Vaccine

Home First-dose coronavirus vaccinations totalled more than 20 million. A study suggested that in the over-eighties, a single dose of either the Pfizer or Oxford-AstraZeneca vaccine was more than 80 per cent effective at preventing hospitalisation. Hospital admissions of 8,452 in the week ending 27 February were 22 per cent down on the week before that. At dawn on 28 February, total UK deaths (within 28 days of testing positive for coronavirus) had stood at 122,705, including 2,340 in the past week, down by 32.3 per cent on the week before that. Six people with the Brazilian variant of coronavirus were detected in Britain, but one could not be traced. In the Budget, Rishi Sunak, the Chancellor of the Exchequer, said borrowing would rise to a peak of 93 per cent of GDP.

The New York Times seems to have developed a strange view of Britain in recent years – or at least since the Brexit vote in 2016. In the NYT’s world, the UK is a desolate place, where locals huddle round bin fires on the streets of London, gnawing on legs of mutton and cavorting in swamps during the summer, ever fearful of the despot Prime Minister, Boris Johnson. So Mr S was not exactly surprised to see that the paper’s latest missive from the Covid frontline in Britain, published today, veered on the negative side, detailing the ‘crushing onslaught of a pandemic’ in hospitals, in what can only be described as an orgy of British despair.

It is worth taking a moment to stand back and applaud Sarah Gilbert and the Oxford vaccine team’s achievement. The data released this evening by Public Health England shows that a single dose of both the Oxford /AstraZeneca vaccine and the Pfizer vaccine cuts the risk of hospitalisation by 80 per cent in the over-80s, the most vulnerable group. It also suggests that the Oxford one, despite its messy trial data, is slightly more effective than the Pfizer vaccine in preventing symptomatic infection among the over-70s. The efficacy of the Oxford vaccine has completely changed the outlook for the UK.

The UK policy of delaying second doses of the Pfizer vaccine has been criticised by some as risky, with Pfizer warning that there is no data on the effectiveness of its vaccine other than for the dosing regime used in phase 3 trials: two doses, 21 days apart. But evidence is steadily trickling through. Earlier in the week I wrote here about the Scottish population-wide study which found that a single dose of the Pfizer vaccine reduced hospital admissions by 85 per cent between 28 and 34 days after the jab. This morning comes Imperial College’s React-2 study, which paints a picture that is, on the face of it, rather less flattering. It tested 154,000 people for the presence of antibodies to SARS-CoV-2, the virus which causes Covid-19.

Winning the war is one thing, winning the peace is quite another. Time and again through history, national governments have thrown everything into a wartime effort, only to forget that there will be a country – or countries – to rebuild once victory has been secured.  This is why the Prime Minister is so keen to talk about Building Back Better and the Green Skills Revolution that he promises will follow just as soon as the vaccine has worked its magic. We are, we are told, going to create a better Britain once we’ve seen the back of Coronavirus. And of course much of Johnson’s blue sky ambition is admirable, and his famous optimism could prove important in the months and years ahead.

As an epidemiologist and doctor who volunteered to return to the frontline in both waves, I have seen first hand the death and suffering from Covid. And, also, the knock-on effects on those affected by cancelled services. Deciding when to end lockdown is, of course, a difficult decision, but I now fear the costs of lockdown will soon start beginning to outweigh the benefits. There is no doubt that Covid-19 has the capability to rapidly overwhelm our healthcare system and cause unprecedented casualties. Indeed, what has transpired over the last year suggests that Neil Ferguson’s figure – that the virus was capable of taking 500,000 lives – looks fairly accurate. Covid clearly had to be suppressed to stop the NHS being overrun and to keep all emergency services running.

With every passing day, more Covid immunity is being gained as hundreds of thousands receive the vaccine. Of course, vaccines take time to mature in the body and offer protection, but with roughly a quarter of the population having now received their first inoculation, our approach to dealing with the virus will inevitably need to shift. The big question is how vaccination has changed the equation for how quickly society can be reopened. Modelling from the PCCF project at Bristol University, on cautious assumptions, suggests that the pace of the vaccine rollout would allow significant reopening with herd immunity achieved in July. First, let’s say how much vaccine immunity has been induced by the vaccine.

Is the British approach of prioritising first doses of Covid vaccines and not promising a second dose until 12 weeks later compromising our ability to fight the disease? It is not a moot point, with several EU figures asserting that it is a risky route to take. As I wrote here a couple of weeks ago, as far as the AstraZeneca/Oxford vaccine is concerned, what evidence we have supports the practice of delaying a second dose until 12 weeks after the first one; the vaccine is more effective that way. However, a question mark has continued to hang over the Pfizer/BioNTech vaccine. There is limited data on the most effective dosing regime in this case because the phase 3 trials did not experiment with delayed doses – everyone involved was given a second dose 21 days after the first.