18th February 2022
UK COVID Deaths – Daily 158 / Daily average 147
Total UK COVID Deaths within 28 days – 160,379
Total UK Deaths with COVID-19 on the death certificate – 181,424 (up to 4 Feb)
James Cook Hospital – Total COVID deaths – 804
All COVID cases within South Tees Hospitals Trust – 108
James Cook Critical Care
COVID cases – 3 (3 ventilated)
Non-COVID cases – 51 (25 ventilated)
Last week, Nicky tested positive for COVID-19. She had started feeling feverish and neither of us were surprised when her lateral flow test returned a weakly positive result. We were, however, a little disappointed as, up until now, both of us had avoided testing positive during the pandemic. Of course, it’s inconceivable that this was the first time either of us had been exposed to the virus. We both assumed that we must have had asymptomatic infections right at the beginning. Back then, we weren’t able to test many people and so most mild infections went unnoticed.
However, we both realised that we were still likely to get re-infected with Omicron and so Nicky was surprised when her PCR test came back negative. It looked like the lateral flow test had been a false positive. I did point out that other viruses were available but I was simply accused of belittling her illness.
Over the next few days my youngest daughter and my son became unwell with similar symptoms. We were worried that maybe the PCR test had been a false negative and that we might be looking at a household outbreak but fortunately their COVID tests came back negative too. Not that Nicky and I couldn’t have done with seven days of isolation in some respects but to succumb to COVID now would have felt like falling at the final hurdle.
The requirement to isolate following a positive COVID test is very much in the news at the moment. Parliament reconvenes on Monday after the half-term recess and the Prime Minister is expected to unveil his long-term strategy for ‘living with COVID’ a month earlier than planned. It is expected that he will announce his intention to remove all remaining COVID restrictions, including the legal requirement to isolate after a positive test.
It would be fair to say that this would be a somewhat controversial decision. It has been described as ‘bonkers’ and ‘a profound mistake’ by some experts who believe it will inevitably result in further spread of the virus. Many fear that the PM is responding to the intense political pressure that he is currently under, rather than ‘following the science.’
But is Boris’ decision really a crazy one? When the Prime Minister talks of ‘living with COVID’, he is, of course, really now talking about living with Omicron. Things have changed and we are in a very different place from where we were just a few months ago. Back then, we were talking about learning to live with a virus that was a serious threat if you were in an at-risk group and/or were unvaccinated. Now though, it’s obvious that the virus is far less dangerous.
If you were to pay a visit to any Intensive Care Unit this would be abundantly clear. Despite a ridiculously high community infection rate, Intensive Care Units nowadays look pretty much like they did back in 2019 before the pandemic began. Of course, you’ll still find the odd COVID positive patient in an isolation room but gone are the dedicated COVID units that were full of horribly sick patients. There’s no need for the hastily converted Theatre Recovery areas that we used as temporary ICUs and the proning teams who spent their days flipping patients are a dim and distant memory.
This is because very few COVID patients are being admitted to Intensive Care anymore. Most of those that are have been admitted with other conditions and have tested positive upon arrival in hospital. A few have bacterial pneumonias which may well be secondary to a COVID infection but no-one is developing COVID pneumonitis like they did before. From our perspective, it feels like the pandemic is over.
Of course, there are still people who remain vulnerable and are at risk of serious disease. The very elderly and those with significant underlying health conditions will clearly be concerned about plans to abolish all measures to suppress COVID-19, especially at a time when there are still a large number of infections in the community. However, despite high case numbers, hospital admissions and deaths are continuing to fall. Indeed, fewer people overall are dying this winter than we would normally expect to.
The level of immunity against COVID-19 within England is extremely high as a result of vaccination and/or natural infection. The Office for National Statistics estimates that 98.1% of the English adult population would have had SARS-CoV-2 antibodies in the week beginning January 10th. This staggeringly high level of immunity means that very few people are now dying. Currently, the infection fatality rate of Omicron in the UK is probably similar to or even lower than that of seasonal influenza.
This lower mortality rate is the justification for treating Omicron differently. But even if fewer people are dying, many fear that removing the requirement to isolate will lead to more infections and more people ultimately becoming unwell enough to require hospital admission. I would argue that this is far from certain and that it is possible that the infection rate may not rise that much. We do know that not everyone who is infected is isolating. The Test and Trace system has only been picking up half the estimated number of infections, meaning that about 200,000 people a day may not know they are infected and have not been officially asked to isolate.
Studies have also shown that many people do not isolate for the full seven to ten day period anyway and this problem appears to be getting worse. There have always been plenty of people who cannot or do not want to isolate. The current law is effectively unenforceable and does not act as much of a deterrent. The ongoing scandal over Downing Street parties has also done nothing to encourage civil obedience.
The legal requirement to isolate will be replaced with advice and guidance instead. The PM has promised that he will be “urging people with the virus to be careful and considerate of others.” Boris has always been keen to move from legal to personal responsibility. The emphasis will be on ‘me’ rather than ‘we’. Of course, when you make isolation a matter of personal choice, the real danger is that you send a message that isolation is no longer important.
However, I suspect that those who have always obeyed the rules will continue to be mindful of others despite the removal of restrictions. Such people will continue to limit social contact when they are unwell or have tested positive. Most of us don’t really wish to spread infectious diseases amongst our family, friends or colleagues.
There are worrying reports that the Chancellor is keen to put an end to free lateral flow and PCR tests for the public. The testing programme costs an eye-watering £15 billion a year so it’s easy to understand the desire to trim costs. Free testing would of course, continue for the clinically vulnerable but the rest of us would have to pay for a COVID test. This does seem rather premature. After all, it’s hard to see how you can advise people to avoid spreading COVID whilst making it difficult and/or costly to obtain a test.
Regardless of what measures are announced on Monday, I doubt very much that the testing and isolation rules will change at the hospital anytime soon. Hospitals have a duty to protect their patients and testing will remain in place for both staff and patients. Staff who do test positive for COVID will continue to be instructed to isolate from their workplace.
Whatever your opinion about the Government’s decision to scrap the legal requirement to isolate, the fact that we are even considering doing so indicates just how far we’ve come. Back in November, before Omicron arrived, very few of us dared to imagine that we might be where we are now. The Prime Minister loves nothing better than exuding optimism and the picture he is painting is an unashamedly positive one. However, unlike Nicky’s lateral flow test, I don’t believe that this is a false positive.
Uh-oh!