The Daily Telegraph
UK is doing far better than feared when roadmap began
WHEN the Government set out its roadmap in February, it said the release dates would go ahead so long as four tests were met. The vaccine programme needed to continue apace; vaccines had to prove effective in reducing hospitalisations and deaths; infection rates had to stay low; and variants should not change the overall risk. So, have those tests been met, and is there really a need for a further four-week delay?
Test 1 – Vaccine programme continues successfully
The rollout has been a tremendous success with 78.9 per cent of the adult population having had at least one dose and 56.6 per cent now fully vaccinated.
The programme, which is jabbing between 500,000 and 750,000 people a day, has taken millions of vulnerable adults out of harm’s way, and slashed the risk of catching the virus, being admitted to hospital or dying.
Public Health England’s (PHE) latest vaccine surveillance report shows that more than 98 per cent of over-50s in England now have antibodies to Covid, either through vaccination or infection and very few people in older groups are ending up in hospital. Overall, more than 77 per cent of the adult population now has protection against Covid-19 from infection or vaccination and, crucially, the under-30s are now being vaccinated, which could have a big impact on the spread of the virus.
Figures show that the virus is now predominantly circulating in younger and unvaccinated people, with the case rate for 20 to 29-year-olds at 121.0 per 100,000 population, compared to just 6.7 per 100,000 for the over-80s. So, getting a handle on infections in younger adults will hopefully nip the new wave in the bud.
Any pause in lifting restrictions will allow more people to have their second dose. Edward Argar, the health minister, said 10million people will be given their second vaccination during the four-week delay.
Dr Simon Kolstoe, senior lecturer in evidence-based healthcare at the University of Portsmouth, said: “Mass vaccination is clearly working. But we can only be confident in lifting all restrictions once we know that the link between large-scale infections and hospital admissions has been broken.
“The vaccine certainly seems to be doing its job in breaking this link, but a few more weeks to get more people vaccinated certainly seems like a sensible option.”
Test 2 – Evidence shows vaccines are effective in reducing number of people in hospital and deaths in people who have been vaccinated
It is now undisputed that vaccines have played a major role in lowering admissions and deaths. Latest PHE estimates suggest that around 42,000 hospitalisations and 14,000 deaths have been prevented by the rollout.
Data from the University of Edinburgh and Public Health Scotland (PHS) yesterday showed this is holding true even for the Indian (delta) variant. Although it is now believed the mutated virus doubles the risk of being admitted to hospital, the risk is cut by 70 per cent for people who have been fully vaccinated.
Although the team found there was a slight dip in vaccine effectiveness between the Kent (alpha) and Indian variants, they also found there are “very few” over-65s testing positive for Covid, suggesting the jabs are protecting the most vulnerable.
The Scottish team calculated that for people who had two doses, or who had their first dose at least four weeks ago, the risk of being hospitalised with the Kent variant was reduced by 72 per cent and the Indian variant by 62 per cent.
Data released from PHE last night suggests the Pfizer/biontech vaccine is 96 per cent effective against hospitalisation after two doses and the Oxford/astrazeneca vaccine is 92 per cent effective against hospitalisation after two doses.
Many of the original outbreaks of the Indian variant were in low areas of vaccination. In areas where there has been a huge effort to encourage uptake, such as Bolton and Bedford, case numbers have dropped.
Dr Jim Mcmenamin, national Covid-19 incident director at PHS, said: “The vaccines are offering not just the prospect of a way for communities to move back to normality, but actual evidence that is happening from the results we have.” Latest figures from PHE also show that just five per cent of Indian variant infections are in people who have been fully vaccinated.
The new data also show that the death rate is still very low, with just 0.1 per cent of people – one in 1,000 – infected by the variant going on to die.
In comparison, the death rate for people catching the Kent variant is 1.7 per cent – 17 in 1,000.
So far, there have been just 42 deaths from the Indian variant, and only 12 in fully vaccinated people.
Test 3 – Infection rates do not surge, resulting in more people in hospital, which would mean the NHS could not cope
This is clearly a sticking point for the Government as infection rates have been surging in recent weeks.
Latest testing data show a 50 per cent rise from last week, and admissions and deaths have also started to creep up, after big reductions in the spring.
One of the issues is that the NHS is now facing a huge backlog from health services that were paused during lockdown, or where people did not seek medical help.
There are fears among NHS leaders that even a slight rise in Covid cases could push hospitals to breaking point, although trusts in hotspots such as Bolton have said they have coped well with the current wave.
There is also good evidence that people who are being admitted to hospital are less sick, require shorter stays, with most unlikely to need intensive care. The most recent Intensive Care & National Audit Research Centre (Icnarc) report shows that just 169 patients have been admitted to intensive care with Covid in the past month in England, Wales and Northern Ireland, equating to fewer than six cases per day.
Statistics show that out of 3,394 patients admitted to hospital in May, only around 5 per cent needed intensive care.
At the peak, 72 per cent of intensive care admissions were due to Covid compared with less than 20 per cent at the moment.
The Icnarc data also show that the chance of dying within 28 days of admission to intensive care has fallen to 20 per cent, compared with around 45 per cent during the first wave.
Test 4 – Scientists’ assessment of the risk is not massively changed by discovery of a new variant
Undoubtedly, the risk of unlocking has changed based on analysis of the new variant and the Government has now accepted it has failed test four, which also places it in danger of failing test three.
Latest estimates suggest that the Indian variant is between 41 and 60 per cent more transmissible than the Kent, and the risk of being hospitalised is about double.
Mark Woolhouse, professor of infectious disease epidemiology, at the University of Edinburgh, said: “The arrival of the [Indian] delta variant has changed the assessment of the risks of reopening: it is more transmissible, causes more severe disease and the vaccines are less effective against it.
The current situation can be said to fail the fourth of the four tests the UK Government set out in February.”
However, not only do vaccinations still appear to be working, but the variant itself may be becoming less infectious.
The number of contacts being infected by a carrier has also dropped, from 13.5 per cent to 11.3 per cent in the last two weeks. Essentially, Britain is now experiencing an epidemic of the unvaccinated.
PHE figures show that two thirds of the 1,234 people with the Indian variant who attended A&E in England between Feb 1 and June 7 were unvaccinated.
Of the 383 cases where attendance at A&E resulted in an overnight admission, 251 (66 per cent) were unvaccinated, and just 42 (11 per cent) were more than 14 days after a second jab.
It is also worth noting that hospital occupancy was forecast to be far worse by now under scientific modelling used to inform the roadmap.
Although there are concerns about hospital numbers, with Covid inpatients currently at around 1,090, the figures are still far less than the Government feared might happen when it announced its release dates in February.
Even under a cautious scenario, in which freedom day was moved to July 5, hospital occupancy was forecast by the University of Warwick to be around 1,750 by now, while Imperial College suggested it would be closer to 7,000.
So Britain is actually doing far better than was expected when the roadmap was released.