UK COVID-19 Update: MPs Briefed on NHS Pressures, LAMP Test Accuracy

Tim Locke

December 01, 2020

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

NHS Pressures

NHS Providers issued a briefing paper for MPs ahead of tonight's Commons vote on England's tiers.

Many challenges, it said,  are not captured in the national data on bed occupancy. Major issues include:

  • Infection control measures reducing capacity by up to 20%

  • Slower or disrupted planned surgery caused by limited theatre space and infection control

  • Despite a lower overall demand for urgent and emergency care, trusts are reporting higher numbers of very sick patients requiring admission and more people in A&E with complex mental health needs

  • Increased staff absences on top of severe workforce shortages

  • Lack of access to rapid turnaround testing

Chief Executive Chris Hopson commented: "There is an immediate need to get through winter, avoiding a damaging third surge in infections with the virus, and ensuring the NHS is able to provide appropriate high quality care for all patients, COVID and non-COVID."

Opposition parties are abstaining from the vote but Boris Johnson is expected to win it despite an anticipated backbench rebellion.

Breaking the Rules

Twenty-six percent of people found it harder to follow second lockdown rules, a King's College London and Ipsos MORI survey of 2244 people across the UK found.

  • 16% felt there was no point following the rules any more

  • 14% had been pressured by family or friends to break rules

  • 34% thought restrictions were not being applied fairly

  • 34% had less trust in Government or official advice

There were gender differences with women more likely to have felt worn out by the pandemic (47% women vs 33% men).

Professor Bobby Duffy, director of the Policy Institute at King’s College London, said: "As the rules change again, the UK government must rebuild confidence in its approach and clearly communicate what it is doing and why."

Latest Data

Latest Office for National Statistics weekly data show the number of deaths registered was 20.8% above the 5-year average.

COVID-19 was mentioned on death certificates for 21.5% of all deaths in England and Wales, an increase of 231 deaths compared with the previous week.

Vaccines 

Pfizer/BioNTech have applied for European conditional marketing authorisations for their COVID-19 vaccine. Moderna made its EU application yesterday.

The European Medicines Agency had already been reviewing data under a rolling review.

The UK's MHRA was asked to begin its Pfizer assessment on 20 November.

LAMP Test Accuracy

The rapid OptiGene RT-LAMP (loop-mediated isothermal amplification) test is accurate and sensitive for testing those with and without COVID-19 symptoms, according to data released by the Department of Health and Social Care.

Sensitivity was 79% and specificity was 100%. In samples with a higher viral load, the sensitivity of the test increased to 94% for saliva and 100% for swabs.

Professor Keith Godfrey who led the first phase of the Southampton saliva testing pilot said: "The saliva LAMP project in Southampton has proved to be very easy for students to use, and is extremely popular with parents and staff. Participation among University of Southampton students has been very encouraging, with 80%  of students in halls of residence and over two thirds of those in private accommodation registered for regular saliva LAMP testing."

Scotland's Bonus

NHS and social care workers in Scotland are getting a £500 one-off payment to thank them for what First Minister Nicola Sturgeon called their "extraordinary service" during the pandemic.

The pro-rated payment is to be paid as soon as possible to staff employed since 17 March 2020, including those who have had to shield, or who have since retired.

Kids' Symptoms

Most children with COVID-19 infection experience mild symptoms or remain asymptomatic, suggests a new report from Imperial College London (ICL).

Univadis from Medscape reported on findings from a systematic review of 128 studies, 29 of which were considered for a meta-analysis. Most of the included studies involved children tested as contacts of COVID-19 patients.

The majority of the children experienced mild COVID-19 symptoms, only 3.8% experienced severe or critical symptoms, and 21% of infected children remained asymptomatic.

No studies assessing transmissibility in children were identified and susceptibility to COVID-19 infection in children was found to be highly variable across studies.

Steven Riley, professor of infectious disease dynamics at ICL said: "We were unable to find any reliable evidence as to how likely children are to be a source of infection compared to adults."

Vitamin Protection?

A preprint observational study from the King's College ZOE COVID Symptom Study app has linked taking vitamins and supplements with a small lower likelihood of women reporting a positive COVID-19 test.

The authors write: "We observed a modest but significant association between use of probiotics, omega-3 fatty acid, multivitamin or vitamin D supplements and lower risk of testing positive for SARS-CoV-2 in women. No clear benefits for men were observed nor any effect of vitamin C, garlic or zinc for men or women. Randomised controlled trials of selected supplements would be required to confirm these observational findings before any therapeutic recommendations can be made."

Commenting via the Science Media Centre, Naveed Sattar, professor of metabolic medicine, University of Glasgow, said: "These are interesting results BUT due to the way the study has been conducted, these data absolutely cannot tell us that taking such supplements ‘protects’ against infection from COVID-19.  It may be that by being more health conscious, some women are less likely to become infected, so that it’s the behaviours that explain these results not the supplements. The lack of any association in men also suggests the results may be confounded in ways not measured since there is no biological reason to think some supplements should work in women but not men. So, let's await the results of randomised trials."

Virtual Ward Visits

Credit: QMUL

Third year medical students at Queen Mary University have followed their lecturer on a surgical ward round thanks to virtual reality kit.

Professor Shafi Ahmed wore HoloLens smart glasses at The Royal London Hospital.

"The pandemic has forced us to think differently about medical education," he said.

"My work over the last 6 years at Queen Mary using Google Glass, virtual reality, holograms, avatars and mixed reality has shown that immersive and exponential technologies represent a paradigm shift in how we deliver effective medical education."

Santa Secrecy

A University of Exeter expert is urging parents to maintain the "vital tonic" of the Santa myth saying this is not the year for total honesty.

Dr Chris Boyle gave some results from the University's international Santa Survey: "My survey results reveal there are many ways where parents can expose the Santa myth by mistake.  The main slip-up beset by parents is being caught in the act."

He added: "The COVID Christmas of 2020 brings so much uncertainty and misery, there is an argument it has never been a greater time to indulge in the escapism of Santa. Christmas is a time of magic, where children believe in implausible things, including Santa - adults, and older children, wish they could believe too. Who can blame them, especially in 2020?"

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

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