New Coronavirus News from 23 Oct 2021

UK government paves way to bring in tough ‘plan B’ Covid rules [The Guardian, 23 Oct 2021]

Michael Savage, Robin McKie and James Tapper

Councils consulted over support for measures such as vaccine passports amid warnings by senior doctors that NHS faces winter illness ‘triple whammy’

New evidence has emerged that the government is paving the way to implement “plan B” measures in England to combat the spread of Covid-19, amid warnings from health chiefs that a “vortex of pressures” is encircling the NHS.

In the clearest sign to date that Whitehall is actively considering additional measures, the Observer has learnt that the UK Health Security Agency (UKHSA) contacted local authorities on Friday to canvass their level of support for the “immediate rollout of the winter plan – plan B”.

The disclosure comes as senior doctors warn that operations are already being cancelled due to NHS staffing shortages and scientists warn of “a triple whammy” of respiratory illnesses this winter, with Covid, flu and respiratory syncytial virus (RSV), which causes cold-like symptoms but can be serious for children and older adults.

Boris Johnson has so far publicly resisted suggestions that he should order the implementation of plan B, a menu of measures which includes the use of vaccine passports at higher-risk venues and mass gatherings, as well as legally mandating the use of face masks in some settings.

However, in a memo marked “official – sensitive”, the agency states that it was urgently seeking the views of council chief executives and leaders to be fed directly into the Cabinet Office.

“This is a tight turnaround as you might appreciate and so a response by close of play would be really helpful,” it states.

A UKHSA spokesperson said they would not comment on leaks, adding: “It is part of UKHSA’s role to provide advice to the government on the ongoing response to the pandemic.” A government spokesperson said: “We are monitoring all the data closely, and the prime minister has been clear that it does not yet show that plan B is necessary. But it is ready should we need to act to avoid a rise in hospitalisations which would put unsustainable pressure on the NHS.”

Downing Street is still hoping that an accelerated booster jab programme can fend off the need for additional measures.

The prime minister on Saturday issued a desperate call to arms for everyone over 50 to have a booster jab when offered one. “Vaccines are our way through this winter,” Johnson said. “We’ve made phenomenal progress but our job isn’t finished yet, and we know that vaccine protection can drop after six months. To keep yourself, your loved ones, and everyone around you safe, please get your booster when you get the call.

“This is a call to everyone, whether you’re eligible for a booster, haven’t got round to your second dose yet, or your child is eligible for a dose – vaccines are safe, they save lives, and they are our way out of this pandemic.”

A further 44,985 Covid cases were reported on Saturday, more than 4,000 fewer than the previous day. Another 135 deaths were reported in England. It came as one of the government’s scientific advisers said he feared another “lockdown Christmas”. Prof Peter Openshaw, a member of the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), said putting measures in place now in order to “get transmission rates right down” was key to having “a wonderful family Christmas where we can all get back together”.

Despite ministerial claims that thousands of beds remain available in the NHS, senior doctors said that operations were already being cancelled. Dr Stephen Webb, president of the Intensive Care Society, said: “In many places, the planned urgent surgery that needs to be done is being cancelled. This is not because of a lack of physical beds, it’s because of a lack of staffing to be able to open those beds. We’ve heard about urgent cardiac surgery being cancelled, major bowel surgery being cancelled, because these patients needs post-operative intensive care beds. That’s not just in one or two areas – that’s across the country.”

NHS officials warned that Covid pressures were adding to staffing issues, efforts to deal with surgery backlogs, long waits in emergency departments and difficulties caused by other infections. “It’s a whole bundle of issues coming together, which form a vortex of pressure,” said Saffron Cordery, the deputy chief executive of NHS Providers. “What Covid has done is exacerbated these challenges and thrown some extra things in.”

Matthew Taylor, the chief executive of the NHS Confederation, who has already called for plan B measures, said: “You [the government] have got to recognise that we need a national mobilisation. You’ve got to recognise there is a health and care crisis coming over the next three or four months and accept it, acknowledge it and encourage the public to do everything they can to help. We may need to just get used to the fact that the booster campaign needs to happen every six months and prepare for that, so I welcome the fact that government has stepped up the message there.”

A senior scientist also warned that the nation faces “a triple whammy” of respiratory illnesses this winter. On top of Covid and flu, comes the threat from disease triggered by RSV, one of the most common causes of coughs and colds in winter. For most people, infection causes mild respiratory illness but in the very young and the elderly, RSV infections can trigger severe illnesses such as bronchiolitis and pneumonia and can lead to hospitalisation and even death.

“We had very few – almost no cases – of RSV last year and that is a worry,” said virologist Prof David Matthews of Bristol University. “Immunity to RSV only lasts a couple of years after previous infections. Because of lockdown RSV rates were very low in the UK last winter. That means there is very little RSV immunity left in the population. For good measure there is no RSV vaccine to protect against the disease.”

The country is now highly vulnerable to RSV infections, Matthews said. “That is a real worry because infections are very capable of putting both the elderly and the very young in hospital and at present we probably have very little immunity to the disease.

“Together with influenza and Covid-19 we are facing a triple whammy this winter, one that could have a grim impact on the NHS. It is extremely worrying. It is another reason we need to keep Covid cases to a minimum and get vaccines – boosters and for children – into as many people as possible.”

Saturday’s coronavirus news: Russia defends Sputnik V vaccine; Britain’s weekly cases at highest since July [The Guardian, 23 Oct 2021]

Michael Savage, Robin McKie and James Tapper

Councils consulted over support for measures such as vaccine passports amid warnings by senior doctors that NHS faces winter illness ‘triple whammy’

New evidence has emerged that the government is paving the way to implement “plan B” measures in England to combat the spread of Covid-19, amid warnings from health chiefs that a “vortex of pressures” is encircling the NHS.

In the clearest sign to date that Whitehall is actively considering additional measures, the Observer has learnt that the UK Health Security Agency (UKHSA) contacted local authorities on Friday to canvass their level of support for the “immediate rollout of the winter plan – plan B”.

The disclosure comes as senior doctors warn that operations are already being cancelled due to NHS staffing shortages and scientists warn of “a triple whammy” of respiratory illnesses this winter, with Covid, flu and respiratory syncytial virus (RSV), which causes cold-like symptoms but can be serious for children and older adults.

Boris Johnson has so far publicly resisted suggestions that he should order the implementation of plan B, a menu of measures which includes the use of vaccine passports at higher-risk venues and mass gatherings, as well as legally mandating the use of face masks in some settings.

However, in a memo marked “official – sensitive”, the agency states that it was urgently seeking the views of council chief executives and leaders to be fed directly into the Cabinet Office.
“This is a tight turnaround as you might appreciate and so a response by close of play would be really helpful,” it states.

A UKHSA spokesperson said they would not comment on leaks, adding: “It is part of UKHSA’s role to provide advice to the government on the ongoing response to the pandemic.” A government spokesperson said: “We are monitoring all the data closely, and the prime minister has been clear that it does not yet show that plan B is necessary. But it is ready should we need to act to avoid a rise in hospitalisations which would put unsustainable pressure on the NHS.”

Downing Street is still hoping that an accelerated booster jab programme can fend off the need for additional measures.

The prime minister on Saturday issued a desperate call to arms for everyone over 50 to have a booster jab when offered one. “Vaccines are our way through this winter,” Johnson said. “We’ve made phenomenal progress but our job isn’t finished yet, and we know that vaccine protection can drop after six months. To keep yourself, your loved ones, and everyone around you safe, please get your booster when you get the call.

“This is a call to everyone, whether you’re eligible for a booster, haven’t got round to your second dose yet, or your child is eligible for a dose – vaccines are safe, they save lives, and they are our way out of this pandemic.”

A further 44,985 Covid cases were reported on Saturday, more than 4,000 fewer than the previous day. Another 135 deaths were reported in England. It came as one of the government’s scientific advisers said he feared another “lockdown Christmas”. Prof Peter Openshaw, a member of the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), said putting measures in place now in order to “get transmission rates right down” was key to having “a wonderful family Christmas where we can all get back together”.

Despite ministerial claims that thousands of beds remain available in the NHS, senior doctors said that operations were already being cancelled. Dr Stephen Webb, president of the Intensive Care Society, said: “In many places, the planned urgent surgery that needs to be done is being cancelled. This is not because of a lack of physical beds, it’s because of a lack of staffing to be able to open those beds. We’ve heard about urgent cardiac surgery being cancelled, major bowel surgery being cancelled, because these patients needs post-operative intensive care beds. That’s not just in one or two areas – that’s across the country.”

NHS officials warned that Covid pressures were adding to staffing issues, efforts to deal with surgery backlogs, long waits in emergency departments and difficulties caused by other infections. “It’s a whole bundle of issues coming together, which form a vortex of pressure,” said Saffron Cordery, the deputy chief executive of NHS Providers. “What Covid has done is exacerbated these challenges and thrown some extra things in.”

Matthew Taylor, the chief executive of the NHS Confederation, who has already called for plan B measures, said: “You [the government] have got to recognise that we need a national mobilisation. You’ve got to recognise there is a health and care crisis coming over the next three or four months and accept it, acknowledge it and encourage the public to do everything they can to help. We may need to just get used to the fact that the booster campaign needs to happen every six months and prepare for that, so I welcome the fact that government has stepped up the message there.”

A senior scientist also warned that the nation faces “a triple whammy” of respiratory illnesses this winter. On top of Covid and flu, comes the threat from disease triggered by RSV, one of the most common causes of coughs and colds in winter. For most people, infection causes mild respiratory illness but in the very young and the elderly, RSV infections can trigger severe illnesses such as bronchiolitis and pneumonia and can lead to hospitalisation and even death.
“We had very few – almost no cases – of RSV last year and that is a worry,” said virologist Prof David Matthews of Bristol University. “Immunity to RSV only lasts a couple of years after previous infections. Because of lockdown RSV rates were very low in the UK last winter. That means there is very little RSV immunity left in the population. For good measure there is no RSV vaccine to protect against the disease.”

The country is now highly vulnerable to RSV infections, Matthews said. “That is a real worry because infections are very capable of putting both the elderly and the very young in hospital and at present we probably have very little immunity to the disease.

“Together with influenza and Covid-19 we are facing a triple whammy this winter, one that could have a grim impact on the NHS. It is extremely worrying. It is another reason we need to keep Covid cases to a minimum and get vaccines – boosters and for children – into as many people as possible.”

New variant? No masks? Here's what's driving the U.K.'s Covid surge [NBC News, 23 Oct 2021]

By Chantal Da Silva

LONDON — What a difference three months can make.

On July 19, Britons celebrated as England marked "Freedom Day," seeing a near-full lifting of Covid-19 restrictions. Covid-related hospitalizations and deaths were relatively low, even if cases continued to rise, and the country's vaccination rollout was largely lauded as a success internationally.

On Thursday, there were more than 50,000 infections recorded in the U.K. in a single day — the highest daily count since mid-July and a higher number than reported in Germany, France, Italy, Spain and Portugal combined. The country also saw 115 deaths, with Tuesday marking a daily death toll of 223 people — the highest since March.

Meanwhile, 1 in 55 people in England were estimated to have had Covid in the week up to Oct. 16, according to the U.K. Office for National Statistics, which means as many as 1 million people may have been infected with the virus that week alone.

The rising deaths, spiraling infection rates and overstretched public health system have prompted calls for the government to reassess the lifting of lockdown and containment measures.

"I think that everyone feels concerned as to what might happen over winter," said Dr. Layla McCay, policy director of the National Health Service Confederation, which represents the health care system in England, Wales and Northern Ireland. "It is better to act now than to regret it later."

Experts said there are a range of factors driving Britain's current surge. As the pandemic nears the two-year mark, they are closely monitoring the country's response to rising cases and whether the U.K. is a warning sign for the rest of the world.

NBC News investigated the cocktail of factors driving Britain’s surge and the lessons that can be gleaned from the country’s experience.

Waning vaccines

Britain was one of the first countries to start vaccinating its population, so Britons enjoyed a return to so-called normal life earlier than most.

But now, there are fears that the immunity gained from Covid vaccinations is starting to wane as the delta variant — which has accounted for approximately 99.8 percent of sequenced cases in England, according to a recent government report — as well as a mutation of the variant known as "delta plus" continue to spread.

"Those deaths are not inevitable. They're preventable."
DR. DEEPTI GURDASANI, CLINICAL EPIDEMIOLOGIST AT QUEEN MARY UNIVERSITY OF LONDON

In addition, the government delayed vaccinating secondary school students, which likely has had a big impact on the virus's spread, according to Danny Altmann, a professor of immunology at Imperial College London.

"I think we paid a very high price for our reticence and delay in vaccinating secondary school children and lost probably a few months on that," he said.

Recent figures released by the Office for National Statistics showed that 1 in 14 secondary school-age children had tested positive for Covid in the week ending Oct. 2.

Because the U.K. rolled out its vaccination program earlier than the rest of Europe, that could also mean protection is waning sooner, especially among older recipients, Altmann added.
"We all assumed that these vaccines would be good and keep us safe for a good year or two, and that possibly would have been true if delta hadn't come along," he said.
Yet, even with the spread of the delta variant, he said the rollout of booster jabs in the U.K. has been slow, which could also be lending to high case rates in the U.K., despite nearly 80 percent of the population over the age of 12 having been fully vaccinated, according to government data.

Dr. Deepti Gurdasani, a clinical epidemiologist at Queen Mary University of London, said she also believed the rollout of the U.K.'s vaccination program, as well as its slow release of booster vaccines, have played a role in the continued rise of Covid cases.

Did 'freedom' come too soon?

The U.K. government's decision to not maintain or reinstate certain Covid containment measures, such as masks being mandatory in enclosed spaces, were also behind the rise, Gurdasani said.

"If you look throughout the pandemic, you can see there is a clear correlation between the level of restrictions in a country and what's happening in the pandemic," she said. "When we have a lockdown, cases always go down because it is an airborne virus."

While many countries across Europe and around the world have maintained different levels of Covid restrictions, including mask mandates, the British government has remained adamant in its commitment to England’s full reopening.

"There is no other way to explain the differences in the pandemic globally," she said. "And there's nothing special about the U.K. population making this happen. ... It's very, very clearly the consequence of policies here compared to the rest of the world."

Mandatory-mask rules do exist on public transport systems, with face coverings required across the Transport for London network, which includes the capital’s underground train system, but those rules are not always complied with, nor regularly enforced.

Ravi Gupta of the Cambridge Institute of Therapeutic Immunology and Infectious Disease agreed with Gurdasani that maintaining restrictions might have helped avoid the U.K.'s current predicament.

"The relaxation [of rules] that happened over summer was a fairly drastic month going from, you know, quite, quite tight measures to very few restrictions," Gupta said. "And I think that, in retrospect, a more graded approach may have prevented the surge that we’re seeing."

The government also abandoned plans to enforce a vaccine passport system in England, with British Health Secretary Sajid Javid saying in September he did not "like the idea at all of people having to ... present papers to do basic things." Wales and Scotland have introduced versions of their own vaccine verification systems, however.

Rise of the variants

The emergences of the delta and then the so-called delta plus variant have garnered attention and produced some fear.

But Gurdasani and Gupta agreed that the arrival of the delta plus variant, which is a mutated version of the delta variant, shouldn't come as much of a surprise.

"I’m not convinced that this is a major step change for the virus," Gupta said.

"It may have an incremental or a small effect on its infectiousness or its ability to avoid immunity," Gupta added, saying it was an expected type of mutation, given the high infection rates.

While the U.K. Health Security Agency issued a report Oct. 15 warning the delta plus variant appeared to be "expanding," it accounted for around 6 percent of Covid cases in the U.K. Gurdasani said at the moment, it does not appear to be the main driver of the rise in Covid cases.

Still, both she and Gupta agreed it was important to keep a close eye on it and other variants.
Ultimately, Altmann said it would be "foolhardy" to try to blame the rise in Covid cases and deaths in the U.K. "on one thing more than the other."

"Things that seem like very minor piecemeal mitigation all add up together on a massive scale," he said. "If you put together ... mask-wearing and ventilation and filters and work from home and transport policy ... and vaccine rollout and you get each one of those a little bit wrong as I think the U.K. probably has, you can end up paying a disproportionately high price for it."

Calls for 'plan B'

The government of Prime Minister Boris Johnson is coming under growing pressure to reimpose restrictions in light of the surging cases and deaths.

On Wednesday, Javid resisted calls for a "plan B" approach, even as he confirmed that Covid cases in the U.K. could reach 100,000 a day as winter approaches.

Speaking at his first news conference since taking up the position June 26 — following former Health Secretary Matt Hancock’s resignation the same day, after he was caught breaching social distancing guidelines by kissing a colleague — Javid acknowledged the NHS has been under "greater pressure."

The situation was not yet "unsustainable," he said, adding that Covid-related deaths in the U.K. "remain mercifully low."

Still, he acknowledged that deaths were "sadly over 100 a day." And at an estimated 2 daily deaths per 1 million people as of Wednesday, according to Our World in Data, the U.K.'s rate is more than double that of Germany's, more than triple that of Spain's and Italy's and more than four times that of France's.

Rather than imposing new restrictions, Javid warned that Britons must all "play our part" and focus on getting vaccinated, including with Covid boosters and flu jabs, to avoid the return of coronavirus rules.

Jonathan Ashworth, a senior member of the opposition Labour Party, struck out at Javid’s response.

"The NHS is not just under pressure; it’s under water," he said in an interview with Sky News, which is owned by NBC News' parent company Comcast.

Ashworth said doctors, nurses and other NHS staff were facing "immense" pressure, and he said he was "shocked that the health secretary was so casual in dismissing them."

Gurdasani agreed, saying she "cannot understand how anyone can say that the number of deaths we are having every week, between 800 to 1,000 deaths every week" are mercifully low.
"Those deaths are not inevitable. They're preventable," she said.

If the country does not change its approach, Gurdasani said she expected those numbers only to rise in the months ahead.

"Most of Western Europe hasn’t accepted that we need to live with that level of deaths," she said. "And you don’t need massive sacrifices to reduce them."