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It is hard not to be extremely excited by the news that a vaccine that is highly effective at stopping people getting severe covid-19 has been licensed for use in the UK.

At a risk of coming across as a candle snuffer, it is worth tempering our exuberance. One licensed vaccine does not mean the pandemic is as good as over.

It is, however, another very valuable tool for ongoing efforts to quell the pandemic. As a World Health Organisation special envoy for covid Dr David Nabarro pointed out, it sits alongside testing, tracing, distancing, masking and hand washing.

The vaccine will be used for directly protecting people most at risk of dying or being made seriously ill by the disease, in the initial phase of the vaccine programme at least.

The top priority is protecting care home residents, care home staff, people outside care homes aged over 80, and frontline NHS staff. That is because the very old and those in care homes are most at risk of mortality or morbidity from the virus, so giving them the vaccine should have a sizeable impact on death rates, and keeping health and care staff healthy is a very good way of ensuring more people do not die for want of care.

But there are fairly sizeable logistical challenges of giving vaccines to old, infirm and potentially housebound people at the best of times, let alone in the midst of a lethal pandemic with a vaccine that is so sensitive to temperature. NHS staff therefore are most likely to be the first to get the vaccine. And, so, all eyes now turn to the trusts, and their plans for achieving the mammoth task of vaccinating their staff.

Swab sample silence

No one wants to talk about a failure in the testing regime for covid. So the news that 523 swab samples were somehow incorrectly categorised by a pathology laboratory raises all sorts of questions which neither the laboratory nor some of the trusts where the swabs originated want to answer.

However, as HSJ has revealed, around 100 patients and NHS staff in the South East were told they had tested positive for covid when subsequent tests were negative. For staff that could just mean some time self-isolating; for patients, it could potentially mean being put on a covid positive ward.

It’s not clear whether that has happened in this case but four of the trusts involved – Frimley Health Foundation Trust, Royal Surrey FT, Ashford and St Peter’s Hospitals FT and Royal Berkshire FT – decided to carry out harm reviews. Frimley’s has completed and found no harm: the others are continuing. The lab in question – the NHS-owned Berkshire and Surrey Pathology Services – has also changed its processes.