UK COVID-19 Update: Oxford Vaccine 'Mistake', Retired Doctors Needed

Tim Locke

November 24, 2020

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

'Mistake' Behind Oxford Vaccine Success

The Oxford/AstraZeneca vaccine is most successful with a half dose followed by a full dose. It turns out the reason behind this unusual approach was a mistake.

"The reason we had the half dose is serendipity," Mene Pangalos, head of AstraZeneca’s non-oncology research and development, told Reuters.

Two full doses were planned in UK trials but when side effects, such as fatigue, headaches, or arm aches turned out to be milder than expected, the dose was checked. "We found out that they had underpredicted the dose of the vaccine by half."

He added: “That, in essence, is how we stumbled upon doing half dose/full dose (group).

"Yes, it was a mistake."

Last night Professor Andrew Pollard, Oxford Vaccines Group, told a Downing Street briefing there's "a hint in the data" that the vaccine may also help stem transmission.

"We have this amazing set up here in the UK where we've been able to swab over 8000 people in the trials every week. And so we can also pick up the cases of asymptomatic infection. And there's a hint in the data that in one of our groups that had the higher efficacy, we were able to reduce the amount of asymptomatic infection. And that may mean that there could be fewer people in the population who are spreaders.

"And that starts to stop the virus in its tracks if we can get there, but it's only a hint at the moment. We need more information."

Today Russia's Sputnik V vaccine team issued a news release saying its efficacy is 91.4%, based on the second interim analysis of data obtained 28 days after administering the first dose (7 days after the second dose).

Retired Doctors Needed

NHS England has set up a webpage for retired clinicians considering coming back to the NHS for the vaccination programme.

Doctors who helped in the first wave, or who have been through the Bringing Back Staff programme checks, should have already been contacted.

"Our research shows us that some 50% of those who offered to return and completed our pre-employment checks would like to support the NHS in the medium to longer term. We are making contact with each person who has made this offer to see how this might happen, whether that be a return to permanent employment; interim support for national programmes like clinical trials, flu vaccinations and continuing healthcare; or a more voluntary arrangement," the page says.

England's Lockdown Exit Risks

The BMA says England's plan to return to a tiered system after national lockdown next week is "full of risks".

Council Chair Dr Chaand Nagpaul commented: "Worryingly, the Prime Minister has revealed a plan that is full of risks and threatens to undo the progress and undermine the difficult sacrifices the public have made in that time."

He continued: "It’s extremely concerning that outdoor events with crowds of up to 4000 people will be allowed to go ahead and groups of 1000 will be allowed to congregate indoors as many of these proposed measures are more relaxed than Tier 3.

"And there’s no change to the illogical Rule of 6 applying indoors– when the Government itself has repeatedly said that mixing of different households indoors is the greatest cause of spread of the virus. A 'rule of 2 households' as proposed in the BMA’s own exit strategy, would do far more to prevent transmission."

ICU Staffing

Critical care staffing remains a concern despite capacity increases, according to a Faculty of Intensive Care Medicine (FICM) member poll.

Findings from 549 responses included:

  • 18% agreed increased capacity could be adequately staffed

  • 54% saw some relaxation in staffing compared to guidelines

  • 80% increased their working hours

  • 71% covered for sick consultant colleagues

  • 88% had leave cancelled

Dr Jack Parry-Jones, FICM workforce chair, commented: "It would be foolish to assume just because we made it through the first time, we will make it through a second time without changes to how we work and are supported."

Analysis by the Health Foundation released today shows that this year and next, COVID-19 alone is likely to result in extra health service costs of around £40bn a year in England.

ONS Data

The latest weekly deaths data from the Office for National Statistics (ONS) for England and Wales show registrations 18.4% above the 5-year average.

COVID-19 accounted for 20.1% of all deaths, 529 deaths higher than the previous week.

ONS infection survey data for October show an estimated 6.9% of people in England would have tested positive for antibodies against SARS-CoV-2 on a blood test in October.

There were regional positivity differences from 10.8% in London compared to 3.1% in the South West.

In today's daily data another 11,299 UK positive tests were reported and 608 deaths. 

There are 16,158 COVID-19 patients in hospital and 1487 ventilator beds are in use.
 

Pay Rise Support

Polling by YouGov for the Royal College of Nursing found 82% of 1715 members of the public support a pay rise for nursing staff. Chancellor Rishi Sunak is due to announce his spending review tomorrow.

Dame Donna Kinnair, RCN chief executive and general secretary, said: "Funding our health and care service is a political choice. We want Government to recognise the skill, experience and responsibility demonstrated every day by nursing staff."

Red Tape

The pandemic has inspired England's Health Secretary Matt Hancock to crack down on bureaucracy.

Changes planned are based on feedback from 600 frontline staff and include shortening appraisal processes, less paperwork for qualified international GPs, and streamlining data requests.

Mr Hancock told the NHS Confederation’s NHS Reset Conference: "Of course, rules and regulations have their place. They can be the cornerstone of safe and high-quality care. But when left unchecked, rules and regulations can outgrow their original purpose – and they can stifle innovation and damage morale."

He added: "I’m determined that we seize this moment and build on the very best of what we have seen over these past 9 months."

Mr Hancock also told the Commons Health and Social Care and the Science and Technology committees joint session that people in the UK are "peculiarly unusual and outliers" because they tend to go to work even when they are unwell.

He advised people to stop "soldiering on".

German Doctor Arrested

A senior doctor in Essen, Germany has been arrested for allegedly killing two seriously ill coronavirus patients with a lethal injection.

Police say the 44 year old confessed to one of the killings and said he wanted to spare the patient and his relatives further suffering.

Test to Release

Privately paid-for COVID testing for international travel arrivals in England could reduce self-isolation times under a new Department for Transport strategy.

From 15 December, 'Test to Release' will see people booking a test for 5 days after arrival from non-travel corridor places. If it is negative they won't need to isolate for the full 14 days.

Health and Social Care Secretary, Matt Hancock, said: "This will be done at the cost of the traveller to protect the capacity of NHS Test and Trace and ensure that any UK resident who has symptoms is able to get a test."

The cost is reported to be between £65 and £120.

Words of the Year

Quarantine is Cambridge Dictionary's Word of the Year based on online search results.

Oxford Dictionaries wasn't able to pick a single winning word this year. Its 'Words of an Unprecedented Year' include COVID-19, WFH, lockdown, circuit-breaker, support bubbles, keyworkers, furlough, Black Lives Matter, bushfires, and moonshot.

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

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