UK COVID-19 Update: Oxford Vaccine Latest, T-cell Data

Tim Locke

November 19, 2020

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

Oxford Vaccine's 'Encouraging' Immune Response

The Oxford/AstraZeneca vaccine produced an "encouraging" immune response, according to phase 2 data on 560 healthy adults published in The Lancet. It was also safe and well tolerated, the research team reported.

Study lead author Professor Andrew Pollard commented: "Immune responses from vaccines are often lessened in older adults because the immune system gradually deteriorates with age, which also leaves older adults more susceptible to infections. As a result, it is crucial that COVID-19 vaccines are tested in this group who are also a priority group for immunisation."

Commenting, Professor Deborah Dunn-Walters, chair of the British Society for Immunology COVID-19 and Immunology taskforce, and professor of immunology, University of Surrey, said: "While this is an ongoing study, the initial results are encouraging. The vaccine appears to be well tolerated in all age groups, with older individuals reporting fewer side-effects.  At one month after giving 2 doses of the vaccine, all age groups showed a similar level of antibody response.  Some age-related differences in the cellular immune response were recorded which require further investigation.  However, if the immune measures recorded in the phase 2 part of this study correlate with protection from SARS-CoV-2, then we would expect positive outcomes from the phase 3 trial."

Meanwhile, the MHRA reacted to Pfizer's further "encouraging" data issued yesterday for its vaccine.

"We look forward to receiving the full results of the trials as soon as possible, after which we will rigorously assess the evidence of safety and effectiveness of the vaccine." MHRA CEO Dr June Raise said in a statement.

T-cell Data

Results from the EDSAB-HOME study of 2800 people using lateral flow antibody home finger prick blood test kits also produced data on T-cells. "About a quarter of the keyworker population studied had high levels of T-cells which recognised SARS-CoV2 in their blood when they joined the study in June 2020," the latest preprint said.

"However, about half the people with high levels of T-cells in their blood have not had COVID-19, as far as we could tell- the cells were probably there because of previous infection with coronaviruses other than SARS-CoV-2.

"Importantly, in our study people with higher levels of circulating T cells appeared to be protected from COVID-19 in the 4 months after recruitment in June 2020. This applies both to people who have been previously infected with COVID-19, and to those who had not."

Dr Rupert Beale, Francis Crick Institute, commented via the Science Media Centre: "About a quarter had highly reactive T-cells, more than half of them had serological evidence of prior infection using tests that would be about 70% sensitive – so only a very small proportion of adults (less than 10%, maybe much less than 10%) would be protected by pre-existing T-cell immunity."

Test and Trace

England's national Test and Trace system is still missing 39.5% of all contacts identified, latest data show.

Downing Street issued a statement accepting there were still improvements to be made.

Local health protection teams reached 98.9% of close contacts who were identified.

ONS

Office for National Statistics data for October show COVID-19 was the third most common cause of death in England and Wales.

The age-standardised mortality rate of deaths due to COVID-19 was 63.5 deaths per 100,000 in England and 81.9 per 100,000 in Wales.

In today's daily data another 22,915 UK positive tests were reported and 501 deaths.

There are 16,409 COVID-19 patients in hospital and 1430 ventilator beds are in use.

Today the WHO Regional Director for Europe Dr Hans Kluge said that currently one person is dying every 17 seconds in the European Region from COVID-19.

Care Home Testing

UCL's Vivaldi 2 study on COVID-19 infection in English care homes is being expanded to check 14,000 residents and staff quarterly.

The study will assess how antibody and cellular immunity to the virus differs among different groups to help inform future policy decisions.

Dr Laura Shallcross, UCL Institute of Health Informatics, said: "Expanding the Vivaldi study will tell us how many people living and working in care homes have been infected with COVID-19, and whether being infected once protects against future infections. This study will help us protect the most vulnerable members of society from this devastating infection."

Arthritis Drug

The international REMAP-CAP trial, led by Imperial College London and the Intensive Care National Audit & Research Centre (ICNARC) in the UK, has reported improved outcomes for critically ill COVID-19 patients treated with tocilizumab.

Unpublished trial data from 303 randomised patients gave an estimated odds ratio of 1.87 for a better outcome with tocilizumab compared to no immune modulation, Imperial said in a news release.

Professor Anthony Gordon from Imperial commented: "These early findings show that treatment with this immune modulating drug is effective for critically ill COVID-19 patients in intensive care units. When we have the results available from all participants, we hope our findings will offer clear guidance to clinicians for improving the outcomes of the sickest COVID-19 patients."

BAME Patients With Severe Kidney Disease

African-Caribbean people with end stage kidney disease (ESKD) are more likely to be admitted to hospital with COVID-19 than other ethnicities, a King's College London study published in Nephrology has found.

First author Dr Antonella Corcillo said in a news release: "Patients with ESKD are at high risk of severe COVID-19 and often have a poor prognosis. The mortality rate of patients hospitalised, as they had very severe COVID-19, was high at 36% and similar to other recent studies internationally. We observed a disproportionately high prevalence of people of Afro-Caribbean ethnicity being hospitalised. We also saw that low blood glucose levels (hypoglycaemia) were common during hospitalisation in this high-risk population and that adjustment of diabetes treatment was frequently required."

Politicians 'Suppressing Science'

Politicians and governments are suppressing science, and when good science is suppressed, people die, according to an article in the BMJ, Univadis from Medscape reported.

In an editorial, BMJ Executive Editor, Dr Kamran Abbasi, says: "The UK’s pandemic response relies too heavily on scientists and other government appointees with worrying competing interests, including shareholdings in companies that manufacture COVID-19 diagnostic tests, treatments, and vaccines. Government appointees are able to ignore or cherry pick science - another form of misuse - and indulge in anti-competitive practices that favour their own products and those of friends and associates.

"As the powerful become more successful, richer, and further intoxicated with power, the inconvenient truths of science are suppressed. When good science is suppressed, people die," he writes.

Christmas Clarification

Yesterday Public Health England's Dr Susan Hopkins answered questions about Christmas lockdown at a Downing Street briefing. She suggested that for every day of eased restrictions, 2 days of restrictions would have to follow.

PHE has now clarified this saying she "misspoke" and SAGE expert modelling indicates that 5 days of restrictions are needed for each day of relaxation.

Consultant's Twins Born While She Was in a Coma

Birmingham City Hospital rheumatology consultant Perpetual Uke has just taken her baby twins home after they were born while she was in an induced coma.

She became ill in March at 24-25 weeks of pregnancy and tested positive for COVID-19. The twins were delivered by cesarean-section.

Mrs Uke told Sky News: "I was pregnant at 24 to 25 weeks, at that stage, and by the time I woke up, I was so disorientated. I thought I'd lost my pregnancy because I couldn't see my bump any more. I was really worried.

"Sometimes I look at them in tears, I never knew they would make it. It is amazing what medical professional science can offer."

https://twitter.com/SkyNews/status/1329326041295450112?s=20

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

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