Research and analysis

HPR volume 14 issue 15: news (25 and 28 August)

Updated 23 December 2020

COVID-19 surveillance update

The latest UK weekly statistics from the NHS Test and Trace service, covering the period 13 August to 19 August, indicated that demand for testing across the country has continued to grow.

The service now consistently reaches the majority of people testing positive, and their contacts. Since mid-June the number of people getting newly tested has increased by 57% with over 440,000 people newly tested in the latest reported week of statistics. Expansion of testing sites and investment in new technologies is expected to raise testing capacity to 500,000 per day by the end of October.

Since NHS Test and Trace was launched 3 months ago:

• the number of people coming forward for a test has increased by 57% since mid-June
• 4,389,503 people have been newly tested under pillars 1 and 2
• in total, 297,138 people have been reached by the service (including both those testing positive and their contacts)
• 80.6% of all contacts identified were reached
• of those testing positive who shared their contact details with the service, contact tracers reached 88.3% of those contacts.

National Weekly Surveillance Report (NWSR)

Summarising the national epidemiological picture, the latest NWSR (including data to 23 August) states:

‘A number of COVID-19 surveillance indicators suggest that COVID-19 activity remained stable at a national level during week 34. Case detections in England decreased from 6,871 in week 33 to 5,965 in week 34. Case rates were highest in North West and Yorkshire and Humber. At a local authority level, incidence is highest in Oldham, although this has decreased from the previous week, followed by Blackburn with Darwen. Case rates were highest in the 15 to 44 year age group. Pillar 1 and Pillar 2 positivity remained stable compared to the previous week.’

The following local authorities are listed as ‘of concern’, or as subject to ‘enhanced support’ or ‘intervention’, in the latest watchlist section of the NWSR, as follows:

• Pendle
• Oldham
• Blackburn with Darwen
• Leicester
• Bradford
• Manchester
• Rochdale
• Northampton (Northamptonshire)
• Salford
• Bury
• Kirklees
• Calderdale
• Tameside
• Preston
• Swindon
• Burnley (Lancashire)
• Birmingham
• Sandwell
• Bolton
• Trafford
• Stockport
• Hyndburn (Lancashire)
• Stoke-on-Trent
• Newark and Sherwood
• Wakefield
• Oadby and Wigston (Leicestershire)
• Luton
• Peterborough
• Slough

The latest epidemic curve for England (below), including data up to 25 August, distinguishes between data from Pillar 1 testing (swab testing in PHE labs and NHS hospitals for those with a clinical need, and the most critical health and care workers) and Pillar 2 testing (mass-swab testing for critical key workers in the NHS, social care and other sectors).

Laboratory-confirmed COVID-19 cases (England) as at 25 August 2020 (by date of specimen collection).

The infographic that accompanies the NWSR provides more detailed trend information, across a wider range of parameters, than the Coronavirus Cases in the UK: daily updated statistics.

Revised guidance on radiation protection in dentistry

Revised Guidance Notes for Dental Practitioners on the Safe use of X-ray Equipment will shortly be published on the website of the Faculty of General Dental Practice [1], revoking and replacing the first edition produced and published in 2001 by the then National Radiological Protection Board (NRPB), now part of PHE’s CRCE [2].

The second edition of the joint PHE/FGDP Dental Guidance Notes sets down principles of good practice on the restriction of radiation doses received by those (mainly staff and patients) involved in dental radiography.

Dental X-ray imaging has become an indispensable tool in the efficient diagnosis of disease and treatment, and more dental radiographs are taken each year in the UK than any other form of diagnostic X-ray image. The second edition of the guidance (known as the ‘Dental GNs’) takes account of developments in dental X-ray equipment, imaging technology and legislation since 2001, covering both the administrative and practical matters. It will be freely available as a PDF document on the FGDP website.

Subjects addressed include:

• existing guidance on dental cone-beam CT (CBCT), hand-held dental X-ray equipment and digital imaging systems
• updated guidance on:
  • radiation controlled areas
  • the training of referrers, practitioners and operators with respect to dental CBCT
  • acceptance, commissioning and routine radiation safety tests for all dental X-ray equipment and the recommended intervals (extended to every 3 years for most dental CBCT equipment) between routine tests
  • a simplified system for image quality rating and analysis
  • a simplified approach to quality assurance of digital imaging systems and viewing screens
• new guidance with respect to the requirements:
  • for dental practices to register with the HSE (or HSENI)
  • to investigate the circumstances when contingency plans are activated, and on the need to rehearse contingency plans
  • to monitor radiation levels at the boundaries of controlled areas
  • to assess doses to persons who need to enter controlled areas
  • for employers to co-operate when employees work with dental X-ray equipment on another employer’s premises, including arrangements for the formal handover of responsibility
  • regarding what should be expected of service engineers who undertake the installation, testing and servicing of dental X-ray equipment
  • when disposing of or selling-on X-ray equipment
  • for record retention
• detailed practical guidance on how to achieve the optimisation of patient dose
• template documents, including a radiation risk assessment and the employer’s procedures relevant to dentistry

The updated Dental GNs do not impose any additional requirements on employers to those already required by the Ionising Radiations Regulations 2017 (IRR17) and the Ionising Radiation (Medical Exposure) Regulations 2017 (IRMER17). Those dental practices that have acted on the regulatory requirements introduced by IRR17 and IRMER17 and are following the advice of their radiation protection adviser (RPA) and medical physics expert (MPE) are likely to be already in regulatory compliance with the new guidance.

The working party that generated the revised Guidance Notes included representatives from all the UK regulatory bodies, and from general dental practice, experts from professional and advisory bodies, and consultant dental radiologists. Adherence to the guidance should materially contribute to and support high standards of radiation protection throughout the UK dental profession.

References

1. FGDP website. Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment – 2nd Edition (forthcoming).
2. GOV.UK. Dental practitioners: safe use of X-ray equipment.

Sexually transmitted infections and National Chlamydia Screening Programme annual data release for England

Annual data on sexually transmitted infections (STI) and screening for chlamydia in England will be published on Wednesday, 2 September [1,2]. The data will provide a comprehensive overview of trends in STI diagnoses, sexual health service provision and chlamydia screening activity in England to the end of 2019 by various demographic characteristics and by geographical location.

The full data release will consist of an annual report and infographic, alongside the STI and National Chlamydia Screening Programme data tables and slide sets. Data at local authority level will be available on PHE’s Sexual and Reproductive Health Profiles.

Further analyses of STI surveillance data received during the first part of 2020 are underway to assess the impact of the COVID-19 response on HIV/STI service provision and epidemiology. Provisional findings will be published within the coming months.

References

1. GOV.UK. Sexually transmitted infections annual data tables (Available from 2 September).
2. GOV.UK. National Chlamydia Screening Programme data tables. (Available from 2 September).

Infection reports in this issue of Health Protection Report (HPR)

Laboratory confirmed cases of measles, rubella and mumps (England): January to March 2020.

Reports of respiratory infections made to PHE from PHE and NHS laboratories (England and Wales): weeks 29 to 32, 2020.

Routine reports of gastrointestinal infections in humans (England and Wales): April and May 2020.

Vaccine coverage report

Shingles VC report (adults eligible from April to December 2019 and vaccinated to end-March 2020) in England.