COVID-19 Healthcare Challenge - November 2020 summary

6th November 2020 by Anne Sakoane

A new lockdown dawns

On the 5th November 2020 in the UK, new national restrictions were imposed as part of the government’s strategy to control coronavirus spread. This followed an announcement on the 30th October from the Office of National Statistics that a nation-wide survey revealed "steeply increasing" infection rates based on a survey delivered in partnership with the University of Oxford, the University of Manchester, Public Health England and the Wellcome Trust.

The case data revealed growth in all age groups, with the greatest increases being recorded in older teenagers and young adults, closely followed by secondary school-aged children across all regions. Lockdown measures have been adopted around the world based on the that stopping people spending time around each other impacts the transmission rates or R number, and therefore slows the exponential growth of the of viral spread.

Though the UK lockdown is expected to be lifted before Christmas, some scientists predict third and fourth lockdowns in the months to follow.

Where are we with testing?

Testing remains one of the most challenging areas in which the UK has yet to establish a truly effective strategy to control COVID-19 spread. Operation Moonshot, a rapid-testing pilot performed in greater Manchester hospitals during October, missed more than half of cases, leading experts to advise the government's mass-testing strategy was not suitable for roll out in any of the planned hospital and care home settings.

Meanwhile, China initiated one of the most ambitious large-scale testing protocols in the world, testing millions of people in the city of Qindao over four days from the 13th October, after which Beijing's National Health Commission reported recording no new cases, though outbreaks have since been reported in some of China's large cities.

On the 17th October, Imperial College London published a report based on the REACT (Real Time Assessment of Community Transmission) study, in which analysis of finger-prick tests carried out at home between 20th June and 28th September indicated a downward trend in the body's antibody response to the virus over time.

Though the consumer pharmacy giant Superdrug re-launched an at-home test for COVID-19 antibodies on the 30th October, only laboratory tests have been evaluated and approved for use by Public Health England to date. A study by Deeks et al. (2020) concluded that "antibody tests are likely to have a useful role for detecting previous SARS-CoV-2 infection if used 15 or more days after the onset of symptoms"¹, however concerns over the accuracy of rapid point-of-care finger-prick antibody tests prevail, especially among community pharmacy officials.

The latest on vaccines

Meanwhile it was reported on the 4th November that the University of Oxford vaccine in development had only a "small chance" of becoming available by the end of 2020, but that an analysis of its efficacy by then may still be likely. As one of the leading experimental vaccines in development and one of the first to publish immunogenecity response and safety data in a phase 2 study, we will be following updates on the performance of the trial's outcome.

References

1. Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Spijker R, Taylor-Phillips S, Adriano A, Beese S, Dretzke J, Ferrante di Ruffano L, Harris IM, Price MJ, Dittrich S, Emperador D, Hooft L, Leeflang MMG, Van den Bruel A. Antibody tests for identification of current and past infection with SARS‐CoV‐2. Cochrane Database of Systematic Reviews, Cochrane Library 2020, Issue 6. Art. No.: CD013652. DOI: 10.1002/14651858.CD013652.

2. Helen Ward, Graham Cooke, Christina Atchison, Matthew Whitaker, Joshua Elliott, Maya Moshe, Jonathan C Brown, Barney Flower, Anna Daunt, Kylie Ainslie, Deborah Ashby, Christl Donnelly, Steven Riley, Ara Darzi, Wendy Barclay, Paul Elliott, for the REACT study team. Declining prevalence of antibody positivity to SARS-CoV-2: a community study of 365,000 adults, medRXiV 2020, medRxiv 2020.10.26.20219725; doi: https://doi.org/10.1101/2020.10.26.20219725

3. Pedro M Folegatti, Katie J Ewer, Parvinder K Aley, Brian Angus, Stephan Becker, Sandra Belij-Rammerstorfer, et al. Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial. The Lancet VOLUME 396, ISSUE 10249, P467-478, AUGUST 15, 2020 DOI:https://doi.org/10.1016/S0140-6736(20)31604-4

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