Coronavirus - General Chat - No statistics

[swill453]

Some news from this morning is that the Chief Executive of AstraZenica has recently said that the UK are on course to have everyone over the age of 50 vaccinated by March

Did he mean "half-vaccinated", ie. first dose only? Presumably. Or am I incorrect?

He undoubtedly meant first dose only. Whether that's considered "half-vaccinated" is debatable.

Scott.

[servodude]

Given the huge numbers of people who won't be getting vaccinated, how are we ever likely to get anywhere close?

Collateral damage?

-sd

[Mike4]

Some news from this morning is that the Chief Executive of AstraZenica has recently said that the UK are on course to have everyone over the age of 50 vaccinated by March

Did he mean "half-vaccinated", ie. first dose only? Presumably. Or am I incorrect?

It's all part of the softening up of the population for only ever getting one dose.

The argument is, that to give someone the two doses (as per phase 3 approval terms) means someone else gets no vaccination. And given the fact that there is always a shortage of vaccine during all mass vaccination programmes, as an immunologist being interviewed on R4 pointed out yesterday, it makes strategic sense to vaccinate twice as many people and give each of them 3/4 of the protection.

Also, given that one dose still confers better than the 50% effectiveness which makes any vaccine useful, had the trials only ever tested single dose this would also have been hailed as a useful vaccine.

I predict one dose is well on track to become normalised.

[88V8]

The one larger concern for me at the moment is when I read about some sections of UK society being much more anti-vaccine than others....

With any luck, Darwin will sort that out. And the quicker the better given the overall damaging effect of low-take up.

V8

[tikunetih]

Whether that's considered "half-vaccinated" is debatable.

Why do you think I wrote it like that?


I note Mike4's comments re morphing towards a single-dose strategy. It's worth a read of the actual, full, lengthy interview (always use primary sources where possible vs. reportage etc) of Pascal Soriot by Repubblica:

https://www.repubblica.it/cronaca/2021/ ... 284349628/

Extract:
Given the fact that a lot of countries have high hopes on the Oxford AstraZeneca vaccine but now there are supply problems, does it makes sense for EU countries to give a second thought to one-dose strategy that the UK is using?

“I think the UK one-dose strategy is absolutely the right way to go, at least for our vaccine. I cannot comment about the Pfizer vaccine, whose studies are for a three-week interval. In our case, the trial we're talking about was conducted by Oxford University. We AZ are conducting the US trial, which we think is going to be ready very soon. Oxford University conducted the so-called Oxford trial in UK and Brazil, and we have data for patients who received the vaccine in one-month interval, 2 or 3 months interval. First of all, we believe that the efficacy of one dose is sufficient: 100 percent protection against severe disease and hospitalisation, and 71-73 percent of efficacy overall. The second dose is needed for long term protection. But you get a better efficiency if you get the 2nd dose later than earlier. We are going to do a study in the US and globally to use two-month dose interval to confirm that this is indeed the case, there are many reasons to believe it is the case with our vaccine. We have a different technology. First of all, when you look at level of antibody production, this is higher if you give the second dose three months or two months later than one month later. Also, if you look at Ebola, its vaccine, which is also using the Adenoviral vector like the Covid one, the second dose needs to be given eight weeks later. Finally, the J&J vaccine with Adenoviral vector also are performing studies on a two-month interval. And J&J has the same technology as ours. Therefore, for our vaccine, there is no doubt in my mind that the way the UK is going is the best way, because right now you have a limited amount of vaccine, but also you have a limited number of doctors and nurses able to inject people. So you maximize the number of people who get one dose. You give them enough protection for two or three months, then you give them the second dose after 3 months. By March, the UK will have vaccinated maybe 28 or 30 million people. The Prime Minister has a goal to vaccinate 15 million people by mid-February, and they're already at 6,5 million. So they will get there".

[gryffron]

It's all part of the softening up of the population for only ever getting one dose.

I don't think that's likely. Evidence is pretty clear that "one dose" protects for anything up to 12 weeks then wears off quite quickly. The second dose boosts this up to several years protection. So if people were only getting one dose, the over 90s would be re-acquiring vulnerability long before they'd finished doing the middle aged.

Gryff

[Julian]

Better to do that well than do something far more ambitious that will fail. And with the UK a net exporter of the virus, foreigners have more reason to fear us than vice versa.

Such a naïve point of view. New and dangerous mutations are cropping up all over the world. It isn't just us exporting ours to them, we need to prevent other countries exporting their (different) mutations to us.

I totally agree. OK, maybe I wouldn't have used the word naïve(*) but I share your disagreement with Lootman's comments. Looking just at South African travel which I feel qualified to do since I have been making 2 round trips there every year for the last decade to escape most of the UK winter, or did until Covid-19 hit. My experience both of my own trips and the numerous friends who have come to visit me there over the years is that routings offered by Emirates, Qatar, Turkish Airlines, Lufthansa, Air France, KLM and Swiss Air are extremely popular with Ethiopian Airlines also coming onto the scene quite strongly in 2019 and pre-Covid-19 2020. I'd say that over half of the trips that I or my friends have made in the last 10 years have been indirect routings transiting through non-UK airports. I am left wondering how this new scheme would catch those indirect journeys. I fear that this is yet another case of the government taking a half-way step that ends up being the worst of both worlds, not going far enough to achieve the desired effect yet still disruptive enough to inflict significant damage on sectors of the economy and personal freedoms.

On another topic, It's interesting to see a few other pessimists posting in the last 24 hours. My guiding principle is that I can't possibly know how all of this is going to pan out but I am definitely trying to prepare myself at least somewhat for a bad outcome.

Sometimes I think too many people, and on occasion I also fall prey to this effect, have been conditioned by TV and cinema to subconsciously think that everything will inevitably turn out OK in the end and, due to the time spans that TV shows and films tend to deal with (my perception is that story arcs over weeks or months are more common than those that span years or decades), that the happy ending doesn't take an extremely long time to arrive.

Yes, I hope that the vaccines will have a major effect not only on the strain they were designed for but also on these new emerging strains. That is definitely a path to a significant return to normality that I can see and there's a very good chance that will all go as planned but this is real life so it is also entirely possible that some new escape variant comes to light and vaccine re-design takes longer than hoped or even turns out to not be as easy as hoped due to some peculiarity in the new strain. I saw an interview with Sir John Bell recently and once you factor in production and at least a simplified regulatory approval, probably by reviewing bridging studies as opposed to completely rerunning phase 1/2/3 clinical trials, he estimated that it would take 6 to 8 months to roll out a re-worked Oxford/AZ vaccine which is the vaccine that he is in charge of. He also gave an estimate for rolling out a re-worked Pfizer/BioNTech vaccine and that timescale was shorter but I can't remember exactly what he said, 3 to 4 months I think but I could be wrong on that. If a really nasty new variant was to emerge in the next few months there is nothing to say that we wouldn't end up almost back at square 1 towards the end of this year while we wait for production and rollout of a new vaccine.

This really could go either way right now and my biggest source of concern is definitely new variants, both existing and potentially yet to emerge. I've been very worried about those for quite a while and have been somewhat perplexed as to why the media wasn't discussing those a month or two ago but at least now they are getting a lot of attention which I think is appropriate.

- Julian

(*) And had I used that word I confess that I wouldn't have used it with your finesse; diaeresis above the "i" duly noted.

[redsturgeon]

The second dose boosts this up to several years protection.

Gryff

Not sure how there can be evidence for this since the trials were just a few months long.

[staffordian]

What are the views here on how the success of the vaccination program might be measured?

I'm thinking along the lines of noting how many hospital in-patients have been vaccinated, and how many days have elapsed between injection and admission (or perhaps a positive test?) which I think is essentially what the much publicised Israeli graph shows.

But is this the best metric, and are there others?

I'm thinking of what easy to comprehend figure might be released on a daily basis, along with the current positive test numbers, hospital admissions and death numbers, but maybe there isn't anything this simple which will give a true picture.

Thoughts?

[Julian]

It's all part of the softening up of the population for only ever getting one dose.

I don't think that's likely. Evidence is pretty clear that "one dose" protects for anything up to 12 weeks then wears off quite quickly. The second dose boosts this up to several years protection. So if people were only getting one dose, the over 90s would be re-acquiring vulnerability long before they'd finished doing the middle aged.

Gryff

I think the extended dosing interval was primarily desperation but in my view justified desperation based on the alarming growth in cases, hospitalisations and deaths we've been seeing in the last few weeks.

I look at this as the current vaccine program having essentially been repurposed as a program primarily intended to get a one-shot prophylactic into as many people's arms as quickly as possible in order to stave off an even bigger disaster during this winter. If second doses can be delivered within 12 weeks and still give the desired longer-term immunity then great but if not I suspect the Government deliberately took that calculated risk perhaps on the assumption that SARS-CoV-2 vaccinations will be an annual event so they would get a second chance to get longer-term immunity into the population with a follow-on program starting in maybe September or October that would strictly adhere to whatever optimal dosing interval is arrived at once more trial results are available over the summer . For for the Oxford/AZ vaccine further trials might even be able to demonstrate superior efficacy of a half-dose/full-dose regimen which would help with any supply issues) and it is also quite possible that by then the vaccines might have been tweaked for the E484K and possibly other mutations so again the potential of increased efficacy vs what we are doing now even if the approved dosing intervals were being adhered to.

I'm not shy of criticising the Government on occasion but in this case my personal hunch is that they got this one right.

- Julian

[gryffron]

The second dose boosts this up to several years protection.

Not sure how there can be evidence for this since the trials were just a few months long.

Vaccines don't provide "immunity", they provide "increased protection". Exactly how much increased protection can be measured as antibody response to a deliberate (inert) infection. That TB jab on your arm is an earlier and rather less scientific example of such a reaction test . By measuring the dropoff in antibody responses over even a short time, they can see how quickly the protection is reducing, and thus predict with fair accuracy how long the protection will be useful. This was all done as part of the trials.

Gryff

[dealtn]

Some news from this morning is that the Chief Executive of AstraZenica has recently said that the UK are on course to have everyone over the age of 50 vaccinated by March

Did he mean "half-vaccinated", ie. first dose only? Presumably. Or am I incorrect?

It's all part of the softening up of the population for only ever getting one dose.

The argument is, that to give someone the two doses (as per phase 3 approval terms) means someone else gets no vaccination. And given the fact that there is always a shortage of vaccine during all mass vaccination programmes, as an immunologist being interviewed on R4 pointed out yesterday, it makes strategic sense to vaccinate twice as many people and give each of them 3/4 of the protection.

Also, given that one dose still confers better than the 50% effectiveness which makes any vaccine useful, had the trials only ever tested single dose this would also have been hailed as a useful vaccine.

I predict one dose is well on track to become normalised.

"... only ever ..." ?

Really? Possible I suppose but I would think unlikely. Perhaps it might become an annual single dose, like the flu vaccine. who knows the most effective interval might even turn out to be 12 months. The 3 week "guess" presumably was chosen as a means of having a shorter trial length. If they had chosen a 12 month interval that trial would still be ongoing and likely nobody (outside of the trial) would have received the vaccine yet, and it would still be awaiting approval.

[XFool]

...Now time for "A Little bit of polit..." Cough!

I know nothing of this so I am only guessing here, but could Pfizer be kicking up a fuss now over the UK ignoring their three week recommendation because Pfizer want to "Get their retaliation in first"? In case of any future problems emerging over the vaccine and resulting lawsuits, they can always cry: "We told you so!"

[tikunetih]

[It's all part of the softening up of the population for only ever getting one dose.

...

I predict one dose is well on track to become normalised.

"... only ever ..." ?

Really? Possible I suppose but I would think unlikely.

Govt stated their plan here: https://assets.publishing.service.gov.u ... -final.pdf

And we can monitor progress of it here: https://coronavirus.data.gov.uk/details/vaccinations

...and re Mike4's point specifically we can keey an eye on those "2nd dose daily" and "2nd dose cumulative" charts to see whether over the coming months they ever pick up or not, and if they do to what extent.

[Lootman]

It looks like the UK is going for a flexible and targeted hotel quarantine programme, with a focus on arrivals from countries with known risk rather than a blunderbuss "one size fits all" approach.

Better to do that well than do something far more ambitious that will fail. And with the UK a net exporter of the virus, foreigners have more reason to fear us than vice versa.

Such a naïve point of view. New and dangerous mutations are cropping up all over the world. It isn't just us exporting ours to them, we need to prevent other countries exporting their (different) mutations to us.

I totally agree. OK, maybe I wouldn't have used the word naïve(*) but I share your disagreement with Lootman's comments. Looking just at South African travel which I feel qualified to do since I have been making 2 round trips there every year for the last decade to escape most of the UK winter, or did until Covid-19 hit. My experience both of my own trips and the numerous friends who have come to visit me there over the years is that routings offered by Emirates, Qatar, Turkish Airlines, Lufthansa, Air France, KLM and Swiss Air are extremely popular with Ethiopian Airlines also coming onto the scene quite strongly in 2019 and pre-Covid-19 2020. I'd say that over half of the trips that I or my friends have made in the last 10 years have been indirect routings transiting through non-UK airports. I am left wondering how this new scheme would catch those indirect journeys. I fear that this is yet another case of the government taking a half-way step that ends up being the worst of both worlds, not going far enough to achieve the desired effect yet still disruptive enough to inflict significant damage on sectors of the economy and personal freedoms.

It would not be that hard to determine the original departure point for arrivals from places like Dubai. In most cases people book through tickets on the same itinerary and so that entire itinerary would be known or could be figured out.

To get around that the flyer would have to book two separate itineraries and then (probably) stay overnight n Dubai or wherever. That would add a considerable cost and time delay to the trip, which would deter most people.

If the government is going to go to the trouble of commandeering hotels and implementing prison-style security on them, then it would be trivially easy to determine where someone came from. And there are passport stamps and records as well - that little chip on your passport has a mine of information on it.

The point here is the 80/20 rule. We can repel 80% of the Covid cases by stopping the 20% of passengers most at risk. When you consider also that every flyer will have just had a negative Covid test, then the government's approach is surely the most prudent. It gives you most of the benefit whilst greatly reducing the burden and hardship on travelers.

[swill453]

And there are passport stamps and records as well - that little chip on your passport has a mine of information on it.

Actually it's only got information which identifies you, and is read-only.

But of course it's a key to look up your movements in other databases.

Scott.

[Lootman]

And there are passport stamps and records as well - that little chip on your passport has a mine of information on it.

Actually it's only got information which identifies you, and is read-only.

But of course it's a key to look up your movements in other databases.

Interesting, I thought it captured movements in and out of the UK, although obviously overseas would be another matter, unless there was some kind of international standard and accord.

Last summer I thought of routing back through Ireland to avoid the need to complete a passenger locator form. Part of why I rejected the idea was that I was not confident I could disguise my original point of departure even if I booked different itineraries. I certainly did not want to get caught out lying.

These checks will not be required for arrivals from Ireland but I assume that Ireland will take steps to match the UK rules in any event. They have their own Covid problems right now.

[XFool]

Last summer I thought of routing back through Ireland to avoid the need to complete a passenger locator form. Part of why I rejected the idea was that I was not confident I could disguise my original point of departure even if I booked different itineraries. I certainly did not want to get caught out lying.

Why do some people seem to have an urge towards 'complification'?

Reminds me of somewhere I used to work long ago. At year end the boss was always 'fiddling' the yearly budget figures. AFAIK he wasn't actually committing any kind of fraud for personal gain (unless I am too innocent?), he just seemed addicted to 'fiddling' with the figures!

[tjh290633]

Better to do that well than do something far more ambitious that will fail. And with the UK a net exporter of the virus, foreigners have more reason to fear us than vice versa.

Such a naïve point of view. New and dangerous mutations are cropping up all over the world. It isn't just us exporting ours to them, we need to prevent other countries exporting their (different) mutations to us.

The next mutation could arise here, of course. The current one began in Kent.

TJH

[Julian]

Better to do that well than do something far more ambitious that will fail. And with the UK a net exporter of the virus, foreigners have more reason to fear us than vice versa.

Such a naïve point of view. New and dangerous mutations are cropping up all over the world. It isn't just us exporting ours to them, we need to prevent other countries exporting their (different) mutations to us.

The next mutation could arise here, of course. The current one began in Kent.

TJH

That's by no means clear regarding the current B1.1.7 variant having begun in Kent. According to numerous experts I've seen interviewed it's considered entirely possible that the it started elsewhere but was detected first in the UK because we do so much more genetic sequencing of the virus compared to most other countries.

... the UK does more genome sequencing (10% of testing samples) than any other European country, except for Denmark, so it may take some time to know the extent of the variant’s spread. “Denmark probably sequences about 20% now and increased its sequencing capacity after the mink variant. The majority of other European countries sequence maybe 1%, and often much less than that, and many have no sequencing capacity whatsoever.”

[ Source: https://www.bmj.com/content/371/bmj.m4944 ]

As another data point the USA is sequencing about 0.3%!

[ Source: https://fortune.com/2021/01/26/covid-va ... africa-uk/ ]

As for "the next mutation could arise here, of course". Absolutely. There is already some disturbing info floating around. Firstly it is thought that the E484K mutation emerged independently in both the South African and the Brazilian variants and I even saw mention a couple of weeks ago that a variant with the E484K mutation had been detected in Liverpool that couldn't be contact-traced to any international travel hence it is possible, if that report has any credibility and if the contact tracing didn't miss anything, that one of the UK strains has acquired the E484K mutation all on its own.

- Julian