It is a shame that people find it necessary to have unnecessary vaccinations just because different governments cannot get their acts together over recognising each others vaccinations. The sooner that is resolved the better.

 

The real world is a great deal more complex than that.

For example, what do you mean by "they work"? 100% efficacy? How are you measuring efficacy - infection, serious illness, hospitalisation or death? Must the efficacy remain stable for all time?

 

The point is somewhat more fundamental though. Once you have delivered the vaccine, and keep doing boosters to those in risk groups, having more restrictions or even lockdowns just prolongs this pandemic and keeps pushing the problem down the road. I am afraid we have to accept that covid will remain endemic, most will get it at some stage, and some may die. Whether that happens tomorrow or next year or the year after has to be balanced against the harm that prolonging restrictions does in terms of other issues like people not going to hospital and dying of things which were treatable etc. and the harm to our way of life and economy. Most people proposing more restrictions now seem fixated on case numbers alone without trying to look at this problem more widely and reached a balanced view.

It is also true that the risks of covid have been significantly reduced over the last 18 months due to better treatments in hospital and of course the vaccine which massively reduces the probability of severe symptoms. The risks associated with covid have changed significantly and therefore our approach to it must change too.

The only reason for restrictions would be to stop a spike which resulted in too many people in hospital (say 20-30k plus) or unacceptable deaths (say 600-700 plus per day), and fundamentally that means lockdowns as everything else is just tickling at the edges when it comes to impact. I am not saying masks don't work, but fundamentally the impact is not particularly high as can be seen around the UK when comparing places with and without mask mandates. I can't see us getting anywhere near these numbers now due to the levels of protection we have with vaccines and antibodies from previous infections.

 

Endemic does not mean "do nothing, we have to live with it". Endemic does not mean no interventions. The plague is endemic. If a single case arise in a community there is a (strong) response. Same with Malaria, it is endemic. The flu is endemic and there is a lot of work behind the scene done to mitigate its damage (for example, the testing of dozens of thousands of animals every year to see what strains are going around and do predictions and models). Sometimes this work is visible only to a small community because a very local response is done.
You seems to think restrictions and measures controls as loss of freedom only while there is a good deal of work that can be done to mitigate it without affecting freedom and going into lockdown. Japan method (except their vaccine rollout) is a good example. They never lockdown, they had a very strong response using aeration, filtering, ventilation, mask usage. All those tools can be used. To compare mask usages as you suggest you need to fix one variable only, and reality does not work like that. The only comparison you can use is the RCT from Bengladesh showing that mask do limit transmission.

 

You've nailed it.

 

We have vaccinated everyone who wants it. We are now vaccinating those between 11-18 not really due to their own risks but to protect society as a whole (the JCVI was clear the risks vs rewards to the individual child were balanced to the extent it was marginal). We have constantly been developing better treatments and there are some promising anti viral treatment drugs on the way - as I noted the risk of death from covid is now significantly less than it was a year ago. I am sure there will be tests and tweaked vaccines coming as the covid strains change, just like flu as you compared it to.

The changes in terms of physical infrastructure such as ventilation is something that can be done, but as with all spending there will be some value threshold which needs to be justified.

I wouldn't class any of that as nothing.

 

I don't disagree with you there, you are quite right. It is the usage of words restrictions and lockdown that makes me tickled. We need to get out of people mind that mitigating COVID (in addition to vaccines) means using those blunt tools. It does not necessarily.

 

The virus is endemic and we will have to live with it, but that does not mean that we should just let it rip.

The UK is clearly a global outlier, with one of the highest infection rates in the world and a rising death rate while the vaccination programme is rapidly falling behind many other nations'. We should not be accepting 200 deaths a day as the price of so-called freedom, even if most of the deaths are amongst those who refuse to be vaccinated (and I don't know whether that is the case). The government has said that it sees no reason to take action yet, but that is simply repeating its mistakes of the last 18 months, when it has repeatedly reacted too late to events. The complacency is astounding.

 

I thought we had lockdowns to protect the NHS from being overwhelmed, now it is to prevent unacceptable deaths which you seem to be defining at the very low rate of 200? To put that in context around 200 people die from smoking every day in the UK.

So you impose restrictions, the death rate goes down a little, you then lift restrictions and the death rate goes back up again a little. Rinse, repeat. Not sure you are actually achieving much tbh, just stringing it out rather than having any effect reducing absolute deaths over time from covid.

 

200 a day is not a low rate. Assuming this would a constant yearly, it adds 73 000 death to circa 575 000 (more or less the average number of death in UK in the past few years). That means going back to mortality level pre-1945.
That 200 people a day die of smoking is irrelevant actually. And we do work to reduce this number (smoking bans in public spaces, work on cancer, advertisement for cigarettes forbidden).
As for the lockdown to protect the NHS, this was government communication. You could go further than that and also add lockdown at the time were to reduce transmission to a manageable level for society. It failed, but those should have been the goal.

 

We've had this discussion of what constitutes a "low rate of deaths" a number of times before. I personally find it a bit in bad taste, but let's park that for a second.

I might be totally na�ve, but the job of the government in this specific situation is to protect its citizens and avoid avoidable deaths. Sure, it's hard to protect old Gavin who's 95 and has a plethora of pre-existing conditions. And, sure, there isn't a lot we can do to protect anti-vaxxer Kevin who's got asthma but refuses to wear a mask or get jabbed but... not all the people who are passing away can be ascribed to either category. This year, 2021, is up 9.5% in terms of deaths versus the 2015-2019 average, according to the ONS.

How much of this delta is made of "avoidable" deaths? I don't know, but I suspect a fair chunk. And I know empathy is not equally spread in this forum, but let's just remember that there's a human cost - to families, friends, society as a whole - for each death. A responsible government should look at these data and do something about it. Sure, we can't go back to lockdowns. But why don't we introduce vaccine passports? Can't we re-instate (and patrol) mask mandates? Government tells us to wear a helmet when biking, or a seatbelt in cars, for a reason. Sure it's a pain, but it helps avoiding an early meeting at the Pearly Gates with St Peter. Why are they abdicating all responsibilities when it comes to Covid?

 

Well as I said it comes down to where you draw the line in terms of actions you do to prevent each death. All restrictions have a cost, and I don't mean just financially. By your reasoning all smoking deaths are avoidable if the government simply bans cigarettes, but zero risk is not the approach so I don't see why it should be with covid either. Vaccine passports are not a no cost option and there are very serious issues about their use which are not trivial. I am afraid if we follow your logic we end up living with permanent restrictions of some sort as covid and deaths from it will always be present. I doubt there will be a time during my lifetime where there are zero deaths from covid in the UK.

Apart from the period January to April this year, most of the deaths in the UK are not due to covid. The rates now for deaths may be higher than expected, but actually covid deaths represents a very small proportion. Weekly death rate is around 10k and covid is not making much impact. Death rates over the last few months have been around 90-150, and yesterdays figure of 223 seems to be an outlier so far considering the last week's figures. You actually have to go back to May to find a day when we were above 200. There are suggestions that some of the excess deaths now may be because people did not go to GPs and hospitals early enough when they had symptoms due to the concern about accessing health services and helping protect the NHS.

18-10-2021 32
17-10-2021 61
16-10-2021 77
15-10-2021 92
14-10-2021 115
13-10-2021 104
12-10-2021 101
11-10-2021 117

I have seen the seat belt and bike helmet argument before many times. It's comparing apples and oranges. Compare the survival rates of having a car accident or bike accident if not wearing those things to the survival rates for everyone who gets covid, they are several orders of magnitude different. But if we are to use the comparison you can argue the vaccine is our covid helmet here. Again if we apply your unavoidable deaths logic we would ask everyone to drive around at no more than 30 mph everywhere, but clearly we don't as we accept that to do so would mean trade offs we aren't willing to accept. As I say, there is no such thing as a zero risk strategy with covid and even NZ has realised that zero risk by zero covid is no longer sustainable.

 

Have I written about zero-risk? No.
I've written about reducing avoidable deaths. There's a fundamental difference. I think HMG ought to be doing its best to reduce avoidable deaths - and right now it's not doing it.

We've already spent a hefty amount of taxpayer's money on a monumental - and frankly useless - T&T system and NHS app. Which are now not being used. I've travelled in several EU countries and the use of a "vaccine passport" is frankly easy and painless.

What permanent restrictions? We already need to have proof of being the correct age when buying alcohol, our passport when travelling, jabs when going someplace exotic, we already have to go through metal detectors in many public places and, if Priti has her way, before we can snitch on the government we must check with government first. And as for these restrictions being 'permanent'... you don't know that.

Rather than cherry-picking the dates that fit the agenda, let's look at the year so far. Below is the data from the ONS for England and Wales. It's pretty clear to me that, when covid deaths rise, deaths rise. Not for nothing, around week 22/26, when we were at very low number of deaths, 2021 was in line with the average (and bear in mind I'm using the deaths with C-19 as the underlying cause, not the "hit-by-a-bus-while-having-covid" scenario).



The example of seatbelts and bike helmets are, indeed, examples. They serve to illustrate a concept, not to define legal precedent. I could've used the policies for other infectious diseases such as dengue, or Ebola. HMG is actively working to reduce the danger deriving from something, and in doing so it implements some rules and checks these rules are enforced. It's doing nothing of the kind over Covid. You don't need to have a vaccine, you don't need to wear a face mask... But the consequences of not doing so can be fatal and often cases are. Why is that?

 

Daily data:

Cases 49,139 (42,776 last Wednesday)
Deaths 179 (136)
Patients admitted 869 (756 on the 9th)
Patients in hospital 7,891 (7,056 on the 12th)
Patients in ventilation beds 850 (780 on the 12th)
People vaccinated up to and including 19 October 2021:
First dose: 49,505,327
Second dose: 45,433,757

The rolling seven day daily average for cases is now up 17.2% on the previous week and the same measure for deaths is up 21.1%. The rolling 7 day daily average for deaths is 136.3 today.

 

Number 10 briefing at 5 apparently.