UK COVID-19 Update: JCVI Phase 2 Priorities, First Jab Infection Data

Tim Locke

February 26, 2021

Editor's note, 26 February 2021: This article was updated with today's daily data.

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

JCVI Phase 2 Priorities

JCVI has issued its recommendations for phase 2 of the COVID-19 vaccination programme after groups 1-9.

Once all phase 1 groups have been offered at least one dose, the next groups are 40-49, 30-39, and 18-29 year-olds.

It decided against prioritising occupations, such as teachers and the police. In a statement it said that would be more complex to deliver and may slow down the vaccine programme, leaving some more vulnerable people unvaccinated for longer.

JCVI COVID-19 Chair, Professor Wei Shen Lim,  said: "The evidence is clear that the risk of hospitalisation and death increases with age. The vaccination programme is a huge success and continuing the age-based rollout will provide the greatest benefit in the shortest time, including to those in occupations at a higher risk of exposure."

Dr Mary Ramsay, head of immunisations at Public Health England, added: "The age-based approach will ensure more people are protected more quickly. It is crucial that those at higher risk – including men and BAME communities – are encouraged to take the vaccine, and that local health systems are fully engaged and reaching out to underserved communities to ensure they can access the vaccine."

A UK government spokesperson said: "All four parts of the UK will follow the recommended approach, subject to the final advice given by the independent expert committee. The UK government remains on course to meet its target to offer a vaccine to all those in the phase 1 priority groups by mid-April, and all adults by the end of July."

Commenting via the Science Media Centre (SMC), Jonathan Ball, professor of molecular virology, University of Nottingham, said: "There has been mounting pressure to prioritise groups according to risk of infection - perceived or real - and that seems a reasonable viewpoint. However, we know that these vaccines are good at protecting from serious disease, and the likelihood of that increases with age. Therefore, continuing to target vaccine rollout according to disease risk makes sense, especially if this simplifies the roll out process."

Latest Office for National Statistics (ONS) data show 97% of over-70s in Great Britain said they had received at least one vaccine dose. Overall, 35% of adults report having received at least one dose of the vaccine, up from 26% last week.

Among the 4% unlikely to accept a jab, the main reasons given were long-term health effects, side effects, and wanting to wait to see how well it works.

As of yesterday, 19.17m people have had a first dose of a COVID-19 vaccine, and 736,037 a second dose.

Single Dose Infection Data

Cambridge preprint research using staff testing data from Addenbrooke's Hospital found a single dose of the Pfizer/BioNTech vaccine can reduce asymptomatic infections four-fold.

Twelve or more days after first vaccination there was 75% protection.

Between 18-31 January 4400 PCR tests a week were used to test similar numbers of vaccinated and unvaccinated staff.

The researchers found:

  • 26 out of 3252 (0.8%) unvaccinated healthcare workers were positive

  • 13 out of 3535 (0.37%) healthcare workers were positive less than 12 days post-vaccination

  • 4 out of 1989 (0.2%) healthcare workers were positive at 12 days or more post-vaccination

First author Dr Mike Weekes said: "This is great news – the Pfizer vaccine not only provides protection against becoming ill from SARS-CoV-2 but also helps prevent infection, reducing the potential for the virus to be passed on to others."

Commenting via the SMC, Dr Simon Clarke, associate professor in cellular microbiology, University of Reading, said: "While this research is encouraging, like the SIREN findings, it relies on studying NHS staff and there appears to have been no assessment made of their pre-existing immune status, which might have been higher than in the general population given healthcare workers’ likelihood of exposure at work.  Pre-exposure to the coronavirus before receiving a dose seems to cause a more potent immune response to the vaccine."

Infections 'Heading in the Right Direction'

Latest ONS infection survey data for the week ending 19 February show:

  • 1 in 145 people in England had COVID-19

  • 1 in 225 people in Scotland had COVID-19

  • 1 in 205 people in Wales had COVID-19

  • 1 in 195 people in Northern Ireland had COVID-19

Sarah Crofts from ONS said: "It is encouraging to see infection rates continuing to head in the right direction across the UK, however they are still high, similar to those seen in mid-October last year.

"Though cases compatible with the new UK variant continue to make up the largest proportion of cases, they have also declined across all countries of the UK."

The UK's R number is unchanged this week at 0.6 to 0.9.

The growth rate is -6% to -2% per day.

Redbridge is the latest area to see surge testing deployment to identify South African variant cases.

In today's daily data another 8523 UK positive tests were reported and 345 deaths.

Another 1117 COVID-19 patients were admitted to hospital. The total is now 15,485 and 2047 ventilator beds are in use.

COVID Inequalities

Higher death rates among many ethnic minorities so far are likely to be driven by a higher risk of infection in the first place rather than ethnicity being an independent risk factor, the latest Government report on COVID-19 and health inequalities found.

The latest OpenSAFELY data show that around 60% of Black people over 70 have been vaccinated compared to 75% for South Asians and 90% of White people.

Equalities Minister, Kemi Badenoch, said: "The latest data shows that this is not a one-size-fits-all situation. Outcomes have improved for some ethnic minority groups since the first wave, but we know some communities are still particularly vulnerable. Our response will continue to be driven by the latest evidence and data and targeted at those who are most at risk."

Dr Chaand Nagpaul, BMA council chair, said: "Progress in both recognising and then tackling this, in order to stop more BAME people becoming ill and dying, has been far too slow, with delayed and incomplete reviews and lack of action.

"It’s positive then to see the steps the Government now appears to be taking, in particular around communication and engagement with people from the most at-risk communities, involving trusted voices and accessible channels."

No ED 'Normality'

The COVID-19 alert level may have been lowered but there's still significant pressure on England's emergency departments.

President of the Royal College of Emergency Medicine, Dr Katherine Henderson, said: "Winter sitrep data shows the emergency departments are still under significant pressure despite falling rates of COVID. Bed occupancy is up on the previous weeks, as are ambulance handover delays. There were three incidences of Trusts experiencing bed occupancy above 99%.

"While the country looks forward to a return to normality, we need to be clear that normality for EDs before the pandemic was anything but normal, and we cannot simply return to the status quo.

"Next week’s budget is an opportunity for the Government to allocate what is needed to ensure the NHS has the capacity it needs long-term."

The i newspaper reported the budget will not include NHS pay rises. Instead Chancellor Rishi Sunak will wait for the NHS Pay Review Body’s recommendations in May.

Lockdown Loosening Concerns

UCL's continuing COVID-19 social study finds 57% of adults are concerned that cases will increase after current lockdown restrictions are eased, and 43% worry that hospitals will be overwhelmed again.

Lead author, Dr Elise Paul, commented: "Our report shows that in January and up to the time just before the plan for easing of restrictions in England was announced on 22 February, a wide range of concerns remain unresolved for many.

"While news of a vaccine means that the relaxing of restrictions is perceived as less dangerous than it was last year, people are understandably still worried about another spike in COVID-19 cases should lockdown restrictions be eased, as well as the subsequent worry about the ability of hospitals to deal with an influx of new patients should this happen. These worries may well be amplified by the second wave of the virus which occurred after the easing of the first national lockdown."

Jabs Get Royal Approval

The 1.7 million people added to the shielding list this month are now being invited for COVID vaccination.

Coronavirus jabs now have Royal approval with the Queen saying it "didn't hurt at all" and urging people who are hesitant about having the vaccines to "think about other people rather than themselves".

It is rare for Royals to talk about health matters. The Queen made her comments in a video meeting with health officials leading vaccine deployment across the UK.

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


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