Coronavirus UK: SAGE say 'no evidence' face shields work

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Hairdressers and barbers should wear face coverings and not just visors in order to help curb the spread of coronavirus, scientists advising the Government say.

The experts warn that plastic face shields being used in hair salons are unlikely to be an effective control for aerosol transmission of Covid-19 – which scientists fear is one way the disease spreads.

In the latest batch of documents released by SAGE today, the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) says the guidance needs to change.

Another report released today revealed an estimated one million Covid-19 patients could have died had there not been efforts to protect the NHS.

They are among dozens in a tranche of papers presented to SAGE, the Government’s Scientific Advisory Group for Emergencies, over recent months to help guide ministers through the crisis.

The newly-released papers released today also revealed:

  • It’s possible humans could end up getting both coronavirus and seasonal flu at the same time amid concern a ‘second wave’ of Covid-19 will occur in the winter;
  • More than half of all Covid-19 patients who have been hospitalised in the UK have been discharged; 
  • An estimated 6,000 people in the UK died as a result of avoiding A&E during the height of the pandemic, which could raise to 16,000 by March 2021;  
  • A recession caused by the Covid-19 pandemic will cause around 25,000 deaths in the long-term, it is estimated;
  • Up to 5,500 people could still be catching the coronavirus every day in England alone.
Hairdressers and barbers should wear face coverings and not just visors in order to help curb the spread of coronavirus, scientists advising the Government say. Pictured: Northampton, July 4

Hairdressers and barbers should wear face coverings and not just visors in order to help curb the spread of coronavirus, scientists advising the Government say. Pictured: Northampton, July 4 

An estimated one million Covid-19 patients could have died had there not been efforts to protect the NHS. Pictured: Members of the public at Wexham Park Hospital on the NHS 72nd birthday, July 5

An estimated one million Covid-19 patients could have died had there not been efforts to protect the NHS. Pictured: Members of the public at Wexham Park Hospital on the NHS 72nd birthday, July 5

Hairdressers should wear face coverings because there is ‘no evidence’ shields protect against Covid-19 

ARE FACE SHIELDS PROTECTIVE? 

In a scramble to find ways to protect people from catching the coronavirus, masks, goggles, visors and gloves have all been touted as possible layers of protection.

Some people have even been seen with homemade attempts, such as wearing lunchboxes or water bottles over their faces.

But do visors work? Some research has shown that people are at risk of becoming more seriously ill with COVID-19 if they receive a larger ‘viral load’ – the first dose of viruses that they are infected with.

Epidemiologist Dr Eli Perencevich and a team of scientists at the University of Iowa said a visor could reduce the amount of virus someone inhaled by up to 92 per cent form 2m away from the source.

They said: ‘Face shields… should be included as part of strategies to safely and significantly reduce transmission in the community setting.’

Dr Robert Glatter, a doctor at Lenox Hill Hospital in New York City, said that early data was ‘promising’.

But research carried out before the pandemic does not show any clear benefits of using visors on their own, other scientists say.

A study by the US Centers for Disease Control & Prevention (CDC) done in 2016 found there is no proof to back up claims that face shields work on their own.

He said viruses or bacteria could come in through around the edges of the visor and still cause infection — and said they should only be used in addition to other PPE. 

Lawrence Young, a virologist and oncologist, University of Warwick, told MailOnline: ‘I don’t know of any systematic studies properly evaluating the benefits of face shields.’

He noted an ‘interesting’ review led by the University of Hong which  comprehensively explored the different types of facial protection measures, including masks. 

The team highlighted the fact that ‘strong evidence is lacking in terms of the effectiveness of face shields against the transmission of viral respiratory diseases’. 

Writing in the journal Oral Diseases, the team add: ‘Because most face shields do not form a tight seal around the side of the face and chin area, they do not offer protection against aerosols leaking in from the margins of the face shields.’

Ministers were told hairdressers should be advised to wear face coverings because there is ‘no evidence’ face shields protect against Covid-19. 

A paper published today, but presented in July, said: ‘It is recommended that guidance for settings where people are in close proximity for a long duration (e.g. hairdressing), and that currently only require face shields to be worn, should be changed to include the wearing of face coverings.’ 

The New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) and the Environmental and Modelling group (EMG) presented the evidence on July 23, almost three weeks after hairdressers re-opened on July 4.

In order to open welcome back clients, hairdressers, barbers, nail technicians and tattooists were told by the government that clear visors would be adequate enough to protect against Covid-19. It is not clear what this guidance was based on.  

SAGE said face shields are ‘likely’ to protect the wearer against large droplets — the most common route of Covid-19 transmission — but there is no hard proof that this is the case. 

Similarly, there is no evidence — and it is ‘unlikely’ — that face shields are an effective control against aerosol transmission.

It is currently unclear if the virus is spread through aerosols — which are tiny particles that linger in the air for long periods of time.  

But NERVTAG and EMG admitted it is possible airborne transmission plays a part in the spread of the coronavirus, but only in areas that are poorly ventilated.

The paper said: ‘Based on the current evidence, it is possible that transmission through aerosols could happen where a person who generates significant amounts of virus is in a poorly ventilated space with others for a significant amount of time.’ 

The World Health Organisation said last month it is looking over evidence that the coronavirus is airborne, and if found to be true, it could mean a change in course for trying to control the disease.  

Adults could get infected with flu and Covid-19 at the same time this winter 

It is possible that humans could end up getting both coronavirus and seasonal flu in the near future, scientists admitted, amid concern a ‘second wave’ of Covid-19 will occur in the winter.

In a report admitted to SAGE on July 23, Public Health England warned that having both viruses at once could exacerbate disease and make people sicker. 

But the agency admitted it’s possible that being infected with both illnesses at the same time wouldn’t be dangerous and would be a rare event.

The paper revealed today said: ‘It is foreseeable that individuals may experience simultaneous or sequential exposure to SARS-CoV-2 and seasonal influenza virus in the near future.’

So scientists at Porton Down, PHE’s laboratory near Salisbury, have suggested that ferrets should be used to test how the viruses could spread and what their effects may be.

Ferrets are often used in scientific tests of viruses because they are very susceptible to becoming infected with human pathogens and even display some similar symptoms.

PHE has suggested that ferrets should be infected with both influenza and the coronavirus to work out what the possible effects of having them both together could be.

They advise that the lung tissue of ferrets should then be examined to work out any respiratory issues.

And they added that the test is a ‘mild challenge model’ that shouldn’t be fatal. 

It is possible that humans could end up getting both coronavirus and seasonal flu in the near future, scientists admitted, Public Health England. Pictured, a woman in Manchester wears a face mask, August 3

It is possible that humans could end up getting both coronavirus and seasonal flu in the near future, scientists admitted, Public Health England. Pictured, a woman in Manchester wears a face mask, August 3

More than 38,000 hospitalised Covid-19 patients in the UK have been discharged

More than half of all Covid-19 patients who have been hospitalised have been discharged home, SAGE were told on July 23.

The COVID-19 Clinical Information Network (CO-CIN) collects information from the all people admitted to hospital in the UK.

In total up until 23 July 2020, CO-CIN has recorded 74,421 patients with confirmed Covid-19. This means it only covers people who have received a positive test result, missing some people out.

It means of the 300,000 cases reported by the Government by that date, a quarter are admitted to hospital.

Of those people, 38,156 people have been discharged since March.

The average length in time in hospital was nine days, and despite people with pre-existing health condition proving to be more vulnerable to the disease, a quarter of patients admitted do not have underlying disease. 

Some 20,794 patients had died in hospitals by July 23, the data said. It may be lower than expected (the Government official tally was 45,554 on this date) because it only accounts for those in hospital with a confirmed test and who had treatment.

NHS England’s own tally for hospital deaths in the country has been around 29,000 for some weeks, but this includes both confirmed and suspected Covid-19 deaths.

Of all patients, 9,226 have required ICU, which was more common in those aged between 50 and 75 years old.

More than half of all Covid-19 patients who have been hospitalised in the UK have been discharged home, figures revealed today show. Pictured: Patient's outcome depending on their age and gender

More than half of all Covid-19 patients who have been hospitalised in the UK have been discharged home, figures revealed today show. Pictured: Patient’s outcome depending on their age and gender

There could have been one million Covid-19 deaths without protecting the NHS  

An estimated one million Covid-19 patients could have died had there not been efforts to protect the NHS, according to a paper called ‘Direct and Indirect Impacts of COVID-19 on Excess Deaths and Morbidity’.

The report, considered at a SAGE meeting on 23 July, gave a scenario which could have feasibly happened had no measures been taken to prevent the outbreak spiralling out of control. 

Experts used infection levels in March to predict how many patients would have required a hospital bed if none of the some 50,000 in the NHS were available.

For these patients, the study assumed a 60 per cent mortality for patients requiring non-critical care beds, and 100 per cent mortality for patients requiring critical care beds. 

It showed that, without social distancing, hand-washing and lockdowns to prevent surging cases, some 1.1million additional fatalities would have over a 12-month period.  

The figure is even after taking into account the thousands of additional beds that were inside the hastily put together Nightingale hospitals. 

The paper, prepared by government bodies including the Department of Health and Social Care (DHSC), said the peak of an unmitigated pandemic would have been so high that ‘no health service could come close to providing the necessary staffing and ventilated beds to treat every patient that would require it’.

In March, the government’s strategy was focused on protecting the NHS from reaching breaking point.  

Although it broadly succeeded, with only a handful of the 4,000 London Nightingale hospitals used, there has been criticism it has come at a cost of the social care sector, which saw tens of thousands of deaths in care and residential homes due to Covid-19. 

One million Covid-19 patients could have died had there not been efforts to protect the NHS, estimates show. Pictured: Health Secretary Matt Hancock opening the NHS Nightingale Hospital in London in April

One million Covid-19 patients could have died had there not been efforts to protect the NHS, estimates show. Pictured: Health Secretary Matt Hancock opening the NHS Nightingale Hospital in London in April 

Around 6,000 patients died from not going to A&E during the pandemic in March and April 

An estimated 6,000 people in the UK died as a result of avoiding A&E during the height of the pandemic, one scientific paper led by the DHSC suggested.

THREE IN TEN ADULTS WON’T GO TO A&E

Roughly three in 10 adults would not feel comfortable attending A&E for urgent care if they needed it, a survey has found.

Data from the Office for National Statistics shows a fifth of respondents (21 per cent) would feel uncomfortable attending. 

Another eight per cent admitted they would be ‘very uncomfortable’, according to the results of the poll. 

Experts fear the knock-on effects of the coronavirus pandemic have been lethal after routine care was disrupted, and amid concerns that patients were reluctant to seek treatment.

The ‘stay at home’ message was driven hard throughout March, April and some of May, and statistics show A&E attendances dropped massively as a result.

Government bodies now estimate that 6,000 ‘excess deaths’ occurred as a result, which are deaths that wouldn’t have been expected had the pandemic not occurred.

An additional 10,000 could occur by March 2021 because footfall is still slow to pick up again. 

The paper did not mention if this would be as a result of a feared ‘second wave’, or as the after effects of the current Covid-19 outbreak.

On top of that, delay in getting treatment could cause some 12,500 excess deaths in the next five years. 

The paper, which was provided to SAGE on July 23, read: ‘Emergency attendance and admissions have decreased since the start of the pandemic; people may have been reluctant to attend accident and emergency departments because of fears or perceptions that they should remain at home, and some causes may have decreased due to lockdown measures.’

March and April were the quietest month in A&E since NHS records began because of Britain’s coronavirus crisis, figures show.

Casualty departments in England recorded just 1.53million attendances in March, down 22 per cent on February and 29 per cent on March 2019.

A&E visits were 57 per cent lower in April 2020, when up to 1,000 Covid-19 deaths were being reported per day, compared to April 2019.

Emergency medics have repeatedly warned patients must come forward if they have medical concerns because delaying treatment can be deadly. 

An estimated 16,000 people in the UK will die as a result of avoiding A&E during the height of the pandemic, papers revealed today said (grey column, Category C i). On top of that, delay in getting treatment could cause some 12,500 excess deaths in the next five years (pink column, Category C iii)

An estimated 16,000 people in the UK will die as a result of avoiding A&E during the height of the pandemic, papers revealed today said (grey column, Category C i). On top of that, delay in getting treatment could cause some 12,500 excess deaths in the next five years (pink column, Category C iii)

A lockdown-induced recession will cause around 25,000 deaths in the long term

A recession caused by the Covid-19 pandemic will cause around 25,000 deaths in the long-term, it is estimated.

The economic hit caused by several months in lockdown means the UK and several other countries are heading towards the worst recession in decades, the effects of which will be felt in a vast number of ways. 

More than half — around 14,000 — of the expected lives lost will be attributed to an increase in cardiovascular diseases, such as a heart attack, within the next two to five years, it is predicted.

The ‘Direct and Indirect Impacts of COVID-19 on Excess Deaths and Morbidity’ paper said about 18,000 deaths will occur as a result of the recession within the next five years.  

Some will be the result of an increase in musculoskeletal conditions, a number of conditions which can lead to disability and are related to inadequate physical activity and poor nutrition — both of which are expected to rise in the UK population due to lockdown — as well as obesity and smoking. 

Around 14,600 deaths are thought to occur in the long-term future — more than five years away — but it is too far away to predict where these will come from.

The DHSC and writers calculated this using two different approaches, including one which assessed the impact of a recession on 15 to 24 year olds’ lives.   

It also said that mental health disorders and self harm will increase in adults within the next few years, but did not estimate this will lead to deaths.

The pandemic-induced recession is expected to have a huge knock-on effect on people’s mental health due to financial worries.  

Currently less people are dying right now than would be expected for this time of year, so in the short-term aftermath, the pandemic has caused a drop in deaths. 

That’s because Covid-19 likely sped up the deaths of people with conditions like dementia and heart disease, so the year’s fatalities have been front-loaded.

Up to 5,500 people could be catching the coronavirus every day

Up to 5,500 people could be getting infected with coronavirus every day in England alone, a paper admitted to SAGE on July 23 has revealed.

An ongoing surveillance study ran by the Office for National Statistics suggested that during the week of July 13-19 there were an estimated 2,800 new infections per day, but this number could have been as high as 5,500.

However, The Scientific Pandemic Influenza Group on Modelling (SPI-M-O) said combined estimates from four models found it was more likely that between 2,000 and 5,000 people were being infected with Covid-19 every day.

It comes as it was revealed today that the UK’s R number — the average number of people each Covid-19 patient infects — could be as high as 1.

Experts say the R needs to stay below one or Governments risk losing control of the epidemic and the virus could spiral back out of control.

England as a whole has remained the same at 0.8 to 1.0, but the East of England is the only region in the entire UK where scientists can say with certainty that the R is below one.

However, the SPI-M-O report noted that extra care should be taken when interpreting the R numbers for Scotland, Wales, Northern Ireland, East of England, London, North West, South East and the South West because the estimates are based on such low case numbers.

And the report added that because numbers of coronavirus cases in the UK are so low, surveys such as the ONS swabbing survey could be overestimating levels of infections because of false positive results.

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