UK COVID-19 Update: Prepare for Winter Second Wave

Tim Locke

July 14, 2020

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

Prepare for Winter Second Wave: Report

The Government has been urged to use the next 2 months to make intense preparations for a potential second wave of COVID-19 this winter.

A report by the Academy of Medical Sciences (AMS) outlines modelling of a 'reasonable worst-case scenario' that could see as many as 119,000 excess hospital deaths between September this year and June 2021.

The authors say they are not making a prediction, but warn that NHS disruption from the first wave of COVID-19, a backlog of patients needing treatment, and the possibility of a 'flu epidemic, pose a serious threat to public health.

Face Coverings Compulsory in English Shops

After some apparent mixed messages in recent days, face coverings are to be made compulsory in shops in England from 24 July with £100 fines possible for those who don't comply.

In the Commons, England's Health Secretary Matt Hancock denied accusations of delayed decision making: "We clearly follow the evidence on face coverings and I set out some of the reasons why now is the right moment to introduce this policy."

Mr Hancock said: "The death rate of sales and retail assistants is 75% higher amongst men and 60% higher amongst women than in the general population."

He added: "There is also evidence that face coverings increase confidence in people to shop."

The BMA criticised the implementation delay saying measures should be brought in immediately. Council Chair Dr Chaand Nagpaul commented: "Up until now the Westminster Government has refused to put in place this logical policy to prevent spread of the virus, and which has been the norm in around 120 countries globally including most of Europe – so this step is long overdue.

"However, why is it waiting another 11 days to implement this policy, when the risk from COVID-19 remains present right now? This needs to happen immediately given that each day that goes by adds to the risk of spread and endangers lives. The BMA also believes that the wearing of face coverings should be extended to all settings where people cannot maintain physical distancing."

Scotland has already made face coverings in shops mandatory and they are becoming mandatory on public transport across the UK.

Phone Ahead for A&E

People with non-life-threatening issues are to be told to phone ahead rather than turning up to a busy waiting room at University Hospital of Wales in Cardiff.

They'll be assessed over the phone and given an appointment time slot if necessary.

The emergency department's lead-doctor Dr Katja Empson told the BBC: "With COVID endemic in our population and the risk that one of those people in the waiting area has indeed got COVID and isn't aware of it - the risk of transmitting that infection, potentially to other vulnerable patients within that, is unacceptable."

Patients' GP Satisfaction Under Lockdown

NHS England's latest GP Patient Survey included data from the first 2 weeks of lockdown, and  found "patients were generally more positive compared with the same period in 2019".

Royal College of GPs' Chair Professor Martin Marshall commented: "Interestingly, today’s survey results indicate a slight increase in patient satisfaction in general practice at the beginning of lockdown. While this only covers a brief period during lockdown, it does add weight to College calls to learn from the different ways general practice has been working during the pandemic. It’s important that we retain things that have worked well, such as using technology to increase options for patients accessing our services, and reducing the bureaucracy GPs undertake to free up their time for patient care."

Overall, 95% of patients had trust and confidence in the last GP or allied health professional they saw with 94% reporting that their needs were met in their last appointment. 

Slow Walking, Higher Severe COVID-19 Risk?

Walking speed may be linked to a person's risk of developing severe COVID-19, a preprint study from the University of Leicester suggested.

The findings are based on an analysis of  414,201 UK Biobank participants. Of these, 972 were hospitalised with coronavirus.

Compared to normal weight individuals, the adjusted odds ratio (OR) for severe COVID-19 in those with obesity was 1.49 (1.24, 1.78).

Compared to those with a brisk walking pace, the OR in slow walkers was 1.84 (1.49, 2.27). Slow walkers had the highest risk of severe COVID-19 regardless of obesity status.

The authors write: "Self-reported walking pace, a simple measure of functional fitness, appears to be a risk factor for severe COVID-19 that is independent of obesity."

French Doctors' Pay Rises

Doctors and health workers in France are getting COVID-related pay rises worth around €8bn.

The announcement came after 7 weeks of negotiations between government and health unions.

Prime Minister Jean Castex said the deal was in recognition of those who worked on the front line, Euronews reported.

Hep C Sofosbuvir/Daclatasvir Combo Promising for COVID-19

An inexpensive two-drug regimen of sofosbuvir (Sovaldi, Gilead Sciences) plus daclatasvir (Daklinza, Bristol-Myers Squibb) taken for 14 days significantly reduced time to recovery from COVID-19 and improved survival in people hospitalised with severe disease, according to University of Liverpool research.

The study used open-label Iranian research data.

The treatment combination "already has a well-established safety profile in the treatment of hepatitis C," said investigator Andrew Hill, PhD.

But although the results look promising, they are preliminary, he cautioned. "We need to remember that conducting research amidst a pandemic with overwhelmed hospitals is a clear challenge, and we cannot be sure of success," he added.

Daily Deaths and Data

Another 138 UK COVID-19 deaths were announced today, taking the total to 44,968.

Another 398 positive cases were reported today taking the total UK confirmed cases to 291,373.

Weekly Office for National Statistics (ONS) data for  England and Wales for the week ending 3 July 2020 (Week 27) show the number of deaths registered was 0.5% below the 5-year average.

That's the third consecutive week that deaths have been below the 5-year average.

Care homes and hospital deaths were also below the 5-year average but deaths in private homes were 755 higher than the 5-year average.

ONS also provided a graph of fatalities by the actual date of death, rather than the date reported.


Scotland Eases Hospital Visiting restrictions

Patients admitted to hospitals in Scotland who do not have COVID-19 are now allowed to meet a designated visitor.

Up to now, hospital visits were highly restricted and permitted only in few essential circumstances such as patients reaching end of life, the need for a birthing partner to be present, or if patients with mental health issues are likely to be distressed in the absence of a visit.

Hospital visitors must adhere to the following:

  • Visit time should be arranged in advance with the ward staff

  • They should not visit any other patient in the hospital

  • They must follow strict hand hygiene and face covering guidance

  • They must maintain strict physical distancing within the hospital's communal areas

  • They should not visit if they have symptoms suggestive of COVID-19

Health Secretary, Jeane Freeman, said: "There is a need to balance the risk of physical and psychological harm that the absence of visitors can cause, with the gradual reduction of COVID-19. We have worked with Health Protection Scotland to plan how we safely restore a person-centred approach to visiting in Scotland’s hospitals."

This section originally appeared on Univadis, part of the Medscape Professional Network.

Extra Parental Leave in Northern Ireland

Parents of babies born during the pandemic will be able to take an additional 3 weeks’ parental leave in Northern Ireland.

Ministers said it recognises the "particular challenges" parents have faced due to COVID-19, the Belfast Telegraph reported. A formal announcement is due on Monday.

Meanwhile, 1 in 3 parents felt out of their depth supporting their children during the lockdown, according to a YouGov survey of 2001 parents of under-18s for Action for Children.

Thirty seven percent were worried their children will struggle to socialise and want to remain at home, despite lockdown measures being eased.


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