UK COVID-19 Update: Reform of Social Care Delayed Again and Caution Urged Over Lockdown Easing

Peter Russell

May 11, 2021

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

Health Plans Outlined in Queen's Speech

The new session of Parliament will include a 'national recovery plan' to boost the UK's prospects following the effects of COVID-19, the Government has pledged.

However, a long-promised reform of social care did not feature among 30 bills trailed by the Queen as part of the State Opening of Parliament.

In the speech, which is written for her by ministers, the Queen said: "My Government's priority is to deliver a national recovery from the pandemic that makes the United Kingdom stronger, healthier, and more prosperous than before."

The speech promised that the Government would "protect the health of the nation, continuing the vaccination programme, and providing additional funding to support the NHS".

Featuring among other announcements were:

  • Legislation to "empower the NHS to innovate and embrace technology"

  • More "tailored and preventative care, closer to home" in a Health and Care Bill

  • Measures to tackle obesity and improve mental health

Success of the COVID vaccination programme would lead to the UK pioneering new treatments against diseases such as cancer, the speech promised.

Much-anticipated reform of social care has continued to be put on the backburner, with Boris Johnson saying: "Later in the year we will bring forward proposals to reform adult social care so that every person receives the dignity and security they deserve."

Prof Martin Green, chief executive of Care England, described it as "a missed opportunity" for a sector that was "on its knees".

Caution Urged as Lockdown Restrictions Ease

The chief executive of NHS Providers has urged caution following Boris Johnson's announcement that a significant easing of lockdown restrictions would go ahead next week.

"Trust leaders have been greatly encouraged by the fall in the number of coronavirus cases and hospitalisations in recent weeks," said Chris Hopson, "but we continue to urge caution to make sure that this national lockdown is the last."

A raft of measures will include a return to indoor socialising, and the reopening of indoor hospitality venues and cinemas from May 17.

The Prime Minister's announcement of the next step on the roadmap out of the pandemic came as the UK's chief medical officers lowered the COVID alert level from 4 to 3.

Danny Mortimer, chief executive of the NHS Confederation, said he hoped "they will be ready to move the dial in the other direction if the science dictates".

With growing concern around new variants, "optimism must continue to be tempered by caution", as "the NHS cannot afford another huge wave of infections and hospitalisations, as we saw in the winter", he added.

This morning, England's Health Secretary, Matt Hancock, said the Government might change the rules around mask wearing next month. He told Sky News that ministers "haven't ruled that out".

In Scotland, a major relaxation of lockdown rules has been announced, with people able to meet in each other's homes, and pubs allowed to sell alcohol indoors from Monday May 17.

First Minister Nicola Sturgeon said most of mainland Scotland would move to level 2 restrictions, although Moray could remain under tighter level 3 rules following a surge in cases.

Some Scottish islands would move to level 1 restrictions.

On Monday, a group of scientists said continued vigilance against new variants, accompanied with public health precautions, was needed to consolidate the success of lockdowns and the COVID vaccine rollout.

The warning followed Public Health England's reclassification of one type of SARS-CoV-2, first identified in India, B.1.617.2, as a variant of concern.

More News in Brief

 

  • The US Food and Drug Administration (FDA) has expanded emergency use authorisation of the Pfizer/BioNTech vaccine to include adolescents aged 12 to 15. "Having a vaccine authorised for a younger population is a critical step in continuing to lessen the immense public health burden caused by the COVID-19 pandemic,” said Dr Peter Marks, director of the FDA's Center for Biologics Evaluation and Research.

  • The number of deaths involving COVID-19 in England decreased to 198 in the week ending April 30 compared with 244 in Week 16, provisional figures from the Office for National Statistics showed. For Wales, the number halved from 14 to 7 during the same period.

  • Demonstrations were organised outside AstraZeneca's Cambridge and Macclesfield offices to demand that the company shared its COVID-19 vaccine technology. The group Global Justice Now has called on Boris Johnson to suspend intellectual property rules on vaccines and treatments.

  • Giving greater autonomy to the General Medical Council (GMC) would allow it to address discrimination and inequality within healthcare, its chief executive said. Charlie Massey told the Westminster Health Forum that the pandemic had "showcased the deep pride we all hold in our health services" but had also exposed a "shameful" side too, in which "too many doctors from ethnic minorities continue to experience disadvantage". Reforms would allow the GMC to focus on supporting and nurturing doctors, "rather than simply stepping in when things go wrong," Mr Massey said.

The Future of GP Consultations

Remote consultations between doctors and patients should be an option but not an automatic default once life returns to normal after the pandemic, the Royal College of GPs said.

A report, The future role of remote consultations & patient 'triage' , acknowledges that both options have their advantages and that decisions about how care is delivered should be a shared one between GP practice staff and patients.

It also rejects Government plans to embed 'total triage' into general practice beyond the pandemic, warning that such a system "must not present a barrier to care".

A poll in September 2020 of 622 GPs, found that 88% thought face to face consultations were important for building and maintaining trusting patient relationships, while 90% felt they could be efficient in delivering the best health outcomes all or most of the time, compared to 75% over the phone, 46% via video, and 18% through online consultations.

Prof Martin Marshall, chair of the Royal College of GPs, said: "People choose to be GPs to care for patients – as a medical specialty one of our key tools is our ability to build doctor-patient relationships in order to deliver holistic care, and our members tell us face to face appointments are important for this. It is possible to build relationships via video or phone consultations, but it's a very different skill to doing so in person, in a consultation room, which GPs have been trained for."

Currently around half of consultations in general practice are being delivered face to face. At the peak of the pandemic, around 30% were face to face and 70% remote as practices tried to cut infection risk by reducing footfall.

Blood Clots and Breathing Problems

People with COVID-19 who are not admitted to hospital have a low risk of long-term complications but may make more GP appointments in the 6 months after infection, research found.

According to the study, in The Lancet Infectious Diseases journal, people who tested positive for SARS-CoV-2 and were not hospitalised had a slightly increased risk of needing treatment for blood clots and breathing difficulties, compared with people who had not been infected with the virus.

They were also at slightly higher risk of starting medications for breathing difficulties and migraines, researchers said.

The study used data from the Danish health registries on all individuals who were tested for SARS-CoV-2 between Feb 27, 2020, and May 31, 2020.

The researchers followed up 8983 non-hospitalised SARS-CoV-2 positive people and 80,894 SARS-CoV-2-negative people during the period from two weeks to six months after the test.

By comparing data from the two groups, researchers assessed the relative risk of starting new medications and of receiving a diagnosis of a new health condition during this time.

After adjusting for variables, the researchers found that among SARS-CoV-2 positive individuals, 31% had initiated new medication treatments during the follow up period.

More specifically, they found that compared with people who tested negative, those with a positive test were at an increased risk of initiating medications to widen the airways (1.8% compared with 1.5%), and medications to treat migraines (0.4% compared with 0.3%).

The risk of receiving a hospital diagnosis for a new health condition was similar for both cohorts. However, among those in the positive test groups, 1.2% received a first diagnosis of breathing difficulties compared with 0.7% in the negative test group.

A first diagnosis of blood clots was identified in 0.2% of people who tested positive, compared with 0.1% who tested negative.

People with a positive SARS-CoV-2 test visited their GP around 20% more often than those who tested negative, and visited outpatient clinics 10% more often. However, there was no difference between the groups in the visits to the emergency department, or being hospitalised.

Commenting on the limitations of the study, co-author Stine Hasling Mogensen, PhD, from the Danish Medicines Agency said: "Our analysis only captures specific symptoms leading to contact with hospitals, so it is likely that the study underestimates symptoms which do not require this level of care, like fatigue and breathing difficulties which are not severe enough for hospitalisation or require initiation of new medical treatment.

"Previous research has found a high level of these symptoms reported by patients, so the differences between patient reports and healthcare encounters could be important to investigate in regards to potential unmet healthcare needs and the need for new medications for treatment."

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

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