Arrow ImagePICU & Rapid Response

Is there evidence for any benefit from using masks at school?

Children are less likely to develop the symptoms of COVID-19, although there haven’t been sufficient studies to confirm whether they are more or less likely to get or pass on the virus. There remains the possibility that they could spread it throughout the wider community. This is one reason why the schools remained closed throughout the lockdown. Some schools are now erring on the side of caution and recommending that the pupils wear masks in enclosed spaces. There are many diagrams to explain the benefit of masks, but I think that this demonstrates it well.

 

 research covid v2

Essentially, the primary benefit of a mask is to prevent somebody with the virus from spreading it. So while a mask may not prevent you from breathing in an infected airborne droplet, if may well stop the droplets you expel through sneezing, coughing etc. There is also evidence to suggest that people who talk loudly or shout are more likely to spread the aerosol that would contain the virus, which may be relevant in schools!

 

What are the testing figures currently telling us?

In the last few weeks, the numbers of cases reported have increased in a number of European countries although they have remained generally stable in the UK. However, the number of COVID-related deaths and seriously ill cases has been steadily falling. What does this actually mean? The challenge is that we are doing many more tests than previously and so are diagnosing people that would otherwise not have been identified, as most of them have very few symptoms or none at all (asymptomatic). This is partly related to the Test and Trace programme, but also proactive testing when a cluster is suspected, as at the Greencore sandwich factory. At the early stage of the COVID-19 outbreak, primarily people who had been admitted to hospital or referred by a GP were tested. So it is not possible to compare the current figures with those reported in April and May. It is important that we monitor the current overall figure as this will reflect lifestyle factors which may influence the transmission of the virus within the community. In Spain, for example, the current spike is likely to be associated with an increase in those on holidays who were unable to maintain the social distancing limit. Also, monitoring local spikes should allow for the identification of specific factors associated with the increased number and therefore inform the introduction of measures to deal with them. It is also worth remembering that, whilst the death rate is now negligible, the long-term effects of contracting COVID-19 remain unclear.

 

Where are we with vaccines?

Although there are reports from Russia that a vaccine is now in use in the clinic, we have no evidence that it actually works as none of the research behind it has been published. There are a number of trials taking place around the world. It is important, however, that all of the evidence that the vaccine is safe and effective has been obtained before a licence for its use in the clinic is approved. Any political pressure to approve a vaccine prior to the completion of proper testing should be resisted. We have one chance to get it right and we need to be confident that the vaccine works and is safe before we allow it to be made available to the wider population.

 

Could you get COVID-19 a second time?

There have been reports today of a person developing the symptoms of COVID-19 for a second time. Although this is a single case, it does raise the possibility that the immune response to the condition may be short lived, at least in some people. Although, another possibility is that many people have contracted it for a second time, but are also asymptomatic, so have gone undetected. Previous studies have suggested that the immune response in people who have a milder form of the condition may be weak and decrease over time. This may explain why it could be possible to develop the condition a second time. More importantly, it provides information about the development of a vaccine. In the initial study of the Oxford vaccine, a booster dose was administered after one month and the immune response was maintained up to three months. This is now being followed over a longer term. However, if the immune response is not maintained, it may be necessary to give an annual booster, which will be a challenge.