Immunisation conference learns valuable lessons from the UK’s COVID-19 experience

Public Health Association of Australia

The COVID-19 pandemic has turned the world on its head. No two countries have managed this public health crisis in exactly the same way, and that’s providing valuable insights for epidemiologists trying to assess what’s worked, what’s not, and how the world can most quickly emerge from this once-in-a-century health emergency.

Just a few short weeks ago, Australia’s Prime Minister, Scott Morrison, travelled to the UK to  attend the G7 summit, where he bumped elbows with his British counterpart, Boris Johnson, and shared lessons learnt on how to control the deadly coronavirus.

At this week’s PHAA National Immunisation Conference, delegates heard first-hand from one of England’s foremost experts in national vaccination policy, Dr Mary Ramsay, from Public Health England.

It’s fair to say England has lived a COVID-19 rollercoaster over the past 18 months. Lengthy lockdowns, pub and school closures, no crowds at football matches, a terrible loss of life and hospitals struggling to cope with several waves of the virus.

The UK story so far

As of today, the United Kingdom has recorded 4.8 million COVID cases and more than 128,000 deaths. The UK is now in the midst of its fourth wave with in excess of 20,000 cases a day; but deaths are down dramatically on numbers in January this year which peaked at over 1800 a day. The number of daily deaths recorded this week have been less than 30 a day and sometimes they’re in the single digits.

Amidst so much doom, gloom, grief and suffering, the UK’s national vaccination strategy has been a shining light. Like so many other countries, the oldest and most vulnerable in the population were at the front of the vaccination queue when it started to roll out in early December last year to reduce morbidity and mortality.

Dr Ramsay said prioritising first doses to those at highest risk saved many lives.

‘By now we have vaccinated over 90% of over 70s, over 85% of over 60s, and over 75% of over 50s,’ she said.

The crucial role of data

Data collection has been a priority for the UK with vaccinations proving effective. Dr Ramsay said people who’ve received a first dose are getting around 75-80% protection. After a second dose that increases to 95% effective. This has seen a dramatic fall in the number of hospitalisations across the UK.

‘This access to real data linked to immunisation has enabled us to demonstrate very quickly that we have high levels of protection both from a single and double dose of the vaccine,’ Dr Ramsay said.

‘We estimate that by the 19th of June in the UK we’ve actually prevented about seven million infections and possibly up to 28,000 deaths through our vaccination program.

‘This all sounds very positive. We thought everything was going great and our data was excellent. But actually, towards the middle of April when we started to lift our restrictions again we began to see another increase in numbers which wasn’t unexpected.’

Arrival of the Delta variant

Dr Ramsay said in a matter of about six weeks of the arrival of the Delta variant of the virus ‘we saw a complete shift in our numbers’.

‘The arrival of Delta in the UK was obviously concerning because the variant appears to be more transmissible and we have a higher rate of hospitalisation.’

The good news is that vaccination is helping to protect against Delta and the level of protection even appears to be higher for Delta than for Alpha, again resulting in fewer people being hospitalised.

‘So basically, we are shifting the disease towards milder infection. At the same time as we’re seeing this massive increase in cases, we’re not seeing a big increase in hospitalisation. In addition, we believe most of these hospitalisations are much more short-lived. Largely because lots of those hospitalisations are in younger individuals who haven’t been fully vaccinated,’ Dr Ramsay said.

She believes the biggest lesson and legacy in the UK has been the rapid and effective implementation of a national vaccination program at scale, largely made possible by an ‘unlimited vaccine supply’.

Comparing the UK to Australia

Comparing the UK to Australia, Dr Ramsay said ‘you have the advantage of time because you haven’t yet exposed your population to the same extent that we have.’

She said British residents were increasingly learning to live with COVID-19 where people ‘worry less about the fact that people are getting infected…there’s been a lot of infection, and most of that hasn’t had consequences, so people are beginning to see that.’

Dr Ramsay thought Australia, having not experienced the same levels of morbidity as the UK, will face difficulties in getting people motivated to get vaccinated.

‘I do believe our population is relatively vaccine accepting…partly because our people were scared.

‘So, it’s very hard, and this is a classic public health conundrum isn’t it. You know you want people to be scared, but you also don’t want to get to that situation.’

For the record, while the UK has recorded 4.8 million COVID cases and more than 128,000 deaths to date, Australia, in comparison, has recorded 30,642 cases and 910 deaths.

Globally the number of cases now stands at 183 million with just under four million deaths.


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