There is a much more positive reality than the PM’S plan suggests

‘Now the elderly and vulnerable are mostly protected, we won’t see any increases in admissions and deaths that prompted the last two lockdowns’

‘If you are driven by the data and not by dates, you should be looking at earlier unlocking because the data are so good’

Tensions are mounting between those who think the Government is dragging its feet in lifting restrictions, and others who are urging caution at all costs.

Yesterday, Sir Keir Starmer urged Boris Johnson to “have a word” with Conservative backbenchers after MP Mark Harper claimed that the modelling used to draw up the roadmap out of lockdown was flawed.

Mr Harper, the chairman of the Covid Recovery Group, said there was a “concerning pattern of assumptions not reflecting the much more positive reality”.

It seems he may have a point. When the modelling was produced on Feb 17, it did largely reflect what was known about the impact of the vaccines.

But a week is a long time in politics and a pandemic, and the data has shifted considerably since then.

Here is how it has altered, and why it matters:

Vaccination impact on the risk of infection

Stopping people getting an infection in the first place is the goal of any vaccine. Yet the efficacy of vaccines has caused considerable confusion, with data suggesting the jabs have an effect anywhere between 10 and 95 per cent, depending on the variants present, the number of doses, and the interval between injections.

For the purposes of the roadmap, the Scientific Pandemic Influenza Group on Modelling (SPI-M) estimated vaccines would reduce by between 24 and 48 per cent the risk of infection after the first dose and 30-60 per cent after the second dose. But real-world results show that vaccination is far more effective.

Early data from Public Health England’s Siren study of healthcare workers suggest the Pfizer jab reduces the risk of infection by 70 per cent after one dose and 85 after the second dose.

Similarly, real-world data from Israel released yesterday show the Pfizer jab is preventing 92 per cent of infections after the second dose. Figures released today from Imperial College also show that 87.9 per cent of people over the age of 80 tested positive for antibodies after two doses of the Pfizer-biontech vaccine, rising to 95.5 per cent for those under the age of 60 and 100 per cent in those aged under 30. The latest data for the Oxford/astrazeneca jab is also encouraging. A single dose was 76 per cent effective in fending off infection between 22 days and 90 days post-injection, rising to 82.4 per cent after a second dose. It means modellers may have considerably underestimated the protective effect of vaccines.

Vaccination impact on symptomatic disease

While preventing infection is the first goal, the next is to stop symptomatic disease. Here the modellers appear to have got the figures spot on.

They estimate that vaccination will reduce the risk of disease by around 88 per cent after two doses. PHE results published this week show vaccine effectiveness in the over-80s is around 57 per cent, rising to 88 per cent after the second dose.

Israel’s real-world results suggesting the Pfizer jab is 92per cent effective may mean the impact turns out to be a little higher than anticipated.

Dr Peter English, consultant in Communicable Disease Control, said: “This is more great news, confirming that the vaccine is around 90 per cent effective at preventing documented infection of any degree of severity from seven days after the second dose.”

Vaccination impact on hospitalisation and death

Preventing a surge in hospitalisations that would put unsustainable pressure on the NHS is one of Boris Johnson’s key four steps to easing lockdown.

But here we are doing far better than modelling suggests.

The SPI-M models are based on 56-70 per cent protection after the first dose and 70-88 per cent after two doses. However, real-world results from Public

Health Scotland published this week show that after two doses Pfizer offers 85 per cent protection from hospitalisation, while the Oxford jab is 94 per cent protective.

Prof Aziz Sheikh, of the University of Edinburgh and lead researcher of the study, said the results gave “great reasons to be optimistic”. He said: “We now have national evidence that vaccination provides protection.”

Israel’s data suggests the Pfizer jab protects 92 per cent against severe disease and 87 per cent against hospitalisation and new trial data released this month also suggest just one dose of the Oxford jab prevents 100 per cent of hospitalisations after 22 days once an immune response has developed.

Coverage

The modellers base their estimates on vaccine coverage of around 79 per cent. Latest estimates show uptake is around 95 per cent. It is unclear from the SPI-M report if they have factored in the number of people who cannot have the vaccine, but uptake appears to be far higher than was expected.

Figures from the Office for National Statistics suggest just one in 100 people refuses the vaccine. Even under the most cautious reopening, the SPI-M model predicts 30,000 deaths and that only 62 per cent of the population will end up being vaccinated, once you remove children and those who can’t, or won’t, have the jab. Yet many experts disagree with such gloomy predictions.

Dr Julian Tang, of the University of Leicester, said: “Now that the elderly and vulnerable are mostly protected, we won’t see any of the dramatic increases in hospitalisation and deaths that prompted the last two lockdowns.”

Roll-out speed

Projections are based on vaccinations of around 2.4 million a week, falling to two million in June.

There is some evidence of a slowing down, and Matt Hancock has acknowledged a fall in vaccine supply in recent days but has promised a bumper week in March. In the first two weeks of February, the UK averaged more than 3 million doses per week, but in the past seven days that has fallen to 2.4 million.

As those needing second doses rises, this will also slow the vaccine programme, but there is little evidence to show it will drop to two million in June.

Other factors

One of the biggest factors apparently missing from models is the vaccines’ impact on reducing transmission.

Oxford University has estimated that its jab may lead to a 67 per cent reduction in community transmission, and that two doses may reduce cases by half.

Yet this does not appear to have been factored into the models, with transmission reduction only coming from behaviours such as hand washing and social distancing. The warmer weather has also not been added into the main models. Experts estimate it could have an impact of up to 25 per cent reduction in transmission, but could also lead to a bigger resurgence next autumn.

One question remaining is whether we should use modelling at all now.

We have enough real-time data to be confident of where the pandemic is going in the next few weeks and positive change will be “baked in” for several weeks once restrictions are lifted.

Giving evidence to the science and technology select committee last week, Prof Mark Woolhouse, of Edinburgh University and a member of SPI-M, also made this point: “If you are driven by the data and not by dates, you should be looking at earlier unlocking because the data are so good. My instinct is to go with the data.”