Tag: Jonathan Van-Tam

JVT: Hardship, but also hope

Deputy Chief Medical Officer Jonathan Van-Tam highlights the importance of continuing to follow the guidance, even after receiving a COVID-19 vaccination

Next Saturday will mark the first anniversary of the World Health Organization’s declaration of a Public Health Emergency of International Concern and next Sunday will be one year on from the first case of COVID-19 detected in the UK. It has been a terrible year as the virus has spread across the world causing misery, hardship, death and severely disrupting all of our lives.

The silver lining has been the incredible work of scientists and healthcare professionals across the world. If you had told me 12 months ago, that the UK would have discovered, in dexamethasone, the first treatment proven to reduce COVID-19 deaths, and vaccinated over 5 million people by this point, I would have been astonished. But that is the place in which we find ourselves. Hardship, but also hope.

Many people have played an important role in getting vaccines in arms, including the teams of researchers behind the development of the vaccines, the volunteers who took part in clinical trials, the Vaccines Taskforce who ensured we had supply of vaccine and the NHS staff and volunteers who are now working hard to administer them to people quickly and safely.

Their work has been incredible and we should rightly celebrate this.

Vaccines do offer the way out of the pandemic and a return to life as we knew it – having a pint before watching your local football team, multigenerational family gatherings and big weddings. These really will return! But to make that happen as quickly as possible we need to bring the number of cases down as soon as we can whilst we vaccinate our most vulnerable. To do that there are some important scientific points I want to highlight:

No vaccine has ever been 100% effective so no-one will have 100% protection from the virus. The way to reduce everyone’s risk is to break the chains of transmission and really push down the number of cases.

Vaccines work by tricking your body into thinking it has to fight the virus. It trains you for this fight by making antibodies and stimulating T-cells; then you are ready if you do come across the real thing. However, like any training, getting up to ‘match fitness’ takes time. Your body’s response, the immune response, is only fully trained up around 2 or 3 weeks after you have each of your 2 jabs. If you are older it’s better to allow at least 3 weeks. You can still get COVID in this time.

Even better and longer lasting protection then comes from the second dose so it is really important that everyone gets the second jab.

Really importantly we do not yet know the impact of the vaccine on transmission of the virus. So even after you have had both doses of the vaccine you may still give COVID to someone else and the chains of transmission will then continue. If you change your behaviour you could still be spreading the virus, keeping the number of cases high and putting others at risk who also need their vaccine but are further down the queue.

We still have a very high number of hospitalisations and deaths. A quarter of hospital admissions for COVID-19 are in people under the age of 55. Despite the speed of the rollout, these are people who will not have the vaccine for a while yet.

Some people are questioning the UK policy of trying to give as many at-risk people as possible the first dose of vaccine in the shortest possible time, inevitably extending the interval before the second dose is given.

But what none of these (who ask reasonable questions) will tell me is: who on the at-risk list should suffer slower access to their first dose so that someone else who’s already had one dose (and therefore most of the protection) can get a second? Everyone on the JCVI priority list is at risk from this nasty virus, and vaccines just can’t be produced at an unlimited rate.

It has been a very difficult year for us all and everyone, including me, is desperate to return to seeing the people we love. The vaccine has brought considerable hope and we are in the final furlough of the pandemic but for now, vaccinated or not, we still have to follow the guidance for a bit longer.

JVT: ‘We are at a tipping point’

The UK’s Deputy Chief Medical Officer Professor Jonathan Van-Tam outlines the current Covid-19 situation:

In our national fight against Covid-19, we are at a tipping point similar to where we were in March; but we can prevent history repeating itself if we all act now.

ONS data show that an estimated 224,000 people have the virus – up from 116,000 last week, hospital admissions for Covid-19 are rising again, as are intensive care admissions. Although the epidemic re-started in younger adult age groups in the last few weeks, there is clear evidence of gradual spread into older age groups in the worst affected areas.

Sadly, just as night follows day, increases in deaths will now follow on in the next few weeks. The good news, is that we are much more certain now that children are usually not badly affected by this virus.

The R for the UK is between 1.2 – 1.5. Roughly this means that every one case generates more than one new case, through onward transmission – so the epidemic grows larger. Every NHS region of England has an R that is well above 1.0, suggesting that widespread increases in transmission continues across the country, not just in the north of England. Scientists estimate that the doubling time in the UK for new infections is between 8 and 16 days and is even faster in some areas.

SAGE is clear that we need to act now.

Winter in the NHS is always a difficult period, and that is why in the first wave our strategy was: “contain, delay, research and mitigate” to push the first wave into Spring. This time it is different as we are now are going into the colder, darker winter months. We are in the middle of a severe pandemic and the seasons are against us. Basically, we are running into a headwind.

The NHS is bracing itself and they will do what they always do, which is work their socks off to help as many people as possible. But we need to be realistic – there is only so much they can do. We all have to help our hard-working NHS staff continue to care for everyone who needs it urgently, and provide as many non-urgent tests, checks and treatments as possible, by helping to stem the rising tide of infections.

People point out that we must not lose sight of the indirect harms of Covid-19. They are absolutely right. We need to keep elective surgeries and non-urgent services open for as long as we can; we need to keep cancer treatment and diagnostic services going; and we need to continue to provide mental health services. And importantly, we need people to come forward for that care when they need it – and we know that, during the first peak, fear of the virus put many off from doing so.

The best way we can do this is to keep the number of Covid-19 cases down. If cases rise dramatically the NHS will need to focus more on dealing with the life threatening situations immediately in front of them; this can mean freeing up staff and space by postponing other non-urgent procedures and treatments. We need to help the NHS by keeping Covid-19 numbers low; and in turn the NHS will be there for us, our families and loved ones.

The principles for how we keep transmission low have not changed. Above all else, if you have Covid-19 symptoms you must self-isolate in line with published guidance and get a test.

At all times, even when you are well, wash your hands regularly, wear a face covering in confined spaces and follow the 2 metre social distancing rules. By keeping our contacts low we reduce the number of opportunities for the virus to spread. I know this is very hard, but it is an unfortunate scientific fact that the virus thrives on humans making social contact with one another.

What I would give to have had the level of data, testing and medical insight we have now back in February and March this year. We now have much-improved testing capabilities, we know in more detail where the disease is, and we have better treatments.

Earlier in the year we were fighting a semi-invisible disease, about which we had little knowledge, and it seeded in the community at great speed. Now we know where it is and how to tackle it – let’s grasp this opportunity and prevent history from repeating itself.

Prime Minister Boris Johnson is expected to announce tougher restrictions for England tomorrow.