UK COVID-19 Update: vaccination first dose protection, 'war zone' hospitals

  • Tim Locke, Medscape.com

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

Vaccination First Dose Protection

Israel's coronavirus tsar Nachman Ash said a single dose of the Pfizer/BioNTech vaccine appeared "less effective than we had thought". His remarks came as record new infections were reported in Israel despite widespread vaccination uptake.

This could have implications for the UK's policy of delaying second doses by up to 12 weeks based on up to 89% protection after the first dose. Israel reported it could be as low as 33%.

Government Chief Scientific Adviser Sir Patrick Vallance told Sky News: "When you get into real world practice things are seldom quite as good as clinical trials."

He added: "We'll get information from Israel, we'll get information from us, we'll see what's happening in the real world. And we should expect to see more data on that over the next few weeks.

"It's quite important not to assume this [the vaccine] protects in the first 10 days because it doesn't."

Variants & Vaccines

BioNTech preprint research suggests its vaccine made with Pfizer blocked infection of the UK virus variant in laboratory studies.

Dr Simon Clarke, associate professor in cellular microbiology, commented via the Science Media Centre (SMC): "While this study confirms that the antibody response is not blunted by the mutations in this variant, it does not assess the effect that these may have on T-cell immunity, so it remains entirely possible that they could indeed have an adverse effect on vaccine-induced immunity."

A preprint from South Africa's National Institute for Communicable Diseases suggested the country's virus variant might partially evade immune protection from therapeutic monoclonal antibodies and convalescent plasma.

Commenting via the SMC, virologist Professor Lawrence Young, Warwick Medical School, said: "It is important that we now determine the neutralising ability of antibodies against virus variants generated in response to vaccination and study the immune response in individuals infected with virus variants."

Norway said its vaccination advice is unchanged, despite reports from BioNTech that it had altered after deaths in older, frail recipients who had the company's vaccine.

However, the Norwegian Institute of Public Health said the guidelines were the same and there should be an individual assessment before each vaccination.

Moderna said it was investigating reports of possible allergic reactions to its vaccine from California’s health department.

California State Epidemiologist Dr Erica Pan said in a statement:  "Out of an extreme abundance of caution and also recognisng the extremely limited supply of vaccine, we are recommending that providers use other available vaccine inventory and pause the administration of vaccines from Moderna Lot 041L20A until the investigation by the CDC, FDA, Moderna, and the state is complete."

'War Zones'

Sir Patrick Vallance also said some UK hospitals currently resemble those in war zones: "This is very, very bad at the moment with enormous pressure and in some cases it looks like a war zone in terms of the things that people are having to deal with."

Another 3887 COVID-19 patients were admitted to hospital according to Wednesday's figures, taking the total to 39,068, and 3947 ventilator beds are in use. 

Another 38,905 UK positive tests were reported and 1820 deaths.

As of Tuesday, 4.6 million first vaccine doses have been given across the UK and 460,625 second doses.

As police chiefs lobbied for frontline officers to be prioritised for jabs, 2000 vaccination programme supply chain workers were added to the priority list. These include some Pfizer and AstraZeneca staff.

"Highly trained workers who have been identified by the Government as being irreplaceable and crucial to the delivery of vaccine supplies will be offered vaccines," a Department of Health and Social Care news release said.

"This will reduce the risk of an outbreak that would disrupt the immediate supply chain, which could have a significant impact on the largest vaccination programme in British history."

Heart Attack Admissions Down

The second wave has brought a new drop in people admitted to hospital with acute heart failure or a heart attack, according to University of Leeds research published in a letter to the Journal of the American College of Cardiology.

Admissions dropped 41% for heart failure and 34% for heart attacks.

Professor Chris Gale, who supervised the data analysis, said: "I am afraid that we are seeing a re-run of one of the preventable tragedies of the first wave - people were either too afraid to go to hospital for fear of contracting COVID-19 or were not referred for treatment."

Professor Simon Ray, president of the British Cardiovascular Society, commented: "This research illustrates again the importance of the message that other medical problems don't stop because of COVID and that people with serious problems like heart attack and acute heart failure still need to be seen and treated urgently to prevent death or long-term ill health."

Long COVID App

Wales has launched an app to support people with long COVID.

Around 1 in 10 people who have had coronavirus experience some long-term cardiac, neurological. or psychological symptoms.

Dr Fiona Jenkins, executive director of therapies at Cardiff and Vale University Health Board said it "offers a huge range of clinical advice and allows you to support yourself, it lets you set goals, track your progress and monitor your symptoms over time".

New Negative Pressure Ventilator

A new negative pressure ventilator which could provide additional treatment options for patients with COVID-19 respiratory failure has been developed by a UK team of anaesthetists, nurses, and engineers. 

Details of the £8000 device are given in the journal Anaesthesia.

Co-author, Dr Malcolm Coulthard, Translational and Clinical Research Institute, Newcastle University, said: "The exovent team focused on exploring the benefits of negative pressure ventilation, founded upon lessons learned from nearly 100 years of using negative pressure ventilation, most memorably during the polio epidemic of the 1950s."

Fertility Fake News

The Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Midwives have issued a joint statement tackling misinformation over COVID-19 vaccines and fertility.

RCOG President, Dr Edward Morris, said: "We want to reassure women that there is no evidence to suggest that COVID-19 vaccines will affect fertility. Claims of any effect of COVID-19 vaccination on fertility are speculative and not supported by any data.

"There is​ ​no biologically plausible mechanism by which current vaccines would cause any impact on women's fertility. Evidence has not been presented that women who have been vaccinated have gone on to have fertility problems."

Cervical Cancer 

RCOG is supporting a charity's call for HPV home self-testing due to falling cervical screening uptake under lockdown.

A survey of 2000 women for Jo’s Cervical Cancer Trust last June found 32% would prefer to take an HPV self sample than going to a cervical screening appointment. Support rose to 62% if testing was easy and reliable.

Dr Morris said: "We want to stress that it’s incredibly important women do still attend their cervical screening appointments as they can be lifesaving.

"We fully support calls to make cervical screening more accessible and would welcome the introduction of HPV self-testing kits as part of the cervical screening programme. In countries where this is already offered there has been significant success and it has increased the screening uptake amongst all women."

Facebook Ban

Emergency medicine consultant Dr Dan O'Carroll was temporarily banned from Facebook on Tuesday.

Dr O'Carroll who comments on ED issues for Medscape UK took issue with someone he called a 'covidiot/anti-vaxxer'.

The social media company said his comments went against community guidelines.

"Well that's nice," he tweeted. "Facebook is helping to spread damaging information."

Adapted from Medscape UK.