UK COVID-19 Daily: lack of pandemic preparation

  • Tim Locke, Medscape.com

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

Government 'Needed Better Grip' on Coronavirus

A lack of Government planning for the economic impact of the coronavirus pandemic attracted heavy criticism from a cross-party committee of MPs.

Parliament's spending watchdog said it was "astonished" that despite a pandemic having been one of the Government's top risks for years, the Treasury waited from the first COVID-19 case being confirmed in England on 31 January until mid-March before initiating economic support schemes.

The Public Accounts Committee (PAC) praised the Government for spending £124.3 billion, including £6.6 billion for health and social care, but said:  "We would have expected the Cabinet Office and the Treasury to have a better grip of the overall Government response to the COVID-19 pandemic."

Preparations for a pandemic included a rehearsal known as Exercise Cygnus in 2016, organised by the Department of Health and Social Care (DHSC), which tested how the country would deal with an influenza-type pandemic. Giving evidence to the PAC, the Cabinet Office said it believed it was "a bit early" to say for sure whether the Government was adequately prepared to respond to the coronavirus pandemic, and acknowledged that "there will be lessons".

Among other major issues, the report said: "We recognise that the Government was faced with a massive challenge to procure a huge quantity of personal protective equipment (PPE) for 58,000 separate sites including hospitals and care homes. But despite a pandemic being identified as the Government’s top non-malicious risk, it failed to stock up in advance."

MPs said that despite assurances from the Government that it had never run out of central supplies of PPE, ministers had acknowledged "daily examples of local shortages".

Stocking up on PPE during the pandemic involved higher purchase prices than the Government would have liked, "but it considers the purchase of this equipment value for money given the alternative of not having enough equipment".

Procurement and delivery of PPE will be the focus of a separate inquiry.

The Government announced on Thursday it was making £100 million available to help develop a manufacturing centre that could produce any successful COVID-19 vaccine "at scale" for people in the UK.

The Cell and Gene Therapy Catapult Manufacturing Innovation Centre in Braintree, Essex, was due to open in December 2021, the Department for Business, Energy & Industrial Strategy said.

The centre – an upgrade of an existing facility – would have the capacity to produce millions of doses of a vaccine each month, the Department said.

Kate Bingham, chair of the Vaccines Taskforce said: "In order to vaccinate our high-risk populations at the earliest opportunity, the Government has agreed to proactively manufacture vaccines now, so we have millions of doses of vaccine ready if they are shown to be safe and effective.

"The acquisition of this state-of-the-art manufacturing centre will not only help us with this, but also ensures we are well-placed as a country to be able to cope with any pandemics or health crises in the future."

The new centre would complement the Vaccines Manufacturing and Innovation Centre that is currently under construction in Oxfordshire following a £93 million Government investment.

Test and Trace

Latest figures from the DHSC showed that 355,597 people were newly tested for COVID-19 under Pillar 1 (testing in hospitals and outbreak locations) and Pillar 2 (national swab testing) in England between 9 and 15 July.

Of those, 3953 new people tested positive for COVID-19.

The DHSC said that 3887 people had their case transferred to the contact tracing system, which reached 79.7% of individuals identified.

As a result, 16,742 people were identified as coming into close contact with someone who has tested positive and, of those, 13,034 people (77.9%) were reached and asked to self-isolate, an increase from 72.0% the previous week.

In total, since the system went live on the 28 May 2020, 2,320,229 people were newly tested under Pillars 1 and 2, and 38,772 new people have tested positive for COVID-19.

Commenting on the latest figures Prof James Naismith, Director of the Rosalind Franklin Institute, and University of Oxford, said: "I remain unclear why we do not automatically test the 13,000 people reached as contacts. 

"It is still a small number and would surely help build public confidence and support especially when coupled with effective isolation of positive cases.  It would also help to identify venues or activities where spread occurs more commonly, for example, if contacts in the street are commonly negative but contacts in the pub are more commonly positive, then we might introduce targeted measures for pubs and relax a little on rules on outdoors."

Fewer Vulnerable People Now Shielding

The easing of lockdown restrictions led to a decrease in the number of clinically extremely vulnerable people who completely followed shielding guidance at the end of June, official figures showed.

The proportion of people shielding in this group was 58% between 24 and 30 June 2020, compared with 63% between 9 and 18 June, according to the Office for National Statistics (ONS).

People aged 50 and over accounted for 78% of the clinically extremely vulnerable cohort, whereas they comprise 37% of the general population of England.

Older people were more likely to follow shielding guidance, while people aged between 50 and 59 years were among the most likely to report lower life satisfaction, and a worsening in their physical health or mental health, the ONS said.

Commenting on the findings, ONS analyst Tim Gibbs said: "Overall we have seen that the percentage of the shielding population who have been following Government guidance has fallen as Government restrictions eased for the general population at the end of June.

"Those shielding between the ages of 50 and 59 seem to be disproportionately affected during the pandemic, reporting a lower life satisfaction [and greater] worsening in physical and mental health than older and younger age groups, and are among the most likely to be furloughed.

"This is a pattern usually seen amongst 20 to 29-year-olds when looking at the overall population."

In England, 2.2 million people were identified as being vulnerable to severe impact from the coronavirus.

The guidance for clinically extremely vulnerable people changed on 1st June when they were advised they could leave the house once a day into open space, if they could keep two metres from others not shielding alongside them.

Does Warmer Weather Slow the Spread of the Coronavirus?

Suggestions that warmer weather might slow down the spread of the SARS-CoV-2 virus are not supported by available data, UK research said.

An analysis in the journal Environmental and Resource Economics found "patchy" data because the reliability of testing in the early phase of the pandemic was questionable. Also, the weather itself might have led to some groups of people with non-COVID conditions being more likely to be tested than others.

"Our study found several problems with trying to understand the influence of weather using existing data on confirmed COVID-19 cases, said Francois Cohen from the University of Oxford's Smith School of Enterprise and the Environment.

According to Dr Cohen: "The existing data can't reliably tell us whether warmer weather slows down the spread of COVID-19, as some earlier studies have tried to assess, so we urge both policymakers and the public to act with caution."

Dr Anant Jani, Oxford Martin Fellow at the University of Oxford, and study co-author, said: "Although we still don’t know the influence of weather on the spread of COVID-19, we are sure of one thing: the virus has been able to spread everywhere, including in very warm areas of the globe, such as Ecuador, Brazil, and India.

"It continues to spread even in warmer states in the United States like Florida, California, and Texas.

"Good weather is no excuse to take risks with a disease that has already killed hundreds of thousands of people."

Ian Jones, professor of virology at the University of Reading, commented to the Science Media Centre: "Some important points emerge, for example that the weather could affect the rate of testing rather than the true incidence of infection, and the general conclusion that we should not assume that risk has gone away if the sun is shining is well made. 

"But the fact is that respiratory viruses are generally seasonal, probably as viruses that transmit on water droplets do so less well if the droplet dries up faster, and temperature, humidity, and UV may be part of the lull in transmission we are now seeing. 

"The flip side, alas, is that the opposite will be true in the autumn and beyond."

Face Coverings Mandatory in England

People in England were reminded that face coverings in shops, shopping centres, and supermarkets from Friday 24 July.

The DHSC said it would also be compulsory to wear a face covering when buying food and drink to take away from cafes and shops.

The rule also applies to banks, building societies, and post offices.

Face coverings will not be mandatory for:

  • Anyone under the age of 11 years

  • People with disabilities or certain health conditions, such as respiratory or cognitive impairments that make it difficult for them to wear a face covering

Failure to comply could lead to a fine of up to £100, as is currently the case on public transport.

The use of face coverings in shops in Scotland was previously made compulsory.

Latest COVID-19 Figures

Public Health England (PHE) is pausing publication of daily death data after England's Health Secretary Matt Hancock ordered an investigation into its methodology.

However, data are still published on another gov.uk page, with 53 UK COVID-19 deaths announced on Thursday, taking the total to 45,554.

Another 769 lab-confirmed positive cases were reported on Thursday, taking the total UK confirmed cases to 297,146.