Commentary

Doc Hines - Covid News & Views - 6th September

Well over 1 million tests have been done daily according to the figures published for the last three days. Today mass testing in schools began in England as the bulk of school children returned. This means we can expect a rise this week in the number of tests being done. The rise of just 2.4% in the last week will easily be surpassed in the coming week.

The numbers testing positive were below 40,000 per day for the weekend, but today, Monday, they have risen to 41,192. The positivity rate continues to climb and stands now at 356.1 per 100k of the population. There has been a rise of 3.6% over the last week.

There was no hospital data released on Saturday or Sunday. Today there are 988 admitted on the one day of the 31st August. 7,606 were in hospital on 3rd September and 1,034 are being treated with a ventilator on that same day. The continuing picture of a small daily rise is seen with all figures.

We are quite frustratingly slow in getting the figure for completed second vaccine for all over 16 and it is still just below 80%. It is reported at 79.9% Let’s hope we make that figure tomorrow. 1st jabs have 88.8% of the population done. That is 48.25 million injections. Several of you have asked me to try and explain the dilemma we have about whether, or not, to immunise children. I think very soon we may get a proposal from the Government. I will try and break the issue down into several parts; 1 . Purely to prevent severe disease and deaths in children from Covid 19 2. To protect adults, particularly like vulnerable parents and grandparents 3. To minimise employment disruption to those responsible for children 4 To minimise the interruption to education of both the children and their peers. 5. Is consent required to immunise a child under 16 assuming, it is voluntary and not compulsory? Can a child consent despite the wishes of one or more of its parents and the reverse, can a child refuse against the wishes of parents or guardians.

To consider 1. First. The risk of a severe adverse reaction to the vaccine such as a fatal myocarditis is about 1 in 2 million. This is much the same as a severe reaction to the disease. If you include the problems with long covid as well, then to vaccinate is just the better option. However, it is not entirely risk free. The JVCI have recognised this by making a compromise recommendation to immunise vulnerable children with Chronic ill health, but not those completely fit. The position they take is to say that they are considering the benefits only in health terms and not in the wider community benefits. This is why others such as paediatricians and public health are being consulted.

Moving to issue 2, one of the reasons put forward in favour of immunisation is to reduce the risk that a child can carry the virus whilst being well and then introduce it to vulnerable grand-parents and neighbours, particularly the 20% who are not immunised. This raises the difficult ethical dilemma to take a risk all be it tiny to to protect the child so much as to protect other adults around them.

Moving to issue 3. Employees need to be able to plan to go back to work. If Covid infects children in significant numbers, then the parents may need to be off work to care for them. As in issue 2 this is not for the benefit of the child but for the benefit of parents and the wider economy, as such is it ethical to immunise children to keep the adult workforce at word? Speaking, not as a teacher, but having them in the family I do appreciate the problems Covid has caused in education with continuing significant problems for all concerned from kindergarten to A level students. Immunising those over 12 will significantly reduce the numbers turning up positive in class. When that does happen, we will still need to track and trace children who have been in close contract, and do PCR or LFTs on them. Finally the hardest one. The issue of consent. I would hope most of you would be talking to children and helping them to understand the whole issue. In most cases there will not be a single reason to immunise. I am normally very in favour of proper informed consent. I suspect many of our teenagers are better informed than some adults. On balance I think I support the idea that for this one episode only, children over the of 12 should be made aware of the reasons for and against vaccine and then allowed to make up their minds themselves. Parents would not be able to override a child’s wish and neither should either parent or legal guardian be able to prevent access to vaccine. This would also reduce the detailed arrangements and whole classes could be immunised together at or after school.

The whole situation must be kept under constant review. Evolving research may well lead us to reconsider the risks and benefits in the future. There were unacceptable delays at Heathrow terminal 5 due to severe overcrowding due to shortages of Border Force staff. Of the 7,000 or more people currently in hospital with Covid 75% have not been fully immunised.

Kenya has just tested 8,129 people and found 840 positive, that is 10.3%, or 1 in 10, of the population! Compare this with our figure in the UK of 1 in 344. Poland donated 400,000 doses of OAZ vaccine to Taiwan. The population of Taiwan is 23.5 million, so only 5% so far jabbed thanks to 6 million doses from Japan and the US. Public Health Wales have reported 70 cases linked to the Green Man Festival held a week or so ago in Wales.

I dropped into my GP surgery to book my flu vaccine today. I knew there were reported shortages. I was told there was no shortages but cannot do it for 3 weeks and it has to be on a Saturday morning! I tried to book a Covid booster for the same time in the other arm. I realise they are not authorised yet, but it is widely leaked they will be approved this week for my age group. The receptionist said she knew nothing of this and refused even to put it in provisionally. It does GPs good sometimes to see the other side of the reception desk. I certainly am not impressed by today’s experience.


Please join in the discussion about children, Covid, and consent. I am sure there are other aspects to this fairly balanced dilemma. We cannot afford to sit on the fence for too long. Views on other aspects of the pandemic are also very welcome. Get your Flu jab and a Covid booster when called. Keep up with the basics, ignore the masses and do what you are comfortable with. That way you can stay safe.

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