Day: 10 July 2021

Infections Decline in the Unvaccinated as They Surge in the Vaccinated – Demolishing the Argument for Vaccinating Children and Young People

I reported last week on the striking fact that, according to data from the ZOE Covid Symptom study, new symptomatic daily infections appeared to be plateauing in the unvaccinated while they were surging in the vaccinated. The trend has continued since then, with infections now entering decline in the unvaccinated while those in the vaccinated (with at least one dose) continue to surge (see graph above).

Around 67% of the population has received at least one vaccine dose, so the fact that there are still more infections in the smaller unvaccinated group means no conclusion can be drawn from the current figures about the vaccines not being effective. Also, while more people are being vaccinated all the time, that steady trend is nowhere near large enough to account for the sharp changes in infection incidence we see here.

With infections in the unvaccinated already peaking and falling, despite the Delta variant, this drives a coach and horses through arguments for the supposed importance of vaccinating children and hesitant young people – including through inducements like vaccine passports for pubs, clubs and restaurants, now being mooted for the autumn.

Why the vaccinated are having their Delta surge later than the unvaccinated is an interesting question. Is it because the vaccines make them more resistant to infection? Does the age difference help explain it? Or is it something else?

Whatever the explanation, the important point is that without any new restrictions or a big new vaccine push, infections in the unvaccinated are already falling. In the current climate of pushes to extend restrictions, delay ‘Freedom Day’, and vaccinate everyone whether they want it or not, this is hugely significant. It means all those arguments to continue restrictions and pile on the pressure for vaccination because of the Delta variant are complete nonsense.

That new daily infections are still rising in the population as a whole is now because they are rising among the vaccinated, not the unvaccinated. They will likely peak soon in the vaccinated, too, just as they already have in Scotland.

New daily positive cases in Scotland (HMG)

It seems that Delta has done its strange summer thing and will soon exhaust itself like the variants before it.

When it does, is there any chance we can stop panicking every time this not-very-deadly virus has a little variant-driven ripple and go back to living as free people again?

Boris Johnson to “Tone Down Freedom Day Rhetoric”

We have almost reached July 19th, yet we appear to be moving further away from what we once considered to be ‘normal’ (just look at the reappearance of plans for vaccine passports). It’s no wonder that the Prime Minister is toning down the “Freedom Day” rhetoric. The Guardian has more.

The final decision about July 19th will be taken on Monday morning, based on modelling from the Scientific Advisory Group for Emergencies (SAGE) about Covid cases and pressures on the NHS.

The Prime Minister still believes it is “now or never”, with a later reopening potentially posing even higher risks as cases could peak as children return to school and winter looms.

Two Whitehall sources told the Guardian that ministers had been spooked by internal polling. One said the data showed just 10% of the public support the policy of scrapping all restrictions at once, while another said substantially more people believed the Government was moving too quickly than at the last reopening step on May 17th. These accounts were denied by Number 10.

A cabinet minister said the Health Secretary Sajid Javid’s admission that there could be 100,000 new Covid cases a day over the summer had raised eyebrows among some colleagues. Medical advisers were fighting a rearguard action to slow down the reopening plan, they added.

Government sources conceded that while Johnson had warned the public at last Monday’s press conference not to be “demob happy”, his cautious message had “got slightly lost” as he announced the scrapping of all restrictions, including mandatory mask-wearing and social distancing. …

Several sources said the most likely outcome of Monday’s deliberations was for the Government to press ahead with July 19th but tone down the “freedom day” rhetoric. One said it “would be political suicide” to U-turn.

Worth reading in full.

A Doctor Asks: The Data Is Looking Good, So Why the Doom-Mongering?

There follows a guest post from our in-house doctor, formally a senior medic in the NHS, analysing the latest NHS England data packet.

Once a month, the NHS releases a more detailed summary of COVID-19 related data than provided in the regular daily updates. Although the data set is far from complete, the monthly packets provide a better impression of what is really happening in hospitals than the daily snapshot. I find this month’s information particularly interesting. Apologies in advance to readers for reverting to a more data-driven ‘chart fest’ format for my latest contribution – but stick with it, because there are some important messages here which have not been widely reported so far.

Take a look at Graph One. This rather complicated graphic shows daily admissions in the vertical orange bars and paired daily discharges in the vertical blue bars. Readers will notice that on every day between April 7th and June 30th, there were more discharges than admissions.

The grey line with the secondary y-axis to the right of the chart shows the total number of ‘COVID-19’ patients in hospital on each given day. For the first period from April 7th to May 25th, this was on a falling trend – that’s what one would expect if there were more discharges than admissions each day.

From May 26th to the end of June, however, the total number of patients in hospital ‘with COVID-19’ was on an upward trend – but on each day of the series, there were still more discharges than admissions. How can that be?

I’ve discussed this issue with colleagues and there are only three interpretations we can think of. One is that there are a very large number of patients contracting COVID-19 in hospital who came into hospital without the virus. The second is that some of the ‘discharges’ are in fact patients who were never admitted to hospital at all, but seen in A&E and then sent home. The other is that the data quality is very poor and gives a misleading impression of the true picture.

Vaccine Passports WILL Be Needed in Bars, Restaurants and Clubs in a Push to Get the Young Vaccinated

We haven’t seen the end of plans for the introduction of Covid vaccine passports, according to the Times. Its splash today says that “Covid certificates” will be needed to enter bars, restaurants and nightclubs under plans to combat a “fourth wave”, though the actual reason – as before, and as in Israel – is to push young people to take the vaccine, following a fall in take-up in this age group.

Entertainment venues in England would be forced to make customers use so-called vaccination passports from autumn, to prove that they had either had both doses or a negative test the day before. Recent figures have shown a reduction in the take-up of vaccines with first doses halving in two weeks. Fewer than 100,000 a day are being given out on average for the first time since April.

Unvaccinated young people are believed to be behind a rise in cases. One in 160 people in England were thought to have the coronavirus after a 58% rise over seven days, according to the Office for National Statistics. It estimates that 332,900 people had the virus in the week ending July 3rd, similar to levels in mid-October, with cases more than ten times higher in those aged 16-24 than the over-70s. …

Government sources said it had been decided not to force Covid certificates to be used as part of the easing of restrictions this month because it would discriminate against younger people who had not had their second jab.

There were also concerns it could have hit the so-called “spontaneous economy” with people being turned away from businesses because they could not prove a negative test result.

However, by mid-September ministers say all over-18s will have had the chance to have both jabs and officials believe that vaccination passports could be mandated for use in premises where social distancing is not possible.

“In autumn vaccine passports could become an important tool that will allow us to keep things open,” a Downing Street source said.

Another Government figure added: “If we can show real benefits of getting vaccinated in terms of everyday life then it could be quite a useful tool.”

While more than 95% of the over-50s have been vaccinated, the rate is 76% in those aged 30-34 and is now plateauing. So far 58% of those aged 18 to 24 have had a first jab.

Helen Stokes-Lampard, Head of the Academy of Medical Royal Colleges, said that dropping the requirement to quarantine for the fully vaccinated could also be a “very helpful incentive” for young people but urged the Government to “redouble efforts” to ensure they accepted the jab. But in a blunt warning she said that it was “unhelpful and potentially dangerous” to think of life returning to normal this month and people should continue to be cautious about socialising.

“July 19th should not be regarded as Freedom Day,” Stokes-Lampard said. “From a medical perspective, it shocks me to think that all restrictions would suddenly be dropped. We are in the middle of a dangerous third wave.”

She said that continuing to wear masks indoors was an “obvious one” in terms of tackling the spread.

Chris Whitty, the Chief Medical Officer for England, is also understood to be concerned that people will give up infection prevention measures once restrictions are lifted.

Worth reading in full.

Pub Takings on Match Days Massively Lower Than Pre-Lockdown Levels

Around 17 million pints would be sold in pubs on Sunday during the Euro 2020 final if it wasn’t for the continuation of social distancing restrictions. Instead, nearly 13 million are expected to be sold, according to the British Beer and Pub Association (BBPA), as pubs across the country struggle to break even. The Guardian has the story.

Billed as the closest thing to being in the stadium itself, sales in bars or pubs showing sport are usually 200-300% higher on big match days during a normal year. However, capacity constraints mean although sales during Euro 2020 are up about 60% on match days, that is only in comparison with poor takings over the past Covid-hit [lockdown-hit] year.

“We are seeing an uplift in drinks sales on match days but because of capacity constraints it is nowhere near as much as it would usually be,” said Kate Nicholls, the Chief Executive of industry trade body U.K. Hospitality. As a rule, pubs were only taking 70% of their usual sales which was not enough to break even, she said.

In Norwich, Dawn Hopkins said her pub, the Rose Inn, will be full, although at the moment that means just 30 customers. “We are obviously fully booked,” she said. “I’ve been turning away people for weeks who want to watch the football but social distancing and the need to be seated limits our capacity. I think everybody’s grateful to be trading again but it’s still very difficult.”

The BBPA estimates nearly 13 million pints will be sold on Sunday, with 7.1 million during the match itself. That total would be nearer 17 million but for Covid restrictions, which mean venues are at 50-60% of normal capacity.

Fuller’s, a pub owner in London and the south-east, said most of its 209 venues were fully booked on Sunday but it could have “taken a lot more” were it not for the “disappointing” restrictions. “It has brought people together though and pubs are the next best thing to being there,” the company added.

Greg Mulholland, of the Campaign for Pubs organisation, said the Euros had brought welcome extra trade but pubs were struggling, with table service challenging and costly. Some landlords said they had been warned by licensing officials they could be fined if fans got carried away, and he hoped the authorities took a “common-sense approach”.

Worth reading in full.

Reductions in Quality of Life Have Vastly Outweighed COVID-19 Deaths, Say Researchers

I noted recently that the British Government still hasn’t published a cost-benefit analysis of lockdown, more than a year after the first one was implemented. Instead, the task has been left to academics and others working outside of government, who’ve found that the costs almost certainly outweighed the benefits.

Now two economists based in Bolivia have attempted something similar at the global level. What they’ve done isn’t quite a cost-benefit analysis, as I’ll explain, but it puts the vast costs of lockdown into perspective.

Lykke Andersen and Alejandra Rocabado compared changes in the quantity and quality of life during the first year of the pandemic. They focus on a sample of 124 countries, which collectively account for 96% of the world’s official COVID-19 death toll.

To measure the quantity of life lost in 2020, the authors used the total number of excess life-years lost. And to measure the quality of life lost, they used the percentage reduction in the Google mobility index, averaged across different categories (retail, residential, etc.)

To simplify their analysis, the authors assume that “a 100% reduction in mobility for a year is equal to a lost year of life”. In other words, if average mobility fell by 20% in a country, then everyone in that country lost 1/5th of a quality life-year. This is a strong (and arguably unrealistic) assumption, but it’s useful for trying to get an overall sense of what happened.

The authors find that the world lost 48 million life-years due to people dying from COVID-19, but lost 1.25 billion quality life-years due to reductions in mobility. This means that the loss in quality of life was 25 times larger than the loss in quantity. The only three Western countries where the ratio was less than 2 were Denmark, Finland and Sweden.

How big is the 48 million number? As the authors note, “Every year, at least twice as many life years are lost due to children dying of diarrhea.” (Note that a child who dies of diarrhoea loses 50 or 60 life-years, whereas the average victim of COVID-19 loses only 5 or 10.)

One caveat is that data on excess deaths are not available for many developing countries, so in these cases the authors had to use official COVID-19 deaths, which are almost certainly undercounts. On the other hand, they used estimates of the average number of life-years lost per death that look to be on the high side. Overall, the 48 million number probably isn’t too far off the true amount.

Another point worth noting is that one can’t attribute the entirety of the 1.25 billion number to the impact of lockdowns. Some reduction in mobility would have happened anyway, due to voluntary social distancing. But even if it were cut in half, the total loss of quality life-years would still be 12.5 times larger than the loss in quantity.

Whether you buy their conclusions or not, Andersen and Rocabado’s paper is worth reading in full.

News Round-Up