[tomtom]

Paper on mask use. Seems fairly comprehensive. Tldr; wearing them good idea - mainly to prevent carriers transmitting rather than uninflected receiving.

https://www.pnas.org/content/118/4/e2014564118

[Snoops]

This the key bit, and we know first hand in Hospitals how PCR antigen tests fail to pick up  25%-40% of all later confirmed COVID-19  cases....

All attention has focused on the dramatic efficacy results: Pfizer reported 170 PCR confirmed covid-19 cases, split 8 to 162 between vaccine and placebo groups. But these numbers were dwarfed by a category of disease called “suspected covid-19”—those with symptomatic covid-19 that were not PCR confirmed. According to FDA’s report on Pfizer’s vaccine, there were “3410 total cases of suspected, but unconfirmed covid-19 in the overall study population, 1594 occurred in the vaccine group vs. 1816 in the placebo group.”

With 20 times more suspected than confirmed cases, this category of disease cannot be ignored simply because there was no positive PCR test result. Indeed this makes it all the more urgent to understand. A rough estimate of vaccine efficacy against developing covid-19 symptoms, with or without a positive PCR test result, would be a relative risk reduction of 19% (see footnote)—far below the 50% effectiveness threshold for authorization set by regulators. Even after removing cases occurring within 7 days of vaccination (409 on Pfizer’s vaccine vs. 287 on placebo), which should include the majority of symptoms due to short-term vaccine reactogenicity, vaccine efficacy remains low: 29% (see footnote).

[tomtom]

This the key bit, and we know first hand in Hospitals how PCR antigen tests fail to pick up  25%-40% of all later confirmed COVID-19  cases....

All attention has focused on the dramatic efficacy results: Pfizer reported 170 PCR confirmed covid-19 cases, split 8 to 162 between vaccine and placebo groups. But these numbers were dwarfed by a category of disease called “suspected covid-19”—those with symptomatic covid-19 that were not PCR confirmed. According to FDA’s report on Pfizer’s vaccine, there were “3410 total cases of suspected, but unconfirmed covid-19 in the overall study population, 1594 occurred in the vaccine group vs. 1816 in the placebo group.”

With 20 times more suspected than confirmed cases, this category of disease cannot be ignored simply because there was no positive PCR test result. Indeed this makes it all the more urgent to understand. A rough estimate of vaccine efficacy against developing covid-19 symptoms, with or without a positive PCR test result, would be a relative risk reduction of 19% (see footnote)—far below the 50% effectiveness threshold for authorization set by regulators. Even after removing cases occurring within 7 days of vaccination (409 on Pfizer’s vaccine vs. 287 on placebo), which should include the majority of symptoms due to short-term vaccine reactogenicity, vaccine efficacy remains low: 29% (see footnote).

So strictly speaking - the vaccine stopped 95% of PCR positive covid cases.

It’s an interesting one - reading the Blog, being generous to Pfizer/Modena they’ve not included some of the data or decisions about data in their publications because it makes it harder to communicate the message (which is something many/most scientists might do)

Not being generous they’re over plying the efficacy and hiding their calculations.

Not releasing the full data (warts and all) helps (initial clarity) but also hinders here - as it leads people (like the Blog writer) to try and join the dots - or make calculations without all the data or by back calculating things from other results presented.

We will find out in the next few weeks when the impact of vaccinations becomes apparent or not!

I thought the behavioural changes in participants who effectively unblinded themselves (if you have a sore arm - it’s pretty clear you’ve not had the placebo) is interesting and wonder if this had any impact “I’ve had the vaccine so am invincible etc..”... 

[Oldmanmatt]

This the key bit, and we know first hand in Hospitals how PCR antigen tests fail to pick up  25%-40% of all later confirmed COVID-19  cases....

All attention has focused on the dramatic efficacy results: Pfizer reported 170 PCR confirmed covid-19 cases, split 8 to 162 between vaccine and placebo groups. But these numbers were dwarfed by a category of disease called “suspected covid-19”—those with symptomatic covid-19 that were not PCR confirmed. According to FDA’s report on Pfizer’s vaccine, there were “3410 total cases of suspected, but unconfirmed covid-19 in the overall study population, 1594 occurred in the vaccine group vs. 1816 in the placebo group.”

With 20 times more suspected than confirmed cases, this category of disease cannot be ignored simply because there was no positive PCR test result. Indeed this makes it all the more urgent to understand. A rough estimate of vaccine efficacy against developing covid-19 symptoms, with or without a positive PCR test result, would be a relative risk reduction of 19% (see footnote)—far below the 50% effectiveness threshold for authorization set by regulators. Even after removing cases occurring within 7 days of vaccination (409 on Pfizer’s vaccine vs. 287 on placebo), which should include the majority of symptoms due to short-term vaccine reactogenicity, vaccine efficacy remains low: 29% (see footnote).

What symptoms?

He said, challenging the the experts with his n=1 anecdotal trump card...

I have, biologically, two children. One, the first, born in the UAE, where they have a substantial mandatory vaccination program, including Chickenpox.
The second, born in the UK, was not vaccinated against Chicken pox. I would have done it, but we were swept up in a cancer battle at that age and before we got to think about it; Chickenpox swept through the school and preschool both children attended.

Number one, developed two (2) clear Chickenpox spots, no fever, slight lethargy, but clearly “symptomatic”. Number two took the full hit. At two years old, that meant firmly securing thick mittens to his hands and enduring days of tears and tantrums etc.

I can’t see how the effectiveness of the vaccine can be truely questioned without much more detail. More than just the “two weeks” cut off etc.
You’d have to go into the severity and nature of symptoms too.
The mild symptoms in this disease are so generic and non specific, they could indicate anything from early stage Ebola to a slight allergy. That severity or lack of, taken with negative tests, improves the potential confidence in the test, surely (either way, sever symptoms + negative test = increased suspicion of test and vice versa) .

[IanP]

This the key bit, and we know first hand in Hospitals how PCR antigen tests fail to pick up  25%-40% of all later confirmed COVID-19  cases....

All attention has focused on the dramatic efficacy results: Pfizer reported 170 PCR confirmed covid-19 cases, split 8 to 162 between vaccine and placebo groups. But these numbers were dwarfed by a category of disease called “suspected covid-19”—those with symptomatic covid-19 that were not PCR confirmed. According to FDA’s report on Pfizer’s vaccine, there were “3410 total cases of suspected, but unconfirmed covid-19 in the overall study population, 1594 occurred in the vaccine group vs. 1816 in the placebo group.”

With 20 times more suspected than confirmed cases, this category of disease cannot be ignored simply because there was no positive PCR test result. Indeed this makes it all the more urgent to understand. A rough estimate of vaccine efficacy against developing covid-19 symptoms, with or without a positive PCR test result, would be a relative risk reduction of 19% (see footnote)—far below the 50% effectiveness threshold for authorization set by regulators. Even after removing cases occurring within 7 days of vaccination (409 on Pfizer’s vaccine vs. 287 on placebo), which should include the majority of symptoms due to short-term vaccine reactogenicity, vaccine efficacy remains low: 29% (see footnote).

So strictly speaking - the vaccine stopped 95% of PCR positive covid cases.

Don't really have the skills to understand all the details but the numbers in the those paragraphs are significantly undermined by the next paragraph,

'If many or most of these suspected cases were in people who had a false negative PCR test result, this would dramatically decrease vaccine efficacy. But considering that influenza-like illnesses have always had myriad causes—rhinoviruses, influenza viruses, other coronaviruses, adenoviruses, respiratory syncytial virus, etc.—some or many of the suspected covid-19 cases may be due to a different causative agent.'

I was able to identify that argument in about 2 mins before reading the article - it does seem to me somewhat unlikely that the vaccine would be 95% effective against PCR positive covid but only 19 to 29% effective against non-PCR positive covid?

[tomtom]

Easy Ian... I thought the main question mark raised by the blog were the 3000 cases of non tested / negative but with covid ish symptoms. That appeared equally (ish) across both groups.

Hence my first statement - strictly speaking the vaccine group had 5% of the number of positive pcr tests than the placebo group.

That’s not the same as saying the vaccine is 95% effective (as Pfizer may have said) - as we don’t know about the false negatives.

[Duma]

I understand a lot of people on ventilators in hospital currently are in the 50-70 age bracket

interested where you get this info from, i've not read anything similar and OMM's link would also seem to contradict it?

Given the low death numbers in those in the healthy and < 65 bracket, I think onerous restrictions after the vulnerable are jabbed will become increasingly hard to defend

[petejh]

What Ian said.

We're doing a lot of testing for *one thing* during the pandemic. What would likely be discovered if all the PCR tests that have been been done to date also magically revealed whatever other viruses the population were carrying?

TT, isn't the term 'suspected covid-19' somewhat irrelevant - what matters are preventing death or critical illness. We aren't parking our lives and economies because people have symptoms of a cold.

[tomtom]

What Ian said.

We're doing a lot of testing for *one thing* during the pandemic. What would likely be discovered if all the PCR tests that have been been done to date also magically revealed whatever other viruses the population were carrying?

TT, isn't the term 'suspected covid-19' somewhat irrelevant - what matters are preventing death or critical illness. We aren't parking our lives and economies because people have symptoms of a cold.

I think you’ve both got the wrong end of what I was trying to say - hope my last post clears that up. I don’t think we’re disagreeing...!

[abarro81]

we know first hand in Hospitals how PCR antigen tests fail to pick up  25%-40% of all later confirmed COVID-19  cases....

25-40% being missed doesn't square with the 95% being missed that would be required for those "suspected COVID" cases to all be COVID with false-negative PCR tests though, does it? (I'm assuming these cases were PCR tested - you'd assume trial participants would be told to get a test if in doubt?) So we can presumably mark that up as "highly improbable". Various other valid sounding points in the article though.

[petejh]

I think you’ve both got the wrong end of what I was trying to say - hope my last post clears that up. I don’t think we’re disagreeing...!

Yep, gotcha.

[spidermonkey09]

interested where you get this info from, i've not read anything similar and OMM's link would also seem to contradict it?

Given the low death numbers in those in the healthy and < 65 bracket, I think onerous restrictions after the vulnerable are jabbed will become increasingly hard to defend

I agree; politically the govt will struggle make that fly even if they wanted to, but I do think that is what a section of scientists would like to see happen.

Anecdotal evidence from girlfriend who is working on intensive care ward. She reckons circa 70% are 50-70 currently with the remainder being younger. On the non-intensive care wards, the % of 70+ is higher. God knows how this slots into the other data, my brain hurts thinking about it!

[Snoops]

Easy Ian... I thought the main question mark raised by the blog were the 3000 cases of non tested / negative but with covid ish symptoms. That appeared equally (ish) across both groups.

Hence my first statement - strictly speaking the vaccine group had 5% of the number of positive pcr tests than the placebo group.

That’s not the same as saying the vaccine is 95% effective (as Pfizer may have said) - as we don’t know about the false negatives.

Agree.

I think the point is when you only have 0.09% (168 people) getting COVID in the placebo arm, excluding >3000 symptomatic people who we would assume on Uk stats that a minimum of 25% actually had COVID (approx 750 people) asks a serious question of the data.
A further point was that significantly more (5x) amount of participants were excluded from the study in the vaccination arm vs placebo ...thats unusual.

The reasons for the above have not been given, hence why the BMJ and also many Doctors/Scientists/Journals internationally have raised it.

The facts will be in hospitalisation's/morbidity vs vaccine which we won't know for a couple of years.

I don't think anyone is suggesting the vaccine is not going to help, but its efficacy is likely to be lower than 95%. Clearly it also seems clear that in patients who have got COVID post vaccination the symptoms are milder...another reason to have it.

The vaccine is GOOD thing!!! But surely we are allowed to challenge unsupported statements, or else we may as well join MAGA   

[Duma]

has anyone got any decent links for info on immunity from infection?

Given the 12.4M figure that's been mentioned for current and past infections (England only) then by mid feb we're looking at ~ a third of the population having at least some degree of immunity?

[petejh]

Easy Ian... I thought the main question mark raised by the blog were the 3000 cases of non tested / negative but with covid ish symptoms. That appeared equally (ish) across both groups.

Hence my first statement - strictly speaking the vaccine group had 5% of the number of positive pcr tests than the placebo group.

That’s not the same as saying the vaccine is 95% effective (as Pfizer may have said) - as we don’t know about the false negatives.

Agree.

I think the point is when you only have 0.09% (168 people) getting COVID in the placebo arm, excluding >3000 symptomatic people who we would assume on Uk stats that a minimum of 25% actually had COVID (approx 750 people) asks a serious question of the data.
A further point was that significantly more (5x) amount of participants were excluded from the study in the vaccination arm vs placebo ...thats unusual.

The reasons for the above have not been given, hence why the BMJ and also many Doctors/Scientists/Journals internationally have raised it.

The facts will be in hospitalisation's/morbidity vs vaccine which we won't know for a couple of years.

I don't think anyone is suggesting the vaccine is not going to help, but its efficacy is likely to be lower than 95%. Clearly it also seems clear that in patients who have got COVID post vaccination the symptoms are milder...another reason to have it.

The vaccine is GOOD thing!!! But surely we are allowed to challenge unsupported statements, or else we may as well join MAGA   

How does the quality of the Pfizer data compare with the data provided by AZ for their vaccine? Could this be a reason for AZ reporting a lower efficacy? Or are AZ doing the same dance?

[JJP]

One thing I heard being discussed but have never checked up on is that Pfizer didnt test asymptomatic trial patients whereas oxford did, thus likely inflating the Pfizer vaccine effectiveness.  I have had the Pfizer one but tbh never looked into the data. 

[IanP]

What Ian said.

We're doing a lot of testing for *one thing* during the pandemic. What would likely be discovered if all the PCR tests that have been been done to date also magically revealed whatever other viruses the population were carrying?

TT, isn't the term 'suspected covid-19' somewhat irrelevant - what matters are preventing death or critical illness. We aren't parking our lives and economies because people have symptoms of a cold.

I think you’ve both got the wrong end of what I was trying to say - hope my last post clears that up. I don’t think we’re disagreeing...!

Late to catch up - my comments were pointing out issues with quoted paragraphs (not your post  ), and definitely not meant to indicate disagreement with your comments 

[sdm]

On the anecdotal front re vaccination progress the wife (NHS, admin rather than frontline) got vaccinated Sunday, dad (81) is booked in for Friday.  Know a number of other NHS people who have had vaccine and a few other over 80s - feels like things are moving.

Yep, wife's had her first jab (Doctor) and my Mum and her friends (mid 70s) are getting contacted and their jabs being booked. It does feel like "it's happening".....

[anecdote]

my 80 yo neighbour has had both his jabs

[/anecdote]

I think all of the healthcare workers and other NHS staff I know have now had at least one dose. Some have had a second dose and many have a second dose scheduled. I don't know if they'll actually get it on their current schedule but it seems that not everywhere is sticking to the longer gap between doses.

Most of them did not have a specific appointment for the first dose, they were on a waiting list. At the end of the day, if all of the vaccine doses hadn't been used up, the staff got them.

Seems to be a good way to get more frontline staff vaccinated quickly. I hope they have a plan to continue using up the spares after all healthcare workers have been done.

[petejh]

A friend sent me this: https://www.personneltoday.com/hr/scientists-surprised-at-construction-industry-covid-clusters/

Unbelievable to me that a Professor on SAGE is surprised at clusters of transmission in the construction industry, and that he claimed people outside that industry were surprised to discover how much work goes on indoors...   These people advise the government!
''But he conceded that many people beyond the sector did not realise that many construction workers actually carried out many tasks inside, in confined spaces.''

What do these people actually think happens outside their offices? It wouldn't surprise me at all if the construction industry was the biggest vector of all non essential work.

[ali k]

Unbelievable to me that a Professor on SAGE is surprised at clusters of transmission in the construction industry

''But he conceded that many people beyond the sector did not realise that many construction workers actually carried out many tasks inside, in confined spaces.''

It wouldn't surprise me at all if the construction industry was the biggest vector of all non essential work.

Agreed. Not just from trades on site either. The meetings I’ve had to attend in the last 6 months have been fucking atrocious - crammed into the same tiny shoe box site cabin offices as always. People moan when you open a window because it’s cold. Last Friday was the final straw and I’ve refused to go to meetings on site until it’s under control again.

Ridiculous thing is covid compliance seems to mean you have to wear a mask in the canteen, corridors, and general office space but not once you get into the meeting room 

[Ged]

That Is indeed bonkers,and good on you for putting your foot down. Tends to not get sorted until people do that.

I had to laugh at a radio presenter the other day talking about how "surely schools are covid secure by now, they've had months to get sorted". As though our resources have somehow increased in that time, or we suddenly aren't expected to have thirty 16 year old crammed into a classroom.

[SA Chris]

I know our kids' primary head had to spend months planning for socially distanced / blended learning approach, where they spent forever seeing how many kids they could fit in, wile still maintaining social distance criteria, and alternate teaching days. Then school went back as normal, with a few minor changes, then totally closed again after Xmas. Was all that planning totally canned? It took her forever!

[Duma]

So given this:
https://www.theguardian.com/society/2021/jan/14/recovering-from-covid-gives-similar-level-of-protection-to-vaccine
And this:
https://www.theguardian.com/world/ng-interactive/2021/jan/10/one-in-five-have-had-coronavirus-in-england-new-modelling-says

If we assume equal infection rates across the population, that's around a third of the population, including all the most vulnerable, with a significant degree of immunity by mid Feb. I'm increasingly optimistic of an easing after half term, and it'll be increasingly difficult to defend onerous restrictions.

[mrjonathanr]

I know our kids' primary head had to spend months planning for socially distanced / blended learning approach, where they spent forever seeing how many kids they could fit in, wile still maintaining social distance criteria, and alternate teaching days.

Seems like the way forward to me. It does not have to be cycles of all shut/open.

Regarding wasted effort, heads spending their Xmas break organising mass lateral flow testing for children was not really necessary, was it?

[SA Chris]

Indeed, why were heads having to organise it??