UK COVID-19 Update: Vaccination 'Milestone', Brexit & Science 

Tim Locke

December 24, 2020

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

Vaccination 'Milestone'

The first formal vaccination statistics from NHS England show 521,594 people had their first COVID-19 jabs in England in the first 13 days of the programme.

Of these, 70.3% were over 80s. Other priority groups were health and care workers, and care home residents.

There are nearly 80 hospital vaccination hubs. More than 500 GP-led centres, and teams have also visited care homes.

National Medical Director Professor Stephen Powis said: "This vaccine presents a number of complex logistical challenges but the NHS response has been nothing short of phenomenal, with hundreds of hospitals and local vaccination centres stood up across the country."

Responding to the figures, the BMA's Dr Richard Vautrey, said the vaccination "milestone" was an "absolute testament to the immense work going on in healthcare settings across the country".

He continued: "Some GPs have told the BMA in recent weeks that they are experiencing delays in the delivery of the vaccine though, and while they are doing everything they can to work around this, these logistical issues must be resolved as a matter of urgency.

"When practices have worked so hard to get prepared, it’s frustrating to hear reports of some vaccine deliveries being delayed, but we expect all sites to be active early in January. This will be particularly concerning for some patients who will have had appointments rescheduled, but we hope that they will understand that their practices are doing everything possible to give them the vaccine as soon as possible.

"Everything must also be done to ensure that staff are properly prioritised for the vaccine and those at highest risk are protected as a matter of urgency."

In Scotland 56,676 people were vaccinated 8-20 December.

The US CDC said 1,008,025 doses of COVID-19 vaccines had been administered over 10 days as of Wednesday morning, and it has distributed 9,465,725 doses.

Extra Measures for New Variant

The London School of Hygiene and Tropical Medicine has released a preprint study modelling the extra transmissibility of the novel SARS-CoV-2 variant VOC 202012/01.

It concludes that a substantially increased vaccine roll-out and school closures in January may be needed to prevent COVID-19 deaths and hospitalisations in 2021 from exceeding those in 2020.

Lead author Nick Davies said on Twitter: "We only explore a few scenarios in this preprint to illustrate what could happen under different potential control strategies. Determining exactly what policies will be most effective will take more work than was possible in the last 5 days."

Infection Survey

The latest Office for National Statistics (ONS) infection survey data show that in the most recent possible time period (14-18 December), London, the South East, and the East of England have the highest percentage of positive cases that are compatible with the genetic makeup of the new variant of the virus.

Overall, there were continuing increases in the percentage of people testing positive in England with an estimated 645,800 people having COVID-19 (12-18 December), equating to around 1 in 85 people.

The survey tests participants regardless of whether they have symptoms.

Sharp increases were again seen in London, the East of England, and the South East. London has the highest percentage of people testing positive.

In Wales, sharp increases were seen with 52,200 people having COVID-19, equating to around 1 in 60 people.

There were also increases in Northern Ireland, with 10,100 people having COVID-19, equating to around 1 in 180 people.

In Scotland, the percentage of people testing positive in Scotland decreased with 37,100 people having COVID-19, or 1 in 140 people.

Test and Trace

England's Test and Trace service reported a 58% increase in the number of positive coronavirus cases detected 10-16 December compared to the previous week.

It reached 92.6% of contacts of positive cases.

It reported more than 4.9 million tests processed UK-wide since testing began. The Department of Health and Social care said that's more than any other comparable European country.

Interim Executive Chair, National Institute for Health Protection, Baroness Dido Harding, commented: "NHS Test and Trace has developed into one of the largest contact tracing and testing systems anywhere in the world and the COVID-19 contract tracing app we launched in September has now been downloaded more than 20.7 million times."

Separate Public Health England surveillance data show case rates have increased across all age groups, with the highest rate 434.6 per 100,000 population in those aged 30-39.

The COVID-19 hospital admission rate was 18.66 per 100,000 in week 51, compared to 15.18 per 100,000 in the previous week. The highest admission rate continues to be in those aged 85 and over.

Flu activity, including GP consultations and hospital admissions, remains low.

Winter Pressures

The NHS is working "flat out" on COVID-19 and winter pressures, NHS Providers' Saffron Cordery said, commenting on the latest performance figures for England.

"Trust leaders tell us in the face of the pandemic, with consequent pressures on space and staffing, bed occupancy at 85% feels like 95%, and we are currently running at 88% so that is posing real problems," she said.

“These pressures are contributing to handover delays for patients arriving by ambulance, which mean crews cannot respond as quickly to other calls where they are needed.

"It is good that bed closures due to norovirus remain relatively low – as that can often accentuate difficulties at this time of year."

There were 13 A&E diverts in the past week.

Ambulance delays of over an hour ranged from 222 to 555 a day between 17-20 December.

Boxing Day Tiers

The BMA is supporting the decision to put more parts of England into Tier 4 from Boxing Day due to high levels of the new virus variant.

Council Chair, Dr Chaand Nagpaul, said in a statement: "The rocketing case numbers mean that moving more of the country into Tier 4 is a necessary step to control the virus, and prevent the NHS from being overwhelmed to the point that local services are unable to meet the needs of seriously ill patients.

"With a possible third strain emerging in South Africa, the second strain in the UK gaining ground and some GPs here reporting delays in deliveries of the vaccine, we are in a very precarious position. Given how quickly cases are increasing, further restrictions may be necessary in the coming days and weeks, and the Government must be ready to act quickly if the science supports this."

Travel

Concerns over the South Africa-related variant B1.351 (also called 501Y.V2) have led to a UK travel ban on passengers from South Africa. British and Irish Nationals, visa holders and permanent residents arriving from South Africa will be able to enter but have to self-isolate for 10 days along with their households.

The border with France is open again for travellers and lorry drivers who can show a negative test result.

Concerns about the variant circulating in the UK prompted New York City Mayor Bill de Blasio to make all visitors from the UK quarantine or face a $1000 fine. "We cannot take chances," he said.

Fauci

Dr Anthony Fauci, director, US National Institute of Allergy and Infectious Diseases, has been addressing the UK virus variant in an interview with WebMD.

"We don't know for sure — but it looks like it has a better capability of transmitting, of going from person to person. There's no evidence that it has any effect on its virulence or, namely, that it makes people more sick. It doesn't.

"The other important issue is whether it's evading the protection of a vaccine, and it doesn't appear that that's the case at all. So, what we need to do is watch it very carefully, and we need to do surveillance in this country [US]. Then there is discussion about: If it isn't already here — which it might well be and we don't know it yet — what do you do? I know the European Union is banning travel from the UK. I think that may be an overreaction now. I would not be against at least making sure that people who fly here, or come to the United States from the UK, be required to be tested before they get on the plane so that you know they're negative when they get here. That, I think, is something that might be considered. I'm not saying we should do it, but we should consider it."

Brexit

Details are still emerging about the UK's new relationship with the EU from January 1 after today's trade deal.

An agreement on science collaboration brought praise on Twitter from Government Chief Scientific Adviser Sir Patrick Vallance: "Really pleased that we will now associate with science programmes in EU. Science is an international endeavour and our partnership with our colleagues in Europe is strong and important for all of us."

England's Health Secretary Matt Hancock tweeted: "There are massive opportunities for our renowned life sciences sector and an even bigger role for our world class regulator @MHRAgovuk."

Xmas Shifts

Sometimes ONS data is surprising but not so much today. Health and care workers are the professions most likely to be at work at Christmas.

Overall, 1.1 million employees worked on Christmas Day 2018. The top professions were:

  • Care workers and home carers (166,000)

  • Nurses (112,000)

  • Nursing auxiliaries and assistants (66,000)

  • Chefs (36,000)

  • Medical practitioners (31,000)

Commenting, David Freeman from ONS said: "Our country’s health and care workers have been very much in our thoughts this year, but these figures remind us that people working in these areas are often passing up on things like spending Christmas Day with their families even in a more normal year."

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

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