Our analysis as described in this research letter highlights the fact that age outweighs many other factors in people with T2DM in relation to mortality from SARS-CoV-2 virus, once infected. This fact should be taken into account in relation to the vaccination programme against coronavirus-19 in people with T2DM in the UK and elsewhere.

Introduction The rapid spread of the pandemic caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)(COVID-19) virus resulted in governments around the world instigating a range of measures, including mandating the wearing of face coverings on public transport/in retail outlets. Methods We developed a sequential assessment of risk reduction provided by face coverings using a step-by-step approach. The United Kingdom Office of National Statistics(ONS) Population Survey data was utilised to determine the baseline total number of community-derived infections. These were linked to reported hospital admissions/hospital deaths to create case admission risk ratio/admission-related fatality rate. Results Overall, we show that only 7.3% of all community-based infection risk associates with public transport/retail outlets. The reported weekly community infection rate was 29,400 new cases at the start (24th July). The rate of growth in hospital admissions and deaths for England was around -15%/week, suggesting the infection rate, R, in the most vulnerable populations was just above 0.8. In this situation, average infections over the evaluated 13week follow-up period was 9,517/week. With face covering of 40% effectiveness, this reduced average infections by 844/week, hospital admissions by 8/week and deaths by 0.6/week; a fall of 9% over the period total. If, however, the R-value rises to 1.0, then average community infections would stay at 29,400/week and face coverings could reduce average weekly infections by 3,930, hospital admissions by 36 and deaths by 2.9/week; a 13% reduction. These reductions should be seen in the context of 102,000/week all-cause hospital emergency admissions in England and 8,900 reported deaths in the week ending 7thAugust 2020. Conclusion We have illustrated that the policy on mandation of face coverings in retail outlets/on public transport may have limited value in reducing hospital admissions/deaths. Impact appears small compared to all other sources of risk, thereby raising questions regarding effectiveness of the policy.

The worldwide outbreak of coronavirus disease-19 (COVID-19) has already put healthcare workers (HCWs) at a high risk of infection. The question of how to give HCWs the best protection against infection is a priority. Our literature review has indicated that the degree of protection required in looking after people with COVID-19 infection, is dependent on the particular environment to which the HCW is exposed. Covering more of the body could provide better protection for HCWs. Of importance, it is not just the provision of PPE but the skills in donning and doffing of PPE that are important, this being a key time for potential transmission of pathogen to the HCW and in due time from them to others. In relation to face masks, the evidence indicates that a higher-level specification of face masks (N95) seems to be essential to protect HCWs from Coronavirus infection. Evidence specifically around PPE and protection from the COVID-19 virus is minimal and at the level of anecdotal reports only.