UK COVID-19 Daily: 'Tsunami'?

Tim Locke

March 26, 2020

These are the UK coronavirus stories you need to know about today.

Deaths

The daily number of people in the UK who died with coronavirus rose by more than 100 for the first time, taking the total to 578.

The data covered a different period than usual with daily reporting now reflecting cases as of 5pm the previous day rather than 9am on the day of the announcement.

The Department of Health and Social Care explained the "revised reporting approach" on Twitter: "Yesterday’s figures [463 deaths, a rise of 43] did not cover a full 24 hour period while we adjust to the new system. These figures comprised the period from 9am 24th March to 5pm on 24th March.

"Figures issued today are recorded as of 5pm 24th March to 5pm 25th March."

The data were also released after the daily Downing Street briefing.

At the online news conference, Dr Jenny Harries, England's deputy CMO, was asked to predict the peak of cases, which she declined to do: "We are only just starting to see a bite, if you like, in the interventions of social distancing that have been put into place, it would be far too early to predict that." 

When the effect of the lockdown measures starts to be seen, she said: "What we'll be looking for is a change in the slope, rather than being a very steep curve upwards, we will be looking for it to be a gentler slope. But we must not take our foot off the pedal."

'Tsunami'

A senior NHS leader has spoken of a "tsunami" of COVID-19 cases in London.

The remarks from Chris Hopson, of NHS Providers, on BBC Radio appear to be at odds with comments by Government Chief Medical Adviser Professor Chris Whitty. Yesterday, Prof Whitty said: "As of today, there is not enormous pressure on critical care [beds] compared to a bad or even normal winter day."

Mr Hopson said hospitals reported an "explosion of demand they are seeing in seriously ill patients," and that for seriously ill patients, they "talk about wave after wave after wave - the word that's often used to me is a continuous tsunami."

He added that staff sickness rates are also high: "We are now seeing 30%, 40% and indeed in some places 50% sickness rates as staff catch the virus or are in vulnerable groups or have to self-isolate."

Today, Dr Harries said: "We are trying to push forward on our testing programme, but right at the top of that list are the healthcare workers and our care workers more generally, and different responders, for example police, under the first line response systems. And that's because we recognise that knowing whether people have had the disease or not, brings people back into the workplace now, but it also means we know what our resilience is going forward, as we move into the depths, really, of the epidemic."

She was also asked if the lockdown could last 6 months. "We may see measures of lockdown going forward over the next 6 months, that would not be an implausible outcome."

She said they'd be "keeping watching the epidemiology, and flexing those interventions at the right time, in the right place, to deliver what we need, and obviously I think the whole country, and myself included, will want to be back to normal as soon as we can".

Scotland Clears Expired PPE Ready to Use

Scotland's First Minister Nicola Sturgeon said face masks that are past their use-by dates have been cleared for use. "We have brought an extra 1.5m million facemasks back into use from the NHS Scotland central stockpile. These protective masks were stockpiled because they were past their expiry date, but they have now undergone extensive testing, which has shown them to be fit for use."

On the wider issue of PPE supplies, she told her daily news briefing: "This is an issue that we attach the highest priority to."

Also today, the Royal College of General Practitioners (RCGP) called for urgent clarification on the use of personal protective equipment (PPE) when seeing patients during the COVID-19 pandemic.

Asked about supplies of PPE and test kits, Dr Harries said: "We have ordered and we have planned ahead. But I think what the public, perhaps, will recognise is that this is a brand new event - it's a pandemic. And every single country is ordering at the same time. And many of the reagents and the items that are used are coming from some single suppliers, but many from international suppliers, many of whom have actually been affected themselves by the pandemic. So I think this is not an issue of a lack of forethought in planning. It is an unprecedented event."

COVID-19 'Saturation'

The European Centre for Disease Control (ECDC) released its latest rapid risk assessment on COVID-19. It said four European countries were "at a high risk of seeing their ICU capability saturated at a prevalence of 10 hospitalised COVID-19 cases per 100,000 population (approximately twice the mainland China prevalence scenario at the peak of the epidemic)."

It said the ICU capacity of the UK and all EU/EEA countries would be exceeded at a prevalence of 100 hospitalised cases per 100,000 population (the Hubei province scenario at the peak of the epidemic).

Overall, it said "the risk of severe disease associated with COVID-19 for people in the EU/EEA and UK is currently considered moderate for the general population and very high for older adults and individuals with chronic underlying conditions."

The ECDC also said better weather in the summer was unlikely to help reduce COVID-19 cases: "There is no evidence to date that SARS-CoV-2 will display a marked winter seasonality, such as other human coronaviruses in the northern hemisphere, which
emphasises the importance of implementing intervention measures such as isolation of infected individuals, workplace distancing, and school closures."

It also said evidence suggests that COVID-19 can survive up to:

  • 3 hours in the air

  • 4 hours on copper

  • 24 hours on cardboard

  • 2-3 days on plastic and stainless steel (but with significantly decreased power)
     

Updated Advice for Pregnant Doctors and Health Workers

Updated COVID-19 guidance was issued by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives for pregnant doctors and healthcare workers.

  • Pregnant women of any gestation should be offered the choice of whether to work in direct patient-facing roles during the coronavirus pandemic.

  • Women who are less than 28 weeks pregnant should practise social distancing but can choose to continue working in a patient-facing role, provided the necessary precautions are taken.

  • Women who are more than 28 weeks pregnant, or have underlying health conditions, should avoid direct patient contact and it is recommended that they stay at home.

In a statement RCOG President Dr Edward Morris said: "Although the evidence to date available offers no evidence of harm, it is not possible to give absolute assurance to any pregnant woman that contracting coronavirus carries no risk to her baby and no risk to her over and above that experienced by a non-pregnant healthy individual. 
 
"In light of the limited evidence, pregnant women of any gestation should be offered the choice of whether to work in direct patient-facing roles during the COVID-19 pandemic, and their choices should be respected and supported."

Chloroquine and Hydroxychloroquine 'Not Licensed for COVID-19'

The drugs regulator MHRA clarified the position on use of the malaria drugs chloroquine and Hydroxychloroquine to treat COVID-19.

It said they are not licensed to treat COVID-19 related symptoms or to prevent coronavirus infection.

It said clinical trials of these medications for coronavirus are underway, and "Until we have clear, definitive evidence these treatments are safe and effective for the treatment of COVID-19, they should only be used for this purpose within a clinical trial."

'Cough Attacks' Are Crimes

The Crown Prosecution Service (CPS) says those who use coronavirus to threaten emergency and key workers will face serious criminal charges for common assault.

These attacks on emergency workers could be punishable by up to 12 months in prison.

Max Hill QC, Director of Public Prosecutions, said in a statement that he was "appalled by reports of police officers and other frontline workers being deliberately coughed at by people claiming to have COVID-19.

"Let me be very clear: this is a crime and needs to stop. The CPS stands behind emergency and essential workers and will not hesitate to prosecute anybody who threatens them as they go about their vital duties."

Free Parking

It took a pandemic to get NHS staff in England the round-the-clock free parking they campaigned for.

As well as free hospital parking, key workers will also be able to use local council parking without time restrictions or charge.

NHS England Chief Executive Sir Simon Stevens said in a statement: "Free parking will make a big difference for hundreds of thousands of frontline staff, but this is just the start, and we will be setting out further support offers over the coming days and weeks, to ensure the NHS looks after those who look after all of us."

Hide Your Lanyard

The Guardian reported on healthcare workers in London being warned to hide their ID outside work due to muggers trying to snatch NHS badges to access the free food and drink some businesses are offering to staff.

It quotes Lewisham and Greenwich NHS Trust’s all-staff briefing on Monday: "Following reports of an attempt to take the ID badges of two members of staff as they were leaving work, please make sure your ID badge is out of sight."

COVID-19: UK & Global Timeline of a Pandemic

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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