NHS

Health chiefs today announced 115 more coronavirus deaths across the UK, as beaches and parks were swamped with thousands of Brits taking advantage of the scorching weather on the first day of lockdown being eased.

Department of Health bosses have yet to release the official Covid-19 tally, which is often higher. The preliminary toll is calculated by adding up all of the individual updates provided by each of the home nations.  

NHS England recorded 108 more patients had died in hospitals. Wales posted five new deaths across all settings, while Scotland and Northern Ireland registered one each – taking the official number of victims to 38,604. 

The UK yesterday announced 113 more Covid-19 deaths, the lowest since lockdown began on March 23 – when 74 deaths were registered.

But officials warn that death numbers released on Sundays and Mondays are usually significantly smaller due to a delay in processing fatalities over the weekend.

In other developments to Britain’s coronavirus crisis today: 

• Some of the 2million pupils returning to primary school were turned away because headteachers ‘weren’t ready’ for them;
• Britons were allowed to meet their friends for socially distant fun and games for the first time since March 23, with the easing of lockdown rules; 
• Number 10 admitted the coronavirus alert level has still not been lowered, despite lockdown rules being eased in England;
• IKEA shoppers at one store formed a giant three hour queue as the DIY furniture giant reopened 19 furniture sites across England;
• NHS Covid-19 contact tracers said the system is ‘obviously not ready’ and admitted they have nothing to do all day – despite being paid up to £27-an-hour;
• The Government’s plan to allow more than 2million vulnerable people outside lacks any scientific rationale and amounts to a PR stunt, an expert warned.

It comes as up to two million pupils were due to return to primary school today. But it was revealed this morning that some were turned away because headteachers ‘weren’t ready’ for them. 

Up to 1,500 primary schools in England are estimated to be defying the Government’s controversial plan to get all reception, year 1 and year 6 children back in the classroom from June 1.

Teachers have admitted they were ‘anxious’ to work and unions demanded the date be pushed back to June 15 at the earliest, amid fears the virus is still spreading at high levels.

Parents have revealed many schools will remain closed for at least another week or more, while some have not yet set a date at all.

At least two dozen councils have refused to reopen their schools or left it up to headteachers, who are trying to find ways to ensure social distancing and have enough teachers to teach ‘bubbles’ of up to ten children. 

MailOnline revealed there was confusion at several schools across London, with some parents arriving with their children only to be informed they couldn’t come in and had to go home again.  

In other developments, ministers are desperately trying to quell a backlash over easing lockdown today despite the coronavirus alert level not having been reduced.

With beaches and parks again swamped as people take advantage of scorching weather, Business Secretary Alok Sharma was forced to deny there is a ‘dash’ to get the country back up and running.

He insisted the new contact tracing system means measures can be tightened again in specific areas if there is a flare up.  

But Downing Street was forced to admit the alert level has still not been reduced from level four to three, even though the guidance suggested easing of lockdown is not possible until it was reduced.

Tories and top scientists have voiced alarm about the consequences of the tweaks in England – which include six people from different households being able to meet up in public places or gardens.

There are concerns it will be impossible to put the ‘genie back in the bottle’ if cases increase, with one MP telling MailOnline the government had gone from ‘baby steps to giant steps’ with nothing in between. 

The Government has frantically urged Britons to act ‘sensibly’ as they enjoy a host of new freedoms, following crowded scenes across the country yesterday before the overhaul officially came into force.   

It came as Ikea stores across Britain today were seeing giant queues form outside, with customers forming three-hour queues as lockdown restrictions were eased.

The car park at Ikea in Wembley, north London, which was until recently a coronavirus test centre, was full of cars this morning as the store opened for business for the first time since the lockdown was imposed.

Aerial photos show hundreds of customers queuing around the block in the stifling heat to get into the shops in Nottingham, Reading and Essex, as the Government urged the country to act ‘sensibly’ amid restrictions being eased.

Massive lines of people could also be seen snaking around the car parks at the Swedish furniture giant’s branches in Wednesbury, West Midlands.

Some eager shoppers had been queuing from as early as 5.30am – over four hours before the store was due to open at 10am today.

Huge traffic jams were also reported in and around the areas as people flocked to their local branch following Boris Johnson’s further easing of lockdown restrictions. 

Contact tracers have warned the NHS system designed to curb the spread of Covid-19 in Britain is ‘obviously not ready’ – and revealed they are being paid up to £27-an-hour to do nothing. 

Health officials warned ‘key bits’ of the programme for England were not yet up-and-running when it went live on Thursday, four days ahead of the billed start date of June 1.

Scores of the 25,000 employees hired by the Government have come forward to say they have had no positive cases allocated to them since the launch, with one even suggesting there was a fault with the system. 

Contact tracers say the system remains ‘shambolic’ and unfit for purpose as millions of pupils return to school today. Workers last week also complained they hadn’t had any training by the time it launched and had waited weeks for log-in details. 

The tracing programme aims to halt the virus and control local flare-ups by asking anyone who has been in contact with a Covid-19 positive case to self-isolate for 14 days.

But there are concerns Britons will refuse to give friends or relatives details, and one call handler revealed two of the three potentially infected contacts she rang went straight to voicemail. 

The goal is to rapidly test anyone who logs Covid-19 symptoms – but antigen testing figures have barely budged in the past few days, and many Brits have to wait days to get their swab results. Around 8,000 Brits have been diagnosed with the disease since the system was launched.

The head of the NHS Test and Trace has said test timings need to improve, and top experts say the system will only work if cases are turned around quickly – otherwise the virus will continue to spread.

The Government has failed to reveal exactly how many people have been tested for eight days now, and has yet to provide information for how many people have been traced so far.   

The government insisted yesterday that the system was running efficiently and had the capacity to handle 10,000 new cases per day. For comparison, statistics suggest fewer than 8,000 Brits are being struck down each day.

Boris Johnson said the programme would be ‘world beating’ but evidence suggests the contact-tracing army has been left ill-prepared and, in many cases, workers have nothing to do – at a cost to the taxpayer of £1.6million per day.  

On a public Facebook group for clinical contact tracers, several reported spending most of their shifts waiting to be assigned cases through the system, called CTAS.

It is supposed to show the patients assigned to a tracer along with unassigned cases that can be picked up. 

One tracer said he had not had any cases on Saturday, while another said two of three calls she made went straight to voicemail, The Times reports. 

One of the 3,000 clinical case workers hired by Public Health England said she had completed three four-hour shifts, at £27-an-hour, but hadn’t made any calls yet. She told The Times: ‘I have had absolutely nothing to do.’ 

The nurse said she had seen ‘zero cases’ on the system throughout three shifts and felt ‘tremendously guilty about doing the shifts and being paid and not having anything to do really’.

‘It’s very obviously not ready,’ she said. ‘Something is not working between CTAS and the test results that are coming in.’

Another contact tracer said he was still waiting for login details to access training, and said the system had been ‘chaotic’.

His job as a ‘tier three’ call handler should be to ring the contacts of positive cases and tell them to self-isolate and curb the potential spread of Covid-19.

Details of those who test positive are passed to a company called Sitel, which is running the track and trace handling across the UK.

Agents read from a prepared script when they are given the name and telephone number of a person who has been diagnosed with Covid-19. 

They ask for the details of friends and family the infected person has come into contact with during the previous two weeks. 

The tracing agent then makes contact with those on their list and informs them they have to self-isolate.

One tracer said colleagues who were on shift were ‘sitting there all day waiting and just refreshing their screens’. He said: ‘They’ve got nothing to do.’

The public have not been given much confidence so far that they will not be phoned by a scammer and told to self-isolate.

When asked how members of the public can be sure a phone call is genuine, Dr Jenny Harries, the Deputy Chief Medical Officer for England, said it was ‘highly unlikely with all the confidentiality around the data systems that you will be contacted inappropriately by anyone’. 

Speaking at yesterday’s Downing Street briefing, she said: ‘I think it will be very obvious in the conversation you have with them that they are genuine in that regard. 

‘I think it will be very evident when somebody rings you these are professionally trained individuals and sitting over them are a group of senior clinical professionals.’  

It followed a warning from a health official that at least 10 per cent of Britons will ignore requests to self-isolate when contacted by NHS Covid-19 tracers, due to lockdown fatigue or having to keep working. 

Professor Isabel Oliver, who helped design the Government’s tracing app, told the Sunday Telegraph that though most people are willing to comply, a minority will disobey instructions.   

The government has so far refused to say exactly how many Brits have been contact traced.

Matt Hancock claimed the 200,000-a-day coronavirus testing target had been met yesterday – but the number of people who have actually been tested has not come close to that figure.

The Department of Health said only 115,725 tests had been carried out yesterday. But it has not been giving out the number for how many individuals were actually tested for eight days now. Some tests are carried out twice. 

The Health Secretary said the UK had the ‘capacity’ for 205,634 tests daily as of yesterday, describing it as ‘one of the greatest national mobilisations we have seen’. 

But the level was also only reached by including ‘capacity’ to conduct 40,000 antibody tests – which tell if someone has previously had the infection, and not if they have it currently. 

Scientists have repeatedly said the contact tracing system will only work if testing is rapid because the aim is to find and isolate contacts of a positive case before they become infectious and spread the virus to others. 

Head of NHS Test and Trace Baroness Dido Harding has said test timings have ‘got to get better and better’.

The launch in England on Thursday came as a shock to some workers who hadn’t been told what to do. Many contact tracers had no idea the system was launching that day. Others hadn’t completed basic training. 

‘People are panicking as there is no information on the websites/systems to make the calls,’ wrote one test and trace caller at 9.39am, on the day test and trace went live, in an internal chat seen by the Daily Mail. 

Others reported being sent their link for training at 8pm the night before the launch, while a manager said the instructions for what to do would ‘cascade’ down from the top on the day of the launch while admitting the process had been ‘frustrating’.

Some 10,000 call handlers were employed by Serco, one of which approached the Mail last week concerned that the system was catastrophically under-prepared. 

‘There’s absolutely no chance it’s ready,’ the 38-year-old whistle-blower from Manchester said. 

‘If it does happen [this week]… there will be catastrophic and continued failings from that day onwards. This is serious – it’s a pandemic, and lives are at risk. I’m genuinely worried about how we are about to be set loose on the public.’

On Thursday an ex-shop worker now paid £10-an-hour as an NHS coronavirus ‘track and tracer’ claimed she had nothing to do.

The call handler, who asked not to be named, told MailOnline she had been paid to sit and do nothing, and warned there was ‘nothing we can do’ about infected Brits who refuse to hand over the names and telephone numbers of people they came into close contact with.  

She said: ‘Everything is voluntary and if they refuse to give us the names and telephone numbers there is nothing we can do,’ said the track and trace agent.

‘We work from a script and try to persuade the person to be co-operative but if they hang up we just move on to the next person. It seems a major flaw, but there is nothing we can really do about it.’ 

One contact tracer told LBC radio on Friday it had been a ‘complete shambles’ so far, and they had not received their logon details for the site.

And before 11am, medical phone handlers reported that the system had crashed, and were greeted with the message that ‘this has been reported as a critical incident’. 

A Department of Health spokesman denied that the whole system had crashed.

‘Anyone in the country can log on and book a test if they have symptoms and we have tracers logged on to do their vital work to help stop the spread of coronavirus and save lives,’ the spokesman said.

‘As with all large scale operations of this kind, some staff did initially encounter issues logging on to their systems and these are rapidly being resolved.’

There are concerns about the fact the local aspect of the tracing system will not be ready until at least the end of June – as told to MPs by Baroness Dido Harding.

One of the contact tracers said she had not been told how to escalate cases, something she is required to do when there is a larger public health concern, such as if a Covid-19 patient has visited a care home or school.

It comes as reception, Year 1 and Year 6 pupils in England return to schools amid anxiety that the move has come too early. 

Several scientists have criticised major changes in the lockdown today, suggesting it is too early to lift restrictions and could cause infections to rapidly rise again. 

So what do you need to know about the NHS Test and Trace system for England? And how will it affect you and your loved ones?

Where do I get a coronavirus test? 

Anyone with coronavirus symptoms – a fever, cough or loss of smell and taste – can now apply to get tested for the infection through the NHS.

Officials offer Brits with tell-tale symptoms the chance to either test themselves at home, or to get swabbed at a drive-through centre. 

The test involves taking a swab of the inside of your nose and the back of your throat, using a long cotton bud.

Anyone going to get tested must drive themselves, or be taken to their local site by someone they live with to prevent unnecessarily spreading the virus.

The NHS says you can take up to three other people you live with to be tested at the same time.  

Home-tests – which involve you taking the swab yourself – are sent through the post and should arrive within 24 hours.  

Officials admit the test is best taken within five days of symptoms starting, and say that you may not get a test if you apply because of supply issues.

Essential workers, such as NHS or social care staff, apply to be tested on a different government-run website.  

How long will it be before I know if I have the coronavirus?

The aim of the scheme is to get all test results processed and returned within 24 hours but it is unlikely to hit that goal right at the start of the rollout. 

That means some people could face lengthy waits to find out if they have tested positive, potentially delaying the tracing process and allowing the virus to spread. 

Baroness Harding said of the test timings so far: ‘Yesterday, the turnaround time of our tests – we returned 84 per cent of all tests in our drive-in centres within 24 hours.

‘And 95 per cent of all tests within 48 hours. I still don’t think that’s good enough. It’s got to get better and better.’ 

Can employers ask for proof someone has been quarantined?

For the first seven days, employees do not need to offer their bosses any proof that they are sick or self-isolating.

But workers who have placed themselves in quarantine need to follow their firm’s usual sickness reporting policy, lawyers say.

Employers can seek evidence that a member of staff has been quarantined after a week off work, the government says.

Officials launched an NHS scheme that allows Brits to get an isolation note, in case they are asked for proof of absence from their employer.

Am I entitled to sick pay while I am self-isolating?

Many Brits who have no symptoms and can work from home will be expected to do so, if they are told to self-isolate.

But statutory sick pay (SSP) is available for people who are unable to carry out their job while they are self-isolating – either because they are sick or their job cannot be done at home.

The SSP – £95.85 a week – is available from the first day you are off and can be paid for up to 28 weeks. Before coronavirus, SSP was only a legal requirement on the fourth day of absence.

Many companies pay employees more than the SSP and have their own policies for how long this can be claimed for.

Workers on zero-hour contracts must prove they earn at least £120 per week before they can claim SSP. Those who earn under that threshold can access Universal Credit.

Brits who are self-employed cannot claim SSP but can apply for an Employment and Support Allowance (ESA) if they are ill.

Who is a ‘close contact’?

A close contact is anyone who has been within two metres (6ft 6in) of the infected person for more than 15 minutes without protective equipment.

The government hopes the requirements of the system will focus the minds of the public on the importance of maintaining social distancing.

When the coronavirus app is up and running, the victim’s mobile phone should automatically identify anyone they have come close to.

Until that happens, patients will identify likely contacts via an online process.

What about Scotland, Wales and Northern Ireland?

Scotland has announced its own system will start today.

Wales’ system is set to start in early June, while Northern Ireland has its own version of the NHS Test and Trace system up and running.

Can I choose where to isolate if I have a small child?

The government is encouraging people not to follow the example of Boris Johnson’s aide Dominic Cummings, who travelled to Durham during lockdown.

Officials want people to stay at home, while councils will offer support to parents who do not have relatives or friends who can help. 

Are there any pitfalls? If so, what are they?

Yes there are pitfalls. This scheme has been cobbled together as quickly as possible by ministers and officials working under extreme pressure.  

Experts immediately said the complexity of the programme meant there could be ‘several points of failure’ while the government’s political opponents said ministers should never have largely ditched contact tracing in the first place. 

Without the app, contact-tracking will be based on the say so of people who have tested positive. That means people will need to remember exactly where they have been and who they have been close in the days leading up to their positive test. 

If people forget or remember inaccurately who they’ve seen, the virus could spread. 

Baroness Harding told the Downing Street briefing: ‘We have 25,000 contact tracers ready to start work tomorrow – that is easily enough to trace down the contacts today when the vast majority of us are in lockdown.’

She said data from the Isle of Wight suggests people have been within two metres of fewer than five others at the moment.

How important is contact tracing to beating coronavirus?

The Royal Society believes that contact tracing reduces infection by up to 15 per cent and will miss cases, but even a marginal effect could be crucial in bringing the R infection rate below one and as close to zero as possible. 

However, world-leading experts from the prestigious scientific academy warned the scheme was ‘not a silver bullet’.

They said if compliance is low and testing times don’t come down, infection rates may only drop by 5 per cent. 

What happens if people refuse to isolate? Will they be fined? 

The government has said that it is relying on the British public to voluntarily self-isolate if they display symptoms of Covid-19.

But it has warned that it will impose penalties if people do not follow its orders. Spot checks could be made to households and fines could be issued.

It is not known how much people would be fined if caught flouting self-isolation. 

A spokesman for the Department of Health and Social Care told MailOnline: ‘We are confident that the public will want to play their part in reducing the spread of the virus to keep themselves, their families and communities safe and to protect the NHS. This means complying with advice to self-isolate.

‘However, if we find that people are not complying with isolation instructions, we will not hesitate to introduce tougher measures, for example making visits to check they’re at home or issuing fines if they are found outside the house.’ 

At yesterday’s press conference, Health Secretary Matt Hancock said the government is ‘confident’ that when told to self-isolate, people will, adding: ‘Now of course we could also mandate that, but in the first instance we’re not going to.

‘This will be voluntary at first because we trust everyone to do the right thing.

‘But, we can quickly make it mandatory if that is what it takes. Because, if we don’t collectively make this work, then the only way forward is to keep the lockdown.’

Could people end up having to self-isolate repeatedly? 

Yes. The government has discussed imposing ‘local lockdowns’ on whole towns if there are future regional flare-ups of coronavirus cases. 

Mr Hancock said that the ability to tighten restrictions in individual regions will be part of the NHS test, track and trace system.

This could lead to local schools, businesses or workplaces being closed in areas with high prevalence of infection, according to the government’s ‘exit strategy’.

However, part of the rationale for the Test and Trace system is to allow local, small-scale action to be taken where there appears to be an outbreak. 

Will I have to self-isolate if I’ve already had a positive antibody test?

Yes, even people who have tested positive for antibodies will have to adhere to the rules.

NHS and care homes workers have been receiving the tests, which scour the blood for the infection-fighting substances, over the past week.

Thousands of private antibody tests were also being sold to Britons on online pharmacies such as Superdrug. 

Antibodies are substances produced by the immune system in response to an infection, and their presence is thought to provide some protection against the illness.

But scientists are still uncertain how long this immunity lasts, or how much protection the COVID-19 antibodies provide.

Private antibody tests are also not 100 per cent accurate, meaning there are some people who will test positive but have never actually had the disease.

This might give them false confidence that they cannot be infected and prompt them to take unnecessary risks.

Will people who have had coronavirus be exempt from self-isolating if they come into contact with a new Covid-19 sufferer?

No. Even people who have had positive tests for coronavirus will have to stay at home for 14 days if they come into close contact with a new sufferer.

The government has said that the scientific advice remains that it is uncertain if people who have had the virus are immune to it. 

What checks are in place to stop it being open to abuse, or pretending to have the disease as a joke? 

The emphasis of the entire scheme is on testing people. So people claiming to have the disease will be tested. There will be very little wriggle room. 

Although if those who test positive fail or refuse to reveal who they have been in contact with, without the app there is very little the contact tracers can do to tell if people are telling the truth.

Who is in charge of the operation where I am? 

Councils and public health officials will be tasked with cracking down on local outbreaks of Covid-19, but it is not clear who will lead those efforts.

It is also not clear today how many staff members would be available to help or if local authorities will get extra funding and powers to act appropriately. 

Why not simply keep going the way we are?    

Though the government claims that lockdown has dramatically reduced Covid-associated deaths, the national restrictions are destroying the economy.

Millions of workers have been furloughed by small businesses and big companies since tough restrictions on movement were introduced by the government.

Over half of the adult population of the UK is now being paid by the state in some capacity, whether in the public sector, on furlough, or benefits.

Business and companies have received hundreds of billions of pounds in emergency loans to date from Chancellor Rishi Sunak.

But this state of affairs cannot continue forever.

Economists estimated in early April that lockdown, which began on March 23, is costing Britain around £2.4billion per day.

The Bank of England forecast that UK GDP contracted by two per cent in the first quarter, and is set to shrink by 30 per cent in the second quarter.

Bank staff believe the economy could ‘bounce’ by around 15 per cent by the end of the year, meaning the UK would be around 15 per cent poorer than before lockdown.

Faced with what the Bank called the biggest economic nosedive in 300 years, the government is trying to restart the engines of UK plc.

The PM has committed himself to bringing Britain out of lockdown safely by managing the risk to public health posed by coronavirus.

The NHS Test and Trace system is meant to help do just that. 

Mr Hancock told the press briefing: ‘Until an effective treatment or vaccine comes through how can we get back to doing more of the things that make life worth living without risking safety or putting lives at risk? NHS Test and Trace is a big part – not the only part – but a big part of the answer to that question.’ 

What is this app people are talking about? 

The NHS Trace and Test system is being launched without its NHS contact-tracing app centrepiece, prompting concerns that without the new technology the government could struggle to tackle the spread of Covid-19. 

Experts believe the app will be crucial to the success of the programme because it can identify contacts much quicker than human contact tracers. 

The smartphone app uses bluetooth to register other phones it has been near for a prolonged period of time. A date has not been set for the nationwide roll out of the app but without it contact tracing will not be as swift as it would be with it. 

Matt Hancock said it is ‘not technical problems’ which are preventing the test and trace app from being rolled out nationwide.

He said: ‘It is that one of the things we learnt about in the Isle of Wight is that rolling out the system where people are asked to isolate, even if they have no symptoms, starts better when it comes in human form from the contact tracers.’

Mr Hancock added that ‘the app is working in the Isle of Wight’, and said that when the government has ‘successfully embedded’ the new NHS Test and Trace system, ‘then that is the time to bring the app to bear’.

He continued: ‘Because the app is a compliment to this system, even without it this system would be successful, but it is a compliment because there are some contacts that you don’t know that you might have made.’

Have other countries used contact tracing?

South Korea has monitored credit card transactions, CCTV footage and mobile phone locations, while Singapore has used police investigations and detective work to piece together where people have been and who they’ve seen.

Iceland saw 40 per cent of the population download its app, though its government says manual tracing is just as important.

Austria introduced a decentralised app operated by the Red Cross, which users can manually control. It was the first to roll out this app. 

How long will the contact tracing scheme run for?

Ministers have not put a time limit on the programme, but it will likely remain in place in some form until a vaccine is developed – which might not be until 2021.

Government scientists are studying how much immunity people have against coronavirus if they’ve previously been infected.

If it turns out that they are completely immune for months then people who have already had the disease may not have to adhere to the rules. 

What class as symptoms of coronavirus? 

Anyone with a new, continuous cough, a high temperature or a change in their sense of smell or taste is asked to immediately book a test.

But researchers have linked 11 other symptoms to the virus, including fatigue, chest pain and diarrhoea.

Experts have previously accused ministers of ‘missing the ball’ by only listing three official symptoms.

Bemcentinib

Who makes it?

It’s a tablet developed by the Norwegian company BerGenBio. It’s known as an AXL kinase inhibitor.

What have studies shown?

Bemcentinib is likely to have been chosen because lab tests have shown it has potent anti-viral activity against several enveloped viruses, including Ebola and Zika virus.

Preliminary data suggest bemcentinib is potentially useful for the treatment of early SARS-CoV-2 infection.

How does it work? 

Lab studies by the University of Iowa found the pill can boost immune response and switch off AXL receptors, which when turned on, allow the virus to enter and multiply in lung cells. 

The number of AXL receptors increases when their environment is stressed, particularly when viruses start multiplying in the body. When AXL receptors are hijacked by invading viruses, the cell’s antiviral powers are switched off and it becomes defenceless to the disease.

Blocking AXL receptors also prompts a type I interferon response, alerting the body to the coronavirus and calls for more immune cells to attack it. 

What does it usually treat?

Bemcentinib was being trialled against cancers, including adult acute myeloid leukemia and non-small cell lung cancer (NSCLC). But it is not approved as a treatment in any country. 

MEDI3506

Who makes it?

MedImmune, a subsidiary of drug giant AstraZeneca. The anti-inflammatory injection is an interleukin-33 inhibitor.

What have studies shown?

No results from Covid-19 patients have been released yet.

How does it work?

Interleukin-33 (IL-33) is a cytokine involved activating the immune system. It acts as an alarm signal to alert various types of immune cells to trauma.

An IL-33 inhibitor such as Medi3506 acts to dampen down the cytokine storm as a result of the immune system going into overdrive in response to an infection.

What does it usually treat?

It’s being tested for chronic obstructive pulmonary disease (COPD), dermatitis, and diabetic kidney disease.

Acalabrutinib

Who makes it?

Calquence, generic name acalabrutinib, is produced by British company AstraZeneca. It is a Bruton’s tyrosine kinase (BTK) inhibitor.

What have studies shown?

Calquence was given to a small number of COVID-19 patients at the Walter Reed General Hospital in Washington. Experts observed it had ‘some clinical benefit’.

AstraZeneca, headquartered in Cambridge, said ‘clinical benefit was observed in select patients with advanced lung disease’.

How does it work?

COVID-19 can kill when it sparks an aggressive immune response that scars the lungs, making it difficult to breathe.

BTK inhibitors blocks the BTK protein which triggers immune responses. The immune response can go haywire following infection which leads to a so-called cytokine storm. A cytokine storm eventually begins damaging the body itself and, if left unchecked, can be fatal.

By suppressing the exaggerated defence mechanism, it may prevent the virus from damaging the lungs.

Jose Baselga, head of oncology research and development at AstraZeneca, told Forbes: ‘The science of acalabrutinib and, I think more than that, of Bruton’s tyrosine kinase situation, is pretty strong. The mechanism is very clear.’

What does it treat?

It’s a medication used to treat a type of non-Hodgkin lymphoma known as mantle cell lymphoma. It works by blocking BTK that contributes to cancer cell growth and survival.

Zilucoplan

Who makes it?

A drug injected under the skin developed by the Belgian company UCB. The treatment was developed originally by Ra Pharmaceuticals.

What have studies shown?

Nothing has been released for Covid-19 so far.

How does it work?

Zilucoplan is a synthetic molecule designed to bind and inhibit portions of the immune system called the complement system. The complement system is made up of a large group of blood proteins that are involved with the immune system but can kill cells and lead to catastrophic lung and tissue damage.

‘A lot of the damage is focused on the blood cells and the very small blood vessels in the lung,’ Dr Wilkinson said. 

By blocking the complement system, zilucoplan may be able to reduce the attack of healthy tissues in the lung, preventing worsening of Covid-19.

What has it been used for?

It has shown to improve myasthenia gravis, a skeleto-muscular disorder, in ongoing clinical trials.

Heparin

Who makes it?

Heparin is an ingredient sold in many different products, marketed as Fragmin, Monoject Prefill Advanced and Innohep.

What have studies shown?

No results have been published yet. It will be given to Covid-19 patients for the first time next month.

How does it work?

Blood clotting problems have emerged in severe and critically-ill COVID-19 patients, affecting the lungs, heart and brain. Some patients are dying from heart attacks or strokes, a complication of the virus.

It’s left doctors considering whether blood thinners should be given to certain patients during their stay and afterwards.

In a number of conditions, heparin has been shown to ‘have a dramatic effect in the lung’ when taken with a nebuliser, said Wilkinson. ‘It is a big sticky molecule which can attach to viruses and stop them from entering cells and secondly it may have an important anti-inflammatory effect,’ he said.

What has it been used for?

Heparin is a blood thinner used to treat and prevent blood clots caused by certain medical conditions. It is also used before surgery to reduce the risk of blood clots.

It is on the World Health Organization’s List of Essential Medicines, the safest and most effective medicines needed in a health system.