UK COVID-19 Update: Infections Still Rising? 1 in 4 Doctors Sought Mental Health Help

Tim Locke

January 21, 2021

Editor's note, 21 January 2021: This article was updated with today's daily data, and to clarify the number of responses to the RCP survey.

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

Infections Still Rising?

Latest preprint data from the Imperial/ONS REACT study finds no decline in coronavirus infections in England early in the latest lockdown.

It says national prevalence increased by 50% from 0.91% in early December to 1.58% between 6-15 January.

Overall, 1 in 63 people were infected, rising to 1 in 36 in London.

Professor Paul Elliott from Imperial said: "Our data are showing worrying suggestions of a recent uptick in infections which we will continue to monitor closely."

However, the latest Public Health England (PHE) surveillance data show case rates declining 11-17 January. The highest case rate was in London at 629.7 per 100,000 people.

PHE's Dr Ruth Milton commented: "Admissions to hospital and critical care remain worrying and are still rising in some parts of the country. This will inevitably lead to more deaths. The need for continued vigilance cannot be stressed enough – we must all continue to follow the rules to help ease the burden on the NHS."

In today's daily data another 37,892 UK positive tests were reported and 1290 deaths.

Another 3709 COVID-19 patients were admitted to hospital taking the total to 38,676, and 3953 ventilator beds are in use.
 

NHS Pressure

Latest NHS England data show the number of adults occupying a critical care bed has increased again, with 54% more intensive care beds open to treat patients than last year.

Director of Policy and Strategy at NHS Providers, Miriam Deakin, commented: "COVID-19 continues to have an unprecedented impact on the NHS, and today’s figures highlight the sustained pressure trusts are facing."

The Guardian reported some single-decker London buses are being converted into four patient ambulances. Special priority bus stops have been put in place at Guy's and King’s College hospitals.

This afternoon is was announced that Northern Ireland's lockdown is being extended to 5 March.

Home Secretary Priti Patel announced new £800 fines for people attending house parties under lockdown.

1 in 4 Doctors Sought Mental Health Help

Royal College of Physicians (RCP) polling with responses from 1890 doctors found 19% have sought informal mental health support during the pandemic, and 10% sought formal support.

Other findings included:

  • 35% felt supported

  • 37% felt determined

  • 64% felt tired or exhausted

  • 48% were worried

On vaccination, 85% had their first COVID-19 vaccine dose and 16% had both doses.

Waiting 12 weeks for the second dose made 58% feel either very worried or slightly worried.

RCP President Professor Andrew Goddard commented: "There is no way to dress it up – it is pretty awful at the moment in the world of medicine. Hospital admissions are at the highest ever level, staff are exhausted, and although there is light at the end of the tunnel, that light seems a long way away.

"I am extremely concerned about the mental health of frontline doctors, who may be suffering from burnout and a feeling of not being valued. I'm not sure that before the pandemic many physicians would have contemplated that they might need formal mental health support in their career."

PPE Upgrade

Labour is supporting calls from the BMA and other health groups for a review of PPE guidance as cases continue to rise and new variants circulate.

Last week, the department of Health and Social Care and Public Health England said there were no plans to change current guidance.

BMA Council Chair Dr Chaand Nagpaul said today: "At a time when our health service is under unparalleled pressure and on the verge of being overwhelmed, having a healthy NHS workforce is absolutely fundamental to continuing the fight against this virus. Failure to act immediately on this will have a devastating impact, not only on the healthcare staff whose lives continue to be placed at risk, but on NHS' ability to care for patients."

Vaccination

More vaccination centres were opening from today, including a mosque in Birmingham and a cinema in Aylesbury.

England's Health Secretary Matt Hancock told MPs 200 jabs a minute are being delivered and that 63% of care home residents have now been vaccinated.

However, concerns remain over vaccination of over-80s in the first wave of priority groups with Mr Hancock admitting a third are still waiting as over-70s began having their jabs.

The Independent reported that hospitals in England have been told they could lose permission to deliver coronavirus vaccines if they give second doses before 12 weeks after the first.

The Evening Standard reported an IT system loophole allowed people in non-priority groups to book jabs using Swiftqueue links shared on social media.

East London NHS Foundation Trust told the paper: "People attending appointments at the Westfield Vaccination Centre will be asked for proof that they have personally been invited for a vaccination and belong to one of these priority cohorts, to ensure that no one who is currently ineligible for the vaccine receives it as a result of making a false online declaration."

Oxford vaccine supplies were protected in a Wrexham warehouse as flood waters rose from storm Christoph. Manufacturer Wockhardt UK said in a statement that it "experienced mild flooding, resulting in excess water surrounding part of the buildings across site.  All necessary precautions were taken meaning no disruption to manufacturing or inlet of water into buildings.  The site is now secure and free from any further flood damage and operating as normal."

Government medical and scientific advisers held a "very helpful discussion" with Israel's Ministry of Health today "to share information and lessons on the science behind the UK and Israel’s COVID-19 vaccination programmes," Sir Patrick Vallance tweeted. Yesterday Israel reported first dose protection with the Pfizer/BioNTech vaccine was lower than expected.

The Telegraph reported that Oxford scientists are preparing to produce new vaccine versions to tackle the UK, South Africa, and Brazilian virus variants.

Human trials of a coronavirus vaccine combining the Oxford/AstraZeneca vaccine with Russia's Sputnik V jab are expected to start early next month, Reuters reported.

Saga said its cruise passengers would need to be vaccinated 14 days before travelling and would also need a COVID test before departure.

Lateral Flow Rapid Testing

Plans to roll out rapid daily testing to schools and colleges in England have been paused apart from at some pilot sites. The risk of false negatives with the new virus variant were cited.

Lateral flow tests are likely to identify COVID-19 cases with higher viral loads, Oxford scientists reported today in a preprint. 

Concerns have been raised over the accuracy of the tests, but the new study, analysing Test and Trace data, found the rapid tests can detect between 83.7% and 90.5% of cases leading to onward transmission.

Oxford's Professor Tim Peto commented. "We know that lateral flow tests are not perfect, but that doesn’t stop them being a game changer for helping to detect large numbers of infectious cases sufficiently rapidly to prevent further onward spread."

Test & Trace

Latest figures from England's Test & Trace service 7-13 January show an improvement in delivering in-person test results the next day to 85% from 63% the previous week.

Of people transferred to the contact tracing system, 12.1% were not reached and 1.2% hadno communication details provided.

Shorter Self-isolation

Self-isolation periods after contact with an infected person could be safely reduced to 7 days if testing is put in place on day 7, according to London School of Hygiene & Tropical Medicine modelling published in The Lancet Public Health .

The World Health Organisation recommends 14 days of self-isolation. The UK recommends at least 10 days.

Joint lead author Assistant Professor Sam Clifford said in a news release: "Our study did not evaluate costs, however, and further studies are needed to address this, as well as to further verify our findings. A large component of the effect of any strategy we modelled was that of strict isolation upon the onset of COVID symptoms, which should be followed at any point after exposure, including after the end of the specified quarantine period or after negative test results."

Faster Discharges

New policies to improve discharge times in England have been welcomed by NHS Providers.

Chief Executive, Chris Hopson, said: "They will give local NHS and care providers more flexibility to discharge medically fit patients safely, swiftly, freeing up hospital beds for those who need them."

The initiatives are:

  • Short-term use of hotels

  • Independent sector hospital-at-home services

  • Funding insurance premiums to allow care homes to take COVID-19 patients

Never Events

The Healthcare Safety Investigation Branch (HSIB) recommends removing some 'never events' from the official list if effective barriers are not in place to stop them happening.

Commenting on its latest report, HSIB Deputy Medical Director, Dr Sean Weaver, said: "Taking these never events out of the current list can still allow the search for more effective barriers where these are possible and in turn improving patient care and making it safer. This is especially important as the knock on effect of COVID-19 on existing patient safety risks can’t be underestimated."

Freeman

Being involved in delivering COVID-19 vaccinations wasn't enough to get an adjournment for his MPTS hearing for former British Cycling doctor Richard Freeman.

His hearing will continue as planned on Friday. A GMC spokesperson said: "We appreciate the pressure on doctors and health services at this challenging time. But we're mindful delayed decisions cause additional stress and we need to take a balanced approach."

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

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