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End of staggered deconfinement: how England got there


In order to vaccinate more people and to cope with the spread of the Delta variant, between 40 and 60% more transmissible, the last stage

At first glance, it is difficult to accuse the British of having dragged on in recent months in the management of the Covid pandemic.

Launched three weeks before all its neighbors in a vaccination campaign carried out with full speed, embarked since last winter in a deconfinement sausage in four very framed stages, England

had recently fallen to minus 2,000 new cases and less than 10 deaths per day, and could reasonably hope to escape a new "wave" of Covid-19.

And yet.

Faced with an increase in the number of daily cases of 50 or even 60% per week, the United Kingdom is now the European country facing the strongest recovery of the epidemic.

Monday evening, Boris Johnson was forced to announce a one-month postponement of the last stage of deconfinement, initially scheduled for Monday, June 21, in England (Northern Ireland, Scotland and Wales have their own strategy).

"We are facing a difficult choice: if we maintain the full reopening on June 21, thousands of people risk dying," said the British Prime Minister.

Reaction too late?

The Delta B.1.617.2 variant, known as “Indian”, is the source of this situation.

Between 40 and 60% more transmissible than the Alpha variant (called "British"), it now represents almost all contaminations in England, according to data from Public Health England.

Appeared in India, B.1.617.2 became the majority across the Channel in just a few weeks.

Why did the UK and Israel, 2 countries with very high vaccination rates, have such different results?

Israel currently 0.2 cases / 100,000 people without lockdown, UK 10 / 100K, delaying reopening

One reason is the delta variant

- Eric Topol (@EricTopol) June 13, 2021

Boris Johnson is accused of lacking responsiveness to take action vis-à-vis the second most populous country in the world. The borders were closed only two weeks after those with Pakistan and between 5,000 and 8,000 people traveled from India to Britain every day during that time. Half of the new cases of this variant across the Channel were then linked to international travel, reports the Telegraph.

"There are very strong historical links between India and the United Kingdom with many trips that remained poorly supervised and secure," points out epidemiologist Antoine Flahault.

“The delay in deciding to put India on the red list is costly.

It was a very political decision which he must have feared that it would cost him voters, ”echoed a French scientist based in London.

Second dose postponed to 12 weeks

By spacing the delay between the two doses of Pfizer and Moderna vaccine by twelve weeks in early January, the British government also took a risk.

More and more studies suggest that two doses are needed to cope with the Delta variant, the effectiveness of only one being limited.

Last January, the "bet" against the Alpha variant was to bring some protection to as many people as possible as quickly as possible.

“You have to be fully vaccinated to be protected against this variant, but they couldn't know that at the time.

It's always easier to comment on the story once it has passed, but the moral of the story is not to deviate too much from the frame, ”Judge Antoine Flahault.

Read also No deaths in 24 hours ... but exploding cases: why the Indian variant makes the British tremble

Boris Johnson also announced, Monday evening, that the deadline was going to be reduced from 12 to 8 weeks for all 40 years and over.

Postponing the last stage of deconfinement by one month could allow more vaccinations by then.

According to BBC calculations, the proportion of the English adult population having received two doses could increase from 57 to 76%.

Compared to Israel, one of the other world champions in vaccination, the United Kingdom also has the distinction of having used AstraZeneca a lot.

60% of the vaccinated received it in the arm.

However, this appears to be less effective than Pfizer against the symptomatic forms (respectively 60 and 88% with two doses, suggest data from Public Health England).

This could, in part, explain why the curve of new cases is rising so quickly.

Avoid a surge in hospitalizations

However, the British health agency published a new study on Monday suggesting that AZ was very effective (92%) against serious forms requiring hospitalization.

But there too, on condition of giving two doses.

With just one, the efficiency drops to 71%.

"The English situation shows that the two doses must be done as quickly as possible", summarizes the immuno-oncologist Eric Billy.

The collective to which he belongs, Du Côté de la Science, has held this line since the very beginning of the year.

Here's the key table from @PHE_uk new report on vaccine efficacy against hospitalization with Delta variant:

After 1 dose

• Pfizer: 94% effective

• AstraZeneca: 71% effective

After 2 doses

• Pfizer: 96%

• AstraZeneca: 92%

Full preprint here:

- John Burn-Murdoch (@jburnmurdoch) June 14, 2021

According to the models of the British scientific committee, the peak of new daily hospitalizations, anticipated in the middle of the summer, could be two to three times less important thanks to the postponement of the last stage of deconfinement. "The aim of vaccination is to break the link between cases, hospitalizations and deaths," British Minister of Health Matt Hancock summed up Monday evening. A situation all the more urgent as daily admissions to the hospital are already up 15% in one week.

Source: leparis

All life articles on 2021-06-17

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