Monday, 23 November 2020

UK Coronavirus Briefing / Vaccine news 23rd November 2020

UK Coronavirus Briefing 23 /11 /20

We had a UK briefing today with remote Bozza-in-an-understairs cupboard, in-person Chris 'Tintin' Whitty, and in-person Andrew Pollard, the director of the Oxford Vaccine Group. 

I spent ages typing up the excellent vaccine trial results ready for tomorrow, but stuff that, I've put them at the bottom. Depending on how much you know, you might want to read that bit first, or last (or just skim it, no-one will know). 

Boris started by saying how great the AstraZeneca / Oxford vaccine news is. We have 100m doses on order. He reminds us that even if all 3 leading vaccines are given authorisation, it'll still be months before everyone gets a jab, and it'll be Winter - virus love Winter. We can't stop restrictive measures now. We have to keep going. 
The new tiers will be tough, because we can't let this beat us after Christmas. He warns a lot of people will find ourselves under harsher restrictions than before lockdown. 
Community mass testing will expand (over 40 local authorities have signed up). We are urged to make use of it.
"This is not the time to let the virus rip for the sake of Christmas parties. Tis the season to be jolly, but it's also the season to be jolly careful, especially with elderly relatives."
"Christmas this year will be different, and we want to remain prudent through Christmas and into the new year." 
Over the next few months we'll employ tiering, testing and the rollout of vaccines to drive down the infection rate. Things should look different by Easter. 
The challenge this Winter is "to fight down any over-optimism", keep washing your hands, don't get complacent. 
Beat the virus by staying apart

Chris Whitty says thanks to everyone who volunteers for studies - we couldn't have done it without you. "It is only science that will get us out of this hole.".
Andrew Pollard of Oxford Uni explained about the vaccine success, and says they'll be investigating different doses in detail to check that people are given the best dose. He also talks about vaccine equity. He deserves a medal for this - this is the fairness aspect of creating a vaccine for everyone, it's easy to move and use, and cheap to buy. (see below.)
Andy explained the vaccines are having a great effect at reducing severe cases, and that's what we need to protect the NHS. We were also able to regularly COVID test over 8,000 of the trial volunteers, which gives us loads of extra information about asymptomatic cases: 
"There's a hint in the data, in one of our groups that had the higher efficacy, we were able to reduce the amount of asymptomatic infection."
THIS IS REALLY IMPORTANT. It's a massive bonus. Stopping spread was target number 3 or 4, after saving lives, reducing ventilation and need for hospitalisation, and we didn't really expect to hit it first time. If we have, even a little, then it'll really help to stop the virus in it's tracks.
Good stuff. 
Press asked about the comment the other day that we'd need 5 days of restrictions for every 1 day we 'let loose' over Christmas. Chris says we need to take responsibilities over Christmas seriously, and then have to be careful during the period after Christmas. We can't let our guard down. We don't know where we'll be after Christmas, it all depends on our behaviour.  
We're hoping to vaccinate everyone who needs one by Easter. 
It seems that an arrangement over shared Christmas relaxations between England, Wales, Northern Ireland and Scotland is not yet finalised. They are hoping to all agree on the same measures over Christmas. Chris says they're all mates and learn from one another. Expect an announcement as soon as they have agreed. "

All this talk of 'saving Christmas' does make me quite sad for Muslims, Jewish people, Sikhs and anyone else who has a Midwinter Festival. No festival is more important than another to the individuals involved. I'm sorry to everyone who hasn't had, or won't have, special dispensation to celebrate together. 

Annoyingly they didn't give us much information about the new new 3 tier system, but it HAS been published. I'll add the link in a comment below - and cover it tomorrow. Some main points:
- Hospitality will stop serving at 10pm, and close at 11pm. Take away, delivery, drive through can open. 
- Spectator sport/events are back from Dec 2, but only in Tier 1 and 2 and limited numbers. 
- Outdoor socialising following the rule of 6 is allowed in all 3 tiers. 
- Leisure and sports facilities will stay open in all 3 tiers, subject to limits on numbers/gathering
- Organised outdoor sport can continue. 

Here's a little something I typed up earlier for the vaccine news background:

Big vaccine news first thing Monday morning with the interim data from the AstraZeneca/London vaccine trial (they still need to polish their report and check the numbers, but the trial has completed). 
It's common to try different doses to see what works best, to find the most suitable point for efficacy, with least side effects and cost. 
Bizarrely patients given a low dose, followed at least a month later by a high dose, had best results, at 90% effective. Giving 2 high doses only seems to be 62% effective at preventing people becoming ill - which is still better than we thought might happen in Spring. 
(Some media initially got into a bit of a mess with the 2 different results, and announced the vaccine was an average 70% effective. Errrrrm...,. It's not possible for 1 person to take more than 1 round of vaccination, you can't be an average of the 2, so that was a particularly confusing figure.) 
The low dose plus high dose combo obviously means we can spread the available vaccines further and protect more people more quickly - and cheaply. 
Andrew Pollard of Oxford Uni: “We think that by giving a smaller first dose, that we're priming the immune system differently we're setting it up better to respond... What we don't know at this moment is whether that difference is in the quality, or the quantity of the immune response.”  
Sarah Gilbert, Oxford Uni Lead, suggests a lower first dose may mimic natural infection more closely. Work has already started to find out more. 
 
The Oxford /AstraZeneca vaccine is also incredibly user-friendly. It can be stored at room temperature, making it very easy to distribute around the world, even to remote regions. The cost is likely to be a mere £2.23 per dose, £4.50 per patient, so the poorest people in the world can also benefit. I'm actually really proud that this vaccine is home grown - and there for everyone.  
"AstraZeneca will now immediately prepare regulatory submission of the data to authorities around the world that have a framework in place for conditional or early approval. The Company will seek an Emergency Use Listing from the World Health Organization for an accelerated pathway to vaccine availability in low-income countries. In parallel, the full analysis of the interim results is being submitted for publication in a peer-reviewed journal."
And that submission has gone in today. 

For comparison, the Pfizer/ BioNTech vaccine has to be stored at -70 degrees and costs around £15 per dose, so £30 per patient. 
The Moderna vaccine can be stored in a regular freezer and costs £18.80 - £27.80 per dose, so £29-£55 per patient.. 

Back tomorrow with the regular report. I'm hoping it'll be short, all of today's news is here! 



Sources: 

https://www.gov.uk/government/publications/covid-19-winter-plan
https://www.gov.uk/guidance/local-restriction-tiers-what-you-need-to-know

Sports/ Events: 
Tier 1 - 4,000 spectators/ 50% capacity for outdoor events, whichever is lower, and 2,000/ 50% capacity for indoor
Tier 2 - 2,000 spectators/50% capacity outdoors, whichever is lower, and 1,000/ 50% indoors
Tier 3 - Ban on spectators remains


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