Covid-19 Update 27/05/20
The prime minister faced questions from senior MPs about his handling of the pandemic and his continued support for Dominic Cummings, his senior adviser. Questions came from members of the government’s Liaison Committee, made up of Chairs from parliament’s Select Committees. This is the first time the prime minister has faced the Liaison Committee, which usually meets 3 times a year to scrutinise the government.
Many questions revolved around the government’s new test, track and trace system in England (NHS Test and Trace), which will ask a member of the public to self-isolate if they have been in close contact with someone with Covid-19. When questioned by the Liaison Committee today, Boris Johnson said that this isolation period would not be legally enforced; however, he suggested that this might be reconsidered dependent upon public compliance. The system will be more effective if tests were made more widely available, so that anyone asked to isolate could get tested immediately so that they need notquarantine unnecessarily. Boris Johnson said that tests would be made available to those with symptoms that have been asked to self-isolate; however, he said that if someone is asymptomatic, they must self-isolate for 14 days without having access to a test. The prime minister said that this was because asymptomatic people might still be infectious, but would not necessarily test positive; however, there are questions as to whether this is more due to the capacity of the NHS Test and Trace. In countries with the most successful test and trace schemes, such as North Korea, everyone is tested, and results are returned in less than 24 hours.
Reports today suggest that many of England’s 25,000 contact tracers have had cursory training and that there has been a lot of conflict between the NHS, public health experts, local councils and central government. Further, the contact tracing app that Matt Hancock had previously said would be ready to roll out mid-may is still not available, with no confirmed updated release date. The NHS Test and Trace scheme is imperative if the country is to overcome the its epidemic. In today’s daily Downing Street briefing, Matt Hancock said that it was a “civic duty” to isolate if told to do so. The NHS Test and Trace has 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.
Nicola Sturgeon has confirmed that Scotland’s equivalent, “test and protect” strategy, will begin tomorrow. This system is largely the same as England’s NHS Test and Trace, 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. As in England, contacts will be asked to self-isolate even if they have no positive symptoms or a positive test result.
Scotland, Wales, N. Ireland: Stay at home. Protect the NHS. Save lives.
England: Stay alert. Control the virus. Save lives.
Main Updates from 27/05/20
- The test, track and trace systems in Scotland and England begin tomorrow, with 2000 contact tracers in Scotland and 25,000 in England.The N. Ireland scheme is up and running, with the Welsh equivalent due to begin next week.The contact tracers will primarily work in call centres, where they will phone those who have tested positive for the virus and ask them with whom they have been in contact. The schemes rely on public good will and voluntarily adherence to isolation when requested to do so.
- Eligibility for testing has increased to include those aged under 5 that have symptoms. This now means that every member of the population exhibiting Covid-19 symptoms is now eligible for a test.
- Localised lockdowns may be used in England as part of the government’s test, track and trace system, in an effort to minimise the risk of subsequent outbreaks. This would mean that any area experiencing a spike in cases would have more restrictions placed upon it. Test and contact tracing systems will allow the government to place specific areas in lockdown, instead of the whole country. Nonetheless, this will rely on the public adhering to the specific restrictions, which will be harder to police if there are regional differences.
- Many patients on the UK’s ‘shielding list’ have received a text telling them that they no longer need to shield and would therefore no longer be eligible for government food parcels. The text has caused alarm, as many receiving it had not been contacted by their clinician in advance. NHS England wrote to doctors on April 10 asking for them to review their lists of shielded patients, but the patients removed from the list should have been contacted by their GP to explain the decisions. The situation has caused a lot of confusion, as many who have been shielding for the entirety of lockdown have received no explanation as to why they are now able to go outside. Patients that received the text include those with cancer, severe asthma and liver disease.
- Over 40 conservative backbenchers have now called for Dominic Cummings to resign or be sacked.
Updated COVID-19 Numbers
In the UK, there have been412deaths since yesterday. This means, that of those that have tested positive for Covid-19, there have been37,460deaths in the UK (2304in 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
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 points 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.
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)
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.