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#Coronavirus - Mind the gap: London tube crush pits minister against mayor

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Britain’s health minister and London’s mayor were at odds on Tuesday (24 March) over whether the city’s transport system could run more services as commuters travelled on packed tube carriages despite warnings to keep apart to control the spread of coronavirus, write William James and Andy Bruce. 

London has seen the most cases of coronavirus of any region in Britain and passengers are being forced to crush against other on services after the city’s local government reduced the number of trains.

Health Minister Matt Hancock said there was no reason why the transport system should be operating fewer services.

“We should have more tube trains running,” he said at a news conference. “There is no good reason in the information I have seen that the current levels of tube provision should be as low as they are.”

Transport for London, which runs the tube network, has advised people not to travel unless their journey is essential and has cut services as workers are told to stay at home. But thousands of healthcare employees and others still rely on the underground system to get to work.

London mayor Sadiq Khan said it was almost impossible to add more tube services because many drivers and staff were on sick leave or being forced to self-isolate.

“We cannot run more services than we currently are,” he said.

Earlier, Khan said the police might carry out spot checks on passengers using the tube amid warnings that tens of thousands of people are ignoring warnings to avoid public transport.

Khan said the police could be used to check individual passengers and ensure they qualify as key workers with a legitimate reason to use the transport network.

coronavirus

EAPM – German Presidency conference a big date, Commission pushes for healthy planet

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Welcome, one and all, to the first European Alliance for Personalised Medicine (EAPM) update of the week, and there is much to look forward to and much to discuss, writes EAPM Executive Director Denis Horgan.

German EU Presidency Conference

EAPM is looking forward very much to its participation in the upcoming German EU Presidency conference on 12 October. Given the present circumstances with COVID-19, the conference will naturally be virtual, but it will be featuring keynote speakers from the world of health and elsewhere – EAPM’s role in the conference has always proved popular in previous years, agenda here, register here.

EAPM on Biomarker Testing

EAPM’s publication, which was launched during ESMO, Bringing Greater Accuracy to Europe’s Health Care Systems: The Unexploited Potential of Biomarker Testing in Oncology, is already winning plaudits, and it can be read here. The report of our series of round tables at ESMO will also be available later this week. 

Concerns raised over accuracy of UK’s 'Operation Moonshot' tests

The scary thing about the UK’s much-publicized problems with Covid-19 testing is not that the system is encountering difficulties — those were inevitable. It’s that the government failed to anticipate them, it has not been transparent about what went wrong or convincing on the question of when the problems will be resolved. Boris Johnson and Health Secretary Matt Hancock have been getting an earful from lawmakers from all parties as stories mounted of a meltdown in the country’s testing system. Many people with COVID-19 symptoms have been instructed to travel hundreds of miles for tests, and those were the lucky ones. 

Hancock has told Parliament on that it would take “weeks” to fix the current problems. Johnson has said only that capacity would be up to 500,000 tests per day by the end of October, compared with capacity of about 375,000 currently. In the meantime, the government will be working out its “prioritization” system for existing testing. 

It is ironic that Johnson has spoken of Operation Moonshot — a bold stretch goal to test 10 million people a day by early 2021 — while now the government is focused on rationing a small fraction of that number of tests. The number of new coronavirus cases seems to be doubling roughly every seven days. Hospital admissions are rising, even if fatalities are still low. In an effort to slow the spread, the government has restricted private gatherings to just six people. Schools in England are already seeing a higher absence rate compared to the same time last year as the merest sniffle or cough sets in motion a chain of reactions that has in some cases resulted in entire year groups being sent home, consequently driving up demand for testing. 

Commission: Healthy planet, healthy people 

Air and noise pollution, the impacts of climate change such as heatwaves, and exposure to dangerous chemicals cause ill health in Europe. Poor quality environments contribute to 13 % (one in every eight) of deaths according to a major assessment on health and environment released today by the European Environment Agency (EEA). Improving the health and well-being of European citizens is more important than ever, with attention currently focused on addressing the COVID-19 pandemic. 

The pandemic provides a stark example of the complex links between the environment, our social systems, and our health. A significant proportion of the burden of disease in Europe continues to be attributed to environmental pollution resulting from human activity, according to the EEA report ‘Healthy environment, healthy lives: how the environment influences health and well-being in Europe.' 

The report, which draws extensively on World Health Organization data on the causes of death and disease, highlights how the quality of Europe's environment plays a key role in determining our health and well-being. It shows how social deprivation, unhealthy behaviours and shifting demographics in Europe influence environmental health, with the most vulnerable hardest hit.

“There is a clear link between the state of the environment and the health of our population. Everyone must understand that by taking care of our planet we are not only saving ecosystems, but also lives, especially the ones who are the most vulnerable. The European Union is devoted to this approach and with the new Biodiversity Strategy, the Circular Economy Action Plan and other forthcoming initiatives we are on the path to build a more resilient and healthier Europe for European citizens and beyond,” said Environment, Oceans and Fisheries Commissioner Virginijus Sinkevičius.

Parliament says common standards essential 

The European Parliament has passed a resolution calling for common definitions for coronavirus cases across member countries. Differences in methodologies in the bloc have made cross-country comparisons more difficult, creating difficulties in interpreting data on the pandemic. The lack of common standards has also meant difficulties in imposing travel policies that depend on data. 

Securing COVID-19 vaccines for EU citizens

The health and industry committees in the European Parliament have hosted a joint meeting about “how to secure access to COVID-19 vaccines for EU citizens: clinical trials, production and distribution challenges”. Clinics are being set up where patients with coronavirus or flu symptoms can go. The idea is that they don’t potentially infect other patients when visiting their doctor, according to the Data Protection Authority. Rapid coronavirus tests and testing in vulnerable nursing homes are also a central part of Germany’s plan for the autumn and winter.

How the EU’s COVAX financing works 

Following the Commission’s announcement on Friday (18 September) about its financing offer for the global COVAX Facility, co-led by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, the facility now aims to accelerate the development and manufacture of COVID-19 vaccines and to guarantee fair and equitable access for every country in the world. 

As part of a EU joint engagement (Commission, member states and European financial institutions, notably EIB) to mobilize resources for the Coronavirus Global Response, the Commission intends to mobilize up to €400 million in guarantees to support COVAX and its underlying objectives as part of a Team Europe effort. The detailed terms and conditions for the EU's participation and contribution will be worked out in the coming days and weeks.

Team Europe is ready to put its expertise and resources at work within COVAX to accelerate and scale-up development and manufacturing of a global supply of vaccines for citizens across the world, in poor and rich countries. The EU's participation in COVAX will be complementary to the ongoing EU negotiations with vaccine companies that aim at scaling up manufacturing capacity of vaccine producers, contributing to global efforts.

The European Commission is committed to ensuring that everyone who needs a vaccine gets it, anywhere in the world and not only at home. No one will be safe until everyone is safe. This is why it immediately responded to the WHO's call for action and has raised almost €16 billion since 4 May under the Coronavirus Global Response, the global action for universal access to tests, treatments and vaccines against coronavirus and for the global recovery, and the Commission also published new testing guidelines joining a similar set of indications put out by the ECDC on Friday. 

French regulator approves saliva tests in certain cases

France’s health technology assessment body has said that it’s acceptable to use saliva-based coronavirus tests in the place of nasal swabs in certain cases. These tests are less sensitive than nasal swabs and should not be used for asymptomatic individuals, the Haute Autorité de Santé said. However, saliva tests should be considered for individuals for whom nasopharyngeal swabs are not ideal, such as for children, the elderly, and those who have any psychiatric disorders.

And that is everything for the start of the week – don’t forget to register for EAPM at the German EU Presidency conference on 12 October, agenda here, register hereEnjoy your week and stay safe.

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Austria

Commission approves modified Austrian liquidity assistance scheme to support companies affected by the coronavirus outbreak

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The European Commission has found certain amendments to a previously approved Austrian liquidity assistance scheme to support Austrian enterprises affected by the coronavirus outbreak to be in line with the State Aid Temporary Framework. The original scheme was approved on 8 April 2020 under case number SA.56840, and provides for temporary limited amounts of aid in the form of (i) direct grants, (ii) guarantees on loans and repayable advances, and (iii) guarantees on loans and subsidized interest rates on loans.

The aim of the original scheme was to enable enterprises affected by the coronavirus outbreak to cover their short-term liabilities, despite the current loss of revenues caused by the pandemic. Austria notified certain modifications to the original scheme, in particular: (i)micro or small enterprises can now benefit from the measure even if they were considered in difficulty on 31 December 2019, under certain conditions; and (ii)an increase of €4 billion in the total budget of the scheme, from €15bn to €19bn.

The Commission concluded that the scheme, as modified, remains necessary, appropriate and proportionate to remedy a serious disturbance in the economy of a member state, in line with Article 107(3)(b) TFEU and the conditions set out in the Temporary Framework. On this basis, the Commission approved the measure under EU state aid rules.

More information on the Temporary Framework and other actions taken by the Commission to address the economic impact of the coronavirus pandemic can be found here. The non-confidential version of the decision will be made available under the case number SA.58640 in the state aid register on the Commission's competition website once any confidentiality issues have been resolved.

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Conservative Party

Johnson to levy £10,000 fine on COVID-19 rule-breakers

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People in England who break new rules requiring them to self-isolate if they have been in contact with someone infected with COVID-19 will face a fine of up to £10,000 ($12,914), Prime Minister Boris Johnson said on Saturday (19 September), writes David Milliken.

The rules will apply from 28 September to anyone in England who tests positive for the virus or is notified by public health workers that they have been in contact with someone infectious.

“People who choose to ignore the rules will face significant fines,” Johnson said in a statement.

Fines will start at 1,000 pounds for a first offence, rising to 10,000 pounds for repeat offenders or cases where employers threaten to sack staff who self-isolate rather than go to work.

Some low-income workers who suffer a loss of earnings will receive a £500 support payment, on top of other benefits such as sick pay to which they may be entitled.

Current British government guidance tells people to stay at home for at least 10 days after they start to suffer COVID-19 symptoms, and for other people in their household not to leave the house for 14 days.

Anyone who tests positive is also asked to provide details of people outside their household who they have been in close contact with, who may then also be told to self-isolate.

To date there has been little enforcement of self-isolation rules, except in some cases where people have returned from abroad.

However, Britain is now facing a rapid increase in cases, and the government said police would be involved in checking compliance in areas with the highest infection rates.

Johnson has also faced calls to reintroduce more wide-ranging lockdown rules for the general public.

However, the Sunday Times reported he was poised to reject calls from scientific advisors for an immediate two-week nationwide lockdown to slow the spread of the disease, and instead reconsider it when schools take a late-October break.

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