Dear Courtfield Patient,
Welcome to the first Courtfield newsletter of the “new term”.
In view of the conflicting news reports about the current state of the pandemic in England, it would seem sensible to start with a review of the most up to date statistics from around the world, which generally paint a very positive picture:
- Despite a relaxation of government restrictions and the return of children to schools, the numbers of people becoming infected, hospitalised, and dying of Covid have remained relatively stable over the course of the past two months, with the peak in daily cases occurring in mid-July.
- Most hospital admissions and deaths occur in those who have not been vaccinated, and of those who have been doubly vaccinated, the vast majority of deaths are in those with underlying medical conditions or in the over 80’s (average age of death is 84)
- As of this week, there were 6,338 patients with Covid in hospitals in England out of a total of 110,000 beds available
- The Office for National Statistics (ONS) has shown that 93.6% of the population of England have protective antibodies
- A study conducted by Imperial College and the University of Padua in Italy has shown that these antibodies remain present for at least nine months after infection. Good antibody levels are achieved irrespective of whether an individual has symptoms or not (i.e., asymptomatic infection will produce the same level of antibodies as someone who has had more severe symptoms)
- The same study- which measured antibody levels repeatedly in the same population over several months- also showed that antibody levels go up as well as down- the rise almost certainly reflecting the response of the body’s immune memory to being re-exposed to the virus circulating in the population
- Antibody levels following vaccination start to drop off after six months (Zoe symptom study], and although this may not be clinically significant [as the body’s immune memory should still allow a previously infected or vaccinated individual to respond more quickly to future infection], a booster vaccination dose is sensible
- A large study from the communicable diseases centre (CDC) in America published this month shows that if you have not had the vaccine, you are:
- 4.6x more likely to be infected
- 10x more likely to be hospitalised
- 11x more likely to die
- An ONS study has shown that in England only 59 fully vaccinated people without serious health conditions have died from Covid out of more than 50,000 deaths in England so far this year. The same study showed that 99% of Covid deaths between January and July were in people who had not had 2 vaccinations
- Since our last newsletter, 3 new drugs (“monoclonal antibodies”) have been approved for use in hospital (sadly there are still no drugs that have been shown to be effective for use in the community)
In our own area, we understand that the numbers of patients in intensive care at Chelsea Westminster hospital has in fact gone down in the past two weeks.
At Courtfield, although we have managed many cases of Covid over the past three months, all have had relatively modest symptoms and made a full recovery. We are not aware of any new cases of long Covid.
IMPORTANT UPDATE TO THE MOST COMMON SYMPTOMS OF COVID
According to the ZOE symptoms study, the main symptoms of Covid in the post vaccinated population have changed and are now:
- Runny nose – 77%
- Headache – 74%
- Sneezing – 67%
- Sore throat – 53%
- Loss of smell or taste – 52%
Symptoms of Covid are therefore now almost indistinguishable from routine seasonal colds, which makes it all the important for those of us with the above symptoms to consider Covid as a possible diagnosis and to take the appropriate action to protect others i.e. to take a PCR test [available free via gov.uk or by dialling 119] and if positive to self-isolate for 10 days.
A lateral flow test is not sufficient to be certain that you or one of your relatives does not have Covid
Should I vaccinate my 12- 15-year-old?
It is well known that the risk of Covid causing serious illness or death in this age group is tiny (2 per million under 18’s). The vast majority of these children had underlying pre-existing conditions.
Whilst the vaccine is completely safe for many children, inflammation of the heart [myocarditis and pericarditis] has been shown to be associated with the second dose of this vaccine at a rate of 162.2 cases per million in healthy boys aged 12 to 15 years and 94 per million in those aged 16 to 17. For girls the rate was 13 per million in 12- to 15-year-olds and 13.4 million in 16–17-year-olds, i.e., in all cases higher than the risk of death from Covid.
Whilst there have been no reported deaths from this condition, we cannot yet be confident that there may not be any long-term cardiac complications of this side effect.
This was the data that led the joint committee on vaccination and immunisation not to recommend routine vaccination for 12- 15-year-olds.
Reduction in cases of long Covid may possibly be a benefit of the vaccine, but studies appear to show that long Covid is less common in children. (Long Covid remains a difficult condition to assess, and more long-term data is needed).
The government have decided to recommend vaccinating this age group in the belief that it will reduce cases of COVID in this age group and thereby reduce time off from lessons. (There may also be social benefits such as hassle-free international travel and access to large social events).
It is for each family to decide what is best for their child and we hope that the facts as outlined above will help you in making a decision about whether to vaccinate or not.
How will you be managing those of us and our families at Courtfield with possible Covid symptoms?
Our staff will continue to run through a checklist of symptoms before offering you an appointment.
If you (or your household contact) exhibit any of the symptoms on the checklist, then one of the medical team will phone you to discuss how best to manage this.
We will always ask you to carry out a lateral flow test, which should screen out those of you who are positive (although as previously stated a negative test does not exclude the possibility of Covid).
Whatever the outcome of the test, we will still see you if it is clinically appropriate to do so. This may however mean seeing you at special times in the surgery- reserved for those who may have Covid symptoms- in order to keep you apart from patients attending for non-Covid related symptoms.
We can also arrange special times for you to be seen if you feel particularly vulnerable or anxious about coming in to the surgery-please let the reception team know when making your appointment.
Is it important to have a flu jab this year?
It is especially important to have flu vaccination this year, as it is generally believed that the incidence of influenza will be much higher this year.
Recent studies have also shown that pneumococcal pneumonia is responsible for nearly 25% of Covid related pneumonia, and as last year, we would strongly recommend that you have pneumonia vaccine as well.
Only one dose is necessary, so a booster is not needed for those that have had it previously.
Our flu/pneumonia vaccination clinics will begin from 6th October. Please phone reception to book an appointment and let them know whether you would like to have the pneumonia vaccine as well as the flu jab.
What about COVID booster doses
These will continue to be administered by the government/NHS and will be offered to those who are particularly vulnerable and everyone over 50, in order of clinical priority. Invites will be sent out to those eligible.
Travel testing
We continue to offer all tests for travel (as well as COVID antibody testing). Please contact reception for details.
Conclusion
Although we are in a much safer position than last year, Covid is not going to go away and is likely to become more prevalent in the autumn and winter months.
It is therefore important to continue to be cautious and in particular to wear face masks in crowded environments, to wash hands regularly, maintain good ventilation and to maintain Vitamin D levels by taking a daily supplement (we are able to check your own Vitamin D levels by means of a simple blood test).
Remember that a runny nose and sneezing are now in the top five of Covid symptoms, so taking a PCR test if these symptoms develop, and then isolating for 10 days is vitally important to protect others.
As always please contact us if you have any questions or concerns
Best wishes from the team at Courtfield Private Practice