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The UK was the first country in the world to approve a vaccine for the prevention of coronavirus, but despite the head start the scheme has hit several stumbling blocks. PoliticsHome sets out the issues slowing down the rollout of the covid jab.

Prime Minister Boris Johnson has repeatedly pledged a target of two million jabs a week, tying the widespread rollout to the scaling-back of lockdown restrictions. The UK, so far, has delivered just one and a half million doses, calling into question whether the vaccine will have been delivered in a sufficient enough quantity for life to return to normal by the Summer.

Despite the continued insistence of ministers that the roll-out was proceeding at pace, there have been several bottlenecks that may have prevented the deployment of the vaccine.

Currently, the UK’s drug watchdog, the MHRA, have approved two vaccines for use; the Pzifer/BioNTech jab and the Oxford/AstraZeneca vaccine.

The Government has secured orders of around 40 million doses of the Pzifer vaccine and a further 100 million from Oxford/AstraZeneca, enough to vaccinate the entire population.

But despite the massive orders, several GP surgeries have reported delays to the deliveries, with some patients who had been booked in for appointments having their slots cancelled at the last minute.

While many GPs have begun the latest round of vaccinations today, others have been forced to push back their vaccination schedule, blaming “logistical” issues.

In a Facebook post to a local community group, one practice manager in Sussex told patients: “Unfortunately all appointments that had been made for this week for the over 80s Covid vaccinations have had to be cancelled due to a logistical delivery problem that was completely out of our control…

“We do not have any control on the deliveries nor do we control how quickly these vaccines are delivered and in what order they are given.”


TESTING AND LOGISTICS

1610074417 563 Heres Why The UKs Coronavirus Vaccine Rollout Is Already Hitting

The Oxford/AstraZeneca jab is easy to store and transport because it can be stored at normal fridge temperatures, unlike the Pfizer doses which must be stored at -94°F until they are ready to be injected.

But under the regulatory requirements of the MHRA, each batch of the vaccine must still be tested for quality and safety by the National Institute for Biological Standards and Control (NIBSC).

It means that one sample from each batch of hundreds of thousands of doses must go through a rigorous testing process, which can take up to 20 days, before the vaccines are approved for delivery.

Those checks come on top of the manufacturers’ own quality checks which are conducted before the vaccines leave the factory, adding a further layer of complexity to the process.

Meanwhile, the sheer volume of batches arriving in the UK mean that extra pressure is being put on the MHRA, with a spokesperson for the regulator saying they were working closely with the manufacturers to ensure doses are released “as quickly as possible”.

They added: “NIBSC has scaled-up its capacity to ensure that multiple batches can be tested simultaneously, and that this can be done as quickly as possible, without compromising quality and safety.”

Other factors playing into the delay, according to ministers, is the delays at the manufacturing sites – a claim that has been disputed by both Pzifer and AstraZeneca.

But even once the doses have arrived, DHSC and NHS England have a complicated process for evaluating where batches must go to ensure that groups of surgeries, known as primary care networks (PCN), with the highest number of at-risk patients, receive the doses first.

Ruth Rankine, director of NHS Confederation’s PCN Network, said: “We are aware of a number of PCN sites that are having problems with vaccine supplies. [The NHS] is aware and is helping to sort out on a case by case basis.

“Because of the vaccine supply, the distribution is being nationally controlled to ensure most effective use of supplies across all vaccination sites. It is important to ensure that there is equity of access to the vaccine for the priority cohorts so there needs to be a balance of which sites get the vaccine and when to ensure that all priority cohorts are covered.”

She added: “Primary care is doing a really fantastic job despite challenging circumstances. With any new programme there will always be teething problems but they have shown tremendous commitment to do what is right for their patients.”


FILL AND FINISH

1610074417 52 Heres Why The UKs Coronavirus Vaccine Rollout Is Already Hitting

Once the vaccines are manufactured, they must be placed into special vials made from borosilicate glass before they can be transported and delivered to vaccine centers – a process known as fill and finish.

But the global nature of the pandemic has put strain on the process, with drug manufacturers warning last year that manufacturing shortages could delay the roll out.

Speaking to PoliticsHome ahead of the Pfizer roll out, Steve Turner, assistant general secretary of union, Unite, said the UK could face particular problems because it lacked a domestic manufacturing capability.

“The problem we’ve got now is what we’ve always complained about around manufacturing, we’ve allowed manufacturing to simply exodus the UK over decades,” he said.

“Our last borosilicate manufacturing plant from glass, which is what vials are made from, it’s a specific type of glass…that withstands extremes of heat and cold and has shock defence mechanisms built into the glass…we don’t manufacture it anymore.

“We closed our last plant in Sunderland in 2007 and allowed that to go offshore. We are now reliant on importing this glass from elsewhere around the world at a point when everybody’s looking for this glass.”

England’s deputy chief medical officer, Jonathan Van-Tam, has also suggested problems with “fill and finish” materials could delay the process.

“The only thing that is going to slow us down is batches of vaccines becoming available.

“Many of you know already that it is not just about vaccine manufacture. It’s about fill and finish, which is a critically short resource across the globe.”

A Department for Health and Social Care spokesperson denied there were supply issues, but industry insiders have expressed fears that there could be more acute shortages as other countries begin their vaccine delivery programmes.


VOLUNTEERS

1610074417 298 Heres Why The UKs Coronavirus Vaccine Rollout Is Already Hitting

To meet the two-million-a-week target, ministers put out a call for volunteers, including retired health care staff, to help meet the schedule, but that too has faced set backs.

One frequent complaint was the amount of beaucracy involved with registering volunteers, with Conservative MP and former GP Liam Fox telling MPs earlier this week that having signed up for the scheme he was required to “complete courses on conflict resolution, equality, diversity and human rights, moving and handling loads and preventing radicalisation”.

While a spokesperson for the Department for Health and Social Care said there had been “no delays” to the programme as a result of accrediting volunteers, Mr Hancock vowed to go through the training programme “line by line”, adding that “some of the training that has been put in place I don’t think is necessary.”


To achieve the government’s ambitious vaccine targets, the government is going to have to move faster to overcome these hurdles, and already there are signs that the pledge might not be hit.

Speaking earlier, Mr Hancock said the number was only a “best case scenario”, prompting a rebuke from Dr Mike Tildesley, a member of the government’s SAGE advisory group, who said: “The government shouldn’t have announced it if it was only a best case scenario.

He added: “Now rather than offering carrots to the public, they need to do everything to meet that goal.”

A government spokesperson said: “Over 1.3 million people, including almost a quarter of people aged over 80 in England, have been vaccinated and the NHS is doing everything possible to roll out doses as quickly as they can be supplied and quality checked.

“From today the Oxford/AstraZeneca vaccine is being rolled out to GP surgeries and vaccinations will be taking place at over 1,000 sites by the end of this week.

“The NHS will be offering a vaccination to everyone in the top four priority groups as set out by the Joint Committee on Vaccination and Immunisation – a total of 13.9 million people – by 15 February.”

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Pelosi to move forward with impeachment if Pence doesn’t act to remove Trump

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“In protecting our Constitution and our Democracy, we will act with urgency, because this President represents an imminent threat to both,” Pelosi said in the letter to Democrats on Sunday night laying out next steps.

The House will try to pass a measure on Monday imploring Pence to invoke the 25th Amendment, through which he and the Cabinet declare Trump “incapable of executing the duties of his office, after which the Vice President would immediately exercise powers as acting president.” If Republicans object, as is virtually certain, Democrats will pass the bill via a roll call vote on Tuesday.

“We are calling on the Vice President to respond within 24 hours,” Pelosi wrote. “Next, we will proceed with bringing impeachment legislation to the Floor.”

But it’s not clear when exactly the Senate will take up the House’s measure. The Senate isn’t scheduled to return until Jan. 19, but will hold pro forma sessions on Tuesday and Friday. In theory, a senator could try to pass the House resolution by unanimous consent, but as of now it appears unlikely that it would pass.

On Monday, multiple House Democrats plan to introduce impeachment resolutions that would become the basis of any impeachment article considered by the House later this week.

Rep. David Cicilline (D-R.I.), who will introduce an article of impeachment against Trump on Monday, said on Sunday that roughly 200 Democrats have co-sponsored the measure.

Currently, 211 voting members (plus three nonvoting members) support Cicilline’s legislation, and they are hoping to reach 217 voting members by Monday morning, enough for the House to impeach Trump, one Democratic source familiar with the matter told POLITICO.

A small number of Democrats have opted not to co-sign the bill, but privately say they will vote to support the resolution on the floor, the source added.

The impeachment effort in the House is likely to be bipartisan, with Democrats expecting at least one GOP lawmaker — Rep. Adam Kinzinger of Illinois — to sign on. A handful of other House Republicans are seriously weighing it, according to several sources, though those lawmakers are waiting to see how Democrats proceed, and some are concerned about dividing the country even further.

Among the GOP members whom Democrats are keeping an eye on are Reps. John Katko of New York, Brian Fitzpatrick of Pennsylvania, Fred Upton of Michigan, Liz Cheney of Wyoming and Jaime Herrera Beutler of Washington.

Across the Capitol, at least two Republicans — Sens. Pat Toomey of Pennsylvania and Lisa Murkowski of Alaska — have called on Trump to resign. On Saturday, Toomey told Fox News, “I do think the president committed impeachable offenses,” but told CNN the next day that he does not believe there is enough time to impeach.

Sen. Ben Sasse (R-Neb.) has also said he would consider articles of impeachment.

Another option has emerged among some Republican and moderate Democratic circles — censuring Trump — though it remains highly unlikely to advance.

A censure resolution would gain far more support in the GOP than impeachment. Some Republicans have privately been pushing for that route and are trying to get Biden on board, according to GOP sources. That group of Republicans is also warning that impeachment could destroy Biden’s reputation with Republicans.

But censure is considered a nonstarter in an incensed House Democratic Caucus, where members see it as a slap on the wrist that gives Republicans an easy out.

The Democrats’ enormous step toward impeachment on Sunday comes after Pelosi and other top Democrats held a private call on Saturday night in which they discussed the potential ramifications that a lengthy impeachment trial could have on Biden’s presidency.

Democratic leaders discussed several options to limit the political effects on Biden’s first 100 days, with one option — floated by House Majority Whip Jim Clyburn (D-S.C.) — for the House to delay the start of an impeachment trial in the Senate by holding on to the article of impeachment.

Senate Majority Leader Mitch McConnell (R-Ky.) has sent out a memo to senators explaining that the Senate could not take up impeachment until Jan. 19 at the earliest, absent unanimous consent.

A final decision has not been made, and House Democrats will discuss the matter on a 2 p.m. caucus call on Monday.

Lawmakers are already privately expressing concerns about returning to the Capitol for multiple days this week, worried about both a potential coronavirus outbreak and whether the building is secure, given how easily an armed pro-Trump mob invaded on Wednesday.

The Capitol physician urged House lawmakers and staff to get tested in a memo Sunday, saying they might have been exposed to someone who had the virus while huddling for safety in a large committee room for hours on Wednesday. During the hourslong lockdown, several Republican members refused to wear masks despite being offered them by Democrats worried about the spread of the deadly virus.

Melanie Zanona, Olivia Beavers and Marianne LeVine contributed to this report.

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Matt Hancock Scraps “Unnecessary Training Modules” Blamed For Slowing Vaccine Rollout

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Matt Hancock has agreed to remove some of the training modules required for volunteers to sign up to deliver the Covid-19 vaccine (PA)


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Matt Hancock said people will no longer need to undertake training including an anti-terrorism course to give the coronavirus jab after MPs said “bureaucratic rubbish” was delaying mass vaccination.

It comes as MPs called for the government to produce targets for the number of people given immunity before lockdown can be lifted.

The health secretary said a series of “unnecessary training modules” are being scrapped to speed up the process of getting people qualified to deliver the jab.

Speaking in the Commons, Sir Edward Leigh said he was shown by his fellow the Tory MP, a qualified GP, the “ridiculous form” he had filled out to start delivering the vaccine.

“When he’s inoculating an old lady, he’s not going to ask her if she’s come into contact with Jihadis or whatever, so the Secretary has got to cut through all this bureaucratic rubbish,” he said.

In response Mr Hancock said: “I am a man after Sir Edward’s heart and I can tell the House that we have removed a series of the unnecessary training modules that had been put in place, including fire safety, terrorism and others.

“I’ll write to him with the full panoply of the training that is not required and we have been able to remove, and we made this change as of this morning and I am glad to say it is enforced.

“I am a fan of busting bureaucracy and in this case I agree with him that it is not necessary to undertake anti-terrorism training in order to inject vaccines.”

Dr Fox had earlier challenged Boris Johnson to drop the “bureaucracy” and “political correctness” of the forms vaccine volunteers must fill out.

He told MPs: “As a qualified but non-practising doctor, I volunteered to help with the scheme and would urge others to do the same. 

“But, can I ask the Prime Minister why I’ve been required to complete courses on conflict resolution, equality, diversity and human rights, moving and handling loads and preventing radicalisation in order to give a simple Covid jab?”

Mr Johnson said he had been “assured by the Health Secretary that all such obstacles, all such pointless pettifoggery has been removed”.

The government has been attempting to recruit thousands of volunteers to help with a mass vaccination programme, and with the recent approval of the more easily deliverable Oxford/AstraZeneca version has today revealed the location of seven mass vaccination centres set to open next week.

The Prime Minister’s official spokesman told journalists at a briefing they would be at Robertson House in Stevenage, the ExCel Centre in London, the Centre for Life in Newcastle, the Etihad Tennis Centre in Manchester, Epsom Downs Racecourse in Surrey, Ashton Gate Stadium in Bristol and Millennium Point in Birmingham, and it is expected they will be run with a combination of NHS staff and volunteers.

But so far the government has not said how many people need to be inoculated before it has an impact on the coronavirus restrictions.

Mr Hancock was asked by a number of MPs if the measures could be eased once the top few tiers in the vaccine priority list had been clear.

Former Conservative chief whip Mark Harper said once the top four groups, which includes care home residents and staff, frontline NHS workers, the clinically extremely vulnerable and everyone over 70 “we’ve taken care therefore of 80% of the risk of death”.

Adding: “What possible reason is there at that point for not rapidly relaxing the restrictions that are in place on the rest of our country?”

The health secretary replied: “We have to see the impact of that vaccination on the reduction in the number of deaths, which I very much hope that we will see at that point, and so that is why we will take this – an evidence-led move down through the tiers, when we’ve broken the link, I hope, between cases and hospitalisations and deaths.”

The ex-Tory minister and another doctor, Andrew Murrison, said: “The logic of anticipating what is going to happen in two or three or four weeks’ time from the number of cases we are getting at the moment is that we can do the same in reverse.

“That is to say, when we have a sufficient number of people vaccinated up we can anticipate in two or three or four weeks’ time how many deaths have been avoided. 

“That means, since it cuts both ways he will be able to make a decision on when we should end these restrictions.”

Mr Hancock replied: “The logic of the case that Dr Murrison makes is the right logic and we want to see that happen in empirical evidence on the ground.

“This hope for the weeks ahead doesn’t take away, though, from the serious and immediate threat posed now.”

The Cabinet minister said the challenge for the government is to increase the amount of doses available, claiming “the current rate-limiting factor on the vaccine rollout is the supply of approved, tested, safe vaccine”.

He added: ”We are working with both AstraZeneca and Pfizer to increase that supply as fast as possible and they’re doing a brilliant job.”

But Labour’s shadow health secretary Jonathan Ashworth called for the government to ramp up its vaccination programme to six million doses a week.

He told the Commons: “The Prime Minister has promised almost 14 million will be offered the vaccine by mid-Feb. That depends on around two million doses a week on average.

“Both [Mr Hancock] and the Prime Minister have reassured us in recent days that it’s doable based on orders.

“But in the past ministers have told us that they had agreements for 30 million AstraZeneca doses by September 2020 and 10 million of Pfizer doses by the end of 2020.

“So, I think people just want to understand the figures and want clarity. Can ministers tell us how many of the ordered doses have been manufactured?”

Mr Ashworth added: “Two million a week would be fantastic but it should be the limit of our ambitions, we should be aiming to scale up to three, then five, then six million jabs a week over the coming months.”

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How South African police are tackling pangolin smugglers

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Quiet, solitary and nocturnal, the pangolin has few natural enemies, but researchers believe it is the most trafficked mammal in the world. The tough scales covering its body are sought after for use in Chinese medicine, in the erroneous belief that they have healing properties.

The animal has also been of interest to researchers during the coronavirus pandemic. Related viruses have been found in trafficked pangolins, though there is continued uncertainty around early theories that pangolins were involved in the transmission of the virus from animals to humans.

After South African police seized a pangolin from suspected smugglers, BBC Africa correspondent Andrew Harding witnessed how vets tried to save the animal’s life.

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