A shortage of vaccines could threaten a further Freedom Day delay as supplies of Pfizer and Moderna jabs are ‘tight’ amid an increased demand – as young people are taking alternatives to AstraZeneca.
In light of the rapidly spreading Indian variant, the Government has brought forward its target for vaccinating all adults until July 19 — the same day the final unlocking has been pushed back until. Ministers had previously pledged to offer jabs to all over-18s by July 31.
And the Prime Minister this week delayed Freedom Day from June 21 to July 19 to give the NHS a ‘few more crucial weeks’ to protect Britons from the Indian, or Delta, variant.
But Britain administered just 368,555 vaccine doses on Monday – well under half the 844,285 it managed on a single day in March. The pace has slowed because of the decision by Government advisers to recommend alternatives to the Oxford/AstraZeneca jab for the under-40s and limited supply of the two alternatives – Pfizer and Moderna.
Ministers have conceded that the supply of the Pfizer jab is particularly ‘tight’ while the Moderna vaccine – which has only just become available – is thought to be similarly limited.
NHS England boss Sir Simon Stevens has said that the health service would ‘finish the job’ of the vaccination programme to the ‘greatest extent possible’ over the next four weeks, and he expects all remaining adults to be offered their first vaccine by the end of the week.
But he told the NHS Confederation’s annual conference ‘supply continues to be constrained’.
Government advisers recommended an alternative to the Oxford/AstraZeneca jab for under-40s after it was linked to fatal blood clots. But this has hugely increased demand for the Pfizer and Moderna vaccines.
Downing Street’s vaccine minister Nadhim Zahawi last week admitted stocks of Pfizer — the main jab being administered to young people — would be ‘tight’ this month.
But in a glimmer of good news, Covid cases appear to be flat or falling in the first areas to be hit by the new Indian ‘Delta’ variant, official figures show.
The infection rate in Blackburn with Darwen, which took over from Bolton as the country’s hotspot at the end of May, is now falling after appearing to peak on June 4 when there had been an average 143 cases per day over the previous week.
The Covid vaccine rollout (pictured: woman is given a vaccine in Cheshire) has slowed to under half its peak speed as Boris Johnson delayed Freedom Day from June 21 to July 19
What are the main variants recognised by the WHO?
First spotted: Kent
Scientific name: B.1.1.7
First spotted: South Africa
Scientific name: B.1.351
First spotted: India
Scientific name: P.1
First spotted: India
Scientific name: B.1.617.2
It remains the worst-affected place in the country but if the trend keeps up the change of fortunes could suggest that, as was seen in Bolton, simple surges in testing and vaccinations and tougher advice on travelling in or out of the area and social distancing could be enough to keep a lid on local outbreaks.
Ministers urged another 3.6million people in Birmingham, Liverpool, Warrington and parts of Cheshire to try to avoid travelling and be more careful about virus control measures in a bid to slow outbreaks there.
Boris Johnson yesterday announced a four-week delay to plans to end social distancing rules on June 21 as planned, saying not enough is known about the Indian variant and how difficult it will be to control.
The other areas that were first to be hard hit by the strain when it emerged in April – Bedford and Burnley – also appear to have arrested the spread of Covid by scaling up local efforts to stamp it out and test and isolate everyone.
Those four areas, Bedford, Blackburn, Bolton and Burnley, were the first to see cases surge, the first to get extra help from the Government to control the virus, and now appear to be the first to see infections levelling off.
But infections are still rising fast in many areas that have been added to the official hotspots where advice has been upgraded, with cases going up in twice as many areas as they are flat or falling.
Department of Health positive test figures show that there has been a plateau in the numbers of people testing positive for coronavirus in those hard-hit areas, offering proof that the Indian variant can be controlled.
Infection numbers appear to have plateaued in Bedford, which was one of the first areas to see cases caused by the new Indian Delta variant take off. The same trend, or even in some cases a decline, is being seen in other hard-hit areas below (Blackburn, Bolton and Burnley)
Extra support to tackle a rise in cases of the Delta variant, which was first recorded in India, has been announced for more areas of the North West and Birmingham. The additional support will be introduced in Birmingham, Blackpool, Cheshire East, Cheshire West and Chester, Liverpool City Region and Warrington, a spokesman for the Department of Health and Social Care said on Monday. The package, which is the same as was announced for Greater Manchester and Lancashire last week, will see more support for surge testing, tracing, isolation support and maximising vaccine uptake after a number of cases of the Delta variant were detected in the areas
Data from the Wellcome Sanger Institute shows how the proportion of cases being caused by the Indian ‘Delta’ variant rose during the first half of May, with hotspots (shown in purple) first emerging in the North West, London and central England
The Wellcome data show that, by the end of May, the variant was accounting for almost all cases in almost all parts of the country. Some areas – those in white – do not have enough data to work out a trend, but by June the strain appeared to have completely taken over England except the Isle of Wight
In Bolton the infection rate had risen to 453 cases per 100,000 people on May 21, with an average of 186 people testing positive each day, but this has since plummeted to 309 per 100,000 and an average 127 daily cases.
There are hopes that the trend there, where the council offered free regular testing to all adults and stepped up its efforts on contact tracing and vaccinations, will translate to other areas that see outbreaks of the variant.
NHS England boss Sir Simon Stevens has said that the health service would ‘finish the job’ of the vaccination programme to the ‘greatest extent possible’ over the next four weeks, and he expects all remaining adults to be offered their first vaccine by the end of the week
It may be beginning to happen in Blackburn, which took over as the hotspot at the end of May with the rate of cases per 100,000 people hitting 667 by June 7, but since dropping to 599. Average daily cases appear to have peaked at 143 on June 4 and since fallen to 128.
In Bedford a similar trend is playing out, with an infection rate high of 208 per 100,000 on May 23 now having fallen to 154 per 100,000, and average daily cases peaking at 52 on May 20 and now down to 38 per day in the past week.
Burnley also appears to have seen a levelling off in cases, although the trend is less certain and only recent. The seven-day infection rate was 370 per 100,000 on June 8 and fell to 367 by two days later, with average daily cases having levelled off at around 47 per day since June 5.
There are 34 areas now on the list of places to face tougher guidance, which offers a ‘package of support’ from the Government to include surge testing, enhanced contact tracing and financial support to Covid cases and their contacts who have been asked to self-isolate.
Recent data from these 34 areas show that infections appear flat in 10 places, are falling in two (South Ribble as well as Blackburn) but are rising in 22 places.
Most of them are recent additions to the enhanced support list and ministers will be hoping the extra measures help to turn the tide on infections in those places, too.
Boris Johnson’s delay to the original June 21 ‘Freedom Day’ by four weeks came amid fears a third wave of Covid could overwhelm the NHS.
The UK administered just 368,555 Covid-19 vaccine doses on Monday (pictured: latest figures) well under half the 844,285 it managed on a single day in March
Before the pandemic took hold in Britain last spring, people made contact with around 11 others every day, on average. But that figure plummetted to around three during the depths of the Covid crisis. The figure currently stands at around 6.5, according to one study called Comix (pictured)
One chart presented by chief medic Chris Whitty showed that hospitalisations have increased 61 per cent in a week in the North West, a trend which was predicted to follow across the rest of the country. It played a heavy hand in the decision to delay Freedom Day
Top scientists hope the move will give the health service more time to vaccinate as many people as possible, offering the nation as much protection against the Indian variant as possible.
Experts say because the mutant strain is so infectious, it will spill into unvaccinated groups and the small percentage of people for whom the jabs don’t work.
As well as pledging to offer jabs to all over-18s by July 19, the Prime Minister’s new vaccination target is also to fully vaccinate two-thirds of adults. The figure currently stands at around 56.9 per cent, or 30million.
He also pledged to shorten the gap between two doses to just eight weeks for over-40s, bringing them in line with over-50s.
The aim of dishing out jabs to all younger adults is entirely dependent on the supply of the Pfizer and Moderna jabs. AstraZeneca’s vaccine is not recommended for under-40s because of its rare links to blood clots.
Sir Simon said: ‘It is now very important that we use the next four weeks to finish the job to the greatest extent possible for the Covid vaccination programme, which has been a historic signature achievement in terms of the effectiveness of delivering by the NHS — over 60 million doses now administered.
NHS leaders ‘relieved’ by lockdown extension
NHS leaders have expressed their ‘relief’ that Boris Johnson has extended the current lockdown restrictions for another four weeks.
Pushing back Freedom Day to July 19 will mean that the NHS can vaccinate ‘many more people’, NHS Providers said as it welcomed the ‘cautious’ approach.
It will also mean that there is ‘less pressure’ on hospitals which are still recovering from the effects of the pandemic.
Chris Hopson, chief executive of NHS Providers, said that a cautious approach ‘is prudent’.
He said: ‘There is welcome increasing evidence that, for this pattern of variants, vaccines are breaking the chain between COVID-19 infections and the high levels of hospitalisations and mortality we saw in previous waves.
‘A delay of four weeks will enable the NHS to do two important things. It will enable us to confirm the extent to which vaccines have broken the chain between infections and hospitalisations and deaths. And, crucially, it will enable us to vaccinate many more people with double doses and a period of protection build up.
‘It will also mean less pressure on hospitals at a point when they are very busy recovering care backlogs and dealing with increased demand for emergency care with significantly reduced capacity, due to the need to prevent the spread of COVID-19 in hospitals.
‘So trust leaders will welcome the decision taken today, for operational reasons. But they will also understand the impact of continuing lockdown measures on people’s lives, mental health and on the economy.
‘Vaccines will enable us to exit this current pandemic soon. But we must all understand that the virus will be with us for a long time yet. So our next task will be to discuss what the NHS, and we as a nation, need to do to live with the virus longer term. That debate has barely started.’
Matthew Taylor, chief executive of the NHS Confederation, added: ‘Health leaders will be relieved that the Prime Minister has listened to their warnings and extended the current lockdown restrictions.’
‘Our members are committed to using this extra time to vaccinate as many adults as they can so that we can protect our population and support the NHS to continue to restore its services for patients,’ he continued.
‘However, if the data continues to show that the Covid situation has not improved come 19 July, the Government has to be prepared to act decisively again and if needed, slam the brakes down further.’
‘By July 19 we aim to have offered perhaps two thirds of adults across the country double jabs.
‘And we’re making great strides also in extending the offer to all adults — today people aged 23 and 24 are able to vaccinate through the National Booking Service.
‘I expect that by the end of this week, we’ll be able to open up the National Booking Service to all adults age 18 and above.
‘Of course, vaccine supply continues to be constrained, so we’re pacing ourselves at precisely the rate of which we’re getting that extra vaccine supply between now and July 19.’
Sir Simon added that just one per cent of hospital beds in England are currently being used by Covid patients.
He said: ‘At the moment about one per cent of hospital beds in England are occupied by patients with a Covid diagnosis and the age distribution has really flipped as a result of vaccination.
‘Back in January, it was 60/40 — 60 per cent of beds occupied by people over 65, 40 per cent under 65.
‘Now it’s flipped to 30/70, so it’s about 30 per cent occupied by people aged 65 and over 70 per cent by younger people whose prospects are much greater.’
Meanwhile the NHS has been given orders to ‘gear up’ for new Covid-19 treatments, which the NHS expects to come online in the next few months which will also help to prevent severe illness and death.
These new treatments are expected to be given to people in the community, without the need for hospital treatment, within three days of infection.
Sir Simon said: ‘We expect that we will begin to see further therapies that will actually treat coronavirus and prevent severe illness and death.
‘Today I’m asking the health service to gear up for what are likely to be a new category of such treatments, so-called neutralising monoclonal antibodies, which are potentially going to become available to us within the next several months.
‘But in order to be able to administer them, we’re going to need community services that are able to deliver through regional networks this type of infusion in patients before they are hospitalised, typically within a three-day window from the date of infection.
‘So the logistics and the organisation and applying the full excellence of the sort of networked NHS services locally through integrated care systems, we’re going to need to harness all of that, to be able to benefit from the new monoclonal antibodies.
‘We are setting out a set of asks as to how to bring that about in each integrated care system so that as and when the treatments become available to us, they can immediately begin to be deployed.’
Mr Johnson delayed the final stage of unlocking by a month after dire predictions by No10’s top scientific advisers warned the Indian strain could kill up to 500 people in a day had Freedom Day went ahead as planned.
Unveiling the bad news, the PM defied fury from Tory MPs and the hospitality industry to insist he could not press ahead until more people are double-jabbed.
He said he was ‘pretty confident’ that restrictions will be able to be lifted by then, adding that the disease cannot be ‘eliminated’ and the country will have to learn to ‘live with it’ in the future.
Chief medic Chris Whitty, flanking the PM as usual alongside Sir Patrick Vallance, told a Downing Street briefing hospitalisations had risen 61 per cent in the North West in just a week, a trend that was predicted to follow suit nationally if June 21 went ahead. ‘The assessment of risk has fundamentally shifted,’ he said.
Downing Street’s vaccine minister Nadhim Zahawi last week admitted stocks of Pfizer — the main jab being administered to young people — would be ‘tight’ this month
Boris Johnson’s delay to the original June 21 ‘Freedom Day’ by four weeks came amid fears a third wave of Covid could overwhelm the NHS
JUST 1 PER CENT OF BEDS TAKEN BY CORONA CASES
Thanks to vaccines, just one in 100 hospital beds is now taken by Covid-19 patients.
NHS England chief Sir Simon Stevens yesterday said jabs had ‘flipped the age distribution’.
He said: ‘Back in January, it was 60/40 – 60 per cent of beds occupied by people over 65, 40 per cent under 65.
‘Now it has flipped to 30/70, so it’s about 30 per cent occupied by people aged 65, and over 70 per cent by younger people whose [survival] prospects are much greater.’
There are 1,030 corona patients in hospital in England – down from a peak of 34,336 on January 18.
In further good news, Sir Simon said the NHS was ‘gearing up’ for the arrival of new Covid treatments, expected within ‘several months’.
It is hoped the drugs – neutralising monoclonal antibodies – will cut hospital cases and deaths and reduce pressure on staff working to clear record waiting lists of five million patients.
The move means that current rules will essentially remain in place until July 19 — with social distancing in force in bars and restaurants, and the edict to work from home where possible staying.
The Joint Committee on Vaccination and Immunisation currently has no plans to revise its guidance on the Oxford/AstraZeneca jab.
But sources said members may reconsider advice if the balance of benefits and risks changes, potentially as a result of a rapid surge in infections.
A total of 79.4 per cent of adults have now received at least one dose of Covid vaccine and 57.4 per cent – more than 30million people – have been given both doses.
Yesterday NHS England chief executive Sir Simon Stevens said all over-18s in England would be able to book a jab by the end of the week.
However, he admitted: ‘Vaccine supply continues to be constrained so we’re pacing ourselves.’
It is thought many people may have to wait a fortnight to receive their vaccine.
Mr Johnson has set a target of offering all adults a first vaccine dose and two-thirds a second dose by July 19.
Professor Karol Sikora, a former World Health Organisation director, said: ‘The Government needs to work hard to get the speed of the vaccination programme back to its peak level.
‘It should be putting pressure on Pfizer and Moderna to increase supplies so we can quickly vaccinate ourselves out of lockdown.’
Dr Simon Clarke, of Reading University, said: ‘It is more likely lockdown will end on July 19 if the UK can increase the number of people it is vaccinating each day.
‘The Government needs to do all it can to maximise uptake as quickly as possible. There are plenty of people who want them.’
Meanwhile, London Mayor Sadiq Khan has lobbied vaccines minister Nadhim Zahawi for an extra 367,000 doses of Pfizer and Moderna jabs.
Are these the numbers that scared Boris?
CASES ARE RISING ACROSS UK BUT BIGGEST SPIKES IN UNDER-30s
Coronavirus cases have undeniably been rising in the UK, and quickly, in recent weeks after the ending of most lockdown rules on May 17 coincided with the takeover of the Indian variant.
The average number of positive tests announced each day is now above 7,000 for the first time since the tail end of the second wave in March, after 7,490 cases were confirmed yesterday after 8,125 on Friday.
There were 50,017 cases confirmed between Monday and Sunday last week, a 50 per cent spike from 33,496 the week before.
But a ray of hope among the rising infections is the fact that cases are up to 17 times higher among young adults than they are in the at-risk elderly, suggesting vaccines are protecting older people.
Public Health England data showed that in the week ending June 6 the highest infection rate was 121 cases per 100,000 people among those aged 20 to 29. Rates were also high in teenagers (99 per 100,000) and adults in their 30s (73).
But they were significantly lower in the middle-aged and elderly, with the lowest rate in over-70s, at 7 per 100,000, followed by 14 per 100,000 among people in their 60s and 32 per 100,000 in people in their 50s.
And while the rate had doubled in just a week in people in their 20s, it rose by only 17 per cent in the over-80s, showing most of the surging epidemic at the time was in young people.
HOSPITAL ADMISSIONS ARE CREEPING UP WITH VARIANT HOTSPOTS LEADING THE WAY
Hospital admissions are creeping up across the UK and more notably in Delta variant hotspots.
The increase has been significantly slower than cases – there was a 15 per cent increase in the most recent week, from 875 new admissions by June 1 to 1,008 in the week to June 8 – but this is likely an effect of the lag between someone getting infected and then getting sick enough to need hospital treatment.
The real test of how well vaccines will taking pressure off hospitals will come in the next week or two, when there has been enough time – two to three weeks – since the spike in cases to see what happens.
Professor Neil Ferguson, Imperial College London epidemiologist and member of SAGE, said scientists were hoping the ratio of cases to hospital admissions could be cut by 85 per cent from the pre-jab rate of around nine per cent.
In the most recent data, for June 8, there were 187 people admitted to hospital with Covid in the UK, the highest since April 14. By Thursday, June 10, there were a total of 1,089 patients in hospital.
The trend of total number of people in hospital has remained relatively flat, fluctuating between 800 and 1,100 for the past month but creeping upwards in the most recent week. Experts say the current surge in cases will see it tick up in the coming days and weeks.
Places where infection rates with the Delta variant are comparatively high – Bedfordshire, London, Birmingham, Manchester and East Lancashire – had the highest admission rates in the most recent data but even those, the worst-hit hospitals, still had only five patients admitted on June 6.
They also have the most people in hospital in total, with 44 Covid patients on wards in Manchester University NHS Trust on June 8. This was the highest in the country and up almost 60 per cent in a week from 28 on June 1.
Inpatient numbers were rising in all but three of the areas with the most patients – falling only in Bolton and Croydon, and flat at King’s College London, while rising in Imperial College London, East Lancashire, Bedfordshire, Salford Royal in Manchester, Southampton and Birmingham.
INTENSIVE CARE CLOSE TO 2021 LOW BUT RISING SLOWLY WITH NORTH WEST WORST HIT
The number of patients with Covid in intensive care remains low in the UK, with only 158 people critically ill in hospital by June 10.
This figure rose slightly compared to previous weeks but the trend has been broadly flat – the lowest point of 2021 was 119 on May 29, just two weeks ago, after it fell from over 4,000 in late January.
More detailed information for England, up to June 8, showed that 47 out of a total 140 intensive care patients were all in the North West.
Just two Indian variant hotspots East Lancashire and Bolton hospitals accounted for 21 of these patients – 15 per cent of the country’s total, or one in seven.
The delay between cases and the need for intensive care is even longer than it is between people getting infected and getting admitted to a general hospital ward, so these numbers could begin increasing in the coming weeks.
But the vaccines are also expected to have an effect on the number of people who become gravely ill. While the jab should stop most people from ending up in hospital at all, even those who do end up in hospital do not seem to be as sick as they used to be.
Chief of the NHS Providers union, Chris Hopson, said last week: ‘What chief executives are consistently telling us is that it is a much younger population that is coming in, they are less clinically vulnerable, they are less in need of critical care and therefore they’re seeing what they believe is a significantly lower mortality rate which is, you know, borne out by the figures.
‘So it’s not just the numbers of people who are coming in, it’s actually the level of harm and clinical risk.’
DEATHS STILL FLAT – BUT QUARTER OF NEW VARIANT VICTIMS WERE FULLY VACCINATED
The number of people dying each day of coronavirus remains relatively flat – the daily average reported deaths is nine and the figure has been between eight and 10 for the past three weeks.
It briefly fell to a daily average of six for four days in mid-May but has not been lower than that at any time in the pandemic, not even last summer when the virus had been all but stamped out.
Deaths usually take between two weeks and a month to react after a spike in cases because it can take people so long to die of Covid after they test positive.
Although the success of the vaccines now means that there were will have to be significantly more cases per death compared to earlier waves of the virus, scientists still expect the number of fatalities to rise and fall along with infections – they just hope there will be fewer.
Professor Neil Ferguson said last week: ‘It’s well within the possibility that we could see another, third, wave at least comparable in terms of hospitalisations as the second wave. At least deaths, I think, certainly would be lower.’
A lingering worry, however, is the fact that vaccines won’t perfectly protect people and that ‘vaccine failure’ is inevitable in some people – most likely the old and frail.
Public Health England figures show that almost a third of the 42 Britons who have so far died from the Indian (Delta) Covid had been given two vaccine doses.
The PHE report showed that of those 42 people who died, 12 were fully vaccinated. From the remaining members of the group, 23 were unvaccinated, while seven had received their first dose more than 21 days before, suggesting they had one-dose protection.
The latest data puts the vaccine effectiveness against symptomatic disease against the Delta variant at 33 per cent after one dose. After two doses, this rises to 81 per cent. This is is lower than the Alpha variant, where the figures are 51 per cent after the first dose, and 88.4 per cent after the second.
DELTA VARIANT NOW DOMINANT IN 263 OUT OF 315 AREAS OF ENGLAND
The Indian ‘Delta’ variant is now dominant in 263 out of 315 areas of England, up from 201 last week.
Surveillance data gathered by the Wellcome Sanger Institute revealed that the variant accounted for more than half of infections in 85 per cent of areas across the country in the two weeks leading up to June 5.
The strain — known by scientists as B.1.617.2 — is more contagious than the Kent ‘Alpha’ variant and is now dominant in every borough of Greater Manchester, Liverpool, Birmingham and London.
The variant is likely to be even more dominant, due to the delay in determining which variant a positive test was caused by – Public Health England said last week it was accounting for 96 per cent of positive tests.
Across the country, the variant is responsible for 88.4 per cent of all cases, according to the Sanger report. The once-dominant Kent strain now only accounts for 11.3 per cent of cases.
Havant, in Hampshire, and the Isle of Wight are the only areas that have not recorded any cases of the Delta variant, according to the statistics. All of the cases examined in those two regions were identified as the Kent mutation.
In nearly 40 parts of England — including Cambridge, Newcastle and York — the strain is thought to be responsible for all Covid infections.
The strain is not yet dominant in 28 areas of the country, such as Doncaster, Sheffield and Southampton.
But 24 regions did not provided data for the weeks leading up to June 5, so it is unclear how those places — which include Darlington and Eastbourne — have been hit by the variant.