the hard and soft science leading our journey
The growing stream of positive news about the effectiveness of candidate C19 vaccines is indeed phenomenally good news. Yet the journey to the good type of herd immunity based on an immunised population will be long and winding. and yes we really are nearly there but how nearly is near. With a second RNA vaccine announced to have 95% protection and several others in the pipeline none of which suffer from the same cold-chain logistics challenges in principle, the path to population immunity is clear. Yet there remains an enormous challenge to get sufficient uptake for things to be getting back to normal by this time next year and indeed at all. As the inventor of the Pfizer vaccine noted 80% must be vaccinated by autumn to beat major outbreaks next winter. This is a very tall order. Further, there are huge trust issues among those who are not naturally classical anti-vaxers. Despite the tragically high levels of deaths and risk in the US, a recent poll...
Until the completion of an eventual mass vaccination program with either the newly announced vaccine or that and others, China stands out as the only large (of course the largest) country to beat the pandemic. Some have doubted the figures but the success of other large south Asian nations to manage the pandemic suggests their success is real. New Zealand, a European western-style democracy has also a very good record in delivering eradication but its size and geography make it an exception to any rule. Without the advantages of a small remote island nation with a leader who acted fast and was able to garner a large national consensus, it is instructive to examine the levers China employed to achieve it. A short article in the Lancet set out the key factors:
The UK and Scottish Government guidance around masks and face-coverings was slow to evolve, and so is guidance on body temperature assessment. Scientists still argue about where and how people should wear masks. Now even their biggest initial opponents accept that masks are part of the solution.
Many of us sensed this at the very beginning of the pandemic, and it turns out to be quite hard for scientists and governments to act on common sense which later becomes quite apparent.
There are traditionally two approaches to the development of guidelines for public health and Medicine.
In non-pandemic conditions, the Evidence-based approach is the best because it...