MODELLING THE IMPACT OF COVID-19 AND ROUTINE MENACWY VACCINATION ON MENINGOCOCCAL CARRIAGE AND DISEASE IN THE UK

Intro Enforced country-wide social distancing and suspension of most non- emergency medical care due to the COVID-19 pandemic will undoubtedly affect public health in multiple ways. While non-pharmaceutical interventions are expected to reduce transmission of several infectious diseases, severe disruptions to healthcare systems have hampered diagnosis, treatment, and routine vaccination. We examine the pre-pandemic community carriage prevalence together with the effect of this disruption on meningococcal disease and vaccination in the UK. Methods By adapting an existing mathematical model for meningococcal carriage and disease, we address the following questions:a) What is the predicted impact of the adolescent MenACWY vaccination on meningococcal transmission pre-pandemic? b) What is the predicted impact of social distancing on current infection rates? c) What effect might reductions in vaccine uptake have on future infection rates? d) Will catch-up vaccination campaigns be necessary for the MenACWY vaccine? Findings Model findings indicate that the MenACWY vaccine programme was already generating indirect protection and supressing transmission. Even without pandemic modelling assumptions, we observe that carriage prevalence could approach near-elimination in around 30 years due to the new lower community carriage prevalence observed by UKMenCar4 and effects of the 2015 MenACWY catch-up campaign. Moreover, COVID-19 social distancing is expected to have accelerated the decline, causing significant long-lasting reductions in the carriage prevalence of meningococcal strains A, C, W, and Y leading to near- elimination in under 20 years. Conclusion In all scenarios modelled, pandemic social mixing effects outweighed potential reductions in vaccine uptake (of up to 50%) causing an overall decline in carriage prevalence.

Mortality in patients requiring home mechanical ventilation during the COVID-19 pandemic: experiences of a regional specialist ventilation unit

P101 Figure 1(A) Monthly mortality of patients under Lane Fox Respiratory Service follow-up, dotted lines represent upper and lower bounds of 95% confidence intervals (B) Proportion of home mechanical ventilation (HMV) users in each disease category who died between 1st March and 30th ApriI by year[Figure omitted. See PDF]ConclusionsDeaths amongst HMV users at our regional ventilation centre were highest in the first two months following the onset of the COVID-19 pandemic. A subsequent fall in mortality may relate to effective shielding advice following national lockdown and departmental guidance offered. The majority of deaths were in patients with obesity-related respiratory failure. These data support previous observations that obesity is a major risk factor for adverse outcomes in patients with COVID-19.