Friday, 26 February 2021

COVID-19 Coronavirus UK Briefing, UK News and World News Update 26th February 2021.

COVID-19 Coronavirus UK Briefing, UK News and World News Update 26th February 2021.

The UK added 8,523 cases today and now has reported a total of 4,163,085 positive cases of COVID-19. We completed 731,410 tests yesterday. 

The counter says 19,177,555 people had been given at least one dose of a vaccine in the UK by midnight last night. 736,037 had received 2 doses. 

15,485 people were in hospital on Wed 24th, with 2,047 using a ventilator yesterday, Thursday 25th Feb. 

In the 24 hours up until 5pm yesterday, we officially reported the loss of another 345 people who have tested positive to COVID-19 within 28 days, making a total of 122,415 losses of life in all settings.

Rep. Of Ireland 218,251 (+773) cases and 4,300 (+29) losses of life.

There have now been a total of 113,784,410 reported cases worldwide. The number of people who have lost their lives worldwide to COVID-19 is 2,523,794. Already 89,371,118 people have recovered.

JCVI vaccine priority phase 2 age 49 -18

"The data on the slides speak for themselves. People are relaxing, taking their foot off the brake, at exactly the wrong time. It's a bit like being 3-0 up in a game and thinking 'well, we can't possibly lose this now', but how many times did you see the other side take it 4-3? Do not wreck this now."
Jonathan Van Tam, UK Deputy Medical Officer, with today's bad news. 

Cambridge University Hospitals have released data today on the Pfizer / BioNTech vaccine efficacy. It's really good. As ever, not-yet-peer-reviewed, but it's basically counting, so pretty secure data.
They compared healthcare workers' regular lateral flow test results with who had been vaccinated, to find out levels of 'asymptomatic transmission'. Remember these are ALL people who had no noticeable symptoms.
12 days or so after immunisation was the first time there was a difference. They saw almost a 50% reduction in positive tests among the vaccinated population.
In tests taken more than 12 days after vaccination, it was even better, with a 75% reduction.
They also found that overall, in the people who still managed to catch COVID, levels of virus were lower, meaning they'll pass it to less people too.
Excellent news. 


This Summer's A Level and GCSE exams will be graded by teachers, using their experience and knowledge, and taking into account we had a pandemic, as opposed to imagining what might have happened if we hadn't. The intention is to give every student a fair chance, rather than penalising those who were more personally affected by COVID than others. 

2602221 COVID R rate 0.7-0.9

We had a UK COVID Data Briefing this morning, which will basically be translated into sentences with shorter words for Matt Hancock to tell us later. The briefing was led by Prof Wei Shen Lim, Chair of the Joint Committee on Vaccination and Immunisation (JCVI) and Dr Marie Ramsey, Head of Immunisations at Public Health England (PHE).
Evidence is now clear - vaccination IS having an impact on outcomes.
1 dose of the Pfizer vaccine reduces symptomatic cases in older people from around 3 weeks after immunisation, and offers an even higher level of protection against severe forms of disease.
Early signs are that the Oxford / AstraZeneca jab is also performing well in this population.
The rates of deaths and hospitalisations in the vaccinated groups are declining more quickly than younger age groups.
Phase 1 was all adults 50+ and those 16+ with underlying conditions. All of those people will be offered a vaccine before Phase 2 begins.
Phase 2 of the programme is adults aged 18-49. They considered 3 main strategies for priority:
1. Personal risk of severe illness
2. Stop or reduce transmission within the population
3. Occupational risk

Their belief is that age is STILL the most important factor. Modelling shows it will not only have greatest impact, it will be easiest to administer at speed (and we currently have high levels of COVID, so we need speed).
Even within occupational groups, it is still age that is the biggest factor (for example it may be that a mechanic aged 45 is still at more risk of being hospitalised with COVID than a taxi driver aged 35, even if 4 of the 35 year old taxi drivers catch COVID for every 45 year old mechanic - hopefully that makes sense!).
(Their chart actually makes it seem men should be prioritised. In people 40-49, twice as many men are admitted to hospital as women.)
They advise that the offer of vaccination in Phase 2 should still be age-based, in the following order:
40-49
30-39
18-29
It's simple to do. "Simplicity has been one of the cornerstones of the current programme in terms of it's speed and it's success."
Attempting to switch to an occupation-based strategy could end up with people getting vaccines even later on than they would have done originally (I have to say it hasn't seemed to work smoothly elsewhere. At first it's great, but after the initial rush, it often becomes sloppy, confused and complicated).
Prof Wei Shen says of occupation "it's not well recorded, structuring an occupational strategy would be very complicated". 'The effort could only really gain 1 week', "so on balance it was simpler to keep everything as simple as possible."
There are some other groups in which risk is higher, and they should be considered when deploying vaccines:
- Men
- BAME
- BMI 30+
- Those living in deprived neighbourhoods.
Press asked questions about vaccine hesitancy. Dr Marie talks about "the right message for the right group". Some groups (for example Muslims) are being bombarded with misinformation about what is in the vaccine. Some Eastern Europeans have never had a vaccine in the UK and don't trust it. We need to address the particular concerns of these groups.
Dr Marie says it is reasonable to accelerate the vaccine programme if local delivery teams are able. (Speed, speed, speed.)
Prof Wei Shen reminds us the JCVI have been asked to advise on minimising severe disease, hospitalisation and loss of life. 

260221 UK Gov Briefing Percentage chart testing positive UK

Sky News have a great set of graphics showing vaccination progress across England, and asking why the 15 areas with lowest rates are in London, with large cities like Manchester and Nottingham also falling well behind average.
They looked more closely at London and Birmingham, and found the higher the deprivation and/or concentration of people from BAME groups, the lower the percentage of vaccinated population.
That's really a tragedy, because it means the people we know are more vulnerable are least likely to be protected. 

The HSJ has looked at vaccinations for Health and Social Care workers and found that London is far behind here too.
Uptake for frontline NHS workers is 94%-97% everywhere except the Midlands 91% and London 76%. (These figures may all be low as some workers will have been vaccinated away from work or may not have been noted.)
Social Care has the same findings, with 68.8%-75.3% everywhere except London, at 54.8%. (Again, these figures may not be entirely accurate.)
It could be that London is just running behind, but if this disparity continues, we are going to see very different outcomes in different parts of the country.

Today's IndieSAGE started with Dr Alice Roberts (Biological Anthropologist and telly lady) saying that the UK Government presented their roadmap out of lockdown on Monday:
"The Prime Minister has also stated that there is no credible route for a zero COVID Britain, but Independent SAGE, which has been calling for a zero COVID approach for over 8 months now, strongly disagrees with this. Aiming for zero COVID is essentially the best way to avoid more unnecessary deaths, and more lockdowns."
(Aim low and you'll always end up with a poorer end result.)
We have had substantially more people die in this second big peak than we did in the first. It's been hard. Deaths and hospitalisations are now falling, with Scotland and England now having less people in hospital than in the first peak.
New cases are still dropping week on week, but it has flattened off slightly, a 12% drop (it was 17% last week, 23% the week before).
Uptake of vaccination is really good, with close on 100% of people 75-79 vaccinated.

260221 Local authority areas with persistent COVID

indieSAGE focussed very much on deprivation, with the release of the studies which have found deprived people are more likely to catch COVID, and when they do, they're more likely to die from it. That impact increases during lockdown (because of types of jobs, housing, inability to self-isolate financially, lack of outdoor places to go to etc).
People who know they cannot afford to self-isolate are also less likely to get a test, and more likely to try and carry on, potentially infecting others.
A chart of the areas with the highest persistent level of new cases per 100,000 population shows the first 5 are in the North West (and include my own area in 1st place "whoop"). Of the top 15 areas: 9 are NW, 3 NE, plus Leicester, Birmingham and Rotherham.
Most of the consistently high places are STILL high now. 

I wrote this up as MY OWN OPINION, but it pretty much sums up the second part of the indieSAGE meeting:
I think the English government's decision to give in at this point and just accept living with a virus which still has potential to overwhelm hospitals, and affects at least 1 in 10 people for over 3 months, is  defeatist and risky. We know COVID can cause lung and other damage in people who are never even admitted to hospital. Vaccination will prevent most people from developing severe disease, but it's not entirely clear if that means it'll also prevent all damage. We risk a large number of weakened individuals who we have to support - financially and otherwise - and potentially for a very long time. We've know how happily COVID will evolve and mutate. B117 is already 1.7 times more deadly than original wild COVID, and COVID is still passing through a lot of people unhindered. Among a semi-vaccinated population, we risk more mutations.
It's not the safest place to sit down and decide to wait it out.
indieSAGE also pointed out that continuing to allow a level of COVID  will continue to disproportionately affect already disadvantaged communities. "Tolerating" a level of COVID is a lot easier from a position of far lower personal risk. 

indieSAGE say Zero COVID is very possible, but maybe a misleading name. They prefer Maximum Suppression Strategy. It's been implemented successfully in many countries, and has not only protected the population's health, but also the economy. These countries are not unique and different, they aren't made of magic, they just aimed for lowest possible number of cases and then held it there. (I hope the UK government feel more positive once case numbers here are a lot lower.)

260221 UK Gov Briefing case rates per 100k popn

Matt Hancock led today's UK Briefing, with Jon Claude Van Tam and Susan Hopkins (MD of NHS England). The graphics were very broken, and Matt struggled a lot at first. (Get him his own remote button!!.)
Hospitalisations have seen a fall of 40% of the last fortnight, but still far too many people in hospital.
Number of deaths has averaged at 380 a day for the last week.
The ratio between hospitalisations and deaths has changed dramatically - the inevitability of people dying is reducing.
It's not all good news, we need to remain cautious. Cases are now at 1 in every 145 people infected, and the rate of decline is continuing, but it's slowing. 1 in 5 Local Authority areas has seen a rise in cases in the last week. (My own area, which turns out to be the worst in the entire chuffing country, has risen in 3 out of the 4 previous weeks.)
He reminds us we are going to try and offer vaccinations to everyone 50+ or with underlying conditions by mid April, then talks about the JCVI's clinical advice (shown above) regarding priority for vaccinations in people 18-49.

Jon Van Tam shows what he calls "sobering slides". It is clear there are pockets of the UK which are going in the wrong direction, and cases are rising rather than lowering. "I'm afraid this battle, at the moment, is not won."

He reminds us the vaccinations are going really well, but we have a long way to go - there are still around 40m doses yet to be administered. He also reminds us "we are not yet collectively, as a country, in the right place" to go out and behave normally. Nothing can change because you've had your first dose of vaccine. "Don't wreck it now."

Press asked about prioritising certain professions. Matt and Jon explained the JCVI decisions and how hard it would be to swiftly continue the rollout while trying to decide who got priority. Jon says professions with highest risk of hospitalisation and death begin with restaurant managers and caterers, metalworkers, food, drink processing - all over 100 per 100,000 for males. Male teachers are (given comparable age) 31.4 per 100,000. It's just too complicated. He says it's better to have a place in a fast moving queue, than be further ahead in one that isn't moving.

Matt fielded questions about vaccine passports / certification. Michael Gove is leading a review, and it's definite something will be needed, as other countries may demand it for entry, or access to facilities while you are there.
It is really fraught with problems, for example around 1.5m adults in the UK can't be vaccinated, but that shouldn't discriminate against them.

Other questions were mainly already covered above, but Jon is clearly disturbed by the rise in cases in some areas. Matt says "this is on all of us". Every single person needs to stick to the rules.

260221 UK Gov daily stats

There's a massive US study (not-yet-peer-reviewed) in the New England Journal of Medicine, looking at the efficacy of the Pfizer / BioNTech vaccine in the real world, and it's more great vaccination news.
They studied 596,618 people, and looked at them 14-20 days after first vaccination, and 7+ days after second dose:
- Documented infection was reduced by  46% (1st vax +14-20 days) and 92%(2nd vax +7 or more)
- Symptomatic Covid-19 was reduced by 57% and 94%
- Hospitalisation reduced by 74% and 87%
- Severe disease reduced by 62% and 92%
- Death from Covid-19 was reduced by 72% and 84%

Israel have vaccinated over 50% of the population, but they estimate they'll have around 10% vaccine hesitancy. The population is quite divided, and already some business and employers are saying they'll demand vaccination before people can enter their buildings.
The Israeli government a few days ago launched a 'Green Passport" for people who are vaccinated or recovered from COVID, which allows them perks such as theatre and concert entry, and access to gyms, hotels, and even synagogues.

The Dutch government have been to court over their 9pm-4.30am curfew, and it's been ruled as legal. They didn't actually stop the curfew at all, they just changed the law to make sure it was legal, but then won anyway. They also extended the curfew by at least three weeks, until March 15th at the earliest. Bit of a loss there for the protestors... 

"504,000 doses of COVID19 vaccine just arrived in Abidjan.
Côte d’Ivoire (Ivory Coast) has become the second country in Africa to receive the vaccines from the COVAX Facility."
Dr Tedros. Head of WHO.

Elizabeth Alexandra Mary Mountbatten-Windsor, or The Queen, as we usually call her, has a new vid out showing her zoom call with the UK Chief Medial Officers. She talked about having the vaccine, and how everyone coming together reminded her of the war. She said:
"It is obviously difficult for people if they've never had a vaccine, they ought to think about other people rather than themselves."
Well, if it's good enough for her...

After today's news that I live in the COVID capital of England, it makes more sense that I know so many people who have had COVID, suffered Long COVID, and lost people to COVID. I also don't feel so guilty for the 8 COVID tests my family have amassed so far.

Cases ARE still dropping in most areas. Vaccine news is brilliant - they DO stop the vast majority of transmission and asymptomatic COVID as well as saving lives. We knew it was too good to be true that everywhere else was struggling with the B117 variant and we were still universally winning. Fingers crossed we can turn round those pockets where it's rising, and if not, we really did buy ourselves some vaccination time...

Remember to treat yourself - you've earned it! Stay At Home, Be Kind To Yourself, Save The NHS.

Some numbers. All were once a coy smile from their mother:

Countries / Cases / Losses of life (since midnight GMT. In larger countries some states /provinces have yet to report today):

USA 29,071,385 (+19,123) 521,298 (+513)

India 11,079,094 (+16,056) 156,970 (+109)

Brazil 10,393,886 not yet reported today 251,661

Russia 4,223,186 (+11,086) 85,304 (+428)

UK 4,163,085 (+8,523) 122,415 (+345)

France 3,686,813 not yet reported today 85,582

Spain 3,188,553 (+8,341) 69,142 (+329)

Italy 2,888,923 (+20,499) 97,227 (+253)

Turkey 2,683,971 (+9,205) 28,432 (+74)

Germany 2,431,820 (+5,001) 70,277 (+274)

Mexico 2,069,370 (+8,462) 183,692 (+877)

Poland 1,684,788 (+11,539) 43,353 (+259)

Iran 1,615,184 (+8,103) 59,899 (+69)

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Sources:

https://www.worldometers.info/coronavirus/

https://coronavirus.data.gov.uk/

https://www.scotsman.com/health/coronavirus-in-scotland-young-childrens-return-to-school-based-on-biased-studies-says-epidemiologist-3141642

https://news.sky.com/story/covid-19-why-cities-are-falling-behind-in-the-uks-vaccination-race-12228718

https://www.cam.ac.uk/research/news/single-dose-of-pfizer-biontech-vaccine-reduces-asymptomatic-infections-and-potential-for-sars-cov-2

https://www.authorea.com/users/332778/articles/509881-single-dose-bnt162b2-vaccine-protects-against-asymptomatic-sars-cov-2-infection?access_token=-hDTQsMUXcCPSpdZV_Lmpg

https://twitter.com/10DowningStreet/status/1365255119261081600

https://www.gov.uk/government/publications/awarding-qualifications-in-summer-2021

https://twitter.com/_MiguelHernan/status/1364700315044438023

https://www.nejm.org/doi/full/10.1056/NEJMoa2101765

https://www.hsj.co.uk/coronavirus/staff-covid-vaccine-uptake-much-lower-in-london/7029581.article

https://twitter.com/DrTedros/status/1365296181086199810

https://twitter.com/RoyalFamily/status/1365231133466722307

https://twitter.com/i/events/1365246337759944704

https://www.youtube.com/watch?v=43zVlQwu7gE

https://publichealthmatters.blog.gov.uk/2021/02/23/covid-19-analysing-first-vaccine-effectiveness-in-the-uk/

https://www.theguardian.com/education/2021/feb/25/teachers-to-get-sweeping-powers-to-decide-exam-results-in-england

https://twitter.com/RoyalFamily/status/1365059142994509831

https://www.reuters.com/article/us-health-coronavirus-netherlands-court/dutch-appeals-court-says-coronavirus-curfew-was-right-move-idUSKBN2AQ1CC

https://www.reuters.com/article/us-health-coronavirus-israel-vaccinated/left-out-israeli-vaccine-refuseniks-fear-exclusion-as-economy-reopens-idUSKBN2AQ0XO

https://www.jpost.com/israel-news/everything-you-need-to-know-about-israels-green-passport-program-659437

https://www.csmonitor.com/World/2021/0226/Israel-s-green-passport-raises-concerns-about-discrimination




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