Bernard Jenkin MP is Chair of the Liaison Committee, and MP for Harwich and North Essex.
A lot has changed since the Government announced its roadmap. Uptake has been higher in over fifties than expected. Vaccine supply looks like it is going to take a hit in April. However, the government’s strategy makes even more sense than it did in February and here is why.
More than half the adult population has had a vaccine dose. In three weeks, the government is set to meet its target of all over fifties; they account for 99 pct of deaths. Many are calling on the government to speed up. The UK is still in the danger zone. A recent paper by Public Health England found, among those who had had their first dose at least 14 days previously, hospitalisation rates were 9 pct in those who had received the Pfizer vaccine and 8 pct in those who had received AstraZeneca. Combined with the reduced risk of becoming a case this is consistent with vaccine effectiveness against hospitalisation of around 80 pct. Imperial College modelled a series of “unlocking scenarios” in February to inform the government’s roadmap. It predicts if restrictions are lifted at the end of April, as the Covid Recovery Group have previously called for, hospitalisations in June will be greater than the January peak.
The assumptions that underpin the model have so far stood up well. Vaccine efficacy after one dose was estimated at 80 pct for severe disease. The vaccine rollout is modelled on 3.2 million vaccines a week; last week it was 3.5 million but in April it will be slower.
The argument that the government promised us data and we got dates, is not relevant. The five-week gap between the stages provides the government with four weeks’ data to allow assessment of the latest changes’ impact, followed by one week’s notice for businesses and communities to prepare.
There is a ray of sunshine on the horizon. A couple of weeks ago I was talking to a public health professional about how many people we needed to vaccinate before we reach herd immunity. He suggested ninety per cent and was not alone. Many were watching Israel unlock with intense interest. They had vaccinated all the vulnerable (but still far less than 90 pct of population) and cases initially appeared to be on the rise. 40 days after exiting lockdown, in Israel, the R number is 0.62. From the peak of mid-January, there are 85 pct fewer daily deaths, 72 pct fewer daily critically ill and 86 pct fewer daily cases. 40 days after exiting the previous October lockdown, R was already at 1.15.
The Imperial model paints a scary picture of a UK third wave in hospitalisations, even if all restrictions are only lifted in July. Israel shows that it might not be that bad. Israel exclusively used the Pfizer vaccine, but early data on the impact on severe disease from the United States implies the same might well be true for AstraZeneca, it seems to undermine the Imperial model assumption that the second dose of AstraZeneca has no effect on severe symptoms.
So, but for the threat of new variants, the news is good. Unfortunately, it is a big “but”. Data on vaccine efficacy for the South African variant is patchy. A small study of 2,026 people determined a miserly efficacy of 10 per cent for AstraZeneca. There were no severe cases in the vaccinated nor placebo group and the participants were young.
The early data for Novavax and Johnson and Johnson are also ominous for efficacy against new variants. With infection levels in France at 15,000 cases a day, that implies that there is at least 750-1,000 cases of the South African variant a day. A lot rides on surge testing, quarantines and booster shots.
The roadmap makes sense. It makes even more sense than it did in February, and as we vote today this is no time to grow complacent. We are still in the danger zone and that’s before you even start thinking about new variants.