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Design of new breathing aid developed by Mercedes to be made freely available

The designs of a new breathing aid developed by engineers at the Mercedes F1 team, University College London (UCL), and clinicians at UCL Hospital have been made freely available to support the global response to COVID-19. It's the latest development in Formula 1’s Project Pitlane effort to help fight coronavirus.

The Continuous Positive Airway Pressure (CPAP) devices, which help coronavirus patients with lung infections to breathe more easily, were developed by engineers at the Mercedes team and University College London (UCL), and clinicians at UCL Hospital after a round-the-clock effort to reverse engineer a device that could be manufactured rapidly by the thousands.

After patient evaluations at UCLH and across sister hospitals in the London area, the device received regulatory approval last week. An order for up to 10,000 has now been placed by the British National Health Service, and the Mercedes AMG High Performance Powertrains technology centre in Brixworth – the facility where the F1 team’s highly successful power units are developed and built – is now building 1,000 devices per day.

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Source: F1, 7 April 2020

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Report finds 'recurrent safety risks' in East Kent NHS maternity care

“Recurrent safety risks” around clinical care at an embattled NHS trust’s maternity service have been identified in a report published on Tuesday.

The Healthcare Safety Investigation Branch (HSIB) has been investigating East Kent hospitals university NHS foundation trust since July 2018 after a series of baby deaths.

Among those treated at the trust was Harry Richford, whose death was “wholly avoidable”, seven days after his emergency delivery in November 2017, an inquest found.

Speaking on Tuesday, Harry’s grandfather Derek Richford said it is clear that sufficient lessons were not learned from his death.

The independent report, published on Tuesday by the Department of Health and Social Care, discusses 24 maternity investigations undertaken since July 2018, including the deaths of three babies and two mothers.

It said: “These investigations have enabled HSIB to identify recurrent safety risks around several key themes of clinical care in the trust’s maternity services.”

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Source: The Guardian, 8 April 2020

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Hospitalising coronavirus patients can cause more deaths, data from Italy suggests

Sending coronavirus patients to hospital can dramatically increase death rates, the experience of two hard-hit Italian regions suggests.

Veneto and Lombardy are neighbouring regions but have seen sharply differing fatality rates since the contagion broke out in northern Italy in late February. Despite having equally well-equipped hospitals and similar levels of wealth, Lombardy’s death rate is around 17% while that of Veneto is around 5%.

One reason for the disparity is that Veneto has tested many more people – the more tests that are carried out, the more positive cases are found, and that brings down the overall death rate among those infected.

But another key factor, experts believe, is that Lombardy admitted more patients to hospital, whereas Veneto urged them to stay at home or treated them in local health clinics.

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Source: The Telegraph, 6 April 2020

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Coronavirus concerns delay treatment for cancer patient

Nick has terminal bowel cancer. He’s been told he won't receive chemotherapy for three months because it would put him more at risk of the coronavirus.

He fears having the treatment taken away would shorten his life.

Current NHS guidelines say cancer specialists should discuss with their patients whether it is riskier for them to undergo or to delay treatment at this time.

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Source: BBC News, 6 April 2020

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ORCHA launches COVID-19 Health App Formulary

Health apps have grown enormously in popularity, even more so during the COVID-19 Pandemic. Since early March, more than 500 health apps contain coronavirus-related keywords in their description.

People are taking advice from these apps, often using them to share sensitive information. Yet, in a time of fake reviews, scams and personal data breaches, not all health apps can be trusted. 

The Organisation for the Review of Care and Health Apps (ORCHA) has launched a health app formulary to help healthcare professionals and consumers know which health apps they can trust. 

As a free to use resource, the site includes reviews of health apps across a range of health conditions relevant to the COVID-19 pandemic, including reviews of COVID-19 apps launched to date.

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Source: ORCHA, 6 April 2020

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Mental health hotline for NHS staff

The NHS is launching a hotline to support and advise healthcare staff during the coronavirus pandemic.

Volunteers from charities including Hospice UK, the Samaritans and Shout, will listen to concerns and offer psychological support.

The phone line will be open between 07:00 and 23:00 every day, while the text service will be available around the clock.

The phone number is 0300 131 7000 or staff can text FRONTLINE to 85258.

It comes as staff face increasing pressure to care for rising numbers of patients who are seriously ill with the virus.

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Source: BBC News, 8 April 2020

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Coronavirus: Ambulance staff 'feeling unprotected'

Ambulance staff are being put at risk by a lack of protective equipment to guard them against coronavirus, according to a trade union.

GMB says its members are "scared" about their own safety and their families. The union claims one in five ambulance staff in London are off sick with coronavirus-related sickness.

The government says hundreds of millions of protective items have been delivered to NHS staff around the country.

According to the GMB Union, 679 frontline ambulance crew in the London Ambulance Service are off sick due to Covid-19-related sickness.

Among those at work, some say they feel unprotected either because of a lack of or inadequate personal protective equipment (PPE).

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Source: BBC News, 8 April 2020

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Government seeks refund for millions of coronavirus antibody tests

The Government will look for a refund for millions of coronavirus tests ordered from China after scientists found they were too unreliable to be used by the public.

Ministers will attempt to recoup taxpayers' money spent on the fingerprick tests after an Oxford University trial found they returned inaccurate results.

The failure is a significant setback because it had been hoped the antibody tests would show who had already built up immunity, therefore offering a swifter route out of lockdown.

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Source: The Telegraph, 6 April 2020

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Adam Price: Wales needs procurement tsar to tackle testing and PPE problems

Plaid Cymru Leader Adam Price has argued that the Welsh Government should appoint a procurement tsar to get to grips with Wales's serious shortage of COVID-19 testing kits, personal protective equipment (PPE) for frontline health and care staff and medical devices for patients.

Wales is currently only testing 1,100 people a day when it was planning to test 6,000. This follows the collapse of an alleged deal between the Welsh Government and private company Roche which would have provided for 5,000 of those tests.

Adam Price made the case for the appointment of a tsar whose "sole responsibility" would be the procurement and supply of COVID-19 tests, PPE, and oxygen and medical devices for Wales.

He cited cases of care homes with just one or two boxes of surgical masks - each enough to last just two days for one patient, as well as hospital staff being forced to wear paper underwear over their hair due to the lack of any other protection.

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Source: Plaid Cymru Party of Wales, 6 April 2020

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Number of NHS doctors off sick 'may be nearly triple the official estimate'

The government could be significantly underestimating the number of medics going off work due to the coronavirus, according to a survey by the Royal College of Physicians (RCP).

The health secretary, Matt Hancock, said on Sunday that 5.7% of hospital doctors were off sick or absent because of Covid-19, but a doctors’ survey of more than 2,500 medics found the rate was almost three times that – 14.6%.

In recent weeks in London, nearly a third of hospital doctors said they were off work for Covid-19 and non-Covid-19 reasons, according to the RCP’s poll of members, conducted on Wednesday and Thursday.

Prof Andrew Goddard, the president of the RCP, said the number who had been off work in London “should be a sobering wake-up call” for the rest of the country, with the largest rises in confirmed cases now being outside the capital including in the West Midlands.

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Source: The Guardian, 5 April 2020

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Doctors lacking PPE 'bullied' into treating COVID-19 patients

Doctors in Britain are being “bullied and shamed” into treating patients with COVID-19 despite not having the masks, gowns and eyewear they need to protect themselves from the virus, frontline medics have said.

Others are being told to hold their breath to avoid getting infected because of persistent shortages of personal protective equipment (PPE) .

The findings raise questions about how far a huge effort by NHS bosses, ministers and the military has succeeded in banishing previously widespread supply problems with PPE.

“Lack of personal protective equipment continues to be a critical issue. It is heartbreaking to hear that some staff have been told to simply ‘hold their breath’ due to lack of masks,” said Dr Samantha Batt-Rawden, the president of the Doctors’ Association UK (DAUK).

“Doctors are dying. Nurses are dying. We are devastated, and can no longer stand by and watch as more dedicated colleagues lose their life,” she said.

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Source: The Guardian, 7 April 2020

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Residential homes 'desperate' for PPE, as two care workers die

The first two coronavirus deaths among care workers in England were announced, as industry leaders hit out at chronic shortages of protective equipment and urged the government to start treating social care as “a second front line”.

Carol Jamabo, 56, a community carer for Cherish Elderly Care in Bury in Greater Manchester, died last Wednesday.

Another carer died in a home run by MHA, the UK’s largest charitable social care provider, which said it was unclear where she contracted the virus. The death of a West Dumbartonshire care worker that emerged on Sunday was also confirmed by the Scottish first minister, Nicola Sturgeon.

The fatalities came amid rising concern that those working in social care still do not have the protection they need amid the Covid-19 pandemic and that, without testing for the virus, staff risk contaminating care homes where elderly people are supposed to be “shielded”.

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Source: The Guardian, 6 April 2020

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Coronavirus: Doctors and nurses will need PTSD treatment after Covid-19 virus peaks in hospitals, warn health leaders

Doctors and nurses will need treatment for post-traumatic stress disorder after working in harrowing conditions on wards during the coronavirus crisis, health leaders warn.

The strain on their mental and physical health is already unprecedented and the virus has not yet reached its expected peak, they say.

NHS staffing is at levels that were previously unthinkable as workers – forced to spend hours in hot conditions while wearing full protective gear – try to keep up with demand amid a lack of equipment.

It comes as the head of intensive care at London’s Royal Free Hospital described in a memo how most units had already shifted from the usual one nurse to one patient ratio to one to six and were running out of key machines and equipment.

Dr Alison Pittard, dean of the Faculty of Intensive Care Medicine, told The Independent: “I am really concerned about the toll this is taking and will continue to take on staff."

“We are used to dealing with emergencies, but we have never been exposed to this sort of demand. We know staff are already struggling physically and mentally and that this will only continue."

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Source: The Independent, 6 April 2020

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NHS staff given conflicting advice over resuscitation of coronavirus patients

Doctors, nurses and paramedics have been given conflicting advice about when to start resuscitation for coronavirus patients, amid fears the procedure could put them at risk of infection.

While Public Health England has said it does not believe CPR creates a risk, the UK’s Resuscitation Council – which is responsible for setting standards for resuscitation in the NHS – has said it believes there is a risk and staff should wear full equipment.

The Independent has seen several examples of different messages being sent out to hospital staff and ambulance workers, and some NHS trusts were forced to change their guidance within a matter of days after PHE changed its stance.

One set of guidance could mean a delay in starting CPR for patients while staff put on protective equipment, while the other means staff could be at risk of being infected with coronavirus.

Ken Spearpoint, a former consultant nurse and resuscitation officer at Imperial College Healthcare Trust, said the situation had led to confusion and created an “ethical dilemma” for some staff who were being forced to choose between the Resus UK’s position and their trust’s guidance.

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Source: The Independent, 6 April 2020

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'High risk' list misses off thousands of people

Thousands of people have been missed off the government's high risk list for Covid-19 despite meeting the criteria.

Among them have been transplant patients, people with asthma and some with rare lung diseases.

Many are worried it will affect their ability to access food and medical supplies as they shield from the virus, unable to leave their homes for at least 12 weeks.

"It's like she's been forgotten," said Bev Pearson, mother of 20-year-old heart transplant patient Lucy Pearson.

Miss Pearson, from Whitsbury in Fordingbridge, Hampshire, had her transplant 14 years ago and still visits hospital for regular check-ups. She has been shielding in the home she shares with her mother, brother and sister - none of whom have been venturing out in an attempt to protect her.

Despite registering her daughter on the government list herself, she said she had received no confirmation.

When she asked her GP she was told it had "nothing to do with the surgery", she added.

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Source: BBC News, 7 April 2020

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Hertfordshire hospital forced to consider who should be refused oxygen

Oxygen supplies at a Hertfordshire hospital inundated with coronavirus patients became so precarious last week that officials considered how to decide who should receive the gas and who should miss out and likely die, the Guardian understands.

The oxygen system at Watford general hospital came close to breaking point on Saturday, when a critical incident was declared and staff had to tell the public not to come to the hospital. Some patients were moved out to prevent the vital system failing.

A senior clinician said: “They were [consulting] the hospital ethics committee every day and considering who they were not going to oxygenate and ventilate if they needed it, and making decisions about who would be triaged to not have oxygen and die.”

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Source: Guardian, 5 April 2020

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NHS worker quit when she was stopped from wearing face mask

A healthcare worker in north-west London quit her job after she was refused permission to wear a protective face mask, the Guardian has learned.

In her resignation letter, Tracy Brennan chastised her superiors at Hillingdon Hospitals NHS foundation trust for forbidding her from wearing a surgical mask she had bought to protect herself – and the patients she was caring for – from contracting the deadly virus.

Brennan, a healthcare assistant, said she had returned to work after self-isolating for 14 days because her daughter had shown symptoms of Covid-19. She said that patients in the ward where she was working, which was not a coronavirus treatment ward, felt comfortable with her wearing the surgical mask and some positively encouraged her to do so.

Brennan wrote: “With a heavy heart and sadness, I feel I have no alternative but to hand this letter in as my formal resignation and will be unable to work my notice due to not being allowed to wear sufficient personal protective equipment (PPE) for the duties I perform.”

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Source: Guardian, 4 April 2020

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Coronavirus UK death toll: why what we think we know is wrong

New figures reveal that what we think we know about the Covid-19 death toll in the UK is wrong. Here’s why.

Every day we get one big figure for deaths occurring in the UK. Everyone jumps on this number, taking it to be the latest toll. However NHS England figures – which currently make up the bulk of UK deaths – in fact reflect the day on which the death was reported, not the actual date of death, which is usually days, sometimes weeks, before it appears in the figures.

The truth is we don’t know how many deaths have taken place the previous day. In fact the headline figure is likely to under-report the number of deaths that actually happened the previous day.

The number we hear about usually counts deaths which took place at an earlier date. The difference matters because by undercounting the number of deaths we are skewing the curve.

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Source: Guardian, 4 April 2020

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Non-acute services to receive 30 million PPE products

Adult social care services are to receive millions of personal protective equipment products following a national audit of personal protective equipment (PPE), HSJ can reveal.

The government will deliver more than 30 million items to local resilience forums in the coming days, for distribution among social care and other front-line services, according to a letter seen by HSJ.

The stock should not be sent to acute trusts or ambulance services, the letter, from health and social care secretary Matt Hancock and housing, communities and local government secretary Robert Jenrick, stated.

Describing an “urgent need” for PPE in front-line services, Mr Hancock and Mr Jenrick asked local planners to distribute this latest batch of stock “only where there is a clear and pressing need”.

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Source: HSJ, 6 April 2020

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Expectant mothers turn to freebirthing after home births cancelled

When Victoria Gianopoulos-Johnson got a call from her midwife to say her home birth would be cancelled, panic took hold. She says she “lost it” for two days, crying constantly, gripped by uncertainty and then anger. Now she has reached the decision to have a free birth, also known as unassisted childbirth.

Maternity rights groups say there has been a rise in the number of women seeking advice about freebirthing owing to pressures on hospitals and new restrictions around birth partners.

More than a fifth of birthing centres and more than a third of homebirth services have closed due to a shortage of midwives and concerns about ambulance response times.

Alison Edwards, of Doula UK, whose 700 members advocate for expectant mothers, says she has seen a threefold increase in calls about freebirthing in the last fortnight.

“Initially women were concerned about staff shortages,” says Edwards. “Now they don’t want to go to hospital at all, it’s about infection. It is inevitable that some who should not be freebirthing because they are in a high-risk category will give birth at home because they fear the alternative – infection from [coronavirus] or spending time in hospital without their partner’s support.”

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Source: Guardian, 5 April 2020

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Coronavirus: Nearly 400 care groups 'face protection shortages'

Almost 400 care companies which provide home support across the UK have told the BBC they still do not have enough personal protective equipment (PPE).

Without protection, providers say they may not be able to care for people awaiting hospital discharge.

Of 481 providers, 381 (80%) said they did not have enough PPE to be able to support older and vulnerable people.

The government said it was working "around the clock" to give the sector the equipment it needs.

The BBC sent questions to the nearly 3,000 members of the UK Homecare Association.

About a quarter of respondents said they have either run out of masks or have less than a week's supply left.

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Source: BBC News, 6 April 2020

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'Dial 999 for stroke emergencies despite coronavirus'

People who may be having a stroke should still call 999 for emergency medical care, even during the coronavirus pandemic, say UK experts.

They are concerned that many are not seeking urgent help when they most need it, possibly due to fear of the virus or not wanting to burden the NHS.

Any delay in seeking help can lead to disability or even death, warns the Stroke Association. Prompt assessment and treatment saves lives, it says.

Data suggest people are currently staying away from hospitals, which is fine unless you really need care.

Latest figures for England and Scotland suggest attendance to Emergency Departments has dropped by over a third on the same week last year. Those who need urgent medical help should still attend, say experts.

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Source: BBC News, 6 April 2020

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NHSE to act over fears covid-19 focus could ‘do more harm than virus’

National NHS leaders are to take action over growing fears that the “unintended consequences” of focusing so heavily on tackling covid-19 could do more harm than the virus, HSJ has learned. 

NHS England analysts have been tasked with the challenging task of identifying patients who may not have the virus but may be at risk of significant harm or death because they are missing vital appointments or not attending emergency departments, with both the service and public so focused on covid-19. 

A senior NHS source familiar with the programme told HSJ: “There could be some very serious unintended consequences [to all the resource going into fighting coronavirus]. While there will be a lot of covid-19 fatalities, we could end up losing more ‘years of life’ because of fatalities relating to non-covid-19 health complications.

“What we don’t want to do is take our eye off the ball in terms of all the core business and all the other healthcare issues the NHS normally attends to."

“People will be developing symptoms of serious but treatable diseases, babies will be born which need immunising, and people will be developing breast lumps and need mammograms.”

HSJ understands system leaders are hopeful that in the coming days they will be able to assess the scale of the problem, and the key patient groups, and then begin planning the right interventions and communications programme to tackle it.

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Source: HSJ, 5 April 2020

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Singapore to open-source national coronavirus encounter-tracing app and the Bluetooth research behind it

Singapore plans to open source a smartphone app its digital government team has developed to track citizens' encounters with coronavirus carriers.

The app, named TraceTogether, and its government is urging citizens to run so that if they encounter a Coronavirus carrier, it’s easier to trace who else may have been exposed to the virus. With that info in hand, health authorities are better-informed about who needs to go into quarantine and can focus their resources on those who most need assistance.

The app is opt-in and doesn’t track users through space, instead recording who you have encountered. To do so, it requires Bluetooth and location services to be turned on when another phone running the app comes into range exchanges four nuggets of information - a timestamp, Bluetooth signal strength, the phone’s model, and a temporary identifier or device nickname. While location services are required, the app doesn't track users, instead helping to calculate distances between them.

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Source: The Register, 26 March 2020

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Increasing physical health check coverage for those with serious mental illness

City and Hackney Clinical Commissioning Group might have the fifth highest prevalence of serious mental illness in England, but last year it achieved the highest physical health check coverage in the country.

This was down to a collaborative approach by the CCG, local trust, GPs, heath informatics, a voluntary sector exercise and diet specialist organisation, and service users themselves.

This alliance model for primary care SMI physical health was named mental health innovation of the year at the HSJ awards.

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Source: HSJ, 20 March 2020

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