UK COVID-19 Update: Vaccine Call-up for All Adults, Delta Variant Cases Surge, Pandemic Surgery Backlog 'Will Rise'

Peter Russell

June 18, 2021

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

Vaccine Call-up For Over-18s

All adults aged 18 and over in England are now eligible to book a COVID vaccine, in what the head of the NHS called "a watershed moment".

The NHS has begun sending out around 1.5 million texts. It said it was braced for high demand after the first group of people in their 20s to be offered vaccines booked more than one million appointments in a single day.

Sir Simon Stevens, NHS England chief executive, said that "hard working NHS staff have given more than 60 million vaccinations in England alone, saving thousands of lives and giving the entire country hope for a brighter future".

Prime Minister Boris Johnson commented: "Offering all adults a jab less than 200 days after the programme launched is one of our country’s greatest collective achievements, saving over 14,000 lives so far.

"I cannot thank NHS staff, the Army, volunteers, manufacturers, and all those involved in this extraordinary national effort enough."

Dr Emily Lawson, NHS England lead for the COVID Vaccination Programme, added: "We know that getting both doses is vital to maximising the positive impact of the vaccines. If you're offered the chance to bring forward your second jab, please do so, and most importantly come forward for both appointments."

People aged 39 and under who are eligible and pregnant women will be offered the Pfizer or Moderna vaccine in line with updated JCVI guidance.

In Northern Ireland and Wales, the COVID vaccination programme had already been open to those aged 18 and over.

As part of the campaign to encourage younger people to take up the offer of a vaccine, the Department of Health and Social Care promoted a short film featuring Eddie Hearn, Ricky Hatton, Conor Benn, Terri Harper, and Campbell Hatton in which they encourage fans to get COVID-19 vaccines, hailing them "the best jab" available.

Boxing promoter, Eddie Hearn, said: "I've seen a few jabs in my time, but the COVID-19 jab is important and will make a big difference."

Delta Variant Cases Rise by 79%

A total of 75,953 cases of the Delta variant of SARS-CoV-2 have now been identified in the UK – up by 33,630, Public Health England said.

It said data up to June 14 showed that 99% of sequenced and genotyped cases across the UK were the Delta variant.

A total of 806 people have been hospitalised with the Delta variant, an increase of 423 since the previous week. Of those, 527 were unvaccinated, and 84 had received both doses of a COVID vaccine.

Dr Jenny Harries, chief executive of the UK Health Security Agency said: "Cases are rising rapidly across the country and the Delta variant is now dominant.

"The increase is primarily in younger age groups, a large proportion of which were unvaccinated but are now being invited to receive the vaccine.

"It is encouraging to see that hospitalisations and deaths are not rising at the same rate but we will continue to monitor it closely."

COVID Cases Rise

The latest COVID surveillance study from Public Health England (PHE) showed an increase of cases in all age groups, regions, and ethnic backgrounds.

Case rates continue to be highest in those aged 20 to 29, with a case rate of 195.9 per 100,000 population. The lowest case rates were in those aged 80 and above, with a rate of 9.6 per 100,000 population.

Hospitalisation rates also rose across all regions, with highest rates in the North West, according to the data up to June 15.

COVID-19 vaccine coverage was 56.1% for a first dose at the end of week 23, and 40.9% for a second dose.

Seroprevalence data indicated that around 79.1% of the population have antibodies to SARS-CoV-2 from either infection or vaccination, compared with 14.8% from infection alone.

Dr Yvonne Doyle, medical director of PHE, commented: "We now know that two doses of either vaccine offers very high levels of protection against hospitalisation from all variants, including Delta, and so it is important to take up the offer of the vaccine to protect yourself and others." 

England's R number is now 1.2 to 1.4, and the growth rate is +3% to +6% per day.

Office for National Statistics (ONS) infection survey data for the week ending 12 June estimate:

  • In England, 1 in 520 people has COVID-19

  • In Scotland, 1 in 600 people had COVID-19

  • In Wales, 1 in 1500 people had COVID-19

  • In Northern Ireland, 1 in 610 people has COVID-19

Reinfection Rates

There have been 15,893 possible reinfections with SARS-CoV-2 in England up until the end of May this year, figures from PHE suggested for the first time.

There were 53 confirmed reinfections, and 478 probable reinfections.

Dr Susan Hopkins, strategic director for COVID-19 at PHE, said: "While we know that people can catch viruses more than once, these data currently suggest that the rate of COVID-19 reinfection is low."

"However, it is important that we do not become complacent about this, and it is vital to have both doses of the vaccine and to follow the guidance at all times to reduce your chance of any infection."

PHE said that work is ongoing to better understand the factors that make someone more likely to catch COVID-19 again, and the impact of vaccine status.

There was currently no evidence that the Delta variant, or any other variants of concern, were more likely to cause reinfection than others, it said, and evidence suggests that most reinfections will not cause symptoms.

Reinfection data will now be published regularly as part of the weekly surveillance report.

Surgery Rates Falling

Surgical activity in England and Wales fell by 33.6% in 2020, resulting in more than 1.5 million cancelled or postponed operations, researchers said.

The study, in the British Journal of Anaesthesia, found that it represented the postponement or cancellation of more than 1.5 million surgical procedures.

The research team, led by Swansea University Medical School, said that the problem would continue to worsen in 2021 and that it could take the NHS many years to catch up on the backlog.

"We predict that by the end of 2021, there will be 2.4 million surgical procedures outstanding, representing more than 6 months of normal surgical activity," the study said, adding that it was "imperative that surgical patients are not the forgotten casualties of the pandemic".

Prof Neil Mortensen, president of the Royal College of Surgeons of England, said that the findings underlined the need for the Government to "make resources available to enable clinicians and health care workers to meet the demand for elective surgery".

In a separate study in the same journal, researchers at Queen Mary University of London  found that 1 in 100 surgical patients were infected by SARS-CoV-2 in the English NHS during 2020, most of whom had required emergency surgery.

Elective surgical patients who developed SARS-CoV-2 infection were 25 times more likely to die while in hospital, the researchers said.

The findings underlined the need for some hospitals to be "designated as surgical hubs for specified types of elective procedures by bringing skills and resources together under one roof in COVID-secure environments", Prof Mortensen said.

Meanwhile, a study by University College London (UCL) found that 12% of all adults in England over 50 had a hospital operation or treatment cancelled in 2020, rising to 20% for those who had two or more comorbidities.

The briefing paper also suggested that while fewer cases of dementia were diagnosed in lockdown compared with before the pandemic, possibly due to lockdown isolation meaning that symptoms of cognitive decline went unnoticed, diagnoses for arthritis, chronic lung disease, diabetes, and hypertension actually increased.

"Our study shows that access to health and social care services during lockdown may have disproportionately affected older people and those with multiple medical conditions," commented Dr Paola Zaninotto, who led the investigation.

Data was drawn from 7289 adults enrolled in the English Longitudinal Study of Ageing (ELSA) who provided data before the pandemic in 2018 to 2019. A comparison was then made with 5825 adults between June and July 2020, and 5339 between November and December 2020.

Of the 623 adults who had had their operations or treatments cancelled between March and December in 2020, nearly half were still waiting in November and December for appointments to be rescheduled, the researchers said.

Diagnosis rates for dementia dropped from 9.09 per 1000 adults prior to the pandemic to 4.53 per 1000 adults in June and July 2020, before a further dip to 3.58 adults per 1000 in November and December last year.

In contrast, diagnosis rates for arthritis increased from 29.11 per 1000 adults before the pandemic to 50.59 per 1000 in November and December 2020.

Dr Zaninotto said the reasons for an increase in diagnoses for some conditions remained unclear, although "fewer opportunities for physical activity and social interaction may have played a part".

Authorisation Extended for Lateral Flow Devices

The Medicines and Healthcare products Regulatory Agency (MHRA) has extended exceptional use authorisation (EUA) for NHS Test and Trace lateral flow devices (LFDs) used as part of the Government's asymptomatic testing programme to August 28.

The MHRA said it followed a satisfactory outcome of a review undertaken after the US Food and Drug Administration last week called on the public to stop using the devices manufactured by US diagnostics firm Innova because "the performance of the test has not been adequately established, presenting a risk to health".

Innova has been an approved supplier of NHS Test and Trace LFDs.

Graeme Tunbridge, MHRA director of devices, said that "the MHRA has undertaken a thorough review to ensure that we were satisfied with the assessment and any action proposed".

He said: "We have now concluded our review of the risk assessment and are satisfied that no further action is necessary or advisable at this time. This has allowed us to extend the EUA to allow ongoing supply of these LFDs over the coming months.

"People can be assured of the MHRA’s work to continuously monitor the tests in use; as is our standard process."

Wales Announces Pause to Lockdown Easing

Wales announced a 4-week pause to COVID restrictions.

First Minister Mark Drakeford said it would allow the vaccination programme to catch up with the spread of the Delta variant.

"We have the lowest coronavirus rates in the UK and the highest vaccination rates for first doses, said Mr Drakeford. "A four-week delay in relaxing restrictions could help to reduce the peak number of daily hospital admissions by up to half, at a time when the NHS is very busy supporting all our healthcare needs."

The regulations for Wales will be reviewed on July 15.

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

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