For East Sussex: Vax and vax again

Figures announced last week by the county’s Director of Public Health Darrell Gale confirmed that East Sussex is recording its highest levels of Covid-19 infection since the peak of the pandemic last December/January. The weekly rolling average of positive tests across the county rose in the last week of November by nearly 29% (from 2,839 to 3,656) putting it fourth highest per head of population in a league table of 149 upper tier authorities nationwide. Figures for the borough of Hastings were up by 23% (from 548 to 673). That’s the reverse of previous waves of the disease when East Sussex, and Hastings in particular, generally recorded rates at the lower end of the scale. 

The age range statistics of those testing positive tell a fuller story, however. A high proportion of those recently infected are of school age or below, most suffering mild or even unnoticeable symptoms.  The number of cases among over 60s is comparatively low, those of over 70s even less. Covid hospitalisations in the East Sussex area (effectively in the Conquest and Eastbourne District General Hospital) which rose sharply in the first half of November have decreased – back from over 60 to 40 as at 30 November.

As to the Omicron variant, which has pushed central government into implementing most of its Plan B restrictions
on travel and face-coverings nationally, Mr Gale told members of the county council’s Health Overview and Scrutiny Committee last Thursday – “We suspect we will have cases [of Omicron] within the county but have no confirmation… My overall message about the new variant is one of caution rather than deep concern.”

Vaccination roll-out

Mr Gale was introducing a Winter Plan for East Sussex which puts the emphasis on the continued roll-out of the double-dose Covid vaccination programme to everyone over the age of 12, plus the offer of boosters “in a phased way” with the aim of reaching all adults by the end of January – a programme that would require 635,000 shots altogether over the two month period. Current delivery in the county is between 80,000 and 90,000 a week. The plan is to “scale up” to around 120,000 per week in order to meet the target. “That’s a challenge, but we’re working on the plans”, he said.

Take-up of the vaccine in the 12 to 17 age-bracket receiving first and second doses “is good”, according to Mr Gale in a message posted the same day on the council website, though he admits that it is is lower than in some other parts of the South-East region. But he made no claim for the teenage vaccination programme benefiting health
or relieving the pressure on the NHS, putting the case rather on educational grounds – “we know that the vaccine reduces transmission of the virus in schools and colleges, which in turn minimises the disruption to individual students and to schools if positive cases are found in classes”.

Mr Gale is following advice from NHS England which has described plans to increase Covid vaccination capacity as a “national mission”. GPs throughout England have been offered increased rates of remuneration for administering jabs. They have also been advised to defer some of the standard services they provide to patients in order to allow them to focus on delivery of boosters. Minor surgery and routine health checks for over 75s and new patients are anticipated to be cut back until at least the end of March.

For and against

Dr Farah Jameel, chair of the British Medical Association’s GP committee, told the Today programme on BBC Radio Four that these measures would release GPs from “filling out paperwork” and pursuing targets she described as “unnecessary and often “undeliverable”, allowing staff to prioritise the most vulnerable patients and support the “national priority” to vaccinate people as quickly as possible.

However, Dennis Reed, director of Silver Voices, a campaign group for older people, said NHS England’s proposals were a “blatant case of age discrimination” that suggested “once you reach the age of 75 your health is of less importance than the rest of the population”. He said that deferring checks for the early warning signs of illnesses such as strokes, cancers and diabetes was “counter-productive” as it would see patients “pushed out of primary care” and being treated in hospitals, which would not ease the burden on the NHS.

Some doctors – local as well as national – are also unimpressed. One Hastings GP, who wishes to remain unidentified, is scathing. “The number of patients with worsening chronic illnesses such as diabetes, heart disease, obesity, and depression I see is overwhelming”, he says. “On the one hand, the NHS imposes experimental drugs misleadingly called ‘vaccines’ on a credulous population without informing it about the real risks associated with them and lying about their efficacy, which obviously is more than dubious. On the other hand it neglects real and serious health problems such as the ones mentioned above, plus cancers and ‘routine’ operations like hip and other joint replacements. Most of these affect older patients, for whom years of delay mean a sentence of ongoing misery and suffering. For an illness with less than 1% mortality, illnesses that cause severe long-term disability and death have been neglected, and I see the consequences of that every day.” 

Overall Covid vaccination rates in Hastings remain well below the national average. Most recently released figures, calculated to 3 December, put the proportion of the population (over 12s) of the borough that have had at least one dose as 79.4%, those with two as 72.6%.  National equivalents are 88.8% and 80.8%.

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