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On this day in 2020...23rd November


MONDAY 23rd NOVEMBER 2020


Facts and figures.

11,299 reported new cases in 24 hours.

608 deaths.


The categories of COVID deaths in the first wave up to the 20th June 2020, published by the ONS:


Care Home deaths – 19,394


Deaths elsewhere:

80+ years - 14,987

75+ years – 4,504

70+ years – 3,502

65+ years - 2,333

60+ years – 1,635

55+ years – 1,433

50+ years – 835

All under 50 – 984


Author’s note. You can see from these figures how the JCVI have come to prioritise the vaccine roll out.


Daily news.

There will be a news briefing later today by Prime Minister Johnson.


**THIRD VACCINE DISCOVERY ANNOUNCED**


It is typical, you are waiting for a vaccine, and three turn up all at once! So, Oxford University and AstraZeneca have announced their findings and it is further good news, although a little odd at the same time.


What are the odds?

Their vaccine is ‘up to’ 90% effective. The oddity relates to the dosage. You are given half a dose which once ingrained you become 70% protected. You then have a second full dose which takes the protection up to 90%. The perplexing bit is that if you administer two full doses, you are only 62% protected. No-one seems to know why.


What’s in a name?

The vaccine is called AZD1222.

The positive elements are that we in the UK have 100 million doses ordered, and all things being equal 4 million doses are planned to be rolled out in December. By the end of March 2021 there will be the equivalent of 40 million doses in bulk form in the UK.

Secondly, this vaccine can be stored at normal fridge temperatures, so it has huge logistical benefits to transport worldwide.


Full of beans.

Thirdly, it is much cheaper than the other vaccines and is described as ‘the price of a cup of coffee.’

Prime Minister Boris Johnson, who is still self-isolating, tweeted.


‘Incredibly exciting news, the Oxford vaccine has proved so effective in trials. There are still further safety checks ahead, but these are fantastic results. Well done to our brilliant scientists at Oxford and AstraZeneca, and all who volunteered in the trials.’


Peter Horby, Professor of Emerging Infectious Diseases and Global Health at Oxford University, tweeted.


‘Oxford jab is far cheaper and is easier to store and get to every corner of the world than the other two.’


Professor Andrew Pollard from Oxford University spoke about how safe it was:


‘We started in April, so we have been following up people for a long time. If you add all the months together, we are at 6,000 years of follow up, so a huge amount of data.’


Vanguard.

It is really great news and Professor of Vaccinology Sarah Gilbert must take much of the credit in vanguarding the research. More than 20,000 volunteers were involved, half in the UK, the rest in Brazil. Astra Zeneca are preparing to make 3 billion doses worldwide.

You will recall the detailed process which I have outlined previously about this vaccine. It uses a weakened version of a common virus which causes a cold in chimpanzees. The virus is genetically modified so that it is impossible to grow in humans.


Serendipity.

Author’s note. I don’t necessarily believe in divine intervention but there is a fascinating insight into how the Oxford vaccine was found ‘by serendipity’ – by accident.


During the trials, those administered the vaccine were given two full doses spread out over a month. One group, however registered far less headaches and arm pain and when they went back to check it was discovered that they had inadvertently been administered only half a dose for the first injection. Amazingly this same group’s results showed a 90% efficacy versus 62% with the two full doses. It was a mistake.


7 pm Press Briefing.


Prime Minister Boris Johnson (remotely as he is still self-isolating), Professor Chris Whitty Chief Medical Officer, Professor Andrew Pollard Director of coronavirus vaccine project Oxford University.


Winter plan.

The Prime Minister said that the national lockdown will end on 2nd December 2020 as planned, however we will return to a Tier system and the highest level of Tier 3 will be more robust.

Shops, gyms and hairdressers will be allowed to reopen under his 54-page ‘Winter Plan.’

The details of how each region is categorised will be announced on Thursday.


Bigger Better Categories.

The BBC categorised the new Tiers for us:


TIER 1: MEDIUM

Follow the rule of six if meeting indoors or outdoors.


Pubs and restaurants to shut at 11 pm.


People encouraged to minimise travel and work from home where possible.


Spectators allowed at sports events and live performances. (limited numbers)


Personal care including hairdressing allowed.



TIER 2: HIGH

No household mixing indoors.


Rule of six will apply outdoors


Pubs and restaurants to shut at 11 pm.


Alcohol only served as part of a substantial meal


Spectators allowed at sports events and live performances. (sparse numbers)


Personal care including hairdressing allowed.



TIER 3: VERY HIGH

No household mixing indoors or outdoors in hospitality venues or private gardens.


Rule of six applies in outdoor public spaces like parks.


Pubs/restaurants closed except for delivery and takeaway


Indoor entertainment venues closed


Guidance against travelling in and out of the area


Personal care including hairdressing allowed.



The Prime Minister said there would be a ‘six-week surge of testing’ in all Tier 3 areas.




Yule be fine.

The government is working with the devolved governments of the UK to develop a plan for Christmas. The PM said,

‘I can’t say that Christmas will be normal this year.’


Test pilot.

A new testing scheme will be piloted in Liverpool where people who come into contact with an infected person will be tested every day for a week. They will only need to self-isolate if they themselves test positive for the virus. The government intends rolling this out through the country in January 2020.



Details.

Some further detail on the announcements:


· Weddings can resume with limited attendees as before. Collective worship and outdoor sports will also be cleared to resume.


· The 10 pm last orders ‘curfew’ on pubs will remain but the pubs will not close until 11 pm. This will allow, in theory, customers to stagger the times they leave rather than all tip out onto the streets at the same time. (No pun intended).


· People can travel abroad but must adhere to the two-week quarantine rules where applicable.


· Rapid testing will be used at the end of the year to allow every care home resident to have two visitors who can be tested twice a week.


· Relatively small amounts of fans can attend sporting events and entertainment venues. In Tier 1 – a 50% capacity or 4,000 spectators whichever is lower. Indoors the maximum is 1,000.


· In Tier 2 – 50% capacity or 2,000 spectators, whichever is lower. Indoors the maximum is still 1,000.


· The virus is being surveilled to track any mutations, but Professor Pollard said we could change fairly quickly, and it would need a conversation with regulators to check the change. At the moment the virus is under no pressure to mutate as there is no vaccine yet.


· There will be no compulsory vaccinations.


· It is true that 1 in 10 people will get it and we have to consider what is required post immunisation if there is still a risk. It seems likely that any infections will be relatively mild and not need hospitalisation.


· It is still unclear whether a vaccinated person who has been infected can pass the virus on. We should be able to reduce asymptomatic infection with the virus and this could seriously reduce transmission in any case.


· From 15th December 2020 a ‘Test to release’ system will start for travellers formerly needing to quarantine. After 5 days since returning to the country you can pay for a test. If negative, you can then carry on as normal. (PCR coronavirus tests vary from £65 - £125).


Long road to spring.

During the briefing the Prime Minister eloquently gave some context to where we are.

‘This year has been in many ways a tragic year when so many have lost loved ones.’

He said it will be a hard winter.

‘Christmas cannot be normal and there’s a long road to spring. But we have turned a corner and the escape route is in sight.’

‘The coming months will be hard, they will be cold, they include January and February when the NHS is under its greatest pressure.’


Exit; pursued by Bear.

He said we should ‘bear down hard’ and in an almost Shakespearean flourish that now was

‘not the moment to let the virus rip for the sake of Christmas parties. Tis the season to be jolly, but tis the season to be jolly careful.’

He also gave a glimpse of hope,

‘I really am now assured things really will look and feel very different indeed after Easter.’

Professor Whitty underlined the promise.

‘Science and also the seasons when we get through to spring, will help to de-risk this infection steadily, step-by-step.’


Risky Christmas.

He said that Christmas is a risk, but 3 things will help to mitigate any risk:


1) Stick to the restrictions in your tier.

2) Over Christmas take opportunities responsibly.

3) After Christmas stay responsible.


COVID rates have fallen in 249 of 315 areas according to PA News Agency (Formerly The Press Agency).



The areas with the highest rates of infection are:

Latest figures per 100k of population


Hull 568.6 Previous week 779.9

Swale 565.0 Previous week 531.0

Thanet 508.0 Previous week 485.5

East Lindsey 493.2 Previous week 539.1

Dudley 484.5 Previous week 547.9

Stoke-on-Trent 482.1 Previous week 548.4

Hyndburn 467.7 Previous week 386.2

Hartlepool 460.2 Previous week 582.9

Boston 450.3 Previous week 478.8

Sandwell 447.6 Previous week 506.6


The areas with the lowest rates of infection are:

Location

Latest figures per 100k of population


Tendring 71.6 Previous week 58.0

Huntingdonshire 70.2 Previous week 125.9

South Hams 67.8 Previous week 103.4

Isle of Wight 67.0 Previous week 76.9

Cornwall and Isles of Scilly 66.3 Previous week 85.5

North Norfolk 63.9 Previous week 51.5

East Suffolk 63.7 Previous week 91.4

West Suffolk 63.7 Previous week 68.1

Teignbridge 55.2 Previous week 73.8

Mid Suffolk 52.0 Previous week 75.1


Family life.

We shouldn’t wish our lives away, but I can’t help but wish that we were the other side of winter and vaccinated.

My son, Harry, has said that he will be travelling from University to his Mother’s, by train, for the Christmas holidays on 10th December 2020. We are unclear whether he will be having two tests prior to ‘being released’ like most universities. I hope so.


Salvation.

I am a little relieved as I wondered if he would need transport back and I am being as strict as I can be in virus avoidance during the winter ahead of vaccine salvation.


Quote of the day.

‘It’s a bizarre but wonderful feeling, to arrive dead center of a target you didn’t even know you were aiming for.’ – Lois McMaster Bujold.


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