UK COVID-19 Update: Alert Level Downgraded, 1 in 7 'Have Antibodies'

Tim Locke

February 25, 2021

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

Alert Level Downgraded

The UK's CMOs have downgraded the alert level from 5, the highest to 4, "following advice from the Joint Biosecurity Centre and in the light of the most recent data".

In a statement they said: "The health services across the four nations remain under significant pressure with a high number of patients in hospital. However, thanks to the efforts of the public we are now seeing numbers consistently declining, and the threat of the NHS and other health services being overwhelmed within 21 days has receded.

"We should be under no illusions – transmission rates, hospital pressures and deaths are still very high."

1 in 7 'Have Antibodies'

The latest preprint findings from Imperial College London's REACT-2 trial found 13.9% of 155,172 people IgG tested had COVID-19 antibodies.

Among those who had the Pfizer/BioNTech jab 37.9% had antibodies, while 9.8% of unvaccinated people had antibodies.

The survey was carried out 26 January to 8 February before the Oxford jab was rolled out.

The authors conclude: "Two doses of Pfizer/BioNTech vaccine, or a single dose following previous infection, confers high levels of antibody positivity across all ages. Further work is needed to understand the relationship between antibody positivity, clinical outcomes such as hospitalisation, and transmission."

Commenting via the Science Media Centre, Dr Simon Clarke, associate professor in cellular microbiology, University of Reading, said: "These are robust data with interesting and meaningful conclusions."

He added: "It is of concern that in studies of individuals aged 70 years or over, a single dose of the vaccine was associated with substantially lower levels of antibodies than in younger age groups, or in those who had had COVID-19 prior to vaccination. This shows that with this vaccine, the immune response is much greater in individuals who have been exposed twice, either through a prior infection or through double vaccination."

The Guardian reported that the JCVI will not be prioritising frontline workers o from Black, Asian and Minority Ethnic groups in the next stages of the COVID-19 vaccination programme.

Yesterday, JCVI Deputy Chair, Professor Anthony Harnden, told the Commons Science and Technology committee there was no good scientific reason to prioritise teachers.

'Inadequate' Rating Over Ambulance Handover Delays

Medway NHS Foundation Trust’s urgent and emergency services have been rated inadequate after Care Quality Commission (CQC) inspectors saw long ambulance handover delays during an unannounced visit in December.

CQC's Nigel Acheson said: "We saw that staff were working hard to provide care to patients in very challenging conditions.

"Given the pressure the trust was under, the decision to inspect during this period was a difficult one. However, we had significant concerns from reviewing our own data, the views of healthcare system partners and information shared by people who worked for and used the service. We had a duty to inspect to support the trust and identify where improvements needed to be made."

Trust Chief Executive James Devine commented: "We have taken a number of steps since the CQC's visit to address the findings from their inspection, including taking immediate action to improve the way we manage pressures within our emergency department. We have implemented an improvement plan to ensure we are consistently providing safe, high quality patient care, which is already making a positive difference to patients’ care."

Maternity Visiting Ban

Maternity departments' lockdown bans on partner visits could have contributed to delays in people seeking care, according to a Healthcare Safety Investigation Branch (HSIB) report.

"These policies meant that women were alone when attending hospital appointments, emergency departments, assessment units, ultrasound scans and on admission to hospital, including in maternity settings and intensive care units. Partners were permitted to be on labour wards only when the woman was in labour and were asked to return home hours after the baby was born," the report said.

"This contributed to decisions to delay attendance at hospital or to self-discharge."

It also found that 'stay at home' messaging and 'safety netting' advice "caused delays in presentation".

Surge Testing

Parts of Buckinghamshire, Lambeth and Ealing in London are the latest to see surge testing deployed to identify South Africa variant cases.

Test and Trace in England reported 84,310 people testing positive 11-17 February, 21% lower than the previous week.

Office for National Statistics (ONS) analysis for England and Wales shows deaths in January were 29.5% and 25.6% above the 5-year average.

The leading cause of death was COVID-19 for the third month in a row. It accounted for 37.4% of all deaths registered in England and 35.2% in Wales.

Serco, the company behind England's Test and Trace service, reported pre-tax profits of £153.3m for last year, up from £80.7m a year earlier, and has begun paying dividends to shareholders again. However, CEO Rupert Soames told the BBC that its coronavirus work added £350m of revenue but accounted for less than 1% of its profits.

Daily Data

In today's daily data another 9985 UK positive tests were reported and 323 deaths.

Another 1142 COVID-19 patients were admitted to hospital. The total is now 16,059 and 2118 ventilator beds are in use.

As of yesterday, 18.7m people have had a first dose of a COVID-19 vaccine, and 700,718 a second dose.

Burnout and Resilience

Yesterday, the Commons Health and Social Care Committee took evidence on workforce burnout and resilience in the NHS and social care in England.

NHS England Chief People officer, Prerana Issar, told the Committee its surveys suggest that 40% of staff felt anxious, compared to 29% last summer. BAME staff were more likely to feel anxious and less likely to feel supported.

Professor Andrew Goddard, president of the Royal College of Physicians, commented: "The RCP was pleased to hear that the Minister of State for Social Care is working with the NHS Chief People Officer to make sure NHS staff get time off and time out.

"As I’ve said before, the past 12 months have been some of the hardest many of us have ever faced in our careers. Scheduled time off when the worst of the pandemic is over will give staff the strength they need to face the next challenge of tackling pent-up demand of non-COVID-19 care.

"But while we agree these considerations are of the utmost importance, the really important part of recovery planning is accepting that we need to grow the NHS workforce. As the Chair of the committee said, without the publication of independent projections of the number of doctors and nurses we need, we simply don’t know if we’re training enough."

Today the Committee published evidence projecting an NHS and social care workforce gap of more than a million by 2033/34.

Northern Ireland's 'Devastating' Waiting List

Northern Ireland’s waiting list figures for October-December have been published with 167,806 people waiting more than 52 weeks for their first consultant-led outpatient appointment.

The most common specialists on the waiting list were ENT, general surgery, and dermatology.

Northern Ireland Director of the Royal College of Surgeons of England, Mr Mark Taylor, commented: "The Health Minister has said himself that our waiting times were unacceptable before COVID, and regrettably will be worse after it. Although some outpatient appointments continued in the last quarter, overall these figures are devastating."

He added: "It is of the utmost importance that we look at a long term strategy to transform our health service, whilst we continue to work on the significant surgical backlog. This will require a 'protected long-term budget'."

Meanwhile, NHS Providers' Miriam Deakin has been responding to NHS England's latest performance figures: "Today’s data demonstrates that while we are moving in the right direction, with 21% fewer COVID-19 patients in hospital this week, the NHS is still operating under more pressure than normal. Staff are continuing to go above and beyond – across acute, ambulance, mental health, and community services – to care for both COVID and non-COVID patients.

"Critical care continues to be under particular pressure, despite the number of patients requiring mechanical ventilation reducing by a fifth this week. As bed occupancy reduces, trusts are starting to very slowly reduce their surge capacity, and the number of beds has decreased by 4% this week. However, there are still 53% more critical care beds than at the same time last year – highlighting the sustained pressure the NHS is still under."

Washing Uniforms

Healthcare uniforms should always be professionally washed to avoid COVID-19 infection at home, according to De Montfort University research.

Using a similar coronavirus, called HCoV-OC43, the team found that infectious virus was present on polyester after 3 days, on 100% cotton for 24 hours, and for 6 hours on polycotton.

Public Health England guidance recommends industrial laundering for healthcare worker uniforms but home washing at 60C or higher should be done if not.

Microbiologist, Dr Katie Laird, said: "While we can see from the research that washing these materials at a high temperature, even in a domestic washing machine, does remove the virus, it does not eliminate the risk of the contaminated clothing leaving traces of coronavirus on other surfaces in the home or car before they are washed."

She added: "This research has reinforced my recommendation that all healthcare uniforms should be washed on site at hospitals or at an industrial laundry. These wash methods are regulated and nurses and healthcare workers do not have to worry about potentially taking the virus home."

Hancock Fact Checked

The independent fact checkers at Full Fact have pulled up England's Health Secretary Matt Hancock over PPE for claiming in a radio interview that the National Audit Office (NAO) "investigated and found there was never a national shortage".

Full Fact said: "The NAO did not find this. It wrote that while trusts told it that they were able to get what they needed in the spring of 2020, healthcare workers reported widespread shortages."

Cancer & COVID

Half of head and neck cancer patients had altered treatment in the second wave, according to the COVIDSurg Collective snapshot survey.

Of the 50%, 28% experienced treatment delays, 10% received radiotherapy instead of surgery, and 12% received de-escalated surgery.

British Association of Oral and Maxillofacial Surgeons President, Austen Smith, commented: "The existing NHS solutions are effective, but work to a time frame that often does not respond quickly enough. It should be possible to coordinate patients’ transfers rapidly from struggling units to centres with some capacity for surgical procedures and post-operative critical care. Many major hospitals can struggle, as centralised services tend to sit within large populations where COVID is a major problem."

A Cardiff University/Cancer Research UK survey of 7543 people found that 45% of those who experienced possible cancer symptoms March-August last year didn't contact their GP, including for 'red flag' symptoms. Not wanting to burden the NHS during the pandemic was among the reasons given.

MMR

Lockdown has led to a big drop in cases of measles, rubella, and mumps, Public Health England reported.

  • There were no new laboratory confirmed measles cases in the UK in the final quarter of 2020

  • There have been no laboratory confirmed cases of rubella reported in the UK last year

  • In England, there were only five laboratory confirmed mumps infections between October and December last year

Interim analyses show lower MMR first vaccine dose coverage last year than in 2019. PHE is working on a catch-up recovery plan.

'Nurses for Jabs' Deal?

The cap by the Philippines Government on the number of nurses from the Philippines coming to work in the UK could be lifted if an agreement is reached to donate coronavirus vaccine doses.

"We are disgusted at how nurses and healthcare workers are being treated by the government as commodities or export products," Jocelyn Andamo, secretary general of the Filipino Nurses United, told Reuters.

Plasma Ban Lifted

The 1998 ban on UK-sourced blood plasma being used to manufacture immunoglobulins imposed due to Creutzfeldt Jakob disease is being lifted after an MHRA safety review.

The decision could allow for convalescent plasma manufacturing for COVID-19 depending on clinical trial outcomes.

Health Minister Lord Bethell said: "The move will also help England become self-sufficient and we will not have to rely only on imports from other countries, ensuring every NHS patient can always access the treatments they need."

Gwyneth Paltrow

NHS England National Medical Director Professor Stephen Powis has rebuked Gwyneth Paltrow for her long COVID recovery tips.

There included herbal drinks, infrared sauna sessions, and a keto/fasting diet for her "fatigue and brain fog".

Prof Powis said: "We wish her well, but some of the solutions she's recommending are really not the solutions we'd recommend in the NHS.

"We need to take long COVID seriously and apply serious science. All influencers who use social media have a duty of responsibility and a duty of care around that."

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

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....