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UK COVID-19 Update: Weekly Testing for NHS Staff Recommended

These are the UK coronavirus stories you need to know about today.

UK COVID-19 Update: Weekly Testing for NHS Staff Recommended

The Commons Health and Social Care Committee's latest report into the handling of COVID-19 recommends routine testing of NHS staff to help keep services running.

The report also warns of tens of thousands of avoidable deaths within a year because of disruption to non-COVID services, such as cancer care.

In a news release the MPs said "a compelling case" has been made for staff testing "and they are yet to understand why it cannot be introduced".

In a statement, Committee Chair Jeremy Hunt expressed pride in the "heroic contribution" of frontline NHS staff but the pandemic "massively impacted normal NHS services, something that could have been mitigated with earlier infection control measures in hospitals and clearer communication to patients whose care was disrupted.

"Weekly testing of NHS staff has been repeatedly promised in hotspot areas - but is still not being delivered. Failure to do so creates a real risk that the NHS will be forced to retreat into being a largely COVID-only service during a second spike."

BMA Council Chair Dr Chaand Nagpaul said the report showed the need for "a credible plan to dig us out of the trenches".

Latest Local Lockdowns

Liverpool, Warrington, Hartlepool, and Middlesbrough are the latest areas in England to come under local lockdown restrictions.

Liverpool's cases are 268 per 100,000 population.

Residents are being urged not to mix with people from different households indoors and to avoid non-essential travel.

Test and Trace

The latest data for England's Test and Trace system for 17 to 23 September show a 61% increase in positive tests from the previous week.

Turnaround times have improved with 70.6% of in-person swab tests received the next day compared with 52.9% the previous week.

Of those transferred to contact tracing, 71.3% were reached. Overall, 71.6% of identified contacts were reached.

In today's daily data another 6914 UK positive tests were reported and 59 deaths.

There are 2276 COVID-19 patients in hospital and 332 ventilator beds are in use.

Meanwhile, The Guardian reported that nurses and other health professionals will no longer play a part in England's NHS 111 COVID-19 call handling.

The decision followed an audit in July after concerns were raised about the quality of some calls, and a number of "clinical incidents" that "may have resulted in harm".

Is Case Growth Slowing?

Imperial and Ipsos MORI's REACT study's latest data suggest that while cases remain high in England, recent measures may be starting to slow the growth in cases.

Between 18 and 26 September 84,610 swab tests were analysed. 

  • 363 people tested positive
  • 55 in every 10,000 people had the virus
  • 1 in every 100 18-24 year olds had the virus
  • 411,000 people were infected on any single day
  • R was estimated at 1.1

Imperial's Professor Paul Elliott commented: "While our latest findings show some early evidence that the growth of new cases may have slowed, suggesting efforts to control the infection are working, the prevalence of infection is the highest that we have recorded to date. This reinforces the need for protective measures to limit the spread of the disease and the public’s adherence to these, which will be vital to minimise further significant illness and loss of life from COVID-19."

DELVE Highlights Vaccine Challenges

The Royal Society's Data Evaluation and Learning for Viral Epidemics (DELVE) report has highlighted challenges for COVID-19 vaccination.

These include:

  • Differences in vaccines' protection and variable effectiveness in different populations
  • The duration of protection and the need for multiple doses or boosters
  • Partial immunity would need higher vaccination rates
  • Monitoring and data collection for safety and effectiveness
  • Scale of production and delivery
  • Public trust in vaccination

One of the lead authors, Dr Fiona Culley from Imperial College London, commented: "Vaccines are held up as our best chance of getting our lives back to some sense of normality, but we have to be realistic. The path to successful vaccines is filled with potential problems in finding vaccines that will work effectively in the ways we need and in being able to roll them out.  Planning now for the different scenarios that might play out will give us the best chance of taking rapid advantage of any vaccines that are proven to be safe and effective."

Meanwhile, the European Medicines Agency (EMA) has begun its first rolling review of a COVID-19 vaccine looking at the Oxford/AstraZeneca vaccine.

In a statement it said: "EMA will complete its assessment according to its usual standards for quality, safety and effectiveness. While the overall review timeline cannot be forecast yet, the process should be shorter than a regular evaluation due to the time gained during the rolling review."

Delirium 

Delirium may be a key COVID-19 symptom in frail older people according to King's College London research published in Age and Ageing.

The findings are based on a study of 322 over-65s who tested positive and were admitted to London's St Thomas’ Hospital between March and May.

The authors wrote: "This is the first study demonstrating higher prevalence of probable delirium as a COVID-19 symptom in older adults with frailty compared to other older adults. This emphasises need for systematic frailty assessment and screening for delirium in acutely ill older patients in hospital and community settings. Clinicians should suspect COVID-19 in frail adults with delirium."

Invest in Cancer Diagnostics

Radiology professionals are calling for more investment in staffing, and replacement of "outdated scanners" and "antiquated" computer systems.

The Royal College of Radiologists (RCR), Society and College of Radiographers, and the Institute of Physics and Engineering in Medicine are making representations ahead of the Government spending review.

RCR President Dr Jeanette Dickson commented: "Patients were suffering long waits for scans before COVID-19 hit, and the UK’s cancer outcomes have continually lagged behind the rest of Europe due to our need to improve early diagnosis rates and access to modern treatment. The coronavirus pandemic has compounded an already desperate lack of resource across imaging and cancer care, but it has also highlighted just how rapidly the NHS can adapt and improve, when it is given trust and provision to do so."

In a separate announcement an NHS England report is recommending setting up community diagnostic hubs for MRI, CT, and other diagnostic services.

Report author Professor Sir Mike Richards said: "The pandemic has brought into sharper focus the need to overhaul the way our diagnostic services are delivered. While these changes will take time and investment in facilities and more staff, it is the right moment to seize the opportunities to assist recovery and renewal of the NHS."

NHS Surcharge Refunds

The Immigration health surcharge reimbursement scheme for overseas NHS staff promised by the Prime Minister in May opened today.

Applications will be processed by the NHS Business Services Authority and UK Visas and Immigration.

Dr Rinesh Parmar, chair of the Doctors' Association UK commented: "The Government has stopped short of granting a route towards indefinite leave to remain and citizenship to those who have served and continue to serve our health and social care system in its time of greatest need. I urge the Home Secretary to think again."

Rule Breaking

As Boris Johnson was telling a news conference yesterday about the importance of everyone following COVID-19 rules, pictures emerged of his dad Stanley shopping without a face mask in London.

Mr Johnson senior apologised and told The Mirror he wasn't "100% up to speed" on the rules after returning from abroad.

Another apology came from former Labour leader Jeremy Corbyn in The Sun. He was pictured breaking the rule of six at a dinner party for nine.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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