8 2GM Tuesday July 28 2020 | the times
News
Patients going to hospital for planned
treatment or operations will not need
to self-isolate for two weeks first.
The National Institute for Health
and Care Excellence (Nice) said yester-
day that most people could instead be
extra diligent with measures such as
social distancing for a fortnight before
admission, and self-isolate only
after taking a Covid-19 test a few days
before.
The new guidance, driven by lower
levels of the coronavirus in the commu-
nity and more availability of testing,
was welcomed by NHS leaders who
said it would help to tackle a backlog of
patients needing treatment.
Layla McCay, a director at the NHS
Confederation, said that health service
leaders had said anecdotally that some
of their patients had been put off going
in for planned treatments because of
the blanket rule that required everyone
to self-isolate at home for 14 days prior
to their elective care. These included
those whose personal circumstances,
such as employment, would not easily
allow it.
Ms McCay said that it made sense for
decisions to be made locally, rather
than having a generic national policy,
“taking into account the patient’s per-
sonal circumstances, staffing, estates,
co-operation with other health and
care organisations, and local variations
in infection rates, all while adhering to
testing, hand hygiene and social dis-
tancing requirements”.
Millions of planned procedures had
to be paused while the NHS turned its
attention to the pandemic and it is not
yet running back at full capacity.
The new guidance from Nice says
that patients should be advised that “to
reduce their risk of getting Covid-19,
they should minimise contact with
others and may need to self-isolate
before their planned care”.
People having planned care “involv-
ing any form of anaesthesia or sedation
should follow comprehensive social
distancing and hand hygiene measures
for 14 days before admission”, the insti-
tute said. “They should also be advised
to have a test for Sars-CoV-2 within
three days before admission and self-
isolate from the day of the test until the
day of admission.”
For all other planned procedures,
including tests designed to help diag-
nose health problems, “people should
be advised to follow comprehensive
social distancing and hand hygiene
measures for 14 days” beforehand.
Those in groups considered more
vulnerable to the virus should still be
told they “may want to self-isolate” for
14 days before a planned procedure,Show went on despite virus
spreading through opera cast
Charlie Parker
Hope, the skeleton of a blue whale that hangs in Hintze Hall in the Natural History
A pet cat has become the first animal in
Britain to test positive for coronavirus
after picking up the infection from its
owners.
The cat was taken to the vet with
shortness of breath and diagnosed with
feline herpesvirus, a common respira-
tory infection in cats. However, the
sample was also tested for Covid-19 as
part of a research programme at Glas-
gow University’s Centre for Virus
Research, which is screening hundreds
of cat samples for the virus.
The pet was confirmed as having the
coronavirus after tests at the Animal
and Plant Health Agency in Wey-
bridge, Surrey, last Wednesday. It has
since made a full recovery.
There have been reports of cats fall-
ing ill from infected households in
Hong Kong, Belgium, France, Ger-
many and the United States. Dogs have
also been infected with the virus, as well
as a tiger and a lion at New York zoo. All
are believed to have got it from humans,
although cases are rare.
While cats and other pets can act as
“fomites” — things that can carry
Cat caught infection from its owner
infection — Professor Christine Mid-
dlemiss, the chief veterinary officer,
said there was no evidence that pets di-
rectly transmitted the virus to humans.
Professor James Wood, head of vet-
erinary medicine at the University of
Cambridge, said the “grooming behav-
iour” of cats made them more likely to
catch infections from their owners
rather than the other way round
because the owner could pass an infec-
tion on to their fur which they lick and
inhale. Their relative size means they
exhale much less breath.
The British Veterinary Association
suggested that owners who had the
coronavirus or were self-isolating with
symptoms should “keep their cat
indoors, if possible” and practise good
hygiene around them.
Downing Street said the infected cat
suffered symptoms of “a respiratory
infection with a nasal discharge and
some shortness of breath”. The prime
minister’s spokesman added: “The test
was carried out by the Animal and
Plant Health Agency laboratory having
been referred by a private vet who the
owners had taken the cat to see.”
Dr William Weir, of the University ofGlasgow’s School of Veterinary Medi-
cine, said the discovery “will likely
reveal more about how this virus
spreads and causes disease”.
He added: “There has been no evi-
dence of transmission occurring
between cats or dogs in the field.”
Daniella Dos Santos, president of the
British Veterinary Association, said:
“While pet owners may be worried by
this news, we’d like to emphasise that
there continues to be no evidence that
infected pets can pass Covid-19 to their
owners. There have been a tiny number
of cases of Covid-19 in domestic
animals worldwide and in all cases, it
appears likely that the transmission
was from infected humans to animals.
“Our advice to pet owners who have
Covid-19 or are self-isolating with
symptoms remains to restrict contact
with their pets as a precautionary
measure and to practise good hygiene,
including regular hand washing. Own-
ers who are confirmed or suspected to
have Covid-19 should keep their cat in-
doors if possible, but only if the cat is
happy to be kept indoors. Some cats
cannot stay indoors due to stress-relat-
ed medical reasons.”Fariha Karim
A soprano who sang in the last show at
the Royal Opera House before lock-
down has revealed that she and most of
the cast caught coronavirus but
“powered through” on stage.
Amanda Forsythe, who specialises in
baroque music and the works of
Rossini, rehearsed and performed
despite showing symptoms after flying
to London from north Italy.
Forsythe, 44, arrived in Britain
in February to prepare for
her role in Fidelio, Beethoven’s
only opera. She was with her two
sons and her ex-husband,
Edwin Elwyn Jones, a con-
ductor who was working in
the city.
“It was bizarre,” she told
the music news website
Leonore Overture. “I had
all the symptoms, rightdown to loss of smell. I had just come
from northern Italy.”
“But even though it was Covent
Garden, I didn’t have a cover,” she said,
referring to understudies. “I was sick
the whole time but I just hung in there.
“Everyone was sick... One tenor and
a bass missed shows. The rest of us pow-
ered through.”
After the final performance before
lockdown Forsythe flew home to the
United States. One challenge has been
maintaining her voice. “I’ll just
warm up. It’s confusing — I’ve
never been in the situation where
I wasn’t learning something new.
The first few months, I was
baking all the time, and wallow-
ing. You can have a drink every
night when you’re not per-
forming. Now it’s time for me
to get back in shape.”
Jokingly, she added: “I
should be everybody’s
favourite soprano. I’ve got
the immunity. I should get
a special pass.”Amanda Forsythe did
not have an understudyNo need to isolate
for 14 days before
hospital treatment
Kat Lay Health Correspondent Nice added. In a statement, it said that
the new recommendations aimed “to
balance the risks associated with
Covid-19 with the potential harms that
can arise from delays in elective
treatment and diagnostic procedures”.
However, surgeons said the guidance
was a “missed opportunity” to give
robust advice on testing for both
patients and healthcare workers.
Professor Cliff Shearman, vice-presi-
dent of the Royal College of Surgeons of
England, said that surgery could only
be restarted safely “by having accurate
and timely testing for healthcare work-
ers and patients”.
He said: “Patients should ideally be
tested on the day of admission as well as
72 hours before surgery takes place to
take account of the level of false nega-
tives in the testing regime.
“Adding to that, all patients should be
tested upon discharge, not only when
they are discharged to other care set-
tings, but also into the community. Cur-
rently there is no mention in the
guidance on testing for healthcare
workers.
“Where possible, patients should be
treated in a Covid-light site where they
are less likely to come into contact with,
and contract, the virus. This means we
have to test staff regularly — preferably
up to twice a week — and they must
have adequate and appropriate person-
al protective equipment.”
Professor Stephen Powis, national
medical director of NHS England, said:
“Local teams have made significant
progress since May in bringing back
services in a way that is safe for patients
and staff.
“This updated guidance, which re-
flects the continued decline in infec-
tions and the increased availability of
testing, will help them now go further
and faster.”
News Coronavirus
The national picture
Daily new lab-confirmed UK cases
Daily new UK deaths
*Counting of cases has changed to remove duplication. Numbers
now include those tested in all settings. Source: Gov.UKCases Deaths
Total UK* 300,111 45,258,
18,
17,
5,41,
2,
1,
556England
Scotland
Wales
N IrelandJul 21
445
Jul 21
79
22
560
22
53
23
769
23
123
24
770
24
61
25
767
25
14
26
7
27
747
26
685
27