Hospital Covid admissions begin rising again after lockdown relaxation

Hospital coronavirus admissions begin rising again after lockdown relaxation – after it emerged 10,000 patients caught Covid while ALREADY on wards

  • Coronavirus hospital admissions have begun to rise again after the second national lockdown was eased
  • Official figures show that the rise in hospitalisations was mainly drive by increases in Tier 2 London 
  • Data also show that 10,000 people contracted the virus while being treated for other illnesses in hospitals 

Coronavirus hospital admissions have begun to rise again after the second national lockdown ended last week, official figures show – after it emerged that more than 10,000 people acquired the disease when they were being treated in hospital for other illnesses.

Data released by the Department for Health indicated that the average number of hospital admissions stood at 1,262 for England on Sunday – up three per cent from the week before.

The growth in hospitalisations was mainly drive by increases in London, which is teetering on the brink of being moved from Tier 2 to the ‘at most risk’ Tier 3 restrictions that would decimate the City’s economy. The East of England, the South East and the Midlands also all experienced a rise in admissions that pushed the national seven-day average up.

In London, the average number of hospital admissions was nine per cent higher from a week earlier, and six per cent higher in the Midlands. The East of England saw a 33 per cent rise in hospitalisations from a week earlier, and the South East 18 per cent.

The figures began increasing on December 2 – the day Boris Johnson’s brutal second shutdown ended – after consistent falls in hospitalisations from a peak of 1,547 on November 14. This is despite the protestations of health officials, including Professor Stephen Powis of NHS England, that hospitals have appeared to ‘turned the corner’.

The analysis by the Times supports Cabinet minister Michael Gove’s widely criticised warning to Tory backbenchers that hospitals would be overrun unless the three-tier regime – which has locked 99 per cent of England in the two highest forms of lockdown – were imposed at midnight on the 2nd.

The PM will review the post-lockdown tier system across England on December 16, with tiers then expected to remain in place until after the Christmas and new year period. Rising hospitalisations in London could fuel efforts by lockdown ‘doves’ in the Cabinet to plunge the capital into Tier 3.

Cabinet minister Michael Gove had wanted London to enter the highest curbs on freedom in the days before the second shutdown ended, but was reportedly overruled by Mr Johnson after the Treasury warned No10 that the move would cause the loss of another 500,000 jobs in the capital. 

Official figures also show that more than 10,000 people acquired Covid-19 when they were being treated in hospital for other illnesses, with one NHS Trust recording that nearly 40 per cent of Covid-19 cases they were treating had been contracted in its wards.

Hampshire Hospitals NHS Foundation Trust said that 139 of its 357 Covid-19 patients (nearly 40 per cent) they had treated had caught coronavirus there, while board papers showed that five patients had died. 

Data submitted to NHS England by trusts with A&E departments that have treated over 100 coronavirus patients since August show that more than 16 per cent of people treated for the virus in hospital had caught it there.  

Epsom and St Helier University Hospitals NHS Trust had the second highest proportion of cases, after Hampshire Hospitals NHS Foundation Trust, at 37 per cent (or 146 cases). Kingston Hospital NHS Foundation Trust recorded 34 per cent (or 91 cases). 

Tameside and Glossop Integrated Care NHS Foundation Trust recorded that nearly almost 22 per cent of Covid-19 patients they had treated were hospital acquired infections.

The shock Telegraph finding is likely to raise fears about control of the disease and whether the NHS has sufficient measures in place to protect patients – let alone whether the health service can ever truly protect patients from the spread of Covid-19.  

Former health secretary Jeremy Hunt, chairman of the Commons Health and Social Care Select Committee, last night said that ‘there is absolutely no justification for this level of hospital infections’.

Jonathan Ashworth, Labour’s shadow health minister, told the newspaper: ‘These are alarming findings that will cause understandable concern for patients and their loved ones. It’s vital robust infection control is in place across hospital trusts and that all frontline staff access ongoing regular routine testing.   

It follows reports that two NHS staff suffered an ‘anaphylactoid reaction’ just after getting the the Pfizer/BioNTech vaccine on V-Day as the UK this week began rolling-out the jab to the over-80s, vulnerable and frontline NHS workers and care home staff in the biggest-ever mass immunisation programme in its history.  

In other coronavirus news:      

  • Professor Chris Whitty warns Britain will need lockdowns until March, even with vaccines, but there are likely to be ‘three or four’ Covid-19 jabs in use by the middle of next year; 
  • Holidays abroad were given the green light for next summer by officials and care homes were told to expect doses of the vaccine by Christmas; 
  • The Oxford University/AstraZeneca vaccine was found to be ‘safe and effective’ in a major study in the Lancet. However regulators face a decision over whether to approve the vaccine with a low-dose initial injection;
  • US regulators inched closer to approving the Pfizer jab for the most vulnerable;
  • Mr Johnson appeared to issue a warning about London following a rise in infection rates, sparking fears it could be plunged into Tier Three next week;
  • Chief scientific adviser Patrick Vallance warned the public may still be wearing face masks a year from now; 
  • A further 616 people died of coronavirus, taking the total to 62,033. Another 12,282 cases were confirmed. 

Coronavirus hospital admissions have begun to rise again after the second national lockdown ended last week, official figures show – after it emerged that more than 10,000 people acquired the disease when they were being treated in hospital for other illnesses

Data released by the Department for Health indicated that the average number of hospital admissions stood at 1,262 for England on Sunday – up three per cent from the week before. The growth in hospitalisations was mainly drive by increases in London, which is teetering on the brink of being moved from Tier 2 to the ‘at most risk’ Tier 3 restrictions that would decimate the City’s economy

The numbers in the capital are moving in the wrong direction, with cases per person up by half in the worst affected corners of the city and chaotic photos from the weekend showing shopping streets packed with people. Red shows areas where the infection rate has risen in a week, while green shows the boroughs that have seen a fall in cases

LONDON INFECTION RATE HIGHER THAN 27 AREAS IN TIER THREE 

London’s Covid-19 infection rate was higher than more than two dozen areas currently stuck under Tier Three restrictions, official data revealed yesterday after Matt Hancock warned the capital is on the verge of being plunged into the toughest measures before Christmas.

Department of Health statistics show the city recorded 169.2 cases of coronavirus per 100,000 people during the seven-day spell ending December 2 — the day England’s national lockdown finished and Number 10 reverted back to its whack-a-mole style approach to thwarting local outbreaks.

For comparison, the city’s Covid infection rate stood at 151.6 in the last seven days before Downing St’s blanket intervention was imposed on November 2.

MailOnline’s analysis of Government figures show London is now recording more cases per day, for its size, than 27 of 61 authorities currently living under Tier Three curbs, including Nottingham, Leeds, Leicestershire, Bristol, Newcastle and Derby.

And 21 out of the capital’s 32 boroughs saw a rise in coronavirus infections in the last week of the shutdown, with the biggest surges in Haringey, Bromley and Kingston.

Asked whether the capital is in danger of being upgraded to Tier Three next week, the Health Secretary pointed to rising cases as he pleaded with people to keep obeying the rules. He urged the capital’s 9million residents to stick by the rules and ‘not push the boundaries’.

Meanwhile, Boris Johnson also highlighted the increase in London in an interview hailing the first vaccines being administered.

City Hall is understood to be braced for bad news when the first review of the tiers in England is carried out next Wednesday (December 16), despite the mayor Sadiq Khan insisting he does not want it to happen. Tier Three rules would inflict yet more devastation on the hospitality industry, with bars and restaurants only allowed to operate takeaway — like during the national lockdown.

Official figures showing a rising number of hospital admissions in London is likely to fuel panic and provoke politicians to call for greater curbs on liberty. 

London Mayor Sadiq Khan urged residents to maintain social distancing and remain masked, saying: ‘The No 1 way to look out for our loved ones and support local businesses in this festive season is to follow the rules, and do all we can to avoid going back into tougher restrictions later this month or any time in the future. 

‘If we begin to act like this virus has gone away, we could see a devastating further surge in cases at a time of year when our NHS is already under enough pressure.’

Mr Khan also tweeted: ‘This is important. We still have a long winter ahead. None of us want London to move into Tier 3.’  

Nickie Aiken, MP for the Cities of London and Westminster constituency, said ‘every single person who breaks the rules adds to the chances of us going into Tier 3’. She issued the warning in a last-ditch attempt to get coronavirus under control in the capital, where infection rates have surged towards the end of lockdown and into early December, rising in two thirds of areas. 

‘We still have a long winter ahead,’ she cautioned today in the Evening Standard. ‘None of us want London to move into Tier 3. Please continue to follow the rules – lives and livelihoods truly are dependent on it’.

Professor John Ashton, a former Public Health England regional director, stressed the Government should push the capital into the highest tier in 48 hours or risk a ‘really terrible situation’.

He warned that without the move they could see deaths going up into Christmas, and may even have to impose a ‘complete lockdown’ to put the lid on the spread of the virus. 

As many as 24 out of the capital’s 32 boroughs – or three quarters – registered a rise in their infection rates a week after England’s lockdown, according to Public Health England data for the seven-day spell to December 3.

Its infection rate at 169.2 cases per 100,000 people yesterday was higher than 27 out of 61 local authorities already under Tier Three restrictions. This was about 12 per cent above the level before lockdown on November 5, when the rate was at 151.6, and is the highest of any region in England.   

Professor Ashton, who has also written a book on the pandemic, told The Guardian that unless action is taken quickly in the capital the Government may have to call a third lockdown.

‘If London doesn’t want hospitals to be full over Christmas the Government need to get a grip today,’ he added to the BBC. ‘Deaths will start going up during the Christmas period and new year unless something is done.

‘London could become a super spreader, sending coronavirus to other parts of the country over Christmas and making a third wave of infections likely in January.’

Stinging the capital, he added: ‘London always gets treated differently from the rest of the country because that is where parliament is and where a lot of the business community is.’ 

And London mayor Sadiq Khan warned that even though the NHS has started giving the vaccine to those who are most vulnerable to the virus, everyone must ‘continue to play our part and keep ourselves and others safe’.

Borough name

Infection rate per 100,000 people (week to Dec 2) 

% change in a week

Havering

Barking

Redbridge

Waltham Forest

Bexley

Newham

Tower Hamlets

Kingston

Enfield

Harrow

Merton

Haringey

Bromley

Greenwich

Hillingdon

Barnet

Hackney

Ealing

Croydon

Sutton

Hounslow

Brent

Lambeth

Wandsworth

Lewisham

Southwark

Islington

Kensington

Hammersmith

Westminster

Camden

Richmond 

346

303.4

292.2

269.7

246.1

243.5

213.4

202.8

200.1

196.3

189.3

180.5

175.4

172.3

169.8

165.7

165.4

164.1

153.6

152.7

147.7

146.5

121.5

118.9

117.4

117

116.3

103.8

93.4

90.7

87.8

80.3 

+28.8%

+21.9%

+1.1%

+21.9%

+19.1%

+9%

+3.7%

+23.7%

+18.9%

+43.7%

+34.4%

+49.2%

+36.2%

+17.8%

+3.8%

+15.5%

+25.3%

-10.4%

+18.1%

+16.7%

-13.4%

-12.8%

+12.8%

+17%

+20.9%

+15.5%

+10.6%

-9%

-17.2%

-7.4%

-6.3%

-7.6%

‘We still have a long winter ahead of us and I urge Londoners to continue to follow the public health rules to protect each other and our NHS,’ he said in a statement yesterday.

Cabinet minister Michael Gove hinted the capital could be kept in Tier 2 providing its residents stuck to the rules. ‘What we want to do is to see areas if we possibly can either stay in their current tier or move down a tier,’ he told Sky News. ‘But it requires us all, particularly in the run-up to Christmas, to be vigilant.’

London’s director for public health, professor Kevin Fenton, cautioned that the virus is again on the increase in the city, including in the more at risk over 60s.  ‘Covid-19 behaves like clockwork – the more contact we have with others, the higher the chance of us catching or spreading the virus,’ he said. 

‘If we want to keep infections down, every one of us needs to remain vigilant and follow the rules as we go about shopping, eating out or meeting friends outdoors. We’ll need to work together to prevent a big surge in cases in London ahead of the festive period so we must all do our bit and limit the spread over the coming days and weeks.

‘We can do this by sticking to the rules, remembering the basics of ‘Hands, Face, Space’, and getting tested and isolating at home if we have any symptoms.’

Despite the mounting warnings, the minister for London have warned it is still ‘too early’ for the Government to decide whether to put the capital in Tier 3. But officials are still airing their concerns in a bid to drive down cases ahead of the tier review.

The Health Secretary Matt Hancock refused to rule out whether the capital would be moved to the toughest restrictions. ‘My message to everybody in London is ‘let’s stick by the rules’ and not push the boundaries of the rules, but rather try to limit the spread of this infection because the case numbers are going up in parts of London, in parts of Essex, in parts of Kent, and we know what happens when case numbers go up, sadly more people end up in hospital and more people end up dying,’ he told LBC radio.

‘So, we’ve got to stick at it and we have got to keep this virus suppressed whilst we get the roll-out (of the vaccine) going. So, my message to everybody in London is ‘please respect the restrictions, respect what needs to be done, keep yourself and your family and your community and your city safe’.’

Talk of lockdown is likely to dash the hopes of people who believed that mass vaccination would bring an end to the much-hated pandemic. However, within 24 hours of the biggest-ever mass vaccination programme in British history, the UK’s drug regulator told anyone with a serious allergy to medicines or food was told not to have the much-vaunted jab.

The number of people set to be barred is not known, though up to seven million people in the country have allergies severe enough to require medical care, according to the NHS – while around 250,000 people need to carry an EpiPen at all times.  

Both the unnamed healthcare workers needed immediate treatment but are ‘recovering well’ after they developed symptoms shortly after receiving the jab. It is not known if either person needed to use the EpiPens they both carry with them at all times. 

They suffered an ‘anaphylactoid reaction’ to the vaccine, which is milder than anaphylaxis, and tends to involve a rash, shortness of breath, swelling of the face and tongue or a drop in blood pressure, the NHS says. 

Both are recovering following the first day of the mass vaccination programme, it is understood (pictured, the vaccine being administered in Glasgow yesterday)

Care home staff receive the Pfizer/BioNtech Covid -19 vaccine at Bradley Manor residential care home in Belfast

Care home staff receive the Pfizer/BioNtech Covid-19 vaccine at Bradley Manor residential care home in Belfast

Care home staff receive the Pfizer/BioNtech Covid-19 vaccine at Bradley Manor residential care home in Belfast

WHAT ARE THE KNOWN SIDE EFFECTS FROM THE PFIZER VACCINE?

The UK medicines regulator advised today that anyone who has a history of ‘significant’ allergic reactions to medicines, food or vaccines should not get the Pfizer coronavirus jab.

Dr June Raine, the chief executive of the MHRA, told Parliament’s Science and Technology Committee that this was not identified in the trials.

‘We know from very extensive clinical trials that this wasn’t a feature,’ she said.

Allergic reactions to the vaccine are ‘very rare’, according to the trials involving more than 40,000 people.

Pfizer found a ‘very small number’ during its phase three clinical studies, or 137 out of 19,000 people who got the vaccine. 

They also identified 12 possible side-effects from the vaccine, with seven identified as ‘very common’ meaning they are likely to affect more than one in ten people. Below are the known side effects.

The patient safety leaflet for the vaccine cautions that anyone with an allergy to any of the active substances in the vaccine should not receive the jab.

It adds: ‘Signs of an allergic reaction may include itchy skin rash, shortness of breath and swelling of the face or tongue.’ 

Allergic reactions to the vaccine are:

Very common (Likely to affect more than one in ten people)

  • Pain at injection site
  • Tiredness
  • Muscle pain
  • Chills
  • Joint pain
  • Fever
  • Headache 

Common (Likely to affect up to one in ten people)

  • Injection site swelling
  • Redness at injection site
  • Nausea 

Uncommon (May affect one in 100 people) 

  • Enlarged lymph nodes
  • Feeling unwell

Despite the two allergy cases the Government is continuing to vaccinate between 5,000 and 7,000 people per day across the UK with 800,000 Pfizer doses already in hospitals and millions more on the way.   

Yesterday the Medicines and Healthcare products Regulatory Agency (MHRA) – which authorised emergency use of the vaccine at a breathtaking speed – gave precautionary advice to all 50 NHS trusts now vaccinating the population that anyone who has a history of ‘significant’ allergic reactions to medicines or food should not receive the vaccine.  

However, British scientists called for calm as public fears of the alleged dangers of the new vaccine – which is said to have an 95 per cent efficacy against infection – threaten to derail the NHS’ mass inoculation programme in the latest stage of the pandemic. 

Professor Graham Ogg of Oxford University urged calm, saying: ‘It will be important to now understand the specific nature of the reactions and the background medical history of the individuals affected so that any risks of reactions can be more closely defined. Staff are always prepared for the possibility of reactions and as with all medications, will continue to submit reports of any further episodes. In the meantime, reasonable precautions have been advised by the MHRA.’ 

Dr Andrew Garrett, Executive Vice President of Scientific Operations at ICON, pointed out: ‘The large clinical trial used to support vaccine approval by the MHRA excluded those with a ‘History of severe adverse reaction associated with a vaccine and/or severe allergic reaction (e.g. anaphylaxis) to any component of the study intervention(s)’.

‘The resulting UK patient leaflet stated that the vaccine should not be given to individuals who are allergic to the active substance or any of the other listed ingredients. In this respect the patient information was similar to the clinical trial exclusion criterion, and the approved vaccine labelling will have reflected the data received and reviewed by the MHRA to date.

‘As more data accumulate from both clinical trials and clinical practice then one naturally expects the safety profile to be updated and refined, as with any medicine. 

‘The MHRA has moved quickly today to strengthen their direction on the basis of two allergic reactions in individuals with a history of allergic reactions – that is, to exclude individuals with a significant history of allergic reactions moving forward.’

He added: ‘Tuesday was a welcome cause for celebration, and there was an enthusiastic response from those vaccinated. Labelling may well expand in the future, but it would be wise to be cautious in these early days to avoid undermining public confidence – particularly given the vaccine is in limited supply. Careful questioning of those about to receive the vaccine is in order.’ 

Dr Penny Ward of King’s College London and Chair of the Education and Standards Committee of the Faculty of Pharmaceutical Medicine said: ‘As these two events occurred in people with a history of severe allergy, it is sensible of the MHRA to draw attention to these reports and to suggest that individuals with a history of severe allergy not receive the vaccine at this time. 

UK regulator dismisses Bell’s palsy fears over Pfizer vaccine

Britain’s drug regulator dismissed safety fears over the Pfizer and BioNTech coronavirus vaccine after a report revealed four people in a trial in the US got Bell’s palsy. The condition, which is usually temporary, causes muscles on one side of the face to droop because of nerves not working properly.

Four cases of it were found in a group of 21,720 people who had the Pfizer vaccine in a trial in the US, compared to none among 21,728 people given a placebo vaccine. But this rate of occurrence is no different to how often it would be expected to happen in a random population – in the UK there are around 20 to 30 cases per 100,000 people per year.

The Food and Drug Administration in the US said in its report: ‘The four cases in the vaccine group do not represent a frequency above that expected in the general population.’ This means that it was almost certainly random that all the people who developed the condition happened to be in the vaccine group, and the same number of people would likely have got it in any group that size, regardless of a vaccine.

And the British counterpart, the MHRA, said: ‘The general safety profile of this vaccine is similar to other types of routinely used vaccine.. 

‘No vaccine would be authorised for supply in the UK unless the expected standards of safety, quality and efficacy are met.’ The Pfizer/BioNTech vaccine, proven to be safe in clinical trials, is now being given to members of the public in Britain, which is the first country to give a jab to its citizens.

‘MHRA is actively monitoring the safety of the vaccine during clinical use and can be expected to provide updates to practitioners as more information is gathered. The prompt reporting of these events using the yellow card scheme and the rapid issuing of additional information to guide practice shows that the safety monitoring system is working well.’ 

And Professor Peter Openshaw, past-President of the British Society for Immunology and Professor of Experimental Medicine at Imperial College London, said: ‘As with all food and medications, there is a very small chance of an allergic reaction to any vaccine. However, it is important that we put this risk in perspective. 

‘The occurrence of any allergic reaction was one of the factors monitored in the phase 3 clinical trial of this Pfizer/BioNTech COVID-19 vaccine, the detailed data from which was released yesterday. In this, they reported a very small number of allergic reactions in both the vaccine and placebo groups (0.63% and 0.51%).

‘Similar to the rollout of all new vaccines and medications, this new COVID-19 vaccine is being monitored closely by the Medicines and Healthcare products Regulatory Agency (MHRA). They will now investigate these cases in more detail to understand if the allergic reactions were linked to the vaccine or were incidental. The fact that we know so soon about these two allergic reactions and that the regulator has acted on this to issue precautionary advice shows that this monitoring system is working well.’

NHS England national medical director Professor Stephen Powis said: ‘The MHRA have advised on a precautionary basis that people with a significant history of allergic reactions do not receive this vaccination after two people with a history of significant allergic reactions responded adversely yesterday. Both are recovering well.’  

In the US vaccine trial carried out by Pfizer, 137 out of around 19,000 people given the vaccine had one or more of these reactions. But 111 who got the placebo also had allergic reactions. Reactions to the jab can include a temperature, nausea, swelling of the arm or in severe cases feeling generally unwell with swollen lymph node glands.  

A Pfizer spokesman said: ‘We have been advised by MHRA of two yellow card reports that may be associated with allergic reaction due to administration of the COVID-19 BNT162b2 vaccine. As a precautionary measure, the MHRA has issued temporary guidance to the NHS while it conducts an investigation in order to fully understand each case and its causes. Pfizer and BioNTech are supporting the MHRA in the investigation.

‘In the pivotal phase 3 clinical trial, this vaccine was generally well tolerated with no serious safety concerns reported by the independent Data Monitoring Committee. The trial has enrolled over 44,000 participants to date, over 42,000 of whom have received a second vaccination’.  

The allergy scare came hours after Britain’s drug regulator dismissed safety fears over the Pfizer/BioNTech vaccine after a report revealed four people in a trial in the US got Bell’s palsy. The condition, which is usually temporary, causes muscles on one side of the face to droop because of nerves not working properly.

Four cases of it were found in a group of 21,720 people who had the Pfizer vaccine in a trial in the US, compared to none among 21,728 people given a placebo vaccine. But this rate of occurrence is no different to how often it would be expected to happen in a random population, the company said.  

EVERYTHING YOU NEED TO KNOW ABOUT PFIZER’S COVID VACCINE

Here, MailOnline answers all the questions about the jab, including who will get it first, how much it costs and where people will be vaccinated.

What could the logistical challenges of delivering it be?

Both the Prime Minister Boris Johnson and Health Secretary Matt Hancock warned that transporting and storing Pfizer’s breakthrough jab ‘won’t be easy’, while Chris Hopson, chief executive of NHS Providers, described the logistics behind the mass roll out as ‘formidable’. 

The problems stem from the fact the vaccine must be kept in long-term storage at -70C. 

To keep doses at this ultra-low temperature, they need to be packaged with dry ice and placed in a special transport box the size of a suitcase which hold 5,000 doses.

These containers can prevent the vaccines from spoiling for 10 days if they remain unopened.

Once the batches arrive at vaccination hubs, they can be stored in standard medical fridges at between 2°C and 8°C for up to five days. 

Or they can be kept in their shipping boxes for up to 30 days if the containers are topped up with dry ice at least once a week.

Welsh Health Minister Vaughan Gething said the logistical issues meant ‘in practical terms at this stage that we cannot deliver this vaccine to care homes’

The sticking point for delivering the jab to places like care homes may be that BioNTech says that the vaccine can only be kept at between 2°C and 8°C for six hours in transit without going off. 

Because the Pfizer suitcases hold 5,000 vaccine doses, smaller quantities would have to be removed from the dry ice suitcases for transport to care homes. 

But once they are in transit the doses could perish after six hours. It’s unclear exactly why this is the case.  

Who is top of the list to get a coronavirus vaccine?

The Joint Committee on Vaccination and Immunisation (JCVI) has examined data on who suffers the worst outcomes from coronavirus and who is at highest risk of death. 

The JCVI’s guidance says the order of priority should be the below.

1. Residents in a care home for older adults and their carers 

2. All those who are 80 years of age and over and frontline health and social care workers

3. All those who are 75 years of age and over

4. All those who are 70 years of age and over and clinically extremely vulnerable individuals, excluding pregnant women and those under 18 years of age

5. All those who are 65 years of age and over

6. Adults aged 18 to 65 years in an at-risk group, such as the morbidly obese

7. All those aged 60 and over

8. All those aged 55 and over

9. All those aged 50 and over

However, because of the aforementioned logistical problems, care homes cannot receive the vaccines straight away, so elderly NHS patients, care workers and NHS staff are receiving the first doses.

Where will people get the vaccine, and who will be administering it?

Work was going on behind the scenes to ensure that NHS staff were ready to start delivering vaccines to the most vulnerable from the start of December. 

Vaccinations yesterday started in 70 NHS hospitals and the operation will be scaled up in the coming days and weeks. 

Nightingale Hospitals and sports stadiums have been prepared as sites for mass vaccination clinics, while GPs and pharmacists will also be involved in the mammoth Army-backed operation to deliver the jab.  

New regulations allowing more healthcare workers — and NHS volunteers — to administer flu and potential Covid-19 vaccines have also been introduced by the Government. They will be supervised by a healthcare professional.

NHS England stated that GP practices offering vaccines must be able to operate from 8am to 8pm, seven days a week including bank holidays when required for reasons such as needing to use up supplies of a vaccine without wasting any.

A letter sent to all practices suggests that it may be necessary for some staff to vaccinate patients on Christmas Day. Vaccination sites are expected to be able to deliver at least around 1,000 jabs per week. The contract to vaccinate begins next Tuesday and GPs will be paid £25.16 for every two jabs they administer.

Volunteers without medical training can put themselves forward through the GoodSAM app to give injections working with St John Ambulance. The role description states: ‘Volunteer vaccinators will be trained to deliver a vaccination to a patient. They will also be ready to act if a patient has an adverse reaction.’

People are also being sought to act as vaccination care volunteers. They will help patients get to the right place for their jab and be on hand to provide first aid if anyone becomes unwell.

Volunteer patient advocates, the third type of helper, will ‘concentrate on the welfare of patients through their experience’.

How many doses of the Pfizer vaccine has the UK bought?  

The UK has secured 40million doses of the Pfizer/BioNTech vaccine, with 10million due in the UK by the end of the year. 800,000 doses are already in the country and ready to be used.

Patients need two doses, meaning Number 10 has only secured enough doses for around a third of Britain. 

However, it is likely other vaccines, including one from Oxford University that the UK has bought 100million doses of, will be approved in the coming weeks and months.

How long does it protect you for?

Regulators yesterday said there was evidence of ‘partial immunity’ just seven days after the first dose, offering a glimmer of hope that the roll-out beginning next week may have an effect before Christmas.

But they insisted the best immunity comes seven days after the second dose, which is given three weeks after the first.

It remains a mystery as to how long immunity against Covid lasts for, with top scientists warning that people may need to be vaccinated against the disease every winter, like the flu.  

 

What type of vaccine is this?

The jab is known as a messenger RNA (mRNA) vaccine.

Conventional vaccines are produced using weakened forms of the virus, but mRNAs use only the virus’s genetic code.

An mRNA vaccine is injected into the body where it enters cells and tells them to create antigens. These antigens are recognised by the immune system and prepare it to fight coronavirus.

What are the advantages of this type of vaccine?

No actual virus is needed to create an mRNA vaccine. This means the rate at which it can be produced is dramatically accelerated. As a result, mRNA vaccines have been hailed as potentially offering a rapid solution to new outbreaks of infectious diseases.

In theory, they can also be modified reasonably quickly if, for example, a virus develops mutations and begins to change. mRNA vaccines are also cheaper to produce than traditional vaccines, although both will play an important role in tackling Covid-19.

Where is the vaccine made?   

Pfizer’s jab is being manufactured at the firm’s plant in Belgium, as well as separate sites in the US. 

BioNTech — the other drug company involved in the vaccine — has two production facilities in Germany that are expected to start churning out doses in the New Year.   

Can the vaccine be transported in a fridge?

Yes, although the vaccine should be kept at -70°C to ensure its long-term preservation, it can be transported by car or van if refrigerated between 2°C and 8°C.

According to the latest data from BioNTech, the company that owns the vaccine, it is only safe to use within six hours of being defrosted if transported in a fridge.

Researchers say this would allow administration of the vaccine to high-risk populations who may be unable to visit vaccination centres, such as care home residents. However, it also says that the vaccine remains stable and viable for up to five days if kept in a stationary fridge — like in a GP surgery – at 2-8°C.

The only difference between the two scenarios is that one involves being chilled and transported, while the other is not moved while being cooled.

Why this difference shortens the vaccine’s shelf-life is currently unexplained. 

Speaking at a virtual press conference, the vaccine’s developers hinted the restrictions would be eased as more data was gathered, indicating the limits are currently overly-cautious to ensure the vaccine reaches society’s most vulnerable people with no drop-off in its efficacy. 

Are they safe?

All vaccines undergo rigorous testing and have oversight from experienced regulators.

Some believe mRNA vaccines are safer for the patient as they do not rely on any element of the virus being injected into the body. mRNA vaccines have been tried and tested in the lab and on animals before moving to human studies.

The human trials of mRNA vaccines – involving tens of thousands of people worldwide – have been going on since early 2020 to show whether they are safe and effective.

Pfizer will continue to collect safety and long-term outcomes data from participants for two years.

Can you get the Covid vaccine privately? 

The Queen and the rest of the Royal Family will not be able to jump the queue for a Covid-19 vaccine and even Boris Johnson will have to wait his turn, it was revealed last month.

No one will be given ‘special treatment’ when the country launches its mass-immunisation drive, according to Government sources.

Even rich companies won’t be able to skip the line, despite fears wealthy corporations would snap up vaccines directly to get their staff back to work and make up for the money haemorrhaged during lockdown. 

Could employers force staff to get a vaccine?

It is ‘highly unlikely’ private employers could force staff to get a Covid jab when one finally becomes available, according to lawyers.

Although most of Britain will need to get vaccinated to achieve herd immunity and stop the disease spreading, a jab can’t be given without people’s consent.

Lawyers at the global firm Morgan Lewis said it was not likely that firms in the UK could start enforcing vaccination.

They said: ‘A vaccine could only be lawfully administered provided that the individual consented to such treatment. It is highly doubtful an employee could be described as consenting to treatment under any degree of compulsion by their employer.’

Will I get a vaccine passport if I get the jab?  

Immunity passports have been touted as the key for getting swathes of society back to normal life, and allowing millions to evade restrictions. This is because they would indicate someone is protected against the virus, and is able to fight it off without getting severely ill or dying.

Bars, cinemas and football stadiums could turn away Britons who have not been vaccinated against coronavirus, the UK’s vaccine minister Nadhim Zahawi suggested.

But ministers have since denied Britons will need ‘immunity certificates’ to go to the pub. Michael Gove was asked yesterday during a round of interviews whether people could need to prove they had been given coronavirus vaccines to enter bars and restaurants. He replied flatly: ‘No.’

Pressed on whether they could be required at theatres or sports centres, he said: ‘No I don’t think so, no.’ 

Mr Hancock said that a vaccine passport ‘isn’t part of our plan’. He told Sky News: ‘While we know that this vaccine protects you from getting ill with Covid – we don’t yet know how much it stops you transmitting Covid until we roll it out broadly.’

Don’t vaccines take a long time to produce?

In the past it has taken years, sometimes decades, to produce a vaccine.

Traditionally, vaccine development includes various processes, including design and development stages followed by clinical trials – which in themselves need approval before they even begin.

But in the trials for a Covid-19 vaccine, things look slightly different. A process which usually takes years has been condensed to months.

While the early design and development stages look similar, the clinical trial phases overlap, instead of taking place sequentially.

And pharmaceutical firms have begun manufacturing before final approval has been granted – taking on the risk that they may be forced to scrap their work.

The new way of working means that regulators around the world can start to look at scientific data earlier than they traditionally would do.

Aren’t there other vaccines?

Yes, recent data from the Oxford/AstraZeneca, and Moderna vaccine trials suggests their candidates also have high efficacy.

Oxford data indicates the vaccine has 62 per cent efficacy when one full dose is given followed by another full dose.

But when people were given a half dose followed by a full dose at least a month later, its efficacy rose to 90 per cent, according to data. But the breakthrough results from trials of Oxford University’s vaccine were based on ‘shaky science’, experts have warned.

The combined analysis from both dosing regimes resulted in an average efficacy of 70.4 per cent.

Final results from the trials of Moderna’s vaccine suggest it has 94.1 per cent efficacy, and 100 per cent efficacy against severe Covid-19.

Nobody who was vaccinated with the vaccine known as mRNA-1273 developed severe coronavirus.

A graph showing vaccine orders made by the EU, US, Canada, UK, Japan and Australia

Which jab is best?

The early contenders all have high efficacy rates, but researchers say it is difficult to make direct comparisons because it is not yet known exactly what everyone is measuring in the trials.

Analysis shows the Pfizer vaccine can prevent 95 per cent of people from getting Covid-19, including 94 per cent in older age groups. 

A technician inspects vials of coronavirus disease (COVID-19) vaccine candidate BNT162b2 at a Pfizer manufacturing site in manufacturing site in St. Louis, Missouri

The vaccine has been tested on 43,500 people in six countries and no safety concerns were raised. Approval means the UK can begin rolling out the vaccine to those most in need, including frontline NHS workers. 

How many doses of other jabs has the UK secured?

The UK has secured access to 100million doses of the AstraZeneca/Oxford University vaccine, which is almost enough for most of the population.

It also belatedly struck a deals for seven million doses of the jab on offer from Moderna in the US.

The deals for 357million doses of seven different vaccines cover four different classes: adenoviral vaccines, mRNA vaccines, inactivated whole virus vaccines and protein adjuvant vaccines.  

How much does Pfizer’s vaccine cost?

Pfizer/BioNTech is making its vaccine available not-for-profit.

According to reports, the Moderna vaccine could cost about 38 dollars (£28) per dose and the Pfizer candidate could cost around 20 dollars (£15).

Researchers suggest the Oxford vaccine could be relatively cheap to produce, with some reports indicating it could be about £3 per dose.

AstraZeneca said it will not sell it for a profit, so it can be available to all countries.

However, the details of the deals made by the UK Government have not been made public.

What is the usual process for developing a vaccine?

Traditionally vaccine development takes several years and includes various processes, including design and development stages followed by clinical trials – which in themselves need approval before they even begin.

The trials take place in three sequential stages – also known as phases. The research will show whether a vaccine generates antibodies but also protects people from disease. They will also identify any safety issues.

Once the trials are complete, the information gathered by researchers is sent to regulators for review. This is thoroughly analysed by clinicians and scientists before being approved for widespread use. Then, after approval from regulators, people can start to receive the vaccine.

Is this different because of the pandemic?

The process looks slightly different in the trials for a Covid vaccine.

While the early design and development stages look similar, the clinical trial phases have overlapped – instead of taking place sequentially.

But won’t that mean that safety is compromised?

Even though some phases of the clinical trial process have run in parallel rather than one after another, the safety checks have still been the same as they would for any new medicine.

The Medicines and Healthcare products Regulatory Agency (MHRA) has adopted the phrase ‘safety is our watchword’.

Regulators have said they will ‘rigorously assess’ the data and evidence submitted on the vaccine’s safety, quality and effectiveness.

And, in most clinical trials, any safety issues are usually identified in the first two to three months – a period which has already lapsed for most vaccine front-runners.

How are regulators acting so quickly?

Regulators have been carrying out ‘rolling reviews’, which means that instead of going through reams of information at the conclusion of the trials, they have been given access to the data as the scientists work.

A rolling review of the vaccine data started several months ago.

This means regulators can start to look at scientific data earlier than they traditionally would do, which in turn means the approval process can be sped up. Regulators sometimes have thousands of pages of information to go over with a fine-tooth comb – which understandably takes time.

Once all the data available on the vaccine is submitted, MHRA experts will carefully and scientifically review the safety, quality and effectiveness data – how it protects people from Covid-19 and the level of protection it provides.

After this has been done, advice is sought from the Government’s independent advisory body, the Commission on Human Medicines (CHM).

What does ‘approved for use’ mean?

For a medicine to be used in the UK it has to be granted a licence. This means that it has been through all the rigorous safety and efficacy checks and regulators are confident in the findings of the clinical trials.

By reviewing the data as they become available, the MHRA can reach its opinion sooner on whether or not the medicine or vaccine should be licensed without compromising the thoroughness of their review.

So what data would the regulator have looked at?

The information provided to the MHRA will have included what the vaccine contains, how it works in the body, how well it works and its side-effects, and who it is meant to be used for.

This data must include the results of all animal studies and clinical trials in humans, manufacturing and quality controls, consistency in batch production, and testing of the final product specification.

The factories where the vaccines are made are also inspected before a licence can be granted to make sure that the product supplied will be of the same consistent high standard.

Husband and wife Ugur Sahin and Oezlem Tuereci are behind the Pfizer Covid-19 vaccine that could change the world

Regulators look at stacks of data before approving any vaccines (stock)

What is the difference between the MHRA and the CHM? 

The MHRA is the British regulator of medicines and medical devices, ensuring their safety, quality and effectiveness.

The CHM advises ministers on medicinal products. It is made up of an independent group of advisers responsible for advising on the need for, and content of, risk management plans for new medicines.

It also advises officials on the impact of new safety issues on the balance of risks and benefits of licensed medicines.

The CHM also offer advice on ‘applications for both national and European marketing authorisations’.

Haven’t pharmaceutical companies already started making vaccines?

Yes. Usually large-scale production and distribution begins only after regulatory approval. But in the case of Covid-19 vaccines, pharmaceutical firms have begun manufacturing before final approval had been granted – taking on the risk that they may be forced to scrap their work.

Source: Read Full Article