What the doctor said...
Hello Everyone,
In herd immunity a large proportion of the population is immune and this prevents the infection from spreading to other people in the community who do not have immunity. So what level or threshold of herd immunity do we need? This figure is very changeable – it is higher if you have more social mixing or if the virus is more infectious like the Delta variant.
The completeness of our immunity is also important to consider. The vaccines are over 90% effective at preventing severe disease, hospitalisations and deaths. However, they are only about 60% effective against you catching an infection even though it might be very mild or you may have no symptoms at all. However, you will be carrying the virus and still be able to pass it on. This 60% figure may be even lower for some of the other variants. Doctors think a herd immunity figure to stop transmission of the Delta virus is over 85%. If you have a vaccine that only prevents infection in about 60% of people then even if you have everybody vaccinated you cannot reach that herd immunity threshold where the disease would be eradicated. We have managed to completely eradicate smallpox by vaccines because they were so effective. Others we have almost eradicated – eg measles and polio. With the nature of this Delta variant and the vaccines, the level of immunity achieved is not high enough. If a new vaccine is developed that is 95% protective against severe disease and 95 % protective against getting the infection then we would have a chance to eradicate it. We know that the virus changes over time into newer variants so the vaccines would also have to change. So the feeling amongst some scientists is that the chances of eradicating this virus is very small and that it will become ‘endemic’ ie a disease that is with us all the time and will probably occur in recurrent outbreaks, especially in communities with low levels of immunity.
Listening to the media and the politicians you might be forgiven for thinking that the pandemic is easing and we are coming out of it. At the moment, however, we are still in the throes of the pandemic with almost 30,000 new infections per day and about 100 deaths per day – that’s about 3,000 deaths a month from Covid. Normally there is a lull in NHS activity in August – this year we are already near winter levels of activity. What can we expect in the winter months?
Seventy-five percent of the adult population in the UK has now been double vaccinated against Covid. The worry is that another variant may emerge which is even better at evading the effects of the vaccines and even more easily transmitted amongst the vaccinated population. The government’s Scientific Advisory Group for Emergencies (SAGE) have suggested that a new more deadlier variant is a real possibility. Ministers are being advised to prepare a contingency plan if this situation arises. However many researchers think that the virus will evolve slowly and gradually reduce vaccine effectiveness so giving us time to develop newer vaccines.
Case numbers of coronavirus infections are now starting to creep up again and scientists expect this figure to rise as social mixing increases over the summer. Then when schools go back there will be a large population of unvaccinated children mixing with adults who were vaccinated 10 months ago and who will have waning immunity. As we all know now there is often a 2-3 week lag from when cases rise and the effect on hospitalisations and deaths. Doctors will be hoping that we don’t get a surge in either. Not only that but there is also the real possibility of children being admitted to hospital with severe Covid disease as well as the increased incidence of Long Covid amongst adolescents and the risk of organ damage. It’s a worrying development that more children are now being admitted to hospitals worldwide. Perhaps we should be paying attention to what is happening in the US. Dallas, Texas, one of the states with low vaccination rates has run out of intensive care beds for children and California has made vaccines or testing mandatory in schools.
The reproduction number ‘R’ is the average number of people infected by someone with the virus. At the very beginning of the pandemic when everyone was susceptible and none of us had any immunity the first variant of coronavirus had an R-value of 3 ie, one person can go on to infect 3 others. However, the Delta variant is much more infectious and this has an R-value of 7. The R-value in England at the moment is 0.8-1.0. This means that one person will probably only pass the infection onto one other – so the pandemic is stable – not increasing or decreasing. Remember though that this particular R-value number is only based on data 2- 3 weeks old. As numbers are creeping up – the R-value is probably now over 1 but we will only know for sure in a few weeks We need the R number to be well below 1 for a decreasing pandemic. Over the last year, it has varied considerably and the likelihood is that it will increase again. Even though we are still in the third wave some scientists are now talking about a ‘fourth wave’ with the return of schools and people moving indoors after the summer.
Sorry if this all sounds like scaremongering but this is the reality of the situation. I’m sure you all know the message by now. This pandemic is going nowhere soon. If we want to carry on meeting people and having some sort of normal life we need to be mindful of any precautions we can take to help protect ourselves, our families and our communities. So masks in public places, good ventilation and good hand hygiene. Perhaps schools & businesses should be thinking about carbon dioxide monitors which can tell you how good the ventilation is in a room.
There is some good news - all 16-17-year-olds in England will be offered their first vaccine by 23rd August. Will they be getting 2nd dose as well? The government has not decided yet but we know that the vaccines are much more effective (over 90%) after 2 doses. As far as routine vaccines go for 12-15 years olds we are still behind most other rich countries which have started to vaccinate this age group. It is thought that the government might give the go-ahead soon and the task would be for schools to carry out this part of the vaccination programme.
From Monday, August 16th – people in England and Northern Ireland who are double vaccinated or under 18 will no longer have to self-isolate if they are identified as a close contact of someone who has tested positive for coronavirus. This is already the case in Scotland and Wales. Instead, you will be advised to have a PCR test and you only have to isolate if it comes back positive.
Stay Safe Everyone
Bye for Now
Dr M Tanvir Jamil
Senior Partner
Burnham Health Centre
In herd immunity a large proportion of the population is immune and this prevents the infection from spreading to other people in the community who do not have immunity. So what level or threshold of herd immunity do we need? This figure is very changeable – it is higher if you have more social mixing or if the virus is more infectious like the Delta variant.
The completeness of our immunity is also important to consider. The vaccines are over 90% effective at preventing severe disease, hospitalisations and deaths. However, they are only about 60% effective against you catching an infection even though it might be very mild or you may have no symptoms at all. However, you will be carrying the virus and still be able to pass it on. This 60% figure may be even lower for some of the other variants. Doctors think a herd immunity figure to stop transmission of the Delta virus is over 85%. If you have a vaccine that only prevents infection in about 60% of people then even if you have everybody vaccinated you cannot reach that herd immunity threshold where the disease would be eradicated. We have managed to completely eradicate smallpox by vaccines because they were so effective. Others we have almost eradicated – eg measles and polio. With the nature of this Delta variant and the vaccines, the level of immunity achieved is not high enough. If a new vaccine is developed that is 95% protective against severe disease and 95 % protective against getting the infection then we would have a chance to eradicate it. We know that the virus changes over time into newer variants so the vaccines would also have to change. So the feeling amongst some scientists is that the chances of eradicating this virus is very small and that it will become ‘endemic’ ie a disease that is with us all the time and will probably occur in recurrent outbreaks, especially in communities with low levels of immunity.
Listening to the media and the politicians you might be forgiven for thinking that the pandemic is easing and we are coming out of it. At the moment, however, we are still in the throes of the pandemic with almost 30,000 new infections per day and about 100 deaths per day – that’s about 3,000 deaths a month from Covid. Normally there is a lull in NHS activity in August – this year we are already near winter levels of activity. What can we expect in the winter months?
Seventy-five percent of the adult population in the UK has now been double vaccinated against Covid. The worry is that another variant may emerge which is even better at evading the effects of the vaccines and even more easily transmitted amongst the vaccinated population. The government’s Scientific Advisory Group for Emergencies (SAGE) have suggested that a new more deadlier variant is a real possibility. Ministers are being advised to prepare a contingency plan if this situation arises. However many researchers think that the virus will evolve slowly and gradually reduce vaccine effectiveness so giving us time to develop newer vaccines.
Case numbers of coronavirus infections are now starting to creep up again and scientists expect this figure to rise as social mixing increases over the summer. Then when schools go back there will be a large population of unvaccinated children mixing with adults who were vaccinated 10 months ago and who will have waning immunity. As we all know now there is often a 2-3 week lag from when cases rise and the effect on hospitalisations and deaths. Doctors will be hoping that we don’t get a surge in either. Not only that but there is also the real possibility of children being admitted to hospital with severe Covid disease as well as the increased incidence of Long Covid amongst adolescents and the risk of organ damage. It’s a worrying development that more children are now being admitted to hospitals worldwide. Perhaps we should be paying attention to what is happening in the US. Dallas, Texas, one of the states with low vaccination rates has run out of intensive care beds for children and California has made vaccines or testing mandatory in schools.
The reproduction number ‘R’ is the average number of people infected by someone with the virus. At the very beginning of the pandemic when everyone was susceptible and none of us had any immunity the first variant of coronavirus had an R-value of 3 ie, one person can go on to infect 3 others. However, the Delta variant is much more infectious and this has an R-value of 7. The R-value in England at the moment is 0.8-1.0. This means that one person will probably only pass the infection onto one other – so the pandemic is stable – not increasing or decreasing. Remember though that this particular R-value number is only based on data 2- 3 weeks old. As numbers are creeping up – the R-value is probably now over 1 but we will only know for sure in a few weeks We need the R number to be well below 1 for a decreasing pandemic. Over the last year, it has varied considerably and the likelihood is that it will increase again. Even though we are still in the third wave some scientists are now talking about a ‘fourth wave’ with the return of schools and people moving indoors after the summer.
Sorry if this all sounds like scaremongering but this is the reality of the situation. I’m sure you all know the message by now. This pandemic is going nowhere soon. If we want to carry on meeting people and having some sort of normal life we need to be mindful of any precautions we can take to help protect ourselves, our families and our communities. So masks in public places, good ventilation and good hand hygiene. Perhaps schools & businesses should be thinking about carbon dioxide monitors which can tell you how good the ventilation is in a room.
There is some good news - all 16-17-year-olds in England will be offered their first vaccine by 23rd August. Will they be getting 2nd dose as well? The government has not decided yet but we know that the vaccines are much more effective (over 90%) after 2 doses. As far as routine vaccines go for 12-15 years olds we are still behind most other rich countries which have started to vaccinate this age group. It is thought that the government might give the go-ahead soon and the task would be for schools to carry out this part of the vaccination programme.
From Monday, August 16th – people in England and Northern Ireland who are double vaccinated or under 18 will no longer have to self-isolate if they are identified as a close contact of someone who has tested positive for coronavirus. This is already the case in Scotland and Wales. Instead, you will be advised to have a PCR test and you only have to isolate if it comes back positive.
Stay Safe Everyone
Bye for Now
Dr M Tanvir Jamil
Senior Partner
Burnham Health Centre
