UK COVID-19 Update: Vaccine Scepticism, Rising Waiting Lists

Tim Locke

November 12, 2020

Editor's note, 12 November 2020: This article was updated with today's new case data.

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

Misinformation Boosts Vaccine Scepticism

UK preprint research has shown how misinformation could drive down coronavirus vaccine uptake by as much as 6.4%.

It is estimated that at least 55% of the UK population would need to have a working vaccine to provide herd immunity.

However, a survey of 4001 people in the UK by the London School of Hygiene & Tropical Medicine (LSHTM) found 54% would definitely accept a vaccine. It was carried out in September before the recent positive vaccine news.

Barriers to having the jab included safety concerns and a desire to wait until others had been vaccinated.

Study lead Professor Heidi Larson said in a news release: "We know misinformation is out there, but until now we did not know how significant its impact really is." 

A second LSHTM study in the journal Vaccine found nearly 90% of UK parents would have a coronavirus vaccine themselves, and 89% would accept a vaccine for their children.

The results came from a survey of 1252 parents and guardians.

Less than 4% would definitely not accept a COVID-19 vaccine for themselves or their children.

People from Black, Asian, Chinese, or other ethnic backgrounds were almost three times more likely to reject vaccination than White respondents. Those from lower income households were nearly twice as likely to say no to jabs than better off families.

Lead author Dr Sadie Bell commented: "To prevent inequalities in uptake, it is crucial to understand and address factors that may affect COVID-19 vaccine acceptability in Ethnic Minority and lower-income groups who are disproportionately affected by COVID-19."

Waiting List Rises

NHS England reported the number of people waiting longer than 52 weeks to start hospital treatment was 139,545 in September, the highest since September 2008.

The BMA called with figures "truly concerning" with Council Chair Dr Chaand Nagpaul saying: "The Government must provide an urgent and comprehensive plan, backed by appropriate funding across secondary, primary and community care to help frontline services cope this winter."

Siva Anandaciva, chief analyst at The King’s Fund, commented:"With nearly 140,000 people now waiting over a year for care and the worst of winter yet to come, it’s clear the NHS won’t be back to ‘normal’ any time soon."

However, Tim Gardner, senior policy fellow at the Health Foundation, struck a positive note: "Today’s data show that the number of urgent referrals for patients with suspected cancer are now back to pre-pandemic levels. This is a major milestone for the health service and testament to the huge efforts of NHS staff."

England's latest NHS staff absence figures show a rise of 25% since last month. Nearly 17,000 more people were off work each day than in early October. Of those, 38% were due to COVID related sickness or self-isolation.

Rapid Test Accuracy Evaluated

Some lateral flow tests, designed to give results in half an hour, are accurate and sensitive enough to be used in the community, according to a Porton Down and University of Oxford evaluation.

Forty kits were evaluated with six making it through to a final phase of testing, including the Innova SARS-CoV-2 Antigen Rapid Qualitative Test which is being used in Liverpool.

Four systems had a sensitivity of more than 70% of all PCR-positive cases and all high viral loads were identified.

In a news release, Sir John Bell, regius professor of medicine at Oxford, said: "The data in this validation report demonstrates that these inexpensive, easy-to-use tests can play a major role in our fight against COVID-19.

"They identify those who are likely to spread the disease and when used systematically in mass testing could reduce transmissions by 90%.

"They will be detecting disease in large numbers of people who have never previously even received a test."

Commenting via the Science Media Centre, Professor Sebastian Johnston, Imperial College London, said: "The headline of the press release is very misleading – it gives the impression that all lateral flow antigen tests have high-sensitivity following extensive clinical testing by PHE/Oxford. This is very far from the truth."

He said that "31/40 devices were not evaluated in any detail as they failed initial testing – the precise fail criteria are not provided in this report but are assumed to be very poor sensitivity, and/or positive results with seasonal CoVs (poor specificity) and/or a high test failure frequency (failure to give a valid result)."

Meanwhile, the accuracy of the AbC-19 rapid finger-prick antibody test for SARS-CoV-2 may be lower than previously claimed, according to a study of 2847 key workers published by The BMJ.

Research by Public Health England, and the Universities of Bristol, Cambridge, and Warwick, suggests that if 10% of people given the test had previously been infected, around 1 in 5 positive test results would be false positives. 

The Government has ordered a million of the test kits for research purposes.

Professor Sylvia Richardson, Royal Statistical Society COVID-19 Task Force, commented: "At a time when reliable, effective testing is vital, and the Government is proposing to spend millions on novel tests, it is hugely important that independent assessment is available prior to purchasing.  More transparency would help the Government implement a cost effective testing strategy."

BAME Risk

More evidence on ethnicity risks has been published by the Universities of Leicester and Nottingham.

An analysis of data covering 18 million people and published in EClinical Medicine by The Lancet found people of Black ethnicity were twice as likely to be infected with coronavirus compared to people of White ethnicity. People from Asian backgrounds were 1.5 times more likely to become infected than White people.

One of the lead authors, Dr Shirley Sze, said: "The clear evidence of increased risk of infection amongst ethnic minority groups is of urgent public health importance – we must work to minimise exposure to the virus in these at-risk groups by facilitating their timely access to healthcare resources and target the social and structural disparities that contribute to health inequalities."

Test and Trace Performance

The latest performance data for England's Test and Trace service show 70.8% of in person tests results were received the day after testing.

Of those transferred for tracing, 85% were reached and asked to provide information about their contacts.

Taking into account all contacts identified, 60.4% were reached.

Changes are being made to the service to reduce the number of calls to family members living together.

Meanwhile, The Guardian reported that "huge IT issues" in the service delayed calls in mid-October.

Latest Data

Latest REACT data from Imperial College London and Ipsos MORI show more than 1 in 80 people in England have coronavirus, or 1.3% of the population. That compares with 1 in 170 in early October (0.6%).

Study author, Professor Steven Riley, from Imperial, commented: "These findings support those of other large studies that are monitoring England’s epidemic, but at the moment it’s too early to tell whether we are seeing a true slowing of growth."

Another 33,470 UK cases were reported today, the highest daily total so far. The rest of today's daily data were not available at the time of publication.

Public Inquiry 

The BMA continued to press for a public inquiry into the UK's handling of COVID-19 after deaths passed the 50,000 milestone yesterday.

Council Chair, Dr Chaand Nagpaul, said: "This is a point that should never have been reached. In March, Professor Steve Powis [national medical director of NHS England] said that if the public adhered to the nationwide lockdown the total toll could be kept below 20,000."

The new figure, he said: "is a terrible indictment of poor preparation, poor organisation by the Government, insufficient infection control measures, coupled with late and often confusing messaging for the public".

Long COVID

A study by clinicians at the Royal Free in London and UCL (University College London) published in Thorax found 69% of 384 hospitalised COVID-19 patients continued to experience debilitating symptoms more than 7 weeks after being discharged to follow-up.

  • 69% were still experiencing fatigue

  • 53% had persistent breathlessness

  • 34% still had a cough

  • 15% reported depression

  • 38% of chest X-rays remained abnormal and 9% were getting worse

Co-lead Professor John Hurst said in a news release: "Understanding 'long COVID' is critical in helping people who have been through this life-changing experience return to health."

Learning Disability Risks

People with learning disabilities were between 4.1 and 6.3 times more likely to die with COVID-19 than the general population, according to a Public Health England (PHE) report.

The risk was also higher in younger groups.

PHE said the disparity may be partly due to other health conditions, such as diabetes and obesity, and difficulties understanding guidance and recognising symptoms. Conditions like Down’s syndrome can also make people more vulnerable to respiratory infections.

Social Care Minister Helen Whately commented: "A third of those with learning disabilities who sadly died were living in residential care. There is now regular testing of staff and residents in care homes, and testing has also been rolled out to supported living settings in high risk areas. We’re also offering free PPE, and the Joint Committee on Vaccines and Immunisation has proposed those living and working in care homes should be top of the list for vaccination."

Nursing Numbers Up

Mid-year figures from the Nursing and Midwifery Council show an increase of 1.1% in nurses, midwives, and nursing associates on the permanent register.

Numbers joining from outside Europe are up 1.8% but this is lower than normal, due to COVID-19 travel restrictions, and problems with overseas exams.

However, NHS Providers' Deputy Chief Executive Saffron Cordery commented: "Nursing gaps are still all-too evident as trusts deal with a second spike of COVID-19, staff absences and burnout, and seasonal pressures."

The Royal College of Nursing has taken a billboard campaign to Westminster calling for a 12.5% pay rise. Chief Executive and General Secretary, Dame Donna Kinnair, said: "The job is tough and complex and yet we are worse off now than years ago." 

NHS England has begun a renewed recruitment drive "to capitalise on the Nightingale effect" from the pandemic.
 

COVID-19 Resilience Programme for Older People

Public health agencies across the UK should launch a National COVID-19 Resilience Programme to support older people through the pandemic, according to The Physiological Society and Centre for Ageing Better, Univadis from Medscape reported.

In a new report, the organisations present polling data from YouGov which show that almost 1 in 3 older people did less physical activity during the first lockdown. Of those, 43% said this was because they no longer had a reason or had less reason to get out of the house and be active; 32% were worried about catching COVID-19; and 29% reported lacking motivation to exercise.

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

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....