UK COVID-19 Update: CVT Risk, and 'Exhausted' Doctors

Peter Russell

April 15, 2021

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

CVT Risk from COVID and Vaccines

The risk of developing cerebral venous thrombosis (CVT) from COVID-19 was "many-fold" higher than from receiving the AstraZeneca/Oxford or Pfizer/BioNTech vaccines, researchers have concluded.

A preprint study by the University of Oxford found that from a dataset of over 500,000 COVID patients, CVT occurred in 39 in a million people.

CVT has been reported to occur in about 5 in a million people after a first dose of the AstraZeneca/Oxford vaccine. In over 480,000 people receiving either the Pfizer/BioNTech or Moderna mRNA vaccines, CVT occurred in 4 in a million.

The researchers said that compared to the mRNA vaccines, the risk of CVT from COVID-19 was about 10 times greater.

Compared to the Oxford vaccine, the risk of CVT from COVID-19 was about 8 times greater.

A similar pattern was seen in portal vein thrombosis (PVT) which occurred in 436.4 per million people who had COVID. That compared to 44.9 per million for the mRNA vaccine group, and 1.6 per million for those receiving the Oxford vaccine.

Prof Paul Harrison/SMC

Study author Paul Harrison, professor of psychiatry at the University of Oxford, said that "all the evidence we have is that the risks of COVID are so much greater than whatever the risks of the vaccine might be compared to background".

Commenting on the preprint, Paolo Madeddu, professor of experimental cardiovascular medicine at the University of Bristol, said: "The major issue here is that the comparison showing the higher risk after COVID-19 does not exclude the possibility the pathogenesis is the same and therefore some common denominator should be searched.

"For instance, if the mechanism is the same, one can speculate that the high occurrence in COVID-19 vs. vaccination is because the whole virus is more thrombogenic than the spike protein alone. 

"These studies are important but seem to be focused on demonstrating the minor risk of vaccination instead of making efforts to explain the cause of complications, taking advantage of the similarities of the events in the two populations."

Exhausted Doctors

The majority of doctors said the pandemic had left them exhausted, a survey by the Royal College of Physicians (RCP) showed.

Most also felt that the NHS would take at least 18 months to recover.

Of the 1142 RCP members who responded:

  • 69% said they were exhausted

  • 31% reported feeling demoralised

  • 59% said it would take at least 18 months to get the NHS back on an 'even keel'

Prof Andrew Goddard, president of the RCP, identified a shortage of doctors as a major cause. "The problem is workforce," he said. "We need to double the number of medical school places and establish transparent processes to ensure we are training enough people now to meet future demand."

Most people Compliant with Self-isolation

Data collected by the Office for National Statistics (ONS) showed that 82% of people in England who were told to self-isolate adhered to the requirement.

The survey, carried out in March, also found that 36% of people who self-isolated following a positive test result said self-isolation had worsened their wellbeing and mental health. Around 28% said they had lost income because they had to self-isolate.

The ONS said the results should be treated with caution because only 1122 people were sampled.

Commenting on the findings to the Science Media Centre, James Rubin, professor of psychology and emerging health risks at King's College London, said the findings were broadly good news, but pointed out that "out of every 6 people who the ONS tried to call, they had a response back from only 1 person".

He questioned whether "people who don't adhere to self-isolation also tend not to respond to surveys asking about adherence".

Call for Focus on Ventilation to Protect Against COVID

Doctors have backed an editorial in the BMJ that called for a focus on improving ventilation in hospitals, workplaces, and schools to help protect against airborne transmission of SARS-CoV-2.

Experts from the universities of Leicester, Edinburgh Napier and Hong Kong, Virginia Tech, and NHS Lanarkshire, Edinburgh, argue that it has become clear that the virus is most likely to transmit between people at close range through inhalation rather than contact with surfaces.

The experts conclude: "COVID-19 may well become seasonal, and we will have to live with it as we do with influenza. So, governments and health leaders should heed the science and focus their efforts on airborne transmission."

"Safer indoor environments are required, not only to protect unvaccinated people and those for whom vaccines fail, but also to deter vaccine resistant variants or novel airborne threats that may appear at any time."

In their response, the British Medical Association (BMA) said it had repeatedly emphasised the strong evidence that good ventilation was vital to stop the spread of COVID-19.

Dr Chaand Nagpaul, BMA chair of council, said: "There has been much discussion by the Government and in the media about 'hands, face and space', but much less about the critical importance of fresh air and throughflow in buildings and on public transport."

The BMA said it wanted to see monitoring equipment installed in healthcare settings that would indicate how well a room was ventilated.

"Crucially, patients and the public need to know they are as safe as they can be and at low risk of becoming infected with COVID-19 when they return to the office, go shopping, or go into leisure settings," said Dr Nagpaul.

Smoking Rates Increase

The stress of the pandemic seems to have fuelled the nation's nicotine habit, with more than half of smokers 'stress smoking' more, it was reported.

A survey by analysts Mintel found that young people in particular were turning to nicotine, with 39% of 18 to 34 year olds saying they were now smoking more regularly.

Also, a further 10% of all smokers had started smoking again after quitting. Overall, 30% of smokers were smoking more regularly since the start of the pandemic, results showed.

Hazel Cheeseman, director of policy at ASH, commented: "The pandemic has been a wakeup call for many of us about our health. A million smokers were galvanised to quit during the first lockdown, but as this research shows, some will have relapsed and those who didn't stop may now be smoking more."

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