Number of RD&E staff test positive for COVID-19

A “significant” number of staff who work on a ward at the Royal Devon and Exeter Hospital (RD&E) have tested positive for coronavirus, prompting safety concerns to be raised.

Anita Merritt www.devonlive.com 

DevonLive understands that more than half of the workforce on the ward at the hospital have tested positive at the site.

The hospital trust has confirmed a “number of staff” have been diagnosed with the virus, but has refused to disclose to DevonLive how many of its staff on the ward have COVID-19, how many are self-isolating, whether the ward remains open and how many of its other hospital staff have tested positive.

The RD&E has said that rigorous contact tracing has been carried out.

It added the personal protective equipment (PPE) staff wear is effective in containing the spread of the virus.

However, a source connected to the hospital – who asked to remain anonymous – claimed that at least half the members of staff on the ward have now tested positive.

They said: “There have now been a significant number of positive cases and large numbers of staff on the ward are self-isolating. Frontline staff are not being screened routinely, and when they are tested they are not being provided with the results urgently.

“More broadly we are hearing from staff who are dissatisfied that they are working when they should be isolating. That’s my greatest concern.

“For those working at the RD&E there needs to be a duty of care with routine testing in place.

“If staff are unknowingly carrying it and being made to work then this is already out of control. The public confidence in the hospital is essential, but equally inpatients and staff are now being very much compromised.

“Once staff are under pressure and are desperately short staffed they end up cutting corners, and then it gets even worse. The UK has lost more than 500 NHS care workers during the first wave. The price is too high.”

An RD&E spokesperson said: “We take infection prevention and control extremely seriously at the RD&E and have very strong processes in place.

“We have had a number of staff who have tested positive for COVID-19 and have carried out rigorous contact tracing. Any staff or patients who have had contact where there might be a risk of transmission have been asked immediately to self-isolate.

“In line with national guidance, staff in clinical areas are required to wear appropriate and effective PPE at all times, and we have evidence that this is effective in preventing the spread of infection.

“Additionally, as part of the COVID-Genomics UK consortium, we are pioneering using ground-breaking genetic sequencing to help understand and control outbreaks in the region.”

Exclusive: ‘Covid graphs were wrong in suggesting daily deaths would soon surpass first wave’

Government forced to reissue key charts used to justify second lockdown after admitting projected fatalities were overstated.

“The use of data has not consistently been supported by transparent information being provided in a timely manner. As a result, there is potential to confuse the public and undermine confidence in the statistics.” – The Office for Statistics Regulation

By Laura Donnelly, Health Editor and Harry Yorke, Political Correspondent www.telegraph.co.uk

Official projections which pushed the country into a second lockdown have been quietly revised to no longer suggest deaths could soon overtake those at the peak of the first wave, The Telegraph has learned.

Graphs presented at a televised Downing Street press conference on Saturday suggested that the UK would see up to 1,500 Covid deaths a day by early December, far beyond the numbers seen in the first wave.

But documents released by Government show that the figures were far too high and have been “amended after an error was found”. The forecast has been revised, reducing the upper end of the scale to around 1,000 deaths a day by December 8 – on a par with the peak of the pandemic in April.

Presenting the graphs on Saturday, Sir Patrick Vallance, Boris Johnson’s chief scientific adviser, said the statistics, which covered a six-week period, presented “a very grim picture” with “greater certainty” than long-term modelling could provide.

But the Government Office for Science has now corrected two of the slides, reducing both the upper end of the range for deaths and that for hospital admissions by one third. While the presentation suggested daily hospital admissions could reach up to 9,000 in early December, the upper end of the range has now been cut to 6,000 in the updated slides.

It comes days after it emerged that separate modelling showing a worst-case scenario of 4,000 deaths a day by the end of December was based on out of date data which has also since been updated.

The revelation prompted former Prime Minister Theresa May to question the Government’s use of statistics and ask whether “figures are chosen to support the policy rather than the policy being based on the figures”.

On Thursday night, leading scientist Professor Carl Heneghan, of Oxford University, said the graphs presented at the weekend had been found to be “riddled with errors”, raising concern that a desire for lockdown had seen forecasts “systematically” exaggerated.

Greg Clark, the chairman of the Commons science and technology committee, said the belated admission of errors was “of great concern”, adding that the changes to the upper range in the forecast on hospital admissions was particularly concerning as this was “the key projection” in the case for lockdown.

Steve Baker, a backbench Tory MP given advance sight of the projections ahead of the Downing Street briefing, said: “Government must accept that public confidence rests on not over-egging the pudding.”

On Thursday, the UK statistics watchdog criticised the Government for a lack of transparency about the data driving its lockdown policies, warning that the failings could create confusion and undermine public confidence.

In other developments, Rishi Sunak, the Chancellor, extended the furlough scheme, under which the Treasury covers 80 per cent of the wages of employees unable to work, until March. 

Dominic Raab, the Foreign Secretary, announced that he was self-isolating after coming into contact with someone who has coronavirus.

Matt Hancock, the Health Secretary, said people were allowed to leave their homes to travel abroad for assisted dying during the lockdown.

Last Saturday, when Boris Johnson announced the lockdown, Sir Patrick presented a series of slides on the outlook for the pandemic including the now-disputed 4,000 deaths graph.

On Tuesday, Sir Patrick and Professor Chris Whitty, the chief medical officer, were questioned by the Commons science and technology committee about the use of the modelling scenarios which MPs said had frightened the public.

Sir Patrick said he “regretted” it if he had not made it clear that these scenarios were models rather than projections and were “not as reliable” as the six-week forecasts he had also presented. He told MPs: “The right graphs to focus on are the six-week medium-term forward projections,” describing the slides on hospital admissions and deaths as the ones “that are important”.

Amid bad-tempered discussions about the long-term scenarios, Prof Whitty said he had “never used anything beyond six weeks in anything I have ever said to any minister on this issue”.

But an addendum to the published slides has revealed that these forecasts contained significant mistakes. A note added to the presentation said: “Plots on slides 4 and 5 have been amended after an error was found in the interquartile ranges for SPI-M [Sage’s Scientific Pandemic Influenza Group on Modelling] medium term projections.

“This does not affect the insights that can be taken from this analysis.”

Although the central forecasts remain unchanged, forecasting 750 deaths a day and 4,290 hospital admissions by December 8, the upper end of the range has been revised down. Instead of 1,500 deaths, it suggests an upper figure of 1,010, while the top range for daily hospital admissions falls from around 9,000 to 6,190.

The changes significantly alter the appearance of the graphs, meaning the shading no longer suggests that deaths in the weeks up to December 8 could dwarf those of the first wave.

Prof Heneghan, the director of the Centre for Evidence-Based Medicine at Oxford University, raised concerns that incorrect data was “systematically” being used to drive the country into lockdown, saying: “It really worries me that, on matters that are this important, we are finding that the data is absolutely riddled with errors.

“I don’t know if the data is being rushed through or if what we are seeing is bias being introduced, but what we are seeing looks systematic. All the mistakes are consistently in one direction, so you have to ask whether it is being done on purpose to suit the policies, like lockdown, they want to impose.”

He urged ministers to be more transparent, saying revisions to data should not be “snuck out” and adding: “We’re in an era where public compliance is essential to public health, and in due course we will need people to take the vaccine. That requires people to trust the Government.”

The SPI-M projections, dated October 28, were a central part of the weekend presentation, with Sir Patrick and and Prof Whitty since emphasising that they were more reliable than long-term scenarios.

SPI-M includes Professor Jonathan Van Tam, the deputy chief medical officer, Professor Neil Ferguson, of Imperial College London and Professor John Edmunds, of the London School of Hygiene and Tropical Medicine, all of whom have advocated national action (watch Boris Johnson giving an update after the start of the national lockdown in the video below).

At a Downing Street briefing on Thursday, Sir Simon Stevens, the head of the NHS, said services were now dealing with the equivalent of 22 hospitals of Covid patients.

Amid growing rows over the figures presented in the case for lockdown, he contrasted the NHS data with other charts, saying: “Those are facts. Those are not projections, forecasts, speculation. Those are the patients in the hospital today. 

“And as we think about the next few weeks, in a sense we already know what is likely to happen, because today’s infection is the intensive care order book for a fortnight’s time.”

Earlier, Professor Yvonne Doyle, the director of health protection at Public Health England (PHE), defended the models used to justify the second national lockdown, saying they were “presented to aid planning”.

The Office for Statistics Regulation criticised the Government for a lack of transparency over publication of data about the pandemic amid concern that it failed to publish the data sources, models or assumptions on the case for lockdown for several days after the televised presentation, only doing so the night before MPs voted on the restrictions.

In a damning statement, it said: “The use of data has not consistently been supported by transparent information being provided in a timely manner. As a result, there is potential to confuse the public and undermine confidence in the statistics.”

A Government spokesman said: “The main consensus projection remains unaltered. The data still clearly shows, and the consensus remains, that without intervention we are likely to breach the first wave of hospital admissions and deaths in a matter of weeks.”

Covid immune response faster and stronger post-infection, scientists say

Scientists have found the strongest evidence yet that people who recover from Covid may mount a much faster and more effective defence against the infection if they encounter the virus again.

Ian Sample www.theguardian.com 

Researchers at Rockefeller University in New York found that the immune system not only remembered the virus but improved the quality of protective antibodies after an infection had passed, equipping the body to unleash a swift and potent attack if the virus invaded a second time.

“It’s very good news,” said Michel Nussenzweig, the head of molecular immunology at Rockerfeller and a senior author of the study. “The expectation is that people should be able to produce a rapid antibody response and resist infection in a large number of cases.”

It is unclear how long the immune system’s memory might last, but Nussenzweig said it could potentially provide some protection for years. The discovery may explain why verified re-infections from the virus are so far quite rare.

When people are infected with coronavirus, the immune system launches a multi-pronged attack. One form of protection comes from T cells, which seek and destroy infected cells, and so prevent the virus from spreading. A second front involves B cells, which release antibodies into the blood. Antibodies latch on to the virus and stop it from invading cells in the first place.

Once the infection has passed, the immune system stands down, but it remembers the virus by storing so-called memory T cells and memory B cells. Should the virus return, these are immediately called to action.

Many studies have shown that the first wave of antibodies to coronavirus wane after a few months, raising concerns that people may lose immunity quickly. In their study of 87 coronavirus patients, the US researchers confirmed that antibodies wane, falling to about a fifth of their peak level over six months, but this may not matter too much, they believe.

When the researchers examined the immune system’s memory, they noticed that six months after infection the antibodies made by memory B cells had evolved to become more potent. These highly honed antibodies could be unleashed within days of re-infection, rather than taking a couple of weeks to build up, as seen in primary infections.

The scientists went on to show that tiny amounts of coronavirus, or protein fragments from inactive virus particles, lurked in patients’ intestines and apparently helped to maintain the immune system’s memory. The remnants of the virus are not thought to be harmful.

“The take-home lessons are that people who have been infected, six months later have persistent B cell memory responses with antibodies that can neutralise the virus and can do it very well,” Nussenzweig said. That could mean wiping out the virus before it takes hold, he added. “We don’t know how long any protection will last, but it might be a really long time. It could be years.”

The study is preliminary and has not been peer-reviewed or published in a journal.

Charles Bangham, a professor of immunology at Imperial College London, who was not involved in the study, said the work suggested there was “a very good chance that if you’re re-exposed, you’ll make a brisker immune response” to the virus. “It remains to be proved that it’s protective, but you would be reasonably confident it would have some beneficial effect,” he said.

Arne Akbar, a professor of immunology at University College London, said: “This is good news for everybody who has been sick with coronavirus.” He said the immune system was like an army that stands down once the threat is over, but remains prepared for a future invasion. “You want the army to be generated again very quickly, and this is what these researchers have found.”

Operation Moonshot: rapid Covid test missed over 50% of cases in pilot

A rapid coronavirus test at the heart of Boris Johnson’s mass-testing strategy missed more than 50% of positive cases in an Operation Moonshot pilot in Greater Manchester, the Guardian can reveal.

Sarah Boseley www.theguardian.com .

The 20-minute tests, on which the government has spent £323m for use with hospital and care home staff with no symptoms, identified only 46.7% of infections during a crucial trial in Manchester and Salford last month.

This means that many of those carrying Covid-19 were wrongly told they were free of the virus, potentially allowing them to infect others.

The tests were due to be used in the UK’s first city-wide mass-testing initiative, which starts in Liverpool on Friday. There was confusion on Thursday night when the council suggested they would no longer be deployed as part of the trial, but the government later insisted that small numbers of NHS staff would be using them in hospitals.

Scientists with Greater Manchester’s mass testing expert group (MTEG) raised significant concerns about the accuracy of the OptiGene Direct RT-Lamp tests this week, and said the technology should not be widely used as intended in hospitals or care homes.

The findings pose significant questions about one of the main tests in the government’s mass-screening strategy, which Johnson heralded this week as the UK’s main route back to normality. The prime minister told MPs on Monday that the government was “rolling out testing of all NHS staff as fast as we possibly can” and that it wanted to introduce rapid, regular testing for hospitals, care homes, schools and universities.

The Salford trial was billed as the first step in the Operation Moonshot mass-testing scheme but was drastically scaled back after just six weeks, in part due to concerns about the accuracy of the OptiGene test, the Guardian understands.

Local leaders had asked the government for the clinical validity data behind the technology, but it is understood this data has not been provided.

The Department of Health and Social Care said the test had been validated in three other trials which differed from Manchester’s findings, however it has not made this data public.

The MTEG, which reports to the region’s health chiefs and the Greater Manchester (GM) mayor, Andy Burnham, revealed their concerns about the Operation Moonshot findings to Martyn Pritchard, the chair of the region’s testing strategy group on Monday.

In a letter seen by the Guardian, they wrote: “The current available data from the Manchester pilot shows low sensitivity (46.7%) of the Direct RT-Lamp platform,” which is favoured for use in hospitals because of its ability to produce results in around 20 minutes.

They wrote that “a high proportion of samples collected from infected individuals in a ‘real world’ setting would not be detected” using the technology, and added: “MTEG have significant concerns and do not feel the data supported the investment in the large scale rollout of Direct RT-Lamp saliva testing in any of the proposed clinical settings considered (hospital staff, care staff, community settings) at this time.”

The Greater Manchester experts said “technical limitations of the system were also a cause for concern”, including the lack of internal controls, and that if not addressed “these may pose a significant risk of errors”. They added: “It should be noted that solutions to these issues are not available at this time and are likely to take considerable resource and time to address.

“It is also of concern that the scale of investment needed [at a ‘new department’ level] to deploy this test at a scale that would be useful and sustainable is unlikely to be cost-effective.

“We remain fully committed to wider asymptomatic testing in the health and care sectors as well as in community settings, however we are not convinced that this is the right platform for widespread deployment across GM.” The experts said they would assess the tests again if there were fixes that “materially improve sensitivity”.

The hospital test is made by OptiGene, a small biomedical firm in Horsham, West Sussex. The government has paid £323m for 600 of its newly developed Genie HT machines and 90m testing kits and chemicals. Each machine can reportedly deliver up to 200 tests an hour.

The DHSC confirmed that the Genie HT machines would be the primary technology deployed to test NHS staff and patients who do not present with coronavirus symptoms.

They do so using two methods: the rapid Direct RT-Lamp, where a saliva sample is added straight to the machine after being made safe by heating, and the RNA Lamp, which takes longer to process because the nucleic acid has to be extracted from the sample.

Prof Mark Wilcox, the co-chair of the DHSC’s technical validation group, said: “The Direct Lamp tests used in Manchester have been validated in other laboratories and in real-world testing for use in different settings.

“It is incorrect to claim the tests have a low sensitivity, with a recent pilot showing overall technical sensitivity of nearly 80%, rising to over 96% in individuals with a higher viral load, making it important for detecting individuals in the infectious stage. The challenge now is to understand the reasons for the difference in claimed sensitivity in one evaluation versus those in multiple others.”

The health secretary, Matt Hancock, announced a six-week trial of OptiGene’s tests at the end of May, which he said “could change the way that we control Covid-19 across the country”. The results of the trial, however, have never been made public. A separate study published last month found that it identified only 67% of infections, meaning it missed one in three cases, and advised anyone who tests negative to take a separate follow-up test to verify the result.

OptiGene referred the Guardian to the DHSC.

Questions have also been raised about a separate rapid saliva test which will be offered to everyone in the community in Liverpool. The public data available on the Innova test is for nose and mouth swabs only, not saliva tests.

The instructions for use say “negative results do not rule out Sars-CoV-2 infection” and should not be used for treatment decisions or “infection control decisions”. The government’s Porton Down laboratory evaluated the test and approved it in August, but only for swab samples and no detailed results have been published.

Johnson earlier told the Commons that the rapid test to be used in Liverpool would be one “that you can use yourself to tell whether or not you are infectious and get the result within 10 to 15 minutes”. The Innova test, however, is for people who already have symptoms and is not approved to be self-read. Any positive case should be confirmed with the gold-standard lab-based PCR swab test.

Experts, including those in Liverpool, are understood to be anxious about the performance of the tests chosen for use in the pilot scheme and to have asked for reassurance from the government. There is concern that doubts over the results will undermine public confidence and affect people’s willingness to come forward for testing.

Bill Esterson, the Labour MP for Sefton in Merseyside, asked the government on Thursday to urgently publish the test’s clinical validity data and said: “It’s very worrying if unreliable tests are being used. It’s crucial that the Liverpool mass-testing pilot succeeds.”

Is a dangerous new coronavirus strain circulating in farmed minks?

The Danish government has ordered the slaughter of all farmed mink in the country after the reported discovery of a mutant form of coronavirus in the animals. It has already spread to humans.

[A disturbing story on many fronts. Travellers from Denmark now required to quarantine – Owl]

Graham Lawton www.newscientist.com 

What do we know about the situation in Denmark?

According to a report in the Danish newspaper Berlingske, 207 mink farms have seen infections of coronavirus. The authorities have failed to contain the virus, and all 17 million farmed mink in Denmark will now be culled, said Denmark’s prime minister Mette Frederiksen at a press briefing on 5 November. Denmark has the world’s largest mink industry.

The Danish prime minister described the mutated virus as “a serious risk to public health and to the development of a vaccine.” However, health minister Magnus Heunicke told the press briefing that there is no sign yet that the mutant virus causes more serious symptoms of covid-19.

Some areas of northern Jutland – the region of Denmark that connects to the European mainland – will be isolated to stop the spread of the virus in humans. Frederiksen said a “mutant” virus has been identified in five farms and 12 people have become infected with it.

What sort of mutant?

We don’t know for sure. There is no scientific publication about it. According to the newspaper report, the Danish State Serum Institute says the virus is sufficiently different from other circulating strains to mean that a vaccine may not work against it, though there is no information on the Institute’s website and it has not yet responded to New Scientist’s requests for comment. Up to now all circulating strains are thought to be similar enough that a single vaccine will immunise against all of them.

The newspaper also said that the 12 infected people “have been found to have an impaired reaction to antibodies.” It is not clear what this means. It could be a mistranslation of “antibody response”, which could mean that the 12 individuals are producing previously unseen antibodies. That would strengthen the claim that the mutant virus may evade a vaccine.

Can mink really catch the coronavirus?

Yes. There are already scientific reports of farmed mink in the Netherlands catching it from humans. And in June more than 90,000 mink were culled in Aragon, Spain after the virus was detected in fur farms.

Can mink pass it to humans?

Yes. One of those reports from the Netherlands says that at least one worker on a mink farm caught the virus from the animals. The worker showed only mild respiratory disease.

What do scientists say?

Francois Balloux, a professor of genetics at University College London (UCL), took to Twitter to describe the report as “highly problematic”. He said his colleague Lucy van Dorp at UCL has already documented numerous coronavirus mutants arising repeatedly in mink, none of which are concerning for humans. The claim that this strain may be resistant to a vaccine is “idiotic”, he said. Such mutations might emerge in humans once we have a vaccine but won’t appear in mink, he said.

Other scientists echoed his views. James Wood at the University of Cambridge in the UK, said he understands that the mutation is on the spike protein, which the virus uses to enter cells and which induces an antibody response. However, “the true implication of the changes in the spike protein have not yet been evaluated by the international scientific community and are thus unclear. It is too early to say that the change will cause either vaccines or immunity to fail,” he said in a statement.

Virologist Ian Jones at the University of Reading in the UK, said that it was not surprising that the virus had mutated, as it would need to adapt to mink. Denmark’s precautionary action would make it less likely that the new virus would spread widely in humans, he said in a statement.

Is the virus likely to spread to other animals?

Yes, very. More than 60 mammal species are known to be definitely or probably susceptible, ranging from gorillas and chimps to foxes, yaks, giant pandas and koalas. Even some whales, dolphins and seals may be able to catch it.

Why did nobody see this coming?

We did. Even before this happened, virologists were concerned about “reverse spillover”, which is when humans pass the virus on to domestic or wild animals. That could be a problem for the animals as some species fall ill and die. It could also spell trouble for us, as animals could become a new reservoir of virus and make the pandemic even harder to control. Animals could also be a crucible for the virus to mutate into another novel coronavirus.

Update on sale of Lot 68 – Shandford Care Home

Abbeyfield had put the former Shandford Care Home in Budleigh Sslterton on sale through Savills at auction on Tuesday, Lot 68.

The Savills’ website indicates that it failed to sell, presumably because it failed to reach its reserve price.

“A well located 26 bedroom former care home, of approximately 11,480 sq ft, with further potential subject to the usual consents. Vacant possession.”

The newly created Shandford Trust will have to wait a bit longer for the expected windfall.

A sign of the economic times?

See previous post.

Update on Ladram Bay retrospective planning application

The Ladram Bay retrospective planning application to retain a section of the viewing deck erected without planning permission was withdrawn on Monday.

It was due to have been considered by the Planning Committee on Wednesday. Planning Officers had recommended refusal.

An enforcement notice was issued by EDDC on the 26th June 2019 seeking the removal of the raised platform, in its entirety. The notice took effect on the 01/08/2019 and a subsequent appeal was lodged. 

This appeal was dismissed on 17 August 2020 and the enforcement notice was upheld for the removal of the platform in its entirety due to its unacceptable visual impact, lack of planning policy support given the location of the site in a designated World Heritage Coast, AONB and Coastal Preservation Area.

The structure needs to be removed by the 17th March 2021.

Given the Carter history at Ladram Bay – What next?