UK COVID-19 Weekly: GP's tributes, kids' school risk

  • Tim Locke, Medscape.com

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

Tributes to Welsh GP

Tributes have been paid to GP Dr David Wood from West Shore Surgery in Llandudno who died recently after testing positive for COVID-19.

The 74-year old had been diagnosed with cancer in December but continued working until lockdown in March.

In 2012 Dr Wood was awarded the MBE for services to education and training in general practice, and to the community in North Wales.

Friend and colleague Dr Mike Bloom told the Daily Post: "He had a great reputation as a GP. His patients really loved him, and he had so much empathy and understanding for them.

"He was such an experienced doctor, who kept up-to-date with everything and was very supportive. He's a huge loss."

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

Primary School 'No Riskier Than Home'

Going to preschool or primary school is no riskier for young children than staying at home, according to preliminary results from new research for Public Health England.

In June and July there were only three positive cases, a child and two staff, out of 12,026 people tested in the COVID-19 Surveillance in School KIDs (sKIDs) study.

Levels of antibodies detected were similar in both staff and students and children and staff who attended school more frequently were no more likely to test positive for antibodies than those who did not attend school or who went less often.

Secondary schools and colleges were not included in the study.

Dr Shamez Ladhani, PHE consultant epidemiologist, commented: "Although these results are preliminary, they should be very reassuring to parents who may be anxious about their children returning to school.

"As has been found in previous research, infection within educational settings is extremely low, and while it appears that children do contract COVID-19, the overwhelming majority experience mild or no symptoms, and are unlikely to pass it on."

Public Health Concerns

More than 100 health groups, including the Association of Directors of Public Health, the Faculty of Public Health, the Royal Society for Public Health, the Academy of Medical Royal Colleges, and the BMA, issued a joint statement raising concerns over the abolition of Public Health England.

"Reorganisation risks fragmentation across different risk factors and between health protection and health improvement. Organisational change is difficult and can be damaging at the best of times and these are not the best of times. A seamless transition from the current to the new system is essential" the statement published in The BMJ said.

Test and Trace

England's Test and Trace programme delivered its weekly update for 20 to 26 August showing a 6% rise in positive tests against a background of a 1% fall in people tested.

Of those transferred for contact tracing, 81.4% were reached and asked to provide information about their contacts compared to 75.2% in the previous week.

Of those close contacts,  69.4% were reached and asked to self-isolate, compared to 77.1% in the previous week.

More than 3 out of 5 non-complex contacts were from the same household as the case they were identified from.

Meanwhile, the BMA responded to reports of people being sent long distances for testing.

"It’s ludicrous that people are being directed so far from their homes for testing," said Public Health Medicine Committee Chair Dr Peter English. "In some cases, it means driving for 3 hours – and back – which is completely inappropriate at the best of times, let alone for someone who may be ill with COVID-19 symptoms. Travelling such distances are expensive, and that’s if individuals have access to a car at all."

England's Health Secretary Matt Hancock said testing was being focused on outbreak areas where cases were higher.

ONS Infection Survey 

The latest results from the Office for National Statistics Infection Survey show around 27,100 people within the community population in England had COVID-19 between 19 to 25 August. That equates to around 1 in 2000 individuals.

There were around 0.36 new COVID-19 infections for every 10,000 people per day, equating to around 2000 new cases per day.

Heather Bovill from ONS commented: "For another week, our evidence suggests that the level of infections and people who currently have COVID-19 in the community has continued to level off.  Through analysing blood samples from a section of our participants, we believe that around 1 in 17 people in England have COVID-19 antibodies and are therefore likely to have had the virus at some point."

Latest UK-wide data show daily cases continue to rise against a background of increased testing. However, hospital admissions and deaths remain mostly flat.

R Number

The UK's R number remains at 0.9-1.1 and the growth rate is -1% to +2% per day.

  • R in England as a whole is 0.9-1.0 but higher in London (0.9-1.1) and the South West (0.8-1.1).

  • R in Northern Ireland is 1.1-1.6

  • R in Scotland is 0.9-1.4

  • R in Wales is 0.5-0.9

New Testing Tech 

Government funding in England has been announced for expanded trials of a 20 minute COVID-19 test as part of a £500m package. Existing community-wide testing pilots in Southampton and [elsewhere in] Hampshire will be expanded.

A new saliva test trial in Salford will look at the benefits of repeat population testing.

Baroness Dido Harding, interim executive chair of the National Institute for Health Protection, commented: "New testing technologies and methods are vital to keep the system evolving and improving, especially as we assess how routine testing could help pick up cases of the virus earlier."

ONS Data on Home Deaths

The latest data from the Office for National Statistics (ONS) show non-COVID-19 deaths of people in their own homes were above 5-year average levels. However, since the week ending 26 July there were below-average levels of non-COVID-19 deaths in hospitals.

ONS commented: "Some of these deaths at home may be people who would have otherwise died elsewhere, particularly in hospitals, where we see much lower levels of mortality than is usual for the time of year. This could indicate patients are not being admitted to hospital or being discharged sooner. For deaths at older ages, it could be that individuals choose to die at home rather than be admitted to hospital."

Growing Evidence for Steroids 

Administering steroids to people critically ill with COVID-19 appears beneficial and could be lifesaving for some, a new meta-analysis and multiple related studies suggest.

Critically ill patients who received systemic corticosteroids were 34% less likely to die over 28 days, for example, compared with others who received usual care or placebo in a prospective meta-analysis of seven randomised controlled trials. 

The meta-analysis was published online in JAMA and the World Health Organisation also issued Living Guidance on corticosteroids for COVID-19.

Lead author Jonathan Sterne, University of Bristol, stressed the importance of the positive UK RECOVERY trial data: "The signal seen in this trial led most ongoing trials of corticosteroids to suspend recruitment."

COVID-19 and Pregnancy

Pregnant women with COVID-19 are less likely to show the major symptoms of infection with SARS-CoV-2 than non-pregnant women of similar age, according to research published in The BMJ.

However, the study involving the University of Birmingham found they might be more at risk of admission to a hospital intensive care unit.

Preterm birth rates were also found to be higher amongst pregnant women with COVID-19 than pregnant women without the disease.

Pre-existing comorbidities were noted as significant extra risk factors for severe COVID-19.

Suicide Numbers

The fact-checking charity Full Fact pulled up England's Health Secretary Matt Hancock on his claim in the Commons that the rate of suicides dropped during the pandemic: "Some cautiously positive news announced today ​by the Office for National Statistics shows that the number of suicides during the peak of the pandemic was down from 10.3 per 100,000 to 6.9 per 100,000."

Full Fact responded: "This is not correct. These figures show deaths registered during this period, not deaths occurring. Most of these suicides took place before 2020, and the ONS has said lower registrations are likely due to the impact of the pandemic on the coroner’s service."

Travel Restrictions

Scotland and Wales introduced separate quarantine restrictions for travellers than England and Northern Ireland this week.

Those returning to Scotland will have 14 days of self-isolation if they’ve been to Greece, for Wales it only applies to certain Greek islands.

Portugal was only taken off the UK-wide quarantine list on 22 August. It is now back on the list for Wales and Scotland.

Scotland's Justice Secretary Humza Yousaf commented: "We are in the midst of a global pandemic and the situation in many countries can change suddenly. Therefore, people should think very hard before committing to non-essential travel abroad."

Adapted from Medscape UK.