#AceHealthReport – May.05: Health services across the UK administered a total of 50,089,549 million vaccines between 8 December 2020 and 2 May 2021, including 34 million people with their first dose and 15 million with their second:
#CoronavirusNewsDesk – Over 50 million doses of the #COVID19 vaccine have been administered in the UK, with over a quarter of adults having received both doses’
Over 50 million doses of the COVID-19 vaccine have been administered
Over 29% of all UK adults have received the strongest possible protection
Data from Public Health England (PHE)’s real-world study shows the vaccines are already having a significant impact in the UK, reducing hospitalisations and saving more than 10,000 lives in England alone by the end of March.
The government remains on track to offer a jab to all adults by the end of July.
Health and Social Care Secretary Matt Hancock said:
Now we’ve delivered the 50 millionth jab, and 29.4% of the adult population have had the strongest possible protection of 2 doses, we have hit yet another incredible milestone in our vaccination programme.
The vaccine is our way out of this pandemic and the rollout had been a huge national effort. I want to pay tribute to the heroic NHS staff and volunteers who have worked tirelessly to deliver vaccines in every corner of the United Kingdom at a phenomenal pace.
We are on track to offer a jab to all adults by the end of July but our work is not over yet. We are now inviting everyone over 40 to get their jab. I had mine last week – it’s simple and easy and I encourage everyone else who is eligible to get the jab.
Vaccines Minister Nadhim Zahawi said:
The UK’s vaccination programme has been a huge success so far with more than 50 million doses administered – a fantastic achievement.
We have one of the highest uptake rates in the world and over 15 million people have now received 2 doses and maximum protection from this dreadful virus.
Every jab brings us one step closer to putting this pandemic behind us. I urge everyone to come forward as soon as they are eligible – the vaccine is safe, effective and could save your life.
An extra 60 million doses of the Pfizer/BioNTech vaccine have been secured by the UK government to help support preparations for the booster COVID-19 vaccination programme from the autumn, if clinically needed.
All vaccines being used in the UK have undergone robust clinical trials and have met the independent Medicines and Healthcare products Regulatory Agency’s strict standards of safety, effectiveness and quality.
Approved vaccines are available from thousands of NHS vaccine centres, GP practices and pharmacies. Around 98% of people live within 10 miles of a vaccination centre in England and vaccinations are taking place at sites including mosques, community centres and football stadiums.
Daily coronavirus tests will be given to as many as 40,000 people who have been in contact with someone who has tested positive for COVID-19, in a new government-backed study designed to gather evidence on safe alternatives to self-isolation for people who are contacts of positive COVID-19 cases.
If successful, the study – led by the UK Health Security Agency (including Public Health England and NHS Test and Trace) – could provide evidence to help to reduce the length of time people who are contacts of positive COVID-19 cases need to self-isolate, as parts of the economy and society reopen through the Roadmap. A reduction in the period of self-isolation from 10 days could help prevent individuals having to miss work, while allowing people to continue to safely participate in society.
The launch of the England-wide exercise builds on the research pilots taking place in businesses, hospitals and schools. Since December over 200 schools, 180 workplaces and over 800 individuals have participated in daily testing pilots, which have proved effective in reducing the need for people to self-isolate, while detecting cases of Covid-19 that would not have otherwise been found. Participants of pilots have been able to safely reduce the length of time spent in self-isolation upon receipt of a negative daily test result.
Currently, anybody who has been notified through NHS Test and Trace as a contact of someone who has tested positive for COVID-19 must self-isolate for 10 days. For those contacts without symptoms, the new study aims to find out if people can replace the need to self-isolate by taking a test every day instead.
Close contacts of people with COVID-19 will be contacted by phone and sent 7 days’ worth of lateral flow tests (LFDs). The contacts are required to test themselves each morning for 7 days. People who test negative and develop no symptoms will be exempt from the legal duty to self-isolate that day and can leave their home to carry out essential activity.
They will need to take another test the next morning to see if they need to self-isolate that day or continue to be exempt. Individuals will still have to adhere to current restrictions, including following the rules on hands, face and space, and only those formally enrolled in the research study will be exempt from usual legal duties.
Health and Social Care Secretary Matt Hancock said:
With around 1 in 3 people not showing any symptoms, regular testing is already playing a critical role in helping us reclaim our lost freedoms – quickly spotting positive cases, helping identify new variants and squashing any outbreaks.
At every stage of this global pandemic, the British public has stepped up and made huge sacrifices – including self-isolating when they are asked. This new pilot could help shift the dial in our favour by offering a viable alternative to self-isolation for people who are contacts of positive Covid-19 cases, and one that would allow people to carry on going to work and living their lives.
Alongside the phenomenal progress of our vaccination rollout – with over 48 million vaccines administered so far – rapid testing is allowing us to get back to doing the things we all love.
When it launches on Sunday 9 May the study will offer people in England who are identified as a close contact of a positive case the opportunity to take part in the study, providing they do not have COVID-19 symptoms, are above the age of 18 and are not in full-time education.
The aim of the study is to compare two approaches to routine testing of contacts in order to determine the potential for onward transmission. The study will take the form of two randomly split groups, one of which will be given one PCR test and asked to self-isolate for the full 10-day period. The second group of participants will be given two PCR tests and 7 LFDs to test daily.
Ahead of the formal launch, the study is starting to collect evidence now on the effectiveness of daily contact testing while there is still prevalence of COVID-19 in the community.
Professor Isabel Oliver, National Infection Service Director at Public Health England and study lead, said:
We know that isolating when you have been in contact with someone who has tested positive for COVID-19 is challenging but it remains vitally important to stop the spread of infection. This study will help to determine whether we can deploy daily testing for contacts to potentially reduce the need for self-isolation, while still ensuring that chains of transmission are stopped.
Contacts of cases are at higher risk of infection so testing them is a very effective way of preventing further spread. This study will play an important part of our evaluation of daily contact testing and how the approach to testing might evolve.
With around 1 in 3 people not showing any symptoms of COVID-19, using regular testing, along with vaccines and social-distancing, are helping us keep infection rates low as restrictions are eased. Everyone in England is now able to access free, rapid, twice-weekly testing using LFDs. Since rapid testing was introduced, 145,765 positive cases of COVID-19 have been detected that would not have otherwise been found.
Since the end of February, there has been a robust surveillance programme in place and regular testing is helping us understand the level of virus circulating in the community. This daily testing study is part of the government’s efforts to control the virus and accelerate the return to a safe, secure normality. Only those formally enrolled in the research study will be exempt from usual legal duties.
Anyone who is identified as a contact by NHS Test and Trace as a contact will be offered to take part in the study. This won’t include people identified as a contact through the NHS COVID-19 app or through an informal channel. A person will be eligible to take part if they:
do not have COVID-19 symptoms
live in England
are not in full-time education
are aged 18 and over
are not under the quarantine rules for arriving in England
People will not be able to take part if they have been informed that they have been in contact with someone who’s tested positive with a variant of concern (VOC) or variant under investigation, or within a known workplace or school where a VOC or variant under investigation is circulating.
The MHRA has reviewed and contributed to the study protocol and is in contact with the Principal Investigator. Following the study, the results will be used to seek MHRA exceptional use authorisation to rollout out self-use LFDs nationally for daily contact testing services.
On daily contact testing the Scientific Advisory Group for Emergencies (Sage) said at its 11 March meeting: “Daily testing approaches may also offer other benefits in some circumstances (for example, fewer days of education missed if used in schools).” https://www.gov.uk/government/publications/sage-83-minutes-coronavirus-covid-19-response-11-march-2021
#AceHealthReport – Mar.12: The cases in South Gloucestershire are all close or household contacts of the 2 existing P.1 cases in the area: They were offered testing in response to the initial cases:
U.K.GOV #Coronavirus Report: Confirmed cases of #COVID19 variants identified in UK: ‘Latest updates on SARS-CoV-2 variants detected in U.K. Four more cases of Variant of Concern VOC-202101/02 (P.1) found in England’
Specialist contact tracing teams have undertaken a comprehensive investigation to identify any further contacts and additional testing has been in place since the initial cases were identified.
The individual in Bradford tested positive for coronavirus (COVID-19) in late February after travelling back from Brazil via Paris on 14 February 2021. Subsequent genomic sequencing confirmed the case as the P.1 variant. Contact tracing teams have followed up close contacts of the individual and advised them to isolate and get a test.
The latest cases bring the total number of P.1 variant cases in the UK to 10 – 7 in England and 3 in Scotland, all of which have links to travel or to a previously confirmed case that has travelled to Brazil.
New Variant Under Investigation (VUI) designated in UK
A new variant identified in the UK has been designated a Variant Under Investigation (VUI) by Public Health England.
VUI-202103/01 (lineage B.1.324.1) was designated a VUI on 4 March after 2 cases were found in the South East of England in individuals who had recently travelled to Antigua.
The variant contains the spike mutations E484K and N501Y, both usually associated with Variants of Concern (VOC), however it does not feature specific deletions that would lead to a designation as a VOC.
Contact tracing teams have completed thorough investigations to identify and follow up any close contacts and no additional cases have been found to date.
Friday 5 March
Contact tracers successfully identify sixth case of P.1 Variant of Concern
Public Health England (PHE) and NHS Test and Trace teams have successfully located the third individual in England who tested positive for the P.1 Variant of Concern that originated in Manaus, Brazil.
Tracing teams narrowed their search to a small number of households in Croydon, South London, when an individual from the borough made themselves known by responding to calls made by specialist contact tracers.
NHS Test and Trace were then able to match the barcode from the individual’s testing pack to the variant test result.
PHE is now carrying out enhanced contact tracing with the individual and other members of their household. The case had been in contact with an individual who travelled from Brazil in early February.
Although investigations are ongoing, current early indications are that all members of the household isolated for the correct amount of time after the traveller returned and after the case developed symptoms.
Doctor Fu-Meng Khaw, Strategic Response Director for PHE and Deputy Chief Medical Adviser for Test and Trace, said:
The identification of this individual is the result of an enormous collaborative effort between specialist teams at NHS Test and Trace and Public Health England.
Staff have been working around the clock to pursue every line of investigation and this is a fantastic result that enables us to fully investigate the circumstances around the case and reduce the risk of onward transmission.
As an additional precaution, we’re working closely with Croydon Council to put in place further testing in the area.
We are continuing to monitor all variants closely and the best way to protect against all COVID-19 infections is to remember the basics of Hands, Face, Space.
Thursday 4 March
New Variant Under Investigation designated in the UK
Sixteen cases of a new variant, VUI-202102/04 (lineage B.1.1.318), have been identified in the UK. The variant has been designated a Variant Under Investigation (VUI) by Public Health England (PHE).
Cases of this variant, understood to have originated in the UK, were first identified on 15 February through genomic horizon scanning. All individuals who tested positive and their contacts have been traced and advised to isolate.
Following assessments, the variant was designated a VUI on 24 February. It contains the E484K mutation, which is also found in 2 existing VUIspresent in the UK, but does not feature the N501Y mutation, present in all variants of concern (VOCs).
The addition of this variant as a VUI means there are now a total of 4 VUIsand 4 VOCs currently being tracked in the UK.
Cases with no travel links
As of 3 March:
a total of 59 cases of the variant VOC-202012/02, first detected in South Africa, have been found in England where no travel links could be established
a total of 26 cases of the variant VUI-202101/01, the P2 variant first detected in Brazil, have been found in England where no travel links could be established
Tuesday 28 February
Cases of Variant of Concern first detected in Manaus identified in the UK
Up to 6 cases of the Variant of Concern first identified in Manaus, Brazil (P.1) have been detected in the UK. Public Health England (PHE) has identified 3 of these cases of the Variant of Concern in England.
Two of the cases in England are from one household in South Gloucestershire with a history of travel to Brazil and there is a third, currently unlinked case.
The cases in South Gloucestershire were rapidly followed up by the PHEHealth Protection Team – cases and their contacts have been identified and retested. One case that had travelled to Brazil has been isolating at home with their household since returning to the UK.
PHE and NHS Test and Trace are following up with all passengers on Swiss Air flight LX318 travelling from Sao Paulo via Zurich and landing in London Heathrow on 10 February, to provide public health advice and test them and their households. Anyone who returned to the UK at that time should have gone home immediately from the airport and isolated for 10 days.
If you were a passenger on the flight and have not been contacted, please call 01174 503 174 to arrange a test for you and your household contacts.
Although the risk to the wider community is considered low, as a precaution, PHE, working in collaboration with South Gloucestershire Council and NHS Test and Trace, is taking swift and decisive action to deploy surge asymptomatic testing as well as increasing sequencing of positive samples from the area. Residents of South Gloucestershire should visit the council’s website for more information on testing. The most important actions are identifying cases and their contacts and supporting these individuals to isolate effectively.
Further investigation is underway regarding the third case in England. The individual did not complete their test registration card so follow-up details are not available. We are therefore asking for anyone who undertook a test on 12 or 13 February and hasn’t received their result or has an uncompleted test registration card, to call 119 in England or 0300 303 2713 in Scotland for assistance as soon as possible.
The P.1 variant has been designated ‘of concern’ as it shares some important mutations with the variant first identified in South Africa (B.1.351), such as E484K and N501Y. It is possible that this variant may respond less well to current vaccines, but more work is needed to understand this.
Dr Susan Hopkins, PHE strategic response director for COVID-19 and NHS Test and Trace Medical Advisor, said:
We have identified these cases thanks to the UK’s advanced sequencing capabilities which means we are finding more variants and mutations than many other countries and are therefore able to take action quickly.
The important thing to remember is that COVID-19, no matter what variant it is, spreads in the same way. That means the measures to stop it spreading do not change. Stay at home and if you do need to go out for essential reasons, cover your nose and mouth, wash your hands thoroughly and keep your distance.
We ask that individuals come forward for testing through the symptomatic and asymptomatic test sites across the countries in order to continue to drive down cases in the community.
Three cases of the variant have also been identified in Scotland but these are not linked to these 3 cases in England.
Tuesday 16 February
Public Health England (PHE) has identified 38 cases of COVID-19 which genomic sequencing has shown to feature a specific set of mutations which are currently being referred to as lineage B.1.525. The set of mutations includes the E484K spike protein mutation, which is present on a number of other variants of concern and variants under investigation.
This variant has been designated a Variant Under Investigation (VUI) and will be referred to as VUI202102/03.
The variant has been detected in other countries, including Nigeria, Denmark and Canada.
Cases are geographically dispersed across England. Enhanced contact tracing and genomic sequencing is underway to monitor the situation as it develops.
Professor Yvonne Doyle, Medical Director at PHE, said:
PHE is monitoring data about emerging variants very closely and where necessary public health interventions are being undertaken, such as extra testing and enhanced contact tracing.
There is currently no evidence that this set of mutations causes more severe illness or increased transmissibility.
The best way to stop the spread of the virus is to follow the public health advice: wash your hands, wear a face covering and keep your distance from others. While in lockdown, it is important that people stay at home, where possible.
Regular updates of confirmed variant cases will be provided on this page.
Friday 15 January
As of Thursday 14 January 2021, 35 genomically confirmed and 12 genomically probable cases of the SARS-CoV-2 variant which originated in South Africa (called VOC202012/02 in the UK, also named B1.351 and 501Y.V2 internationally) have been identified in the UK.
Two variants of interest have also been identified in Brazil. The first variant is variant under investigation (VUI) 202101/01 – this variant has a small number of mutations. The spread and significance of this variant remains under investigation. In partnership with COG-UK, 8 genomically confirmed cases of this variant have now been identified in the UK. All necessary public health action is being taken to follow-up the cases.
The second variant has been designated a Variant of Concern by NERVTAG, now termed VOC202101/02, and this variant has more mutations. We have NOT detected this second Brazil originated strain in the UK– this has been detected in Manaus and travellers arriving in Japan.
Laboratory work has begun on the VOC 202012/02 in the UK and is routinely undertaken on all variants under investigation or of concern once samples are available.
Dr Susan Hopkins, COVID Strategic Response Director at Public Health England, said:
We are continuing efforts to understand the effect of the variants on transmissibility, severe disease, mortality, antibody response and vaccine efficacy.
For now, our advice remains the same following detection of a Brazilian variant in the UK, even though this is not the variant detected in Manaus with more mutations: the best way to stop the spread of the virus is to wash your hands, wear a face covering and keep your distance from others. Whilst in lockdown, it is important that we also stay at home unless it is absolutely essential to go out.
Through COG-UK, the UK is a global leader in SARS-CoV-2 genomics, providing around 48% of the genomic data supplied to GISAID, the scientific initiative which allows global, real-time surveillance of the COVID-19 pandemic.
WGS is vital to the global response to the pandemic, allowing us to monitor and understand the evolution of new COVID-19 variants and respond with timely public health interventions.
The restrictions follow new data on the steep rise in incidence of the B1.351 variant, which has vastly increased the risk of community transmission between these 9 southern African countries, as well as the Seychelles and Mauritius which have strong travel links with South Africa.
From 15 January 2021, the DfT has also imposed a subsequent travel ban to the UK from several South American countries and countries with strong travel links to Brazil. Passengers who have been in or transited through Argentina, Brazil, Bolivia, Chile, Cape Verde, Colombia, Ecuador, French Guiana, Guyana, Paraguay, Panama, Portugal (including Madeira and the Azores), Peru, Suriname, Uruguay and Venezuela in the last 10 days will no longer be granted access to the UK.
British and Irish Nationals (and or third country nationals with residence rights in the UK) who have travelled from or transited through these countries must self-isolate for 10 days, as must members of their household. Contact tracing and testing of close contacts of confirmed cases will be used to identify and manage potential transmission. The decision to impose these restrictions has been taken to prevent the spread of the variant of coronavirus, known as VOC202101/02, into the UK.
The Isolation Assurance Service (IAS) will be contacting all returnees from all southern African countries, Mauritius and Seychelles to reinforce the advice to self-isolate, to encourage testing even if asymptomatic and to inform anyone treating/testing them of their recent travel.
Wednesday 23 December
The 2 cases were identified in the UK on 22 December 2020 and both have been in contact with someone who has travelled from South Africa. PHE’s Health Protection Teams have followed up with both cases and contact tracing is underway.
The new variant named B1.351 (also referred to as 501Y.V2) was first detected in Nelson Mandela Bay, South Africa, in samples at the beginning of October. Molecular dating suggests that it could have been in circulation from the end of August.
The rapid spread of the variant in South Africa could be an indication of increased transmissibility but this is not yet confirmed. PHE is investigating this variant and will share its findings in due course. There is currently no evidence to suggest that the variant has any impact on disease severity, antibody response or vaccine efficacy. Epidemiological and virological investigations are also ongoing in South Africa.
It is not uncommon for viruses to undergo mutations; seasonal influenza mutates every year. More than 4,000 variants of SARS-CoV-2 have been identified in the UK and variants have been observed in many other countries.
Dr Susan Hopkins, Chief Medical Adviser on COVID-19 to PHE & Test and Trace, said:
We are investigating this new variant of SARS-CoV-2 which originated in South Africa. Viruses often evolve and this is not unusual. We are carrying out work as a priority to understand the potential risk this variant may cause. It is important to say that there is currently no evidence that this variant causes more severe illness, or that the regulated vaccine would not protect against it.
The best way to stop infection is to stick to the rules – wash our hands, wear a face covering and keep our distance from others.
The recommended control measures to limit the spread of the new variant continue to be testing, following the existing public health guidance and abiding by the restrictions, including ‘Hands, Face, Space’ and limiting your number of contacts. DfT have announced new restrictions for everyone arriving in the country from South Africa.
The report published today (31 October) reviews the potential health impacts of shale gas extraction.
This review of the scientific literature focusses on the potential impact of chemicals and radioactive material from all stages of shale gas extraction, including the fracturing (fracking) of shale.
As there is no commercial shale gas extraction in the UK, the draft report looks at information from countries where it is taking place.
Dr John Harrison, Director of PHE’s Centre for Radiation, Chemical and Environmental Hazards, said:
The currently available evidence indicates that the potential risks to public health from exposure to emissions associated with the shale gas extraction process are low if operations are properly run and regulated.
Where potential risks have been identified in other countries, the reported problems are typically due to operational failure.
Good on-site management and appropriate regulation of all aspects of exploratory drilling, gas capture as well as the use and storage of fracking fluid is essential to minimise the risks to the environment and health.
Most evidence from other countries suggests that any contamination of groundwater, if it occurs, is likely to be caused by leakage through the vertical borehole. Therefore good well construction and maintenance is essential to reduce the risks of ground water contamination.
Contamination of groundwater from the underground fracking process itself is unlikely because of the depth at which it occurs.
Dr Harrison said:
PHE will work with regulators to ensure appropriate assessment of risk from all aspects of shale gas extraction.
The report makes a number of recommendations, including the need for environmental monitoring to provide a baseline ahead of shale gas extraction, so that any risks from the operation can be appropriately assessed.
Effective environmental monitoring in the vicinity of the extraction sites is also required during the development, production and post-production of shale gas wells.
In due course it will also be important to assess the broader public health impacts such as increased traffic, the impact of new infrastructure on the community and the effect of workers moving to fracking areas.
The draft report is being made available for comment for one month. PHEwill be pleased to be made aware of any peer-reviewed or published reports that are relevant to the findings or recommendations.
Notes to Editors
Review of the potential public health impacts of exposures to chemical and radioactive pollutants as a result of shale gas extraction: Draft for Comment. See a copy of the draft report.
Public Health England’s mission is to protect and improve the nation’s health and to address inequalities through working with national and local government, the NHS, industry and the voluntary and community sector. PHE is an operationally autonomous executive agency of the Department of Health. www.gov.uk/phe