Commentary

Doc Hines - Covid News and Views - 4 June 2021

I hope none of you have been caught out by the sudden move of Portugal to the amber list rather than the green list from 4 a.m. on Tuesday. The race is now on to get back before the deadline and face 10 days quarantine at home. This is a rule enforced by law and breaking quarantine rules can bring hefty fines. I have warned several times that this could happen. This is just not the time to have a holiday abroad. The Prime Minister has repeatedly told us not to travel abroad unless essential and holidays are not considered essential.


7 countries have moved up from Amber to Red status which means quarantine now has by law to be in a Government approved hotel at a cost of £1760 each plus the costs of testing. The countries involved are Egypt, Costa Rica, Sri Lanka, Afghanistan, Bahrain, Sudan and Trinidad and Tobago.

There is a welcome and growing campaign to reverse the Government’s decision to reduce the amount of Overseas Aid it makes available this year. It is pleasing to see two former Prime Ministers backing this campaign. As part of the G7 we should be leading the world in its provision of help to poorer countries. Of course, money is tight for Government this year, but it is so much tighter elsewhere. Remember as a global community we are just not safe from Covid until we are all immunised across the world. We must start by assisting the Covax scheme in its bid to supply vaccine to everyone that needs it.


Only days after we are told to call the Covid variants by their new names, up pops a new one which the media have dubbed the Nepal variant. It seems this is a variant of the Delta (Indian) mutation. the science media centre have called this K417N . They say it is just one of thousands of mutations identified but it is not one of concern or under investigation at the present time. Officially it should be known as Delta plus K417N variant. this means there are two variants combined in this strain of the virus.

So far 91 cases have been identified in the world. The first case in the UK was notified on 24th April. Since then, further cases have been identified in the UK, Portugal, USA, India, and Japan. It is its presence in Portugal which has prompted the UK Government to make it amber to reduce risk of importing more cases to the UK.


There are 14 cases found in Japan and 13 of those had travelled from Nepal. This is how it got its name from Nepal.

It is possible that the effect of this new mutation can be very similar to the Beta (South African) variant which may well be less well neutralised by the vaccine and may be significantly more transmissible.

In the UK today it was announced that the Pfizer vaccine has now been approved for children in the 12-18 year age band. Now the debate will begin about whether it should be given. Firstly, we need to consider whether it is needed. There is no doubt that a lot of the cases being seen in the UK are in this age group. The rest are in people who for one reason or another have not been immunised. Generally, children are thought to be less likely to have severe episode or to die. It can however be very significant, children are dying of the disease. My own great niece has been very poorly with long Covid and a myocarditis.

In one study of 2,000 children in this age group who were given the vaccine there was not one case of any significant reaction, other than transient sore arms. In the control group who had a placebo there were 16 children who caught Covid 19.


We then need to look at the ethical situation. Should we be immunising adults in the rest of the world first? The USA have started to immunise children and France is due to start in a day or so.


Having looked at the data carefully, I will be encouraging my grandchildren to be immunised if it is offered. These steps are very often difficult for parents. I remember my concerns when they were allowed to ride a bike on the road, unsupervised, when they had a sleep over or made other steps towards adulthood.


In an interesting legal challenge, a restaurateur from Brick lane East London challenged the law. He had been fined for keeping his restaurant open and serving meals during the lockdown. In his defence he quoted the 1215 Magna Carta. Under article 61 of that Act he claimed the right of lawful rebellion against being forced to close. The prosecution argued that Article 61 of the Magna Carta was actually removed in 1216. And the legal expert said that the Magna Carta was now a legal ornament rather than a living instrument. The poor man had his fine increased to £2,000 plus costs.


The R number has risen slightly across the UK and is now between 1 and 1.2. This confirms what we will see in the figures that the pandemic is spreading again.


The number of daily tests being done remains lower than we were used to: 806k today and 854k yesterday. The number of tests that were positive is now rising rapidly, 5,274 yesterday and 6,238 today. There has been a rise of 39% in the last 7 days. There is now no doubt that we are seeing an exponential rise in new cases, in some areas by 75% in a week.

What makes these figures incongruous is that this rise is yet to be seen in the hospital data . 123 people were admitted on 31st May last time a figure was released. There are now 954 in hospital on 2nd June and 134 on a ventilator. All these figures are showing a small rise, but not yet at a rate that could overwhelm the NHS.


I understand why there is some hesitation in interpreting these figures but I feel we should all be prepared for the June date to be postponed until after the end of the school term.

Just to illustrate the difficulty with statistics a paper has just been published looking at people who have had a Covid illness despite having at least one jab. The cases were in the UK over the last 3 months. The authors of the paper suggested that the symptoms were different, and that sneezing was a very prominent symptom. They seem to have forgotten that up to 50% of the population have a hay fever like allergy causing frequent sneezing. If follows that 50% of the Covid sufferers also had an allergic condition which caused sneezing. I suggest it was nothing to do with Covid, they usually have a dry nose and no sneezing, but due to hay fever coincidentally.


As always, your contributions are very helpful and I look forward to reading them. Stay safe and avoid putting yourself at risk.

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