UKH

We hear that in the first week of the covid vaccination programme 138,000 have been vaccinated. As a big fan of Tim Harford, he of the BBC's More or Less programme, I ask myself "is that a big number?". It turns out that it isn't. A quick calculation - other answers are available - suggests that at that rate it will take over eight years to vaccinate the whole UK population. Early days yet, of course, but let's hope this programme will be more successful than Test & Trace.

That’s about half the number we need to do a day for the next 9 months (assuming a 2 dose vaccine) I reckon.

Not bad for the first week - big logistics machines tend to rumble in to life slowly but surely.

Here’s hoping.

The news has generally just been “wow big number” with no context - as usual.  I worry about this giving people the wrong idea and leading to them being less committed to the rules on gatherings.

There are so few places (Hospitals/health centres/surgeries issuing the vaccine at the moment.
As the roll out of distribution increases, the number of people treated per day will increase, initially at least.  There will be a slowing down after the 21 day mark as 1st round recipients receive their second dose.
I don't know how long it will take to treat the whole population, but I don't think 8 years is an accurate calculation, given the current level of issue compared to the potential level of issue.

Not that it has any scientific value, but we've vaccinated twice the amount of people in a week than have died from this over the last 12 months. Let's not be too gloomy.

That rate will increase, at least while supplies remain available. Faltering stop-start supply lines if we get ahead of Pfizer in delivery rate will really complicate management of the project and will knock public trust in it. Personally I think we're only likely to get maybe 30% vaccinated before the government can no longer resist the pressure to let it rip through the rest of us anyway. Either way it's clear the route to herd immunity is going to be long, bumpy and with some quite creative solutions needed to massively increase the delivery rate. The longer vaccination drags out, the more people at risk in the final tsunami of covid as solidarity over behavioural control measures breaks down.

There's a big expectation management job being largely overlooked here.

jk

If it's like flu and you need a different vaccine every year they're going to need to vaccinate a substantial fraction of the population within a few months of the vaccine becoming available every year.

I make it 18 years to get round everyone twice. However this number does not include community hubs. While I do not expect a Conservative Government to take public health terribly seriously I do believe they will manage to substantially increase this. However even if a million doses were administered daily (surely far beyond the abilities of Hancock) we're still looking at 4-5 months.

I'd be delighted to be proved wrong.

Why are you assuming that vaccination will proceed at a constant rate? These are just the early emergency doses for the NHS and the most vulnerable, the rate of vaccination will ramp up significantly.

I wouldn't be too negative about it. The Oxford/AZ vaccine should be approved soon - no need for all the cold-chain logistics and available in larger quantities.

I am impressed with it. Father - in-law had his. Also 2 people I know who work in the care sector. 
 

well done to anybody in here who is involved. 

We currently have a limited number of vaccines, we don’t want to get to a situation in three weeks where we haven’t got the vaccines to give the second dose.

Currently vaccines seem to being administered either select hospitals or a single point in each local authority. Two of those that I’ve seen figures for (Halifax and Rochdale) are doing 300 people a day each.

Once we have the numbers of vaccines we need, which the bulk of will the Oxford vaccine I assume, this will be rolled to multiple centres in a local authority, plus doctors, pharmacists etc, event work places potentially. My work place is a vaccine centre, I saw it in operation yesterday. First day of operation, so probably isn’t even included in the figures.

I don’t underestimate the governments ability to f*ck things up, but I don’t think we can judge them on these numbers, because of the supply issues.

I'm not. I was just trying to point out the height of the mountain

I'm not being negative. Sorry if it comes over that way. 

That's great! If everyone knows 3 people who've had the vaccine it'll be sorted in no time.

I expect a S-curve with aberrations due to circumstances-mistakes etc

Yes the mountain is huge but we are at the foot of it in amazingly quick time. It's like planning an everest expedition and getting to the foot of it a year before you thought you would even be in Nepal. Still got a big mountain to climb but the situation is much better than expected.

As above. Well done to all those involved with the vaccination program.

Can I have mine at the correct temperature please.

The limiting factor on the speed of rollout is the supply of microchip implants being personally handcrafted by Bill Gates.

As others have said still a fair mountain to climb. I look like I have a fairly quiet work schedule early next year so thought I would do my bit and have signed up as a potential vaccinator. Let's see if I get a call to help out!

For anyone who is interested https://vaccine-jobs.nhsp.uk/index.html 

But it is NOT like flu. Immune evasion in coronaviruses is slow, caused by antigen drift. They have a rather stupid genome organisation with overlapping coding regions within a single genome.

This makes it necessary that their RNA-dependent RNA-polymerase that copies their genome even has some proofreading activity, unlike most other viral polymerases but similar to our own DNA polymerases.

It is also the reason why they have to invest in systems to prevent our immune systems from forming long term memory.

In contrast, influenza viruses have 8 genes, all encoded on separate RNA "minichromosomes" that are packaged into virus particles pretty much randomly. Two of these encode for the proteins at the surface against which most antibody immunity is directed, and which determine how effectively a given strain infects a given species (hemaglutinin and neuraminidase, hence HnXm designation for strains).

Thus, if a Chinese or Vietnamese farmer living above his ducks and pot bellied pigs gets an infection with a human virus and a bird or pig virus, new strains can easily be mixed together when one double or triple infected cell in his body produces virus particles with 6 human adapted matrix and nonstructural genes, plus one or two genes encoding pig or bird surface proteins.

This is called antigen shift, where a large part of your immune response can become obsolete by one single evolutionary event, and is pretty much restricted to influenza viruses.

CB

We've also done vaccination programs, and do them every winter just to a smaller population, it's much easier than track and trace. 

Also we only need to vaccinate about 50-60% to significantly slow this thing down, and even if we just vaccinate the at risk we massively reduce pressure on ICU's. Care homes alone count for something like 40% of ICU admissions in the US.

WOW.  Somebody spouting about CV19 who actually know what they're talking about.  Am i on the right forum?

The average age of death from CV19 is 82.  Why vaccinate the entire population?

Speaking as one who has probably had it (it was pre mass testing and before the local GP could understand that anyone who had been skiing in Italy was highly likely to have it;  "No I haven't visited Wuhan, have you seen the news about Italy?!")

For most of us blokes its just a shitty two days in bed, for the ladies its, "What's the fuss about you lingerer?  What, you want a cup of tea in bed! There's DIY to be done!"

Surely by now you have got the message about long Covid?? Young people who were previously fit and healthy are being totally floored and as yet we don't know how long for. My friend (38, female, no underlying health conditions, healthy weight) has just been signed off work for another 2 months, she contracted it on March 1st. That's the best part of a year so far, and it is showing no signs of letting up. She is far from alone in this and they haven't nailed down what factors make someone more likely to end up with it. We are destroying large swathes of our working age population!

Don't worry, I'm sure someone will be along shortly trying to de-bunk CB. Or they'll ask for a link to the information.

That's what normally happens.........

Steve, I know someone who is very fit marathon runner. This was there facebook post today.

"In case you don’t think Covid is that big of a deal- I ran a marathon on September 19. I ran for an hour in the woods on October 24. I was diagnosed with Covid on October 26. I was admitted to my hospital ICU on November 3. I got on a treadmill 2 days ago. I was able to run, for the first time, 1/4 mile, twice, at a 13 minute/mile pace. That was progress for me. You really don’t want this disease. Please wear your mask, socially distance and wash your hands. Also, get vaccinated!!"

1. You dont know you had it.

2. We all get hit differently, there's some genetic link, past exposures etc but it is deadly for even some young people.

In the US I think it was July was the deadliest month for ages 25-40 year age group in two decades. Seems a coincidence.

https://jamanetwork.com/journals/jama/fullarticle/2774445?guestAccessKey=e7...

and here:

https://www.nytimes.com/2020/12/16/opinion/covid-deaths-young-adults.html

"The average age of death from CV19 is 82.  Why vaccinate the entire population?"

Then this.. FFS

Really? Because that's how you protect the at risk population. That's how we eradicated small pox and polio. 

We're not going to get anywhere like 100% vaccinated though. Anti-vaxxers have made sure of that. Even in the UK I'd be amazed if we get much over 60%. But if that's most of the at risk, then those who actually give a shit about others, we're a significant way down the road to normality.

That is an incredably hyperbolic statement. We are not "destroying large swathes of our working age population". The number of working age people who have caught covid and had got a severe case of it and still suffer effects from it months later is a tiny minority of a small minority of a minority. That does not destroy a population. Try growing a brain capable of rational analysis.

Maybe slight hyperbole, but a higher percentage of people than are being killed by it.

Obviously, we haven't been living with the virus for long enough to get proper long term data on it yet, but so far, according to the Covid Symptoms Study app:

Extrapolating out to the general UK population, which has a different age and gender makeup compared with the COVID Symptom Study app users, the team estimated that around one in seven (14.5%) of people with symptomatic COVID-19 would be ill for at least 4 weeks, one in 20 (5.1%) for 8 weeks and one in 45 (2.2%) for 12 weeks or more.  

It's certainly not looking like being insignificant!

300,000 American's have died.

65,000 Brits.

The Average age of death is 82 or so. If you live until 82 in the UK your life expectancy is 89-90 years. So that's 7-8 years of life lost, almost 10% of life gone. That's quite a lot of years being taken away, quite a lot of time grandkids won't see their grandparents.

http://www.riskprediction.org.uk/index_lifeexp.php

The amount of data we have on the long-term effects on recovered or asymptomatic patients is currently.... you guessed it... zero. Nobody knows what happens more than 1 year after infection, because nobody caught it a year ago. Is it a safe bet that once you're recovered you won't see any effects? Probably, but in the global clinical trial to find out what happens in life after covid I'd rather be in the control arm thanks.

That is nothing to do with the working age population which was the point under discussion.

Because if we vaccinated everyone over 60 and then dropped all control measures, the average age of deaths from then on would be about 58 and healthcare would be overloaded - about 3 weeks later than if we’d not done those vaccinations.

I agree with you but the large swathes bit of the post gripped my shit as it obviously wrong with about 1 seconds thought. I'm not some anti mask moron, i'm a pro science person who also lothes lazy thinking or lack there of.

Surely administering a million doses a day is beyond the abilities of anyone? Give the guy a break, he looks exhausted already.

I heard that it might only be 50% of the population vaccinated by the end of 2021. 

I can't help think that we are not being told what the timeline and targets for vaccination are because its not good news.

They must have at least a provisional delivery schedule from Pfizer, how many doses they will get each week. They must have figured out based on that projection how many vaccinators they need and how many people will get vaccinated each week. That would give them a slowest possible scenario. Other vaccines are coming along and again, they'll know what the provisional delivery rate will be. From the above they can work out the longest and shortest times to get 60% of the population vaccinated.

...but they're not sharing those timelines with us. 

I think the first batch was 800,000 doses for whole UK so they will be finished in a few weeks in time to start doing the second shot. Not seen any date for subsequent batches.

Long-Covid - somewhere between 5% (https://covid.joinzoe.com/post/long-covid) & 20% (https://www.theguardian.com/society/2020/dec/16/long-covid-alarm-as-21-repo...) of those who have had Covid.

I'm going to take your word for it since I have absolutely no clue and you clearly have expert knowledge.

How long do you think the Covid vaccinations will last before they have to do them again?

Conveniently:

1. It's basically the same group of people who get the flu vaccine;

2. We already do that with the flu vaccine.

So if that's the case either there will end up being a combined vaccine, or they'll just do both at the same time.

Good start but...

67m people. 50m adults. 100m doses. 70m for herd immunity. That’s 1.4m a week. 200k a day to do it in a year. 400k a day to do it in 6 months. Every day for six months. Including home visits for the frail and disabled.

Been pondering the return to the office. Can’t see it happening in a business as usual way until well into next autumn, possibly later.

The real issue will be when they relax restrictions after Easter once the most vulnerable have been vaccinated. People will soon find out that it’s not over yet...

I agree we're a long way off being out and will face restrictions for a year, maybe longer yet. But even just vaccinating at risk and the elderly, and then those who seem to be worst affected like front line workers we reduce the mortality and hospitalization rate massively and it'll be harder to justify stringent measures.

we can’t know at this stage unfortunately.

Immunity doesn't last - there have been reinfections already. Because of this it is unlikely that herd immunity will ever be attained without an annual mass vaccination e.g. everyone, not just those on the flu vaccine list. So Covid-19 will continue to circulate and kill those with suppressed immune systems every winter without annual mass vaccination.

There have been very few proper reinfections. It suits the government to have people believe that immunity doesn't last as that justifies not exempting people who have had it from the rules. Here is the closest thing to a proper study that I am aware of:

https://www.ox.ac.uk/news/2020-11-20-prior-covid-19-infection-offers-protec...

The study only covers a six month period hence they are unable to conclude that immunity doesn't last longer than that but I would be very surprised if everyone's immunity dropped off sharply after 6 months

Not necessarily.

Infection with a real virus also leads to expression of virus proteins whose main function is to suppress immune memory formation by interfering with the communication between cells that tells some immune cells to become memory cells when the acute job of fighting the virus is over.

From the point of the virus this is ideal: Once the host will have spread the virus to others, it is not adaptive to kill him. Much better if he recovers and is available again next time round.

Neither the mRNA vaccines (i.e. Biontech and Moderna) nor the modified vaccine viruses (i.e. Oxford/AZ) contain the information for the immune modifying proteins, so one would expect that the vaccine response lasts longer than immunity caused by regular infection.

How long, noone knows. What we do know, however, is that due to their genome organization and mode of replication coronaviruses are rather stable genetically (which is why they need that immune memory trick, they cannot simply change quick enough to evade the host immune system as other viruses do). In particular, they are incapable of the kind of catastrophic antigen shifts that influenza viruses do, which can make entire population immune naive in one go.

More likely, as the virus changes our immune system will gradually become less and less reactive, until it will at one point allow a reinfection. This will hopefully be lighter than the original one because some defenses are still there, at which point you start again.

However, to be sure we need at least a few years and infection cycles.

This is also my favourite "out there" hypothesis: What if natural herd immunity against a coronavirus eventually, after first killing millions, looks like annual winter colds?

This comes from the speculation that the disastrous "Russian" flu of 1889 (the last big one before the Kansas/Spanish flu) may in fact not have been caused by an influenza virus, but by a coronavirus that is now circulating as a cause of common colds. Not that that really helps right now in dealing with the pandemic phase, but I find it highly interesting.

CB

I think this theory is interesting too. The other cold-causing coronaviruses can cause severe illness with similar features to covid, particularly in the elderly, and children often get a cold-type illness if they do get covid.

Is that really that “out there” or is it most likely outcome? Even maybe inevitable? How else could it go? (genuinely interested to hear thoughts on that, especially from cb294, wintertree et al. Less so from people who make up crap.)

I’ve had some interesting water cooler chats about this, all with physicists who are definitely not biochem/epidemiologists, but we’ve had a few interesting thought experiments come up.

My favourites are:

What would happen if you turned off flu for a few decades then turned it back on again? (Kinda obvious)

What did the year after the common cold (well, ok, any one of them) was ‘invented’ look like for humanity?

What’s the most probable steady state with covid?

Will the evolutionary pressure to be less deadly have a significant effect as immunity grows and over what timescale?

And, interesting but a bit darker, assuming I last more than the next 20 years, am I more likely to die of flu or covid?

Thoughts on those have led most of the people I interact with most to conclude, after quite a lot of really interesting debate, that long term this will become like flu 2.0 or mumps 2.0 or something. 
Discuss. But try to keep it interesting. 

Seems perfectly reasonable to me.  As long as there already broadly similar viruses circulating, with at least some common antigens, there is already a degree of resistance - enough that the new virus is at least survivable by most people, then decent herd immunity should develop over a number of years.  Still pretty bad news for a lot of people in the short term though.

It doesn't always seem to work this way with bacterial infections, especially if they produce long-term chronic disease - we still don't seem to deal very well with TB or syphilis, despite hundreds of years of them being quite common in the population.  Both survivable in the short term but definitely not something we choose to live with (which is why the increase in antibiotic resistance is so worrying).

Of course, if something really nasty comes along - something highly contagious, lethal and novel (at least in the population concerned) all bets are off as to whether there's sufficient genetic diversity in the population to ensure a viable minority survive.  Smallpox exterminated whole populations where they were small and isolated.  Even now, a proper outbreak of Ebola or, even worse, some novel haemorrhagic virus recently jumped from another species would be extremely bad news.  Good luck with herd immunity developing in time to make any difference with something like that.

Coronaviruses including OC43 cause about 15% of all seasonal colds, that is not speculative. What IS speculative, still, that this virus was responsible for the 1890 Russian "flu".

Of course, people looking for virus DNA in permafrost graves in Siberia did find some non-remarkable influenza A viruses, but it is not clear whether these caused the "flu". If I was still working in virology, this is what I would have written a grant for last spring: Let's go to Spitsbergen or Siberia and dig up some graves from 1890, and check for OC43 in lung tissue...

There is plenty circumstantial evidence related to mutation rates and molecular clocks, but that is so much handwaving. However, that "flu" was a bit weird because it was attacking not only the lungs but there were plenty neurological cases.

I believe it is essential to know whether this is what the natural endgame for a corona pandemic looks like: A pandemic phase with millions of deaths (even back then despite much less travel), followed by partial immunity in the population, and a case fatality rate that just blends in to your usual death by pneumonia you see in old people the world over, and otherwise mild symptoms because you catch it young and then have some partial protection.

CB

I think that's a pretty bold claim.  Over 5 million people in the UK likely had covid in the UK the first "wave", and only ~0.3 million of them were detected and recorded as having had covid.

In the second "wave" about 1.6 million people have been recorded as having covid.  

Being detected as a re-infection requires someone to have been detected in both "waves".  

By my reckoning, the probability of someone infected in the first wave going on to be detected as infected in the first wave and to be infected and then detected as infected in the second wave is about 0.14% - assuming probability of infection each time is random and independent.

So, however many re-infections are detected, there could be close to 700 (=1/0.14%) times as many actual ones going unnoticed.  Then of course it takes time to identify a re-infection and to collect, communicate and disseminate that data.  

P = (0.3 m / 5 m) x (1.6 / x 66.7 m)

You can fairly argue with my assumption over the infections being independent, but I personally take very little solace in the few re-infections reported; given the probabilities and the likely bell-curve distribution of time to re-susceptibility  I think we're just starting to see the uptick at -3 sigma.  

As much much of the data it can be interpreted optimistically or pessimistically.  No doubt we'll know soon enough.  

Naturally immunity is unlikely to fall off a cliff suddenly as you say, but immunity can also fail with changes to the virus, e.g. if a major component is swapped for another one - after all this virus suddenly became effective after taking a part from something else, it seems.

This just is not true. Others have argued below. Please read cb24s response re natural v vaccine derived immunity.

But natural re infections are rare, extremely rare. That's the same for any disease, even chicken pox. 

I don't think it's at all obvious. You would possibly have a pandemic due to the loss of immunity. In 1977, AH1N1 came back from extinction (probably as a lab accident / deliberate release),, having disappeared following the 1958 AH2N2 flu pandemic. It was still going strong until displaced by the 2009 AH1N1pdm09 novel influenza that itself caused a pandemic.

I think reinfection might be part of what is going on with the new mutation. I think a small but significant proportion of the population are just ignoring precautions and exposure, rapid growth and immunity in that group occurs much faster than in the general population who are being properly cautious. A new strain might bypass that group immunity and a smaller version of the touch paper we saw in March flares again. It could also be the new mutation is just noticably more infectious. Either way being especially careful with precautions in the next months looks very important.

That's one of my two guesses at how the mutation could affect spread - as seen on The Pub.  The UKC microbiologists/immunologists and my offline colleagues are leaning towards it being a more infectious mutation rather than causing a decreased immunity, but I'm wondering if the specific mutation to the receptor binding subdomain has blocked a key neutralising antibody, which makes it more infectious to those with immunity from a past infection - but not necessarily to anyone else.  If so, the new version is re-energising the network of people who due to work and/or caring responsibilities can't follow the rules well enough, and those who won't follow them by personal choice.   If this is right, the spiking rates will fade after the new variant spreads through this network; if we're wrong and it's just more infectious, well that's bad news.  If we're wrong and it has the same immunity and the same infection potential, then I just don't understand why lockdown started failing part way through and why that effect appeared to spread from Kent.  

https://www.ukhillwalking.com/forums/the_pub/how_can_a_virus_be_faster-728968?...

I'm going to stand by my post. If we take the 1st wave to be Feb 28th - June 30th and the second wave to be Sept 1st - December 17th then there were 314,000 recorded cases in the 1st wave and 1.62 million cases in the 2nd wave. This suggests that about 2.5% of the population has caught (and got a positive test result)* it in the second wave. If people had the same chance of catching it in the 2nd wave regardless of whether they caught it in the 1st wave or not then there should be around 7800 people in the UK with a positive test result from both waves (314,000*0.025). I can't find a definitive number of people who have had a confirmed reinfection in the UK but worldwide the number of confirmed reinfections seems to be in the 10s to low 100s depending on your choice of source. This would suggest that the overwhelming majority of people gain immunity, or to put it another way, off the data currently available, it would appear that having had the disease gives a greater efficacy rate than any of the vaccines that are in the process of being approved. There's lots of anecdotal accounts of reinfections from people who didn't manage to get a test in the first wave when they think that they first had it but until we start at least high 100s of people with confirmed reinfections in the UK then I'm inclined to think that most of them didn't actually have coronavirus in the first wave.

*edited to add

I agree with your estimates - there same basis as mine but looked at a different way.

If we say we're 3 sigma from the mean time to re-infection then only 0.3% of people are currently susceptible to re-infection so your 7800 becomes about 24 people which is a much smaller number.  That's 3 sigma is a number I pulled out of my behind by the way - but  6-9 months is not a very long time, I'd naively expect immunity to fade over several years so where you see small numbers as a sign it barely happens, I see it possibly as the leading edge of an impending bell curve.  Ultimately we just don't know right now.

I don't know how many re-infections are in the results, and I've not seen a definitive number given for the UK - without that data (be it 0 or a positive number), we're probably wasting our time discussing it much.  I don't even know if anyone is following up re-infections to verify them, or that the reporting mechanism for that will be - if at all.

Unless and until I understand if and how the data is actually being systematically examined and reported for re-infection, absence of evidence does not become evidence of absence.  I assume gov are doing this because it makes sense, but can anyone point to details?

The other point to make is that immunity is no more a binary status than infection, with strength of infection going on to influence strength of immunity, and strength of immunity going on to influence probability and severity of re-infection.  There's some suggestions that having antibodies makes it more likely that a re-infection will be milder and hence asymptomatic, so with our symptomatic testing these won't generally be detected.  Depending on how contagious one is and how far along mass vaccination is, this level of infection may or may not actually matter.

I think it's way too soon to stake anything on reinfection, and whilst I agree with your numbers I hope I've made a case that it can be interpreted optimistically or pessimistically depending on how you feel about it.

To find a more optimistic stance, we both assume independent probabilities of re-infection but in practice the same sub-populations are at higher risk in both waves which makes the lack of more reported re-infections all the more significant; but but but it's still early days and the data around other viruses doesn't support to me extrapolating the current situation forwards.

This is where scare mongering starts.  One off anecdotal evidence.  People a VERY AFRAID of covid because the press and social media pump up the one single case.  

CV19 is ageist, sexist and racist.

Smallpox killed 30% of people infected with it compared to CV19's ~1.4% (Imperial college estimate 1% in high income countries¹)  - Smallpox is a disease to be scared of.  1918 Spanish flu probably killed around 10-20% of those infected.  And "THE plague" (Black death) which Covid was often compared to in the beginning may have bumped of as much as 50% of the population (Estimates vary from 30% upwards).

The Imperial College also state that "Age-specific IFRs [Infected fatality rates] increased from 0.1% and below for individuals under 40 years to greater than 5% among individuals over 80 years¹", so if you're under 40 you are 50 times less likely to die of Covid should you catch it than an 80yr old.  If you're under 20 the difference is higher (I just can't find the statistic right now).

CV19 is now endemic.  After decades of efforts we have failed to rid the world of polio (often due to anti vaccers and I'll not mention the CIA here either).  Its highly unlikely we'll get rid of CV19.  We should vaccinate those who need the vaccination as we do with flu and allow natural resistance as we do with flu amongst the younger age groups.  Current research suggest CV19 doesn't mutate as easily as Flu so a vaccine for vulnerable groups and a bout of CV19 at school/uni may be all that's necessary to keep it under control. 

1. https://www.imperial.ac.uk/news/207273/covid-19-deaths-infection-fatality-r...

Current research from Holland shows almost everyone on a ventilator with covid ends up with permanent lung damage. That's more than the numbers who have died. Long covid estimations from initial research seem to be very roughly around 5% of infections of those with no emergency care required. This isn't anecdote, its thousands of tracked cases. A lot of anecdotal evidence on here indicates a significant proportion of those with long covid are working age people with no underlying health conditions. I know no-one who has died of covid but I know 4 people with long covid, the youngest is 25, was fit and with no previous health conditions.

However above all of this, hospitals need to be prevented from overload otherwise covid death rates typically triple and lots of extra excess deaths occur from other health conditions because treatment and staffing is severely affected. We are at the cusp of that right now in parts of the UK, notably so in NI.

On your endemic point antibody testing indicates less than 10% of the population in England and Wales have had the virus since the first cases. At any time less than 1% will have the virus (because lockdowns and other measures have kept it that low).

This isn't scaremongering its harsh reality; the fools are the people encouraging other adults that getting covid almost certainly won't be an issue.

That was an MD. My Wife's an MD, it was a factual account of what he has been through. 

He was older but it is a very real threat to healthy people. 

Again though, you have no proof you had it and tell me to not repeat anecdotal information?! The guy going around saying its not that bad.. "I had it" when he probably just had man flu..

All this is just conjecture by an uninformed person. Seriously get informed, get educated. 

"We should vaccinate those who need the vaccination as we do with flu and allow natural resistance as we do with flu amongst the younger age groups" (it looks like the fatality rate is 10x that of the flu for the younger).

What are your qualifications and experience to say this?

The IFR for covid at all ages appears to be 10x higher than for flu.

No.  Most people still have no effective immunity to it.

Vaccination mountain, you say?

https://www.theoutbound.com/germany/backpacking/hike-around-the-summit-of-m...

I agree

Watching the counter (currently 75k) on this video and reading some of the comments should give a clue as to the size of the social mountain that the vaccine faces:

https://www.youtube.com/watch?v=QBcCwlXN_OY&feature=youtu.be

A rough poll amongst people I know suggests around 50% plus or minus a few are interested in taking it.  Given the serious adverse effects report from Pfizer the other day showing a rate of 0.8% vs 0.4% for the placebo (I'm writing this from memory, I can prob find the report if anyone is really interested), there will be literally thousands of these videos in the coming months.

I think we can confidently predict that D-notices will be handed out in due course, which won't help.

The counter is now at 85k, after about 5 mins.

So someone is standing up for a while in (probably) a warm room, and she faints. Yes, it could be a vaccine side effect (far less severe than a Covid side effect!), or it could be totally unrelated. I have fainted on numerous occasions, I have fairly low blood pressure and am reasonably prone to it. It's not that uncommon. 

I completely agree.

However, that is not the point.

Dipshits gonna dipshit.

What's impressive if that is the case is that 0.4% of people having a placebo vaccination of saline had a serious adverse effect.

Just to be clear:

"Adverse events classified as serious† were reported in a similar proportion among recipients of vaccine and placebo, overall (0.6% vs. 0.5%) and by system organ class; they represented medical events that occur in the general population at similar frequency as observed in the study."

https://www.cdc.gov/vaccines/acip/recs/grade/covid-19-pfizer-biontech-etr.h...

This is not the report I read.  I think all adverse reactions (including a sore arm, mild temperature etc etc) were at 29%.  I'll try and find the original, which was actually laid out for ease of reading.

The video is now at 108k views.  The general point is that there is not just a supply problem, as discussed above.  There is also a demand problem.

Here is another example of a video that is going viral that will undermine confidence:

https://twitter.com/HotepJesus/status/1339569461137977345

1.6 million views.  I have no way of telling if it is real.

I'm really not sure how we will be able to deal with this.

Interesting.. you can find videos but not scientific reports. As a scientist I much preferred youtube over a peer reviewed Journal article.

There isn't a demand problem. There may be after 50-60% of the population have been vaccinated but right now demand massively outstrips the supply. To suggest otherwise is entirely without merit.

Which makes me wonder why you keep posting links to anti- videos when it’s the minority opinion - especially as your 20:44 link must have been posted within an hour or so of that video coming out (given your dViews/dt update).  What were the odds of you randomly stumbling across it in its first hour, ey?

It wouldn’t be so suspicious except yesterday you were pushing hard a website clearly set up with decent (but not declared) funding to push a treatment that just hasn’t got the evidentiary weight behind it and had scientists so compromised that they themselves used the term “miracle cure”.

Anything "hotepjesus" tells me must be legit. That is a solid handle for someone who knows what they're talking about.

Hint: that's how you tell if it's real

Edit: The tagline "Hoteps been told you" adds more credibility than any peer review ever could. 

Polls consistently show between 60 to 70% are going to take the vaccine. That's probably enough. I feel for the friends and family of those who will die of stupidity after turning down the vaccination before herd immunity is achieved.  More so for the friends and family of those willing to take it but infected beforehand by idiots.

If serious adverse reactions were common it would be all over the internet, given so many conspiracy theorists seem to have a point to prove. I'd happily see the platform senior management face serious jail time for facilitating the spread of these dangerous unscientific ideas;  those it influences are already killing people and slowing our return to a more normal life with all the economic damage that entails.

I would see a sore arm or a temperature as a good thing as it indicates that the body has mounted an immune response to the vaccine. Even if I end up feeling lousy and in bed for a couple of days, that’s still a lot better than getting Covid.

If I get a choice, I’d opt to get vaccinated on a Monday so that I’m good to go climbing by the weekend even if I get a sore arm or whatever.

I have found my sore arm isn't sore when I am using the muscles, I went straight from the vaccine to lifting loads of boxes at work all day. However it was sore in the evening after having done that. If that is typical, then you will likely be able to climb and just have an achy evening. 

Latest ONS survey said 78% would have the vaccine with 95% of over 70s saying yes... 

Exactly, some kind of reaction is often just a sign of an immune response. Which is exactly what we want. Sadly these people who say they are just asking questions don't know questions to ask..

Phew! Glad it's in the arm and not my arse like the last time.

You’ve had it already? That good going! To be honest, I couldn’t care less if it meant I couldn’t climb for a week. What is more important is that so many people would stop getting sick and dying and we could all get our old lives more or less back... including being able to go climbing without dancing around ever shifting restrictions.

Here we are saying 20 million could be vaccinated by the year end. I know many who have been vaccinated already, my wife is due to get hers soon, possibly just in the new year. With the second vaccine being sent out I think tomorrow, possibly today, it'll speed up now. They are saying the one dose alone could be up to 80% effective, we should really see the impact by February. Once ICU capacity starts to increase they are going to have to relax restrictions going into March. Hopefully people can be patient for just 2-3 more months.

I think a new variant with 70% increased transmission rate resulting in r 0.4 higher changes everything.

The way it was a few weeks ago someone with a work from home lifestyle like me could wait six months and have very low chance of catching Covid.  If this new variant is as bad as they are saying it is more like if you aren't vaccinated you are very likely to catch it and there will be a ton of other people catching it at the same time and no capacity in hospitals.

If they have candidate vaccines with manufacturing capacity ready which are safety tested but not yet approved because they are waiting on efficacy data  they should start using them immediately and they should completely reprioritise who gets vaccinated first to focus on protecting essential services and reducing r. 

Did you have the pleasure of watching Hancock on Marr today?
"The virus is now out of control."
No shit, pal, you and your cohorts and cronies haven't been in control since January, apart from the purse strings.

What annoys me is, they'll all get away with it.

He looked like he was about to burst in to tears. I was actually struggling not to feel a bit sorry for him. 

20m but this year end or next year end? Surely it’s not possible to vaccinate 20m people in 10 days?

I think WFH plus good Covid discipline (hand washing, decent face mask in shops etc, minimising social contact) would see you through. The issue is whether to go to the wall but that will be taken out of our hands soon enough. 

He looked very sombre/worried....he knows how bad this is going to get.

I think its (year end 2020) very doable - thats 2 million a day, if you could vaccinate 500 people in a day (easy I reckon based on my GP's flu vaccination performance) then you only need 4000 people actually giving the vaccine each day - in a country the size of the US that should be fairly straightforward if the underlying logistics is up to scratch.

I think if there is no efficacy data then you should not use the vaccine - if it had 0 efficacy then you would be eating resource and getting highly vulnerable people to congregate to receive the vaccine.

Yeah this year. A country of 50 states, that's 400,000 a state, all the cities vaccinate a few 10,000s a day. It'll be almost 3 weeks of vaccinating. I suspect we'll get there pretty quick. My own city is saying everyone will be vaccinated by June. my wife's hospital system is 14,000 employees they are saying they'll be fine by March/April. My Facebook and Instagram have many people already getting it. Those are all front line covid workers, obviously having a wife as an MD many of our friends are in the medical field.

They are vaccinating for 17 days this year. Obviously they work weekends too.. my wife's been in all weekend.

Great to hear. 1m a day really would be something. Would still take best part of a year to do all the adults in the US though...

Don't feel sorry for him he was telling massive porkies. As Health Secretary he knew this a week ago at least. The time was needed to discuss in cabinet how to get more convincing evidence to fight off the backbenchers. Yet again lives have been sacrificed by this government to placate tory libertarian backbench idiocy.  UKC amateurs picked this up, health journals published doom laden editorials, its certain the government knew. Boris took the piss out of the Labour leader on Wednesday and said he wanted to cancel xmas. Its hard to figure if incompetence or being c*nts is the dominant factor from this shambles of a cabinet. This will almost certainly be very bad.

Andrew Marr challenged Nandy today when she said the UK is the worst in Europe for deaths. He said Italy and Spain were higher... that's only true on UK government declared deaths which are a massive underestimate. The best UK measure is ONS stats where we are still the highest. More BBC dangerous bias.

We won't get much over 60% of adults vaccinated. I reckon by June/July most adults who want it vaccinated.

210 million over 18s, we're allowing down to 16 but they are down the line unless high risk. So about 130 million to vaccinate. I'm hoping we start vaccinating kids in the new school year in the fall but we'll see. They are certainly very low risk so not so crucial.

According to Dr Susan Hopkins,  speaking on Sophie Ridge on Sunday, the government was made aware on Friday but what does she know?

The government only saw the latest detailed analysis on Friday. The trends and the link to the new mutation were known well before that. You realise that lost week will probably cause thousands of extra deaths again?

The hidden narrative is this massive increase in restrictions might be the final nail in the coffin for the Boris leadership for tory backbenchers. They are more deranged than he is. Power games in a national crisis.

I know bugger all about viruses but the doctor seemed to explain how they had done all sorts of procedures before presenting the final analysis to the government. That seems sensible to me. I’m sorry if that doesn’t fit your narrative but that’s what she said.

You are misrepresenting her evidence, the latest detailed evidence was presented in Friday. The epidemiological evidence of a severe problem was presented long before that. This is the joint BMJ and HSJ narrative nearly a week ago now and this will have taken back-channel routes before publication. They wanted things fixed, not to embarrass Boris and Matt.

https://www.hsj.co.uk/comment/government-must-stop-household-mixing-this-ch...

Boris lampooned the Labour leader when he raised this at PMQs on Wednesday. Labour wanted to cancel xmas.

I’m not misrepresenting her evidence.

I even gave you a source as to where she said it.

https://twitter.com/RidgeOnSunday/status/1340641599122976772?ref_src=twsrc%...

Sophie Ridge wasn’t best pleased as she appeared to want to hear what you are stating, that the government knew and delayed acting, but that’s not what Dr Hopkins said.

Even for your logical gymnastics this is special. My evidence of extremly severe covid growth issues was a week ago from a combination of the two major publications and you are arguing semantics on what the government were told on Friday by a single researcher. I have to admire your gumption. You didn't need  the Friday details to see the scale of the problem but you do if you want to defuse a backbench rebellion. This is the third time in serious circumstances the government have called restrictions a week late.

You are also ignoring the crazy internal political pressure in the tory party. The influencial Covid Recovery Group are really angry with these underwhelming restrictions. 

https://www.independent.co.uk/news/uk/politics/boris-johnson-tory-mps-covid...

I’m never sure that your description of Dr Hopkins as a single researcher is an accurate one.

That’s certainly not how she was portrayed on the TV yesterday.

But I’m glad that your evidence preceded that of the people advising the government.

I'm sure a few other researchers who directly advised government will make statements in the next few days as the true scale of this growing mess becomes evident. I will really welcome examining the details of the public enquiry later on. Either the government knew or they were idiots as we knew on UKC on wintertree's data analysis. Border closures today are just the latest stage of the coming chaos. How many times does it take before ministers understand denying exponential growth is not a viable policy.

I wonder how much influence Hancock actually has in all this. Is he just caught up in these power games? Does he just have to go along with the massive porkies or resign? Maybe he should resign - but would that actually do any good? I can see why he might be in turmoil and close to tears on national TV.

I just don't believe him. I have sympathy as it's almost a requirement to lie as a minister and these lies are going to have unusually brutal outcomes. His backbenchers want him gone as he 'believes' the scientists, so for sure it's better he stays than anyone they want replaces him.

I don't think it will be a case of no efficacy data but incomplete efficacy data.  The point where you say 'Approved for emergency use' should move to an earlier stage in the process because the size of the emergency just got much larger.  We need to get all the pharma manufacturing chains churning out vaccine so as to multiply the rate the population gets immunised and r is reduced.

Possibly the only true thing you've posted on here in weeks, if not months.

Have you considered a career in politics?

Even the Daily Mail diverges with you on this one (bet you didn't expect that to ever happen), pointing out that your beloved leader was well aware of the new strain well before Friday, and indeed before he addressed the nation last Wednesday. I’m sorry if that doesn’t fit your narrative but that’s life.

With your amazing powers of observation and analysis you will, of course, have noted from previous posts of mine, that Johnson isn’t my beloved leader, he’s a buffoon. While he may have been aware of the existence of a new strain he wasn’t, according to Dr Hopkins, aware of its full effects until last Friday.

If you think that isn’t true then maybe you could converse with Dr Hopkins herself. I’m sure that she’ll have no problem in issuing a public apology when you point out that she’s lying on national TV.

That’s funny.  

lol

You didn’t read Offwidth’s link, did you? You certainly haven’t addressed the points it makes- that it was painfully obvious that Christmas would need to be ‘cancelled’ well before Johnson finally abandoned his Canute-like denial of reality. Here’s a quote, to save you the bother of having to click the link: 

“The government was too slow to introduce restrictions in the spring and again in the autumn. It should now reverse its rash decision to allow household mixing and instead extend the tiers over the five-day Christmas period in order to bring numbers down in the advance of a likely third wave. It should also review and strengthen the tier structure, which has failed to suppress rates of infection and hospitalisation.

This joint editorial is only the second in the more than 100 year histories of The BMJ and HSJ. We are publishing it because we believe the government is about to blunder into another major error that will cost many lives. If our political leaders fail to take swift and decisive action, they can no longer claim to be ‘protecting the NHS.’”

(with apologies to King Canute- he was actually much more evidence based and aware of his limitations than our current leader is)

Yes I read the article and numerous other press reports about what should be done.

We’ve had pressure to cancel Christmas, not cancel Christmas, have a circuit break, don’t have a circuit break, have a lockdown, don’t have a lockdown, put regions into tiers, don’t put regions into tiers, open up businesses, close businesses, close schools, keep schools open, etc, etc, etc.

While the scientists make the judgments based on the medical effects of Covid there is, as you are well aware, much more to running the country. And yes that includes trying to keep your own MPs on side. And, of course, most importantly preventing the NHS from being overwhelmed.

I’m in favour of an extreme total national lockdown for as long as it takes because in my personal position I won’t be really affected.

I also understand that many others have totally different opinions because their personal circumstances are completely different to mine and the effects on their lives will be more severe.

There's already robotic vaccination machines for animals.  No reason why automated vaccination couldn't be made to work for humans.  Potentially a lot faster, less chance of infection because no human proximity, and a lot less hassle with handling vaccine doses.  A robot vaccinator could potentially use ultrasonic tech to squirt vaccine through skin without a needle or non-visual light imaging so robot can see blood vessels under the skin and aim better than a human.

The problem is that they'd have needed to start funding this tech a year ago.  It's actually surprising they didn't since it was obvious they'd need to vaccinate millions quickly.

The key issue in this is ‘is the NHS going to cope’. Everything else is, in the end, secondary to this, as once hospital capacity is overrun then the economy stops anyway. 
 

It’s been abundantly clear that Christmas on the terms being suggested was not viable for some time now. Party management is not an acceptable reason for delaying necessary decisions- that is placing Johnson’s personal and work situation above the requirements of the country. The votes to take the required action were there; yes, it may have meant cooperation with labour, and yes that would have been damaging for his future standing with sections of his party. But this isn’t really about Johnson. It’s about avoiding the NHS being overwhelmed with resulting tens of thousands of avoidable deaths, and the knock on greater economic impact. 

Johnson has been given countless opportunities to establish a reputation alongside Churchill, as a great leader in times of crisis. On every occasion, he fails, more people die, and the economic damage worsens. 
 

your replies are odd, too. You readily agree he is an idiot, etc on these threads; but yet here you are, batting for him again, looking for any angle to reduce his culpability. You are in an increasingly rare band. What makes you keep the faith?

But we know how to vaccinate millions. The bigger issue is supply lines then monitoring post vaccine. Ar my wife's place I think it's a 15 minute wait period after. It slows down how many they can give out. It's not like waiting for your sugar cube.

To be clear: Canute was in no way trying to deny reality; rather, he was attempting to demonstrate to his obsequious courtiers that reality could not be denied, and that he himself had no god-like powers to do so.

In other words: please leave the poor canute out of this ...

Yes that’s what I was referring to (far too obliquely as it turned out!!)

I’m not batting for Johnson just trying to get a handle on what exactly is going on.

I’m not one of those who dismisses the opinions of experts as some people do so I’m a bit confused when what I heard an expert on TV appear to give a different account to what I’m reading here.

From your link. In this case, my take on it is that the Friday notification was more information on the new variant- expanding on what had already been notified the previous Friday.

that will have been an explanation of why numbers were so high in some areas; but the high, and rising, numbers were already known, as well as foreseeable consequences of these- hence the HSJ/BMJ editorial. 
 

The different accounts are not in conflict, they are talking about different things, and the more recent information provides context and explanation; the need for action was already established 

I understand that the evidence for high and rising numbers was known but what wasn’t firmly established was the reason(s) why this was happening.

So I suppose that the government could have introduced more severe measures and cancelled Christmas while the scientists worked out exactly what was happening and why.

Which would keep the infection rates lower and protect the NHS.

That the government chose not to do so is a reflection of their level of competence and the economic, social and political pressure that they are under. Or that they don’t care and are content to let people die.

I don’t believe they want people to die but obviously others have a different opinion.

In my opinion, from the data tweeted by the Milton Keynes lab yesterday, it was bloody obvious 14 days ago from lab data in labs that are part of the state.  It was pretty obvious to me by last Tuesday from the cases data, and the government showed no signs of acting accordingly by either date.

I'm sure you can reach in to your excuse book but the only ones I can think of involved cabinet and the PM ultimately being responsible for governance and the timely flow of information in a crisis situation.  And failing.  Miserably.  Again.

So some scientists and yourself knew why the rates were rising long before the scientific advisers said that they were sure?  Have I got that right?

This isn’t an attempt to discredit what you’ve said but an attempt to establish a definitive  timeline.

I'm saying that the lighthouse lab data tweeted yesterday was enough to call "Panic Stations" two weeks ago.

I first noted Medway as a rising concern on Nov 30th [1].  On Dec 4th I noted that Medway was still "soaring" despite the restrictions and despite 3 conservative Kent MPs voting against further restrictions.  [2]

December 14th just after the new mutation is announced on the News I produced a plot showing how the failure of lockdown apparently spread out geographically from the Thames Estuary area where the new virus was described as being prevalent. [3]

[1] https://www.ukhillwalking.com/forums/off_belay/friday_night_covid_plotting__2-...

[2] https://www.ukhillwalking.com/forums/off_belay/friday_night_covid_plotting__2-...

[3] https://www.ukhillwalking.com/forums/off_belay/friday_night_covid_plotting__3-...

If I could put enough together from publicly available information on my sofa 7 days ago, the government should have been able to do so quite some time sooner, and the reasonable worst case projection from that would have been enough to act then.

That's weasel words.  

I knew enough to be very concerned.  Others knew enough to be very concerned.  The government apparently said "Fuck it, the advisors aren't sure, let's wing it and hope everything works out okay".  Hint - it rarely does in a crisis.  Claiming "the science isn't sure" is a cop out used by people afraid to show leadership in the face of public opinion - which that've been immolating for some time now. 

Thanks for that explanation  and for going to the trouble of posting those links.

Edited to add -

And then you had to edit your post and add your weasel words bit! 

I thought they were in the original; the edit closed in under two minutes from when I posted it.

I never claimed to definitely know why rates were rising.  You are trying to reframe this to a case of definitive information.  There still isn’t definitive information yet now 40 nations have closed borders with us.

A crisis like this revolves around making decisions with provisional data and the best understanding at the time.  To try and re-frame the debate as about solid proof...  I stand by my comment.

in a pandemic with cases doubling every few days, it isn’t possible to wait for firm establishment of reasons. There’s a need to act quickly, on incomplete information. The government have repeatedly failed to act quickly enough, leading to longer, higher peaks than would otherwise be the case. Longer, higher peaks are more expensive. Yet, no lessons are learned, and we make the same error again and again.

yes

yes- and the economy. We are now looking at no relaxing controls until spring. The price tag for that is going to be eye watering.

I don’t think the cabinet sit down around the table rubbing their hands with glee as they debate how to kill proles. But the playbook for dealing with pandemics was literally written 100 years ago, and hasn’t changed that much since then. Clear, consistent messaging; act rapidly to control outbreaks to avoid widespread transmission; test, test, test, and trace, trace, trace; keep the trust of the public. On every one of these the government’s performance has been abject. 

As to why- an airborne pandemic is small state laissez faire right wing thinking’s worst nemesis. It requires decisive and extensive state intervention. And it can’t be overwhelmed by relentless propaganda gushing from compliant media, like so many other battles the right wing has picked; it needs competence, trust in experts, and cross party consensus, none of which are in the current Conservative party world view.

So I don’t think Johnson is trying to kill people; it’s just that the combination of his political worldview, and personal shortcomings, and his unwillingness to acknowledge these and adapt, end up with killing people as the outcome. At the start of the pandemic, that was unfortunate. 9 months in, it’s unforgivable.

It's very simple.

Every time Johnson has something awkward to do, or something on which he might be questioned at Prime Minister's Questions, or face down the loonies in his own party, he bottles it.

He instead does something that makes himself look good, or as "Mr. Generous". He then delays any painful decisions until it's too late for any questions to be directed that he has to answer.

He leaves things until he can retreat due to illness, or escape abroad for some meeting, or better still, close Parliament for a break - even an illegal one.

He's a damn coward.

Yes, but the step in the analysis after that is that these people haven't understood the situation.  If government don't lockdown now all that happens is that things get so bad that they need to lock down anyway.  It isn't avoidable.

Yes and he just can't cope with dealing with a crisis and the idea of bringing bad news. A lot of people can't.

Him and Trump have been brutally exposed by Covid, I really think it cost Trump the election. I don't have any sympathy because they are both woefully unfit to lead and used populist arguments to get in power and thought that would be enough. 

Interesting if he holds on though and what happens to Bojo and Brexit post the pandemic, all through this there has been a few articles, even back in the summer, pointing out the roaring 20s followed the last global pandemic. There's supposedly evidence that in all major disease outbreaks, even in ancient times, people don't spend and the economy collapses and then bounces back as people feel more confident after.

https://www.google.com/amp/s/amp.theguardian.com/world/2020/dec/21/epidemio...

https://www.theatlantic.com/ideas/archive/2020/05/i-predict-your-prediction...

Isn't this the exact reason China started the Pandemic?

Yeah, this is the big conundrum.. China created a deadly virus to bring down Trump at the same time the Trump supporters walk around saying it's just the Flu. They need to get their ducks in a row..

To add, it seems like the MK lab wasn’t plotting this data until just before their tweet.  It seems a bit of luck meant what was effectively quality control data allowed them to retrospectively categorise their detections as old/new variant.  It seems like other teams were sequencing this new strain and following it however, but not the lighthouse labs.  So the big picture wasn’t there until a day or two before that tweet.

Here is a bit more on the demand side of the vaccination mountain:

https://www.bloomberg.com/news/articles/2020-12-17/fears-prompt-some-medica...

I think the demand side is going to very quickly change with these new strains.  Before, plenty of people had reasonably well protected themselves with lifestyle changes and were not in fear of catching it if they waited a few months.  If it looks like there's very high chance of catching it despite lifestyle changes that changes the actual and perceived risk/reward for vaccination.

My vaccination is now booked for early Feb. Student on front line NHS duty. First appointment available I could make.