UK COVID-19 Update: Wales Moving to Alert Level 1, Lateral Flow Test Accuracy

Tim Locke

July 14, 2021

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

Wales Moving to Alert Level 1

Wales is moving to alert level 1 from this Saturday (17 July). This had previously been pushed back due to rising Delta variant cases.

Ministers had already said face coverings will still be required on public transport and in health and social care settings.

Level 1 allows up to six people to meet indoors, and organised events for up to 1000 people seated, or 200 standing.

The next step would be alert level zero from 7 August "if the public health situation allows".

First Minister Mark Drakeford said: "We are entering a new phase of the pandemic. Cases of the virus have risen sharply since the delta variant emerged 6 weeks ago but, thanks to our fantastic vaccination programme, we are not seeing these translate into large numbers of people falling seriously ill or needing hospital treatment.

"We can be reasonably confident that vaccination has weakened the link between infections and serious illness. But there is still a risk that this third wave of the pandemic could cause real harm – either direct harm from the virus or indirect harm from for example people having to isolate."

Scotland is also keeping its mask mandate when it moves to level zero next week.

The Mayor of London, Sadiq Khan, said face coverings will be a 'condition of carriage' on London's public transport after England's restrictions are lifted.

"By keeping face masks mandatory we will give Londoners and visitors the reassurance and confidence to make the most of what our city has to offer, while also protecting our heroic transport workers and those who may be vulnerable and rely on the network to get around our city," he said.

Lateral Flow Tests '95% Accurate'

A UK and Austrian study published in EClinicalMedicine found that lateral flow tests can detect COVID-19 with 95% accuracy as long as they are used at the onset of infection and symptoms.

Data covered 2500 people with mild to moderate flu-like symptoms assessed by GPs in a district of Austria last October and November. Positive lateral flow tests were followed up with PCR tests.

Dr Jasmina Panovska-Griffiths, University of Oxford, said: "In our study, both shorter duration of symptoms and higher viral load were significantly associated with positive lateral flow tests. This highlights the necessity of testing at early infection with lateral flow tests, and shows that in patients who are newly symptomatic, the two testing methods have similar levels of accuracy.

"Our study is the first study to demonstrate that point-of-care antigen testing using lateral flow tests combined with clinical assessment of symptomatic patients can rapidly and accurately detect SARS-CoV-2 infection in primary care."

Oncologist Shortage

The Royal College of Radiologists (RCR) says an oncology staffing shortage is affecting the ability to tackle the pandemic cancer diagnosis and treatment backlog and is jeopardising patient care.

RCR's census from 62 UK cancer centres found 52% of clinical directors said oncologist shortages are negatively impacting patient care, and this year’s newly trained consultants will only fill 55% of vacancies. 

Dr Tom Roques, RCR’s oncology workforce lead and main author of the census report, said: "The chronic, crushing pressure on the clinical oncology workforce has been emphasised yet again in our latest staffing statistics. Despite growth in consultant numbers over the past year – predominantly in England – shortages continue. To meet basic demand, right now the NHS needs nearly 200 extra clinical oncology consultants." 

He said there were "some really exciting developments in non-surgical cancer care, from fast-track stereotactic radiotherapy for prostate cancer patients, to using artificial intelligence programmes to speed up planning. 

"But it’s hard to see how we can implement these new treatments and improve outcomes for our patients when the workforce is exhausted and facing massive patient backlogs, with no time to rest or roll out advances." 
 

App Deletion

Savanta ComRes polling suggests 20% of those with the NHS COVID-19 app on their phone will delete it when England’s restrictions are lifted on Monday.

The poll also found a third of 18 to 34-year-olds who used to have the app have now deleted it.

Professor Henry Potts, University College London, told The Guardian there's evidence people were getting ready for a rise in cases "what will happen is that the more the app presents an inconvenience for people and the more they see COVID-19 as less of an issue, then the more likely they will be to stop using the app".

'Dangerous Trend' Mixing Jabs

The World Health Organisation has warned individuals against mixing jabs from different manufacturers unless local health authorities recommend it.

WHO Chief Scientist, Soumya Swaminathan, told a news briefing: "We receive a lot of queries from people who say they've taken one and they're planning to take another one so it's a little bit of a dangerous trend here where people are in a data-free, evidence-free zone as far as mix-and-match. There's limited data on mix-and-match.

"There are studies going on; we need to wait for that and maybe it will be a very good approach but at the moment we only have data on the Oxford/AstraZeneca vaccine followed by Pfizer. So it will be a chaotic situation in countries if citizens start deciding when and who should be taking a second, third or fourth dose."

Mandatory Care Jabs

Last night, MPs backed a law change to make COVID-19 vaccination mandatory for England's care home staff from the autumn.

Some MPs complained they had not been shown a policy impact document before being asked to vote on the measure.
 

Elective Recovery Fund

NHS Providers Chief Executive, Chris Hopson, commented on changes to the elective recovery fund: "It is understandable that the Government wants to see progress here and that NHS England has reviewed the threshold levels which have been set to access the elective recovery fund, adjusting from 85% of 2019/20 activity levels to 95%."

He cautioned: "Some trusts are already having to cancel planned operations and are converting surgery recovery wards in order to treat to COVID-19 patients." 
 

Health Bill

MPs vote on England's Health and Care Bill's second reading in the Commons later today. The BMA has questioned whether it is right to bring in "wholesale reforms" during a pandemic.

EveryDoctor's campaign says the Bill should be scrapped: "This Bill will accelerate NHS privatisation. If we want a future NHS which takes care of patients and staff and stops private companies from profiting from the NHS, then we need to think differently."

The Royal College of Anaesthetists welcomed the Bill "with cautious optimism".

President, Professor Ravi Mahajan said: "The introduction of integrated care systems signals a shift in focus towards collaboration over competition, joined-up working over legislative barriers, and prevention over cure. If the promises laid out in the Bill are delivered, we remain hopeful that the reforms could help facilitate better, safer, and more efficient care."

NHS Providers said the Bill sets out "the biggest reforms to the NHS in nearly a decade" but that it needs to give "a transparent, costed and funded long-term workforce plan".

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

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