UK COVID-19 Update: 'Cautious' End to England's Lockdown, Positive Vaccine Data, Shielding Review

Tim Locke

February 22, 2021

Editor's note, 22 February 2021: This article was updated with today's daily data.

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

'Cautious' End to England's Lockdown

Prime Minister Boris Johnson gave the details of his plan for a "roadmap that will guide us cautiously but irreversibly towards reclaiming our freedoms".

Four tests have to be met, he told the Commons:

"First, the vaccine deployment programme continues successfully.

"Second, that evidence shows vaccines are sufficiently effective in reducing hospitalisations and deaths.

"Third, that infection rates do not risk a surge in hospitalisations, which would put unsustainable pressure on the NHS.

"And fourth, that our assessment of the risks is not fundamentally changed by new variants of COVID that cause concern.

"Before taking each step, we will review the data against these tests."

Under step 1, all schools in England will reopen to all pupils on 8 March with regular testing of secondary school pupils.

Exercise rules will be relaxed the same day to let individuals meet one other person from a different household outdoors, including for coffee or a picnic.

From 29 March: "People will no longer be legally required to stay at home but many lockdown restrictions will remain."

Step 2 allows the reopening of non-essential retail, hairdressers, indoor leisure, and gyms from 12 April.

Step 3 begins "no earlier than 17 May" with indoor mixing and the reopening of pubs and restaurants.

Step 4 begins "no earlier than 21 June, with appropriate mitigations, we will aim to remove all legal limits on social contact".

There will be reviews on international travel restrictions and of "the potential role of COVID status certification in helping venues to open safely".

Reaction

Health groups have been reacting to the PM's plans.

The Royal College of Anaesthetists and the Faculty of Intensive Care Medicine issued a joint statement welcoming the PM's announcement, saying: "Any changes to restrictions based on dates not data would be irresponsible at best and at worse risk thousands more lives and extend the on-going financial hardships for millions."

Dr Jennifer Dixon, chief executive of the Health Foundation, said: "As we see the light at the end of the tunnel, the Government needs to ensure that no one is left behind, particularly the most vulnerable."

Chief Executive of NHS Providers, Chris Hopson, said: "In our letter to the Prime Minister last week, we set out four evidence-based tests on infection rates, NHS capacity, the progress of the vaccination campaign and our ability to combat new variants, with a call for caution and an emphasis on data, not dates. 

"Today’s roadmap shows those calls have been heeded, but it is vital the government continues to take a cautious and evidence based approach over the coming months."
 

Positive Vaccine Data 

Public Health England (PHE) data just released show the Pfizer/BioNTech vaccine gives high levels of protection against infection and symptomatic disease after the first dose.

One dose reduces a person's risk of COVID-19 hospitalisation and death by more than 75%.

The jab also gives protection against the main UK virus variant first identified in Kent.

PHE’s SIREN study of under-65 year-old healthcare workers shows one dose reduces the infection risk by more than 70%, rising to 85% after the second dose.

The risk of COVID-19 mortality in over-80s is 56% in vaccinated people compared to unvaccinated individuals at least 14 days after the first dose.

Over-80s who develop COVID-19 infection after vaccination are around 40% less likely to be hospitalised than unvaccinated people.

Dr Susan Hopkins, strategic response director, Public Health England, told a news briefing hosted by the Science Media Centre: "Overall, we're seeing a really strong effect to reducing any infection, asymptomatic and symptomatic. That's the first time that this has been done in a systematic way for the Pfizer/BioNTech vaccine, and also then allies to what we saw with some of the early data released from AstraZeneca."

Analysis is also being done on the Oxford/AstraZeneca vaccine but that hasn't been released yet.

Scottish Study

Also released today as a preprint , University of Edinburgh research found that 4 weeks after the first dose, the Pfizer/BioNTech jab reduced the risk of hospitalisation by up to 85%, and the figure was up to 94% for the Oxford/AstraZeneca vaccine.

Combined vaccination results for over-80s saw an 81% reduction in hospitalisation risk.

Lead researcher, Professor Aziz Sheikh, said: "These results are very encouraging and have given us great reasons to be optimistic for the future. We now have national evidence – across an entire country – that vaccination provides protection against COVID-19 hospitalisations. Roll-out of the first vaccine dose now needs to be accelerated globally to help overcome this terrible disease."

More than two-thirds of 65 to 69-year-olds have now had their first COVID jabs across England.

As of yesterday, there have been 17.7m first doses delivered across the UK, and 624,325 second doses.

Mr Johnson set a "stretching target" to offer a first dose to every adult by the end of July.

In today's daily data another 10,641 UK positive tests were reported and 178 deaths.

Another 1304 COVID-19 patients were admitted to hospital. The total is now 18,462 and 2469 ventilator beds are in use.

SAGE

More SAGE papers on the latest data and modelling were released to coincide with the PM's announcement. There could be another "large wave" of infections  if all lockdown restrictions are lifted by the end of April. Some measures will be needed beyond this year.

Chief Scientific Adviser Sir Patrick Vallance told a news briefing: "We are in a 'not very good position' which is getting better."

He added: "It's likely you get an increase in cases when you start to open up, so that's likely. Exactly when that occurs, and exactly how high the numbers are, it’s not possible to be precise."

Sir Patrick said: "The sooner you open up everything, the higher the risk of a bigger resurgence, the slower you do it, the better. And importantly, if you want to understand what you're doing because we don't know for sure what the effects of the different measures are, do steps with enough time between them that you can measure data."

He said the UK could be "flying blind" unless time is taken to measure changes to the lockdown.

Shielding Review

A review is being carried out into the inclusion of gestational diabetes in the QCovid algorithm which has been used to ask 1.7m more people to shield.

The Royal College of Obstetricians and Gynaecologists said in a statement: "We're aware some postpartum women with a history of gestational diabetes (GD) have been asked to shield. We're investigating this as there's no previous suggestion that once women are no longer pregnant, a history of GD alone would be linked to severe illness from COVID-19."

NHS Digital said in a statement: "Because the risk assessment is based on routinely coded data from multiple systems some women may have been identified as having diabetes when in fact they had gestational diabetes."

It added: "QCovid is a ‘living’ model with a commitment for the population risk assessment approach to be refined and updated for increased precision as new information becomes available. Active review is underway and further information will be communicated as soon as it is available."

Surge Testing

Brentwood in Essex and New Addington, Croydon are the latest areas to be targeted for surge testing to detect South Africa variant cases.

Two cases of the Nigerian 'variant under investigation' have been found in Wales linked to international travel.

Missed Symptoms

Data from King's College London's ZOE app suggests that 31% of people who are ill with COVID-19 don’t have any of the classic three symptoms: temperature, cough, anosmia.

The team's study, published in the Journal of Infection , suggests that  testing people with any of seven key symptoms: cough, fever, anosmia, fatigue, headache, sore throat, and diarrhoea in the first 3 days of illness would have detected 96% of symptomatic cases.

Study lead, Professor Tim Spector, said: “We persuaded the Government to add anosmia to the list back in May and now it is clear we need to add more."

Care Home Visits

The Alzheimer’s Society welcomed the announcement on allowing named people to visit care home residents in England after testing, and wearing PPE.

However, the charity's James White said: "We ask the Government to provide clarity on how this will work in practice, and whether it will allow for flexibility in exceptional circumstances, such as an older loved one needing support to visit."

NHS Staff Support 

NHS England is setting up more mental health and wellbeing hubs modelled on the Greater Manchester Resilience Hub set up after the Manchester terrorist attack in 2017.

National Mental Health Director, Claire Murdoch, said: "NHS staff are used to dealing with the extremes of life on a daily basis, but this year has been exceptional, and in what is likely to be the toughest year in their career, staff have put their minds and bodies to the limit treating hundreds of thousands of seriously ill-patients with COVID-19.

"So it is vital that the people that played such a big role getting this country through the pandemic are given additional support, and I would urge anyone working in the NHS whether you are a porter, a nurse, paramedic or other role to please ask for help from one of our 40 mental health support hubs as they open over the coming weeks."

Psychological First Aid Training

Carers and people who work with children and young people aged up to 25 can access a PHE online Psychological First Aid (PFA) training course from today on how to offer practical and emotional support for COVID-19-related emergencies.

Clare Perkins, director of the PHE Mental Health Programme, said: "Children and young people will react to the COVID-19 pandemic in different ways. The PFA training course will help professionals, volunteers, parents and carers better identify the signs of those who are struggling and give them timely effective support that is right for them – helping them feel safe and able to help themselves."

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

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