Friday, January 01, 2021

Coronavirus 47 New Pandemic

 "A patch of lily pads is growing in a pond and it doubles in size every day. After thirty days, lily pads cover the pond entirely. On what day do they cover half the pond?"

"The greatest shortcoming of the human race is our inability to truly appreciate the exponential function."

2021 does not start well. We have two, related, issues.

The UK government has decided to delay the second dose of vaccine from the promised three weeks after the first to twelve weeks. Consent from those who got the first dose of the vaccine is a contract, now broken by the Government. They have now been thrown into an unregistered trial without medical oversight or evidence of benefit from one dose, receiving an off-label drug. Government has overruled the license for political expediency.

Despite many months of opportunity to plan and build the production capacity, logistics and infrastructure for a rapid rollout of a vaccination programme, ready for when a vaccine might become available, that time was squandered and we now face a shortage. The solution, in the Government's eye, is to delay the second dose.

Manufactures and doctors are appalled. It reduces the efficacy of the programme by an unknown amount. It trashes the statistical analysis that might have been done on the efficacy of the vaccination roll-out. It can no longer be used as a trial. It is a non-randomised, non-controlled, non-trial on some of our most vulnerable people. The implications are, literally, immeasurable.

If the proposed vaccination regime provides a weakened level of population immunity it risks an enhanced selection pressure for the vaccine to mutate further. It could turn out to be worse than useless; we do not and cannot at this stage know.

And here lies the second issue. The emerging B117 SARS-CoV-2 lineage spreads faster than its predecessors. It continued to grow during the November lockdown in which other lineages shrank. R was greater than 1. That spells disaster for 2021. We have to regard the new variant as a whole new pandemic, which spreads more rapidly than the original version. We know that the Tier System and the partial 'Lockdown' that keeps education and much commerce and manufacturing open, does not send R below 1.

The government intends to send children to school on Monday 4th January and expects people to travel to work. If they have half an ear open to scientific opinion they will know that these policies will lead to a greater mortality and morbidity through 2021 than we experienced in 2020.

For what purpose?

Further reading:

Eric Voltz et al. Transmission of SARS-CoV-2 LineageB.1.1.7 in England: Insights from linkingepidemiological and genetic data  

Harald Vöhringer et al. Lineage-specific growth of SARS-CoV-2 B.1.1.7 during the English national lockdown 



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