UKH

Over 400,000 for the fourth day on the trot. Nearly 600,000 yesterday. My word, the public sector can deliver the goods!

That, Serco and G4, is how it’s done😊.

The US did 4 million the other day. Pretty impressive for such fragmented supply lines and healthcare systems. Admittedly someone also ruined 15 million johnson and johnson doses..

This can't be true, tom_in_somewhereinScotland said we were going to run out.

I'm looking forward to dose 2 in early May, AZ & clot free.

While we're doing corrections, turns out all the "the UK hasn't exported any vaccines" noise might have been a bit presumptive:
https://www.dw.com/en/australia-receives-astrazeneca-vaccines-through-uk-re...

So after all of Rom's increasingly unhinged rantings, it turns out that the EU is engaging in vaccine nationalism and preventing free trade from within its borders, whilst the UK is allowing facilities within its borders to honour the contracts, and even to pick up the slack caused by the behaviour of the EU?

Shocked.  Shocked I tell you.

Yeah. I mean.... Yeah.

The public and private sectors are working together to deliver the goods; phenomenal achievement and it just keeps going.  The results to date have been nothing short of astounding IMO.  So many people involved in so many ways, and it just keeps working.

Entirely agree when this started I said to myself that at 18 months we'd be in a good position if we had a vaccine identified and were in early clinical stage....................

On the other hand I thought we'd be absolutely cranking the testing within 6 months, but we have only just got to the stage of offering it to everyone regularly.

GPs, who are doing a fair chunk of it, aren't in the public sector, they are private businesses contracted to the public sector.

It's more "look what can be done without backhanders and under-table dealing with Matt Hancock's golf mates, or tendering to the lowest bidder and wondering why it's rubbish".

tom_in_somewhereinScotland quoted the UK government's own statements.

They were expecting 5 million AZ doses from India which they aren't getting due to Indian export controls and the EU has now agreed with AZ that all but 1.5m doses of AZ production in the EU is going to the EU.

https://www.theguardian.com/world/2021/apr/08/almost-all-dutch-made-astraze...

The UK's chances of vaccinating 75% of the adult population ahead of the EU are dependent on the one dose Johnson and Johnson vaccine arriving in July.   One dose makes a big difference. 

https://www.theguardian.com/society/2021/apr/11/uks-covid-vaccine-programme...

However, first to 75% fully vaccinated isn't the whole story.  The EU and US are using more of the Pfizer vaccine which is more effective than either AZ or Johnson and Johnson which means they will reach herd immunity with a smaller fraction of the population vaccinated.

I'm looking forward to my second dose of AZ as well. 

Don't talk to me about sodding GPs, biggest, overpaid waste of space on the planet (in my experience )

Interesting seeing as you've been quite vociferously anti OAZ.

You are ignoring CIs and conflating central efficacy values for different things.

OK. I do know that but allow us public servants (or in my case ex.)a small feeling of satisfaction at what we can do.

At any rate, as we stand in line at the vacc centres, and become astonished at the feeling of community and the common good. Do we really think the private sector could have achieved this?

AZ UK can produce about 2m doses a week from what I understand, may be 2.5m. All of that will be swallowed up by second doses. Moderna is round the edges at the moment. So it comes down to Pfizer imports.

In any case, you are broadly right I think - we are experiencing a (relative) shortage, which is why there are hardly any first doses at the moment. Still, we are in a much better situation currently compared to most other countries.

The EU states are sticking to a 3 week gap between doses I think, which will slow them down.

I agree with the OP that keeping the Sercos of this world out of it was a good move. 

I think you and the other posters here involved in the delivery can take more than a small amount of satisfaction from all this.

I’ve put a plot below I did a few days ago - the ratio of cases 3 months ago to now, by age.  An 80 fold reduction in the first age group to be vaccinated; almost unbelievable.

Not if the contracts were given to G4S, Serco and a bunch of pop up companies whose newly minted directors had the right ear, no I don’t.

I very much wish that test and trace had been achieved by pouring resources in to pre-existing national, regional and local public health teams; and further that the Lansley reforms had not changed them so much over the proceeding years.  I think that could have got us up to speed much faster; it seems this approach is being used for enhanced contact tracing over worrying variants which is encouraging.

I think that fair and transparent contracting based on demonstrated competency, resource and proven ability to adapt/scale is fundamentally more important than public/private status.  Clearly the public sector was very well placed for final stage delivery of the vaccines and I am immensely glad that it stands out as a success, and that the government took the approach they did of throwing money and other resources at the right people and organisations at the right times.  I hope to see more of that sort of thing...

My position hasn't changed.

Pfizer is somewhat better than AZ.  For someone in my age group AZ is orders of magnitude better than not being vaccinated.    AZ is what I was offered, I was very happy to take it and I'll be going for my second dose as soon as they offer me it.

I'm going to repost the link from my earlier post because the second graph is very interesting.  It shows the relative pace of vaccination in the UK, EU and US.  Look at the UK curve shooting up in July when the Johnson and Johnson vaccine arrives, presumably because it is a one dose rather than a two dose vaccine.

https://www.theguardian.com/society/2021/apr/11/uks-covid-vaccine-programme...

But J&J is 66% effective at preventing disease compared with 95% for Pfizer according to the CDC.  The US government told AZ it should not claim more than somewhere between 69 and 74% effective.  If the goal is herd immunity you will get there with a smaller fraction of the population vaccinated if you are using 95% effective vaccines than 66% effective ones.

https://www.nature.com/articles/d41586-021-00785-7

Yes, but I think we are slowing down a bit while others are speeding up because we are more dependent on imports and there is now more competition for them.

Keeping Serco out of anything is a good move!

My experience in a vaccination centre run by NHS Scotland was incredibly smooth.  The centre could clearly have handled a lot more people than it was actually doing so my guess is the throughput is limited by vaccine supply.

The UK is effectively slapping its largest supplier of vaccines in the face. 

The EU has sent the UK more than 21 million doses.  It asked the UK to allow AZ to send some from the UK to the EU in fulfilment of a contract with the EU.  The UK refused to send any to the EU until its own needs were met.

Then the UK sent vaccines to Australia on the sly.   Australia didn't get the vaccines it ordered from the EU because the EU decided not to export to countries with low levels of infection while it had a serious problem itself.  

So, the Tories made their Brexit political point by preferring Australia to the EU, and in the process p*ssed off the largest supplier of vaccine to the UK.  No AZ vaccine from India as a result of their export ban.  They wanted to fill that gap with some from Belgium and that's not going to happen now because the EU read the riot act to AZ which is now complying with its contract and apart from 1.5 million doses all the AZ production from the EU plants will go to the EU until the contract with the EU is fulfilled. 

The Tories acted like idiots and as a result got their arse kicked and now we have to deal with having less vaccine. 

Everyone but you agrees that the number is 'at least 76%'.

Looking forward to finding out which end of the ci you quote when we start taking about valneva.

FFS. Here is the paragraph in the Nature article I cited which gives the numbers that I quoted.   Apparently the responsible US government agency does not think the number is 'at least 76%'.

"The following day, the US National Institutes of Allergy and Infectious Diseases (NIAID) said that an independent data safety monitoring board (DSMB) overseeing the trial had concerns that AstraZeneca could have presented “outdated information” that provided an incomplete view of the vaccine’s efficacy. In a letter obtained by The Washington Post, the DSMB told the NIAID that it had urged the company to communicate an efficacy of 69–74%, based on more current data."

I got the information for all the vaccines except AZ from the CDC website which provided a single number for vaccines used in the US.  That website didn't provide an AZ number and the source I found gave a confidence interval rather than a single number.   I didn't choose which end of the confidence interval for AZ I provided both ends.

"The UK is effectively slapping its largest supplier of vaccines in the face."

Are you one of these folk who deliberately conflates a private manufacturer with an economic and political organisation?

"The UK refused to send any to the EU until its own needs were met."

The UK government invested heavily in AZ for the development of an effective vaccine that can be stored in a conventional fridge, freely gave away the IP rights, invested heavily in equipment and supply chain logistics in the EU to increase production there, is selling the vaccine at cost as well as supplying key raw materials that allows for the manufacture of the Pfizer vaccine. A funny kind of slap in the face. 

In response various EU politicians have gone out of their way to rubbish and undermine a vaccine to the point where vast numbers of people are refusing to use it.

No mention in all of this of the capacity to do 2 million tests a day. In the USA it is only 3 million a day. Despite all the justifiable critics of the tracing system ( which is a shambles), one of the WHO recommeneded measures is the capability to do tests. It has been quietly ramped up, issues ironed out and capacity built. These things take time.

One of the other successes on the vaccination programme has been the use of voulnteers , this was set up by the guy who headed up the Olympics volunteering effort.

Let us hope we do not blow all this good work like Chile.

I am still amazed that other countries are not following our 12 week gap between doses.

There is a fascinating piece  in the Economist outling some of the political goings on within the EU about the vaccine procurement programme. Its not plain sailing. For example you would think that in a global pandemic situation the EU would have had it as one of their priorities. Typically the EU has 300 meetings a month on various issues.There were barely any meetings after signing the deal( it became a fallow issue).There were more meetings on what to do with Mali over a couple of months.

It has not been a successful procurement programme. The worst thing being that Germany, Sweden, France and Italy all had deals in place early like the UK. But decided to roll them into the EU programme.They could easily  have been in a similar position to the UK.

They have also been unlucky, the French vaccine being developed by Sanofin failed. if that had come on stream then things would also have been different.

There are two sides to every story.

Its not good that the EU is behind for all of us. I would far prefer it was level pegging.

Yes, I think it's important to bear in mind that when people talk about "billions being wasted on a test and trace system which doesn't work" in fact most of that money is going on testing which most certainly does work.

Hopefully, now that cases are down, the tracing part can be made to work effectively thus protecting us from any potentially harmful mutations getting established in the population.

That's where you can choose to make your own luck by investing heavily in multiple different candidates before the trials are underway, or at least completed.  For all the UK has been accused of nationalism over this, the procurement has been anything but with candidates and production facilities contracted and pre-funded around the world, and no sign of nationalistic prejudice in the messaging to the public over vaccine choice, nor any sign of NIH syndrome over where tax money was speculatively spent.

Indeed.  tom_in_edinburgh was suggesting that " they [the EU] will reach herd immunity with a smaller fraction of the population vaccinated" but the reality - when not trying to make a cheap anti-UK point - seems to me that herd immunity is an exceptionally tight target with this virus, and the EU is very unlikely to be able to make it in some of its most populous nations even with a hypothetical 100% efficacy vaccine given local uptake.  Which is really bad news for the UK and everyone else, as it means the next generation of variants are coming sooner rather than later, and what we really need to do is slow the Red Queen down a bit more.

The growing anti-AZ bias stoked by things like the "pseudo-ineffective" nonsense is certainly not going to harm the bottom line of those supplying alternative for-profit vaccines, but I suspect that it's contribution to hesitancy is going to cause broader harms. 

Not sure why you got a few dislikes as what you’re saying is essentially correct. What I would add though is that even if the EU catch up and potentially overtake us, I’d still rather be ahead at this stage. 

On your other post, the whole vaccine nationalism has been rather ugly on both sides.

I think uptake will improve with time. For those who are hesitant, it’s one thing to be told by the government etc that this vaccine is good for you and safe but what’s going to be a lot more persuasive is hearing the same thing after a friend or family member has been vaccinated. 

I think the more questionable (all?) of the PPE deals were done without tendering

That's the first bit  - "backhanders and..."

Tendering processes unfortunately take time. The Uk was bidding for PPE manufacturing capacity along with every country. Tendering to comply with UK rules was not really a viable commerical or govt option.Manufacturers of PPE did not give a hoot.Hard reality.

20th March was the day that really delivered 844,285 across 1st and 2nd jabs.

No.  I'm the one who thinks that is a bogus argument to justify the UK's vaccine protectionism using a exclusivity clause in a contract rather than the defense production act or an export control.

True.  They wouldn't allow AZ to supply the EU from its factory in the UK despite the EU's contract with AZ explicitly mentioning supply from the UK.

It looks to me that AZ entered into conflicting contracts with the UK and EU.  That's something which would normally be sorted out in a court but in this case the legal path is too slow and nobody wants the distraction when the overriding priority is making more of the stuff.

The EU bought 400 million doses of AZ in June 2020 with deliveries forecast to start in Dec 2020.  It didn't get any when the UK was getting millions of doses.  It still wasn't getting many when AZ started shipping millions of doses from AZ factories in the EU to the UK.   Of course the EU said f*ck that, you owe us 400 milllion doses.

The fact is the AZ vaccine is a good vaccine but it is about 20% less effective than Pfizer, and it has more side effects.   In an insurance based healthcare system there isn't the same culture of 'you get what the NHS gives you' and when the infection figures were low anyway there was less incentive to get what was going quickly rather than wait for something better.

I don't think anyone has a problem with the tendering process being expedited or even by passed, that does not mean it needed to descend into blatant racketeering and cronyism. There are huge departments in both Whitehall and the NHS that deal with procurement that are perfectly capable of removing steps from the procurement process without relying on spivs and pub landlords. There are reports of suppliers of PPE being passed over in favour of companies that had just been registered. There was a crisis but all the institutions of govt were still functioning, we weren't a failed state. What we saw might have been justifiable if the aims had been achieved but there is substantial evidence that billions were thrown at nascent companies who then provided no or inadequate PPE as a result of which people died.

The "hard reality2 of the situation called for pragmatism and a stream lining of procurement not the abandonment of any morality or governance.

It just illustrates that the process of government tendering was not upto the task in a global pandemic. The situation is not particularly unique as for example the French and Germans have also been caught out in the same way and its now sucking in some of their politicans.

But that is what you get if your supply chain are just not robust or resiliant enough or you have no emergency stock.. And put yourself in the hands of the manufacturers- they did not give a fig - and were rubbing their hands with glee.You had deals being done with cash from USA  buyers buying anything that moved as supplies loaded onto planes.

It was a cowboy free for all for a couple of months.Tendering was a waste of time.

And for all the complaints. of Uk manufactueres, they simply did not have the capacity there and then to do anything.I looked at a couple, they were useless.

I expect lessons have been learnt.

What I (and many others) take issue with is not the manufactures but middlemen inserting themselves into that supply chain for no other reason than they had govt contacts. There are, according to reputable accounts, legitimate suppliers who were ignored. There were always going to be issues but that doesn’t mean it needed to turn into a cowboy free for all. The supply chain might not have been able to cope but that doesn’t mean every rule needs to go out the window, it doesn’t take a rendering process to weed out companies that had no history, no stock, no expertise. 

Fair play to those doing the injections....it must be as repetitive as hell!

Yes, I think the guy that did mine used to be a javelin thrower - made me jump.😂

For those who don't read the news, if you are over 45 you can now book your jab online. Good progress! I thought they might delay it.

Quite agree. But you also have an example how a tendering process can completley fail...the EU vaccination programme. Two extremes in a global pandemic.

Paradoxically the Uks vaccination programme is a blend with reputable suppliers ( which I would expect with that product, money and a we need to get this done attitude).

The PPE situtation is classic for what is a textile process, middlemen, reptuable manufacturers who could not deliver in a pandemic, money ,lots of people claiming they can do something,the public baying for something to be done and politicans not knowing what to do.

This whataboutery is getting tedious now so this will be my last post. You tried with the “Germany and France also had problems” now we’re on to “look at how well our vaccine procurement” worked but they are both irrelevant. The fact is the govt has given billions to companies and individuals with no history of supplying PPE (in some cases no history at all). The govt and NHS do this sort of procurement every day and they were struggling because of the demand but they had contacts and suppliers and knowledge of the requirements etc. There was no reason to think that a pub landlord had a secret supply of PPE that were not available to existing procurement channels. There was no need to call on these people because, as was proven and would have been obvious at the time, they had nothing to offer. 
Some people got a lot of our taxes and became very rich through cronyism. 

Yes they did.Never denied that. but you are ignoring the pandemic situation.It would have been far better if they had the stocks of PPE in reserve. They were not and were beholden to the market which included middlemen who had in effect bought up the available stock and were then free to screw the govt..Free for all.Reasonably predictable.