UK COVID-19 Update: 'A Merry LITTLE Xmas'

Tim Locke

December 16, 2020

These are the UK coronavirus stories you need to know about today.

'Small, Short, Local Xmas'

Relaxation of lockdown over Christmas will continue despite yesterday's joint warning from the BMJ and HSJ. However, there's some confusion after today's ministerial statements.

Prime Minister Boris Johnson told the Commons the four UK nations had reached a "unanimous agreement" to keep the plans for three household mixing but said people should "exercise a high degree of personal responsibility".

Wales' First Minister Mark Drakeford recommended that only two households should meet. "A smaller Christmas is a safer Christmas and a shorter Christmas is a safer Christmas," he said.

He also announced another Wales-wide lockdown from December 28.

Scotland's First Minister Nicola Sturgeon also made a statement recommending people only get together on 1 of the 5 days, and not stay overnight unless it is unavoidable.

Mr Johnson later told a Downing Street news briefing: "Having looked at the latest data with our colleagues in the devolved administrations in Scotland, Wales, and Northern Ireland, we've decided that the overall situation is, alas, worse and more challenging than we'd hoped when we first set the rules."

The PM continued: "We are collectively, across the UK, governments at every level, asking you to think hard, and in detail about the days ahead, and whether you can do more to protect yourself and others. We're keeping the laws the same but we all want to send the same message."

He echoed the message about a smaller Christmas, adding: "Have yourself a merry little Christmas and I'm afraid this year, I do mean little."

Chief Medical Adviser Professor Chris Whitty added: "Keep it small. Keep it short. Keep it local."

When it came to the difference between the law and the guidance, "Just because you can doesn't mean you should," he said.

Wales later said the two household limit will become law not just guidance.

The BMA had requested a review of the plans, with Chair of Council, Dr Chaand Nagpaul, saying: "The health service and its staff are already being stretched to the limit as they care for those with COVID as well as trying to treat the tens of thousands of patients who have been waiting months for surgery. Add to this the usual winter pressures and the fact we have less beds than this time last year and we have a recipe for catastrophe."

Vaccination 'Really Good Start'

The first week of COVID-19 vaccination saw 137,897 jabs carried out across the UK.

  • England: 108,000 jabs

  • Scotland: 18,000

  • Wales: 7897

  • Northern Ireland: 4000

Vaccines Minister Nadhim Zahawi said on Twitter that it was "a really good start" and that the number will increase "as we have operationalised hundreds of PCN (primary care networks)".

However, there have been reports of vaccination clinics being cancelled at short notice due to supply problems.

A report from the National Audit Office (NAO) looks at the Government's purchase of up to 267 million doses of five vaccines at an expected cost of £2.9 billion and rollout plans.

In England, it was estimated that 25m people could be vaccinated in 2021 "if and when, sufficient vaccine becomes available". That's just over half of the adult population of England (45.5m).

NAO Head Gareth Davies said: "Developing and securing an effective vaccine is central to reducing the impact of COVID-19 on society and saving lives. Government has worked quickly and effectively to secure access to potential vaccines, using the available information to make big decisions in an inherently uncertain environment.

"With one vaccine now approved for use and its rollout started, significant challenges remain. Efficient delivery to the UK population presents complex logistical challenges and requires excellent communication with the public."

Vaccine Willingness

BAME groups are less likely to want to have COVID-19 jabs, according to polling commissioned by the Royal Society for Public Health (RSPH).

Among BAME respondents, 57% were likely to accept a COVID-19 vaccine, compared to 79% of White respondents. Confidence was lowest among Asian ethnicity respondents (55%).

Overall, 76% of 2076 adults polled 4-6 December would have the jab if advised to do so by their GP or health professional but 8% were unlikely to do so.

Thirty-five percent of BAME respondents who were unwilling to be vaccinated said they would be likely to change their minds if given more information by their GP about how effective it is.

RSPH Chief Executive Christina Marriott said in a news release: "It is highly concerning that both those living in poorer areas and those from Minority Ethnic communities are less likely to want the vaccine.  However it is not surprising.  We have known for years that different communities have different levels of satisfaction in the NHS and more recently we have seen anti-vaccination messages have been specifically targeted at different groups, including different ethnic or religious communities.

"But these are exactly the groups which have suffered most through COVID.  They continue to be most at risk of getting ill and most at risk of dying. So the Government, the NHS and local public health must rapidly and proactively work with these communities.  And their most effective ways of working will be with the local community groups."


The Office for National Statistics has estimated that long COVID affected 9.9% of people who had COVID-19 after 12 weeks.

The most common symptoms were fatigue, cough, and headache.

Dr David Strain, University of Exeter Medical School, commented via the Science Media Centre: "These preliminary data are very concerning, suggesting that 10% of people who have experienced COVID are left with residual symptoms after 3 months - more than twice the rate than we previously thought. It also highlights that the majority of people who contract COVID have symptoms for over a month."

Pregnancy Appointments

Latest guidance changes in England say that pregnant women can have one person to accompany them to appointments, scans, labour and delivery.

Pregnant women "value the support from a partner, relative, friend or other person through pregnancy and childbirth, as it facilitates emotional wellbeing," the guidance said.

Dr Edward Morris, president of the Royal College of Obstetricians and Gynaecologists, welcomed the guidance, and said more clarity was needed: "With increasing prevalence of the virus in many areas and more than 60% of the country under Tier 3 restrictions, decisions about visiting and access for partners and families will need to be based on local information and testing capacity, and clearly communicated to women and their families.

"We also call on the Government to clarify legislation which suggests women attending for medical care who test positive for COVID-19 or who are in mandatory self-isolation cannot be accompanied by a support person."

GP Appointments

A survey of 1004 UK GPs for Cancer Research UK finds 38% said their practice was finding it hard to meet demand for remote consultations, and 35% for face-to-face appointments. 

Many also reported increased waiting times for cancer-related diagnostic tests and procedures:

  • 75% for ultrasounds

  • 69% for upper GI endoscopies

  • 62% for lower GI endoscopies

  • 61% for chest X-rays

  • 55% for blood tests

  • 49% for CT scans

  • 46% for MRI scans

Dr Jodie Moffat, the charity's head of early diagnosis, commented: "GPs and NHS staff have worked incredibly hard during this challenging year to manage the increased strain COVID-19 has put on an already stretched system. But many patients are still a long way off receiving the swift cancer diagnoses that will give them the best chance of being treated successfully, and worryingly we don’t yet know what the long-term impact on cancer stage and survival will be."

Telemedicine Concerns

Yesterday we reported how telemedicine is getting a bad press. Now a survey finds 83% of doctors are worried that the move to remote consultations could leave some vulnerable patient groups behind. Factors include digital literacy, disability, language, location, or internet problems.

Polling for the Medical Protection Society (MPS) involved 1250 UK doctors and found that 70% agreed telemedicine had unquestionable benefits during the pandemic, and that it will remain a fundamental tool in practice.

Dr Pallavi Bradshaw from MPS commented: "As doctors have highlighted in our survey, if patients feel excluded from telemedicine, this could lead to a breakdown in the doctor/patient relationship or conditions going untreated.  A significant number of doctors are concerned about the potential for medicolegal disputes and investigations to arise from this and other limitations of telemedicine."

Travel Testing 'Chaos'

Testing for international passengers arriving in the UK who are willing to pay for it began yesterday under the Test to Release scheme.

However, Sky News reported the scheme got off to a "chaotic start" with 11 of the private testing firms involved having trouble providing the service, and one asking to be withdrawn as a provider.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.


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