How are we doing on vaccination?

There’s never a perfect time to assess a fast moving situation like our vaccination programme - details age fast, as in a war.

Still, there’s a pattern of questions sent to me, and a shortage of clear info about what’s happening in Gloucestershire. So here goes, in simple Q&A format:

How are we doing on vaccination?

There’s never a perfect time to assess a fast moving situation like our vaccination programme - details age fast, as in a war.

Still, there’s a pattern of questions sent to me, and a shortage of clear info about what’s happening in Gloucestershire. So here goes, in simple Q&A format:

Who’s responsible for the vaccination programme in Gloucestershire?

The co-ordination of the COVID Vaccination programme in Gloucestershire is led by Gloucestershire Hospitals NHS Foundation Trust, Professor Steve Hams is the nominated Senior Responsible Officer, and is supported by colleagues from local NHS organisations and our Primary Care Network (or PCN: ie the GP surgeries) with NHS England driving national vaccination policy, planning and distribution - so a public and private partnership 

Who does what?

Our A&E hospitals trust (at GRH so far and now CGH as well) has been inoculating health & care professionals while the surgeries (at ten ‘vaccination centres’ across the county) inoculate everyone else (eg Rosebank on Stroud Rd in Gloucester). Our Health & Care Trust (which runs all our other Community Hospitals, mental health and much else) will also be vaccinating soon.

What about Public Health?

Public Health (part of the County Council) has an important policy role, deciding for example on mass testing sites (like the new one in the Friendship Cafe), trend analysis, awareness campaigns on virus and vaccination, and combating fake news deniers: but doesn’t deliver vaccinations.

How many vaccines can we deliver and do we have enough distribution capacity and sites?

The 10 centres and hospitals used so far could deliver c30,000 vaccinations a week: at that pace everyone in the Top 4 categories would be vaccinated fast. 

The challenge is not distribution or sites (no more needed at the moment, with vaccinations starting next week in Boots Eastgate St and another community pharmacy in Bishops Cleeve). Vaccine supply is the issue, because everyone wants more of the Oxford vaccine faster than Astra Zeneca can produce it.

Why is the Oxford vaccine so important?

Because it can be kept at fridge temperature, because the government invested in it, negotiated a good price for  the vaccine doses  and pre ordered 100m doses. (It’s also manufactured down the road in Oxfordshire).

The Pfizer vaccine storage temperatures (at minus 75 degrees) and handling is more complicated and cannot be used eg at homes. We (UK) have ordered some Moderna vaccine but much less, and this will only available in the Spring.

So how many people have been vaccinated in Gloucestershire so far?

55,000. That’s well above our share of the 3 million vaccinated in the whole country (Gloucestershire is c1% of the population = 30,000 of 3 million): we got started fast and our PCN/NHS are well organised. 

But this is not a race against our neighbours - the whole country needs to reach the same goals broadly together. 

And will we reach the Feb 15th target for all in the Top 4 categories on time?

Yes - barring a manufacturing disaster no-one can anticipate, all our local health leaders are confident we will have vaccinated on time the 129,000 (20% of the county) which has included all the oldest plus health, care home and social care staff (See more information
Top 4 JCVI groups for COVID19 vaccination
And why does this matter?
Because the aim is to protect those most likely to need hospitalisation if they catch the virus - and half of those in hospital with the virus are over 70 years old. 
So if our elderly are safely inoculated then more of our c600 A&E beds available for all adults (ie excluding maternity and children’s ward beds) will be freer for non virus cases (currently over 200 beds are occupied have COVID19 patients). We know that for every 20 older care home residents vaccinated we can save 1 life.  
The risk of the NHS being ‘overwhelmed’ should then diminish fast - recognising there is a time lag from infection to hospital of up to 10 days.

Why are the priorities so biased against the young? 
They’re not: they’re biased to keep people out of hospital, so that if anyone needs A&E hospital bed (eg from a sports or car accident) it’s there for them. Most young, if they catch the virus, won’t need to go near a hospital. But until their parents and grandparents are inoculated the young can pass it on to someone more vulnerable. Which is why the social distancing rules that we all hate do matter.

I know someone over 80 who hasn’t been contacted - why have they been forgotten?
They haven’t. Different surgeries started receiving and distributing vaccines at different times and have slightly different vaccine supplies and demographics. Please be patient. (It’s  important no-one misses their appointment: any no-show holds the process back). The NHS estimates that a life is saved with every 250 of the Top 4 categories vaccinated.

What about those at home too ill or old to get to a vaccination centre?
Home vaccination is being led by our Primary Care Networks, alongside support from our Health & Care Trust.

How does the booking system for ‘community pharmacies’ work?
The same way as for a surgery vaccination centre: the appointment letters are done through an NHS England booking system. Please don’t ring Boots Gloucester or turn up on spec.

What about making teachers a priority?
Yes I think there is a good case for teachers being a high priority in Phase 2.  They’re less likely to need hospital than say the over 60s, but if we want schools, parents, pupils and employers to have certainty about when schools are open for all then this is the way to do it. Of course there are many others with a good case too: police, young with learning difficulties, nursery staff, Royal Mail posties, supermarket staff and many others. But I’ve made the case in Parliament and privately and I hope Ministers encourage the Joint Committee on vaccination & Immunisation (JCVI) to consider it.

Talking of decisions, why are churches and mosques still open?
Probably because politicians got so widely criticised for closing collective worship in the first Lockdown, as did faith leaders who went along with that. Both prefer to leave decisions to local leadership and consensus.
In practice most CofE and other church services in our county are virtual. The mosques have closed in Bristol but not yet in Gloucester. 

Is the rollout of the vaccine a bit of a shambles and should the Army be in charge?
I believe all the evidence locally is that the roll out has been as good as supply and advance notice of it allows. All the Armed Forces medics have been involved in the NHS for a long time, and the Army’s logistics and planning teams are fully involved, which is why Brigadier Prosser is often at the No10 press conferences.

Why is it so difficult to get simple daily info?
Getting accurate data daily is a challenge everywhere (and much information from authoritarian regimes can be taken with a bucket of salt). Things have got better since the early days when care home data was at best patchy. Now there are easy to find national stats (See here) or local (See here). 
Top Image: COVID19 vaccination does administered (Source: Our world in data)
Bottom Image 2: Seven day Gloucestershire COVID19 data (Source: data.gov.uk)

But I agree there is too much held back by the NHS. Every week I chair a meeting with all our county’s MPs, the Heads of our NHS Trusts, Primary Care, Public Health, the County Council and the Clinical Commissioning Group (which organises NHS spending). I find it frustrating that their transparency with us -  reflecting trust built up over the last 9 months, not always replicated elsewhere - mostly cannot be shared with a wider audience. 

But I think that quite soon we will get more openness eg on vaccine supplies. That may partly come from increased Astra Zeneca confidence in the manufacture of a new vaccine.

Are you being defensive - and trying to cover up for government mistakes?

The opposite. I think we have something remarkable to be (quietly) proud of. The government invested early in virus vaccine research itself, raised £8 billion at a Global Vaccine Alliance summit we hosted, created our own Vaccine Taskforce with private sector investor specialists to identify (in June) the leading candidates for success, and pre bought vast quantities cheaply early. 

Then our regulators did their job fast, we gave the first vaccine approvals and vaccinated the first patients in the West. We remain far ahead of our European neighbours as these charts show (green means the most dense distribution of the vaccine: compare Northern Ireland and the Republic of Ireland):

COVID19 vaccination doses per 100 people (Source: Sky News)

It’s still just about true that we’ve vaccinated more than in the whole of the rest of Europe put together, although that cannot last. 

Are you making a political point about the advantages of Brexit?

No, trying to avoid politics if possible. Let just say that the vaccine analysis, purchase distribution isn't the best case for centralised European purchasing. Nor does it help the arguments of those who dislike multinationals (Astra Zeneca's commitment to sell the vaccine at cost across the world is exemplary). 

I believe the vaccine story shows academics, government, private sector and regulator in the UK can and have worked together nationally and locally very effectively

So everything has been perfect over the last year?

Far from it.  We haven't faced a pandemic for 100 years and our response was bound to be less than perfect. 

Democracies have had a harder time of it: confucian societies are better philosophically equipped to take direction, and had experience of SARS. We still give virus deniers oxygen because we believe in the freedom to talk and write nonsense (well exploited by social media bots).

Then there have been organisational weaknesses, touched on in the report of the Joint Committee on National Security Strategy (of which I’m a member). There are several ‘lessons to be learnt’ here which can be summarised as Be Better Prepared for the next, not the last, war. 

But more detailed analysis will have to wait until a formal enquiry after the pandemic has been tamed, and we’ve learnt how to live with it.

What do you think History will make of this situation?

The amazing thing to me, a non scientist, is that science has created a solution, a new vaccine, so fast. In 1918-1919 we lost more people to ‘Spanish’ Flu than to fighting in World War 1: there was no scientific answer. 

Chief Scientist Sir Patrick Vallance told me a vaccine for a new virus normally takes 10 years: we did it in less than 9 months. 

UK has played a key role in this, and whenever someone asks what exactly is the value of our Union, or wants an example of ‘Better off Together’ I just think ‘vaccine?’ It may be the vaccine that saves our Union.

And 2021?

Of course there’s always something new that can go wrong, but I’m feeling optimistic about 2021 - despite all the difficulties so many are facing at the moment. Those clouds will start to lift.

My next e news will be to share with you some of the good news in Gloucester many of my constituents haven’t been able to get out and see in Lockdown.

Meanwhile let me know your thoughts and what other virus and vaccine info you would value? 

Best regards,

PS do send any questions you may have to [email protected] 

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