UK COVID-19 Daily: 2 metre rule review

  • Tim Locke, Medscape.com

  • UK Medical News
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These are the latest UK coronavirus stories you need to know.

Two Metre Rule Review

The Prime Minister is holding a review of the current 2-metre social distancing guidance.

Many businesses have said they won't be able to reopen if 2m stays in place. The World Health Organisation guidance says 1m is enough. It isn't clear if the review will be ready by the 4th July deadline for restaurants and pubs to reopen.

Foreign Secretary Dominic Raab told the Downing Street briefing: "There's no magic to one or other particular measure. There will be different levels of risk, whether it's at 2 metres, 1.5 metres, or 1 metre."

He said: "We're finding that the scientific basis is constantly evolving," and added: "Ultimately the politicians need to answer the judgement calls that we make based on the evolving science."

COVID-19 Immune Response 'Stable 2 Months After Diagnosis'

COVID-19 antibodies remain stable in the blood of most infected individuals almost 2 months after diagnosis and possibly longer, according to UK preprint research.

However, one problem it highlighted was antibodies were not detectable in 2%-8.5% of patients exposed to the virus.

The St George’s, University of London and St George’s University Hospitals NHS Foundation Trust-led research assessed 177 people diagnosed with COVD-19.

Corresponding author, Professor Sanjeev Krishna, from St George's, University of London, said in a news release: "Our results provide an improved understanding of how best to use viral and antibody tests for coronavirus, especially when not every person exposed to the virus will have a positive response. We need to understand how best to interpret the results from these tests to control the spread of the virus, as well as identifying those who may be immune to the disease."

Commenting via the Science Media Centre, Prof Danny Altmann, British Society for Immunology spokesperson and Professor of Immunology at Imperial College London, said: "While it’s reassuring that most have antibodies at 2 months, it would be remarkable for an immune response not to last this long – our real concern is to see what happens at 1 or 2 years, for which we need to wait and see. The flip-side of their data is the question of what is happening in the 10% or so who produce no antibody. If you extrapolate to global figures, it means that of the estimated 8 million or so cases globally, some 800,000 carry no protective antibody."

'Inequality Commission'

Boris Johnson used a wide ranging paywalled Telegraph article to announce a "cross-governmental commission" to look at race and other inequality in the UK. The article was later reposted on the 10 Downing Street website. "There is much more that we need to do; and we will. It is time for a cross-governmental commission to look at all aspects of inequality, in employment, in health outcomes, in academic and all other walks of life,” the PM wrote.

The Chair of the Equality and Human Rights Commission, David Isaac, commented via twitter: "We know the scale of the problems we face to tackle the entrenched racial inequality in our country. It is not new. There have been countless reports and the data exists exposing all the issues. Now is the time for urgent action."

Dominic Raab said: "I don't accept that this is yet another review on top of the ones that’ve come before. We have made progress, it's not enough. We're still restless to bring further change."

Daily Deaths and Data

Another 181 UK COVID-19 deaths were announced on Saturday, 36 on Sunday, and 38 on Monday, taking the total to 41,736. Numbers are usually lower after a weekend.

There were 93,163 tests counted on Sunday. This figure includes home tests that have been sent out but not yet processed. This takes the total tests to 6,866,481.

Figures for the number of people tested were last given on 22nd May.

Another 1056 positive cases were reported on Monday taking the total UK confirmed cases to 296,857.

There were 430 people admitted to hospital in the UK (excluding Scotland), and 395 mechanical ventilator beds are in use by coronavirus patients.

There are 5507 people in hospital with COVID-19, down from 6826 a week ago.

ONS Data on Shielding and Anxiety

The Office for National Statistics (ONS) has produced more insights into COVID-19 with its Shielding Behavioural Survey for England. 

Tim Gibbs from ONS said in a statement: "More than 2.2 million people were advised by the Government to shield during the coronavirus pandemic as they had been classified by the NHS as clinically extremely vulnerable. While it is difficult to pinpoint the exact number of people who were completely shielding, 62% reported that they were fully following official advice."

Data were also produced on levels of anxiety. Dawn Snape from ONS said: "Our figures show that the equivalent of 19 million adults in Great Britain report high levels of anxiety.

"One particularly striking finding is that 39% of people who are married or in a civil partnership, reported high levels of anxiety. This compares with 19% pre-pandemic. It may in part be because of the challenges of homes-schooling alongside work and other responsibilities.

"Another marked change is in those aged 65 years or older. Prior to the coronavirus pandemic, we consistently saw lower anxiety ratings in those aged 65 years and older, but now we are seeing the highest levels of anxiety amongst this group in lockdown."

More News in Brief
  • Imperial College London's COVID-19 RNA vaccine begins human trials this week. Animal testing indicated it may help produce antibodies.

  • A&E care needs to be rethought after COVID-19, the Royal College of Emergency Medicine (RCEM) says. "We’re very anxious about maximum occupancy levels within our departments,” RCEM Vice-President Dr Adrian Boyle told the Observer. "Pre-COVID we had crowded emergency departments with people next to each other cheek by jowl. We just cannot go back to that."

  • The Royal College of Physicians has produced a nine-point plan for "resetting" NHS services after COVID-19. Steps include integrated ways of working, increasing the workforce, and a better deal for overseas staff.

  • The editor of the Lancet, Richard Horton, said: "The UK response to coronavirus is the greatest science policy failure for a generation." He makes the claim in a new book The Covid-19 Catastrophe: What’s Gone Wrong and How to Stop It Happening Again, the Guardian reported. He said the Scientific Advisory Group for Emergencies (SAGE) became "the public relations wing of a government that had failed its people".

  • Namilumab and infliximab have been selected for inclusion in the multi-arm, multi-stage CATALYST trial which is assessing drug candidates to treat COVID-19 in hospitalised patients. "We hope that by using a treatment that is already used to treat inflammation in other autoimmune conditions we may be able to manage inflammation associated with COVID-19 early," said Sir Marc Feldmann, professor of immunology at the University of Oxford.

  • New hospital rules on masks and face coverings came into force for staff, patients, and visitors in England on Monday. BMA Council Chair Dr Chaand Nagpaul said clarity was needed on similar measures for primary care. "It is imperative that we do all we can to prevent the spread of infection in healthcare settings, so that patients and visitors can attend hospital and GP practices without fear of contamination.  The wearing of masks by staff and face coverings by the public will be key to enabling this."

  • NHS Providers appealed to the Government not to make any more surprise announcements, like hospital masks and face coverings,  without consultation. Chief Executive Chris Hopson said: "Important decisions affecting the operations of NHS trusts should not come as a surprise to those expected to deliver them."

  • Polling of 1983 people for the Health Foundation finds 86% now believe the national government has a 'great deal' or 'fair amount' of responsibility for ensuring people generally stay healthy. That's up from 61% in 2018. "This research shows that people increasingly expect and want protection from government at a time of crisis," Health Foundation Chief Executive Dr Jennifer Dixon commented.

  • The Prime Minister has rejected England footballer star Marcus Rashford's letter  "written from the heart" asking for free school meals to continue in England over the summer holiday. Downing Street said: "The PM understands the issues facing families across the UK which is why last week the government announced an additional £63m for local authorities to benefit families who are struggling to afford food and other basic essentials."

Adapted from Medscape UK.