This article was updated on 1 May and again on 6 July. Since its original publication on 17 April, the number of COVID-19 clinical trials has increased from 524 to 2,378. There is no cure for COVID-19. Researchers are testing existing drugs to see if they act against SARS-CoV-2 or alleviate the symptoms of the disease. New drugs are also in development, but this is at a very early stage. Results from trials on existing drugs have already been reported with some positive findings. Dexamethasone is a cheap steroid drug that reduces the risk of death of ventilated patients by 35% and by 20% for patients requiring oxygen therapy. Remdesivir is an antiviral drug; there is good evidence that it can reduce the length of time that hospitalised COVID-19 patients are ill. Negative findings are valuable because they allow researchers to focus on other drugs; there is good evidence that hydroxychloroquine does not offer any benefits to treat COVID-19 patients. Research to see if it might have a protective effect for at-risk groups, such as healthcare workers, is ongoing. There are numerous trials in progress to test a range of drugs that act on the immune system.

Contact tracing apps could be used to control the COVID-19 outbreak. Most of them work by automatically registering another smartphone when it is too close for an extended period of time. Then if a user tests positive for Coronavirus in the future, the contact tracing app notifies these contacts. Some countries like Singapore and Australia have already adopted or rolled out their own contact tracing apps. Concerns have been raised about misuse of personal data. Initial data suggests there has been slow uptake of this new technology by users, and it's unclear if contact tracing apps have had or will have an effect on the pandemic.

The POST board has approved 7 new POSTnotes. Effective biodiversity indicators, Hydrogen, Living organ donations, Mental health impacts of COVID-19, Mental health impacts of COVID-19 on healthcare workers and carers, Reforestation, Smart cities

  • Work programme

    A POSTnote on effective biodiversity indicators will review the evidence base for the likely indicators of the UK Biodiversity Strategy to 2030. It will look at the challenges associated with these, such as vagueness of targets, incomplete understanding of the mechanisms driving changes in the state of biodiversity, data availability and the optimal number required. It will also review the wider value of biodiversity indicators. Provisional start date: September 2020.

  • Work programme

    A POSTnote on reforestation will summarise the strategies for identifying optimal areas for successfully restoring woodlands and the possible means of incentivising this. It will look at the evidence for the optimal approaches for providing climate and biodiversity benefits, and the challenges that will need to be addressed. Provisional start date: September 2020.

  • Work programme

    A POSTnote on smart cities will give an overview of the current landscape and the infrastructure smart cities require. It will look at the benefits and challenges of smart cities and progress towards developing them in the UK and elsewhere. Provisional start date: September 2020.

  • Work programme

    A POSTnote on hydrogen will cover the latest developments in low-carbon hydrogen production, as well as developments in applications across transport, industry and heat more generally. We will invite views from the Board on the potential contents of this POSTnote – specifically on a choice between a single note covering all of these aspects, or two separate notes covering applications across industry and transport. Provisional start date: September 2020.

  • Work programme

    A POSTnote on mental health impacts of COVID-19 will summarise the latest findings from research on how COVID-19 has affected the mental health of the UK population. It will highlight which groups are vulnerable and their mental health outcomes. It will also discuss policy approaches to protect mental health and how health services can adapt to improve outcomes for those affected. Provisional start date: September 2020.

  • Work programme

    A POSTnote on mental health impacts of COVID-19 on healthcare workers and carers will outline the short and long-term mental health impacts of COVID-19 on this group. It will review policy approaches and support services dedicated to supporting healthcare worker mental health, with focus on special measures implemented during a pandemic. Work currently in production.

  • Work programme

    A POSTnote on living organ donation will set out the scale and nature of living donation in the UK and analyse the policies set out in government strategy to increase living donor activity. It will seek to explore the ethical frameworks around donation relating to altruism, autonomy and reciprocity, and the ethical principles that guide clinical teams. The note will also explore how the change to an opt-out consent system for deceased donors might influence living donation. The role of social media in finding donors is also topical, as recipients seek suitable donors outside the NHS transplant system. Websites that seek to match donors and recipients, some of which charge recipients a fee to register, are a recent development in the UK; guidelines advise clinical centres not to proceed with such cases. Provisional start date: November 2020.

  • Rapid response

    An infected person produces respiratory droplets when talking, coughing and sneezing. These are responsible for the transmission of virus between people. Droplets can travel up to 2m, with finer aerosols containing smaller viral particles travelling even further. Numerous complex and interacting factors influence how they move and settle onto surfaces, and how infectious they are. The further away a person is, the fewer droplets they will be exposed to and so their risk of being infected with the virus reduces. The advice on 2 m distancing is a risk assessment based on relative not absolute risk; 2 m does not represent zero risk. Measures to mitigate the increased risk of reducing physical distancing include ventilation, physical barriers (screens and face coverings), reduced building occupancy and enhanced cleaning. These will vary according to the context. The wider range of social distancing practices will need to be maintained to contain viral transmission even if the 2 m advice changes. Social distancing and other public health measures are likely to be needed long-term, until a vaccine or more effective treatments for COVID-19 are available. There are numerous knowledge gaps about SARS-CoV-2 transmission; research to address them will inform policy-making.

  • POSTnote

    There is increasing interest in using machine learning to automatically analyse remote sensing data and increase our understanding of complex environmental systems. While there are benefits from this approach, there are also some barriers to its use. This POSTnote examines the value of these approaches, and the technical and ethical challenges for wider implementation.

  • Rapid response

    There is insufficient scientific evidence to know whether the presence of SARS-CoV-2 antibodies confers protection from subsequent infections, and if so at what level. Antibodies are only one part of the immune response to infection. Tests that detect SARS-CoV-2 antibodies are available. They can determine whether someone has had COVID-19. Tests can reveal those who are unaware that they had COVID-19 because they had mild or no symptoms. Test samples must be analysed in a laboratory – no home tests are authorised for use in the UK. The Government provides antibody tests for NHS and social care staff, hospital patients and care home residents. Commercial test kits are available for private use. These are of varying quality and results must be interpreted with caution. A positive test does not necessarily mean that someone will be protected from subsequent infections. There are concerns that access to private tests of variable quality will discourage the public from practising effective public health measures. Antibody tests are an important tool to understand the spread of the virus and how many people in a population have been infected. They are being used in infection surveillance surveys in the UK and elsewhere.