Dr Joe Pajak looks back at last week’s coronavirus situation in the UK, one year on and over 100,000 lost lives, the various opinions of health professionals on the UK vaccine dosing interval, and more...
First published in January 2021.
Covid-19, One Year On...
Where did it all begin? Around a year ago now, a new virus was causing severe lung disease in Wuhan, China. It rapidly started to spread to other countries, and in no time, there were more than 500 confirmed cases globally and a number of people dying from the virus.
A year on, over 100 million people have been infected and over 2.16 million people have died of the virus worldwide.
In the UK, over 3.5 million people caught Covid-19 and sadly over 100,000 people died in one year. A figure, Prime Minister Boris Johnson said at Tuesday’s Covid-19 press conference, he took “full responsibility” for, saying of the government’s action during the pandemic, “We truly did everything we could” and “I’m deeply sorry for every life lost.”
Note: The actual number depends on which method of counting deaths is actually used.
Boris Johnson. | Number 10
Turning Up The Pressure
We must never forget the data represent the suffering experienced by real people, and that over 100,000 real people have now died in the UK in the past year due to Covid-19. Many of whom were working on the frontline, or were among those people who are more vulnerable in society.
At Wednesday’s PMQs in the House of Commons, Labour’s Keir Starmer asked the Prime Minister: “The question on everyone’s lips this morning is: why? The Prime Minister must have thought about that question a lot, so will he tell us why he thinks that the United Kingdom has ended up with a death toll of 100,000 — the highest number in Europe?” Boris Johnson replied that “there will indeed be a time when we must learn the lessons of what has happened, reflect on them and prepare. I do not think that moment is now, when we are in the throes of fighting this wave of the new variant, when 37,000 people are struggling with covid in our hospitals.”
Keir Starmer went on, accusing the PM of a huge number of mistakes: “The reality is this: the Prime Minister was slow into the first lockdown last March; slow in getting protective equipment to the frontline; slow to protect our care homes; slow on testing and tracing; slow into the second lockdown in the autumn; slow to change the Christmas-mixing rules; and slow again into this third lockdown, delaying 13 days from 22 December before implementing it. I fear that he still has not learned that lesson.”
The Liberal Democrats leader, Sir Ed Davey, again called for a commitment from the PM to set up “an inquiry sometime this year, so that we can find out why our country has seen the worst death rate from covid in the world, learn the lessons, and give bereaved families the answers and the justice that he owes them.”
Adding weight to the pressure on the Government, the SNP’s Ian Blackford said, “The UK Government response has been defined by a lack of leadership, last-minute U-turns, mixed messaging and devastating policies. All of this has had an effect on the scale of the pandemic,” to which Boris Johnson replied, “There are no easy solutions when we are facing dilemmas as tragic as the ones being confronted by countries around the world.”
In essence, the Leaders of the Opposition’s argument is that the dreadful situation has occurred because of complacency, a lack of preparedness, a failure to follow the science, poor government decision-making, and delayed action.
Boris Johnson at PMQs. | UK Parliament
Extending Vaccine Dosing Interval?
The amazing development of vaccines to protect us against Covid-19 brings the most hope, alongside a range of actions to prevent further transmission.
The vaccines currently developed, and in use in the UK, require two doses, this presents another challenge given the urgency and need to vaccinate so many in Britain, let alone the globally. But what is the evidence for extending vaccine dosing interval?
The British Society for Immunology recently called on the government to make “full evidence for decisions around covid-19 vaccines available immediately to build public trust.”
Dr Duncan Robertson, Lecturer in Management Sciences at Loughborough University explained that, “If we are chasing the statistic of the number of people given the first dose, we risk overlooking the vulnerable, the hard to find, and the disadvantaged. These are the groups where the outbreaks can and do occur, risking resurgence in the virus and a further cycle of lockdowns.”
The latest UK data indicates that only 474,156 people have had two doses of the vaccine, while 7,164,387 have had one dose. The majority of these people now await their second dose in order to complete the required vaccination dosing and achieve the vaccine protection from Covid-19.
This needs to be considered in light of the minutes from the 7 January 2021 SAGE meeting, where it was reported:
“The decision has been taken in the UK to delay the second vaccination dose until 12 weeks after the first. The unquantifiable but likely small probability of the delayed second dose generating a vaccine escape mutant must be weighed against the measurable benefits of doubling the speed of vaccine-induced protection to the most vulnerable. These benefits are particularly significant when prevalence is high.”
So, while it continues to be very positive news that there has been an increasing number of first vaccination doses, the government needs to take great care in its vaccination strategy. The current vaccines in use in the UK both clearly require a second dose, according to the manufacturers, to give the full protection expected.
Professor Kailash Chand, Honorary Vice President of the BMA, for instance, wrote that:
“Staff illness rates are significantly higher than usual, and confidence within the profession is certainly now very badly shaken by disregard to manufacturer’s and World Health Organisation’s recommendations to give the second dose within 21 to 28 days.
“The Government must learn lessons from its past failures on many counts, like the fiasco of ‘test, trace and isolate’ initiatives. Please stop gambling with the health of at-risk individuals including healthcare workers, and allow the second doses of the Pfizer vaccine to be given between 21 and 28 days after the first.
“Science is not on the side of the delayed second dose of the Pfizer/BioNTech vaccine. The Joint Committee on Vaccination and Immunisation and Public Health England should revisit and reverse their decisions based on emerging scientific evidence.”
Isolating a bit more the UK in its decision, the US Centers for Disease Control and Prevention (CDC) has taken the side that the second vaccine dose “should be administered as close to recommended interval as possible. If not feasible, second dose may be administered up to 42 days after the first dose.” – i.e. a maximum six-week gap compared to the UK’s maximum 12-week gap.
For information, according to this report published by the BMJ, the Pfizer vaccine efficacy was found to be 52% after the first dose and 95% after the second dose.
There will be other studies, and further data from current and future trials, and from the vaccination programme.
Bristol Covid-19 Vaccination Centre. | Number 10
Richest Countries First
Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, raised the alarm on how “the world is on the brink of a catastrophic moral failure” by the poorest nations on the planet being kept away from vaccine supplies for their populations whilst the richest nations purchased doses by the hundreds of millions.
“The promise of equitable access is at serious risk. Over 39 million doses have now been administered in at least 49 higher-income countries. Just 25 doses have been given in one lowest-income country.
“COVID-19 surprised even some of the world’s richest and most powerful nations. It caught them unprepared, and revealed a collective failure to invest in emergency preparedness.
“There will be enough COVID-19 vaccine for everyone. But right now, we must work together as one global family to prioritize those most at risk of severe disease and death, in all countries.”
Dr Tedros Adhanom Ghebreyesus. | UN/Elma Okic
Covid Patients Readmitted After Discharge
A new research, still to be peer-reviewed, found that 29.4% of COVID-19 hospital patients in England who leave hospital after being discharged are eventually readmitted within 140 days – seven times higher than non-COVID patients – and 12.3% of them die. The risk of post-discharge illness is greater in young and ethnic minority individuals.
This is a striking illustration of the harm the virus does, and not simply in the old.
Royal Derby Hospital. | Geograph/Chris Allen
Nothing to do with Covid-19, or its devious variants, should surprise any of us, anymore.
Time for us all to ‘fight the good fight’, together, one world, one enemy, one foe, invariably.
- Daily summary: Coronavirus in the UK | UK Government
- Coronavirus (COVID-19) NHS Advice | PMP Magazine
- Vaccination Data | UK Government
- Seventy-fifth SAGE meeting on COVID-19 - 7 January 2021 | SAGE
- Science is not on the side of the delayed second doses | Pulse Today
- Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States | CDC
Dr Joe Pajak, Professional experience applied scientific research and development, then director of a national children’s charity, trustee of a disability charity, and governor of NHS foundation trust hospitals.
Check their Voting Record:
🗳️ Keir Starmer
🗳️ Ed Davey