UK COVID-19 Daily: Three Studies Report on BAME Risks

Tim Locke

May 07, 2020

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

Three Studies Report on BAME Risks

Three studies published today give new insights into COVID-19 ethnicity risks.

The Office for National Statistics said its results showed that the difference between ethnic groups in COVID-19 mortality is partly a result of socio-economic disadvantage and other circumstances, "but a remaining part of the difference has not yet been explained".

In another study, University of Oxford and the London School of Hygiene & Tropical Medicine (LSHTM), researchers analysed the pseudonymised health data of more than 17.4 million UK adults. Study co-lead Professor Liam Smeeth said in a news release: "It is very concerning to see that the higher risks faced by people from BME backgrounds are not attributable to identifiable underlying health conditions."

BAME groups are 2-3 times more likely to die in hospital with COVID-19, according to a separate UCL analysis of NHS data. Lead author, Dr Rob Aldridge, said in a news release: "Our findings support an urgent need to take action to reduce the risk of death from COVID-19 for BAME groups."

Earlier this week Public Health England began a review into why the severity of COVID-19 varies between people.

COVID-19 Child Hyperinflammatory Condition Cases Detailed

A Lancet article gives more details of the "unprecedented cluster" of UK children affected by a Kawasaki-like suspected COVID-19-related hyperinflammatory condition.

All children were previously fit and well, six were of African-Caribbean descent, five were boys, seven were obese, four children had family exposure to COVID-19.

One child died from a large cerebrovascular infarct.

Treatment included intravenous immunoglobulin, antibiotics, and aspirin.

Children were discharged from PICU after 4–6 days and are receiving ongoing surveillance for coronary abnormalities.

The team from the South Thames Retrieval Service for Children, Evelina London Children’s Hospital Paediatric Intensive Care Unit, write: "We suggest that this clinical picture represents a new phenomenon affecting previously asymptomatic children with SARS-CoV-2 infection manifesting as a hyperinflammatory syndrome with multi organ involvement similar to Kawasaki disease shock syndrome. The multifaceted nature of the disease course underlines the need for multispecialty input (intensive care, cardiology, infectious diseases, immunology, and rheumatology)."

Including these eight children the hospital has now managed more than 20 children with a similar clinical presentation. Ten of these tested positive for COVID-19 antibodies.

Commenting via the Science Media Centre, Prof Jon Cohen, emeritus professor of infectious diseases, Brighton & Sussex Medical School, said: "Some caution is needed in jumping to the conclusion that this is 'paediatric COVID'. The investigators report that 4 of the 8 cases had been exposed to Coronavirus; hence, it is perhaps not surprising that they had detectable antibodies. 

"Secondly, the clinical syndrome described, that of atypical Kawasaki shock syndrome, or toxic shock syndrome, can be precipitated by various stimuli and it is conceivable that this cluster was caused not by COVID but as a result of some other infective or non infective stimulus. 

"Nevertheless, the media reports that followed the initial description of these cases resulted in similar clusters being described in several other specialist centres, lending credence to the fact that this is indeed a new, but thankfully rare, concerning clinical syndrome."

Lockdown Loosening Speculation Damped Down

Downing Street has moved to play down speculation about major relaxation of lockdown measures when Boris Johnson makes a TV address on Sunday evening. 

Headlines this morning included: 

  • "Hurrah! Lockdown Freedom Beckons" (Daily Mail)

  • "First Steps to Freedom From Monday" (Daily Express) 

  • "Happy Monday" (Sun)

Changes, a spokesperson for the PM said, would be "very limited" and taken with "maximum caution". 

A spokesperson for the Welsh Government said: "Some of the reporting in today’s newspapers is confusing and risks sending mixed messages to people across the UK."

Scotland's First Minister Nicola Sturgeon said today the restrictions in Scotland "must be extended" and that easing them would be "very, very risky".

"The virus is not beaten. It remains deadly and infectious," Foreign Secretary Dominic Raab told the daily Downing Street briefing.

Playing down expectations he said: "I think it's safe to say that any changes in the short-term will be modest, small, incremental, and very carefully monitored, and as of now there is no changes." 

Daily Deaths and Data

Another 539 UK COVID-19 deaths were announced today taking the total to 30,615.

Of the 383 deaths in English hospitals, patients were aged between 28 and 100. Of these,   41, aged between 28 and 96 had no known underlying health condition.  

Dr Jenny Harries, deputy chief medical officer for England gave an update on the latest data.

Daily tests: 86,583, below the 100,000 daily target for the fifth day in a row. "There has been a little bit of a technical hitch in the lab over the weekend but that's now starting to rise again," Dr Harries said. 

There were 5614 new COVID-19 cases reported today.

Hospital bed occupancy:  "Just about all regions have come right back down to relatively low levels compared with the peak. Of course I say relatively, for the number of people in hospitals, that still represents a huge workload for NHS frontline staff, but it does show a decrease of 16% over the last week."

On critical care: "Less than a third of critical care beds are occupied by COVID-19 patients, and that's been decreasing right across the UK over the last 2 weeks."

On deaths: Dr Harries highlighted the midweek 7 day rolling average: "This is the lowest I think that we've seen since the end of March.” 

R is now 0.5-0.9. Professor Sir Ian Diamond, national statistician, said: "I think the consensus is that it is below 1 everywhere, lowest probably in London, but certainly some variation across the different regions."  

He added: "R has probably gone up just a little bit" from the last estimates he said, "and that is driven by the epidemic in care homes."

Mr Raab said: "The single biggest challenge we've got in care homes, the ebb and flow of people in and out of them, particularly when they're not showing signs of having the virus. So, at least that's something we can control and really focus on with laser-like precision and that's what we'll do."

NHS and Healthcare Deaths

Among recently announced NHS deaths was nurse Lalaine Lopez Pesario, 54 from Mumbles Nursing Home, Swansea.

The home's Director Yolanda Jones paid tribute: "Lalaine was a kind, caring person and also a dedicated nurse. Her sudden loss brought a huge sad impact to our home and the rest of the community. She was compassionate and treated everyone with extra care and love. She brought light to our home as she loved to dance and sing."

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

More News in Brief

  • On April 18th ministers promised a consignment of 400,000 much needed gowns would arrive from Turkey the next day. The arrival was delayed by 4 days. Now it has emerged the stock was impounded because it failed quality tests. In a statement, the Department of Health and Social Care said: "All deliveries of PPE are checked to ensure the equipment meets the safety and quality standards our frontline staff need. If equipment does not meet our specifications or pass our quality assurance processes it is not distributed to the front line."

  • The first COVID-19 patients have received convalescent plasma transfusions supplied by NHS Blood and Transplant under the REMAP-CAP clinical trial. Fourteen units have been delivered made from the blood of recovered patients. Professor Anthony Gordon, chief investigator for REMAP-CAP, said in a  news release: "The REMAP-CAP trial has been specifically designed to provide answers about the best treatment options for the most seriously ill with COVID-19. It is fully adaptive, meaning that new treatments can be added as we learn more, the sample size isn’t fixed and it keeps recruiting until it finds that a treatment is better, worse, or the same as another. It also “learns” from that data so that patients are more likely to receive those interventions that are performing best."

  • Doctors have been given updated guidance from the GMC and other UK regulators on mentioning suspected COVID-19 on the medical certificate cause of death (MCCD). When there has been no positive test, "it is satisfactory to apply clinical judgement. Doctors are expected to state the cause of death to the best of their knowledge and belief, it is not required that the cause must be proven. Doctors are under a duty to complete the MCCD as accurately as possible. The inclusion of COVID-19 in any part of the MCCD is a matter for the doctor completing the form and there should be no expectation or pressure placed upon them to include or exclude it during the pandemic period."

  • COVID-19 guidance has been issued to help reduce deaths among care home residents with diabetes. A COVID-19 Response Action: Diabetes Management in Care Homes, from a group of diabetes expert groups, stresses that a quarter of UK care home residents have diabetes, and: "The epidemiology of COVID-19 incidence, severity of illness and mortality seem to be shifted towards older people particularly those with multiple comorbidities such as diabetes, hypertension, and cardiovascular disease."

  • The work of statistician Professor Sir David Spiegelhalter has been cited by ministers suggesting it is too early to make international comparisons for the UK's COVID-19 deaths. He's now tweeted: "Polite request to PM and others: please stop using my Guardian article to claim we cannot make any international comparisons yet. I refer only to detailed league tables - of course we should now use other countries to try and learn why our numbers are high."

  • Southampton General Hospital now has a Banksy in its corridor. It is called Game Changer and shows a child who has dumped his superhero toys to play with a supernurse character instead. The artist left a note saying: "Thanks for all you’re doing. I hope this brightens the place up a bit, even if it's only black and white." https://twitter.com/paulahead_UHS/status/1258072683843145728

     

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

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....