Research and analysis

HPR volume 14 issue 14: news (28 July and 3 August)

Updated 23 December 2020

COVID-19 surveillance and guidance update

The Department of Health and Social Care’s (DHSC’s) Contain Framework, published in early July, has been supplemented by further guidance on the Government’s Approach to Managing Local Coronavirus Outbreaks in England, published on 27 July.

Managing local outbreaks, the new guidance explains, involves actions encompassing: case monitoring (supervised by the Joint Biosecurity Centre and Public Health England (PHE) using the national, regional and local data available via the coronavirus dashboard); engagement and communication; testing; and local restrictions or national intervention.

Underlining the importance of further development of the NHS Test and Trace service in underpinning local outbreak management, the detailed policy paper Breaking chains of COVID-19 transmission to help people return to more normal lives: developing the NHS Test and Trace service (also referred to as the NHS Test and Trace business plan) was published on 30 July.

Up-to-date information on areas in England with local restrictions is available. Local restrictions were variously newly imposed or relaxed in late July, including for Leicester, Luton and Blackburn with Darwen. Restrictions were also in place for the North West of England from 31 July.

PHE and Public Health Wales data on COVID-19 prevalence, broken down by local authority, has been used by the Financial Times to produce an insightful visualisation, How the outbreak has unfolded in England and Wales, that usefully distinguishes between isolated clusters and community spread, from March up to mid-July.

On 3 August, DHSC announced it had signed contracts for the supply of new rapid, point-of-care coronavirus tests that will start to become available in hospitals and care homes, as well as laboratories, in the coming weeks. Oxford Nanopore’s LamPORE rapid test can process swab and saliva samples to detect the presence of COVID-19 in 60 to 90 minutes with the same sensitivity as the established polymerase chain reaction (PCR) lab technique. A second point-of-care testing technology, known as DnaNudge, developed at Imperial College, makes the PCR technology available in miniaturised equipment for use in non-lab environments.

National Weekly Surveillance Report (NWSR)

Summarising the national epidemiological picture, the latest NWSR (including data to 29 July) states:

‘There were small increases in COVID-19 activity noted in England across a number of surveillance indicators during week 30… At a local authority level, activity was highest in Blackburn with Darwen where incidence has continued to increase. Activity in Leicester continued to decrease.’

A significantly larger number of local authorities are listed as ‘of concern’ in the latest Local Authority Watchlist section of the NWSR, as follows:

• Blackburn with Darwen
• Leicester
• Oldham
• Bradford
• Hyndburn (Lancashire)
• Rochdale
• Pendle (Lancashire)
• Trafford
• Calderdale
• Kirklees
• Manchester
• Bolton
• Burnley (Lancashire)
• Tameside
• Stockport
• Bury
• Wigan
• Rossendale
• Oadby and Wigston (Leicestershire)
• Luton
• Eden (Cumbria)
• Sandwell
• Northampton (Northamptonshire)
• Peterborough
• Rotherham
• Wakefield

The infographic that accompanies the NWSR provides more detailed trend information, across a wider range of parameters than the Coronavirus Cases in the UK: daily updated statistics.

The latest epidemic curve for England (below), including week 30 data (up to 29 July) distinguishes between data from Pillar 1 testing (swab testing in PHE labs and NHS hospitals for those with a clinical need, and the most critical health and care workers) and Pillar 2 testing (mass-swab testing for critical key workers in the NHS, social care and other sectors).

Laboratory-confirmed COVID-19 cases (England) as at 29 July 2020 (by date of specimen collection).

Coronavirus Infection Survey

Latest data from the Office for National Statistics-led Coronavirus Infection Survey (CIS), that collates results from testing a cross-sectional sample of the population in England who live or work outside of institutional settings, was released on 31 July.

ONS concludes that, at national level, the trend of a decreasing number of people testing positive in England, seen in earlier reporting periods, has halted and there is evidence that incidence of new infections has increased.

ONS provisionally estimates that for the week 20 July to 26 July, 35,700 people in England had a COVID-19 infection (95% confidence interval: 23,700 to 53,200), equivalent to about 1 in 1,500 individuals.

On antibody status, the latest report notes that, as of 28 July, 6.2% of adults (95% confidence interval: 5.0% to 7.6%) from whom blood samples were taken tested positive for COVID-19 antibodies, equivalent to 1 in 16 people, or 2.8 million people, in England.

RIDDOR-reported cases

Reduced economic activity in recent months contributed to a statistically significant decrease in fatal occupational injuries in Great Britain in financial year 2019/20, according to provisional Health and Safety Executive (HSE) official statistics covering occupational injuries and diseases reported to HSE and local authorities under “RIDDOR” reporting regulations. There were 111 such fatal accidents in GB in 2019 to 2020 (the lowest on record), 38 fewer than in 2018 to 2019.

Also published this month was information about work-related COVID-19 disease reports made by employers between 10 April and 11 July. RIDDOR-reported coronavirus cases (most from the healthcare and social care sectors, which are subject to investigation by HSE) fell week-on-week since peaking in late April.

Most work-related disease data, including data on deaths consequent to RIDDOR-reported COVID-19 cases, will be published by HSE later this year. Latest mesothelioma statistics, published this month, indicated that past exposure to asbestos killed 2446 in GB in 2018.

COVID-19 guidance update

Recently published or updated new infection prevention and control guidance included that for food businesses, updated on 22 July.

Also, a new illustrated guide for health and social care workers working in the community was added to the PPE personal protective equipment hub resource webpage.

On 30 July, existing infection prevention and control guidance relating was amended to take account of revised advice, from all UK chief medical officers, that the self-isolation period for those in the community who have coronavirus symptoms, or a positive test result, was extended from 7 to 10 days.

Similarly, guidance was updated to take account of the pausing of shielding for people defined as extremely vulnerable on medical grounds.

The Department for Transport updated its travel corridors webpage so as to remove Serbia, Spain and Luxembourg from the ‘exempt’ list of countries from which travellers arriving in the UK do not have to self-isolate (on 10, 25 and 30 July, respectively).

Independent review of drugs: public consultation

DHSC has launched the second phase of its Independent Review of Drugs, led by Dame Carol Black, starting with an online public consultation on effective interventions to prevent illicit drug use, improve treatment and recovery, and reduce harm caused by substance misuse in England.

Open until 6 August, the online consultation is particularly aimed at those using drug services, those in recovery and those with lived experience of addiction to illicit drugs.

Launch of the second phase of the review follows publication in February of a detailed first phase report covering the market, supply dynamics and trends in illicit drug use in the UK. Key outputs from the first part of the review were:

• a 20-page executive summary, published in February
• a 125-slide PowerPoint ‘evidence pack’, Review of Drugs: evidence relating to drug use, supply and effects, including current trends and future risks

The report, United Kingdom Drug Situation 2019: Focal Point Annual Report, produced by the UK Home Office, PHE and the Devolved Administrations, has also been published.

Infection reports in this issue of HPR

Routine reports of gastrointestinal infections in humans (England and Wales): May and June 2020

Laboratory reports of respiratory infections made to PHE Colindale from PHE and NHS laboratories in England and Wales: weeks 24 to 28, 2020.