Coronavirus

[Dave2002]

We have all been wondering how and when the vaccinations will impact on cases and deaths. Someone (whose name I forget) posited that the first effect would be on the number of deaths.

This is a chart from today's NHS England Hospital data. It shows the percentage of the number of deaths in relation to the January peak, for each age group. One has to be careful not to read into it than is warranted but the chart might show the vaccines (as distinct from the lockdown) beginning to have some effect on the number of deaths. A clearer picture will no doubt emerge in the next week or two.

The over 80s, who were first in line for the vaccine, show the greatest decline followed by the 60-79s, whereas the 0-59 age group who have not had the vaccine show the least decline.

That is an interesting graph, though it might be possible to put several interpretations on it. One very simple one might have been that as the conditions during winter worsened, older people tended to become ill and die earlier, so now in the first part of 2021 the remaining members of those high end groups are now the fitter ones who are more likely to survive. Also their behaviour patterns may be different from other groups, with some people being very risk averse, and not mixing with others. The more gung-ho members of each group might have experienced problems - with consequences - earlier on. It is possible that the data reflects the impact of vaccination, but it is not by any means assured.

Currently it might show that for people currently in hospital or about to be hospitalised, that they are slightly more likely to die if they are relatively younger. It would be interesting to have graphs similar to this, but for different age bands.
0-59 is a wide age band, and while we assume that most of the deaths are at the higher ends of the range, say 40-49 or 50-59, there might still be some trends to be gleaned with a finer level of detail.

[Frances_iom]

A few more thoughts.
...The majority of people are thick and stupid and a lot of them lack any sort of moral compass. ..

thank goodness then for leaders like Trump to offer them moral guidance - maybe the Burmese military are correct and only those willing to shoot such stupid creatures deserve to rule

[oddoneout]

A few more thoughts.

1) Mix'n'match. Studies ongoing to determine whether the second jab can be a different vaccine to that of the first. Regardless of the science, the govt will state that "It is OK" to mix'n'match. Why? Logistics and the available supply. At the moment, hubs etc have no idea exactly how much and of what type they are getting each day/week. That might get better in the future. Assume it doesn't. So how are they going to manage those second jabs if the science says 'You should not mix the vaccines' ? Simple answer - they can't.

2) The vaccination centres are failing to remind people about the three week delay before assuming maximum efficacy and the need to maintain social-distancing etc. The majority of people are thick and stupid and a lot of them lack any sort of moral compass. Especially if any of the conversations heard by my wife while waiting in the 'recovery' area yesterday are to go by. These conversations focussed on the best way to get round the quarantine restrictions if/when they return from that holiday in Dubai.

And that is why a Health Passport is essential IMO. People will, and do, lie if it suits them. The Health Passport knocks that on the head. If someone does not wish to have a vaccination then that is their prerogative. What is not their prerogative is to lie, and bring back Covid from their seaside frolics.

People find always find ways round what doesn't suit them so I don't see that it will knock non-compliance on the head, but if done competently should greatly reduce preventable problems.
In principle I don't have an issue with the idea of a Health Passport, although for someone such as myself who doesn't travel and doesn't have a regular passport it is perhaps not a priority. However what I do have problems with is the idea of any such scheme coming within shouting distance of government influence, and the problems of the chaotic state of IT use and data management within the NHS. When I was able finally to access my GP records online there were several errors which had to be corrected but also several which can't be corrected I was told - those relating to my vaccination record... It's the result of rubbish software I imagine, but ticks have been put in for jabs I haven't had(the plethora that have been introduced over the last 20 years or so), with made-up (nonsensical in some cases) dates for first and where relevant second doses , but the smallpox one isn't noted. My records at the general hospital I very occasionally attend not only have mistakes, but those mistakes seem to vary across departments, and address updates for instance seem to be done on a case by case basis. Wonder how many appointments go astray like that?
I have zero trust in authority's intention and capability to deal with my personal details with integrity and care, much of that I can do little about, and I suspect that my stated wishes regarding my medical records have been over-ruled by current 'emergency rules' but I don't wish to add knowingly to the rich pickings that are made available to outside interests without my consent. The experience about 10 years ago of being able to download a price list for the various packages of NHS records on offer, with the minimum( in effect none) of scrutiny and control over who was buying and the use to which such data would be put, has rather coloured my views since, not least as there was complete and continued denial that such lists existed; they have now been hidden away behind various creations and renamings of bodies 'responsible for' but no doubt it wouldn't take much effort to access them The fact that the GP surgery had no idea about the opt-out scheme for patients when I asked didn't increase my confidence, and when the national information leaflets eventually appeared they contained the obligatory "we take your privacy very seriously" line which as you can imagine I was, erm, not reassured by.
Fortunately for authority the majority of the populace don't seem that fussed about such matters as they go about their lives, or at least not enough to take action (such as looking for and using opt-outs) until something affects them directly.

[Anastasius]

thank goodness then for leaders like Trump to offer them moral guidance - maybe the Burmese military are correct and only those willing to shoot such stupid creatures deserve to rule

You might think that. I certainly don't.

[Anastasius]

...
Fortunately for authority the majority of the populace don't seem that fussed about such matters as they go about their lives, or at least not enough to take action (such as looking for and using opt-outs) until something affects them directly.

But at least the opt-outs are there.

[Dave2002]

And that is why a Health Passport is essential IMO. People will, and do, lie if it suits them. The Health Passport knocks that on the head. If someone does not wish to have a vaccination then that is their prerogative. What is not their prerogative is to lie, and bring back Covid from their seaside frolics.

I don't think a Health Passport is a solution, though up to date vaccination certificates might be a partial solution. It is not unreasonable for other countries to refuse admission if someone hasn't had the necessary vaccinations, and then the decision is (or ought to be) whether to travel or not. Anyone who was unwilling to have a vaccination would not then be able to travel, but they would have had a choice.

Actually it is, of course more complicated than that, given the current state of what we know about Covid-19. It has still not been ascertained with high certainty that having been vaccinated prevents someone passing on the virus, or a variant of it. It may be the case that someone is vaccinated, then becomes largely immune, but can still spread the disease. Asymptomatic cases will continue to be a problem.

That also makes travel more complicated, because it is possible that someone's status re Covid-19 (or similar) diseases can change rapidly. Someone may have been vaccinated - say 5 months previously - become largely immune, then come into contact with asymptomatic carriers of a new variant which has minimal effect, but still renders that person able to spread the disease further. Testing would still be needed to reduce this risk if people want to/need to travel.

One other factor which might be underestimated by people in the UK - compliance. I'm sure it would be very easy to obtain fake documentation which would enable people to travel (and of course spread diseases further) - and there are many around the world who are not averse to aiding and abetting that kind of non-compliance. Probably many (but not all) in the UK would not do that, but in some cultures it might be the norm. Fake documents are often cheaper than real ones!

[Serial_Apologist]

You might think that. I certainly don't.

I don't imagine Frances meant that literally - though I must admit I've recently had occasion to wonder...

[Serial_Apologist]

I don't think a Health Passport is a solution, though up to date vaccination certificates might be a partial solution. It is not unreasonable for other countries to refuse admission if someone hasn't had the necessary vaccinations, and then the decision is (or ought to be) whether to travel or not. Anyone who was unwilling to have a vaccination would not then be able to travel, but they would have had a choice.

Actually it is, of course more complicated than that, given the current state of what we know about Covid-19. It has still not been ascertained with high certainty that having been vaccinated prevents someone passing on the virus, or a variant of it. It may be the case that someone is vaccinated, then becomes largely immune, but can still spread the disease. Asymptomatic cases will continue to be a problem.

That also makes travel more complicated, because it is possible that someone's status re Covid-19 (or similar) diseases can change rapidly. Someone may have been vaccinated - say 5 months previously - become largely immune, then come into contact with asymptomatic carriers of a new variant which has minimal effect, but still renders that person able to spread the disease further. Testing would still be needed to reduce this risk if people want to/need to travel.

One other factor which might be underestimated by people in the UK - compliance. I'm sure it would be very easy to obtain fake documentation which would enable people to travel (and of course spread diseases further) - and there are many around the world who are not averse to aiding and abetting that kind of non-compliance. Probably many (but not all) in the UK would not do that, but in some cultures it might be the norm. Fake documents are often cheaper than real ones!

My understanding of the latest position on infectivity, from about a fortnight ago, is that once immunised with Phase 1, a possible "carrier" is extremely unlikely to pass on the virus.

[johnb]

That is an interesting graph, though it might be possible to put several interpretations on it. ... It is possible that the data reflects the impact of vaccination, but it is not by any means assured.

Very true. It is too early to definitely attribute the pattern as being solely due to the vaccinations. Nevertheless it is more or less what one would expect to see as a result of the vaccination programme.

Currently it might show that for people currently in hospital or about to be hospitalised, that they are slightly more likely to die if they are relatively younger.

We know that that is unlikely to be the case.

It would be interesting to have graphs similar to this, but for different age bands.
0-59 is a wide age band, and while we assume that most of the deaths are at the higher ends of the range, say 40-49 or 50-59, there might still be some trends to be gleaned with a finer level of detail.

The deaths of people aged 0-59 only amounted to 7% of the total Covid deaths in England's NHS hospitals during the period looked at in the chart. The 40-59 age group accounted for 6% of the deaths and those aged 0-39 just 1%. Therefore, the 0-59 age group shown in the chart overwhelmingly consists of the those aged 40-59.

[Frances_iom]

I don't imagine Frances meant that literally - though I must admit I've recently had occasion to wonder...

years ago I was warned that sarcasm was wasted on children and Americans - maybe now with greater experience I ought to extend the categories.

Of course I don't believe it but if the OP holds to their belief in the stupidity of the general population what hope is there for democracy to survive - the Trump phenomenon in the US lays bare the utter failure of the American government to address significant social problems caused in the main by globalisation and Reaganite economics (as also waged by Thatcher which compounded by 10years of Tory austerity led to Brexit) - in both countries there is significant bias in the voting system (recall that Trump also had a minority of the popular vote in his first election) compounded by a extremely partisan press/TV/advertising system based on vast amounts of money. In both countries there is poor education in civics together with power being transferred away from local regions which leads to the popular + at times justified belief that their vote doesn't count.

[teamsaint]

My understanding of the latest position on infectivity, from about a fortnight ago, is that once immunised with Phase 1, a possible "carrier" is extremely unlikely to pass on the virus.

The consensus seems to be that the vaccines are likely to reduce transmission to a considerable degree, but extremely unlikely to stop it completely.
I think I saw a tentative figure of two thirds reduction jn transmission somewhere.

[Dave2002]

Very true. It is too early to definitely attribute the pattern as being solely due to the vaccinations. Nevertheless it is more or less what one would expect to see as a result of the vaccination programme.



We know that that unlikely to be the case.



The deaths of people aged 0-59 only amounted to 7% of the total Covid deaths in England's NHS hospitals during the period looked at in the chart. The 40-59 age group accounted for 6% of the deaths and those aged 0-39 just 1%. Therefore, the 0-59 age group shown in the chart overwhelmingly consists of the those aged 40-59.

Thanks for the clarification.

I noticed that the Welsh government adviser was making a point earlier today that if anyone had been offered a jab - and turned the offer down - they could still change their mind, and would be able to be vaccinated. The take up in care homes amongst workers hasn't been as high as in some other groups. It would be helpful if some of the refusers could change their minds, and this message could reach those people.

[teamsaint]

Thanks for the clarification.

I noticed that the Welsh government adviser was making a point earlier today that if anyone had been offered a jab - and turned the offer down - they could still change their mind, and would be able to be vaccinated. The take up in care homes amongst workers hasn't been as high as in some other groups. It would be helpful if some of the refusers could change their minds, and this message could reach those people.

There is quite a degree of historical vaccine hesitancy among healthcare professionals,as demonstrated in the survey from Leicester reported yesterday.

Plenty of other examples of studies on this.

https://theconversation.com/covid-vaccine-even-healthcare-workers-may-be-hesitant-but-new-evidence-can-be-reassuring-151404

[oddoneout]

years ago I was warned that sarcasm was wasted on children and Americans - maybe now with greater experience I ought to extend the categories..

Trouble I have these days is that what I assume to be sarcasm turns out more and more to be a person's actual view, which I find disconcerting, and the fallout can be less than pleasant . It's one reason why I am selective about online platforms(only two) as there is a chance to get to know a little about how the land lies.
It is easy to dismiss bad decisions as stupidity, and it is the more comfortable stance to take as it implies that there is nothing to be done to remedy the situation.

[Simon B]

There is quite a degree of historical vaccine hesitancy among healthcare professionals...
https://theconversation.com/covid-va...ssuring-151404

Isn't a form of "Selection Bias" likely to be at play here? Medical professionals, in the broadest sense, are confronted frequently and forcefully by the consequences of adverse responses to medication and procedures. Being as human as the rest of us, a good proportion are thus likely to intuitively overestimate their risk. It should also be acknowledged that in general there is rather a lot of iatrogenic disease. It's also notable that the effect is less pronounced in Doctors - who on the whole have expended the greatest effort in training themselves to be guided by rational and detached judgements.

It is rather like asking police accident investigators or relatives of victims about road safety. They can tell you a great deal about consequences but are understandably (or not in the case of some of the more ludicrous pronouncements of certain lobbying organisations) often irrational when it comes to balanced risk-reward evaluations. Not a popular point of view, but that is also irrelevant.

Hopefully they (the healthcare workers) can be persuaded in greater numbers over time. The data about care workers in particular declining vaccine in significant numbers is very concerning especially given the emerging evidence for efficacy.