Day: 15 July 2021

What’s Behind the Covid Surge in the Netherlands?

The Netherlands has been in the news this week after Prime Minister Mark Rutte apologised for reopening nightclubs at the end of June following a surge in infections that came in the following two weeks. Rutte has now closed them again for a month amid allegations that he made a “criminal choice” and “put people in danger”.

The rise in positive tests certainly looks alarming – though note the past four days has seen a slowdown.

However, the rise needs to take into account that when night clubs and other venues reopened there was a requirement that guests presented a negative COVID-19 test (or proof of vaccination, but few in the relevant age group are vaccinated) within 40 hours prior to entry. This means lots of asymptomatic or mild infections in young adults are now being picked up that were previously going under the radar.

“Open a Window”: How Many Are Dying Because This is Still the Best ‘Treatment’ the NHS Offers to Those Suffering With COVID-19 at Home?

The highly recommended HART bulletin this week has a piece on how the NHS is failing Covid patients by not offering any adequate early treatment, despite the now plentiful evidence of the clinical effectiveness of a number of safe, repurposed drugs.

Nearly a year and a half after the country was locked down to protect the NHS, how is the NHS performing in managing the very condition that so threatened it?

If you suspect that you or a member of your household is suffering from COVID-19 the advice is to get a test and contact NHS 111 for advice. When you do this you are asked a series of questions designed to ascertain how seriously ill you are. If you report “red flag” symptoms such as severe breathlessness or oxygen saturations below 90% quite rightly you are advised to call 999. But what about the less severe cases? The National Institute for Health and Care Excellence (NICE) has issued guidance to clinicians on how to assess and manage patients with COVID-19. Patients not severely ill and requiring hospital admission are managed in the community. The guidance advises symptomatic treatment such as a teaspoon of honey or linctus or even morphine sulphate tablets to suppress coughing. This in itself is bizarre advice, given that the British National Formulary (BNF) only recommends morphine for treatment of cough in palliative care with a ‘reminder of the risk of potentially fatal respiratory depression’.  Paracetamol or ibuprofen is recommended for fever. For breathlessness it advises to keep the room cool and open a window. For agitation and anxiety it even recommends a trial of a benzodiazepine (a tranquiliser medication) despite this potentially leading to respiratory depression.

What does not feature in the guidance is early treatment of COVID-19 in the community. Drug treatments such as dexamethasone and remdesivir are recommended for hospital patients. There are a number of established medicines such as ivermectin, hydroxychloroquine, zinc and famotidine which have been advocated for early treatment. The evidence in favour of ivermectin, in particular, is growing rapidly as this meta-analysis by HART member Professor Norman Fenton and his colleague Professor Martin Neil shows.

Similarly, early administration of inhaled budesonide (an asthma drug) has been shown to reduce the likelihood of needing urgent medical care and reduced time to recovery while a peer-reviewed study in the USA showed fluvoxamine (a common antidepressant drug) prevented clinical deterioration in outpatients with clinical COVID-19.

The U.K. has been quick to roll out COVID-19 vaccines that are still undergoing their clinical trials yet seems reluctant to explore the possibility of cheap treatments with long established safety records. Surely this begs the question why?

Read the bulletin in full here and sign up to receive the next one here.

Ipsos MORI Poll Showing Large Support for Permanent Restrictions Far Off the Mark, New Data Suggests

A new polling organisation, Prolific, has challenged recent polling by Ipsos MORI that suggested a surprisingly high percentage of Brits believe lockdown restrictions should stay in place “permanently”.

Prolific believed that if the questions asked by Ipsos MORI were changed slightly, the results would come out very differently. How right it was! The results of its own poll have been published in the Financial Times.

A 70-person Oxford-based polling start-up called Prolific… decided to carry out their own 24-hour survey, using a representative sample of 978 people in the U.K. – very similar to the Ipsos poll which surveyed 1,025 people – to see what the results would be if they changed the questions a little. As they explained to us: 

“We ran pretty much the same study as Ipsos, but we… adapted our survey accordingly. Specifically: 

“We added a timeframe to the study, ‘Until Restrictions lift on July 19th’ We removed the word ‘rule’ from the study and replaced it with ‘idea’ 

“We modified the wording of the scale items to make it seem less like a rule, e.g. ‘Having to wear masks in shops and on public transport’ → ‘Wearing a mask in shops and on public transport’ .”

Prolific also changed the question that Ipsos had asked about restrictions remaining in place “permanently, regardless of the risk of Covid” to “permanently, even if there were little to no risk of Covid” – as we pointed out in our post earlier this week, the word “risk” tends to have negative associations, 

And it turns out the results from all these changes were rather different. Specifically: 

“Just three per cent support a permanent curfew, compared to 19% according to Ipsos.

“Just six per cent support permanent closure of nightclubs, compared to 26% according to Ipsos.

“13% supported a permanent 10-day quarantine when returning from foreign holidays, compared with 31% according to Ipsos. 

When it came to masks, there was slightly less of a difference between the two polls: 31% said they should continue to be worn in shops and on public transport, compared with 40% in the Ipsos poll who said wearing a mask in a public place should be mandatory. 

Here is what the Prolific poll results look like as a whole, compared with the Ipsos results represented as crosses (full key below):

What a difference! And as Will Jones recently highlighted, “actions speak louder than words”. The fact that so many people are deleting the NHS Covid app – or never downloaded it in the first place – is surely an indication of the true level of support behind Covid restrictions.

Worth reading in full.

In What Circumstances are Lockdowns Justified?

We’re publishing a guest post by Dr David McGrogan, an Associate Professor of Law at Northumbria Law School, asking whether the state is ever justified in imposing a lockdown? Dr MrGrogan thinks it might be justifiable in certain limited circumstances, but those haven’t arisen over the past 16 months and are unlikely to rise in the near future.

Whether we like it or not (spoiler alert: none of us does), lockdowns, mandatory face mask wearing, social distancing and so on are now tools of public health policy and will be deployed again – probably next winter. We must continue to oppose this. But we must also recognise that for most of the population – and certainly for our politicians – the question simply is no longer whether these restrictions should be imposed, but which ones and in what circumstances. My personal answer to those questions is ‘none’ and ‘never’, but I have to recognise that insisting on ideological purity on this point will get us nowhere.

We need, in other words, to think seriously about when governments should be permitted to use these extraordinary powers if we have to accept as a matter of fact that they evidently do in practice have them.

Our courts have been singularly unhelpful in providing any guidance on this, having repeatedly spurned opportunities to do so. So have our legislators, who – with honourable exceptions such as Steve Baker and Charles Walker – have at best been pusillanimous, and at worst simply egged the Government on. It is incredible that 18 months into all of this it should still be the case that Government ministers simply appear on TV and in newspapers to tell us what we can and cannot do from month to month without any principled or evidentiary basis, let alone any reference to legal principle. But that is indeed what is happening. This is a humble attempt to remedy that situation.

First, let’s begin by granting that governments should have emergency powers and that this is arguably ultimately what being a government is all about. Few would suggest that the Government’s widespread use of emergency powers during WWII was illegitimate, to use the paradigm example. And let us also grant that there may be circumstances in which governments should exercise those powers to protect the health of the population through controlling disease. If the ‘brain-eating amoeba’, which has an IFR above 95%, were to somehow become airborne and communicable, for example, then there are few who would suggest that the government should not act to attempt to restrict its spread. Magistrates have for many years had the power to order quarantines and restrictions on movement for individual people or groups of people in order to stop the spread of disease, and there is nothing unusual about it – although one does have to say that in cases of truly serious emergency like the imaginary one described above, there probably would not need to be any legal restrictions because people would just stay at home anyway.

Sainsbury’s and Tesco to Continue Telling Customers to Wear Face Masks After ‘Freedom Day’

A growing number of retail giants are going to continue asking customers to wear face masks in their stores after the much-anticipated ‘easing’ of restrictions on ‘Freedom Day’. The Government says that it “expects and recommends” people to continue mask-wearing after July 19th – a plea that has so far been backed by Waterstones, Sainsbury’s, Tesco and more. What’s most disappointing is that this appears to be what customers want. BBC News has the story.

Sainsbury’s said signs and tannoy announcements would remind shoppers to cover their faces.

Tesco said it wanted to “be on the safe side”.

The chain will also continue to limit the number of shoppers in store at any one time.

The Government has said it “expects and recommends” shoppers in England to wear face masks from Monday. But the legal requirement to cover your face in enclosed spaces will end. Different rules apply in the devolved nations.

The new guidance leaves firms to decide their own safety policies after July 19th when Covid rules are lifted. …

Primark has said it won’t have signage requesting customers to wear masks but hopes they will continue to do so. John Timpson, Founder of the keycutting and shoe repair chain, said the decision would be left to customers.

Sainsbury’s said its strategy reflected feedback from customers and colleagues, with the majority of those surveyed in favour of keeping the mask policy in place.

The chain said some Covid measures, such as screens between self-service checkouts and checkout queues, would be gradually removed. However screens between checkout staff and customers will remain in place. …

Dr Roger Barker, Policy Director at the Institute of Directors, said: “Like everybody else, businesses across the country having been awaiting ‘Freedom Day’ with bated breath.

“But instead we have had a series of mixed messages and patchwork requirements from Government that have dampened that enthusiasm.”

Worth reading in full.

Norwich Pub Becomes First in Britain to Announce Vaccine Passport Checks for Punters

A report in the Telegraph suggests that the Government could urge pubs, bars and restaurants to check vaccine passports. One pub in Norwich didn’t need any persuading and has become the first in the country to announce that it will discriminate against unvaccinated Brits.

Philip Cutter, the Landlord of The Gardeners Arms, decided to introduce vaccine checks after two of his 25 bar staff tested positive for Covid, forcing him to shut for 10 days, according to reports. He also appears to have been egged on by Public Health England, which warned against relying on people being honest when submitting Covid test results to show at the door. The MailOnline has more.

Customers will be asked to show their vaccination card or NHS phone app showing proof of vaccination before they are allowed in his pub and his neighbouring café and bar called The Murderers.

Mr Cutter said: “I have not heard of any other pubs doing this. It just seems a common sense thing to do to protect my staff and customers and my business going forward.

“I know nightclubs have been asked to consider looking into some sort of vaccination passport. We are a busy city centre venue so we are not very different.

“If we were in a position where this Delta variant was not running riot, then we would be looking at things slightly differently.

“But there is a lot of virus out there and I want to do my best to protect everyone in my building.”

Mr Cutter said that people would only be admitted with proof of having been vaccinated at least two weeks earlier to give them a chance to have developed antibodies.

He added: “I have had a lot of support from older customers who are really pleased and say they will feel more comfortable about coming in.

“However, there are one or two people who are virulently against the idea, and see it is as yet another measure to curtail their freedom.

“But with around 80% of British adults having been vaccinated, I think that the majority of people are going to be happy with it. …

“I don’t want to turn anyone away, but I have got to make a call to protect my customers, staff and business.

“All it takes is one person to come in with some semblance of the virus to pass it on.” …

He added: “We’re not trying to discriminate or embarrass anyone, we’re just trying to make sure our staff and customers are safe. …

“We spoke to Public Health England about doing lateral flow tests instead, but they said the issue is you have to trust the person who submits the details.”

Worth reading in full.

The Pingdemic: More Than Half a Million People in England ‘Pinged’ by Test and Trace App in Just One Week

Given the number of people being ‘pinged’ by Test and Trace, it is no wonder that so many are deleting the NHS Covid app or never bothered downloading it in the first place. The latest figures show that in just one week, more than half a million people in England alone were told they needed to self-isolate after coming into contact with someone who tested positive for Covid. Sky News has the story.

A total of 520,194 alerts were sent to users of the NHS Covid app in the week to July 7th, telling them they had been in close contact with someone who had tested positive for coronavirus.

This is up from 356,677 the previous week – a rise of 46% – and is the highest weekly figure since data was first published in January.

It comes as some companies are reportedly missing 20% of their workers.

Factories across Britain are in danger of closing down as a result of employees being ‘pinged’ by the app, union Unite warned.

The union said large numbers of workers are being told to self-isolate, with companies in the automotive industry particularly affected.

This morning Communities Secretary Robert Jenrick said the Government is “concerned” about the number of people off work due to being ‘pinged’ by the app.

Mr Jenrick told LBC radio today: “It is important that we have the app, that we take it seriously, that when we do get those messages we act accordingly.”

But Mr Jenrick said ministers would give “further thought” on how the Government can ensure it is a “proportionate response”.

Worth reading in full.

Police Arrive at House in Riot Van to Check 12 Year-Old Girl Is Self-Isolating

A Manchester mother is demanding an apology from the local police force for sending officers in a riot van to check that her 12 year-old daughter was self-isolating. The young girl was left “petrified” after officers shouted through the house to see if she had been following the rules, according to her mother. The home was visited twice, leading the girl to believe “she was going to get arrested at any moment”. The MailOnline has the story.

Officers visited the home of Kathryn Crook in Middleton, Greater Manchester, to check that Charlotte, 12, was adhering to Covid guidance after catching the virus.

Ms Crook, 45, says her daughter was terrified by the experience, alleging the behaviour of Rochdale Public Health Officers and Greater Manchester Police was “inappropriate and heavy-handed”.

She is now urging those involved to apologise for what she says was “overkill”.

Officers first visited the family home on July 11th and asked to speak directly to Charlotte, before quizzing her mother on whether she was self-isolating.

Ms Crook said: “They would not tell me and my husband why they wanted to speak to my daughter.     

“I suggested again that she was only 12 and as her mother, I should be the one they should speak to.

“My daughter by this time was stood behind me crouching thinking she had done something wrong and was petrified.

“The female police officer who stood at our door then proceeded to shout through to my daughter to check she had been isolating.

“I spent Monday trying to find out why this had happened only to be told by Rochdale Public Health Department that they had authorised this to happen.”

The furious mother later wrote to her MP Chris Clarkson to express her concern, and his office is now investigating the incident.  

She added: “During Monday we also received a letter addressed to our daughter from Rochdale council stating that she must get in touch with them as a matter of urgency about her isolating.

“I called the phone line and they said it was standard practice, even though the leaflet read as if aimed at an adult. I was also told the person who had signed it no longer works there.”

Ms Crook says the family then received another visit from GMP on June 12th.

“We settled down and just after 9pm got a knock at the door,” she said.

“It was the police again, this time in a riot van and coming to ‘check’ again that my daughter was isolating. 

“Me and my husband were so annoyed by this. The neighbours had also seen all of this and came out to show their support for us.

“They could see what had happened and a riot van in the street is a bit much. This time, however, the policeman was polite and was much more forthcoming than the two that had been the previous night. 

“It was terribly upsetting again for my daughter and she had another meltdown again thinking the police were going to arrest her.”

Worth reading in full.

News Round-Up