19th December 2020
UK COVID Deaths – Daily 534 / 7-Day average 436
Total UK COVID Deaths within 28 days – 67,075
Total UK Deaths with COVID-19 on the death certificate – 76,287 (up to 4th Dec)
James Cook Hospital – Total COVID deaths – 374
All COVID cases within South Tees Hospitals Trust – 80
James Cook Critical Care
COVID cases – 15 (9 ventilated)
Non-COVID cases – 39 (13 ventilated)
The big news today is the announcement of a new tier of restrictions. Tier four is to be introduced in London and the South East where the numbers of new cases have risen dramatically. Tier four restrictions resemble those of the first lockdown. People should ideally not leave their homes and non-essential retail businesses, ‘personal care centres’ and gyms must close. Travel in and out of tier four is not allowed unless deemed essential.
At an emergency briefing, the Prime Minister went on to explain that the plans to relax restrictions over Christmas have been scrapped for those in tier four. For the rest of England, the rules that allowed three households to meet over five days during the Christmas holiday have changed. They will now be allowed to meet only on Christmas Day.
The surge in cases that London and the South-East are seeing is believed to be due a new variant of the coronavirus that may have originated in the UK. Its prevalence appears to be increasing and it may now be the dominant variant in London. The main concern is that this new variant of the virus may well be more infectious. Catchily named VUI-202012/01 (‘Variant Under Investigation’ and the date it was classified), it has 23 different mutations but the important one is a mutation in the virus spike protein. The spike protein is the part of the virus that binds to receptors on human cells and gains entry, causing infection.
Viruses mutate constantly and the SARS-CoV-2 coronavirus that causes COVID-19 has already mutated many thousands of times. There have been up to 4000 different mutations of the spike protein alone. Very few of these have changed the virus in any meaningful way. The only variation that has altered the virus’ behaviour is the D614G variant which appears to have increased its ability to spread. This mutation arose back in March and is now the most common variant around the world. However, the D614G variant mutation did not seem to lead to any increase in the severity of the disease.
The UK has now officially informed the WHO that this new VUI-202012/01 variant appears to spread more quickly. Whilst this is clearly worrying, there is no suggestion that this new mutation would prevent vaccines from working. COVID-19 vaccines produce antibodies against many regions in the spike protein, so it’s unlikely that change to one part of the protein would render any vaccine ineffective. COVID-19 cases are also rising in all other areas of the country, with the exception of the Yorkshire and the Humber region which was the only area where case numbers fell last week. On Teesside, case numbers have slowly risen in most areas but we are much better off than London and the south-east where the growth in new cases is alarming. The virus appears to be spreading amongst all age groups but the largest increase in cases has been seen amongst 30-39 year-olds.
As case numbers rise, inevitably so do hospital admissions. Hospitals in Kent are postponing all non-urgent treatment as the number of COVID-19 patients has risen above that seen during the first wave. Teesside remains in tier three and we are fortunate at James Cook that we are yet to see any increase in admissions over the past fortnight; our number of COVID patients remains fairly static. In a rare, glass-half-full moment, we have decided to turn one of our two COVID ICU’s over to the care of non-COVID patients, whose numbers are increasing as winter draws on. This means that we have placed all the ventilated COVID patients in just the one ICU. We have moved all the CPAP and recovering COVID patients to the Female SAU. This move enables us to use all our beds as efficiently as possible and allow us to be more flexible.
However, separating the two ICUs involves re-erecting the ‘wall’ again. Honestly, that bloody partition goes up and down quicker than my teenage daughter’s mood. Sadly, the way things are going, I’m certain it won’t be long before we see our COVID numbers start to rise and we’ll have to tear it down again.
Sigh.
I read in the press today that the government is proposing to vaccinate all secondary school children. This appears to be another knee jerk reaction and stupid response. Given we do not know if vaccination stops the spread of COVID what’s the point. Also we keep getting told younger age groups are less likely to get seriously ill from the virus. I understand this is really difficult for any government but this government’s incompetence is mind boggling. Shut down the country, enforce the rules to get on top of this health problem. The economy is already trashed and is a long term project to put right. Fight one enemy at a time, lives now, economy later. The government is trying…
@nomoresurgeons.com Hi. I think that the younger age groups have let their guard down and this is why infections are spreading quickly in that group. I don’t believe the new variant of the virus targets them more than any other group. Under normal conditions, an awful lot of successful NHS effort goes in to help keeping people over the age of 70 alive. The extension of people’s life expectancy to allow people to stay healthy and live longer is one of the greatest achievements of modern medicine and the hypocrisy that some people demonstrate really angers me. Not one of these people will refuse successful treatment when they get to seventy on the grounds that they’ve ‘had a good innings’! Ours is…
@m.gallagher40 I’m not entirely sure why vaccination has become so unpopular. There is very little genuine evidence for the fears that people voice. In the late 90’s, Andrew Wakefield’s ‘research’ study linking the MMR vaccine to autism in 1998 did done untold damage. The study was subsequently retracted as it was discredited and he was struck off the medical register for dishonesty and performing unnecessary procedures on children without ethical approval. Despite this, many people still believe that vaccines are dangerous. Fake news and conspiracy theories have not helped the situation either. Cheers, Richard
Thank you as always for this info. Not what we wish to hear but necessary for us to realise we all need to stick to the rules. Best wishes to you and yours during this hectic and scary time, and to all who work with you.
South Africa has a similar one termed 501.V2 which is causing a big spike. It's worth looking at the 30 day maps, almost obvious which ones are showing this surge pattern, Germany, South Korea, France and maybe the USA but it's hard to decide due to the chaos and misinformation from the Trump administration.
I checked the Imperial College Map and it was evident last week before Matt Hancock mentioned it that something odd was going on. Many South East areas have doubled in a week https://imperialcollegelondon.github.io/covid19local/#map
Richard, do you think the lower age groups affected are due to this new variant type? If so that will really shock many who were quite happy to decide anyone over 70 has…