Thursday, 21 January 2021

COVID-19 Coronavirus UK and World News Update 20th / 21st January 2021.

COVID-19 Coronavirus UK and World News Update 20th / 21st January 2021.

The UK added 37,892 cases today and now has reported a total of 3,543,646 positive cases of COVID-19. We completed 640,856 tests yesterday. 

The counter says 4,973,248 people had been given at least one dose of a vaccine in the UK by midnight last night, and 464,036 are fully vaccinated. 

38,676 people were in hospital on 19th, with 3,953 using a ventilator yesterday, 20th January. 

In the 24 hours up until 5pm yesterday, we officially reported the loss of another 1,290 people who have tested positive to COVID-19 within 28 days, making a total of 94,580 losses of life in all settings.

Country / Cases / Losses of life / Losses of life per 100,000 population.
Wales 185,035 / 5,399 / 171.2
Scotland 168,219 / 7,070 / 129.4
Northern Ireland 98,351 / 1,975 / 104.3
England 3,092,041 / 81,379 / 144.6

Rep. Of Ireland 179,324 cases and 2,768 losses of life. (Not yet reported today.) 

There have now been a total of 97,601,280 reported cases worldwide. The number of people who have lost their lives worldwide to COVID-19 is 2,090,444. Already 70,097,292 people have recovered.

House parties new fine £800 UK Government

The latest REACT random study data for 6th to 15th January suggests in most English areas cases were still rising. We are still seeing the effects of Christmas, but with a 3 week old lockdown you'd hope for some positive signs. On 15th January more people in the UK had COVID than in mid December - not good news.
The hopeful news is that since the 15th Jan we are beginning to see daily reported cases drop, so fingers crossed that the last week made all the difference...
The main findings from the eighth REACT study (6-15 Jan) show:
- national prevalence increased by 50% from 0.91% in early December to 1.58%, or 158 out of every 10,000 people infected
- national R was estimated at 1.04
- regional prevalence was highest in London where it had more than doubled from 1.21% to 2.8%. It had also more than doubled in the South East (0.75% to 1.68%); East of England (0.59% to 1.74%); and West Midlands (0.71% to 1.76%). It increased in the South West (0.53% to 0.94%) and North West (0.92% to 1.41%). There was a decrease in Yorkshire and The Humber (1.39% to 0.84%). It was stable in the East Midlands (1.04% to 1.16%) and North East (1.26% to 1.18%)
- prevalence increased nationally in all adult age groups and was highest in 18 to 24 year olds at 2.51%. Prevalence in the over 65s more than doubled from 0.41% to 0.94% 


It turns out Priti Patel, UK Home Secretary,  wanted to close the borders back in March 2020, but was over-ruled. Shame...
(Yet again it's a female who called for strict measures, sadly in our case she didn't get them.) Had we closed the borders the instant we knew there was a problem in Italy during February half term, we may have had a very different year...

UK Education Secretary Gavin Williamson has said on the telly today that he will give as much notice as possible before reopening English schools to all pupils, and that will be at least 2 weeks. 

Vaccines don't affect fertility UK NHS ad with smiling lady and text

There was a UK briefing today with Priti "I wanted to close the borders a year ago, Grrr" Patel. alongside were Dr Vin Diwakar, NHS Regional Medical Director for London, and Martin Hewitt, Chair of the Police Chiefs Council.

200 people are being vaccinated every minute.

Priti says, with her backing, the Police WILL enforce breaches of COVID regulations. Because a few people are spoiling it (and making everything take longer!) by breaking the rules, from next week a new fine will be in place. Anyone found attending a house party will be liable to an £800 fine. This will double for each repeat offence, to a maximum £6,400 and will apply at any gathering of more than 15 people in homes.
"The science is clear" it places everyone and the Police who have to attend at risk. (There are thousands of examples of sorry, or dead, party-goers on the internet.)
Martin says he hopes increased fines will act as a deterrent. "Personal decisions are critical. That remains the case today. The death figures in recent days are shocking and I urge everyone to take notice."
(Remember the Police are also the people who have to attend every home death - they are not having a great year.)
"This is about saving lives."
From August until 17th Jan, 250 fixed penalty notices with a £10,000 fine have been issued in England to people for large gatherings. In future all those in attendance will also be fined £800.
He gives examples and talks about police injuries from assaults, and police contracting COVID in the course of their work. 1,688 emergency services workers have been assaulted in the last 6 months. 

Vin talks about new venues offering vaccinations today - including pharmacies and GP's, a Mosque, football stadia etc. He says "if you are called for the vaccine, please come forward. It could save your life" and thanks religious leaders for speaking out against anti-vaxxer's campaigns.

Public asked about the super long term and 'can't we manage this with annual vaccines like we do the flu'. Well, obviously that is a possibility... he didn't get an answer.

A teacher asked why he had to have so many kids in his school with the broadening of 'keyworker' status (see below for stats). Priti just stated facts and did a really bad job of making any sense. Vin thanked keyworkers and talked about school guidance. Not an answer.

Northern Ireland has extended their lockdown until March 5th. Press asked is that possible/likely here? Priti referred to the number of people in hospital and dying and the fact we are currently under lockdown. "It's too early to even speak of other measures". I agree. She talked about mutant strains and safeguarding delivery of the vaccine.

Vin says we ARE seeing some glimmers of the effect of the lockdown. It's not yet fed through to intensive care, but the pressure on 999 services is very slightly less. Hopeful signs.

Press asked about booking foreign Summer holidays. Priti is getting justifiably annoyed now. "It is far too early to speculate around restrictions such as the point you've just made, booking a holiday...we have thousands of people in hospital... people should not be travelling unless it is critical and essential."

Press asked should we make restrictions tighter, and also about borders being secure against new virus strains? Priti talked about policing and fines, and says it's under constant review. Didn't really mention borders.

Martin says Police aren't 'blaming the public'. "The vast majority of people are doing their level best." He is most annoyed about those people going out of their way to break the law completely irresponsibly (organising massive parties with sound systems, decks, lighting etc).

Stupid press asked again about foreign holidays. Priti leapt through the screen and scratched his eyes out. She actually didn't, she was very controlled. She reminded us again about all of the dead people and repeated it's too early to even speculate. Vin backed her up. He reckons you can only make decisions a maximum of 2 weeks in advance and that's on projections which might not happen, so it's always subject to change.

Press asked about enforced hotel quarantine for UK arrivals (this is incredibly common worldwide), Priti didn't really answer.
Press asked about Police being immunised before 50-60 year olds, Priti says the priority has been decided (based on preserving life). Martin didn't actually say he disagreed with the Government, but he pointed out it's not handy to have lots of Police off work isolating/sick, and he'll fight to ensure Police are immunised when they should be.
Vin went off on one about how he trusts the vaccines and would have one himself. He talked about studies. (I think you guys probably already have a far better idea than most already.) He's obviously a little exasperated this week.
Apparently our vaccine programme is "world-class". It's pretty impressive. We are doing very well relative to the world average. Sadly we are also currently losing more people than anyone else in the world, on average, so we really need it to be. 

WHO Africa Update 190121 lists all countries in Africa, alongside cases and losses of life

India have started exporting the Covishield (Oxford / AstraZeneca) vaccine, in the most equitable way imaginable: 
"The Government of India has received several requests for the supply of Indian manufactured vaccines from neighbouring and key partner countries. In response to these requests, and in keeping with India’s stated commitment to use India’s vaccine production and delivery capacity to help all of humanity fight the Covid pandemic, supplies under grant assistance to Bhutan, Maldives, Bangladesh, Nepal, Myanmar and Seychelles will begin from 20 January 2021. In respect of Sri Lanka, Afghanistan and Mauritius, we are awaiting their confirmation of necessary regulatory clearances."
India plan to continue to assist less wealthy countries, while maintaining stocks for domestic use, and for paid orders, as well as their commitment to the World Health Organisation's COVAX initiative. (India saves the world.)

But... disastrously there has been a truly massive fire today at the Serum Institute of India's vaccine manufacturing plant in Pune, India.
They assure us COVID vaccine production won't be affected as the fire is in a different unit on the site, but I think it may put expansion plans behind. 

Brazil were hoping to receive 2m doses of Covishield imminently, but there hasn't yet been the 'go-ahead' for the consignment to leave India. Whilst they wait, President Bolsonaro has bought 6m doses of SinoVac from China instead. 

California has the world's 4th "variant of concern", L452R. It's a new discovery and may be more transmissible, but it's too early to say. As Kristian G Anderson (respected California Immunology & Microbiology Professor with his own Scripps Research Lab) says:
"We need more data. L452R may turn out to be important or it may not - we don't know.
Most critical point - we can't blame current surges on variants - it's our own continued failure to do what is necessary...
While we're busy with things that may or may not be important, we have variants that we *do* know are problematic.
B117 (UK variant) is already here, it's rising rapidly in frequency (doubling ~weekly), and it *will* crush our healthcare system if we don't specifically deal with it. Focus!"
A huge job for you there guys - best of luck and government support. 

The South African variant of concern is continuing to be a concern.
Preliminary data (not peer-reviewed) from South Africa "suggests that the novel variant 501.V2 wasn't recognised by antibodies in 21/44 serum samples collected from people infected in the first wave".
Basically almost half the antibody samples didn't even recognise the SA variant as the same virus.
There are lots of caveats - it is only 44 samples, which is very few. Different people in different geographical areas have different antibody cocktails, results from different cohorts of people and strains (virus ancestry) need to be looked at. This was using plasma from recovered patients in a test tube, it only sees the antibodies - T cell immunity will also play a part in a live human.
Obviously the SA variant is a concern not just for antibodies and reinfection, but for vaccines.
BioNTech previously said that 'vaccine escape' is to be expected and their vaccine can be tweaked within around 6 weeks when necessary. Oxford say they are constantly preparing for vaccine tweaks. I would be utterly stunned if they weren't already all over this and possibly as much as half way to a fresh vaccine formulation just in case.
Studies checking vaccine efficacy against the SA variant are obviously ongoing and we don't have access to any data yet - preliminary data is expected, but we are warned final analysis might not be until next month.  

The USA has a new president and on his first day in office he:
- made masks mandatory on Federal property
- launched a 100 Day Masking Challenge
- extended pauses on evictions, foreclosures and student loan repayments
- Rejoined the Paris Climate agreement
- Rejoined the World Health Organisation
- there's a new Director at the CDC
- some other stuff
Ahhhhhh. That's better... 

Bad news guys. Glastonbury's cancelled. The festival, not the town. Your 2020 ticket deposit will still be valid for 2022. 

I mentioned on Tuesday that 'less than 10 individuals' had a severe reaction to their Moderna vaccinations at a single US clinic. Six female healthcare workers developed allergic reactions and were treated immediately, so they're fine now. The batch was being used in 287 clinics and no other events were reported. No-one can find anything wrong, and all distribution of that batch has now been resumed.
It's bad luck, and bizarrely similar to the UK, when 2 female healthcare workers also developed severe allergic reactions on the first day of immunising, but with the Pfizer/ BioNTech vaccine. (The UK only recently bought in to Moderna's vaccine, so our stocks won't arrive for a few months yet.)
The US CDC have been logging 'adverse events' after vaccination, and estimate around 11.1 in every million people has been affected. 

Dont let a coffee cost you your life UK Govt queue of people in masks and text

Latest school attendance figures for England are interesting, especially compared to the previous lockdown. We have around 4-5 times the number of  'children of critical workers' attending in person - approximately 709,000 children.
'During the 2020/21 autumn term, average on-site attendance in state-funded schools was 86%, which dropped to 14% following the restriction of attendance to vulnerable children and children of critical workers only.'
"Attendance on 13 January was 21% in state-funded primary schools, 5% in state-funded secondary schools and 30% in state-funded special schools." On-sight attendance during the first lockdown in May 2020 was approximately 4% in state-funded primaries, 1% in state-funded secondaries and 8% in state-funded special schools.

There is increasing home use of pulse oximeters to check oxygen levels, and the NHS are handing them out to some of the more 'at risk' COVID patients. It's the device with a clip that goes over your finger, and can instantly give you a blood oxygen reading. Occasionally patients with COVID don't feel any symptoms of oxygen deprivation, and aren't even out of breath, despite having very low levels. 

HSJ are reporting that people are attempting to jump the queues, by ringing numbers on other people's vaccination invitations and booking themselves appointments. It's totally unfair and egotistical, and they all know better. And it makes it boring for everyone now, because you might have to start proving who you are. Take ID and your invitation letter just in case. If you turn up, even with an appointment, but you haven't been invited and you aren't in a priority group, you will be turned away. 

A 61 year old gentleman with end stage renal failure and Hodgkin Lymphoma was referred to the Royal Cornwall Hospital in Truro with shortness of breath, where he tested positive for COVID. He spent 11 days in hospital and was sent home to convalesce.
4 months later his tumour had massively reduced and his overall health greatly improved. The COVID-fighting reaction that happened in his body was also tumour-fighting. Sometimes even bad luck can be on our side. I wish him the very best with every extra minute...

Some numbers. They all represent people very much like you...

Countries / Cases / Losses of life (since midnight GMT. In larger countries some states /provinces have yet to report today):

USA 25,052,415 (+53,345) 416,941 (+1,036)

India 10,623,920 (+12,201) 153,013 (+107)

Brazil 8,639,868 not yet reported today 212,893

Russia 3,655,839 (+21,887) 67,832 (+612) 

UK 3,543,646 (+37,892) 94,580 (+1,290)

France 2,965,117 not yet reported today 71,652

Italy 2,428,221 (+14,078) 84,202 (+521)

Turkey 2,412,505 (+6,289) 24,640 (+153)

Spain 2,412,318 not yet reported today 54,637

Germany 2,097,706 (+7,511) 50,639 (+343)

Poland 1,457,755 (+7,152) 34,561 (+419)

Iran 1,354,520 (+6,204) 57,150 (+93)

Ukraine 1,177,621 (+5,583) 21,499 (+241)

Netherlands 932,884 (+5,774) 13,337 (+89)

Czechia 917,359 (+8,162) 14,973 (+65) 

Canada 729,751 (+4,256) 18,573 (+111)

Romania 703,776 (+2,878) 17,554 (+69) 

Belgium 684,256 (+3,006) 20,572 (+18) 

Portugal 595,149 (+13,544) 9,686 (+221) 

Sweden 542,952 not yet reported 10,921 (+29) 

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Sources:

https://www.worldometers.info/coronavirus/

https://twitter.com/sidhant/status/1351524732324048896/photo/1

https://coronavirus.data.gov.uk/

https://www.mea.gov.in/press-releases.htm?dtl/33399/Supply_of_Indian_manufactured_vaccines_to_neighbouring_and_key_partner_countries

https://twitter.com/i/events/1351580531708706817

https://theprint.in/diplomacy/bolsonaro-goes-with-chinas-sinovac-for-now-as-india-delays-covishield-delivery-to-brazil/588069/

https://twitter.com/K_G_Andersen/status/1351727436661067778?s=19

https://twitter.com/AdamJKucharski/status/1351228542143651840?s=09

https://t.co/jGFWcguRFU

https://twitter.com/CDCDirector/status/1351991282244214787?s=19

https://www.biorxiv.org/content/10.1101/2021.01.18.427166v1

https://www.thesun.co.uk/news/politics/13797841/priti-patel-did-want-borders-last-march-confession/amp/

https://www.hsj.co.uk/coronavirus/leading-hospital-offered-covid-jabs-on-demand-for-several-weeks/7029346.article#.YAlrd9rBwcc.twitter

https://www.bloomberg.com/news/articles/2021-01-20/biden-to-swiftly-unwind-trump-policies-on-immigration-health

https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.17116

https://explore-education-statistics.service.gov.uk/find-statistics/attendance-in-education-and-early-years-settings-during-the-coronavirus-covid-19-outbreak/2021-week-3

https://www.sfchronicle.com/bayarea/article/California-likely-able-to-release-huge-lot-15886349.php

https://twitter.com/janhavee/status/1352189543135502336?s=19

"Fire breaks out at COVID-19 vaccine manufacturing plant in India" https://twitter.com/i/events/1352193026886516736?s=09

https://www.gov.uk/government/statistics/weekly-all-cause-mortality-surveillance-2020-to-2021

https://www.gov.uk/government/news/january-2021-findings-from-covid-19-study-published

https://twitter.com/i/events/1352180360247820288

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0445-remote-monitoring-in-primary-care-jan-2021-v1.1.pdf

https://www.cebm.net/covid-19/what-is-the-efficacy-and-safety-of-rapid-exercise-tests-for-exertional-desaturation-in-covid-19/

https://www.bbc.co.uk/news/health-55733527



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