UK COVID-19 Update: MHRA Assessing Vaccine, Infections 'Levelling Off'

Tim Locke

November 20, 2020

Editor's note, 20 November 2020: This article was updated to include the latest on the MHRA assessing the Pfizer/BioNTech vaccine.

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

MHRA Assessing Vaccine

Free NHS flu vaccination is being extended to 50-64 year olds from 1 December, meaning doctors may still be delivering flu jabs as coronavirus vaccination begins.

The Department of Health and Social Care said: "The roll-out of the flu vaccine to over 50s is separate to any future COVID-19 vaccine roll-out and people will be able to receive the flu and COVID-19 vaccinations in parallel. The NHS is well equipped to administer both."

This evening, England's Health Secretary Matt Hancock told a Downing Street briefing that the Government has asked the MHRA to assess the suitability of the Pfizer/BioNTech COVID-19 vaccine. "Pfizer/BioNTech have already begun supplying data to the MHRA and will submit their full data in the coming days," he said.

Infections 'Levelling Off'

COVID-19 infections in England may be levelling off, Office for National Statistics (ONS) infection survey data suggest.

Between 8-14 November, ONS estimates 664,700 people in England had COVID-19, equating to around 1 in 80 people.

The highest infection rates are among secondary school children, older teenagers, and young adults.

There were 7.14 new infections for every 10,000 people per day, equating to around 38,900 new cases per day.

In Scotland, infection rates increased throughout most of October but now appear to have levelled off. In the most recent week 33,800 people had COVID-19,  equating to 1 in 155 people.

In Wales, ONS said infection rates seem to have peaked around the end of October, with rates decreasing over the past 2 weeks, with 18,400 people in Wales having COVID-19 in the most recent week, equating to 1 in 165 people.

In Northern Ireland, rates peaked around the middle of October. In the most recent week 13,600 people had COVID-19, equating to 1 in 135 people.

Katherine Kent from ONS commented: "There are early signs that the national level of infections in England might be levelling off but this hides a lot of variation at a regional level." 

The UK's R number is now 1.0-1.1 down from 1.0-1.2 last week.

The growth rate is 0% to +2%.

Reinfection

People who’ve recovered from COVID-19 are highly unlikely to contract it again for at least 6 months after first infection, according to a University of Oxford preprint study of UK frontline healthcare workers.

The study took place between April and November, and 89 of 11,052 staff without antibodies developed a new infection with symptoms. None of the 1246 staff with antibodies developed an infection with symptoms.

Co-study lead Professor David Eyre said: "Being infected with COVID-19 does offer protection against reinfection for most people for at least 6 months.

"We found no new symptomatic infections in any of the participants who had tested positive for antibodies."

The authors conclude: "Further work is required to determine the long-term duration and correlates of post-infection immunity."

People Most Infectious in First Week 

COVID-19 patients have the highest levels of virus in the first 5 days and show no evidence of the live virus in their body 9 days after onset of symptoms, a systematic review led by the University of St Andrews published in The Lancet Microbe found.

Lead author, Dr Muge Cevik, said in a news release: "This is the first systematic review and meta-analysis that has comprehensively examined and compared viral load and shedding for these three human coronaviruses.

"It provides a clear explanation for why SARS-CoV-2 spreads more efficiently than SARS-CoV-1 and MERS-CoV and is so much more difficult to contain. People are most likely to pass on coronavirus within the first 5 days of having symptoms.

"Our findings are in line with contact tracing studies which suggest the majority of viral transmission events occur very early, and especially within the first 5 days after symptom onset, indicating the importance of self-isolation immediately after symptoms start."

Remdesivir Reaction

Co-chief investigator of Oxford's RECOVERY trial, Professor Martin Landray, has reacted to the WHO Guideline Development Group advising against use of remdesivir for COVID-19, published in The BMJ.

"The trials reported to date have shown no impact of remdesivir on survival," he told the Science Media Centre."People will argue about the need for earlier use but even if there were modest benefits (say, an improvement in survival of one-fifth), people with mild disease are at low risk so the absolute numbers of lives saved would be small.  Remember too that this is a drug that has to be given by intravenous infusion for 5 to 10 days and costs around £2000 per course.  So remdesivir is not cheap, it is not convenient, and it has no impact on the mortality among the people at highest risk."

Visas Extended

The BMA has welcomed renewed visa extensions for international doctors following lobbying by health unions.

Council Chair Dr Chaand Nagpaul said: "Our international colleagues have worked tirelessly and selflessly during the pandemic.

"We owe this vital group of staff a huge debt of gratitude and they should never have had to worry about their immigration status."

Meanwhile, NHS workers seem set to avoid a reported public sector pay freeze in England.

Health Secretary Matt Hancock wouldn't speculate on the Chancellor's spending review plans, but told the BBC he "will always fight for the NHS".

Latest Lockdowns

Scotland's highest level 4 restrictions come into force in 11 council areas this evening.

At a news briefing, First Minister Nicola Sturgeon admitted she was "utterly scunnered and fed up" with new restrictions.

A fortnight of tighter restrictions has been announced for Northern Ireland from Friday 27 November. Household gatherings will be banned other than for support bubbles.

ONS data show 50% of adults in England had enough information about Government plans to manage the pandemic under national lockdown. That compares with 34% in Tier 3, 37% in Tier 2, and 45% in Tier 1, 2 weeks ago.

Tim Vizard from ONS commented: "We have seen some changes to behaviours and experiences of adults during the national lockdown in England, compared with 2 weeks prior when England was under local tier restrictions. We’ve found fewer people are leaving the house to meet up with others and are having fewer physical contacts outside their household. We also found fewer people say their wellbeing is being affected by the pandemic than did a fortnight ago."

Baricitinib 

The arthritis drug baricitinib could improve COVID-19 survival among elderly patients, according to an international study led by scientists at Imperial College London and the Karolinska Institutet, Sweden, Univadis from Medscape reported.

In the early-stage study, published in the journal Science Advances , 83 patients with a median age of 81 years and all experiencing moderate to severe COVID-19 infection were given baricitinib.

In the study, the patients, who were in multiple hospitals across Italy and Spain, had a 71% reduced risk of dying compared with patients who had not taken the drug. The study also found that 17% of patients who were given the drug died or needed to go on a ventilator, compared with 35% in the control group.

Imperial's Professor Justin Stebbing, co-lead author, commented: "This is one of the first COVID-19 treatments to go from computer to clinic and laboratory. It was first identified by an AI algorithm in February, which scanned thousands of potential drugs that could work against this virus.

"The study suggests this drug can aid recovery of patients with moderate to severe COVID-19, and may provide a new weapon in our arsenal against the virus. Large-scale clinical trials of this drug, to further investigate its potential, are now under way."

The US FDA has authorised a baricitinib combination treatment with remdesivir for COVID-19.

Nasal Spray

A University of Birmingham preprint study describes laboratory experiments to suggest a polysaccharide polymer nasal spray may be effective in giving protection against the SARS-CoV-2 virus for up to 48 hours.

The spray is made from products already used in food and medicines.

Lead author, Dr Richard Moakes, said: "Products like these don’t replace existing measures such as mask wearing and handwashing, which will continue to be vital to preventing the spread of the virus.

"What this spray will do, however, is add a second layer of protection to prevent and slow virus transmission."

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

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