Covid-19 update: 30 April

by Seamus Ward

30 April 2021

The Covid news this week was dominated by the situation in India, where a second wave has spread devastation across the vast country. No-one could fail to be moved by the reports of desperate searches for hospital beds, therapeutic drugs or cylinders of oxygen. It is a human tragedy that will be felt keenly in the NHS, with many staff holding family ties to the continent.

Infection rates in India reached more than 300,000 cases every day in the last week and a total of 200,000 deaths, though it appears both figures are under-reported. Much of the concern centres around the emergence of a new variant, known as B.1.617. It is a ‘double mutant’ with two significant mutations on the virus’ spike, potentially making it more difficult to be recognised by antibodies.HFMA Covid-19

Scientists will be watching closely as variants are unlikely to be contained within any country’s borders. Indeed, 193 cases of the variant have been reported across the UK, though another 200 cases of strains linked to B.1.617 have also been found in England. Public Health England has not labelled B.1.617 a variant of concern, but a variant under investigation with cases followed up with contact tracing.

There is some laboratory evidence that B.1.617 may be slightly more transmissible and that antibodies may find it more difficult to deal with it. But Jeff Barrett, director of the Covid-19 genomics initiative at the Wellcome Sanger Institute, told the BBC that there did not appear to be evidence that vaccines are failing to stop the variant. He added: ‘I think we obviously have to watch carefully, but at present there’s no reason to panic about it.’

The UK and other countries have acted to support India, with the UK government sending support in the form of ventilators and oxygen concentrators, and the Northern Ireland Executive contributing large-scale oxygen production equipment. There is increasing debate about whether vaccines should be taken off patent, potentially allowing greater production.

Travel restrictions remain in place as there are high infection levels in some other countries, including Brazil, which has recorded more than 400,000 deaths.

Health and social care secretary Matt Hancock said the news from India was a warning that the Covid crisis is not over, and that the UK must remain vigilant. The situation in the UK continues to be largely positive. A BBC analysis found that around 22 million people live in areas of the UK that have not reported any Covid-19 deaths in April. Fewer than 600 deaths were reported within 28 days of a positive Covid test in April – in January it was more than 32,000.

UK cases

The most recent figures show a continued downturn in cases, with 15,811 between 23 April and 29 April, a fall of almost 9% compared with the previous seven days. Just over 1,000 people were admitted to hospital in the week to 25 April, down more than 15% on the previous week. On 27 April, there were 1,553 patients in hospital with coronavirus. However, 157 deaths within 28 days of a positive test were recorded between 23 April and 29 April, up slightly (0.6%) compared with the previous seven days.

The vaccination programme continues apace, with the NHS in England inviting people over 40 to book their first jab this week. Uptake of the first dose among the over-50s is over 95%. By 27 April, 34 million people across the UK had received one dose of a vaccine (64.5% of adults) and 14 million had received two doses (almost 26% of adults).

Mr Hancock hailed Office for National Statistics figures that showed 68% of adults in England have Covid antibodies – 61% in Wales, 63% in Northern Ireland and 58% in Scotland. The presence of antibodies indicates a previous infection or vaccination.

There was further promising news on the efficacy of the Pfizer and AstraZeneca vaccines. A Public Health England study found that people who are infected three weeks after receiving their first dose of either vaccine were between 38% and 49% less likely to transmit the virus to their household contacts than those who have not received a vaccine. PHE said this was on top of the protection the vaccine gives in preventing symptomatic infections. This is 60% to 65% four weeks after a single dose.Danny Mortimer

NHS Confederation chief executive Danny Mortimer (pictured) said the findings offered hope and reassurance that the vaccines can reduce illness, death and transmission. However, he added: ‘We must not overestimate public protection against the virus and the tragic scenes in India remind us that no-one and no country can be an island in tackling the pandemic. The best insurance policy is protection beyond borders.

‘With new variants of the virus still spreading, there is still much we do not know about them, including whether or not the vaccines currently in use can effectively protect against them. Vaccination remains just one tool in our fight against the virus, and with questions over supply and workforce capacity, it is imperative that we all continue to do our bit, by maintaining social distancing, mask wearing and hand hygiene.’

The Department of Health and Social Care announced it had purchased a further 60 million doses of the Pfizer/BioNTech vaccine to support an autumn booster programme. The programme will be based on clinical need and protect the most vulnerable, and full details will be issued by the Joint Committee on Vaccination and Immunisation (JCVI) in due course.

NHS Providers chief executive Chris Hopson welcomed the fact that preparations for a booster campaign were taking shape. But the ongoing vaccination programme and its considerable success had taken a lot of hard work from the NHS.

‘This has been and will remain a major commitment for the NHS alongside the many other challenges it now faces in dealing with the longer-term impact of Covid-19,’ he said.

‘It does reinforce, though, the need for the NHS to create the right workforce model to deliver Covid-19 vaccines long term. What's been achieved so far has depended on diverting large numbers of NHS staff from their day jobs, which is not sustainable.’

Restrictions relaxed

Shops, restaurants, gyms and other hospitality services in Northern Ireland opened today, 30 April, after four months of lockdown. The easing of restrictions there now means up to 15 people from three different households can meet in a private garden.

Scotland launched a new service, Check in Scotland, that aims to speed up contact tracing. Users will be able to log their contact details when they visit venues such as bars, restaurants and places of worship, as well as close contact services such as hairdressers, that display a QR code poster. Details can be input via an online form or the new Check in Scotland app, and will be retained for 21 days for test and trace purposes.

Chief medical officer Gregor Smith said the system would allow business to easily collect customer details – customers who cannot use Check in Scotland must have their details collected using pen and paper. ‘Together with the Protect Scotland app, Check in Scotland will help contact tracers reach people faster if there are coronavirus cases linked to a venue they have recently visited,’ he added.

‘The faster we can contact people who might have been exposed to Covid-19, the faster we can stop the spread of the virus, and keep moving towards the return of everyday activities.’

Earlier in the week NHS Scotland made available free lateral flow home testing kits for anyone without Covid symptoms. In Wales, the rapid tests can now be ordered for home delivery – enough to cover seven weeks, testing twice a week. Minister for health and social services Vaughan Gething (pictured) said: ‘We want to make it as easy as possible for people to access tests and we particularly want to support people who volunteer or are unable to work from home to get regularly tested.Vaughan Gething

‘As we continue to ease restrictions, routine testing of asymptomatic people will be an additional tool to help tackle the spread of the virus and keep Wales safe.’

NHS Test and Trace said there was a 9% decrease in the number of positive cases in England recorded between 15 April and 21 April, continuing a trend seen since early January. Turnaround times for pillar 2 community testing remained steady with the results of 90.5% of in-person tests returned within 24 hours (90.3% in the previous week). More than 12,000 positive cases were transferred to the contact tracing system, 20% fewer than the previous week, with 89% contacted. A similar proportion of close contacts were reached. Almost 21,000 people were quarantining at home and 4,800 in a managed quarantine hotel – around 50 more in hotels than the previous week.

Independent Sage, a group of scientists who offer impartial advice, urged the government to shift funding away from national test and trace to local contact tracing run by local government. It said that the national system had repeatedly missed its close contact tracing target and there were increasing concerns that UK cases caused by the B.1.617 variant identified in India have been rising due to international travel.

The scientists added that the need for a fully functioning test and trace system was more pressing as restrictions eased. There was evidence that local authority-run test and trace can effectively suppress outbreaks, they added.