UK COVID-19 Update: RCEM Warns of 'COVID Explosion'

Tim Locke

October 09, 2020

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

RCEM Warns of 'COVID Explosion'

The President of the Royal College of Emergency Medicine (RCEM) has warned  COVID-19 "will continue its explosion across the country" unless effective precautions are taken as we head towards winter.

Dr Katherine Henderson was responding to NHS England's latest performance statistics showing that on 1 October 96% of hospital beds were occupied and 4-hour performance at emergency departments was down by 6% since May 2020.

She added: "At the start of the pandemic the Government asked us to protect the NHS to save lives. It needs to make this message clear again to the public and set out a comprehensive and consistent strategy for the winter. Without this, we fear our Emergency Departments and the NHS will be overwhelmed."

The heads of the Royal College of Anaesthetists and the Faculty of Intensive Care Medicine, Prof Ravi Mahajan and Dr Alison Pittard, also issued a cautionary statement: "Given the recent dramatic spike in both the number of cases and hospital admissions it is clear that we could soon be back to where we were in April if we are not all extremely careful. This is a matter of national importance and we will only get through this if we all work together."

The latest data from UCL's COVID-19 Social Study show 27% of people in England have 'no confidence” in the Government’s handling of the coronavirus pandemic. At the start of lockdown this figure was 6%.

Second Wave Shielding

The Times reported that a return to shielding is being planned for hundreds of thousands of clinically vulnerable people in England's infection hotspots.

Shielding was 'paused' at the end of July.

The measures are thought to be part of a widely leaked three-tier system of local restrictions in England to be announced next week.

'Striking Increase' in Positive Tests

The latest data from the Office for National Statistics (ONS) Infection Survey show infections have risen rapidly with an estimated 224,400 people in England having coronavirus from 25 September to 1 October. That equates to around 1 in 240 people.

There were around 3.16 new COVID-19 infections for every 10,000 people per day, or around 17,200 new cases per day.

Katherine Kent from ONS commented: "We’ve seen another striking increase in the number of people testing positive for COVID-19 across England in this week’s figures. Rates have been highest in the north of the country and amongst young adults.

In Wales, 6100 people had COVID-19, equating to 1 in 500 people.

In Northern Ireland, 0.22% people had COVID-19, or around 1 in 500 people.

Participants are still being recruited in Scotland.

REACT Latest Data

The continuing REACT study by Ipsos MORI and Imperial College London also produced its latest data today that show 1 in 170 people in England had the virus between 18 September and 5 October with 45,000 new infections a day.

  • Highest infection rates were among 18-24 year olds, 1 in 80 in this group in England was infected.

  • Across all ages 1 in 170 was infected.

  • The prevalence in the North West of England was 1 in 100.

  • Prevalence was highest among Asian and Black participants (0.90% & 0.73% vs 0.45% in White participants).

Professor Paul Elliott from Imperial commented: "Our robust findings paint a concerning picture of the growing epidemic across England. While certain areas are worse affected, if left unabated then infection trends will follow nation-wide and could lead to high levels of unnecessary death and illness from the disease."

R Latest

The UK's R number is lower at 1.2-1.5 down from 1.3-1.6 last week. The growth rate is +4% to +9% per day.

England's R is England 1.2-1.5 with a growth rate of +4 to +8.

The East of England has the current highest growth rate of +5 to +11.

R in Scotland is 1.3-1.6.

R in Wales is 1.3-1.6.

Northern Ireland's R number is around 1.5.

The expert SAGE advisory group said it was "almost certain that the epidemic continues to grow exponentially across the country, and is confident that the transmission is not slowing".

In today's daily data another 13,864 UK positive tests were reported and 87 deaths.

There are 3660 COVID-19 patients in hospital and 436 ventilator beds are in use.

More BAME Risk Evidence

More evidence of the additional COVID-19 risks for people of different ethnicities is highlighted in King's College London (KCL) research published in EClinicalMedicine.

Black patients have an increased risk of needing hospital admission for COVID-19, and Asian patients have an increased risk of dying in hospital from COVID-19, compared to White patients.

KCL cardiologist Professor Ajay Shah said in a news release: "The finding that Black versus Asian patients are affected in quite different ways, and that significant risk persists even after adjustment for deprivation and long-term health conditions, is striking. It strongly suggests that other factors, possibly biological, are important and that we may need different treatment strategies for different ethnic groups. For Black patients, the issue may be how to prevent mild infection progressing to severe whereas for Asian patients it may be how to treat life-threatening complications."

Rapid Bedside Testing

Hospital infection control may be improved with rapid point-of-care (POCT) testing instead of centralised PCR testing, according to University Hospitals Southampton NHS Foundation Trust research published in The Lancet Respiratory Medicine.

Median time for POCT results was 1.7 hours compared with 21.3 hours for standard tests.

The non-randomised study involved 1054 patients and the QIA-stat-Dx POCT system.

Lead author, Dr Tristan William Clark, commented: "We believe that molecular POCTs should be urgently integrated into care pathways to reduce coronavirus transmission within hospitals to prevent the next wave of the pandemic overwhelming health services around the world."

Social Impacts

Latest ONS social impact data for Great Britain show 43% of people socialising less often.

Levels of non-socialising were higher in local lockdown areas than other parts of the country lockdown (34% vs 25%).

The 'rule of six' was broken by 7% in local lockdown areas and 9% elsewhere.

Fake Doctors

Earlier this week we reported on the Great Barrington Declaration, launched by a group of experts questioning the need for tough lockdown restrictions aimed at curbing the spread of coronavirus.

However, it has emerged that among the real names, signatories include Dr Harold Shipman, Dominic Cummings of Durham 'Univercity', and Dr Person Fakename.

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

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