Why UK's Vaccinated Has Higher rate of Infection than the Unvaccinated?

10 October 2021

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1) Update : 13 December 2021

Introduction

The UK Heath Security Agent (UKHS) has regularly published COVID-19 vaccine surveillance reports weekly.  In its week 42 report,  it attached this table:

It also attached this chart

The table clearly shows the rate of hospitalisation and death  of those vaccinated is higher than that of the unvaccinated for age above 30. In some cases,  twice as much. Many netizens especially those anti-vax took & cited this table and the chart to mock the pro-vax.  

What Could be the cause?

UKHS explained that it could be due to a variety of reasons, including differences in the population of vaccinated and unvaccinated people as well as differences in testing patterns.  But what exactly does this mean and why does this happen?

What does it mean and Why?

The infection rate discrepancy between the vaccinated and unvaccinated always happen and is commonly found when the majority of the population is vaccinated.   This also happened recently in Singapore.  The Singapore Authority had to stop publishing such information in late September when such data become meaningless and misleading.   We are not comparing the effectiveness of vaccines.

To understand why it happens,  lets us examine a simple and extreme example.  Imagine we have a population of 10,000 people.  9,000 are fully vaccinated and stay active with constant human-to-human contacts and interactions.   The other 1,000 are unvaccinated and always stay in isolation or in a rural area away from busy streets.  In this case,  it is always likely that the rate of infection of the vaccinated is always higher than the unvaccinated in this population.

If we must compare the vaccine effectiveness,  we must make sure the comparison is always done on the fairground.  We must know if the vaccinated and unvaccinated are exposed to Covid on an equal and fair basis.   This is only possible only when the unvaccinated are not aware they were not vaccinated.   

This was exactly what the vaccine manufacturers had done when they first carried out the vaccine efficacy test earlier.  Then,  all participants were jabbed;  half with vaccines & others half with placebo.  The unvaccinated always thought they were vaccinated  They were expected to behave the same when they returned back to the community.    

Using the raw real-world data,  the remaining few unvaccinated,  knowing they are more vulnerable,   will always take extra precautionary steps to prevent themselves from exposing themselves to Covid infection.  If we were to use such raw real-world data for comparison,  we are actually not comparing vaccinated against unvaccinated but other things like vaccinated against the various Covid control measures. By using the same argument,   if the vaccinated were to take the same and stringent control measures as the unvaccinated,  quite sure the results would be much different.

Then How Do We Rate them?

When a situation like the above extreme example was to happen and we must rate them,  a fairer rating system is to compare the rate of infection (or the attack rate) of the vaccinated against a known benchmark,  An example is shown on this webpage.

In Conclusion

It is always important to know what we are comparing.  Sometimes, it is better to omit and ignore such data instead of comparing them and getting meaningless results or answers.

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Update: 13 December 2021

One can always take all extra precautions to avoid being infected but one cannot cheat death.  This superimposed chart from Our-World-in Data shows that the unvaccinated has 5 times the death rate compared to the vaccinated.  The ratio was 8:1 at the peak just a week ago.

References:

1.  UK's week 42 report;

2. Example on vaccine effectiveness comparison

Latest Update of Singapore's Covid-19 Charts

Updated Daily from 20 October 2021

MOH  resumed publishing Covid data by vaccination status again in early October after a brief stop in September.  This time,  they concentrate on reporting the data for hospitalization and severely sick patients.  The latest data are shown by vaccination status in terms of vaccinated(V) and Not-Fully-Vaccinated (NFV).   

This article will resume tracking the vaccine effectiveness.  The charts will be updated daily. 

1)  Vaccination Rates

2)  Attack Rate for Hospitalisation

This chart shows the Hospitalisation attack rates of vaccinated(V) and the Not-Fully-Vaccinated (NFV)The data is extracted from MOH's chart. The rate is worked out based on this formula

The working of such a formula is explained in this wiki. 

The chart shows the % of people who are hospitalised after having exposed to Covid-19. The right axis shows the ratio between vaccinated and not fully vaccinated.  The attack rate assumes:

1.  The population of NFV excluded those whose age is less than 12 years old (the minors) and also,  their infection figures adjusted to reflect the same.  The population of the minors is about 250,000;

2.  Those having infected will have natural immunity and 40% of them are NFV

3)  Attack Rate for Patients in O2 or ICU Beds 

Similar to Chart 1 but for patients who are severely sick requiring O2 support or ICU beds.

The chart shows the % of people who become severely sick after having been exposed to Covid-19. The right axis shows the ratio between vaccinated and not fully vaccinated.

4)  Full-Doses Vaccine Effectiveness for hospitalised & those required O2 & ICU )

This chart works out the Full-Doses' vaccine effectiveness for those who are severely sick & in O2 or ICU beds. It uses the data extracted from MOH's chart. The effectiveness is worked out based on the same formula in this wiki.

The chart shows that Fully Vaccinated people have more than 80% chances of avoiding hospitalisation & 90% chances of becoming severely sick as compared to Not Fully Vaccinated people.

Note 1:  The sudden dip could have been caused by spikes and delays in testings

Note 2:  The Chart was split to show ICU(unstable) & ICU(critical)  on 30 October 2021.

5)  Booster-Dose Vaccine Effectiveness for hospitalised & those required O2 & ICU ) 

This chart works out the Booster-Dose's vaccine effectiveness who are severely sick & in O2 or ICU beds. It uses the data extracted from MOH's chart.

The chart shows that people with Booster-Dose have more than 95% chances of avoiding hospitalisation & severely sick as compared to Not Fully Vaccinated people.

Note 1:  MOH's started to provide booster shot information on severely sick patients from 6 October 2021

Note 2:  The Chart was split to show ICU(unstable) & ICU(critical)  on 30 October 2021.

6)  Infection Number vs Hospitalisation/Dead  Numbers

This chart shows the number of Infections vs Hospitalisation published by Singapore MOH.   If the infection is due to new waves,  hospitalisation figures will usually rise in tandem.

7)  Number of Deceased

This chart shows the number of deceased as published by Singapore MOH

8)  Imported as % of Local Cases

The imported cases have cropped up the end of December 2021.  This  chart shows the import cases as % of local cases

9)  Weekly Infection Growth Rate

This Chart from MOH Singapore shows how serious is the spreading of the infection and if the infection spread has been controlled.  If the growth rate is less than 1.0,  it will mean that the infection spread has slowed down.

10)  % of people severely sick and Dead according to Vaccination Status 

This MOH Singapore chart shows the % of people becoming severely sick (Requiring O2 support and ICU) and Dead after having exposed to Covid infection.   For the period (1 May to 31 Oct 2021) as shown in this MOH webpage

11)  Daily new Cases and Case Fatality Rate (CFR)

Our World in Data has published 2 useful comparison charts that will tell how serious is the present pandemic in various countries.  These 2 chart shows the situation in ASEAN Countries.   It will be less worrying if a country has very high new Cases but very low CFR especially when the country has a lot of new asymptomatic cases.  This is presently the case in Singapore.

Reference:

1.  MOH Twitter

2.  Covid-19 Situation Report (Summary)

3.  Covid-19 Situation Report (Detail)

4.  News Highlight (Daily)

5.  Statistic

6.  Download MOH Singapore Data

a)  Raw from MOH/Data.sg

         

b)  Extracted

Why Discriminate Against Unvaccinated?

21 October 2021

Nowadays,   it is common for countries to restrict the movement of the unvaccinated.  Some do not allow unvaccinated to enter PUBs,  some,  to enter malls and public places. This has made many people very unhappy.   Some even take the matter to the street,  protesting against the Government for unfairness and discrimination, and for disrupting their daily and family life. This article will try to illustrate why there is such a rule using the available data provided by MOH of Singapore.

Singapore's New Covid Rule

Singapore changed its Covid rule on 9 October 2021.  The new rule allows only groups of up to 2 fully vaccinated persons to dine in at hawker centres and coffee shops, and to enter shopping malls and attractions.  The Authority did not elaborate much on the reasons for such a move when they first announced the new rule. 

 

Possible & Likely Reasons for such Move

The following are the possible and likely reasons:

1.  The number of those severely ill patients requiring oxygen support and ICU has risen exponentially;  most of these patients are unvaccinated and many of them are seniors;

3.  The existing and available medical facilities have almost been exhausted;  it is expensive and wasteful to increase the facilities unless it cannot be avoided.   

The Explanatory Charts

MOH has published several data and charts as shown in the appendix.   Among them,  only the following chart could explain and back up the reasons.  This chart shows that the Not-Fully-Vaccinated (NFV) are using up more than 50% of oxygen and ICU facilities at the present date.  But the number of unvaccinated at present is less than 10% of the population if we were to exclude those below 12 years old.

Click picture to enlarge

   

The following charts expanded from the MOH's data show the attack rate of those severely ill patients recently admitted to the hospital.      The rate is worked out based on this formula

The working of such a formula is explained in this wiki.

The chart shows  the % of people who become severely ill after  having exposed to Covid-19. 

1)  Attack Rate for Severely ill Vaccinated/Not-Fully-Vaccinated (NFV) Patients

2)  Number of Deceased

One can readily see from the above 2 charts that the attack rate of the unvaccinated and the number of death have risen significantly in recent weeks.  Most of the death are Not-Fully-Vaccinated patients (NFV).    They, unfortunately, loaded up the existing and available medical facilities.   This must-have prompted the Singapore Government to introduce the new Covid Rule as the first step to restrict the movements of the NFV.

References:

1)  Singapore's New Covid Rule:  sg.gov

2)  Attack Rate Definition:  Wikipedia

3)  Chart source 1:  MOH,  Singapore

4)  Chart source 2:  Latest Update of Covid-19 MOH Charts

How Best to Verify if an Air-conditioning Fan Coil Requires a Chemical Washing

Chemical washing of air conditioning units is always expensive.   It is a difficult decision to make for the novice especially when the air conditioner is still in good working condition after the last servicing.  Also,  chemical washing of air conditioning units can be messy involving a lot of after-service work such as floor cleaning,  etc.  This article will describe a simple and yet cost-effective way to verify if chemical washing is necessary.

How They Tell? 

The very experienced will often determine if a chemical washing is required by just visually inspecting the condition of the fan coil.  The more responsible mechanics might carry out air flow, refrigeration pressure, or cooling coil temperature measurements.  But the result of these is just "Greeks" to the Novice.  Some might like to be convinced if the expensive chemical washing work is required.  

A quick and dirty method to tell if chemical washing is required is to use backlight inspection.  This method will use a bright light shining from the back of the fan coil unit.  The Novice can easily use this method to verify if a chemical washing is required.  

What's Needed? 

All one needs is a very bright inspection lamp that can be inserted behind the coils.  This lamp must be small & thin enough to "snake" through the very narrow space around and behind the axial fan as shown. 

This brightly lighted lamp behind the cooling coils will allow one to inspect the fins.   If the fins are badly clogged with dirt,  one could hardly see the bright light emitted by the lamps.   

Where to Buy this lamp?

This lamp can be purchased from Internet Shopping.  

The alternative is to construct such a lamp using the following components from eBay:

To make these cheap eBay lamps as inspection lamps,  one might have to stiffen the lamp wiring with some sort of thin gauge stainless wire or equivalent.  

One could also construct this inspection lamp quickly using  SMD LEDs powered by AA-size batteries with steel wire as stiffener as shown in the following picture.  The number of batteries to be used will depend on the rating of the LEDs.   Usually,  3 batteries would be more than enough to power up the LED lamp.  The addition of a small copper heat sink would ensure lasting performance.   The SMD LEDs can be extracted from spoilt LED lamps.

 The Result

    

Why do We Need to Be Concern about Some Vaccine Effectiveness Studies (Part 2) ?

In Part 1,  we found that those studies done using real World Data are actually not measuring the vaccine effectiveness but a combination of vaccine and the other Covid-19 control measures.   These other control measures are shutdowns & isolation,  mask-wearing, etc.    This Part 2 will suggest a way where we can use to monitor how effective are these combined Covid-19 control measures.  We can term this "the effectiveness of the Covid-19 control measures". 

How?

By comparing the attack rates of Covid-19 against those data obtained from the vaccine efficacy trial results or an acceptable level or limit.

What data?

From the vaccine efficacy trial results for the 3 vaccines,  namely,  Pfizer, Moderna & Johnson & Johnson,   we can obtain the following data:

a)  The average attack rate for the vaccine group was 0.24% and for the placebo group,  1.25%.  The standard efficacy formula is as follows

b)  Using the same standard formula,  we can plot out a chart showing the attack rates of the vaccine group against vaccine efficacy as shown in the following chart

Chart 1:  Attack rates of Vaccinated Group at various Vaccine Efficacies

Comparing the Attack Rates

Using the attack rates at various vaccine efficacies,  we can draw up a chart showing how effective is the Covid control measures as compared to the vaccine efficacies shown in Chart 1.  This is Chart 2 which plotted  "the Attack Rates by Vaccination Status".  This chart uses Singapore MOH's Real World Data

Doubleclick picture for latest updates

Interpretation?

1. Chart 2 illustrated that Singapore has good control over Covid-19 infection at present. It uses a combination of the following measures:

a) Vaccination: To date, 80% of the 5.9 million residents have received full-dose and 85% of them have at least 1-dose;

 b) Mask wearing & social safety distancing for all residents are compulsory for all indoor as well as outdoor activities;

 c) All social, religious gatherings and sporting events are controlled by having a cap on the maximum number of attendees as well as other controls;

         d) Business events and other events are curtailed;

e) Other measures are as shown here

2. The above control measures in Singapore are showing to have a Covid attack rate even better than the 95% vaccine efficacy;

3. The remaining 15% of the unvaccinated residents in Singapore have exercised good control measures to prevent themselves from getting infected. As many as 60,000 Singaporeans have already been infected before Singapore rolled out its vaccination program in Feb 2021. They would have the natural immunization without acquiring vaccines. Many could have been infected without noticing it because they were asymptomatic. The unvaccinated residents in Singapore have better attack rates at the present moment.

4. We can use this method to monitor how effective are our control measures and what would happen if we relax any of the control measures.

Conclusion

1. We could monitor the effectiveness of the control measures implemented in various countries by comparing the Covid-19 attack rates of the residents against those of the Vaccine Trial Tests;

2. The real World Data cannot be used to measure the vaccine effectiveness unless one can discount the effect due to all the biases and other Covid-19 control measures that will affect vaccine effectiveness calculation;

3. The standard formula cannot be used when more people in the population have been vaccinated.

The charts and table as shown will be updated daily and presented on this webpage.

Coronavirus Vaccination Status in Hong Kong

17 May 2021

Notices

The data and graph from SCMP are readable again from 22 November onwards.   The other Graphs have been updated

Hong Kong Government has been publishing data about the number of people taking Sinovac and BioNTech coronavirus vaccines.   The data has been collated and plotted by South China Morning Post (SCMP) of Hong Kong and a copy of which is mimicked here for the convenient of the readers

Courtesy: SCMP

The data has also been analyzed and graphically plotted as shown in the following which is self-explanatory

2)  Total Number of Covid-19 Doses in Hong Kong

3)  Daily 1st Covid-19 Doses in Hong Kong

4)   Daily Covid-19 Doses in Hong Kong

5)  Cummulative 1st Covid-19 Doses in Hong Kong

6)  1st Dose growth against average in Hong Kong 

The pick-up rate of the 1st dose takers was fast in the first month after the roll out. Hong Kong rolled out a vaccination plan at the end of Feb 2021.  The growth was later boosted by introducing BioNTech in early March.  But this growth rate had a setback and dropped to -70% against the average at the end of March. This was because BioNTech was suspended for 10 days for a packaging problem. The growth pick up steam from 4th April. By mid-April, it grew to 88% against the average. Growth slowly declined thereafter to the present -39%  on 19 May.

 

7)  % Population with at least 1 Dose & with Full Doses

For more other details,  please refer to this other webpage:  

The Comparison of Real World Covid Charts

Hong Kong Vaccination Data Download in CSV file

     

https://tinyurl.com/h5j7zb9e

The Updates From the Ministry of Health (MOH) of Singapore

8 September 2021

12 September 2021 Update:   MOH has stopped publishing details about infection and death rate according to vaccination status.  This page will not be updated.

Singapore's Ministry of Health (MOH) has recently changed its reporting format.   It now concentrates on reporting how well the vaccinated and unvaccinated Singapore residents have performed when they have been infected.    The idea is to encourage more residents to take vaccines.  It paid special attention to those elderly aged residents who are most vulnerable to be infected.

This article is using these MOH's real World data and transforms some of them to show the vaccine effectiveness used in Singapore as an example.  The information has been used on this webpage.   

Note:  The information in this article will be updated daily until further notice.  

Chart 1: % of Population vaccinated with 1 dose and full 2 doses

This chart shows the vaccination status of Singapore residents over the period specified. It can be used to roughly estimate the vaccine effectiveness by assuming entire Singapore as one community

Chart 2: Infection According to Vaccination Status

This chart shows the number of infections according to Vaccination Status as shown in MOH Figure 3: Local Cases in the Last 28 Days by Vaccination Status & Severity of Condition

Chart 3: The Virus Attack Rates by Vaccination Status (Infection)

This chart shows the attack rates of vaccinated and the unvaccinated of those infected. The data is extracted from the same source as Chart 2. The attack rate is explained in this wiki.

TTSH Breakout on 28 April 2021

Bukit Merah Breakout on 13 June 2021

KTV Breakout on 13 July 2021

Fishery Market Breakout on 18 July 2021

Dormitory in Woodlands Breakout on 23 Aug 2021

Note The attack rate is for a 28-day interval as stated by MOH from 9 Sept 2021

Chart 4: Attack Rates of Severely ill (O2 +ICU)

This chart shows the attack rates of vaccinated and the unvaccinated, who are severely ill and required oxygen or ICU support. The data is extracted from Figure 3: Local Cases in the Last 28 Days by Vaccination Status & Severity of Condition. The attack rate is explained in this wiki

Note 1:  6.00E-5 in vertical scale=0.006%

Note 2: The attack rate is for a 28-day interval as stated by MOH

Chart 5: The Attack Rates of Death

This chart shows the attack rates of vaccinated and the unvaccinated who have left the World. The data is extracted from Figure 3: Local Cases in the Last 28 Days by Vaccination Status & Severity of Condition. The attack rate is explained in this wiki

Note 1:  6.00E-6 in vertical scale=0.0006%

Note 2: The attack rate is for a 28-day interval as stated by MOH

Note 3:  No Death so far 1 dose; one Fully dosed 90-year-old died on 17 August

The MOH Real-World Data in CSV file

Is It True Those Vaccinated Having a Better Chance of Survival Against Covid Variants?

There are lots of arguments about the Covid vaccine isn't good.  Besides not knowing if there are long-term effects of taking them,  many argued that those vaccinated are also having more infections.  More have landed up in hospitals as evidenced by this chart published daily by the Singapore Ministry of Health (MOH). 

Isn't that Proves Vaccine is not Good and Effective?

It is very true if one is looking at those numbers.  More are infected will mean vaccines are not effective.  People require oxygen and ICU supports will mean vaccines are not necessarily working.

This is not true if one analyses further to find out why.    It is due to the following reasons; 

1.  More Singaporeans are now vaccinated and therefore,  more will be infected;

2.  Vaccine protection will depend on one's physical condition.  The elderly ones will like to be infected even if they had the full doses.  Most of them landed in the hospital are either weak or reported to have underlying diseases;

3.  Most elderly ones are already fully vaccinated;  

4.  Bulk of those serving customers in markets, stalls, and counters must have been vaccinated under a certain requirement.  These people are constantly exposed to Covid infection.  Their chances of getting the infection are higher;

These factors have distorted the infection rate of the vaccinated and unvaccinated.  There are also other factors as illustrated in this article.

How Do We Judge?

If we must judge by vaccine effectiveness against catching Covid,  we must make sure they are compared fairly using the correct methods to minimise the variables,  the unknowns,  and the biases.  This article has some examples.  If not,  we could only compare how they perform after they have been admitted to the hospitals.   Hospital records are usually more reliable.

How They Perform in Hospital?

We can compare them in terms of attack rates which is base on the following formula:

The terminology is explained in this wiki.

Using this formula,  we can draw up the following 2 charts by collecting the real World data published by MOH.

Chart 1: Attack Rates of Severely ill (O2 +ICU)

This chart shows the attack rates of vaccinated and the unvaccinated, who are severely ill and required oxygen or ICU support. The data is extracted from Figure 7: Local Cases in the Last 28 Days by Vaccination Status & Severity of Condition.

Chart 2: The Attack Rates of Death

This chart shows the attack rates of vaccinated and the unvaccinated who have left the World. The data is extracted from Figure 7: Local Cases in the Last 28 Days by Vaccination Status & Severity of Condition.

We can that those unvaccinated are having worst performance in hospitals.  Many have lost their lives.

What about the Recovery Rate?

There is no such recovery rate formula for the 28-day fixed period as given by MOH.  But we can define it as Admission/Discharge rate as follows:

We can then come up with this chart that shows the hospital admission rate and the discharge rate of those infected people.

This chart clearly shows that when the cases in the KTV lounge broke up on 13 July,  most of the admission were either not vaccinated or having one dose.   When the cases in the Fishery market broke up on 18 July,  many full-dose people got infected.  This is because most of the people in the stall owners in the market were required to be vaccinated.  The other observation is that vaccinated people were discharged very quickly from the hospital.    

This other chart shows the same but in terms of numbers still remaining in the hospital for the 28-day interval.   It clearly shows that the number of discharges is much faster for vaccinated people.

The charts shown in this article is updated daily here