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Vaccination centres

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So we are to have seven regional vaccination 'super centres'. I'm not sure the is sensible from a logistical point of view.

Let's say we want those centres to do the bulk of the 2 million vaccinations, and allowing them to work 16 hours a day, and do equal numbers in each centre. That requires each centre to do 41,000 vaccinations a day, or 2550 an hour, or 42 per minute. Allowing a 15 minute post-injection anaphylaxis alert time, that requires waiting space for 640 people.

Assuming each injection takes 2 minutes, that's a parallel processing path of 84 slots.

Those numbers sound...challenging.

Then there's the issue of access. Seven regional centres means long journeys for most people. If we want to prioritise the elderly first, those journeys will be difficult to impossible.

My father (90) has been called for vaccination this week, but, even though it's only 8 miles away, it would have been difficult, had he not still been reasonably mobile, and able to drive.

He did ask about transport, and the suggestion was to use the bus. That doesn't seem a great idea if were trying to isolate (my parents were regular bus pass users prior to this, but haven't used it at all since March). Another suggestion was a taxi; that would cost £60 round trip, and that also has transmission risks.

So, even with local vaccination centres, there are access problems. For a small number of regional centres, access and throughput seem to be beyond practical implementation.

I guess we'll see how it works.

In reply to captain paranoia:

I can see the benefit of the big centres in big population centres, but not doing the sorts of numbers you are talking about.

5-10,000 a day would make sense, hundreds of places doing 500 a day each and thousands of places (doctors surgeries) doing 50-100 a day.

 jkarran 11 Jan 2021
In reply to captain paranoia:

> Let's say we want those centres to do the bulk of the 2 million vaccinations, and allowing them to work 16 hours a day, and do equal numbers in each centre. That requires each centre to do 41,000 vaccinations a day, or 2550 an hour, or 42 per minute. Allowing a 15 minute post-injection anaphylaxis alert time, that requires waiting space for 640 people.

You have to assume this has been thought through by capable people with a grasp of the problem. We can only hope they weren't then overruled by someone whose mate's fund's conference centre was running out of money.

As people will be called individually rather than in bubbles/families, it's not just forty something people per minute, all day, every for months, it's nearly that many cars in and out. Maintaining 2 seconds separation (and ignoring any disruptions like lights) that requires more than 1 lane in and out dedicated to vaccinations.

> Those numbers sound...challenging.

Hmm.

> Then there's the issue of access. Seven regional centres means long journeys for most people. If we want to prioritise the elderly first, those journeys will be difficult to impossible.

I suspect the super-centres won't in reality be doing the lion's share (I hope they're not simply Nightingale style dazzle, breaking out the cammo for the cameras), we have tented vaccination hubs in the P&R carparks here plus what's being done in conventional settings.

> I guess we'll see how it works.

Yes. Hopefully much better than we fear.

jk

In reply to captain paranoia:

>  Assuming each injection takes 2 minutes, that's a parallel processing path of 84 slots.

I'm imagining a queueing system something akin to all the security gates at a major airport. could be challenging to anyone in a wheelchair or not used to being cattle herded like that.

> Those numbers sound...challenging.

Oh yes, challenging indeed.

> Then there's the issue of access. Seven regional centres means long journeys for most people. If we want to prioritise the elderly first, those journeys will be difficult to impossible.

I saw the map - If you live in Cornwall then it's Newquay (?) or Plymouth, a not insignificant drive to either for some.

 elsewhere 11 Jan 2021
In reply to captain paranoia:

The large centres can seat 10,000-100,000 people so there is space to wait. There's circulation space for 10,000-100,000 people leaving at the end of an event so there is loads of indoor space for social distancing whilst getting in & out for vaccination. There's loads of car parking and no traffic jams when operating at 1%-5% of normal capacity. They're often pretty much on one level and very wheelchair friendly. And finally, they're empty!

Offloading the logistics of getting 2M people a week to & from the vaccination centre onto the individuals probably makes sense as like your dad, the majority can manage it. Logistically it's far easier than taking the vaccinator to the individual.

Post edited at 13:09
In reply to elsewhere:

Large centres are the answer. But a lot more than seven are required. There will be at least one unused sports centre in every town. Use them all. That was really my point; divide and conquer.

And I agree that taking vaccines to individuals is certainly not the answer (although it will be required in a small number of cases, such as those in assisted living), and not what I was suggesting.

 dread-i 11 Jan 2021
In reply to elsewhere:

>The large centres can seat 10,000-100,000 people so there is space to wait. There's circulation space for 10,000-100,000 people leaving at the end of an event so there is loads of indoor space for social distancing whilst getting in & out for vaccination. There's loads of car parking and no traffic jams when operating at 1%-5% of normal capacity. They're often pretty much on one level and very wheelchair friendly. And finally, they're empty!

I'd agree with some of that. I've been to events in Excel in London, where the next trade show along was showing helicopters, with several parked up for display. Having several rooms the size of a dozen football pitches is great. However, with excel, the issues is in getting there. The DLR runs by the side of it, but that gets pretty busy at the best of times. Also, it can be a fair old walk from the station to the actual hall.

With car parks and traffic jams, major concert or sports events handle tens of thousands of people, but traffic us usually jammed up for some distance around. The idea of giving people injection in their cars, waiting and then releasing them in a stream, sounds reasonable. With empty roads and a bit of load balancing, e.g. an entire household in one car, cars from north and south given different timings to reduce load on certain roads, it sounds workable.

They should do everything possible to deter people from just showing up, on the off chance.

 elsewhere 11 Jan 2021
In reply to dread-i:

I think the big venue might work when they are down to the 65+, 60, 55+,50+ age groups who are progressively more mobile (physically & driving).

There's a traffic jam when 100% capacity empties out after an event but I doubt there will be when 10-30% of normal capacity arrives and leaves in 8-12 hours.

 neilh 11 Jan 2021
In reply to captain paranoia:

You are given alternatives if you cannot get there or have issues.

These centres will possibly just be practising for the larger moretransport  mobile numbers as they move down the age range. Put it this way if I was offered a vaccination this week 200 miles away I would be there at the alloted time.

A bit of perspective.On the other hand you can try getting one in France . Might take you  seriously alot longer...........with alot of form filling and an interview before hand.

For once maybe we should count our blessings.

In reply to captain paranoia:

I'm sort of hoping that the large centres are headline-grabbing examples to get the public engaged with the idea and will be followed up with some slightly smaller centres. The cynic in me thinks they are headline-grabbing to deflect attention away from elsewhere. In reality, I think once vaccine supply isn't the bottle neck we will probably see all sorts of tempory vaccination centres.

In reply to captain paranoia:

There are large centres, there have been for weeks, my workplace is one (Council building with  a large public space on the ground floor), we have another about 4 miles away.

These centres are set up to do 300-500 people a day. I am hoping what I am seeing locally is replicated nationwide and there are hundreds of such centres.

I’ve just checked, vaccines currently being administered at 1,000 sites, which isn’t enough, hopefully will be a lot more in a week. 2.4m given so far.

Post edited at 14:13
 jkarran 11 Jan 2021
In reply to Toerag:

> I saw the map - If you live in Cornwall then it's Newquay (?) or Plymouth, a not insignificant drive to either for some.

The nearest to me is 90min+ drive (each way) and York's pretty well connected. Realistically they're not going to be doing the bulk of the work, they only really bolster the capacity of their cities and immediate environs and then (if used safely) only for a less vulnerable, more mobile subset of the population who aren't yet invited. They'll probably prove useful toward the middle-end of the project when supply has ramped up and we get to to a less invitation lead regime but certainly not a silver bullet for reaching the over 70s! Then again, by that point we'll have necessarily built extensive locally accessible capacity. Being a cynic I fear they could be little more than another white elephant, a way to funnel money to racecourses and conference centres while generating a photo-op for the army.

jk

In reply to Andy DB:

> I'm sort of hoping that the large centres are headline-grabbing examples to get the public engaged with the idea

Looking for the locations, I found this map, showing the super centres, and the local hospital hubs.

https://www.bbc.co.uk/news/uk-england-55566404

Clearly, as my parents are being invited for local vaccination in the small, local hospital, these supercentres aren't the only vaccination sites. Vaccination has been going on since mid-December, and not at super centres.

So my OP is a bit too negative, but, given that Johnson is at the Bristol centre today, it's obviously a useful PR exercise. The BBC reporter actually asked him why he had travelled to Bristol, as that didn't seem an essential journey... Of course, Johnson said it was part of his job, although it might just as well have been done at the Excel centre...

Post edited at 14:19
 freeflyer 11 Jan 2021
In reply to captain paranoia:

> I'm sort of hoping that the large centres are headline-grabbing examples to get the public engaged with the idea

> Clearly, as my parents are being invited for local vaccination in the small, local hospital, these supercentres aren't the only vaccination sites. Vaccination has been going on since mid-December, and not at super centres.

I think you and Andy DB are on the money. Bubble mate works part-time in her local GP surgery and last few days they've been contacting 1,000 patients to tell them not to come for their second jab, followed by contacting a different 1,000 to tell them to come for their first one.

Apart from the FFS aspect of that, once the logistics are sorted out I don't see why it shouldn't happen quickly. After all, if E484K or another variant turns out to escape the current set of vaccines, we'll all need another one.

In reply to captain paranoia:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/951284/UK_COVID-19_vaccines_delivery_plan.pdf
 

Looks like this 7 are the first of about 50, alongside 206 hospital sites and 1,000 local centres.

In reply to The New NickB:

Thanks. That looks far more sensible. I'm significantly reassured from my post-headline news position this morning...

Post edited at 15:02
 ianstevens 11 Jan 2021
In reply to jkarran:

> You have to assume this has been thought through by capable people with a grasp of the problem. We can only hope they weren't then overruled by someone whose mate's fund's conference centre was running out of money.

Have you been following the actions pdf the UK government for the past 18 months?!?!?!

 Jenny C 11 Jan 2021
In reply to captain paranoia:

My GP has been doing vaccinations since December, not just for their parents but also as a centre for other practices in the local community. Downside is that vaccination is taking priority over normal duties, meaning an even slower service for patients as there are less routine appointments available.

Personally I do think that vaccination hubs are a great idea, BUT these should be in the local area (we all understand the definition of local, don't we?). So as someone else suggested sports halls and community centres, rather than enormous exhibition centres. 

Post edited at 15:41
In reply to Jenny C: and Captain Paranoia

CP: I reckon your opening info is way off.

The plan is to have 2,700 vaccine centres. I reckon the bulk will be still be carried out health centres/GP’s as in your example. In Leigh (Grter Manc) they have been using Leigh Sport village (the rugby stadium) which is doing a massive number based on reports. 
I do think these new massive hubs have a function and I think the aim is for them to vaccinated 1,000’s a week.   They are local to their community (lots of people live near Man City’s stadium) and they have the infrastructure (described upthread).

I also understand that we vaccinate 15 million people for normal flu, so this is more than doable

 elsewhere 11 Jan 2021
In reply to neilh:

> For once maybe we should count our blessings.

You may be right. I was very pleased when an elderly uncle in England got vaccinated in December.

I've been trying to find daily/weekly figures, the best I've found is https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-vaccinations/.

The total number of vaccinations for COVID-19 in England as reported by the date of publication. All figures are as recorded on the National Immunisation Management Service (NIMS) database.

Cumulative Total Vaccinations to Date

8th December 2020 to 10th January 2021 - 2,333,764 (provisional data)

    Of which, 1st dose - 1,959,151

    Of which, 2nd dose - 374,613

In the week ending the 27th December a total of 243,039 people received an NHS vaccination for COVID-19 in England.

In the week ending the 3rd January a total of 308,541 people received an NHS vaccination for COVID-19 in England. This takes the total vaccinations given since vaccinations began on the 8th of December to 1,112,866

Hopefully this means 2,333764 - 1,112,866 = 1,220,898 vaccinated in week ending 10th Jan - exponential growth of vaccinations would be fantastic and is pretty much what we need. That's assuming mostly first vaccinations now as second vaccinations being delayed.

Post edited at 17:25
In reply to The New NickB:

BBC reported that the plan is to have 2,700 vaccination centres. They could be talking rubbish I guess. 
Ed: Hancock just reported that since Thursday when Oxford vaccine started to be used, an average of 210,000 people a day been vaccinated.  Bloody impressive!!

Post edited at 17:28
 elsewhere 11 Jan 2021
In reply to mick taylor:

> BBC reported that the plan is to have 2,700 vaccination centres. They could be talking rubbish I guess. 

> Ed: Hancock just reported that since Thursday when Oxford vaccine started to be used, an average of 210,000 people a day been vaccinated.  Bloody impressive!!

At last some good news! 

 Bacon Butty 11 Jan 2021
In reply to elsewhere:

And they've upped the mid Feb target from 13,5 to 15M.

I might get done by the end of March

In reply to mick taylor:

> CP: I reckon your opening info is way off.

I agree. NewNickB's link shows a much better situation than was presented in the news this morning. As upthread, I'm much more reassured by this.

I over-reacted to the puff piece in the news trumpeting just these seven new centres, and not mentioning the smaller scale infrastructure they are using & planning to use.

 wintertree 11 Jan 2021
In reply to captain paranoia:

> I over-reacted to the puff piece in the news trumpeting just these seven new centres, 

It's really easy to get drawn in by the negativity of all this given the number of obvious things that could have been done better.  I try very hard to mind against doing that because it's just not personally helpful, and its easy to get drawn in to.

On that front of being drawn in to negativity - I prefer to harness it as a way of looking forwards at what we should do.-It’s great that the vaccination is scaling up so well.  However, the pandemic isn't over until it's over globally.  I fear that if we don't go for hard borders crossed inwards only with MIQ - and that only open to people with a negative test before travelling, and push for and hold near elimination, the cycle will repeat again next winter one way or another.  

I'm not much of one for wide spread campaigning, but I am gong to put together the best case for this that I can and send it far and wide.  Not now, because home schooling is sapping the time I had for everything.  But late spring.  

Post edited at 18:04
In reply to wintertree:

>  However, the pandemic isn't over until it's over globally.  I fear that if we don't go for hard borders crossed inwards only with MIQ - and that only ope to people with a negative test before travelling, and push for and hold near elimination, the cycle will repeat again next winter one way or another.  

Exactly. We'll have herd immunity for the variants the vaccine can protect us from, but not those that have mutated elsewhere since.  The whole world needs herd immunity to all the strains active around the world at the same time to kill the virus off, anything else results in the situation we currently have with flu.....except Covid is more infective and hits harder .

 wintertree 11 Jan 2021
In reply to Toerag:

> except Covid is more infective and hits harder  .

And unlike flu, this coronavirus is only just getting started adapting to its current hosts.  It’s a kitten compared to SARS and MERS.  Hard to believe playing with fire has gone so far and the threats are still not recognised very clearly.

In reply to captain paranoia:

Good stuff. Let’s hope the good news about vaccination roll out doesn’t encourage people to ignore the regs. 

In reply to mick taylor:

The government report I linked to seems to be suggesting about 1450 in England, which obviously isn’t 2700 even when the Scotland, Wales and NI are taken in to account, but I hope they are right.

My wife had to go to Salford Royal, her 82 year old aunt went to a CCG site about a mile from home.

In reply to wintertree:

> It's really easy to get drawn in by the negativity of all this given the number of obvious things that could have been done better.

Guilty...

In reply to The New NickB:

I actually played back tv to double check and they did say 2700. Anyway, it’s the first time I’ve felt the government has had a plan, of any description. I/we need any ounce of positivity given the totally negative situation we are (and will be) in for some time. 
Wife and me just been chatting about the possibility of visiting family in Fife at Easter, but I’ve learnt not to be too optimistic when it comes to this!

 nniff 11 Jan 2021
In reply to captain paranoia:

I have a new vaccination centre 1.5 miles away from me as the crow flies.  Cheerily, I have a pop-up mortuary 1.8 miles away.

Not quite sure what to make of that

My father in law is now eligible, being well into his 80's and has an appointment for 1 Feb, with a second three weeks later.  For the vaccination, I hasten to add.

Regardless of all this, the other world carries on.  My wife runs a prep school, and the father of three young kids at the school (all under eight) had a stroke on Saturday and died on Sunday.  Totally crap day at work for her today, but not as bad a day as for the remains of that family.

Post edited at 18:38
 Jenny C 11 Jan 2021
In reply to mick taylor:

My GP claims to have done 1,000 vaccinations last week. Really don't care where vaccinations are being done so long as they get them done ASAP and with minimal disruption to other healthcare provision.

I think we all need to recognise that given the hardship of lockdown, traveling for a vaccine reality isn't a big deal. Had a bit of an argument with mum about this as she was stressing over the possibility of traveling to the far side of Sheffield - if she's was asked to go to Leeds or even Rotherham I might have had some sympathy, but they both drive so what's there problem?

 wintertree 11 Jan 2021
In reply to Jenny C:

>  but they both drive so what's there problem?

Quite a few people I know are developing a sort of agoraphobia (not quite the right word) after spending so long confined to home and their immediate localities as much as possible.  People who have travelled the world are becoming nervous about going to the next town.  I think the effects have been seeping insidiously in to them for quite some time.

 marsbar 11 Jan 2021
In reply to wintertree:

I was like that after the first lockdown.  

 neilh 11 Jan 2021
In reply to captain paranoia:

Lockdown is a tactic, vaccination is the big strategy. Always has been imho. Whitty was saying this from day 1.

The numbers being vaccinated are eye catching compared to Europe. 

its too easy to look at day to day stuff rather than the big picture. 


 

In reply to neilh:

> Lockdown is a tactic, vaccination is the big strategy. Always has been imho. Whitty was saying this from day 1.

Given our inability to eliminate with TT&I, that was never in doubt.

Using the lockdown tactic inadequately has brought us to this crisis point.

It's a pleasant surprise to see the government apparently managing something well, but I guess logistical organisation is something that is probably largely immune to political influence (barring outsourcing to inadequate private contractors).

My sister has had to fight really quite hard to qualify to vaccinate (in spite of 40 years nursing experience). That's not an isolated experience. So it's not all plain sailing on the organisational front.

 jkarran 12 Jan 2021
In reply to mick taylor:

> Good stuff. Let’s hope the good news about vaccination roll out doesn’t encourage people to ignore the regs. 

The shift in government and press output this week suggests that threat is now on the radar. Next threat is the 'economy first' tory back benchers when the death rate starts to fall.

jk

 elsewhere 12 Jan 2021
In reply to wintertree:

It makes sense to offer free vaccination world wide paid for by richer countries like the UK. If shared with other richer countries, it's almost peanuts compared to the costs so far within the UK so far. It might save the UK vast amounts of money within the UK by reducing the rate of transmission into the UK or reduces the risk of a new variant that needs a new vaccine.

 neilh 12 Jan 2021
In reply to elsewhere:

As I understand it that is what will happen.The richer countries effectively subsidise the cost of the vaccine to poorer countries.Its one of the advanatages of the Oxford vaccine-- its cheap-and will have been designed with that in mine from Day 1. I look at the Pzier one as one for rich countries.

 elsewhere 12 Jan 2021
In reply to neilh:

> As I understand it that is what will happen.The richer countries effectively subsidise the cost of the vaccine to poorer countries.Its one of the advanatages of the Oxford vaccine-- its cheap-and will have been designed with that in mine from Day 1. I look at the Pzier one as one for rich countries.

Good point. I know pharma pricing varies for richer/poorer countries. Hopefully UN/WHO/other will support national vaccination programmes - it make economic & public health sense for us and saving lives is good thing generally.

Post edited at 11:20
In reply to neilh:

> You are given alternatives if you cannot get there or have issues. <

Thats great but its extremely poorly advertised, This morning I was helping a very worried neighbour in her 80s. She'd had a letter telling her to visit the website and fill in an online form, however she was only given a choice of major centres all totally unreachable without hours on public transport. Nowhere was there an option to say "can't get there" and she was worried she'd miss vaccination. I tried a couple of searches but could find no details of what she should do (nor on her GP practice's website)..

I told her to ring her surgery and they were able to inform her that there would be more local centres sometime in the future and they would contact her (presumably there is some NHS IT system to let her GP know she hasn't taken up the initial offer). 

There must be loads of people in their 80s and 90s who can't get to the existing centres.


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