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UK COVID-19 Daily: lockdown hindsight, support bubbles

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

Could Earlier Lockdown Have Halved Deaths?

A former Government scientific adviser has told the Commons Science Committee that starting the UK's lockdown a week earlier could have reduced COVID-19 deaths "by at least a half".

Imperial's Professor Neil Ferguson resigned fromSAGEafter admitting breaching the lockdown.

"The epidemic was doubling every 3 to 4 days before lockdown interventions were introduced," he told the committee.

"So, had we introduced lockdown measures a week earlier, we would have reduced the final toll by at least a half."

He conceded experts had "underestimated how far this country was into the epidemic" at that time.

He also said care home deaths could have been halved with effective shielding.

The chief scientific and medical advisers were back at the Downing Street briefing with Boris Johnson on Wednesday. This may suggest a pattern of them appearing with the PM on Wednesdays.

Government Chief Scientific Adviser Sir Patrick Vallance was asked about Prof Ferguson’s comments: "We absolutely should go back and look. It's very important to understand, very important to shape whatever it is we do in the future. So I think those are important scientific questions to address, and they haven't yet been fully addressed."

Government Chief Medical Adviser Professor Chris Whitty said: "Part of the problem we had at that stage was that we had very limited information about this virus. There's still a lot we don't know but we know a lot more now."

He said all measures need to be considered to have the "biggest impact on reducing the virus, but have the least impact on society" which he said was "clearly a very complicated balancing act".

Mr Johnson said: "All such judgments, I think, will need to be examined in the fullness of time."

Prof Whitty was asked if there were any decisions he looks back on and regrets: "It's not a matter of do we ever look back. We always look back. That is the whole point of having a scientific and medical method is you look back and you say, what could we have done better and what can we do for the future? So we absolutely should. There's always a question of timing and there's always a question of what do you do now, even in the middle of something, and be very clear, we are not at the end of this epidemic, not by a longshot."

Sir Patrick added: "Will we have got everything right? No. For sure we wouldn't. There's some things that we will have got wrong. and we need to make sure that we understand what they are. Learn from them, and get them right next time."

Prof Whitty conceded: "If I was to choose one, it would probably be looking at how we could speed up testing very early on in the epidemic."

Support Bubbles

The latest loosening of England's lockdown is the introduction of 'support bubbles' from this weekend.  

Prime Minister Boris Johnson told the Downing Street briefing: "We will allow single adult households, adults living alone, or single parents with children under 18, to form a support bubble. A support bubble with one other household. 

"All those in a support bubble will be able to act as if they live in the same household, meaning they can spend time together inside each other's homes, and do not need to stay 2 metres apart."  

Zoos, safari parks, and drive-in cinemas are the latest businesses being allowed to open in England from next Monday. However, indoor attractions at zoos, like reptile houses, stay closed. 

Places of worship are opening for individual prayer this weekend.

Mr Johnson was asked if future relaxation of the 2 metre rule would be a political decision, and whether he'd go against scientific advice. "I think there's a balance of risk to be struck," he said.

Sir Patrick said: "It is not a scientific rule. It is a risk-based assessment on when risk reduces, and the risks are associated with distance." 

Health Workers' COVID-19 Intubation Risk Analysed

One in 10 healthcare workers involved in intubation of serious ill COVID-19 patients later report symptoms or test positive, new research has found.

The Guy's and St Thomas' NHS Foundation Trust led study covered 1718 healthcare workers from 503 hospitals in 17 countries and is published in the journalAnaesthesia.

The authors wrote: "We did not detect an association with the use of PPE in accordance with WHO standards, though perhaps the wide range of combinations of PPE reported may have hampered our ability to identify any relationship. Regardless, a significant concern highlighted by the data is the insufficient utilisation of PPE in more than 12% of cases."

Those affected were more likely to be female "though the reasons for this are unclear".

Cases also varied by country, including:

  • UK 13%
  • Ireland 18%.
  • Sweden 16%
  • Australia 9%
  • USA 8%

The authors concede that infections may not have occurred during intubation, and asymptomatic cases may have affected self-reported data.

However, they conclude: "This information should inform decision-making and planning of safe and sustainable delivery of health care services globally. Future work should focus on screening and identifying interventions to reduce risks to healthcare workers providing care for COVID-19 patients."

Scotland's First Test and Protect Data Published

Scotland has published its first data from the newTest and Protectprogramme that launched on 28th May.

There have been 681 positive tests with 741 contacts traced.

Health Secretary Jeane Freeman said in a statement: "The average number of people traced for each positive case reflects that we are still in phase 1 of lifting lockdown restrictions and people should not be mixing with large numbers of people outside of their own household."

England's Test and Trace service launched at the same time and its first data is expected to be published tomorrow.

Scotland's COVID-19 deaths have now reached 4000, according to the latestNational Records of Scotlanddata.

Between weeks 12 and 23, most excess deaths occurred in care homes (2442). That's 82% higher than average. However, deaths are now "just above" usual levels.

In the same period, deaths at home or non-institutional settings were 60% above average, while hospital deaths were 5% above average.

Daily Deaths and Data

Another 245 UK COVID-19 deaths were announced on Wednesday, taking the total to 41,128.

There were 170,379  tests counted on Tuesday. This figure includes home tests that have been sent out but not yet processed.

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

Another 1003 positive cases were reported on Wednesday.

Another 443 people were admitted to hospital in the UK (excluding Scotland) with COVID-19 and 492 mechanical ventilator beds are in use across the UK by coronavirus patients.

Government Chief Scientific Adviser Sir Patrick Vallance said the UK's R remains between 0.7-0.9. "It remains below 1 and it remains below 1 across the UK," he said. 

"Growth rates, again, are important to look at," he said, "suggesting that the epidemic is shrinking in every region."

More News in Brief

  • TheNHS Confederationis warning of a big rise in NHS waiting lists, which it said already stood at 4.2 million before COVID-19. It has produced a report on 'Getting the NHS Back on Track' and haswritten to the Prime Ministerabout the next phase. It warns: "Over the last 12 weeks, we have seen the public’s admiration and appreciation for the NHS and care services. However, if that support is to be maintained we need to manage expectations, including how quickly we can restore key patient services. It will not be possible simply to ‘switch on’ NHS services. The Government has a vital role to play in making this clear and providing reassurance that every possible step is being taken to control the virus, as we start to resume routine services."
  • "My mask protects you, your mask protects me," is a key message from a new modelling paper inProceedings of the Royal Society Aon effectiveness of facemasks in managing the spread of COVID-19. The authors write: "We conclude that facemask use by the public, when used in combination with physical distancing or periods of lock-down, may provide an acceptable way of managing the COVID-19 pandemic and re-opening economic activity."
  • AWorld Health Organisation officialhas clarified an earlier statement saying that for patients with truly asymptomatic disease, countries are "not finding secondary transmission onward. It's very rare." However, in a Q&A on Tuesday WHO COVID-19 technical lead, Maria Van Kerkhove said that while "the majority of transmission that we know about" is through individuals with symptoms, "there are a subset of people who don't develop symptoms, and to truly understand how many people don't have symptoms – we don't actually have that answer yet."
  • With more patients turning to telemedicine under COVID-19 theBBC reportedthat the GP app provider Babylon has confirmed a data breach.  In a statement, it said: "On the afternoon of Tuesday 9th June we identified and resolved an issue within 2 hours whereby one patient accessed the introduction of another patient's consultation recording." However, it blamed temporary software problems rather than a malicious attack.
  • TheNational Institute for Health and Care Excellence(NICE) has issued an Evidence Standard Framework for COVID-19 viral tests and antibody tests. NICE said robust accuracy studies help give an understanding of how frequently a test will return correct and incorrect results, and whether it can be used in the NHS.
  • TheEuropean Medicines Agencyhas confirmed previous advice that ACE inhibitors and ARB medicines should continue to be used. It said 20 recently published studies on COVID-19 risks and outcomes with ACE inhibitors and ARBs were reviewed and showed that concerns were not supported by the latest clinical evidence.
  • The weekly Clap for Carers may have ended but plans are being made by the 'Together' campaign for one more event on Sunday 5th July to mark the 72nd birthday of the NHS. A minute’s silence is also planned on 4th July to remember those who died with COVID-19.

Adapted from Medscape UK.

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