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Cut to self-isolation period may increase Covid hospital risk, says NHS chief | Coronavirus



Reducing self-isolation to five days for positive Covid casescould increase the infection risk for vulnerable patients in hospital if the approach is not completely safe, a senior NHS leader has said.

Since 22 December, people in England who test positive for Covid can cut their self-isolation period from 10 days to seven if they have a negative lateral flow test on day six and day seven and no high temperature. Scotland, Wales and Northern Ireland have stuck with the 10-day rule.

However, pressure has been rising on the government to consider further cutting self-isolation to five days, with some experts tentatively backing the idea. It has also gathered momentum within the hospitality industry, but they still believe it is the job of scientists to ascertain the move’s safety.

Now Chris Hopson, the chief executive of NHS Providers, has weighed into the debate, suggesting the decision is far from simple – even if it might help tackle staff absences in the NHS.

“Covid-19 keeps throwing up policy decisions requiring difficult judgments between competing objectives. Reducing Covid isolation from seven days to five is another one of these,” he wrote on Twitter.

In a series of tweets, Hopson noted one consideration is high staff absences due to self-isolation across the economy, including in the health service.

“If staff absence rates and care quality/patient safety risk rise, pressure for a change to the isolation period will, inevitably, rise as well,” he said.

However, Hopson noted that a shift to a shorter self-isolation period could be problematic if it increases the risk of hospital-acquired Covid infections. And if people do remain infectious after five days of self-isolation, there could be a rise in community infection rates – a concern given the uncertain impact of Omicron on older populations.

Another issue is that there have been disruptions in the availability of lateral flow and PCR tests.

“A policy based on people needing negative PCR or lateral flow test results to exit isolation requires rapid, reliable and widespread access to those tests. This is not, currently, consistently the case,” he wrote.

Hopson added there is considerable debate within the scientific community as to whether, or to what degree, people with Omicron are infectious after five days.

Leading figures in the hospitality industry, where festive takings have been down by as much as 60%, said a shorter isolation period could relieve some of the pressure on the struggling sector.

Phil Urban, the chief executive of the 1,700-strong pub and restaurant group Mitchells & Butlers, which owns the Harvester and O’Neill’s chains, stressed that it was for the government’s scientific advisers to determine the length of the Covid isolation period.

But he said a shorter gap would help the industry. “If people are isolating who are fine otherwise, the shorter the time period, the better it is. That would certainly be helpful.”

The trade body UK Hospitality said a shortage of tests meant the industry was being hit by a double whammy of staff taking longer to come back to work and customers staying away. “We’re kind of agnostic [on five-day isolation] because it’s so far out of our sphere of expertise,” said the chief executive, Kate Nicholls.

“It’s welcome news that they’re looking at it but we’d only want that if it was safe. We do need to make sure that we have a continued ready supply of lateral flow tests.”

The US has recently announced it is moving to a five-day self-isolation period for those with Covid but no symptoms – albeit with mask-wearing for a further five days. However, some experts have criticised the move as the US does not require people to have negative Covid tests before exiting self-isolation.

Lawrence Young, a virologist and professor of molecular oncology at Warwick medical school, said the time to becoming and remaining infectious varies from person to person, and by variant, with some evidence suggesting it takes only two to three days between infection and becoming infectious with Omicron.

“This infectious period can occur before the onset of symptoms and last for between two and three days after you become symptomatic,” he said.

Young added that the current seven-day plus testing approach adopted in the UK is sensible and provides a margin for person-to-person variability. But, he added: “Reducing the self-isolation period to five days without robust evidence is a concern and could only be introduced with the strict enforcement of lateral flow testing.”

A paper by scientists at the UK Health Security Agency, yet to be peer reviewed, suggests that relying on two negative lateral flow tests alone would risk a high proportion of people being released while still infectious due to false negatives, suggesting a mandatory isolation period is also necessary.

“A mandatory isolation period of longer than seven days will not provide much more safety but lowering this mandatory isolation point will increase the percent of ‘false releases’ dramatically,” said the team.

A government spokesperson said: “There are no further changes to the isolation period planned at this time, but we keep all rules under review based on the latest health data.”

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Solar storms may cause up to 5500 heart-related deaths in a given year



In an approximate 11-year cycle, the sun blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field, which may disrupt our body clock and ultimately affect our heart


17 June 2022

A solar storm

Jurik Peter/Shutterstock

Solar storms that disrupt Earth’s magnetic field may cause up to 5500 heart-related deaths in the US in a given year.

The sun goes through cycles of high and low activity that repeat approximately every 11 years. During periods of high activity, it blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field.

These so-called solar storms can cause glitches in our power grids and bring down Earth-orbiting satellites. A handful of studies have also hinted that they increase the risk of …

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UK Covid infection rate rising, with more than a million cases in England | Coronavirus



Coronavirus infections are rising in the UK, figures have revealed, with experts noting the increase is probably down to the more transmissible BA.4 and BA.5 Omicron variants.

The figures from the Office for National Statistics (ONS), based on swabs collected from randomly selected households, reveal that in the week ending 11 June an estimated one in 50 people in the community in England are thought to have had Covid – around 1.13 million people.

The figure is even higher, at one in 45, in both Wales and Northern Ireland, while it was highest in Scotland where, in the week ending 10 June, one in 30 people are thought to have been infected.

While the figures remain below the peak levels of infection seen earlier this year, when around one in 13 people in England had Covid, the findings are a rise on the previous week where one in 70 people in England were thought to be infected. Furthermore, the data reveals increases in all regions of England, except the north-east, and across all age groups.

Experts say that a key factor in the increase is probably the rise of the Covid variants of concern BA.4 and BA.5.

“Infections have increased across all four UK nations, driven by rising numbers of people infected with the BA.4 and BA.5 Omicron variants,” said Kara Steel, senior statistician for the Covid-19 Infection Survey.

While Steel said it remained too early to say if this was the start of another wave, others have warned it may already have begun, with increased mixing and travelling among other factors fuelling a rise in cases.

Among concerns scientists have raised are that BA.4, BA.5 and another variant on the rise, BA.2.12.1, replicate more efficiently in human lung cells than BA.2.

Prof Azra Ghani, an epidemiologist at Imperial College London, said the latest figures were not surprising, and might rise further.

“This increase in infection prevalence is likely due to the growth of the BA.4 and BA.5 Omicron subvariants, which as we have seen elsewhere in Europe, appear to be able to escape immunity generated from previous Omicron subvariants,” she said.

“It is therefore possible that we will continue to see some growth in infection prevalence in the coming weeks and consequently an increase in hospitalisations, although these subvariants do not currently appear to result in any significantly changed severity profile. This does however serve as a reminder that the Covid-19 pandemic is not over.”

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NHS to offer women in England drug that cuts recurrence of breast cancer | Breast cancer



Thousands of women in England with breast cancer are to benefit from a new pill on the NHS which reduces the risk of the disease coming back.

The National Institute for Health and Care Excellence (Nice) has given the green light to abemaciclib, which cuts the chance of breast cancer returning after a patient has had surgery to remove a tumour.

Trials showed that patients who had the drug with hormone therapy had a more than 30% improved chance of their cancer not coming back after surgery, compared with hormone therapy alone.

“It’s fantastic thousands of women with this type of primary breast cancer will now have an additional treatment option available on the NHS to help further reduce the risk of the disease coming back,” said Delyth Morgan, the chief executive of charity Breast Cancer Now.

“The fear of breast cancer returning or spreading to other parts of their body and becoming incurable can cause considerable anxiety for so many women and their loved ones.

“New effective treatments such as abemaciclib, which can offer more women the chance to further reduce the risk of the disease recurring, are therefore extremely welcome and this is an important step change in the drug options available for this group of patients.”

The twice-a-day pill is suitable for women with hormone receptor-positive, HER2-negative, node-positive early breast cancer at high risk of recurrence who have had surgery. About 4,000 women will benefit initially, Nice said.

Helen Knight, the interim director of medicines evaluation at Nice, said the draft recommendation came less than a month after abemaciclib received its licence.

“The fact that we have been able to produce draft recommendations so quickly is testament to the success of our ambition to support patient access to clinically and cost effective treatments as early as possible,” said Knight. “Until now there have been no targeted treatments for people with this type of breast cancer.

“Abemaciclib with hormone therapy represents a significant improvement in how it is treated because being able to have a targeted treatment earlier after surgery will increase the chance of curing the disease and reduce the likelihood of developing incurable advanced disease.”

Abemaciclib works by targeting and inhibiting proteins in cancer cells which allow the cancer to divide and grow. It normally costs £2,950 for a packet of 56 150mg-tablets, but the manufacturer, Eli Lilly, has agreed an undisclosed discounted price for NHS England.

“Thanks in part to this latest deal struck by NHS England, NHS patients will be able to access another new targeted drug for a common and aggressive form of breast cancer,” said Prof Peter Johnson, the cancer director of NHS England.

“Abemaciclib, when used alongside a hormone therapy, offers a new, doubly targeted, treatment option, helping to increase the chances of beating the cancer for good, as well as meeting the NHS’s commitment to delivering improved cancer care under our long-term plan.”

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