UK COVID-19 Update: Germany Suspends Oxford Vaccine for Under-60s, and 'Third Wave' Intensifies in France

Peter Russell

March 31, 2021

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

Germany Restricts Use of Oxford Vaccine

Germany has suspended routine use of the AstraZeneca/Oxford vaccine for people under 60 because of concerns over cases of rare cerebral vein thrombosis.

Vaccination with the AstraZeneca/Oxford vaccine was suspended in Germany on March 15 as a precaution but resumed after the European Medicines Agency recommended on March 19 that the vaccination programme should continue. The World Health Organisation has also backed the vaccine's continued use.

Germany's Federal Ministry of Health said yesterday that its Standing Vaccination Commission had since noted an accumulation of blood clot cases almost exclusively affecting people under the age of 60 who had received the Oxford vaccine, some of which were fatal.

Yesterday it was reported that Berlin's state hospital groups Charite and Vivantes had stopped using the vaccine in women under-55 as a precautionary measure.

Canada's National Advisory Committee on Immunisation has recommended stopping use of the Oxford vaccine in under-55s while investigations continue into blood clotting events.

Commenting to the Science Media Centre, Dr Peter English, a retired consultant in communicable disease control, said: "Right now, in the middle of a pandemic, with case numbers rising alarmingly, any risk from vaccination has to be set against the risk of disease.

"A decision may be thought of as 'precautionary'; but if people are not vaccinated, because use of the vaccine is suspended, or because of a drop in confidence in the vaccine caused by the decision, some of them will get ill from COVID-19, and some of them will die.

"Any decision to withhold the vaccine will directly cause excess, avoidable COVID-19 deaths."

Earlier today, a UK Government minister said he was "One hundred percent confident in the efficacy" of the AstraZeneca/Oxford vaccine. "It is a safe vaccine and the UK's vaccine rollout is saving people's lives right across the country every day," Housing Secretary Robert Jenrick told Sky News.

Macron Under Pressure as Hospitalisations Soar in France

The French President Emmanuel Macron will deliver a TV address to the nation tonight, his office confirmed, as the number of patients in intensive care exceeded 5000 on Tuesday, the highest number this year.

Nearly 9 out of 10 intensive care beds are currently occupied by COVID-19 and other health cases, France 24 reported, quoting health ministry sources.

According to Reuters, the Elysee Palace did not say whether the President would announce further restrictions to counter a third wave of COVID, as the country’s death toll nears 100,000.

France has been under a nightly curfew since the middle of December.

Anne Hidalgo, Mayor of Paris, told French TV station BFM that schools should be closed.

Shielding to End

Today is the last day for an estimated 3.8 million people in England deemed clinically extremely vulnerable to shield at home.

The shielding advice has been in operation since January 5.

From April 1, these people – accounting for around 6.8% of the population – will no longer need to shield themselves. However, they are being advised to take extra precautions, including working from home where possible and keeping social contacts to a minimum.

More than 9 in 10 clinically extremely vulnerable people have been vaccinated with a first dose of a COVID-19 vaccine, the Department of Health and Social Care said.

Pfizer Vaccine 'Effective in Adolescents'

Pfizer said its COVID-19 BNT162b2 vaccine "demonstrated 100% efficacy and robust antibody responses" during a phase 3 trial involving 2260 adolescents aged 12 to 15.

Side effects were generally consistent with those seen in the 16 to 25 year age range, Pfizer said in a press release.

The company said it was planning to submit data to US and EU regulators for permission to expand use of the Pfizer/BioNTech vaccine in this age group.

Last week, Pfizer and BioNTech began the first stage of trials to evaluate the safety, tolerability, and immunogenicity of their vaccine in children aged 6 months to 11 years.

Post-lockdown Controls

As the UK moves out of lockdown, scientists have suggested tighter control measures, including social distancing and facemasks, might be needed to curb the spread of COVID-19.

Mathematical modelling has been developed by scientists at the universities of Cambridge and Liverpool to predict how emerging diseases, such as COVID-19, would spread under different scenarios.

The study, published in the Journal of the Royal Society Interface, examined non-spatial measures such as face coverings, handwashing, and social distancing as well as spatial measures including lockdown and travel restrictions.

"More effective use of control measures like facemasks and handwashing would help us to stop the pandemic faster, or to get better results in halting transmission through the vaccination programme," said Yevhen Suprunenko, a research associate at the University of Cambridge, who led the investigation.

Government 'Must Address Healthcare Staffing'

The Government must develop plans to support health and care staff who are struggling because of the pandemic, retain those considering leaving the sectors, and attract new recruits, a think-tank said.

A global shortage of healthcare workers, coupled with migration rules, mean that the NHS and social care can no longer automatically fill vacancies from abroad, a paper from the Institute for Public Policy Research said.

Estimates from 2020 showed there were 85,000 staff shortages across the NHS, and 112,000 vacancies in the social care sector, the authors said.

"Working in an understaffed system leads to burnout, moral injury, and mental health problems among the workforce," they wrote.

The Royal College of Physicians (RCP) said it had warned that 1 in 4 healthcare staff could leave the NHS in England due to the pressures of the pandemic.

Prof Andrew Goddard, RCP president, said it had published a fully costed blueprint for expansion back in January, adding that "we now need government to set out its own plans for increasing the clinical workforce".

Danny Mortimer, chief executive of the NHS Confederation, commented: "The Government and NHS England have said that they accept the importance of the wellbeing of staff as part of the NHS's recovery, and this needs be reflected in practice in a proportionate response to restoring elective care while also managing rapidly growing demand for mental health services.

"This report rightly reinforces that the time is now to give the NHS all it needs to help staff get back on track. That includes urgent long-term investment from the Chancellor to address long-standing vacancies across all our key professions."

Study Urges Aerosol Precautions Review

New research has challenged guidance that special aerosol precautions are only needed when using oxygen therapies for patients with COVID-19.

The study, published in the journal Anaesthesia, compared emissions from 10 healthy individuals during six respiratory activities, ranging from quiet breathing to coughing. Participants produced up to 100 times more aerosol particles when they coughed than they did during treatment with oxygen therapies.

The researchers concluded that "exertional respiratory activities themselves are the primary modes of aerosol generation and represent a greater transmission risk than is widely recognised currently".

Co-author Prof Tim Cook, from the Department of Anaesthesia and Intensive Care Medicine at the Royal United Hospitals NHS Trust in Bath, said: "Our findings strongly support the re-evaluation of guidelines to better protect hospital staff, patients, and all those on the front line who are dealing with people who have, or are suspected of having, COVID-19."

Cancer Care Treatment 'Swaps'

Thousands of people with cancer can continue to have access to treatments at home during the pandemic, the NHS announced.

It said around 8000 people had already benefited from treatment 'swaps', and patient access would be extended into the summer, with the potential to extend the scheme until the end of March next year.

More than 30 different drugs are available to treat patients, offering benefits such as fewer hospital visits, or a reduced impact on their immune system, NHS England said.

Treatment options included:

  • Venetoclax in acute myeloid leukaemia as an oral alternative to standard chemotherapy

  • Nivolumab or pembrolizumab for patients with bowel cancer whose cancers have a specific genetic fingerprint

  • Ixazomib in myeloma as an oral alternative to treatment which would require more hospital visits and injections

  • Atezolizumab as first-line immunotherapy for bladder cancer instead of chemotherapy

Clare Turnbull, professor of cancer genomics at The Institute of Cancer Research, said: "It’s reassuring to see the NHS prioritising cancer patients and working to maintain and expand access to more 'COVID-friendly' cancer treatments.

"These treatment swaps, such as targeted cancer drugs that can be taken at home and have less of an impact on patients' immune system, have the potential to make a huge difference in keeping vulnerable patients safe. This is an important step among many that are needed to tackle the cancer backlog that has built up over the past year."

End-of-life Contact

Priority must be given to ensuring that relatives are allowed to connect with a family member who is dying, academics have said.

Researchers at the universities of Oxford, Sheffield, and Liverpool said end-of-life experiences for families have been badly affected by the pandemic.

Allowing contact, using video or phones, as well as regular updates from health workers about a loved one's condition, could help relatives recover better in the aftermath of bereavement.

The study, published in the journal Palliative Medicine, also stressed the importance of allowing relatives to say goodbye in person before death where possible, and preparing children for the death of a family member.

Dr Jeff Hanna from the University of Oxford, who led the study, said: "This timely research reports important recommendations for health and social care professionals as they provide end-of-life care during a pandemic. They have a pivotal role in facilitating vital interactions between relatives and their loved ones."

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