Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

Public opinion on vaccination in the UK is extraordinary now - like I didn't think we as a society would be able to get to this level of unanimity in the 21st century. According to the latest ONS survey the proportion of people who have had or would accept the vaccine is up to 94%. That remaining 6% is split into 3% who are hesistant who say they're not sure and 3% who have or would refuse. According to doctors and health professionals doing the outreach a lot of the remaining vaccine hesitancy is very specific now - normally people with pre-existing conditions or who take medications and don't know if it's safe to have the vaccine or not until they speak to a doctor.

In addition someone did a polling on people's feelings about anti-vaxxers - a third think they're being selfish and about 40% think they're stupid

I'm genuinely really surprised by how attitudes have moved. I think part of it is huge trust in the NHS - although even non-medical things like lockdown measures have 80%+ support so maybe we're just a more socially trusting society than we thought, perhaps a little more Northern European a little less Anglo-Saxon. I thnk it probably also helps that people basically don't distinguish between vaccines - so in much of Europe there are different attitudes about the different vaccines, in the UK Pfizer and AZ are seen as broadly the same and views on their safety and effectiveness have moved in lockstep (this did change briefly when the AZ suspensions were in place - there was an increase in people cancelling or refusing that vaccine then). The same has happened with Moderna but fewer people know about it because we've approved it but not actually received any. I think in this sense the lack of choice may be having an effect - they're all just "NHS vaccines" just like whatever generic you get prescribed is the medicine you get.

I also wonder if we over-estimated the level of anti-vaxxer views because we look at other countries like the US and France where it is more prevalent and basically just assume the same issue will be present here - and, relatedly, if we judge too much based on social media. If that's part of it I think there are probably wider lessons. Also I think the fact that unlike most vaccination campaigns this starts with elderly people who can make their own decisions and want the vaccine rather than children is helpful. Anti-vaxxer sentiment does seem to grow the younger you get - but they are least at risk.

[mongers]

Shelf, I think the impact of consumerism on people's thinking  over the last 40 years plays a role. The NHS, a public service was never privatised unlike most other 'utilities' so people don't have an expectation that they need a high level of service for what they are 'paying'.

So as you say people are widely grateful for what service they get for free, whereas in many European countries there are more complicated goods and services 'transactions' that people are involved in when they deal with health issues, a back-door for consumerist thinking to creep in; 'is this the right product for me' thinking or 'I consider myself special so need a more exclusive product/vaccine, than the mass market one'.

[Tamas]

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So as you say people are widely grateful for what service they get for free, whereas in many European countries there are more complicated goods and services 'transactions' that people are involved in when they deal with health issues, a back-door for consumerist thinking to creep in; 'is this the right product for me' thinking or 'I consider myself special so need a more exclusive product/vaccine, than the mass market one'.

Which European countries would that be?

[Sheilbh]

Shelf, I think the impact of consumerism on people's thinking  over the last 40 years plays a role. The NHS, a public service was never privatised unlike most other 'utilities' so people don't have an expectation that they need a high level of service for what they are 'paying'.

So as you say people are widely grateful for what service they get for free, whereas in many European countries there are more complicated goods and services 'transactions' that people are involved in when they deal with health issues, a back-door for consumerist thinking to creep in; 'is this the right product for me' thinking or 'I consider myself special so need a more exclusive product/vaccine, than the mass market one'.

I think there's definitely a bit of that - I remember reading a story about Belgium and some people were starting to call the AZ vaccine the "Aldi vaccine". In Europe, where social insurance is more the norm, I think it's more a general expectation of choice and control over healthcare.

I think in the UK we are relatively rare in the "take what you get and be grateful" attitude - and with it the unhelpful "doctor knows best" attitude, even when they don't or get things wrong. It's more difficult to get a second opinion or challenge doctors here. I'm sure I'm not alone in having family horror stories of that sort of issue. But I think as individuals do not really expect to have much choice or agency in relation to healthcare - whereas I think that's the norm in Europe where they have social insurance. On balance I generally think social insurance is a better system for most healthcare results - but in this sort of situation the NHS model is really helpful both in rolling out a single, easily repeated procedure at pace, consolidated nationwide electronic medical records and high levels of trust.

And one other not irrelevant factor is that because the NHS is run the way it is, it can only really spend money on treatments that work. If you're running an insurance model - even social insurance - so in Italy and France homeopathy is considered a medicine by law, and about 20% of Italians and 55% of French people have used homeopathic treatment. That's mad but somewhat justifiable in an insurance system, in a system like the NHS it'd be unforgivable to waste money on something that studies show is no more effective than a placebo.

In other good news in how vaccines work - Italy focused on healthcare workers as the first group to get vaccinated (to some frustration because lots of administrative staff/bureaucrats in the healthcare system managed to get their doses while the elderly are second in the queue). But there's been a five-fold fall in infections since December even though Italy has been going through a third wave. I think about 80% of healthcare workers have been vaccinated and they're working through the elderly now.

[Tamas]

I am not sure there's that big a difference in Europe that you guys make it out to be... In Hungary I paid "societal insurance" tax to cover healthcare, here I pay "national insurance". Sure, in Hungary your access is limited if you don't pay at all, but that's quite a recent development. But it's not like we are not paying for healthcare in this country.

[Sheilbh]

I am not sure there's that big a difference in Europe that you guys make it out to be... In Hungary I paid "societal insurance" tax to cover healthcare, here I pay "national insurance". Sure, in Hungary your access is limited if you don't pay at all, but that's quite a recent development. But it's not like we are not paying for healthcare in this country.

I totally get that - and as I say I generally prefer the French/German model (and I think it had structural benefits in the early days of the pandemic around increasing testing capacity for example). And national insurance is just a quite regressive tax - it has nothing to do with insurance and hasn't for about 100 years. But from my understanding in most of Europe there is choice in your healthcare provider, it's easy to go to another doctor for a second opinion, there's far less gatekeeping etc. Which is why in general I think that is a better, if more expensive, system.

In this specific moment I wonder if our system is part of the reason there's more acceptance of the vaccine because people aren't used to choice so the idea of distinguishing between vaccines makes no sense plus it's something the NHS is very good at - a simple easily repeatable procedure (in contrast with the testing capacity early on in the pandemic). I also think there's very high levels of trust in the NHS in a way that I don't think there would be with your social or not health insurance company. I don't particularly trust my workplace pension for example

[Zoupa]

I don't get the reverence of the rosbifs for the NHS. Nearly every democracy out there (and several non-democracies) have nationalized healthcare systems.

I suspect it might be one of the only public service left in the UK that is not total shit. Is that why?

[Valmy]

I don't get the reverence of the rosbifs for the NHS. Nearly every democracy out there (and several non-democracies) have nationalized healthcare systems.

I suspect it might be one of the only public service left in the UK that is not total shit. Is that why?

Maybe because they are so culturally close to the US they are aware of how shitty life would be without it.

[Richard Hakluyt]

I think that the reverence is actually a lie, promoted by government so that they can make cuts to NHS finance with impunity  :tinfoil

Interesting and relevant chart at the start of this BBC article https://www.bbc.co.uk/news/health-47472472

Note how less than half the public were satisfied in the 1980s and 1990s, a period of poor financing by Tory governments.

New Labour gave the NHS above-inflation increases for many years and the NHS share of GDP climbed; you can see the satisfaction rising in the period 2001-2010 to a peak of 70%. Then the Tories got back in and the NHS got poor financial settlements and satisfaction levels started to fall. The NHS is in desperate need of another bout of New Labour style funding; it isn't going to get it as the people in charge of the UK are oligarchical cunts.

[Richard Hakluyt]

I should add that while satisfaction levels vary the support for a NHS free at the point of delivery seems to be almost universal.

[Tamas]

While the official line in Hungary is still that hospitals are managing just fine and nurses/doctors telling otherwise are fearmongering, two hospitals just opened "volunteer programs" (one is calling it Spartacus Project for whatever reason) on their Covid wards. They are waiting for ideally vaccinated people or those who have already caught the virus the last 6 months, and are in good physical shape, to go through a training on stuff like using PPE and then helping out on these wards.

The situation must be terrible.

In far better news, my parents are scheduled to both get Pfizer jabs on Wednesday.

[Sheilbh]

I don't get the reverence of the rosbifs for the NHS. Nearly every democracy out there (and several non-democracies) have nationalized healthcare systems.

I suspect it might be one of the only public service left in the UK that is not total shit. Is that why?

I think it's the equivalent of war/Churchill nostalgia for the left. It's linked to the sort of 40s all in it together/national unity, plus the Attlee government. Plus it's been probably the most regularly reformed public service but the mental image is still that it is basically an old school public service - centralised and answerable to the man in Whitehall. I think it's like the BBC for some people in that it sort of speaks to an idea of what Britain/Britishness is.

Also the "alternative" in the UK imagination is the US - there's not much awareness of other healthcare models like social insurance and they also seem maybe a little too complex and close to a privatised insurance system.

I find the whole "our NHS" stuff a bit baffling - as I say I think a lot of this stuff can be quite harmful and lead to "doctor knows best" cock-ups and coverups because people believe too much in the institution. In general I think the French or German model is better. But I think that trust is a part of why people in the UK have been more pro-vaccine than most the whole time, but that that sentiment has also grown.

While the official line in Hungary is still that hospitals are managing just fine and nurses/doctors telling otherwise are fearmongering, two hospitals just opened "volunteer programs" (one is calling it Spartacus Project for whatever reason) on their Covid wards. They are waiting for ideally vaccinated people or those who have already caught the virus the last 6 months, and are in good physical shape, to go through a training on stuff like using PPE and then helping out on these wards.

The situation must be terrible.

I imagine the volunteers will also start "fearmongering" soon too.

In far better news, my parents are scheduled to both get Pfizer jabs on Wednesday.

I take back my criticism of your dad

[Tamas]

Yeah his gamble will be paying off it seems. 

[Tamas]

The Chinese CanSino's vaccine (called Convidecia) with official efficacy (3rd round trials still ongoing in the 3rd world) of 65% has also been approved in Hungary.

For approving these Chinese vaccine, a government decree back in 29 January declared that in an emergency such as this, the Hungarian authorities do not have to go through their usual test process, it is enough if at least one EU or EU member candidate have done so. Luckily for Hungary, Serbia has already approved both Chinese vaccines, which is good enough apparently, so on they go.

Meanwhile the government couldn't delay publishing the procurement contracts for the various vaccines any longer. Two points of interest: the Russians are seriously behind the agreed schedule (the Hungarian government is eager to dismiss this while pouncing on any slight delay from the EU), and that the Chinese procurement was not only multiple times more expensive than any other ones, but also was channeled through a tiny Hungarian contractor and some Indonesian/other Asian subsidiary they also used for the record-expensive respirator purchase from China.

[Sheilbh]

Meanwhile the government couldn't delay publishing the procurement contracts for the various vaccines any longer. Two points of interest: the Russians are seriously behind the agreed schedule (the Hungarian government is eager to dismiss this while pouncing on any slight delay from the EU), and that the Chinese procurement was not only multiple times more expensive than any other ones, but also was channeled through a tiny Hungarian contractor and some Indonesian/other Asian subsidiary they also used for the record-expensive respirator purchase from China.

The point on Russia is really important. They are signing lots of deals largely for geopolitical reasons and their strategy to supply is similar to AZ with lots of distributed subcontractors. But as with AZ from everything I've read they're nowhere near the level they need to be at to actually deliver (yet). I think I read that they're looking at factories in Europe (Germany and Italy ring a bell?) which would improve things.

While I think Sputnik is going to be part of the global solution to this, I don't think it's as simple as if we approve them then it'll be easy because they have the supply.

Edit: Incidentally - just on the Guardian and saw that Germany is considering allowing family visits for Easter. The combination of the new variant spreading/becoming dominant, cases rising again and making an exception for a traditional family holiday is giving me strong Deecember flashbacks. I really, really hope they don't do it - it was an absolute disaster for us and caused so many avoidable deaths.