Friday, 14 May 2021

COVID-19 Coronavirus UK and World News Update and Indian Variant B1617.2 Briefing with Boris 14th May 2021.

COVID-19 Coronavirus UK and World News Update and Indian Variant B1617.2 Briefing with Boris 14th May 2021.

The UK added 2,193 cases today and now has reported a total of 4,446,824 positive cases of COVID-19. We completed 982,881 tests yesterday.

The counter says 36,115,955 people had been given at least one dose of a vaccine in the UK by midnight last night. 19,319,010 people had received 2 doses and are fully vaccinated.

1,060 people were in hospital on 12th May, with 129 people using a ventilator yesterday, 13th May.

In the 24 hours up until 5pm yesterday, we officially reported the loss of another 17 people who have tested positive to COVID-19 within 28 days, making a total of 127,668 losses of life in all settings.

Up until Friday 30th April 151,765 people had COVID listed as a cause on their death certificate.

Rep. Of Ireland 254,870 (+420) cases and 4,941 (+4 ) losses of life.

There have now been a total of 162,235,671 reported cases worldwide. The number of people who have lost their lives worldwide to COVID-19 is 3,364,278. Already 140,092,589 people have recovered.

UK Govt Briefing slide chart showing variant of concern B1617.2 in Bolton

Scottish restrictions are due to change, and because of the number of cases in Glasgow City, and the fact they are driven by Indian Variant B1617.2, both Moray and Glasgow City will stay at Level 3 for at least another week. Sorry guys.

Welsh restrictions are going to change, and First Minister Mark Drakeford has stated very clearly that he doesn't want people going on holiday abroad, even though it'll be allowed.

“We are monitoring the situation very carefully and will not hesitate to take further action if necessary.
It is imperative we all continue to be vigilant, and if you live in one of the 15 areas where we’ve introduced surge testing, make sure you get a free PCR test."
Matt Hancock, UK Minister for Health, this morning.

UK Govt Briefing slide showing weekly cases of variant of concern B1617.2

Surge testing areas now include Formby, Sefton. Congratulations. Take 1 PCR test and see the results Monday morning.
The other surge testing areas are:
Hillingdon - HA4 postcode in Ruislip
London - Woodlands area of Hounslow
Redbridge - targeted areas within the IG1 and IG6 and IG5 and IG7 postcode areas
Kensington and Chelsea - targeted areas within the W11 postcode
Tower Hamlets - targeted areas within E1 postcodes
Bolton  - targeted areas within the BL3 postcode
Worcestershire - targeted areas in Redditch
(Birmingham areas have been removed from the list.)

Extra vaccinations are to be sent to Bolton, for 'surge vaccination' due to the dramatic rise in cases, which is again driven by B1617.2. 

The R (reproduction) range for England is 0.8 to 1.1 and the growth rate range for England is -3% to +1% per day as of 14 May 2021.

140521 daily vaccination totals

Soooo. Last night I reported on some tricky maths and basically suggested that as we don't seem able to contain the Indian Variant B1617.2, we need it to be less than around 2.2 x as catchy as original wild COVID in order to avoid a substantial wave over the next few months. My initial reaction when I worked that out was that we have 2 hopes there. 'No' and 'Bob', but it's always worth keeping your fingers well crossed (and avoiding mixing with other households).
It's all to do with UK level of immunity outperforming, or beating, level of transmissibility. We need to stay ahead.
It seems SAGE have also done the maths, and I'm afraid they came to the same conclusion.
Surge vaccination is going ahead in Bolton, and vaccination centres in Bolton and Blackburn will be open for longer hours. 2nd doses will also be given earlier. Getting the 2nd dose will increase level of immunity in most of those people by a good 10% or more. 3 months ago that made just a small difference - but that difference could mean everything now. We need to eke as much as we can out of this.

There's still no reason to suspect that B1617.2 is more deadly, there are no reports of wards full of kids in India, it is just super catchy. Even if we get hundreds of thousands of cases in the UK, then as long as we can give everyone who needs it some oxygen, our loss of life and long term or permanent injury should be incredibly small compared to previous waves. Sheer volume of patients is the big issue for the UK Government. They have promised the NHS will not have to cope with 40,000 extra patients in our hospitals again. We really need to try to avoid that, because it will inevitably include some people, including some young and healthy people, who won't go home.

Chart showing COVID hospitalisation in Greater Manchester UK Briefing 140521

This variant, B1617.2, is spreading rapidly WHILE we are in lockdown. Unlocking will only speed it up. (That's me easing you into the bad news very gently.)

indieSAGE today went through the UK's '4 Tests' to unlock, to see if we should go ahead with the reopening on Monday:
1. The vaccine programme is continuing successfully. (Big Tick)
2. Vaccines are sufficiently effective in reducing hospitalisations and deaths in those vaccinated. (BIG Tick)
3. Infection rates do not risk a surge in hospitalisations which would put unsustainable pressure on the NHS. (Erm... Tick....ish)
4. Our assessment of the risks is not fundamentally changed by new "variants of concern". (Ahhhh.... Bolton, we have a problem)
They looked into whether we are simply finding more cases of B1617.2 because we are surge testing, and because more travellers are bringing it in.
Bad news, the answer is no.
Even when you remove positive cases from surge testing, and all cases directly linked to travel, in the week ending May 1st, over 10% of the UK's positive cases that are were randomly sent to the lab to see which variant it is, came back as B1617.2. It is a big concern, and VERY IMPORTANTLY, the data we have is already 2 weeks out of date.
In London 25% of sequenced cases were B1617
In the North West 20%.
In places like Yorkshire and the Humber and the North East it was still below 5%
They feel that the UK Government could be doing all kinds of things at the moment, and they aren't moving quickly. They also believe very strongly we should immediately change our idea of a travel Red List. Travellers mix with other travellers, they don't just travel in a straight line there and back, and we can't even say where the 'dangerous' variants are going to be. We need to quarantine ALL arrivals in future - in fact now, and for the future.

140521 indieSAGE proportion of variants of concern by region

Boris held an 'urgent' briefing today. It wasn't planned. He hates a late finish on a Friday, yet he is still always late. He was understandably gruff and nervous, and accompanied by Chris "if I blurt it out, it's the truth" Whitty.
Warning: It's bad news. I did try and gently ease you in.

Boris started by saying we have seen a lot more cases of B1617.2 and there are some important unknowns.
"We believe this variant is more transmissible than the previous one, in other words it passes more easily from person to person, but we don't know by how much. I'm told that if it's only marginally more transmissible , we can continue more or less as planned, but if the variant is significantly more transmissible, we're likely to face some hard choices."
He says we will know more in the coming days. This really is a very rapidly evolving situation.
"The good news is that so far we have no evidence to suggest our vaccine will be less effective in protecting people against severe illness and hospitalisation".
We are in a very different position to last time we faced a lot of cases. Boris says we should trust in our vaccines and keep monitoring the situation very carefully.
"The race between our vaccination programme and the virus may be about to become a great deal tighter."
It's more important than ever that people get their second dose.
IMPORTANT BIT:
"We will accelerate second doses to those over 50 and the clinically vulnerable, right across the country."
2nd doses will come as soon as 8 weeks after 1st doses. Anyone over 38 is also prioritised to come forward for vaccination.
Boris does have good news overall. He says the data doesn't suggest hospitals are likely to become overwhelmed. This is also an IMPORTANT BIT:
"This is a balanced decision. I do not believe, that we need on present evidence, to delay our roadmap, and we will proceed with our plan to move to step 3 in England, from Monday. But I have to level with you. That this new variant could pose a serious disruption to our progress, and could make it more difficult to move to step 4 in June."
“This doesn’t mean that it’s impossible that we will be able to go ahead with step four, I don’t think that’s the case at all. But it does mean there is now the risk of disruption and delay to that ambition. And we have to be utterly realistic about that.”
(These are negative words from Boris. He is being genuinely realistic about a delay.)

He reminds us that if the NHS was likely to face unsustainable pressure, we would see the signs a long way in advance, and we won't let that happen.
He apologises to Bolton for being under lockdown and suffering from infection outbreaks for longer than anyone else, and says he won't make business stay closed.
There will be lots of targeted activity, including surge testing, vaccinating, the Army will be involved. Think carefully about the risk when you see people.
"I want us to trust people to be responsible, and to do the right thing. That's the way to live with this virus, while protecting the NHS and restoring our freedoms... And it's very clear now we are going to have to live with this new variant of the virus as well, for some time."
"We will do whatever it takes to keep the public safe."

140521 indieSAGE proportion of variants of concern by region

Chris with the slides. Cases, hospitalisation and losses of life have kind of plateaued, but with hospitalisations and deaths at a very low level.
He has a new chart, sequenced cases. It shows 'confidence' that B1617.2 is more transmissible than the UK/Kent B117. (That's a bad sort of confidence.)
Although cases are rising in affected areas, there isn't yet any uptick in hospitalisations. (Hopefully that is not just a lag, it should have begun to show, so it appears vaccination success is visibly keeping hospitalisations down.)

Press asked lots of questions that have either been covered, or are "I'm afraid we can't say more at this stage" because we simply don't have the data.

Chris answered questions about vaccination priorities, and he was referring to the study I covered yesterday - should we prioritise a dose for young people, or second doses for older people? Chris says clearly according to the JCVI data, we will have a "net benefit" from giving second doses to the most vulnerable people.

Press asked how we could have met the Government's own 'Four Tests', when the fourth one is about Variants of Concern, and we have a big issue with a Variant of Concern. Chris chatted about not having the data, and how the situation is almost the same as last week. He says B1617.2 is likely to become our dominant variant, and talked about the race between the variant and the vaccination.
He says we don't have data yet to know whether B1617.2 is spreading mainly in younger people because that's where it got to first, or if it shows effect of vaccination. Hopefully the latter.
No. It didn't answer the question.

Boris ended by saying again that we have to be realistic, and no options are off the table.

In essence, the Indian Variant is too much of an unknown at the moment, and we only have India and Nepal to go on. and what's happening regionally, they don't look good. 

140521 indieSAGE variants of concern numbers weekly

Good news now from Public Health England:
"Our latest analysis indicates that the COVID19 vaccination programme prevented 11,700 deaths in those aged 60+ in England up to the end of April.
It also suggests that at least 33,000 hospitalisations were prevented in those aged 65+ in England."
Those are numbers I'll be happy to see go up and up. 

Good news for the UK prison service too. Since the start of the pandemic 16,676 prisoners or children in custody have tested positive for COVID-19. It can be hard to stop the virus spreading in any communal living arrangement.
Last month (April) there were 150 new confirmed cases, which is a massive 91% reduction compared to the number of new cases the month before (March 2021).

Although high school children 11-16 don't have to wear face coverings from Monday by the English Government rulings, it's actually possible your local authority, school leaders, or pupils themselves, may ask for it to continue. Your school will let you know.
"The reintroduction of face coverings for pupils, students or staff may be advised for a temporary period in response to particular localised outbreaks, including variants of concern."

I'm attempting to refer more often to B1617.2 by its number. It is known as the Indian Variant no.2, but really that technically should be "the second variant first discovered in India". We actually have no way of knowing where in the world it originated, nor should we ever associate any "blame".
Any one of us can create variants inside our bodies, and pass them on without ever knowing. Some of you reading this will have done just that.
When it's in optimal conditions (e.g.warm smooshy damp lungs with no antibodies attacking it), a virus churns out bajillions of copies of itself, and like an old photocopier, very many are not perfect. Most errors, or mutations, do nothing, most of the rest die before they go anywhere. Just a few might escape and get into another host body, but even then, whether they manage to attach and start copying themselves is often mostly down to chance. Millions of mutations occur, very few ever make it big. 

140521 indieSAGE variants of concern by number

India is NOT the only country having an horrific time right now. Nepal's health system also appears to have collapsed, and there are reports of mass graves near the Indian border. They are reporting more cases per 100,000 population than India or anywhere else right now. Other countries which Dr Tedros and the World Health Organisation are particularly worried about include Sri Lanka, Vietnam, Cambodia, Thailand and Egypt.

A restaurant owner in India is on the run after police recovered over 500 imported Chinese oxygen concentrators at his property. (I hope to goodness they've been sent somewhere they can be used.)
Indian companies have ordered over 60,000 oxygen concentrators recently, according to Chinese trade records. It's fine to buy them, not fine to hoard and sell them at ridiculous prices on the black market, while people are dying in the street outside.
Russia is apparently also receiving massive orders from India for oxygen supply related medical equipment.

Portugal have announced today that holidaymakers from the UK will be welcome from Monday. Turned out to be a great day for that one... (retract, retract!!)

Hoax of the Day:
Nope, the vaccinations are NOT full of metal, and they won't make your arm magnetic. So many people have been vaccinated now that I can hardly believe anyone could still fall for this.
There'd be comedy photos of people wearing spoons all over Facebook.  

We WILL still get there. We're still on the right track, we can see the lights in the distance, we just hit a muddy patch and have a bit of a hill ahead. We've already climbed bigger, and we'd have been very lucky to have had a smooth downhill all the way. Even if we can't bring B1617.2 under control, we can get through this bit, and far more of us will still be standing at the end. 

Have a good weekend, don't forget your treat - you need it this week! I'm back Sunday. Stay well, Meet Outdoors, Save The NHS.

Some numbers. All people, very much like you:

Countries / Cases / Losses of life (since midnight GMT. In larger countries some states /provinces have yet to report today):

India 24,320,668 (+274,548) 265,041 (+2,691)

Iran 2,732,152 (+10,145) 76,433 (+202)

Russia 4,922,901 (+9,462) 115,116 (+393)

Nepal 439,658 (+8,467) 4,669 (+203)

Italy 4,146,722 (+7,567) 123,927 (+182) 

Ukraine 2,143,448 (+7,562) 47,620 (+287)

Chile 1,273,516 (+6,915) 27,647 (+127) 

Japan 665,547 (+6,874) 11,255 (+90)

Philippines 1,131,467 (+6,784) 18,958 (+137)

Netherlands 1,589,282 (+5,515) 17,423 (+10)

Malaysia 462,190 (+4,113) 1,822 (+34)

Mexico 2,375,115 (+3,632) 219,901 (+311)

USA 33,629,571 (+3,474) 598,583 (+43) 

Poland 2,849,014 (+3,288) 71,311 (+289)

Sri Lanka 136,685 (+889) 892

Thailand 96,050 (+2,256) 548 (+30) 

Cambodia 21,499 (+358) 147 (+5)

Vietnam 3,816 (+106) 35 

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Sources:

https://www.worldometers.info/coronavirus/

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

https://www.manchestereveningnews.co.uk/news/greater-manchester-news/matt-hancock-issues-warning-over-20594299

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/985138/10_May_Schools_Guidance.pdf

https://twitter.com/PHE_uk/status/1393130158920450051

https://www.gov.uk/government/news/covid-19-vaccines-11-700-deaths-prevented

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/986121/HMPPS_COVID19_Apr21_Pub.pdf

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/984846/FINAL_Face_coverings_in_education_guidance.pdf

https://www.gov.uk/government/news/covid-19-vaccines-11-700-deaths-prevented

https://www.standard.co.uk/news/uk/second-covid-jabs-could-be-brought-forward-indian-variant-cases-soar-b935067.html

https://www.bbc.co.uk/news/uk-57109660

https://www.gov.uk/guidance/surge-testing-for-new-coronavirus-covid-19-variants

https://www.ndtv.com/delhi-news/khan-chacha-town-hall-restaurant-businessman-navneet-kalra-seeks-anticipatory-bail-in-oxygen-concentrators-case-2438648

https://www.hindustantimes.com/india-news/indian-companies-to-buy-60-000-oxygen-concentrators-from-china-101620464287465.html

https://twitter.com/i/events/1392938253720768512

https://twitter.com/i/events/1393184047959052289

https://twitter.com/kakape/status/1393192014502580229

https://news.sky.com/story/covid-19-how-quickly-will-englands-lockdown-end-these-are-the-tests-the-pms-roadmap-must-pass-12225234

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/986711/2021-05-14_COVID-19_Press_Conference_Slides_for_broadcast_updated.pdf


indieSAGE - https://www.youtube.com/watch?v=QHIQa8KEEw8




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