Covid-19 Update Tuesday 23/06/20
In the final daily Downing Street briefing Boris Johnson has announced the easing of lockdown in England. Exactly 3 months after Boris Johnson put the nation into lockdown, the 2m physical distancing rule has been reduced to 1m+ across England from July 4. This means that people should remain 2m apart where possible, but where this is not possible, the distance has been reduced to “1m plus” where people should stay at least 1m apart. The following easements in England will also be in place from July 4:
- Two households of any size can gather in any setting, including indoors, with physical distancing. The meeting does not always have to take place between the same two households; however, only 2 households should meet at any one time.
- Restaurants, pubs & cinemas can reopen with safety measures.
- Caravan parks, B&Bs and hotels can also reopen.
- Places of worship can open to congregations, but no singing will be allowed.
Sectors not reopening at the beginning of July include conference centres, salons, nightclubs, tattoo parlours, indoor gyms and swimming pools. For businesses that are able to open, Covid-secure guidance is being administered to allow companies to ensure the safety of both customers and staff. Regardless of the distance, other mitigation measures will also be in place in most sectors, such as face coverings on public transport and plastic barriers in retail and hospitality. Pubs and restaurants will be table service only, with people unable to stand at bars. Meanwhile, people are still being asked to work from home if possible.
Scotland, Wakes and N. Ireland yet to announce whether they will change their 2m distancing rule, thoughthe Scottish government announced today that all pupils in Scotland will be able to return to school full-time in August, so long asCovid-19 continues to be suppressed.
There is a calculated risk associated with all decisions to ease lockdown, which makes it important to adhere to physical distancing (1m or 2m depending on the setting), strict hand hygiene and self-isolation if symptomatic.
Naturally, there is concern that the easing of restrictions in England is coming too soon. On average, there are still >1000 cases being reported a day, which is much higher than the number of daily cases seen in other countries when they began easing restrictions. The UK is also still experiencing a comparatively high daily death toll than other countries coming out of lockdown. There is a balance to be found between public health risk and continuing damage to the economy. Scientific advisors have said that they want the 2m distance to be retained indoors and that the easing of all of the measures above is premature. Nonetheless, there is also scientific concern about health risks associated with a poor economy due to Covid-19.
In the absence of a vaccine, the world must now find a way to live alongside Covid-19. To avoid resurgence of the virus, it is imperative that you self-isolate if you become symptomatic, as this removes the virus from circulation. Chains of transmission also need to be reduced, which is why physical distancing measures are still important between members of different households in all settings. Enforcement of Covid-secure guidance remains challenging, so resurgence of the virus can only be avoided by public cooperation. Cases might be lower, but this is only as a result of the nationwide lockdown measures. It is critical that every individual, household, and firm takes the precautions seriously, otherwise the virus could once more become unmanageable. A second lockdown would be infinitely more detrimental.
Scotland, Wales, N. Ireland: Stay at home. Protect the NHS. Save lives.
Updated COVID-19 Numbers
In the UK, there have been280deaths since yesterday (171 in the past 24 hours and 109 previously unrecorded deaths from April, May and June). This means, that of those that have tested positive for Covid-19, there have been42,927deaths in the UK (2476in 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 toprovide 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.