UK COVID-19 Update: 'Hospital Rationing', Segmentation, Kids' Meals

Tim Locke

October 26, 2020

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

'Hospital Rationing' Newspaper Report Denied

NHS England and professional bodies issued a strong denial of The Sunday Times (paywall) claims that "Coronavirus 'rationing' kept old and frail away from hospitals" during the first wave.

The paper quoted from "triage tool" guidelines it said had been devised by England's CMO Professor Chris Whitty excluding over-80s.

A spokesperson for the Intensive Care Society said: "The decision-making guidance is derived from work commissioned from an expert group for consideration by Government, which was subsequently stood down on 28/29 March 2020, without DHSC or NHS implementation, after a review of capacity and pandemic trajectory.

"It therefore remained in draft and unpublished at this point.

"Subsequently the draft document was further adapted and refined for release as an independent professional and academic publication.

"The final version, which does not include numerical scoring, was issued for release by the Society on 28 May 2020 with endorsement by other professional bodies across the four nations, and carries the status of clinical guidance.

"No interim versions were released, published, endorsed or authorised by the Society or any of the above bodies before 28 May 2020.

"As a professional body, the Intensive Care Society forms guidance to support those working within intensive care.

"Implementation of guidance is the responsibility of individual Trusts."

App Trial Data

In September, the Health Foundation criticised a lack of data being published on NHS England's contact tracing app trials on the Isle of Wight.

Now Lancet Digital Health has reported on testing and tracing on the island in May, including the first version of the app that was later abandoned.

The authors wrote: "Between May 6 and May 28 2020, 160 COVID-19 cases on the Isle of Wight were reported to traditional contact tracing, resulting in 163 individuals receiving a notification and request to self-isolate. During the same period, 1524 people reported symptoms to the app, resulting in 1188 people receiving an exposure notification."

However, "Data from the UK Contact Tracing and Advisory Service and time series of cases traced by the app are not yet publicly available."

Overall: "We observed significant decreases in incidence and R on the Isle of Wight immediately after the launch of the Test and Trace programme. The Isle of Wight had a marked reduction in R, from 1.3 before the Test and Trace programme to 0.5 after, by one of our measures, and went from having the third highest R before the Test and Trace programme, to the twelfth lowest afterwards compared with other UTLAs [Upper-Tier Local Authorities]."

Meanwhile, the BBC reported on issues experienced with the latest version of the app for people upgrading to the new iPhone 12 who are wrongly being told 'Unfortunately, you can't run this app'.

The problem is linked to setting up the phones from iCloud backups and can be solved by turning on 'exposure notifications' in the settings.

US Trial of Oxford Vaccine Resumes

AstraZeneca is resuming the US trial of the Oxford vaccine after approval by regulators.

It was paused in September after a report of a serious neurological illness, believed to be transverse myelitis, in a participant in the UK trial.

SAGE Rejects Segmentation  

The latest papers released by SAGE advisers shows the idea of segmenting the population into broad age and risk groups, with fewer restrictions for others, was rejected.

Such a plan formed the basis of the widely-criticised Great Barrington Declaration.

Reasons it would not be viable, SAGE said, included:

  • It would not be possible to prevent the virus spreading from younger people to older people

  • A very large proportion of the population would need to withdraw from daily life for many months causing negative effects

  • An uncontrolled epidemic in younger age groups would have dire consequences for the NHS as well as having unknown long-term effects in those infected

  • It isn't known if long-term immunity results from infection with SARS-nCOV-2

  • A further epidemic in older people would happen once segmentation ended

Latest Data

Today's daily data were not available at the time of publication.

Northern Ireland's South Eastern Trust confirmed it has two patients and seven members of staff in a ward in Ulster Hospital who have tested positive for COVID-19.

Nine other patients are self isolating and the ward has been closed to further admissions and visitors. In a statement it said: "Additional infection prevention and control measures are in place to contain any further spread."

Welsh Lockdown Essentials

The Welsh Government took to twitter to clarify that women's sanitary products were essential items.

The move came after Tesco wrongly told shoppers it couldn't sell them under firebreak restrictions.

https://twitter.com/WelshGovernment/status/1320676047134822400

In England, Warrington moves into Tier 3 tomorrow.

Council leader Russ Bowden commented: "We know that our case numbers in Warrington remain stubbornly high, but what is more concerning is the number of admissions into hospital. The upsetting and grim reality is that there are more people in hospital, more people in intensive care beds and more people being taken by the virus, and we need to do all we can to try to bring this under control."

Lockdown Mental Health

The initial 6 weeks of lockdown had a significant impact on the UK population’s mental health and well-being, a new study suggests. The findings were published in the British Journal of Psychiatry, and reported by Univadis from Medscape.

In a large-scale longitudinal survey, researchers assessed 3077 adults in the UK for mental health factors, including pre-existing mental health conditions, during three ‘waves’ of lockdown between 31 March 2020 and 11 May 2020.

The findings showed that suicidal thoughts increased over the first 6 weeks of the lockdown and 26.1% of respondents experienced at least moderate levels of depressive symptoms across all three waves. Females, individuals aged 18-29 years, those coming from more socially disadvantaged backgrounds and those with pre-existing mental health conditions were likely to have worse mental health outcomes.

Study lead Prof Rory O’Connor, University of Glasgow, commented: "While public health measures, such as lockdown, have been necessary to protect the general population, we know the effects of COVID-19 on the population’s mental health and wellbeing are likely to be profound and long-lasting."

Free Meals for Kids

Thousands of paediatricians have signed an open letter calling for a Government U-turn on free school meals for low-income families during holidays.

The letter, following footballer Marcus Rashford's campaign, says: "Childhood hunger is an issue that should transcend politics. Few would disagree that one of our most basic human responsibilities is to ensure children have enough to eat."

Professor Russell Viner, president of the Royal College of Paediatrics and Child Health commented: "I've rarely seen such anger among our members. We care for children who don't have enough to eat. We see far too many of them."

The BMA called the Government's refusal to reverse its decision "shameful".

Separately, a coalition of nearly 80 organisations, headed by the Royal College of Physicians (RCP), has been launched to campaign for urgent action on health inequalities.

RCP President Professor Andrew Goddard commented: "Health inequalities are not an issue to be addressed once the pandemic is behind us; a focus on them is one way in which we can tackle COVID-19 in the short term, and help to reduce its impact upon the health and prosperity of the UK in the longer term."

Better Hospital Food

Bake Off's Prue Leith is promising better hospital food for staff and patients as part of the latest 'blueprint' for standards.

"The review provides best-in-class examples of how hospitals can serve delicious, nutritious and nicely presented meals on a budget," she said.

"Food is not only important to health, but to morale. Hospital mealtimes should be a moment of enjoyment and a pleasure to serve."

The review states that under COVID-19: "It would be easy for hospital food, yet again, to be deprioritised. That would be a mistake.

"The pandemic has shone a light on the importance of good food and proper nutrition."

NHS England's 2018 staff survey found 39% of hospital staff felt that food and catering facilities offered in their workplaces were poor.

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

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