Covid-19 news: Nine new symptoms recognised by the NHS

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A staff member at a testing centre in Halifax, England, takes a covid-19 lateral flow test on 4 January

A staff member at a testing centre in Halifax, England, takes a covid-19 lateral flow test on 4 January

OLI SCARFF/AFP via Getty Images

Latest coronavirus news as of 11am 4 April

The symptom list has been expanded days after officials ended free universal testing in England

For most of the pandemic, the NHS in England has only recognised three covid-19 symptoms: fever, a new and continuous cough, or a loss of taste or smell – which many experts considered too limited.

Now, as 4.9 million people were estimated to be infected in the UK in the week ending 26 March, the NHS has expanded its symptom list to include:

  • Shortness of breath
  • Fatigue or exhaustion
  • Body aches
  • A headache
  • A sore throat
  • A blocked or runny nose
  • Loss of appetite
  • Diarrhoea
  • Nausea or vomiting

This list more closely matches that of the US Centers for Disease Control and Prevention, which recognised many of these symptoms early in the pandemic.

The NHS’ list stops short of some of the World Health Organization’s (WHO) symptoms, however, which also considers skin rashes, red or irritated eyes, or discolouration of the fingers or toes to be less common signs of infection. Chest pain, confusion, or a loss of speech or mobility can occur in severe cases, according to WHO.

Writing on Twitter, Tim Spector, lead scientist of the Zoe covid-19 symptom tracker app, said: “NHS official Main symptoms of coronavirus (COVID-19) have finally changed after 2 years of lobbying and Zoe app user input – hurrah!”

Last month, Spector said the UK’s narrow symptom list was probably contributing to its infection surge.

“Many people are no longer isolating when they have symptoms, either because they feel they don’t have to anymore or because they or their employers still don’t recognise symptoms like runny nose or sore throat as covid,” he said.

Other coronavirus news

Covid-19 vaccines are being rolled out for 5- to 11-year-olds in England. In February, the UK’s Joint Committee on Vaccination and Immunisation said two low-dose vaccines, administered 12 weeks apart, would prevent “a very small number of children from serious illness and hospitalisation” in any future covid-19 wave. Vaccination programmes were already underway for this age group in the rest of the UK.

Shanghai’s recorded covid-19 cases are increasing. The locked-down city in China recently extended its restrictions, despite initial signs that infections may be declining. On April 3, Shanghai reported 8581 new asymptomatic covid-19 cases and 425 symptomatic cases, compared with 7788 new asymptomatic cases and 438 symptomatic cases the day before.

Bizarre lockdown dreams may have reflected our claustrophobia and sense of being out of control. University College London researchers analysed more than 850 dreams submitted online to the Lockdown Dreams project between March 2020 and March 2021. From 23 March to 15 June 2020, which corresponds with the UK’s first lockdown, just over seven in 10 (71 per cent) of the participants reported having more vivid dreams, compared with pre-pandemic. These included being locked indoors or unable to get to loved ones standing outside.

Essential information about coronavirus

Where did coronavirus come from? And other covid-19 questions answered

What is covid-19?

Covid-19 vaccines: Everything you need to know about the leading shots

Long covid: Do I have it, how long will it last and can we treat it?

What’s the fairest way to share covid-19 vaccines around the world?

Covid-19: The story of a pandemic

What to read, watch and listen to about coronavirus

New Scientist Weekly features updates and analysis on the latest developments in the covid-19 pandemic. Our podcast sees expert journalists from the magazine discuss the biggest science stories to hit the headlines each week – from technology and space, to health and the environment.

The Jump is a BBC Radio 4 series exploring how viruses can cross from animals into humans to cause pandemics. The first episode examines the origins of the covid-19 pandemic.

Why Is Covid Killing People of Colour? is a BBC documentary, which investigates what the high covid-19 death rates in ethnic minority patients reveal about health inequality in the UK.

Panorama: The Race for a Vaccine is a BBC documentary about the inside story of the development of the Oxford/AstraZeneca vaccine against covid-19.

Race Against the Virus: Hunt for a Vaccine is a Channel 4 documentary which tells the story of the coronavirus pandemic through the eyes of the scientists on the frontline.

The New York Times is assessing the progress in development of potential drug treatments for covid-19, and ranking them for effectiveness and safety.

Humans of COVID-19 is a project highlighting the experiences of key workers on the frontline in the fight against coronavirus in the UK, through social media.

Belly Mujinga: Searching for the Truth is a BBC Panorama investigation of the death of transport worker Belly Mujinga from covid-19, following reports she had been coughed and spat on by a customer at London’s Victoria Station.

Coronavirus, Explained on Netflix is a short documentary series examining the coronavirus pandemic, the efforts to fight it and ways to manage its mental health toll.

Stopping the Next Pandemic: How Covid-19 Can Help Us Save Humanity by Debora Mackenzie is about how the pandemic happened and why it will happen again if we don’t do things differently in future.

The Rules of Contagion is about the new science of contagion and the surprising ways it shapes our lives and behaviour. The author, Adam Kucharski, is an epidemiologist at the London School of Hygiene and Tropical Medicine, UK, and in the book he examines how diseases spread and why they stop.

Previous updates

An aerial view of empty roads in the Pudong district of Shanghai, China, on 31 March

An aerial view of empty roads in the Pudong district of Shanghai, China, on 31 March

Xiang Xinrong/VCG via Getty Images

1 April

People living in the city’s eastern districts were due to come out of a five-day lockdown today

On 28 March, China’s largest city introduced a two-stage, 10-day lockdown in a bid to control its omicron outbreak. Initially, the lockdown was planned to affect eastern Shanghai for five days, followed by an additional five days of restrictions in the city’s western districts.

China’s health officials announced on 31 March they will instead lift restrictions on the east side in stages. With western Shanghai starting its five-day restrictions today, these extended measures plunge the city’s 26-million-strong population into lockdown.

People are instructed not to leave their homes, even to dispose of rubbish or walk their dogs, Reuters reported. Most of the city’s public transport has also been suspended and all non-essential businesses are closed.

Despite the lockdown extension, Shanghai’s reported case numbers are falling. On 31 March, the city reported 4144 new asymptomatic cases and 358 new symptomatic cases, compared with 5298 asymptomatic cases and 355 symptomatic cases the day before.

Other coronavirus news

Nearly all secondary school students in England have antibodies against the SARS-CoV-2 virus, according to the Office for National Statistics’ Covid-19 Schools Infection Survey. More than 7000 primary and secondary students from 150 schools were tested for antibodies in January and February. Extrapolating the results out across England, an estimated 96.6 per cent of secondary school students and 62.4 per cent of primary school pupils had SARS-Cov-2 antibodies at the beginning of the year. England is due to roll out a low-dose Pfizer/BioNTech vaccine for five- to 11-year-olds this month, which will include most primary pupils. The pre-existing antibodies among younger children therefore came about via a natural infection.

Pregnant people who are vaccinated against SARS-CoV-2 virus are almost twice as likely to get covid-19 compared with people who are vaccinated but not pregnant, according to an analysis of about 14 million hospital patients in the US. Pregnancy is the greatest risk factor for breakthrough covid-19 infections, above being an organ transplant recipient or having an immune system deficiency, the study found. This may be because certain aspects of the immune system are suppressed during pregnancy.

Covid-19 vaccines provide significantly more protection among people who have previously been infected with SARS-CoV-2 virus, according to two studies published in the journal Lancet Infectious Diseases. A Brazilian study linked the CoronaVac, Oxford/Astrazeneca, Janssen and Pfizer/BioNTech vaccines to increased protection against a moderate-to-severe reinfection, while a Swedish study found covid-19 vaccination provides at least nine months’ of additional protection for people who have had the virus before. The studies did not look at the level of protection among people who fought off covid-19 after catching it post-vaccination.

A person at a covid-19 test centre in Newcastle-under-Lyme, UK, on 21 December

A person at a covid-19 test centre in Newcastle-under-Lyme, UK, on 21 December

Nathan Stirk/Getty Images

31 March

In the UK, the risk of being reinfected with SARS-CoV-2 virus is 10 times higher with omicron than delta 

The Office for National Statistics’ (ONS) Covid-19 Infection Survey estimates the number of reinfections that occurred in the UK between July 2020 and 20 March 2022.

From 20 December 2021 to 20 March 2022, when omicron was the dominant variant, the risk of reinfection was about 10 times greater than when delta dominated, defined as mid-May 2021 to 19 December.

Reinfection definitions vary. The ONS defines it as a positive PCR test result after a number of negative results, following an initial infection. The specific number of negative results required between infections depends on when the reinfection occurred, as definitions have changed over time.

Covid-19 immunity, whether naturally acquired or via vaccines, wanes over time, leaving people more vulnerable to reinfection. Omicron has also evolved to better evade immunity.

“Risk of reinfection from omicron is much higher than any other previous variant, with those unvaccinated more likely to be reinfected than those vaccinated,” Sarah Crofts from the ONS said in a statement.

Other coronavirus news

The World Health Organization (WHO) expects covid-19 to become less severe over time. A WHO report sets out how countries should react to a worst-case, best-case and intermediate-case scenario for the pandemic. In the best-case scenario, less severe variants will emerge and booster vaccines will be unnecessary. In the worst-case scenario, a more harmful variant will evolve and immunity will wane.

“Based on what we know now, the most likely scenario is that the COVID-19 virus continues to evolve, but the severity of disease it causes reduces over time as immunity increases due to vaccination and infection,” Tedros Adhanom Ghebreyesus, WHO’s director-general, said at a press briefing on 30 March.

The emergence of the less severe omicron variant made many people optimistic that SARS-CoV-2 was evolving to be more transmissible, but less dangerous. This does not always occur in a virus’ evolution, however.

Vaccinating 5- to 11-year-olds reduces their risk of being hospitalised with omicron by 68 per cent. In the US, Pfizer/BioNTech vaccines have been available for this age group since October 2021, despite young children being at very low risk of severe covid-19. A nationwide study of 1185 children has now found two Pfizer/BioNTech doses considerably cut their risk of being hospitalised while omicron was circulating. The UK recently started offering 5- to 11-year-olds a vaccine, but the potential heart risks of immunising children are unclear.

Commuters arrive at London's Waterloo station in February, the month all remaining covid-19 restrictions were lifted in England

Commuters arrive at London’s Waterloo station in February, the month all remaining covid-19 restrictions were lifted in England

WIktor Szymanowicz/NurPhoto/Shutterstock

30 March

Self-isolation rate dropped from 80 per cent to 64 per cent after the legal requirement changed to guidance

Fewer than two-thirds of people who test positive for covid-19 in England are choosing to self-isolate, according to an Office for National Statistics (ONS) survey.

Using the NHS Test and Trace database, 1369 adults in England who tested positive for covid-19 before 24 February, when the legal requirement to self-isolate was dropped, were asked about their behaviour while infected. They were interviewed between 28 February and 8 March, when self-isolation was advised but not legally required.

Fewer than two-thirds (64 per cent) said they fully self-isolated, compared with 80 per cent in a similar survey last month.

“Now the legal requirement to self-isolate after testing positive for coronavirus (COVID-19) has been removed in England, our data today reveal more about adherence to these rules,” Tim Gibbs from ONS said in a statement.

“Compliance with self-isolation rules was significantly lower than the level reported in February 2022, when self-isolation was a legal requirement.”

Other coronavirus news

The omicron BA.2 sublineage is now the dominant variant in the US, the Centers for Disease Control and Prevention (CDC) announced today. For the week ending 26 March, the variant made up an estimated 55 per cent of new cases.

The total number of covid-19 cases in Asia has surpassed 100 million, according to Reuters. The continent is reporting more than 1 million new cases around every two days, driven by a BA.2 surge.

More than 400 million students worldwide are affected by the partial or full closure of schools, according to Unicef. While countries such as the UK have opened school gates, restrictions still apply in 23 nations, including the Philippines, Honduras and Trinidad.

People walk along Princess Street in Edinburgh, Scotland, on 15 March

People walk along Princess Street in Edinburgh, Scotland, on 15 March

Jeff J Mitchell/Getty Images

28 March

Estimated infections have already surpassed past records in Wales and Scotland

The number of suspected covid-19 cases in the UK is approaching a record high.

The Office for National Statistics’ weekly Covid Infection Survey suggests 4.26 million people across the UK had the SARS-CoV-2 virus last week, just shy of the record 4.3 million infections estimated in the first week of 2022.

In England specifically, covid-19 cases are approaching a new record, with an estimated 3,485,700 people having the SARS-CoV-2 virus in the week ending 19 March, equating to around 1 in 16 people.

This record may have already been broken in Wales and Scotland, where an estimated 192,900 and 473,800 people had covid-19 last week, respectively. Northern Ireland may be faring best of the four UK nations, with an estimated 108,700 people having covid-19 in the week ending 19 March, equating to one in 17 people.

The estimated number of true cases is considerably higher than the officially reported incidences. As of 25 March, 599,244 people had tested positive for covid-19 in the past seven days across the UK. Deaths within 28 days of a positive test remain relatively low, however, with 950 recorded fatalities in the past seven days.

“Our latest data show infection levels have continued to increase in England, Wales and Scotland, driven by the rise of the Omicron BA.2 variant,” Sarah Crofts from ONS said in a statement.

“Northern Ireland was a few weeks ahead of the rest of the UK in this rising variant where we now see a welcome decrease. Meanwhile, Scotland has now reached the highest level of any UK country seen in our survey.

“Across England, infections have increased in all regions and age groups, notably the over 50s who are at their highest levels since our survey began.”

Other coronavirus news

Fewer than half of the immunocompromised people in England have received a covid-19 booster jab, according to NHS data.

The Joint Committee on Vaccination and Immunisation recommends people with a weakened immune system have a reduced-dose booster three months after receiving a third full-dose jab. But just 255,422 of the 561,356 immunocompromised people in England had received a booster as of 24 March.

A Freedom of Information request by Blood Cancer UK reveals that of 6 February, white British people who have a suppressed immune system were the most likely to have received a booster jab, with 17 per cent being immunised. This is compared with 2 per cent of their counterparts from a Bangladeshi background and 4 per cent from a Black Caribbean background.

Shanghai will introduce a two-stage, nine-day lockdown in an effort to curb its omicron surge. The city reported more than 3000 symptomatic cases yesterday, accounting for nearly 70 per cent of China’s total incidences.

The eastern half of the city will be locked down from today until 1 April, followed by its western side until 5 April.

A preventative antibody therapy produced by AstraZeneca has received European Union approval, a week after it was approved in the UK. Evusheld is a combination of two long-acting antibodies that attach to the SARS-CoV-2 virus’ spike protein, preventing it from entering human cells.

Evusheld is recommended for adults and children over 12 who have a suppressed immune system and may not mount a sufficient immune response after covid-19 vaccination. People in an adult clinical trial who received Evusheld were 77 per cent less likely to develop symptomatic covid-19 if exposed to the SARS-CoV-2 virus, with protection lasting at least six months.

WEIFANG, CHINA - MARCH 24: Workers wearing personal protective equipment (PPE) conduct disinfection work at a shopping mall on March 24, 2022 in Weifang, Shandong Province of China. (Photo by Zhang Chi/VCG via Getty Images)

Workers disinfect a shopping centre in Weifang, Shandong province in China, on 24 March

Zhang Chi/VCG via Getty Images

25 March

Shanghai’s recorded cases jumped by more than 60 per cent in one day

China is continuing with its zero-covid strategy despite recording a record 4988 symptomatic cases today, with asymptomatic infections being logged separately.

The surge of the more-transmissible omicron variant has prompted different provinces to introduce varying restrictions. These are being met with increasing resistance from local people, particularly after a nurse in Shanghai died of an asthma attack when a hospital was closed for covid-19 disinfection earlier this week.

Shanghai, a city of about 25 million people, reported a record 1609 cases today, an increase of more than 60 per cent in just 24 hours.

Despite the surge in cases, health officials are persisting with their strategy.

“Only by doing dynamic zero-COVID can we eliminate the hidden dangers of the epidemic, avoid the run on medical resources that may be caused by large-scale infections and prevent a large number of possible deaths of the elderly or those with underlying diseases,” said Wu Zunyou at China’s Center for Disease Control.

Other coronavirus news

The vaccine uptake gap between ethnic minority groups and white groups in the UK is at least partly due to the former having lower levels of trust in the medical establishment and poor past healthcare experiences, according to a study in the BMJ Open. As of 13 January 2021, 42.5 per cent of white people in the UK who were not living in a care home had been vaccinated, compared with 20.5 per cent of their Black counterparts. Low trust and poor past experience may explain around a quarter of the vaccine uptake gap, with the remaining discrepancy being unknown and a “cause for concern”, the researchers write.

Long covid symptoms may differ according to the SARS-CoV-2 variant that caused the initial infection, according to researchers at the University of Florence, Italy. The team looked at more than 400 people who were hospitalised with covid-19 between early 2020 and June 2021. At 4 to 12 weeks post-discharge, 76 per cent of the participants reported at least one lingering symptom.

Those who became infected in 2020, when the original SARS-CoV-2 strain was circulating, were more likely to experience a loss of smell, impaired hearing and difficulty swallowing. When the alpha variant was dominant between January and April 2021, more of the participants went on to experience muscle aches, insomnia, brain fog and depression or anxiety.

The dominant omicron BA.2 sublineage that has caused a surge in cases and hospitalisations across Europe could pose a considerable risk for the US, where vaccination rates are lower, the Financial Times reported. According to John Hopkins University, 66.19 per cent of people are fully vaccinated in the US, compared with 73.83 per cent in the UK. This comes after the US’ Chief Medical Adviser Anthony Fauci said that while BA.2 will probably cause an uptick in cases, he is not expecting a surge.

Ambulances outside Leeds General Infirmary hospital in January 2022

Ambulances outside Leeds General Infirmary hospital in January 2022

OLI SCARFF/AFP via Getty Images

24 March

Covid-19 caused 5.6 per cent of all deaths in England in February

Covid-19 was the third leading cause of death in England and the sixth biggest driver of fatalities in Wales last month.

According to the Office for National Statistics, covid-19 was the primary cause of 5.6 per cent of all deaths in England in February. This is compared with the 11.6 per cent of deaths caused by dementia, the leading driver of fatalities last month. Ischaemic heart disease, brought on by narrowing of the arteries, was the leading cause of death in Wales, accounting for 10.8 per cent of fatalities.

Across the UK, the number of recorded SARS-CoV-2 cases increased by 16.9 per cent in the past week, according to government data. This is probably due to the widespread easing of restrictions and the more-transmissible omicron BA.2 sublineage. Deaths within 28 days of a positive test increased by 17.9 per cent, however, covid-19 may not have directly caused all these fatalities.

A separate ONS infection survey suggests that 98 to 99 per cent of people across the UK have antibodies against the SARS-CoV-2 virus. However, it is unclear what antibody threshold is required to protect an individual from different covid-19 variants.

“The vast majority of the UK population now have antibodies against COVID-19, hopefully protecting most from developing severe symptoms,” said Sarah Crofts from ONS in a statement.

Other coronavirus news

A SARS-CoV-2 variant that is resistant to the widely-used antiviral drug remdesivir has been detected in an immunocompromised person. The person, who was in remission for stage four non-Hodgkin’s lymphoma, had covid-19 for six months before they required supplemental oxygen. Their viral load then increased while being treated with the antiviral remdesivir. A team from the Yale School of Public Health found an enzyme that is involved in the replication of SARS-CoV-2 virus had mutated, making it resistant to remdesivir. This mutation is thought to have occurred due to the virus replicating in the person for so long, with their immune system unable to fight it off.

“The threat of antiviral resistance is a critical concern, given the rate that the virus introduces mutations in the genome,” said study author Albert Ko in a statement. “A big question is whether this will happen with the other drugs, paxlovid and molnupiravir, we are using to treat our patients.”

Moderna plans to seek regulatory approval in the US for its vaccine for children under 6 years old. This comes after trials revealed two doses of the jab were 38 per cent effective at preventing infections in 2 to 5 year olds and 44 per cent effective in children aged between two years and six months. If authorised, the covid-19 vaccine would be the first to be approved for under 5 year olds in the US.

Nearly 840,000 of 2.2 million AstraZeneca jabs donated to Kenya via the global Covax scheme expired before they could be used, the BBC reported.

People eating outside at a cafe in Neal's Yard near Covent Garden, London, UK.

People eating outside in Covent Garden, London, UK

Matthew Ashmore / Alamy

23 March

Nearly half of UK adults see friends and family less than they did before the pandemic

On the two-year anniversary of the UK’s first lockdown, life may still be far from normal for many, a survey suggests.

Bobby Duffy at King’s College London and his colleagues interviewed 1229 adults between 4 and 7 March and found that just under a third (31 per cent) said they feel lonelier now than they did before the pandemic, rising to 39 per cent among those aged 16 to 34. Nearly half said they see their loved ones (46 per cent) or leave the house less (45 per cent).

One third said their mental and physical health has deteriorated, with 36 per cent saying they have gained weight and 32 per cent reporting a decline to their quality of sleep.

“These findings, marking the two-year anniversary of the first national lockdown, are further evidence of how over that time life in the UK has changed for many people, affecting a range of aspects of our physical and mental health,” Gideon Skinner at the data supplier Ipsos, who was involved in the research, said in a statement.

But the pandemic may have also prompted positive changes for some people. Just under a third (30 per cent) of the adults interviewed said they are exercising more, while 23 per cent of those aged 16 to 34 said their mental health has improved.

Other coronavirus news

Long covid could cause a generation to be affected by disabilities, immunologist Danny Altmann at Imperial College London has told The Guardian. The Office for National Statistics estimates that in late January, 1.5 million people in the UK were experiencing lingering symptoms more than four weeks after catching covid-19 – which is 2.4 per cent of the total population. Altmann warns the lifting of restrictions suggests covid-19’s impact is not being taken seriously.

South Korea has now reported more than 10 million covid-19 cases since the start of the pandemic. The spread of the more transmissible omicron variant has caused its daily recorded cases to spike, from 5100 on 20 January to 404,665 on 18 March. Covid-related deaths have also doubled in about six weeks, with 321 fatalities recorded on 21 March, fuelling demand for funeral homes. South Korea’s case numbers and death toll are relatively low compared with other countries, however, which is probably partly due to 87 per cent of its population being double vaccinated.

A small study suggests covid-19 cannot be transmitted via an organ donation from an infected person. Emily Eichenberger at Duke University School of Medicine, North Carolina, and her colleagues looked at four recipients who received a liver, kidney or pancreas from four donors who’d tested positive for SARS-CoV-2 virus while terminally ill. None of the recipients contracted covid-19 via the transplant, according to results presented at the European Congress of Clinical Microbiology & Infectious Diseases in Lisbon. In February 2021, a different team reported that SARS-CoV-2 virus had been transmitted from a lung donor to a recipient.

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A pharmacist checks a customer’s blood sugar levels

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22 March

Covid-19 linked to a 46 per cent increased risk of type 2 diabetes

People who have had covid-19 within the past year may be more at risk of developing type 2 diabetes for the first time or being prescribed medication to manage their blood sugar levels.

Ziyad Al-Aly at the VA Saint Louis Health Care System in the US and his colleagues reviewed the medical records of 181,280 individuals who tested positive for covid-19 between March 2020 and September 2021, using data from the US Department of Veterans Affairs. The team compared the number of new diabetes cases among these veterans with that of more than 8 million people who had no evidence of a covid-19 infection. None of the participants had diabetes at the start of the study.

Covid-19 was linked to a 46 per cent higher risk of developing type 2 diabetes or requiring blood-sugar-lowering medication, even among people with a mild or asymptomatic covid-19 infection.

Type 2 diabetes occurs when the body cannot make enough insulin or the hormone that is produced does not work properly. SARS-CoV-2 virus may inflame insulin-producing cells, decreasing their efficiency, Al-Aly told The Washington Post.

The link between covid-19 and type 2 diabetes was observed among all the participant groups, regardless of their sex, ethnicity or age, said Al-Aly.

In August 2020, a different team uncovered a link between covid-19 and type 1 diabetes in children, with four NHS trusts in London seeing around double the usual number of new cases during the early months of the pandemic. Type 1 diabetes occurs when the body mistakenly attacks cells in the pancreas, causing no insulin to be produced.

Among adults, a team in Germany also recently linked covid-19 to a 28 per cent higher risk of type 2 diabetes.

Other coronavirus news

Pregnancy complications may be up to three times more likely among individuals who have tested positive for covid-19. Researchers analysed the medical records of 43,886 pregnant individuals in northern California between March 2020 and March 2021. Some pregnancy complications such as a preterm birth, clots and sepsis were up to three times more common among people who had a known covid-19 infection.

“The most important thing people can do to protect themselves and their baby is to get vaccinated,” co-author Mara Greenberg at The Permanente Medical Group said in a statement.

The number of people with covid-19 in Scottish hospitals has reached a record high, with 2128 cases on 20 March, surpassing the previous peak of 2053 in January. This comes after Scotland recently lifted many of its covid-19 restrictions. Not everyone with SARS-CoV-2 in hospital is necessarily admitted for covid-19.

Chinese officials have locked down 9 million people who live in the northeast city Shenyang amid the country’s current omicron wave. China reported 8024 cases yesterday.

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A Pfizer/BioNTech covid-19 vaccine injection

SYSPEO/SIPA/Shutterstock

21 March

The Pfizer/BioNTech vaccine is thought to have helped an immunocompromised person clear the covid-19 virus

Two doses of the Pfizer/BioNTech vaccine are thought to have cleared the SARS-CoV-2 virus from a person who first tested positive more than 7 months earlier. This is the first known time a covid-19 vaccine has been used to treat, rather than prevent, the infection.

Ian Lester has the rare genetic disease Wiskott-Aldrich syndrome, which weakens the immune system. Lester, 37, first tested positive for SARS-CoV-2 in December 2020. His immune system was unable to fight off the infection naturally for at least 218 days.

“Given the persistent positive PCR tests and impact on his health and mental health, we decided on a unique therapeutic approach,” said Stephen Jolles at Cardiff University’s School of Medicine in a statement.

“We administered two doses of the BioNTech Pfizer vaccine, one month apart, and very quickly saw a strong antibody response, much stronger than had been induced by the prolonged natural infection.”

Lester was confirmed to have cleared SARS-CoV-2 72 days after the first vaccine dose and 218 days after his infection was detected.

“To our knowledge, this is the first time mRNA vaccination has been used to clear persistent COVID-19 infection,” said Mark Ponsford, at Cardiff University.

Other coronavirus news

England has rolled out a booster jab programme for people aged 75 and over, care home residents and people aged 12 and over who have a weakened immune system. The Office for National Statistics estimates one in 20 people in England had covid-19 in the week ending 12 March. It is hoped that the booster programme will protect people amid surging cases of the omicron BA.2 sublineage. Similar boosters are already being administered to some groups in Scotland and Wales.

China reported two covid-19 related deaths on 19 March, its first official covid-19 fatalities since January 2021. Both people died of underlying medical conditions, with mild covid-19 symptoms, according to Jiao Yahui at China’s National Health Commission. The deaths occurred in the province Jilin, where more than two-thirds of the country’s cases have been reported amid its current covid-19 wave. On 19 March, China’s reported new infections hit a rolling seven-day average of 2333 infections.

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A police officer wearing personal protective equipment in Manzhouli, China

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16 March

Covid-19 is surging in China, with more than 5000 new cases a day

China yesterday reported 5280 new SARS-CoV-2 cases, more than double the previous day’s count and its highest daily tally since the start of the pandemic. The surge has prompted the introduction of full or partial lockdowns in various cities across the country.

China has been pursuing a strict ‘zero covid’ strategy, which until recently had largely kept outbreaks under control. The omicron variant, however, is more transmissible than previous variants and is probably driving the current surge.

Cities across the country are now in full or partial lockdowns. The north-east province Jilin is the worst affected, accounting for more than 3000 of China’s new reported cases on 15 March. Speaking on 14 March, Jilin’s governor vowed to “achieve community zero-Covid in a week”.

China’s rising cases correspond with a global increase in SARS-CoV-2 transmission. A World Health Organization report reveals the number of new reported infections between 7 and 13 March increased by eight per cent compared to the previous week. The number of new weekly cases had been declining since the end of January.

Other coronavirus news

Face covering rules in Scotland will remain in place until April. On 15 March, Scotland reported 38,770 new covid cases, up from a daily average of 6,900 three weeks ago. As a result, coverings will continue to be required on public transport and in shops, although other covid restrictions will be lifted on 21 March. The BA.2 omicron sublineage, which is even more transmissible than the initial omicron variant, accounts for 80 per cent of Scotland’s SARS-CoV-2 cases, according to first minister Nicola Sturgeon, who added it is “prudent” to keep mask rules in place. A small study has linked covid-19 with cardiovascular changes among unvaccinated people without any pre-existing medical conditions. Fábio Santos de Lira from São Paulo State University and his colleagues looked at 38 people, aged 20 to 40, less than six months after they were infected with SARS-CoV-2. Even mild or moderate infections were linked to cardiovascular changes that resulted in a raised heart rate, which affected some of the participants’s ability to climb stairs or walk.

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Commuters exit a London Overground train, Liverpool Street, London

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14 March

Nearly 400,000 people in the UK tested positive for the coronavirus last week

Government statistics show 399,820 people tested positive for SARS-CoV-2 in the UK between 5 and 11 March, an increase of 143,956 (56.3 per cent) on the previous seven days. Between 1 and 7 March, hospitalisations increased by 16.9 per cent from the previous week. Deaths within 28 days of a positive test are rising more slowly, with a week-on-week increase of 2.8 per cent as of 11 March. Easing restrictions, waning immunity and the more transmissible omicron sublineage BA.2 are thought to be driving the surge in cases.

Amid the rise in infections, ministers have been criticised for scrapping England’s React study at the end of March. React randomly tests about 150,000 people across the country for SARS-CoV-2 each month to gauge nationwide infection levels. Talking to The Guardian, one scientist called the move “about as far from ‘following the science’ as you can get”, while another accused ministers of “turning off the headlights at the first sight of dawn”.

Ministers are also being urged to consider offering older people a fourth vaccine dose. In England, people with a suppressed immune system, living in a care home or aged 75 or older are set to be offered an additional jab in April. Some scientists are calling for the age requirement to be set lower. However, a small Israeli study of healthcare workers found a fourth dose increased some antibody levels, but this did not translate into boosted immunity.

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China’s covid-19 cases have doubled in 24 hours amid its worst outbreak in two years. Nearly 3400 new cases were reported on 13 March, double the previous day. This has prompted schools to shut in Shanghai, China’s biggest city, and regional lockdowns to be introduced in several north-eastern hotspots. The surge in cases is thought to be driven by omicron and a rise in asymptomatic infections.

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Many countries have scaled back their coronavirus restrictions, but Iceland is going further with a plan to let infections spread

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Laboratory culture system using VeroE6 cells tested negative for covid-19.

Rockett et al, 2022

10 March

The monoclonal antibody sotrovimab has been linked to a drug-resistant mutation in SARS-CoV-2.

A study in Australia suggests that sotrovimab, a treatment for covid, may cause the coronavirus to acquire mutations that enable it to resist the drug.

Sotrovimab neutralises SARS-CoV-2’s spike protein, which the virus uses to enter cells. Given through a drip, sotrovimab can be administered to people within five days of their infection to prevent symptoms from becoming severe.

Rebecca Rockett from the University of Sydney and her colleagues reviewed the first 100 people who received sotrovimab at a healthcare facility in New South Wales between August and November 2021, when the delta variant of the virus was dominant. Eight of the people who were treated persistently tested positive for SARS-CoV-2, and had airway samples collected before and after they received sotrovimab.

In four of these patients, SARS-CoV-2 developed spike mutations between six and 13 days after sotrovimab was administered, with these genetic changes making the drug ‘effectively inactive’, said Rockett, as reported in The Guardian.

The researchers are calling for increased genomic surveillance around sotrovimab’s use. “What we don’t want to see is resistant virus disseminating in the community, because that will mean that a lot of other people can’t use this drug as well,” said Rockett.

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The WHO has warned the pandemic is “far from over”. The number of global recorded deaths between 28 February and 6 March declined by 8 per cent compared to the previous week, with recorded infections also falling by 5 per cent. “Although reported cases and deaths are declining globally, and several countries have lifted restrictions, the pandemic is far from over – and it will not be over anywhere until it’s over everywhere,” Tedros Adhanom Ghebreyesus, WHO’s director-general, said on 9 March. “The virus continues to evolve, and we continue to face major obstacles in distributing vaccines, tests and treatments everywhere they are needed.”

A surveillance programme that looks for SARS-CoV-2 in wastewater has been rolled out across Northern Ireland, the BBC reported. Wastewater samples from 31 sites are being collected every day and sent to a Queen’s University Belfast laboratory for testing. Gauging infection levels in specific areas may help to prevent large SARS-CoV-2 outbreaks, with the technology also looking for new variants.

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Students queuing up for covid-19 nucleic acid tests, Qingdao, Shandong province, China

Wei Zhe/VCG via Getty Images

9 March

Covid deaths and new infections are continuing to decline after the peak of the omicron surge

The number of global recorded covid deaths between 28 February and 6 March declined by 8 per cent compared to the previous week. In its weekly update, the WHO reported the number of recorded new SARS-CoV-2 infections also decreased by 5 per cent week-on-week.

In the week starting 28 February, more than 10 million new covid cases and 52,000 deaths were reported across the WHO’s six regions.

Case numbers only increased in the Western Pacific Region, rising by 46 per cent. Covid deaths rose in the Western Pacific and Eastern Mediterranean regions, by 29 per cent and 2 per cent, respectively, with fatalities falling elsewhere.

The surge in infection caused by the omicron variant appears to have peaked in February. But the WHO has stressed that countries vary in their testing strategies and therefore any trends should be interpreted with caution.

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However, in the UK, reported coronavirus cases have increased by nearly two-fifths week-on-week. According to government data,322,917 people reported a positive test between 2 and 8 March, an increase of 90,944 (39.2 per cent) from the previous week. Hospital covid admissions are also rising, with 8763 people admitted between 26 February and 4 March, an increase of 11.1 per cent from the previous week. Deaths have slightly declined, however. Between 2 and 8 March, 729 people died within 28 days of a positive test, 12 (1.6 per cent) fewer than the previous week.

The number of cancer research studies funded in the UK fell by 32 per cent in the first year of the pandemic, according to figures from the National Cancer Research Institute. The money awarded to these projects plunged by 57 per cent, The Guardian reports. The closing of charity shops and cancelled fundraising events are thought to have contributed to the problem.

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Covid-19 booster jab information campaign, Putney, London, UK

Amer Ghazzal/Shutterstock

7 March

Booster jabs substantially increased protection against omicron but efficacy starts to fall after two months

The protection given by vaccine booster shots against the omicron variant starts to decline after two months, a study has found.

Researchers at the UK Health Security Agency looked at covid-19 infections in the UK between 27 November 2021 and 12 January 2022 – the period in which the omicron variant started to spread widely. The data included over one million people who had been infected with either the delta or omicron variant.

The researchers only looked at whether people developed a mild illness and not whether someone was hospitalised or not.

They found that a booster dose substantially increased protection against developing mild illness from the omicron variant. Two doses of the Pfizer/BioNTech vaccine were only 8.8 per cent effective against the omicron variant after 25 or more weeks. But a third booster dose of this vaccine increased protection to 67.2 per cent. However, this then dropped to 45.7 per cent after 10 or more weeks.

A Moderna booster, given to those who had received two initial doses of the Pfizer jab, was 73.9 per cent effective against mild illness from the omicron variant after two to four weeks. This then dropped to 64.4 per cent after five to nine weeks.

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Mainland China logged its highest daily number of symptomatic coronavirus infections in two years yesterday. China reported 214 domestically transmitted cases with confirmed symptoms on Sunday – it is the nation’s highest number of cases recorded in a single day since March 2020.

The global recorded death toll from covid-19 has passed six million. The toll, compiled by Johns Hopkins University, stood at 6,000,394 as of Monday midday.

This number is likely to be a gross underestimate of how many people have actually died from the virus globally. This is due to poor reporting and testing mechanisms in many parts of the world.

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Baricitinib

Felipe caparros cruz/Alamy

4 March

Immune-suppressing treatment reduces deaths even in people already taking existing covid-19 medicines

Another treatment has been shown to help people hospitalised with severe covid-19: an arthritis medicine called baricitinib, which works by dampening the immune response. In the later stages of covid-19, overactivity of the immune system contributes to damage to the lungs and the blood clotting system, which causes tiny blood clots to form throughout the body.

Baricitinib was already being used in some countries, but a large UK trial has now shown that adding it to the other treatments used against covid-19 further reduces the death rate by 13 per cent. Most people in the study were already being given the steroid treatment dexamethasone, the first medicine shown to reduce deaths in covid-19, which also suppresses the inflammatory immune reaction. When this result is combined with other trials, it suggests baricitinib could reduce deaths by one fifth.

Baricitinib works by blocking the actions of an immune system compound called interleukin-6 (IL-6), which is raised in severe covid-19. It comes in tablet form, making it easier to give than another IL-6-blocking medicine called tocilizumab, given through a drip. Nearly a third of people in the trial also received tocilizumab and they still had the additional reduction in deaths from baricitinib.

“As an oral agent with a short half-life and potentially less expensive, this makes baricitinib a more attractive agent after steroids in low/middle-income country settings,” said Athimalaipet Ramanan, at the University of Bristol, UK, in a statement.

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Panic buying has begun in Hong Kong amid fears of an impending lockdown, as cases of covid-19 and deaths due to the virus are soaring. The city, which is in the middle of an omicron surge, has relatively low vaccination rates among its elderly. Two of Hong Kong’s largest retail chains have started rationing some food and medicines.

Measuring fourteen proteins in the blood can help predict if people will get severe covid-19, according to a study that used a genetic technique called Mendelian randomisation to link people’s genes with their risk of illness. The study found six proteins that cause higher rates of hospitalisation or death and eight that protect against such outcomes. One of the risky proteins determines a person’s blood group, supporting previous studies that have suggested people with blood group A are more likely to be admitted to hospital with covid-19.

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A woman waters plants in her house

Samuel de Roman/Getty Images

3 March

Pandemic linked to increase in depression and anxiety worldwide

A World Health Organization (WHO) briefing suggests that depression and anxiety have risen substantially during the coronavirus pandemic, with women and young people among the worst affected.

Based on a review of existing evidence into covid-19’s impact on mental health, the briefing largely attributes the rise to the unprecedented stress of social isolation, as well as grieving loved ones, financial worries and fear of infection.

Most of the countries surveyed (90 per cent) have included mental health support in their covid-19 recovery plans, however, the WHO has stressed there are still gaps in care.

“The information we have now about the impact of covid-19 on the world’s mental health is just the tip of the iceberg,” said WHO’s Tedros Adhanom Ghebreyesus, in a statement. “This is a wake-up call to all countries to pay more attention to mental health and do a better job of supporting their populations’ mental health.”

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The WHO has conditionally recommended molnupiravir as the first oral antiviral drug for people with non-severe covid who are most at risk of hospitalisation, such as older age groups or people who are immunocompromised. The recommendation is based on six studies with a total of 4796 participants between them. The review found that, when given within five days of the onset of mild symptoms, administering four molnupiravir tablets twice a day for five days can reduce the risk of hospitalisation by 30 per cent.

Covid restrictions are thought to have resulted in there being 720,000 fewer dengue fever infections in 2020 than would normally be expected. The team behind the work were surprised by their findings, having anticipated that rates of the mosquito-transmitted infection would have risen when people were forced to spend more time at home. The latest results, published in The Lancet Infectious Diseases, contradict previous research by a different team,  who warned that an additional 2008 dengue cases may have occurred a month in Thailand amid its 2020 restrictions.

The pandemic may be intensifying pre-existing inequalities between the sexes. US researchers reviewed datasets on issues like healthcare access, economic concerns and safety for 193 countries between March 2020 and September 2021. They found girls were 1.21 times more likely to have dropped out of school than boys, while women were 1.23 times more likely to report an increase in gender-based violence than their male counterparts.

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In vitro fertilisation

Mike Kiev/Alamy

2 March

A study of 43 countries suggests the coronavirus pandemic has substantially pushed back fertility treatments, with Scotland facing some of the biggest delays.

A team involving researchers at Monash University, Australia, sent surveys to fertility clinics across Asia, Africa, Europe, North America and South America from October 2020 to September 2021.

Treatment delays were reported in 34 countries, with people waiting an average of 59 days for IVF or an intracytoplasmic sperm injection, when a single sperm is inserted into an egg in a laboratory. Frozen embryo transfers were delayed by an average of 60 days. These occur when embryos from a previous IVF cycle are thawed and inserted into the womb.

The study, which is due to be published in Reproductive Medicine, found that the largest delay in fertility treatments was 228 days, reported by a clinic in Scotland. Austria, China, Germany, Hong Kong, Norway and Portugal were the only countries where the clinics surveyed reported no delays.

On 19 March 2020, the European Society for Human Reproduction and Embryology advised people to avoid procedures like IVF due to uncertainty around how the coronavirus affected pregnancies. Two days earlier, the American Society for Reproductive Medicine announced a “delay (to) any but the most important care cases”.

“The need to stop or delay treatment was guided by the uncertainty of the virus, and the [need] to reduce the burden of non-essential medical treatments in hospitals to allow resources to be allocated to dealing with people with COVID-19”, said Elizabeth Cutting, at Monash University, in a statement.

“While there was advice regarding virus exposure and transmission, there was a uniform lack of advice regarding the provision of psychological support and how to prioritise patients”.

Other coronavirus news

Compulsory coronavirus vaccines for care home staff are being scrapped in England from 15 March. The policy previously required anyone working in a Care Quality Commission-registered care home to have two vaccine doses, unless medically exempt. Amid fears of a staffing crisis, the government has said public immunity to the coronavirus is now high due to widespread vaccine uptake and many people recovering from the omicron variant.

Nerve damage may play a role in some cases of long covid. A small study of 17 people experiencing long-term symptoms found that 59 per cent had signs of nerve damage, possibly caused by an overactive immune response. “I think what’s going on here is that the nerves that control things like our breathing, blood vessels and our digestion in some cases are damaged in these long COVID patients,” said neurologist Anne Louise Oaklander, reported by Reuters.

Preliminary laboratory studies suggest that modified T-cells could help treat covid in people on immune-suppressing drugs. Researchers in Germany genetically modified the T-cells of people who had recovered from covid-19 to make them resistant to the drug tacrolimus, which is commonly given to people who have had an organ transplant to prevent rejection. The modified cells then attacked the coronavirus while exposed to tacrolimus in a laboratory experiment.

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A child receives a dose of Pfizer/BioNTech covid-19 vaccine

Alexandre Schneider/Getty Images

1 March

Study suggests that protection from two doses of the Pfizer/BioNTech covid-19 vaccine quickly wanes in children between five and 11

Protection against infection and hospitalisation from the Pfizer/BioNTech covid-19 vaccine falls relatively rapidly in children aged 5 to 11, according to a preliminary study.

Researchers analysed covid-19 cases and hospitalisations among 365,502 fully vaccinated children aged between five to 11, and 852,384 aged between 12 and 17, all of whom lived in New York. They looked at data from 13 December 2021 to 30 January 2022, during a surge of covid-19 infections from the omicron variant.

The team found that, for the older children, the Pfizer/BioNTech vaccine’s protection against hospitalisation fell from 85 per cent in mid-December to 73 per cent by the end of January. But the drop was steeper for children aged five to 11, with protection against hospitalisation declining from 100 per cent to just 48 per cent.

For protection against infection, effectiveness dropped from 66 per cent to 51 per cent among the 12 to 17 age group, and from 68 per cent to 12 per cent in the younger age group.

Florian Krammer, at Mount Sinai’s Icahn School of Medicine, told the New York Times: “The difference between the two age groups is striking,”

Those in the younger age group receive a 10 microgram dose of the vaccine, compared with 12 to 17-year-olds who receive a 30 microgram dose, which could explain some of the discrepancy in the vaccine’s effectiveness over time.

Other coronavirus news

Researchers may have found a case of deer-to-human covid-19 transmission in Canada. In a preliminary study published on 25 February, the team traced at least one case of covid-19 in humans back to a strain of the virus found in white-tailed deer.

White-tailed deer had previously been found to be infected with covid-19 in the US and Canada. For the study, the researchers took samples from hunted deers in Ontario, Canada and found 17 were infected with a previously unknown strain of covid-19.

They then found that one person, who had been in contact with deer, had tested positive for similar strain.

Hong Kong today reported 32,597 new infections and 117 deaths – the city’s highest figure since the pandemic began. The city has seen a huge surge in covid-19 cases, with only 739 new cases on 1 February. Hong Kong’s fatality rate is currently one of the highest in the world, which may partly be due to lower vaccination rates in older age groups. To tackle the current surge, the city plans to begin mass testing its 7.4 million residents in mid-March.

 

See previous updates from February 2022, January 2022, November to December 2021, September to October 2021, July to September 2021, June to July 2021May 2021, April-March 2021, February 2021, January 2021, November/December 2020, and March to November 2020.

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