Will cases going up matter as much with vaccinations?

[MonsterMash2210]

One things I am trying to establish in my mind is how safe opening up and easing restrictions will be since we now have vaccinations rolling out.

Everything I read about the vaccines seems to be quite positive. We have a (surprisingly) successful vaccine program. They appear to offer some protection against known variants. They appear to offer some reduction in transmission. They also reduce the severity of the disease.

So, (please do correct me if I am wrong) I would expect given the above that even if we do have an explosion in cases that it wouldn’t necessarily be the case that we would have an explosion in hospitals and death?

I am just hearing so much conflict in regards to this. The above makes sense to me but I am not an expert in science so admit I may be wrong.

It would make sense to me that once a lot of people have been vaccinated we don't even count cases ? Surely we just go by hospital admission ? Also there's not a huge need for everyone to test unless they're very ill in hospital. But if hospital admissions start going up again, then we would need to change strategy again. So perhaps my idea is a little risky. The safest thing to do is probably to keep testing the same and keep the same protocols for the rest of this year and watch the situation closely. But yes, technically once everyone is vaccinated- it shouldn't matter so much how many cases we have.

No, it shouldn’t. We should be focussing on hospitalisations because the plan has been to stop the nhs being overwhelmed and vaccinating the people more likely to end up in hospital should do that. People have started freaking out about potential mutations now though so there’ll be some demanding that we pursue a zero covid approach.

@bumbleymummy I agree with you. I think we can also just see if the variants are spreading by testing people in hospital. Some of the variants are really new and we don't even know if they actually are as potent as the original one. We could wait and see what happens I guess and if we see lots of people with the SA variant ending up in hospital, then we can reassess. But I do worry that it might be too late then and that they need to keep testing to know what's going on. I think that's what they'll do.

Yes the cases wouldn't matter if those cases are all mild. They should start looking at hospital admissions, if the whole point is to reduce pressure on the NHS.

Scientists are concerned that lots of cases will lead to more new variants and some of them could be vaccine resistant and more virulent.

Currently about 50% of ICU patients are under 60. It will take some time still until people in their 50s are vaccinated, and they are certainly at a risk. Younger age groups are at a smaller risk but of course lots of cases in these groups means the number of serious cases will raise in proportion. This seems to be a risk many are willing to take for themselves but what about people who don't have a choice - low paid workers who can't work from home, in already bad conditions at factories, food production and distribution, taxi drivers etc. Many are also from BAME groups and already at an increased risk plus vaccine take up has been lower.

Yes and no. The best estimate of vaccine effectiveness is around 95%, which may mean that at least 5% remain vulnerable - possibly more depending on which jab and how well it deals with any possible future new variants.

That's potentially enough of the population to cause new spikes, which we will need to flatten. So I would expect the need to test and trace, and SI will remain for quite some time, and the infrastructure remain in place beyond that so it can be reintroduced rapidly if there any sudden increases in hospital admissions.

I expect that masks will remain a requirement for many indoors places (and public transport), and for the next year or so venues will be open for people in small groups, not massed mingling.

Thank you everyone, this is all helpful and makes sense.

So, we definitely still need to be cautious then but there is still a lot of hope.

That is very good news!

@nordica

Scientists are concerned that lots of cases will lead to more new variants and some of them could be vaccine resistant and more virulent.

Currently about 50% of ICU patients are under 60. It will take some time still until people in their 50s are vaccinated, and they are certainly at a risk. Younger age groups are at a smaller risk but of course lots of cases in these groups means the number of serious cases will raise in proportion. This seems to be a risk many are willing to take for themselves but what about people who don't have a choice - low paid workers who can't work from home, in already bad conditions at factories, food production and distribution, taxi drivers etc. Many are also from BAME groups and already at an increased risk plus vaccine take up has been lower.

A lot of the current ICU patients will fall into the CEV group which will be vaccinated as part of group 4. There really aren’t huge proportions of younger people with no underlying conditions in hospital at the moment.

I'm not sure what are the negatives of continuing to test and trace (robustly, not as we are doing now) to keep on top of things until vaccines and therapeutics improve?

Why do people find that difficult? I'm genuinely curious

@stilllovingmysleep

I'm not sure what are the negatives of continuing to test and trace (robustly, not as we are doing now) to keep on top of things until vaccines and therapeutics improve?

Why do people find that difficult? I'm genuinely curious

I am very much in favour of anything that will help us flag up anything that could potentially cause us any future problems.

I just want (more than anything) that there is some hope in the future.

It looks like my understanding is right but we are still in a delicate place.

It sounds like the Government (at the moment) are intending to be cautious. Whether that will stay that way is another thing.

Yes it will matter. The more cases and community spread the more chance the virus will mutate which could undermine the entire vaccination programme which they have been doing very well with.

There is still a lot of people unvaccinated and don't forget of the people who are the bast majority have not had the 2 vaccines so are not fully vaccinated yet.

I wonder about this too. If vaccinated people still catch it but symptoms are mild, they may not bother to get tested, thinking it’s just a cold, when they could infect anyone else in their family. I hope all 9 groups get vaccinated by the time restrictions are properly lifted.

I believe the problem is while the vast majority of deaths, hospital admissions and "serious" cases are groups 1-4, there are a small percentage of the "young healthy" groups who do get very sick. If everyone catches covid in say a 3 week period, then that small % would be enough to push the NHS to breaking. So we still need to slow the spread of covid amongst the young healthy population (ensuring spreading out the young healthy ones ending up in hospital over a longer time period the NHS can cope with). So we can open up, but not go crazy straight off.

This is why they are still planning on vaccinating every adult, not just the most vulnerable.

(I'm not sure if I explained that very well!)

@gallbladderpain

There is still a lot of people unvaccinated and don't forget of the people who are the bast majority have not had the 2 vaccines so are not fully vaccinated yet.

There are also a lot of people who have natural acquired immunity from having the virus.

Scientists are concerned that lots of cases will lead to more new variants and some of them could be vaccine resistant and more virulent.

This may very well be a stupid question. But is this worry not the case with all viruses, eg flu? I know covid isn’t flu, but we don’t attempt to have zero flu cases in case it mutates into a far more deadly strain? Does flu not have the potential for this?

I heard a good interview on the radio earlier with an epidemiologist who thought that once we get to low cases we need a robust test, trace and isolate programme with support and incentives for people to isolate. She was concerned that continued high level of cases even with vaccination would lead to new variants and potentially those which evade the vaccine. Obviously we know the vaccine can be tweaked but probably not quick enough to avoid future lockdowns if we get a surge in hospitalisation due to a new variant.

@Meredithgrey1

Scientists are concerned that lots of cases will lead to more new variants and some of them could be vaccine resistant and more virulent.

This may very well be a stupid question. But is this worry not the case with all viruses, eg flu? I know covid isn’t flu, but we don’t attempt to have zero flu cases in case it mutates into a far more deadly strain? Does flu not have the potential for this?

Yes, it does. In fact, it is less stable than vivid and mutates more often.

Less stable than covid*

I am no scientist but my understanding of this is because we can vaccinate a wide section of the population including children so that helps keep rates low enough to ensure there is minimal opportunity for the virus to mutate.

So, (please do correct me if I am wrong) I would expect given the above that even if we do have an explosion in cases that it wouldn’t necessarily be the case that we would have an explosion in hospitals and death?

Spot on

Scientists are concerned that lots of cases will lead to more new variants and some of them could be vaccine resistant and more virulent.
This may very well be a stupid question. But is this worry not the case with all viruses, eg flu? I know covid isn’t flu, but we don’t attempt to have zero flu cases in case it mutates into a far more deadly strain? Does flu not have the potential for this?

Also spot on. This is what they mean by “learning to live with covid”. We will likely have an annual covid vaccine programme like we do with flu, which attempts to predict and vaccinate against the coming strains. Some years it will be more accurate, some less. There will be covid deaths every winter like there are flu deaths every winter.

It seems to me that a more severe illness is caused partly by age snd health issues but also viral load. If say all teachers and parents were fully vaccinated but children not and rules completely relaxed children would be exposed to a higher viral load in school if say 15 people had it in a class at once and they would be more at risk of serious illness due to inhaling more covid.

@Yorkshirepuddingforever

I am no scientist but my understanding of this is because we can vaccinate a wide section of the population including children so that helps keep rates low enough to ensure there is minimal opportunity for the virus to mutate.

Uptake of the flu vaccine is actually pretty low. It’s only offered to the more at risk groups (and more recently children too) and even within those groups, a lot of people decline.

As the vaccinations get rolled out the focus should be on the number of hospitalizations and deaths rather than number of cases. If people are only getting it mildly then we can live with that.

Very helpful everyone, so it sounds like we are just waiting for cases to continue to drop, vaccinations to roll out, and for systems to be put in place to ensure we can ‘live with the virus’.

This all makes a lot of sense and I can understand why there is a lot of caution for the rest of the year.