Monday, March 8, 2021

UK’s Covid vaccine rollout is a much-needed win after bungled pandemic response

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“She wanted my contacts. She knew that I knew everybody in the industry,” Bates, a lobbyist who heads the UK BioIndustry Association, told CNN. “Kate Bingham said to me, ‘we’ve never made a vaccine that’s worked against a human coronavirus. This is a long shot.'”

By that time, the British government had one of the highest national death tolls globally, having dragged its feet to impose lockdown restrictions, shown reluctance to enforce rules and following futile attempts to track and trace the spread of the virus. Its border was also still wide open, and the government was throwing money at a rotating cast of private sector consultants to secure basic personal protective equipment (PPE) — an effort that appeared more successful at generating controversy than securing supplies.

But the government’s foresight in backing coronavirus vaccines has turned into one of the most surprising success stories of the pandemic.

Despite its widely criticized pandemic response, which has led to more than 117,000 deaths and more than 4 million coronavirus cases to date, the UK has now administered 15 million coronavirus vaccine doses — a target set by the government to reach everyone in its top four priority groups by February 15. The groups include everyone over 70, frontline health and social care workers, those living in care homes and the clinically extremely vulnerable.
This total is more than Germany, France, Italy, Spain, Poland and Belgium combined. The UK has the third-highest vaccination rate worldwide behind Israel and the UAE.

Nadhim Zahawi, the UK’s minister for Covid-19 vaccine deployment, confirmed the goal had been accomplished a day early in a post on Twitter Sunday. “We will not rest till we offer the vaccine to the whole of phase 1,” Zahawi wrote, referring to the priority groups set out by the government.

Temporary vaccination centers, like this one at Basingstoke Fire Station in southern England, have been set up across the country.

UK Prime Minister Boris Johnson celebrated the moment, calling it a “significant milestone” and an “extraordinary feat.”

“In England I can now tell you we have now offered jabs to everyone in the first four priority groups, the people most likely to be severely ill from Coronavirus, hitting the first target we set ourselves,” he wrote on Twitter.

The British government also plans to give a first dose to the remaining risk groups and adults over 50 by the end of April.

Across the country, soccer stadiums, horse racing tracks, cathedrals and mosques are being used as mass vaccination sites. And through the National Health Service (NHS), the government can reach almost every person in the country to schedule a vaccination appointment.

In the southern English town of Basingstoke, a working fire station is being used for vaccinations. To accommodate the program, engines have been moved outdoors, emergency deployment routes have been overhauled and a small army of soldiers, firefighters, volunteers and nurses have moved in.

“It feels like a wartime effort,” says Mark Maffey, the NHS architect who led the transformation of the fire station and three other vaccination sites in the area.

Staff prepare to give the Pfizer/BioNTech vaccine to patients at a vaccination center set up inside Salisbury Cathedral on January 20.

Big bets on ‘longshot’ vaccines

The centralized NHS is key to getting shots in arms, but it was an early series of big bets on then-unproven vaccines that really vaulted the UK ahead of the global pack.

Cautious not to repeat its PPE-purchasing mistakes and unwilling to rely solely on public servants who lacked expertise in vaccine procurement, Britain’s Chief Scientific Adviser Patrick Vallance pushed Downing Street to bring in outside experts to form the vaccine taskforce.

On paper, the unusual combination of public servants and current and former industry insiders seems like a recipe for conflicts of interest, but they were accountable to ministers and government auditors, explains Bates, who left the committee last month.

The taskforce was quick to get behind a vaccine being developed by a group of scientists at the University of Oxford who had been working on a shot for the Middle East Respiratory Syndrome — a disease caused by another type of coronavirus — before shifting their focus to Covid-19. It wasn’t long before a vaccine was developed, but the challenge would be getting it manufactured on an industrial scale, which is where AstraZeneca came in.
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The British-Swedish pharmaceutical company was chosen because of its iron-clad commitment to prioritize the UK market, which, according to both parties, involved providing all doses made in the UK to the British government, and only exporting doses once the country had been supplied. In exchange, the UK government agreed to invest heavily in the vaccine’s manufacture.

“I wasn’t going to settle for a contract that allowed the Oxford vaccine to be delivered to others around the world before us,” Health Secretary Matt Hancock told UK radio station LBC earlier this month.

Of the more than 100 vaccines in development worldwide at the time, the taskforce short-listed around 20 based on how quickly they could be trialled and made available. Ultimately, they chose seven based on the makers’ ability to scale up production for the UK. Those seven included the three that have been approved to date by Pfizer/BioNTech, Moderna and Oxford/AstraZeneca. Two others from Novavax and Johnson & Johnson have also shown promise in Phase 3 trials published last month.

Bates says bureaucratic hoops were kept to a minimum. “I think having a small group makes decisions easier and faster,” he said, adding that Bingham “having the hotline to the Prime Minister also made sure that the chains of command were very short at key moments when decisions were made.”

Going it alone

The speed at which the UK has been able to approve and administer vaccines is due in part to the country’s decision to go it alone, rather than joining the European Union’s procurement effort. When the EU offered the UK the chance to join forces, it insisted it drop any ongoing contract discussions.

“That didn’t feel like the right thing to do, so the UK didn’t do it,” said Bates, estimating the decision “probably gave us at least three months’ advance work, which is proving invaluable.”

The UK’s decision not to join Europe’s procurement strategy was controversial. Last March, Martin McKee, a European health professor at the London School of Hygiene and Tropical Medicine, predicted in the Guardian newspaper that Britain would pay more and get fewer vaccines by going it alone.

“The timing of the pandemic … could provide an opportunity to reflect on whether an isolationist ideology really is such a good idea,” wrote McKee.

His view has since changed. “I fully concede that I was wrong on this one,” McKee told CNN. “I give full credit to Kate Bingham … she did very well.”

But Britain’s head start left Europe frustrated and lagging behind — prompting a diplomatic spat across the English Channel. At one point in January, EU leaders even threatened to restrict exports of vaccines produced in Europe to even the score.
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Last month AstraZeneca clarified that it never contractually promised Europe it would be supplied with doses at the same rate as the UK. “Basically, we said we’re going to try our best,” the company’s CEO Pascal Soriot explained to Italian newspaper La Repubblica.

McKee believes the UK’s success is also due to the well-organized and centralized NHS system, giving the country an advantage many other countries lack. The fire station in Basingstoke is able to inject more than 1,000 vaccine doses per day. Nationwide, daily injections have at one point topped 600,000. NHS staff, emergency services and ordinary volunteers are all starting to see their efforts pay off.

The firefighters now trained to give shots in Basingstoke work under Steve Apter, the deputy chief fire officer for the county of Hampshire. Last summer Apter’s mother was hospitalized with Covid-19 symptoms and later died of pneumonia. Her test eventually came back negative, but her symptoms meant she was isolated for days, unable to have her family at her bedside.

Steve Apter, the deputy chief fire officer for the county of Hampshire, leads the team of firefighters who have now been trained as vaccinators.

“The sense of helplessness was overwhelming,” he recalled. He is proud of how the fire service is contributing to the vaccination effort and can’t help but feel a sense of national pride too.

“I’ve never experienced such open sense of shared purpose than we’re seeing now.”

A previous version of this story stated that Steve Bates was not paid for his role on the taskforce. It has been updated to clarify that the UK government did compensate Bates’ organization for his time spent on the taskforce.

CNN’s Matt Brealey, Darren Bull and Mark Baron contributed to this report.

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