UK COVID-19 Daily: R rises, safe singing

  • Tim Locke, Medscape.com

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

R Rises

The UK's latest R number for the UK has risen to 0.9-1.1 and the growth rate is -3% to +1% per day.

Commenting via the Science Media Centre, Dr Michael Head, senior research fellow in global health, University of Southampton, said: "We are seeing increases in new daily cases, and now we have an R number estimate that is approximately at the 1.0 threshold. The data suggests that as people mix more freely, there are probably increases in community transmission. This is to be expected, but highlights the problems in coming out of lockdown, particularly when there are many thousands of active cases in a population.

"Suppressing COVID-19 is extremely difficult. We know that most cases are transmitted within the indoor environment. It’s currently August, and so outdoor meetings are possible, but as we head towards the winter, fewer people will be inclined to meet outside. That raises difficult questions about how best to handle social contacts across the winter months, particularly with the increased potential for transmission from younger populations, who usually have relatively mild cases, on to vulnerable populations where the consequences can be more serious."

Lockdown and Travel Changes

Portugal has come off the 14 day quarantine list for returning travellers, but Croatia, Austria, and Trinidad and Tobago have been added to the UK-wide list from 4 am on Saturday.

Scotland has also added Switzerland to its list.

Oldham, Pendle and Blackburn in England, all on the Public Health England watchlist, are introducing strict social distancing measures to help avoid full local lockdowns.

Weekly incidence data per 100,000 population are 103.1 in Oldham, 95.3 in Blackburn, and 75.5 in Pendle. That compares with the England-wide rate of 11.9 for 100,000.

People from different households are no longer able to meet and public transport is designated for essential use.

Birmingham has been added to the watch list as an 'area of enhanced support' and Northampton is now an 'area of intervention'. Restrictions are being lifted in Wigan, Rossendale, and Darwen.

From Monday, Scotland is allowing organised outdoor contact sports, some outdoor live events, driving lessons, opening of child contact centres, face-to-face advice services, bingo halls, amusement arcades and casinos, snooker and pool halls, indoor bowling and both static and travelling funfairs.

New legislation will allow local authorities to shut specific premises breaching guidelines and police in Scotland will have powers to break up large gatherings.

Wales is to trial small scale outdoor performances and sporting events, and indoor visits to care homes are planned to be allowed from August 29. Overall though, First Minister Mark Drakeford said: "The return of pupils is the most significant important activity which will take place in Wales during the next 21 days and most of the headroom we have is being devoted to making this a success."

A rise of cases in Northern Ireland has led to new restrictions. The number of people that can participate in outdoor gatherings is reduced from 30 to 15 from next week.

The current limit on meeting in private homes is being reduced from 10 people from up to four households to 6 people from no more than two households.

Safe Singing 

Indoor events involving singing were banned because of concerns it would spread more respiratory particles than just talking. However, the University of Bristol led preprint PERFORM study data suggests that's not the case.

The study involved 25 professional performers breathing, speaking, coughing, and then singing and speaking ‘Happy Birthday' at 50-60, 70-80, and 90-100 dB. 

Although aerosol mass increased by a factor of 20-30 times as speaking and singing became louder, singing did not produce very substantially more aerosol than speaking at a similar volume.

No differences were found between different musical styles, including choral, musicals, opera, gospel, rock, and pop.

Corresponding author Jonathan Reid commented: "Our research has provided a rigorous scientific basis for COVID-19 recommendations for arts venues to operate safely for both the performers and audience by ensuring that spaces are appropriately ventilated to reduce the risk of airborne transmission."

Test and Trace Data

The latest testing and contact tracing data for England show a 27% rise in positive cases while the number of people tested fell by 2%.

Testing turnaround times were slower with 60.5% of swab tests results given within 24 hours compared with 70.3% the previous week.

Processing delays led to a decrease of 3% of cases being handed to the contact tracing system. Of the 4803 referred, 78.8% were reached and asked to give details of contacts. Of the 16,897 people identified as being contacts, 71.3% were reached and asked to self-isolate, slightly lower than 74.2% the week before.

ONS Infection Survey 

The latest estimates from the ONS COVID-19 Infection Survey using household swab tests show that 24,600 people in England had COVID-19 between 7 to 13 August, equating to around 1 in 2200 people.

ONS estimates there were 0.44 new COVID-19 infections for every 10,000 people, or around 2400 new cases a day.

In Wales, around 1300 people had COVID-19, around 1 in 2400.

Katherine Kent from ONS commented: "Our analysis of the results from recent weeks suggests there is not currently enough evidence to say whether the number of new cases per week has done anything other than levelled off when compared with last week’s estimate."

July's Deaths

Deaths in July in England were 576 over the 5-year average, according to Office for National Statistics (ONS) data. However, deaths were below the 5-year average in each separate week. ONS said the difference was due to July 2020 having an additional weekday than the same month in most of the years making up the 5-year average.

Heart disease was the leading cause of death in Wales, and dementia in England.

COVID-19 was the eighth most frequent underlying cause of death in England and didn’t feature in the top 10 in Wales.

The COVID-19 age-standardised mortality rate was 21.0 per 100,000 in England compared with 16.7 per 100,000 in Wales.

In the year so far to the end of July, deaths in England were 35,123 above the 5-year average, and 1096 higher in Wales.

COVID-19 was the underlying cause of death in 13.7% of all deaths in England and 10.8% of all deaths in Wales.

Make Face Coverings a Social Not Medical Intervention

Making the wearing of masks and face coverings a social intervention rather than a medical one could increase uptake, according to University of Oxford research published in The BMJ.

The authors write: "Wearing face coverings is being rapidly introduced as a public health intervention in countries with no cultural tradition of doing so. For successful uptake, such interventions need to be grounded in the social and cultural practices and realities of affected communities, and campaigns should not only inform, but also work to shape new sociocultural norms."

Being able to personalise cloth face coverings may make them more desirable as accessories, they said.
Social Impact

Newly released ONS social impact data among adults in Britain found:

  • 69% said police should be very strict or strict in enforcing COVID-19 rules

  • 55% strongly supported targeted lockdown measures

  • 90% of those with school-age children who had not already returned to classes said it was very likely or fairly likely the children or young people in their household will go back to school or college when they re-open

  • 11% questioned had used this month's Eat Out to Help Out restaurant discount scheme

Adapted from Medscape UK.