New lockdown in England, including school closures, announced by Johnson, 4/1/21

[DB]

Which is why it is so important that the criteria for lifting lockdown are clearly evidence based, and not based on arbitrary assumptions about timescales. Having heard Steve Baker this morning, and despite his attempts to navigate round the point, "arbitrary" was the best I could have described his target date as being.

There isn't anything 'arbitrary' about the very likely impact of vaccines, or about seasonality.

 

[Yew]

Which is why it is so important that the criteria for lifting lockdown are clearly evidence based, and not based on arbitrary assumptions about timescales. Having heard Steve Baker this morning, and despite his attempts to navigate round the point, "arbitrary" was the best I could have described his target date as being.

He stated quite explicitly it was based on vaccinations. And that's before we consider that we must weigh the risks from Covid with the massive harms that their mitigations cause.

 

[DB]

Unfortunately "irreversible" is now meaningless, as we've heard before that there wouldn't be repeat lockdowns.

This is the trouble with this government's clumsy and muddled presentation, and it's partly why we're doing particularly badly in terms of the economic effects.

Indeed - I don't think anybody, either those for or against lockdowns, now believes a word he says after a year of blatant U-turns.

 

[Carlisle]

Indeed - I don't think anybody, either those for or against lockdowns, now believes a word he says after a year of blatant U-turns.

Yes, one poll on the radio a few days ago had around 70% believing there’ll be another lockdown

 

[yorksrob]

Which is why it is so important that the criteria for lifting lockdown are clearly evidence based, and not based on arbitrary assumptions about timescales. Having heard Steve Baker this morning, and despite his attempts to navigate round the point, "arbitrary" was the best I could have described his target date as being.

On the contrary, the onus should be on the authorities to fully justify with evidence, each and every restriction in place at any given moment in time. So far there has been absolutely no evidence presented that the package of restrictions imposed in lockdown is justified as a whole. There is no evidence that not allowing people to mix outdoors, for example, has a significant effect on transmission.

 

[alansheppard77]

Yes, one poll on the radio a few days ago had around 70% believing there’ll be another lockdown

so nobody believes the vaccine is going to work then

 

[DB]

so nobody believes the vaccine is going to work then

In a lot of cases it'll be more that people don't trust him not to keep on movijng the goalposts so that an 'acceptable' level of infections is always something which we haven't reached yet.

 

[duncanp]

Which is why it is so important that the criteria for lifting lockdown are clearly evidence based, and not based on arbitrary assumptions about timescales. Having heard Steve Baker this morning, and despite his attempts to navigate round the point, "arbitrary" was the best I could have described his target date as being.

Whilst it is important that the criteria for lifting lockdown are evidence based, you have to give some idea of timescales, even if you don't specify an exact date.

You can't say to businesses that are closed "..we will let you reopen when the infection rate is below X, and the number of people vaccinated is above Y, without giving some indication of when you expect to reach X and Y, based on the latest available data.

There are many businesses that are on their last legs financially, and without some indication of when they will be allowed to reopen, many of them will not survive.

So in the roadmap out of lockdown I would like to see something like:-

".....we will allow you to reopen when <specify criteria>. We expect to meet these criteria between <start date> and <end date>. We will be able to confirm you reopening date by <confirmation date>.

This will give businesses a chance to plan for reopening, by ordering stock and bringing staff back off furlough, as required.

 

[Yew]

Whilst it is important that the criteria for lifting lockdown are evidence based, you have to give some idea of timescales, even if you don't specify an exact date.

You can't say to businesses that are closed "..we will let you reopen when the infection rate is below X, and the number of people vaccinated is above Y, without giving some indication of when you expect to reach X and Y, based on the latest available data.

There are many businesses that are on their last legs financially, and without some indication of when they will be allowed to reopen, many of them will not survive.

So in the roadmap out of lockdown I would like to see something like:-

".....we will allow you to reopen when <specify criteria>. We expect to meet these criteria between <start date> and <end date>. We will be able to confirm you reopening date by <confirmation date>.

This will give businesses a chance to plan for reopening, by ordering stock and bringing staff back off furlough, as required.

It's time to stop worrying about cases, and consider vaccinations and hospital occupancy only.

 

[duncanp]

It's time to stop worrying about cases, and consider vaccinations and hospital occupancy only.

I think you have to look at all the statistics, not just cases.

We need to look at vaccinations, numbers admitted to hospital, numbers in hospital, efficacy of the vaccine, to what extent does the vaccine inhibit transmission, test positivity and deaths, but not only how these figures are now, but what are they likely to be in the future.

 

[Bertie the bus]

We need to look at vaccinations, numbers admitted to hospital, numbers in hospital, efficacy of the vaccine, to what extent does the vaccine inhibit transmission, test positivity and deaths, but not only how these figures are now, but what are they likely to be in the future.

I disagree. Hospital numbers are the only important figures. All the rest is noise. What impact will each relaxation have on people requiring hospital treatment and what will occupancy rates be? Within that the number of people vaccinated and the effectiveness of the vaccine will be important as they will have an impact on hospital admissions but we certainly don't need z will happen when u, v, w, x and y are at certain levels.

 

[6862]

Johnson has revealed the easing of lockdown plans to be "cautious but irreversible", while also saying there are target dates in mind but easements can be subject to delays:

Coronavirus: Plan to exit lockdown 'cautious but irreversible', says Boris Johnson

Boris Johnson says the government will set out its plans on 22 February, which could include target dates.

www.bbc.co.uk

Unfortunately "irreversible" is now meaningless, as we've heard before that there wouldn't be repeat lockdowns.

This is the trouble with this government's clumsy and muddled presentation, and it's partly why we're doing particularly badly in terms of the economic effects.

I think bramling is right that Boris's proclamation that the lockdown easing must be 'irreversible' doesn't mean anything at all. The government has done countless U-turns over the past year, so I'm fairly certain they would happily introduce a new lockdown at some point in the near future if they wanted to. I suspect this statement from Boris is just an attempt to pacify his backbenchers, and he has no intention of sticking to it.

 

[Domh245]

I think you have to look at all the statistics, not just cases.

We need to look at vaccinations, numbers admitted to hospital, numbers in hospital, efficacy of the vaccine, to what extent does the vaccine inhibit transmission, test positivity and deaths, but not only how these figures are now, but what are they likely to be in the future.

We only need to look at the statistics that cause issues: Hospitalisation and capacity, and deaths. Whether or not somebody returns a positive test matters not one bit if neither they, nor anyone they might pass it on to, will become seriously ill

The problem is that as the vaccine rollout continues to progress, the relationship between cases and the "limiting statistics" become increasingly uncertain. You only need look at the Warwick and Imperial papers modelling the impact of releasing restrictions where (presumably) 95% confidence intervals cover practically the entire graph when looking at deaths and hospitalisations

 

[takno]

I think you have to look at all the statistics, not just cases.

We need to look at vaccinations, numbers admitted to hospital, numbers in hospital, efficacy of the vaccine, to what extent does the vaccine inhibit transmission, test positivity and deaths, but not only how these figures are now, but what are they likely to be in the future.

The trouble is that people are still looking at case numbers as a leading indicator of hospital admissions, and assuming that they will continue to work in the same proportions. Until we have a better idea of what the future relationship between those figures is, the case numbers are probably worse than useless

 

[35B]

Whilst it is important that the criteria for lifting lockdown are evidence based, you have to give some idea of timescales, even if you don't specify an exact date.

You can't say to businesses that are closed "..we will let you reopen when the infection rate is below X, and the number of people vaccinated is above Y, without giving some indication of when you expect to reach X and Y, based on the latest available data.

There are many businesses that are on their last legs financially, and without some indication of when they will be allowed to reopen, many of them will not survive.

So in the roadmap out of lockdown I would like to see something like:-

".....we will allow you to reopen when <specify criteria>. We expect to meet these criteria between <start date> and <end date>. We will be able to confirm you reopening date by <confirmation date>.

This will give businesses a chance to plan for reopening, by ordering stock and bringing staff back off furlough, as required.

I don't think there is much difference between us - the key one being that the anticipated dates would always be conditional, and that the confirmation may not be subject to a deadline.

He stated quite explicitly it was based on vaccinations. And that's before we consider that we must weigh the risks from Covid with the massive harms that their mitigations cause.

He did state it was based on vaccinations - that was what stuck out when I listened. It was based solely on when vaccinations will be administered, and made no allowance either for the time taken for them to become effective, or for any consideration of whether the vaccination programme will achieve the quality of result the CRG's plan assumes.

Given his, and CRG's, track record of ignoring bad news in the past, it was not a plan that gave me any confidence would be viable or effective. Instead, it struck me as being entirely arbitrary, and liable to make things worse rather than better. In the best case, it could delay opening up; in the worst, it could generate more cases, hospitalisations, deaths, and restrictions by opening up too much, too fast.

It's time to stop worrying about cases, and consider vaccinations and hospital occupancy only.

I think you have to look at all the statistics, not just cases.

We need to look at vaccinations, numbers admitted to hospital, numbers in hospital, efficacy of the vaccine, to what extent does the vaccine inhibit transmission, test positivity and deaths, but not only how these figures are now, but what are they likely to be in the future.

We only need to look at the statistics that cause issues: Hospitalisation and capacity, and deaths. Whether or not somebody returns a positive test matters not one bit if neither they, nor anyone they might pass it on to, will become seriously ill

The problem is that as the vaccine rollout continues to progress, the relationship between cases and the "limiting statistics" become increasingly uncertain. You only need look at the Warwick and Imperial papers modelling the impact of releasing restrictions where (presumably) 95% confidence intervals cover practically the entire graph when looking at deaths and hospitalisations

I'm with @Domh245 on this - we need an understanding of the correlations between cases and hospitalisations as the population liable to catch Covid changes. My hope and expectation is that the combination of a smaller target population who are less prone to suffer seriously from the disease will lead to a dramatic reduction in the impact Covid has on the population as a whole, allowing for a dramatic change in the risk analysis. However, I'm not inclined to bank on that assumption until it's actually visible - unlike @yorksrob, I don't consider the burden of proof now, if it ever was, to be on the government to prove in advance the efficacy of their measures.

 

[Yew]

I think you have to look at all the statistics, not just cases.

We need to look at vaccinations, numbers admitted to hospital, numbers in hospital, efficacy of the vaccine, to what extent does the vaccine inhibit transmission, test positivity and deaths, but not only how these figures are now, but what are they likely to be in the future.

Most of those feed into hospitalisations though.

== Doublepost prevention - post automatically merged: 15 Feb 2021 ==

He did state it was based on vaccinations - that was what stuck out when I listened. It was based solely on when vaccinations will be administered, and made no allowance either for the time taken for them to become effective, or for any consideration of whether the vaccination programme will achieve the quality of result the CRG's plan assumes.

Given his, and CRG's, track record of ignoring bad news in the past, it was not a plan that gave me any confidence would be viable or effective. Instead, it struck me as being entirely arbitrary, and liable to make things worse rather than better. In the best case, it could delay opening up; in the worst, it could generate more cases, hospitalisations, deaths, and restrictions by opening up too much, too fast.

The dates suggested include a reasonable amount of time for the vaccinations to become effective.

Groups 1-9 cover over 80% of hospitalisations. The NHS should be able to cope with the remaining 20% even in the unlikely situation where there is no reduction inspired from immunity. Cases don't matter very much when those most likely to be hospitalised are vaccinated, the goal is to stop the NHS being overwhelmed, not to stop all deaths. Quite simply, it's time to stop moving the goalposts and get back to normal.

The onus is not on us to prove it's safe to unlock, it's on those who support restrictions to prove that they are effective, necessary, and that the harms outweigh the benefits.

 

[duncanp]

We only need to look at the statistics that cause issues: Hospitalisation and capacity, and deaths. Whether or not somebody returns a positive test matters not one bit if neither they, nor anyone they might pass it on to, will become seriously ill

The problem is that as the vaccine rollout continues to progress, the relationship between cases and the "limiting statistics" become increasingly uncertain. You only need look at the Warwick and Imperial papers modelling the impact of releasing restrictions where (presumably) 95% confidence intervals cover practically the entire graph when looking at deaths and hospitalisations

Whilst hospitalisation, capacity and deaths are the important metrics, the other metrics can be used to predict the numbers in hospital and the number of deaths in the future, which is crucial when considering how and when to lift the lockdown.

If the vaccines are effective against tranmission of the virus, that means fewer cases in future, which in turn means fewer serious cases and deaths.

Declining test positivity means suggests fewer infections are taking place, which again means fewer cases in the future.

If vaccines are effective in preventing serious disease, that means fewer hospitalisations in the future.


The really important metric though is the rate of hospitalisation (ie. the percentage of people who test positive who end up in hospital) and whether that is declining over time, and in particular whether the rate is significantly lower amongst people who have been vaccinated.

If the rate of hospitalisation is lower amongst people who have been vaccinated, it suggests that as more people are vaccinated there will be fewer and fewer people in hospital, which then makes it safer to release restrictions.

 

[Yew]

The really important metric though is the rate of hospitalisation (ie. the percentage of people who test positive who end up in hospital) and whether that is declining over time, and in particular whether the rate is significantly lower amongst people who have been vaccinated.

If the rate of hospitalisation is lower amongst people who have been vaccinated, it suggests that as more people are vaccinated there will be fewer and fewer people in hospital, which then makes it safer to release restrictions.

There is clear evidence that hospitisation rates are lower amongst the vaccinated groups.

 

[duncanp]

There is clear evidence that hospitisation rates are lower amongst the vaccinated groups.

Which is good news, because it means that hospitalisations are going to decline even further as more and more people are vaccinated.

So even if there is a increase in cases when things do reopen, it won't matter as much as it did before.

Talking of vaccinations Boris Johnson has said that he hopes to have everyone in categories 5 - 9 done by the end of April.

But the Telegraph published a graph today showing that, at present rates of vaccination, people in these categories will be done by the end of March.

So I think there is a bit of leeway there in case there are unexpected delays, but it also gives Boris an opportunity to bring some reopenings forward if things go well.

Pubs reopen on St George's Day (23rd April) ? - that certainly would be cause for celebration.

 

[35B]

There is clear evidence that hospitisation rates are lower amongst the vaccinated groups.

Excellent. In which case defining a threshold for the relaxation of restrictions based on being able to provide normal healthcare services and having sufficiently low burden on hospitals should not be overly onerous, and support both quick relaxations and general public health.

 

[scotrail158713]

Talking of vaccinations Boris Johnson has said that he hopes to have everyone in categories 5 - 9 done by the end of April.

But the Telegraph published a graph today showing that, at present rates of vaccination, people in these categories will be done by the end of March.

So I think there is a bit of leeway there in case there are unexpected delays, but it also gives Boris an opportunity to bring some reopenings forward if things go well.

Apparently there is going to be supply issues with the vaccine over the next couple of weeks, meaning that the rate of vaccination may slow a bit. This may explain why the government are aiming for the end of April.
The story below is from Glasgow, but the issue appears to be UK-wide.

Mass Covid vaccinations at Glasgow centre halted due to shortages

MASS vaccinations of the COVID-19 jab have been halted at the flagship Louisa Jordan coronavirus centre in Glasgow due to a shortage of supplies. Senior NHS sources have said that staff have been a…

www.thescottishsun.co.uk

MASS vaccinations of the COVID-19 jab have been halted at the flagship Louisa Jordan coronavirus centre in Glasgow due to a shortage of supplies.
Senior NHS sources have said that staff have been advised not to come into the multi-million pound field hospital on two days this week - as they will not have enough doses for patients.
Last night, Scottish Labour health spokeswoman and leadership candidate, Monica Lennon said Scotland could not afford for vaccinators to be stood down, ‘even for a day’.
She added: ‘SNP ministers must reassure the public that this won’t happen, after all getting Scotland vaccinated must be our collective top priority.
‘The NHS Louisa Jordan is a vital national asset in our race against the virus and must be used to its full potential.
‘We can’t risk any slowing down of the vaccination programme.’
The Scottish Government has previously publicised the success of the vaccination process at the Clydeside facility, with 65 vaccine stations inoculating 5,000 people per day.
However, the rollout appears to have stalled due to shortages of the Pfizer vaccine highlighted by health secretary Jeane Freeman last week.
She predicted the number of people being vaccinated could halve over the next few weeks, amounting to 200,000 fewer doses than anticipated.
Pharmaceutical company Pfizer is in the process of ramping up its global supplies, which has resulted in some short-term supply changes.
A Scottish Government spokesperson said: "Our vaccination programme will flex to respond to supply and as the First Minister and Health Secretary indicated last week, we are expecting slightly less supply over the next few weeks so it is to be expected there will be less vaccinations than in previous days.

 

[duncanp]

Apparently there is going to be supply issues with the vaccine over the next couple of weeks, meaning that the rate of vaccination may slow a bit. This may explain why the government are aiming for the end of April.

I think the supply issues are more to do with the fact that they are going to have to start giving people their second doses from the beginning of March.

So your are right to say that is why the government has set a target date for the end of April for vaccinating groups 5 - 9.

It is always better to underpromise and overdeliver than the other way round, but if things go well then there is scope for bringing some reopenings forward.

 

[ChrisC]

I think the supply issues are more to do with the fact that they are going to have to start giving people their second doses from the beginning of March.

So your are right to say that is why the government has set a target date for the end of April for vaccinating groups 5 - 9.

It is always better to underpromise and overdeliver than the other way round, but if things go well then there is scope for bringing some reopenings forward.

I always thought this would be the case once they have to start giving people their second doses. It’s to be expected and makes sense that perhaps they will not be able to keep up the first doses at the same rate. As most people received an appointment date and time for their second dose they will almost certainly have to prioritise those to keep them within the 12 weeks.

 

[Yew]

I think the supply issues are more to do with the fact that they are going to have to start giving people their second doses from the beginning of March.

So your are right to say that is why the government has set a target date for the end of April for vaccinating groups 5 - 9.

It is always better to underpromise and overdeliver than the other way round, but if things go well then there is scope for bringing some reopenings forward.

Not a huge number though, the number of vaccinations through December was, overall, pretty low.

 

[Nicholas Lewis]

presser by BoJo was cautious - infection level very high, hospital levels too high, admissions too high. We are aiming for end of April for all over 50 plus second doses.

we must be patient (oh dear what's he setting us up for next week)

this lockdown must be the last one so we will need to cautious coming out as it must be irreversible ( definitely sounds like hes opting for tip toeing but maybe that's just expectation management sow e are all pleasantly surprised next week)

Whitty

-on cases significant progress but still too high above Septembers level

-on hospitalisation too high but heading right direction

-deaths remain high but going down

-vaccination going well and its impact will build up over time

 

[Domh245]

Whilst hospitalisation, capacity and deaths are the important metrics, the other metrics can be used to predict the numbers in hospital and the number of deaths in the future, which is crucial when considering how and when to lift the lockdown.

If the vaccines are effective against tranmission of the virus, that means fewer cases in future, which in turn means fewer serious cases and deaths.

Declining test positivity means suggests fewer infections are taking place, which again means fewer cases in the future.

If vaccines are effective in preventing serious disease, that means fewer hospitalisations in the future.


The really important metric though is the rate of hospitalisation (ie. the percentage of people who test positive who end up in hospital) and whether that is declining over time, and in particular whether the rate is significantly lower amongst people who have been vaccinated.

If the rate of hospitalisation is lower amongst people who have been vaccinated, it suggests that as more people are vaccinated there will be fewer and fewer people in hospital, which then makes it safer to release restrictions.

The problem though is that it is increasingly difficult to make these predictions with any degree of accuracy whilst the effects of vaccination continue to be understood. Projecting the current trends forward (even the tricky multifactor ones like ICU occupancy) are no doubt possible to do, but there'll be plenty of assumptions in there around who was vaccinated and when, and the magnitude of the impact of the vaccine was which starts to widen the predictions. The fact that everything is trending in the right direction is heartening though.

You're right about the data we are seeing from the vaccination programme(s) around reduced hospitalisation but the really tricky bit is predicting what happens once restrictions are eased and the trajectory of things from there. Reopening schools will inevitably lead to cases increasing amongst children which then after a couple of weeks will start to have an impact on case rates in parents, and then slowly through the rest of the population as we saw in September/October. Vaccine rollout will continue to filter down through the age ranges with varying efficacy (itself with large confidence intervals) over time from when people were jabbed, so again, a complicated model with lots of variables that can only really predict a month in advance at most with any certainty.

It'd be very easy for Boris to just say "nothing opens until Group 9 has had dose one + 3 weeks" or similar, but quite clearly he wants to start easing restrictions sooner than that. The absolute ideal situation is to open things up in such a way that ICU occupancy falls to normal and stays there, but predicting what to open and when in order to achieve this is (needless to say) nigh on impossible, which is why I expect we'll see an overly cautious "release" threshold when the roadmap comes out next week

 

[brad465]

I always thought this would be the case once they have to start giving people their second doses. It’s to be expected and makes sense that perhaps they will not be able to keep up the first doses at the same rate. As most people received an appointment date and time for their second dose they will almost certainly have to prioritise those to keep them within the 12 weeks.

Not a huge number though, the number of vaccinations through December was, overall, pretty low.

Not to mention that half a million have already had both doses so that's a group already sorted.

Also we should be getting new vaccines available soon in the form of Moderna from April and the J&J one if approved soon, so if all AZ and Pfizer doses have to be allocated for second doses, then the only constraint to worry about is staff to administer them.

Elsewhere all stats are continuing a firm head in the right direction, with reported cases now under 10,000 (9,765) and down 29% over the last 7 days, while deaths and hospital admissions continue to drop at rates above 25% over the last 7 days.

 

[DB]

It'd be very easy for Boris to just say "nothing opens until Group 9 has had dose one + 3 weeks" or similar,

It wouldn't - he'd immediately have backbenchers going for him if he did that. Hence keeping it vague.

 

[chris11256]

It's interesting that Boris keeps saying that it'll be irreversible, despite during the Q&A he refused to rule out a fourth lockdown if needed.

Realistically there's nothing that backbenchers can do until the end of march when the lockdown legislation expires. Although there's nothing stopping the government using another statutory instrument which comes into effect instantly and not giving MP's a vote on it for weeks.

 

[6862]

this lockdown must be the last one so we will need to cautious coming out as it must be irreversible ( definitely sounds like hes opting for tip toeing but maybe that's just expectation management sow e are all pleasantly surprised next week)

But he then said he couldn't guarantee that he won't announce another lockdown in the future. I imagine he's rather pleased with himself for making us all think that he doesn't want more lockdowns, but actually what he has said really gives him free reign to do whatever he wants (which is likely to impose another lockdown).