UK COVID-19 Daily: health professionals get tracking app first

  • Tim Locke, Medscape.com

  • UK Medical News
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These are the UK coronavirus stories you need to know about on Monday.

Health Professionals Get Tracking App First

Matt Hancock, England's health secretary, has confirmed plans to trial the NHSX contact tracing app on the Isle of Wight. 

"From tomorrow we will begin to pilot 'test, track, and trace' on the Isle of Wight, starting with health professionals and rolling out this week to all citizens."

He told the daily Downing Street briefing the trial can be run "in proper scientifically controlled conditions" on the island.

He continued: "Tonight, the contact tracing capability will go live. And then tomorrow, NHS staff on the island will be able to download the app, and from Thursday, each one of the 80,000 households on the island will get a letter from the Chief Nurse with comprehensive information about the trial. 

"Islanders will then be asked to instal the app. Once you've installed the app, it'll start logging the distance between your phone and other phones with an app nearby. It's been designed with a form of Bluetooth that conserves power, so the app won't drain your battery. And this log of proximity information will then be securely stored on your phone. 

"If you become unwell with COVID symptoms you inform the NHS via the app. Other app users who you've had significant contact with in the last few days will then be sent an alert by the NHS along with advice about what to do. A test ordering function will then be built-in."

Read more about the app and privacy implications here.

Hancock: Compulsory COVID-19 Child Vaccination Not Ruled Out

Last year Matt Hancock said there may be strong arguments for compulsory MMR vaccination for children. On Monday, he was asked if that might apply to a future COVID-19 vaccine. "Whilst I don't rule anything out," he said, "we're proceeding on the basis that just such a huge proportion of the population are going to take this up because of the obvious benefits to individuals and their families, and their communities, and indeed the whole nation that there'll be enormous demand for it as and when the science is safe to proceed." 

Professor Jonathan Van-Tam, England's deputy CMO, added: "It is more likely than not that the first vaccines will be licenced in adults in the first instance." 

He added: "So far the epidemiological evidence is not showing us that there is a massive burden of disease, or burden of mortality, in children, it is actually completely at the other end of the scale, it is in the elderly." 

The Commons was told on Monday that 601 people are now taking part in the human trial of the University of Oxford's COVID-19 vaccine.

Boris Johnson has been contributing to the Coronavirus Global Response International Pledging Conference on Monday. "To win this battle, we must work together to build an impregnable shield around all our people, and that can only be achieved by developing and mass-producing a vaccine," the PM said. "It’s humanity against the virus - we are in this together, and together we will prevail." 

Next month the UK hosts the Global Vaccine Summit. 

Deaths and Case Data

Another 288 UK COVID-19 deaths were announced on Monday, taking the total to 28,734.

Figures are typically lower on Mondays due to weekend reporting delays.

Of the 204 deaths in English hospitals, patients were aged between 26 and 101. Of these, three patients aged between 41 and 58 had no known underlying health condition.  

Professor Van-Tam gave the Downing Street briefing an update on the latest data.

Another 85,186 COVID-19 tests were carried out or put in the post in the last 24 hours, the second day in a row it has gone below the 100,000 daily target. The daily capacity is now 108,000.

There were 3985 new COVID-19 cases reported in the past 24 hours: "I have to say that new cases need to come down further, we have to continue to track this index, and we have to get cases lower." 

On hospital bed occupancy: "Overall there are now steady declines in the number of people in hospital. This is good news."

On critical care bed use: "Across all four nations you can see largely continuing declines."

He added: "There is plenty of ICU capacity, which is extremely good." 

On deaths:  "If you look at the…7 day and smoothed out rolling average there is this slow but consistent decline which is absolutely going in the right direction now." 

NHS and Healthcare Deaths

Among recently announced NHS deaths was Moorfields Eye Hospital doctor Paul Kabasele who was based at Croydon University Hospital.

Chief Executive David Probert paid tribute: "Paul was a much-loved member of the Moorfields family. Through the past decade, he provided an exceptional level of care to his patients. He was incredibly hardworking, kind, gentle and a joy to work with. He will be sorely missed by many and his death is a huge loss to us all."

Dr Kabasele also collaborated on University College London research into the epidemiology of uveitis.

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

Experts Review Masks for the General Public

The Royal Society's Data Evaluation and Learning for Viral Epidemics (DELVE) group says face masks "could offer an important tool for contributing to the management of community transmission of COVID-19 within the general population". 

Face coverings, not masks, are already recommended in Scotland and Boris Johnson has said masks might be 'useful'.

DELVE Chair Venki Ramakrishnan said in a statement: "While social distancing and maintaining hygiene, such as washing hands, remain of prime importance to reducing transmission, the evidence shows that, if used widely and correctly, face masks, including home-made cloth masks, can help to reduce viral transmission in situations where social distancing is difficult to maintain consistently. Such situations include busy public transport, shopping, and other potentially crowded public or workspaces.  The British public has shown a great willingness to take action to reduce the spread of this terrible pandemic and I am sure they would take this latest additional step. The more people who do this, the more effective it will be in helping us protect each other."

Commenting via the Science Media Centre, Dr Simon Clarke, associate professor in cellular microbiology, University of Reading, said: "This report from the Royal Society, while interesting, represents a set of valid opinions rather than any conceptual advance in our understanding of the usefulness of face-masks or coverings.

"It falls short of delivering new evidence and too casually dismisses precautionary principle when addressing the possibility that masks and coverings could have negative effects on people’s behaviours.  Until more evidence is delivered in either direction, that’s all advice can be based on – opinions."

Prof Trish Greenhalgh, professor of primary care health sciences, Nuffield Department of Primary Care Health Sciences, University of Oxford, welcomed the findings but said: "One issue not covered by the report is the danger that widespread use of masks by the public could deplete stocks of medical-grade masks for healthcare workers.  Medical-grade masks are not needed outside of healthcare settings. A cloth mask provides very good protection, and is more comfortable to wear."

From Monday, all Eurostar passengers have to wear masks due to French and Belgian government guidelines. The rail company said: "If you don’t have a mask you may be refused travel on our services. We’d like to advise you that fines may be imposed in France and Belgium if you’re not wearing a mask."

Non-COVID-19 Care Concerns

The BMA released more details of its latest survey with responses from more than 16,000 members across the UK, this time about non-COVID-19 care.

Questions included:
  • To what extent is prioritisation of patients with possible or confirmed COVID-19 in your place of work or the local NHS affecting the care available to those patients with no COVID-19 symptoms? 'Significantly worsening' said 30% while 26% said 'slightly worsening'.

  • Which one of the following areas relating to the coronavirus pandemic is of most concern at the current time? Longer-term impact on patient clinical demand' said 40%, while 23% said 'longer-term impact of new working arrangements'.

  • How frequently, if at all, are you experiencing any shortages of medicines, medical gases or other therapeutics in your place of work? 'Some of the time' said 24%.

  • Have any current, or expected future, shortages forced you to provide less effective treatment to your patients than you would normally? 'Yes occasionally’' said 26% while 5% said 'yes, frequently'.

More News in Brief

  • As the London ExCeL Nightingale field hospital is put on standby until a possible second peak, a new type of temporary community hospital is opening in Surrey for recovering COVID-19 patients. The  300 bed NHS Seacole Centre in Leatherhead is named after Jamaican-born nurse Mary Seacole who cared for soldiers from the Crimean War. NHS England chief executive Sir Simon Stevens, said in a statement: "I fully expect that this will be just the first of a number of Seacole services that will now begin to be established across the country as the NHS moves through the peak of inpatient coronavirus care and the need for community health and rehabilitative services grows."

  • NHS Trusts in England are being told to only buy PPE through centralised procurement to avoid them bidding against each other, the FT reported. NHS Providers' Chief Executive  Chris Hopson said in a statement: "It makes sense to co-ordinate procurement in the way the Government and NHS England are suggesting, with trust procurement leads playing a key role in the process. This way we get the best of both worlds - the maximum number of people across the NHS seeking to purchase much needed equipment, but appropriate co-ordination between national and trust levels to ensure we maximise value for taxpayers."

  • The previously 'secret' list of members of the Scientific Advisory Group for Emergencies (SAGE) has been partly published. They include Government Chief Scientific Adviser Sir Patrick Vallance and Chief Medical Adviser Professor Chris Whitty. The list does not include the PM's chief adviser Dominic Cummings. However, two participants did not give permission to be named. 

  • More insight into how the lockdown is affecting people was published on Monday by the Office for National Statistics (ONS). The number of people reporting ‘low’ happiness more than doubled, from 8.7% during October to December 2019, to 20.7% between 3rd and 13th April. Lucy Tinkler from ONS said in a news release: "All measures of personal well-being, which include anxiety and happiness, are at their worst levels since we began collecting data in 2011. This was particularly the case for those who have already been financially affected, as well as those renting and the self-employed. The most recent data showed a slight improvement in anxiety compared to previous weeks, but remained much higher than before the pandemic."

  • Even when the lockdown is lifted many people would be concerned about venturing out again. An Ipsos Mori poll found 60% would be uncomfortable going back to bars and restaurants, using public transport or going to a large gathering such as a sporting event. More than 40% would be reluctant to go shopping, or to send children back to school.

Adapted from Medscape UK.