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UK COVID-19 Update: 'Highly Concerning' New Variant, More of England in Tier 4 on Boxing Day

Editor's note, 23 December 2020: This article was updated to amend hospitalisation data.

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

New Variant of SARS-CoV-2

Two cases of a new "more transmissible" variant of the SARS-CoV-2 virus linked to South Africa have been identified in the UK.

Matt Hancock, England's Secretary of State for Health and Social Care, told a Downing Street news conference that both cases were contacts of people who travelled to the UK from South Africa over the last few weeks.

"This new variant is highly concerning, because it is yet more transmissible, and it appears to have mutated further than the new variant that has been discovered in the UK", he said.

Details of the latest variant were scant, but the Government said in the meantime it was taking immediate action to restrict travel from South Africa.

It also announced that anyone who had close contact with someone who had travelled from South Africa in the last two weeks must quarantine immediately and "restrict all contact with any other person, whatsoever".

An analysis of the latest variant was being undertaken by scientists at Porton Down, Mr Hancock said.

More Areas of England to Enter Tier 4

In a further dampening of hopes for Christmas celebrations, the Government confirmed widespread speculation about a tightening of lockdown measures by announcing that more of the South East and East of England would face tougher restrictions from Boxing Day.

In his sombre Downing Street news conference, Mr Hancock said that more areas of England would be put in tier 4.

These were:

  • Sussex
  • Oxfordshire
  • Suffolk
  • Norfolk
  • Cambridgeshire
  • Parts of Essex not already in tier 4
  • Waverley in Surrey
  • Hampshire, including Portsmouth and Southampton, but excluding the New Forest

He said that Bristol, Gloucestershire, Somerset, Swindon, the Isle of Wight, the New Forest, Northamptonshire, Cheshire, and Warrington would be escalated to tier 3.

Cornwall and Herefordshire would be escalated from tier 1 to tier 2.

Across the country, cases of COVID-19 rose 57% in the last week. The average hospital admissions due to COVID-19 stand at 1909 each day, the highest figure since mid-April. There were 18,943 people in hospital with the disease.

"We simply cannot have the kind of Christmas that we all yearn for," Mr Hancock said.

"This Christmas, and the start of 2021, is going to be tough," he warned.

In today's daily data another 39,237 UK positive tests were reported and 744 deaths.

Blair Calls for New Vaccination Plans

Tony Blair called for the UK's plans for vaccination against COVID-19 to be "altered and radically accelerated" in response to the new variant of SARS-CoV-2.

A roll-out of the Pfizer/BioNTech vaccine has already begun. The former Labour Prime Minister said the UK's capacity to vaccinate the population could be boosted within days if regulators also approved the AstraZeneca/Oxford vaccine for emergency use.

Mr Blair said that while two doses are needed of both vaccines for maximum protection, the UK should consider using all the available doses in January as first doses, rather than keeping back half for second doses.

"We should continue to prioritise frontline health staff and the most vulnerable, but let this not hold up vaccinating others," he wrote in The Independent. "The aim should be to vaccinate as many people as possible in the coming months."

"As it is now, much of the country will not be vaccinated until spring or summer," he wrote. "The economic and health damage, physical and mental, caused by such a timetable will be colossal."

However, Mr Blair's suggestion had a cool reception from scientists giving evidence earlier to a Commons select committee. Prof Wendy Barclay, from the department of infectious disease at Imperial College London said the idea was "too risky" to try without further evidence.

Prof Peter Horby, who chairs the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG), said: "You can't assume that one dose is as good or half as good or whatever as good as two doses, because the data you have is on two doses."

AstraZeneca Confident its Oxford Vaccine is Effective Against New Variant

Hopes that the AstraZeneca/Oxford vaccine may have moved a step closer to approval in the UK rose after scientists submitted final data to the regulator.

The Medicines and Healthcare products Regulatory Agency is currently assessing the vaccine.

"This is the next step towards a decision on the deployment of the vaccine, which is already being manufactured, including here in the UK," Mr Hancock said.

Earlier, AstraZeneca claimed the vaccine should be effective against new variant SARS-CoV-2.

The Reuters news agency reported that the pharmaceutical company sent an email saying the vaccine "contains the genetic material of the SARS-CoV-2 virus spike protein, and the changes to the genetic code seen in this new viral strain do not appear to change the structure of the spike protein".

It added that studies were under way to fully probe the impact of the variant.

Regulatory Approval for Self-test Kits

Use of the Test and Trace COVID-19 self-test kit has been given exceptional use approval by the Medicines and Healthcare products Regulatory Agency.

The antigen lateral flow test (antigen LFT) can give a result in 30 minutes for asymptomatic individuals.

The MHRA said that anyone receiving a positive test should follow the information in the instructions for use provided with each kit.

Anticoagulant Trial Paused

Enrolment for part of three linked studies investigating the effects of full doses of anticoagulants in hospitalised COVID-19 patients has been 'paused' because of concerns over efficacy and safety.

The international trials involved are the REMAP-CAP, ACTIV-4, and ATTACC studies.

The clinical trial platforms, spanning four continents, are testing whether there is a benefit of full doses of blood thinners to treat adults hospitalised for COVID-19 on the ward or in the ICU compared to the lower dose used to prevent blood clots in patients in hospital.

A statement from the University Health Network said full dose anticoagulation drugs did not improve outcomes for critically ill patients.

It said a "potential for harm in this sub-group could not be excluded".

Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, told the Science Media Centre: "The pausing of this trial is not done lightly, but safety of participants is paramount, and shows that trial monitoring is effective.

"Getting the dose right in anti-coagulation is often difficult. A delicate balance exists between under-dosing and failing to prevent clots, and over-dosing causing excessive bleeding."

Martin Landray, professor of medicine and epidemiology at the University of Oxford, commented: "Nothing in this report alters the ongoing need for randomised clinical trials of blood thinners in patients who have less severe COVID, particularly in hospital, or of other treatments that might reduce blood clotting in different ways, such as aspirin."

Brexit Deadline: 'Cliff-edge Moment for the NHS

The NHS Confederation has appealed to Boris Johnson to seek a 1-month extension to the Brexit transition period to help avoid a disruptive "cliff-edge" moment on 31 December.

The letter to the Prime Minister warned that the NHS would be "battling the greatest challenge in its history" from 1 January during a traditionally busy time of the year.

It said failure to secure a Brexit deal would compound problems, risking the health of patients and the working conditions of staff.

This afternoon there were reports of encouraging signals from the UK-EU trade talks.

Sturgeon Says Sorry for Face Mask Lapse

Scotland's First Minister apologised after she was pictured infringing COVID-19 restrictions by removing her face mask at a funeral wake.

A photograph, published by the Scottish Sun, showed Nicola Sturgeon talking to customers in a bar from a distance but not wearing a face covering.

Anyone who breaches the face covering rule in Scotland can be fined up to £60.

Speaking at First Minister's questions today, Ms Sturgeon said: "These rules do apply to me, just as they do to everyone else."

Chelsea Pensioners Receive the Vaccine

Chelsea Pensioners began receiving the Pfizer/BioNTech COVID-19 vaccine today.

Around 300 residents of the Royal Hospital Chelsea, including Bob Sullivan, a 98 year old D-Day veteran, were offered the vaccine.

With an average age of 82, Chelsea Pensioners are in the first priority group to be vaccinated.

Pam Richards, 88, who served with the Women's Royal Army Corp said: "I think the vaccine is really important. You’re not just protecting yourself, you’re also protecting everyone else."

No Turkey for Nigella

Celebrity cook Nigella Lawson revealed that "for the first time ever" she will not be serving up Christmas turkey this year because COVID-19 lockdown restrictions meant she would not be holding festive family celebrations.

She explained in a BBC podcast: "It's not going to be a normal family Christmas, therefore, I think I will feel less sad doing something that is just a lovely lunch," without making her "feel what's missing".

However, Nigella, whose latest series Cook, Eat, Repeat concludes with a Christmas special, won't go hungry. She will be cooking pork instead.

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

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