UK COVID-19 Update: 'Bristol' Variant of Concern, Extra Symptoms, 'Inadequate' PPE

Tim Locke

February 10, 2021

Editor's note, 10 February 2021: This article was updated with today's daily data and information from WHO and a Downing Street briefing.

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

'Bristol' Variant of Concern

NERVTAG (New and Emerging Respiratory Virus Threats Advisory Group) has put another SARS-CoV-2 variant of concern under investigation.

VOC202102/02 has the E484K spike protein mutation and was found through genomic sequencing of an outbreak in the South West of England.

The same mutation was found on the variant of concern VOC202012/01 detected last month among hospital staff in Liverpool.

Dr Susan Hopkins, COVID-19 strategic response director, Public Health England, said: "While we expect that the vaccines will still prevent severe illness and deaths, we are taking public health action on clusters of variants with E484K to reduce the risk of spread in our population.

"We will be implementing the necessary public health action to mitigate the spread of these variants and will continue to monitor them closely."

London School of Tropical Medicine & Hygiene preprint research found the original UK variant is linked with a 35% higher risk of mortality. The authors also wrote that it "is not only more transmissible than preexisting SARS-CoV-2 variants but may also cause more severe illness".

Postcodes in Lambeth in London are the latest to be targeted for surge testing to identify South Africa virus variant cases.

Single Jab Protection

The Sun reported data due to be published soon will show one dose of the Pfizer/BioNTech jab reduced the symptomatic infection risk by 65% in younger adults, and 64% in over-80s, and the Oxford/AstraZeneca vaccine "offers similar protection".

Commenting via the Science Media Centre, Professor Paul Hunter, University of East Anglia, said: "The reports of the effectiveness of the current vaccines in the UK, if correct, are greatly reassuring that the UK vaccination strategy is the correct one. However, these data are still preliminary data that have not yet been published in full either in a peer-reviewed article or as a pre-print.

"Nevertheless, what has been reported in The Sun does have the ring of truth to me. The report that it takes longer for the over 80s to reach maximum protection compared to only 15 days for younger age groups is something that I think indicates that the sources of The Sun’s leaks had in fact seen the analyses as I doubt anyone would make that up."

The World Health Organisation's Strategic Advisory Group of Experts (SAGE) has issued guidance on the Oxford vaccine, saying it should be given to over-18s with no upper age restrictions. It also advises two doses should be given at 8-12 weeks.

It is also recommended the jab for the South African variant but the guidance says: "Indirect evidence is compatible with protection against severe COVID-19, however, this remains to be demonstrated in ongoing clinical trials and post-implementation evaluations. These preliminary findings highlight the urgent need for a coordinated approach for surveillance and evaluation of variants and their potential impact on vaccine effectiveness. WHO will continue to monitor the situation; as new data become available, recommendations will be updated accordingly."

As of yesterday, 13m people in the UK have had a first dose of a COVID-19 vaccine, that's 1 in 4 adults, and 519,553 a second dose.

Prime Minister Boris Johnson told a Downing Street briefing: "If we can keep the pace up, and keep the supplies of vaccine up, we hope to reach everyone in cohorts 1 to 9 by the end of April." 

Transport Secretary Grant Shapps said today that it was "too soon" for people to book a holidays, at home or abroad. He said decisive factors would include progress on vaccinations, hospital admissions, and deaths.

Mr Johnson commented: "I'm afraid it is just too early for people to be certain about what we'll be able to do this summer." 

Daily Data

In today's daily data another 13,013 UK positive tests were reported and 1001 deaths.

Another 1872 COVID-19 patients were admitted to hospital. The total is now 26,684, and 3164 ventilator beds are in use.

Extra Symptoms

Imperial's REACT study involving data from more than a million people has identified a wider set of COVID-19 symptoms.

The authors suggest that adding chills, headache, lost appetite, and muscle aches to the diagnostic criteria could increase case detection.

Chills were linked with positive tests across all ages, headaches were more common in 5 to 17-year-olds, appetite loss in over-18s, and muscle aches in 18 to 54-year-olds.

Infected 5 to 17-year-olds were less likely to report fever, persistent cough, and appetite loss compared with adults.

Around 60% of infected people in the study did not report any symptoms in the week before their test.

REACT Director, Professor Paul Elliott, commented: "These new findings suggest many people with COVID-19 won't be getting tested – and therefore won't be self-isolating – because their symptoms don’t match those used in current public health guidance to help identify infected people. We understand that there is a need for clear testing criteria, and that including lots of symptoms which are commonly found in other illnesses like seasonal flu could risk people self-isolating unnecessarily.

"I hope that our findings on the most informative symptoms mean that the testing programme can take advantage of the most up-to-date evidence, helping to identify more infected people."

Inadequate PPE

The lives of frontline staff were at risk because of inadequate PPE supplies at the start of the pandemic, a report from the Commons Public Accounts Committee has found.

The Department of Health and Social Care (DHSC) told the Committee no setting ran out of PPE but it heard "compelling evidence" from organisations representing frontline workers that stocks ran perilously low, single use items were reused, and some was not fit for purpose.

A lack of PPE was among the things which "contributed significantly to the deaths in care homes during the first wave", the committee said.

Committee Chair Meg Hillier said: "Frontline workers were left without adequate supplies, risking their own and their families’ lives to provide treatment and care. We’re at a dangerous new phase of the pandemic, in our third national lockdown with no defined end in sight. The Government needs to acknowledge the errors and be better prepared."

On procurement she said: "Government had permission to procure equipment at pace and without tendering under the law, but acting fast did not give it license to rip up record keeping on decisions. It did not publish contracts in time and kept poor records of why some companies won multi-million pound contracts."

BMA Chair of Council, Dr Chaand Nagpaul, said the report contained "the appalling and awful truth about health and social care staff  having to care for people with COVID-19 or suspected COVID-19 without any or enough PPE to protect themselves from infection."

He added: "The Government needs to listen to the experiences of doctors, of all health and social care workers, understand the life threatening risks they had to take to care for their patients and then, do everything possible to make sure no healthcare worker is ever put at risk in this way again."

The DHSC said it had worked "tirelessly to procure, produce, and deliver PPE".

Almitrine Bismesylate

Oxford is leading a trial of almitrine bismesylate to see if it is beneficial for patients seriously ill with COVID-19.

The 4 month trial will recruit around 116  patients across three centres: the Royal Berkshire Hospital, Oxford University Hospitals’ John Radcliffe Hospital, and University Hospital of Wales in Cardiff.

Chief Investigator, Dr Nick Talbot, said: "If Almitrine proves beneficial for our patients, we think it would represent a really important new approach in the management of COVID-19."

Pharmacists' Consider Strike

The Guardian reported strike action is being considered by pharmacists in England over a £370m debt from a pandemic support package that's left some facing closure.

It quotes National Pharmacy Association Chair Andrew Lane: "No one wants to let their patients down, so strike action is the last thing any pharmacist would want to do. Instead, we need to continue to make the evidence-based case and appeal to the Government to do the right thing by the nation’s heroic pharmacists and the patients they serve."

Boris Johnson was asked when pharmacies would be paid for additional costs during the pandemic. "I will want to make sure that they're reimbursed as soon as possible," he said.

Delayed Treatment

A survey of 2000 people for the medical negligence law firm Patient Claim Line found 49% had experienced delayed NHS treatment under the pandemic, and of those 45% said their condition worsened because of the delay.

Senior Litigation Executive, Kirsty Parkes, commented: "More and more patients are being added to waiting lists daily for 'non-urgent' surgeries, for example hip replacements; maxillofacial procedures; or non-urgent vascular or urological procedures. In the meantime, these patients are often experiencing severe levels of pain and discomfort and are unable to carry on with their daily lives as a result."

HSJ reported today that more than 100,000 people were waiting for urgent priority two operations in late January.

Jabs for Knights & Royals

Prince Charles, 72, and Camilla, 73, have had their first COVID-19 jabs. Officials did not say which brand they received.

Meanwhile, Sir Elton John, 73, and Sir Michael Caine, 87, are fronting a new NHS England video urging people to take up the offer of coronavirus vaccination.

Sir Elton is shown auditioning for an ad promoting the jab and says: "The more people in society who get vaccinated, the more chance there is of eradicating the national COVID pandemic."

Sir Michael says the vaccine "didn’t hurt", adding: "Not many people know that."

Source: NHSE

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


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