Testing to be based on clinical need in hospitals, care homes and prisons
Routine COVID-19 testing in hospitals, care homes and prisons is to be substantially reduced following clinical and scientific advice.
Due to the success of the vaccination programme and improved treatments, Public Health Scotland and Antimicrobial Resistance & Healthcare Associated Infection Scotland have recommended a return to pre-pandemic testing.
This means testing will be based on person-centred clinical decisions, rather than a routine policy for all individuals. Routine testing will continue for patients moving from hospitals to care homes and will be reviewed based on future advice and outbreaks. Tests will also continue to be available for those eligible for antiviral treatment.
The new guidance will come into effect by 30 August 2023.
Chief Medical Officer Professor Sir Gregor Smith said: “Due to the success of vaccines in protecting people, and the availability of improved treatments, now is the right time to revise the advice on routine COVID-19 testing across health and social care settings and prisons. This will ensure the testing regime remains effective and proportionate.
“Routine testing will remain when patients are discharged from hospital to care homes, to provide additional reassurance for these settings, and testing will still be required when clinically appropriate.
“The clinical advice tells us that focusing on the risk to individuals under general infection control procedures will allow our hospital, social care and prison staff to better protect those in their care and that there is no longer a requirement to apply separate COVID-19 guidance across the board when so many are now protected from its worst harms.”
COVID CASES ON THE RISE
This UK Health Security Agency fortnightly flu and COVID-19 report brings together the latest surveillance data along with the latest public health advice.
The latest report was produced on 3 August:
COVID-19 case rates continued to increase this week compared to our previous report. 5.4% of 4,396 respiratory specimens reported through the Respiratory DataMart System were identified as COVID-19. This is compared to 3.7% of 4,403 from the previous report.
The overall COVID-19 hospital admission rate for week 30 was 1.97 per 100,000 population, an increase from 1.17 per 100,000 in the previous report.
ICU admission rates have decreased to 0.05 compared to 0.07 in the previous report.
Those aged 85 years and over continue to have the highest hospital admission rates; these have increased to 20.49 per 100,000 from 9.8 per 100,000 in the previous report.
Admission rates among those aged 75 to 84 years have increased to 9.45 per 100,000 from 5.54 in the previous report.
Dr Mary Ramsay, Head of Immunisation at the UK Health Security Agency (UKHSA), said: “We continue to see a rise in COVID-19 cases in this week’s report. We have also seen a small rise in hospital admission rates in most age groups, particularly among the elderly.
“Overall levels of admission still remain extremely low and we are not currently seeing a similar increase in ICU admissions. We will continue to monitor these rates closely.Regular and thorough hand washing helps protect you from COVID-19 and other bugs and viruses.
“If you have symptoms of a respiratory illness, we recommend staying away from others where possible.
“The NHS will be in contact in autumn 2023 when the seasonal vaccine is available for those who are eligible due to health conditions or age, and we urge everyone who is offered to take up the vaccine when offered.”
Restrictions tightened due to spread of new variant of COVID-19.
Scotland will significantly tighten protections against Coronavirus (COVID-19) to prevent the spread of the new, highly contagious strain of the virus.
Following confirmation that the new variant of COVID-19 spreads substantially more quickly, the First Minister announced that Scotland needs to act now.
To keep people safe, the First Minister announced:
the planned easing of restrictions around Christmas will be limited to Christmas Day itself, and not the previous 5 day window that was planned
legal household limits will still apply – a maximum of 8 people from 3 households – however advice is to minimise the numbers. Where possible, people should celebrate the festive period at home in their own household and meet with others outdoors
other than for specific exemptions, travel between Scotland and the rest of the UK will not be legal
travel within Scotland will be allowed on Christmas Day
from Boxing Day, all of Scotland will have Level 4 restrictions applied, including the closure of non-essential retail and hospitality. The only exceptions will be Orkney, Shetland and the Western Isles, and the other island communities where restrictions have been reduced in recent weeks, who will be placed in Level 3
from Boxing Day, in line with existing law, travel across local authority boundaries between areas in Level 3 or 4 will not be legal other than for specific exempt purposes
The First Minister also set out new plans for the return of schools in the New Year. Teachers will return to work as planned and children of key workers and the most vulnerable children, will return to schools as planned.
For the majority of pupils the holiday period will be extended until 11 January and learning will begin online from then until at least 18 January.
All these measures will be kept under regular review.
The First Minister said: “Last week it was confirmed that a new variant of the virus had been identified in the UK, and I advised Parliament that a small number of cases of it had already been identified in Scotland.
“While further analysis is required to establish this one way or another, we already have a concern that this strain may be driving what appears to be faster transmission in some hospitals and care homes.
“That’s why we have decided to act and to act firmly.
“Firstly, we are asking everyone to redouble your personal efforts in sticking to the rules and following FACTS.
“Secondly, we intend to maintain a strict travel ban between Scotland and the rest of the UK. This will remain in place throughout the festive period. We simply cannot risk more of this strain entering the country if we can possibly avoid it.
“Thirdly, we now intend to change the law to allow mixing indoors in a bubble on Christmas Day only. The household limits will still apply – a maximum of 8 people from 3 households – is the law. But the advice will be to minimise numbers as far as possible.
“My message is stay home, stay safe and enjoy Christmas. That is in your own interest and the interest of everyone you love.”
First Minister @NicolaSturgeon has announced Scotland will significantly tighten protections against Coronavirus to prevent the spread of the new, highly contagious strain of the virus.
Speaking about beyond Christmas, the First Minister said: “To limit, as far as we can, the risk of this strain spreading further than it has within Scotland, we intend to apply Level 4 measures to all of mainland Scotland for a period of three weeks from one minute after midnight on Boxing Day morning.
“The only exceptions will be Orkney, Shetland and the Western Isles, and the other island communities where we have reduced restrictions in recent weeks, who will go into Level 3 but with strict restrictions on who can travel to and from those islands.
“The situation the new strain presents means that until we are sure it is firmly under control – until we are sure we are not facing the same situation as the south of England today faces, we must slightly change our plans for the way our schools work.
“Schools still open next week will close as planned – we are not changing that. They were then due to reopen from 5 January with all councils areas back by the 7.
“Instead of that, here is what we are going to do – for the children of key workers – such as nurses in our hospitals – schools will open and stay open as normal. They will also open as normal for the most vulnerable children.
“All teachers will also return to work as scheduled and planned. For the majority of pupils, however, the holidays are being extended until 11 January. Starting on that date, learning will be online until at least 18 January.
“After that, assuming we are confident we have the virus under control we will aim to reopen schools more fully but at least until then, schools will go online only other than for the children of key workers and the most vulnerable.”
Following the First Minister’s statement, confirming a three week Tier 4 lockdown in Scotland from Boxing Day, Rhea Wolfson of the GMB Scotland Women’s Campaigns Unit said:“The Scottish Government can’t wait until mid-January to roll out workplace testing for home carers – they need to find a way to bring this forward immediately.
“We can’t have 14,000 home carers in Scotland, supported only with PPE, working through a lockdown prompted by a more transmissible strain of COVID-19.
“Failure to act now to protect these key workers and their service users would be an exacerbation of the negligence they have already endured.”
EIS General Secretary Larry Flanagan said: “The EIS welcomes the decision to delay the return of pupils after the Christmas break until January 11th and that for the vast majority of pupils for this return to be to an online platform, with only the children of key workers and vulnerable children being in school.
“With a large number of schools already closed for the break, this late decision will once again create planning challenges for teachers but schools are much better prepared for remote learning than was the case in March. Given that the EIS has been calling for a ‘firebreak’ around the Christmas break, we view this announcement as being the correct one.
“It would make sense for those schools which are still open to move immediately to remote platforms.”
Prime Minister Boris Johnson had earlier given a statement at the coronavirus press conference:
Good afternoon, I am sorry to report that the situation has deteriorated since I last spoke to you three days ago.
Yesterday afternoon, I was briefed on the latest data showing the virus spreading more rapidly in London, the South East and the East of England than would be expected given the tough restrictions which are already in place.
I also received an explanation for why the virus is spreading more rapidly in these areas. It appears this spread is now being driven by the new variant of the virus, which we first learned about earlier this week.
Our advisory group on New and Emerging Respiratory Virus Threats – NERVTAG – has spent the last few days analysing the new variant.
There is no evidence the variant causes more severe illness or higher mortality, but it does appear to be passed on significantly more easily.
NERVTAG’s early analysis suggests the new variant could increase R by 0.4 or greater. Although there is considerable uncertainty, it may be up to 70% more transmissible than the old variant.
This is early data. It is subject to review. It is the best we have at the moment, and we have to act on information as we have it because this is now spreading very fast.
The U.K. has by far the best genomic sequencing ability in the world, which means we are better able to identify new strains like this than any other country.
The Chief Medical Officer last night submitted our findings so far to the World Health Organisation and we will continue to be totally transparent with our global partners.
There is still much we don’t know. While we are fairly certain the variant is transmitted more quickly, there is no evidence to suggest that it is more lethal or causes more severe illness. Equally there is no evidence to suggest the vaccine will be any less effective against the new variant.
Our experts will continue their work to improve our understanding of the variant.
So we are learning more about this variant as we go.
But we know enough already to be sure that we must act now.
I met ministers on the Covid Operations Committee last night and again first thing this morning, and Cabinet met at lunchtime to agree the following actions.
First, we will introduce new restrictions in the most affected areas – specifically those parts of London, the South East and the East of England which are currently in tier 3.
These areas will enter a new tier 4, which will be broadly equivalent to the national restrictions which were in place in England in November.
That means:
Residents in those areas must stay at home, apart from limited exemptions set out in law. Non-essential retail, indoor gyms and leisure facilities, and personal care services must close.
People must work from home if they can, but may travel to work if this is not possible, for example in the construction and manufacturing sectors.
People should not enter or leave tier 4 areas, and tier 4 residents must not stay overnight away from home. Individuals can only meet one person from another household in an outdoor public space.
Unlike the November national restrictions, communal worship can continue to take place in tier 4 areas.
These measures will take effect from tomorrow morning.
All tiers will continue to be regularly reviewed in line with the approach previously set out, with the next formal review point taking place on 30 December.
Second, we are issuing new advice on travel.
Although the new variant is concentrated in tier 4 areas, it is nonetheless present at lower levels around the country.
We are asking everyone, in all tiers, to stay local.
People should carefully consider whether they need to travel abroad and follow the rules in their tier.
Those in tier 4 areas will not be permitted to travel abroad apart from limited exceptions, such as for work purposes.
Third, we must, I am afraid, look again at Christmas.
As Prime Minister, it is my duty to take the difficult decisions, to do what is right to protect the people of this country.
Given the early evidence we have on this new variant of the virus, and the potential risk it poses, it is with a heavy heart that I must tell you we cannot continue with Christmas as planned.
In England, those living in tier 4 areas should not mix with anyone outside their own household at Christmas, though support bubbles will remain in place for those at particular risk of loneliness or isolation.
Across the rest of the country, the Christmas rules allowing up to three households to meet will now be limited to Christmas Day only, rather than the five days as previously set out.
As before, there will be no relaxation on 31 December, so people must not break the rules at New Year.
I know how much emotion people invest in this time of year, and how important it is for grandparents to see their grandchildren, and for families to be together.
So I know how disappointing this will be, but we have said throughout this pandemic that we must and we will be guided by the science.
When the science changes, we must change our response.
When the virus changes its method of attack, we must change our method of defence.
As your Prime Minister, I sincerely believe there is no alternative open to me. Without action, the evidence suggests infections would soar, hospitals would become overwhelmed and many thousands more would lose their lives.
I want to stress we are not alone in this fight – many of our European friends and neighbours are being forced to take similar action.
We are working closely with the devolved administrations to protect people in every part of the UK.
Of course there is now hope – real hope – that we will soon be rid of this virus.
That prospect is growing with every day that passes and every vaccine dose administered.
The UK was the first country in the western world to start using a clinically approve vaccine.
So please, if the NHS contacts you then get your vaccine – and join the 350,000 people across the UK who have already had their first dose.
Yes, Christmas this year will be very different, but we must be realistic. We are sacrificing our chance to see loved ones this Christmas, so we have a better chance of protecting their lives so we can see them at future Christmases.
As sure as night follows day, we will beat back this virus.
