UK COVID-19 Update: Vaccine Human Challenge Trials, Manchester Latest

Tim Locke

October 20, 2020

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

Vaccine Human Challenge Trials Planned

Imperial College London is leading a world-first exploration of coronavirus vaccine human challenge trials.

UK COVID Challenge will work with the Department for Business, Energy and Industrial Strategy, the private company hVIVO, and the Royal Free London NHS Foundation Trust.

Healthy volunteers aged 18 and 30 with no previous history or symptoms of COVID-19 will be recruited.

They'll be infected with the smallest amount of virus needed for a person to develop COVID-19 in a virus characterisation study.

Although there are risks with human challenge trials, they make it easier to test and compare vaccines without varying infection rates in the population.

The study will have special ethical oversight and will need Medicines and Healthcare products Regulatory Agency (MHRA) approval before it begins, potentially early next year.

Lead researcher Dr Chris Chiu from Imperial commented: "Our number one priority is the safety of the volunteers. My team has been safely running human challenge studies with other respiratory viruses for over 10 years. No study is completely risk free, but the Human Challenge Programme partners will be working hard to ensure we make the risks as low as we possibly can."

Co-investigator Professor Peter Openshaw added: "Deliberately infecting volunteers with a known human pathogen is never undertaken lightly. However, such studies are enormously informative about a disease, even one so well studied as COVID-19."

Among those commenting via the Science Media Centre, Dr Doug Brown, chief executive of the British Society for Immunology, said: "By carrying out this type of study in a controlled environment, researchers can learn at pace about the disease, which will ultimately increase our ability to control the pandemic and save lives."

Government Chief Scientific Adviser Sir Patrick Vallance sounded another note of caution on vaccination yesterday. "I think it is unlikely that we will end up with a truly sterilising vaccine that completely stops infection. It is likely that this disease will circulate and be endemic," he told the joint Commons and Lords National Security Strategy Committee.

Manchester Latest

Greater Manchester was given a noon deadline to accept a deal to go into the 'very high' Tier 3 local lockdown. That passed without agreement.

The decision came down to local officials saying they were £5m short of the £65m financial support they requested from the Government.

Boris Johnson told a Downing Street briefing he'd be imposing Tier 3 status on Greater Manchester from Friday. "Not to act would put Manchester's NHS, and the lives of many of Manchester's residents at risk," he said.

NHS England National Medical Director Prof Stephen Powis said: "There are more patients in hospitals in Greater Manchester alone at the moment than there are in hospitals in the entire South East, and South West of the country."

England's Deputy Chief Medical Officer Prof Jonathan Van Tam was asked if he supported a Wales-style 'national firebreak'.

In areas where the virus is out of control he said "hard measures are needed". But he didn't think the same measures were appropriate for areas where lower levels of the virus are seen.

Daily Data

In today's daily data another 21,331 UK positive tests were reported and 241 deaths.

Figures are often higher after a weekend.

Dr Yvonne Doyle, medical director, Public Health England, commented: "The trend in deaths is rising sharply. Tragically we know that older people and those with underlying health conditions tend to suffer more if they become unwell. We all have a responsibility to follow the restrictions to help stop the virus spreading to those who are at greater risk."

There are 6431 COVID-19 patients in hospital and 629 ventilator beds are in use.

Source: Gov.uk

ONS Data

Latest weekly Office for National Statistics data show deaths in week 41 in England and Wales were 1.5% above the 5-year average with COVID-19 accounting for 4.4% of all deaths.

Home deaths remain above the 5-year average, with hospitals and care home deaths below the 5-year average.

Next Wave 'Needs Better Risk Management'

The next wave of the pandemic needs better planning for risk management for vulnerable groups, according to a study in the British Journal of General Practice.

A University of Oxford led analysis of 4,413,734 GP records found those living in households of more than nine, such as care homes, had a 5 times higher risk of COVID-19 death than the general population.

The authors write: "Planning for subsequent peaks needs to better manage risk in males, those of black ethnicity, older people, people with learning disabilities, and people who live in multi-occupancy dwellings."

A separate study of 215 patients on an acute ward at Fairfield General Hospital in Greater Manchester found frailty, old age, and comorbidity were the main predictors of COVID-19 death.

Of the 86 COVID-19 deaths, 53% of the patients aged 75 to 85 years died, and 62% of the patients aged above 85 years died.

Using Clinical Frailty Scale scores, 67% of patients with a score of 6 died, 82% of patients with a score of 7 and 8 died, and all patients with a score of 9 died.

The research is published in BMC Geriatrics .

Carer Fatigue

Unpaid carers will be pushed to the limit this winter due to services impacted by COVID-19, according to a survey for Carers UK.

Among its findings:

  • 4 in 5 unpaid carers are providing more care for relatives

  • 78% dealt with increased care needs during the pandemic

  • 67% were worried about coping with restrictions

Chief Executive Helen Walker commented:"Government must prioritise carers in its plans, carry out an urgent review of breaks’ services and ensure that wider social care services have enough funding to manage over winter."

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

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