UK COVID-19 Round-up: Monoclonal Antibody Approved, Jabs Saved 'Nearly 100,000 Lives' 

Tim Locke

August 20, 2021

Editor's note, 20 August 2021: This article was updated with additional ONS data.

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

Monoclonal Antibody

The MHRA has approved the UK's first monoclonal antibody treatment for COVID-19.

Regeneron/Roche's Ronapreve binds to the virus in the lining of the respiratory system, blocking access to cells, and is administered either by injection or infusion.

Clinical trial data show Ronapreve can prevent infection, improve symptoms of acute COVID-19 infection, and reduce the likelihood of hospitalisation.

The drug was used to treat former US President Donald Trump last autumn and had been studied in hospitalised patients as part of the RECOVERY trial.

Commenting via the Science Media Centre, Martin Landray, professor of medicine & epidemiology, Nuffield Department of Population Health, University of Oxford, said: "This licensing decision is an important step forward. There have been a number of trials in the out-of-hospital setting, each with positive results – reducing viral clearance and reducing the risk of hospitalisation. There have been no major safety concerns.

"The challenge going forward will be in determining which patients should be prioritised for this treatment. COVID is not a rare disease and many people get better of their own accord after a few days of a nasty flu-like illness. It would be hard to justify giving what are likely to be limited supplies of a relatively expensive treatment to huge numbers of people who are likely to get better on their own. On the other hand, it may play an important role in patients who are at higher risk of developing severe infection and who are more likely to end up in hospital."

Jabs Saved 'Nearly 100,000 Lives' 

Public Health England (PHE) estimates the COVID-19 vaccination programme in England has so far prevented:

  • More than 82,100 hospitalisations in those aged 65 and over

  • 95,200 deaths

  • 23,957,000 COVID-19 infections

So far, 75.7% of those eligible across the UK are fully vaccinated, and 87.3% have received a first dose.

PHE said 62,311 pregnant, or possibly pregnant, women have received a first dose up to 31 July. That's up 10,587 on the 18 July figures.

Of the total, 43,737 have received a second dose.

This week the MHRA said that after a "rigorous evaluation" into reports of changes to menstrual cycles and related symptoms in women who had received a COVID vaccine it concluded that the proportion of people experiencing such conditions was "low in relation to both the number of people who have received COVID-19 vaccines to date and how common menstrual disorders are generally".

Menstrual changes, it said, were "mostly transient in nature", adding: "There is no evidence to suggest that COVID-19 vaccines will affect fertility and the ability to have children."

Infection Survey 'Mixed Picture'

The ONS infection survey to 14 August estimates:

  • 1 in 80 people in England had COVID-19

  • 1 in 200 people in Scotland had COVID-19

  • 1 in 130 people in Wales had COVID-19

  • 1 in 50 people in Northern Ireland had COVID-19

The Delta variant accounted for 99% of all UK cases.

ONS said the percentage of people testing positive increased in 35 to 49 year olds and decreased for those in school year 7 to school year 11; 25 to 34 year olds, and those aged 70 and over. The trend was uncertain for all other age groups.

Kara Steel from ONS said: "Across the UK the picture is mixed - whilst we continue to see rates decreasing in England and Scotland there has been an increase in Wales, with an uncertain trend in Northern Ireland.

"The fluctuating picture we see across the four nations underlines the need for the comprehensive picture of infection rates our survey provides, which would not be possible without the continuing contributions of all our study participants."

England's R number is now 0.9 to 1.2 and the latest growth rate range is -1% to +3%.

Jabs vs Variants

A preprint study by scientists at the University of Oxford released this week found that both the Pfizer/BioNTech vaccine and the AstraZeneca/Oxford vaccine offered good protection against the Delta variant but that effectiveness was reduced compared with the Alpha variant.

There was greater early protection seen in those who had received the Pfizer vaccine but a faster decline in effectiveness compared with those who received the AstraZeneca jab.

Sarah Walker, professor of medical statistics and epidemiology at the University of Oxford, who led the research, said: "We don’t yet know how much transmission can happen from people who get COVID-19 after being vaccinated – for example, they may have high levels of virus for shorter periods of time.

"But the fact that they can have high levels of virus suggests that people who aren't yet vaccinated may not be as protected from the Delta variant as we hoped."

The Office for National Statistics (ONS) infection survey estimated that around 9 in 10 adults have antibodies against SARS-CoV-2. Antibodies increased in younger age groups as the vaccination programme made progress in these age groups but ONS said "there are signs of a decrease among older age groups across the UK".

Moderna for Kids

The Moderna Spikevax COVID-19 vaccine was approved for 12 to 17-year-olds by the MHRA this week. It is already approved for 18s and over.

The Joint Committee on Vaccination and Immunisation (JCVI) is yet to issue advice on deploying the vaccine to this group.

Boosters

JCVI met on Thursday but reports said booster jabs in the autumn had not been discussed.

However, England's Health Secretary Sajid Javid said yesterday: "We are going to have a booster scheme. It will start some time in September.

"I couldn't tell you exactly when because before we start it... we need to get the final advice from our group of experts, our independent scientific and medical advisers, the JCVI, and so we're waiting for their final opinion."

Latest ONS social impact data suggest 87% of adults would be likely or very likely to have a booster COVID-19 vaccine if offered.

The data also show 89% adults report wearing face coverings when outside their home despite this no longer being mandatory in all settings in England.

Test & Trace

England's Test and Trace service reported 190,508 positive coronavirus cases in the week to 11 August, a rise of 6% on the previous week.

However, 14.1% of cases referred to contact tracing could not be reached.

In the same week, 255,474 contact tracing app alerts were sent in England. That's down 18% from 311,265 the previous week. This is the first full week of data after the app's logic was tweaked after complaints about a 'pingdemic'.

Across the UK, positive cases rose by 7.8% over the last week. The rate per 100,000 population is now 299.7.

Mask Aggression

Doctors in Northern Ireland reported facing increasing cases of aggression from patients and hospital visitors refusing to wear face masks during NHS appointments.

The BMA said there was also growing resistance to being tested for COVID before attending routine appointments or going to emergency departments.

In July, Wales saw its worst 4-hour performance since records began.

Only 60.7% of patients were admitted, transferred, or discharged within 4 hours.

Dr Suresh Pillai, vice president of the Royal College of Emergency Medicine Wales, said: "There can be no doubt about it, the health service is in a severely challenging situation. The current pressures on staff and departments are unrelenting. Performance has deteriorated for the second consecutive month."

He added: "We are quickly approaching autumn and winter when these pressures and demand are likely to further increase. Staff are already facing burnout, exhaustion, stress, and moral injury. The health service and its workforce need the assurance that there is a robust and comprehensive plan to manage this likely increase in demand and provide adequate resources for staff and departments."

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

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