UK COVID-19 Update: Riskiest Jobs for COVID-19

Tim Locke

June 26, 2020

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

Riskiest Jobs for COVID-19

Male security guards have a higher risk of death than those in other jobs, the Office for National Statistics (ONS) reported today. Men in other 'elementary professions' had an age standardised mortality COVID-19 death rate of 39.7 deaths per 100,000, while for the security guards it was 74.0 deaths per 100,000.

Men and women working in social care were also significantly more at risk with rates of 50.1 deaths per 100,000 for men and 19.1 deaths per 100,000 for women.

In a news release Ben Humberstone, ONS deputy director of health analysis and life events said: "There are lots of complex things playing out during the pandemic and the risk of death involving COVID-19 is influenced by a range of factors including the job someone does, but also age, ethnicity, and underlying health conditions. We also know that people living in the most deprived local areas, and those living in urban areas such as London, have been found to have the highest rates of death involving COVID-19.

"Today’s analysis shows that jobs involving close proximity with others, and those where there is regular exposure to disease, have some of the highest rates of death from COVID-19. However, our findings do not prove conclusively that the observed rates of death involving COVID-19 are necessarily caused by differences in occupational exposure."

COVID-19 and Children

A survey of UK paediatric consultants has found 32% report seeing delayed presentations in non-COVID-19 emergency care during lockdown.

The British Paediatric Surveillance Unit carried out a snapshot poll of senior paediatricians in April with 752 reponses which is reported in Archives of Disease in Childhood.

Diabetes was the most common delayed presentation, but sepsis and cancers were also reported.

Professor Russell Viner, president of the Royal College of Paediatrics and Child Health, commented: "We know a lot more than we did 3 months ago about the impact of COVID-19 on children and young people. One of the few consistent points of good news is that children are unlikely to become unwell, even if exposed to the virus. The impact for children is what we call ‘collateral damage,’ including long absences from school and delays or interruptions to vital services. We know that parents adhered very strongly to the ‘stay at home advice’ and we need to say clearly that this doesn’t apply if your child is very sick."

A separate study found that children with COVID-19 generally experience a mild disease and fatalities are very rare. The analysis of 582 patients from across Europe led by UCL Great Ormond Street Institute of Child Health is published in The Lancet Child & Adolescent Health journal.

Although the majority of children aged from 3 days to 18 years with COVID-19 were admitted to hospital (62%), only 8% required treatment in intensive care.

In a news release, lead author Dr Marc Tebruegge,said: "We were reassured to observe that the case fatality rate in our cohort was very low and it is likely to be substantially lower still, given that many children with mild disease would not have been brought to medical attention and therefore not included in this study. Overall, the vast majority of children and young people experience only mild disease. Nevertheless, a notable number of children do develop severe disease and require intensive care support, and this should be accounted for when planning and prioritising healthcare resources as the pandemic progresses."

Brain Complications

A small observational study published in The Lancet Psychiatry of 153 UK COVID-19 hospital patients found brain issues linked to the virus.

Stroke was the most common complication among 125 cases reported in detail. Of the 77 stroke patients, 57 had an ischaemic stroke, 9 had a haemorrhagic stroke, one had a stroke caused by inflammation in the blood vessels of the brain.

Another 39 patients experienced confusion or changes in behaviour, with 7 having encephalitis and 23 were diagnosed with psychiatric conditions. However, these conditions could have been previously undiagnosed.

Co-author Professor Sarah Pett PhD from University College London commented: "It is critically important that we continue to collect this information to really understand this virus fully. We also need to understand brain-complications in people in the community who have COVID-19 but were not sick enough to be hospitalised. Our study provides the foundations for larger, hospital and community-based studies. These studies will help inform on the frequency of these brain complications, who's most at risk of getting them, and ultimately how best to treat."

Elective Surgery Backlog

One in 3 surgeons in England were unable to undertake any elective or planned procedures in the last 4 weeks, according to a survey by the Royal College of Surgeons in England (RCS).

The survey was completed by 1,741 surgeons and surgical trainees. Of those who had resumed surgery, 30% reported it was only possible for cancer patients.

RCS is making recommendations to restore surgery, including:

  • Same day COVID-19 test results for patients

  • Twice-weekly tests for surgical staff at COVID-light sites

  • Use of private sector capacity

  • Use of recently retired surgeons

Tourism Concerns

The BMA is telling staycationing holidaymakers in England they may have to self-isolate if there are local outbreaks at holiday destinations.

Holiday accommodation is reopening on July 4th but the packed beach seen yesterday at Bournemouth has raised concerns about the virus being carried between regions by tourists.

England's CMO Professor Chris Whitty warned on Twitter: "If we do not follow social distancing guidance then cases will rise again. Naturally people will want to enjoy the sun but we need to do so in a way that is safe for all."

In a radio interview England's Health Secretary Mr Hancock said the Government had powers to close beaches and other public areas if people flout safety restrictions.

Dr Lucy-Jane Davis, chair of the BMA south west regional council commented: "We know that many people are looking forward to a holiday in the South West, along with other rural tourist hotspots across the country, but we also know this will present specific challenges as and when tourism returns. These areas are likely to see a large increase in population with visitors and seasonal workers. Our hospitals and GPs have been working flat out, but we have relatively limited and already stretched NHS resources, compared to the likely number of visitors."

Northern Ireland Scraps 2 Metre Rule

Northern Ireland is following England in scrapping the 2 metre rule replacing it with one metre with mitigations.

The BMA's Northern Ireland Council, Dr Tom Black, commented: "Relaxing the physical distance rule to one metre will expose people to greater risks of getting COVID-19. However, given the prevalence of the virus is lower in Northern Ireland than in other parts of the UK, this change to social distancing is acceptable only if accompanied by a clear and strong recommendation from our government that people should wear appropriate face coverings in all indoor spaces outside of their own homes and in any circumstances outside of the home where there is potential contact at less than 2 metres.

"We also want to see how the Northern Ireland Government will measure the impact of this latest relaxation and to show there are clear and robust measures to ensure these changes do not result in more people becoming infected, ill, or die [sic]; or contribute to a second spike which could overwhelm the health service should that occur this winter."
 

Test and Trace Concerns

Six new walk through COVID-19 testing centres have been set up in England after criticism that the current drive-in centres put people without cars at a disadvantage.

The centres are in Newcastle, Rochdale, Leeds, Brent, Newham, and Slough. Mobile testing is also being expanded.

However, the latest statistics from England's test and trace system found it failed to reach  a quarter of positive cases.

In its third week, of the 6923 who had cases transferred to the programme, 1791 (25.9%), couldn't be reached, and no contact details were provided for a further 263 cases.

In a letter to the BMJ today, experts raise concerns that the "ad hoc" test and trace system in England relies too much on private companies.

Professor Allyson Pollock and Dr Peter Roderick of Newcastle University, and Professor Alison Macfarlane of City, University of London, questioned why a new system was set up when a "straightforward" public health system was already in place and expressed concerns over "failings in this parallel system".

Yesterday, MPs voted against a Labour plan for routine weekly COVID-19 testing for NHS and care workers by 344 votes to 198.

However, there's Government funding for a UCL study giving repeat testing to around 10,000 care home staff and residents.

Chief investigator Dr Laura Shallcross commented: "This study will provide unique insights into the proportion of care home staff and residents who have already been infected with COVID-19, and the proportion with an antibody response. We will also collect detailed information from care homes to try and understand why some have had outbreaks and others have not."

Daily Deaths and Data

Another 186 UK COVID-19 deaths were announced today, taking the total to 43,414.

There were 165,665 tests counted yesterday. This figure includes home tests that have been sent out but not yet processed. This takes total tests to 8,911,226.

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

Another 1006 positive cases were reported today taking the total UK confirmed cases to 309,360.

The R number for the UK remains at 0.7-0.9.

The growth rate is -4% to -2%.

R in Scotland is 0.6-0.8.

R in Wales is 0.7-1.0.

R in Northern Ireland is 0.5-0.9.

R was highest in England in the North West  at 0.7-1.0, and lowest in the South West at   0.6-0.9.

Lockdown Enjoyment

A third of people in the UK have actually enjoyed the lockdown, according to UCL’s continuing COVID-19 Social Study with more than 70,000 participants.

Another 46% have not enjoyed lockdown and 21% have mixed feelings.

Meanwhile, levels of ‘complete’ and ‘majority’ compliance with lockdown measures have stopped decreasing over the past week.

Levels of confidence in the Westminster government to handle COVID-19 remain lower in England than elsewhere in the UK but have not decreased any further in the past week.

ONS figures released today showed that 43% of adults have made changes in their lifestyle that were for the better during the pandemic. Reasons included spending less time travelling, more quality time with people they lived with and a slower pace of life.

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

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