1. Long-term care residents/staff
2. Hospital workers
3. Anyone 85+ years old.
Care homes are all mostly small, with a handful of employees.
EDIT: Wales has just said it's going to be really hard getting the Pfizer vaccine out to care homes: https://www.pulsetoday.co.uk/news/clinical-areas/immunology-...
* older adults’ resident in a care home and care home workers
* all those 80 years of age and over and health and social care workers
* all those 75 years of age and over
* all those 70 years of age and over
* all those 65 years of age and over
* high-risk adults under 65 years of age
* moderate-risk adults under 65 years of age
* all those 60 years of age and over
* all those 55 years of age and over
* all those 50 years of age and over
* rest of the population (priority to be determined)
[1] https://www.gov.uk/government/publications/priority-groups-f...
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.
So we don't know how beneficial your 2 above would be.
https://www.medscape.com/viewarticle/941030?src=soc_tw_20111...
The results announced up to now just showed that the vaccines reduce chance of a vaccinated person becoming sick.
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.
Where do I sign up?!
Or you could go by demographics. The hardest hit groups in the worst spreading areas. Etc.
You're right that it's not a trivial thing, but if you wanted to do it, reasonable approximations could be found.
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's a good chance that situation will create a black market both for vaccines (real and fake) and forged proof of vaccination.
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)
The UK government has ruled out having a vacination passport (for good reason in my opinion).
Strong opinions, loosely held.
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.
I have no doubt there are some pretty interesting models being developed to determine the best course of action.
I believe that most experts are expecting it won't.
Which hospital / trust are you with? I had mine done at Royal Free.
> 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.
Priority ranking is here: https://www.gov.uk/government/publications/priority-groups-f...
Though this is generic and should change depending on the results on vaccine trials (should there be evidence of differential effectiveness).
That will take until February or so to complete.
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.
[0] https://www.pewresearch.org/science/2020/09/17/u-s-public-no...
The more people that get vaccinated, I think the easier it'll be to start vaccinating more and start getting back to normal fingers crossed
Selfishly, I guess we should be happy that there is an anti-vaxxer sentiment; it means the rest of us will get our vaccines faster.
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.
To me a chainsaw is a safe tool to use. Dangerous, but safe. To others it is not. Is a chainsaw a "safe" tool?
And the FDA itself talks about approved drugs being safe and effective: https://www.fda.gov/drugs/drug-information-consumers/fdas-dr...
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".
Happens extremely rarely though.
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.
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.
https://www.itv.com/news/2020-11-10/covid-vaccine-will-enoug...
...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.
This whole thing becomes moot once the vulnerable are vaccinated, no need for creepy immunity passports.
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.
However, through my partner I am friends with many classical singers. They are absolutely worried about damaging their instrument.
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.
https://immunizebc.ca/sites/default/files/graphics/vaccine-s...
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.
People who do take the vaccine are likely still able to spread the virus.
The pandemic is not going to go quietly any time soon.
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.
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."
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.
The Oxford vaccine is far cheaper (15x) and easier to store so long term it has a lot of competitive advantages.
1. https://www.theguardian.com/uk-news/2020/nov/23/oxford-covid...
[1] https://clinicaltrials.gov/ct2/show/NCT04516746 [2] https://www.reuters.com/article/uk-health-coronavirus-astraz...
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.
https://www.bbc.co.uk/sounds/play/p08ztv8h (starts around 7:30)
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:
https://spectator.com.au/2020/11/what-we-know-so-far-about-t...
> 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.
Please don't under-estimate our ability to fuck this up, probably by giving the distribution contracts to a crony.
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.
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.
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.
That is a very tactful way of describing what has gone on in this country for a while
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.
That's like beating your children but comforting them that they atleast have food on the table and clothes on their back.
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.
[0] - https://www.ifs.org.uk/publications/14901
[1] - https://www.theguardian.com/politics/2019/jun/01/perfect-sto...
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.
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.
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
How does this relate to your point about a culture of self-criticism?
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:
https://spendmatters.com/uk/dhl-challenges-loss-of-nhs-logis...
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.
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 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).
> 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.
Unsourced Tory propaganda.
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:
https://www.kingsfund.org.uk/blog/2019/10/ERIC-data-nhs-esta....
"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):
https://committees.parliament.uk/publications/1779/documents...
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)
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
Unsourced, never heard this.
https://theconversation.com/coronavirus-four-issues-that-hav...
"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.
Are you sure about that? The median income in the US is less than $33k.
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.
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.
tl;dr quango = power without accountability.
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 governments change and might or might not be incompetent, those structures largely remain the same.
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.
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
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.)
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.
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.
>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.
From: https://www.nao.org.uk/report/government-procurement-during-...
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".
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.
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.
[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.
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.
https://www.thetimes.co.uk/article/coronavirus-in-scotland-a...
"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."
[1] https://nationalinterest.org/blog/the-buzz/britains-innovati...
The whole article is a fascinating read, especially when I noticed that it was written in 2016 :-O
If the private company does a good job does it matter that they are mates with a tory? Seems little short-sighted of you if I must say.
[1] https://nationalinterest.org/blog/the-buzz/britains-innovati...
https://www.occrp.org/en/daily/13239-court-to-look-into-uk-g...
https://www.dailyrecord.co.uk/news/politics/record-view-cron...
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.
Then tell me if this site is not the largest community for autistic software developers, diagnosed or not.
This is in no way meant as an offence to anyone.
Signed: someone also on the spectrum.
There are too many commas in your sentence :)
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.
> 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.
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.
[1] https://en.wikipedia.org/wiki/Persian_Gulf_naming_dispute
Has anyone proposed a viable alternative?
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).
Indeed. I suppose if Ireland's full name were "The Republic of Little Britain" there wouldn't be a controversy about the term "British Isles".
> there's no political entity of Great Britain (and never has been).
Unless you include the Kingdom of Great Britain (1707–1801):
https://www.forbes.com/sites/barrycollins/2020/11/15/amazon-...
So not even a mild case of the zombs?
https://metro.co.uk/2020/11/25/zombie-mink-rise-from-grave-a...
If I carried the decimal correctly, 5 thousand out of 58 million is less than 1% of 1%.
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.
This approach is incredibly selfish. Would you pursue it if you were held responsible for consequences of that behaviour, as drunk drivers are?
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.
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.
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.
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.)
> 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.
Any news on this?
Down-voter: I literally quoted https://www.who.int/docs/default-source/coronaviruse/situati....
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 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.
Here's a study that finds that around 44% of infections happened in the presymptomatic stage: https://www.nature.com/articles/s41591-020-0869-5?fbclid=IwA...
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.
Most people who play one round of Russian Roulette don't die, either.
You are doing a fantastic job of proving my point.
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.
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.'
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.)
Hard to walk or smile when you're dead.
1. More than 5,000 people under 50 in a population of 66 million will have serious side effects from COVID.
2. In fact, nearly 3,000 people under 50 have already died from COVID in the UK.
3. This is despite only a small percentage of the population (3-10%) having been infected by COVID.
4. Even if you are under 50, and don't die to COVID, you are going to kill other people, by spreading it to them.
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.
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.
> 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.
> Please don't post comments saying that HN is turning into Reddit. It's a semi-noob illusion, as old as the hills.
https://twitter.com/latikambourke/status/1334106542480777216
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.
My question was more where is there room to speed this stuff up?
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.
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.
Wait post Brexit to see if you change your mind about that one.
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.
Maybe there are extraordinary arrangements being made for the vaccine, but it won't be because of a good prevailing open-market logistics situation.
Edit: here's the Road Haulage Association warning of severe supply chain disruption https://www.bbc.co.uk/news/uk-54021421
Edit 2, since responses are unexpected:
> HMRC's assumption is that there'll be 11 million new customs declarations a year on goods going from GB to NI as of January 1
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...
Am I missing something here?
"3. Developed country with great logistics."
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.