Chasing data on the vaccination programme - Blog by Dr Austin Tanney
It's hard to believe that I am writing this just after the one year anniversary of the first lockdown.
In the last 12 months, Covid has had an utterly devastating effect on our country. In the UK 126k people have tragically died. Here in Northern Ireland we have lost more than 2.000 of our families, our friends and our neighbours. Our lives have been transformed by this global pandemic.
Through the lockdown and the restrictions, it often seemed like we were fighting an uphill battle. Over time, treatments have improved, and many lives have been saved. To reduce the spread of the disease and to prevent the overwhelming of our amazing healthcare system we have all made personal sacrifices.
It's been a hard year.
But as scientists worldwide valiantly worked on developing a vaccine, a light at the end of the tunnel began to appear. On the second of December 2020, the MHRA approved the Pfizer/ BioNTech vaccine for use. Six days later, the first person was vaccinated.
Since then, the progress has been phenomenal. Here in Northern Ireland over 700,000 people have received their first dose. This is almost 50% of the adult population.
In an ideal world, when we started rolling out the Covid vaccinations, we would have done so with a perfectly developed system. With a lofty objective of vaccinating the entire adult population as quickly as is physically possible, an amazing workforce has been mobilised and incredible progress has been made.
The key simple objective has been getting vaccines into people's arms. The core primary focus has been to reduce deaths, hospitalisations and illness. To save lives and livelihoods.
The thing is, vaccination is a medical procedure. We have to record all medical procedures. We need systems to book vaccinations, ways to record that the vaccination has happened and the ability to report on the progress and the uptake.
We also, of course, need to track how well the vaccine works. We know it's not 100% effective, no treatment ever is, but we do know that the effectiveness is very high. However, we need to be able to monitor in real terms and in real time how well it works.
We also don't really know how long the vaccine conferred immunity will last. We need to be able to track this.
To do all this we need good data, well captured and well analysed.
In an ideal world we would have built the perfect system for this. But building digital systems takes time. Unsurprisingly, it takes a lot more time to build a good digital system than it does to mobilise medical staff to deliver vaccines, something they are used to doing as part of routine care.
So accepting that we don't live in an ideal world, we set out to build a system that would do what we needed to do. This had to be built in an “agile” way. Build something, release it, use it, iterate and improve. This is a common way of working in the software industry but when working with medical data, we have an extra focus on security and robustness. Even the first iteration has to be extensively scrutinised and tested to ensure it meets our exceptionally high standards for medical software.
So in reality, on the digital side of things, we have been playing catch up. Systems were put in place that worked, that were secure and that were robust but imperfect, and we improved upon them. On day one, the means by which we knew how many people had been vaccinated in any given site was quite simple and basic.
We counted them.
We counted them and reported the numbers.
Not ideal, we all accept and admit that, but reality.
Over time we have iterated, we have improved, we have built a system that works really well, but it's a constant game of catch up. As we iterate and improve, new sites open, more vaccinators are brought on board, the supply of vaccines increases and more and more people are vaccinated every day.
Each day is a success, each day brings us closer to winning the battle against Covid. But we are still playing catch up.
On the 10th of March, we launched our public facing Covid vaccinations dashboard. This is something that we had wanted to do for a while. We truly believe in openness and transparency. Up until the launch of the dashboard, daily updates were made by the Department of Health staff via Twitter to let everyone know what progress was being made. The Health Minister gave regular press briefings to ensure there is an open flow of information to the public. The launch of the dashboard was a great step forward. Now you can see not just how many people are vaccinated but how many first doses, how many second doses, how many from each cohort and where the vaccines are being delivered.
Getting this information out still requires a lot of manual collation, manual processing and manual updates. Of course, we are rigorous in how this is done. Numbers are checked, double checked and checked again. Software has been written to process and format the data to ensure its consistency and despite this, we still manually check it, multiple times.
We are moving towards a point where all of this is fully automated, all the data is collected in a single system and no manual checks are needed. We aren't quite there yet. But we are very close. It's been a monumental effort by a huge number of people to get us where we are and to ensure we can safely and effectively roll out this vaccination and prevent tragic losses of life. The people working on this project have worked tirelessly and amazing progress has been made. While exhausting and often frustrating, it's also incredibly rewarding.
As of today, over 800,000 vaccines have now been administered and it has taken a concerted and herculean effort across the entire health service, while still maintaining the standard of care we have all come to expect from our healthcare system.
Over the next few weeks we will continue to work hard to provide more information on the vaccine rollout and to share the success of this program with everyone.
Dr Austin Tanney is Head of Digital and Data Strategy at the Strategic Investment Board and has been working with the Department of Health on the vaccination programme.