

[brogdale]

That's a bit patronising tbh. Plenty of 'old folk' will be able to understand why this has happened and make their own mind up as to whether it is OK.

Apols if it sounds patronising; I'm just basing my observations on the experience of fielding calls from family members affected. I know that generalising from specifics is always flawed, but I'm so angry about this that I can't see beyond the hurt/confusion and anxiety this botched decision from these useless cunts has caused.

 

[andysays]

It's political, not clinical/scientific.

That's what it looks like, and my fear is that in a couple of weeks it will change again for reasons of political expediency.

(waiting for someone to suggest that if we only give people half the dose, we can make the vaccine go twice as far, for instance...)

 

[cupid_stunt]

This is awful, you can feel the real despair in it, a thread where a doctor is pleading with the government to be allowed to show the public images from inside hospitals, to convince the deniers that covid is real and the nhs is not coping.

The worst part of that thread -

1. Like every NHS doctor and nurse on here, I am being constantly abused (I've even, on occasion, been threatened with rape or death) for saying Covid is real, deadly, and overwhelming our hospitals right now.

This makes me so fucking angry.

 

[StoneRoad]

The gov't have buggered it up again, I think we are agreed on that !

In my opinion, they should carry on with the +3 weeks for the second jab with the highest priority cases, using the Pfizer jab. That is, all the healthcare & over 80s. Use up the Pfizer stocks on the most vulnerable & key workers in the next groups down (again two teams, one for each jab)...

Roll out the first Oxford jab to the over70s & vulnerable over 18's, with second jabs as soon as possible after the 3 weeks, as a separate second team.

Then go down the age groups as planned with the first jab and a delayed second jab, again with the second jabs run by a second team.

Thus - you need six teams (& back up admin) and planned bulk jab sites.
For Pfizer that has to be hospital hubs (cold chain) feeding other sites - you've six hours from dilution to last use at 'fridge temperatures.
The Oxford jab can get far more widely distributed as it needs only domestic 'fridge storage ...

 

[LDC]

Apols if it sounds patronising; I'm just basing my observations on the experience of fielding calls from family members affected. I know that generalising from specifics is always flawed, but I'm so angry about this that I can't see beyond the hurt/confusion and anxiety this botched decision from these useless cunts has caused.

I haven't looked into the clinical reasoning and research behind this change, but I think (hope?) it will be there. I accept it might feel harsh on some people, but I expect it's like lots of this stuff; difficult decisions get made that are marginally better for the masses but that are sometimes worse for some individuals.

 

[LDC]

The worst part of that thread -



This makes me so fucking angry.

I made the mistake of looking at her Twitter and some of the comments on it from anti-lockdown/conspiracy people. It really is very, very depressing and anger inducing.

 

[MrSki]

Woke up to this on the radio this morning. Maybe they should play it at the press conference so people can hear the real situation. Well worth a listen to the end.

 

[Sue]

Woke up to this on the radio this morning. Maybe they should play it at the press conference so people can hear the real situation. Well worth a listen to the end.

He was on The Reunion yesterday. Came across as an extremely decent man.

BBC Radio 4 - The Reunion, The Covid-19 ward

Michael Rosen and the medical staff who cared for him during his battle with coronavirus.

www.bbc.co.uk

 

[Red Cat]

I haven't looked into the clinical reasoning and research behind this change, but I think (hope?) it will be there. I accept it might feel harsh on some people, but I expect it's like lots of this stuff; difficult decisions get made that are marginally better for the masses but that are sometimes worse for some individuals.

Back in April I saw a lecture on the history of triage and nightingale hospitals used as an example of how you might have introduce care that benefits more people but might be less effective than that in a specialist unit. It sounds similar to this process.

eta triage will always be political because it's about distribution of resources

 

[William of Walworth]

I made the mistake of lookng at her Twitter and some of the comments on it from anti-lockdown/conspiracy people. It really is very, very depressing and anger inducing.

I deliberately decided not to look at Dr Clarke's Twitter, and I'm very glad I didn't, from what she and others have said about the responses on it

I wonder whether (for her own health) she could try to shut down her account, at least temporarily?
But does that mean the conspiraloons have beat her?

 

[William of Walworth]

The gov't have buggered it up again, I think we are agreed on that !

In my opinion, they should carry on with the +3 weeks for the second jab with the highest priority cases, using the Pfizer jab. That is, all the healthcare & over 80s. Use up the Pfizer stocks on the most vulnerable & key workers in the next groups down (again two teams, one for each jab)...

Roll out the first Oxford jab to the over70s & vulnerable over 18's, with second jabs as soon as possible after the 3 weeks, as a separate second team.

Then go down the age groups as planned with the first jab and a delayed second jab, again with the second jabs run by a second team.

Thus - you need six teams (& back up admin) and planned bulk jab sites.
For Pfizer that has to be hospital hubs (cold chain) feeding other sites - you've six hours from dilution to last use at 'fridge temperatures.
The Oxford jab can get far more widely distributed as it needs only domestic 'fridge storage ...

I like these strategy suggestions

The more supplies of vaccines (from both Pfizer/BioNtech and especially from Oxford/AZ) that get made and distributed, the less this crazy, ultra-short-termist 'one jab only' swerve** would IMO become a thing .......

**Not that that's necessary anyway , especially not when you're still at the very elderly/very vulnerable people stage of the vaccination rollout .....

Very much agreeing with reactions from brogdale and most others about this

 

[William of Walworth]

And with this from the BMA (attachment) !! -- well spotted, brogdale

View attachment 246248

Very elderly and often frail folks have got their cabs/carers booked for the dates on the appointment cards they were issued with a jab 1.
What sort of cunts think this is an acceptable way to treat these people?

 

[elbows]

Tbh I have also been somewhat alarmed at the abandon with which news, politicians and other influential people including Independent Sage have been throwing the narrative of the much more infectious new strain around.

I was going to ask on the covid mutations thread, but I guess it is of wider interest, where we are at with that.

So just after the news broke before Christmas, high-profile virologists cautioned against extrapolating from epidemiological data to actual properties of the virus.

Ten days is a long time at the moment in virology, so there might be more evidence now?
Guardian had a piece yesterday on a study in its early stages finding respiratory samples patients with the strain having a high viral load in 35% of cases against 10% with the old strain, which could be a step towards demonstrating the actual higher transmissibility?

It did occur to me yesterday that if this turns out to be over-hyped and the horrific transmission and hospitalization rates are instead down to the rubbish tiers/schools open without mitigations and failure to trace, isolate and support - it could well give more fuel to the anti-vaxx flames and the turning away from experts in future. Or maybe it won't matter. Who knows anymore.

Most knowledge in this pandemic has been extrapolated in ways that arent perfect but have to do in the absence of stronger stuff that takes longer.

In the case of the new variant, their initial stance is formed by things like:

The viral load in new variant samples (takes less cycles to get a positive result in the lab)
The way it came to be the dominant strain in some areas over a certain period of time.
Some previously known theoretical implications of particular mutations.
The bad trajectories of key data in the regions in question, before the national measures even ended.
Probably some institution-specific genomic data that I have no access to (eg genomic surveillance during hospital outbreaks).

In terms of what elements of this I could test myself, apart from keeping an eye on what experts and studies say, I suppose analysis could be performed involving:

Study the rise in infections in places like London before the national measures ended. Very much including age-specific rates. Combine that with data such as the weather, and mobility data, including shop footfalls. Try to establish whether any of these other factors correlate to the rise in cases.

Another way of looking at it is to see what made NERVTAG change their confidence about increased transmission of the new strain from moderate to high.

Here is the initial NERVTAG paper with moderate confidence reached: Box

This is the 2nd paper where their confidence changed to high: Box

The increase to high confidence appears to be down to a bunch of additional modelling exercises of different types, and PHEs analysis where they use the s-gene part of tests coming back negative as a proxy indicator for these being new variant cases. Thats a useful trick to perform since although we have a large genomic sequencing capacity in this country, its still only done on 5-10% of test samples, and it takes time to get the results. Using s-gene dropout stuff is a useful way to estimate new variant levels based on a far higher number of test samples (since several of the major lighthouse labs use s-gene detection as one part of their test analysis, producing lots of data)

Modelling certainly has limits, and one of the most obvious ones is that a limited number of scenarios end up getting modelled. So getting one of those models to match up with real data that was observed is not quit proof of anything, there could be other scenarios that they didnt model which could also provide a good match.

For now I stick to keeping a somewhat open mind but still being prepared to lean quite strongly in a certain direction.

 

[existentialist]

Woke up to this on the radio this morning. Maybe they should play it at the press conference so people can hear the real situation. Well worth a listen to the end.

I shouldn't have read the comments on that tweet. I now feel physically sick.

 

[2hats]

First shot of the Pfizer vaccine gave about 90% protection after 11 days so they're already pretty safe

Do you have a reference for that?

 

[MrSki]

This is worrying.

 

[Supine]

Do you have a reference for that?

Not the one I originally saw but a summary here which is similar

 

[hash tag]

Hey people do not go out celebrating tonight, stay home, stay safe says the Standard in one headline.
In the next, come see Patti Smith live tonight at Piccadilly!

 

[platinumsage]

.

 

[platinumsage]

Not the one I originally saw but a summary here which is similar

The data for severe disease (which is what matters) is on the last page of this: https://www.nejm.org/doi/suppl/10.1056/NEJMoa2034577/suppl_file/nejmoa2034577_appendix.pdf

 

[editor]

Lambeth MPs quite reasonably asking for urgent clarity on the decision to open schools in Lambeth whilst keeping schools closed in neighbouring boroughs.

Lambeth MPs look for answers about the ‘inconsistency in the Government’s school closure policy’