• Derek R @DerekR Mod Iver Heath - 2y

    This week's (30/08/21) message from the doctor.

    Hello Everyone,

    The latest survey from the Office of National Statistics (ONS) covering the week ending 20th August estimates that 1 in 70 people in England has the virus. The figures are a lot higher than 12 months ago when ‘only’ 1 in 1900 people was infected. At that time there were no vaccinations. Now just over 60% of the total UK population (ie not just the adults) are double jabbed and we know that the vaccines have a significant protective effect. The last time infection rates were this high was at the beginning of 2021 when there were 2,300 hospital admissions and over 1000 deaths daily. Now even though case numbers are similar we have 700-800 admissions and 100 deaths per day. So the vaccines are working. However, infection rates are rising again with numbers in Scotland have doubled in the last week. That may be due to schools re-opening there earlier than in England. The likelihood is that as children and young adults return to school and university in the rest of the UK there will be a fresh wave of infections being passed on to older parents, grandparents and the vulnerable. In fact, SAGE – the Scientific Advisory Group for Emergencies - has warned the government that it expects an exponential rise in Covid cases and a high prevalence by the end of September which the government needs to plan for. We know that the immunity acquired from the vaccines can start to wane after about 6-9 months and that in a small percentage of people the vaccines don’t work as well. This is the reason that the government has set up its booster programme – the details of which we are still waiting. Many countries in Europe and North America have already started to vaccinate children from 12 yr and up not only to protect community transmission to the elderly but also to protect the children themselves. We know that a small proportion of children can get serious consequences from Covid-19. If a very large number of children get an infection then that small proportion becomes a big number – some will end up in the hospital and some will develop ‘Long Covid.’ That is why the government is looking at following the lead of other countries and vaccinating all children over 12 and not just those who are vulnerable. In addition, scientists are still recommending that all those attending school and university continue to wear masks, have carbon dioxide monitors installed (these check the quality of ventilation in a classroom), and get regular testing. Even though we have high vaccination rates in the UK many people have missed out on their 2nd dose of the Astra-Zeneca (AZN) vaccine. This has been mainly due to fears of clotting from the vaccine and other possible vaccine side effects. As more people are vaccinated we are able to collect more data worldwide. Both Pfizer and AZN are very safe and millions of people have had them in the UK and worldwide without any significant ill effects. The risk of a clot and dying from the AZN s extremely low. However, Covid itself causes severe clotting disorders and it is believed that is why many deaths occur from respiratory failure and cardiac arrest. Long Covid also seems to occur due in part to the clotting effects of the virus. So the risks of getting the virus and its consequences are very high compared to the extremely small risk from the vaccines. Please do get your vaccine if you have missed it.

    Worldwide Delta variant cases are spiralling. The US has been particularly affected by a significant increase in deaths of non-vaccinated people and a shortage of intensive care beds. Even children as young as 5 years are being admitted to intensive care particularly in the South where vaccination rates are low due to misinformation and misplaced ideas on ‘freedom to choose'. The infection is much more rampant and some children have inevitably caught the virus and have become very ill. Australia is imposing more restrictions and infections and deaths continue unabated in developing poorer countries that lack any sort of effective immunisation programme.

    What level of immunisation do we need to aim for? Previously some scientists said that we needed to aim for over 70% for ‘herd immunity’ – some are now saying possibly 90% of the total population – this includes children. Many feel this is an impossible figure to reach. The current vaccines were designed for the original Wuhan Strain of the virus but they do seem to work well for most people with the Delta strain. The vaccines are great at preventing hospitalisations and deaths but they do not stop people who have double jabbed from carrying the virus and passing it on. As I’ve already mentioned above immunity seems to wane after 6-9 months and a booster jab should prolong protection. As well as vaccinating children 12 yrs and above – some countries are also looking at jabbing younger children. Vaccines for 5-11 yrs old may be approved soon. Then later this year vaccines for 2-4 yr olds may be coming online and eventually by early next year vaccines for 6 months to 2 yr old may be approved.

    However, a high rate of immunisation may not be enough by itself. Delta is twice as contagious as other variants and may well be the most contagious virus we will see in our lifetime. It has surged even in countries with high vaccination rates such as Iceland (over 70% vaccinated) and Israel. Many of the leading Covid experts worldwide think that immunisation together with other preventative measures are essential if we are to get to the ‘new normal’. So some of the additional measures that are being talked about now are very good quality masks for everyone. Cloth masks are ok but only partial protection - they are best for catching your aerosols when you breathe out but are not very good at protecting you from inhaling other peoples' aerosols. So they are only really effective if everyone wore them. Other measures our society may need is to reduce indoor dining, carbon dioxide metres for all indoor venues, HEPA air filters, vaccine passports, upper air UV disinfection and regular testing. However, all these preventative measures cost money and it is up to the government to look at and assess these.

    So the consensus seems to be that we will have to aim for a ‘New Normal’ where we don’t aim to live with the virus but take preventative measures until the vaccine is available to everyone. Then eventually the virus may die out as it has nowhere to spread. When will that be? No one knows yet.

    At the Burnham Health Centre, we are still keeping the doors closed and patients have to ring for an appointment – some face-to-face appointments are directly available but most Doctor appointments are telephone first. If the doctor cannot sort out the problems or you need to be seen then you will be made an appointment usually for the same day. I know many of you are frustrated at having to call and can’t just walk in but the last thing we want at the surgery is a waiting room full of people with potential covid infections spreading to other patients or staff. You can book an appointment by telephone or going online and using ‘Patient Access.’ The current situation is reviewed regularly and I will keep you updated. A worldwide surge in demand for blood tests has caused a shortage of collection tubes in the UK. Many GP surgeries have had to cancel routine blood tests at short notice. Burnham Health Centre is OK at the moment but if we start running low we may need to keep the blood tubes for urgent blood tests only.

    Burnham Vaccination Update
    We have a Pfizer clinic running this Saturday 4/9 from 0900-1300. This is for first doses for people aged 16 years and second doses from 8 weeks. We are also vaccinating 12-15-year-olds if they are immuno-compromised or living with a family member who is immuno- compromised. We do not at present have any more Astra-Zeneca vaccinations.

    We are awaiting updates on the booster programme and are ready to proceed when given the go-ahead.

    Stay Safe Everyone

    Bye for now

    Dr M Tanvir Jamil
    Senior Partner
    Burnham Health Centre

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