I think it's mostly because NHS organisations are already well organised for distribution of vaccines to staff. They're large organisations with thousands of employees.
Care homes are all mostly small, with a handful of employees.
In Denmark where I live, a large proportion of infected people are age 20-29, and I wonder if it would make sense to vaccinate them first when you get to "rest of the population". Even though they have a smaller risk of getting seriously ill, that could be an effective way to lower transmission.
That is:
1. Immunize the age group that is dominating in the hospitalization statistics, then
2. Immunize the age group is accounting for the majority of transmission, then
3. Immunize the rest.
Because A.) Approx 1 20yo in a million will have life threatening complications. Plus B.) there are a lot more of them than their (are people who have non-negligible chance of dying + people around those with non-negligible chance of dying).
The lockdown is justified by certain measurable factors, such as hospitalization rates, the risk of death, and the risk of major complications, and as we vaccinate the population, these factors will decrease. They will decrease quickly at first and then very slowly taper off to zero. (Remember there will be idiots who avoid the vaccine altogether.) It makes sense to ask when Covid crosses the line from a risk that justifies lockdown to a risk that does not.
We don't know yet whether the vaccine stops people from being asymptomic spreaders. We do know that it is effective at stopping people from getting ill.
So we don't know how beneficial your 2 above would be.
So I should only get the vaccine if I fear for being sick, similarly to the flu, right? I do not want the vaccine. I have been exposed to many COVID-19 positive people and I am fine, thus, I do not want a rushed vaccine.
I don't know why you've been downvoted, because this is really important to point out. The vaccine does not, as far as we know, prevent you from spreading COVID; it simply tries to prevent you from having any symptoms. So while it will be effective at keeping people out of hospitals, it may not actually do anything to stop the spread of the virus.
From a sheer infection control standpoint it makes a sense to vaccinate hypermobile social superspreader nodes first. Anyone who comes into contact with lots of people is going to be responsible for more onward infection chains than a reclusive grandma. The butterflies among the young are probably key drivers of spread. Take them out of the susceptibility picture and everyone benefits.
If you want to keep the amount of dead people to a minimum, then it makes sense to first vaccinate those who are most likely to die.
HN-ians like to model stuff, and i get that. To do it properly we need to know how many "young"(active ppl) there are, how many old with lung problems, the rates of propagation in and between those, and probably other stuff. But the goal is to keep the deaths down, and my opinion is that by far the smartest way is to first vaccinate the vulnerable people and those who deal with them directly (nurses, etc.). There's also a lot of points about practicality. For example; If i get infected not much happens (i'd just have to isolate myself, even with heavier symptoms). But if my mother gets those severe symptoms she would need to go to the hospital, if she would live at all.
Even if the math says it's better to vaccinate the young ones first, i'd still argue that it's overall safer to vaccinate the vulnerable ones first.
Smartphone mobility and social graph data that’s already being collected and analyzed. Rather than just using existing tech to target ads and build surveillance capitalism profiles, it could be used in the public interest. On an opt in basis naturally; but as frictionlessly as possible via cookie tracker popups and updates to FAANG terms of service perhaps.
Stranger things have happened in 2020 than that! It’s a win-win. Superspreader nodes either get their vaccine or they become aware of how much they’re already tracked may begin to consider the nuances and implications.
There is a considerable Moral Hazard element to this, but it would make sense to vaccinate the most irresponsible people first, since they're the ones spreading it most.
How do you know whether someone is being 'irresponsible' before they catch the virus? Do you follow them around, taking photographs? Imagine the social stigma, for starters. Do you live in the real world, or a computer game?
It's not realy moral hazard, it's about what is the goal.
If the goal is to slow down the pandemic, then the "irresponsible spreaders" should be vaccinated first.
On the other side, if the goal is to punish "irresponsible spreaders", then they should be vaccinated last. But that also means that pandemics would not be slowed down, and the ones taking that decision will be responsible for further spreading.
There are far, far too many of them compared to the number of vaccination treatments currently available. It wouldn't make a dent. Better to treat the much smaller number of people in high risk groups.
I have a suspicion that once the vaccine rolls out and is working then everybody will throw caution to the wind. It’s going to be interesting to watch this unfold.
Fully expect the same. Basically, if you are less than 65 years old and not working in one of the early access professions, forget all concerns about vaccine safety. Buckle up to face the virus natively in that third wave that will sweep through unmitigated once the high mortality groups are vaccinated.
There may be places you won't be allowed to go and things you won't be allowed to do (like work, maybe) unless you show proof of having been vaccinated.
There's a good chance that situation will create a black market both for vaccines (real and fake) and forged proof of vaccination.
You are painting a scenario that could theoretically become an issue if vaccination somehow got stuck at some point close to or far beyond the 50% mark for some reason. E.g. to deliberately exclude some part of the population, or in some "the vaccine is actually a carrier for something else" movie plot. But if the limits of vaccination are just the confines of ramp-up and particularly if priority is given to the elderly, it's just a phantom fear. Not allowed to go to work unless you are older than 75? Right...
At first glance forgery seems like a very real threat considering how hard it is to tell vaccine from sodium chloride (entire testing procedures are based on this), but the same difficulty is also working against a black market: why pay if the seller can't give event the slightest indication that it's not a fake and the fake has no intrinsic value at all? You'd have to fake the distribution structures and not the product and an elaborate fake structure isn't something that suddenly pops up from some dark market investment, it could only evolve from simpler black market schemes. But those won't happen, at least not in time (except maybe in places with a truly corrupt regular distribution system, where it would start with "redistributed" real vaccine and then slowly shift over to fakes)
There may be places you won't be allowed to go and things you won't be allowed to do (like work, maybe) unless you show proof of having been vaccinated.
The UK government has ruled out having a vacination passport (for good reason in my opinion).
As I recall, the UK government very loudly and repeatedly refused to rule out a second national lockdown, despite calls to do so. Now, Boris Johnson said that he really didn't want to carry out a national lockdown and that it was a last resort, but that's not the same thing at all. Didn't stop the press calling it a u-turn anyway of course.
The Flip-flop / U turn complaint has always irked me. People don’t know the future, people change their minds. I would be disappointed if government were given new information and didn’t change their mind if it was now clear they should do so.
I am not saying that the government can't change their minds, new things pop up, future is hard. I am just saying that relying on "they promised us to not do that" is dumb. They will do anything once circumstances change.
This isn't a fair comparison, or reasoned in good faith.
The UK government changed their mind about a second lockdown given new evidence. The virus got much worse and they responded. What new evidence is there that the UK government is going to start vaccination passports? Has something changed?
That's the wrong question. The right one is "may something change in the future?" And an answer on this: "maybe, we don't know, nobody knows the future".
That being said, extrapolation of the exponential curve a month forward is one of relatively simple ways to predict the future. And yet, it was _completely_ unexpected for the UK government. Think about that.
that has already been ruled out in the UK and by many other nations and it is also not something that the WHO advocates so I dont see that getting leverage ever. Except in authorotarian regiemes where it would not be about the vaccine anyway.
There are people far smarter than I am developing plans for this, but I'm assuming the thinking is "it's better to vaccinate the person who could die from Covid than to vaccinate the person who could potentially give it to them".
I have no doubt there are some pretty interesting models being developed to determine the best course of action.
This only would makes sense if there would be evidence that the vaccines are so-called _sterile_ vaccines. Which means vaccinated people cannot transmit the virus to others. But, absolutely no covid-19 vaccine can be considered as sterile, because there is just no data for it. So, it is, for now, just a self-protection vaccine.
Older Adults' is a shortened term for certain divisions e.g. Older Adults' Mental Health in UK medical circles. it's a bit of a catapostrophe, but I suspect it was copied, pasted, then added to without due attention
Would the vaccine work on those groups? My understanding is that you need baseline immuno-response to develop the resistance with help of vaccine.
Isn't one point of vaccination of population to protect exactly that population who can't receive the vaccination?
I'm going through the transplant pipeline right now, and I've been told to expect that it should still work, but probably at a lower effectiveness than someone not on a post-transplant drug regimen. I'm really hoping the timing works out so I can get it pre-transplant though.
I'm Canadian, so I imagine it's a completely separate system (for example, I don't know what a "trust" is). I go to my local hospital which has a pretty large nephrology department.
At first I missed NHS staff on the list; it's tucked in the second bullet point as part of "health and social care workers". A footnote attached to it says:
> The final decision on the prioritisation for health and social care workers will be dependent on vaccine characteristics and the epidemiology at the start of any programme.
So in the UK we have a really good set of expert bodies that put forward reccomendations on these things, the JCVI being the vaccines body. They are every bit as good as the current government are terrible.
The FDA already recommended (it's not binding) that front-line healthcare workers and seniors in long-term care are the first wave of 20M people (40M doses).
20% points seems to be the drop as the rapid approval process became a victim hyper-partisanship in the US. The push for a rapid approval has been viewed, by the left, as a political ploy by the right instead of a well-planned & scientifically supported approval process. Early polls about taking a vaccine showed much higher support for it before it was politicized. [0]
Support dropped by 20%. Surprisingly, it dropped by about the same amount for both the political right & left, although support on the left started at a higher level. This may indicate that even people on the right were influenced by the perception of a too-rapid approval process.
Having worked in the pharmaceutical industry, if I ever said my FDA approved drug was "safe and effective" I'd have the FDA dropping the hammer on me.
The FDA does not prove a drug is safe. No drug is 100% safe. The FDA determines whether the risks of the treatment are outweighed by the benefit.
I have no doubt that additional safety signals will pop up from Covid vaccines as the treated population expands by 100x. Most likely they will not be severe and the risk will still outweight the benefit.
But to say "we've tested the vaccine on a 15,000 people so we know it's safe to vaccinate 1B+ people" is not something the FDA would agree with.
Nothing is 100% safe. The word "safe" is used by almost everyone to mean a feeling they get. Something is safe to them if it feels safe. Flying is "safe" if you don't fear flying. It is not if one is afraid of getting on an airplane. Is driving a car "safe"? It is if you don't feel scared when driving in a car. Any other use of the word would need to have some statistical evaluation of the situation. Saying the risks of the treatment are outweighed by the benefit is a great rational way of saying drug is safe enough to use, but most people don't use the word safe in that way.
To me a chainsaw is a safe tool to use. Dangerous, but safe. To others it is not. Is a chainsaw a "safe" tool?
It might be a matter of "do as I say, not as I do". If you look up prior FDA violations, you'll see the FDA get pretty ticked about not clearly laying out the safety risks of a medication - as such, using language such as "our drug is safe" would go directly against that.
The FDA is incredibly strict when it comes to advertising. I remember reading about one violation where the ad had a tagline for an ADHD medication "So you can concentrate on the important things" and showed a picture of a child studying. The FDA said "the image implies that your medication will improve the ability of a child to study and you have submitted no data to the FDA to support this claim".
Oh boy, these people completely have missed the approved, and then later withdrawn medications. There have been quite a fuckton of them, or late black box warnings.
A seatbelt might strangle you in one in a million crashes, but colloquially, we can all agree that seatbelts are safe.
No drug is safe, but in this case, not taking a drug is not safe. If it's safe enough to vaccinate 15,000 people, when 300 of them are expected to die without vaccination, it's incredibly unlikely that side effects discovered on 1 billion people will not make the vaccine the safe choice.
Conversely, I am finding the reaction to anti-vaccine sentiment from some politicians to be pretty creepy. Already there is talk of compulsory vaccination or "vaccine passports". Labour (the UK opposition party) were even calling for spreading "misinformation" online to be illegal.
I find this ridiculous considering the massive challenge we have ahead of us just to get the vaccine to the millions of people who desperately want it.
Sure, if we get to the point where everyone who wants the vaccine has had it, and there are still people dying from COVID, then we can discuss illiberal measures to increase vaccine take-up. (I'd still be opposed to them).
Getting worked up about this stuff when not a single person (outside of the trial groups) has been vaccinated yet just demonstrates our politicians' (on all sides) tendency towards authoritarianism.
I'm not sure I agree. The maths says that we need about 70% of the population to take the vaccine in order for it to no longer be a threat. We also have polling that says about 53% will refuse to take the vaccine. So we're already at the point where something else must be done such as adding incentives, a passport system or better advertising etc. OR continued lockdown measures and enforcement of mask wearing. It's not a theoretical problem we're already there.
> The maths says that we need about 70% of the population to take the vaccine in order for it to no longer be a threat
...to no longer be a threat to an unvaccinated person.
This isn't like the childhood vaccines, where we need herd immunity to protect the children who are too young to be vaccinated.
Provided that everyone who wants the vaccine can get it, I don't see the problem with letting everyone else make their own decision.
The current priority list of people is nowhere near 70% of the population anyway. Most people under 50 won't have the opportunity to be vaccinated for months. So this absolutely is a theoretical problem, at least for now.
Given that Covid is such a mild disease for most young people, I predict that by the time the elderly and vulnerable have been vaccinated, this will be a non-issue anyway.
Yeah, the only reason I'm holding to the guidelines is for elderly and immunocompromised. I don't care about catching covid and nor anybody I know not in one of those categories.
This whole thing becomes moot once the vulnerable are vaccinated, no need for creepy immunity passports.
I used to agree but a few of my 20-29 year old friends have had much worse experiences than expected. One had some neurological side effects, which is rare but happens, that affected his eye movement and made it impossible for him to read or work comfortably.
It wasn't healing and it turned out he had an undetected issue processing folic acid I believe, which has an effect on how your body heals from neurological damage. He's recovering now after 3 months but has to take folic acid and other supplements 5 times a day.
Other friends have had persistent diminished lung capacity for months on end; these are folks who had no co-morbidities and in their 20s.
Yea I'm not totally concerned about catching it but if I do, I increase my likelihood of hurting others. That's been the logic of most of my peers (early 30s, late twenties).
However, through my partner I am friends with many classical singers. They are absolutely worried about damaging their instrument.
>This isn't like the childhood vaccines, where we need herd immunity to protect the children who are too young to be vaccinated.
It's not only too young children who might not be legitimately unvaccinated...some people who are immunocompromised or otherwise medically unable to take certain vaccines must also rely on herd immunity for protection.
> ...I don't see the problem with letting everyone else make their own decision.
Pandemics have, since time immemorial, been an exception to the "I can do what I want" rule.
Much like allowing parents to fall into conspiracy theory traps and refuse to allow their children to be vaccinated against measles, resulting in that disease suddenly becoming a threat again, if we're going to get back to normalcy we can't let half the population ignore the vaccine.
But, since we are going to let half the population ignore the vaccine, prepare for a long, drawn-out period of time during which the disease will flare up, lockdowns will be imposed, more people will needlessly die, and conspiracy theories will continue to make a mockery of civilization.
It's still unknown whether vaccines convey sterilizing immunity. Even if they don't, there will be no political will to institute lockdowns if the people who are getting sick could have been vaccinated. If unvaccinated people getting Covid-19 creates undue strain on the healthcare system, the calls will be for mandatory vaccination, not for lockdowns.
Restricting social interaction and business is a crushing approach to solving the problem, with severe consequences to health and economics. It's brute force, like securing a computer using an air gap. The only reason lockdowns have been used in 2020 is because we have no other options available, but a free and readily-available vaccine changes the calculus.
While the healthcare is centralised, the data is not, and often poorly federated between a multitude of organisations. Scotland has unified this much more and is far better placed to monitor for efficacy and side effects.
I'm pretty sure the "column limit" claim was a false online theory that just stuck around because we're in such a post-truth era that even the definition of post-truth is itself post-truth... The reputable news coverage all said it was the number of rows that was the problem.
I suspect the bulk of the population will receive the 'Oxford' vaccine. It's still going through the approval process but the UK has ordered more of it. I believe the Pfizer vaccine is targeted to front line workers and the clinical vulnerable.
Yeah, there was a ton of news on that vaccine last week.
After a bit of push-back the laboratory acknowledged that this 90% efficacy was comparing a much younger vaccinated population than the one that got placebo.
That has put some doubts on the entire procedure (with countries forcing them to publish details), but it doesn't look like a real problem right now. Anyway that one high efficacy result is very likely flawed.
Anyway, what I get is that the important part is this: "Nobody getting the actual vaccine developed severe-Covid or needed hospital treatment."
We don't need the super-high efficacy numbers (>90%) that the other vaccines are reporting for this to stop the virus. Typical flu vaccines are ~ 50%, I think the Oxford vaccine's results show that they've achieved this.
The efficacy does not need to be super-high, provided enough people decide to actually go get vaccinated, and the percentage of skeptical people seems to be quite high.
Plus, any given vaccinated individual would have to rely less on others being vaccinated as well.
But I am grateful that vaccines got developed and tested so quickly anyway.
Yes I think they only need to hit 50% for approval. Conservatively they were getting 62% as I recall and the 'experimental endpoint' dose got them to 90%.
The Oxford vaccine is far cheaper (15x) and easier to store so long term it has a lot of competitive advantages.
There's certainly been issues with how parts of the trial was run. However, it's not insurmountable. It's possible to untangle some of the past data and the trials aren't over yet and these aren't the last trials so we will have better data soon and it could all check out.
This vaccine is appealing in particular because it's a lot cheaper to make and a lot more straightforward to distribute and even with questions over how the trials were run it's still looking like the good results will probably hold up mostly.
My understanding is that that trial condition (half->full) was administered accidentally (thus not pre-registered) and nobody expected it to work better, and the sample size is small and on the wrong age groups.
The half dose was an 'experimental endpoint'. Always planned but not seen as critical. FDA rules now stipulate you can only register on primary endpoints declared before the trial starts. I suspect AZ have argued that the accelerated nature of the process should take this into account.
I don't think that gives an accurate picture of what happened. Even AstraZeneca themselves are calling the half-dosage a mistake. Their US trial of that vaccine does not currently contain a half-dose arm [1], though it likely will be amended to do so. As best I can read it, the dosage amount was planned but it was intended to represent the "full" dosage and not to be a half-dosage, but was updated when they noticed unusually mild physical symptoms in people receiving the vaccine. [2] I haven't seen anything to support the idea that a half-dosage was an intended endpoint, whether secondary or otherwise. Do you have a source for that?
No, the results are not valid, or at least not in a useful way. The group who have received the wrong dose isn't a random sample from the treatment group, so we don't know whether it's more effective or not. It could even be less so.
I don't know what the regulator will do about this situation; it's clear that the vaccine is effective in at least one of the dosing regimes administered, but being entirely certain as to which is better is probably impossible to determine from the data available.
My understanding is that the results are still useful and can be include in the statistical analysis. This is what I heard form the BBC's Newscast podcast
Professor Jennifer Rogers (clinical trial statistician):
> "There was some planned dosing differences anyway but this one happened by accident. Now that doesn't mean these results are completely invalid - doesn't mean that at all. You can make changes to your protocol and you can make changes to what you're gonna analyse all the way up until you actually see your data.... If you haven't seen what the data looks like, you are allowed to make changes to your protocols and it is quite common, it does happen that people make changes as to what they're going to analyse.
> "So this change was carried out with discussion with the regulators so it was all fine..."
Now I tried to find the same information reported online and I found this from the same Professor:
> It is perfectly acceptable to make changes to the protocol prior to database lock, so the protocol could have been updated to include this additional analysis (the point of closing a database is to ensure a trial can remain blind, meaning researchers can’t carry out ad-hoc analysis or potentially selectively report results before proper analysis takes place). However, according to version 14 of the protocol, dated 9 November 2020, the primary analysis was set to be the efficacy of two doses of vaccine (across both half and full dose), with secondary analyses being the efficacy of at least one full dose and efficacy of two full doses of vaccine. Efficacy of half dose with a full dose booster was not considered as a secondary analysis in the protocol and so could be an ad-hoc analysis post database lock.
So I'm not actually sure whether AstraZeneca announced the change to their analysis before or after they started looking at their results. If they announced they were going to include the half-doses before database lock then they can use them as valid results.
Ignoring the 90% that is was based on a population below 55, a 70% efficacy is still a success for the Oxford vaccine, as it can be stored in a regular fridge. This makes distribution outside health settings much easier. I would happily take the Oxford vaccine if it was offered to me.
I'm sure the UK is in the top twenty countries in the world for logistics infrastructure. It's easy to read news stories about your country messing things up, and quietly not read foreign-language media about poorer countries messing things up a lot more by comparison, and get a biased perspective.
We had excellent Public Health test and trace departments who had a wealth of experience of tracing people for sexual health purposes. But we still chose to give the contract to Dido Harding despite her poor record at NHS Improvement.
And I saw what happened to NHS Logistics, which was one bit of the NHS that wasn't losing money. It was running well. It was privatised to DHL in 2006 for purely ideological reasons, and then for several years was terrible. Ten years later, after Lord Carter's report into efficiency and productivity, we set up a new org called NHS Supply Chain and in effect re-nationalised it by giving the responsibility to a company which is owned by the Secretary of State for the Department for Health and Social Care. I don't think anyone has really learned any lessons from that.
From a high level overview and global perspective, what the OP is saying, or meant, is that comparatively speaking UK is much better than possibly 80% of developed countries. Not to say NHS is without flaws, far from it. But if you step outside and look around the world many are surprised how awful public health services and logistics can be.
So to put it another way, It is not that NHS is good, it is just the others are worse. Although this conclusion or opinion also makes me rather sad.
What you're missing is that amongst a certain class of Brit, and across much of the West, relentless and savage cultural self-criticism has become the norm, and a currency used for in-group signalling. Even when people in the UK should be celebrating, as literally the first country in the world to develop an approved C19 vaccine in record breaking time, and enjoy the privilege of a free health system that can roll it out within _weeks_ they still find a way to twist it. Asking them to truly recognise the fact that there indeed exists big differences between the UK and much of the world in this respect will fall on deaf ears - it doesn't serve their purpose - which to be clear, isn't truth-telling or (heaven forbid expressing pride in their national achievements) it's a habit of personal advancement at the expense of others and dissolving their own culture in an acid bath of manifold criticism. It's only where this sort of criticism is expressed in forums with international readers, many in far less fortunate positions, does it begin to reveal itself for the pathology that it is.
Much of what you say is true, but doesn't negate the point of the comment you are assuming the motivation of.
The UK national infrastructure does have a history of dubious at best procurement, outsourcing and "consultancy" decisions in supplying it's services - those public services often then coming under extreme criticism from the same quarters as your attack - who are often the same private sector blowhards who cause many of the problems in the first place.
Far more public sector hating and damage comes from there than from the virtue signallers you (rightly) criticise.
Completely agree. Same thing happens in the US - to hear some Americans speak they have become a dictatorship with a tyrant in charge, and the whole system is broken. Meanwhile they continue to have free and fair elections, first amendment rights, the ability to take their government to court etc. In my country (in west africa) just voting against the dictator in charge can get you banned from getting any employment, send you to jail to be tortured etc. And marching on the streets in peaceful protest has actually had people sent to death row awaiting execution. I guess it’s a matter of perspective :)
Seriously. I encourage anyone who thinks the US or any other Western country is a dictatorship to move to a developing nation and give it a try. I have.
Once you've interacted with a corrupt bureaucracy or wondered whether the medicine you bought is counterfeit or realized the only thing stopping the cops from shaking you down is luck, you get a new found appreciation for stability, reliability and fairness (yes not always) of developed countries.
I'm not from the UK but assuming the grandparent is right, you're saying they should be thankful that their country isn't as corrupt as other countries even though there's blatant corruption in something as important as the COVID response?
That's like beating your children but comforting them that they atleast have food on the table and clothes on their back.
A better analogy would be living in a nice comfortable house, which is much better than nearly all other houses - but then someone spots a problem with the chimney and starts comparing it to other houses’ chimneys, some of which have better chimneys, some of which have better chimneys but a worse overall house, and some of which are fantasy chimneys that could theoretically exist if only we all spent a bit more time thinking about chimneys. And in amongst all this chimney woe, the fundamental qualities of the house and the fundamental privilege of having such a house go forgotten.
Not quite. A substantial number of people in the UK live in poverty - between 20 and 25% [0].
This has been made worse by terrible political decisions, such as Brexit [0]. Specifically, austerity and political decisions (not limited to corruption) is linked to 130,000 preventable deaths [1]. Those same "budget cuts" for austerity exist while money is sent to "consultants" to "help fix things".
Not everyone in the UK has it well. The government, quite frankly, is fairly shit. And corrupt.
Thanks for the great example. The poverty chimney needs to be considered in conjunction with the security doors and the air quality windows and the human rights carpets and the unemployment basement and the healthcare bathroom and so on... before deciding on the house’s value.
A certain amount of self-criticism and cynicism is healthy and stops society from becoming complacent and sliding backwards. The more developed a country is, the higher the need for it is to maintain its status. As the US has shown in recent years, complacency erodes democracy, national status and personal quality of life.
To take the example of the NHS - it is constantly under attack by budget cuts, fragmentation and privatisation. Would it still be something to be proud of in a few decades if everyone stopped holding leaders to account?
I think you are arguing that some people are not genuine. If the price of progress is hearing people you don't care for virtue signalling, that's fine by me. I'd much rather have too much, and risk some of it not being genuine or warranted, than too little.
And I would argue that the people who genuinely want better demonstrate more national pride and a better understanding of their own culture than those sitting back and patting themselves on the back.
> Even when people in the UK should be celebrating, as literally the first country in the world to develop an approved C19 vaccine in record breaking time
The UK has one of the first (Oxford/AstraZenica), but this news about the first approved is not a vaccine developed in the UK. But I'm still happy to celebrate the Turkish couple's German company that's owned by Pfizer, as I will be when Oxford hopefully release more good news on top of their initial press release.
And our culture is far from perfect in the UK. Criticising a country's problems doesn't prevent also celebrating its positives.
Well, a country is a shared endeavour isn't it? We collaborate together by following our national laws, paying our taxes, follow our customs and traditions and engage in cultural renewal and repair when required. In this way, everyone in the country is responsible for fostering a peaceful and prosperous environment that can prove to be fertile infrastructure for advancements and breakthroughs. Why not take some small measure of pride in this? It's a generational effort.
Isn't it essentially the same human instinct that drives the desire to increase representation in media for underrepresented groups of people? We relate to people who are "like us" in some dimension. Sure, it doesn't make sense in a sterile intellectual sort of way, but why does that matter? It's still real.
> Patriotism is the belief that your country is the best by virtue of you having been born in it
I can't find the original quote but I 100% agree with you that it is pretty odd to take pride in something you have an extremely tangential relationship with
I've got to say that you yourself seem to fall victim to the very thing that you're criticizing (namely, polarizing over a national pride thing) as the vaccine is neither developed nor produced in UK. In fact, given the demand, it's not clear supply of the vaccine will allow for NHS' projections.
NHS Logistics didn't run well. As is consistently true of government run organisations it was run so badly that most of the NHS didn't even try to use its services. At the time of the privatisation the NHS sourced around half a million products but only acquired 50,000 of them via NHS Logistics. The entire purpose of privatising it was to try and make it work better and thus to encourage the NHS to buy more centrally to get bulk discounts, something that wasn't going to happen for as long as doing so required them to work with a small, sclerotic socialised bureaucracy.
Why would anyone think that an organisation which had no economies of scale, nor any demonstrated expertise in logistics in a competitive environment, be better at delivering things than DHL, a world famous delivery and logistics company that the NHS frequently chose to use anyway in preference to its own operation? That's ideology.
How much did NHS Logistics workers care about the health of the citizens who paid their salaries? Not at all: even though many of them were going to keep their jobs anyway they reacted to privatisation by going on strike and picketing trucks to stop them delivering supplies to hospitals. That's ideology. Fortunately it didn't kill anyone, but only because hospitals were already mostly bypassing the striking workers already due to aforementioned poor performance.
The NHS had its limits thrown into sharp focus this year. Mass testing is a bad idea, but putting that to one side for a moment, Germany and indeed most other places were able to ramp up test volumes far faster than the UK did, because Germany used private labs from the start when the NHS insisted on only using NHS labs, despite being given direct commands to scale up testing as fast as possible. That's ideology.
Finally, the supply chain hasn't been effectively renationalised. The contract changed from DHL to Unipart:
Supply Chain Coordination Ltd is what the name suggests: a relatively small coordinating body that manages contracts for various services, including contracts for logistics provisioning.
The brutal reality about the NHS is that not a single country in the world has copied this model. If it was good we'd see other countries adopt it but they don't. They don't adopt it because it's not good: this model is a relic of a time when the British public had just won a world war and as such had been exposed to years of war propaganda that made the government look artificially competent. In countries where that didn't happen the idea you'd want a single, centralised government agency to run every aspect of something as vital as healthcare was seen as insane: after all, if you go down that route why not have the government supply all food too? All entertainment? Why not run a fully USSR-style economy? Well because we know it doesn't work, that's why. There's nothing magical about the NHS that renders all those experiences irrelevant.
Your last paragraph caught my interest. Can you point me at countries that are widely accepted to have done a better job?
My own experience of the NHS (as a non-Brit who lived in the UK for more than a decade) is that it is inefficient at the small things (sitting in a waiting room for an hour - but being shamed if I show up 10 minutes late for my appointment) but brutally effective at big important things (treatment for life threatening diseases - worked well, but the biscuits were rubbish). I know this isn't data, but I also know that British people love to carp about the NHS, and having lived with health services in two other industrialised countries, I quite liked it.
The problem with British people's opinions of the NHS is that they routinely conflate the NHS with healthcare. (BTW, I am British myself). You're doing the same thing here.
The NHS is not healthcare. The NHS is not doctors or nurses or life saving operations. The NHS is not hospitals. All first world countries have these things, but none have an NHS except Britain.
The NHS is a bureaucracy that manages resource allocation. That's it. That's all it boils down to.
When you saw life saving operations working as hoped, that isn't happening because of the NHS. You'd see the same in France, Germany, Sweden, the USA, Japan or many other places. We don't judge the skill of a bureaucracy or institution based on the skill of individual employees, we judge it based on factors like:
1. How much overhead does it impose?
2. How competent is it at organising its operations?
3. How agile is it, how able is it to react to new circumstances and continually improve itself?
4. How many people can access its services, who might want to use them?
5. If it fails at any of those criteria, how easy is it to switch to a competitor?
The NHS varies from average to poor when evaluated by these criteria, with the exception of (4) where it gets the best possible score because it even happily treats people who flew in to the UK specifically for free treatment! But if we exclude that edge case then it becomes pretty average again, because universal access is solved in other societies using insurance schemes of various kinds (sometimes mandatory and subsidised). The exception is the USA where for cultural reasons a lot of people don't like being forced to buy health insurance.
Although its overhead is reasonable when evaluated in pure GDP terms, this is achieved partly through building up large maintenance backlogs which is hardly sustainable: true cost of the NHS to the UK should probably be higher than is actually reported. The government has tried several times to force the NHS to spend money on maintenance and upgrades but usually fails: the NHS takes whatever money was granted to it for this purpose and immediately spends it on daily operations in violation of their agreements. Nothing happens because to Brits the NHS is a holy religion, so NHS management don't really feel accountable.
The biggest problem with government run industries is not that they can't carry out their mission at all. Soviet factories successfully made steel and rockets, after all. Their problem is lack of agility and lack of quality. Agility: see the NHS testing ramp-up problems discussed in sibling threads. Quality: see how slowly the NHS ramped treatment back up after the April shutdown. Other countries did much better in that regard, because private hospitals desperately want to treat people in ways that the NHS just doesn't. How could it be otherwise: if private hospitals don't treat people then they run out of money and go bust, like any other business. If the NHS doesn't treat people, its staff basically get a paid holiday with no negative consequences. Of course that affects people's behaviour.
I said average to poor, that's true except for (5) where the impact is catastrophic. Its tax funded status means the private health sector is seriously throttled in the UK. So only the rich can work around NHS failures, and even then not always (private hospitals don't do the full range of treatments in the UK).
The principle of "free at the point of use" is the critical factor in the NHS; while other countries manage to achieve that with different organisational structures. (4) is critical. Any whiff of ineligibility by payment is completely unacceptable, and rightly so, or we'd end up with the US disaster. From a political point of view, we have to defend the existing system because otherwise the US one will be forced on us. Nobody in UK politics will give us the Swiss system.
> tax funded status means the private health sector is seriously throttled in the UK
This doesn't make sense? Bupa exists?
Private health insurance is quite cheap in the UK compared to America because anything complicated or expensive can and will be dumped back on the public sector.
> this is achieved partly through building up large maintenance backlogs which is hardly sustainable: true cost of the NHS to the UK should probably be higher than is actually reported. The government has tried several times to force the NHS to spend money on maintenance and upgrades but usually fails: the NHS takes whatever money was granted to it for this purpose and immediately spends it on daily operations in violation of their agreements. Nothing happens because to Brits the NHS is a holy religion, so NHS management don't really feel accountable.
Nobody in UK politics will give us the Swiss system
How do you know? Nobody talks about alternatives to the NHS in the UK, even though it's an obvious topic that should be talked about all the time (the UK's a highly visible exception to the consensus of other rich countries and that would normally provoke debate). You don't actually know what the alternatives to the NHS are because any attempt to be honest about the system's problems are immediately met with a horde of leftists yelling things like "Tory propaganda", and insisting that anyone who criticises the NHS inexplicably hates nurses/babies/life saving operations, etc. They successfully shut down political debate every time.
It's entirely plausible that if there was a serious, honest and rational debate in the UK about healthcare then the country would move towards a European system. Why not? The UK aligns with European neighbours far more often than it does with the USA and that will likely continue even after Brexit.
Re: Bupa. Aren't you agreeing with me here, then? The private healthcare sector in the UK is anaemic compared to other countries because it's so hard to compete against "free". They end up trying to offer slightly better quality around the edges. They can offer complicated or expensive operations too, but people are already being forced to pay the government for them regardless of their own personal evaluation of quality or need, so hardly any market exists. Bupa is a minnow compared to its equivalents in the rest of the world, and how many competitors to Bupa can you name? The British healthcare market exists forgotten in the shadows because the NHS drowns it.
[Unpleasant facts] Unsourced Tory propaganda.
This is what I mean. It's not propaganda, it's actual reality that Labour and leftists live in denial of. Literally the first result for [nhs maintenance backlogs] is this:
"In 2018/19, the total cost of tackling the backlog of maintenance issues in NHS trusts rose by 8.4 per cent to £6.5 billion. And of this over half, £3.4 billion, was for issues that present a high or significant risk to patients and staff (see Figure 1). Now, if these numbers don’t quicken the pulse, a little more context is needed. High-risk issues are identified where repairing or replacing NHS facilities or equipment ‘must be addressed with urgent priority in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution’"
Or you can read about it direct from Parliament (see section 2):
Note that this backlog is just to restore physical objects to an "acceptable state" (quoting the Parliament document here). It's not to actually make the NHS better than it used to be, just the cost to stop it being so degraded it's actually dangerous: "One director of an NHS trust told me that broken gutters in his hospital lead to water seeping through the walls when it rains heavily. This happens so frequently that nurses now give ‘water updates’ in their shift handovers, so incoming team members know when they will have to start unplugging electrical equipment".
That was the backlog before an epidemic of bad data and advice from government run bureaucracies destroyed the economy that has to pay for it. The government no longer has any financial strength left to tackle this issue, and risks triggering serious inflation by trying to print its way out.
There are many other places you can read about this. The NHS is decaying away because its managers are terminally incapable of making the difficult decisions management requires. Given a choice between paying down their maintenance backlog or giving nurses a pay rise, they do the latter every single time even when commanded by ministers not to. Sometimes they even fail to spend the money they were given and end up with a "surplus", just through managerial incompetence.
That's not "Tory propaganda". It's reality, and exactly how the Soviet union looked at the end of its days.
> Any whiff of ineligibility by payment is completely unacceptable, and rightly so, or we'd end up with the US disaster
Lots of European systems require e.g. payment for GP appointments and aren't anything like the US system. Likewise, the UK makes people pay for dentistry, spectacles.
> From a political point of view, we have to defend the existing system because otherwise the US one will be forced on us
This sounds like unsourced propaganda...
> Private health insurance is quite cheap in the UK compared to America because anything complicated or expensive can and will be dumped back on the public sector.
Most private healthcare in the UK covers complicated and expensive cancer treatments, including ones not covered by the NHS, so this doesn't hold water. (There are a few cheaper, less common insurance plans that don't cover cancer and are designed to complement the NHS coverage, AFAIK)
You're going to have to provide sources for this lot. When we're talking about corruption we're talking about things like the no-bid contract to Platform-14 for PPE. Or the "Seaborne Freight" incident.
Tiny firms and shell companies are "an organisation which had no economies of scale, nor any demonstrated expertise in logistics in a competitive environment". DHL at least has a track record of large scale delivery.
> NHS insisted on only using NHS labs, despite being given direct commands to scale up testing as fast as possible
"Part of the reason the UK has had difficulty in meeting the 100,000 tests daily goal was because of its focus on centralised testing centres. In contrast to the robust and wide-reaching testing programmes in Germany and South Korea, the UK government initially decided to centralise all of its laboratory testing in a few large hubs"
And yes of course there's corruption and incompetence in government - in procurement as well as everything else. The fact that governments routinely fail to even write proper contracts to buy things should give pause for thought when considering how well they'd handle running the entire operation.
So, not an NHS decision but a political decision by the relevant cabinet minister? That changes the answer. It's important to distinguish between decisions made by "the NHS" (to the extent that this isn't just individual trusts, or NICE, or whatever) and political decisions made by the government which are ideological.
Mandatory health insurance. Look at the Swiss type system or really more or less any modern healthcare system. Pro-NHS Brits love to compare it exclusively to the USA, but most countries do far better than both.
That's not an alternative, health insurance is mandatory anyway by virtue of us being made of flesh – the alternative is going bankrupt due to having no leverage after getting treatment for anything.
No it isn't. Healthcare isn't infinitely expensive, the world is full of people who can pay cash for healthcare (or take an insurance policy with a very high excess which approximates the same thing).
"Full of people" is an idiom, it means there are lots of them. It doesn't mean all of them. There are lots of cheap medical interventions and lots of people who earn more than $33k a year.
It's a fairly stereotypical British trait to be self deprecating. If we were singlehandedly saving the world from a rogue asteroid the general sentiment would probably be "let's hope we don't mess this up".
Government is a continuum, and I don’t remember a time that it wasn’t riven with cronyism. A book came out in 2005 called The Essential Guide to Quangos and I’m willing to bet it wasn’t Blair’s government that invented them (and it certainly didn’t put a stop to them).
No government has ever or will be completely uncorrupt or efficient. Thatcher bent various rules for her shady son. Labour arranged all those dodgy PPI deals. Humans will be human. But in my 54 years on this planet and living in the UK I don't remember a government being anything like this corrupt or inefficient. Everyone politician with a brain, spine or conscience was fired and replaced by Brexit 'loyalists'. And here we are. One of the worst responses to the pandemic in the world and I don't know if I will even be able to get fresh veg in January. So much for British exceptionalism.
I live in Japan and the response by the government here was and is in sharp contrast to that in the UK (a super soft lockdown that ended before the summer is one example), yet it has been akin to comedy show from the beginning, before it hit the UK.
Still, there has not been the same hit from the disease, which only underlines that the differences in effect that are seen worldwide are about differences in population and geography - being overweight, having a very low friction of movement (e.g. excellent transport links, many borders), and not being low in vitamin D etc - far more than they are about government response.
I'm not saying the UK government has done well but it's striking to me that, from a distance, the criticisms of the UK and US I see coming from my friends are very similar, very parochial, and seem driven by media headlines rather than anything objectively sound.
In short, I'd give it another few years before you judge them more harshly than the government that brought us the Iraq war, for one.
The quango is the worst of all worlds, so it's not surprising that the concept was invented by governments.
I haven't seen the word used outside the UK so a definition might be useful: a quango, or quasi non-governmental organisation is the platypus of the British government world. As the name implies it's neither a part of the government nor the private sector. Instead, quangos are paid for by taxpayers but are completely unaccountable to them, as they can't be directly controlled by ministers or the civil service.
The theory behind this is that governments are crap at things because elected politicians interfere with the expert work of technocrats. So by setting up artificial blockades to political interference, power is transferred to technocrats and things should work better.
In practice what happens is that the government ends up hiring people who aren't very good at what they claim to be expert in, and who get corrupted by whatever unaccountable powers have been delegated to them. But they aren't easily fixable because they're "independent".
The Electoral Commission is a good example of a completely broken quango. Its only goal in life is to organise elections and referendums in ways that everyone agrees is completely fair and trustworthy. It is a staggering failure: the board of directors is full of people who publicly state very strong political opinions. It engaged in a legal vendetta against people who campaigned for Brexit. It has constantly prosecuted pro-Leave campaigners and got its ass kicked in court, where judges have repeatedly dismissed cases on the grounds that they have no evidence and/or are engaged in malicious legal behaviour. They've referred cases to the police that were then dropped for lack of evidence. Senior staff have posted on Facebook that they cried when the Tories won the election. Nobody who has followed these sagas can possibly believe these people are neutral, independent or even possess basic competence, but as they're a "quango" there isn't much of a framework to fix it beyond changing the law to totally abolish them.
Opinion, not necessarily fact, but my understanding of the "piss up in a brewery" outlook comes from Parliament, not the government. The structure of Parliament is that the opposition has to challenge everything the government in power says and does in order to keep them in check, even when the opposition has exactly the same views on the policy being discussed; this leads to arguing for the sake of arguing even when common sense would say "this is entirely agreeable to practically everyone".
I'm not saying that the government shouldn't be kept in check, but the fact that the UK government appears to move with all the speed of a striking slug appears to be the fault of the system they are required to follow, not the government itself.
While I appreciate your point I think the current UK government have done more than average to "shake up" the civil service. Others might describe these changes in less charitable terms.
> It's a fairly stereotypical British trait to be self deprecating. If we were singlehandedly saving the world from a rogue asteroid the general sentiment would probably be "let's hope we don't mess this up".
was this always so? i've noticed this while living in London and, coming from a literal 3rd world country, I do not understand it. i'm trying to find when this started... i don't it started anytime in the recent past. seems to have been going on for a while.
It's an interesting question. I'm sure you could probably do a study and find that on average British people are no more self-deprecating than the average; and yet it does appear as one of those commonly accepted parts of the British psyche.
I've noticed a shift in the last decade or so from self deprecating to self loathing. People seem loath to admit that we are one of the richest, most privileged, most developed countries in the world.
I do not believe that it is a stereotypical British trait to be self deprecating.
Being self deprecating is very common in a large number of countries, among all those who are reasonably intelligent or educated, to be able to notice how many bad things exist around them.
As others have already mentioned, this is caused by the fact that people can see directly the many bad things that exist in their neighborhood, but they have very little information about how things are bad elsewhere, and they hope that at least in other distant places the same mistakes are not being made.
they're pushing for more cycling, more climate measures, more taxes on IT giants etc
and these are Conservatives, the opposite of left-leaning.
on the other hand, their Covid response was the same as Spain, Italy, France etc i.e. pretty bad. but they also approved the vaccine really quick, and we're getting that next week.
so overall, a meh, like most other countries where I lived.
as a point of reference, from the countries I lived in, I consider Singapore and Tokyo to be a notch above the rest of the world when it comes to governance.
but most government of the countries i've lived in were the same as the UKs: they only react, they're politicians, they're detached from the real world etc etc
To me the Conservative party feels fairly centrist at the moment, or at least they certainly aren't as right-leaning as our Big Media seems to portray them. Just a personal thought.
It’s a very English trait to think of itself as a self-deprecating, gentle and peace-loving nation while also being inordinately proud of the Empire and its conquests.
Even success story South Korea has been doing a lot worse than you'd think from the BBC coverage. For example, they ran this article about Europe struggling with Covid that made it sound like South Korea's test and trace is working so well, they can even reopen pubs and nightclubs: https://www.bbc.co.uk/news/world-54482905 In reality, pub closures and social distancing measures had only been lifted the day before the article, every time they've lifted them before cases have gone up and they've had to reimpose them, and this time was no exception. You wouldn't know that from the BBC coverage, at all. If the UK was doing the same thing, there'd be endless headlines about U-turns, arbitrary and unpredictable measures that change for no reason, the cost to businesses of both the closures and the uncertainty - but because it's happening in South Korea readers are given the false impression that it isn't happening at all.
A huge part of the perception that the UK is failing at dealing with Covid-19 due to awarding contracts to cronies comes from exactly this comparison with a South Korean success story that is a complete and utter media illusion. (They're also testing at something like a twentieth the rate of the UK - not enough to offer free testing to everyone with potential symptoms like we do, let alone do regular testing of all medical staff or any of the other things our press says our government is incompetent for not achieving - but you wouldn't know that from the UK media coverage either. Judging from their media reporting on the number of people awaiting results, they're probably not even doing any better at returning the results to people fast either.)
Sometimes they even just outright lie. When the UK hit 100,000 Covid tests in a day, the BBC ran a completely false claim that Germany reached that level of testing a month before the UK when in reality they didn't until several months after us. The BBC kept that claim in an article that was prominently featured on their news front page for a month after they were aware it was false meaning a substantial proportion of the entire UK population probably saw it. I still see it popping up everywhere. (They also claimed that meeting the 100,000 a day goal was faked by counting tests when they were sent out rather than when they were completed. In reality, it was met either way, and one of the minsters involved even pointed this out in a BBC interview - but people who followed the BBC coverage wouldn't know about it.)
Sure, but the political party currently in government (and the particular people from that party in government) have shown great inclination to put "Favour for an old friend" above "This makes sense to not kill thousands of people" in their priorities.
The UK has universal healthcare so the infrastructure and public understanding are in place to actually do the vaccination programme per se. I have every confidence that the NHS medics will do their part efficiently as they do every year for the Flu shot I get, but getting frozen vaccine delivered to local NHS clinics is a logistics problem and an opportunity for somebody's wife's best friend's ex-boyfriend to be given a £100M contract even though he has no relevant experience and is obviously the wrong choice.
Six months later, with headlines about vaccine shipments defrosting abandoned in carparks miles from their intended destination and tens of thousands more dead the government will announce it had a brain wave, the Army (always the people drafted in when policy has failed) will now deliver vaccines. Don't worry about the money which has meanwhile mysteriously increased to £250M due to "performance payments" which somehow didn't involve performance but did involve payments - that's water under the bridge, can't be helped ...
Remember when we were going to do a snap Brexit, no transition, just drop dead one day suddenly? Basically the same group of fools paid people with no relevant experience and no ships to provide last minute ferry services. How do you provide ferry services with no ships? You don't, you just pocket the cash.
OP appears to have got lost on the way to /r/unitedkingdom where similar comments are generated by angry bots all day, every day.
Some perspective would be nice.
When you tell your buyers to go grab every last bit of PPE they can and cut them a blank cheque to do it of course you're not going to get the best price, especially when every other country in the world is doing the same things.
Do you focus on the 10s of millions of pieces delivered successfully? Absolutely not, get the tinfoil and red yarn out, we'll dig up something questionable. I've seen some other countries equipping medical staff in bin liners and gaffer tape, on reflection we have it pretty good.
I mean, even their own watchdogs say that there were problems:
>In the months following the emergence of the COVID-19 pandemic in March 2020 in the UK, government awarded around £18 billion of contracts using emergency procurement regulations to buy goods, services and works to support its response to the pandemic. Government was having to work at pace, with no experience of using emergency procurement on such a scale before and was developing its approach at the same time as procuring large quantities of goods and services quickly, frequently from suppliers it had not previously worked with, in a highly competitive international market. This procurement activity secured unprecedented volumes of essential supplies necessary to protect front-line workers. Our separate report on the supply of PPE looks in detail at the extent to which demand for that equipment was met and the value-for-money achieved.
While government had the necessary legal framework in place to award contracts directly, it had to balance the need to procure large volumes of goods and services quickly, with the increased commercial and propriety risks associated with emergency procurement. We looked in detail at a sample of contracts selected on a risk basis. Although we found sufficient documentation for a number of procurements in our sample, we also found specific examples where there is insufficient documentation on key decisions, or how risks such as perceived or actual conflicts of interest have been identified or managed. In addition, a number of contracts were awarded retrospectively, or have not been published in a timely manner. This has diminished public transparency, and the lack of adequate documentation means we cannot give assurance that government has adequately mitigated the increased risks arising from emergency procurement or applied appropriate commercial practices in all cases. While we recognise that these were exceptional circumstances, there are standards that the public sector will always need to apply if it is to maintain public trust.
And remember everyone, when reading reports like this one should replace any soft seeming rebukes with phrases such as "these muppets had no idea what they were doing" and "this looks incredibly corrupt, but if we say that this report will never be released".
The infrastructure, absolutely. A serious road, rail and air network, lots of companies with lots of experience and all the right gear and so on.
Where we fuck up is in the competency of the people in charge of awarding contracts.
Be it Grayling giving millions of pounds to a ferry company with no ferries owned or leased, or indeed any experience at all with ferries (and, wonderfully, with a T&Cs on their website copy-pasted from a pizza delivery site). As a wonderful finale, the government was sued by EuroTunnel because they awarded the contract without going through the proper process (which, of course, would have meant that the drawbacks of a pizza delivery business offering ferries might have been identified); we gave millions to a Ferry company incapable of delivering anything, and then millions to an actual transport company in compensation for breaking the rules on tendering.
Or be it KFC awarding their chicken distribution (despite warnings from people who knew) to a company with no experience in or facilities for cold food distribution, leading to KFC going literally out of business for a couple of weeks because they had no chicken in the stores.
We Brits have a competent infrastructure and the ability for the people in charge to award contracts to entirely the wrong parts of it.
I know it's guaranteed internet points to deride the current government, and the ferry thing is/was despicable, but I think it's highly unlikely they're going to put KFC in charge of logistical operations for the vaccine rollout.
Large PPE contracts were given to companies with no experience in making nor providing PPE, while companies with some experience were ignored. (Sometimes these contracts were awarded to personal contacts of ministers -- one was given to a bloke in the pub who happened to have the minister's contacts in WhatsApp.
The point being made is that you have to give out the contracts to vetted companies who can actually deliver on it. Just because there's a cheapest option that, on paper, seems to tick all the boxes, doesn't mean said option is actually any good.
Well thanks for chipping in [0]. Got anymore glib, smug responses to things that nobody said?
[0] I don't actually mean "thanks". That's childish and passive-aggressive of me, and I shouldn't do it. What I really mean is to suggest that I think you've added nothing to this and that you're addressing a point that nobody made, for reasons only you know. I would guess that it's some kind of hyperbole, and that what you kind of mean is "oh, for something as important as this, someone will do a proper job" which is at least a meaningful statement (if perhaps something of a triumph of hope over experience), but if I have to pick apart your snark to get the actual meaning, I'm doing your job for you. Can you not just write clearly, and state what you mean?
Both of the massive fuckups I listed were highly unlikely, but they still happened.
Yeesh, it was a light hearted joke about KFC because of the mildly amusing tangential link you made between the logistical problems of a fast-food retailer and a nationwide once-in-a-lifetime government backed vaccine rollout.
No, I didn't actually interpret your comment as a claim that KFC will be in charge of the rollout. There's no need to be aggressive.
Yes the British MOD has a record of being very good at logistics [1]
"One country that has achieved an unparalleled level of efficiency and responsiveness in its logistics and sustainment activities is the United Kingdom (UK). The British Ministry of Defense (MOD) has wholeheartedly embraced outsourcing many of these functions to the private sector."
Also of interest:
"One of the primary reasons why the MOD is willing and able to enter into long-term PBL-based service and support contracts with private companies, not just British firms but global providers, is because of its attitude towards the private sector. The MOD views the private sector as a positive contributor to their mission. It works hard to establish a collaborative relationship. MOD officials are demanding and insist on adherence to contracting requirements. But they treat the private companies as partners, not adversaries."
I had the good fortune of first-hand experience of working with the MoD for a small slice of the mobile testing unit logistics, and would absolutely echo the sentiments expressed in that blurb.
The whole article is a fascinating read, especially when I noticed that it was written in 2016 :-O
The MOD has been heavily involved in logistics from the start; they were the ones delivering the PPE to the NHS stockpiles (my understanding is that the biggest hospital in the region acts as storage and a distribution centre for the smaller, more rural hospitals that don't have storage space). They weren't involved with taking PPE from those local distribution centres to the actual hospitals, however, that was up to the NHS to do what they had always done, and for some areas this was the bottleneck where shipments slowed or were even lost.
To be fair there has been some shocking failures directly related to cronyism, largely the huge failure of track and trace and dire situation around PPR procurement. All of these were closed bids (no one else could submit an offer) and all were won by relatives or those close to an elected official in government (mostly the health secretary). Legal action is just been granted for this to go to court and gain transparency into the £billions of hidden contracts.
The issue is not that things are being given to private companies that are mates with a Tory. The issue is that too many of these things are turning out to be given to private companies that are mates with a Tory where no basis exists for believing they can deliver, when other, qualified companies exist. Or, as in Serco's case, with no penalty clauses in place if they don't.
Again, for clarity: using the private sector isn't a problem. Corruption is. Failing to get results is.
I'm all up for chucking money at a big problem and sorting out the mess later, but this is a depressingly predictable mess, and chucking money at the problem bought us a demonstrably worse outcome than we should have had.
I know you are /s but just in case you didn't realise - the spreadsheet part was only on the export of the data from the tracking system (when it was sent to Gov).
Indeed logistics will matter as the vaccine needs to be transported at around -80°C. So let’s hope nothing happens which might cause delays in shipping from Belgium to the U.K. after 31st December.
Look at the way people communicate here, how little empathy they show, the complete sense of humour, how anal they can be about not about the big picture that the other person is arguing for but, say, choice of words, someone's formulation of a sentence, use of the oxford comma, whatever really.
Then tell me if this site is not the largest community for autistic software developers, diagnosed or not.
Look at the way people communicate here, how little empathy they show, the complete sense of humour, how anal they can be about not about the big picture that the other person is arguing for but, say, choice of words, someone's formulation of a sentence, use of the oxford comma, whatever really.
Some people’s insecurities make them allergic to (admittedly tenuous) attempts at humor in face of absurdities and so they downvote as if they’re on Reddit.
The United Kingdom is made up of the island of Great Britain and a part of the island of Ireland (Northern Ireland). It also includes many other smaller islands
You're probably thinking of Great Britain by itself, which is the island containing the main parts of the countries of Scotland, England, and Wales.
While you're right that it is called that (by many), some people object to it:
> In Ireland, the term "British Isles" is controversial, and there are objections to its usage. The Government of Ireland does not officially recognise the term, and its embassy in London discourages its use. Britain and Ireland is used as an alternative description, and Atlantic Archipelago has also seen limited use in academia.
I'm Irish and I've always found the controversy a bit ridiculous; it's a classic example of Irish people's distaste for all things English being taken to a nonsensical extreme. You never hear Brits complaining about the Irish Sea being called such.
I don't know, given the Isle of Man is in the middle of it, maybe it should be The Manx Sea? If we don't want anyone to own it, maybe call it The Sea of Sodor?
A similar controversy exists in the Arab world about what to call the Persian Gulf, where the names "Arabian Gulf" or simply "The Gulf" are preferred. [1]
Amusingly (but perhaps not surprisingly), British imperialism briefly waded into this dispute as well:
> Following British attempts to control the seaway in the late 1830s, the Times Journal, published in London in 1840, referred to the Persian Gulf as the "Britain Sea", but this name was never used in any other context.
I guess that's reasonable, though it appears the name goes back to the 1st century, so the UK is named after the Isles, rather than the other way around?
Great Britain may have been named after one of the isles, but the controversy arises because the UK spans (part of, but not all of) the two main isles.
> Has anyone proposed a viable alternative?
I don't know what would count as "viable" if you reject "Britain and Ireland" and "Atlantic Archipelago".
> Great Britain may have been named after one of the isles
Great Britain is the largest island of the isles. The UK's full name is The United Kingdom of Great Britain and Northern Ireland; ie there's no political entity of Great Britain (and never has been).
No, I don’t think you can fairly say a country is an archipelago unless it’s solely composed of islands all of which are entirely the territory of that state.
The hippocratic oath doesn't pertain to a doctors effect on an entire society, but to her patient. Utilitarian medical ethics do not apply in any sane society.
Worth noting that COVID-19 probably triggers GBS in some people (like many infections). So maybe the vaccine triggers GBS in rare cases, but the disease appears to also sometimes cause long term problems (neurological and otherwise).
1976 was potentially problematic because there was a massive immunization program because of fears of a pandemic, but H1N1 was not actually spreading.
2020 is obviously a different story. The pandemic is here.
As someone who had GBS and was put into a coma at 16. I'm very uneasy about the vaccine, but I also don't want COVID.
I'm likely going to end up taking the vaccine as soon as it's available and hoping GBS doesn't happen again, just so I can go back to my life ASAP. Depends on how the risk of GBS with the vaccine compares with the risk of GBS from COVID.
I do not want the vaccine, but it might be mandatory here in Eastern Europe. My family member was tested positive, and I lived with him, we were under quarantine. No symptoms, ever! I do not want to the vaccine, damn it.
I don't want to have to be sober to drive my car on public roadways, and yet, here I am, acknowledging that I have some basic responsibility for the safety of people around me.
This approach is incredibly selfish. Would you pursue it if you were held responsible for consequences of that behaviour, as drunk drivers are?
That's a poor analogy. Remaining sober doesn't have potential negative side effects unless you're already addicted to alcohol/benzos.
The fact is that the COVID vaccines, as with any medicine, will have side effects, and some of those side effects may be life-altering. There are valid concerns about the vaccines and these effects that cannot simply be brushed off as anti-vax nonsense.
> This is false when it comes to the COVID-19 vaccines under development. They do not—and are not meant to—prevent people from contracting and spreading the virus. They only reduce the symptoms. This does not help herd immunity (other than perhaps allowing the virus to spread faster, I guess).
Some other HN-er said this. If this is true, then it should be my decision. Since I have been through it without symptoms, I am supposedly immune for 6 months, but even after that, I do not really care. I care about it personally as much as I care about the flu. I have not vaccinated myself against the flu in years. Let it be my decision, please. I am not an anti-vaxxer, but when it comes to the COVID-19 vaccine, I am a bit wary. I do not mind tested vaccines that have been around for decades and have been extensively researched and are pretty known to be safe.
This is a bad argument. The two aren't comparable. Drinking a lot of alcohol and getting into a car is a choice. The intent doesn't even matter in most countries since it's a "Strict liability" crime.
The government forcing you to take an injection is literally not your choice. Not to mention, we know drunk driving impairs people and increases risk. There are tons of studies that show that (they also show sleep deprivation is worse than alcohol for driving, but that's not illegal ... probably because it's not measurable, or it's hard to gauge intent).
This vaccine has been rushed through the process with zero long-term Longitudinal studies. A drug company can yell 95% effective all they want, but the fact is, this is a HUGE unknown. The vast majority of normal scientists in other fields cannot do this research themselves and there aren't even any published papers yet we can look at.
This is a bad argument. You want some more bad arguments? Look at the Buck SCOTUS decision which lead to forced serialization, or the SCOUTS decision that lead to Japanese internment camps. You know what those two decisions were dependent on? Jacobson. The vaccine case.
> Drinking a lot of alcohol and getting into a car is a choice.
Not taking a vaccine and interacting with other people is also a choice.
> they also show sleep deprivation is worse than alcohol for driving, but that's not illegal
Drowsy driving is difficult to prove, but generally held to be within the coverage of reckless driving laws. Some jurisdictions have expressly included coverage of it, as well, at least in the context of establishing the necessary illegality in vehicular homicide statutes (NJ and Arkansas.)
Taking a rushed vaccine with God knows what long-term effects is not going to be a choice. Have fun with it. You are playing Russian roulette that I do not wish to play. In majority of the cases COVID-19 is not lethal at all, there should be no mandatory vaccines, especially not when we have no knowledge of its long-term effects and so on and so on. If you want you can take the Chinese or Russian vaccine. I do not want to. Anecdotal: my grandmother (over 70) has been in contact with 4 COVID-19 positive people. She developed no symptoms. I think this is way too overblown. She has been in contact with many old people, too. No symptoms.
> Apr 2, 2020: Asymptomatic transmission refers to transmission of the virus from a person, who does not develop symptoms. There are few reports of laboratory-confirmed cases who are truly asymptomatic, and to date, there has been no documented asymptomatic transmission.
If you have news on it, say so instead of down-voting. I want to know how likely it is for asymptomatic people to spread the virus. I swear, I will keep checking the responses because I am curious how likely it is that people will catch it from me, excluding the fact that I do not leave the house for weeks (I work remotely).
> You are playing Russian roulette that I do not wish to play. In majority of the cases COVID-19 is not lethal at all
You accuse them of playing Russian roulette while you justify not taking the vaccine with "the majority of COVID cases aren't lethal"?
> I think this is way too overblown.
1.5 million people have died.
> I want to know how likely it is for asymptomatic people to spread the virus. I swear, I will keep checking the responses because I am curious how likely it is that people will catch it from me
If you're trying to determine the risk of someone catching it from you (and assuming that you'd immediately self-isolate when you start experiencing symptoms) you should be looking at pre-symptomatic transmission rather than just asymptomatic transmission.
But did they die FROM or WITH covid? That's the million dollar question. Here's CDC data that says 94% of Covid-19 deaths involved one or more comorbid conditions... i.e. these are not healthy people struck down in their prime... https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#Co...
Point is, just a raw number doesn't actually make a great argument.
Even worse, it's a number without context. The most recent annual death stat I could find was for 2017 which saw about 54,750,000 deaths. So '1.5m dying from covid' is less than 3% of this year's deaths.
In my opinion, and the opinion of many others, those numbers seem a fair argument for the "overblown" POV.
I am certain many reported cases here are false, or "with COVID-19" cases as the other guy has said. I know, because a family member works at the hospital and we know what is going on there. They make up lies about the cause of death for funds they get after COVID-19 patients. This is our reality, sad but it is what it is.
I'd love it if people questioning vaccine safety had actual numbers, instead of empty platitudes like '>50% of people who get COVID don't die'. (And if they made an apples to apples comparison with the numbers of not vaccinating. They never do, though, because the numbers don't help their argument.)
Most people who play one round of Russian Roulette don't die, either.
Look, I know for a fact that I was positive before. I was asymptomatic. I have an autoimmune disease. I do not want the vaccine for myself. Does the vaccine actually stop the spreading of COVID-19? Because according to other posts, we do not know that it does, all we know is that people would take it for their own safety, but do not know if it actually stops transmission, in which case we are just talking about whether or not I decide to risk my own health. I would risk it, considering I have been asymptomatic positive before, and I do not know what this vaccine would do to me given that I have an autoimmune disease. The vaccine seems much riskier to me, than COVID-19. That, plus I barely leave the house.
Are you meant to reply to me? It seems quite odd. What numbers do you want from me? I think it is quite useful to know that 1) I have an autoimmune disease, 2) the vaccine has unknown side-effects especially for me, 3) I have been through COVID-19 without any issues, and 4) we do not know if it actually stops transmission. To get the vaccine is risky for me, regardless of your imaginary numbers.
Show me evidence it stops transmission, and show me evidence it is safe for people with autoimmune diseases. If they come back good, I might take that particular vaccine. If not, then get off my back. If it does not stop transmission, it should be my choice, and you are just giving me a selfish opinion. I am NOT going to risk my health, period. Risk yours if you wish.
> Not to mention, we know drunk driving impairs people and increases risk.
How is that different from not vaccinating against a dangerous, contagious disease. It increases risk, and it kills people around you.
> This vaccine has been rushed through the process with zero long-term Longitudinal studies.
There are zero long-term longitudinal studies for the dangers of COVID, too (Or of odds and dangers of losing immunity years after an infection.) Do you get to just assume that there aren't any, without extending the same latitude for vaccination?
Look at the comments in this subthread. Look at the arguments made against vaccination. They aren't data-driven. Not a single number is listed in them. No number of studies are going to convince people whose argument for not getting vaccinated is 'I don't think it's a big deal, and I don't want to, and I will only talk about personal responsibility, because I don't care about my impact on anyone else.'
I would be shocked if any state made vaccination mandatory today (and I'd probably also be surprised if any of those SCOTUS decisions would be upheld/made today although, given the circumstances around Korematsu, who knows).
But might universities and workplaces make it a requirement once a vaccine becomes readily available? That wouldn't surprise me in the slightest. And that may force some tough decisions on skeptics who would have liked to see more time. (Which doesn't include myself.)
The vast majority of people under 50 who catch CoV2 recovery completely with minimal symptoms. There is a trade-off and people need to be able to evaluate those risk and make those decision individually.
If there's an effective vaccine, those who do not want to risk infection from COVID can make the choice to take the vaccine. Those who feel that the risk that they will become infected is one that they are willing to take can do that. Nobody is put into danger that they do not choose to accept.
Taking the choice not to take the vaccine is not taking a choice about personal risk.
It's like driving drunk. It's personal risk AND risk to every other person around you.
When you do not vaccinate, and then go out and about, you are inflicting risk on immuno-compromised persons, for whom the vaccine doesn't work well.
Unless we lock anti-vaxxers in their homes, or unless we hold them criminally liable for infecting someone else, it's not a question of their personal risk.
Do you know that there are quite a few people who can't get vaccinations? Most of them also can't afford to self isolate.
Choosing to not get a vaccination primarily endangers you personally, but definitely also raises the danger level to those who have no choice in the matter.
What is a 'vast majority', please post actual figures.
> and make those decision individually
if you can somehow ensure people who get sick can't spread it, sure it's down to the individual, but it's a society-level problem. That's what "infectious" means.
The worst year of the Polio epidemic in the United States was 1952 where 3145 people died and about 21,000 had some level of lasting (but not necessarily permanent) health impact.
I personally don't think the state should mandate vaccinations by the way, even though such a mandate would almost definitely be a net good to society.
That's his point. A decade ago, the comments on this site were 99% relevent, solid technical feedback and analysis. The top post being layperson speculation with a joke response topping it bears a much stronger resemblance to reddit than to hn's origin.
You are being down-voted, but our politicians are saying exactly this. Well, either you vaccinate yourself, or you have to remain at home. How they are going to enforce it? No clue. Perhaps proof of being vaccinated before entering Government buildings, or the workplace.
> Boris Johnson says he strongly urges everyone to be vaccinated (jabs rolling out next week) but says it is 'no part or ambition of this country to make vaccines mandatory - that's not how we do things.'
In a recent article about the Moderna vaccine, it was mentioned that the actual development only took 2 days.... and it was done in January!
Given how short of a time it took to actually develop this thing, could we have drastically sped up this process by maybe being a bit more risky with the trials? At this point ~1.5 million people have died from the virus.
I've really struggled with this knowledge that we've had a vaccine which it turns out is 95% effective for practically the entire course of the pandemic at at this point... and our conservative "moral" process was to let 1.5 million people die while we vet it.
There are 321 vaccine candidates under development as of September with about 30 in clinical trials. Throughout the year there were probably many, many hundreds or thousands more discarded at early stages of development and evaluation. How would you have selected this particular candidate over all the other possibilities that got dropped?
I understand your point, I really wan't try to make some kind of moral criticism of the process. I realize it was developed for a reason. My question was more about the point that especially with this new mRNA process, we're going to be able to develop these things blazingly fast. But the process for approvals is still glacier slow (and this was already the SPED UP timeline).
My question was more where is there room to speed this stuff up?
Efficacy (the main thrust of Phase 3 trials) could be sped up and made more thorough by deliberately exposing participants. I think one could argue that deliberate exposure and waiting around for enough people to be "naturally" exposed are pretty equivalent in terms of end results, but that's not a winning argument so far. Might be harder to recruit when you know you're definitely getting exposed vs. no change in risk from the no-action option.
But that does presume your methods of exposure are equivalent to what's happening in the real world, both in terms of method and dose. And those are both open questions here and could have bearing on efficacy.
To be fair, a lot more than 1.5 million people could have died if there were delayed adverse affects of the vaccine and we'd already done a mass rollout. I think it's probably good that we put it through a proper trial process.
Also, we'd still have had to wait for production ramp up which I believe has been done in parallel to the testing, so it may not have saved that much tie.
Whether or not it would have been a good idea to loosen the approval process aside, accelerating it would likely not have had much of any effect on saving those lives. The bottleneck is production capacity. As I understand it Moderna and Pfizer/Biontech have both been building production capacity and creating vaccines as fast as possible, but have only now created enough to vaccinate a few tens of millions of people combined. If they had been approved in the summer, when they went to Phase III trials, they might have, perhaps, been able to turn out a few thousands vials a day which is not really enough to meaningfully impact the spread or death rates even if you were able to highly target high-risk groups.
We also have a fairly old, fat, and alcoholic population so if this doesn't work we're probably not getting out of this lightly (even relative to where we are now)
Ok, apart from that, the ideal guinea-pigs would have been the House of Commons and The House of Lords. The former are ultimately replaceable by the electoral process, and the latter are equivalent to a Care Home, albeit taxpayer-funded and all the residents wear ermine-collared red gowns.
To your point 3, Belgium may well have great logistics but the UK government has knowingly undermined and compromised UK logistics (the whole industry is crying out) as part of their Brexit process.
Maybe there are extraordinary arrangements being made for the vaccine, but it won't be because of a good prevailing open-market logistics situation.
Your comment has nothing to do with the logistics of rolling out a mass vaccination programme, but how exactly have the UK government’s Brexit negotiations “undermined and compromised UK logistics”?
Negotiations are ongoing to secure a trade deal with the EU once the transition period is over. The UK are also securing trade deals with other countries, including Canada and Japan.
Both sides recognise failure to reach a deal, or to extend the transition period, would be damaging for both sides.
Which is precisely why both sides are negotiating a deal to ensure that doesn’t happen...
Which I now realise I misread as "Developed in a country" (i.e. Belgium, where it's manufactured). An entirely different, erroneous, reading of the sentence.
Therefore my comment addressed the nature of cross-channel shipping which authorities I respect have repeatedly warned about.
It's too late to edit to add that clarification about the misreading. But that's what was missed.
If the army steps in to provide logistics at a time of national crisis, that's great. But it's not what I would expect this government to do based on the recent historical evidence: We've been in a national crisis for a while and the government has routinely preferred to neglect public-sector expertise and go private in a vast array of public procurement. Much of it has been highly questionable judgment (ministers awarding contracts to friends with penalty clauses).
1. Heavily impacted by Covid-19.
2. Centralised health care system makes it easier to compare results and efficiency. E.g. it's UK which figured out that dexamethasone is efficient against Covid https://www.who.int/news/item/16-06-2020-who-welcomes-prelim...
3. Developed country with great logistics.