Day: 24 May 2021

Almost 9,000 Patients Died Within 28 Days after Catching Covid in English Hospitals

Up to 8,700 patients died within 28 days after catching Covid while in hospital for another medical problem, according to NHS data provided by the hospitals themselves. University Hospitals Birmingham is the trust which has recorded the highest number of hospital-acquired Covid infections, as well as the highest number of deaths from Covid caught in hospital. The Guardian has the story.

NHS leaders and senior doctors have long claimed hospitals have struggled to stop Covid spreading because of shortages of single rooms, a lack of personal protective equipment and an inability to test staff and patients early in the pandemic.

Now, official figures supplied by NHS trusts in England show that 32,307 people have probably or definitely contracted the disease while in hospital since March 2020 – and 8,747 of them died.

That means that almost three in 10 (27.1%) of those infected that way lost their lives within 28 days.

Guardian graphic based off figures from freedom of information requests.

The Guardian obtained the data under freedom of information laws from 81 of England’s 126 acute hospital trusts.

The responses show that every trust had to grapple with what doctors call nosocomial or hospital-acquired infection. Many hospitals were unable to keep Covid-positive patients separate from those without the disease, which led to its lethal transmission.

According to the FoI responses, University Hospitals Birmingham trust had the highest number of deaths (408), followed by Nottingham University Hospitals (279) and Frimley Health (259). Nine trusts had 200 or more deaths.

However, the numbers of deaths are influenced by factors such as a hospital’s size, number of single rooms and capacity of its intensive care unit, and the makeup of its local population and level of infection among them, as well as weaknesses in infection control procedures.

At a handful of trusts, about a third of all people who died after catching Covid had become infected in hospital. They include Royal Cornwall hospitals (36%), Salisbury (35.2%) and Kettering general hospital (31.2%).

The answers provided to the Guardian reveal that the 8,747 who died were all in hospital for another reason, such as treatment for a fall, flare-up of a serious illness, or to have an operation.

The figures include people who died in hospital and after discharge. They do not distinguish between those who died of Covid, with Covid or of another condition potentially exacerbated by the virus, such as a heart attack.

Worth reading in full.

Wuhan Institute of Virology Researchers Were in Hospital with Possible COVID-19 in November 2019, Says U.S. Intelligence Report

The Wall Street Journal has published an article summarising an undisclosed U.S. intelligence report claiming that three researchers from the Wuhan Institute of Virology (WIV) sought hospital care in November 2019 for possible COVID-19, a month before China reported the first cases of COVID-19 on December 8th, with the implication that they were infected in the lab and were among the first patients to become infected with the disease. Reuters reports on the Wall Street Journal story:

The newspaper said the previously undisclosed report which provides fresh details on the number of researchers affected, the timing of their illnesses, and their hospital visits – may add weight to calls for a broader investigation into whether the COVID-19 virus could have escaped from the laboratory.

The Journal said current and former officials familiar with the intelligence expressed a range of views about the strength of the report’s supporting evidence, with one unnamed person saying it needed “further investigation and additional corroboration.”

This may seem to add weight to the lab leak theory. However, the timing doesn’t fit with some other keys pieces of data.

A leaked report from China looked back at hospital records and suggested the first patients infected with COVID-19 were being admitted to Wuhan hospitals in October, before any putative lab leak in November.

A U.S. military intelligence dossier which came to light in April 2020 documented a runaway epidemic in the Hubei region (of which Wuhan is the capital) in November (though the Pentagon has denied the existence of this dossier), which fits with the leaked Chinese report but not the U.S. intelligence report, since a November outbreak would not have had time to become a region-wide epidemic in the same month. It takes some weeks for a first cluster of cases to spread throughout a population of millions and cause a noticeable number of hospital admissions. Regional newspaper reports also suggest Covid was already circulating in Hubei in mid-November.

A November lab leak also seems too late given the virus was already infecting people around the world in December, with the first official UK fatal infection being caught in England in December.

Putting this together, it could mean one of three things: 1) The reported WIV staff sickness in November, as documented in the latest U.S. intelligence report, was not the original lab leak, just part of the later epidemic, or a second leak from the same lab and the original leak happened earlier (say, in September); 2) Covid did not leak from the WIV at all and there is another reason Wuhan was the first epicentre; 3) this was the leak and the reports implying an earlier epidemic are somehow incorrect or unrelated.

The plot thickens.

Why Ministers are Telling the Truth When they Say ‘Herd Immunity’ Was Never Government Policy

Home Secretary Priti Patel appeared on Andrew Marr on Sunday and repeated the Government line that “herd immunity” was never the Government’s strategy. “Our strategy was always about protecting public health, saving lives, and protecting the NHS,” she said.

Outside Government it seems to be accepted, including by its defenders, that this is untrue and herd immunity was originally part of the Government’s plan. Referring to allegations by Boris Johnson’s former Chief Adviser Dominic Cummings that the Government was following a herd immunity strategy until March, UnHerd editor Freddie Sayers writes:

Cummings’s big accusation that the initial pandemic response plan, based on flu, included the goal of herd immunity is long-established, as is the fact that the Government initially considered it, then deviated from it rapidly when its implications became clear.

If this is so, why does the Government continue to deny it?

Anne-Marie Trevelyan, the Minister for Business, appeared on Good Morning Britain today to try to explain:

It was never the policy of this Government. Boris Johnson was very clear that the only thing that mattered was that we make sure that we saved lives and we keep our NHS safe and able to function, not only to protect those who might get Covid but also everybody else. … I’m very comfortable that the Prime Minister never had as his policy herd immunity.

Trevelyan was asked about remarks by Chief Scientific Adviser Sir Patrick Vallance on March 13th 2020, when he said: “Our aim is to try and reduce the peak, broaden the peak, not suppress it completely. Also, because the vast majority of people get a mild illness, to build up some kind of herd immunity so more people are immune to this disease.”

The Times explains the distinction Trevelyan and the Government are seeking to draw.

15 Brits Have Suffered from Blood Clotting Disorders after Their Second AstraZeneca Covid Vaccine

15 cases of blood clotting have be found in Brits recently given their second dose of the AstraZeneca Covid vaccine up until May 12th, according to the U.K.’s medicines regulator. The occurrence rate is around one in 600,000 (nine million have been given two doses of the AZ vaccine to date) – though this could increase as younger people are given their second doses of the vaccine, given that people below the age of 40 are more likely to suffer from clotting after the first dose. The MailOnline has the story.

Scientists told MailOnline it was “disappointing” the extremely rare complication was becoming more frequent in double-jabbed patients. The clots – which can occur in the brain – are happening alongside abnormally low platelet levels, known as thrombocytopenia. 

But the Medicines and Healthcare products Regulatory Agency (MHRA) said symptoms were “milder” and less frequent than after the first dose. 

As of May 12th, the MHRA had spotted 294 cases of the clots in Britons given an initial injection, affecting about one in 80,000. The conditions were found to be occurring more frequently in young people, which has led to the British jab being restricted for use in under-40s. 

Scientists believe in some people, the immune system sees the vaccine as a threat and over-produces antibodies to fight it. These lead to the formation of clumps in the bloodstream, which can become deadly if the clots move towards vital organs and cut off supply.

Around 15 million people are still waiting on their second AstraZeneca vaccine, with millions of eligible under-40s yet to be fully inoculated.

The current guidance says younger people who had their first dose before the jab was restricted should come forward for their second. 

Department of Health bosses do not provide data on vaccine take-up by age, making it impossible to say how many younger adults are booked in for their top-up.  

Professor Paul Hunter, an expert in medicine at the University of East Anglia, said it was “disappointing” there had been more clotting cases after the second dose.

But he highlighted that they were even less common than a first dose and less severe, urging people to continue to come for their second.

Worth reading in full.

Only 7% Of Loneliness Support Organisations Have Returned to Normal Service, According to a New Review

Millions of older people are still at risk of suffering from loneliness because many support organisations closed permanently during lockdown and only seven per cent have returned to normal service since, according to a new review by 10 leading loneliness charities. The Guardian has the story.

Loneliness, social isolation and living alone are all associated with an increased risk of early death, the Older People’s Task and Finish Group has said.

The group, part of the Department for Digital, Culture, Media and Sport Tackling Loneliness Network, also says that so many support organisations closed for good during lockdown that millions of older people are continuing to suffer loneliness, depression and deteriorating physical health. 

The network, Co-Chaired by Independent Age and the Alzheimer’s Society, has found that only seven per cent of 96 support organisations questioned have returned to normal service after the pandemic.

Almost three-quarters of older people questioned in the network’s survey said they had no or significantly less support from the charities they had relied on before the pandemic.

“For people who told us loneliness was not just a product of lockdowns and shielding, but a symptom of their everyday life before the pandemic, the easing of restrictions is not a silver bullet,” said Deborah Alsina, the Chief Executive of Independent Age.

Some older people are coping well since restrictions began to lift, but the group found that a sizeable minority are finding life is just as tough as during lockdown. 

“The extremely damaging side-effects of lockdown – long periods of isolation, a loss of routine and social interaction – have caused significant mental health as well as physical health deterioration for people with dementia, many of them just ‘giving up’ on life, fading away,” said Fiona Carragher, the Director of Research and Influencing at the Alzheimer’s Society.

“Many people we’ve spoken to are concerned that their isolation and loneliness will continue as restrictions ease because the support services they used previously have either shut down or are yet to be reinstated,” she added.

A further survey by Age U.K. found that, compared with before the pandemic, one in three respondents said they had less energy, one in four were unable to walk as far as before, and one in five felt less steady on their feet.

In addition, one in five found it harder to remember things, and more than one in four felt less confident about spending time with family.

Worth reading in full.

Taking the Average of 2019 and 2020, Sweden Had Lower Mortality Than Both Denmark and Finland

Faced with mounting evidence that lockdowns did not substantially reduce COVID-19 deaths in most of the countries where they were implemented, lockdown proponents have fallen back on what Paul Yowell calls the “neighbour argument” – i.e., the argument that comparing Sweden to its neighbours shows that lockdowns really do work.

On May 10th, a tweet plotting cumulative COVID-19 deaths per million in Sweden, Norway and Finland – which referred to the “Nordic natural experiment” – garnered over 6,000 likes. 

However, this argument isn’t convincing for a whole number of reasons, as I’ve outlined in two previous posts. For example: the other Nordics had a head start on Sweden; border controls – not lockdowns – made the difference in the first wave; and once you include the Baltics, Sweden no longer stands out.

However, suppose we just look at the mortality figures. Do they show that Sweden had an exceptionally bad year? Far from it. As I’ve noted before, the country saw age-adjusted excess mortality up to week 51 of just 1.7% – below the European average. 

Now, it’s true that all three other Nordics saw negative excess mortality (of up to –5% in Norway’s case). Because mortality rates declined gradually from 2015 to 2019, no change from 2019 to 2020 yields a negative value for excess mortality. In addition, there may have been fewer flu deaths and car accidents, thanks to social distancing. 

However, one reason why Sweden’s excess mortality figure isn’t lower is that the country saw particularly low mortality in 2019 (which brings down the average of the last five years). In that year, Sweden had the lowest mortality of all four Nordics – its rate was 4% lower even than Norway’s.

As several commentators have pointed out, this meant that there were more frail elderly people alive at the beginning of 2020 than there otherwise would have been. So even in the absence of a pandemic, you’d have expected to see a slight rise in mortality – owing to the “dry tinder” effect.

If we take the average of 2019 and 2020, then Sweden’s age-standardised mortality rate was 15.8 per 100,000, Denmark’s was 17.6, Finland’s was 16.4 and Norway’s was 15.5. In other words, Sweden’s was lower than both Denmark’s and Finland’s, and was only slightly higher than Norway’s. 

Of course, the average of the last two years isn’t a measure of the impact of the pandemic (and other relevant events). For that, we can need to compute the excess mortality for 2019–20, by comparing the average mortality rate in those two years to the average over the preceding four years. When we do that, the numbers come out as follows: –3.3% in Sweden, –4.4% in Demark, –4.8% in Finland and –4.9% in Norway. 

Although Sweden still saw the least favourable change (i.e., the smallest decline in mortality), the disparity with respect to its neighbours is much reduced. 

This exercise is not meant to obscure the fact that Sweden saw a moderate rise in mortality last year, unlike the other Nordics. It’s simply meant to put that rise in mortality into perspective. After all, having a sense of perspective is very important when trying to evaluate the measures that were taken during the pandemic.  

NHS Dental Patients Are Being Forced to Wait for up to Three Years for an Appointment

NHS dental surgery waiting lists have gotten so long that patients are being forced to wait until 2024 for an appointment, according to a new report. Waiting lists were long before 2020, and have only been made worse by lockdowns. Some people, unable to wait in pain, have gone into debt to meet private dentistry bills, while others have turned to pulling their teeth out themselves and performing “DIY fillings”. The Mail has the story.

A number of surgeries have thousands on their waiting lists and others have closed their books to new patients.

But some of the same practices will offer an appointment within a week to those who can afford to pay privately, according to research by Healthwatch England.

It found that one in three patients have felt pressured into paying for private care because of unbearable pain. Others say they have been driven into debt to meet dentistry bills.

Those who are unable to go private can be left waiting for up to three years to be seen, the report finds. Even emergency care entails waits of up to six weeks.

The delays can lead to “worsening of their dental problems and losing their teeth”, the report says. Healthwatch England claims public opinion of NHS dentistry has never been lower and highlights a “twin crisis” of lack of access and affordability. 

The number of dental surgeries offering NHS treatment fell from 9,661 in 2014/15 to 8,408 in 2019/20. The British Dental Association said dentistry was the only part of the NHS operating on a lower budget than a decade ago.

Spokesman Shawn Charlwood said: “For too long meaningful reform of NHS dentistry has been repeatedly kicked down the road. Covid has pushed a system already in crisis to breaking point, with millions left with no options.”

The Healthwatch England report highlights the case of a patient who needed hospital treatment after they overdosed on the painkillers they were taking to ease their dental problems.

Others have been told to use DIY filling kits or have been prescribed antibiotics with no prospect of a follow-up appointment to treat the underlying problem.

Some who called NHS 111 seeking emergency care were told to “use salt water” and carry on calling dental practices until they could find help. Waiting times just to get through to a surgery can be over an hour…

Four in five of those who contacted the organisation in the first three months of the year said they had struggled to access care quickly enough. And the number of complaints it received about dentistry was up 22% on last year.

Worth reading in full.

Britain’s Covid Epidemic Will be Over if Vaccines Work Against Indian Variant

The coronavirus crisis will be over in the U.K. shortly if the current vaccines work against the Indian variant, one of the country’s top scientists said on Radio 4’s Today programme this morning. MailOnline has more.

Professor Andrew Pollard, one of the main researchers behind the Oxford/AstraZeneca jab, said the pandemic in the U.K. could be “over” if the vaccines cut the risk of hospitalisation and death as well in the real world as analysis suggests.

Lab studies by Public Health England have found two doses of AstraZeneca or Pfizer’s jab provide a similar level of protection against symptomatic disease from the Indian variant as they do for the Kent version, which caused the country’s devastating second wave.

Professor Pollard said that a few more weeks were needed to firm up this claim, but he added that, traditionally, vaccines offer ‘much, much higher’ protection against hospitalisation and death than mild infection.

However, both Pfizer and AstraZeneca’s jabs were only 33 per cent effective at blocking symptoms of the Indian strain three weeks after one dose, compared to 50 per cent against the Kent variant. Officials say it highlights the importance of getting both injections.

Professor Pollard told BBC Radio 4’s Today programme: “If the current generation of vaccines are able to stop people going into hospital, whilst there is still mild infections, people are getting the common cold with the virus, then the pandemic is over.

“Because we can live with the virus, in fact we are going to have to live with the virus in one way or another, but it doesn’t matter if most people are kept out of hospital because then the NHS can continue to function and life will be back to normal. We just need a little bit more time to have certainty around this.”

Ministers say England is on track for all restrictions to be dropped as planned on June 21, despite fears the rapid spread of the Indian variant would jeopardise ‘freedom day’.

Worth reading in full.

Announcement on Social Distancing and Mask-Wearing Post-Lockdown Expected This Week

The Government’s messaging on unlocking appears to be moving in the right direction. Asked when the Government will reveal more details about the final step of the roadmap out of lockdown, the Prime Minister’s spokesman said last week: “We need time to assess the latest data on this [Indian] variant… so I’m not going to give a set time for doing that.” Yesterday, the Chief Executive of the U.K. Health Security Agency said the numbers are “looking very good” for a June 21st reopening, and reports now suggest that an announcement from the PM on what will be included in the final step of the roadmap should take place this week. The specific date for Step Four will not, however, be announced until June 14th at the earliest. The Express has more.

England’s fourth and final stage in the roadmap back to normality is due to commence from June 21st at the earliest. The step will see most legal restrictions lifted as the U.K. returns to a semblance of normality.

Crucial reviews on whether social distancing and mask-wearing should remain beyond next month, as well as whether limits on numbers at weddings can be lifted, are set to be published this week.

The decisions are separate to the four-stage roadmap with the Cabinet Office carrying out an investigation on their necessity in recent weeks.

Relaxing the “one metre plus” rule and mask-wearing are seen as key parts of the return to normal, with the hospitality industry warning lower numbers in bars and restaurants due to the restrictions are taking their toll on businesses.

The commencement to Stage Four without the ending of compulsory social distancing would deal a significant blow to those hoping to put Covid firmly behind them this summer.

A fortnight ago the Prime Minister vowed to unveil the reviews by the end of this month.

Downing Street backtracked on the pledge last week following concern about the Indian variant of the virus spreading through the U.K.. …

Mr Johnson is now thought to be so confident in the data that he intends to make his announcement on the Covid reviews this week as was originally planned.

The announcement will not confirm if Stage Four is going ahead on June 21st but will give a clearer sense as to how much of pre-pandemic life will return when the last step is implemented.

The Prime Minister has said at least four weeks is needed to assess the impact on infections from the most recent easing of restrictions on May 17th.

A decision on Stage Four will be announced on June 14th at the earliest.

While the Indian variant is now thought to be dominant in some parts of the U.K., scientists are optimistic.

Worth reading in full.

Stop Press: Sky News thinks otherwise and has reported that the review of social distancing rules is likely to be delayed because of the Indian variant.

News Round Up