UK COVID-19 Update: December Vaccination Planning, NHS High Alert

Tim Locke

November 04, 2020

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

GPs on Standby for December Vaccination

NHS England has written to GPs asking them to prepare for a possible December coronavirus vaccination programme.

NHS England is also moving to its highest alert level from midnight as the 4 week national lockdown begins.

Oxford vaccine trial chief investigator Professor Andrew Pollard was asked by MPs on the Science and Technology Committee if his vaccine would be ready by Christmas: "There is a small chance of that being possible but I just don't know," he said.

NHS England Chief Executive, Sir Simon Stevens told a news conference: "We are obviously planning on the off chance that at least some vaccine is available before Christmas, but that's not the central assumption that we're operating on."

Different vaccines pose different logistical challenges, he said, with some needing to be kept at -70C or below.

"So it's going to be a combination of what GPs are able to do, community pharmacists, but also mass vaccination centres," which he said will include some of the Nightingale field hospitals.

"And then we're going to need roving teams who will prioritise care homes and social care staff, and other vulnerable groups, but the bulk of this is likely to be the other side of Christmas but we want to be ready in the event that those optimistic signs that you've been hearing about come to pass."

Sir Simon was asked, on a scale of 1 to 10, how certain was he of at least some coronavirus vaccination before Christmas if it were available, "I would answer 10 out of 10," he said.

He was also asked who'd be eligible for vaccination: "Our working assumption is that the most vulnerable people are the elderly, folks living in care homes, health and social care staff will be at the front of the queue, but with others who are at higher risk in short order, followed potentially then by a much wider group thereafter."

NHS Capacity

Sir Simon said that with around 11,000 COVID-19 patients now in hospital: "That's the equivalent of 22 of our hospitals full of coronavirus patients."

 

Source: NHS England

NHS England National Medical Director, Professor Stephen Powis added that despite the new lockdown, "our hospital admissions, and our hospital numbers, are baked in already for the middle of November".

Dr Alison Pittard, consultant in intensive care medicine, Leeds, and dean of the Faculty of Intensive Care Medicine, said: "In my own hospital, we are now seeing numbers admitted to hospital higher than those that we saw during the peak in mid-April."

Sir Simon cautioned: "The infection rate today is the order book for intensive care for Dr Pittard in 2 or 3 weeks time."

Dr Pittard acknowledged "the toll that the first wave has taken on doctors, nurses, and allied health professions".

She was asked about reports that some ICUs are no busier than normal: "Quite frankly, to hear stories that say that we're not working as busy as we normally do is demoralising."

Sir Simon was asked what he'd say to MPs thinking of voting against England's lockdown today: "Our job in the NHS is just to set out the facts, the frankly indisputable facts about the number of coronavirus patients we're currently looking after, and the consequences if infection continues to grow."

MPs have now backed the lockdown plan.

Daily Data

In today's daily data another 25,177 UK positive tests were reported and 492 deaths.

There are 12,320 COVID-19 patients in hospital and 1142 ventilator beds are in use.

GP Practice Testing

NHS England is making coronavirus test kits available to GP surgeries on a voluntary basis.

Tests can be offered to patients who present with COVID-19 symptoms, and they can also be used for staff testing.

GPs' Second Wave Concerns

Doctors’ Association UK (DAUK) has held a cross-party briefing for MPs to explain what it says is a crisis facing primary care in the second wave of the pandemic.

DUAK's survey of nearly 900 GPs found:

  • 55% are not confident of access to adequate PPE

  • 52% say their current premises are not suitable to cater for COVID and non-COVID patients at the same time

  • 72% reported problems with patients not having access to Wifi or mobile data for video consultations

  • 78% felt that the COVID-19 pandemic has impacted negatively on their mental health

  • 48% felt unsupported by NHS England

  • 42% had problems delivering the seasonal flu vaccination programme - with 78% of those having supply problems

DAUK committee member and GP, Dr Vinesh Patel, commented: "We spoke to MPs about the important issues those working on the ground in primary care are facing such as reduced capacity to see 'hot' patients in the run-up to winter, the impact of digital deprivation on our patients, a rising workforce and its undeniable pressures on the mental health of primary care staff, as well as the disconnect between media messages and what is actually going on in primary care."

Nowcast and Forecast

The latest 'nowcast' and forecast data from the MRC Biostatistics Unit, University of Cambridge, show daily estimated infections across England at 77,600, with new infections doubling every 15 days.

Lead researcher, Professor Daniela De Angelis, commented: "R t values are slowly decreasing, but they remain above 1 in all regions. The number of infections has increased to around 80,000 per day and will continue to increase, leading to a steep rise in mortality in the near future. Curtailing this transmission requires sustained social distancing interventions. We welcome the new measures announced on 31 of October."

New 'Shielding' Guidance

New guidance to replace the old shielding advice has been issued to clinically extremely vulnerable people in England ahead of tomorrow's lockdown.

Individuals are "strongly advised to stay at home at all times", apart from taking exercise or attending medical appointments.

Deputy CMO, Dr Jenny Harries, said in a statement: "Our guidance for this group of individuals has always been advisory, but I would strongly urge all those who are clinically extremely vulnerable to take these extra precautions to keep themselves as safe as possible."

Self-isolation Software Error

Test and Trace in England gave 7230 people the wrong start and end dates for self-isolation due to a software error. New advice was later given to 4775 people.

"We have reassessed the self-isolation periods for a number of people who were contact traced, following close contact with someone who tested positive for COVID-19," a Department of Health and Social Care spokesperson said.

Car Sharing

The Guardian reported six University Hospitals of North Midlands Trust staff have developed COVID-19 symptoms after failing to wear masks while car sharing.

In an email to staff, Medical Director, Dr John Oxtoby, said: "It is essential that all staff who are car sharing wear a mask for the full journey to and from work.

"This week we had to send six members of staff home as they did not wear masks and have now developed COVID-19 symptoms."

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

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