UK COVID-19 Daily: WHO immunity clarification

  • Tim Locke, Medscape.com

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

WHO Immunity Clarification

The World Health Organisation issued a clarification after it tweeted about antibody tests and 'immunity passports': "There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.”

It took down the old tweet and instead said: "Earlier today we tweeted about a new WHO scientific brief on 'immunity passports'. The thread caused some concern & we would like to clarify: We expect that most people who are infected with #COVID19 will develop an antibody response that will provide some level of protection.”

Experts have commented via the Science Media Centre:

Prof Babak Javid, principal investigator, Tsinghua University School of Medicine, Beijing, and consultant in infectious diseases at Cambridge University Hospitals, said: "The initial WHO statement was very confusing and highlights how technically precise language such as ‘no evidence to support’ can have very different meanings to scientists and the general public.  In the clarification, the WHO acknowledges that although it is true that we just don't know whether natural infection provides long-lasting immunity, or to what degree of protection (ie. 'no evidence'), this does NOT mean they do not expect some degree of immunity to be afforded by natural infection, quite the opposite."

Dr Tom Wingfield, senior clinical lecturer and honorary consultant physician, Liverpool School of Tropical Medicine, said: "People who were infected with other coronaviruses like SARS and MERS produced antibodies against these illnesses following infection, for up to 3 years in some cases. However, it is not clear whether the presence of these antibodies means that a person is immune to a repeat infection." 

Dr Simon Clarke, associate professor in cellular microbiology, University of Reading, said: "It's reasonable to expect that some of the immune response generated during an episode of COVID-19 will persist for some time after the infection has been resolved, giving protection against re-infection.  At this stage, nobody knows for sure whether this is indeed the case or for how long it will protect someone, it could be weeks, months or years and it would be unwise to make predictions that are not based on any evidence.  It's worth remembering that we've only known about this disease for about 4 months, so cannot at this stage have any knowledge about whether immunity lasts beyond this rather limited time frame."

Mobile Testing

The Armed Forces are running eight mobile testing units travelling around the UK in areas of most need, including care homes. There are plans for 96 units to be on the road by May. Civilian contractors will be used in Northern Ireland.

National Testing Coordinator Prof John Newton said in a news release: "New mobile testing units will help us achieve our goal of 100,000 coronavirus tests a day, providing tests to vital frontline workers wherever they need them."

There were 29,058 tests for COVID-19 carried out on Saturday taking the total to 669,850. 

At the Downing Street briefing Prof Stephen Powis, national medical director of NHS England was asked about restarting contact tracing: "The lower the number of new cases in the population, the easier it is to do because it involves contacting less people overall."

He continued: "If there are 4000 new cases a day, and you have to contact trace, say, on average 30, that's 120,000 people to contact trace. If it's 2000 it’s half that. 

"So the point is getting the infection rate as low as possible will put us in a position where contact tracing will be at its most effective." 

Environment Secretary George Eustace was asked about reports of travellers to the UK having to self-isolate for 2 weeks. "As we move to a new phase at some point in the future," he said, "international travel could become a more significant part of the risk to manage.

"At the moment, all of the evidence suggests that it is only a tiny proportion of the cause of the coronavirus outbreak. 

"If we got to that point, a number of measures would be considered, but no decisions have been even taken in this space yet." 
 
Deaths and Data

Another 413 UK hospital COVID-19 deaths were announced on Sunday, the lowest this month, taking the total to 20,732. Weekend reporting may have lowered Sunday's numbers.

Of the 336 deaths in English hospitals patients were aged between 28 and 100. Of these,  22 aged between 41 and 94 had no known underlying health condition.  

Prof Stephen Powis, national medical director of NHS England told the Downing Street briefing: "The number of deaths in hospitals ... is now starting to decline."

On the 4463 new cases reported on Sunday: "The benefit of social distancing is beginning to be reflected in the number of new cases determined by testing. We are not seeing increases in that we are seeing a fairly stable number, and that of course is also on the backdrop of an increased number of tests becoming available."

There are 15,953 people in hospital with COVID-19 down from 16,411 on Saturday. "We now have a very definite trend in reduced number of people in hospitals," Prof Powis said.

On critical care bed occupancy: "You can see that proportion is declining, as indeed is the absolute number." 

Prof Powis was asked about the "green shoots" in the data he mentioned some weeks ago and whether the UK had now turned a corner? "I can't emphasise enough that this is not the time to say, actually we've done a good job we need to stop complying with our social distancing instructions and the government guidance. This is exactly the time to keep that up."

Among recently announced NHS worker deaths were

Ate Wilma Banaag was a nurse at Watford General Hospital. The hospital trust paid tribute: "She is remembered for being a gentle, softly spoken and hardworking nurse with an unforgettable and infectious smile. She enjoyed her job caring for elderly patients and she will be very much missed."

Ade Dickson was a mental health nurse at the Barnet Crisis Resolution and Home Treatment Team. The hospital trust said: "Ade was a highly respected colleague who will be deeply missed by his family, friends, Trust staff and patients."

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

More News in Brief
  • The BMA has written again to the Chancellor over death in service benefits for healthcare workers whether they are a current member of the NHS Pension Scheme or not. BMA Pensions Committee Chair Dr Vishal Sharma, said the delay "is particularly galling for the many doctors, nurses and other healthcare workers who continue to put themselves at risk to protect and care for patients against this deadly virus, with the knowledge that their families will be provided no financial support if the worst should happen. This really is a shambolic, unacceptable and frankly shameful situation." Last week the Scottish Government committed to providing a death in service package for all NHS workers.

  • The BBC reported that Birmingham's Nightingale field hospital at the NEC hasn't admitted any patients 10 days after its official opening. This was a "good thing" it quoted University Hospitals Birmingham NHS Foundation Trust chief executive Dr David Rosser saying, because the NHS had "absorbed" additional COVID-19 pressures.

  • The Department of Health and Social Care has been debunking fake news. It tweeted: "News circulating on social media that the first volunteer in a UK #coronavirus vaccine trial has died is completely untrue. Before sharing unsubstantiated claims online, use the SHARE checklist to help stop the spread of harmful content."

  • Another recovered COVID-19 patient is due back at work full-time tomorrow. Prime Minister Boris Johnson has been recuperating at Chequers after spending time in ICU at St Thomas' Hospital in London. He's said to be "raring to go" but concerned about relaxing lockdown measures causing a second peak. The Sunday Telegraph said the PM has been quoting the Roman statesman Cicero: "The health of the people should be the supreme law."

Adapted from Medscape UK.