Friday 20 November 2020

COVID-19 Coronavirus UK and World News update 20th November 2020.

 COVID-19 Coronavirus UK and World News update 20th November 2020.

The UK added 20,252 cases today and now has reported a total of 1,473,508 positive cases of COVID-19. We completed 395,436 tests yesterday. 

16,444 people were in hospital on Wednesday 18th, with 1,426 using a ventilator yesterday, 19th November. 

In the 24 hours up until 5pm yesterday, we officially reported the loss of another 511 people who have tested positive to COVID-19 within 28 days. We now very sadly have a total of 54,286 officially reported losses of life in all settings.

Country / Cases / Losses of life with COVID on the Death Certificate. 
England 1,267,276 / 54,873
Northern Ireland 49,085 / 1,105
Scotland 86,630 / 4,855
Wales 70,517 / 3,040

Rep. Of Ireland 69,802 (+329) cases and 2,018 (+8) losses of life.

There have now been a total of 57,644,523 reported cases worldwide. The number of people who have lost their lives worldwide to COVID-19 is 1,372,340. Already 39,970,534 people have recovered.

Northern Ireland Circuit Breaker from 27th November

Travel corridor update: Bonaire / St Eustatius / Saba, Israel, Jerusalem, Namibia, Northern Mariana Islands, Rwanda, Sri Lanka and Uruguay and the US Virgin Islands will be added to exempt lists (usually do not need to quarantine) for England, Northern Ireland and Wales at 4am, Saturday 21 November.

The Scottish tier changes took place at 6pm tonight. East Ayrshire, East Dunbartonshire, East Renfrewshire, Glasgow City, North Lanarkshire, Renfrewshire, South Ayrshire, South Lanarkshire, Stirling, West Dunbartonshire and West Lothian will move Tier 4. Inessential hospitality, retail, leisure etc. will be closed. Extra restrictions on gathering also apply. Check gov dot scot for more details. 

Northern Ireland will be having a circuit-breaker lockdown from 27 November to 11th December. Inessential retail, hospitality and leisure etc will close. Extra restrictions on gatherings will apply. Check nidirect dot gov for more details. 

This week's COVID19 surveillance report from Public Health England (PHE) showed that case rates have fallen amongst 20-69 year olds, but have increased in those aged over 70. They are rising pretty rapidly in the 10-19 age group too. 

The UK Government have announced £1b of 'catch up funding' for UK schools. This funding includes:
- a one-off universal £650 million catch up premium for the 2020 to 2021 academic year to ensure that schools have the support they need to help all pupils make up for lost teaching time
- a £350 million National Tutoring Programme to provide additional, targeted support for those children and young people who need the most help, which includes tutoring, a 16 to 19 tuition fund, and an oral language intervention programme for reception-aged children.
It sounds a lot, but there are over 10 million pupils in the UK, so it works out at £80 per pupil, and £240 per place in special schools, hospital schools etc. That doesn't buy very much private tuition. 

Today's indieSAGE briefing was more hopeful. There are some positive signs, but a lot of regional variation. Coming out of restrictions safely will be hard. 
We did have a little plateau in hospital admissions, then a rise, but it looks now like it's genuinely dropped a little. 
Losses of life should hopefully begin to drop next week. The increase in losses of life has partially plateaued (hopefully not reflective of the temporary plateau we saw in hospital admissions). 
Case numbers need to start dropping more quickly for a secure exit to lockdown. 
Cases are still rising in school-age children under 16, and indieSAGE will look more closely at this next week. 

indieSAGE countries that locked down and the effect its had

There was a UK COVID briefing with in-person Matt Hancock, self-isolating Jonathan Van-Tam-Damme (UK Deputy Chief Medical Officer) and self-isolating Steve Powys (NHS England). 
Average new cases each day are at 22,287, down from 24,430 a week ago. Today the ONS survey says the R rate has dropped to 1.1 at maximum and the 2nd peak is definitely flattening. 
We have 16,409 people in hospital today, and yesterday 511 people lost their lives. 
Matt tells us about vaccines and reminds us they eradicated Polio, mean we no longer fear Smallpox, and save lives from flu every year. (We don't appreciate how different our world is now due to vaccines, we are really spoilt.)
The UK is rolling out free flu jabs in England to all over 50's from the 1st December. Your GP will contact YOU. Remember catching COVID and flu at the same time doubles your chances of dying. HAVE YOUR FLU JAB. 
Matt updated us on Vaccine news (see yesterday's report). Pfizer/BioNTech have submitted a request for authorisation. That goes to the independent regulator, the MHRA. The Government has formally asked them to consider this application, and data has been submitted. 
Vaccines will be deployed fairly to all across the UK, prioritising groups at greatest risk. They will be done at Vaccination Centres, community medical centres and hospitals. If it's approved, we can start vaccinations next month, with the bulk next year. The NHS have been asked to deploy at the speed the vaccine can be produced. 
Steve Virtual Powys showed us a slide with hospital inpatients. You can see a small plateau, but we know it has popped back up in the last 3 days. It'll be next week before inpatients begins to drop. Infection rates are falling now though. 
We aren't yet in Winter. It's really critical we don't have any more patients in hospital, because we won't be able to keep up with other hospital care, and the backlog will just get bigger. 
Press asked, BAME communities are 3 to 4 times more likely to die from COVID. Will they be given priority behind the elderly, NHS/care workers and the extremely clinically vulnerable? Jon Van Virtual Tam answered that it has been considered, but age and comorbidities are actually higher risk factors and priority. We do see a much higher rate of comorbidities in the BAME community, and from a younger age, so therefore it follows that more of the BAME community will be called when this group is vaccinated. 
(Bizarrely Jon said "over" at the end of his answers. Bless.)
Press asked about Christmas. Matt says "it's still too early to tell". We still haven't made those decisions. He knows it's important we can keep people safe, but allow people to see loved ones. We are hoping for a consistent set of rules across all 4 nations. Jon Van Morrison says we all have a responsibility to behave now, get the figure down, and it'll all be safer and more possible. 
We are reassured several times that we can only go as fast as science, and if the regulator decides the Pfizer/BioNTech vaccine isn't suitable, it won't be used. 
We don't yet know exactly what percentage of the population will need to be vaccinated, as we don't yet know how much a vaccine will prevent transmission. It's impossible to tell until it's rolled out in large scale. It stops 95% of people from becoming ill with COVID, but it doesn't stop you actually inhaling and catching it. (Whether that leaves you with a window where you can pass it on is really unknown, but if it exists, it's likely to be hours at most.)
Matt says he's planning a small Christmas so far, with his father-in-law, who is in a support bubble with his family.

Mass vaccination sites are being proposed and decided upon around the UK. Derby Arena is apparently being offered up, and Charnwood Borough Council have confirmed their offices will be taken over by the MOD for around 9 months from mid-December.  

The US CDC held their first press briefing yesterday since August. They have spent the last few months being muzzled, belittled and ignored by Trump and his cohort, and have really struggled to retain credibility. They've retracted or amended several pieces of advice and information, including that COVID can be airborne. Now hopefully they'll speak freely and do the job that we all expected them to after watching all of those movies over the years - help save us from the pandemic. 
They have just published updated guidance regarding mask-wearing and Thanksgiving, and advise all Americans NOT TO TRAVEL FOR THANKGIVING.
They have a list of questions you should ask yourself before deciding "is it worth it?", which basically amount to things like "will you be travelling to an area where hospitals are already overwhelmed?", "is the journey going to put you at risk?", and "would it really be okay if you passed it on to a vulnerable relative?". (Blunt, but it's something we're all going to have to consider carefully.)

201120 PHE Surveillance Report cases

The Oxford COVID-19 Government Response Tracker (OxCGRT) is collecting information on COVID response in more than 180 countries, and unsurprisingly has discovered that the places with the lowest levels of restrictions are the places with the highest number of cases and losses of life to COVID. It's particularly clear in the USA, where the governors of Iowa, North Dakota and Utah have just imposed mask mandates for the first time since the outbreak began. North Dakota currently has the highest mortality rate in the world according to the CDC tracking.  

Bozza's Bezzie of the Week:
Home Secretary Priti Patel - after being found guilty of bullying by independent watchdogs, saying she didn't know it was bullying, and then being completely let off by Bojo without so much as a warning. 
Boris "considers this matter now closed", although she has actually officially apologised since then. She spat it out though and it was all "I'm sorry but". The head of the independent standards committee isn't impressed - he's resigned. 
Anyone else got deja vu? 

Talking of unpopular, a guy in South Australia caused a very strict 6 day lockdown and utter panic, as he claimed to have caught COVID from a pizza box, bought in a takeaway. That would be the first known case of COVID from food packaging, and there were even fears of a mutation making it extra-catchy. 
He's now confessed to actually working in the takeaway himself (possibly cash-in-hand), and he caught COVID from a security guard who works at a quarantine hotel. People who have lost work and money are furious. 
South Australian Premier Steven Marshall said today:
"The selfish actions of this individual have put our whole state in a very difficult situation." 
The South Australian lockdown allowed only 1 person to leave the house for essential activities each day. The ban on outdoor exercise was immediately lifted, and other restrictions will end early. 

Bad news for Remdesivir. The World Health Organisation have now officially stated it shouldn't be used with COVID patients:
“There is currently no evidence that it improves survival or the need for ventilation.”
Remdesivir's makers, Gilead Sciences are understandably "disappointed". It's actually had emergency authorisation in 50 countries, and looked really hopeful initially. It's plausible that it does speed recovery in some patients who are going to be very ill, but in order to work effectively, it has to be given before you can know which patients those are, and at thousands of dollars per patient, the cost very quickly mounts up. Patients given the drug have to be closely monitored for side effects, and it's almost impossible to accurately assess any benefit, as you can never know 'how poorly' someone was going to be. Risks and costs, but only flashes of hope. Shame. 

Supermarket spread UK

Over 900 members of staff working for the USA's Mayo Clinic have contracted COVID-19 in the past TWO WEEKS. 93% caught it in the community. Dr. Amy Williams, dean of clinical practice is quoted in 'Twin Cities' as saying: 
“It shows you how easy it is to get COVID-19 in the Midwest.”
“Our staff are being infected mostly due to community spread, and this impacts our ability to care for patients. We need everyone in the communities we serve to do their part to limit the spread of COVID-19.”
The clinic is mainly based on 3 sites, and when you add in staff self-isolating or caring for vulnerable family members, the Rocester site is missing 1,000 employees. Their ICU is full, and further rooms are being adapted to accommodate extra beds. It's not all great in the USA right now.

The UK's RECOVERY Trial is getting some great results which are benefitting medics and patients worldwide, and the latest is Tocilizumab. This is an anti-inflammatory which targets the specific parts of the immune system that can go into overdrive in some patients with coronavirus. While the virus itself can do significant harm, it's the bodies own over-reaction to that threat which is more likely to lead to death. 
Tocilizumab has such a clear benefit that they believe they have enough evidence already. It's unclear yet exactly whether it actually saves lives or just speeds up recovery, and data will take a while to collate, but this one does look really hopeful. Scientists are urging caution because other studies haven't seen such a big effect. Although Tocilizumab trials have ended, information will still be gathered from patients given the treatment, so even after these final trial results are published, there'll still be much more to learn. 

The UK's RECOVERY Trial is currently testing: 
- Low-dose Dexamethasone (now only recruiting children - trial stopped early in adults as benefits proven)
- Azithromycin (a commonly used antibiotic)
- Tocilizumab (an anti-inflammatory treatment given by injection - trial stopped early as benefits proven)
- Convalescent plasma (collected from donors who have recovered from COVID-19 and contains antibodies against the SARS-CoV-2 virus)
- REGN-COV2 (a combination of monoclonal antibodies directed against coronavirus) Also known as Regeneron, Trump's 'miracle' cure. 
- Aspirin (commonly used to thin the blood). 

Alcohol Awareness Week 191120

Adar Poonawalla, CEO of the world's largest vaccine maker, the Serum Institute of India, has said the Oxford University/astraZeneca COVID-19 vaccine could be available by January-February 2021 to frontline workers in India, and to the general public by March-April. A dose will cost $5-6 (Rs 370-450 / £3.56- £4.57) with a maximum retail price of Rs 1,000 (£10.16) for two doses.

John Curtis, a taxi driver from Romford, has become the first patient in England to receive a transfusion of convalescent plasma, and then donate one himself. His donation could even be particularly fabulous, as he was very ill, and the plasma has his antibodies and a few remaining antibodies from his donor. 
"Men who needed hospital treatment for COVID are more than three times more likely to have high enough antibody levels than men who had the virus but did not need hospital treatment." Professor David Roberts.
If you were hospitalised with COVID and are now fully recovered, please consider donating plasma for someone else. Donations are taken at NHS Blood and Transplant’s 23 blood donor centres around the country, and at pop-up plasma donor centres. 5 are already open and 14 more are opening in November and December. Google NHSBT Plasma Donors. You could save a life. 

We have hopeful news this week, and all of the vaccine candidates are giving better results than we expected back in Spring. We ARE getting there. We may have another 6 or 9 months to go before we can stand in a queue without a mask again, but we can see an end, and this time next year it's more than likely you'll be choosing what outfit you'll be wearing for the Christmas do, and I'll be feeding my family their tea at a decent hour! 

Have an excellent weekend. Have a break, spoil yourself. Stay Well, Do NOT Give Up Now, Save The NHS. 

Some numbers. All with pretty much the same hope and dreams as you:

Countries / Cases / Losses of life (some countries / states /provinces yet to report):

USA 12,145,938 (+72,688) 259,130 (+797)
India 9,047,936 (+43,611) 132,732 (+530)
Brazil 5,987,219 (+4,130) 168,218 (+77)
France 2,086,288 not yet reported today 47,127
Russia 2,039,926 (+24,318) 35,311 (+461)
Spain 1,589,219 (+15,156) 42,619 (+328)
UK 1,473,508 (+20,252) 54,286 (+511)
Argentina 1,349,434 not yet reported today 36,532
Italy 1,345,767 (+37,242) 48,569 (+699)
Colombia 1,225,490 not yet reported today 34,761
Mexico 1,019,543 (+4,472) 100,104 (+576)
Peru 943,917 not yet reported today 35,446
Germany 895,304 (+17,095) 13,990 (+202)
Iran 828,377 (+13,260) 43,896 (+479)
Poland 819,262 (+22,464) 12,714 (+626)
Plasma Donation -

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