UK COVID-19 Update: Experts' Unlocking Caution, Budesonide Shortens Recovery Time, Snorkel Mask 'Hack'

Tim Locke

April 12, 2021

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

Experts' Unlocking Caution

More lockdown measures were lifted in England today with non-essential shops, hairdressers, gyms, and outdoor hospitality able to reopen.

Non-essential shops could also open in Wales, and some travel restrictions were lifted.

More measures were relaxed in Northern Ireland and the 'stay at home' rule has been replaced with 'stay local' and 'work from home'.

However, Prime Minister Boris Johnson urged people to "behave responsibly" as restrictions are lifted. Some scientific experts also sounded notes of caution.

Dr Mike Tildesley from the Scientific Pandemic Influenza Group on Modelling (SPI-M) told Times Radio unlocking could have an impact on infection rates: "It's hard to tell categorically but I think we do need to remember that with any form of reopening there's going to be more mixing, and so we might expect that that could lead to higher risk.

"We might expect it could have a resurgence."

In a Sky News interview, former Government Chief Scientific Adviser, Sir David King, pointed to the experience in Chile: "Chile is a country where the rate of vaccination amongst the population was third highest in the world – they were ahead of us in terms of the number of people who have had the vaccine – and they’re suddenly now into a third wave."

Inhaled Budesonide Shortens Recovery Time

Oxford's PRINCIPLE trial has found inhaled budesonide shortens recovery times by a median 3 days in over-50 COVID-19 patients treated outside of hospital.

The interim results from the randomised study are reported in a preprint.

Joint Chief Investigator, Professor Chris Butler, said the study "found evidence that a relatively cheap, widely available drug with very few side effects helps people at higher risk of worse outcomes from COVID-19 recover quicker, stay better once they feel recovered, and improves their wellbeing.

"We therefore anticipate that medical practitioners around the world caring for people with COVID-19 in the community may wish to consider this evidence when making treatment decisions, as it should help people with COVID-19 recover quicker."

Commenting, Professor Simon de Lusignan, Medical Director for the Royal College of GP’s Research and Surveillance Centre, said: "These latest results from the PRINCIPLE trial are both exciting and important." 

He added: "Having easily accessible medication that can help patients recover faster from COVID-19 will enhance the care we are able to deliver, close to home, where patients want it most."

 

Vaccination

The weekend saw a UK record number of second COVID-19 vaccine doses delivered in a day. As of Saturday, 32,121,353 first doses had been delivered and 7,466,540 second doses.

The Evening Standard reported that healthy under-50s could start to be offered jabs as soon as tomorrow under phase 2 of the vaccination programme.

Last month the NHS warned of supply constraints during April with the focus put on second doses.

Public Health England published guidance ahead of the Moderna vaccine rollout in England. People will be observed for 15 minutes after their jabs, the same as Pfizer/BioNTech. There's no observation period for Oxford/AstraZeneca but people are advised not to drive for 15 minutes. The minimum period between Moderna doses is 28 days.

Moderna vaccination began in Wales and Scotland last week.

France has said under-55s who received a first dose of the AstraZeneca vaccine will be offered a mRNA vaccine for the second dose instead. The mix and match recommendation by the Haute Autorite de la Sante hasn't yet been evaluated in clinical trials.

Vaccine Induced Thrombosis & Thrombocytopenia

The British Society for Haematology's Expert Haematology Panel has issued guidance on Oxford/AstraZeneca vaccine induced thrombosis and thrombocytopenia.

However, the authors concede: "There are currently no robust data to inform management of this condition. In the absence of evidence, these are pragmatic guidelines based on experience of managing alternative similar conditions and the theoretical risks and benefits

of interventions. As evidence emerges, recommendations are expected to change. Patient management should be individualised according to specific circumstances."

Recommended investigations include:

  • Full blood count

  • Coagulation screen, including Clauss fibrinogen and D Dimers

  • Blood film to confirm true thrombocytopenia and identify alternative causes

Steps to manage suspected cases include:

Radiotherapy & Cancer Backlog

Urgent investment is needed in advanced radiotherapy to help deal with the NHS cancer treatment backlog, according to the Institute of Cancer Research (ICR).

Despite advances, radiotherapy was only seen as 'cutting edge' by 8% of people polled for ICR, compared to 50% for targeted drugs, 43% for immunotherapy, and 58% for proton beam therapy.

ICR Chief Executive, Professor Paul Workman, said: "Radiotherapy is a life-saving treatment for so many people with the potential to play a major role in clearing the backlog of cancer care during the COVID-19 pandemic, but the myths and misconceptions that surround it are surprisingly difficult to shift. We need to ensure that radiotherapy has support from both the public and the Government, so that patients do not miss out on advanced treatment, and can gain improved access to the clinical trials which are so vital for driving forward advances."

App Update Blocked

England and Wales' COVID-19 app has had an update blocked by Apple and Google because it would have broken rules on location sharing when checking in at venues.

The BBC said the Department of Health and Social care "declined to discuss how this misstep had occurred".

Snorkel Mask 'Hack'

Imperial experts have documented how reusable snorkel masks can be adapted as PPE particulate respirators.

In data published in PloS One, out of 56 subjects tested, 75% passed filtering testing with the snorkel mask compared to 55% with a FFP3 respirator mask.

Filters were connected using 3D-printed connections, which can be downloaded from its 'advanced hackspace'.

The authors conclude: "This adaptation is therefore a promising PPE solution for healthcare workers during highly contagious viral outbreaks."

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

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