Our total reliance on a vaccine and putting life on hold until it's rolled out

[Bikeman78]

I'd like to question what do we mean by getting back to normal?
In terms of leisure etc I agree with you.
But in terms of work - if people are able to work just as effectively remotely (appreciate this is often industry, company and individual dependent) then why shouldn't they be pushing for that change to remain?
And in terms of traffic - I can't be the only person who thinks the increase in air quality and the reduction in air pollution during lockdown was a good thing.

I agree, if people want to work from home, let them carry on. Less road congestion and almost everyone can get a seat on a train. For me, normal is going out where and when I like, no face masks, no petty one way systems.

 

[hwl]

I find it frustrating that there appears to be a lack of evidence on who is getting the virus, and how it's being spread, since July or so. Is it "young" people who are getting it, and passing it on to "old" people? Under what circumstances and in what environments is this thing being spread?

I feel that better knowledge would better inform a response. So there's going to be a vaccine, so it's going to get partial take-up, so it's going to be partially effective. Fine. But even having 15% of a population additionally immune to the virus in some way can have a significant effect. But if it's the "young" who are getting infected, they're the ones who should be getting the vaccine, not "old" people like me (almost 60). I'm not going to get it because I don't go out and about these days, and I'm happy not to.

Giving the vaccine to the "vulnerable" may not be the correct approach. The people who need it are the people most likely to benefit from it, and if it means that "young" people don't get the virus in the first place and then don't pass it on to "old" people who die from it, that might be better than targetting the "old" people in the first place.

It's not simple. But I am frustrated by the lack of evidence at the moment - I need to do more research I think.

I think the vaccination strategy they are going for is based around initially how to rapidly reduce the risk of NHS overload as quickly as possible, that then gives you plenty of other options 2-3months later. If you follow this thinking for initial vaccine roll out (Plenty of reasons be more cautious given general vaccine effectiveness in elderly and some vaccines for those with high BMI /diabetics) then using the priority strategy they have, it might be an order of magnitude more effective than initially targeting the young.

I find it frustrating that there appears to be a lack of evidence on who is getting the virus, and how it's being spread, since July or so. Is it "young" people who are getting it, and passing it on to "old" people? Under what circumstances and in what environments is this thing being spread?

I feel that better knowledge would better inform a response. So there's going to be a vaccine, so it's going to get partial take-up, so it's going to be partially effective. Fine. But even having 15% of a population additionally immune to the virus in some way can have a significant effect. But if it's the "young" who are getting infected, they're the ones who should be getting the vaccine, not "old" people like me (almost 60). I'm not going to get it because I don't go out and about these days, and I'm happy not to.

Giving the vaccine to the "vulnerable" may not be the correct approach. The people who need it are the people most likely to benefit from it, and if it means that "young" people don't get the virus in the first place and then don't pass it on to "old" people who die from it, that might be better than targeting the "old" people in the first place.

It's not simple. But I am frustrated by the lack of evidence at the moment - I need to do more research I think.

The regional case rate data shows the 10-19 and a lesser 20-29 surge in early September, the 10-19 case rates are now starting to decline from peaks but all the other age group case rates are rising. It gradually works its way around e.g. all age groups use supermarkets. The lag appears to be a minimum of 3+ weeks

 

[GRALISTAIR]

(in the USA they must have a different meaning of the term "liberal" as most people in the UK who I know who describe themselves as "liberal" are against lockdowns)

It (the term liberal) is often used in an almost pejorative sense here. Trump et al use it frequently and it usually is ascribed to the Democrat Party. Many Democrats prefer the term progressive. Here the problem is we are in a very toxic election year as everyone knows. Current state of play is that Republicans want to open everything up and Democrats want to lock things down (very generalized). The problem was/is that Trump proposed opening up everything back in May saying the cure can not be worse than the disease. So sadly, because Trump proposed it, many are against it - opening up the country. But it is the same here in the USA - guess who has got hurt the most and burdened with more debt and bad symptoms and death - yes you guessed it - the minorities and the poorer people. Poorer people are not as able to social distance and even in their own houses have more people crammed together. There has to be a fairer way and lockdown is NOT the answer imho.

Even if we got a vaccine or two or three, not everyone will take it even if offered. I am a scientist and dont understand the rationale of refusing vaccines but hey ho.

The key points here is that, regardless of right vs left, libertarian vs authoritarian, locking down disproportionately affects:

• younger people
• disadvantaged people
• people in lower income jobs
• people in public-facing jobs
• mental wellbeing
• people in smaller homes
• people in higher density housing
  etc...

Locking society down until a vaccine has been rolled out is ostensibly to benefit older/wealthier people; they are blunt instruments akin to using a sledgehammer to crack a nut, which could cause major societal and economic problems for years to come.

You are totally correct. Absolutely totally no doubt whatsoever.

Lockdown should now be a thing of the past.

 

[DB]

Even if we got a vaccine or two or three, not everyone will take it even if offered. I am a scientist and dont understand the rationale of refusing vaccines but hey ho.

Leaving aside the anti-vaxxers, I think a fair number of more reasonable people are concerned, rightly or wrongly, that it might end up being rushed and not sufficiently tested for safety.

 

[philosopher]

I agree, if people want to work from home, let them carry on. Less road congestion and almost everyone can get a seat on a train. For me, normal is going out where and when I like, no face masks, no petty one way systems.

I agree with this. Longer term working arrangements should be based on a negotiation between the employer and employee similar to how salary is negotiated.

But come 31st March and if Coronavirus is still about but there's still no vaccine, then we just have to see the end of all this social distancing, face mask, local lockdowns, etc then, so that we can get back to normal, albeit having to still live with Coronavirus. By then we would have put up with these restrictions for 12 long months. We just can't continue with all this madness indefinitely until when or if a vaccine is found. This is all wearing people down. It's ruining the economy, and people's livelihoods and mental health.

If by the 31st March, then life has returned to what it was like in August and there is a clear strategy on how and when the remaining restrictions are going to be removed, regardless of where we are with a vaccine then I would be happy. I appreciate the ‘August normal’ still was not great, but it was a good deal better than what we have now. At least that way there would be some light at the end of the tunnel.

 

[GRALISTAIR]

Leaving aside the anti-vaxxers, I think a fair number of more reasonable people are concerned, rightly or wrongly, that it might end up being rushed and not sufficiently tested for safety.

Then it becomes a risk/reward thing. In life there is risk with everything and necessity is the mother of invention.

 

[adc82140]

It has been extremely annoying after we had got the daily deaths down to very low figures and there was some hope on the horizon of all these restrictions being lifted by Christmas, that we've now got this blasted second wave and daily cases, deaths, hospital admissions have all shot right up and are still continuing to do so. The government aren't going to lift these seemingly never-ending social distancing and face mask restrictions/laws anytime soon whilst these numbers are still continuing to increase. There is just no end in sight again at the moment, as there was back in March and April.

Once we do finally reach the peak and all the stats start falling, then there is some hope on the horizon. It may well take at least a few months though from that peak to get those down to very low numbers again. But once the deaths are down to very low numbers again, then that should be the time that all these restrictions should be lifted at a fast rate, and we can start getting back to normal again. I'm prepared that these restrictions are going to continue until as late as the end of March 2021 when the law that requires the government to make these restrictions will then expire, unless this is extended again.

But come 31st March and if Coronavirus is still about but there's still no vaccine, then we just have to see the end of all this social distancing, face mask, local lockdowns, etc then, so that we can get back to normal, albeit having to still live with Coronavirus. By then we would have put up with these restrictions for 12 long months. We just can't continue with all this madness indefinitely until when or if a vaccine is found. This is all wearing people down. It's ruining the economy, and people's livelihoods and mental health.

You have really got to stop reading so much into these figures. If we tested for any other respiratory virus, you'd see the infections, hospitalisations and unfortunately deaths rise during the autumn. I'm actually surprised that the I fevtionrate and deaths are so low given that we're nearly at the end of October. Don't forget also that even Conservative estimates have us at 100000 infections a day in April, some are even estimating up to 350000 a day, so we're nowhere near that.

 

[jfollows]

The Economist (https://www.economist.com/leaders/2020/10/17/britain-should-not-resort-to-a-new-national-lockdown but it's behind a paywall) suggests something like 30,000 cases now versus 150,000 cases at the peak in March/April.
I heard some politician yesterday claim the cases were now at the same level as they were then - that's simply untrue.


Facts, facts, facts, please, not conjecture (that's not aimed at comments here, just at politicians who make silly claims).

I think this chart is really important to consider in the light of the "facts" we're being barraged with today. Question its derivation, by all means, but assuming it's broadly accurate as I think it is then everyone needs to remember that we're currently nowhere near the bad place we were in in March/April. Could we get there again? Possibly. What do we need to do to ensure that we don't? Exactly the question to ask and have answered.

Article text:

Going full circuit
Britain should not resort to a new national lockdown

The costs would outweigh the benefits

In one sense it marks the return of politics as usual; in another it is a sign of looming crisis. On October 13th Britain’s opposition Labour Party split sharply from the government, calling for a “circuit-breaker”, a two- or three-week national lockdown to cut the spread of covid-19. As Europe and America struggle with a surge in cases, other governments may also come under pressure to do the same. It would be a mistake. The benefits of a national lockdown no longer justify the costs. At this stage of the pandemic governments should focus on local measures.

The impulse to do something is understandable. New reported daily cases in Britain are at a record seven-day average of over 15,000 and are doubling every two weeks. Local leaders are angered by confusing orders from Whitehall (see article). No wonder Labour has seized on Boris Johnson’s faltering performance.

Backers of a short, sharp lockdown say it would save lives—perhaps 7,000 or so according to modelling for scientists advising the government. By cutting the virus’s spread, the National Health Service would be spared the sort of overload that caused so many deaths in Italy earlier in the year. Once the epidemic had been reset at a lower level, the tracing system might be able to deal more promptly with the daily burden of new cases, helping to lower the rate of infections.

A national lockdown makes sense only if a country is completely overwhelmed and underprepared—as at the start of the pandemic. Neither is true of Britain today. Although the recorded number of cases in Britain is over three times its peak in April, the comparison is misleading. For all the system’s faults, the daily volume of tests is over 20 times what it was then. Mild cases that would have gone unreported six months ago are now picked up (see chart). This helps explain why deaths, at around 450 last week, are still just 8% of what they were in April. The fatality rate will increase, because it lags behind cases by three to four weeks. But better treatments are also saving lives. In choosing to act, deaths are more important than cases.

It is not clear that a national circuit-breaker would have lasting benefits. The disease would start to accelerate again as soon as it was lifted. As the year draws on, people will spend more time indoors, where the virus spreads easily. The burden of proof is on the proponents of a circuit-breaker to show that the well-documented shortcomings of Britain’s tracing system could be fixed by a three-week reorganisation or by a temporarily lower caseload. Compliance is also in doubt. Although polls support tough action, Britons seem to make an exception for themselves. A recent paper finds that just 18% of those who should have isolated themselves in the summer stuck strictly to the rules. If people flout them, the circuit-breaker may be kept for longer than three weeks, lowering compliance still further.

It would also be economically ruinous. In April, at the height of the first lockdown, Britain’s output was one-quarter lower than it had been in February. The imf argues that lockdowns may be worth it if they create an economy that can fully reopen for business. But nobody is suggesting that a short circuit-breaker could suppress the virus to that extent. And the trade-off would be even less worthwhile if you factor in the toll on mental health, the delay in treating other illnesses and the effects on long-term employment and education.

To get covid-19 under control Britain should focus on sustainable local measures: identifying vulnerable groups, finding ways to protect them, identifying trade-offs, instigating local testing and recruiting leaders to generate local support. A circuit-breaker sounds like a scientific solution to a runaway problem. The reality would be a costly mess.

 

[brad465]

Define " normal" - That assumes back to normal or life as it was before is possible.
Some change has already happened, some is yet to come.
e.g.
The growth in internet shopping in 2020 (measured post shops reopening to remove the lockdown peak) is equivalent to about the previous 4 years growth - that genii isn't going back into the bottle so physical retail will be smaller than it was before, that will probably mean many fewer stores in lots of areas.
More home working for some.
A larger NHS (/PHE etc) budget so everyone is paying more tax.
globally companies are looking at hiking automation levels again which is generally not good for low /medium skilled employment

These all have knock on effects which then cause other changes.

Normal in the sense of no social distancing, mask wearing is not a legal requirement and no limit on gatherings would be normal enough, anything else is open to interpretation depending on the wider economic and societal views.

 

[hwl]

The Economist (https://www.economist.com/leaders/2020/10/17/britain-should-not-resort-to-a-new-national-lockdown but it's behind a paywall) suggests something like 30,000 cases now versus 150,000 cases at the peak in March/April.
I heard some politician yesterday claim the cases were now at the same level as they were then - that's simply untrue.

The most recent surveillance testing report suggest that PCR tests were capturing ~55% of the cases. I.e. a reasonable current new case estimate is 1.81x the daily positive number

e.g. today 26688 +ve tests reported ---> 48523, substantially lower than min 100k estimate for earlier in the year.

 

[DustyBin]

My hope is that the powers that be know this is all nonsense, and that they will try and use the first 'vaccine' (I put it in inverted commas because it evidently will not mean that nobody ever gets or dies of covid again if they have it, which seems to be the common (mid)understanding) as a 'circuit breaker' to jolt society out of the hypochondriac state it is in, even if it isn't much different from a placebo.

We live in strange times and it may be wishful thinking but I could see a scenario in which, like how quickly people have become solely occupied with the need to focus on covid and ignore other health and economic issues, even a near placebo vaccine could make covid a distant memory and have it lumped in with other respiratory illnesses that we just have to deal with once the most vulnerable etc have had their injection. This is of course essentially the position of our scientific advisors in March this year - don't shut the world down, take common sense precautions if unwell etc.

Whether they think this or they actually believe what they say in the case of Hancock saying nothing changes until the 'real' vaccine comes in is a different matter but it's my hope at least..

And as this virus is showing signs of already going endemic, I'm not sure the current costs are justifiable either. Most of the identified common cold coronaviruses in circulation can be attributed to a big spike epidemic in the past, but they've now settled into society. As this one will do. It can still be dangerous, but so are other regular viruses - I read recently 8% of winter deaths in care homes pre-2020 are attributable to 'the common cold'.

I agree with @big_rig above that I think the most realistic endgame is a vaccine of sorts being released, and then the government can extricate themselves out of this mess by saying the vaccine is here so the restrictions can ease. Then they can hope people don't do too much digging.

I too agree with this. A 'vaccine' is the government's way out, it doesn't need to be effective, it just needs to exist so that they can lift restrictions without being accused of killing millions. When cases and deaths spike again they can say that the virus has mutated or simply attribute them to something else like a bad flu.... Am I cynical?

 

[bramling]

I too agree with this. A 'vaccine' is the government's way out, it doesn't need to be effective, it just needs to exist so that they can lift restrictions without being accused of killing millions. When cases and deaths spike again they can say that the virus has mutated or simply attribute them to something else like a bad flu.... Am I cynical?

No I’d say that’s pretty spot-on. It provides a convenient vehicle of blame, and gives them an exit strategy which allows them to justify having spent what may well by then by coming up to a trillion pounds.

 

[Carlisle]

I too agree with this. A 'vaccine' is the government's way out, it doesn't need to be effective,

Given the entire world’s governments & media are obsessed with Covid an ineffective vaccine would be outed pretty sooon .

 

[brad465]

For all the total reliance on a vaccine, there does seem to be a large number who currently refuse to take it, although if this survey is close to being representative, the UK could have relatively high compliance:

Tens of millions of people 'will refuse to be vaccinated against Covid-19'

International survey suggests many people still won't take a coronavirus vaccine

metro.co.uk

Tens of millions of people will refuse to be vaccinated against Covid-19, according to new research.

An international survey found almost three in 10 are reluctant to receive a future jab – potentially stalling its success.

It involved 13,426 participants in 19 countries hit hard by the pandemic, including Britain. Around 700 people in each country were asked if they would take a Covid-19 vaccine if it is proven safe and effective.

In the UK, less than three out of four people (71 percent) said they would – just below the average.

The British, US and Spanish scientists called for urgent action to improve public trust in immunisation. Even before the crisis, the World Health Organisation declared vaccination hesitancy one of the Top 10 threats to global health in 2019.

The idea of a rushed vaccine being a concern has of course been spoken about on here before, but there does seem to be similar views elsewhere.

 

[DustyBin]

Given the entire world’s governments & media are obsessed with Covid an ineffective vaccine would be outed pretty sooon .

I did consider that, but as seemingly nobody knows how many people have died OF COVID in the first place it wouldn’t take much to alter the narrative. In fact, it would be relatively easy to start attributing the majority of COVID deaths to ‘traditional’ non-COVID causes given that the vast majority of victims are elderly and/or suffer from serious comorbidities. I honestly don’t think this is that far fetched, it’s not like the government have been straight with us up to this point....

 

[DelayRepay]

The idea of a rushed vaccine being a concern has of course been spoken about on here before, but there does seem to be similar views elsewhere.

I have to say I will not be rushing to the front of the queue for a Covid vaccine, and I'll want to think very carefully before I have one. The risk of long term consequences needs to be carefully considered. Without wishing to sound callous, that may be another reason to start by vaccinating the elderly.

I do think we'll find a vaccine, and it'll end up being a bit like winter flu where those who are likely to suffer badly are vaccinated, others can get a vaccine if they want, and some people will choose not to be vaccinated and deal with the consequences. That's for individuals to decide.

To answer the original question, I do think a vaccine is the best route back to 'normal' and I think finding, testing, approving and distributing one (or more) is rightly a priority. BUT I don't think we can lock ourselves in our houses for an unknown period until that happens. So the strategy until then should focus on protecting the vulnerable (support for those who wish to shield, for example). Such a strategy would be completely aligned to the proposal that the vulnerable should be the first to receive a vaccine.

 

[DustyBin]

Interesting piece here (with link to original article):

Covid-19 vaccine expectations unrealistic: BMJ expert

None of the trials of Covid-19 candidate vaccines currently under way are designed to detect a reduction in serious outcomes such as hospitalisation or death, according to a leading public health expert.

www.rte.ie

None of the trials of Covid-19 candidate vaccines currently under way are designed to detect a reduction in serious outcomes such as hospitalisation or death, according to a leading public health expert.

Writing in the BMJ medical journal, associate editor Peter Doshi warned that not even the phase three trials under way in the race for a vaccine can prove their product will prevent people contracting Covid-19.

He said those hoping for a breakthrough to end the pandemic would be disappointed, with some vaccines likely to reduce the risk of Covid-19 infection by only 30%.

"None of the trials currently under way are designed to detect a reduction in any serious outcome such as hospital admissions, use of intensive care, or deaths," he said.

"Nor are the vaccines being studied to determine whether they can interrupt transmission of the virus."

This supports what some of us have been saying, i.e. that a vaccine is unlikely to be particularly effective.

 

[Bantamzen]

Interesting piece here (with link to original article):

Covid-19 vaccine expectations unrealistic: BMJ expert

None of the trials of Covid-19 candidate vaccines currently under way are designed to detect a reduction in serious outcomes such as hospitalisation or death, according to a leading public health expert.

www.rte.ie

This supports what some of us have been saying, i.e. that a vaccine is unlikely to be particularly effective.

I really wish this sort of thing were more widely talked about, way too much has been staked on a quick vaccine which in all likelihood will not happen. It could be many months, maybe even years before something even relatively effective will be available to the majority of people. The time for having a more rationale, and realistic discussion is way overdue.

 

[Bletchleyite]

I really wish this sort of thing were more widely talked about, way too much has been staked on a quick vaccine which in all likelihood will not happen. It could be many months, maybe even years before something even relatively effective will be available to the majority of people. The time for having a more rationale, and realistic discussion is way overdue.

I agree, provided that discussion isn't one sided, and does consider options such as periodic planned "circuit breaker" lockdowns with more normal periods in between and doesn't simply consider allowing the virus to spread.

 

[yorksrob]

I agree, provided that discussion isn't one sided, and does consider options such as periodic planned "circuit breaker" lockdowns with more normal periods in between and doesn't simply consider allowing the virus to spread.

Well, it can be discussed, and likely to be evaluated as unworkable on a medium to long term basis.

 

[Bletchleyite]

Well, it can be discussed, and likely to be evaluated as unworkable on a medium to long term basis.

Then we need to discuss other options too. "Let it rip" is going to be evaluated as unworkable, too.

 

[yorksrob]

Interesting piece here (with link to original article):

Covid-19 vaccine expectations unrealistic: BMJ expert

None of the trials of Covid-19 candidate vaccines currently under way are designed to detect a reduction in serious outcomes such as hospitalisation or death, according to a leading public health expert.

www.rte.ie

This supports what some of us have been saying, i.e. that a vaccine is unlikely to be particularly effective.

Well, if a vaccine doesn't make it less likely to be caught or less dangerous when it is caught, it rather makes me wonder what's the point.

That said, there must be something going on in the bodies of people who are asymptomatic that renders this virus controllable. It's a question of finding out how to replicate it.

 

[DB]

Then we need to discuss other options too. "Let it rip" is going to be evaluated as unworkable, too.

You do love that phrase!

I've not seen anyone on here sugget no measures at all - but the worthwhile ones would be protecting those particualrly at risk so far as is possible, while letting normal life carry on far as possible. The only way out of this is herd immunity, and trying to prevent it from circulating among the younger and health population is massively damaging to society - and doesn't actually prevent it from circulating anyway.

 

[Bletchleyite]

Well, if a vaccine doesn't make it less likely to be caught or less dangerous when it is caught, it rather makes me wonder what's the point.

Remember to read that in the context of who the writer is. A scientist will not write about hunches. If the trials don't prove it will stop people dying, they will say that. It doesn't mean it won't, it's just that the default position is the null hypothesis, i.e. if you don't prove it does then it doesn't.

 

[brad465]

You do love that phrase!

I've not seen anyone on here sugget no measures at all - but the worthwhile ones would be protecting those particualrly at risk so far as is possible, while letting normal life carry on far as possible. The only way out of this is herd immunity, and trying to prevent it from circulating among the younger and health population is massively damaging to society - and doesn't actually prevent it from circulating anyway.

While "letting it rip" isn't a good idea, I don't think that would happen if we did completely open up, given levels of immunity in the population, though unlikely to be at herd immunity levels, should be enough to prevent it from growing extremely rapidly, like what we're seeing with the current wave/peak. Taking extra care with personal hygiene and cleaning surfaces plus good ventilation where possible, with maybe voluntary shielding for a time for those most vulnerable will allow near-normality without the virus being "let rip" I think.

 

[Bantamzen]

I agree, provided that discussion isn't one sided, and does consider options such as periodic planned "circuit breaker" lockdowns with more normal periods in between and doesn't simply consider allowing the virus to spread.

And provided we also talk about whether or not "circuit breakers" are actually effective, and not just yet another can kicking exercise.

Then we need to discuss other options too. "Let it rip" is going to be evaluated as unworkable, too.

You seem obsessed about not letting "it rip". But what do you think is going to happen every time measures are relaxed? Answer, the virus will start to spread again. This is what viruses do, have been doing, and will continue to do. The entire world is demonstrating this, yet all we can come up with is more lockdowns.

Didn't someone once say that the definition of madness was doing the same thing over & over again and expecting different results? Asking for a friend....

 

[43066]

Then it becomes a risk/reward thing. In life there is risk with everything and necessity is the mother of invention.

For young healthy people the “risk” from Covid is similar to that posed by flu. I suspect many in that position will take the same approach to a Covid vaccine as they do the flu vaccine.

 

[MikeWM]

I've not seen anyone on here sugget no measures at all - but the worthwhile ones would be protecting those particualrly at risk so far as is possible, while letting normal life carry on far as possible. The only way out of this is herd immunity, and trying to prevent it from circulating among the younger and health population is massively damaging to society - and doesn't actually prevent it from circulating anyway.

Indeed I am increasingly convinced that the evidence is pointing to the current approach making things significantly worse.

As it is, the chances of vulnerable and non-vulnerable people catching it are fairly even as we're 'protecting' everyone more-or-less equally.

But a period of 'focused protection' - until we hit herd immunity - would tilt those odds so that the non-vulnerable are far more likely to catch it than the vulnerable. In the medium term this will mean fewer serious cases and fewer deaths.

 

[HSTEd]

I agree, provided that discussion isn't one sided, and does consider options such as periodic planned "circuit breaker" lockdowns with more normal periods in between and doesn't simply consider allowing the virus to spread.

Assuming the full costs of this eternal war on the virus are considered in a sober fashion without resort to overly emotional appeals to "save the photogenic pensioners"

 

[DB]

Assuming the full costs of this eternal war on the virus are considered in a sober fashion without resort to overly emotional appeals to "save the photogenic pensioners"

And "saving lives" needs to be qualified - what it actually seems to mean in many caes is "delaying the death of an elderly and seriously ill person for a month or two".