T-cell Immunity ‘May Last Longer Than Antibodies’

These are the UK coronavirus stories you need to know about today.

T-cell Immunity ‘May Last Longer Than Antibodies’

UK preprint research gives evidence that T-cell immunity to SARS-CoV-2 may last longer than antibody immunity.

The research is from the UK Coronavirus Immunology Consortium (UK-CIC) and Public Health England.

It assessed cellular immune response at 6 months following primary infection in 100 healthy adults with asymptomatic or mild-to-moderate COVID-19.

Study author, Dr Shamez Ladhani, consultant epidemiologist at Public Health England, said: “Cellular immunity is a complex but potentially very significant piece of the COVID-19 puzzle, and it’s important that more research be done in this area. However, early results show that T-cell responses may outlast the initial antibody response, which could have a significant impact on COVID vaccine development and immunity research.”

Professor Paul Moss, UK Coronavirus Immunology Consortium lead from University of Birmingham, said: “To our knowledge, our study is the first in the world to show robust cellular immunity remains at 6 months after infection in individuals who experienced either mild/moderate or asymptomatic COVID-19. Interestingly, we found that cellular immunity is stronger at this time point in those people who had symptomatic infection compared with asymptomatic cases. We now need more research to find out if symptomatic individuals are better protected against reinfection in the future.”

Commenting via the Science Media Centre, Professor Charles Bangham, chair of immunology, Imperial College London, said: “These results provide reassurance that, although the titre of antibody to SARS-CoV-2 can fall below detectable levels within a few months of infection, a degree of immunity to the virus may be maintained.  However, the critical question remains: do these persistent T-cells provide efficient protection against re-infection?  It will also be important to follow the antibody and T-cell immunity in people who develop the syndrome of long COVID – the persistent and sometimes debilitating condition that follows acute SARS-CoV-2 infection in a still uncertain proportion of people.  Finally, the data in this paper reinforce the need for care in interpreting the results of serological (antibody) tests: it is still unclear how well either the antibody titre or the T-cell frequency correlate with actual protection against reinfection.”

2 Weeks to See Benefit of England’s Second Lockdown

NHS England’s Medical Director, Professor Stephen Powis, has cautioned that it’ll take until half way through England’s 4 week national lockdown to see improvements in infections. “It takes around a fortnight for today’s infections in the community to result in hospital COVID admissions – so what happens over the next 2 weeks is partly baked in. But the measures announced today [Oct 31] will help reduce the number of admissions beyond that,” he said in a statement.

“Daily hospital COVID admissions are now higher than on 23 March when the Prime Minister announced the first national lockdown.

“NHS doctors and nurses in many areas of England – including Liverpool, Lancashire, and Nottinghamshire – are now treating more COVID-19 patients than at the peak of the first wave.”

Three of the Nightingale field hospitals in the North of England are ready to mobilise, he said, with Manchester taking its first patients this week.

Hospitals will find it hard to treat both COVID patients and those with other illnesses unless the public strictly follows the new rules from Thursday, Dr Alison Pittard, dean of the Faculty of Intensive Care Medicine told The Guardian.

“The NHS won’t collapse but patients with non-COVID illnesses will suffer if we don’t control transmission and more people will die,” she said.

UK Lockdowns

Boris Johnson addressed Parliament this afternoon to gain support for the lockdown ahead of a vote on Wednesday. It should pass the Commons with Labour’s backing.

However, the Chair of the influential Conservative backbench 1922 committee Sir Graham Brady told the BBC the measures would be “denounced as a form of evil in any totalitarian country”.

Wales’ First Minister Mark Drakeford set out what were called simpler national measures after the 17 day ‘firebreak’ ends next Monday.

Restaurants, cafes, pubs, and gyms will be able to reopen but restrictions remain on household mixing.

“We will be coming out of our firebreak just as England begins its month long lockdown. and it is really important that as we open up, Wales doesn’t become an escape for people seeking to circumvent the new tighter restrictions imposed by the Prime Minister.” Mr Drakeford said.

Scotland’s five tier lockdown system began today. However, First Minister Nicola Sturgeon said she may have to consider a national lockdown to take advantage of furlough support if that scheme is time-limited.

COVID-19 Impact on NHS Staff

The Independent reported that tens of thousands of NHS staff are off sick or self-isolating because of coronavirus.

It said that in some parts of England almost 50% of staff absences are linked to COVID-19.

More than 76,200 NHS staff were absent from work on Friday, including 3575 doctors.

Meanwhile a Medscape UK survey of more than 1000 doctors suggests the number of doctors reporting burnout increased to 37% this year from 22% when we last asked in 2018.

“This latest survey absolutely aligns with what the Doctors’ Association UK is hearing from members,” commented Dr Natalie Ashburner, wellbeing lead for the Doctors’ Association UK (DAUK).

“NHS staff were already suffering from high rates of burnout and mental illness in the context of a decade of chronic underfunding of services, lack of staff, and erosion of pay and working conditions.”

SAGE Modelling ‘Overestimated Deaths’

The Centre for Evidence Based Medicine at the University of Oxford says the deaths data SAGE used to advise on England’s 4 week lockdown may have been an overestimation due to outdated information.

The worse case modelling from SAGE put November daily deaths at up to 4000. The Oxford team believes this could be four times too high. “Two  SAGE model estimates have already proven to be invalid. We consider these analyses need checking with the raw data to verify the estimates against the actual death data and further verify whether the lower estimates reflect the actual data,” Daniel Howdon and Carl Heneghan wrote.

Latest Intensive Care National Audit & Research Centre (ICNARC) data for COVID-19 patients admitted to critical care since September show:

Daily Data

In today’s daily data another 19.950 UK positive tests were reported and 136 deaths.

There are 10,918 COVID-19 patients in hospital and 978 ventilator beds are in use.

Scotland’s Face Covering Exemption Cards

The Scottish Government has introduced an exemption card for people who are unable to wear a face covering. It’s hoped the move will boost their confidence and safety when accessing public spaces and using public services, Univadis from Medscape reported.

All individuals who can wear a face covering have a legal obligation to do so where it is mandated by law. However, there are some people who are unable to wear a face covering, owing to health conditions, disabilities or other circumstances. The card will help protect them against discrimination.

Eligible individuals can request a physical card from Disability Equality Scotland and a digital card is also available.

The charity’s Chief Executive Officer Morven Brooks said: “The launch of the Scottish Government exemption card will help disabled people to feel more comfortable and confident to go about their daily lives free from fear of harassment and abuse.”

WHO Chief Self-isolates

World Health Organisation Director General Dr Tedros Adhanom Ghebreyesus is in self-isolation, he tweeted: “I have been identified as a contact of someone who has tested positive for #COVID19. I am well and without symptoms but will self-quarantine over the coming days, in line with @WHO protocols, and work from home.”

Meanwhile, The Duke of Cambridge contracted COVID-19 earlier this year but did not reveal the diagnosis to avoid alarming the country, it was reported.

It is understood that Prince William tested positive in April, shortly after his father, the Prince of Wales. According to The Sun , which first reported the story, Prince William was treated by palace doctors, and self-isolated at the family home in Norfolk before making a full recovery.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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