The course of the UK COVID 19 pandemic; no measurable impact of new variants.

IntroductionIn November 2020, a new SARS-COV-2 variant or the Kent variant emerged in the UK, and became the dominant UK SARS-COV-2 variant, demonstrating faster transmission than the original variant, which rapidly died out. However, it is unknown if this altered the overall course of the pandemic as genomic analysis was not common place at the outset and other factors such as the climate could alter the viral transmission rate over time. We aimed to test the hypothesis that the overall observed viral transmission was not altered by the emergence of the new variant, by testing a model generated earlier in the pandemic based on lockdown stringency, temperature and humidity. MethodsFrom 1/1/20 to 4/2/21, the daily incidence of SARS-COV-2 deaths and the overall stringency of National Lockdown policy on each day was extracted from the Oxford University Government response tracker. The daily average temperature and humidity for London was extracted from Wunderground.com. The viral reproductive rate was calculated on a daily basis from the daily mortality data for each day. The correlation between log10 of viral reproductive rate and lockdown stringency and weather parameters were compared by Pearson correlation to determine the time lag associated with the greatest correlation. A multivariate model for the log10 of viral reproductive rate was constructed using lockdown stringency, temperature and humidity for the period 1/1/20 to 30/9/20. This model was extrapolated forward from 1/10/20 to 4/2/21 and the predicted viral reproductive rate, daily mortality and cumulative mortality were compared with official data. ResultsOn multivariate linear regression, the optimal model had and R2 0f 0.833 for prediction of log10 viral reproductive rate 13 days later in the model construction period, with (coefficient, probability) lockdown stringency (-0.0109, p=0.0000), humidity (0.0038, p=0.0041) and temperature (-0.0035, p=0.0008). When extrapolated to the validation period (1/10/20 to 4/2/21), the model was highly correlated with daily (Pearson coefficient 0.88, p=0.0000) and cumulated SARS-COV-2 mortality (Pearson coefficient 0.99, p=0.0000). ConclusionThe course of the SARS-COV-2 pandemic in the UK seems highly predicted by an earlier model based on the lockdown stringency, humidity and temperature and unaltered by the emergence of a newer viral genotype.

The smartphone: an evolution or revolution in virtual patient healthcare during and beyond the COVID-19 pandemic ? An evaluation and comparison of the smartphone against other currently available wearable technologies in a secondary care setting during the COVID-19 pandemic.

Smartphones are now commonly used, for virtual outpatient consultations, to help reduce disease transmission during the COVID-19 pandemic. Nosocomial spread of COVID 19 and hospital acquired infections are usually from staff or students to patients. Reducing non- essential staff numbers on ward rounds may reduce the risk. We describe the novel use of smartphones, with Microsoft Teams, to live stream inpatient interactions, radiological images, pathology results, charts and patient review between an office-based and ward team (virtual ward round) and for teaching medical students in secondary care. After Research and Ethics, Digital services and Information Governance approval we compared a smartphone and head-worn device (Realwear HMT-1). Data collection was by participant questionnaire. Statistical analysis was performed using the Mann - Whitney test. There was no statistically significant difference in audio and video feed quality between the smart phone (p value = 0.3) and Realwear device (p value = 0.41). However the smartphone was preferred during ward rounds and was 85% cheaper than the Realwear device. Urology medical staff numbers on the ward were reduced by 50%. Ward round efficiency improved as administrative tasks could be performed by the office team during the virtual ward round. Virtual ward rounds using smartphones can facilitate remote communication between staff, students and patients. Staff in isolation or shielding can also assist front line colleagues from home. Smarter use of the smart phone may help reduce staff numbers on wards and reduce the number COVID-19 and nosocomial infections, potentially reducing morbidity and mortality locally and globally.

Parameatal Cyst : A report of Two Cases and Review of Literature

Cyst formation in the parameatal area is a relatively rare entity and not many cases have been reported in the literature. Two such cases are reported here. First patient was a 46 year old sexually active male who developed a spherical, cystic swelling of 1 cm in size on right lip of external urethral meatus. The second case was a 4 year old boy who presented with asymptomatic recurrent left parameatal swelling. In both the cases, cysts were completely excised and defects were sutured. Histologically, the cyst walls were lined by tall squamous and columnar epithelium. Good cosmetic results were obtained in these two cases without any recurrence at 2 two months follow up.