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UK COVID-19 Update: Test & Trace 'Failings', Delaying Ops, Inflammatory Protein Identified

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

Test & Trace Failures

The Commons Public Accounts Committee's report on England's £37 billion Test and Trace programme found taxpayers have been treated like a bank cash machine to pay for the "huge expense" of a system that has twice failed to prevent England going into lockdown during the pandemic.

BMA Council Chair, Dr Chaand Nagpaul, said in a statement: "This report lays bare the huge failings of the Test and Trace system and the scandalous, eye-watering sums of money wasted on the unaccountable private sector as opposed to the public sector."

He added: "While not solely to blame, the ineffectiveness of Test and Trace has contributed to a higher number of cases, greater pressure on the NHS, and ultimately a higher death toll – now the highest in Europe."

Prime Minister Boris Johnson told the Commons: "It is thanks to NHS Test and Trace that we're able to send kids back to school and begin cautiously and irreversibly to reopen our economy and restart our lives."

The Department of Health and Social Care issued new data on the accuracy of lateral flows tests. Dr Susan Hopkins, Public Health England, said: "We’ve looked very carefully at the evidence that’s emerging from LFD tests that have been delivered at home and in testing sites over recent weeks, and real-life scenarios suggests they are at least 99.9% specific which means that the risk of false positives is extremely low – less than one in a thousand – which is a very good test.

Delaying Operations After COVID-19

Surgery should be delayed for 7 weeks after a positive COVID-19 test, according to University of Birmingham led COVIDSurg Collaborative research published in Anaesthesia.

The results come from 140,231 patients in 1674 hospitals across 116 countries last October.

Public Health Registrar, Dr Dmitri Nepogodiev, said: "We found that patients operated 0-6 weeks after SARS-CoV-2 infection diagnosis are at increased risk of postoperative death, as were patients with ongoing symptoms at the time of surgery. We recommend that whenever possible surgery should be delayed for at least 7 weeks after a positive SARS-CoV-2 test result, or until symptoms resolve if patients have ongoing symptoms for 7 weeks or more after diagnosis."

Surgeon and COVIDSurg chief investigator, Dr Aneel Bhangu, added: "Decisions regarding delaying surgery should be tailored for each patient, since the possible advantages of delaying surgery for at least 7 weeks following SARS-CoV-2 diagnosis must be balanced against the potential risks of delay. For some urgent surgeries, for example for advanced tumours, surgeons and patients may decide that the risks of delay are not justified."

Inflammatory Protein Identified

UK researchers have identified a blood marker, a cytokine called GM-CSF, which could help identify people at a higher risk of developing severe COVID-19.

The findings published in Science Immunology come from analysis of blood samples taken from 471 patients hospitalised with COVID-19 across England from the ISARIC4C study.

Dr Ryan Thwaites, National Heart & Lung Institute, Imperial College London said in a statement: "People may be familiar with the term 'cytokine storm', in which patients hospitalised with COVID-19 have increased levels of inflammatory proteins in their body linked with severe outcomes and death. Our new study shows that there are many inflammatory markers raised in COVID-19, but that these are more in the range of a 'response' than a 'storm'." 

He said GM-CSF "appears to specifically mark out severe COVID-19 and may play a role in driving severe disease. In future studies, we need to determine whether elevated levels of this protein in the blood at an early stage allows us to identify patients at increased risk of becoming very ill and may benefit most from receiving targeted treatments aimed at GM-CSF."

BAME Jab Priorities

Not prioritising ethnic minorities on the JCVI vaccine priority list is putting these groups at a significantly higher risk of COVID-19 illness and death, argues Professor Azeem Majeed, Imperial College London, and colleagues in the Journal of the Royal Society of Medicine.

"The UK’s colour-blind vaccination model disregards the unequal impact of the pandemic on minority ethnic groups, rendering it an enabler of structures that are known to systematically disadvantage BAME communities," they write.

Commenting via the Science Media Centre, Dr Peter English, consultant in communicable disease control, said: "I understand and sympathise with the views of the authors of this commentary about prioritising people in BAME groups for vaccination; but, from my experience of running vaccination programmes, I suspect that the marginal benefits that might be available from vaccinating some groups slightly earlier are likely to be outweighed by the problems this would cause."

Vaccines Minister Nadhim Zahawi was due before the Commons Women and Equalities Committee this afternoon. Committee Chair Caroline Nokes said: "There has been a clear difference in the success of vaccine uptake amongst different communities. We will be asking the Government what work they have undertaken to understand the reasons for the disparities, and what action they are taking to support more equal uptake. This problem must be solved urgently, or there is a real risk that existing health inequalities will be further exacerbated."

Meanwhile, the UK has denied EU claims that exports of COVID-19 vaccines were banned. The BBC reported that Foreign Secretary Dominic Raab has written to European Council President Charles Michel over the "completely false" claims.

UK Variant Mortality

The UK virus variant is 30-100% more deadly than previous strains, new Universities of Bristol and Exeter analysis published in The BMJ has found.

Data was analysed from 54609 matched pairs of patients of all age-groups and demographics for different variants between November 2020 and January 2021. There were 227 deaths attributed to the new variant, compared to 141 attributable to earlier forms of the virus.

Ellen Brooks-Pollock, University of Bristol, said: "It was fortunate the mutation happened in a part of the genome covered by routine testing. Future mutations could arise and spread unchecked."

Office for National Statistics (ONS) data released today show COVID-19-related deaths were higher for men than for women: 63,700 compared with 53,300 between March 2020 and January 2021, in England and Wales.

Daily Data

In today's daily data another 5926 UK positive tests were reported and 190 deaths.

Another 634 COVID-19 patients were admitted to hospital. The total is now 9435 and 1293 ventilator beds are in use.

As of yesterday, 22,809,829 people have had a first dose of a COVID-19 vaccine, and 1,254,353 a second dose.

Bath A&E 'Requires Improvement'

Royal United Hospital Bath's A&E department has kept its 'requires improvement' rating after a Care Quality Commission (CQC) focused inspection in January.

CQC's Amanda Williams said: "We found a team that was focused on safety and protecting patients from infection during a very difficult and challenging time.

“However, high levels of demand on the emergency department were impacting on patient waiting times and we had concerns about staffing levels, particularly at night, and in the paediatric department. 

"Yet despite these pressures, there were many examples of good practice. Leaders were aware of current challenges and were in the process of making improvements. We continue to monitor the trust and will return in due course to check on the progress of improvements we’ve told them to make."

A hospital spokesperson said: "We and the CQC recognise the impact of heavy demand on services. We also share their concerns about staffing levels at what was a particularly busy time of the coronavirus pandemic.

"We note and will address the CQC findings. Work is already well underway on a £2.5m building project that will further improve our emergency care facilities. This will increase capacity, enable patients to be seen quicker, and speed the flow of patients from ambulance to emergency department treatment."

Pollen & COVID-19

Could pollen in the air be driving COVID-19 infections? A new study, published in the Proceedings of the National Academy of Sciences, investigated using data from 248 airborne-pollen-monitoring sites in 31 countries, including the UK.

It found that when pollen in an area spiked, so did infections, after an average lag of about 4 days. The study authors say pollen seemed to account for, on average, 44% of the infection rate variability between countries.

"When we inhale pollen, they end up on our nasal mucosa and here, they diminish the expression of genes that are important for the defense against airborne viruses," said study author Stefanie Gilles, PhD, chair of environmental medicine at the Technical University of Munich in Germany.

Gender Inequities 

University College London research published in PLOS ONE found the pandemic and lockdown has exacerbated gender inequities in housework, childcare, and mental health.

The findings come from a continuing longitudinal study with 17,452 respondents completing an online survey last April and 14,811 in May.

Women spent around 15 hours a week on housework compared with less than 10 hours for men.

Women spent 20.5 hours a week on childcare and homeschooling in April, and 22.5 hours in May, compared with around 12 hours for men in both months.

The authors wrote: "Juggling home working with homeschooling and childcare as well as extra housework is likely to lead to poor mental health for people with families, particularly for lone mothers."

ONS data released today show:

  • Women were more likely than men to be furloughed
  • Women consistently spent more time on unpaid childcare and unpaid household work throughout the pandemic than men
  • A greater proportion of women reported that home schooling was affecting their well-being than men
  • Women often experience feelings of anxiety, loneliness, depression, and being worried about coronavirus more so than men

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

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