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UK COVID-19 Daily: lifting medical school numbers cap?

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

Lifting Medical School Numbers Cap? 

The cap on medical school places in England could be lifted after the A level grades fiasco, Health Secretary Matt Hancocktold the BBC.

Numbers are regulated to help NHS workforce planning.

Some students have been accepted on courses based on last week's discredited 'algorithm' grades. Now more are eligible based on teacher assessments following this week's U-turn.

Medical schools have asked for urgent assurance over funding additional places.

The Royal College of GPs (RCGP) haswritten to the Governmentseeking assurances.

"Students who have worked hard to meet medical schools’ admission criteria deserve a chance to become doctors," wrote RCGP Chair, Professor Martin Marshall. "We are glad to hear that the Government has decided to move away from using algorithmic moderation, having recognised problems with the system applied. However, we understand that there may not be enough medical school places for students who were initially downgraded through the moderation system, as medical schools have begun allocating places based on previously announced results. These places are currently strictly limited by a Government cap on funding.

"We have previously estimated that there needs to be at least 20% more medical student places at undergraduate level and the equivalent training places for subsequent specialty medical training just to sustain general practice into the future. It is vital for the future of general practice that we have enough doctors training and qualifying to meet the needs of our growing population."

Heathrow Ready for Arrivals Testing

Heathrow Airport has put arrivals testing facilities in place at Terminal 2 to try to reduce or end quarantine arrangements if ministers agree to a policy change.

It said a survey found half of the passengers would be prepared to pay for a test to ease travel restrictions. The tests would cost £150 but that could be reduced with government subsidies.

The airport is proposing a two-test approach with a second confirmatory test a few days after the first. 

If both tests are negative the passenger would be allowed to end their quarantine early.

Major ONS Infection Survey Expansion

The Office for National Statistics is expanding its COVID-19 infection survey to include 400,000 participants in England. Samples are also taken in Scotland, Wales, and Northern Ireland.

Participants give self-administered nose and throat swabs samples and answer a few short questions during a home visit by a trained health worker. 

They will be retested every week for the first 5 weeks, then every month for 12 months.

A fifth of participants aged 16 and over will also provide monthly blood samples for antibody testing taken by health professionals.

Professor Sir Ian Diamond, UK National Statistician, commented: "Vigilance is key to containing this pandemic and the extra data on the spread of infections and antibodies at local level will be invaluable to the planning of effective local responses.     

"Following this expansion, the ONS-led COVID-19 Infection Survey will be the biggest of its kind in this country. If you’ve been approached to take part then please do so. You will be helping us all to contain this terrible virus and get on with our lives."

Antibody Study

Ten thousand health workers have now agreed to take part in Public Health England's SIREN COVID-19 immunity study. Eventually, all four UK nations will be involved.

The SARS-CoV-2 Immunity & Reinfection Evaluation study is looking at whether specific COVID-19 antibodies provide immunity.

PHE's Prof Susan Hopkins commented: "Every day we learn more and more about the impacts of becoming infected with COVID-19, but we don’t know if you can get it again, if you can pass it on, or if you develop immunity. We urgently need to find out the answers to these questions as rapidly as possible."

Effective Test and Trace to Reduce R 

The R number could be reduced by as much as 26% with effective testing and tracing, according to Imperial College London research published inLancet Infectious Diseases.

To achieve that reduction in R, 80% of cases and contacts need to be identified and there needs to be immediate testing following symptom onset and quarantine of contacts within 24 hours, researchers say.

However, current English test and trace performance is below that level. In thelatest data79.7% of positive cases referred to the service were reached and asked to provide information about their contacts. Of these, 74.2% were reached and asked to self-isolate.

Prof Nicholas Grassly from Imperial commented: "We need to use testing to prevent transmission in two ways: first, to identify infected individuals and their contacts to reduce transmission through isolation and quarantine, and, second, to detect outbreaks so that local lockdowns can be applied when needed.

"Our results show that test and trace can help reduce the R number but needs to be carried out effectively and quickly to do so. Test and trace alone won’t be enough to control transmission in most communities and other measures alongside will be needed to bring the R number below one."

Tracing Apps 'Largely Unproven'

The effectiveness of COVID-19 contact tracing apps is "largely unproven", according to aCochrane rapid reviewof digital contact tracing technologies.

Northern Ireland's applaunched last month, England's latest version using Apple/Google technology is being trialled.

The Cochrane authors conclude: "Stronger primary research on the effectiveness of contact tracing technologies is needed, including research into use of digital solutions in conjunction with manual systems, as digital solutions are unlikely to be used alone in real‐world settings.

"Future studies should consider access to and acceptability of digital solutions, and the resultant impact on equity. Studies should also make acceptability and uptake a primary research question, as privacy concerns can prevent uptake and effectiveness of these technologies."

Mental Health Telemedicine 'Here to Stay'

Telemedicine for mental health professionals will outlast the pandemic to some extent, according to international research led by UCL and King’s College London in two studies published inSocial Psychiatry and Psychiatric Epidemiology.

The studies' corresponding author Prof Sonia Johnson from UCL said: "Most people we surveyed support partial adoption of remote working, but they caution that telemedicine doesn’t work for everyone, and there are still major challenges to be addressed for it to be truly effective. The voices of the digitally excluded are especially in danger of not being heard."

Leicester's Lockdown Easing

There was some easing of Leicester's local lockdown on Wednesday with nail bars, outdoor pools, and beauty salons reopening. 

However, rules over gatherings in private homes and gardens remain in place. 

Scotland's First Minister Nicola Sturgeon said it was "not yet safe" to remove restrictions in the Grampian area.

Rising cases in Northern Ireland have led to Health Minister Robin Swann warning extra measures may be needed when the Government meets on Thursday. "The time is coming for the Executive to consider fresh and concrete actions to prevent further spread of the virus. That could include imposing localised restrictions, or introducing more general measures or a combination of both," he said.

Misleading Reports of COVID-19 Fake News

The fact-checking charityFull Factsays it cannot say whether COVID-19 misinformation killed 800 people.

It saidseveral reportsmaking the claim have been based on a research paper from theAmerican Journal of Tropical Medicine and Hygienewhich it says only provides “weak evidence”.

News items reported there had been thousands of hospital admissions in Iran and hundreds of deaths for people drinking methanol or alcohol-based cleaning products.

However, Full Fact points out some of the deaths in Iran could have been due to people drinking for pleasure rather than wrongly thinking it could cure or prevent COVID-19.

Adapted from Medscape UK.

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