Covid-19 in the UK: policy on children and schools

Key messagesPandemic policy on children and schools reflected UK based scientific narratives that did not align with global scientific consensusGovernment relied on evidence that downplayed the seriousness of covid-19 in children, underestimated the benefits of precautionary measures, and overestimated the harms of vaccinationReturn to school in September 2020 with minimal emphasis on masking and air quality, and inadequate support for isolation may have accelerated community transmissionThe public inquiry should explore why the UK was an international outlier in its approach to protecting children and making schools and communities safe

Vaccinating adolescents against SARS-CoV-2 in England: a risk-benefit analysis.

OBJECTIVE: To offer a quantitative risk-benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England. SETTING: England. DESIGN: Following the risk-benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12-17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence. PARTICIPANTS: All 12-17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre. MAIN OUTCOME MEASURES: Hospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12-17 year olds in England over a 16-week period under different estimates of future case incidence. RESULTS: At high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date. CONCLUSIONS: Given the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10-19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Monteverde youth perceptions of pro- and anti-tobacco advertising in Costa Rica [PowerPoint]

Abstract A Power Point on the youth perceptions of tobacco advertising in the Monteverde region of Costa Rica. Abstract Spanish Un Power Point de las percepciones de la juventud de la publicidad del tabaco en la región de Monteverde de Costa Rica.https://digitalcommons.usf.edu/community_health/1049/thumbnail.jp

Percepciones de los jóvenes de Monteverde hacia los afiches a favor y en contra del tabaco en Costa Rica [PowerPoint]

Abstract A Power Point on the youth perceptions of tobacco advertising in the Monteverde region of Costa Rica. Abstract Spanish Un Power Point sobre las percepciones de la juventud sobre la publicidad del tabaco en la región de Monteverde, Costa Rica.https://digitalcommons.usf.edu/community_health/1050/thumbnail.jp

Perceptions of Monteverde youth (14-18 years of age) towards pro- and anti-tobacco advertising in Costa Rica

Abstract A study on the youth perceptions of tobacco advertising in the Monteverde region of Costa Rica. Although health risks associated with tobacco use are well documented in the world, tobacco companies continue to seek new smokers to increase sales. As a result, youth have been one of the main targets of tobacco advertising because smokers usually begin smoking in their teen years. This study focused on the youth perceptions of tobacco advertising in the Monteverde region of Costa Rica. Our hypothesis states that while pro-tobacco advertisements attract the attention of youth (between ages 14 and 18 years) to become smokers and/or to continue smoking, anti-tobacco advertisements do not adequately target this same youth audience. Our study used preliminary interviews with adults, focus groups with youth, and a survey to gather data. The focus groups were comprised of three to four participants from the Colegio de Santa Elena. The volunteers were also asked what they would like to see on pro- and anti-tobacco advertisements. Based on their responses, we found that there is a greater consensus of their perceptions with the pro advertising than the anti-tobacco advertising, and that youth feel that anti-tobacco advertising should be more abundant in the area as well as more appealing for youth. We believe that this study has implications for future youth anti-tobacco campaigns and interventions. Abstract Spanish Un estudio sobre la percepción de la publicidad del tabaco en la region de Monteverde, Costa Rica.https://digitalcommons.usf.edu/community_health/1045/thumbnail.jp