UK COVID-19 Update: which SAGE advice was 'ignored'?

  • Tim Locke, Medscape.com

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

Which SAGE Advice Was 'Ignored'?

As Boris Johnson gave a news conference to say the UK's rising coronavirus cases were  "flashing at us like dashboard warnings in a passenger jet", details emerged of recent scientific advice that had not been followed in England.

At the same news conference, just hours after the three tiers of lockdown were announced, Chief Medical Adviser Professor Chris Whitty conceded: "I am not confident nor is anybody confident that the tier 3 proposals for the highest rates, if we did the absolute base case and nothing more, would be enough to get on top of it."

The September 21 SAGE expert group's' minutes show a recommendation for an immediate 'circuit breaker' time-limited lockdown that was not followed in England. Scotland, which receives the same briefing material, did announce 16 days of restrictions for central Scotland.

SAGE also advised universities should only provide online tuition.

The experts also said Test and Trace is only having a "marginal impact" due to testing delays and low levels of engagement.

Closure of bars, pubs, cafés and restaurants, would have a 'moderate impact', SAGE said.

Commenting via the Science Media Centre, Professor James Naismith, Director of the Rosalind Franklin Institute, and University of Oxford, said: "The Government has opted to wait and see if less stringent measures can avoid a severe second wave.

"Of course, we all hope that the current measures will be enough.  As SAGE clearly states, lockdowns and social restrictions cause serious harm.

"There is a risk that we will end up having to lock down again (perhaps with a different name but in effect the same thing).  If we do so the duration of lockdown will likely be longer as a result of delay."

Hospital Cancels Routine Operations 

University Hospitals Plymouth NHS Trust is temporarily pausing non-critical planned surgery at Derriford Hospital, apart from day case procedures, due to "a growing number of COVID patients".

Chief Operating Officer, Kevin Baber, apologised for the "stress and inconvenience" but said in a statement: "We have to ensure patients who have suspected or confirmed COVID are safely cared for away from those patients without COVID. This involves reconfiguring our wards to ensure everyone remains safe."

Care Home Relatives Designated 'Key Workers'

The Alzheimer's Society welcomed the announcement of a pilot scheme for those with family members in care homes where they can be designated as key workers to allow visits.

CEO Kate Lee commented: "Keeping coronavirus out of care homes has to remain an absolute priority, so these key family carers must get the regular testing and PPE they need to visit safely. This will give people with dementia better care and quite simply enjoyment of life that’s an essential right, while keeping them safe during the winter."

Shielding

England is not restarting shielding despite rising coronavirus cases.

Precautions for those who are clinically extremely vulnerable differ depending on the tier an area is in but will not automatically be triggered by an area going into the very high-risk category.

Lockdown Request

Essex County Council is asking the Government to put it into the 'high' lockdown category.

The county's Public Health Director Dr Mike Gogarty commented: "Across the county, we have moved from gradual to exponential growth with [the] number of cases rising exponentially.

"We want to act now to minimise the impact on the public health and the economy and by doing so we believe we can shorten the period of enhanced restrictions."

Latest Data

In Tuesday's daily data another 17,234 UK positive tests were reported and 143 deaths.

The latest nowcast and forecast data from the Cambridge MRC Biostatistics Unit show:

  • There are 47,000 daily infections in England

  • Daily deaths are likely to be 240 to 690 by 26 October

  • R is above 1 in all regions with a 100% probability, apart from the South West

The latest weekly data from the Office for National Statistics (week 40) show the number of registered deaths in England and Wales was 4.1% above the 5-year average.

'Novel coronavirus (COVID-19)' accounted for 3.2% of all deaths.

Hospital and care home deaths were below the 5-year average but private home deaths were above the 5-year average.

Junior Doctors' Second Wave Rotas

The BMA has called for all junior doctors' second wave rotas to comply in full to the Terms and Conditions of Service for NHS Doctors and Dentists in Training (England) 2016 (TCS).

In a statement, it said: "To ensure that efforts are sustainable in the weeks and months to come, it is of paramount importance that staff are not working in a manner that compromises their health, safety or wellbeing, nor that of their patients."

Meanwhile, the RCN responded to news that some Nightingale hospitals are being mobilised. Susan Masters, director of nursing, policy and public affairs, commented: "If nurses are to be deployed away from their usual jobs into frontline positions, such as ICU, they should not be put into roles that are outside their skills and competencies. They must be given the right support and training for the role they’re being sent into.

"The Government must ensure that there are enough nursing staff with the right training in specialist equipment such as ventilators to provide the level of critical care needed by patients who will be treated there."

Vitamin D Trial

In June, a National Institute for Health and Care Excellence (NICE) rapid evidence review found no data to support using vitamin D supplements to reduce the risk or severity of COVID-19.

Now Queen Mary University of London is starting a 6 month trial called CORONAVIT involving more than 5000 people. It will assess if correcting vitamin D deficiency over the winter will reduce risk and/or severity of COVID-19 and other acute respiratory infections.

Lead researcher Professor Adrian Martineau said in a statement: "There is mounting evidence that vitamin D might reduce the risk of respiratory infections, with some recent studies suggesting that people with lower vitamin D levels may be more susceptible to coronavirus."

Phantom App Message? Ignore It

The BBC reported how the COVID-19 tracing app for England and Wales has received a partial fix for a 'phantom message' problem.

Pop-up alerts suggesting a virus contact appeared briefly before disappearing.

That's not been stopped but a second message will now follow saying to ignore the first.

The Department of Health and Social Care blamed underlying Apple/Google notifications. However, Scotland and Northern Ireland's apps have not had the same issue.

Adapted from Medscape UK.