Credit UKHSA
#17,209
With the UK's NHS hospital system already swamped by high levels of flu, COVID-19 and scarlet fever - between China's near complete blackout of information on their COVID epidemic, and the upcoming Lunar New Year's Travel season (see Taiwan travel advisory) - the UK's Health Security Agency has decided to increase sequencing of COVID cases with recent travel history to China.
This comes on the heels of Friday's announcement of Precautionary and temporary measures introduced to improve COVID surveillance from China. :
- From 5 January, people flying from mainland China to England will be asked to take a pre-departure test. In addition, a sample of arrivals will be tested for COVID-19 to enhance existing measures to monitor for new variants
While it is important to note that we've no indication of any new, or unusual, variant emerging in China the lack of any official information is disconcerting.
Details of this new guidance follows:
Guidance
COVID-19: enhanced genome sequencing for hospitalised patients returning from China
Published 3 January 2023
The UK Health Security Agency (UKHSA) is continuing to closely monitor the prevalence and spread of new SARS-CoV-2 variants and is keeping available international data under review.
China is currently experiencing its largest and most serious coronavirus (COVID-19) wave since the start of the pandemic. While the number of publicly available genomes shared from China are much lower comparative to the UK, the available genomes from China and from other countries where testing has occurred suggests that the Omicron sub-lineages – including those known to exist in Europe – are circulating. While travel to the UK from China is currently low, it is likely to increase once quarantine requirements on return to China are removed on 8 January 2023.
However, if new sub-lineages or variants emerged that could evade the immune response of highly vaccinated individuals then they could pose a threat if they were successful enough to out compete other variants and spread internationally. There is an established process for identifying and classifying variants within the UK.
As a precautionary measure, we are therefore requesting your assistance in the coming weeks to identify any COVID-19 hospitalised cases who have arrived from China in the preceding 14 days for sequencing. This will allow us to undertake enhanced surveillance on the variants circulating in China.
The recommendations on who requires testing and infection prevention and control measures in healthcare settings and the community is unchanged.
Action for healthcare professionals
Clinicians involved in the assessment or management of COVID-19 patients are asked to:
- identify whether travel from China has taken place in the preceding 14 days for patients presenting with COVID-19 symptoms compatible with SARS-CoV-2
- collect a specimen for PCR testing if individuals have symptoms compatible with SARS-CoV-2
- include China travel details on SARS-CoV-2 PCR request forms and/or electronic requests
- alert your NHS laboratories when sending a PCR swab for SARS-CoV-2 from patients presenting to healthcare settings within 2 weeks of arrival from China, particularly if they are presenting with severe illness
Action for NHS labs
Labs are asked to:
Professor Sir Steve Powis – National Medical Director, NHS England
- ensure there are clear local arrangements, reflecting this update in guidance, for testing and sampling of suspected SARS-CoV-2 cases and identifying a relevant travel history
- identify swabs from patients presenting to healthcare settings within 2 weeks of arrival from China and send these swabs to UKHSA labs for expedited sequencing
- label with travel history to allow rapid sequencing in UKHSA labs
Dr Thomas Waite – Deputy Chief Medical Officer, Department of Health and Social Care
Professor Susan Hopkins – Chief Medical Advisor, UKHSA
