Tuesday 14 September 2021

COVID-19 Coronavirus UK and World News Update and COVID Response: Autumn And Winter Plan UK Briefing 13th / 14th September 2021

COVID-19 Coronavirus UK and World News Update and COVID Response: Autumn And Winter Plan UK Briefing 13th / 14th September 2021

UK Daily Statistics:
Cases: 7,282,810 (+26,628)
In Hospital on Monday 13th: 8,413
Using A Ventilator on Monday 13th: 1,056
Losses of Life: 134,446 (+185)
Tests: 1,043,118
Vaccinations 1st Dose: 48,458,700 (89.2% of UK 16+)
Vaccinations Fully Vaxxed: 44,108,746 (81.2%)

Rep. Of Ireland: 367,536 cases and 5,155 losses of life (not yet reported today)

World: 226,367,764 reported cases and 4,657,189 losses of life.

140921 UK Briefing slides 2020 compared to 2021

"You have to take it as it comes. I think anybody that can say, with confidence, they know how this is going to work over the next few months, has not fully understood, I think, the range of possible ways this could happen."
Chris Whitty, Chief Medical Officer for England. 

As I reported yesterday, children in the UK aged 12 and over WILL be offered a COVID vaccination, initially a single dose of Pfizer/BioNTech vaccine.
"The NHS, working with school immunisation teams, will offer a first dose of vaccine to 12-15 year olds from next week, the week commencing 20 September."

At the UK Data Briefing this morning with the JCVI and Jon Van Tam, they recommended a UK Booster Programme should go ahead - and EVERYONE over 50 should be invited to receive a dose of mRNA vaccine, either Pfizer BioNTech (1 full dose) or Moderna (half dose in trials works just as well).
This is in addition to Booster Doses for our most vulnerable people, who will probably have already started receiving your invitations - vaccinations for you guys start next week too.
Booster doses should be no earlier than 6 months after the 2nd dose, deployed in the same order as original vaccinations. This should mean our most vulnerable people's protection is highest over Winter.
I'm honestly really impressed with this. Research clearly shows a booster of a different jab REALLY boosts immunity and helps with variants. It's an incredibly prudent move by the UK Government. The vast majority of over 50s will have already received 2 doses of Oxford AstraZeneca.
If you already had 2 doses of Pfizer, don't be disheartened, a 3rd mRNA booster will also greatly improve your immunity, and reduce your chances of catching, transmitting and becoming very ill with COVID.
If you can't take mRNA vaccines, a 3rd dose of AstraZeneca will also boost your immunity by a significant amount.
This is not the beginning of a regular 6 monthly vaccination, it is an ongoing changing situation.
Younger people may not need booster doses, as their protection should remain high over Winter.
No-one will be penalised for not accepting a booster dose (2 doses is fully vaccinated).
Please do NOT forget other vaccinations, or think they aren't important - it is safe to have your COVID and flu vaccinations on the same day (although I guess you're likely to feel a bit washed out for a few days afterwards!).

140921 UK Briefing slides positive tests compared to this time last year

And just to bring you back down to Earth with a bump, the World Health Organisation Press Briefing today was, as usual, about vaccine equity. There are now enough vaccines for everyone on the planet, yet only 2 African nations have vaccinated more than 40% of their populations. Over the whole of Africa, only 3.5% of people are vaccinated.
“More than 5.7 billion doses have been administered globally, but only 2% of those have been administered in Africa”
Dr Tedros.
There is some good news. Finally vaccine deliveries for COVAX and poorer nations are coming through more quickly, and they should have 20% coverage for the 90 poorest nations by the end of this year - meaning healthcare workers will at least be vaccinated. 

"More than half NHS hospitals operating at ‘unsafe’ occupancy levels" is the latest story in the Health Services Journal. The headline probably covers it (and its not about to improve any time soon). Our hospitals are very busy, and some haven't had a break from that pressure for a long time. 

The UK have cancelled their contract for Valneva to produce 100million doses of vaccine. Now this is the vaccine that was due to be made in Livingston, Scotland, and the plant has recently expanded, but its future is now in doubt.
Please please let this not be political fighting between Boris and Nicola, because if it is, it's in very poor taste. The contract has been very quietly cancelled - Valneva are the ones who have broken the story, in a press release where they refer to themselves in the 3rd person:
"Valneva SE, a specialty vaccine company, today announced that it has received a termination notice from the UK Government (“HMG”) in relation to the Supply Agreement for its COVID-19 vaccine candidate, VLA2001. The contract provides HMG with the right to terminate. HMG has alleged that the Company is in breach of its obligations under the Supply Agreement, but the Company strenuously denies this."
Valneva's vaccine may no longer have a buyer, but it is still going ahead and in UK trials, with results likely in a month or so. It targets the whole virus, so the hope is it'll be good at fighting a range of variants.
It might make an excellent booster actually. Fingers crossed.

140921 UK Briefing slides in hospital compared to this time last year

We know that many countries under-report COVID deaths, some COVID-related deaths in the UK are NOT reported as COVID, and some people have COVID on their death certificate when they would have died without catching COVID. The figures will never be 100%.
Monday's updated ONS data release has been adjusted to account for age - Age standardised mortality rates or ASMR. This is generally more accurate, because it's a better comparison of 'like for like'.
The data shows that actually being in the UK and fully vaccinated makes you 10 times less likely to die from COVID than someone who is unvaccinated.
Excellent news - and it sits nicely with other studies. Around 10% seems to be a recurring number.
Very interestingly the ONS data also shows that using ASMR, deaths from NOT COVID were 75% higher in unvaccinated people.
So... are we under-reporting COVID-related deaths? Or does being vaccinated make you super human? Or is it simply down to the fact that, ignoring age, the people most likely to die from an earlier death are also the people least likely to go and get vaccinated?
If you are deprived, poor, Asian or black, you are less likely to be fully vaccinated than a rich white person. This thing is free, easily accessed and you don't even need to give your real name. Book it. 

13% of people who have been fully vaccinated and still died from COVID in England and Wales were immunocompromised.

Only 59 fully vaccinated people without serious health conditions died from Covid-19 in England this year.

"Latest Public Health England (PHE) estimates suggest that 143,600 hospitalisations (up to 22 August), 112,300 deaths and 24,702,000 infections had been prevented as a result of the vaccination programme, up to 27 August 2021"
UK Gov

140921 UK Briefing slides deaths compared to this time last year

Today's briefing is to announce the UK COVID Response: Autumn And Winter Plan, which helpfully was published earlier today. Here's a summary:
The country is learning to live with COVID-19, and the main line of defence is now vaccination rather than lockdown, with Test & Trace keeping numbers down. We are expecting a rise in cases, despite them already being substantially higher than at this point last year.
Over autumn and winter, the Government will aim to sustain the progress made and prepare the country for future challenges, while ensuring the National Health Service (NHS) does not come under unsustainable pressure. The Government plans to achieve this by Plan A:
a. Building our defences through pharmaceutical interventions: vaccines, antivirals and disease modifying therapeutics.
b. Identifying and isolating positive cases to limit transmission: Test, Trace and Isolate.
c. Supporting the NHS and social care: managing pressures and recovering services.
d. Advising people on how to protect themselves and others: clear guidance and communications.
e. Pursuing an international approach: helping to vaccinate the world and managing risks at the border.

In case Plan A doesn't work out, we have a Plan B:
"SAGE and SPI-M modellers now deem the most pessimistic scenarios in the step 4 modelling to be unlikely, except in the case of a new dangerous Variant of Concern or significant waning immunity. However, there remains considerable uncertainty and scenarios which place the NHS under extreme and unsustainable pressure remain plausible. As a result, the Government must continue to monitor the data and prepare contingencies."
The Government’s Plan B prioritises measures which can help control transmission of the virus while seeking to minimise economic and social impacts. This includes:
a. Communicating clearly and urgently to the public that the level of risk has increased, and with it the need to behave more cautiously.
b. Introducing mandatory vaccine-only COVID-status certification in certain settings (all nightclubs, indoor 500+, outdoor 4,000+ close setting, outdoor 10,000+ any size/space).
c. Legally mandating face coverings in certain settings.
The Government would also consider asking people once again to work from home if they can, for a limited period. The Government recognises this causes more disruption and has greater immediate costs to the economy and some businesses than the other Plan B interventions, so a final decision would be made based on the data at the time.

The last part is the legal stuff. The following are the parts of the Coronavirus Regulations which they want to extend until 24th March 2022:
a. The Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) Regulations 2020, which impose legal requirements to self-isolate on positive cases and unvaccinated close contacts. Self-isolation will remain crucial in breaking chains of transmission throughout autumn and winter.
b. The Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020, which enable local authorities to respond to serious and imminent public health threats.
c. The Health Protection (Coronavirus, International Travel and Operator Liability) (England) Regulations 2021, which impose testing and quarantine requirements on arrivals in England, will remain

140921 UK Briefing slides inpatient admission by age and vaccination status

And today's UK Briefing was with Boris, Chris the English Chief Medical Officer and Patrick Vallance, the UK Science Chief. . Boris' Mum died yesterday. I'm genuinely sorry to anyone who lost a parent yesterday, especially if you had to carry on as if it didn't happen.

Boris started by giving us updates on how well the vaccination programme is going, preventing hospitalisations and deaths. He said we should still remain cautious - wear masks in busy places, distance, don't go mad visiting everyone etc.
He reminded us how many vaccines the UK will give to COVAX over the coming months.
Then Boris basically covered everything I wrote about above. He said we don't see a need for the COVID passports at the moment, and we are confident we shouldn't need to bring in restrictions, but there is a need for a plan B.
Chris Whitty did the slides. "A gradual drifting up", "a general upward trend". He expects the numbers to go up as we head into colder weather.
Slides show the differences in hospitalisations and cases compared to this time last year. We have a lot more cases, but considerably less percent are in hospital. Even so, we also have a lot more people in hospital, and are losing more people than the same time last year - Chris says we can go ahead because last year that growth would have been exponential, this year the vaccinations shouldn't let that happen unchecked.
There are slides showing the risk ratios by age depending on whether you are vaccinated or not. It's stark.

Press asked what thresholds do the Government have for deciding we need Plan B? Boris said Plan B has several 'shots in the locker' and you wouldn't just do everything at once. Patrick talked about vaccines. Chris came along with some sanity and said we need to keep an eye on what's happening, and that we don't suddenly have an increase. (I think the answer is 'we'll play this one by ear'.)

Press asked why we don't take 'mild suppressive measures' now, to avoid overwhelming the NHS later?  Boris talked about vaccines, and said we are still encouraging everyone to be sensible. Chris says we actually ARE taking measures, most of us are being sensible and cautious, and we've improved things like ventilation.

Patrick talked about Booster jabs - The people who seem to have waning protection from their original vaccinations are the ones with lowest immunity and largest chance of becoming very ill, so giving them boosters is saving lives. Pat and Chris both explain that we can't simply decide to send our doses of -70degrees Pfizer vaccine to Africa, logistics won't work.

"It's a very bad variant, and that's the reason we've had such trouble in the last year, as has every country around the world. We have not faced a Winter with the Delta variant, so it is possible that the combination of Winter events plus the Delta variant, which is highly transmissible.... could trigger all or some of Plan B."

Press asked about Nikki Minaj, who has been sharing some fantastic COVID disinformation today. Apparently her cousin's friend ('s hairdresser's dog walker's neighbour) has discovered he is unable to father children, and has felt the need to find something to blame. Chris said;
"There are a number of myths that fly around, some of which are just clearly ridiculous and some of which are clearly designed just to scare. That happens to be one of them."
First time I've heard the whole room laugh... 

140921 UK Briefing slides deaths by age and vaccination status

Researchers as UAMS (University of Arkansas for Medical Sciences) investigating Long COVID have discovered that a really disruptive antibody can show up weeks after initial infection.
This antibody attacks and interferes with angiotensin-converting enzyme 2 (ACE2). This enzyme helps regulate your immune system, so disrupting it means the body isn't fighting the right thing.
The researchers compared 67 previously infected patients and 13 with no history.
81% of blood samples from previously infected patients had the antibody.
None of the samples from people who hadn't had COVID contained the antibody.
We don't know exactly how it occurs, but we know that some people have heart, lung and other organ damage after COVID that can be seen and measured on scans. Now we have another measurable effect that really could be responsible for causing harm, and preventing recovery.
So never again should anyone say Long COVID is imaginary. I'm bored of that.

If you have an Apple product then there is an emergency update to prevent known spyware. Users of iPhone,  Mac and Apple Watches are being urged to install it - now would be a good time if you've been ignoring it already.

The deadline for first jabs for people who work in older adult care homes is approaching. Someone asked how many hadn't yet been jabbed?
There'll be fresh numbers later this week, but up until the 9th September there were 467,656 older adult care home staff, of whom 462,048 were eligible, and 424,686 of those had received at least 1 dose = 91.9% coverage. 386,401 had received 2 doses = 83.6%
If you enter an older adult care home, as staff or as a volunteer (e.g. hairdresser, podiatrist, electrician, community arts etc.), and haven't yet been jabbed, you have 2 days! First jabs should be in by 16th September so that you are fully vaccinated by the 11th November cut off.  

The news of UK teenagers being vaccinated was big in my home. My children's greatest fear has always been that they would catch COVID and pass it on to someone who would die. Young as they may be, they fully understand survivor guilt, and they have enough of it already. That massively influences their feelings. They are also well aware of several people we know with Long COVID. The idea of being vaccinated (for the 11 year old probably not until next year) brings them a large degree of comfort.
The 4 UK Chief Medical Officers made it clear last night that no child should feel singled out for either being vaccinated or not being vaccinated.
You have not lived someone else's life. They may be really keen, a little hesitant, really scared. They may believe the hoaxes that vaccines make you magnetic, or they might be Trump-style, willing to try anything, fully tested or not. But you can't know all the reasons why they reached that point, so you can't really judge them for it.

No numbers or people today because it took long enough and I ran out of time (and space)! I have a nice dahl simmering... Back Thursday...






















Data Briefing: 



Boris Briefing:





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