UK COVID-19 Update: Jabs Cut Care Home Infections, Vaccination Inequality

Tim Locke

March 29, 2021

Editor's note, 29 March 2021: This article was updated with information from a Downing Street briefing.

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

Jabs Cut Care Home Infections

A University College London preprint study found infections in elderly care home residents dropped by 62% from 5 weeks after a COVID-19 vaccine first dose, and 56% after 4 weeks.

Data came from 10,412 people in 310 care homes between December and mid-March who were given either the Pfizer or Oxford-AstraZeneca vaccine. Infections were confirmed with PCR tests.

"Our findings show that a single dose has a protective effect that persists from 4 weeks to at least 7 weeks after vaccination," said.Laura Shallcross, from UCL. "Vaccination reduces the total number of people who get infected and analysis of lab samples suggests that care home residents who are infected after having the vaccine may also be less likely to transmit the virus."

Commenting via the Science Media Centre, Dr Peter English, immediate past chair of the BMA Public Health Medicine Committee, said: "The really good news from this study is that it is further evidence that vaccination is likely to have the potential (if we can vaccinate enough people, and if the virus has a low enough R0) to generate herd immunity, as it seems to prevent infection even in older people. If people are not infected, they cannot be infectious.

"This paper presents findings from an ongoing study. It is likely that data on the effectiveness of a second dose of vaccine will be presented in due course. A second, 'booster' dose of vaccine is likely to increase the quality and duration of the immune response, and thereby reduce further infections and the possibility of spread."

Updated JCVI Guidance

JCVI says over-16s living with adults who are immunosuppressed should be prioritised for COVID-19 vaccination.

Professor Wei Shen Lim, JCVI COVID-19 immunisation chair, said: "Our latest advice will help reduce the risk of infection in those who may not be able to fully benefit from being vaccinated themselves."

NHS England has already been asked to make the changes.
 

Unlocking Caution

Golf courses and other outdoor leisure venues opened again today in England, and people were able to meet outside again under the rule of six after 'stay at home' rules were lifted. However, a new campaign urges 'Let’s take this next step safely", and the Government's slogan has been updated to 'Hands, Face, Space and Fresh Air'.

Professor Catherine Noakes, Leeds University, who advised on a new public information film, said: "The closer you are to people, the greater the risk of breathing in infected particles. When we are outdoors, the risk of infection is significantly lower as fresh air disperses and blows COVID-19 particles away, and we have more space to social distance from each other."
 

WHO Wuhan Report Leak

The AP news agency reported that the World Health Organisation's joint investigation with China into the origins of COVID, will say a lab leak is "extremely unlikely", and that SARS-CoV-2 transmission from bats to humans through another animal is the most likely scenario.

The agency received a leaked copy of the report which may be subject to change.

New Vaccination Milestone

The UK's vaccination campaign reached a new milestone at the weekend with 30 million first doses delivered, around 57% of adults, and 3.5 million second doses, around 6% of adults.

April will be "second dose month", according to vaccines minister, Nadhim Zahawi, as supply constraints will affect first doses.

There's no official date for rollout of the third approved vaccine from Moderna other than 'spring'. Reports over the weekend said 500,000 doses could be available next month.

The MHRA is carrying out rolling reviews of data from Janssen and Novavax.

Prime Minister Boris Johnson told a Downing Street briefing that in addition to Novavax manufacturing its vaccine at Fujifilm in the North East of England, the Vaccine Task Force has reached an agreement for GlaxoSmithKline to finish and bottle vaccines in the region.

Fifty to 60 million doses would be made available, he said, subject to MHRA approval.

The Observer   reported on 'secret' jabs given to avoid wasting vaccine doses. "You can’t use my name," one GP told the paper, "or which city I am in. If you do, we will all get an email telling us that we shouldn’t be doing it. But we are also not allowed to waste vaccines."

Vaccination Inequalities

Office for National Statistics (ONS) data show the percentage of people vaccinated was lower among all ethnic minority groups compared to the White British population.

The rates for different ethnic groups were:

  • White British 91.3%

  • White Other 81.6%

  • Indian  86.2%

  • Mixed  80.4%

  • Other   77.6%

  • Chinese 76.7%

  • Pakistani 74.0%

  • Bangladeshi 72.7%

  • Black Caribbean 68.7%

  • Black African   58.8%

The lower vaccination rates were seen in some religious groups:

  • Muslims 72.3%

  • Buddhists 78.1%

  • Sikhs 87.0%

  • Hindus 87.1%

Rates were also lower in deprived areas and among people with disabilities.

On Saturday, a letter from the Commons Women and Equalities Committee criticised the Government for failing BAME communities and young women on vaccine uptake. Committee Chair, Caroline Nokes, said: "The reasons for disparities in vaccine uptake are complex. Some of the groups with lower uptake rates are also among those who are at greater risk from COVID, which is especially worrying."

Patients Returning to A&Es

Royal College of Emergency Medicine (RCEM) winter flow data show 71,722 emergency department attendances in the third week of March. That's higher than the previous highest total set in the first week of the project in October last year.

Twelve-hour stays have also increased but remain low as a proportion of all cases. Levels of available beds continue to be largely static.

RCEM Vice President, Dr Adrian Boyle, said: "While the NHS is manifestly in need of a recovery period, there are already indications that there may be little respite. We expect hospital activity to increase in the coming weeks and months as NHS services return to normal."

'Safe' Breast Cancer Treatment 

A UK-wide study of patients with early breast cancer led by the University of Manchester found care was just as safe during the pandemic as it was before.

The study is published in The British Journal of Cancer and involved  3776 patients across 64 hospitals between March and May last year.

One percent of patients tested positive for COVID but there were no deaths.

The authors credit the adoption of special multidisciplinary guidelines, published early in the pandemic, and shorter courses of radiotherapy under Fast Forward.

However, some patients did potentially miss out on breast reconstruction surgery which could lead to a build-up of cases.

Co-author and surgeon, Professor Cliona Kirwan, said: "Outcomes are as good as they were before the pandemic took hold, and that’s a result of the fantastic work of everyone in multi-disciplinary teams across the UK."

International Arrivals Testing

Lateral flow tests will be needed for lorry drivers and other quarantine-exempt professions arriving in the UK from 6 April.

The rules will only apply if people are here for more than 2 days.

Meanwhile, Oxford University researchers have reported on a new cheap, rapid, COVID-19 antibody test in Nature Communications.

The haemagglutination test detects spike-protein binding antibodies in people who have tested positive for COVID-19. Ten million kits are being offered free to scientists in countries that cannot afford expensive solutions.

Sounds Like COVID?

Study participants are being recruited for a Test and Trace study to see if someone needs a COVID-19 test by algorithms listening to a forced cough.

The coughing sounds will be submitted via a smartphone or tablet from people using COVID-19 test sites.

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

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