Today’s Update

Monday, 29th November 2021

Mandatory Masks Return to Secondary Schools

By Toby Young

In a late addition to the raft of Covid restrictions announced by the Prime Minister yesterday, the Department for Education has issued new guidance today requiring secondary school students to wear masks in communal areas starting tomorrow. MailOnline has more.

The DfE sent an email update to schools and childcare providers which said: “Face coverings should be worn in communal areas in all settings by staff, visitors and pupils or students in Year 7 and above, unless they are exempt.

“Pupils or students (in Year 7 or above) should continue to wear face coverings on public and dedicated school transport, unless they are exempt.”

The update comes after the UK Health and Security Agency (UKHSA) said an individual, who is longer in the country, tested positive for the Omicron variant after travelling to Westminster in London and the infection was “linked to travel to southern Africa”.

Worth reading in full.

I wonder why this wasn’t announced yesterday? Is it because the Government knew it would play badly in the Sunday newspapers and on the Sunday morning talk shows? It has essentially sneaked the news out late on Sunday.

Needless to say, it makes zero sense. After all, if the Omicron variant is actually less dangerous than the Delta variant – and all the evidence we’ve amassed about it so far suggests it is – then shouldn’t we be encouraging schoolchildren to catch it so they can then experience a mild, cold-like illness and thereafter enjoy better protection against COVID-19 than if they’d been vaccinated? That is, the small number of schoolchildren who haven’t already caught and recovered from the virus?

As a parent of three children who will have to wear masks in school tomorrow, I am livid.

Stop Press: Those refusing to wear masks in shops and on public transport face being fined £200, rising to £400 for a second offence – the same penalty system as before. The Telegraph has more.

NHS Chief Stephen Powis Claims the “Overwhelming Majority” of Covid ICU Patients are Unvaccinated. But Is He Using Out-of-Date Data From July?

By Will Jones

Uh-oh. I’ve been ‘fact-checked’ again. This time by the oracles at a website called ‘Logically‘, which I can only assume was a name chosen ironically. The claim they are ‘fact-checking’ is “COVID-19 vaccines don’t work because most people in U.K. hospitals with the virus are vaccinated”, which is a bad start since it’s not a claim I make in the article in question, or indeed anywhere. In fact, in the article I state that on current data the vaccines appear to “protect people well against severe disease and death”, meaning the ‘fact check’ is aiming at a straw man that bears no relation to the piece.

Having stuffed her target full of straw, the author ‘Pallavi’ spends most of her ‘fact check’ wholly missing the target. Alleging that my article “fails to disclose all the details mentioned in the [UKHSA] report, thereby misrepresenting official data and promoting vaccine misinformation”, she points out that the UKHSA cautions against using the raw data to estimate vaccine effectiveness. Indeed it does, and in the article in question I do not use the raw data to estimate vaccine effectiveness. The article is not about vaccine effectiveness. It is responding to a claim in a Guardian article that “in hospital, COVID-19 has largely become a disease of the unvaccinated”. It is making the point that, according to official data, 71% of adult Covid hospital patients and 82% of Covid deaths in the month ending November 14th were in vaccinated people – which is indisputable, and the ‘fact check’ does not dispute it. The point was not to estimate vaccine effectiveness from these figures – to do that we’d need to take into account the proportions vaccinated and unvaccinated, at a minimum – but to counter the claim that “in hospital, COVID-19 has largely become a disease of the unvaccinated”.

In the course of supposedly refuting my errors the ‘fact check’ even quotes from “a recent report by the Official [sic] for National Statistics” which claims that “the age-adjusted risk of deaths involving COVID-19 between January and September 2021 was 32 times greater in unvaccinated people than fully vaccinated people”. This is the same ONS report that the U.K. Statistics Authority publicly criticised for being misleading in its use of statistics for making precisely that claim.

Pallavi writes that “the COVID-19 pandemic has given rise to a lot of potentially dangerous misinformation”, and, libellously, refers to the Daily Sceptic as “a website that often propagates COVID-19 misinformation”. Hmm, unlike Logically, which publishes ‘fact checks’ that attack straw men and cite discredited reports.

Meanwhile, the Sunday Times has added its authority to the Guardian‘s unsubstantiated claims about hospitals being deluged with unvaccinated Covid patients. It published an article today stating that intensive care beds are “filled with unvaccinated Covid patients”. The paper quotes Professor Stephen Powis, the National Medical Director of NHS England, saying: “Data shows that the overwhelming majority of people admitted to intensive care with Covid are not fully vaccinated. Since July one in four critical beds have been consistently occupied by a Covid patient, with the latest statistics available showing three quarters of them are unvaccinated.”

What “data” and “latest statistics” is Powis referring to? The Sunday Times article containing his quote doesn’t say, but if you click on the words “overwhelming majority” it takes you to another piece in today’s paper, this one by Dr. Rachel Clarke. The subhead of that article is “Some 75% of those suffocating in intensive care with the coronavirus are unvaccinated” and she repeats this claim in her piece, stating: “Of the Covid patients treated in intensive care in recent months, the majority – nearly 75% according to the latest data – have chosen not to be vaccinated.”

Earlier today, Toby asked Rachel Clarke on Twitter if she could point him towards the “data” she’s referring to and she replied by citing the latest ICNARC report.

Is this the data both she and Professor Powis are referring to or just Dr. Clarke? A similar tweet from Toby to Stephen Powis went unanswered, but it’s not unreasonable to assume they’re both citing the latest ICNARC report, not least because the latest one includes for the first time a breakdown of vaccinated and unvaccinated patients receiving critical care in English NHS hospitals. (Clarke refers to separate NHSE data showing the same thing, but I can’t find anything on the internet.)

Now there’s a slight problem with the ICNARC data Clarke cites, which is that it only covers the period May 1st to July 31st.

So is the data for May 1st to July 31st what Professor Powis means by “since July” and what Dr. Clarke means by “recent months”?

The problem with extrapolating from this ICNARC data to make sweeping statements about the current ratio of unvaccinated to vaccinated Covid patients in ICU – as the Sunday Times subhead does and Dr. Clarke does, and Professor Powis appears to – is that it stops before the Delta wave gets properly underway and before the surge in infections in the vaccinated over the summer, when the epidemic became dominated by vaccinated people.

If this is what’s going on, it’s reminiscent of the ‘sleight of hand’ by NHS England chief Amanda Pritchard earlier this month, when she claimed that: “We have had 14 times the number of people in hospital with COVID-19 than we saw this time last year.” It quickly turned out that by “this time last year” she was referring to August rather than October or November, and was widely ridiculed for such an obviously incorrect and scaremongering statement when Covid hospital admissions at the time were plainly lower than in autumn 2020. She never apologised and instead tried to make it look like she was misunderstood, which, if Powis’s latest intervention is of a similar kind, suggests there may be no intention in the upper echelons of the health service to communicate clearly and accurately about the current risks posed by the virus.

In fact, given the data from UKHSA over the autumn showing a higher proportion of Covid hospitalisations and deaths in the vaccinated (67% and 82% respectively in the week 46 report), it seems most unlikely that three quarters of Covid ICU patients in the same reporting period were unvaccinated. Why, though, do we not have data in the public domain more recent than July so we can see for ourselves rather than having to extrapolate and speculate? We have up-to-date data on hospitalisations and deaths by vaccination status, so why doesn’t the UKHSA add a column to its table for ICU admissions as well?

The biggest problem with Powis’s statement is not that it appears to be a misleading way of communicating statistics, but that it is being used against the unvaccinated in what seems to be a concerted effort to turn them into scapegoats and pariahs. “These are beds that would have historically been used to provide life-saving surgeries for the most seriously ill patients,” he says. This echoes the words of the anonymous medic in the Guardian last week: “If everyone got vaccinated, hospitals would be under much less pressure; this is beyond debate. Your wait for your clinic appointment/operation/diagnostic test/A&E department would be shorter. Your ambulance would arrive sooner. Reports of the pressure on the NHS are not exaggerated, I promise you. … Most of the resources that we are devoting to Covid in hospital are now being spent on the unvaccinated.”

This is an ugly and dangerous road. Not only is there currently no publicly available data to back up these assertions – at least, nothing more recent than July 31st – but even if there was it would be no excuse to demonise and delegitimise the minority who, for whatever reason, remain unvaccinated. Our health service chiefs, and the journalists who report on their comments, need to do better than this.

Covid Hospital Admissions are Falling in England, as are the Total Number of Covid Patients – and Omicron Looks Unlikely to Change That

By Luke Perry

There follows a guest post by the Daily Sceptic’s in-house doctor, a former NHS consultant now in private practice. He’s looked at the latest NHS England data and points out that there are fewer than half as many Covid patients in English hospitals than there were this time last year, not 14 times as many, as was claimed recently.

On Friday November 26th, the South African Institute for Communicable Disease released a statement in relation to the Covid variant now referred to as Omicron.

The variant had been first detected on November 12th from specimens collected in Gauteng Province and the molecular structure was characterised by November 22nd. The statement from the South African Institute on November 26th considered that the Omicron variant did not meet the WHO criteria for being either a ‘variant of interest’ (VOI) or a ‘variant of concern’ (VOC). Yet less than 24 hours later, the WHO had classified the Omicron variant as a ‘variant of concern’.

The definitions of variant classification are clearly laid out by the WHO. Classification of a ‘variant’ usually proceeds stepwise, from VOI to VOC. Classification of a VOI requires data collection to verify different effects of the specific variant and upgrading it to a VOC requires evidence that the variant is definitely evading prior immunity or making humans more severely unwell than previously.

I cannot find any evidence in the open sources to date that shows infection with the Omicron variant carries any greater risk of hospitalisation or death than the currently dominant Delta variant. One obvious possible reason for this absence of evidence is that the variant was only identified very recently. Given the known time lag between infection, the development of severe disease and hospitalisation, there has not been sufficient time to assess whether this particular new strain is clinically significant or not. It might be, but we just don’t know.

Simply put, it is not yet clear whether this new variant is a bad one (more infectious and more lethal) or a good one (more infectious but less severe). Opinion is clearly divided on how this situation will develop. Dr. Angelique Coetzee, the Chair of the South African Medical Association, speaking on Marr on Sunday 28th said that so far all the known patients infected with Omicron had very mild symptoms and none of them had been admitted to hospital.

Looking at the ‘charts that matter’ this week, we see a continual reduction in Covid admissions to hospitals (graph one). It’s important to note that all of these admissions are likely to be the Delta variant rather than the Omicron variant.

Graph one

Graph two shows that the total number of Covid positive patients in hospitals also continues to fall – from this we can reasonably infer daily discharges are higher than daily admissions.

Graph two

The Pritchard ratio (the number of patients in hospital with Covid divided by the number at the same date in 2020) is approximately 0.43 – so there are currently fewer than half the number of Covid inpatients compared to this time last year – not 14 times as many. Covid positive patients occupy approximately 4% of NHS hospital beds.

ICU numbers show a similar pattern (graph three).

Graph three

I was encouraged to see in last week’s report from the Intensive Care National Audit and Research Centre (ICNARC) that vaccination status has now been included in the data. The absence of this important information from such a reliable and credible audit has puzzled me for months.

Table 16 of the report shows that overall, 75% of patients in ICU with severe Covid are unvaccinated and there is a gradient of incidence with increasing age – 90% of admissions in the youngest age group (18-29 years-old) were unvaccinated compared to 39.3% in the over 70s.

Nevertheless, the data presented only refers to the period from May 1st to July 31st. I find it surprising that there isn’t more up to date information available. Clearly, the proportion of the population double vaccinated at the end of November is likely to be higher than it was at the beginning of May and that may have a significant bearing on the ICU admission figures. Further, a casual glance at graph three above shows that the incidence of ICU cases between May 1st and July 31st is very different to the period from September 1st to November 26th. Surely, there must be more up to date information about vaccination status of ICU patients available? Why not publish it, unless it tells a different story to the one the NHS wants to tell?

Overall, the trends as we go into winter are fairly stable or on a gradual downslope. The numbers are substantially better than this time last year. Professor Chris Whitty acknowledged as much at the Downing Street press conference on November 27th. The widely predicted resurgence of influenza has so far failed to materialise. The National Influenza and Covid Surveillance report shows extremely low levels of both flu and Respiratory Syncitial Virus (a common winter respiratory infection in children) – both far lower than at this stage in prior years.

In politics, as increasingly in clinical medicine, decision makers are fixated on blame – as in who gets it when things go wrong.

The reimposition of travel restrictions and mask mandates in England in response to the identification of the Omicron variant marks the crossing of a new threshold in ‘non pharmaceutical interventions’. At the start of the pandemic, the WHO stated that societal restrictions should be regarded as a last resort – mainly because of the known economic and wider adverse public health consequences.

We have now come to a situation where societal restrictions are imposed on the basis of fear about what might happen, rather than a rational analysis of what has happened and is currently happening. Patrick Vallance acknowledged in the Downing Street press conference that, as yet, there is still no clear data suggesting Omicron is more dangerous than the Delta variant.

Simply put, the Government now reaches for societal interventions as the first resort to a perceived public health threat, rather than as a last resort. This is a worrying precedent as it opens the door to arbitrary restrictions by the executive on the population based on opinion rather than quantifiable facts. I’m sure the implications of that shift are obvious to readers.

Stop Press: According to the Telegraph, backbench Conservative MPs who are sceptical about the effectiveness of NPIs are asking for a House of Commons vote about the new restrictions on Tuesday. Read more on that story here.

U.K. May be Panicking Unnecessarily Over Omicron Variant, Says Doctor Who Discovered It

By Toby Young

The South African doctor who discovered the Omicron variant said on Marr this morning that the U.K. may be panicking unnecessarily about the new Covid strain. Metro has more.

Dr Angelique Coetzee said that patients had been presenting with ‘extremely mild’ symptoms in her country, though the population there is significantly younger than in the UK.

The chair of the South African Medical Association suspects the variant is already widely in the UK but added she had not seen any confirmed cases admitted to hospital – adding that other colleagues had seen the “same picture”.

But other experts have disagreed with the characterisation of the variant, especially given the limited amount of data available.

It comes amid growing concern and new restrictions following the discovery of the strain, which experts fear may be able to evade vaccines and be more transmissible.

Those fears are yet to be confirmed, however.

She told the BBC’s Andrew Marr show she first encountered the variant in a man in his early 30s who presented with tiredness and a mild headache, but none of the usual coronavirus symptoms.

She said: “What we are seeing clinically in south Africa, and remember I’m at the epicentre – that’s where I’m practising – it’s extremely mild. For us, that’s mild cases.”

When asked if the UK was “panicking unnecessarily”, she said: “I think you already have it there in your country and you’re not knowing it, and I would say, yes, at this stage I would say definitely.

“Two weeks from now maybe we will say something different.”

She listed symptoms of Omicron as extreme tiredness, headaches and a scratchy cough – but not a loss of smell or taste.

“Your doctors might be more focussed on the Delta symptoms and missing this, because it is easy to miss this,” Dr Angelique added.

Worth reading in full.

So the symptoms are tiredness, headaches and a scratchy cough? Sounds a lot like a cold.

Watch the clip from Marr on Twitter here.

Sajid Javid Says the U.K. Is “Nowhere Near” a Return to Full Lockdown Measures

By Luke Perry

Sajid Javid has said that the Government is “nowhere near” bringing back full lockdown restrictions in the U.K., saying that the measures “carry a very heavy price”, such as economic damage and negative mental health outcomes. The Health Secretary also said that “people should continue with their plans as normal for Christmas” despite the emergence of the Omicron variant. The Sun has the story.

Health Secretary Sajid Javid has said “we’re nowhere near” reintroducing working from home or social distancing measures to combat Covid.

He told Sky’s Trevor Phillips on Sunday: “We know now those types of measures do carry a very heavy price, both economically, socially, in terms of non-Covid health outcomes such as impact on mental health.

“So, if one was to make decisions like that they would have to be done very, very carefully and we’re not there yet, we’re nowhere near that.”

He added that people should plan for Christmas as “normal”.

“I think it’s fair to say that the nature of this pandemic is it would be irresponsible to make guarantees,” Javid said.

“As for Christmas, I think people should continue with their plans as normal for Christmas, I think it’s going to be a great Christmas.”

It comes as compulsory mask-wearing is set to return next week in a bid to save Christmas from a super-mutant coronavirus.

Boris Johnson ordered the move after at least two cases of the fast-spreading Omicron variant were found in the U.K.

He also urged people to get booster jabs, saying: “It’s more vital than ever.”

Mask-wearing will again be compulsory in shops and buses, trains and taxis in England from Tuesday.

Overseas travel and self-isolation rules have been tightened after the first two cases of the super-strain were detected in Britain.

Scientists will explore how the booster programme can be extended, including to those as young as 18 years-old.

Omicron, discovered only days ago in southern Africa, has been declared the worst variant yet by one expert, while there are fears it might reduce vaccine protection over time.

The Prime Minister’s measures, outlined at a Downing Street briefing, aim to slow down its spread until scientists know just how dangerous it is.

But Johnson stopped short of imposing a devastating shutdown of pubs and restaurants in the run-up to Christmas.

He insisted that if the public stick to the rules and get their jabs, there will be no need for another last-gasp festive lockdown…

Despite the reassurances, the mere prospect of fresh Covid curbs will send shockwaves through the hospitality industry which saw takings fall by almost 80% in the festive period last year.

Johnson refused to give any guarantees but he is clear that there will be no lockdown like last year, and people were not being asked to work from home.

In a further move, he announced plans to step up the pace of the jabs programme.

Worth reading in full.

Omicron Variant Spreads to Denmark And The Netherlands – And Could Lead to Restrictions Tightening in Europe

By Luke Perry

Denmark has recorded just two cases of the Omicron variant so far, with the Netherlands reporting 13; both nations found that all carriers of the new variant recently arrived from southern Africa. The Dutch Health Minister said that he expects more cases to rapidly appear within the country, with the Danish health authorities also actively monitoring its spread. Meanwhile, the U.K. is introducing new measures to directly tackle the variant, whereas elsewhere in Europe, various nations imposed lockdown restrictions in response to a sharp increase in Covid cases before the Omicron variant landed on the Continent, and could expand the restrictions further still. The Express has the story.

With large parts of Europe, including Austria, Germany and potentially France, already vying to ramp up restrictions in response to a recent increase in non-Omicron Covid cases, eyes will now be on leaders to see how they choose to respond to the emerging variant. But numerous health officials have played down fears of the variant and two of the world’s largest Covid vaccine producers have said they will be able to “very quickly” update their jabs “if they need to”.

The latest European countries to report Omicron Covid variant infections are the Netherlands and Denmark.

Dutch health authorities announced that 13 cases of the variant were reported among passengers who arrived in Amsterdam on Friday on two flights from South Africa.

This was out of a total of 600 passengers, 61 of whom tested positive for Covid.

Health Minister Hugo de Jonge said: “It is not unlikely more cases will appear in the Netherlands.

This could possibly be the tip of the iceberg.”

Denmark also announced two cases of the variant on Sunday.

Both people who were found to have been infected by the variant had travelling from South Africa.

In response, Director of the State Serum Institute Henrik Ullum, quoted in Reuters, said: “This was to be expected, and our strategy is therefore to continue intensive monitoring of the infection in the country.”

Beyond Europe, health officials in Australia have reported two cases of the variant in people who had arrived in the country from southern Africa.

Prime Minister Boris Johnson led a press conference on Saturday afternoon after two Omicron cases were reported in Britain.

He said that “we simply don’t yet know enough” about the variant, but insisted that a “precautionary approach” must be taken against it.

This includes the reintroduction of face mask mandates and the tightening up of travel restrictions.

All people who travel to Britain must now self-isolate until a PCR tests shows they are Covid negative, even if they are displaying no Covid symptoms.

Worth reading in full.

New York State Declares a Public Emergency Due to The Omicron Variant

By Luke Perry

The Governor of New York state, Kathy Hochul (pictured), has signed an executive order declaring a state of emergency, which won’t be lifted until at least January 15th. Fears over the new Omicron variant have persuaded the Governor to act, with Hochul tweeting that: “While the new Omicron variant has yet to be detected in New York state, it’s coming.” The Independent has more.

The state of New York has declared a new public emergency over the emerging Omicron variant of Covid, warning New Yorkers: “It’s coming.”

New York Governor Kathy Hochul signed an executive order on Friday lasting until at least January 15th that branded the state’s rates of Covid-transmission as a disaster requiring urgent aid to local governments.

The Omicron variant has alarmed health officials since its discovery in Botswana earlier this month, spreading rapidly through South Africa and into Europe and Asia.

Scientists fear it could become a so-called ‘escape variant’ that is resistant to current Covid vaccines, and the World Health Organization (WHO) has classified it as a ‘variant of concern’.

President Joe Biden has imposed new travel restrictions on Botswana, South Africa and six other sub-Saharan African countries, also urging Americans to get their vaccines and booster shots. As of Friday, the variant has not been spotted in the U.S.

Hochul said: “We continue to see warning signs of spikes in Covid this winter, and while the new Omicron variant has yet to be detected in New York state, it’s coming.

“Today I signed an executive order to help boost hospital capacity ahead of potential spikes. Through this action, we will also be able to acquire critical supplies more quickly to combat the pandemic.

“I urge New Yorkers to take advantage of our greatest weapon in the pandemic: the vaccine. Get vaccinated and get the booster as soon as you are able.”

Worth reading in full.

News Round-Up

By Luke Perry

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