What is the NHS Test and Trace system and how does it work?

The NHS Test and Trace system, a scheme that will help people with Covid-19 to track down those they have come into contact with, has been officially launched.

Sabrina Barr, James Crump

 

29/05/2020

1/118 SLIDES © Mohammad Ponir Hossain/Reuters

Members of the police force wear protective masks as they join a yoga session to boost their immune systems in Dhaka, Bangladesh, on June 14.

At the daily coronavirus press conference on Wednesday (May 27), Matt Hancock said that the system will be vital to stopping the spread of the virus, until a vaccine is found.

The health secretary said that the system will allow the UK to start “doing more of the things that make life worth living, without risking safety”.

The release of the system coincides with an easing of lockdown rules on Friday 29 May in Scotland and on Monday 1 June in England, which will enable people to socialise outside with groups of up to eight in the former and six in the latter.

What is the NHS Test and Trace scheme?

The aim of the NHS Test and Trace scheme, which was launched on Thursday 28 May, it is to prevent further transmission of the coronavirus by tracking down people who have come into contact with those who have tested positive for the virus.

© Provided by The IndependentIt should allow those who develop symptoms of Covid-19 to be tested “quickly”, in addition to providing “targeted asymptomatic testing of NHS and social care staff and care home residents”, the NHS states.

The scheme was launched with the help of 25,000 contact tracers, who were tasked with tracking down those who have been in close contact with people infected with Covid-19.

If they find someone who has been in close contact with someone with the virus, then they will contact them and tell them that they need to self-isolate for 14 days.

An app to accompany the system was supposed to be ready for mid-May, but has been delayed for several weeks to an unspecified date.

The app is currently being trialled on the Isle of Wight before becoming more widely available.

How does it work?

If someone develops symptoms of the coronavirus, they are first advised to self-isolate for seven days, while members of their household are told to self-isolate for 14 days from the point the infected person started showing symptoms.

They can then ask to be tested for the virus, which the NHS states must be done “in the first five days of having symptoms”.

“Do not wait. Ask for the test as soon as you have symptoms,” the health service stresses.

When you are tested for Covid-19, this may take place at a drive-through regional testing site, at a mobile testing unit, in an NHS facility or you may receive a home testing kit.

© Provided by The Independent image

How to get a coronavirus antibody testing kit

However, the NHS adds that there is “very high demand” for tests with priority being given to people in hospital and essential workers, which is why “even if you are successful in requesting a test, we cannot guarantee you will get one”.

If you receive your test result and it is positive, the NHS Test and Trace service will contact you either through email, text or phone. Text messages will come from the NHS, while calls will come from 0300 0135000.

“Children under 18 will be contacted by phone wherever possible and asked for their parent or guardian’s permission to continue the call,” the NHS adds.

You will then be asked to sign into the NHS Test and Trace contact tracing website at contact-tracing.phe.gov.uk, where you will be asked to provide contact details for people you have been in contact with.​

It will not be possible for most people to have the details of everyone they have been in contact with, so the tracers will ask to be taken step-by-step through your movements.

They will then attempt to find the contact details for anyone they think might be infected, and will try to warn them.​

© Provided by The Independent image

Contact tracers will not tell police if people have breached lockdown

If you are informed that you’ve been in close contact with a person who tested positive for Covid-19, you will need to stay at home for 14 days from the day you were last in contact with them.

You are advised to not leave your home for any reason, to not have any visitors at your home except in the case of essential care and to “try to avoid contact with anyone you live with as much as possible”.

“People you live with do not need to self-isolate if you do not have symptoms,” the NHS adds.

“If you live with someone at higher risk from coronavirus, try to arrange for them to stay with friends or family for 14 days.”

What is close contact?

Anyone who lives in the same household as an infected person, has been within one metre of them, or has been within two metres for at least 15 minutes, will be considered a close contact.

© Provided by The Independent imageTo be classified as a close contact, a person will have had to have been within that proximity to an infected person during the two days before they showed symptoms and during the seven days after.

While the NHS Test and Trace scheme is currently voluntary, Mr Hancock has indicated that the government could eventually force people to participate if required.

What criticism has the Test and Trace scheme received?

Following the launch of the Test and Trace scheme, it was reported that MPs had been told during a private conference call with Baroness Dido Harding, chair of the service, that it won’t be “fully operational” until the end of June.

This news came amid widespread reports of issues with the system, which saw tracers unable to log onto their computer systems.

What are the UK lockdown rules now?

Liberal Democrat MP Daisy Cooper said the government was following a “high risk strategy” by easing lockdown restrictions four weeks before the scheme is “fully operational”.

The government was recently warned by a leader in disease control that the Test and Trace scheme will be “a car crash” as currently designed.

Gary McFarlane, a director of the Chartered Institute of Environmental Health (CIEH), revealed the government had shunned an offer from the institute to help train thousands of contact tracers, instead turning to Serco and other outsourcing giants.

Only a small number of local council environmental health workers who are already skilled in tracing victims after outbreaks will be used.

Mr McFarlane warned: “We must absolutely have local intelligence on the ground,” adding: “I’m concerned that, if the system is not well designed with a very clear purpose identified at the outset, it could be a car crash.”

Stay at home to stop coronavirus spreading - here is what you can and can't do. If you think you have the virus, don't go to the GP or hospital, stay indoors and get advice online. Only call NHS 111 if you cannot cope with your symptoms at home; your condition gets worse; or your symptoms do not get better after seven days. In parts of Wales where 111 isn't available, call NHS Direct on 0845 46 47. In Scotland, anyone with symptoms is advised to self-isolate for seven days. In Northern Ireland, call your GP.

Coronavirus and you: Supporting mental health through
lockdown and beyond

https://www.msn.com/en-gb/news/uknews/what-is-the-nhs-test-and-trace-system-and-how-does-it-work/ar-BB14KprF

What's So Hard About Developing A Coronavirus Vaccine? We Asked A Scientist

As the coronavirus pandemic continues to spread around the globe, the best hope for truly getting it under control is a vaccine that would protect people from contracting Covid-19. Scientists in the U.S., China, the U.K. and elsewhere are racing to develop a vaccine and there have been some promising signs that one of the many vaccine candidates under development may prove effective against the virus.

Jeffrey Young

 

11 hrs ago  28 June 2020

© ASSOCIATED PRESS FILE - In this Oct. 7, 1954 file photo, Dr. Jonas Salk, developer of the polio vaccine, holds a rack of test tubes in his lab in Pittsburgh, Pa. On Friday, April 24, 2020, The Associated Press reported on stories circulating online incorrectly asserting that any virus which originated from nature has its remedy and cure from nature, and only viruses made in laboratories require vaccines. Human viruses like measles and polio have all originated in nature and require vaccines, said Vincent Racaniello, a professor of microbiology and immunology at Columbia University. "To say that any virus that originated from nature has its remedy in nature, ignores the fact that all human viruses came from nature, and that we have made vaccines for many of them." (AP Photo/File)

In the U.S., President Donald Trump has predicted a vaccine will arrive before the end of the year. Dr. Anthony Fauci, director of the National Institutes of Health’s National Institute of Allergy and Infectious Disease has said it’s a question of “when and not if” a vaccine against this coronavirus, known as SARS-CoV-2, will be developed, and also predicted that could happen before year’s end. 

With Covid-19 taking lives and crushing economies around the world, stopping the spread would provide tremendous relief. But the progress of science is characterised more by failure than success. Researchers are working on almost 200 potential vaccines for this coronavirus, and there’s no guarantee any of them will ever work, let alone one that’s ready for wide use within months.

Creating a safe, effective vaccine that quickly would be unprecedented. In addition, no one has ever attempted to produce a new vaccine, distribute it to every corner of the world and carry out an immunisation campaign on this scale and with this much speed.

To get a better understanding of the challenges facing vaccine researchers, HuffPost spoke to Vincent Racaniello, a professor of microbiology and immunology at Columbia University’s Vagelos College of Physicians and Surgeons in New York. 

Is it realistic to expect a vaccine for the novel coronavirus by this winter?

No, I think it’s highly unrealistic to expect a vaccine by the end of 2020. We haven’t made any vaccine in that short of time. That would be a year from January, when we first saw circulation in the U.S. Eighteen months is optimistic. What would be more realistic, in my view, would be next summer. But, you know, vaccines can take five to 10 years and longer. The polio vaccine took 50 years to develop. Certainly, we’ve advanced in our technology so we can do it faster now, but I would say, no, the end of this year is completely not feasible, in my view. However, I would love to be surprised.

How would a SARS-CoV-2 vaccine work to prevent people from becoming ill?

What vaccines do is they’re introduced into you ― they can be injected, or they can be taken orally, or through any number of other routes ― and they turn on your immune system to make a response to the virus that’s in question, in this case SARS-CoV-2, without making you sick. Then you have an immune response and, most importantly, your immune response comes with a wonderful feature called “memory,” so it remembers what it’s encountered so that whenever it sees that agent again, it will respond. So that’s what a vaccine tries to do ― it tries to produce immune memory without any of the pathogenic or disease consequences of a real infection.

Is this similar to what the human immune system does itself when it fights off infections?

Absolutely. If you get influenza or a common cold virus or any other virus ― if you survive, of course ― then you have immune memory, and then whenever you encounter the virus again, you should mount a nice response and you should prevent infection entirely. You won’t even know that you’ve encountered the virus.

What are the primary challenges to developing new vaccines for any disease?

There are many, but the main one is understanding what’s needed to protect you from infection. We’ve been talking very generally about the immune response but, in fact, there are different components. There are cells and proteins involved, and so we need to know which is important for the particular virus. That’s one of the reasons that it took 50 years to make a polio vaccine, because people had to figure out what was important. Now, for this new virus, we don’t have the time to do that, so we’re making a lot of assumptions about what’s important, and we hope that they’re right. 

How do governments, pharmaceutical companies, academic institutions and scientists decide how to prioritise the development of vaccines for some diseases over others?

I hate to say, this is very sad and this is an indictment of the whole system for making vaccines, but the main priority is profit. 

The companies that make vaccines, they’re all for-profit companies and they need to see that they can make a profit off of their vaccine. So all the vaccines that we have are there because many, many people are infected with viruses like influenza, measles, mumps, rubella, shingles and polio. They infect a lot of people and the companies can make money from them.

However, there are many diseases out there that are far less prevalent but nevertheless they kill people. Companies aren’t interested in making vaccines for those diseases because there’s no profit to be made. I think that’s a fatal flaw with our vaccine system that has to be fixed and it’s why we don’t have a vaccine ready for this particular virus. We could’ve, but no company was interested. Same for antiviral medications. That’s why we’re in this situation we’re in right now.

One could think of creative ways to get around that. Governments can get involved, for sure. We’re hobbled in this country by the political paralysis of our government and its unwillingness to invest in science completely, so that’s stymied that. Now, since this SARS-CoV-2 has emerged, there are new nonprofits that have popped up saying, “We’re going to fund vaccine development.” In the end, it’s just a matter of someone raising money, and there’s plenty of money out there to do this. Think about the money we’re spending on recovery in the U.S. ― trillions. If a fraction of that money had been spent on developing a vaccine, we’d be out of this problem.

There are no vaccines available for any strains of the coronavirus, including the one that causes Covid-19. Why is that?

After SARS-1 in 2003, it went away. We were able to stop it. The virus disappeared. So most companies said, “We’re not interested in making a vaccine. There’s no market.” But a few academics went ahead and they made an experimental SARS vaccine, but it never got beyond that because there’s no financial support.

It’s not hard. In fact, it would’ve been not very hard to make a vaccine that could protect against many coronaviruses that come out of bats. But again, no financial backing for that and, even more, no research report. In the U.S., the NIH was not willing to support that kind of fundamental research because its budget is too limited.

There are many novel coronavirus vaccine candidates in development. What will determine which, if any, are used?

Unfortunately, they’re mostly not even in phase 1 in people. A handful are in phase 1 and a couple in phase 2. Those have been pushed and those are going to be the ones that finish first, so they’ll have an advantage. Now, whether they work or not is important, obviously, so if they don’t work, that’s the end of that and the others are going to have to catch up. 

The others are not even out of the laboratory. Some of those may never get out of the lab. It may turn out there are too many problems developing those. Others might, but as companies see that other companies have a head start, they might decide not to put resources in it because they’ll lose money. Many of these companies have never made vaccines before. Very few companies have, and I think that’s a factor. If you haven’t made a vaccine, you’re going to have more problems because you don’t know what you’re doing.  

All of those things are factors, and then of course production is a factor. I hope we have more than two vaccines because I don’t see how you could make 7 billion vaccine doses with just two companies. I think we need at least 10 vaccines to be able to cover the whole planet.

What are the potential downsides of deploying vaccines developed quickly during an emergency like the SARS-CoV-2 pandemic?

We could take a lesson from the polio vaccine in the 1950s. It was only about 50% effective, yet that’s what they had so they went ahead with it. And that meant that a lot of kids whose parents lined them up for shots weren’t protected. It also meant that companies had rushed production. In fact, a lot of kids got polio from that early vaccine because it wasn’t made properly. You could imagine that these early SARS-CoV-2 vaccines, because they’re rushed through, are not as optimal as they could be and they’re not going to be as effective. In most cases, the vaccine candidates are not infectious so I’m not too worried about them causing the actual disease. 

If you try to scale up vaccine production for hundreds of millions of doses, things could go wrong. Normally, we take a lot of time to do this. Everyone is being assured that we’re doing things in a safe way, but I think there’s still room for things to go wrong when you rush things.

People say, “Well, if they’re rushing it, I’m not going to take it,” and I think that’s a valid concern. What I often say is if you rush a vaccine and there’s a problem and you hurt people, then you will never get people to take it for many years. Once there’s a negative view of a vaccine because of some side effect, then people are very reluctant to take it. We have to make very sure that this is safe. We cannot make shortcuts. We have to test it in enough people ― thousands of people ― to make sure there are no side effects. 

If a novel coronavirus vaccine were developed, what would need to happen for it to be deployed widely and safely?

You need a lot of doses, first of all, because I do not want it to be distributed only to wealthy countries. That’s not the point of vaccines. The developed nations are making the vaccine, but they have to understand they have to share it with everyone, and I do hope that happens here. That’s my primary concern. 

You have to make enough of it. If we only have one vaccine that turns out to work, it’s going to be really hard to make enough doses for everyone. Another issue is these vaccines are going to have to be cold, probably frozen, and not everywhere has that capability. Finally, what about the delivery? Most of these vaccines need to be injected. That means you need at least 7 billion needles. I don’t even know if we have 7 billion needles in the world, so I hope someone’s thinking about that ahead of time. And you need people to inject them. You can’t just do it yourself. You need a trained health care worker, which isn’t available everywhere. 

Has a vaccination campaign of this scale ever been attempted?

No, never. We’ve never had to immunise everyone. We’ve always had to select groups, like for childhood disease where we do mass campaigns. There is no precedent for this, for having to immunise every person on the planet.

This transcript has been edited for length and clarity.

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https://www.msn.com/en-gb/news/uknews/whats-so-hard-about-developing-a-coronavirus-vaccine-we-asked-a-scientist/ar-BB164Dc8

The many health problems caused by COVID-19 - Scientists just beginning to understand

Scientists are only starting to grasp the vast array of health problems caused by the novel coronavirus ...

By REUTERS

PUBLISHED: 11:04 BST, 26 June 2020 | UPDATED: 22:09 BST, 26 June 2020

 
 
 
 
 
• e-mail
 

By Julie Steenhuysen

CHICAGO, June 26 (Reuters) - Scientists are only starting to grasp the vast array of health problems caused by the novel coronavirus, some of which may have lingering effects on patients and health systems for years to come, according to doctors and infectious disease experts.

Besides the respiratory issues that leave patients gasping for breath, the virus that causes COVID-19 attacks many organ systems, in some cases causing catastrophic damage.

"We thought this was only a respiratory virus. Turns out, it goes after the pancreas. It goes after the heart. It goes after the liver, the brain, the kidney and other organs. We didn't appreciate that in the beginning," said Dr. Eric Topol, a cardiologist and director of the Scripps Research Translational Institute in La Jolla, California.

In addition to respiratory distress, patients with COVID-19 can experience blood clotting disorders that can lead to strokes, and extreme inflammation that attacks multiple organ systems. The virus can also cause neurological complications that range from headache, dizziness and loss of taste or smell to seizures and confusion.

And recovery can be slow, incomplete and costly, with a huge impact on quality of life.

The broad and diverse manifestations of COVID-19 are somewhat unique, said Dr. Sadiya Khan, a cardiologist at Northwestern Medicine in Chicago.

With influenza, people with underlying heart conditions are also at higher risk of complications, Khan said. What is surprising about this virus is the extent of the complications occurring outside the lungs.

Khan believes there will be a huge healthcare expenditure and burden for individuals who have survived COVID-19.

LENGTHY REHAB FOR MANY

Patients who were in the intensive care unit or on a ventilator for weeks will need to spend extensive time in rehab to regain mobility and strength.

"It can take up to seven days for every one day that you're hospitalized to recover that type of strength," Khan said. "It's harder the older you are, and you may never get back to the same level of function."

While much of the focus has been on the minority of patients who experience severe disease, doctors increasingly are looking to the needs of patients who were not sick enough to require hospitalization, but are still suffering months after first becoming infected.

Studies are just getting underway to understand the long-term effects of infection, Jay Butler, deputy director of infectious diseases at the U.S. Centers for Disease Control and Prevention, told reporters in a telephone briefing on Thursday.

"We hear anecdotal reports of people who have persistent fatigue, shortness of breath," Butler said. "How long that will last is hard to say."

While coronavirus symptoms typically resolve in two or three weeks, an estimated 1 in 10 experience prolonged symptoms, Dr. Helen Salisbury of the University of Oxford wrote in the British Medical Journal on Tuesday.

Salisbury said many of her patients have normal chest X-rays and no sign of inflammation, but they are still not back to normal.

"If you previously ran 5k three times a week and now feel breathless after a single flight of stairs, or if you cough incessantly and are too exhausted to return to work, then the fear that you may never regain your previous health is very real," she wrote.

Dr. Igor Koralnik, chief of neuro-infectious diseases at Northwestern Medicine, reviewed current scientific literature and found about half of patients hospitalized with COVID-19 had neurological complications, such as dizziness, decreased alertness, difficulty concentrating, disorders of smell and taste, seizures, strokes, weakness and muscle pain.

Koralnik, whose findings were published in the Annals of Neurology, has started an outpatient clinic for COVID-19 patients to study whether these neurological problems are temporary or permanent.

Khan sees parallels with HIV, the virus that causes AIDS. Much of the early focus was on deaths.

"In recent years, we've been very focused on the cardiovascular complications of HIV survivorship," Khan said. (Reporting by Julie Steenhuysen; additional reporting by Caroline Humer and Nancy Lapid in New York; Editing by Bill Berkrot)

https://www.thisismoney.co.uk/wires/reuters/article-8462989/Scientists-just-beginning-understand-health-problems-caused-COVID-19.html


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