Right, the vaccine is coming - when we get our normality back?

[Whenismumhome]

Normality as in no more masks, Perspex screens, social distancing and lockdowns etc etc - just back to normal like it was in 2019.

Surely by summer we will have some sort of normality back?

Ha, I’m imagining granny having a grand old time flying abroad with grandpa, or on cruises again. Will be a turnaround.

*You said we don’t know who was in the trials - age? Sex? Ethnicity? Underlying conditions?

• I said yes, we do know who was in the trials in these groups, again this is public information now.*

We don't have info with regards to underlying conditions.
www.pfizer.com/science/coronavirus/vaccine

We know who was exempt from trials - TTC, Pregnant, Bipolar, Mental heath, organ donation recipient, GA within the past I forget, high blood pressure, heart problems, CKD and a whole lot more.

Now it's going out. who is still exempt? Clinical trials on many of those vulnerable with health issues either haven't started yet or have only recently began.

No, it has not been tested on absolutely everybody, yes it will be good to see more information (I’m breastfeeding, I don’t want to be ruled out of getting the vaccine for years!). But it is just not true to say that we don’t know who the vaccine was tested on. It is just not.

@TheNighthawk

I still can't see where you have provided a link. Please can you provide one or point me to where you already did.

All we know who it has been tested on is those who are healthy aged 16 - ?? (I cannot remember).

Studies have started with some who are vulnerable due to health, and in the USA trials started on those 12+. in October.

We know that a % of citizens from the USA have diverse backgrounds. No info about the backgrounds from the other 5 countries that I can find.

Surely until patient info and exemptions are released it is hard to pinpoint when things can get back to normal?

@GoldenOmber

See my reply to BlueBlancmange

I said that we do know what they were looking for- symptomatic covid, as is in the trial protocol.

• You said ‘But were they?’ and linked to someone else saying they should have been measuring something else as the endpoint

If you actually read that link you will see that they were probably not measuring the endpoint correctly, throwing the results into doubt.

You said ‘Sorry, no we don’t’ and criticised the studies for not being targeted towards identifying benefit in specific groups individually, and criticised AstraZeneca for having different protocols around swabbing

This is very important. We do not know the benefits in these groups. And we need to. In addition there are specific, vital groups which have not been addressed. My point about AstraZeneca's swabbing was as a potential confounder in the endpoints.

Thus, these trial results - all of them - need to be regarded with circumspection.

They are ‘just the start’ of a move back to normality. Nobody thinks the world will ping back to normal as soon as they personally are vaccinated, but if your point is that a 95% effective, safe, widely available vaccine won’t actually end the pandemic once enough people have got it, then you are being deeply committed to pessimism in the face of all available evidence.

But, judging by the reaction to the vaccine news, including from people who should know better, people DO think that the 'world will just ping back to normal'.

The vaccine cannot be regarded as 95% effective - it does not prevent the spread of infection. This is crucial. You will see this from the links I posted. Vaccines would not usually be approved unless they DO prevent spread.

Do we socially distance and wear masks to avoid the transmission of polio and measles, both of which are still around, and both of which are more highly infectious than covid? No. No we don’t. So we’re not going to with this, either. Sorry to the people who are hoping we will, but it’s not going to happen

Polio is a GI infection and is spread by faecal-oral transmission. Vaccination for polio is 99% effective against both infection and onward transmission, measles 97% against both infection and transmission. Uptake of both vaccines is extremely high, so an infected person is unlikely to be encountered at present in UK.(though for measles there is a problem in Germany due to anti-vaxxers, hence compulsory measles vaccination for school entrance etc., but this is the approach, not distancing, due to high vaccine efficacy.)

We will still have to continue hygiene measures. If not, we will see a surge in covid and its longer term sequelae.

Denial is a wonderful thing. Not.

@TheNighthawk

www.telegraph.co.uk/global-health/climate-and-people/prof-peter-piotvaccine-candidates-far-protective-anyone-predicted/

Just a week later, and Professor Piot seemed to be feeling much more optimistic, even if he does still think some precautions should remain.

Nighthawk restrictions are there because hospitalisation are too high.

Can you answer

• do you disagree with JVT and first phase of vaccine rollout stopping 99% of deaths?

• why you think hospitalisation will be so high that MPs will continue to vote fir restrictions?

Even if we pass it on, if majority do not get ill enough or die we will remove SD as it is damaging to economy.

Not overnight but by Easter. How long do you suggest SD / restrictions will remain?

@BlueBlancmange

@TheNighthawk

I still can't see where you have provided a link. Please can you provide one or point me to where you already did.

I didn't provide the link because you mentioned the study so I assumed you were familiar with it.

This is a link to the bioRxiv preprint:
www.biorxiv.org/content/10.1101/2020.05.13.093195v1.full.pdf

[quote BlueBlancmange]@TheNighthawk

www.telegraph.co.uk/global-health/climate-and-people/prof-peter-piotvaccine-candidates-far-protective-anyone-predicted/

Just a week later, and Professor Piot seemed to be feeling much more optimistic, even if he does still think some precautions should remain.[/quote]
I think he is saying much the same as in his paper. He reiterates the point that precautions must continue and there is much about the vaccines we don't know. Also that there will be other techniques to help with this pandemic, so the vaccines are just one part of the many measures needed.

He also makes the interesting contrast between the UK and Laos in the effectiveness of quarantines, etc. which boils down to people actually doing what they are asked to do. This is a point which has been made before in the context of other countries which have lower covid rates, of course, and something which will continue to be relevant.

So much will need to be answered by the phase IV trials (ie us) which is why we need to have some caution for some time yet.

If you actually read that link you will see that they were probably not measuring the endpoint correctly, throwing the results into doubt.

I don’t agree, and also that’s not what you were saying. You were saying we didn’t know what they were measuring and you guessed it was severe lung disease. We do know what they were measuring, and it was not severe lung disease.

This is very important. We do not know the benefits in these groups.

Yes, yes we do - we know as much as we can know from the breakdown of data we have. (eg - Pfizer have said the vaccine worked just as well in the older age groups.) And again, what you said was that we don’t know who was included, which is a totally different thing from “we do know exactly who was included but we don’t yet have further comprehensive studies on every single one of these groups.”

But, judging by the reaction to the vaccine news, including from people who should know better, people DO think that the 'world will just ping back to normal'.

When the vaccines have been rolled out - yes. Because that is what will happen. I am sorry if you find this difficult to accept, but it is what is going to happen.

The vaccine cannot be regarded as 95% effective - it does not prevent the spread of infection.

We do not yet know for certain if it does. That is the kind of info we’ll only be able to gather once more people start to take it in roll-out programmes. What we do know, however, is that it prevents symptomatic cases (because that is what they were measuring), and it would be very surprising if it didn’t therefore reduce infections as a result. Worst-case scenario is that we end up with partially reduced transmission of what presents in vaccinated people as maybe nothing and maybe a bit of a cough.

Vaccines would not usually be approved unless they DO prevent spread.

No, that isn’t true. And again, it most likely DOES prevent spread, we just don’t have comprehensive data proving that yet. You’re going from “we don’t definitely know this is true” to “therefore, it’s definitely not true.”

We will still have to continue hygiene measures.

We really won’t. I can’t tell if you are very afraid of this or very keen on this, but either way, your devotion to the idea is out of line with the way we have dealt with every other infectious disease ever.

@TheNighthawk

Come off it, it's got a far more optimistic tone. I very much doubt you would have considered linking to this article to try to make your point.

Can you answer

• do you disagree with JVT and first phase of vaccine rollout stopping 99% of deaths?

I think Van Tam actually said that 99% of covid deaths had been in the elderly or clinically vulnerable, who are in the first priority group for the vaccine rollout. Therefore the hope is that once this group has been vaccinated any further deaths from covid in them will be prevented.

We don't completely know. It will depend on a sufficient immune response in these groups. Early indications are that immune response was good in elderly trial subjects but numbers of very elderly were not large. Vulnerable groups contain immunosuppressed people who may be unable to mount a sufficient response, but others should be ok.

why you think hospitalisation will be so high that MPs will continue to vote fir restrictions?

Even if we pass it on, if majority do not get ill enough or die we will remove SD as it is damaging to economy.

Not overnight but by Easter. How long do you suggest SD / restrictions will remain?

I don't think hospitalisations will be so high. I agree that MPs will not vote for restrictions. (of course, it depends what you mean by restrictions) and that the economy needs to recover, no matter what.

It really does puzzle me that there is seemingly so little concern about long covid, which I think is going to amount to a huge personal and societal (not to mention NHS) burden over time. In my first post I wrote:

However, pragmatically, there has to be an economic recovery, and I think that some semblance of normality will be encouraged simply to facilitate that, even if it means more people suffering from long covid.

The vaccines will likely result in fewer direct and immediate deaths from covid, so masking the delayed mortality and morbidity and allowing resumption of a great deal of economic activity without the backlash for governments that would otherwise occur.

And that is what I think will happen. We will muddle through, with denial and mis-steps, incurring a huge burden of chronic disease and disability along the way.

@TheNighthawk

And that is what I think will happen. We will muddle through, with denial and mis-steps, incurring a huge burden of chronic disease and disability along the way

Well, we're pretty f*cked then, aren't we? As you say, the economy needs to recover and I don't see how that will be possible if social distancing needs to be maintained indefinitely. From what I can see though, much of what you are saying is speculation, so let's hope the scientists and epidemiologists who are showing more optimism than you are right, and you are wrong. Because really, if what you say is right, we might as well all shoot ourselves now.

@TheNighthawk

However, as even your beloved Professor Piot does not appear to be echoing your doom-laden prophesies about a chronic disease-drenched future, I'm not going to share your concerns quite yet.

@TheNighthawk

Can I ask what your credentials are by the way? Are you qualified in any relevant area?

Nighthawk what information from trials do we have re long covid?

We have a vaccine with limited data (only age and a mention of a % of cultural background in one country)
A lot of various medical conditions that were excluded in stage 1 still haven't even been tested.
Stage 3 clinical trials are still continuing and started to include those excluded people
The vaccination can lesson symptoms so there is still the risk of Long CV?
There is still no clear indication of if the vaccinated can pass on CV if they get it, although they can still be asymatic?
No immunity until after 28. days and it's unknown how long this will last because Stage 3 ongoing trials. Both doses have to be taken, although some could be put off after the first dose because of the various things.
Reactions? - Whatever reactions other vaccines have?
We know one was seriously ill, just not in how seriously ill?
The process is completely new in human vaccinations
There is no list yet for the ingredients used
Peer reviews don't exist but they do take time

Is there anything I have missed?