England continue to face disruption to preparations for their Guinness Six Nations opener against Italy after Nick Isiekwe was forced to return from their camp in Girona because of illness.
Isiekwe will be unable to take part in the Stadio Olimpico showdown on Saturday week with the gap created in Steve Borthwick’s 36-man squad being taken by Charlie Ewels.
Isiekwe was a possible bench option for the round one fixture in Rome and his departure from England’s warm-weather training base in Spain is another setback for Borthwick.
A crisis has developed in midfield after Ollie Lawrence was ruled out until later in the Championship because of a hip problem, while Oscar Beard is out with concussion.
It raises the prospect of either of the uncapped Fraser Dingwall or Max Ojomoh partnering Henry Slade in the centres in another overhaul of England’s midfield.
Only Dingwall and Ojomoh have played regularly at inside centre with the options available to Borthwick already depleted by Owen Farrell’s absence from the Six Nations for mental wellbeing reasons and Manu Tuilagi’s groin issue.
Hooker Luke Cowan-Dickie has also been ruled out against Italy because of an unspecified medical condition, but he could return for the round two appointment with Wales at Twickenham.
Ewels, the Bath second row, won the last of his 30 caps in the 2022 Six Nations and will be competing with Alex Coles to provide bench cover for Maro Itoje and Ollie Chessum.
England depart Girona for Rome on Thursday when Borthwick will name a starting XV that will be led for the first time by Jamie George.