UK COVID-19 Update: NICE VITT Guidance, Cancelled Cancer Ops, General Practice 'SOS'

Tim Locke

July 29, 2021

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

NICE VITT Guidance

The National Institute for Health and Care Excellence (NICE) published a rapid COVID-19 guideline on vaccine-induced immune thrombocytopenia and thrombosis (VITT).

VITT is rare with 14.2 cases per million doses.

People who are acutely unwell with suspected VITT should be sent to an emergency department immediately.

For other suspected cases in primary care, a full blood count should be taken.

VITT is confirmed using an ELISA test. However, if healthcare staff suspect that a patient has VITT they should start treatment in consultation with a haematologist without waiting for ELISA results.

Dr Paul Chrisp, director of NICE’s Centre for Guidelines, said: "Although VITT is a very rare condition, it’s crucial that healthcare professionals feel supported and able to swiftly identify and treat the small number of people who do develop it."

Test and Trace

The Test and Trace service in England recorded an 18% rise in positive cases 15-21 July compared with the previous week.

This figure of 307,758 is the highest weekly number of people testing positive since mid-January.

UK daily cases had been falling for 7 days in a row but rose again yesterday.

Public Health England surveillance indicators suggest that at a national level COVID-19 activity "decreased in some indicators" in week 29.

The hospital admission rate was 7.06 per 100,000 population, up from 6.06 per 100,000 population the previous week.

Dr Yvonne Doyle, PHE medical director, said: "Case rates remain high across the country, and we continue to monitor the data closely so we can understand how the pandemic is progressing. The pandemic is certainly not over, and I continue to urge caution."

The NHS COVID-19 app sent a record 678,102 contact tracing alerts in England, and 11,211 in Wales, the NHS said.

Of the 295,315 people transferred to England's Test and Trace system, 14.8% were not reached so couldn't be asked to provide details of recent close contacts.

Cancelled Cancer Ops

Some scheduled cancer operations are being cancelled in Belfast due to COVID-19 pressures.

"Regrettably, the Belfast Trust has made the difficult decision to cancel some cancer-related procedures which we are currently working to reschedule as soon as possible," a statement said.

"COVID-19 admissions continuing to rise has put increasing pressures on hospitals, which led to the trust taking the extremely difficult decision to cancel surgeries in order to expand our support teams caring for COVID-19 patients.

"We do not underestimate the anxiety and distress this causes patients and families affected and we sincerely apologise for this."

General Practice 'SOS'

The Royal College of GPs has issued an 'SOS' action plan for post-pandemic general practice.

College Chair, Professor Martin Marshall, said: "The launch of our five point action plan sends out an SOS for general practice – and crucially, it also provides realistic solutions for halting the crisis and protecting the care of our patients and the wider NHS by investing in the hardworking GPs and their teams who provide that care."

The plan includes:

●     Ramping up efforts to recruit 6000 more full time equivalent GPs in the next 3 years
●     Reducing bureaucratic burdens and unnecessary workload by 2024
●     Improving the recruitment and integration of at least 26,000 other staff members by 2024
●     Fit for purpose building and technology by 2024
●     A strong voice for GPs in the new integrated care systems

"We simply do not have enough GPs to meet the needs of a growing and ageing population, with increasingly complex conditions, on top of managing the fallout and work backlog from the pandemic. If general practice collapses, the rest of the NHS will follow not far behind it," Prof Marshall said.


Fewer people in England are sticking to self-isolation rules after coming into contact with an infected person.

The Office for National Statistics (ONS) said full adherence was 79% 5-10 July. That's similar to data for early June but lower than the 86% reported 10-15 May.

Adherence was lower in 18-34 year olds (75%) compared with 35-54 year olds (86%).

PPE Fails Safety Tests

The BBC reported how 1.2 million Fang Tian branded FFP3 masks supplied to the NHS failed safety tests and had invalid BSI safety markings and a "false" CE mark.

The Department of Health and Social Care said the masks represented a "very small proportion" of overall stocks.

Travel News

Scotland and Wales followed England in allowing quarantine-free arrivals for fully vaccinated EU and US travellers.

However, Welsh Health Minister Eluned Morgan said: "We regret the UK Government’s proposals to further remove quarantine requirements. However, as we share an open border with England it would be ineffective to introduce separate arrangements for Wales."

She added: "We will continue to press the UK Government for reassurances that it will be maintaining consistent and robust PCR surveillance - including pre-departure tests, PCR testing on day 2 and the genomic sequencing of results as one mitigation against importing vaccine escape variants."

Pfizer Jab Protection 

Pfizer/BioNTech's COVID-19 vaccine continues to show strong protection against serious illness and hospitalisation after 6 months, but overall protection against the virus appears to wane after a half a year, according to a preprint study.

The study included more than 45,000 people worldwide and suggests a gradual "declining trend in vaccine efficacy" over 6 months after two doses.

A third booster dose of the vaccine increases neutralising antibody levels against the Delta variant by more than five times compared to levels after a second dose in people aged 18 to 55 years, new data from Pfizer showed in a quarterly earnings report.

NHS England's latest pop-up vaccination site for staff and visitors opens today at the Thorpe Park Resort.

Across the UK, 71.1% of adults are fully vaccinated, and 88.3% have received a first jab.

PHE estimates that 60,000 deaths and 22,057,000 COVID-19 infections have been prevented as a result of the COVID-19 vaccination programme, as of 23 July. 

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


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