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Omicron surge leads to changes in testing in Wales

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AS OMICRON figures significantly rise throughout the country, Eluned Morgan MS, Minister for Health and Social Services, has made changes to the PCR testing system.

Those testing positive on a Lateral Flow Test (LFT) but have no symptoms will no longer be required to get a follow-up PCR test.

All four UK nations have agreed upon changes as part of a strategy to reduce the pressures on the PCR testing system and increase access to those experiencing symptoms.

Those who are asymptomatic and have a positive LFT will be required to start their isolation immediately.

Another change announced is un-vaccinated close contacts of positive cases will now be able to replace the PCR test with LFTs on day two and eight.

In a statement, Eluned Morgan said: “Wales Covid-19 testing capacity has increased significantly in NHS Wales laboratories and as part of a UK testing programme which is the biggest in Europe with almost 400 million PCR tests carried out since the start of the pandemic.

“As the omicron wave sweeps across the country demand for PCR testing has reached unprecedented levels across the UK. This has resulted in the UK Health Security Agency (UKHSA) constraining bookings at times to avoid exceeding the UK programme laboratory capacity and compromising turnaround times for results.

“Since Christmas Day, daily bookings at test sites across Wales have reached up to 28,000 – a record high.

“I have agreed some immediate changes to the PCR testing system that will help reduce pressure and help increase access for those who have symptoms and need to book a test.   

“The first change will mean that people who are unvaccinated contacts of positive cases and are self-isolating for 10 days should now take a lateral flow test on day two and day eight instead of a PCR test. This will help to increase PCR testing capacity.  This change will come into effect immediately.

“Secondly, together with the other UK nations, we have agreed that if a person showing no symptoms has a positive lateral flow test they will no longer be advised to have a follow-up PCR test to confirm the result, unless they are in a clinically vulnerable group, which may need early access to treatment or have been advised to do so as part of a research or surveillance programme.

“As the prevalence of coronavirus is above 1%, the risk of false positives from lateral flow devices decreases. This means there is less value in having a follow-up PCR test to confirm the result. At higher prevalence levels, data suggests that lateral flow tests and PCRs have a similar positive predictive value.

“This change will come into effect from 6 January and we estimate it will reduce the demand for PCR tests by between 5% and 15%.

“Without a follow up PCR tests it is even more important for people to report the result of every lateral flow test they do and self-isolate as soon as they test positive. Without reporting, contact tracing will not be possible, nor will advice and support be provided by the system.

“We need everyone to continue to play their part in disrupting the transmission of Covid-19 by reporting their lateral flow test results on the gov.uk website or by calling 119.

“Positive results from lateral flow tests already flow into the Wales contact tracing system to speed up the contact and support required to help all those who need to self-isolate.

“NHS and social care staff access testing from our NHS Wales laboratories. We may need to introduce further changes to protect PCR tests for key workers through the UK testing programme if demand continues to grow in the coming days and weeks.

“We may also need to introduce other temporary emergency interventions for non-vulnerable symptomatic individuals to manage demand and safeguard capacity to find the cases most likely to result in harm.

“We recognise these changes will potentially increase demand for lateral flow tests. There are no current issues with supplies but we are aware of issues with distribution for people to access tests at some collection points including pharmacies.  UKHSA manage the logistics and deliveries across the UK and we are working closely with them to improve the situation. More than 4 million tests were distributed to workplaces, people’s homes and collection points in Wales last week.”

Commenting, Welsh Conservative and Shadow Health Minister Russell George MS said: “This change is welcome on two fronts: firstly, it will preserve an increasingly precious supply of PCR tests and, secondly, preserves consistency across the United Kingdom.

“Of course, testing itself merely identifies carriers of the virus but won’t beat it. We can only do that through vaccinations and everyone who is eligible should be taking up their booster jab at the earliest opportunity.

“Soon, we will be able to live with the virus rather than just talk about returning to the freedom that is the birth-right of all Brits.”

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Omicron peak could come in ‘the next 10 to 14 days’ in Wales

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THE FIRST MINISTER Mark Drakeford has said he is ‘hopeful’ figures in Wales could start to reduce from around two weeks’ time.

The comments came during the live briefing held yesterday lunchtime in Cardiff, with the First Minister referring to modelling several times and comparing it to what has been recorded in firm figures.

The First Minister said of the above slide, “It shows you how the modelling that we’ve had done for us here in Wales shows how the Omicron wave wave is expected to behave. The blue line shows how cases are predicted to grow over the coming weeks. The black line shows the actual confirmed cases.

“As you can see, the actual cases are following very closely the predicted wave, and what the wave shows is the speed at which the Omicron wave will break over us and then how cases decline at a relatively rapid rate as well.

“Now we haven’t reached the peak of that wave yet, it could be within the next 10 to 14 days. But we will get to the top of the wave and then hopefully we will see the numbers reducing again here in Wales.

“The latest figures show that there are more than 2300 cases per 100,000 people across Wales. Cases are highest amongst 20- to 39-year-olds but we are also now seeing rises in older age groups. As community transmission increases rapidly, while the figures are clearly concerning, they are in line with what the modelling forecasts told us.”

“Every close contact is an opportunity for it to spread.”

Data was also released on the number of people to being admitted to hospital with coronavirus, “The latest figures show that there are now a total of 994, just under 1000, COVID-19 patients in our hospitals in Wales and that is a 43% increase on a single week and that number is the highest we have seen in Welsh hospitals since March of last year”.

“There are now around 40 people are so ill in hospital that they have to receive critical care and the majority of those people are people who have not been vaccinated. Very sadly since just the start of this year, public health Wales has reported 38 New deaths from coronavirus.”

When asked about reversing restrictions, and what timeframes could be involved, the First Minister said, “As people will have seen from the model that we showed earlier, the position over the next 10 days to two weeks is not going to be one that is easing.

“The numbers are likely to continue to rise. So it will not be until we have past the peak of infections and we are sure that we can see the pressures on the spread of this virus in the community are beginning to reduce, and will then take a while as it always does to feed through into reducing pressure on health services, hospital services, critical care services.

“So I don’t anticipate that over the next fortnight we will be in a position to move away from the level of restrictions we currently have in place. But, we will track it every day. We will review it every week. And when we see that corner being turned and we can see the number as we hope coming down reasonably rapidly. That will be the point at which we will be able to assess when it is safe to begin to lift the extra restrictions and protections we put in place so far.”

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Public Health Wales apology over lack of clarity on smear test changes

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PUBLIC HEALTH WALES has apologised and admitted it hasn’t “done enough” to explain the reasons for increasing the length of time between cervical screening tests.

The change, which was announced on Tuesday, means people aged between 25 and 50 with a cervix will now wait five years until another test, rather than three, providing no human papillomavirus (HPV) cells are detected.

HPV is a very common virus that most people will come into contact with at some time during their lives. One or more high-risk types of HPV are present in over 99.8% of cervical cancers.

HPV testing was successfully introduced in Wales in 2018 and almost nine out of 10 results show no high-risk HPV.

There are about 160 cases of cervical cancer diagnosed every year in Wales and it is the most common cancer in women under the age of 35.

But Public Health Wales has admitted it has failed to give clear information over the change, leading to concerns cancers could be missed.

In a tweet this weekend PHW said: “We are sorry. We haven’t done enough to explain the changes to cervical screening and have caused concern. We are working to make this clearer and more information will be available as soon as we can today and in the coming days.”

Cancer charities have sought to reassure women concerned by the change. Cancer Research UK has said people should be aware increasing the gap between screenings is “safe” and the new form of testing means people are invited for further based on their risk of developing cancer rather than their age.

An online petition, calling for the reintroduction of the three year gap between routine smear tests, has now attracted more than 680,000 signatures.

Alice Davies, Cancer Research UK’s health information manager, said people should be aware the decision to increase the time between screenings was made on scientific advice and due to a new way of testing samples which detects human papilloma virus (HPV) and means doctors are better able to identify those at risk of developing cervical cancer.Ms Davies said: “As the new test is more accurate at finding those at risk of cervical cancer, screening intervals can be safely extended from three to five years.

“If someone is HPV positive then their next screening interval will be shorter than five years. The new test allows women to be invited back for screening based on their risk of developing cervical cancer, rather than just their age.

“Overall this makes the programme more accurate, and means people don’t have extra rounds of screening that wouldn’t give them any benefit, while offering more screening to people at higher risk.”On Wednesday Public Health Wales said it accepted it has to do more to explain the reasons for the change.

Charity Jo’s Cervical Cancer Trust, described as the UK’s leading cervical cancer charity, has sought to reassure people concerned about the changes.

It has said the change has been introduced following advice from the UK National Screening Committee which recommended the five year gap between tests due to the use of HPV tests which are more sensitive and effective.

It said this means the advice is most women aged 25 to 49 can, as those aged 50 to 64 are, can be tested every five years rather than three.

The charity says the improved testing will likely mean more lives saved by identifying those at greater risk of cancer earlier.

According to Jo’s Cervical Cancer Trust women in Wales, and Scotland, are invited back based on the result of the screening.

If those show high-risk HPV and cell changes you will be invited to colposcopy.

If it identified high-risk HPV but no cell changes you will be invited for cervical screening in one year.

If there is no HPV you will be invited for cervical screening in five years.

Public Health Wales says HPV testing was introduced in Wales in 2018 and almost nine out of 10 results show no high-risk HPV.

Heather Lewis, consultant in public health for Cervical Screening Wales said: “The HPV test we now use in Wales is more effective at identifying people at higher risk of developing cell changes which can cause cervical cancer.

“The evidence shows that it is therefore safe to extend the time between cervical screening tests for people who do not have HPV identified.”

HPV is a very common virus that most people will come into contact with at some time during their lives. One or more high-risk types of HPV are present in over 99.8% of cervical cancers.

Increasing the time between smear tests will also reduce risks from screening.

Head of Programme for Cervical Screening Wales at Public Health Wales, Louise Dunk said: “Testing everyone who attends for cervical screening using a test for high risk HPV will identify those at risk and prevent more cancers than just examining the cells alone.

“It is a really positive development that this more effective test will mean that women and people with a cervix, who test negative for HPV, now only need to attend their testing every five years, rather than three.”

There are around 160 cases of cervical cancer diagnosed every year in Wales and it is the most common cancer in women under the age of 35.

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Most stupid and inappropriate calls to the Welsh Ambulance Service revealed

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THE WELSH AMBULANCE SERVICE has revealed the most inappropriate calls made to 999 in the past year.

Among them was someone who had eaten a mouldy tomato and someone who had got their plaster cast wet.

One person with an earring lodged inside their ear asked for a “lift” to the Emergency Department, while another dialled 999 for a papercut.

Of the 470,653 incidents recorded by the service in the last 12 months, nearly a quarter were non-essential, including someone with diarrhoea and someone enquiring about their medication.

In the face of unprecedented demand, the ambulance service is reminding people only to call 999 in a serious or life-threatening emergency.

Chief Executive Jason Killens said: “Our ambulance service exists to help people who are seriously ill or injured, or where there is an immediate threat to their life.

“That’s people who’ve stopped breathing, people with chest pain or breathing difficulties, loss of consciousness, choking, severe allergic reactions, catastrophic bleeding or someone who is having a stroke.

“People with something stuck in their ear still have a clinical need, but calling 999 for that is ill-judged when there are so many other ways to access more appropriate help.

“Non-essential calls represent nearly a quarter of our total 999 calls, and time spent dealing with these could be time spent helping someone in a life or death situation.”

As Covid-19 tightens is grip, the Trust is asking the public to think about the many alternatives to 999.

Director of Operations Lee Brooks said: “Winter is traditionally our busiest period, and we also have a global pandemic to contend with.

“It’s easy to make fun of the people who call 999 foolishly, but actually, these people do have a legitimate clinical need – they just don’t know where to turn for it.

“We’re asking the public to educate themselves on the NHS services available in their area, of which there are many.

“The symptom checkers on the NHS 111 Wales website are a good place to start for advice and information, or you could phone 111 to speak to a nurse or health information advisor.

“Also think about your local pharmacist, dentist and optician, as well as your minor injuries unit and GP.

“Also ensure you have a well-stocked medicine cabinet for things which can be treated at home, like coughs and colds, sore throats and grazed knees.

“Every single one of us has a responsibility to use NHS services wisely and protect them for those who need them most.

“Help us to help you, and think twice before you call 999.”

Examples

The following are real 999 calls made to the Welsh Ambulance Service in the past year –

Call 1

Caller: Basically, I had a piercing a few weeks ago in my ear. Everything’s been fine but last night I woke up and the piercing had gone. I can’t find the piercing and it feels like it might be in my ear drum.

Operator: Right, OK.

Caller: Normally I would go to A&E myself but I don’t actually have any money. A lift to A&E would be amazing.

Call 2

Caller: My neighbour came here and she gave me a sandwich, cheese and tomato. Anyway, I feel quite sick now. I looked at the tomatoes and there’s mildew on them.

Operator: OK, is that why you’re requiring an ambulance?

Call 3

Caller: I was mucking about with my plaster cast and it’s coming apart. I don’t know whether to get a taxi or an ambulance.

Operator: From the information you’ve given, you require a more detailed assessment by a nurse. An ambulance will not be sent at this time.

Caller: Oh, you’re joking. Are you being serious?

Operator: We’re extremely busy at the moment.

Caller: I’ll get a taxi.

Call 4

Caller: I cut my arm, my arm’s cut.

Operator: How did you do that?

Caller: I sliced it on a piece of paper.

Operator: When did this happen?

Caller: About half an hour ago.

Operator: Is there any serious bleeding?

Caller: No.

Call 5

Operator: Tell me exactly what’s happened.

Caller: Basically, my mum drank apple vinegar but mixed it with water and lemon. Now she has diarrhoea.

Call 6

Caller: Oh, hi there. Basically, I’ve got my hand in a cast. It’s been in there for three weeks and I’ve got it wet.

Operator: OK.

Caller: It’s not an actual emergency, I just need to get to hospital.

Call 7

Caller: What it is, right, I’ve got different medication and I don’t know whether I can take these or not now.

Operator: What’s your telephone number?

Caller: I don’t want an ambulance, I just don’t know if I can take my meds or not.

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