UK COVID-19 Update: Eye of the Storm, Second Dose Jabs Begin

Tim Locke

December 29, 2020

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

Eye of the Storm

The NHS is back in the "eye of the storm" in COVID-19's second wave, according to NHS England's Chief Executive Sir Simon Stevens.

In his New Year message he thanks staff for their hard work during 2020 which "has probably been the toughest year most of us can remember".

He also struck a positive note on vaccines and added: "Sometimes the worst of circumstances bring out the best in people."

The BMA's Council Chair Dr Chaand Nagpaul wrote to Sir Simon to say staff need vaccinating without delay: "With cases of COVID-19 rocketing and hospitalisation levels higher than in the first peak, healthcare workers are now, as you recognise in your New Year message, 'in the eye of the storm'. It is therefore imperative that frontline staff are protected from the virus so that they can be available to treat patients." 

Milestones

UK deaths within 28 days of a positive COVID-19 test passed the 70,000 milestone on Christmas Day and now stand at 71,567.

Yesterday's reported positive cases reached their highest ever daily number at 41,385 and today they are higher at 53,135.

Dr Susan Hopkins, senior medical advisor at Public Health England, commented: "We are continuing to see unprecedented levels of COVID-19 infection across the UK, which is of extreme concern particularly as our hospitals are at their most vulnerable. Whilst the number of cases reported today include some from over the festive period, these figures are largely a reflection of a real increase."

There are 21,286 people in hospital with COVID-19, the highest so far, and 1529 mechanical ventilation beds are in use.

Doctors Association UK President and critical care doctor Samantha Batt-Rowden tweeted: "We have reached a new peak, with more patients in hospital with COVID than ever before in the UK. How has it come to this...was Christmas really worth it?"

https://twitter.com/sbattrawden/status/1343647635299852289?s=20

 

Under Pressure

Many hospitals are under pressure from rising emergencies and admissions.

These included Lewisham and Greenwich NHS Trust in London. It declared an internal incident at Queen Elizabeth Hospital (QEH) on Sunday "as a precautionary step due to the high number of COVID-positive patients we are seeing at the hospital. We have been following our plan to cope with a second wave of COVID-19 and are working closely with hospital and healthcare partners in south east London.

"All our patients have received the treatment they need, including intensive care treatment for COVID-19 and oxygen therapy as required. We are continuing to monitor the situation to ensure that this remains the case."

Cardiff and Vale Health Board made an appeal at the weekend for medical students to volunteer to help with proning patients. "Huge thanks for the amazing response for volunteers," said ICU doctor Matt Morgan.

The Scottish Academy of Medical Royal Colleges and Faculties said that despite the start of vaccination, "it will take months for this to make a significant difference, and the short-term situation facing our NHS and public health services remains bleak".

Southend Hospital in Essex asked staff to consider cancelling holidays to help deal with increased pressure.

An internal email from Diane Sarkar, chief nursing officer and David Walker, chief medical officer reported by Essex Live said: "Demand on our services is continuing to increase and we are finding ourselves in an increasingly difficult situation. With this in mind we are asking all clinical staff if they would consider giving up their booked annual leave and returning to work.

"We know your annual leave is important and this is not a request we are making lightly but if you are able to come back into work and support your colleagues care for patients who need us we would be extremely grateful."

Second Dose Jabs

Second doses of the Pfizer/BioNTech vaccine began today with the world's first recipient, Margaret Keenan, 91, back at Coventry University Hospital for her second jab.

Latest figures show that 616,933 people have had their first dose.

There are reports of imminent approval of the Oxford/AstraZeneca vaccine by the MHRA this week with plans being drawn up for vaccination to begin next week.

The jab is easier to store and 100 million doses have been ordered. Clinical trials showed a half-dose, full dose regimen was more effective than two full doses.

AstraZeneca Chief Executive Pascal Soriot told the Sunday Times: "We think we have figured out the winning formula and how to get efficacy that, after two doses, is up there with everybody else.

"I can't tell you more because we will publish at some point."

Vaccination has begun across Europe after EMA approval last week.

However, in Germany eight care home workers from Vorpommern-Ruegen were given five times the normal Pfizer/BioNtech vaccine dose.

Four were taken to hospital with flu-like symptoms.

Local health officials said BioNtech had previously reported that larger doses were tested in the Phase 1 study without serious consequences.

Eating Disorders

The Royal College of Paediatrics and Child Health (RCPCH) is warning of a rise in eating disorders under lockdown over the Christmas and New Year period.

Some RCPCH members have reported a quadrupling of anorexia nervosa and other food restriction disorders compared with the same period last year.

Some children have become severely ill by the time they are seen by doctors, thought to be due to reduced access to services and face-to-face consultations.

Waiting lists for eating disorder treatment have been overwhelmed and there's a shortage of specialist inpatient beds.

Dr Karen Street, a consultant paediatrician at the Royal Devon and Exeter Hospital in Exeter and officer for child mental health at the RCPCH, said in a statement: "We are extremely concerned about many children and teenagers' wellbeing because of the pandemic. Many of them are just not coping.  Eating disorders are often related to a need for control – something many young people feel they have lost during the pandemic. Many have described needing a focus and goals which, in the absence of anything else, has for some centred around eating and exercise."

Schools

School testing at the start of term in England is being supported, mostly remotely, by 1500 members of the armed forces.

Students will self-swab under supervision of staff or volunteers.

Last week, a preprint from the London School of Hygiene and Tropical Medicine concluded that school closures in January may be among measures needed to prevent COVID-19 deaths and hospitalisations in 2021 from exceeding those in 2020.

Teaching unions have been calling for more remote learning rather than a return to classrooms.

Ministers have said plans for a staggered start to term will be kept under review.

Social Care

Former Health Secretary and Commons Health and Social Care Committee Chair, Jeremy Hunt, says Boris Johnson has a "now or never" chance to put long-term funding in place for social care in England.

In October, the Committee called for £7 billion extra social care funding a year by 2023-24 and a £46,000 cap on a person's costs.

In Mr Johnson's first speech as PM he promised to "fix the crisis in social care once and for all".

"I think the biggest battle now is with the Treasury, because the sums of money are eye-watering," Mr Hunt told the PA news agency.

Mr Hunt cited public support for the care sector during the pandemic and said a new tax may be needed to fund care for an ageing population.

"We were even more bankrupt as a country after the Second World War and then we had the imagination and vision to set up the NHS, and I think this is another 1948 moment." he added.

The Department of Health and Social Care issued a statement saying: "We remain committed to sustainable improvement of the adult social care system and will bring forward proposals as soon as possible."

And Finally

The French fashion designer Pierre Cardin died today at the age of 98.

Despite his many successes, his 1970s designs for nursing uniforms of the future did not catch on.

https://twitter.com/AmenityFashion/status/452499556429602816?s=20

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

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