NEWS
Study models impact of COVID vaccine on deaths and ICU admissions
A new modelling study published in Anaesthesia shows that the UK’s coronavirus vaccination programme is already reducing daily deaths. However reductions of hospital and intensive care (ICU) admissions will likely take several weeks longer, with large reductions seen by the end of March and continuing into April. The study is by Professor Tim Cook (consultant in anaesthesia and intensive care medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK, and Honorary Professor, School of Medicine, University of Bristol, UK) and Mr John Roberts, of the COVID-19 Actuaries Response Group. The authors explain that the reason that vaccination will affect deaths, hospital admissions and ICU admissions at different rates is due to the different age ranges for each: the average (median) age of patients dying with COVID-19 is 83 years, whereas the average of those hospitalised is 73 years and those admitted to intensive care is 61 years. Furthermore, around three quarters of COVID-19 deaths recorded in the UK so far have been in people aged 75 years and over. Thus, since vaccination is initially targeting mostly people aged 70 years and over, the first phase of vaccination will have a proportionally greater effect on deaths. The authors add that the model includes
certain assumptions. These include complete take-up of the vaccine and complete success of the vaccine at preventing hospital
admission or death. Current evidence suggests vaccine uptake will be near to 100% in higher risk groups (with most of groups 1-4 already vaccinated) and that the vaccines are particularly effective at preventing disease progression; the model therefore represents a best-case scenario. The model predicts that with most of groups 1-4 vaccinated, daily deaths will reduce by some 88% by the second half of March. At the same time, hospital admissions will have fallen by around two thirds (66%) and ICU admissions by only a little more than one third (36%). The authors also highlighted the benefits that will be seen if high vaccination rates are continued into the next three priority groups: group 5 (all those aged 65 and over), group 6 (adults aged 16 to 65 years in an at-risk group) and group 7 (all those aged 60 years and over). The authors said: “Vaccinating
through groups 5-7 in addition to groups 1-4 will have a substantial impact on all three factors: reducing deaths by 96%, hospital admissions by more than 80% and ICU admissions by almost two thirds.” At the current rate of progress, most people in groups 1-7 will have received their first dose by the end of March, so these reductions will be seen in the second half of April. The study provides some support for the UK Government strategy of delaying the second dose of vaccine, as within approximately three months half of the adult population can be vaccinated with their first dose. The authors added that this strategy “will optimise the impact of vaccination on deaths and healthcare service pressures”. Access the full paper at: https:// associationofanaesthetists-publications.
onlinelibrary.wiley.com/doi/full/10.1111/ anae.15442
Calls to redouble efforts to vaccinate agency and temp nursing staff
With more than 24,000 responses, a recent survey by the Royal College of Nursing (RCN) found that 85% of respondents had received at least one dose of the COVID-19 vaccine, including 7% who had received both doses.
The RCN described the latest figures as “a significant achievement” for the vaccination programme, but pointed out that 15% of respondents hadn’t received the vaccine. The results show that of those who haven’t yet been offered it, 70% work in non-NHS settings.
Overall, regardless of where they worked, more than two in five agency nursing staff and one in four temporary staff, who often cover short-staffed areas, had not received a vaccine – compared to just one in eight hospital workers.
The RCN called on the Government to
“redouble its efforts to reach agency and temporary nursing staff who are being left
behind in the vaccination programme.” RCN chief executive and general
secretary, Dame Donna Kinnair, said: “Temporary and agency staff work in our communities and hospitals, with patients and the public – and they face the same level of risk as their NHS colleagues. Every effort must be made to reach all nursing staff to ensure the protection of patients and vulnerable people. “The Joint Committee on Vaccination and Immunisation (JCVI) guidance is clear that the COVID-19 vaccine should be available to all health and social care staff. This is irrespective of where they are employed, including agency staff and those employed in the independent sectors.
“Employers are ultimately responsible for ensuring all their staff are able to access the vaccine. But the Government must intervene now, as our members have proven this is clearly not the case.”
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WWW.CLINICALSERVICESJOURNAL.COM MARCH 2021
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