‘PERILOUS MOMENT’
LONDON: United Kingdom Prime Minister Boris Johnson said yesterday the UK was in ‘‘a race against time’’ to roll out Covid19 vaccines as deaths hit record highs and hospitals ran out of oxygen, and his top medical adviser said the pandemic’s worst weeks were imminent.
A new, more transmissible variant of the disease is surging through the population, with one in 20 people in parts of London now infected, threatening to overwhelm the National Health Service (NHS) as hospitals fill up.
The death toll in the UK has soared to more than 81,000, while more than 3 million people have tested positive.
In a bid to get on top of the pandemic and restore some degree of normality by spring, the UK is rushing out its largest vaccination programme; shots are to be offered to about 15 million people by mid next month.
‘‘It’s a race against time because we can all see the threat that our NHS faces, the pressure it’s under, the demand in intensive care units, the pressure on
ventilated beds, even the shortage of oxygen in some places,’’ Johnson said on a visit to a vaccination centre in Bristol, in
southwest England, yesterday.
‘‘This is a very perilous moment. The worst thing now for us is to allow success in rolling out a vaccine programme to breed any kind of complacency about the state of the pandemic.’’
Chief medical adviser Chris Whitty earlier said the situation was set to deteriorate.
‘‘The next few weeks are going to be the worst weeks of this pandemic in terms of numbers into the NHS,’’ he told the BBC.
‘‘Anybody who is not shocked by the number of people in hospital who are seriously ill at the moment and who are dying . . . I think, has not understood this at all. This is an appalling situation.’’
Health Minister Matt Hancock said there were now more than 32,000 Covid19 patients in hospital, far more than the about 18,000 admitted at the peak of the pandemic’s first wave in April last year.
Johnson’s Government is pinning its hopes on a mass vaccination programme.
Its plan, announced yesterday, envisages 2 million shots being delivered to about 2700 centres a week in England by the end of January, with the aim of immunising tens of millions of people by spring and all adults having been offered a vaccine by autumn.
The first daily vaccination statistics showed nearly 2.3 million people had so far received their first doses of a Covid19 vaccine and nearly 400,000 their second. — Reuters
TRIAGE is always crude and messy, and there are always mistakes, but the goal is to save as many lives as possible in an emergency where there are not enough medical resources to save everybody. That certainly applies to the Covid19 pandemic, and there is certainly roughandready triage going on right now in hospitals across the world.
But there is also something approximating triage happening with regard to vaccines in the United Kingdom now. The estimable Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases for almost half his life, was denouncing it on the media only the other day. But just this once, he may be wrong.
Britain was one of the first countries to start vaccinating people last month when the PfizerBioNTech vaccine became available, and it now has been the first to administer the AstraZeneca vaccine, but both require a second shot three weeks after the first.
At the same time, however, the UK has been ground zero for the new strain of the Covid19 virus, romantically named VUI/202012/01 (or B.1.1.7 for short). More than half the world’s reported infections are there, and the reason it’s spreading so fast is that it’s 30% more infectious than the older variant.
Daily infections in the UK tripled in three weeks, and now regularly exceed 60,000. Deaths from Covid19 are now well over 1000 a day, and may stay up there until a sufficient fraction of the population has been vaccinated. Therefore the faster the vaccinations can be done, the fewer people will die or suffer ‘‘long Covid’’ symptoms.
So the chief medical officer of England, Chris Whitty, and his counterparts in Scotland,
Wales and Northern Ireland took a brave and potentially momentous decision. They announced that the scheduled second shot of the vaccine would be postponed to 12 weeks after the first for everybody who hadn’t already had it — effectively, for almost everybody in the country.
The advantage of doing it that way is obvious. Whatever speed the vaccinations are being done at, you will be processing twice as many people in the same time if you don’t have to devote half your resources to giving second shots at the same time.
In England, under Prime Minister Boris Johnson’s Government, that may be no better than Donald Trump’s pathetic ‘‘warp speed’’ vaccination programme in the United States, which promised 20 million inoculations by the end of December and managed about four million.
From foolishly delayed lockdowns to a shambolic testandtrace programme that still doesn’t work, the British Government has failed every test it was set. The United Kingdom still leads the United States by a hair in the race for the coveted world title of ‘‘secondworst Covid death rate for a large developed country’’. (Italy still leads the field.) But all the more reason to speed up the vaccinations.
Now, the obvious drawback with this oneshotnow, oneshot12weekslater approach is that nobody is getting the full protection that would come with a booster shot after only three weeks. Or at least that’s the consensus, although you can find researchers who argue that later is better.
Prof Andrew Pollard of the UK’s Joint Committee on Vaccination and Immunisation is one of them. “If you have a longer gap between that first and second dose,” he told the Guardian, “then the strength of the booster tends to be stronger. That’s what we see with almost every other vaccine that’s ever been tested.”
There certainly is an element of triage in this. A few people who don’t get their second shot on the original schedule may contract the virus and die while waiting 12 weeks for the booster. However, a lot more people will avoid dying from
Covid19, because twice as many will have received that single shot in the same time.
There is now a steady stream of spokespersons for the pharmaceutical firms that produced these vaccines publicly warning that there is ‘‘no evidence’’ that a single shot gives protection for more than three weeks. Of course there isn’t. All the tests were done with a second shot after just three weeks, so how could there be?
However, it’s just as true to say that there is no evidence that the vaccine’s protection fails after three weeks, and a lot more relevant. The lawyers told those spokespersons to say what they said in order to protect the firms from possible lawsuits, but it would be almost unprecedented in the history of vaccines if the single shot’s protection were to fail so quickly.
That’s not how vaccines work.
Shortterm efficacy from the first dose of the PfizerBioNTech vaccine is around 90%; for the AstraZeneca jab, it’s 70%. As Prof Pollard said, “From three weeks after the first dose, we’re not seeing anyone who’s vaccinated admitted to the hospital or developing severe disease.”
In a pandemic, this radical measure is just common sense, and others should take heed.