UK COVID-19 Update: New Variant SARS-C0V-2 – London to be Placed Into Tier 3

Peter Russell

December 14, 2020

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

London and Surrounding Areas to Enter Tier 3

London and other parts of South East England will move into the highest level of COVID-19 restrictions from midnight on Wednesday, the Government announced.

It said tier 3 status would also apply to parts of Essex and Hertfordshire.

The Government had been due to review the 3-tier system on Wednesday but brought forward an early tightening of restrictions in response to a surge in cases.

Announcing the move, Matt Hancock, Secretary of State for Health and Social Care, also said that a new variant of SARS-CoV-2 had been detected in the UK that was growing faster than existing variants.

"We have currently identified over a thousand cases with this variant, predominantly in the South East of England," he told the House of Commons in a statement this afternoon.

Turning to the decision to impose tier 3 restrictions on the capital and some surrounding areas, Mr Hancock said: "When the virus moves quickly, we must move quickly too."

From 00:01 on Wednesday, tier 3 restrictions will apply to:

  • Greater London

  • Brentwood, Harlow, Epping Forest, Castle Point, Rochford, Malden, Braintree, Chelmsford, Thurrock, Southend-on-Sea – in Essex

  • Broxbourne, Hertsmere, Watford, Three Rivers – in Hertfordshire

The tighter rules mean that people will only be allowed to see friends and family they do not live or bubble with in outdoor public places.

Hospitality venues will need to close, except for those providing takeaways and deliveries.

Mr Hancock told MPs it remained unclear whether "very sharp, exponential rises in the virus across London, Kent, parts of Essex and Hertfordshire" were due to the new variant of SARS-CoV-2. The World Health Organisation had been informed, while Public Health England scientists were analysing the data, he said.

Mr Hancock said there was "currently nothing to suggest that this variant is more likely to cause serious disease, and the latest clinical advice is that it's highly unlikely that the mutation would fail to respond to a vaccine".

The Prime Minister was urged to exercise extreme caution over relaxing COVID-19 restrictions this week.

In a letter to Boris Johnson on Sunday, NHS Providers said health trust leaders were worried that high infection rates in the north of England during the autumn may now be spreading to the south of the country. They were also concerned that, unless rates decrease, the spread of the virus could quickly gather pace as soon as restrictions are relaxed.

They warn that rising levels of infection could lead to more hospital admissions, just as the NHS enters its traditional busiest period.

The letter, signed by Chris Hopson, chief executive of NHS Providers, says: "Whilst infection rates have been dropping in many northern parts of the country, we are now seeing a worrying increase in infection rates across a wide range of areas, including Essex, Kent, London, and parts of Lincolnshire.

"It is particularly concerning that these increases come at the tail end of a second national lockdown."

Although the letter stopped short of calling for a review of the temporary relaxation of social contact rules over Christmas, it urged the Prime Minister to take a personal lead in ensuring a better public debate about the risks of social mixing during the five day period over Christmas.

In an opinion article in The Guardian at the weekend, Sir Patrick Vallance, the Government's chief scientific adviser, said while we should celebrate the science that had led to COVID-19 vaccine development, "let’s not throw away the gains we have made by allowing the virus to spread while we wait for vaccination to take effect".

School Closure Call

Hours before the latest COVID-19 restrictions were announced, the Government was urged to consider allowing schools and colleges in London to be allowed to close early in the run up to Christmas.

Sadiq Khan, London's Mayor, said there had been "significant outbreaks" among 10 to 19 year olds in the capital's secondary schools, sixth-form colleges, and further education colleges.

He also suggested a delay to schools reopening after New Year.

It came as schools across the Royal Borough of Greenwich in southeast London were told to consider closing at the end of today because of an "exponential growth" of the pandemic.

In a statement, Mr Khan also called for an increase in regular asymptomatic testing, including for students and staff.

Mr Khan called for an economic package to be put in place to compensate London's tourist and hospitality sector.

"Time is running out to get the virus under control in our city which is why I urge the Government to heed my call and provide us with the extra support we desperately need," he said.

On Sunday, Danny Thorpe, leader of Greenwich council, said he had been briefed by Public Health England that the pandemic in the borough was in a period of exponential growth that demanded immediate action.

Pupils have been told to resort to online learning for the time being.

Meanwhile, the Welsh Government announced plans to begin rolling out serial testing in schools and colleges from January.

Any pupils or staff identified as close contacts would be asked to either self-isolate as normal or to take a lateral flow test at the start of the school day for the duration of the self-isolation period. 

Individuals who tested negative would continue attending school as normal, while those who tested positive would be required to self-isolate and book a confirmatory test.

GPs Due to Begin Administering the Vaccine

GP practices in England are expected to start administering the COVID-19 vaccine this week.

The NHS said practices in more than 100 areas of the country should receive their first doses of the Pfizer/BioNTech vaccine later today.

However, some reports surfacing on social media suggested there had been delays in distributing the vaccine, which requires ultra-cold storage. One GP in Kent complained on Twitter that despite expecting vaccine delivery today and having 80 patients booked in for inoculation in the morning, her surgery was told supplies would not arrive until some time on Tuesday.

Pending deliveries, GPs, nurses, paramedics, pharmacists, and other NHS staff will work alongside GPs to vaccinate those aged 80 and over in surgeries and community vaccination centres.

Health and care staff are also being prioritised to receive the vaccine.

Care home residents throughout the UK will also receive their first vaccine later this week.

The latest phase of the vaccine roll-out is being co-ordinated by GP-led primary care networks. More practices and community pharmacies in other parts of England will join the programme on a phased basis during December and in the coming months, the NHS said.

Dr Nikki Kanani, a practising GP, and NHS Director of Primary Care, said: "This is the greatest vaccination programme ever undertaken by the NHS and, to help vaccinate people safely we will be working with local communities to deliver it in convenient and familiar settings."

People in priority groups will be contacted directly by the NHS when it is their turn to receive the vaccine.

Prof Martin Marshall, chair of the Royal College of GPs, said: "GPs and our teams are about to embark on an enormous challenge, delivering the COVID-19 vaccination programme in the community whilst also delivering the expanded flu vaccine programme and the usual care and services our patients rely on us for."

'No Benefit' from Azithromycin: Preprint

A preprint of a study from the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial has reported no benefit from azithromycin, a widely used antibiotic, in patients hospitalised with COVID-19.

Azithromycin was one of several potential treatments undergoing clinical trials to assess its efficacy for patients hospitalised with COVID-19.

A total of 2582 patients were randomised to azithromycin and compared with 5182 patients randomised to usual care alone.

A preliminary analysis showed no significant difference in the primary endpoint of 28-day mortality (19% azithromycin vs. 19% usual care).

Researchers said the preliminary results suggested that azithromycin use in patients hospitalised with COVID-19 should be restricted to those who had a clear antimicrobial indication.

Dr Stephen Griffin, associate professor in the School of Medicine at the University of Leeds, commented: "Whilst azithromycin, sometimes combined with hydroxychloroquine, has been proposed as a therapy in smaller studies and anecdotal accounts, it has never been clear exactly what its mode of action might be versus SARS-CoV2, or whether its anti-inflammatory properties are effective in combatting the immune pathology associated with severe disease. 

"Like hydroxychloroquine, it is now clear that healthcare professionals can, with some confidence, stop prescribing this drug to hospitalised patients and instead focus upon medicines with proven benefit."

The RECOVERY trial is currently testing some of these suggested treatments:

Community Testing

The first 67 local authorities in England have been picked to start community testing programmes.

All the authorities chosen are currently in tier 3. The Government said it hoped access to rapid-turnaround lateral flow tests would help them on a route out of the toughest restrictions.

More than 1.6 million test kits are expected to be delivered this month.

Local authorities include Oldham, Lancashire, and Kirklees.

More tier 3 areas are expected to be included in the scheme in the coming weeks.

Matt Hancock, Secretary of State for Health and Social Care, said: "With one in three people with coronavirus showing no symptoms, increased community testing is a vital additional tool at our disposal to help identify those who are infected and infectious, but unaware that they might be spreading the disease."

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

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