‘… the race between our vaccination
programme and the virus may be about to become a great deal
tighter.’ Boris Johnson, 14 May 2021.
The Covid-19 numbers
By the end of May, the worldwide Covid-19 data reached 170 million
cases and 3.5 million deaths. In the UK, there have now been
over 4.4 million confirmed cases and nearly 128,000 people have
died. However, throughout most of May, these UK figures
remained broadly unchanged. For instance, the number of new
cases plateaued at about 2,500 each day, while the death rate was
typically less than 10 per day. Such stability provides some
reassurance that the virus is being largely contained.
Moreover, in late-May only 900 UK Covid-19 patients were
hospitalised with 120 on ventilators – those figures were 1,700
and 240 respectively in April.
However, a new facet of the UK pandemic has been the onset of
coronavirus hot spots. Data released at the end of May
showed a daily upswing to over 4,000 new cases. Up to 75% of
these were thought to be caused by the so-called Indian variant,
B.1.617.2. But were these increases the result of simple
viral spreading, more vigilant testing, or the easing of recent
lockdown restrictions? These variant attacks, though too
early to translate into hospitalisations, may halt the lifting of
all Covid restrictions planned for the UK on 21 June. Could
this be the start of a third wave?
The UK vaccination programme remains on target. During May,
the landmark of 60 million given jabs (38 million primary plus 24
million booster doses) was passed. Currently, most areas of
the UK are vaccinating anyone aged over 30. Just 7 months
after the ambitious vaccination roll-out began, the target of
offering a first jab to all UK adults by 31 July still looks
realistic, though half of all UK adults are waiting for their
second jab and a quarter have not yet had their first.
Further afield, Covid-19 is ravaging in several places, but
nowhere worse than in India with as many as 400,000 new cases and
4,000 deaths in a single day during May. In total, India has
recorded 26 million cases and more than 300,000 deaths. It
has now become the epicentre of the global pandemic. The
plight of its people, struggling in overstretched hospitals,
searching for medical oxygen and gathering wood for funeral pyres
will be among our harsh and lasting images of the pandemic.
By contrast, though still reporting the highest total of deaths in
the world – some 600,000 – the spread of coronavirus in the US
continues to slow. For instance, during a week in mid-May,
the country enjoyed no days in which Covid-19 infections exceeded
30,000 cases – its lowest figure since June 2020.
As ever (but notforever),
let the truth be retold, ‘This pandemic is far from over.’
India’s pandemic
No country has been harder hit by Covid-19 than India.
During the country’s second wave, in the week leading up to 13
May, it reported an average of 4,029 deaths every day. At
the same time it suffered a world record of 414,188 new cases in
just one day – 5 times more than its nearest contender,
Brazil. And, of course, these figures, from a country as
diverse as India, are underestimates. There is good
evidence, such as the discovery of scores of bodies floating in
the Ganges, that Covid-19 deaths are inadequately recorded among
its rural populations.
But Covid-19 is not India’s only current medical dilemma.
During May, more than 9,000 cases of a deadly ‘black fungus’
disease were reported. This infection, caused by exposure to
mucor moulds and known as mucormycosis, has been increasingly seen
among patients recovering and recovered from Covid-19. It
has a mortality rate of 50% and is thought to be linked to the use
of steroids in Covid-19 treatments and diabetes in
immune-compromised patients. Treatments, sometimes involving
the removal of an eye, are expensive and in short supply.
The B.1.617 variant
This is the so-called ‘Indian variant’, though India’s government
has, perhaps understandably in the face of angry criticism about
its handling of severe shortages of oxygen, vaccines, hospital
beds and life-saving drugs, recently ordered social media
platforms to cease using that term. Yet its use is simply
shorthand, akin to the ‘Kent’ and ‘South African’ variants, rather
than tripping over their clumsy labels of B.1.1.7 and
B.1.351. The original B.1.617 variant, now generally
referred to as B.1.617.1, first appeared in India in October 2020
and is believed to be the principal cause of the recent
second-wave surge across India. According to the World
Health Organization (WHO), B.1.617.1 has now been detected in as
many as 50 countries across six continents.
As this Indian variant has spread across the world, three
different ‘sub-lineages’ have been identified, each with a
different mix of mutations. However, there is currently no
evidence that any are more deadly than earlier variants of
coronavirus, but they are believed to spread more quickly.
Indeed, B.1.617 mutations may make them easier to pass on, and/or
make them more resistant to the immune system’s responses.
These include the L452R mutation, which may help the virus escape
the body’s response (as induced by either infection or
vaccination). And it may increase the binding of the virus
to ACE2 receptors on the surface of human cells thereby easing the
onset of Covid-19 infection. And the P681R mutation (also
present in the Kent variant) may make transmission easier.
In addition, the B.1.617.1 and B.1.617.3 sub-lineages also carry
the E484Q mutation, similar to the E484K mutation first identified
in the South African variant. This may also help the virus
evade the immune response. So, in a nutshell, B.1.617 may be
no more deadly than earlier variants, but it probably does spread
more easily and quickly, perhaps by as much as 50% – no more
virulent, more transmissible.
Outside of India, the country with the most recorded B.1.617 cases
is the UK. All three sub-lineages are now present in the
UK. On 6 May 2021, Public Health England (PHE) named one of
the three sub-lineages, B.1.617.2, as a ‘Variant of Concern’ after
a steep increase in UK cases, from 202 to 520 in a single
week. By the end of May, the UK weekly cases had risen to
6,959, double the previous week’s figure of 3,535. As Boris
Johnson stated, the government is ‘anxious’ about this variant.
UK infections of B.1.617 were first discovered in Bolton during
mid-April, where, by the beginning of May, 71 cases had been
recorded. Initially, the cases were linked to international
travel, to widespread community transmission in areas of dense
urban housing and to regions with low vaccination rates. As
Matt Hancock confirmed, the majority of people in hospital with
Covid-19 in Bolton were eligible for the vaccine but had not had
it.
The variant soon became dominant in NW England, in Bolton and
nearby Blackburn with Darwen, as well as Sefton and distant
Bedford. Then it was detected in Nottingham, South
Northamptonshire, Leicester, Hillingdon and other London
areas. It was spreading, and fast. Additional surge
testing, tracing, and isolation support measures were deployed in
these hot spots together with enhanced drives to vaccinate
people. Data on the B.1.617.2 variant showed the number of
cases across the UK had risen from 1,313 cases to 3,424 during a
mid-May week. Tests indicated that B.1.617.2 was
outcompeting the two other B.1.617 sub-types, and replacing
B.1.1.7, the Kent variant, as the most common variant driving new
infections in the UK. Was this due to its predicted 50%
greater transmissibility? Then on 21 May, the government,
amid some communication confusion, advised people not to travel
unnecessarily into and out of eight designated hot spots,
including Bolton, Blackburn with Darwen, Leicester and Hounslow,
and to avoid meeting indoors. Were these case increases the
inevitable outcomes of easing restrictions?
Failures in the NHS Test and Trace (NHST&T) service may also
have contributed to this spread of the B.1.617.2 variant. A
software error meant that eight local authorities did not have
access to the full data on positive test results in their areas
between 17 April and 17 May. Apparently, this IT glitch
meant that 734 positive tests were not reported to local
authorities, meaning that contacts could not be traced
locally. For example, Blackburn with Darwen council was
eventually told about 164 cases of which it had been
unaware. The people affected were subsequently traced, but
another 130 infected people had passed their 10-day isolation
period and could not be followed up. Furthermore, the UK
government delayed adding India to its red list of countries, from
which travellers must quarantine in a hotel on return, until 23
April, almost a week after the problems with the NHST&T
service started.
And as if to confirm the dynamic and unpredictable nature of
variant emergence and transmission, at the end of May, yet another
one, known as VUI-21MAY-01 or AV.1, was designated a ‘Variant
Under Investigation’ by Public Health England (PHE). There
had been 49 cases of this variant, mainly concentrated in
Yorkshire and Humberside. Though it has been detected in the
UK, Greece and Chad, its origin and impact remain unclear.
Of variants and vaccines
Because the proliferation of variants, both new and old, are of
the greatest public concern, the burning question arises, can the
current vaccines cope? Hitherto, the experts had provided
merely mumbled messages of optimism. But on 22 May, Public
Health England (PHE) published the outcome of a study entitled,
‘Effectiveness of COVID-19 vaccines against the B.1.617.2
variant.’
The results showed that two doses of either the Oxford-AstraZeneca
or the Pfizer-BioNTech vaccines are highly effective against the
Indian variant, as they are against the Kent variant. Both
vaccines were only 33% effective against the Indian variant just
three weeks after the first dose compared with 50% against the
Kent variant. However, after two doses of either the
Oxford-AstraZeneca or the Pfizer-BioNTech vaccines, their efficacy
against the symptomatic disease of the Indian variant was
approximately 60% (66% against the Kent variant) and 88% (93%
against the Kent variant) respectively. It is thought they
are likely to be even more effective at preventing the more
serious consequences of hospital admissions and deaths.
The authors of the study concluded, ‘Overall, we found high levels
of vaccine effectiveness against symptomatic disease after two
doses. These estimates were only modestly lower than vaccine
effectiveness against the B.1.1.7 variant. It is likely that
vaccine effectiveness against more severe disease outcomes will be
greater. Our findings would support maximising vaccine
uptake with two doses among vulnerable groups in the context of
circulation of B.1.617.2.’
These data caused the Health Secretary, Matt Hancock, to enthuse,
‘This new evidence is ground-breaking – and proves just how
valuable our Covid-19 vaccination programme is in protecting the
people we love.’ Moreover, he is ‘increasingly confident’
that the final stage of easing restrictions in the UK can now take
place on 21 June. In other words – go, get your booster
shot. And, next month, by the time you readCoronavirus
– Part 8(June 2021), we may well be
free(ish).
Vaccines from Janssen and CureVac On 28 May, the Medicines and
Healthcare products Regulatory Agency (MHRA) approved yet
another vaccine for use in the UK – that makes four in
total. This Janssen vaccine is manufactured in Belgium
by a subsidiary company of the American pharmaceutical giant,
Johnson & Johnson.
This vaccine had already been authorised by the US Food and
Drug Administration (FDA), the World Health Organization (WHO)
and the European Medicines Agency (EMA). However, two
days before the UK approval, on 26 May, the Belgium government
had suspended its use for those under the age of 41.
Why? Because the EMA was reviewing the death of a
37-year-old woman in Belgium who suffered from blood clots and
low platelet counts after receiving the Janssen jab.
This Janssen product has the dual advantage as a single-dose
vaccine that can be stored in a domestic fridge. It is
reported to provide 67% protection against Covid-19 infection
and 85% against the severe disease and hospital
admissions. Like the Oxford-AstraZeneca it is an
adenovirus-based vaccine and has similarly been linked to some
rare blood-clotting issues. This means that it will
probably be recommended in the UK only for people over 40,
perhaps as a booster in the autumn. The UK has ordered
20 million doses for expected delivery later this year.
The UK's Joint Committee on Vaccination and Immunisation
(JCVI) has yet to announce its proposed patient cohort for
this Janssen vaccine.
The world has quickly become accustomed to the novel
technology of mRNA-based Covid-19 vaccines. Two of the
most successful and widespread jabs employ this know-how,
namely, those made by Pfizer-BioNTech and Moderna.
Together, they have already delivered protection to tens of
millions of people across some 90 countries. They are
about to be joined by a third mRNA vaccine developed by a
collaboration between the biotech giant GlaxoSmithKline (GSK)
and CureVac, a small German biopharmaceutical company.
CureVac’s first-generation mRNA Covid-19 vaccine, known as
CVnCoV, is currently in late-stage Phase 3 human testing with
36,500 participants. Planned regulatory approval from
the European Medicines Agency (EMA) is expected by early June
2021. Then production, prior to its roll-out, will be
stepped up to 300 million doses this year and one billion in
2022.
CureVac has also developed a second-generation mRNA vaccine,
officially known as CV2CoV. It is expected to deliver
broader protection against newly-emerging variants. In
Phase 1 trials, started in June 2020, CV2CoV showed strong
immune responses. In addition, it has demonstrated
effectiveness against a number of Covid-19 variants, including
B.1.1.298 (the Danish), B.1.1.7 (the Kent) and B.1.351 (the
South African). GSK and CureVac are expecting to launch
the Phase 2 human clinical trials of CV2CoV in the third
quarter of 2021. The COV-Boost study
‘Compare and contrast’ sounds like examination rubric. But
at last, a clinical trial has been launched to assess the effects
of giving third booster doses of seven different Covid-19
vaccines. This COV-Boost study is being led by University
Hospital Southampton NHS Foundation Trust and is being funded by
£19.3 million of government money.
It will be the first in the world to provide data on the impact of
a third dose on people's immune responses. The study, which
will take place at various sites in England, Scotland and Wales,
will involve 2,886 participants and vaccinations will begin in
early June. The seven vaccines on trial are from
Oxford-AstraZeneca, Pfizer-BioNTech, Moderna, Novavax, Valneva,
Janssen and CureVac. You can sign up athttps://www.covboost.org.uk/home
The experimental design of the trial is comprehensive. Third
vaccine doses will be given at least 10 to 12 weeks after a second
dose and could be a different brand to the one originally
used. All participants will be monitored throughout the
study for any side effects and will have blood samples taken to
measure their immune responses on days 28, 84, 308 and 365.
Initial findings are expected in September. The results are
important to inform the UK’s Joint Committee on Vaccination and
Immunisation (JCVI) on the efficacy and likelihood of any proposed
booster Covid-19 vaccination programme this coming autumn. Should children be vaccinated against
Covid-19?
Vaccinating children from a few weeks old against measles, mumps,
polio, diphtheria and several other deadly diseases, is a routine
and widely-accepted medical procedure. So what about
Covid-19 jabs for youngsters?
Some countries have started. For example, in mid-May, the US
Food and Drug Administration (FDA) expanded its authorisation for
the use of the Pfizer-BioNTech vaccine to include adolescents from
12 to 15 years of age. Already around 600,000 US youngsters
have been vaccinated. Next year, the USA plans to vaccinate
even younger children if the future safety data warrant such a
strategy. Although the UK is making significant progress
vaccinating adults, any decisions relating to children are
currently on hold.
Here is the crucial question – will vaccinating children save
lives? That question is clouded by international
dimensions. For example, in poor countries, would it be best
if vaccines designated for children were given to healthcare
workers and the vulnerable? The World Health Organization
(WHO) maintains that wealthy countries should postpone plans to
immunise children and instead donate the vaccines to the rest of
the needy world. Moreover, it is clear that children are
very rarely seriously affected by Covid-19. Children
typically display only mild symptoms, or are asymptomatic. A
multinational study, published during May inThe
Lancet, reckoned that worldwide fewer than 2 out of every
million children die from Covid-19. On the other hand,
vaccinating children could help save adult lives by contributing
to herd immunity and thereby disrupting the spread of the
virus. And while young children do not generally appear to
be super spreaders, older teenagers can be. In the UK at
present, it is only children judged to be at ‘very high risk of
exposure and serious outcomes’ who are being vaccinated.
So perhaps it is surprising that more than 25% of 16 and
17-year-olds in England have Covid-19 antibodies in their blood
despite most remaining unvaccinated. Do such children
already have sufficient immunity without the need for
vaccination? Could such immunity be a valuable legacy of
Covid-19 hot spots?
Perhaps, if there were unlimited quantities of vaccines, the case
for the extensive jabbing of children might be more
convincing. As yet, the risks and the benefits of such a
policy have not been fully weighed. As yet, there is no
satisfactory answer as to whether it would be a worthwhile
strategy.
UK public inquiry within a year
Some politicians and commentators have pressed for an early, even
an immediate, public inquiry into the government’s handling of the
pandemic. Others want to wait until after the plague is
largely over and after the expected resurgence during the coming
winter to allow a more comprehensive retrospective.
In mid-May, the UK government announced that the inquiry will
begin formally in April 2022. Boris Johnson, speaking in the
House of Commons, said, ‘It is absolutely vital for the sake of
the bereaved, for the sake of the whole country, that we should
understand exactly what happened, that we should learn the
lessons. We owe it to the country to produce answers within
a reasonable timescale.’ The inquiry will be on a statutory
basis and will be able to compel, ‘the production of all relevant
materials and take all evidence in public, under oath.’
There will be much to unearth. Critics of the government’s
Covid-19 strategies want answers about why, for instance, it
waited so long to impose lockdowns, failed to protect care home
residents and their carers in the early stages of the pandemic,
and did not ensure sufficient stocks of personal protective
equipment (PPE) for health workers. In addition, there have
been allegations of cronyism surrounding contracts for healthcare
equipment. And, perhaps above all other questions, is this,
why has the UK suffered one of the worst Covid-19 death tolls in
the world, with almost 128,000 fatalities?
The Wuhan great escape
InCoronavirus – Part 6(April
2021), the origin of the Covid-19 virus was discussed. In
particular, the inconclusive outcome from the World Health
Organization’s (WHO) team of experts after its month-long
fact-finding mission to Wuhan was cited. The WHO team
concluded that the virus probably jumped from live animals to
people, probably originating in bats and probably passing to
humans through unidentified intermediate animals, or maybe from
infected frozen wild animals, or perhaps from farms in southern
China.
However, there is another, maybe better, theory in
circulation. And it is gaining some traction. It says
that the pandemic started when the coronavirus escaped from a
laboratory in Wuhan. In fact, some scientists have named the
facility as the Wuhan Institute of Virology (WIV).
The WHO team dismissed this ‘lab leak’ theory. Peter Ben
Embarek, the head of the WHO team, said it had examined various
hypotheses and concluded that the evidence weighed against the WIV
or another of Wuhan’s labs being the source. He maintained
that while ‘accidents do happen’, virus leaks from high-level
biosafety labs are ‘extremely rare’ and the WIV set-up made it
‘very unlikely that an escape could happen from a place like
that.’
However, in a recent letter to the journalScience(14
May 2021), under the title, ‘Investigate the origins of COVID-12’,
a group of mainly US scientists from leading universities
criticised the WHO team for rejecting the leak theory. They
wrote, ‘Yet more investigation is still needed to determine the
origin of the pandemic. Theories of accidental release from
a lab and zoonotic spillover both remain viable. Knowing how
COVID-19 emerged is critical for informing global strategies to
mitigate the risk of future outbreaks.’
And they continued, ‘As scientists with relevant expertise, we
agree … that greater clarity about the origins of this pandemic is
necessary and feasible to achieve. We must take hypotheses
about both natural and laboratory spillovers seriously until we
have sufficient data. A proper investigation should be
transparent, objective, data-driven, inclusive of broad expertise,
subject to independent oversight, and responsibly managed to
minimize the impact of conflicts of interest. Public health
agencies and research laboratories alike need to open their
records to the public. Investigators should document the
veracity and provenance of data from which analyses are conducted
and conclusions drawn, so that analyses are reproducible by
independent experts.’
And there are other supporters of the ‘lab leak’ theory. A
US intelligence report had previously stated that three staff
members from the WIV became ill in autumn 2019, shortly before the
first patient with Covid-like symptoms was recorded in the city on
8 December 2019. Now that report has been revised to ‘staff
were hospitalised’ in November 2019. Did they have
Covid-19? The WIV has yet to share publically its research
logs, health records and so on. In mid-May, the US House
Intelligence Committee raised ‘serious concerns’ that the original
outbreak of Covid-19 pandemic was linked to the WIV. On 26
May, a key meeting of the WHO’s decision-making body is expected
to discuss in detail the next phase of an investigation into the
origins of Covid-19. Chinese authorities have long rejected
the ‘lab leak’ theory instead suggesting that the virus entered
China in food shipments from another country.
These persistent denials, doubts and theories are set to
linger. Maybe they will never be settled. Yet, it
would be nice to know definitively where this wretched virus
originated.
How to vaccinate the world
Experts say that people in poor countries will probably not be
vaccinated against Covid-19 before the end of 2022. That
seems like a distant endgame, but how would even that remote goal
be achieved?
True, the world has already taken possession of hundreds of
millions of doses – hats off to the pharmaceutical and biotech
companies for their manufacturing prowess, a round of applause for
the scientists who have designed and produced the different
vaccines in record time, and a warm smile for the politicians who
have somehow managedMission: Impossibleso
far. But the world needs not millions, but billions of
doses. About 11 billion doses will vaccinate 70% of the
world's population, assuming two doses per person. This is
also the quantity needed to achieve herd immunity.
But this will not be a simple exercise. For a start, there
are obvious global inequalities. Look at a table of the
proportion of adults who have had one dose. The list
currently runs from Gibraltar at 100% through to the UK at 57% and
finally to lowly Syria at 0%. ‘Levelling up’ needs to become
more than a political slogan.
And there are other disparate factors. What about, for
instance, the ordering, paying, distributing, let alone the actual
event of vaccinating? Have you experienced the poverty,
bureaucracy, road conditions and healthcare facilities in, say,
Nepal or Mali?
And why should poor countries be tied into competing for vaccine
purchasing contracts with rich countries? Already there is
the COVAX project (seeCoronavirus – Part 5(March
2021)), a scheme in which international funders have pledged to
supply sufficient doses to vaccinate one-fifth of the world’s
population. So far it has garnered 1.1 billion doses.
A modest beginning.
Or why not encourage poor countries to manufacture their own
vaccines? It may be technically difficult, but surely it is
not impossible. After all, there is considerable expertise
around the world. The principle of ‘give a man a fish and
you feed him for a day; teach a man to fish and you feed him for a
lifetime’ makes sound vaccine sense too.
By the beginning of March it was reckoned that global production
of vaccines had reached 413 million doses. Production growth
over the coming months is expected to be exponential, so by the
end of 2021 the total is predicted to be between 9.5 and 12
billion doses. Yet some analysts think these numbers are too
optimistic because they exclude problems with raw material
supplies, export licences, distribution networks, political
setbacks and so on.
And vaccines are not just liquids in syringes. For a start
they can require 200 or so components, often to be purchased from
competitive global markets. They include the chemical
reagents for culturing and purifying the vaccines but also the
glass vials, filters, laboratory equipment and a 101 other minor
accessories. All are essential to arrive at the
‘fill-and-finish’ final product. Encouragingly, some
previously competing companies are collaborating in these
tasks. For example, GSK (UK) and Novartis (Switzerland) are
manufacturing 100 million and 250 million doses, respectively, of
the vaccine for CureVac (Germany). The biggest deal involves
Oxford-AstraZeneca (UK), which has signed manufacturing contracts
for 2.9 billion vaccine doses with 25 companies in 15 countries.
There are three main types of Covid-19 vaccines – viral vector;
whole virus, and messenger RNA (mRNA). They represent 22%,
35% and 43% respectively of the current total global
production. Of these, mRNA vaccines are relatively simple to
generate, but awkward to scale up. Production bottlenecks
inevitably occur because of the novel components required and
their limited number of suppliers.
But delays and glitches are not just practical, they are also
intellectual. That is why India and South Africa plus 100
other countries, including the United States, Russia and China and
organisations such as the WHO, are campaigning for temporary
waivers of the intellectual-property rights on the various
vaccines in order to ease their manufacture in poorer
countries. This, the campaign's supporters argue, will
unleash production. But this India–South Africa proposal is
being opposed, most notably by the EU, the UK, Japan and most of
the big pharma companies. They argue that waiving
intellectual-property rights is complex and unnecessary, and even
undesirable. As yet, it remains ‘an idea in progress, but
making progress’.
Vaccinating the people of the world ASAP is a massive
undertaking. As has been said many times, ‘No-one is safe
until everyone is safe.’ Now it looks as though it will be
the end of 2022 until we will all be Covid-19 secure. Smell that Covid virus?
Have you ever been sniffed for drugs (or explosives!) by a dog at
an airport? Have you ever been tested for coronavirus by a
lateral flow test (LFT)? Now the two technologies have been
merged. A preliminary study has recently shown that sniffer
dogs are remarkably adept at detecting the infection on the
clothes of Covid-19 patients – dogs have up to 100,000 times more
sensitive noses than humans. Clothing from both variant
sufferers and from those who were asymptomatic did not faze these
‘canine biosensors’.
Six dogs were trained by the Medical Detection Dogs charity.
The best performer, Tala, a golden labrador, was able to identify
Covid-19 samples with a 94% accuracy, while even the poorest
performer was 82% accurate – a typical LFT is reckoned to be 83%
correct. Even so, the dogs returned 16% false positives, or,
in other words, 48 people on a planeload of 300 passengers.
The procedure obviously needs tweaking. Nevertheless,
trained dogs could be a faster, cheaper and more accurate means of
initially screening people, say at airports and large spectator
events. It is estimated that two dogs could screen 300
people in 30 minutes. Positive suspects could then be
confirmed, or otherwise, with the gold-standard PCR (polymerase
chain reaction) tests.
Additional smelly environments are wastewater treatment
plants. Once it was realised that people infected with
Covid-19 shed whole virus particles and viral fragments in their
faeces, the science of ‘sewage epidemiology’ received an upgrade
and sewage-surveillance programmes became fashionable. More
than 50 nations are now monitoring the spread of Covid viruses in
sewage.
The UK government has recently expanded its sewage-testing
programme to detect early signs of the presence of the
coronavirus. The current effort is considerable.
Almost 70% of England’s population is now covered and their
excreta is being analysed for genetic fragments of the virus – a
new, dedicated analytical laboratory in Exeter had been opened for
that purpose. Over 500 locations are being monitored and
sampled at least 4 days per week. It is reckoned that this
sewage-based testing can pick up infection hot spots a week before
conventional medical-based tests.
This additional detection scheme is an early-warning system and
able to identify local outbreaks as well as the existence of
variants. It is already being used to monitor and track the
spread of the Indian variant. Its great advantage is its
ability to test for the virus at a community level and therefore
alert local councils and their public health teams to target
resources more accurately.
Good things from Covid-19?
It is a hard, and perhaps even hard-hearted amid the legions of
maladies and deaths, to find anything good to emerge from this
Covid-19 pandemic. But here and there are little rays of
sunshine. Two such have been dubbed the ‘Chris Whitty
effect’ and the ‘Nightingale effect’.
Apparently, the affable Dr Whitty, chief medical officer for
England, has inspired thousands of additional school students to
apply for careers in healthcare – consider the power of his
straight-talking, fact-laden TV appearances. According to
figures from the Medical Schools Council (MSC) and the
Universities and Colleges Admissions Service (UCAS), applicants to
university courses in medicine for autumn 2021 entry have jumped
by 20% and those for nursing by 25%
In addition, the ‘Nightingale effect’ has increased the number of
nurses, midwives and health visitors in the NHS by 3.5%, that is,
by more than 11,000 staff during the last year. Such a surge
in applicants and employees in the caring professions must count
as good news.