Infected Covid-19 Brits should get Netflix to self isolate at home, SAGE papers reveal 


Coronavirus-infected Britons should be given Netflix, Now TV and Amazon Prime to encourage them to stay at home, according to scientists advising the Government.

The Independent Scientific Pandemic Influenza Group on Behaviours (SPI-B) has urged health chiefs to consider a self-care package to boost poor self-isolation rates. 

Its recommendation comes on the heels of a study by King’s College London which showed just one in five Britons with tell-tale symptoms of coronavirus are choosing to self-isolate.

The idea was pondered in a scientific report handed to the Scientific Advisory Group for Emergencies (SAGE), which then presents the findings to the Government to help inform public health policy. 

Other scientific documents published today discussed that women were most at risk of catching the coronavirus because they typically do more housework, therefore exposing themselves to other family members’ germs.  

The latest batch of scientific papers handed to SAGE also revealed:

  • Muscle pain, fatigue and blisters on the feet are symptoms highly suggestive of Covid-19;
  • Up to a third of people with Covid-19 show no symptoms, but may be just as likely to spread the virus to others;
  • Lockdown restriction banning household mixing in Northern England – but keeping pubs open – does ‘not support the values’ of swathes of people;
  • Genetic differences are ‘unlikely’ to explain why BAME people are more at risk of Covid-19
  • Visitors to care homes have barely any impact on cases while staff-to-staff transmission may increase outbreaks more.

Health chiefs should consider giving out quarantine packages including free access to Netflix to motivate Covid-19 patients to self isolate

Health chiefs should consider giving out quarantine packages including free food and passes to streaming sites to motivate Covid-19 patients to self isolate

Covid-19 patients may benefit from a free Netflix, Now TV or Amazon Prime pass, if health chiefs take the advice of SAGE to offer more incentive to self-isolate.

SPI-B, a sub-committee of SAGE, said a deal with entertainment companies to provide free access to either streaming sites or online games free of charge could combat boredom, and therefore encourage people to stay indoors.

Research has shown that adherence to self isolation is ‘likely very low’ at less than 20 per cent. But in order to stop the train of transmission, it needs to be far higher.

The reasons for this are multi-faceted and include that people are unable to take paid sick leave from work. People also report breaking quarantine most commonly to go to the shops for food and medicine.

SPI-B said self-isolation rates would improve if the Government gave out of a self-care package, including financial support and freebies.

This should be ‘taken up as a priority by the Department of Health and Social Care’, scientists said, because the evidence is ‘sufficiently compelling’.

The paper, dated September 16, said: ‘Given the role of boredom and frustration in non-adherence to isolation, identifying ways to combat this may also be productive. 

‘For example, a partnership with the entertainment industry to provide free access to online games or streaming services could be considered.

‘Particularly for younger adults and children, a partnership with entertainments or sports industries might identify novel “money can’t buy” activities or products only available to those who have self-isolated.’

It also said for people who do not have friends and family to rely on to pick up food shopping, food will ‘need to be provided’.

Women may be most at risk of Covid-19 ‘because they do the chores’

Middle-aged women may be the most at risk of catching the coronavirus because they do the laundry in the home, SPI-B has warned.

The team looked into how the coronavirus may spread in different types of housing, from multi-generational, crowded, nuclear, shared, rented and for those who live alone.

Their paper reports that women typically take on the burden of housework, including cleaning of surfaces, cooking and the laundry, and are therefore exposed to other family members’ infections most.

Respiratory droplets that contain the coronavirus can remain on surfaces and materials for up to three days.

Scientists said: ‘While we would not want to reinforce the burden of domestic work on women, it may well be important to communicate safer Covid-19 practices to them.’

In their paper they noted mothers doing housework in nuclear families or crowded housing with multi-generations of ages may be most at risk.

But lone parents who take care of young children may also be typically infected this way, the report said.

People who lived in shared housing, where the load of domestic chores is split typically among young students, men and those in key worker roles, were also noted as a group at particular risk of Covid-19 generally.

Women who do the laundry and chores may be most at risk of Covid-19

Women who do the laundry and chores may be most at risk of Covid-19

Muscle pain, fatigue and blisters on the feet are symptoms highly suggestive of Covid-19

Muscle pain, fatigue and blisters on the feet are clear indicators of Covid-19, scientists have told the Government.

But they won’t be added to the NHS’s definition of the disease because it would swamp testing sites.

The only three recognised symptoms of coronavirus are a high temperature, new, continuous cough and loss or change to your sense of smell or taste.

But it’s also known that symptoms of the virus are far ranging, and vary between age groups.

A paper prepared by the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) presented on September 17 noted loss of smell and taste, fever, chest pain, muscle pain, a hoarse voice, diarrhoea, delirium, feet blisters and red welts on the face and neck as highly specific to Covid-19 in the seven days prior to a positive test result.

That’s based on data from the Covid Symptom Study app, a database of millions of phone users who report signs of the disease and test results, and The First Few Hundred study, of early Covid-19 patients in China.

NERVTAG also noted a scientific review which said muscle fatigue or pain may occur in up to half of Covid-19 patients – more than a sore throat or headache.  

It said including multiple symptoms in case definitions of the disease given by health chiefs will increase sensitivity of testing – the ability to correctly identify those with the disease.

But it would be at the cost of reducing specificity – the ability of the test to correctly spot those without the disease – because symptoms such as muscle pain could be caused by a number of illnesses.

It would also drive up test demand because more people would qualify for a free test.

The paper noted that two studies have measured the sensitivity and specificity of the current UK definition of Covid-19, finding it to be between 85 and 95 per cent sensitive, and between 17 and 49 per cent specific.

In the US, a wider range of symptoms are listed by the CDC as being caused by Covid-19, including chills, fatigue, muscle pain, fatigue and headaches.

Therefore, the definitions’ specificity is much lower – about 12 per cent.

Therefore, adding on symptoms to the UK’s list would cause the specificity to drop to some 19 per cent, according to the Covid Symptom Study app, from King’s College London.

The app said this could increase the number of people wanting a test by 48 per cent – which may be why the health chiefs are reluctant to expand their list. 

A paper prepared by the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) noted loss of smell and taste, fever, chest pain, muscle pain, a hoarse voice, diarrhoea, delirium, feet blisters and red welts on the face and neck as highly specific to Covid-19 in the seven days prior to a positive test result (orange bar), That's based on data from the Covid Symptom Study app, a database of millions of phone users who report signs of the disease and test results, and The First Few Hundred study, of early Covid-19 patients in China

A paper prepared by the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) noted loss of smell and taste, fever, chest pain, muscle pain, a hoarse voice, diarrhoea, delirium, feet blisters and red welts on the face and neck as highly specific to Covid-19 in the seven days prior to a positive test result (orange bar), That’s based on data from the Covid Symptom Study app, a database of millions of phone users who report signs of the disease and test results, and The First Few Hundred study, of early Covid-19 patients in China

Up to a third of people with Covid-19 show no symptoms, but may be just as likely to spread the virus to others

Up to a third of people with Covid-19 do not show symptoms – but carry the virus for just as long as those who do.

ALMOST 90% OF COVID-19 PATIENTS DON’T HAVE THREE MAIN SYMPTOMS

Almost 90 per cent of Covid-19 patients don’t have any of the three main symptoms of the disease on the day they are tested, scientists have revealed.

Researchers analysed data from 36,000 volunteers who were swabbed for the virus between the end of April, a month after lockdown began, and end of June.  

But just 16 of 115 people who tested positive for Covid-19 had a fever, cough or had lost their taste or smell — the only symptoms listed by the NHS — on the day their sample was taken. 

When fatigue and shortness of breath were added to the ‘core’ symptoms list, just 23 per cent had the warning signs. 

Although 158 people in the survey were suffering from at least one of the three tell-tale symptoms when they were tested, only 10 per cent of those had the virus. This adds to evidence that thousands of people suffering from coronavirus-like symptoms will need to be tested this winter because it is the only way to find out if they have the disease. 

The University College London study suggests at least 70 per cent of Covid-19 cases in the UK may be asymptomatic. But others say the actual number is much lower as false-positives in tests could lead to someone wrongly being diagnosed with the virus. 

This means the Government’s beleaguered testing regime — where people are only tested if they have symptoms of the virus — may be missing thousands of ‘silent’ transmissions and infections spreading across the country.  

Experts have suggested all university students should be swabbed before they head home to enjoy the Christmas break, on the back of the research.

Researchers led by the University of College London reviewed 22 studies looking into how many cases were ‘asymptomatic’. They gave a pooled estimate of 28 per cent, with a range of 20 to 35 per cent.

It’s far lower than previous predictions of 80 per cent, which may have wrongly included those who are ‘presymptomatic’, meaning they do not show symptoms for a period of time that they are infectious before becoming sick.

Early population-based data collected from English households by the Office for National Statistics, a branch of the Government, found that only 22 to 29 per cent of people are asymptomatic.

Whether or not asymptomatic Covid-19 cases play a significant role in spread of the coronavirus is less clear.

Nine studies generally showed that the viral load – how much virus a person is carrying – and duration of viral shedding – how long they release viral particles for – was similar in those without symptoms to those with.

The authors noted a lower viral load typically means infectiousness decreases, suggesting transmission ability is similar between symptomatic and asymptomatic patients whatever their viral load. But they did not specifically comment on transmission rates between the two types of carriers.

The review was also not able to pinpoint if certain groups or ages of people are more or less likely to have tell-tale symptoms. But said some studies have shown young people and children may make up a significant proportion of so-called ‘silent carriers’. 

Lockdown restriction banning household mixing in Northern England – but keeping pubs open – does ‘not support the values’ of swathes of people

Banning social mixing in households in Northern England, but keeping pubs open, does ‘not support their values’ of swathes of religious and minority ethnic people, the SPI-B said.

The paper, discussed at a SAGE meeting on September 17, discussed support mechanisms among different groups in England.

It noted that ‘kinship in post-industrial working class, Hindu, Muslim, Sikh, Orthodox Jewish, BME and African-Caribbean communities extend far beyond the physical households’, either due to their culture or religion.

SPI-B said those groups have a more extensive concept of family, with responsibilities such as childcare shared over a larger network of people.

The paper said: ‘This makes it likely that households will have a greater density of connection in flows of care between them. These connections are very important for the economic and psychological well-being of these communities.

‘This is why the government’s recent introduction of social restrictions in Northern England that allow meeting in pubs and restaurants but prevent people meeting in households is so problematic and confusing to the public.

‘It does not match people’s values and priorities nor their needs for support.’

It is illegal to meet people indoors from other households in huge chunks of the North East and other parts of England. But no closures of pubs have happened, although it is rumoured this is next after the 10pm curfew came into force mid-September.

It adds that self-isolation, imperative to slowing the spread of the coronavirus, may be more difficult in these groups because there is a higher ‘sense of responsibility’ for individuals to help each other out.

A knock-on effect could be a higher rate of transmission, and ‘highly unfair’ stigmatising. 

Banning social mixing in households in Northern England, but keeping pubs open, does 'not support their values' of swathes of religious and minority ethnic people, the SPI-B said. Pictured: A pub in Newcastle on Thursday October 8

Banning social mixing in households in Northern England, but keeping pubs open, does ‘not support their values’ of swathes of religious and minority ethnic people, the SPI-B said. Pictured: A pub in Newcastle on Thursday October 8

WHITE PEOPLE ARE FUELLING COVID-19 WAVE 

White people are fuelling England’s latest surge in coronavirus infections, official data has shown. 

Cases among white people – who make up 80 per cent of the population – have risen by more than two-and-a-half times in the last fortnight.

A Public Health England report found cases soared from 37.3 per 100,000 people to 97 in the two weeks up to October 4. It marks the biggest increase among any ethnic group in the country.  

Rates of coronavirus are still higher in minority ethnic groups, but they account for a far smaller portion of the public. 

For example, the virus is still more prevalent among Pakistanis, who are recording 254.2 infections each week per 100,000 people, up 20 per cent in the same time period.

Among Indian people the rate rose by 62 per cent, from 93.1 to 150.9 per 100,000, and for other Asian people it increased by 63 per cent, from 69.9 to 113.9 per 100,000.

Black people’s rate rose 72 per cent, from 41 to 70.7 per 100,000. And in mixed/multi-ethnic groups there was a 250 per cent spike from 45.1 to 77.6 per 100,000. 

Genetic differences are ‘unlikely’ to explain why BAME people are more at risk of Covid-19, scientists say   

Genetic differences are unlikely to explain why people of Black, Asian and ethnic minority background are more at risk of Covid-19 in the UK, SAGE has concluded.

The ethnicity sub-group of SAGE said ‘genetics alone cannot explain the higher number of severe cases and deaths since ethnic minorities are very genetically diverse’.

Its paper, considered by SAGE on September 24, said predisposing genetic factors may influence infection susceptibility and also change how their immune system responds, seen in diseases like malaria and tuberculosis.

But for ‘most other conditions where such ethnic differences in health are observed, they reflect underlying social differences which have been affected by ethnicity rather than genetic differences’.

There are a number of specific factors that are likely to have led to the disproportionate burden of Covid-19 on non-white people.

This includes that some underlying health conditions, a Covid-19 risk factor, are more common in ethnic groups.

For example, the ISARIC-CCP study identified diabetes as a potentially important factor for the poorer Covid-19 outcomes of South Asians, accounting for 18 per cent of the greater risk of death.

High risk of exposure to the virus may be driven by the fact those of ethnic groups are overrepresented in key worker jobs, where they interact more with other people.

For example, more than a quarter of Black people are employed in key worker positions, such as a nurse, carer, bus driver or shop assistant.

There has been debate about whether living in a multigenerational home – where families spanning various ages – contributes to higher cases of Covid-19 in a specific area.

The paper said: ‘The combination of overcrowded housing and multi-generational households among minority ethnic groups could lead to greater exposure to infection.’

It also said unclear public health messaging is likely to explain why BAME groups have faced the brunt of Covid-19 if English is not their first language.

High risk of exposure to the virus may be driven by the fact those of ethnic groups are overrepresented in key worker jobs, where they interact more with other people. Pictured: The proportion of people in different ethnic groups who work in health and social care and key worker jobs

High risk of exposure to the virus may be driven by the fact those of ethnic groups are overrepresented in key worker jobs, where they interact more with other people. Pictured: The proportion of people in different ethnic groups who work in health and social care and key worker jobs

Visitors to care homes have barely any impact on cases while staff-to-staff transmission may increase outbreaks more

Visitors to care homes has barely any impact on the spread of coronavirus in care homes, early data suggests, but staff-to-staff transmission may be a large problem.

The Social Care Working Group (SCWG) reported that ‘weak evidence’ links outbreaks in care homes to family members or friends who visit.

Modelling studies have shown a visitor only contributes to one additional Covid-19 case in an outbreak of 30, which is not considered ‘significant’.

SCWG, which gives updates on the care home crisis to SAGE, therefore recommended that the risks and benefits of shutting care homes to visitors should be re-assessed, given that ‘isolation can be harmful to residents’.

Local directors of public health have the authority to close care homes if the spread of coronavirus is rising in the community.

But Age UK have warned visitor restrictions on care homes could mean the elderly don’t see their family for a year, considering they first closed in March.

The paper said genomic analysis – which involves tracing the pathways of transmission based on the DNA of people’s virus – has found strong evidence of staff to staff transmission.

A Public Health England report published in May said agency staff helped to fuel Britain’s coronavirus crisis in care homes because they switched between them.

Despite the findings, overall SCWG said there are multiple ways the coronavirus is introduced into care homes, from lack of testing, discharging Covid-19 positive hospital patients to care homes, and doctors visiting.

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