Tuesday 29 June 2021

The Long Shadow of Covid


Since Friday 25 June, 13 individuals have recovered and 71 new cases have been identified. 24 cases have been identified through seeking healthcare, 23 through inbound travel, 2 through planned workforce screening and 22 cases through contact tracing.

The number of active cases in the Island is 172. 118 cases are symptomatic and 54 cases are asymptomatic. 

As cases continue to rise exponentially in Jersey, a lot of posts below the Government statistics say that there is nothing to worry about because there are no cases in hospital and no deaths. This is a grave mistake, and this also seems to be driving government policy to take no action. They seem to assume vaccines are so effective they can continue to open up society, and they are ignoring the science.

I'd like to look at two areas of concern: long Covid and deaths among the vaccinated. Neither of these seem to feature strongly in the government speeches by the Chief Minister or Health Minister, but one is happening now, and as cases rise, I predict with certainty that others will also occur.




















Long Covid

Jon Ashworth, MP, on Question Time, summed up the issue of long covid, as well as noting that the vaccine is also not 100% effective:

"We know that this virus, sadly, remains extremely dangerous. Now, I am fed up of the sodding restrictions. I am fed up of these restrictions, right? I am sick of them. But I am also aware that since the 1st of May, we have had 260,000 confirmed cases of this virus. In the last week, 80,000. In the coming weeks, because of the way it grows, we are going to see more of this virus grow amongst the unvaccinated, it spreads like wildfire amongst the unvaccinated."

"Those are Matt Hancock's words. And yes, for those who are vaccinated, the link between hospitalisations and deaths has been reduced, but it has not been severed and many of those people who get the virus today, tomorrow, next week, even if they don't end up in hospital, although some of them well, many of them will live with long-term serious conditions, debilitating conditions, whether that is fatigue, memory loss, for some, it is anxiety and depression, for some it presents as hair loss, teeth loss, some even suffer psychosis. It remains a very serious, deadly virus and we should not be complacent."

Victor Adebowale., Chair of the NHS Confederation, also picked up on this:

"I think the data is softening the link but it's not broken, that's the point I was trying to make. That's the point about the caution. And I do think there is a real concern about thinking that vaccination alone is the way out of this. Of course the vaccination programme has been amazing and all credit to everyone who has been part of doing that but on its own, it's not going to get us to safety. Interestingly, Kate mentioned Israel and Israel now is actually seeing some cases going back up again. The point is that we need to put in place something that this government has failed to do right from the start which is the basic public health provisions around test, trace and supported isolation so that we are not only relying on the vaccination."

And Caroline Lucas, MP, noted that the UK government was starting to take Long Covid very seriously:

"We have nearly 2 million people, it was said today, who are living with long Covid. That can have debilitating impact. I have been part of the all-party group on coronavirus. We have taken evidence from people with long Covid and it is not just people being a bit short of breath, it is people who have been running marathons one month and are in wheelchairs the next. It is deeply serious. Let us not forget either that we don't have all of our population vaccinated yet. A little bit more caution for a little bit longer along with some public health measures put in place will get us to the place that all of us really want to be."

When I posted on this on Facebook below the Jersey statistics, I also received information on local cases of Long Covid:

"A new study has found that around two million people may be suffering from long Covid in the UK. Imperial College London researchers working on the React survey found that about a third of people who report coronavirus symptoms have one or more symptoms that persist for at least 12 weeks. The team said long Covid could present a “major challenge” and may “ultimately affect millions of people in the UK alone."

These comments range from the mild (but still stressful) to the debilitating. I know one other case and they are still being signed off work, having chronic fatigue, and they were fit, walking 3-4 miles a day before.

"14 months on and my sense of smell still not back to normal"

"16 months on and have multiple symptoms that won’t go away and the most worrying one is that I can’t walk for long periods or do any type of slight strenuous work that i am in bed ridden for 2 days straight. I wouldn’t wish long covid on my worst enemies"

"My sister in law is suffering long covid after catching covid at the start of the pandemic. It’s dreadful and she is still signed off work. It will be interesting to see the stats for long covid in patients who picked up the virus following double vaccination."

There are currently no statistics on the prevalence of long covid in the general population of Jersey.



















Deaths of the Vaccinated

Vaccination does not provide 100% immunity, and the more spread there is among the unvaccinated - very high with the Delta variant - the more chances that older people with vaccinations will end up in hospital and dead. And at the moment, only around 52,000 have been double vaccinated, and when you consider a population of at least 110,000, that means the virus has at least half of the population to spread amongst.

At the moment, it is also spreading amongst those with no vaccinations currently due - i.e. under 17s, who can easily pass it to parents, maybe in their 20s or 30s, who can end of infecting vaccinated grandpa and granny, who may then end up in hospital and die. This is because the risk profile of vaccine effectiveness is age dependent, just as death from covid is age dependent. And as numbers rise, the chance of death increases.

https://www.theguardian.com/theobserver/commentisfree/2021/jun/27/why-most-people-who-now-die-with-covid-have-been-vaccinated?

This piece, worth reading in the link, is by top statisticians: David Spiegelhalter is chair of the Winton Centre for Risk and Evidence Communication at Cambridge. Anthony Masters is statistical ambassador for the Royal Statistical Society. Here's a snippet:

"It could sound worrying that the majority of people dying in England with the now-dominant Delta (B.1.617.2) variant have been vaccinated. Does this mean the vaccines are ineffective? Far from it, it’s what we would expect from an effective but imperfect vaccine, a risk profile that varies hugely by age and the way the vaccines have been rolled out."

"Consider the hypothetical world where absolutely everyone had received a less than perfect vaccine. Although the death rate would be low, everyone who died would have been fully vaccinated."

"The vaccines are not perfect. PHE estimates two-dose effectiveness against hospital admission with the Delta infections at around 94%. We can perhaps assume there is at least 95% protection against Covid-19 death, which means the lethal risk is reduced to less than a twentieth of its usual value."

"But the risk of dying from Covid-19 is extraordinarily dependent on age: it halves for each six to seven year age gap. This means that someone aged 80 who is fully vaccinated essentially takes on the risk of an unvaccinated person of around 50 – much lower, but still not nothing, and so we can expect some deaths."

References for Long Covid:

https://www.theguardian.com/australia-news/2021/jun/28/health-systems-should-be-prepared-doctors-brace-for-tsunami-of-long-covid
https://www.bbc.co.uk/news/health-57584295

References for Deaths of Vaccinated
https://www.theguardian.com/theobserver/commentisfree/2021/jun/27/why-most-people-who-now-die-with-covid-have-been-vaccinated?
https://www.walesonline.co.uk/news/wales-news/nearly-30-those-dying-delta-20812363

No comments: