UK COVID-19 Update: Cancer Delays, Test & Trace Statistics

Tim Locke

June 11, 2020

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

Cancer Delays & A&E Data

Despite the NHS stressing it is open for more than just COVID-19, A&E attendances in England were just 1.26m in May, down from 2.17m at the same time last year.

BMA Council Chair Dr Chaand Nagpaul commented: "The staggering reduction in patients attending A&E is of great concern, meaning that patients with emergencies are not being treated at a time when overall excess mortality in the UK is amongst the highest in Europe."

There was also a big drop in cancer referrals. "The shocking drop in the number of GP referrals for cancer treatment (down 60% from last year), and GP referrals to specialist care (down three quarters from last year), is incredibly concerning. It is, therefore, vital that services resume as soon as possible and that the Government provides the NHS with the support, resources, and capacity for this to happen safely whilst the pandemic continues. The longer the backlog persists, patients’ conditions will grow more acute or go undiagnosed," Dr Nagpaul said.

Test & Trace Statistics

One in 3 people who tested positive for COVID-19 couldn't be reached by England's Test and Trace programme which launched on 28th May, first data from the project show.

Of the 8117 people testing positive for COVID-19 up to 3rd June, 5407 (67%) were asked to give details of who they'd been in close contact with, and 31,794 contacts were identified. Of those, 26,985 were contacted and advised to self-isolate.

Most attempts to ask about people's contacts happened within 24 hours (79%).

The 33% of people testing positive who were not reached (after 10 attempts) and asked to provide contacts includes those with unavailable or incorrect contact details, or who did not respond to text, email, and call reminders.

Local data isn't yet available.

Testing coordinator Professor John Newton told a news briefing: "The things that make a difference to how effective this programme is are the speed, the compliance, and the coverage. And we want to increase all of those."

Head of Test and Trace, Baroness Dido Harding, admitted that not all data is being published yet: "There is some error in the data which is why these are experimental statistics and why they will improve over time."

She was asked about the reports of some of the 25,000 contact tracers who say they've still been given nothing to do.  "I think it is a good thing that we have excess capacity. We needed to get this service stood up in advance of lockdown measures being released," she said.

Overall she said: "These numbers show that the vast majority of the British public is embracing this and see the seriousness and importance of it."

She gave no update on progress with the NHSX smartphone app that's still being tested on the Isle of Wight: "The app will come in due course," she said.

Chris Hopson, chief executive of NHS Providers, commented: "There is still a way to go to build a fit for purpose regime, let alone a world class one. We are also running risks that could have been avoided had this work started many weeks ago."

At the Downing Street briefing the Health and Social Care Secretary for England, Matt Hancock, was asked if enforcement measures to make the system work better had been ruled out. "We're not ruling it out," he said, "but we don't think we need it." 

Nurse's Inquest

An inquest has heard how nurse Dominga David, 62, developed symptoms after sitting with a patient at University Hospital Llandough who later tested positive for COVID-19, the Standard reported.

Coroner Graeme Hughes said a full inquest was required as there was "reason to suspect that her death may be related to her employment".

Mrs David joined the hospital in 2004 after moving to the UK from the Philippines.

When her death was announced, hospital Chief Executive Len Richards said she "will be remembered as an exceptionally hard worker and a respectful, kind and compassionate person when interacting with patients, families, and colleagues alike. The teams say she was part of their family and she was well-loved by everyone."

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

COVID-19 'Discrimination'

Society's response to COVID-19 discriminates against ethnic minorities and migrants, according to UCL and University of Newcastle global health experts writing in the Journal of the Royal Society of Medicine.

Lead author of COVID-19: the great unequaliser, Dr Delan Devakumar, Institute for Global Health, UCL, said in a news release: "Black, Asian and minority ethnic and migrant groups have a greater risk of contracting COVID-19 infection, as they are more likely to live in poor and overcrowded accommodation and do precarious forms of work or work in the gig economy. They are also more likely to get a severe form of the infection."

The paper says many undocumented migrants are less likely to seek help, or delay seeking help until disease is more advanced.

The UK’s ‘hostile' immigration policy is also criticised for barriers to NHS access, such as upfront charging and the data sharing with the Home Office.

RCPCH Updates Child Shielding Guidance

The Royal College of Paediatrics and Child Health (RCPCH) has updated guidance for clinicians about the shielding of clinically vulnerable children and young people.

The initial guidance covered a broad range of conditions which has been modified as evidence emerged. Now most children managed in primary care with asthma, diabetes, epilepsy, and kidney disease do not need to continue to shield and can go back to school when they reopen.

Group A children should shield, including those with severe cerebral palsy, neuromuscular disabilities, severe motor impairment, severe metabolic disease, specific immunosuppression as part of cancer therapy.

Group B children need individual assessments, including some cardiac conditions, sickle cell disease, and immunodeficiency.

Guidance co-author, Dr Liz Whittaker, said in a statement: "We need to get the balance right between clinical risks and the social impact of shielding. We know this has been a tough period for lots of children, young people, and their loved ones. This guidance is to help doctors have evidence-based discussions with parents and carers."

Daily Deaths and Data

Another 151 UK COVID-19 deaths were announced today, taking the total to 41,279.

There were 197,007 tests counted yesterday. This figure includes home tests that have been sent out but not yet processed.

Figures for the number of people tested were last given on Friday 22nd May.

Another 1266 positive cases were reported today.

There are 5911 people currently in hospital with coronavirus, down from 7309 this time last week.

Another 462 people were admitted to hospital in the UK (excluding Scotland) with COVID-19 and 440 mechanical ventilator beds are in use across the UK by coronavirus patients.

Two UK nations updated R numbers today:

More News in Brief

  • Can the food industry be blamed for some COVID-19 excess deaths? That's the view of Graham MacGregor, Queen Mary University of London, and colleagues writing in the BMJ. He told Medscape News UK : "The biggest cause of death in the UK is unhealthy diet… it coincides with an acute pandemic – COVID-19. The two interact, and this is another reason why the Government needs to do something."

  • Even though lockdown measures have been easing, many people are still concerned about catching the virus, ongoing UCL research with more than 90,000 adults finds. At the start of lockdown half of adults were worried about catching the virus and becoming seriously ill. Now just 35% are worried and 15% are seriously worried. Lead author, Dr Daisy Fancourt, commented: "Catching the virus is still a bigger stressor amongst those surveyed than finance, potential unemployment, or worries about access to food."

  • Office for National Statistics data show that feeling 'very worried' or 'somewhat worried' about the effect COVID-19 was having on their lives was higher among disabled adults than among non-disabled adults (74% vs 69%). This was lower than in April, when 86% of disabled adults reported feeling this way.

  • The BMA and other health groups have written to the Prime Minister about delays to ending the Immigration Health Surcharge for health workers. The exemption was announced on 21st May. Dr Chaand Nagpaul, BMA council chair, commented: "There is no point scrapping the charge for individuals if they are still forced to pay thousands of pounds for their families or have already spent great sums to cover their visa for years to come."

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

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