Vaccine rollout in the UK

[raven]

ETA: the other key stat is the number first dosed as at 3 Jan 2021, which was 1.1 million. These will start coming in for second jabs during March - but not such a large figure that will materially change the above basic maths. There's another 1.3 million first doses in the week beginning 4 Jan 2021 which is when the proper program started up. So there's around a week's worth of second doses that will need to be done by 31 March at the current 2.6m pace.

Have you factored in to those numbers the 469,000 odd lucky people who've had their second vaccine already? (Most of them seem to have got it in second week of Jan according to the gov figures.)

Millennie Al said: Lives saved or years saved? What if different people disagree? Is it ethical to impose our ethics on others?

Someone has to make the decision. That's what we elect leaders are for. Or in this case, the JVCI.

UK strategy is initially based on reducing deaths/hospitalisations and thus strain on the NHS. According to the UK plan (here), dosing strategy for Phase 1 is protecting the greatest number of at-risk people in the shortest possible time; for
Phase 2 it's achieving protection of the whole UK population from COVID-19.

Phase 1 is all the vulnerable and everybody over 50. Phase 2 is all other adults, and:

Phase 2 of the roll-out may include further reduction in hospitalisation and targeted vaccination of those at high risk of exposure and/or those delivering key public services.

So they are thinking of prioritising essential workers. I think the sort of vaccinating Millennie Al is talking about, vaccinating a firebreak around case, isn't going to work because you really need to know where cases are to do that sort of thing. Even if the sheer munbers of cases we've got wasn't making tracking& trace too difficult for that, there's the problem that - and afaik this hasn't changed since the beginning, someone correct me if it has - testing misses about a 1/3 of positives. Whether that's asymptomatic cases or false negatives, I'm not sure.

The plan also says this about second doses during Phase 1:

... for every 1,000 people boosted with a second dose of COVID-19 vaccine (who will as a result gain marginally on protection from severe disease), 1,000 new people do not benefit from substantial initial protection which is in most cases likely to raise them from 0% protected to at least 70% protected. These unvaccinated people are far more likely to end up severely ill, hospitalised or in some cases dying without vaccine. Halving the number vaccinated over the next 2 to 3 months because of giving 2 vaccines in quick succession rather than with a delay of 12 weeks does not provide optimal public health impact. Operationally this means that second doses of both vaccines will be administered towards the end of the JCVI recommended vaccine dosing schedule of 12 weeks. This will maximise the number of people getting the vaccine and therefore receiving protection within the next 12 weeks.

[lpm]

ETA: the other key stat is the number first dosed as at 3 Jan 2021, which was 1.1 million. These will start coming in for second jabs during March - but not such a large figure that will materially change the above basic maths. There's another 1.3 million first doses in the week beginning 4 Jan 2021 which is when the proper program started up. So there's around a week's worth of second doses that will need to be done by 31 March at the current 2.6m pace.

Have you factored in to those numbers the 469,000 odd lucky people who've had their second vaccine already? (Most of them seem to have got it in second week of Jan according to the gov figures.)

Meh. This is just playing around with a day's worth. 350k first doses today.

I've been taking round weeks, have called March 28 days. Looks like we'll beat the 15 Feb target by 2 or 3 days and my 31 March estimate has similar cushion. It all depends on % take up of the vaccine and how that drops as we go down the cohorts. Presumably vaccine refusers will be well correlated to age. Maybe 95% at 80 year olds, 90% for 70s, down to 80% for 50 year olds? Nobody knows.

But whatever, the govt's published target of "spring", or "end of April" which I think came from a verbal interview, is easily too prudent. Even my target of 31 March is comfortable. The entire program will be done by 30 Sept, maybe even 31 Aug if you don't chase after young refusers with a needle.

I suspect people will be still debating various priorities while the NHS gets on and delivers it. Some academic committee will recommend doing teachers before 40-50 year olds and the NHS will have to break it to them that they've already done 40-50 year olds, teachers and taxi drivers.

[Millennie Al]

I think the sort of vaccinating Millennie Al is talking about, vaccinating a firebreak around case, isn't going to work because you really need to know where cases are to do that sort of thing.

I'm thinking of big chunks. So, for example, you might vaccinate lots of people in Scotland before moving on to Wales, and then England on the grounds that if you vaccinate enough people in one area (maybe 30%-50% if other measures are maintained) you can eliminate the virus in that area which protects all of the people there, thus magnifying the effect of your vaccine. If you instead spread it out evenly you only protect the people actually vaccinated for much longer.

[nezumi]

I have my first vaccine on Monday! I'm bizarrely excited, even though I know I'm not protected til jab 2 and that there are a lot of new variants that make it potentially less effective.

Still... Eeeeeeep!

[lpm]

Excellent! But you will be almost completely protected from death and serious illness two to three weeks after your 1st jab. No need to be excessively cautious.

I think the way to look at it is that the 1st dose takes you down two notches on the seriousness scale, the 2nd dose takes you down a third. If it's currently:

1% death
15% hospitalisation
30% pretty ill at home like flu
30% mildly ill at home like a cold
25% no symptoms

then at the start of March your chance of death has been downgraded to ill at home. While what previously was the risk of hospitalisation becomes the risk of being mildly ill:

0% death
0% hospitalisation
1% pretty ill at home like flu
15% mildly ill at home like a cold
84% no symptoms

The 2nd jab will then take you to the worst 1% case being mildly ill and highly likely to never be noticeably ill.

Obviously tiny risks will still exist, same as crossing any road. But while you are now avoiding crossing any roads and staying in as a result, after the 1st jab it's more like being able to cross roads but being extra careful while doing so?

[nezumi]

Does that mean I can do my own shopping? Because boy do I miss being able to go grab a bottle of wine at the drop of a hat.

[lpm]

I'm not a medical adviser but I'd guess the first jab puts you into the risk category I'm now in.

I go to the supermarket - but always wear a mask, use hand sanitiser, keep my distance from Homo sapiens and pangolins, and I go weekdays at 8 pm when it's really quiet rather than Saturday morning. Freedom, but exercised cautiously.

Plus the cases are raging out there right now, but hopefully by 1 March when your 2/3 weeks wait are up there will have been a halving and then another halving of cases, bringing the risk of catching anything well down. In April - assuming the govt holds out with most of the lockdown instead of chucking our progress away - we could be down to 1,000 official cases a day from the 60,000 peak.

[headshot]

As LPM says, if you reduce your risk by using several layers of mitigation, it becomes so low as to not be reasonable to not do things.

Consider your actions this time last year. Cases were raging then too. Did you go shopping then? With mask, sanitiser and distancing, you’re taking way less risks than you did when you weren’t informed.

[Tessa K]

Good to know that Matt Hancock gets his vaccine strategy from Hollywood rather than, say, from medical experts.

https://www.bbc.co.uk/news/uk-55917374

[Sciolus]

He'd be much better off getting the cabinet together and playing the board game.

[FredM]

Good to know that Matt Hancock gets his vaccine strategy from Hollywood rather than, say, from medical experts.

https://www.bbc.co.uk/news/uk-55917374

Good job he hadn't watched Outbreak instead, the monkey search would still be under way.

[basementer]

He'd be much better off getting the cabinet together and playing the board game.

Let's send him a copy of Pandemic: Reign of Cthulhu. He might go on LBC and talk about shoggoths.

[shpalman]

What about I Am Legend?

Anyway, senior government sources believe that every adult will have had two doses of coronavirus vaccine by the end of August but Chris Whitty apparently doesn't.

[Fishnut]

My neighbour (the one on long-term chemo) has been given an appointment for her first vaccination, my mum's partner has got his tomorrow and both parents of a friend of mine get their first doses on Friday. From my limited view they seem to be doing a really good job of getting this rollout done.

But I find that rather than making me happy it makes me really angry because it shows that the ability to handle the pandemic capably has always been there, it's just the government ignored the vast wealth of competence and experience in favour of letting their mates profit off the destruction of people's lives.

[raven]

I think the sort of vaccinating Millennie Al is talking about, vaccinating a firebreak around case, isn't going to work because you really need to know where cases are to do that sort of thing.

I'm thinking of big chunks. So, for example, you might vaccinate lots of people in Scotland before moving on to Wales, and then England on the grounds that if you vaccinate enough people in one area (maybe 30%-50% if other measures are maintained) you can eliminate the virus in that area which protects all of the people there, thus magnifying the effect of your vaccine. If you instead spread it out evenly you only protect the people actually vaccinated for much longer.

Wouldn't you need more than 50% coverage to eliminate it completely? And people do this annoying thing called travelling.... Plus if you did Scotland first, everybody in England, Wales and NI would be up in arms at having to wait. At least this way it's everybody at highest risk first.

[Millennie Al]

you might vaccinate lots of people in Scotland before moving on to Wales, and then England on the grounds that if you vaccinate enough people in one area (maybe 30%-50% if other measures are maintained) you can eliminate the virus in that area which protects all of the people there, thus magnifying the effect of your vaccine. If you instead spread it out evenly you only protect the people actually vaccinated for much longer.

Wouldn't you need more than 50% coverage to eliminate it completely? And people do this annoying thing called travelling....

50% is enough if R < 2 due to social distancing and other measures. And you stop that annoying thing! You need to act like Australia where the newly uninfected area is kept that way by extensive boundary measures such as quarantine.

Plus if you did Scotland first, everybody in England, Wales and NI would be up in arms at having to wait. At least this way it's everybody at highest risk first.

That's where you get to decide whether you prefer saving lives or being fair.

[Millennie Al]

Good to know that Matt Hancock gets his vaccine strategy from Hollywood rather than, say, from medical experts.

https://www.bbc.co.uk/news/uk-55917374

From the article:

Contagion was made in the hope that it might prevent a future worldwide pandemic like coronavirus, according to epidemiologist Dr Ian Lipkin.

He was the scientific adviser for the film and he said it took a "long time to try and get all the details as accurate as we possibly could make them".

so it was, albeit indirectly, from a suitable medical expert.

[PeteB]

How Soon to See the Vaccine's Benefits?

[lpm]

That's a useful chart, but I think a bit optimistic on early progress - I think the lags are bigger than they think. There's 14 days for jab to be effective. Then for a non-jabbed person a lag after an infection of about 5 days to symptoms, another 5-10 till hospitalisation, another 5-30 days till death. So at least 30 days and more like a month and a half, with the main rollout starting from 4 Jan.

So we shouldn't expect even the first hints until the end of this week, more realistically late Feb for a clear signal. But then it will happen very fast.

I don't think people are prepared for the fact that the population with 88% of deaths will be 1st dosed by 15 Feb, which means 88% of the death rate will vanish from the stats by the end of March. The IFR is going to come plummeting down.

Those charts from James Annan are about to look weird - the deaths one will dive downwards while cases follow a more normal trajectory. I think his methodology is about to be screwed up, with it easy to imagine rising cases vs sharply falling deaths.

[raven]

50% is enough if R < 2 due to social distancing and other measures. And you stop that annoying thing! You need to act like Australia where the newly uninfected area is kept that way by extensive boundary measures such as quarantine.

Yeah, but there's no evidence so far that Johnson's lot have the political will to impose the strict lockdown/containment measures you'd need to get your region-by-region vaccination plan to work so it's all a bit moot. I mean poor Yvette Cooper has been banging on about proper quarantine measures for international travellers for months, and they've only just got round to proposing that, and even now not sorted out the details.

But countries like Australia and Taiwan, yeah, they could do area by area if they wanted to.

[raven]

I don't think people are prepared for the fact that the population with 88% of deaths will be 1st dosed by 15 Feb, which means 88% of the death rate will vanish from the stats by the end of March. The IFR is going to come plummeting down.

Those charts from James Annan are about to look weird - the deaths one will dive downwards while cases follow a more normal trajectory. I think his methodology is about to be screwed up, with it easy to imagine rising cases vs sharply falling deaths.

That'll be good, and doubly good if there's a big drop off of hospitalisations too. Then we've just got to hold our nerve while the rest of us get vaccinated.

In other good news, I'm hearing of shielders getting called up now although it's patchy. And my brother-in-law is getting his jab next week. He's not even 40 yet, but he's asthmatic so I guess he's in that 'clinically vulnerable' group. His area is really on the ball, racing through the groups.

[mediocrity511]

Our area is cutting it fine with the first 4 groups deadline. CEV OH got his appointment booked today but it isn't until 13th of February.

[Blackcountryboy]

All the teachers and TAs where my daughter teaches have been told to get their vaccinations. It is Special Needs (School for Autistic Children in Birmingham). She understands that Birmingham have decided to push Teachers in Special Education up the queue because of the problems of maintaining social distancing with special needs children. Some of the school staff have had their vaccination.

[headshot]

[my brother-in-law is getting his jab next week. He's not even 40 yet, but he's asthmatic so I guess he's in that 'clinically vulnerable' group. His area is really on the ball, racing through the groups.

Is he in a shielding group, or chronic asthmatic in group 6?

Frau HS is in the latter group.

[Blackcountryboy]

I have a friend who had Car T-cell therapy couple of years ago, it was horrible and left him with his immune system shot to pieces. He had his first vaccination yesterday. He is 56.