UK COVID-19 Update: PM 'Didn't Buy NHS Overwhelmed Stuff', Do COVID Jabs Trigger Bell's Palsy?

Tim Locke

July 20, 2021

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

PM 'Didn't Buy NHS Overwhelmed Stuff'

Boris Johnson's former chief adviser Dominic Cummings has come out with more claims about the handling of the pandemic. He tells a BBC programme tonight that the PM said: "I no longer buy all this NHS overwhelmed stuff."

Mr Cummings also said the PM resisted last autumn's lockdown because those dying were "essentially all over 80".

It is also claimed Mr Johnson wanted to visit the Queen, now aged 95, in person early in the pandemic despite Downing Street staff becoming ill with COVID-19. Downing Street denied this.

Mr Cummings has made previous claims before about Downing Street's handling of the pandemic, including to a Commons committee. However, he didn't back up the allegations with proof.

Downing Street said the Prime Minister had taken "the necessary action to protect lives and livelihoods, guided by the best scientific advice".

There's been criticism of the current pandemic response in England from former regional Director of Public Health for the North West Professor John Ashton, author of Blinded by Corona.

"After more than a year of hands-on experience, our government remains as blinded by Corona as they were at the start. The world is watching us open-mouthed. Freedom Day is a terrifying experiment with a petri dish of [a] million people," he said.

Matthew Taylor, chief executive of the NHS Confederation, called England's lifting of restrictions "a gamble". He added: "With nearly 50,000 [daily] cases and rising, and with some predicting that we could reach 200,000 a day later in the summer, caution has to be key."

Downing Street said today that people should still self-isolate if pinged by England's Test and Trace service. The clarification was issued after Business Minister Paul Scully suggested that people could make an informed decision about isolation.

Deaths

Registered deaths in England and Wales were 6.2% above the 5-year average in the week ending 9 July.

COVID-19 accounted for 1.9% of all deaths, higher than the previous week, the Office for National Statistics (ONS) said.

Do COVID Jabs Trigger Bell's Palsy?

BMJ Case Reports features a single Bell's palsy case the authors said "strongly suggests" was attributed to Pfizer/BioNTech vaccination, "although a causal relationship cannot be established".

Symptoms appeared within 5 hours of the first dose, and more severe symptoms 2 days after the second dose.

The patient was a 61 year old White man with no previous history of Bell's palsy but with a high BMI, high blood pressure, high cholesterol, and type 2 diabetes. Both doses were given in his left arm.

The condition has now almost resolved following steroid treatment.

The latest MHRA Yellow Card COVID-19 vaccine reporting says: "The number of reports of facial paralysis received so far is similar to the expected natural rate and does not currently suggest an increased risk following the vaccines. We will continue to monitor these events, including through evaluation of electronic healthcare record data."

Kids' Jabs Welcomed

The BMA responded to the plan to offer COVID-19 vaccines to some vulnerable children, or those with vulnerable family members.

Dr Penelope Toff, BMA public health medicine committee co-chair, said: "This new guidance is welcome and we now await further details from NHS England on how these vaccines will be given, so people should not contact their GP just yet.

"It is vital that those eligible include adolescents living in multi-generational households and communities, particularly in more deprived areas where we know older and vulnerable family members are at greater risk of severe illness.

"We also hope this will further encourage adults who are already eligible to come forward and take up the offer of vaccination and to ensure they have their second dose.

"We are glad to hear that the JCVI will continue to keep this guidance under review and are still considering whether the benefits of vaccinating all adolescents might outweigh any potential risks, particularly with cases rising exponentially and concerns about pressures on the health service and increasing numbers of people with long COVID."

The Royal College of Paediatrics and Child Health also welcomed the announcement. But in a statement it said: "Clarity and more detail about who exactly will be included in these groups is required as a matter of urgency both for families and also for paediatricians and primary care professionals who will inevitably be asked for advice from patients and their parents or carers."

Scotland's CMO is writing to the JCVI asking that the benefit of COVID-19 vaccination for all 12 to 17-year-olds is kept under ongoing review. First Minister Nicola Sturgeon said it was important not to rule it out when other countries already vaccinate this age group.

Northern Ireland's Chief Scientific Officer, Professor Ian Young, told the BBC nearly 1 in 5 adults have not yet come forward for their first COVID-19 vaccine dose: "And that means 18% who are just as susceptible to the most severe effects of COVID as they were earlier in the epidemic."

Clubbers' Jab Proof

Experts have been commenting via the Science Media Centre about the announcement of full vaccination proof being needed in England from the autumn for entry to nightclubs and other venues with large crowds.

"This announcement reflects some of the difficult choices ahead of us," said Professor Rowland Kao, University of Edinburgh.

"While such a move would certainly reduce risks to individuals, vaccinated individuals are still at a substantial risk of becoming infected especially with the Delta variant, and even though there is good evidence that all our vaccines are currently providing good protection against severe infection and hospitalisation, we do not yet know the extent to which they may transmit to others."  

Dr Peter English, retired consultant in communicable disease control, said: "It would have been far preferable to keep indoor nightclubs closed until disease incidence (the number of new cases per day) is much lower and decreasing.

"Vaccination is not a foolproof way of preventing infection and transmission; but it does reduce the risk.

"Given that the Government has not heeded the advice to keep nightclubs closed, requiring vaccination certificates may help reduce the risk. Full vaccination is necessary to prevent the prevalent Delta variant - at least 2 weeks since the second dose of vaccine.  Of course, vaccination certificates will need to provide proof of full vaccination in a way that cannot easily be forged."
 

Lockdowns 'Don't Cause More Harm Than COVID'

The impact of lockdowns on health is unlikely to be worse than that of the pandemic itself, according to an international review in BMJ Global Health.

The authors wrote: "However, the excess mortality data do not refute the position that lockdowns have caused harm in some instances. Comparing the UK and Sweden, for example, does not show a clear benefit of lockdowns in terms of excess mortality (the UK imposed three national lockdowns, yet both countries had very severe impacts)."

The paper looked at people avoiding A&E departments in England and disruption to services. The authors said: "Where there are data indicating an association between government interventions and disruptions to healthcare utilisation, it is yet again challenging to disentangle whether the association relates to restrictions intended to prevent COVID-19 cases or the epidemic itself."

The authors said there are likely to be mental health problems, particularly in children, due to lockdowns: "Missing school clearly affects children’s mental health, but so does losing a loved one to COVID-19."

Travel News

The UK is now on the highest level of US 'do not travel' guidance with "a very high level of COVID-19 in the country".

The CDC Level 4 Travel Health Notice says: "Your risk of contracting COVID-19 and developing severe symptoms may be lower if you are fully vaccinated with an FDA authorised vaccine."

Extreme Heat

Hot weather could put more pressure on top of COVID-19 for emergency departments in parts of England and Wales this week.

The Met office has issued its first ever extreme heat amber warning that says: "The wider population are likely to experience some adverse health effects including sunburn or heat exhaustion (dehydration, nausea, fatigue) and other heat related illnesses."

Public Health England issued a level 3 Heat-health watch alert.

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

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