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Will a vaccine really be the silver bullet we all pray for? ASK DR ELLIE CANNON


At least for now, the government has played its hand. After weeks of confusing and conflicting regulations, growing public unrest and increasing Covid-19 cases, they have revealed their grand plan: to suppress the virus as much as possible to save lives until a vaccine is available.

As we all know, corona falls are spiral shaped. And we, the British public, are to blame, according to the Prime Minister. There have been "too many violations" of the rules, he said in his address last week.

Right now we're in a kind of limbo – we're supposed to work from home when we can, with curfews and, in Scotland, stricter restrictions on visiting each other's homes.

And of course, if people "don't follow the rules … then we reserve the right to go further," said Boris Johnson.

I am sure that when I experience an unsettling feeling of Deja Vu, I am not alone. Are we about to have another full lockdown? It is unbearable to think about it. Health Secretary Matt Hancock seemed to think that everything was pretty simple – the vaccine, widely reported, is already in production. He thinks it will be ready "early next year" or maybe even this year, depending on who he spoke to.

Then and only then can we all breathe easy. The ongoing cycle of planning regulations, restrictions and closings – and increasingly draconian ways of enforcing those measures, fines and snooping – may come to an end. We will be saved, a fairytale ending to the pandemic.

The proverbial carrot dangled from a stick. Almost, but not quite within reach.

Every Friday I take a Covid swab at home and send it off, writes DR. ELLIE CANNON

Apart from the fact that there is one big catch to this strategy. Ask any scientist who knows what they're talking about and they will tell you that the vaccine just doesn't offer that type of solution.

Of course, I understand why people are clinging to this dream – the Hollywood that ends with the pandemic. I say this both as a general practitioner and as an ordinary person whose life, like everyone else's, has been turned upside down this year. I'm deeply invested – a fully enrolled guinea pig that participated in the vaccine study myself. I very much wish it was true. But I do believe that as a doctor, it is my duty to be honest: when the blow finally hits it will not be the magic bullet or silver bullet that make these ministers what it is.

To say otherwise is at best wrong, which seems unlikely given the following of the scientific advisors at their disposal. At worst, it is deeply insincere. Mr Hancock and Mr Johnson could have done well to engage in an interview with Oxford's star vaccine scientist Professor Sarah Gilbert earlier this month in which she urged people to soften their expectations of vaccination. She added, "It won't be like the films where there is a breakthrough and suddenly the world is protected."

And I couldn't agree more. Vaccines are not a panacea. First of all, some people just don't choose the push. At the moment, a large number of people seem nervous.

A recent poll found that 15 percent of Britons would say no, up from 5 percent in March. In America, up to 40 percent say they would oppose it.

Others just don't get around to it. Most vaccines require two doses to be given, which makes it even more likely that people will forget, miss, or postpone it.

Others may not be suitable – for example, people with immune system disorders and people with certain types of cancer.

Covid fact

Human trials are ongoing for 42 possible Covid 19 vaccines.

Vaccinations are not recommended in these patients as they can affect treatment.

And there needs to be the capacity and infrastructure to vaccinate many people quickly – and as we've seen, those responsible for these kinds of things can often be "surprised" by spikes in demand.

Professor Stephen Evans, 77, an expert on medicines at the London School of Hygiene and Tropical Medicine and a participant like me in the vaccine study at Oxford, added: “There have to be good systems to keep track of who has been vaccinated and who has not been vaccinated and the data need to be able to revert to GP records.

"It is not clear that the planning for this massive computing task has been completed, but it is critical to ensure that the vaccine is truly effective in actual use, and not just in studies."

We know from the studies that the Oxford vaccine is safe. It causes mild, temporary side effects in some people – headache and generally feeling below average are the most common. I didn't have any side effects. And we know it elicits a strong immune response in adults ages 18 to 55, which means scientists are optimistic that it offers protection against Covid-19. But it will take time to figure out how much.

More than 35,000 volunteers are taking part in the study, spread across a number of countries. Some of us had the right push, others a placebo or a dummy version. Researchers now have to watch and wait to see how many in each group catch Covid-19.

Every Friday I take a Covid swab at home and send it off. I will get my result back in about 48 hours. So far everything was clear to me. But it's important to understand: no vaccine is 100 percent effective. Take part in the UK flu vaccination program, which is considered a success. In a good year, it prevents a little more than 50 percent of cases. However, in the winter of 2017, it only protected 15 percent of those who had it overall (there were more than 25,000 deaths).

This was partly due to the bite failing to protect against the most common strain of flu this year (more than 60 strains are currently identified).

Professor Sarah Gilbert pictured has urged people to moderate their expectations of the vaccination

The professor Sarah Gilbert pictured has urged people to moderate their expectations of the vaccination

With age, the immune system weakens and reacts less “enthusiastically” to vaccinations. Since the 2017 disaster, older adults have had a new, souped-up version of the flu vaccine, and deaths from the virus have been remarkably low in recent years. But it takes time and a lot of research to get these things right.

Aware of this phenomenon, the Oxford Process has specifically recruited people over 70 for the final phase.

Hopefully we will soon know more about how well it works in older adults – those we know are the most susceptible to the virus. However, many experts, including Prof. Gilbert, have suggested that it may take some refinement before we can find a version that works best for this age group.

Then the question arises, how long does immunity last? Recent studies suggest that antibodies in patients in whom Covid-19 has already decreased after three months. Could it be the same with the vaccine? We don't know and we may not know for years.

Dr. Charlie Weller, director of the vaccines program at Wellcome Medical Research Facility, says, "If we're lucky enough to get a (Covid) vaccine or two that are both safe and effective, they are still likely not to be fully provided with immunity or in everyone Age group or person to be effective. & # 39;

And even if everything goes well, there is broad consensus that in the first year it will not be possible to produce, pack and provide enough cans for everyone. The neediest will be at the top of the queue, such as those in high-risk groups, along with healthcare and other frontline workers.

Regardless of how you cut this cake, the fact remains: a vaccine alone is not a way out of all of this.

Covid fact

More than a quarter of Britons live under stricter Covid-19 restrictions.

While Mr Hancock and Mr Johnson were discussing repression, Shadow Health Secretary Jonathan Ashworth made another proclamation: "No death from Covid is acceptable".

The old zero-covid plan – complete elimination of the virus. Unfortunately this is also flawed.

As we have seen, falls cannot be reached in island states like New Zealand that have closed their borders. Currently 35 cases have been reported, presumably safely isolated. But with the virus endemic around the world, they will have a hard time keeping it going if they ever start allowing people to enter and leave the country.

My good friend Dr. Elisabetta Groppelli, a virologist at St. George & # 39; s Hospital in London, was working in Sierra Leone during the 2015 Ebola outbreak.

However, a Get To Zero strategy has not only failed, it has likely done more harm than good. The virus was found to be dormant in the patient's body, causing it to recur and further transmission.

Dr. Groppelli stated, “The biggest problem with this strategy was that we as public health officials had to half-change the message.

This created confusion, suspicion, and a feeling of helplessness. One patient said to me: “You told us we were free of Ebola. If we got to zero everything would be fine. But the virus is still here in our body. & # 39; & # 39;

Dr. Groppelli believes there is a broader teaching. "Going to zero was a good slogan," she said. "However, because every slogan hides important details, it is inherently prone to misinterpretation and dangerously leads to mental shortcuts and unrealistic positivity."

Concluding that zero is simply not an honest approach, she adds, “Let's be realistic and honest with one another. We have to find a way to coexist with the virus, which means limiting its spread as much as possible and above all protecting the most vulnerable. & # 39;

Ultimately, Mr Ashworth and anyone else who finds the idea of ​​a Covid death uncomfortable will have to steel themselves.

Because even if we have a vaccine, people will die from it. Maybe hundreds every day, like the flu.

Last week, Chief Medical Officer Chris Whitty and Chief Scientific Officer Sir Patrick Vallance warned that without action, we could see up to 200 virus deaths a day by mid-fall.

Every death is a tragedy. But just as people are born, we also die. This is why it is important to look at deaths from Covid from a perspective.

According to the Bureau of National Statistics, there were 34,750 deaths from all causes in England in August alone – 2,060 fewer than the five-year average.

Vaccines are not a panacea. First of all, some people just don't choose the push. At the moment, a large number of people seem nervous

Vaccines are not a panacea. First of all, some people just don't choose the push. At the moment, a large number of people seem nervous

One in ten of them, roughly 3,897, died of dementia or Alzheimer's disease – that's 130 a day.

Another 130 per day (on average) died from heart disease.

Covid-19 wasn't even among the top ten causes of death in England or Wales in August – with 482 deaths, it ranked 24th after lung cancer, colon cancer, prostate cancer, liver disease and even flu.

Over a year, around 165,000 people die from cancer of all kinds, which corresponds to an average of 450 people per day.

Accidents at home, often at home improvement, are often fatal. About 6,000 people die this way every year – that's about 16 people a day.

Every day, five people die in road accidents in Great Britain and 69 are seriously injured.

Infections – including C.diff and stomach problems – kill 5,937 per year, or about 16 people a day.

There were 5,691 suicides last year, 1,413 of them in the last three months. Almost three quarters were men, making suicide the biggest murderer of men under the age of 45.

Nobody, least of all me, wants to see the spate of deaths caused by Covid-19 earlier this year again. But I would argue that if we saw winter at just a few hundred a day, we'd get away with it pretty lightly.

Please do not consider this numb. How would I feel if it was one of my own family members? Devastated, of course.

But as a doctor, I am also deeply concerned about the death, disease, and misery that would undoubtedly result from an ongoing cycle of lockdowns and restrictions.

Aren't deaths due to missed cancer screenings, unreported heart problems, or avoiding a family doctor as important as deaths from Covid? Weren't the thousands of deaths from excessive dementia worth preventing?

The reason we closed the country in the spring was to prevent a health disaster from hundreds of thousands of incredibly sick people who flood miserably unprepared hospitals. And the plan just worked.

However, such measures will never provide a solution and are not sustainable either. They just delay the inevitable. Relax, the numbers go up and people start to die. And not even a vaccine, wonderful as it may be, can completely prevent this.

Yes, we should distance ourselves socially, wear masks and wash our hands a lot. More people working from home keep transportation networks less busy for those who can't.

At the moment this is a reasonable approach. We should aim to keep Covid-19 levels manageable and to find ways to protect the vulnerable. Nor should we become embroiled in the terror caused by claims that we are in a “second wave” when the overall death toll is expected to rise.

Suppression or lockdown should be used wisely to get answers and create plans: ensure profitability, optimize testing, and increase hospital capacity. If we have to lock up again, it means we didn't do what we knew we should.

As the virologist Dr. Simon Clarke said it will prove one thing: the government I have supported so far has failed.

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