UK COVID-19 Update: December Vaccination Programme?

Tim Locke

October 16, 2020

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

December Vaccination Programme?

More details have emerged of a possible coronavirus vaccination plan for later this year.

Doctors in the West Midlands were asked to prepare for mass coronavirus vaccination as early as next month, the BBC reported on October 2.

Now Pulse says the NHS is in discussions with the BMA and others over a December vaccination programme. It quoted a source close to the talks saying the chances of it happening were "50/50".

All the Government would say is that it will do everything needed to roll out a successful vaccine quickly and safely.

Meanwhile, new laws and changes to the Human Medicines Regulations 2012 have been introduced to allow more healthcare workers to administer flu and coronavirus vaccines.

After training, this could include independent nurses, allied healthcare professionals, paramedics, physiotherapists, pharmacists, and student nurses and doctors.

The UK would also begin rolling out a coronavirus vaccine without European approval if it became available this year.

Deputy Chief Medical Officer Professor Jonathan Van-Tam commented: "COVID-19 vaccines are being developed at speed which, if successful, will save lives.

"All vaccines must undergo three stages of clinical trials and be assessed for safety and effectiveness by the regulator before they are given to patients.

"The measures outlined today aim to improve access and strengthen existing safeguards protecting patients."

Latest Restrictions

Lancashire agreed to follow Liverpool into the 'very high' Tier 3 lockdown measures, meaning the closure of hospitality and some other business.

No agreement has yet been reached with Greater Manchester. At a Downing Street news briefing Boris Johnson described the situation as "grave and it worsens with each passing day".

If agreement cannot be reached the PM said he would need to intervene to protect the NHS.

Sir Patrick Vallance, chief scientific adviser, confirmed at the briefing that SAGE suggested a 2 week 'circuit breaker' in September to try to get cases back to August levels, but said "where we are now, of course, it's a different situation".

New rules have come into effect in Scotland making face coverings mandatory in workplace settings, including canteens.

Wales' ban on travel from UK virus hotspots begins at 6pm today.

Italy, Vatican City, and San Marino, are added to the UK self-isolation travel list from Sunday morning. Crete has been added to England's no-quarantine list.

Ventilator Doctor's Family 'Faces Deportation'

Forty-four-year-old consultant cardiologist Dr Basem Enany is currently on a ventilator in Leeds General Hospital with Guillain-Barré complications from COVID-19.

However, the Guardian reported that his wife and daughters face removal from the UK when his contract expires at the end of November.

He hadn't finished his job application and visa paperwork when he became ill. His wife said it was like "a bad dream".

The Press Association quoted a Home Office spokesperson: "Dr Enany is here entirely legally and has every right to remain in the UK. Our thoughts are with his family, and we will be urgently contacting them and his employer so we can help at this difficult time. Health and social care professionals from all over the world play a vital role in hospitals and care homes across the UK and we are hugely grateful."

Rising Infections

Office for National Statistics (ONS) latest weekly Infection Survey data show infections rising despite the latest restrictions.

An estimated 336,500 people in the community population in England had coronavirus from 2 to 8 October, equating to around 1 in 160 people.

There were around 5.11 new COVID-19 infections for every 10,000 people per day, equating to around 27,900 new cases per day.

Ruth Studley from ONS said these were "the highest levels we have seen since the survey began in May. Like previous weeks, infections continue to be highest in the north of England and among older teenagers and young adults".

Sir Patrick said the infection numbers "have taken a big increase again in the last couple of weeks".

The UK's R number is now 1.3-1.5 compared with 1.2-1.5 last week.

"The epidemic is growing, probably between 4% and 7% per day," Sir Patrick said.

The growth rate is +4% to +7% per day.

England's R is 1.2-1.4.

Scotland's R is 1.3-1.6.

Wales' R is 1.0-1.4.

Daily Data

In today's daily data another 15,650 UK positive tests were reported and 136 deaths.

There are 5311 COVID-19 patients in hospital and 580 ventilator beds are in use.

Ethnicity Risks

ONS latest data for England and Wales confirm earlier findings on increased BAME COVID-19 risks:

  • Males with a Black African ethnic background had the highest rate of death involving COVID-19, more than 2.7 times higher than White males.

  • Black Caribbean ethnic background females had the highest rate, almost twice as high as White females.

  • People from a South Asian ethnic background in England had a higher prevalence of cardiovascular diseases and diabetes, which are associated with increased COVID-19 mortality, while those of Chinese background had the lowest prevalence.

Ben Humberstone from ONS commented: "Our statistical modelling shows that a large proportion of the difference in the risk of COVID-19 mortality between ethnic groups can be explained by demographic, geographical and socioeconomic factors, such as where you live or the occupation you’re in. It also found that although specific pre-existing conditions place people at greater risk of COVID-19 mortality generally, it does not explain the remaining ethnic background differences in mortality."

Health Workers' PTSD

A University of East Anglia (UEA) review of published evidence found mental health problems, including post-traumatic stress disorder, anxiety, and depression are common among healthcare staff during and immediately after pandemics.

Trainee clinical psychologist Sophie Allan from UEA said in a statement: "There is some evidence that some mental health symptoms such as post traumatic stress symptoms get better naturally over time but we cannot be sure about this. The studies we looked at had very different methods - for example they used different questionnaires about mental health - so we need to be cautious about the results."

The findings are published in the European Journal of Psychotraumatology.

Lockdown Adherence

Latest ONS data on compliance with restrictions in Great Britain show that of those who met up with people from other households, either outdoors or indoors, 17% maintained social distancing sometimes, not very often, or never.

International research led by Cambridge University with 101,000 survey participants in 55 countries found that personality plays a role in following lockdown rules.

First author, PhD researcher Friedrich Götz, commented: "Extroverts are gregarious and sociable, and they found it especially hard to stay cooped up at home and not see other people. They were most likely to break lockdown rules, and stayed at home less than people of any other personality type during March and April."

The findings are published in American Psychologist.

5 Minute Test

Oxford physicists have developed a rapid SARS-CoV-2 test giving results in under 5 minutes using fluorescence labelling and machine learning.

The work is described in a preprint, so has not yet undergone peer review.

Professor Achilles Kapanidis commented: "Unlike other technologies that detect a delayed antibody response or that require expensive, tedious and time-consuming sample preparation, our method quickly detects intact virus particles; meaning the assay is simple, extremely rapid, and cost-effective."

The test is expected to be available next year.

Today Boris Johnson stressed the importance of newly available rapid testing, and said hotspots, such as Liverpool and Lancashire would get access to this as a priority.

Cytokine Storm Blood Test

Scientists have identified a blood cytokine profile that could help identify patients with COVID-19 at risk of experiencing a potentially life-threatening immune-mediated hyperinflammatory state, better known as a 'cytokine storm'.

Univadis from Medscape reported how researchers at the University of Southampton analysed blood samples from 100 COVID-19-positive patients hospitalised between 20 March and 29 April 2020.

The findings published in the journal Respiratory Research showed that elevated levels of cytokines interleukin (IL)-6, IL-8, tumour necrosis factor, IL-1ß and IL-33 in the blood at the time of admission were associated with an increased risk of requiring intensive care, artificial ventilation and of mortality. The risk was most pronounced for IL-1ß and IL-33.

A blood test for the five cytokines could help doctors identify individuals who have the highest risk of deteriorating.

Professor Tom Wilkinson who led the study said: "It is increasingly apparent that COVID is highly heterogeneous. Only by applying these techniques to stratify the condition will we be able to target the key mechanisms of disease with the best treatment for that individual."

Second Wave HIV Guidance

The British HIV Association (BHIVA) has updated its guidance for HIV services in light of the second COVID-19 peak, Univadis from Medscape reported.

Key points include:

  • BHIVA does not advise extending the interval between routine monitoring for more than 12 months

  • Services should do all they can, within their capacity, to support people to attend for investigations

  • Where it is not possible to undertake usual monitoring, ART should still be prescribed in all but exceptional cases

  • Core service elements should be maintained during the pandemic

BHIVA is planning a registry of suspected/confirmed COVID-19 cases amongst people with HIV, and services are encouraged to document relevant cases.

Miss England

Junior doctor Bhasha Mukherjee, 24, from Derby, becomes the longest serving Miss England, Yahoo News reported.

The 2019 winner will have held the crown for 20 months by the time the contest is held again next year due to COVID-19.

https://twitter.com/missenglandnews/status/1316347811772862465

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

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