Covid-19 Update Sunday 31/05/20
Communities & Local Government Secretary, Robert Jenrick, took today’s Downing Street briefing. He outlined changes to the shielding guidance and updates on how the risk of the virus for homeless people has been countered by the government. There was an effort to put an end to rough sleeping and remove the pressure on shelters in order to reduce transmission of the virus amongst this vulnerable group. Robert Jenrick announced that 6,000 new supported homes will be made available for rough sleepers, so that those removed from the streets will not need to return after the pandemic. 3,300 will be available within the next 12 months. Support staff will be hired for these new homes to offer physical and mental health support to those that move in. There are calls for the government to tackle the causes of homelessness throughout the UK, as this is the only way to end the rough sleeping crisis.
As for the portion of the population that are currently shielding, Robert Jenrick announced that shielding restrictions will begin to be eased. The shielding group include people of all ages with dangerous pre-existing conditions, from cancer to severe asthma. During this period, they and members of their household have had to ‘shield’, which has meant not leaving the house for any reason. Now however, the clinically extremely vulnerable (and therefore most at risk of severe illness if they contract Covid-19) will face fewer restrictions but are still not able to return to work or school. In England, vulnerable people who have been shielding throughout the pandemic will be able to go outside from Monday. Now the prevalence of the virus within the community has reduced, the government believe that they can advise those that are shielding to take initial steps to spend time safely outdoors. This means that in England, shielded people can spend time outdoors with members of their own household, or if they live alone, with one other person from another household. If people comply with physical distancing, the government believe that their updated guidance for those that are shielding is safe. Nonetheless, all the guidance is advisory, and those that are shielding must not do anything that makes them feel unsafe. From now, shielding guidance will be reviewed alongside the restrictions for the remainder of the population: the next review will be June 15. Decisions regarding those shielding across the devolved nations are yet to be announced.
Though the government announced the changes to their shielding guidance today, some health professionals have said that these changes have come “out of the blue”. There have been issues in the shielding system: some that should have been asked to shield have still not received a letter asking them to do so, whilst some others that have been shielding recently received a text message telling them that they no longer needed to do so.
Main Updates from Sunday 31/05/20
- The Association of Directors of Public Health (ADPH) have said that the easing of rules in England were “not supported by the science”. From tomorrow in England, groups of up to 6 people will be able to meet outdoors, but there are concerns as pictures of crowded beaches and tourist spots this weekend have shown that many are not abiding by physical distancing measures as it is. The president of the ADPH, Jeanelle de Gruchy, has warned that “the government is misjudging the balance of risk between more social interaction and the risk of a resurgence of the virus”. As a result, the ADPH have called on ministers to postpone easing of restrictions until the UK’s test-and-trace systems are fully established and the public resolve to comply with physical distancing and hygiene. This comes following reports that public health directors have realised that the test-and-trace systems are not currently robust enough to stop resurgence of the virus.
- There are concerns over the government’s outsourcing of tasks to private companies throughout the pandemic. Despite focus being on the achievements of the NHS throughout the crisis, the government has relied heavily on a range of companies, including Randox, Faculty, Serco, and Deloitte. Workers manning drive through test sites and now running the new ‘NHS test-and-trace’ scheme are supplied by outsourcing companies such as Serco and Sodexo. People working within local councils have expressed concerns about being left in the dark regarding a number of decisions the government has made in response to the pandemic. The privatisation of the government’s Covid-19 response has meant that some public health sectors are not receiving important information from the centralised, privately contracted operation. A decade of austerity saw the fragmentation of the NHS, the result of which has been a country inexcusably ill-prepared for a crisis, especially due to the lack of local control.
- The government has said that it has reached its goal of having capacity to carry out 200,000 tests a day. Nonetheless, tests being carried out per day remain well below that level, with 115,725 over the last 24 hours. There has also been criticism over lack of transparency about how the government are counting these tests – many patients will have multiple tests to confirm results and issues have meant that not all tests carried out have received results. Truthfully, the numbers and goals cited by the government are arbitrary. The best part of April was lost too focusing on a target of carrying out 100,000 tests per day at the expense of producing a clear and practicable strategy. Whilst capacity for 200,000 tests per day sounds like a lot, what matters more is the infrastructure to carry out all the necessary tests and to produce results quickly. This is not happening and is imperative for the success of test and trace schemes.
- The Open Rights Group (ORG) is preparing a legal challenge to England’s ‘NHS test-and-trace’ scheme. They are concerned after Public Health England (PHE) said it would retain “personally identifiable” data of those who test positive for 20 years, whilst data of those who are asked to self-isolate but do not get sick will be kept for 5 years. The ORG also highlighted that the government did not complete a legally mandated data protection impact assessment. Health Secretary Matt Hancock and those in charge of the test and trace programme have said data collected will remain entirely confidential. Meanwhile, some politicians have called for new legislation to safeguard data privacy.
Updated COVID-19 Numbers
In the UK, there have been 113 deaths since yesterday. This means, that of those that have tested positive for Covid-19, there have been 38,489 deaths in the UK (2362 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.
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.