Day: 10 June 2021

NHS Told to Differentiate Between Patients in Hospital “For Covid” and Those in Hospital “With Covid” – and Not Before Time

After almost 15 months of various forms of lockdown, hospitals have finally been told to change the way they collect data on patients who test positive for Covid. They have been instructed to differentiate between those who are actually sick with Covid symptoms and those who test positive but are actually ill with something else. The Independent has the story.

NHS England has instructed hospitals to make the change to the daily flow of data sent by NHS trusts and told the Independent that the move was being done to help analyse the effect of the vaccine programme and whether it was successfully reducing Covid sickness…

One NHS source said the new data would be “more realistic” as not all patients were sick with the virus, adding: “But it will make figures look better as there have always been some, for example stroke [patients], who also had Covid as an incidental finding.”

In a letter to hospital bosses on June 7th, shared with the Independent, NHS England’s Covid Incident Director, Professor Keith Willett, said that from now on NHS England wanted “a breakdown of the current stock of Covid patients into those who are in hospital with acute Covid symptoms (and for whom Covid is the primary reason for being in hospital); and those who are primarily in hospital for a reason other than Covid (but for whom the hospital is having to manage and treat the Covid symptoms alongside their primary condition)”.

He added: “In lay terms, this could be considered as a binary split between those in hospital ‘for Covid’ and those in hospital ‘with Covid’. We are asking for this binary split for those patients newly admitted to hospital and those newly diagnosed with Covid while in hospital.”…

NHS England data on hospital admissions is published daily at a regional level and several days later on the Government’s dashboard. An internal daily dashboard of Covid data tracks infections across hospitals but is not made public.

Professor Ian Douglas from the London School of Hygiene and Tropical Medicine said: “I think there are good arguments for presenting these data separately – people in hospital ‘with’ vs ‘for’ Covid, as it does partly address the burden to health services due to the virus. Not completely though, because people in hospital with Covid will presumably also need to be treated differently to avoid further spread, which places some extra burden on the hospitals.

“I’ve got no idea what the split is like at the moment, and importantly we won’t know retrospectively what the trend is. Following on from that, there are only a few days before any announcement about June 21st, which may not give us long enough to be sure about what direction the ‘for Covid’ numbers are going.”

This change resembles the recent shift in the definition of a “case” by the CDC in America, where an infection in a vaccinated person is now only a “case” when the person is hospitalised or dies, whereas with the unvaccinated any positive PCR test still counts as a “case”, no matter how mild or asymptomatic.

Now, I’m all in favour of a more restrictive and conventional definition of case that gives a more realistic picture of the impact of the disease. But one can’t help suspect it’s more about politics than science when the kind of change many of us have been calling for since the start only comes once it helps to create the impression that the vaccines are working.

The Independent report is worth reading in full.

Moderna Hopes Its Covid Vaccine Will Be the Second to Be Authorised for Use in American Children

Moderna has asked the U.S. Food and Drug Administration (FDA) to extend the emergency use of its Covid vaccine to American children aged 12 and over. The FDA approved the use of the Pfizer Covid vaccine in children a month ago on Thursday, and earlier this month the U.K.’s medicines regulator did the same for British children. The MailOnline has more.

When the [Moderna] vaccine was originally authorised for use by the FDA in December 2020, it was only for those aged 18 and older. 

However, recent Phase Three clinical trial data showed no children who were given the immunisation fell ill with the virus within 14 days of their second dose, while four children given the placebo later tested positive.

According to Moderna, this is “consistent with a vaccine efficacy of 100%”.

It comes exactly four weeks after Pfizer received approval from the FDA to administer its vaccine to children between ages 12 and 15. 

As of Thursday, more than seven million U.S. children between ages 12 and 17 have received at least one dose of the vaccine.

Still, only about one in three parents said they would immunise their children right away.

Although children can contract Covid and pass the disease on to others, they tend to not get very ill and make up about 0.1% of deaths.

“We are pleased to announce that we have submitted for an emergency use authorization for our Covid vaccine with the FDA for use in adolescents in the United States,” said Moderna CEO Stéphane Bancel in a statement

“We are encouraged that the Moderna Covid vaccine was highly effective at preventing Covid and SARS-CoV-2 infection in adolescents.”…

Moderna’s study included 3,732 adolescents from ages 12 to 17 enrolled at sites across the U.S….

Side effects were mild or moderate with the most common being pain at the site of injection, similar to adults in the clinical trial last year.

Other common symptoms were fatigue, headache, muscle pain and chills, but no serious side effects were reported. 

Worth reading in full.

SAGE Member – and Communist – Susan Michie Says We Will Need Face Masks and Social Distancing “Forever”

Susan Michie, Professor of Health Psychology at UCL and a leading member of SAGE, says that mask-wearing and social distancing will need to stay in place “forever”, not only for Covid but also “to reduce other [diseases]”.

The top Government adviser and long-time member of the Communist Party of Britain (once nicknamed “Stalin’s nanny” because she tried to smuggle Communist literature into a political conference in a baby’s pram), told Channel 5 News that measures adopted by Brits over the past 14 months should now become a part of our “normal” routine behaviour, just as wearing car seat belts has become commonplace.

Vaccines are a really important part of pandemic control but it is only one part. [A] test, trace and isolate system, [as well as] border controls, are really essential. And the third thing is people’s behaviour. That is, the behaviour of social distancing, of… making sure there’s good ventilation [when you’re indoors], or if there’s not, wearing face masks, and [keeping up] hand and surface hygiene.

We will need to keep these going in the long term, and that will be good not only for Covid but also to reduce other [diseases] at a time when the NHS is [struggling]… I think forever, to some extent…

I think there’s lots of different behaviours that we have changed in our lives. We now routinely wear seatbelts – we didn’t use to. We now routinely pick up dog poo in the parks – we didn’t use to. When people see that there is a threat and there is something they can do to reduce that [to protect] themselves, their loved ones and their communities, what we have seen over this last year is that people do that.

This line – that “what we have seen over the last year is that people do that” – is faintly reminiscent of Professor Neil Ferguson’s comments when looking back to when Italy imposed a nationwide lockdown last February: “[China] is a communist one-party state, we said. We couldn’t get away with [lockdown] in Europe, we thought… and then Italy did it. And we realised we could.” Professor Michie has realised that she – and the Government – can “get away with” telling people to continue abiding by Covid regulations.

Professor Michie continues:

I think that we can just begin to adopt routines. When we go out of the house, we check that we’ve got our phone, we’ve got our keys, we’ve got tissues, we’ve got a face mask in case we need to use it. It’s not going to be a huge big deal, the kind of behaviours that we are talking about.

Unsurprisingly, Channel 5 News made absolutely no effort to scrutinise these claims. The programme’s presenter raised no objection to the idea that mask-wearing and social distancing could continue “forever”, resorting only to friendly laughter. Professor Michie’s co-panellist, a fellow scientist at UCL, Dr Shikta Das, said: “I think Susan has made a very good point here,” adding that the vaccine roll-out has created a “false sense of security”. She concluded: “I don’t think we are yet ready to unlock.” How’s all that for balance! At last Ofcom won’t have any complaints about this programme.

The video is worth watching in full.

England’s NHS Waiting List Hits Five Million for the First Time

In striving to “protect the NHS”, we have instead placed it under record levels of pressure. The number of people waiting to start hospital treatment in England alone continues to rise and has passed five million for the first time. The number waiting for more than a year remains significantly higher than before Covid – and lockdowns – began. The number of people who actually require treatment will be higher still since many are expected to be living with undiagnosed diseases, such as breast cancer, having been reluctant to burden the health service with check-ups during the pandemic. The Guardian has more.

NHS England’s latest set of monthly performance figures, published on Thursday, show that the waiting list stood at 5,122,017 in April – up 171,720 in a month.

The total has risen from the 4.95 million who were on it in March, which was itself almost 252,000 up on the 4.698 million recorded in February – a month-on-month rise of 5.4%.

The number of people being forced to wait at least a year for treatment in hospital, especially surgery, has fallen for the first time in over a year but remains a serious problem. Thursday’s figures also show that 385,490 people have now been waiting more than 52 weeks, 50,637 down on the 436,127 who were in that position last month.

Such long waits are a new phenomenon. In contrast, in March last year – before Covid triggered a suspension of much NHS care – just 3,097 patients had faced such an unusually long delay.

Ministers, NHS chiefs, medical groups and health charities are worried that growing numbers of patients are facing lengthening waits for vital care including cancer treatment, a hip or knee replacement, heart operations and surgery to remove cataracts to improve eyesight.

Worth reading in full.

Stop Press: Professor Karol Sikora, on Lucy Johnston’s “Sketch notes on a pandemic” podcast, says: “I’ve been working in oncology for nearly 50 years and I’ve never seen a crisis like this before.”

News Round-Up

Vaccination Doesn’t Add Any Protection to that Gained from Previous Infection – Study

A new study (not yet peer-reviewed) of over 50,000 employees of the healthcare system in Cleveland, Ohio, has found that previous infection provides very robust protection against re-infection and, importantly, that there is no gain to being vaccinated as well.

U.S. Senator Rand Paul tweeted the study’s conclusion: that it means vaccines should be prioritised for the not-previously-infected at home and abroad, not wasted on the already immune.

The confirmation of the protection provided by natural infection is very welcome, as is the finding that vaccinating the previously infected is superfluous. Given the significantly higher risk of adverse events for those previously infected (up to three times higher according to the ZOE Lancet study) and the world shortage of vaccines, there would seem to be a moral imperative to cease vaccinating the previously infected.

The study’s finding is particularly robust because of the large sample size and because there were zero instances of re-infection among the previously infected (both vaccinated and unvaccinated). This was despite the study period beginning at the peak of Ohio’s winter wave, so the unvaccinated had plenty of exposure to the virus. Other studies have found the relative risk reduction offered by previous infection to be 80% against all re-infection and 90% against symptomatic re-infection, so the results in this study were even higher than usually observed.

However, the study’s findings for vaccine effectiveness in the not-previously-infected are much less reliable.