Coronavirus - the new strain XX

[Seanm]

You mean balance the risk of a heart inflammation with unknown long term consequences on the one hand, against the risk of having to do a week of school with zoom on the other?

The JCVI statement stressed that the direct health risks and benefits were very finely poised: not hard to see how even a very slightly wider or different remit would tip the balance the other way. And we shouldn't trivialise the consequences of disrupted schooling: if it were just a week on zoom in wouldn't matter but it's not - it's widespread, frequent disruption for an indefinite length of time, on the heels of two very difficult school years that have done children a lot of damage.

 

[mandryka]

The JCVI statement stressed that the direct health risks and benefits were very finely poised: not hard to see how even a very slightly wider or different remit would tip the balance the other way. And we shouldn't trivialise the consequences of disrupted schooling: if it were just a week on zoom in wouldn't matter but it's not - it's widespread, frequent disruption for an indefinite length of time, on the heels of two very difficult school years that have done children a lot of damage.

Presumably other countries have had to face up to the same dilemma, but as far as I know they've hidden the complexities from public view. From a political point of view -- I don't mean party politics I mean political theory -- what do you think of that?

There's a side of me which is proud to be part of a country which is engaging and trusting the people so much.

(It would be great if someone could explain Wei Shen Lim's final answer to me a bit, I think I understand it, but I'm not sure.)

 

[IanW]

An updated report from the BBC following the CMO presentation, with data for the medical risks (per 1 million people):

Intensive care admissions reduced: 2
Hospital admissions prevented: 87
Cases of myocarditis: 3 to 17

But no mention of Long Covid or internal organ damage.

Along with information as to educational benefit of children not losing as much school time:

https://www.bbc.co.uk/news/health-58547659

 

[mandryka]

An updated report from the BBC following the CMO presentation, with data for the medical risks (per 1 million people):

Intensive care admissions reduced: 2
Hospital admissions prevented: 87
Cases of myocarditis: 3 to 17

But no mention of Long Covid or internal organ damage.

Along with information as to educational benefit of children not losing as much school time:

https://www.bbc.co.uk/news/health-58547659

Have a listen to the final answer by Wei Shen Lim on the press conference because it directly bears on this sort of reasoning (I think, but I'm not sure.)

 

[IanW]

Have a listen to the final answer by Wei Shen Lim on the press conference because it directly bears on this sort of reasoning (I think, but I'm not sure.)

What part? I have read the text transcript and do not know what point you are trying to make?

 

[mandryka]

What part? I have read the text transcript and do not know what point you are trying to make?

1:02:23 in the video here

 

[IanW]

1:02:23 in the video here

Thanks.

The answer he gives suggests that all those figures have been assessed along with the educational benefits (ignoring any benefits to the wider community) and with all that information considered, they are recommending offering the vaccine to 12 to 15 year olds.

 

[mandryka]

Well, I don’t get that. The journalist says that if he looks at the figures there’s a huge benefit to vaccinating kids - vaccinate 1M children prevents 87 hospitalisations and 3 - 17 children would get myocarditis, and they’d soon recover. This is what you quoted.

And obviously JCVI doesn’t want to say that there’s a huge direct benefit of vaccinating kids, they say there’s only a marginal direct benefit.

The prof says that you can’t just equate 1 hospitalisation = 1 case of myocarditis because you must take into account the severity of the hospitalisation - which is hidden from public view.

But I don’t understand how the prof’s response justifies his view that there’s only a marginal direct benefit.

Anyway, it’s not important!

Thanks.

The answer he gives suggests that all those figures have been assessed along with the educational benefits (ignoring any benefits to the wider community) and with all that information considered, they are recommending offering the vaccine to 12 to 15 year olds.

 

[hc25036]

Well, I don’t get that. The journalist says that if he looks at the figures there’s a huge benefit to vaccinating kids - vaccinate 1M children prevents 87 hospitalisations and 3 - 17 children would get myocarditis, and they’d soon recover. This is what you quoted.

And obviously JCVI doesn’t want to say that there’s a huge direct benefit of vaccinating kids, they say there’s only a marginal direct benefit.

The prof says that you can’t just equate 1 hospitalisation = 1 case of myocarditis because you must take into account the severity of the hospitalisation - which is hidden from public view.

But I don’t understand how the prof’s response justifies his view that there’s only a marginal direct benefit.

Anyway, it’s not important!

If I’m reading that right, for 1million vaccinations (at a cost of say £50 million) you save 87 hospitalisations? Purely objectively the normal cost:benefit requirements for approval are orders of magnitude less than that (ie if I developed a drug at the rough cost of vaccination for that return, it would not be approved on the basis of cost).

I've not really followed the detailed arguments because I have been very much with the JCVI all along.

 

[Seanm]

Presumably other countries have had to face up to the same dilemma, but as far as I know they've hidden the complexities from public view. From a political point of view -- I don't mean party politics I mean political theory -- what do you think of that?

There's a side of me which is proud to be part of a country which is engaging and trusting the people so much.

I don't really know, have they? Hidden things I mean. Not all of them, surely.

Seems to me there’s been really impressive levels of transparency in some areas (data, scientific discussion and decision-making) while in others nothing at all is clear (political decisions). If there’s ever a proper audit into which bits of British governance are fit for purpose that might be the place to start. It’s why it’s so frustrating to see bodies like the JCVI and Sage being discussed as if they were mere fronts. I doubt they’re perfect but from here they seem to be a world away from Boris’ grubby clientelism.

Ironically, you seem to take Boris and Javid at face value while treating JCVI, CMO etc. statements as mostly all subtext (I mean, I take it you’re being ironic).

 

[mandryka]

Ironically, you seem to take Boris and Javid at face value while treating JCVI, CMO etc. statements as mostly all subtext (I mean, I take it you’re being ironic).

I can see why you think that I'm taking Javid etc at face value -- I think what I want to do is try and get really clear about what they're saying. You've got to remember also that my academic background taught me to do very close reading of texts (you know, texts like Aristotle and Wittgenstein) -- so it's a reflex to be a bit careful about claiming that Javid said this or Boris said that. I must admit yesterday it did cross my mind that I was treating Javid's interview on Marr like a section from the Nichomachean Ethics. I quite like that sort of thing!

I didn't intend to treat JCVI's discourse as full of subtext -- but I do do the close reading thing with them too.

I think these guys are pretty careful about what they're saying actually. I would be if I were them -- and the ministers who've been to Oxbridge have all been taught very well how to express exactly what they want to express, no more no less -- that's the Oxbridge way.

 

[Seanm]

Whitty’s 26 point letter to Javid is quite something on that score:

https://www.huffingtonpost.co.uk/en...-12s-can-go-ahead_uk_613f4f94e4b090b79e86d53d

Exceptionally clear on the CMOs’ advice, the rationale informing it, the different remits of the MHRA, JCVI and CMOs, and why none of the advice given by these bodies in this case is contradictory. It’s a bit of a masterpiece in its own way and evidence of some fancy footwork within and between these bodies: can’t have been easy for each to stay in their own lane on the decision but reading this you can see how important it is that they stick to their different remits.

 

[Mullardman]

If I’m reading that right, for 1million vaccinations (at a cost of say £50 million) you save 87 hospitalisations? Purely objectively the normal cost:benefit requirements for approval are orders of magnitude less than that (ie if I developed a drug at the rough cost of vaccination for that return, it would not be approved on the basis of cost).

I've not really followed the detailed arguments because I have been very much with the JCVI all along.

Surely the point is that reducing incidence in younger people not only limits serious illness in that group.. but also helps to limit spread in the wider population?

 

[Mullardman]

Boosters for over 50's looking like being on the cards.

I won't be refusing the offer.

Meanwhile, my youngest was turned away for a second jab, at a centre mostly injecting college kids. I thought that was a bit mean and rather against the general call to get jabbed.. but Hey!. She went there because she has a 12 week old baby and getting about with her isn't that easy while her partner is at work.

 

[gavreid]

11% of Israel kids who caught the virus now suffer from long covid.

https://www.timesofisrael.com/more-...o-got-virus-now-suffer-from-long-covid-study/

Aditionally, as I've posted previously, the threat of myocarditis is significantly greater from covid than from vaccination.

No mention of either yesterday, but I would think that the impact of long covid on education is far from trivial.

 

[IanW]

Well, I don’t get that. The journalist says that if he looks at the figures there’s a huge benefit to vaccinating kids - vaccinate 1M children prevents 87 hospitalisations and 3 - 17 children would get myocarditis, and they’d soon recover. This is what you quoted.

And obviously JCVI doesn’t want to say that there’s a huge direct benefit of vaccinating kids, they say there’s only a marginal direct benefit.

The JVCI have their remit of looking at the situation from the individual's viewpoint and I can see why they have concluded what they concluded.

The prof says that you can’t just equate 1 hospitalisation = 1 case of myocarditis because you must take into account the severity of the hospitalisation - which is hidden from public view.

But I don’t understand how the prof’s response justifies his view that there’s only a marginal direct benefit.

What do you think he is trying to get across there? Is he saying that 1 hospitalisation is on average much more serious for the individual and the health service than 1 case of myocarditis? And hence 1:1 mapping is not valid and that there is a stronger case for vaccination of 12 to 15 year olds.

Anyway, it’s not important!

Not really, but you do like to dig into the words and try to find some additional or hidden meaning.

From my viewpoint we have 3 levels of assessment / judgement for vaccination of 12 - 15 year olds:

The first is for the individual, which the JVCI says is very marginal, but the figures do suggest a benefit.
The second is for keeping schools teaching more pupils, more of the time and that is the case after vaccination.
The third is would these vaccinations reduce community transmission and numbers in hospital etc and just based on evidence from adults this is the case. But this is not considered as a reason to vaccinate 12-15 year olds, it is seen as a positive by product.

 

[gavreid]

Speaking in a personal capacity, he [Ravi Gupta of NERVTAG) said scientists warned the prime minister to “take this slowly” when restrictions were eased in July or face a “knock-on effect” in the future.

Now, he said, the UK is seeing “the result of that advice not being heeded and we’re now in a position where we’re talking about lockdowns again. With the correct planning, this could have been avoided.”

https://www.theguardian.com/world/l...08fea27f0e6d20#block-614043088f08fea27f0e6d20

 

[mandryka]

Not really, but you do like to dig into the words and try to find some additional or hidden meaning.

.

No. I dig into the words to find what they say, to reveal the explicit meanings precisely to avoid additions are suggesting that things are hidden.

The third is would these vaccinations reduce community transmission and numbers in hospital etc and just based on evidence from adults this is the case. But this is not considered as a reason to vaccinate 12-15 year olds, it is seen as a positive by product.

Why have you decided to adopt a point of view is not in line with the experts on the JCVI? They said

There is considerable uncertainty regarding the impact of vaccination in children and young people on peer-to-peer transmission and transmission in the wider (highly vaccinated) population. Estimates from modelling vary substantially, and the committee is of the view that any impact on transmission may be relatively small, given the lower effectiveness of the vaccine against infection with the Delta variant.

The first is for the individual, which the JVCI says is very marginal, but the figures do suggest a benefit.

In fact the figures suggest a large benefit to me, which the Professor denied, which made me think I don’t understand the figures!

 

[IanW]

NWhy have you decided to adopt a point of view is not in line with the experts on the JCVI? They said

Perhaps I should have not used the term transmission, but it is correct in a wider sense. The more 12-15 year olds that are vaccinated, the less virus will be in circulation. There is an enormous amount of data supporting this for adults and at some point there will be conclusive data for 12-15 year olds.

In fact the figures suggest a large benefit to me, which the Professor denied, which made me think I don’t understand the figures!

Doesn't look like a large benefit to me, but it is definitely a benefit worth having.

 

[Seanm]

Does anyone know the official definition of “hospitalisation” in the UK?