UK COVID-19 Update: Twice-weekly Staff Testing, Pfizer/BioNTech Vaccine Planning

Tim Locke

November 10, 2020

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

Twice-weekly Staff Testing

Asymptomatic patient-facing staff in England are to be issued with Innova lateral flow home test kits to be used twice-weekly.

Deputy Chief Executive of NHS Providers, Saffron Cordery, commented: "If this test is sufficiently reliable it could make a real impact on curbing the spread of infection and help to avoid unnecessary staff absences."

However, she criticised the notice given by NHS England: "It would therefore, once again, have been better to have had this news with more notice and in greater detail. Trusts and frontline staff could then have been clear on how this new approach will work in practice, along with evidence of the tests’ reliability so they could be confident in supporting their introduction."

Meanwhile, the mass public testing underway in Liverpool is being expanded to 50 more areas with each director of public health getting 10,000 antigen lateral flow kits.

Pfizer/BioNTech Vaccine Planning

Last night the Government issued a statement on the positive Pfizer/BioNTech vaccine saying the UK has procured 40 million doses.

The BMA's GP committee England Chair, Dr Richard Vautrey, said practices "will stand ready" to deliver the vaccine once it is approved by the MHRA.

Plans are being drawn up for longer clinic hours, 7-days a week, so the two doses necessary of the chilled storage vaccine can be given 21-28 days apart. This comes with an extra £150m funding for GPs in England, Health Secretary Matt Hancock said.

England's Deputy CMO Professor Jonathan Van-Tam told a Downing Street news conference yesterday he was "hopeful" some vaccines could be delivered before Christmas, but it was "not yet certain".

He also cautioned that it isn't yet known whether any of the candidate vaccines prevent a person passing the virus on to someone else.

Meanwhile, The Guardian reported that Kate Bingham, head of the vaccines taskforce, is expected to quit at the end of the year. She'd been criticised this week for spending money on a private PR agency.

Childhood Vaccination

Public Health England has asked GPs to put recovery plans in place, where needed, after falls in childhood vaccination rates under lockdown.

"Overall vaccination counts for Hexavalent and MMR vaccine remain lower at 3.8 and 2.8 percentage points lower by week 43 in 2020 than the overall vaccination counts by week 43 in 2019," a PHE report said.

In a news release, PHE said there was "a continued recovery since April, but uptake is still behind on previous years – and health experts are concerned these may fall again, leaving thousands of children vulnerable to serious illness."

Latest Data

Office for National Statistics data show the number of deaths registered in England and Wales the week ending 30 October was 10.1% above the 5-year average by 996 deaths.

'Novel coronavirus (COVID-19)' accounted for 12.7% of all deaths, up from 9.1% the previous week.

Hospital deaths were above the 5-year average for the second week in a row.

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

In the latest lockdown changes in Scotland, Fife, Angus, and Perth and Kinross move to level 3.

Wales announced there will be no GCSE, AS, or A level exams next year. They'll be replaced by teacher-managed assessments.

GPs' Second Wave Response

The Royal College of GPs says it is appropriate for most practices to now be providing a 'level 3 or 4' response.

Under level 3: "Some non-essential work stopped or delayed. Local prevalence of COVID-19 and staffing factors will determine the amount of non-essential work that can continue."

Under level 4: Significant volume of non-essential work stopped. Local prevalence of COVID-19 and staffing factors will determine the amount of non-essential work that can continue. This de-prioritisation of services should be decided in conjunction with local commissioners and system partners."

There is a final step in the planning, level 5: "All non-essential work stopped to allow general practice to cope with very significant, potentially overwhelming, demand relating to COVID-19...acute deterioration in long-term conditions and new symptoms indicating potentially serious disease."

Second Wave Concerns

Royal College of Physicians member polling results from 451 doctors found 92% are concerned about the impact increasing COVID-19 admissions will have on their hospital’s ability to deliver effective care.

RCP President, Professor Andrew Goddard, commented: "These results confirm that the NHS is in the midst of a second COVID-19 wave, and we face a long and difficult winter ahead.

"Hospitals have been gearing up for this challenge, and access to staff testing and PPE is clearly much improved. We are still seeing delays in processing test results though, and this needs to be addressed urgently to ensure we maintain the staffing capacity to cope.

"We must also do all we can to ensure that services are maintained for our non-COVID patients. This survey shows that patients are starting to present with more severe illnesses than prior to COVID-19, and they need to know the NHS is able to care for them."

'Wobble Room'

The BBC reported on an initiative for stressed staff at the Royal Derby Hospital, known as the 'wobble room'.

The idea behind it is to provide a place for frontline staff to get some respite from COVID-19 pressures.

A sign inside reads: "You are not alone. Kindness will get you through. Embrace the challenge. Look after each other. You are stronger than you think."

COVID-19 and Psychiatric Diagnoses

An Oxford University led study published in The Lancet Psychiatry found 20% of coronavirus-infected people are diagnosed with a psychiatric disorder within 90 days.

The most common conditions were anxiety, depression, and insomnia, plus a significantly higher dementia risk.

"Although preliminary, our findings have implications for clinical services, and prospective cohort studies are warranted," the authors said.

Severe COVID-19 Rare in Newborns 

Severe COVID-19 infection appears to be rare in newborns, according to Imperial College London and University of Oxford research using UK-wide data and published in The Lancet Child and Adolescent Health.

Between March and April, 66 babies required hospital treatment for COVID-19, equating to one in 1785 births (0.06%).

BAME background babies accounted for 45% of severe infections, and 24% were premature.

Of those infected nearly 90% made a full recovery.

Co-author, Dr Chris Gale, from Imperial, commented: "Most babies only develop mild symptoms when infected with the virus and make a full recovery. This research also supports UK and international guidance to keep mother and baby together even when the mother is known or suspected to have COVID-19."

Kids' Lockdown Regression

The education watchdog Ofsted has found that some children have regressed in basic skills and learning under lockdown.

Some young potty-trained children have lapsed back into nappies, it said, often where  parents could not work flexibly.

Other findings included mental distress, eating disorders, self-harm, and lost physical fitness.

App News

The husband of Baroness Dido Harding, head of England's test and trace programme, was told to self-isolate by her app.

Weston-super-Mare MP John Penrose tweeted: "It never rains but it pours.... my NHS app has just gone off, telling me to self-isolate, which I'm doing. No symptoms so far *crosses fingers*."

Baroness Harding shared early data with a committee of MPs today on compliance with isolation: "From surveys we've run from the end of August through to the middle of September shows 54% of people telling us that they didn't leave home during the period that they were asked to isolate. It's not 100% but it is slightly better than the other surveys," she said.

Meanwhile, Northern Ireland's StopCOVID NI app will soon tell users when a period of self-isolation ends.

Rather than just isolating for 14 days from getting a notification people will be given a specific date for when their isolation period can end.

Health Minister Robin Swann said: "Feedback though our app support line, indicates a public appetite for greater precision in the period of self-isolation, relating the advice to the date of their actual ‘close contact’ with someone who has tested positive for COVID-19."

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

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