UK COVID-19 Update: Janssen Single Dose Jab Approved, 'Colossal' Surgery Backlog

Tim Locke

May 28, 2021

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

Janssen Single Dose Jab Approved

A single-dose coronavirus vaccine from Janssen, part of Johnson & Johnson, has been approved for use by the MHRA. It will become the fourth vaccine to be rolled out.

The jab, called Ad26.COV2-S [recombinant], has been shown to be 67% effective overall at preventing moderate to severe COVID-19.

The phase 3 ENSEMBLE trials suggested it gives 87% protection against severe disease.

Dr June Raine, MHRA chief executive, said: "We have undertaken a thorough review of the conditional marketing authorisation application submitted by Janssen, including the information on quality, safety, and effectiveness. I am pleased to confirm today that this authorisation has been granted.

"This is encouraging news for the public and the healthcare sector. We now have four safe and effective vaccines approved to help protect us from COVID-19."

The JCVI hasn't yet issued recommendations on the vaccine's use.

'Colossal' Surgery Backlog

The Royal College of Surgeons of England is calling for an extra £1bn a year for new surgical hubs to tackle the "colossal elective surgery backlog" that's built up under the pandemic. 

President Professor Neil Mortensen said: "We need Government support for a ‘New Deal for Surgery’ to reduce the colossal backlog in elective surgery and to help the NHS weather future pandemics. Surgery must be available on the NHS all year-round, not stop and start. If a dangerous new variant of COVID-19 takes hold, or another bad flu arrives in the autumn, we cannot allow surgery to grind to a halt again or waiting lists will become insurmountable."

It published Savanta ComRes polling of 2203 adults suggesting broad public support for the plans.

Meanwhile, the BMA held a meeting yesterday with England's Health Secretary Matt Hancock over NHS England's recent letter instructing doctors to hold face-to-face appointments.

General Practice Chair Dr Richard Vautrey said: "The BMA believes that GPs should feel empowered to deliver care in what they believe is the best way for their patients, and retain flexibility of access  – be it in-person or remotely - rather than submitting to arbitrary targets of face-to-face appointments that may not meet the diverse needs of patients, increase workload and waiting times, and ultimately diminish the quality of care we can provide."

Variants Spreading

Yesterday evening, at a Downing St briefing, Matt Hancock said up to three quarters of new COVID-19 cases could now be due to the Indian variant.

Cases have risen by 3535 to 6959 since last week.

Commenting via the Science Media Centre, Professor Rowland Kao, University of Edinburgh, said: "The higher proportion of the variant cases is at least in part due to the very low numbers of cases overall, that have resulted in the very low overall disease burden we see today. Thus even small outbreaks would produce a much higher proportion. It also reflects, at least in part, the fact that many of the communities into which it was first introduced are ones where [there are] conditions for higher rates of transmission (with higher density households, people working in jobs that make physical distancing difficult). 

"Given that current estimates suggest the vaccine is less effective against this variant (particularly for those with only one dose), and that many working age adults are still unvaccinated or have had only one dose, then continued spread of this variant can only be expected.  Evidence that it may also be inherently more transmissible must be monitored closely but is not yet definitive.  Importantly we do not yet have evidence that suggests that this variant causes substantially more severe disease in vaccinated individuals.  We must still be wary of contacts between the many who are still unvaccinated, especially those who are at higher risk of severe COVID – this is only likely to become more of a problem if cases do continue to rise, increasing the probability that they become infected."

Ireland's Deputy Prime Minister Leo Varadkar said today it was too soon to restore the Common Travel Area due to the prevalence of the Indian variant in the UK.

Meanwhile, Public Health England said there have been 109 cases detected across the country of a further Variant Under Investigation first detected in Thailand, VUI-21MAY-02.

Infection Survey

Office for National Statistics (ONS) infection survey data for the week ending 22 May show:

  • In England, the percentage of people testing positive for COVID-19 remains low but there are potential signs of an increase with around 1 in 1120 people estimated to have COVID-19.

  • In Scotland, the percentage of people testing positive has increased with around 1 in 630 people having COVID-19.

  • In Wales, the percentage of people testing positive remains low with around 1 in 3850 people having COVID-19.

  • In Northern Ireland, there are early signs of a potential increase in positive tests and around 1 in 820 people has COVID-19.

Sarah Crofts from ONS said: "We have seen a rise in cases that are not compatible with the UK variant, suggesting that we may be seeing the first signs of variant B.1.617.2 [Indian variant] in our data.

"We will continue to closely monitor infection rates as restrictions ease."

England's R number is now 1.0 to 1.1. Last week it was 0.9 to 1.1.

The growth rate is 0% to +3% per day.

Scotland's R number could be as high as 1.3, and  daily case numbers are the highest since March 25, First Minister Nicola Sturgeon said today.

Protecting Care Homes

Mr Hancock was again questioned at the Downing Street briefing about patients being released from hospital to care homes without COVID-19 testing.

The PM's former adviser Dominic Cummings claimed Mr Hancock had lied about the issue.

Yesterday Mr Hancock said: "My recollection of events is that I committed to delivering... testing for people going from hospital into care homes when we could do it.

"I then went away and built the testing capacity for all sorts of reasons and all sorts of uses, including this one, and then delivered on the commitment that I made."

Earlier this year, the Government had announced plans to prevent movement of staff between care homes in England to reduce virus transmission. That's now been amended to measures to reduce staff movement.

Acting Royal College of Nursing England Director Patricia Marquis commented: "The Government’s climbdown is the right decision. We warned last year that this move would have a significant negative effect on social care staff who may have felt they were being scapegoated for spreading COVID-19 when in fact they are integral to safe and effective care measures to stop cross infection.

"There is a workforce crisis in social care and a ban would have compounded an already difficult situation. A ban would have undermined safe, person-centred care and punished unfairly diligent care home workers."

More News

  • US research published in NEJM involving 2260 12 to 15-year-olds found the Pfizer/BioNTech vaccine "had a favourable safety profile, produced a greater immune response than in young adults, and was highly effective against COVID-19". The study was funded by the pharmaceutical companies. 

  • Japan has extended its state of emergency in Tokyo to 20 June with the Olympics due to start on 23 July. No overseas spectators will be allowed but no decision has yet been made on domestic fans.

  • Oxford is setting up a new centre of global research collaboration and excellence, called the Pandemic Sciences Centre. The centre's Director, Professor Peter Horby, said: "The COVID-19 pandemic has shown us that spectacular advances are possible through an alliance of science, the public sector, and industry – creating digital disease control tools, diagnostic tests, and life-saving treatments and vaccines at unprecedented speed. But it should not take a pandemic to make this happen. This level of innovation and multi-sectoral collaboration must be applied, day in and day out, to prevent another catastrophe like COVID-19."

  • A study of a pilot indoor music event in December in Barcelona using testing, mask-wearing, and improved ventilation has been published in the The Lancet Infectious Diseases. Lead author, Dr Josep Llibre, said: "Our study provides early evidence that indoor music events can take place without raising the risk of SARS-CoV-2 transmission when comprehensive safety measures are in place, but it is important that our findings are considered in light of the situation in Spain at the time – when cases were not high and many restrictions were in place. As a result, our study does not necessarily mean that all mass events are safe."

  • The University of Essex is testing a smartphone app that analyses the sounds of a person's cough to help detect COVID-19. Trials have been taking place in remote parts of Mexico.

  • Respiratory expert, Dr Matthew Knight, West Hertfordshire Hospitals NHS Trust, is back on Twitter after being banned for supposedly spreading COVID misinformation. He'd posted about the need for research into air filters for indoor hospitality venues. "I stand by it - COVID is airborne, and measures to reduce spread will be vital as we open up society. COVID has not disappeared." he tweeted on his return to the platform.

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

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