UK COVID-19 Update: Latest on Jabs vs Variants, 'Pingdemic' Record, Pay Strike?

Tim Locke

July 22, 2021

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

Latest on Jabs vs Variants

The Pfizer/BioNTech and Oxford/AstraZeneca vaccines were less effective against symptomatic COVID-19 when people were exposed to the Delta variant of SARS-CoV-2 compared with the Alpha variant, according to a study in the New England Journal of Medicine.

After two doses:

  • Pfizer/BioNTech was 93.7% effective against Alpha, and 88% against Delta

  • Oxford/AstraZeneca was 74.5% effective against Alpha, and 67% against Delta

"The fact [that] there is still notable effectiveness is encouraging. However, complacency is not warranted, since the virus will continue to cause at least mild disease even in some [of] those vaccinated with two doses," Stephen Evans, an epidemiologist at the London School of Hygiene & Tropical Medicine told Medscape Medical News.

Pay Strike?

There's been more reaction to the 3% NHS pay rise for England and Wales that was announced yesterday evening. It was said to be in recognition of "extraordinary" pandemic efforts.

Doctors' Association UK said it was "callous" to exclude junior doctors from the increase.

Chair, Dr Jenny Vaughan, said: "Any improvement on the derisory 1% previously offered to NHS workers is welcomed, but 3% barely takes the edge off the erosion of doctors’ pay over two decades. Doctors in the NHS have suffered a 30% pay cut in real terms, and after inflation this 'pay rise' will ultimately be a pay freeze. DAUK’s campaign 'fair say for fair pay' demonstrated the extremes staff have been put through during the pandemic - the effects of which are only starting to be realised.

"It is time to pay and we hope the BMA and the HCSA as well as allied health professional unions will join us in voicing our discontent - including taking industrial action."

Patricia Marquis, England director of the RCN, told the BBC: "Our next steps will be to consult with our members about their view on the award.

"And once we have their view - which we suspect will be to say they are unhappy about the level - we will then be considering with them what the next steps might be, which could include consideration of industrial action most certainly."

'Pingdemic' Record

England's Test and Trace service recorded a 33% rise in positive cases in the week to 14 July.

A record 618,903 alerts were also sent to users of the NHS COVID-19 app in England and Wales.

There were 115,709 positive cases in England linked to the app.

Many companies are complaining about high numbers of staff isolating after being 'pinged' by the app.

Jon Crowcroft, professor of communications systems, University of Cambridge, has been explaining the 'pingdemic' numbers to the Science Media Centre.

"The test +ve rate went to 50k a day for nearly a week so 500,000 pings represents about 10 contacts per +ve case (or roughly one a day).  BUT you have to allow for the fact only 20M out of all adults have the app running – so say a 25% chance of contact between people with the app.  So you’d need about four contacts a day – if most of these are in public transport and pubs, this is pretty unsurprising (typical crowd in a pub might involve five to ten people at a table watching footie)," he said.

"Six percent of contacts lead to infection, so we might infer about 30,000 infections out of the pings.  Note there are therefore actually four times that many actual infections (ie, ones from contacts between people not running the app) – ie, about 120,000 new cases, which will show up about 5-7 days after the contact so sometime this weekend, we might predict 120,000 cases.  BUT 65% of people are vaccinated – let’s take double dose cases: about 2/3 chance of infected person being vaccinated and 2/3 chance of contact being vaccinated.

"Evidence says that vaccination reduces transmission by 2-4 times, and so about 50% of those contacts that might have led to infection, won’t.  So the 6% is reduced to about 3% perhaps, so the more plausible prediction is perhaps 60,000 new cases this weekend."

Prof Crowcroft added: "Calls to reduce the sensitivity of the app are totally misguided – it would be totally pointless running it then.

"Calls to change the advice to people on what to do when pinged are much more sensible.  If you are vaccinated (or previously had COVID), then the sane advice would be to do two tests for 2 successive days (even lateral flow).  You go back to work, but test for 2 days – if both tests are negative, stay at work.  If either test is positive, isolate."

Surveillance Data

Public Health England surveillance indicators suggest that at a national level COVID-19 activity increased in week 28.

Case rates continued to be highest in those aged 20 to 29, with a 7-day rate of 1154.7 per 100,000 population. 

The lowest case rates were in those aged 80 and above, but the highest hospital admission rates are in those aged 85 and above.

PHE Medical Director, Dr Yvonne Doyle, said: "Case rates in people aged 20-29 are at the highest across any age group recorded since the pandemic began."

Remote Chemo Monitoring

Remote cancer chemotherapy monitoring systems will be vital for future services, "particularly with blended models of care delivery arising from the COVID-19 pandemic," according to a UK and international study in The BMJ.

"Significant reduction in symptom burden supports the use of ASyMS (Advanced Symptom Management System) for remote symptom monitoring in cancer care," researchers concluded.

Mental Health Standards

NHS England is proposing new mental health standards with patients requiring urgent care being seen by community mental health crisis teams within 24 hours of referral, and 4 hours in the most urgent cases.

Paul Farmer, chief executive of Mind, commented: "A huge number of people have developed a mental health problem since the start of the pandemic and some groups have been hit particularly hard, including young people, those on low incomes and people from racialised communities, but not got help early on. With increasing numbers of people reaching crisis point, it is critical that they get the right mental health support quickly, which these standards would help to achieve."

Eating Disorders

The BBC reported on NHS Digital data that show 3200 under-20s were admitted to hospital with eating disorders in the past year, nearly 50% higher than the previous year.

It quotes Tom Quinn from the eating disorders charity Beat, who said the pandemic and lockdowns had had a "massive impact".

Less Distancing & Handwashing

Before many lockdown measures were lifted, survey data show 65% of people didn’t always maintain social distancing compared to 50% at the end of 2020.

UCL's COVID-19 Social Study found that only 15% of 18 to 29-year-olds always maintained the recommended distance.

When it came to handwashing and sanitiser use, 44% of adults always used them when recommended compared to 55% at the end of 2020.

Lead author, Dr Elise Paul, said: "Our report shows that even before the lifting of restrictions on 19 July, complete compliance with guidelines was relatively low. One reason for this could be that as people knew restrictions were about to lift, they became less strict about following them. Equally, the rhetoric from the Government that despite an increase in cases, COVID-19 is no longer as big a threat as it was before a large proportion of the most vulnerable had been fully vaccinated may also have played a part."

The Department of Health and Social Care launched a new campaign to remind people in England of the importance of continuing with healthy behaviours, such as handwashing and better ventilation, to help reduce the spread of COVID-19.

It features GP Dr Amir Khan who said: "All these actions are common sense and second nature to us now, I would encourage people to keep doing them and help keep life moving."

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

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