Covid: How close is the light to the end of the tunnel?

The largest vaccination program in UK history is rolling out. This week, some GPs in England will join leading hospitals to start offering the jab.

The plan is to immunize everyone over 50 and younger adults with underlying health problems. The rest of the population could follow suit. But how long will all this take?

Vaccinating 55 million people (children are not being considered for jab at this stage) is a daunting task. It will take many months, perhaps the better part of a year.

There is currently a vaccine approved for use, manufactured by Pfizer and BioNTech.

The UK has managed to order 40 million doses of the vaccine, enough to cover 20 million people given that two doses are needed.

So, in the short term at least, the UK will require another vaccine to be approved for use.

Fortunately, regulators are evaluating the merits of two more, including one from the American firm Moderna. But the problem with that is that the UK has been able to order just seven million doses, and the earliest they can be supplied is spring.

This is why there is so much hope for a vaccine produced by the University of Oxford and AstraZeneca.

There are already between five million and 10 million doses on hold with a total of 100 million on order; again two doses are needed, so it is enough for 50 million people, which combined with the Pfizer jab means there should be enough for the entire population. next year.

Will it be approved? It will be a surprise if it is not. The team behind this is confident and emphasized that they met all the criteria for approval when the full data behind the clinical trials was published in The Lancet this week.

Much was made of the fact that it does not appear to be as effective in stopping infection as the Pfizer vaccine (70% versus 95% effective), but what they both do at levels close to 100% is stop serious diseases. If people don’t die from Covid or are left with long-term problems, the most serious consequences of the pandemic are over.

Also, implementation will be easier with the Oxford vaccine. This is because it does not need to be kept in ultra-cold storage like Pfizer’s, which has led to strict rules on its movement.

For example, the NHS still cannot get it to nursing homes, even though residents and staff are the top priority for vaccination, while GPs have only three and a half days to deplete doses when they receive childbirth. It is, says one GP, “a logistical nightmare” to work with.

Vaccine manufacturing is known for not always going well.

In fact, Pfizer has already had to reduce the quantity it is expected to deliver to the UK – it ships from Belgium.

10 million doses were originally forecast for the end of 2020, but now the government has been told that it expects only five million, and only 800,000 of that are currently in the country, making Health Secretary Matt Hancock’s goal of vaccinating “millions before Christmas” seems like a stretch.

Oxford vaccine is manufactured in the UK, so the supply should be more reliable from that point of view. However, production will continue to depend on the availability of the right ingredients, and with a global race to produce vaccines already underway, it would be surprising if that didn’t mean some setbacks down the road.

Another potential hurdle is Brexit. A no-deal Brexit could cause problems importing all kinds of goods, especially via the Calais to Dover shipping route. The government says it has identified safe routes to get essential products into the country. But the concerns obviously persist.

All of this combined is why Dr Richard Vautrey, who is the head of GP for the British Medical Association, says that supply is probably the biggest “risk factor” to implement.

He says that if there is enough vaccine, he is “sure” that GPs and their practice nurses could vaccinate millions of people a week.

Large-scale vaccination depends on people coming forward. Many fear that achieving good absorption is not a given because people may refuse to be vaccinated; it will not be mandatory.

Ipsos Mori and King’s College London looked at this over the summer. Their survey of more than 2,000 adults reportedly found that only half of the people planned to get vaccinated.

However, the truth is somewhat more nuanced. If you add those who said it was quite likely, the numbers jumped to almost three-quarters.

What’s more, the oldest age groups were the least likely to say they would reject the vaccine.

It is understandable, since they are the ones most at risk. More than nine out of 10 deaths occur among those over 65, and this is really the crucial issue when it comes to the vaccine schedule and how quickly life will get back to normal.

There are 12 million people over the age of 65. Once significant numbers are vaccinated, the risk of the NHS being overwhelmed disappears and the high number of excess deaths seen in the population decreases.

How long will that take? Well, GPs managed to vaccinate the population over 65 against the flu in just over two months this fall – 77% showed up for the vaccine.

The flu vaccine is given in a single dose, but doctors believe it should be perfectly possible to finish the vaccination for all people over 65 who are willing to receive the vaccine by the end of March, if availability allows.

That would trigger, or at least give the option to trigger, further relaxation of the restrictions.

It’s what UK government medical director Professor Chris Whitty called “risk elimination” this week when he appeared before MPs at the Health Select Committee.

His point was that we could quickly get to a situation where the level of death and illness caused by Covid was at a level that society could “tolerate”, just as we tolerate between 7,000 and 20,000 people who die from the flu each year.

That would allow for a gradual move away from the harsher restrictions, he says, perhaps only requiring a bit of continued social distancing and the use of face covers in some settings.

Spring may not be the end of the pandemic, but it certainly should be the beginning of the end.