Monday 12 July 2021

Boris Is Going For It. England Briefing 12th July 2021

Boris Is Going For It. England Briefing 12th July 2021

Cases: 5,155,243 (+34,471)
Loss of Life: 128,431 (+6)
In Hospital on Thursday 8th: 2,731
Using a Ventilator on Thursday 8th: 417
1st Dose: 45,923,721 (87.2% of UK adults)
2nd Dose: 34,872,131 (66.2%)

120721 England Briefing hospitalisations across time

I know this will be mentioned at the UK Briefing today, so I'm covering it now. 
On Sunday night the England football team reached their first major final in 55 years - an excellent achievement. 3 very young English men, who are far better footballers than 'Dave from down the pub' ever will be, stood in front of millions of people and failed to score a penalty goal. Rather than tell them "you did grand, be proud of where you are, 3 years to practise and mature your skills, see you again for the next one", the UK felt determined to try and put them all off football for life, by abusing them online and bringing out the very worst and most disappointing racism and hatred.
They even daubed racist insults on the mural of Marcus Rashford in Withington, which was painted to say 'thank you' when he secured 3m British children free lunches when they weren't in school during the pandemic, and raised over £20m to provide food to struggling families.
And did it make anyone feel better?
Many, MANY people are pointing out that the UK is purportedly led by someone who refused to condemn booing of football players 'taking the knee' before matches, has previously referred to black children as piccaninnies" and said Muslim women wearing burkas "look like letter boxes".
Everyone is responsible for their own actions, but leadership starts at the top, and our 'top' repeatedly sets a ridiculously low bar. If he says anything ridiculously hypocritical, I may not be able to maintain my air of complete politeness.  

120721 England Briefing hospitalisations and vaccinations

Today's UK Briefing was with the long time racist, and bumbling ex-journalist, Boris Johnson. Alongside, as it was a very important briefing, were Sir Patrick Vallance, the UK's Chief Scientific Adviser, and Chris Whitty, England's Chief Medical Adviser.
I honestly can't imagine how this is going to play out....

Boris starts by discussing the football. He reminds us they've done the best in any tournament "that I can remember". Then he says to the racists  "shame on you"! "I hope you crawl back under the rock from which you emerged."
Yes! I agree. 100%. Hey, he said it...

120721 England Briefing hospitalisations and vaccinations dose 1 and 2

"We've come to a stage in the pandemic where there is no easy answer and no obvious date for unlocking. We have cases rising significantly, with more than 30,000 per day, and we can see what is happening across Europe, as the Delta Variant takes hold among our friends.
We know that we are going to see more hospitalisations and more deaths from COVID, but we also know that this wave was clearly foreseen by our scientists when we first set out that roadmap in February. And if anything so far, we are in the middle range of their projections for infections, and at the lower end of their projections for mortality.
And we also know now that if we were to delay this 4th Step, for instance until September or later, then we would be reopening as the weather gets colder, and as the virus acquires a greater natural advantage - and when schools are back".
Here it comes...
"So, we think NOW IS the right moment to proceed. When we have the natural firebreak of the school holidays in the next few days. But it is absolutely vital that we proceed now with caution, and I cannot say this powerfully or emphatically enough..."
(So really remember this part.)
"This pandemic is NOT over. This disease, Coronavirus, continues to carry risks for you and your family. We cannot simply revert instantly from Monday 19th July to life as it was before COVID.

120721 England Briefing comparing waves with current situation

We will stick to our plan to lift legal restrictions, and to lift social distancing, BUT, we expect and recommend that people wear a face covering in crowded or enclosed spaces, when you come into contact with those you don't usually meet, such as on public transport."
The Government instruction to 'Work from home when you can" is being removed, but they don't expect everyone in the office on Monday, they want a gradual return.
Nightclubs and similar can reopen, but they ask them to make use of the NHS COVID pass to prove natural or vaccinated immunity.
They ARE updating the advice for the clinically extremely vulnerable.
(I hope it's good because right now they must feel like they are looking into the abyss...)
They are asking everyone to think of others as well as yourselves.
The "tough border policy" (lolz) will remain in place, including quarantine from Red List countries.
The Test, Trace and Isolate system will stay in place. 

120721 England Briefing vaccinations chart

Because they delayed by 4 weeks, 7m more jabs have been administered.
By next Monday, 2/3 of adults will have received a second dose, and EVERY adult offered a first dose.

Boris reminds us it's really important to be cautious, and "get that jab".

Chris with the slides. He can barely speak, his mouth is a sandpit.
Vaccines are going well. He shows estimated vaccine efficacy against Delta Variant.
(After the briefing I dug around. The 'ranges' are actually AstraZeneca -Pfizer&Moderna)
After 1 dose chance of symptomatic infection is reduced by 32-38%
After 2 doses it is reduced by 78-80%
(That is excellent. And I'll be honest, it's higher than some other figures I've seen.)
After 1 dose chance of hospitalisation is reduced by 69-88%
After 2 doses it is reduced by 91-98%
(Also excellent, AND I'm happy to report, more similar to other figures.)
On 8th July 2,731 people were in hospital with COVID. That is still far below the Autumn/Spring peak. 

Chris explains that case numbers are at a similar trajectory to Autumn last year. Hospital admissions are still rising, at a much lower, but still exponential rate. Deaths again, even lower, but still exponential.
'The key point is when will it reach peak and turn over?'

"If we go slowly with the next stage of the road map, the expectation is this will not reach the point where it is putting unsustainable pressure on the NHS."

He repeats Boris' point that we WILL have more hospitalisations and more people will die.
Chris says Delta Variant isn't posing more of a risk to us, and nor are any of the other known variants we're looking at, so we have passed that test. (Erm... hurrah?)

The World Is Looking At Us With Disbelief Ravi Gupta Oxford University co the Financial TImes
image: Financial Times

He summarises scientific and medical opinion in support of what has been said.
- There is very wide agreement that the 4 week delay we've just had would have a big difference in hospitalisations and deaths.
- There is extremely wide agreement that whenever we go through the next step, there will be an "Exit Wave". The more slowly we do this, the lower the wave, the less pressure on the NHS. (The less chance we overwhelm the NHS I think Chris.). The less people catch COVID overall and the less people will die. (True that. If we overwhelm, we could lose 14-17% of hospitalised people.)
- The thing they aren't entirely agreed on is the right date.
Chris stumbles and suggests we are making use of the Summer holidays and trying to avoid Winter. There is no clear evidence that going at a different time would have a better outcome.
(There won't be any clear evidence though, will there? That's fairly obvious, and as timing for something like this goes, it has a logic.)
He reminds us the evidence on vaccinations is overwhelming. 

Public asked what sort of measure would be used to decide if restrictions come back? Boris says obviously we rule nothing out. If an extreme circumstance arises, we will do something.
(Press asked again later, and there are no figures or 'cut off point'. We'll just assess the situation.)
Pat agrees. He talks about monitoring, and he also reminds us epidemics 'double', so you have to think ahead. 

Public asked will being double-vaccinated prevent you passing on the virus?
Pat talks about Alpha Variant (pointless. I can tell you about chicken pox if you like?). Pat and Chris summarise that roughly 1/4 of people can still pass it on. Pat says the likelihood of you giving it someone else is reduced by 95% because you won't be as likely to catch it. (Possibly useful if you want to think about how much more safe visiting your Nan might be.)

Press asked about hospital staff not self-isolating. Chris says we have to balance risks. We need staff in hospitals. Not really an answer.
He looks shattered. I don't think he's slept since the last briefing (or the slapdown from the World Health Organisation). 

Lots of repeats of "cautiously". It is definitely todays' buzz word. I think they are twitching. They don't want everyone running for it from the off... Modelling must show more people are likely to be hospitalised than they previously expected. 

120721 England Briefing background vaccine Delta efficacy figures

Press said we aren't really a nation which are very good at following caution, we're used to following rules. Boris again says they want us to have responsibility. (I bet you do!)
More press asked, what should we do after July 19th then? Should we behave as we have been doing? Should we go to nightclubs that are reopening, festivals, mass events etc?
Boris says we shouldn't go mad. "Don't be de-mob happy about this." Think of others as well as yourself. He mentions shielded and highly vulnerable people - which is nice. I'd hate to think he'd forgotten you.
Boris again says "if we waited until September". To be honest Boris, most of the world is stunned you've decided to go for it at all full stop. That's the comparison I want, not a comparison with a mythical September option. 

Pat reminds us you MUST self-isolate if you test positive. If you have symptoms, get a test. Give ventilation priority. 

Press have now had some moments to read the data that's been released while this briefing is happening, and ask about the timing and the expected loss of life this will entail. Boris says "there isn't an optimal time" and then flusters a lot. 

Chris talks about Winter respiratory viruses. He says a 'reopening surge' is expected and isn't necessarily anything Ministers would do anything about, and the same for Winter viruses.

Richard Horton, Editor the Lancet and herd immunity by transmission

All day long the has been a 'last gasp' effort (using Boris' hilarious joke there) by medics and health journalists to get across the fact that what the UK are doing is very risky. And not very fair. 

According to Journalist Rebecca Thomas - Sandwell and West Birmingham NHS Trust have had to open up covid-19 wards again, and cancel some other care, including Cancer operations. They had "50 inpatients with COVID and 8 in ICU last week", and University Hospitals Birmingham are "having to seek mutual aid for Cardiac cases due to strained ICU staffing capacity". 

Sarah-Jane Marsh, Chief Executive of Birmingham Women's and Children's NHS Foundation Trust:
"Time to stand our Covid system response back up due to the numbers of patients in general and ITU beds across our city. No one has the physical or mental resilience for this wave but its here, and so we must find some inner strength to start again."

Professor Mel Pickup from Bradford Teaching Hospitals:
"Additionally, whilst our inpatient numbers currently are lower (but growing) it’s very much the case that they are sicker & a younger cohort. 50 % of all our inpatients are either on high levels of CPAP or ventilated in ITU."

Dr Teresa Kelly, Greater Manchester:
"Those small numbers include pregnant women who have a low rate of uptake of vaccination and an increased risk of complications. With staffing short in maternity services even a small number of women with Covid can stretch the service."

The Financial Times:
"Other countries are also struggling. Israel — seen as an exemplar for its vaccination campaign — has reintroduced mask wearing indoors, while some US states are experiencing an alarming resurgence of the virus."

Sarah-Jane Marsh, Chief Exec Birmingham Women's & Children's NHS Trust:
"I understand the sentiment that hospital admissions are relatively small so the NHS should “just cope”, but health care systems are finally tuned to meet the patterns of need they have historically experienced and these additional patients are tipping an already delicate balance."

My thoughts really are with medical staff, many of whom haven't had the luxury of time off from this. In several areas around the country COVID wards barely closed. I honestly can't begin to appreciate how you must be feeling right now. I'm so sorry. 

Also in my thoughts are people who are very vulnerable to COVID. People with lowered immunity, people who can't make antibodies, people who can't be vaccinated. Never think you don't have value. You really REALLY do.

I feel I've said it so long, but we really have come so far. This day was inevitable really, and thanks to the vaccinations we will, hopefully over 99.5% of us, get through this unscathed. It's a wild move, and their maths had better not let us down, but hey. It could even work.

It's going to get bumpy, and possibly really bumpy... you might need a coat.
Back tomorrow with the regular news... 



Dr Tee - image -

Ravi Gupta image:

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