Boris UK Road Map Out Of Lockdown Briefing 22nd Feb 2021

Boris UK Road Map Out Of Lockdown Briefing 22nd Feb 2021

Cases: 4,126,150 (+10,641)
Losses of life: 120,757 (+178)
In hospital: 18,462 (18th Feb)
Using a ventilator: 2,469 (19th Feb)
First vaccination: 17,723,840
Second dose: 624,325

BIG real world data released today by Public Health England shows a really good reduction in cases among populations vaccinated with the Pfizer / BioNTech vaccine. There isn't yet enough data on the Oxford vaccine for an 'early data' report, because we started using that later, but it'll be along shortly and looks just as good so far...
"Early data from PHE’s SIREN study shows a promising impact on infection in healthcare workers aged under 65. Healthcare workers in the study are tested for coronavirus (COVID-19) every 2 weeks – whether or not they have symptoms." This data shows:
"One dose reduces the risk of catching infection by more than 70%, rising to 85% after the second dose."
We also have really good early data for our older friends and family:
- One dose is 57% effective against symptomatic COVID-19 disease in those aged over 80. This effect occurs from about 3 to 4 weeks after the first dose.
- Early data suggests the second dose in over 80s improves protection against symptomatic disease by a further 30%, to more than 85%.
- Hospitalisation and deaths rates are falling in all age groups – but the oldest age groups are seeing the fastest decline since the peak in mid-January.
- Those over 80 who develop COVID-19 infection after vaccination are around 40% less likely to be hospitalised than someone with infection who has not been vaccinated.
Very importantly: These high levels of protection are also seen against the variant of concern (B.1.1.7) first identified in South East England in December 2020. (That's the more transmissible Kent/UK variant B117 which accounts for over 80% of UK cases now.)

"The Prime Minister will today set out the government’s roadmap for cautiously easing lockdown restrictions in England" was the announcement this morning. We really need to go by data, and not set hopeful dates that we can't step back from...
The 4 main factors, or 'tests', they will consider are:
1. The vaccine deployment programme continues successfully.
2. Evidence shows vaccines are sufficiently effective in reducing hospitalisations and deaths in those vaccinated.
3. Infection rates do not risk a surge in hospitalisations which would put unsustainable pressure on the NHS.
4. Our assessment of the risks is not fundamentally changed by new Variants of Concern (including anything with that pesky E484K mutation which is more resilient to antibodies).
As these 4 tests (which they just made up, and I'll be honest, seem pretty erm... 'loose') are being met, reopening is due to start March 8th as planned. This date was chosen because it is 3 weeks after the top priority groups in Phase 1 should have had their first vaccine dose, so the vast majority who are especially vulnerable or over 60 should have a healthy degree of immunity.

Vaccines Minister Nadhim Zahawi made a right mess of attempting to clarify this point earlier:
"It is not a coincidence that the 8th March is the date we that have focussed on, because if you take the mid-April date where we will have given at least 1 dose to all over 50's, offered that 1 dose protection to all over 50's. If you go 3 weeks after the middle of April, that takes you to the first week of March."
Eh what? No it doesn't. Yes all over 50's should have been offered their first dose before mid April, that is true, but in this case he's referring to 'over 60's' and 'February' (one of only 2 months we usually like to have before March). 

Boris laid out his reopening plans for England in a very slick virtual address to parliament earlier. Sadly it's all based on anticipated dates, which usually leads to some disappointment, so remember these are ALWAYS subject to change. They do not seem to be trying to race through it, it's cautiously spaced. I'm a bit concerned by the fact we ARE jumping straight in with both feet on March 8th, but at least we should have time to accurately see what effect school reopening has before we carry on. Here you go: 

STEP ONE:
8th March
- ALL schools reopen to ALL pupils for in-person teaching. (It's likely secondary pupils will be wearing masks more often.)
- "Childcare and children’s supervised activities can also resume where necessary to enable parents to work or engage in similar activities."
- Further Education (college) can reopen to in-person teaching
- Practical Higher Education (Uni) can reopen to in-person teaching
- Care home residents will be allowed 1 regular named visitor
- Outdoor recreation (e.g. picnics) can resume. This can be alone, with 1 other person or with your household or support bubble

29th March
- People will no longer be legally required to 'Stay At Home'.
- Outdoor gatherings of 2 households or up to 6 people allowed
- Organised Outdoor sports for adults and children can resume, as well as reopening of outdoor sports facilities for individuals and bubbles. 

STEP TWO
12th April AT THE EARLIEST
- Non-essential retail can begin to reopen
- Hospitality (pubs, bars and restaurants) may offer table service to seated customers outdoors
- Personal care can reopen (nails, hair etc)
- Public buildings can reopen (libraries, museums etc)
- Outdoor attractions may reopen (zoos, drive-in cinema etc)
- Indoor gyms can reopen for individuals / households / support bubbles only
- Self-contained holiday lets such as campsites and self-catering cottages can take bookings - for individuals / households / support bubbles only.
- Up to 30 people may attend a funeral. Up to 15 may attend a wake or commemoration, or a wedding or reception. 

STEP THREE
17th May AT THE EARLIEST
- Limits on outdoor mixing lifted, but a maximum of 30 people will still apply.
- 2 households or groups of up to 6 people will be able to mix indoors
- Hospitality will be able to start offering table service to seated customers indoors.
- Travel rules will be examined to see if foreign travel can be allowed
-  Up to 30 people at many types of significant life event - weddings, receptions, bar mitzvahs, Christenings, funerals and wakes
- indoor entertainment venues may reopen (cinemas, children’s play areas etc).
- The accommodation sector, including hotels, hostels and B&Bs can reopen. 
- Indoor adult group sports and exercise classes can resume.
- Some larger performances and sporting events in indoor venues can go ahead. [with a capacity of 1,000 people or half-full (whichever is a lower number), and in outdoor venues with a capacity of 4,000 people or half-full (whichever is a lower number). In the largest outdoor seated venues, where crowds can be spread out, up to 10,000 people will be able to attend (or a quarter-full, whichever is lower).]

Before Step 4 there will be a full review of social distancing laws and guidance, including 1 metre plus, the wearing of face coverings and other measures. "This will also inform guidance on working from home – which should continue wherever possible until this review is complete."

STEP FOUR
21st June AT THE EARLIEST
- We should have results from pilot studies conducted by the Events Research Programme, which will give us better understanding of how to keep larger crowds safe.
- Nightclubs and other high risk environments can reopen.

(This applies to England, and it's likely a lot will be very similar with the devolved nations, but bear in mind it may not be exactly the same.)

So Boris had a UK Briefing in order to explain everything to us. Alongside to complete the COVID Triumvirate were Chris Whitty, England's Chief Medical Officer and Patrick Vallance, the Chief Scientific Advisor.

Boris started by talking about vaccination "creating a shield around the entire population".

Whenever we ease the lockdown, whether it's today, in 6 months, or 9 months, there will be people who will die from COVID, just as there are with the flu. (He's clearly not considering attempting zero COVID.)

Boris outlines the Steps as above. A few bits and pieces I missed out:
All secondary and college pupils will have to wear face coverings for the coming term. Secondary pupils will have twice weekly lateral flow testing.

The UK Government WILL support business and individuals throughout. Boris says he knows some people will want to be more cautious, and some will want us to speed it up. He says "we can't persist indefinitely with restrictions that have separated families and loved ones for too long, threatened the livelihoods of millions, kept pupils out of school."

"There is light ahead, leading us to a Spring and a Summer l which I think will be seasons of hope; looking and feeling incomparably better for us all, and from which we will not go back."

Chris with the slides. Clearly the figures are still very high, but going down steadily with significant week on week falls.
He explains how vaccinations are bringing down the number of people who succumb more quickly than the number in hospital - because a lot of younger people end up in hospital, and regularly for a long time.

Chris explains the data I started the post with, and studies released over the last week. He talks about less people in the community being infectious or able to become infectious, and how that will lead to breaks in the chain of transmission. He also talks about good data we've also had regarding the time gap between doses, and efficacy.

Chris explains that we have spread out the 'Roadmap Steps' in 5 week gaps so that we can accurately measure what effect each step has. We don't want to have to lock down again, so we want to ensure we don't get ahead of ourselves and mess it up.
Patrick seconds the importance of knowing exactly what is happening before we take each step, rather than 'flying blind'. 

Public asked about 2nd doses. Boris assures him we have the supplies in place. 

Public also asked about vaccine equity - worldwide sharing. Boris did not mention the fact we are rolling out to general population, he just talked about our donations to COVAX (the World Health Organisation programme). 

Press asked a mix of 'are we nearly there yet?' and sensible questions. 

Numbers have been floated regarding the number of people who may die if we reopen now, suggesting it could be 30,000 more people. Chris says the vaccination will get the rates right down, but COVID will be a problem in the Winter for the next few years (he's clearly given up any thoughts of zero COVID too then.)

Press asked about the new '4 Tests' , which have little relationship to the previous 'tests'. Chris talked about having to keep the 'R' below 1 not being as important now that we have so many people vaccinated. The natural R rate will drop because it simply can't spread like it could through a non-vaccinated population. 

Boris took on questions about domestic use of 'vaccine certification'. He says it's not really ideal because it it discriminatory (a lot of people can't be vaccinated for medical reasons). 

Press asked about this plan being 'irreversible'. Thankfully Boris said he can't guarantee it won't be reversible, but that is his intention. (Excellent answer.). He warns that the new variant (the UK /Kent B117) is capable of spreading very, very fast if you unlock too quickly. 

Chris Whitty took on questions about the 'Big Bang' return to school all at once. He said papers misquoted him and it has to be weighed up - you disadvantage every child who is out of school, and the risk to children is incredibly low. (How many school children live alone? I wish they'd stop forgetting children have families, and not every parent, guardian or sibling is young, fit and healthy.)
He says with each step we will see a surge in cases, this is expected, but obviously it should just be a quick surge and then steady off again.
We have a natural firebreak over the Easter holidays, and with the extra measures (masks, testing etc) we will be able to watch carefully. He then says teaching staff aren't high risk (sorry Chris, we know they are 2 to 4 times the risk of catching COVID than the general population), but they are part of the early wave of 'general population' vaccinations.
Patrick backed Chris. He said we have 2 weeks in school, then 2 weeks to really examine the data over Easter. "It's the right thing to do."

Boris says "his goal, his ambition" is not to go back. He hopes businesses will be reassured by this.

Press asked about NHS staff being compelled to take the vaccine in the future? Chris said his professional view is that health and social care staff should be vaccinated in order to best protect their patients/residents.

Boris says he doesn't believe this will fundamentally change our big cities. I don't either. History tells us that people take a little while to get their confidence back, to feel under control, and then a couple of years later they really party.... 

..

.

Sources:

https://coronavirus.data.gov.uk/

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/963491/COVID-19_Response_-_Spring_2021.pdf

https://twitter.com/SpillerOfTea/status/1363811472883785731

https://www.gov.uk/government/news/prime-minister-to-publish-roadmap-for-cautiously-easing-covid-restrictions

https://www.gov.uk/government/publications/covid-19-response-spring-2021/covid-19-response-spring-2021-summary

https://www.gov.uk/guidance/national-lockdown-stay-at-home

https://www.gov.uk/government/news/first-real-world-uk-data-shows-pfizer-biontech-vaccine-provides-high-levels-of-protection-from-the-first-dose