UK COVID-19 Update: long waits 100 times higher 'alarming'

  • Tim Locke, Medscape.com

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

Long Waits 100 Times Higher 'Alarming'

Long waits for hospital care of more than a year in England are now over a 100 times higher than before the pandemic, according to latest figures.

The current 4.4 million long waiting list included 162,888 long waits compared with 1321 last year.

NHS England sounded a positive note with a spokesperson saying: "Over the summer some predicted that waiting lists would hit 10 million by Christmas, but thanks to the work of NHS staff, the waiting list is still lower than it was this time last year, and median waits for planned care shortened over the past month. 
 
"Although COVID hospitalisations almost doubled during November, for every COVID inpatient the NHS treated, hospitals managed to treat five other inpatients for other health conditions. With cancer referrals and treatments now back above usual levels, our message remains that people should continue to come forward for care when they need it."

BMA Council Deputy Chair Dr David Wrigley commented: "It is quite frankly alarming that the number of patients waiting more than a year for care is now 123 times higher than last October – the highest since May 2008. These are patients in pain, distress, and needing treatment.

“Worryingly, despite lower demand in A&E, the number of 12-hour trolley waits has doubled since last November as emergency departments are still struggling to cope. We are also seeing a drop across many key cancer performance targets since last year, which begs serious concern for the health and welfare of these often seriously ill patients."

Updated Jab Allergy Information

The MHRA issued more information about allergic reactions to the Pfizer/BioNTech vaccine.

Chief Executive, Dr June Raine, said updated guidance was issued to COVID-19 vaccination centres last night about the management of anaphylaxis "following two reports of anaphylaxis and one report of a possible allergic reaction following immunisation".

Vaccination is not advised for any person with a history of anaphylaxis to a vaccine, medicine, or food.

Anyone having a reaction to the first dose should not have the second dose.

Dr Raine said: "Anyone due to receive their vaccine should continue with their appointment and discuss any questions or medical history of serious allergies with the healthcare professional prior to getting the jab.

"You can be completely confident that this vaccine has met the MHRA’s robust standards of safety, quality and effectiveness. The safety data has also been critically assessed by the Government’s independent advisory body, the Commission on Human Medicines. No vaccine would be approved unless it meets these stringent standards – on that you can be sure.

"We have in place a robust and proactive safety monitoring strategy for COVID-19 vaccines which allows for rapid, real-time safety monitoring at population level. The fact that these incidents were picked up and reviewed shows that to be the case."

In a Downing Street briefing, England's Health Secretary Matt Hancock said: "I can confirm that we will shortly expand our vaccination programme further to 10 more locations in England, and from next week, we plan to begin vaccinations in GP led sites, and vaccinate in care homes by Christmas. We'll keep on expanding this rollout to reach more and more people."

'Patient A' Goes Home

On Wednesday, the woman who made history by being the first to be vaccinated left hospital in Coventry. 

Maggie Keenan, 90, was an inpatient at the time of the jab. She said it had been "a massive day" for her and the rest of the world "as we all look to get back to some sort of normality".

She added: "It has all been such a whirlwind and everything hasn’t really sunk in yet. I feel great and I’m so pleased to be able to go home and to spend some quality time with my family. 

"I would like to say thank you to the hospital and its staff for the care and support shown to me during my stay – they have been truly amazing."

Insects in Box of PPE

The Commons Public Accounts Committee has been hearing evidence of PPE problems from the BMA and Royal College of Nursing.

Sky News reported evidence from Dr Emily McWhirter, RCN: "We received some stock where the elastics on the masks were just rotten, they just broke, you couldn't use them, they didn't create any sort of seal," she said.

In one box of gowns a "load of insects came out". 

Some stock had been given new use-by date stickers covering up older dates, the committee heard.

Test and Trace

Latest changes in England's Test and Trace system allowing several adults in a household to get a single call means performance data cannot be compared with previous weeks.

In the latest figures, taking into account all contacts identified, 85.7% were reached.

Also, 96,415 people tested positive for COVID-19 at least once in England between 26 November and 2 December. Positive cases peaked 5 November to 11 November.

Separate Public Health England surveillance data suggest that COVID-19 activity at a national level plateaued between 30 November and 6 December.

Case rates were highest in London amid speculation it may be moved into the highest tier of lockdown measures.

Matt Hancock said cases were also rising most among secondary school pupils and announced tonight: "We need to take targeted action immediately. Having spoken to the leaders of London's councils and to the mayor. We've decided to put in place an immediate plan for testing all secondary school aged children in the seven worst-affected boroughs of London, in parts of Essex that border London, and parts of Kent."

The hospital admission rate for COVID-19 in England was 13.7 per 100,000 in the latest week, compared to 14.7 per 100,000 in the previous week.

Gender Risk

Men are 2.84 times more likely to need admission to intensive care, and 1.39 times more likely to die from COVID-19 than women, according to a study published in Nature Communications.

Co-senior author, Dr Claire Deakin, UCL, said in a news release: "We know from previous work that women generally have a stronger immune response to pathogens that invade the body, like viruses.

"This better initial response could help them to clear the infection more quickly and may explain why men have a higher risk of severe infection with viruses like SARS-CoV-2. Women also have a more robust longer-term protection against pathogens."

Second Wave Mortality

Experts have written an article in The BMJ on why the COVID-19 mortality rate is lower in the second wave.

In 'Lightening the viral load to lessen COVID-19 severity', they point to:

  • Proportionally fewer infections in over-60s

  • Improved treatment

  • Lower intake of virus on average at the time of infection, due to social distancing, mask wearing, and ventilation

Stephen Burgess, Medical Research Council Biostatistics Unit, University of Cambridge commented: "Wearing a mask and only meeting in well-ventilated areas will not only reduce the risk of catching coronavirus, but also reduce the chances of developing severe disease if you do get infected."

Anxiety 'Peaked in March'

UCL social study data published in Lancet Psychiatry says levels of anxiety and depression were worst in the early stages of the March lockdown but improved fairly rapidly after restrictions were introduced.

Lead author, Dr Daisy Fancourt said in a news release: "The fact that poor levels of mental health for most people did not continue to worsen over this period is slightly at odds with data from previous epidemics, in which mental health was found to worsen during quarantine. However, there are several key differences between this pandemic and others.  Firstly, the fact that the majority of people in England during lockdown were allowed some trips outside of the home may have eased the mental burden.

"There was also substantial prior warning in England that a lockdown was likely to come which could explain why people may appear to have become psychologically affected prior to the lockdown announcement. Many individuals had already ‘locked down’ voluntarily before the official announcement suggesting the psychological toll was already being experienced.

"Thirdly the rise of home-based leisure activities and virtual communication during the lockdown may have helped in contrast to previous epidemics where 'fear of missing out' was reported to be a challenge."

#MyCOVIDVax

Dr Dan O'Carroll was the first of Medcape's UK contributors to tweet pictures having his COVID-19 jab.

"Privileged to be amongst the first vaccinated. A phenomenal achievement by the scientific community. Hopefully the first steps to putting this horrible disease behind us," he said.

Please share your pics when the time comes using the hashtag #MyCOVIDVax