Easing of Restrictions from 10th May

[Paul O Mahoney]

It's quotes like this that really bother me

At the NPHET briefing on Thursday, Prime Time asked Professor Philip Nolan, Chair of the Irish Epidemiological Modelling Advisory Group, if he'd run the models without the step change in social mixing included, and what the outcome would be.

"I did, and the answer is: it’s modest," he said. "Frankly, it is anywhere between Alpha-only and the optimistic scenario."

So we are only seeing a 'modest' change in the forecasts by not opening indoor hospitality on the 19th. Given that they are now seeing a risk (but won't tell us the probability) of anything from Alpha only outbreak with hospitality closed to a more severe outbreak than Alpha if opened, why aren't we locking down again? The answer has to be the probability of an outbreak like January to be so unlikely that NPHET are prepared to take the risk.

So the question still remains. How much extra risk would we have taken on by opening up indoor hospitality on the 19th? They have obviously modelled it.

If he did he should publish the results or make them available.

 

[Paul O Mahoney]

Other countries model on their own prevalent conditions.

That's what should happen but we are in "emergency mode" now.

Resources need to be put at this as the next one is around the corner.

 

[EmmDee]

I am amazed at the Vaccine centre at the Aviva is been halted to facilitate a rugby international. Where is the priority in this instance.
Surely there are rugby grounds in the country which this match could have been used. I wonder how many unvaccinated people will be at this match.
Baffling.

Isn't it moving to UCD not being shut. I think they are doing the same with other grounds where activity will start during the Summer and into the Autumn.

The Aviva will have a number of games over the next month and then you have football and rugby in the Autumn.

 

[Leo]

95% efficacy does not mean that 95% of the population are protected from getting covid and that 5% have zero protection. It means the chance of getting Covid or severe Covid is reduced by 95% compared to an unvaccinated population. 100% of the unvaccinated population will not get Covid. It will only be small % of that population

No, efficacy only applies to controlled trial conditions where the non-control groups are exposed to sufficient virion load to contract the virus. You're talking about contagion outside of trial conditions, so you need to talk in term of effectiveness.

 

[Leo]

It's not really nphet that is the issue but the power that they have been given by the government and media, why ?

What powers do they have?

If you want to direct your ire at someone, perhaps ask why more than a year later why we still lag behind many who spend far less than us on heath in terms of intensive and critical care capacity. That limited capacity, and the fear of it being overrun is a driver behind continued restrictions.

 

[Sunny]

No, efficacy only applies to controlled trial conditions where the non-control groups are exposed to sufficient virion load to contract the virus. You're talking about contagion outside of trial conditions, so you need to talk in term of effectiveness.

Leo, we are talking about what Philip Nolan said and what you agreed with when you are saying:

So if you understand that 95% efficacy means that 95% of a cohort will be protected, surely you understand that this means 5%, or 1 in 20 will not be protected?

If it wasn't so, and that 5% had some level of protection, then the efficacy would be higher.

That is not what efficacy is. I know the difference about what they mean when they talk about how efficant an vaccine is and how effective a vaccine is in the real world. It doesn't matter what term you want to use. What you say above is simply not true. A 95% efficacy or a 95% effectiveness does not mean that 5% of the population are un-protected or 95% of the population are protected for the reasons why I explained above. Saying 25,000 elderly vaccinated people are at risk of this variant is simply not correct. It's not a matter of opinion. It's maths.

 

[Leo]

Leo, we are talking about what Philip Nolan said and what you agreed with when you are saying:

I didn't mention what Philip Nolan said, I simply explained the efficacy term should not be applied to individuals or non-trial conditions.

 

[Sunny]

I didn't mention what Philip Nolan said, I simply explained the efficacy term should not be applied to individuals or non-trial conditions.

Your understanding that you stated is incorrect. 95% efficacy does not mean 95% of the population are protected and 5% aren't. It means people with the vaccine are 95% less likely to catch Covid or severe covid than non vaccinated people. It's a subtle but important point when you have people claiming that 5% of vaccinated people are 'not protected' from covid and you are trying predict future case numbers, hospitalisations and deaths.

 

[joe sod]

The Pfizer trial found an infection rate of 0.74% in the placebo group and 0.04% in the vaccinated group.

Therefore, the vaccine reduced the infection rate by 0.7%.

But even with corrected figures this statement is still wrong, the vaccine reduced the infection rate by 95%, that's all anyone needs to know and was widely publicized data by Pfizer from last November. Why did you go to all the rounds to say that it reduced it from 0.74% to 0.04%, even after correction, it's still a 95% reduction its "classic damn lives and statistics stuff" you were trying to engage in

 

[Sophrosyne]

@joe sod do you understand how efficacy in clinical trials is worked out?

 

[settlement]

Yeah 95% efficacy is the important data. The reduction in covid rate of 0.7% is a bit misleading as it doesn't capture scaling and the knock on effect of having fewer cases in the community which reduces the r rate etc. That's why scientists use efficacy as the truest measure of a vaccine.

 

[Paul O Mahoney]

Yeah 95% efficacy is the important data. The reduction in covid rate of 0.7% is a bit misleading as it doesn't capture scaling and the knock on effect of having fewer cases in the community which reduces the r rate etc. That's why scientists use efficacy as the truest measure of a vaccine.

Is there methodology used to understand the effects of vaccines, they hardly ignore it and it must be an important variable.

Edit; not in the trials but in the general population.

 

[settlement]

Is there methodology used to understand the effects of vaccines, they hardly ignore it and it must be an important variable.

Edit; not in the trials but in the general population.

Yes, healthcare practitioners report all side effects and these are counted, analysed etc for patterns. Eg you get a vaccine and 1 week later you get a rash, your nurse or doc will report this

 

[Leo]

Your understanding that you stated is incorrect. 95% efficacy does not mean 95% of the population are protected and 5% aren't.

Efficacy DOES NOT apply to the population at large, it's a measure that refers to candidates in trial conditions.

It means people with the vaccine are 95% less likely to catch Covid or severe covid than non vaccinated people.

The 95% efficacy rates quoted IS NOT a measure of how sick someone will become! Pfizer efficacy there is ~100%.

 

[Sophrosyne]

Yeah 95% efficacy is the important data. The reduction in covid rate of 0.7% is a bit misleading as it doesn't capture scaling and the knock on effect of having fewer cases in the community which reduces the r rate etc. That's why scientists use efficacy as the truest measure of a vaccine.

Is there methodology used to understand the effects of vaccines, they hardly ignore it and it must be an important variable.

Edit; not in the trials but in the general population.

That’s correct. I explained here, how Pfizer arrived at the efficacy rate, i.e., by dividing 0.70 by the infection rate of the placebo group, 0.74% = 95%.

The efficacy rate, while truly remarkable, is theoretic rather than an absolute. It is the rate that would be expected if the people and conditions in the clinical trial exactly mirrored real world.

Real world effectiveness can be higher or lower depending on prevailing conditions such as attack rates, variants, underlying illnesses, behaviour, exposure, transmissibility, vaccine availability & uptake, etc.

They will vary from country to country and areas within countries.

Vaccine effectiveness is discovered during its rollout in the real world by observation, data collection and study and this is going on worldwide.

And that is what NPHET and its contributors do all day every day in the Irish context.

Doubtless their work was and continues to be obstructed by the cyber-attack on the HSE’s IT systems.

Israel, which is more on with vaccinations than other countries, has put a lot of work into analysing real-world vaccine effect - here.

But as you can see, because the real world cannot be controlled in the same way as in a clinical trial, analysis can be tortuous.

 

[24601]

I think the main point here is that the risk of breakthrough infections resulting in serious illness/death for fully vaccinated people is not 5% as insinuated by Nolan. To suggest that this is the case is misleading at best and intentionally scaremongering at worst.

 

[Sunny]

Efficacy DOES NOT apply to the population at large, it's a measure that refers to candidates in trial conditions.


The 95% efficacy rates quoted IS NOT a measure of how sick someone will become! Pfizer efficacy there is ~100%.

Use Efficacy or effectiveness to your hearts content. You are still wrong when you say

So if you understand that 95% efficacy means that 95% of a cohort will be protected, surely you understand that this means 5%, or 1 in 20 will not be protected?

If it wasn't so, and that 5% had some level of protection, then the efficacy would be higher.

You pulled up another poster for correctly pointing out that Philip Nolan was incorrect when he said

We have almost 500,000 people aged 70 and over. Even if the vaccine is 95% effective in preventing severe disease, 25,000 people remain vulnerable.

That was either badly worded or complete scare mongering and we still don't know if this statement is reflected in the model.


Also the 95% efficacy at trial does measure how sick you become to a certain extent as it only captures symptomatic cases i.e. All the identified covid cases in the trial had to show symptoms. It didn't include asymptomatic cases. The Pfizer vaccine does not have 100% efficacy in adults with regard severe illness (as defined by the FDA). Even at the initial trial, there was 1 severe case in the vaccinated group versus 3 severe cases in the placebo group. It had 100% efficacy in trials for 12-18 year olds.

The last I heard about vaccine effectiveness was 96/97 % against infection, serious illness or death and about 90/91% against asymptomatic infection. Though not sure with the Delta variant what it is now.

 

[Leo]

The last I heard about vaccine effectiveness was 96/97 % against infection, serious illness or death and about 90/91% against asymptomatic infection. Though not sure with the Delta variant what it is now.

So you're back confusing efficacy with effectiveness?

The Pfizer vaccine does not have 100% efficacy in adults with regard severe illness (as defined by the FDA).

It's 100% per CDC criteria, 95.3% for FDA.

Even at the initial trial, there was 1 severe case in the vaccinated group versus 3 severe cases in the placebo group. It had 100% efficacy in trials for 12-18 year olds.

Are you referring to the phase 3 clinical trial? If using FDA criteria, the placebo group had 21 severe cases versus 1 in the vaccinated group. Using CDC criterial, there were 32 cases of severe disease in the control group versus 0 among the vaccinated.

 

[Sunny]

So you're back confusing efficacy with effectiveness?

It's 100% per CDC criteria, 95.3% for FDA.


Are you referring to the phase 3 clinical trial? If using FDA criteria, the placebo group had 21 severe cases versus 1 in the vaccinated group. Using CDC criterial, there were 32 cases of severe disease in the control group versus 0 among the vaccinated.

Why do some people on this board just refuse to accept they are wrong? It is just tiresome having to go back debating pedantic points while ignoring the main point.

I am not confusing anything about efficacy or effectiveness. Why don't you tell me why you are correct with the below statement that you made.

So if you understand that 95% efficacy means that 95% of a cohort will be protected, surely you understand that this means 5%, or 1 in 20 will not be protected?

If it wasn't so, and that 5% had some level of protection, then the efficacy would be higher.

It is completely wrong. It isn't a matter of opinion. Tell me what you think 95% efficacy means then and how none of the 5% have any protection. You are basically saying that in the trial period, Pfizer discovered the vaccine protected 95% of the people and didn't work for 5%. That is not what the trial shows. The trial showed that a vaccinated person was 95% less likely to get sympomatic covid than someone who wasn't vaccinated. That is very different to saying the vaccine protected 95% of people and the other 5% got no protection. All the vaccine efficacy does in trial conditions or vaccine effectiveness in real world conditions does is show the proportionate reduction in the attack rate of the virus between the vaccinated group and the unvaccinated group. To suggest like you and Philip Nolan have done that 5% of the elderly population who have been vaccinated have no protection is completely wrong.

 

[Bluefin]

What is this debate about efficiency and effectiveness really about?

Is it just another element being used by people who don't really want indoor dining and socialising opened up without being guaranteed 100% there's no chance of being exposed to any Covid19 virus!

Risk is part of life - every time you get in a car, walk or cycle 150 people every year fail to come home and probably 10 times more are seriously injury with life changing injuries but we still do it.