December 31 2020

Public Health England data apparently released today shows that those with the new mutant strain from England of Covid 19 are 54% more likely to pass it on to others than if you had the non variant strain. If there is contact with someone with a positive test for the new variant you would have a 15% chance of catching the virus. This compares with a 9.8 % chance of contacting it from the common variant that is prevalent in the UK. What does this mean ? In medicine we assess information by means of a technique called critical appraisal. Well the answer to the question is not much, without much more information. How was the research carried out? How many episodes of spread were studied? What was the definition of contact? It could mean passing 2 metres apart on a country walk taking all of a few seconds, or it could mean an intimate cuddle indoors in a warm stuffy room. There is of course no data forthcoming. It does not tell me if the information is published anywhere nor whether there has been a peer review. I have heard other suggestions that the risk of spread is up to 70% more. We just do not know with any degree of accuracy. It is well worth learning to look at data like this before deciding how much value to put on it.
The Oxford Astra Zenica vaccine can deliver 2 million doses a week. Compared to the 200,000 we have managed with the Pfizer vaccine in the last week. The NHS target is that they can deliver 2 million jabs per week. The Chief Executive of Astra Zenica says they can continue indefinitely production at 2 million doses a week. We have 100 million on order at present. Other countries will have also ordered large amounts, we are not told if we will get all the vaccine first. Would that be ethical even? We can certainly move ahead quickly now and get the first jabs done.
There, again, is confusion and mis-information about as to exactly how much response there will be to the first full dose and at what stage sufficient antibodies and T cell responses to give some but not full protection until a second jab is given up to 12 weeks later. I would like to believe the optimists who say that the first jab alone will after 3 weeks give enough protection not to get a severe illness which could cause death. We still don’t know whether the disease is still transmissible after one or two doses without being infected.
My suggestion last night that we might like to reconsider the priorities for the vaccine produced a very lively debate with some horrified at my suggestion and others understanding the merits of the plan. I am sure my thoughts will not be taken up though. What did bring even more controversy was the issues of parental discipline being too lax, allowing late teens and young adults to get away with being in large groups and ignoring the rules. How many of you will admit to being with the Mods or Rockers? How many joined the coffee shop culture around a jukebox? Did your parents know where you were? Changes in laws, cultural belief and practice has changed over the generations but I suspect this has always been there in the background.
The plan to mass swab all school children and students worries me. If we have the vaccine why not just immunise them? I am afraid there will be an unacceptably high number of false negatives due to inadequate sampling. The children are to be shown how to do the swabs themselves. I fear a number of positive cases will be missed. Clinical staff need to do a few nasal and throat swabs before they are confident of doing them properly and collecting an adequate specimen. It usually requires the operator to make the subject gag. Can and will children do that adequately? I appreciate the legal aspects but surely a way round them could be found so they are done properly. Parents, teachers, an older pupil or even a class friend could do them. We must be able to rely on the results.
Several other areas have declared internal major incidents today, the Northern Ireland Ambulance Service Control room has an outbreak with a lot of staff off work. There have been long delays answering 999 calls.
France has found the South African Variant today.
In Wisconsin an employee has been sacked for deliberately damaging 500 doses of the Pfizer vaccine which has had to be destroyed.
There seems to be confusion and misunderstandings about the Nightingale hospitals being decommissioned particularly the one at London’s Excel Centre . The explanation as I understand it is that the new tower block of wards at the Royal London Hospital had the top two floors left empty when it was built to give room for future expansion, A decision was made to open and equip those wards as a Covid Centre and some equipment was brought back from Excel to the London to get them up and running. This makes sense as the senior staff at the Royal London can supervise the additional wards as they are in the same hospital. One of the reasons the Nightingale facilities have not been used is because of a lack of staff. I understand the DH has ordered all the rest to be made ready again, but where the staff will be found I do not know.
Around the world some have finished with New Year, whereas others have only just got up. For those of you here enjoy your quiet New Year at home with a nice fire and hopefully lovely goodies to eat. You will remember this New Year for the rest of your life, whereas we have all forgotten what we did exactly even 10 years ago. Remember Covid loves a crowd. That the one thing we can and must deprive it of completely.
It just remains for me to wish you and your loved ones a very happy and healthy Covid free New Year. I know many of you will be sad for many different reasons. We must take comfort we are all in this together. For those of you at work tonight thank you for your commitment to keep us all safe. Our happiness can grow week on week in the coming months if we stay apart and practise the Basics of Hands , Face, and Space.
Happy New Year everyone and I will be here, DV tomorrow.
Ps. DV Latin for God Willing, Deus Vault

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