Vaccine Progress, Approval, and Deployment

[35B]

Firstly is Open total capacity?

As i said its too high currently but im interested in where its headed to inform policy and timelines. So there is good correlation between cases, hospital admissions and ICU occupancy with a lag of 2 weeks roughly between each of them. So you can forecast that with cases down over last few weeks hospitalisations reducing that ICU bed occupancy will react accordingly. Yes it will stay at a high level because its has a long decline tail but as long as its declining then absolute numbers shouldn't be a reason for keeping full restrictions in place. .

Once we can see that trend following through, as part of a pattern, I agree. It's banking on that prediction that worries me.

 

[Yew]

Once we can see that trend following through, as part of a pattern, I agree. It's banking on that prediction that worries me.

People that don't get admitted hospital pretty reliably don't get transferred to ITU.

 

[DelW]

My sixty-seven year old mother got a call off her GP surgery this afternoon arranging for her to have her first vaccine next Tuesday. So they've definitely started in on group five members!

I'm 68 with no particular health issues and had my first jab today. I had a phone call from the local surgery* late afternoon yesterday, offering me a choice of two locations about 5 - 10 miles away, and my preferred (closer) one had a slot at 5pm today.

Very quick and efficient, lots of volunteers guiding people through each stage. I was in and out in about half an hour, including the 15 minute monitoring period to check for adverse reaction.

(* the "scam phone calls" thread usefully warned me that a "number withheld" call might be about Covid appointments, so I answered it first time!)

 

[Ediswan]

Clearly, but ICU occupation certainly is the laggiest ...

Is 'laggiest' a dictionary word ? If not, it should be.

 

[yorkie]

Is 'laggiest' a dictionary word ? If not, it should be.

Yes it is; these days probably most frequently used to describe online experiences, e.g. online gaming

 

[Domh245]

Firstly is Open total capacity?

As i said its too high currently but im interested in where its headed to inform policy and timelines. So there is good correlation between cases, hospital admissions and ICU occupancy with a lag of 2 weeks roughly between each of them. So you can forecast that with cases down over last few weeks hospitalisations reducing that ICU bed occupancy will react accordingly. Yes it will stay at a high level because its has a long decline tail but as long as its declining then absolute numbers shouldn't be a reason for keeping full restrictions in place. .

Open is capacity in this case, yes.

The correlation is (just about) there, and to be fair with the latest data actually giving London the slightest of declines the correlation starts to become more apparent than when I'd last checked (ICU beds plotted on right axis for ease) although the numbers used to offset the different lines relative to ICU don't feel right, particularly when you see in the ICNARC report that acute admission to ICU tends to be fairly short

It doesn't only lag on the way down, you know?

This is true, but given what we've seen about cases tending to bounce back even harder post lockdowns, pushing for things to reopen at the end of this month off the back of modelling showing that we might* hit normal ICU occupancy at some point in the future and how that fits in with projected vaccinations and wider case rates does seem particularly risky, especially when it's mostly ICU occupiers that are coming up for vaccination. I can certainly see why, when the uncertainty is high and the population is as compliant as it is, they're not rushing out of lockdown and for once, I think they might have gotten it right

*it is a model after all!

 

[rumoto]

There is an interesting interview with Hancock at the Telegraph; he thinks that the vaccine will have been offered to all adults by September and "hopefully a bit before that".

He also hopes to live with Covid like flu by end of this year; this is the date where all restrictions may end in the UK.

Exclusive: We hope to live with Covid like flu by end of the year, says Matt Hancock

Health Secretary believes vaccines and new drugs can turn virus into a treatable condition

www.telegraph.co.uk

Exclusive: We hope to live with Covid like flu by end of the year, says Matt Hancock​

Health Secretary believes vaccines and new drugs can turn virus into a treatable condition



Matt Hancock has said he hopes vaccines and treatments will have turned Covid into a disease we can "live with, like we do flu" by the end of the year.

"I hope that Covid-19 will become a treatable disease by the end of the year," Mr Hancock told The Telegraph, saying new treatments will be important in "turning Covid from a pandemic that affects all of our lives into another illness that we have to live with, like we do flu. That's where we need to get Covid to over the months to come".

He said he hopes every adult in the UK will be offered a vaccine "a bit before" September as the rollout of jabs continues to progress at pace.

 

[Huntergreed]

There is an interesting interview with Hancock at the Telegraph; he thinks that the vaccine will have been offered to all adults by September and "hopefully a bit before that".

He also hopes to live with Covid like flu by end of this year; this is the date where all restrictions may end in the UK.

This actually seems pretty reasonable, although I would hope we would learn to “live with it” long before the end of the year. Restrictions in any form by mid-summer are just not acceptable.

 

[Domh245]

An interesting story coming out of France that they're deciding to forgo the first jab for those who've previously had covid (in the last 6 months)

It's certainly an interesting strategy, and one that would appear to make sense given the role of the second dose as a 'longevity' treatment. It'll be a nightmare to actually implement of course compared to just giving everyone their 2 doses and being done with it, but given how well France's rollout is going at all, it won't have too much of a difference!

France's health authority is recommending that anyone previously infected with Covid-19 should only receive one vaccine jab, instead of the normal two doses.
People who recover from Covid have some immunity and should be inoculated three-six months afterwards, it said.
France is the first country to issue this advice.
It has delivered nearly 2.8 million vaccinations so far, the health ministry said.
"A single vaccine dose will... play the role of reminding" the body of someone previously infected with coronavirus how to fight the disease, the Haute Autorité de Santé (HAS) said.
The recommendation comes as governments around the world are rushing to vaccinate their populations and try to return life to normal.
At least 3.4 million people in France have had confirmed Covid-19 infections but the true figure is thought to be higher. Around 81,000 people have died - the seventh-highest figure in the world.
France's inoculation programme began in December but is lagging behind that of other countries like Israel, the United Arab Emirates and the UK.
The three main vaccines used globally are administered in two doses, delivered several weeks apart.
But HAS said that four studies suggest that a single dose in someone who has recovered from coronavirus produces a sufficient immune response to protect against further infection.
"People who have already been infected retain an immune memory," HAS said in a press release. "The single dose of vaccine will thus act as a booster."
The agency has not said how this recommendation could be acted on or how France would identify who has already contracted Covid-19 and when.
People with suppressed immune systems should still receive two doses, the agency added.

 

[Nicholas Lewis]

This is true, but given what we've seen about cases tending to bounce back even harder post lockdowns, pushing for things to reopen at the end of this month off the back of modelling showing that we might* hit normal ICU occupancy at some point in the future and how that fits in with projected vaccinations and wider case rates does seem particularly risky, especially when it's mostly ICU occupiers that are coming up for vaccination. I can certainly see why, when the uncertainty is high and the population is as compliant as it is, they're not rushing out of lockdown and for once, I think they might have gotten it right

*it is a model after all!

I can't accept managing relaxation through whether ICU bed occupancy are at normal levels that will delay any change for far too long. We know that ICU occupancy will fall away much slower than cases or hospitalisation so its a lagging measure we need to use leading indicator which is case level positivity blended with the ONS survey and they both have fallen by 2/3rds since the peak and thats feeding through into hospital admission rates now. I agree that holding the line for so long as proven worthwhile but this time round its becoming too established with the doves that we need keep the lockdown on for much longer. The virus is seasonal so vaccine / lockdown or not it will moderate naturally so the economy needs to be progressively opened up from March but with a level of surveillance through routine testing in some control areas to provide early warning of transmission not wait for people to become symptomatic before seeking a test. The govts approach though is sounding like we will open say primary schools wait a few weeks to see whats happened then move on but at that pace summer will be gone.

 

[yorkie]

An interesting story coming out of France that they're deciding to forgo the first jab for those who've previously had covid (in the last 6 months)

it makes sense while they are really short of vaccine supplies, though it sounds like a lot of hassle, and it is unclear how they would determine who those people are (maybe they have a record of who tested positive, though that isn't great for anyone who had a false positive!)

 

[johntea]

Interestingly the hospital where I work has now had to shut down their staff vaccination centre for several weeks as they've got to the point now where they've given enough of the workforce the first jab so if they kept it open they would have too many left over vaccines and would have to throw them away, although I believe they're advising remaining staff they may be able to just book in at one of the various recently opened general public vaccination sites

They are sticking to the 12 week gap between doses

Also of interest is how quickly 80% or so of the workforce have booked in, been processed compared to the flu vaccination season which can last for several months and has nowhere near 80% takeup!

 

[Yew]

Open is capacity in this case, yes.

The correlation is (just about) there, and to be fair with the latest data actually giving London the slightest of declines the correlation starts to become more apparent than when I'd last checked (ICU beds plotted on right axis for ease) although the numbers used to offset the different lines relative to ICU don't feel right, particularly when you see in the ICNARC report that acute admission to ICU tends to be fairly short
View attachment 90511



This is true, but given what we've seen about cases tending to bounce back even harder post lockdowns, pushing for things to reopen at the end of this month off the back of modelling showing that we might* hit normal ICU occupancy at some point in the future and how that fits in with projected vaccinations and wider case rates does seem particularly risky, especially when it's mostly ICU occupiers that are coming up for vaccination. I can certainly see why, when the uncertainty is high and the population is as compliant as it is, they're not rushing out of lockdown and for once, I think they might have gotten it right

*it is a model after all!

Previous times the bounce has been delayed, and we didn't have millions of people vaccinated.

 

[HSTEd]

Even with having to issue second doses, at the current rate vaccination rates will advance by something like 3% of the adult population each week.

This means a significant spike starting in the summer from a low base would be in a race with the vaccine that it might not win.

 

[hwl]

it makes sense while they are really short of vaccine supplies, though it sounds like a lot of hassle, and it is unclear how they would determine who those people are (maybe they have a record of who tested positive, though that isn't great for anyone who had a false positive!)

Agreed, in the France's case it might also provide useful excuses given poor supply combined with anti-vax culture to reduce pressure on the government by lowering targets.

Israel have done similarly, they are delaying vaccinating anyone who has previously tested positive till after they have vaccinated those who haven't.

Their medical data systems are in far better shape than almost all other countries so should have better chance of getting it to work than anyone else.

Even with having to issue second doses, at the current rate vaccination rates will advance by something like 3% of the adult population each week.

This means a significant spike starting in the summer from a low base would be in a race with the vaccine that it might not win.

Once we get to roughly double the current number vaccinated and continue vaccinating, it will be very difficult to get a spike in ICU admissions etc.

As long as we don't see significant SA / Manaus type strains with 501Y + 484k mutations were will also start seeing large transmission reduction benefits at that point. (Still large transmission in under 50s as hardly any vaccinated at that point).

Yes it is; these days probably most frequently used to describe online experiences, e.g. online gaming

It has been used by engineers for very very long time.

The correlation is (just about) there, and to be fair with the latest data actually giving London the slightest of declines the correlation starts to become more apparent than when I'd last checked (ICU beds plotted on right axis for ease) although the numbers used to offset the different lines relative to ICU don't feel right, particularly when you see in the ICNARC report that acute admission to ICU tends to be fairly short

This is true, but given what we've seen about cases tending to bounce back even harder post lockdowns, pushing for things to reopen at the end of this month off the back of modelling showing that we might* hit normal ICU occupancy at some point in the future and how that fits in with projected vaccinations and wider case rates does seem particularly risky, especially when it's mostly ICU occupiers that are coming up for vaccination. I can certainly see why, when the uncertainty is high and the population is as compliant as it is, they're not rushing out of lockdown and for once, I think they might have gotten it right

*it is a model after all!

The numbers are patients in ICU (and they can often be in for weeks) not admission rates (driven by case rates) hence the offsets are mostly a function of time spend by patients in ICU.

We'd need all the underlying data to do multivariate analysis to disaggregate the two drivers (and their evolution over time when new treatments are introduced and vaccination is rolled out).

I can't accept managing relaxation through whether ICU bed occupancy are at normal levels that will delay any change for far too long. We know that ICU occupancy will fall away much slower than cases or hospitalisation so its a lagging measure we need to use leading indicator which is case level positivity blended with the ONS survey and they both have fallen by 2/3rds since the peak and thats feeding through into hospital admission rates now. I agree that holding the line for so long as proven worthwhile but this time round its becoming too established with the doves that we need keep the lockdown on for much longer. The virus is seasonal so vaccine / lockdown or not it will moderate naturally so the economy needs to be progressively opened up from March but with a level of surveillance through routine testing in some control areas to provide early warning of transmission not wait for people to become symptomatic before seeking a test. The govts approach though is sounding like we will open say primary schools wait a few weeks to see whats happened then move on but at that pace summer will be gone.

The problems is as soon as there is virtually any relaxation the case numbers will stop falling and then start going up and R could easily be >1. While under 18 transmission rates are lower than adult levels and under 12 even lower still reopening education as the first step with circa 10M pupils and staff as well as many parents under 50 (with minimal direct impact from vaccination for quite a while) will end up having a reasonable impact and they will need to monitor the impact of this and the vaccination impacts at that point before round 2 of relaxation.

 

[Richard Scott]

The problems is as soon as there is virtually any relaxation the case numbers will stop falling and then start going up and R could easily be >1. While under 18 transmission rates are lower than adult levels and under 12 even lower still reopening education as the first step with circa 10M pupils and staff as well as many parents under 50 (with minimal direct impact from vaccination for quite a while) will end up having a reasonable impact and they will need to monitor the impact of this and the vaccination impacts at that point before round 2 of relaxation.

Why is this a problem? There will be next to no hospital admissions in this age group. The problem is kids not getting their education and people's wellbeing. The importance of this far outweighs the negatives of a few people needing hospital treatment.

 

[yorkie]

Why is this a problem? There will be next to no hospital admissions in this age group. The problem is kids not getting their education and people's wellbeing. The importance of this far outweighs the negatives of a few people needing hospital treatment.

It will be deemed a problem because it increases the risk that some vaccinated people (no vaccine is 100 per cent effective) will still become ill; I agree with you that the overall risk to society of keeping things closed is greater; we simply have no option but to accept some Covid deaths will continue for some time.

Another reason some want us all to remain locked down until (a few weeks after) everyone has had a second dose is that you increase the risk of 'escape mutations' if the virus circulates while having to work harder to get past the immune responses, however the experts I've listened to don't believe these mutations will escape all antibody responses (just some), and they don't believe t-cell immunity is reduced. In other words, we may continue to see symptomatic cases but they will be much milder and we will probably need a booster jab at some point.

Problem is, this area is not fully studied, there are many unknowns and some people like to spread fear uncertainty and doubt (FUD) by exaggerating the risks of variants and it's difficult to disprove claims of theoretical doom and gloom.

A colleague of mine said she is worried by reports of new variants being dangerous for children. I immediately did research in that and found there to be no evidence. But much of the general public does not do the depth of research we do, and can be easily mislead.

The spread of FUD by extremists, whether they be anti vaxers on one side, or "zero Covid" nutcases on the other extreme, can be dangerous. I see both sets of extremists as a threat to our society.

 

[Nicholas Lewis]

Israel have done similarly, they are delaying vaccinating anyone who has previously tested positive till after they have vaccinated those who haven't.

Their medical data systems are in far better shape than almost all other countries so should have better chance of getting it to work than anyone else.

Thats interesting and given the good data coming from Israel on there mortality rates this suggests that with seroprevalence estimated at 12% last week in UK along with 14m+ 1st doses we will bearing down on case rates substantially by end of the month.

Why is this a problem? There will be next to no hospital admissions in this age group. The problem is kids not getting their education and people's wellbeing. The importance of this far outweighs the negatives of a few people needing hospital treatment.

It isn't a problem but people are making it so and ignoring the cataclysmic impact this is having on all other aspects of society and ignoring the slow burn of the damage being done that will rear its head in a whole host of mental health issues that we are even less equipped to deal with than Covid. Our society accepts 1000's of road deaths a year and no one questions driving we just find solutions to reduce the impact year on year Covid has to be treated the same. Boris needs to show some leadership and represent all sectors of our society and make it clear we have to get society functioning again and there maybe some collateral damage but for greater good. I also reckon that will be a lot more popular than people believe it would be as the majority remain unimpacted.

 

[hwl]

Why is this a problem? There will be next to no hospital admissions in this age group. The problem is kids not getting their education and people's wellbeing. The importance of this far outweighs the negatives of a few people needing hospital treatment.

A quarter of Covid ICU admissions are under 50, it isn't just the kids but their families, staff and their families too. High numbers still ending up in ICU from those age groups will prevent starting to attack NHS waiting lists in earnest which is now rather a lot of people. Hence tapered reopening step by step rather than big bang so there is isn't a spike before May (as Boris said this afternoon Step 1. Schools step 2. "Other" retail Step 3. Hospitality) . Reopening schools first (as we should) it is hard to have other major reopenings at the same time where there is lot of extra transmission in the under 50s.

But we are a while from just the under 50s are unvaccinated (very few 50-69 year olds are and that is where half the covid ICU admissions are), it will theoretically take 5.5 weeks at the current pace to cover the 50-69 age group but the wall of second doses will start to hit during that time so the actual rate will be slower.

 

[Richard Scott]

A quarter of Covid ICU admissions are under 50, it isn't just the kids but their families, staff and their families too. High numbers still ending up in ICU from those age groups will prevent starting to attack NHS waiting lists in earnest which is now rather a lot of people. Hence tapered reopening step by step rather than big bang so there is isn't a spike before May (as Boris said this afternoon Step 1. Schools step 2. "Other" retail Step 3. Hospitality) . Reopening schools first (as we should) it is hard to have other major reopenings at the same time where there is lot of extra transmission in the under 50s.

But we are a while from just the under 50s are unvaccinated (very few 50-69 year olds are and that is where half the covid ICU admissions are), it will theoretically take 5.5 weeks at the current pace to cover the 50-69 age group but the wall of second doses will start to hit during that time so the actual rate will be slower.

Yes but a quarter of what number (you say high numbers but how many, please don't just use words as meaningless)? Quoting a fraction is also meaningless, if it's a quarter of 4 then it's a small number. That proportion is bound to rise as more at risk groups are vaccinated. It's exactly the nonsense that will be pedalled by those wanting further restrictions, oh 95% of admissions are under 50, will be the cry soon. Well, what a suprise. Usual lies, damn lies and statistics.

 

[DB]

Yes but a quarter of what number? Quoting a fraction is meaningless, if it's a quarter of 4 then it's a small number. That proportion is bound to rise as more at risk groups are vaccinated. It's exactly the nonsense that will be pedalled by those wanting further restrictions, oh 95% of admissions are under 50, will be the cry soon. Well, what a suprise. Usual lies, damn lies and statistics.

Also, what proportion of these under 50s have known health conditions which put them at particular risk? If this applies, it's likely that they will have been prioritised for a vaccine in any case.

 

[hwl]

Also, what proportion of these under 50s have known health conditions which put them at particular risk? If this applies, it's likely that they will have been prioritised for a vaccine in any case.

As covered on the previous page relatively few.

 

[VauxhallandI]

A quarter of Covid ICU admissions are under 50, it isn't just the kids but their families, staff and their families too. High numbers still ending up in ICU from those age groups will prevent starting to attack NHS waiting lists in earnest which is now rather a lot of people. Hence tapered reopening step by step rather than big bang so there is isn't a spike before May (as Boris said this afternoon Step 1. Schools step 2. "Other" retail Step 3. Hospitality) . Reopening schools first (as we should) it is hard to have other major reopenings at the same time where there is lot of extra transmission in the under 50s.

But we are a while from just the under 50s are unvaccinated (very few 50-69 year olds are and that is where half the covid ICU admissions are), it will theoretically take 5.5 weeks at the current pace to cover the 50-69 age group but the wall of second doses will start to hit during that time so the actual rate will be slower.

Where were they all when the ICU was full of 85 year olds?

It feels like there are of cohorts of people just waiting for ICU to open up to need ICU

 

[hwl]

Yes but a quarter of what number (you say high numbers but how many, please don't just use words as meaningless)? Quoting a fraction is also meaningless, if it's a quarter of 4 then it's a small number. That proportion is bound to rise as more at risk groups are vaccinated. It's exactly the nonsense that will be pedalled by those wanting further restrictions, oh 95% of admissions are under 50, will be the cry soon. Well, what a suprise. Usual lies, damn lies and statistics.

A quarter before the impact of vaccination, which indicates that just vaccinating groups 1-9 won't eliminate Covid ICU admissions. Numbers depend on case rates which is why so much effort is being put into minimise case rates.

 

[philosopher]

Yes but a quarter of what number (you say high numbers but how many, please don't just use words as meaningless)? Quoting a fraction is also meaningless, if it's a quarter of 4 then it's a small number. That proportion is bound to rise as more at risk groups are vaccinated. It's exactly the nonsense that will be pedalled by those wanting further restrictions, oh 95% of admissions are under 50, will be the cry soon. Well, what a suprise. Usual lies, damn lies and statistics.

Of those quarter hospitalised who are under 50, I would have thought a high percentage are clinically vulnerable or clinically extremely vulnerable. The clinically extremely vulnerable should have been vaccinated by now, while the clinically vulnerable should be vaccinated after the 65 to 70 year old's have been vaccinated. This is the vaccination schedule from Wikipedia

COVID-19 vaccination in the United Kingdom - Wikipedia

en.wikipedia.org

Order	Priority group	Number eligible (estimated)[50]
1	residents in a care home for older adults and their carers	0.8m
2	all those 80 years of age and over, and frontline health and social care workers	5.7m
3	all those 75 years of age and over	2.3m
4	all those 70 years of age and over, and clinically extremely vulnerable individuals	4.4m
5	all those 65 years of age and over	2.9m
6	all those aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality	7.3m
7	all those 60 years of age and over	1.8m
8	all those 55 years of age and over	2.4m
9	all those 50 years of age and over	2.8m

 

[hwl]

Of those quarter hospitalised who are under 50, I would have thought a high percentage are clinically vulnerable or clinically extremely vulnerable

For ICU admissions (as previously covered) a high percentage aren't.

 

[packermac]

The second dose is not required for short term reduction of severe symptoms.

From about March 10 you will be essentially good to go. This is the basis behind us delaying the second dose.

You may think that I do not. It will be good enough for me for a quick visit to a local shop or a walk on the seafront that we have done only done once since last March.
But certainly not to get on a train and certainly not to spend over 18 hours stewarding a mainline tour. I am looking at June before any thought of real activity and that is fine as I mentally wrote off two years last March, so that would be a gain of 9 months down to good work by the science community (that so many of you on here want to seem to rubbish!)

 

[HSTEd]

Half the remaining hospitalisation below 50 is in the 40-49 demographic.

 

[Кряква]

You may think that I do not. It will be good enough for me for a quick visit to a local shop or a walk on the seafront that we have done only done once since last March.
But certainly not to get on a train and certainly not to spend over 18 hours stewarding a mainline tour. I am looking at June before any thought of real activity and that is fine as I mentally wrote off two years last March, so that would be a gain of 9 months down to good work by the science community (that so many of you on here want to seem to rubbish!)

Fair enough. Every study I've read indicates that the Pfizer vaccine (after 21 days of the first dose) is >90% effective at preventing all symptoms, with the remaining 10% being made up of essentially severe colds.

Slightly different premise, but https://www.timesofisrael.com/hmo-s...tions-among-523000-fully-vaccinated-israelis/ shows real hard data at the population level - coronavirus essentially ceases to exist after vaccinations.

I wrote off two months last March; giving up two years would be 4% of my remaining lifespan for a virus that has an 0.5-1% fatality rate across the population, it makes no sense at this point even if I knew I had a 100% probability of contracting it the moment I stepped outside my front door.

I wish you the best of luck, as long as you don't endorse legally restricting me e.g. shortening my usable lifespan for your own benefit, we can get along just fine.

 

[Richard Scott]

For ICU admissions (as previously covered) a high percentage aren't.

You haven't provided any evidence for this or actual numbers, just keep pushing the quarter figure. Are we going for zero ICU admissions now? I'm sure there's a percentage in the flu season that end up there who are in this age group? To be blunt if a number of them lost some weight bit would help rather than expecting rest of us to give up our lives for them they could help themselves? Seems personal responsibility has gone out of the window?