Month: July 2021

What are the arguments in favour of reducing the gap between doses of the Pfizer Covid-19 vaccine to 3-4 weeks?

Early on during the pandemic, the UK government took the decision to give second doses of the Pfizer Covid-19 vaccine after 12 weeks rather than the recommended 3-4 weeks. It has now reduced the gap to 8 weeks and is considering reducing the gap to 3-4 weeks. What are the arguments in favour of reducing the gap between doses to 3-4 weeks?

1. Giving the two doses of the Pfizer vaccine 3-4 weeks apart is in line with the manufacturer’s guidance.

2. This is what most other countries using the Pfizer vaccine are doing.

3. Evidence from randomised controlled trials and subsequent evidence from real-world data provides strong evidence that two doses of Pfizer vaccine given 3-4 weeks apart provide excellent protection against severe disease and death

4. Data from Public Health England shows that two doses of vaccine provide much better protection against the delta variant than one dose. Hence, giving second doses after 3-4 weeks instead of after 8-12 weeks could help reduce the current ratee of infection in the UK

5. Many people are keen to get their second dose of Pfizer vaccine quickly because of concerns about other family members or to help them travel.


Why we should continue to wear face masks

The government’s chief medical officer says he will continue to wear a face mask when appropriate. We should follow his example. Covid-19 is an infection that is largely spread indoors – particularly in crowded, poorly ventilated areas – through inhaling droplets and aerosols produced by infected people when they cough, sneeze, sing, talk, or breathe. Face masks are a simple method of reducing the risk of infection – but only if they are worn by large numbers of people. The main function of a mask is to reduce the emission of droplets from infected people into the air. The droplets are captured by the mask and hence less virus enters the air. Much of the benefit of wearing face masks goes to other people but they can also benefit the wearer, particularly if a high-specification FFP2 mask is worn that filters out more particles and droplets when the wearer breathes in air.

Wearing face masks will reduce the spread of the coronavirus and help protect others. This is very important in settings where we are in contact with older and more vulnerable people – such as in supermarkets and on public transport. Wearing a mask has no major side effects, and does not change a person’s oxygen or carbon dioxide levels. Widespread wearing of face masks has been an important part of the pandemic control strategies of countries that have been more successful in containing the spread of Covid-19. Vaccines are essential and can protect us from developing a more serious illness. But we must maintain the use of other control measures, such as the use of face masks, until we are past the worst of the Covid-19 pandemic.

Lifting of Covid-19 restrictions in England – What are the implications for public health?

Why are all restrictions being lifted even though Covid cases are rising?

The number of cases of Covid-19 has been increasing since May and there are now nearly 30,000 cases each day in the UK. In the past, such a high number of cases would have led to a large number of people admitted to hospital and also an increase in deaths. Fortunately, because of vaccination, the number of people with a severe Covid-19 illness is now much lower than previously. For example, in the last week, there have been around 20 deaths per day on average from Covid-19 across the UK. This compares to more than 1,000 deaths per day during some days in January. The number of hospital admission is also low, with around 300 hospital admission each day in the UK. The government believes that vaccination is breaking the link between the number of cases and the number of people with severe illness; and it therefore safe to end Covid-19 restrictions in England on 19 July. The government accepts that the number of Covid-19 cases will remain at a high level.

Will the 1m social distancing rule be scrapped everywhere?

The 1m social distancing rule will end in England on 19 July, meaning that people can mingle indoors and outdoors in larger groups. Indoor businesses like night clubs will also be allowed to open.

Will we still be advised to wear masks even though it’s no longer a rule, and why?

The government has said that wearing masks will be a personal choice, except in a few higher risk settings such as care homes. Many scientists, doctors and public health specialists disagree with this decision and would like to have seen mask wearing remaining compulsory until the number of Covid-19 cases was at a much lower level than it is now.

Should I keep wearing a mask in public transport?

My advice would be to continue to wear a mask on public transport after 19 July as this protects others from the risk of infection. However, this will be optional once Covid-19 regulations end in England. It is possible though that some airlines will continue to make mask use mandatory on their flights.

What’s the risks of maskless shopping?

The risk of acquiring an Covid-19 infection is much higher in crowded, poorly-ventilated indoor settings. Once the 1m rule is scrapped, shops will be much more crowded than they are now, which will make them a higher-risk setting for transmission of infection. If you are in a vulnerable group – such as the elderly or with a serious medical problem – you may wish to consider wearing a more protective FFP2 mask when you are shopping or in other crowded, indoor spaces.

And of singing in church?

A number of large Covid-19 outbreaks have been linked to places of worship. When people sing, they expel more air and make transmission of infection more likely in crowded, indoor settings, such as churches. Because churchgoers are often elderly, churches may wish to retain some social distancing measures after 19 July to protect the members of their congregation.

If my employer wants me to go back to the office but I don’t feel safe, can I refuse?

Employees with at least 26 weeks of service have the right to ask for flexible working, which can include working from home. Employers must consider the request but can decline it if there are good business or operational reasons for doing so. If you do have to work in the office, your employer should carry out a risk assessment to ensure your working environment is safe for you.

What might happen in schools if measures are scrapped but children aren’t vaccinated?

In recent weeks, many schools have experienced Covid-19 outbreaks, with around 640,000 children across England currently at home because there has been a case in their bubble. As most schools will close around 19 July for the summer holiday, there won’t be an immediate effect on schools. However, when schools re-open in September, there will be a risk that we will see further outbreaks in schools because children have not been vaccinated. We should be looking at implementing other mitigation measures to reduce the risk of infection in schools, such as ventilation and air cleaning systems, as has been done in countries such as the USA.

I’ve had both vaccines – can I still catch it, and how bad could it be?

The vaccines used in the UK provide good protection against symptomatic infection (around 80% after two doses) and even better protection (over 90%) against hospital admission and death. However, some people who are fully immunised can still get infected and a small proportion of these people will develop a severe illness that could result in hospital admission or death as no vaccine is 100% effective.

I haven’t had the vaccine – what precautions should I take?

You should continue to follow government regulations on social distancing and wearing face masks until 19 July. After then, you need to bear in mind that Covid-19 infections remain at a high level and so you should continue to be cautious in crowded, poorly-ventilated indoor spaces; particularly if you are from a more vulnerable group at higher risk of a serious illness if you become infected.

Is there a risk scrapping Covid measures could send us back into lockdown?

It’s likely that Covid-19 cases will remain at a high level during the summer because of the ending of Covid-19 rules and greater mixing of people in indoor settings. However, vaccination should keep deaths and, to a lesser extent, hospital admissions at a low enough level to avoid another lockdown. There is though always a risk that even more infectious variants of the coronavirus may emerge that will make current vaccines less effective and precipitate another lockdown.

What about vaccination?

Currently, around 86% of adults in the UK have had one dose of vaccine and 64% have had two doses. As two doses of vaccine are needed to provide effective protection, this means there are still many people who are at risk. Do attend for your first vaccination if you have not already done so and attend for your second vaccination when this is due. Many areas are offering walk-in vaccination clinics, which you can attend without an appointment.

How risky are pubs now people can order and drink at the bar?

Crowded, poorly ventilated locations such as pubs will be high risk settings for transmission of Covid-19 once restrictions end on 19 July. Because people in pubs will be drinking and lose some of their social inhibitions, and also speaking loudly, this adds to the infection risk.