UK COVID-19 Update: London moves to 'high risk' tier 2

  • Tim Locke, Medscape.com

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

London Moves to 'High Risk' Tier 2

London has been moved from the Medium to the High Risk COVID-19 Tier 2, with a ban on households mixing indoors.

London Mayor Sadiq Khan said: "Nobody wants to see more restrictions but this is deemed to be necessary in order to protect Londoners."

Other areas moving to Tier 2 from Saturday include most of Essex, Elmbridge, Barrow-in-Furness, North East Derbyshire, Erewash, Chesterfield, and York.

England's Health Secretary Matt Hancock announced the restrictions in the Commons, saying "things will get worse before they get better".

Discussions are continuing over the status of Greater Manchester and Lancashire.

Test and Trace Performance

England's Test and Trace weekly statistics show:

  • 76.8% of people who were transferred to the contact tracing system were reached and asked to provide information about their contacts

  • 37.4% of close contacts were not reached to be asked to self-isolate

Commenting, Deputy Chief Executive of NHS Providers, Saffron Cordery, said: "It’s deeply unfortunate that at this point with infections rising, admissions increasing, and winter looming, there’s still clearly a long way to go until our test and trace system is fit for purpose."

Daily Data

In Thursday's daily data another 18,980 UK positive tests were reported and 138 deaths.

There are 4941 COVID-19 patients in hospital and 563 ventilator beds are in use.

Is 'Long COVID' Four Syndromes?

'Long COVID' may not be one syndrome but possibly up to four different syndromes, according to a new review by the National Institute for Health Research (NIHR).

Some patients experience 'classic' post-critical illness symptoms, others reported fatigue and brain fog, a third group experienced permanent organ damage, while another had symptoms that moved around the body and did not steadily progress towards recovery.

The review authors said the challenge now was to design research that integrated the needs of those who have the condition with clinical models of care, and which recognise the social and psychological consequences of ongoing COVID.

Excess Heart Deaths

British Heart Foundation analysis of ONS data found there have been nearly 800 heart and circulatory disease excess deaths in under-65s since the pandemic began.

The charity's Associate Medical Director, Dr Sonya Babu-Narayan, commented that "these figures further highlight that delays in care are likely contributing to more deaths than we would expect to see otherwise. It’s particularly concerning that we are seeing this trend in people under 65 continue even after the first peak of the pandemic."

Patients' Confidence in GPs

A survey for the Patients Association found most patients confident about visiting GP surgeries in person, with 35% 'very' and 31% 'somewhat' confident about it.

During the pandemic, 36% of the 513 respondents had visited their GP practice in person and 79% had used GP services overall. Phone calls resolved issues in 62% of cases.

The charity's Chief Executive, Rachel Power, commented: "In reopening its primary care services, the NHS must ensure that the options for accessing GP premises meet the needs of all patients, and build on the strong confidence in visiting their GPs that patients continue to hold."

UK Urged to Back Vaccine Challenge Trials

A group of international experts, including Nobel laureates, have written an open letter to England's health secretary Matt Hancock asking for UK support for vaccine human challenge trials.

They write that this approach "can greatly accelerate the development of a COVID-19 vaccine and improve our scientific understanding of the virus".

In September, the Government confirmed that challenge trials were being considered.

Herd Immunity Theories Criticised

Last week a group of experts signed the Great Barrington Declaration in favour of herd immunity to combat COVID-19.

Now a separate group of 80 researchers have written an open letter to The Lancet saying herd immunity approaches to coronavirus are a "dangerous fallacy".

The letter is referred to as the John Snow Memorandum, and signatories include some Independent SAGE experts, including the former chief scientific adviser Sir David King.

Brexit and COVID-19

Leaving the EU single market at the end of the year will create "new and wide-ranging problems" for the majority of NHS medicines and medical devices which come from or via the EU, according to a report from the Nuffield Trust.

It says stockpiling measures will help but cautions that medicines shortages have become more common and appear to fluctuate easily.

Adapted from Medscape UK.