Covid-19 Update 04/06/20
Throughout the UK’s epidemic, parliament has been operating under a “hybrid” system in which some MPs have attended parliament in person, whilst others have taken part via video link and votes have been carried out online. The government has decided to stop this and insists that all parliamentarians return in person, whilst practicing physical distancing measures. This has been criticised, as under current restrictions, attendance is harder for those that are shielding and those from more distant constituencies. Further, due to physical distancing, not all MPs will fit in the chamber and votes will take much longer. Now, the Commons has now backed government concessions that will allow MPs who can’t attend parliament for health reasons to continue to question the government via video link and also to cast votes by proxy. This will only be possible for MPs that are clinically vulnerable. Many remain unhappy that the majority are still expected to attend in person. A debate is due to take place on Monday to allow MPs to continue to attend via video link.
At today’s Downing Street press briefing, Transport Secretary Grant Shapps said that face coverings would be mandatory on English public transport from June 15. This is the date when the next set of restrictions are due to be eased in England, with the reopening of non-essential shops. As it is harder to practice physical distancing on public transport, face coverings will be enforced by transport operators and the police. Wearing a face covering will be a condition of travel, so passengers will be unable to take their journey if not wearing a suitable covering. People are still being asked to primarily stay at home, including working from home where possible. This means avoiding public transport where possible, as it does not have capacity to cope under physical distancing restrictions. Fewer people should be travelling, but those that are still commuting are being asked to use their own cars, walk, or cycle. Though face coverings are being made mandatory, they do not mean that it will be safe for more people to use public transport – research regarding the effectiveness of face coverings remains contradictory; therefore reducing contact still remains the best way to minimise transmission.
Main Updates from Thursday 04/06/20
- A research misconduct scandal is unfolding at a global scale. A US company, Surgisphere, said it had data from over 96,000 Covid-19 patients from 671 hospitals worldwide. This data was used to inform research and subsequently, studies on Covid-19 have been published based on Surgisphere’s database. Surgisphere’s credibility has been called into question in recent days, as well as Sapan Desai’s background. When the scientific papers resulting from these data were to be reviewed, an independent audit company was denied access to the full database by Surgisphere’s CEO, Sapan Desai. As a result, reviewers that have to scrutinise all scientific publications were unable to conduct peer review of the papers. The most notable impact of this possible misconduct has been on a study recently published in The Lancet regarding the impact of hydroxychloroquine treatment on the outcomes of Covid-19 patients. The lead author, Professor Mandeep Mehra, used Surgisphere’s data to form his publication, but then ordered the independent audit of the company’s database once questions were raised about its accuracy. Failure of Surgisphere to comply with the audit led to Prof Mehra seeking a retraction, as scientific integrity meant that he could not allow his work to remain published if there were doubts regarding the accuracy of its foundation.
- The third Gavi vaccine alliance summit was opened today, taking the form of a virtual pledging event hosted by the UK. The vaccine alliance works to immunise millions worldwide against endemic infectious diseases, such as measles. Today, $8.8bn was raised for the continuation of this work. During the summit, a $2bn procurement fund was also announced, which will allow poorer countries to have access to doses of a coronavirus vaccine if one becomes available. If an effective vaccine is developed, global cooperation will be necessary to ensure that it is distributed fairly. If developing countries are not afforded the same access to a vaccine as richer countries, the risk of SARS-CoV-2 becoming endemic and never being eradicated remains high. The worldwide fight for PPE and ventilators at the start of the pandemic makes the likelihood of countries offering support for poorer nations seem small. Gavi’s procurement fund will provide guarantees for candidate vaccines and investment in manufacturing capabilities, to increase supply availability, which should indirectly benefit developing countries by shortening the queue.
- The levels of CO2 in the atmpsphere have reached a new peak this year, in spite of global lockdown. Without lockdown, the peak would have likely been higher; however, the difference caused by the pandemic is too small to overcome the other causes of yearly fluctuations. The build up of CO2 continues even when emissions fall overall. In early April, daily emissions fell by an average of 17% globally, but as lockdowns are eased, the annual fall is predicted to only be between 4 and 7%. At this trajectory, the ability to meet the goals of the Paris agreement has not been noticeably improved worldwide.
- England’s NHS Test and Trace scheme is not expected to be operating at the promised “world-beating” level until September or October. The chief operating officer of the scheme, Tony Prestedge, said that he expected the scheme to run for 24 months and that turnaround times for tests would initially be 2 to 3 days, but should improve in time.
- The business secretary Alok Sharma is self-isolating and has been tested for Covid-19 after developing symptoms on Tuesday. The minister spent time with Boris Johnson and Rishi Sunak at No 10 the day before becoming unwell, but the government has stated that physical distancing was practiced, so it seems unlikely that the prime minister and others in attendance will need to self-isolate. The results of his Covid-19 test have not yet been confirmed.
Updated COVID-19 Numbers
In the UK, there have been 176 deaths since yesterday. This means, that of those that have tested positive for Covid-19, there have been 39,904 deaths in the UK (2395 in Scotland).
Another reminder that the figure is an under-report due to a reporting delay – as deaths can take up to 10 days to report, we are likely underestimating the steepness of the curve each day (i.e. on 30th March, NHS England reported 159 deaths in the 24 hours to 5pm on Sunday 29th March; however, this number was revised up to 463 5 days later and could still be updated again). Note – the government are now reporting death figures of those that have died in hospitals, care homes and the wider community, though the reported deaths still only include those who had tested positive for the virus. The numbers WILL be an underestimate.
When comparing countries, it is important to remember huge differences in population and demographics.
Further, daily counts are volatile, so need some smoothing to see any real underlying trends. World in Data uses a rolling 7-day average and looks at deaths per million for accuracy: https://ourworldindata.org/grapher/daily-covid-deaths-per-million-7-day-average
Previous Important Information
The list of Covid-19 symptoms recognised in the UK: The full list of symptoms: loss of smell, loss of taste, a new continuous cough and a high temperature.
Before restrictions can be adjusted, the government has highlighted 5 tests that they need to be confident of:
- That the NHS is able to provide sufficient treatment across the UK
- There is a sustained and consistent fall in daily death rate, showing that we have moved past the peak
- There is reliable data showing that the rate of infection is decreasing
- The operational challenges (including supply meeting demand of testing and PPE) now and in the future are manageable
- There is no risk of resurgence and second peak that overwhelms the NHS
A second lockdown would result if restrictions are lifted too soon. This would have serious outcomes on the economy and public health.
Tests are available at nhs.uk/coronavirus or by dialling 119. Everyone with symptoms is eligible.
4 acceptable reasons to leave home:
- Necessary shopping (food), though this should be limited
- Medical need (i.e. travel to hospital for treatment)
- To provide care (only if strictly necessary)
- For exercise outside, such as a run or cycle (only once per day, individually or with members of your household)
Track and Trace Systems
The English “NHS Test and Trace” system and Scotland’s “Test and Protect” scheme are vastly similar. There are 3 steps if you have Covid-19 symptoms:
- Start isolating (7 days for the individual with symptoms, 14 days for the household).
- Book a test
- If results are negative – the individual and household stop isolating if everyone feels well. If results are positive – share contacts via the NHS Test and Trace and continue to isolate.
If you have been in close contact with someone who tests positive for Covid-19:
- You may be alerted by NHS Test and Trace
- Isolate for 14 days after that close contact
- If you develop symptoms, book a test, and isolate the entire household for 14 days.
- If the test is negative, the household stops isolating, and the individual completes their 14-day isolation.
- If the test is positive, you begin a new 7-day isolation and your household completes a 14-day isolation.
Scotland’s First Minister defined a “close contact” as people within your household, people with whom you have had face-to-face contact and people with whom you have been within 2 metres for 15 minutes or more. Nicola Sturgeon also confirmed that self-isolation requires only leaving the house for a Covid-19 test, so an individual should not leave home for exercise or to obtain food or medicine.
A reminder that face coverings are thought to be helpful in reducing the transmission of the virus from the person wearing it to others, NOT the other way around. Issues with the face coverings becoming contaminated themselves and limited effectiveness means that a covering will not effectively protect a wearer from contracting the virus. A face covering is helpful in reducing transmission from someone already infected with Covid-19, by reducing the spread of aerosol droplets. You are protecting others in case you are infectious without realising, you are not protecting yourself. Hand washing and physical distancing remain the best ways to protect yourself.
Remember: even if you are not ill, you can still transmit the virus and of course, you can contract the virus. Even if you are not classified as “vulnerable”, you are able to transmit the virus, which will increase the impact on the NHS.
The original advice around hygiene, handwashing and social distancing still applies.
Please also see previous update documents.
- An app, the ‘COVID Symptom Tracker’, is available for the general public to download. The idea is for people to check-in each day whether you have COVID-19 or not – this will let researchers study the symptoms of the virus and track how it spreads. The app was designed by King’s College London, Guys and St Thomas’ Hospitals and a health science company (ZOE Global Ltd). It is available on Android and Apple devices. Please download and spread the word – all data (even negative) is of huge importance in the global fight against COVID-19.