UK COVID-19 Update: Liverpool to Trial Mass COVID-19 Testing

Peter Russell

November 03, 2020

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

Mass COVID-19 Testing for Liverpool

Everyone living or working in Liverpool will be offered a test for COVID-19 in the first trial of whole city testing in England.

The tests will be available to everyone, whether they have symptoms or not.

The Government said that the pilot, due to start on Friday, would help collect data to determine how mass testing could be achieved, and how fast and reliable COVID-19 testing could be rolled out more widely.

"These tests will help identify the many thousands of people in the city who don't have symptoms but can still infect others without knowing," said Prime Minister Boris Johnson. "Dependent on their success in Liverpool, we will aim to distribute millions of these new rapid tests between now and Christmas and empower local communities to use them to drive down transmission in their areas.

"It is early days, but this kind of mass testing has the potential to be a powerful new weapon in our fight against COVID-19."

Liverpool is in local tier 3 restrictions with weekly cases running at 410.4 per 100,000, as of 25 October.

Residents and workers in Liverpool will be tested using a combination of:

  • Existing swab tests

  • Lateral flow tests, which can deliver results within an hour without the need for laboratory processing

  • New loop mediated isothermal amplification (LAMP) technology which can help deliver significant volumes of saliva tests without the need to swab

The LAMP technology is due to be deployed in Liverpool University Hospitals NHS Foundation Trust for NHS staff.

The tests will be to be provided through a partnership between Liverpool City Council, NHS Test and Trace, and the Ministry of Defence, with logistical support from armed forces personnel.

Testing will be carried out in a wide variety of settings including hospitals, care homes, schools, universities, workplaces, and test sites, as well as using home kits.

Positive results will be collected by NHS Test and Trace and published as part of the daily case numbers.

"Mass testing will help us to control this virus, by finding it even before people get symptoms," said Matt Hancock, Secretary of State for Health and Social Care.

On Tuesday, the Government announced that UK testing capacity had increased to 519,770 to help meet demand over the winter months.

Commenting on the Liverpool trial to the Science Media Centre, Dr Luke Allen, academic clinical fellow at the University of Oxford, said: "This is exactly the kind of mass-testing that should have been introduced months ago.

"If it can be implemented smoothly then we will have a much clearer picture of how the virus is spreading."

Dr Alexander Edwards, associate professor in biomedical technology at the University of Reading, said: "Technology and testing is one of our most powerful tools, but technology is nothing without a joined-up and supportive public health strategy."

UK Coronavirus Deaths Increase

The number of people who died with COVID-19 in the UK increased by 48% in the week ending 23 October compared with the previous week, official provisional figures showed.

The Office for National Statistics (ONS) reported 1126 deaths in week 43 where novel coronavirus was mentioned on a death certificate compared with 761 in the week ending 16 October.

Overall, the number of deaths registered in the UK in the week ending 23 October was 12,292, which was 1222 deaths higher than the five-year average, and 364 deaths more than the previous week.

The North West and the North East of England both experienced the highest proportion of deaths involving COVID-19 (19.0%).

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

 

'Perfect Storm' Warning for Social Care Over Immigration Plans 

Independent providers of adult social care have written to the Home Secretary warning that post-Brexit immigration plans could create "a perfect storm" in workforce shortages in the sector.

Care England were responding to the Government's recent rejection of the Migration Advisory Committee's (MACs) Shortage Occupation List (SOL) recommendations.

The MAC recommended adding to the SOL senior care workers and several other health occupations who meet the required skill level for the skilled worker visa route.

In a letter to the MAC on 22 October, Priti Patel insisted she wanted to "pause and assess how the UK labour market develops", taking into account "the very uncertain future many resident workers in the UK are unfortunately facing" during the pandemic.

The letter also takes issue with the planned 'points based' immigration system which Care England said does not provide sufficient routes for adult social care workers to enter the United Kingdom.

Prof Martin Green, chief executive of Care England, said: "The adult social care sector is already afflicted by a workforce crisis as a result of COVID-19. These plans have the potential to further exacerbate the pressures upon the sector."

Younger Children May Not Be a Coronavirus Risk to Adults in Their Household

There is no evidence of an increased risk of severe outcomes from COVID-19 for adults living with younger children, a study preprint found.

The OpenSAFELY cohort study led by the University of Oxford and the London School of Hygiene and Tropical Medicine said the findings had important implications when decisions were made on keeping schools opened or not.

The research, which involved 9,157,814 adults aged 65 and under, found that living with children up to 11 years old was not associated with an increased risk of being infected with SARS-CoV-2 infection, COVID-19 related hospital admission, or ICU admission, compared with those living in households without children.

The study, conducted between February and August 2020, which includes the period of school closures during the spring, also found that it was associated with a reduced risk of death from COVID-19.

Living with children aged 12 to 18 years was associated with a small increased risk of recorded SARS-CoV-2 infection, but not associated with other COVID-19 outcomes.

The authors said that "beneficial changes in immune function from exposure to young children" were one possible factor behind the findings.

Dr David McAllister, senior clinical lecturer at the University of Glasgow, commented: "Strengths of the study include its representativeness and the large sample size, which meant that they were able to examine the risks before and after schools were closed, as well as among people above and below 65 years old, and among those who were shielding."

Support for Cancer Patients

More help is needed for cancer patients and their carers because of the effects of coronavirus, researchers said.

Research undertaken as part of the Macmillan ENABLE Study identified rising levels of stress and anxiety, restrictions on seeing loved ones, and limited opportunities to enjoy important activities during the pandemic contributing to a lack of wellbeing.

Dr Lynn Calman, ENABLE project lead and deputy director of the Macmillan Survivorship Research Group at the University of Southampton, said: "It is crucial that health professionals are able to recognise the effect the outbreak is having and develop strategies to help people facing significant health challenges to improve the quality of their lives."

C-section General Anaesthesia Rates Fell During Pandemic

The proportion of caesarean section deliveries carried out under general anaesthesia in six hospitals in North West England approximately halved during the first wave of the pandemic, researchers said.

The study, in the journal Anaesthesia, showed a decline in rates from 7.7% to 3.7%.

The lower rate was also found among the small number of women having caesarean sections who had tested positive for COVID-19.

The study authors said that while they did not want to draw specific conclusions about the influence of COVID-19 on rates of anaesthesia, guidelines at the start of the pandemic recommended using regional anaesthesia for caesarean section in preference to general anaesthesia to reduce the risk of SARS-CoV-2 infection in healthcare workers.

They also noted that most of the maternity units benefitted from the presence of more experienced and skilled personnel in delivery suites during the study period which could have led to higher regional anaesthesia rates.

The researchers said: "Overall, we conclude that the general anaesthesia rate for women having caesarean sections declined significantly during the peak of the COVID-19 pandemic.

"Anaesthetic decision-making, recommendations from these anaesthetic guidelines, and the regular presence of an on-site anaesthetic consultant in the delivery suite could be among the key factors that potentially influenced this decline."

One of the important questions this study raises is: why do trainees seemingly choose general anaesthesia more frequently when they are working solo?" commented Dr Tim Meek of the Association of Anaesthetists.

"Possible explanations include lack of confidence in their regional anaesthesia skills, a perception that general anaesthesia is always quicker and, perhaps most importantly, a disproportionate focus on target decision to delivery times as the key marker of success.

"We should now aim to identify what enables consultants to provide regional anaesthesia confidently and focus on equipping trainees with those tools to the benefit of the women and babies we all care for."

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

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