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UK COVID-19 Update: Vaccination Phase 2, 'No B.1.1.7 Increased Disease Severity'

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

Vaccination Phase 2

The target to offer COVID-19 vaccination to all over-50s and priority groups 1-9 has been met 3 days ahead of time. 

NHS England Chief Executive Sir Simon Stevens said: "Vaccinating 19 out of 20 people aged 50 and over is an incredible milestone."

The programme moved on to appointments for those aged 45 and over today, which crashed the booking site for some people.

Credit: PA Media

The JCVI also published its advice to governments and the NHS on vaccination of under-50s.

It stuck to an age-based approach starting with those aged 40-49, then 30-39, and 18-29. It also endorsed "operational flexibility" in delivery of the programme for low-uptake groups, storage issues, and avoiding wasted doses.

The UK's health ministers have agreed to follow the recommendations.

In other vaccine news:

  • England became the latest part of the UK to begin delivering the Moderna vaccine at more than 20 sites, including the Madejski Stadium in Reading and the Sheffield Arena.
  • Ireland's National Immunisation Advisory Committee is no longer recommending the Oxford/AstraZeneca for under-60s or those with higher-risk medical conditions.
  • The US CDC and FDA are recommended pausing the rollout of the Johnson & Johnson’s vaccine after six clotting cases "out of an abundance of caution". The company said it is delaying the rollout of the jab in Europe.
  • The South African variant may partly evade protection from the Pfizer/BioNTech jabs, according to real-world data in a preprint from Israel.
  • Two recent articles in The NEJM pointed to platelet factor 4 (PF4) as a causal link to severe thrombotic complications after Oxford/AstraZeneca vaccination.

B.1.1.7 More Transmissible, No Increased Disease Severity

The UK virus variant is more transmissible but does not increase disease severity or risk of death, according to an observational study of patients in London hospitals published in The Lancet Infectious Diseases.

Dr Julian Tang, honorary associate professor/clinical virologist, University of Leicester, commented via the Science Media Centre: "It's a relief that my former UCL/UCLH colleagues have finally debunked the idea that the B.1.1.7 variant causes more severe disease."

A second study in The Lancet Public Health based on Zoe COVID Symptom Study app data found that "there was no apparent increase in the reinfection rate, vaccines are likely to remain effective against the B.1.1.7 variant".

Meanwhile, surge testing is being deployed in Wandsworth and Lambeth in south London where 44 confirmed cases, and 30 probable cases, of the South African variant have been detected. Dr Susan Hopkins, chief medical adviser, Test and Trace said the cluster of cases "is significant".

The Department of Health and Social Care said it was "the largest surge testing operation to date".

Scotland's Lockdown

Travel restrictions within Scotland will be eased from Friday, ahead of schedule, and six adults from up to six households will be able to meet outside, First Minister Nicola Sturgeon announced today.

She said she was "extremely confident" further measures could be eased on April 26, including for shops and hospitality.

Prime Minister Boris Johnson conceded today that easing lockdown will increase mortality.

"As we unlock, the result will inevitably be that we will see more infection, sadly we will see more hospitalisation and deaths," he said.

Deaths

Office for National Statistics (ONS) data show weekly registered deaths in England and Wales to 2 April were below the 5-year average for the fourth week in a row and were the lowest for 6 months. However, ONS said the data were affected by the Easter bank holidays.

COVID-19 accounted for 4.9% of all deaths compared with 7.2% the previous week.

There's been a total of 151,313 UK deaths with COVID-19 mentioned on the death certificate.

Deaths within 28 days of a positive test stand at 127,100.

4.64m 'Missed Out on Hospital Treatment' Last Year 

The Guardian reported on Health Foundation data that show the number of patients having elective operations in England last year dropped by 4.64 million.

GPs referred six million fewer people for diagnostic tests and hospital treatment.

The Health Foundation estimates millions of "missing patients" could make the overall NHS waiting list grow to 9.7 million by 2024 as people begin seeking treatment after the pandemic.

Meanwhile, Dr Adrian Boyle, vice-president of the Royal College of Emergency Medicine, told the Independent that emergency departments face a return to dangerous overcrowding within weeks, along with long ambulance waits. He blamed a wider NHS "system failure" to support patients.

COVID & Cancer Mortality

Imperial research published in The European Journal of Cancer found UK cancer patients were 1.5 times more likely to die after being diagnosed with COVID-19 than patients from Italy, Spain, France, Belgium, and Germany.

The study looked at 924 patients from EU countries and 468 from the UK. Patients in the UK had higher case fatality rates (40.38% vs 26.5%), and higher risk of death at 30 days.

The authors concluded: "UK cancer patients have been more severely impacted by the unfolding of the COVID-19 pandemic despite societal risk mitigation factors and rapid deferral of anticancer therapy. The increased frailty of UK cancer patients highlights high-risk groups that should be prioritised for anti-SARS-CoV-2 vaccination."

Carabao Cup

The Manchester City vs Tottenham Carabao Cup final at Wembley will be a pilot event for fans returning to grounds. However, those classed as clinically extremely vulnerable, and their households, are excluded.

The SpursAbility disabled fans group said the policy was "direct discrimination" and pointed out that vulnerable groups have already been offered vaccination and may be at less of a risk than unvaccinated groups.

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

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