UK COVID-19 Update: More 'Mutations of Concern', Tributes to Captain Tom

Tim Locke

February 02, 2021

Editor's note, 2 February 2021: This article was updated to include today's daily data and the death of Captain Sir Tom Moore.

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

More 'Mutations of Concern' 

More coronavirus "mutations of concern" have been found - 32 Liverpool and 11 in Bristol, England's Health Secretary Matt Hancock told the Commons.

Door-to-door surge testing is already taking place in several areas of England after 11 out of 105 UK cases of the South African variant were detected in people with no travel history.

That will now be extended to the new areas.

The Times reported that unpublished SAGE advice on 21 January cautioned that "reactive, geographically targeted" travel bans "cannot be relied upon to stop importation of new variants".

That was nearly a week before the latest travel restrictions were announced.

A Public Health England technical briefing reports the E484K virus mutation that's seen in the South African and Brazilian variants, and linked to impacting vaccine efficacy, has been detected in the UK variant.

Dr Julian Tang, honorary associate professor/clinical virologist, University of Leicester, commented via the Science Media Centre (SMC) that the development was "worrying...though not entirely unexpected".

He continued: "Unfortunately, the lack of control of these different variants in the UK may lead this population to become a melting pot for different emerging SARS-COV-2/COVID-19 variants – so we really need to reduce our contact rates to reduce the opportunities for viral spread/replication to reduce the speed with which these different virus variants can evolve.

"Closing borders/restricting travel may help a little with this, but there is now probably already a sufficient critical mass of virus-infected people within the endemic UK population to allow this natural selection/evolution to proceed – as this report suggests – so we really need to stick to the COVID-19 lockdown restrictions as much as possible.

"If this E484K mutation is acquired by most of the UK B.1.1.7 variants – the recent reassurances from recent studies showing that the mRNA vaccines will still offer optimum protection against the original UK variant – may no longer apply."

Scotland's lockdown measures are staying in place until at least the end of the month, First Minister Nicola Sturgeon announced today.

Sputnik Jab - Different doses

The Lancet reported phase 3 interim analysis of randomised trial data for Russia's Sputnik vaccine.

Two different doses of the adenovirus-based jab offered 91.6% efficacy against symptomatic COVID-19.

Three-quarters of nearly 20,000 participants had the vaccine, the rest received a placebo.

Co-lead author, Dr Inna Dolzhikova, Russia's Gamaleya National Research Centre for Epidemiology and Microbiology, said the vaccine "has shown high efficacy, immunogenicity, and a good tolerability profile in participants aged 18 years or older".

Commenting via the SMC, Dr Alexander Edwards, associate professor in biomedical technology, University of Reading, said: "There are some exciting details in this. Although the adenovirus approach is similar to others (including AstraZeneca/Oxford and Janssen), two different versions are included in what’s known as 'heterologous prime-boost'. This aims to drive higher immune responses to the target 'spike' by using two slightly different jabs - the only shared element of the inoculation being the COVID-19 spike. This is thought to [be] beneficial for adenovirus based vaccines as otherwise if you have two identical vaccine doses, your immune system can be so efficient that it eliminates the second dose so quickly that your immunity to spike isn’t boosted as much.

"Whilst heterologous prime-boost has been discussed and explored experimentally for the past 20 years, this could be the large-scale human trial that finally proves how well the approach can work to prevent a widespread human disease. Further clinical trials are urgently needed to understand the best way to combine different vaccine doses for maximum protection, especially if regular vaccine programs similar to the annual influenza programme become important." 

Symptoms Update

Changes are needed to the UK's official COVID-19 symptoms list to include runny nose (coryza), and other indicators, according to an open letter to England's CMO supported by 140 East London GPs and healthcare professionals.

The letter is published in The BMJ and comes from Dr Alex Sohal, a Tower Hamlets GP and honorary clinical senior lecturer in primary care, Queen Mary University of London.

The letter says: "It is vital to now change the UK COVID-19 case definition and test criteria to include coryza and cold, making them consistent with WHO. Tell the public, especially those who have to go out to work and their employers, that even those with mild symptoms (not only a cough, high temperature, and a loss of smell or taste) should not go out, prioritising the first 5 days of self-isolation when they are most likely to be infectious. Thus test more of those with symptoms, identify more infectious cases, and reduce spread, implementing SAGE advice and saving lives. This will help to get—and keep—us out of this indefinite lockdown, as COVID-19 becomes increasingly endemic globally. Ignoring this will be at our peril."

Deaths

Office for National Statistics (ONS) data for the week ending 22 January (week 3) show the third highest weekly deaths recorded in England and Wales during the pandemic.

Deaths were 41.3% above the 5-year average by 5460 deaths.

COVID-19 accounted for 45.1% of all deaths, the highest so far.

ONS estimates that the number of deaths actually occurring (rather than registered) in week 3 was between 17,342 and 21,653.

In today's daily data another 16,840 UK positive tests were reported and 1449 deaths.

Another 2981 COVID-19 patients were admitted to hospital. The total is now 34,783, and 3832 ventilator beds are in use.

As of yesterday, 9.6m people have had a first dose of a COVID-19 vaccine, and 496,796a second dose.

Intensive Care Mortality 

Falls in COVID-19 intensive care mortality are slowing down, according to a universities of Bath and Bristol meta-analysis of global studies published in Anaesthesia.

A previous analysis published last July, 2020 showed overall ICU COVID-19 mortality fell from almost 60% at the end of March 2020 to 42% at the end of May 2020.

Clarity over which treatments do and do not provide benefit helped, the authors say.

The new analysis using studies up to October 2020 shows ICU mortality slowing but falling again to 36%.

The authors write: "Our analysis includes studies published only up to October 2020. Since then, several variant viruses have emerged and in some countries transformed the trajectory of the pandemic through December 2020 and into January 2021. This has increased the demand on ICU in those locations and will merit further analysis in due course. To counter this, vaccination is now available in many countries and we can hope that this will also, over several months, positively impact on the pandemic trajectory and demand on ICU care."

Alcohol Deaths

Lockdown saw alcohol-related deaths reach a new high last year.

ONS figures for January to September 2020 show 5460 deaths, up 16.4% on the previous year.

Commenting, Ben Humberstone from ONS said: "The reasons for this are complex and it will take time before the impact the pandemic has had on alcohol-specific deaths is fully understood."

There were statistically significant rises in 30-49 year olds in quarter 2 and 40-69 year olds in quarter 3.

Male alcohol-related deaths continued to be more than twice those for females.

Tributes to Captain Tom

NHS fundraiser Captain Sir Tom Moore has died at the age of 100.

He'd been treated in hospital for pneumonia and COVID-19. 

He didn't have a COVID jab due to the pneumonia treatment.

Liz Lees, chief nurse, Bedfordshire Hospitals NHS Foundation Trust said: "It has been our immense privilege to care for Captain Sir Tom Moore.

"We share our deepest condolences and sympathies with his family and loved ones at this incredibly sad time. We’d also like to say thank you, and pay tribute to Captain Sir Tom Moore for the remarkable contribution he has made to the NHS."

His sponsored garden walk raised nearly £33m for NHS charities.

https://twitter.com/MattHancock/status/1356637223488225280?s=20



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

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