By the beginning of March, everyone over 65 in Scotland and anyone considered “clinically extremely vulnerable” should have received (if they want it) their first dose of Covid vaccine.
That was the timetable set out this week by Health Secretary Jeane Freeman, on the basis of current supply projections and assuming no serious logistical hitches.
Given that the over 65s alone have accounted for 62 per cent of all Covid-related hospital admissions in Scotland, many are banking that an easing of restrictions and something approaching normality will have returned by Easter.
U-turn as ban on vaccinations in outbreak-hit care homes dropped
The reality, however, is that normality – if that means an end to social distancing, facemasks and a resumption of free-and-easy international travel – remains far off.
Clinical trials have only shown that the vaccines help to prevent people developing Covid symptoms, and in particular becoming seriously ill and dying.
Nearly two thirds of hospitalisations for Covid in Scotland have occurred among people aged 65 and older
It is not yet clear whether vaccinated people are also protected from becoming asymptomatically infected or from transmitting the virus, which would leave the unvaccinated – and those who cannot be vaccinated due to health conditions, possibly including cancer patients undergoing treatment – at risk.
Severe national lockdowns, which are predicated on the need to “protect the NHS and save lives”, are likely to be rolled back from March onwards once those most at risk from hospitalisation have been vaccinated. But this will not bring an end to the virus.
Firstly, over-65s make up around 17 per cent of Scotland’s population, which leaves well over 80% still exposed (excluding those younger people vaccinated on account of severe health conditions or occupation).
In March, there will still be thousands of unvaccinated people at high risk due to underlying medical problems such as diabetes, heart disease, asthma or obesity.
Scotland is lagging behind some other parts of the UK on vaccine delivery (Source: Travelling Tabby)
Remember how easily this coronavirus has managed to spread – taking off at exponential rates – at times over the past year when household mixing was banned; when people were limited to socialising in groups of six; when bars and restaurants were subject to curfews, bans on serving alcohol, or even closed altogether; when the public has been discouraged from using public transport, required to wear face coverings in shops, and eventually told to stay at home except for essential purposes.
Just over 5% of the adult population in Scotland has had a first dose of Covid vaccine
Even then, cases have continued to spread. So consider how explosively this virus could take off if all public health measures were suddenly abandoned overnight – especially with new, more contagious variants on the loose.
Inevitably, the number of healthy people under 65 becoming sick would climb, and those struck by the debilitating and life-changing misery of ‘Long Covid’ would grow.
GPs call for bigger role in delivery of Covid vaccine in Scotland
For this reason, be prepared for limits on household mixing, hospitality curbs, facemasks, and maybe even working-from-home to continue for many months to come.
Perhaps then, we should just be much faster in rolling out the vaccines? Israel has already vaccinated 72% of people over 60 and expects its entire adult population to be fully immunised, including second doses, by the end of March.
There is more to the Israeli success than drive-thru immunisation hubs and 24/7 delivery, however.
It has is also benefitted from guaranteed shipments of 400,000-700,000 per week in exchange for providing Pfizer (as well as and the World Health Organization) with data about the age, gender and medical history of those vaccinated, along with details of any side effects and the vaccine’s efficacy.
We may not be able to match Israel on speed, but the world as a whole will gain from the lessons learned there – particularly what it can tell us about infection and transmission.
Queues outside a mass vaccination centre in Tel Aviv, Israel
Preliminary data this week from the first 1.7m vaccinations suggests those given a first dose of Pfizer jag were around 50% less likely to test positive for the virus 14 days later.
However, Dr Sharon Alroy-Preis, the Health Ministry’s acting head of public health, stressed that 17% of Israel’s seriously ill patients were people who had had their first inoculation.
“As time goes on, after two weeks, the number of positive cases of coronavirus among those vaccinated decreases,” she added.
Are we prioritising the Covid vaccine fairly?
Of the 375 people hospitalised with Covid after vaccination, 244 were admitted in the first seven days – suggesting infection could pre-date immunisation – but this fell to just seven people after 15 days.
Of course, unlike Israel, the UK is also staggering doses at 12 weeks, which will delay optimum protection for the oldest and most vulnerable.
The over 65s, for example, will not get their second doses until the end of May.
This carries the risk that the ‘semi-vaccinated’ might lower their guard too soon, while some scientists fear the UK strategy could backfire and encourage the emergence of new variants – especially vaccine-resistant strains.
Others rebuff this, arguing that an eight to nine week window is not really significant given the mutation rate of the virus.
It is also likely that vaccines could be successfully tweaked, if necessary.
But normality cannot truly return until herd immunity is achieved. That depends what the vaccine does to transmission: the more it stops it, the sooner herd immunity arrives.
But there is also the issue of vaccine hesitancy.
If a vaccine is 90% effective at preventing disease and uptake is 70%, then 63% of the population is shielded from becoming sick from Covid. If uptake is 95%, then 86% of the population is protected.
As for foreign holidays: that too depends on transmission.
Even once the UK reaches herd immunity, vaccinated Brits – if they can still unwittingly spread the infection – may face entry bans into countries whose own populations are not yet widely immunised.
This might include Australia and New Zealand, where infections are low and their Governments in no great hurry to vaccinate.
So expect an end to lockdown by Easter; but pre-pandemic normality could be years away.