UK COVID-19 Update: confused about lockdown? The PM was

  • Tim Locke, Medscape.com

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

Lockdown Confusion

The latest local lockdown area from this evening is the North East of England covering  Durham, Gateshead, Newcastle, North Tyneside, South Tyneside, Northumberland, and Sunderland.

The Department of Health and Social Care said incidence rates were more than 100 per 100,000 in six of the seven areas last week.

Mixing between households is restricted in most cases.

Critics said different restrictions in different areas has created confusion.

Boris Johnson had to take to twitter earlier to correct an answer he gave to a reporter about the North East lockdown: "Apologies, I misspoke today. In the North East, new rules mean you cannot meet people from different households in social settings indoors, including in pubs, restaurants and your home. You should also avoid socialising with other households outside."

Future Government powers for emergency restrictions are likely to come under parliamentary scrutiny if Conservative rebels get their way. The current powers are due for renewal this week and were passed when the Commons wasn't sitting.

Northern Ireland has announced the introduction of 11 pm closures for the hospitality industry, an hour later than the rest of the UK.

Otilimab COVID-19 Trial

The first UK patient has received the experimental drug otilimab for severe COVID-19-related lung disease at  Manchester Royal Infirmary as part of a clinical trial.

The OSCAR (Otilimab in Severe COVID-19 Related Disease) study is funded by GSK and looks at use of the drug that was developed to treat rheumatoid arthritis.

Manchester study lead Dr Andy Martin said in a statement: "The patients eligible to take part in this study are those experiencing very severe lung difficulties due to COVID-19 infection and are receiving oxygen or ventilator support.

"We are conducting this study to see whether otilimab...could...potentially ease the effect of coronavirus on the lungs, dampening the impact of the virus on the immune system."

Dr Tim Felton, Wythenshawe Hospital, added: "The primary endpoint of this study is that participants are alive and free of lung failure after 28 days – so this research is potentially life-saving."

'Re-imagining' the NHS

The NHS in England has already been changed "sometimes in ways previously unimagined" by COVID-19, according to a report by the NHS Confederation.

The call for more realism about what can be delivered, and the need for more funding, is based on survey results from 250 NHS leaders.

BMA Council Chair Dr Chaand Nagpaul commented: "As this report rightly highlights, we need to see ambitious action and proper resourcing and investment – beyond what has been promised. Doctors have repeatedly warned us in recent months that they are concerned about the NHS’ ability to cope with the backlog with a recent survey exposing their fears over a second peak. It is therefore vital the NHS can remain steadfast in the challenging months and years ahead and has the capacity to cope with COVID and non-COVID patients, without creating more backlog."

The BMA has also asked for clarity on how the Government has calculated PPE supplies needed for the second wave.

Student Lockdown

The Independent SAGE unofficial group of experts has called for locked down university students in areas such as Manchester and Glasgow to have the right to return home, accommodation fees to be refunded, and for lectures to be delivered online.

The measures are needed because of the "rapidly deteriorating situation" in halls of residence across the UK, the Independent reported.

Official SAGE minutes from 3 September cautioned: "A significant risk associated with [further education] is the potential to facilitate wider transmission between households and workplace settings, by providing greater connectivity within a community."

The anger expressed by many students in news reports was also predicted: "Disagreements, mistakes and transgressions will happen. Preventing anger, confrontation and stigmatisation will be important. Students and staff should be encouraged to adopt a supportive attitude, while engagement, explanation, and encouragement should be considered for transgressions as well as enforcement."

On Tuesday, in the Commons, the Education Secretary Gavin Williamson said students in England will be able to go home for Christmas if they want to but some may have to self-isolate at the end of term.

Deaths

Tuesday's daily reported UK COVID-19 cases reached 7143, the highest recorded so far.

There were 71 deaths, 2049 COVID-19 patients are in hospital, and 297 ventilator beds are in use.

The latest Office for National Statistics data show weekly deaths to 18 September were 2.8% above the 5-year average, but lower than the previous week.

COVID-19 mentioned on death certificates accounted for 1.5% of all deaths in England and Wales.

Deaths at home were around a third higher than the 5-year average.

Professor Karol Sikora, who comments on cancer issues for Medscape UK, tweeted: "There will be a number of reasons, but it at least needs to be seriously considered in the wider debate.

"We know from Government stats many aren't seeking medical help. This is one consequence of that."

However, Professor Sir David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication, University of Cambridge, commented via the Science Media Centre: "This may be an overall positive development since most people would prefer to die at home than in hospital – it depends on the care and support the family are receiving. Only eight out of these 700 extra at-home deaths in England and Wales had COVID on the death certificate."

Global COVID-19 deaths have passed the 1 million landmark, according to Johns Hopkins University in the US.

The UK now ranks 14th in the world for confirmed cases, and 5th for deaths behind the USA, Brazil, India, and Mexico.

COVID-19: Timeline of a Pandemic

Kids '44% Less Likely to Be Infected Than Adults'

A UCL-led study found children are 44% less likely to be infected with COVID-19 than adults.

A previous preprint meta-analysis from May has been updated for publication in JAMA Pediatrics.

Lead author Professor Russell Viner said in a news release: "Our findings show children under 12 to 14 years appear significantly less likely to contract COVID-19 from infected others.

"Data for teenagers are less clear and we must therefore assume they are as susceptible as adults. Susceptibility is a key part of the chain of infection, and our findings support the view that children are likely to play a smaller role in transmitting the virus and proliferating the pandemic, although considerable uncertainty remains."

However, the study does not shed light on the infectivity level at which children can pass on the virus once they are infected.

Dementia Care 'Anger'

The Alzheimer’s Society has published a report highlighting the extra burden carers of people with dementia have faced under lockdown.

It surveyed nearly 1000 carers and found:

  • 95% said extra caring hours had negatively impacted their physical or mental health

  • 69% felt constantly exhausted

  • 64% felt anxious

  • 49% felt depressed

  • 50% had developed sleeping problems

  • 14% had no time to see a GP about a health problem

  • 13% had an injury from caring

Alzheimer’s Society Chief Executive Kate Lee commented: "I’m so angry that families and friends out in the community have been left to fend for themselves as the people they love with dementia have declined in front of their eyes. They have been fighting against the odds to give decent care to their loved ones."

Adapted from Medscape UK.