Well, 2020 was quite a year. I’m sure it’s one that most of us are glad is over.
Here in the UK, we have been badly hit by the covid-19 pandemic, indeed we have one of the worst death rates in the world. It didn’t have to be this way: as an island nation with a well developed health system, we could have handled the pandemic far better. Unfortunately, we have a government of incompetent idiots who have simply not been up to the job of dealing with it.
As I write this in early January 2021, covid-19 cases are at high levels and rising rapidly, following a reasonable approximation to exponential growth since the beginning of December with a doubling time of just over a fortnight. This is, frankly, terrifying, given that hospitals are already stretched to their limits.
But there is a ray of hope, in the shape of vaccines. We now have 3 vaccines approved for use in the UK, and over a million people have already been vaccinated. It has been an extraordinary achievement to get not one, but 3 vaccines invented, tested in large clinical trials, and approved in such a short space of time. The scientists, clinicians, clinical research professionals, statisticians, regulators, and last but by no means least clinical trial volunteers should be incredibly proud of what they have achieved.
It will take many months or possibly even years to vaccinate the whole UK population. But sensibly, vaccination is being prioritised for those most at risk, mainly starting with older age groups. The government have promised that they will have vaccinated the 15 million people at highest risk by the middle of February, including everyone over 70 as well as health and social care workers and those who are clinically extremely vulnerable.
They will break that promise of course, just like they break all their promises.
But hopefully at some time in the next few months, even if not as early as mid-February, all those high risk people will have been vaccinated. What does that mean for getting our lives and the economy back to normal?
Vaccinating that number of people will certainly not give us any meaningful herd immunity, but given that most deaths from covid-19 occur in the elderly, we would expect that vaccinating all the over 70s will dramatically cut the death rate.
At that stage, there may be a temptation on the part of politicians to open up the economy again, taking the view that perhaps it doesn’t matter if covid-19 is still circulating widely if few people are dying from it.
I think this would be a mistake. First, just because most deaths from covid-19 occur in the elderly, it does not mean that younger people don’t die from it at all. Very approximately 10% of covid-19 deaths are in people under the age of 60, and if the virus is spreading rampantly through the population and millions of people are infected, then the absolute numbers of younger people who die will not be negligible.
But there is a further reason to be cautious: long covid.
There is still much that we don’t know about long covid, but what we do know is that a small proportion of patients continue to have significant symptoms weeks or even months after the acute infection. It has been estimated that about 1 in 10 patients still have symptoms after 12 weeks.
If millions of people are being infected, then that suggests that hundreds of thousands of people may suffer from long covid.
What we don’t yet know is how long the symptoms of long covid last. Maybe most people will be back to normal within a year, or maybe the symptoms are generally permanent. We simply do not yet have enough long term data to know, given that the disease only first appeared just over a year ago.
Some of the symptoms of long covid are very worrying. Quite apart from potentially permanent lung and heart damage, one study found that cognitive performance could be reduced in a manner equivalent to 10 years of ageing.
If the symptoms of long covid do turn out to be permanent, then having hundreds of thousands of people affected by them would be nothing short of a public health catastrophe.
So while there will be a temptation to get back to normal life once deaths from covid are much reduced following vaccination of those at higher risk, I think that temptation needs to be resisted for a while longer until enough of the population have been vaccinated to give significant herd immunity.
At any rate, much as I miss my local pubs, I will not be going back to them until after I’ve had my vaccine.
Still confident in the confidence intervals used to assess the vaccine, especially in the over 65s?
Be interested in your thoughts
https://garycornell.com/2020/12/09/statistics-in-the-pfizer-data-how-good-is-the-vaccine/
The data from trials showing efficacy in older age groups is indeed a bit thin, but that’s not the only evidence we have.
We know that the vaccine is effective in younger age groups. We also that the vaccine provokes an immune response in older adults, which, while not quite as strong as that in younger adults, is still pretty good.
https://www.nejm.org/doi/full/10.1056/NEJMoa2027906
So yes, it’s possible that the vaccine is a bit less effective in the elderly, but it seems a reasonable guess that it is still effective enough to be worth giving.
And now that we have the vaccine being rolled out, we have real world data that can also tell us more. It’s a bit too early to see what’s happening in the UK, but early data from Israel are promising.
https://www.bbc.co.uk/news/health-55706855
I come here for your statistical perspective so am a bit taken aback by the politics. I work on the testing side of things and am all too aware of the massive problems the UK faced at the beginning of the pandemic. The government was criticised heavily in the media despite the fact that many of the testing problems stemmed from PHE and the DHSC. Having transformed that side of things (largely by bypassing PHE) so that we are now the most tested large nation on earth and are leading the way technologically, I read not a single word of praise for the people who made that possible. In this post, you attack the government while praising virtually anyone else for the success of the vaccine response and simply criticise again based on your prediction of a broken promise. A prediction that is looking a little wayward now . I don’t think this is a very fair, well informed or critical post so am a bit disappointed. Not that I think the government is above criticism, but knowing what I do about some of that criticism, I can’t help but feel that much of it is irrational, unbalanced and not very well researched.
If it’s irrational to blame a government who have given us over 100,000 deaths, then I guess I’m irrational.
Most objective people recognize that the virus is responsible for “giving us” the deaths and yes, attacking people from a position of ignorance is irrational and not very laudable. Forgive me but I am tired of stupid tribal politics , the blame culture, perpetual outrage and relentless negativity. You aught me on a bad day.
And I’m tired of a government who are so spectacularly incompetent that tens of thousands of people have died unnecessarily, so I guess we’re all having a bad day.
Fine, according to you from your position of relative ignorance. You are entitled to an opinion but it isn’t one you can justify with statistics. If this now a tub thumping left wing political blog then fair enough, I read some of those as well.
You might respect the fact that I might just know a bit more than you, being involved in the response and admit that you were wrong to claim, based on a clear prejudice that the vaccination target would not be reached.
Yes, I am delighted to admit that my prediction that the vaccine target would be missed was wrong.
But I find it really interesting that you think the question of whether the UK’s extraordinarily high death rate is acceptable is a left vs right issue. Personally I see it more as a competence vs incompetence issue.
I don’t think anyone, irrespective of their political leanings can defend the Governments woeful response to the pandemic. It’s not as if we couldn’t see this coming, as we watched it unfold in Italy. We were just completely unprepared, period. Initial advice? Mostly just mild flu for the majority. Wear a mask? No point. Lock down early? No point. Cheltenham festival? It’s outdoors so not a problem. Dare I mention Care homes? No system of track and trace.? Celebrate Christmas and hope for the best? Where to start with this shambles. Fair play though to the vaccine effort, and credit where it’s due. But let’s see what the eventual public inquiry says… I reckon it may be less than complimentary!