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"'I feel less safe without Covid measures"

Medically vulnerable people say the decision to end Covid restrictions means their freedoms being eroded.

Prime Minister Boris Johnson announced that legal requirements, including the need to self-isolate if you test positive, will end on Thursday.

Two clinically vulnerable women in the West say not knowing who is infected means it is now more dangerous for them to leave their homes.

"It doesn't feel safe," said Chloe Ball-Hopkins, from Gloucestershire.

"My friends and family will continue to try and keep me safe, my partner will keep me safe, they'll continue to test before they meet me," said the 25-year-old from Wotton-under-Edge.

Miss Ball-Hopkins has already had her fourth vaccine dose as she is considered extremely clinically vulnerable.

She has a rare form of muscular dystrophy called nemaline myopathy which affects her respiratory system, and contracted sepsis in 2019 which undermined her immune system further.

Miss Ball-Hopkins said that while the easing of restrictions would feel like freedom to much of the population, it meant the opposite for her.

"I'm supposed to go out and live my life normally yet now I won't know if someone next to me in a supermarket is literally breathing Covid down on me, as I'm in a wheelchair.

"I was actually probably safer in January when everyone was wearing masks than I will be in a week's time. That makes no sense," she said.

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Source: BBC News, 22 February 2022

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Ovarian cancer symptoms are being ignored, UK charity warns

GPs and women are still ignoring key symptoms of ovarian cancer despite better awareness of the disease, a charity has warned, prompting fears that yet more patients will be diagnosed late and “die needlessly”.

Symptoms include frequently having a swollen tummy or feeling bloated; pain or tenderness in the tummy or the pelvis; having no appetite or feeling full quickly after eating, and an urgent need to pee or needing to pee more often, according to the NHS.

However, Target Ovarian Cancer is concerned that despite successful campaigns to boost awareness of the disease, many are still failing to act on the vital signs. “Key symptoms are being ignored – both by those experiencing them and their GPs,” a spokesperson said.

A poll of 1,000 women for the charity found 79% did not know that bloating was a symptom, while 68% were unaware abdominal pain was a sign, and 97% did not know feeling full was another. Most women (99%) did not know that needing to pee more urgently was also a sign, while evidence suggests women can often be told by their GP that their symptoms are more a symptom of irritable bowel syndrome (IBS), Target Ovarian Cancer said.

Ovarian cancer kills about a third of women with the disease in the first year after diagnosis, and is often diagnosed in the late stages. There are about 7,500 new ovarian cancer cases in the UK every year.

“These figures are incredibly disappointing,” said Annwen Jones, the chief executive of Target Ovarian Cancer. “We know we’ve shifted the dial in the past 10 years through the dedication of thousands of Target Ovarian Cancer’s campaigners, but it is not enough. Knowing the symptoms is crucial for everyone.

“We need to make sustained and large-scale government-backed symptoms campaigns a reality. Progress is possible. If we do this, fewer people will be diagnosed late, fewer will need invasive treatment, and, ultimately, fewer will die needlessly from ovarian cancer.”

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Source: The Guardian, 22 February 2022

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Every hospital trust in England limiting visitors despite move towards ‘living with Covid’

Patients face limits on visitors in every hospital trust in England, The Telegraph has revealed, with restrictions set to continue even once the country moves to "living with Covid".

It comes as Boris Johnson announces that all Covid regulations including self-isolation will be abolished at the end of February. 

The health service supports keeping some visiting restrictions in place while Covid remains in circulation among the general population, it is understood.

A spokesman said: "The NHS regularly reminds hospitals that visits for patients should continue to go ahead as much as possible and extra measures should already be in place so that this can be done safely."

NHS England encourages trusts to facilitate visits "wherever possible, and to do so in a risk-managed way", but it is up to individual trusts to set their own policies based on UK Health Security Agency guidelines.

Analysis by The Telegraph found that at least 34 hospital trusts across England still have routine visits suspended, with exceptions such as those for patients receiving end-of-life care and people with dementia. All 125 trusts have some form of visiting restriction in place. The most common policy is to have one named visitor per patient for the entirety of a patient's stay, who can only visit for one hour once a day.

Helen Wildbore, the director of the Relatives and Residents Association, said limiting patients to one nominated visitor put pressure on families, leaving the carer "exhausted".

She added: "If you’re going into hospital and you're not able to have your family with you, you're going to come out worse." In some cases, patients who needed hospital care had chosen not to go because they were worried about being isolated from family, she said.

Caroline Abrahams, the Charity Director at Age UK, said it was "imperative that hospitals open their doors to visitors again as wide as they possibly can" as the pandemic eases.

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Source: The Telegraph, 18 February 2022

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Visiting restrictions and the impact on patients and their families: a relative's perspective

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Diabetic patient found dead on hospital roof after medics ejected him while he was in shock

A diabetic pensioner died on the roof of a hospital after staff physically ejected him despite being in a “confused” state.

Stephen McManus, a long-term Type 1 diabetes patient, had earlier been rushed to Charing Cross Hospital in west London while suffering a hypoglycaemic episode.

Despite colleagues having expressed concerns about his slurred speech and erratic behaviour, a junior doctor decided the 60-year-old had the mental capacity to go home.

He was wheeled out of the building by security guards, despite having no phone, money and being in his slippers. His family had not been contacted to inform them he was being discharged.

Some time later Mr McManus re-entered the building and managed to gain access to a construction area, somehow finding his way onto the roof.

He was found dead the next morning following a police search after his family reported him missing.

An inquest has begun trying to establish why Stephen was allowed to leave the hospital in the first place and how he was able to access a potentially dangerous zone.

Mr McManus’s family say the case raises profound questions about the treatment of diabetic patients in the NHS.

“My father was an extremely vulnerable patient and the nature of his removal from the hospital is inexplicable, Jonathan McManus, his son, told The Telegraph.

“Had he been kept in hospital he would no doubt be alive today.”

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Source: Yahoo News, 19 February 2022

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USA: Covid infection increases risk of mental health disorders, study finds

Having Covid-19 puts people at a significantly increased chance of developing new mental health conditions, potentially adding to existing crises of suicide and overdoses, according to new research looking at millions of health records in the US over the course of a year.

The long-term effects of having Covid are still being discovered, and among them is an increased chance of being diagnosed with mental health disorders. They include depression, anxiety, stress and an increased risk of substance use disorders, cognitive decline, and sleep problems – a marked difference from others who also endured the stress of the pandemic but weren’t diagnosed with the virus.

“This is basically telling us that millions and millions of people in the US infected with Covid are developing mental health problems,” said Ziyad Al-Aly, chief of research and development at the VA St Louis Healthcare System and senior author of the paper. “That makes us a nation in distress.”

The higher risk of mental health disorders, including suicidal ideation and opioid use, is particularly concerning, he said.

“This is really almost a perfect storm that is brewing in front of our eyes – for another opioid epidemic two or three years down the road, for another suicide crisis two or three years down the road,” Al-Aly added.

These unfolding crises are “quite a big concern”, said James Jackson, director of behavioural health at Vanderbilt University’s ICU Recovery Center, who was not involved with this study. He is also seeing patients whose previous conditions, including anxiety, depression and opioid use disorder, worsened during the pandemic.

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Source: The Guardian, 18 February 2022

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Netherlands: First Long Covid legal cases involve healthcare staff

At least five people in the Netherlands who developed Long Covid through their jobs are planning to sue their employers for financial and emotional damage, according to RTL Nieuws. But lawyers, unions, company doctors and academics expect many more cases will arise and say they could take years to reach a conclusion, RTL said.

One case involves a residential care nurse who was told to take care of a patient without protective clothing. It later transpired that the unit manager knew the patient may have had coronavirus. The nurse has been at home for almost two years with Long Covid, and her salary has been reduced in line with sick pay regulations.

Ambulance worker Lenny Wagemans is also holding her former employer responsible for her illness. She picked up coronavirus in March 2020 after a patient coughed all over during a trip to hospital. She too did not have a face mask or other protection. 

Dealing with work related illnesses is often complex and with Covid it is difficult to establish exactly where an infection took place, said Utrecht University researcher Marlou Overheul. ‘You might have picked up coronavirus somewhere else and that can have an impact on a damages claim,’ she said.

The Federation of Dutch Trade Unions said last month over 500 healthcare workers face losing their jobs because they are suffering from Long Covid and have been on sick pay for the regulation two years.

MPs have voted in favour of a motion which calls on the government to formally recognise Long Covid as an illness and which will ensure all nursing staff are entitled to invalidity benefits. The government has asked the national health council to make recommendations about how to deal with Long Covid which will be published in the first quarter of this year.

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Source: Dutch News, 20 February 2022

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USA: Doctors are more likely to describe black patients as uncooperative, studies find

Medical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits. They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signalling that the patient has been uncooperative and may exhibit problematic behaviours.

Two large new studies in the US found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races.

The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. About 8% of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.”
 
The second study, published in JAMA Network Open, analysed the electronic health records of nearly 30,000 patients at a large urban academic medical centre between January and December 2018. The study looked for what researchers called “stigmatising language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain.
 
Overall, 2.5% of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6% of medical notes on white patients contained such terms, they were present in 3.15% of notes about Black patients.
 
Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7% of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.”

The labels have consequences, warns Dr. Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. 

“Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.”

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Source: The New York Times, 20 February 2022

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Ministers warned getting rid of free Covid tests will lead to £500 ‘caring tax’

Abolishing free Covid tests for those who look after the vulnerable will amount to a “tax on caring” that would cost them more than £500 a year, ministers have been warned.

All remaining domestic Covid regulations that restrict public freedoms are ending, with Boris Johnson announing a move away from government intervention to “personal responsibility”. However, the scale of free testing to be retained is still being thrashed out within government.

Current data suggests that nearly 4 million people take regular Covid tests, including those who visit and help vulnerable relatives. That number also includes vulnerable people who work in settings that could put them at greater risk, where they have face-to-face contact with others.

Research based on the average cost of tests internationally, compiled by the Liberal Democrats, suggests that people who take two tests a week face an average bill of £534 a year. It comes after the government’s own scientific advisers have warned that removing free testing will “increase anxiety” and limit the “social participation outside the home” of those who are clinically vulnerable or who live with someone in that position.

“Charging people for the tests they need to safely see vulnerable loved ones is a tax on caring that risks leaving millions of people in lockdown by stealth,” said Ed Davey, the Lib Dem leader. “It means vulnerable people will see fewer loved ones and will be able to enjoy less of their lives. It is unfair and unjust. Ministers need to scrap these plans to stop a ‘cost of living with Covid’ crisis. Throughout the pandemic, people have been trying hard to do the right thing and keep others safe. The government should not be making that harder.”

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Source: The Guardian, 19 February 2022

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Early end to England’s isolation rules is a: "perilous and politicised pandemic response"

Today the Government is expected to announce the end to all Covid restrictions, including ending self-isolation and free testing in the country. However, in an open letter to the UK's Chief Medical Officer and Chief Scientific Officer, the UK science and medical communities say this is a "HUGE mistake".

The open letter expresses concern about the Government plans to end testing, surveillance surveys and legal isolation of Covid-19 cases and asks the Government to clarify the scientific advice underpinning these policy decisions as they do not believe there is a solid scientific basis for the policy.

"It is almost certain to increase the circulation of the virus and remove the visibility of emerging variants of concern." 

"The emergence of new variants and a resultant wave of infections can occur very quickly, potentially within just several weeks. The ability to rapidly detect and characterise new variants and to scale up necessary responses (such as TTI and vaccinations) quickly will be very important. Considerations for future response preparedness and surveillance infrastructure should take this into account." 

"We believe humanity is in a race against the virus."

The letter goes on to say that some form of surveillance must be continued to ensure the situation is well understood and new variants of concern identified. Lack of testing is not only detrimental to controlling the spread of SARSCoV2 and detecting new variants, it also puts people who develop Long Covid at a great disadvantage by not having a confirmation of their infection, which is integral to the diagnosis, support and care they need to receive. For the 1 in 4 people in the UK who are clinically vulnerable, the current approach appears a perilous and politicised pandemic response.

The authors of the letter are asking members of the UK science and medical communities to sign the open letter.

Read the letter in full and sign here

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Millions in England face ‘second pandemic’ of mental health issues

Millions of patients in England face dangerously long waits for mental health care unless ministers urgently draw up a recovery plan to tackle a “second pandemic” of depression, anxiety, psychosis and eating disorders, NHS leaders and doctors have warned.

The Covid crisis has sparked a dramatic rise in the numbers of people experiencing mental health problems, with 1.6 million waiting for specialised treatment and another 8 million who cannot get on the waiting list but would benefit from support, the heads of the NHS Confederation and the Royal College of Psychiatrists have told the Guardian.

In some parts of the country, specialist mental health services are so overwhelmed they are “bouncing back” even the most serious cases of patients at risk of suicide, self-harm and starvation to the GPs that referred them, prompting warnings from doctors that some patients will likely die as a result.

“We are moving towards a new phase of needing to ‘live with’ coronavirus but for a worrying number of people, the virus is leaving a growing legacy of poor mental health that services are not equipped to deal with adequately at present,” said Matthew Taylor, the chief executive of the NHS Confederation, which represents the whole of the healthcare system in England.

“With projections showing that 10 million people in England, including 1.5 million children and teenagers, will need new or additional support for their mental health over the next three to five years it is no wonder that health leaders have dubbed this the second pandemic. A national crisis of this scale deserves targeted and sustained attention from the government in the same way we have seen with the elective care backlog.”

One family doctor in Hertfordshire, Dr David Turner, said he was so concerned about the situation that he had chosen to speak out publicly for the first time in his 25-year career. “I and many other GPs feel the issue has become critical and it is only a matter of time before a child dies,” he told the Guardian.

Turner said access to child and adolescent mental health services (CAMHS) was “never great pre-Covid” but was now “appalling”. The double whammy of a spike in demand and underinvestment in CAMHS was putting patients at risk, he added.

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Source: The Guardian, 21 February 2022

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Baby deaths force end to NHS targets for natural births

The NHS has abandoned targets that encouraged hospitals to pursue “normal births”, over fears for the safety of mothers and babies.

Maternity units were told in a letter to stop using caesarean section rates to assess their performance. It comes after repeated scandals in maternity units, blamed in part on a focus on pursuing natural births at the expense of safety.

The letter from Jacqueline Dunkley-Bent, NHS England’s chief midwife, and Dr Matthew Jolly, the national clinical director for maternity, instructed “all maternity services to stop using total caesarean section rates as a means of performance management”.

It added: “We are concerned by the potential for services to pursue targets that may be clinically inappropriate and unsafe in individual cases."

A final report into the deaths of dozens of babies at the Shrewsbury and Telford Hospital NHS Trust will be published next month. It is expected to be highly critical.

The midwife leading the inquiry, Donna Ockenden, has said women “felt pressured to have a normal birth” at the trust, adding: “There was a multi-professional, not midwife-led, focus on normal birth pretty much at any cost.”

Hayley Coates, 29, lost her son Kaylan after staff at Nottingham University Hospitals NHS Trust ignored her pleas for a caesarean section in March 2018. A coroner ruled that neglect contributed to Kaylan’s death. He suffered a fractured skull when he was delivered with forceps and was starved of oxygen.

Coates, a mother of three, said she welcomed the NHS England letter, adding: “I was just ignored when I asked multiple times for a caesarean section. I was told repeatedly: ‘You will have this baby naturally, you don’t want to go to theatre.’ If I had gone to theatre many hours before, my baby wouldn’t have died. They have a duty of care, and the mother’s wishes are supposed to be priority.”

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Source: The Times, 20 February 2022

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Government rejects calls to address nurse burnout and shortage

The government has rejected calls for an overhaul of NHS workforce planning amid concerns of staff shortages and a mounting backlog of patients.

It comes after a House of Commons health and social care committee report in 2021 found burnout among nurses and other healthcare professionals had reached an emergency point.

MPs had called for immediate action to support exhausted staff through a plan to cover staffing needs for the next two decades, led by Health Education England.

But in a government response to the report, the Department of Health and Social Care (DHSC) rejected calls for independent annual reports on workforce shortages and future staffing requirements.

Instead, a new duty in the recently introduced Health and Care Bill will require the health and social care secretary to publish reports on workforce planning in England every five years.

The duty is intended to compliment ‘investment on workforce planning and supply already underway’, the government’s response states.

But UNISON national nursing officer Stuart Tuckwood said a lack of an independent view on what is needed to support the NHS workforce risked the government focusing on cost ‘above all else’.

"The urgent focus for this year must be on preventing further gaps from appearing in the workforce, including nursing teams."

"The failure to grade staff properly for the jobs they do, ensure fair pay for additional hours and deliver flexible work patterns are all reasons cited by nurses, healthcare assistants and other staff for leaving."

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Source: Nursing Standard, 17 February 2022

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Doctor with Long Covid who suffered violent shakes and hallucinations attacks Boris Johnson's plan to 'live with virus'

A doctor who has suffered violent shakes and hallucinations during her ongoing 15-month battle with long COVID has criticised the government's plan to "live with the virus".

Dr Kelly Fearnley told Sky News she contemplated ending her own life due to the debilitating long-term effects of coronavirus, which she caught while working on a COVID ward in November 2020.

The 35-year-old from Leeds, who was previously fit and healthy, initially had flu-like symptoms before she suffered shortness of breath and painful rashes over her body, as well as swelling around her eye.

More than a year later, she is still unable to return to work due to the effects of long COVID, which have included violent shakes lasting up to 14 hours at a time, hallucinations, night terrors, severe pins and needles in her arms and legs, and a resting heart rate of 140 beats per minute.

With Prime Minister Boris Johnson set to unveil his "living with COVID" plan on Monday, Dr Fearnley branded it a "strategy of denial, driven by the need to cut costs" and she felt "angry and let down".

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Source: Sky News, 20 February 2022

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Families to take part in Nottingham maternity inquiry

Seventy families have come forward to be a part of an independent review into maternity services at Nottingham University Hospitals Trust (NUH).

The aim of the review is to "drive rapid improvements to maternity services". It comes after an investigation found 46 babies suffered brain damage and 19 were stillborn between 2010 and 2020.

The Clinical Commissioning Group (CCG) and NHS England are jointly leading the review of maternity incidents, complaints and concerns at Nottingham University Hospitals (NUH).

Cathy Purt, programme director of the review, said during a Nottingham City Council Health Scrutiny Committee meeting on Thursday: "We have had 70 families come forward 19 families have had their first interview with us."

"We have secured via the CCG specialist psychological support for the rest of the families so they will now be able to come forward and have their interviews as well.

"40 staff have come forward so far and more are coming as we go."

The review will cover information dating back to 2006, and is expected to be completed by November 30 2022.

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Source: BBC News, 18 February 2022

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111 callers eight times more likely to abandon calls in some areas

Callers to NHS 111 services are twice as likely to be judged as needing an ambulance in some regions as others – and up to eight times more likely to abandon their calls.

An HSJ investigation has revealed striking differences in performance between 111 providers. The new integrated urgent care data set, published by NHS England, shows the differences in performance across the country. HSJ analysed data from April to December last year – the first year this data set has been produced.

For example, 15.7% of answered calls to North East Ambulance Service Foundation Trust resulted in an “ambulance disposition” while just 7.7% of calls to London Ambulance Service Trust did so. A total of 14.2% of callers to the privately owned Practice Plus Group were judged to require an ambulance.

41.9% of calls were abandoned before being answered by NEAS and 30.6% of those made to the West Midlands Ambulance Service University FT ended the same way. In contrast just 5.2%of callers from Lincolnshire to services provided by Derbyshire Health United abandoned their calls.

The “standard” for abandoned calls is just 3%, but the average performance across England was 24.1%.

In a statement, the Practice Plus Group said its staff were trained to a high standard on NHS Pathways and it was confident its staff were making appropriate and safe decisions. Over 70 per cent of decisions to instigate a category 3 or 4 ambulance callout were validated in January. As a result ambulances were dispatched in just 20 per cent of those cases, with other patients being directed to alternative pathways.

“We are always looking to enhance the service which is why we are running developmental training for our call handlers in more effective probing to reduce the category 2 ambulance disposition numbers and have introduced GoodSam video technology as part of an NHSE pilot which will support clinicians with eyes on with a patient,” the company added.

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Source: HSJ, 18 February 2022

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Potentially harmful instructions given to pregnant women calling 999

The 'pre-arrival instructions' given by 999 (emergency services) call handlers to pregnant women/people experiencing maternity emergencies is a 'postcode lottery', with potentially harmful advice being given in some cases, the Healthcare Safety Investigation Branch (HSIB) has warned.

A national investigation by the HSIB examined the factors influencing the pre-arrival instructions given to pregnant women/people awaiting an ambulance because of an issue with their pregnancy. The instructions given by 999 call handlers are generated by a clinical decision support system (CDSS), with two CDSSs in use by ambulance services in England: an international system and a UK-based system.

The investigation reference case involved a 30-year-old woman who received advice from a 999 call handler that was in conflict with maternity clinical guidance. Similar concerns were identified in 15 HSIB maternity investigations, which all involved pre-arrival instructions generated by a CDSS that had the potential to cause harm to the woman or pregnant person and/or their baby.

The investigation found no evidence of a regulatory mechanism for 999 call handler pre-arrival instructions, and stakeholders acknowledged a gap in maternity emergency guidance relating to the non-visual, non-clinician-attended environment.

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Source: Medscape UK, 18 February 2022

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NHSE wants ‘urgent’ meetings over ambulance handovers risk

NHS England and the Care Quality Commission have asked systems with large numbers of ambulance handover delays to urgently hold a meeting to try to fix the problem by “balancing the risks” of long 999 waiting times.

The request was made in an email to chief executives, which warned the service was “in a difficult position with all parts of the urgent and emergency care pathway under considerable strain… most acutely in ambulance response times which in turn is linked to challenges in handing patients over to emergency departments”.

The NHSE headed letter was signed by its chief operating officer, nursing director and medical director, but also by the CQC’s chief inspector of hospitals Ted Baker.

It said there was a “strong correlation” between handover delays at hospitals — which take place where A&Es are unable to receive patients from ambulances — and long delays for category two ambulances. This is because ambulances have to wait for long periods outside the hospitals.

The letter said: ”It is vital that we have a whole-system approach to considering risks across the urgent and emergency care pathway to provide the best outcomes for our patients. This may mean consideration of actions to be taken downstream to help improve flow and reduce pressures on emergency departments.”

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Source: HSJ, 17 February 2022

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'My child is in pain - but I'm helpless'

Thomas Hebbron is one of the forgotten victims of the pandemic.

He was diagnosed with leukaemia in February 2019 - a year before Covid hit the UK.

The eight-year-old, from Leeds, has been treated with chemotherapy which has continued throughout the pandemic, but his health has suffered in other ways - and his mother believes the unrelenting focus on the virus is to blame.

Pre-pandemic he was seen in person by doctors every two weeks. But that changed to monthly video calls, and liver and urinary problems went undetected.

His treatment also affected his fine motor skills and has weakened his legs, but he has not seen an occupational therapist since before the pandemic.

"I want to take this pain away from him," says his mother, Gemma. "I don't want to sit and watch him in this pain, but I can't do anything. I just feel completely helpless."

Thomas's story is not unique. An analysis by the Nuffield Trust and Health Foundation has for the first time laid bare how access to core health services in England has been squeezed, threatening to leave behind a generation of young people.

The review has looked at both physical and mental health services and come to the same conclusion - support has been badly disrupted and the plight of children overlooked.

The Nuffield Trust and Health Foundation have been joined by the Royal College of Paediatrics and Child Health (RCPCH) in calling for a dedicated plan for children to help them recover from the pandemic.

Dr Camilla Kingdon, RCPCH president, said the figures "do not take into account the many other 'hidden' waiting lists of children waiting for community therapies and diagnostic assessments, especially for autism".

She added that children are "struggling" and, despite services being stretched, no-one should be deterred from speaking to a health professional.

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Source: BBC News, 18 February 2022

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Bionic eyes: Obsolete tech leaves patients in the dark

Hundreds of people who had retinal implants to improve their sight face an uncertain future as the technology they rely on is now obsolete.

Second Sight stopped making its Argus II bionic eyes several years ago to focus on a brain implant instead. According to IEEE Spectrum it is now hoping to merge with a biopharmaceutical firm which does not make eye implants.

IEEE Spectrum reports that Second Sight actually discontinued its retinal implants - which effectively take the place of photoreceptors in the eye to create a form of artificial vision - in 2019.

Patients contacted by IEEE Spectrum voiced concern.

One, Ross Doerr, said Second Sight failed to contact any of its patients after its financial difficulties in 2020. "Those of us with this implant are figuratively and literally in the dark," he said.

Another user, Jeroen Perk, had problems when his VPU system broke in November 2020. "I had no vision, no Argus, and no support from Second Sight," he said.

Elizabeth M Renieris, professor of technology ethics at the University of Notre Dame, in the US, described the development as a cautionary tale.

She told the BBC: "This is a prime example of our increasing vulnerability in the face of high-tech, smart and connected devices which are proliferating in the healthcare and biomedical sectors."

"These are not like off-the-shelf products or services that we can actually own or control. Instead we are dependent on software upgrades, proprietary methods and parts, and the commercial drivers and success or failure of for-profit ventures."

Ethical considerations around such technology should in future include "autonomy, dignity, and accountability", she added.

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Source: BBC News, 17 February 2022

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Government 'destroying lives' by ignoring review recommendations on vaginal mesh and harmful medicines, campaigners warn

Campaigners found to have been harmed by medical products have written to the health secretary warning that government inaction is "causing pain and destroying lives" by ignoring review recommendations.

Some 18 months ago, an independent review recommended financial help for people damaged by some products and drugs that had been prescribed by UK doctors.

The government - which set up the Independent Medicines and Medical Devices Safety Review in the first place - has chosen to ignore several of its recommendations.

Alleged victims of vaginal mesh, and the drugs valproate and Primodos, have written to Health Secretary Sajid Javid and Maria Caulfield to say they feel ignored.

The letter states: "Our members gave evidence to the two-year-long review, sometimes travelling long distances, often with disabilities."

"Families shared intimate details of their medical problems, their daily struggles, their difficulties parenting, sometimes even their sex lives. The panel, led by Baroness Cumberlege, was set up by the government to listen, assess and direct policy towards the best course of action.
 
"What was the point of this exercise and the hard work of the panel, if their key recommendations are then ignored by the government?"

In the letter, campaigners say: "The decision not to offer an agency for redress (Cumberlege recommendation 3) means that the review has lost its teeth."

"Still, no one is facing consequences of medical failures other than the patients. At a time when the public is being asked to put its faith in vaccines, this is a bad look for the government."

Kath Sansom, of the campaign group Sling the Mesh, said: "Women must dutifully accept their health has been irreversibly shattered by a medical product they were told was safe, some now needing a disabled blue badge, and they must put up and shut up."

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Source: Sky News, 17 February 2022

MeshPrimodosSodiumValproate_LettertoMariaCaulfield_170222.pdf

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Men urged to check prostate cancer risk after thousands miss diagnosis in pandemic

Thousands of men are being urged to check their risk of prostate cancer amid warnings that more than 14,000 have missed a diagnosis during the pandemic.

New figures show that the disease accounts for a third of those not treated for cancer during the pandemic, making it the cancer most likely to have been missed and putting lives at risk.

Experts said many men had held off visiting their GP which meant they could now be missing out on vital treatment. NHS figures suggest nearly 50,000 fewer cancer diagnoses across the UK in the Covid crisis, including 34,000 in England.

Experts said prostate cancer made up the largest group of missed cases, followed by breast cancer, of which around 8,000 cases have gone undiagnosed.

Prostate Cancer UK and NHS officials are urging men to use an online tool to assess their risk, with those found to be at high risk urged to then visit their GP.

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Source: The Telegraph, 17 February 2022

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The millions of people stuck in pandemic limbo

When the coronavirus pandemic began, Emily Landon thought about her own risk only in rare quiet moments. An infectious-disease doctor at the University of Chicago Medicine, she was cramming months of work into days, preparing her institution for the virus’s arrival in the United States. But Landon had also recently developed rheumatoid arthritis—a disease in which a person’s immune system attacks their own joints—and was taking two drugs that, by suppressing said immune system, made her more vulnerable to pathogens.

Normally, she’d be confident about avoiding infections, even in a hospital setting. This felt different. “We didn’t have enough tests, it was probably around us everywhere, and I’m walking around every day with insufficient antibodies and hamstrung T-cells,” she said.

Two years later, Covid-19 is still all around us, everywhere, and millions of people like Landon are walking around with a compromised immune system. A significant proportion of them don’t respond to Covid vaccines, so despite being vaccinated, many are still unsure whether they’re actually protected—and some know that they aren’t. Much of the United States dropped COVID restrictions long ago; many more cities and states are now following. That means policies that protected Landon and other immunocompromised people, including mask mandates and vaccination requirements, are disappearing, while accommodations that benefited them, such as flexible working options, are being rolled back.

This isn’t a small group. Close to 3% of US adults take immunosuppressive drugs, either to treat cancers or autoimmune disorders or to stop their body from rejecting transplanted organs or stem cells. That makes at least 7 million immunocompromised people.

In the past, immunocompromised people lived with their higher risk of infection, but COVID represents a new threat that, for many, has further jeopardised their ability to be part of the world. From the very start of the pandemic, some commentators have floated the idea “that we can protect the vulnerable and everyone else can go on with their lives.” Seth Trueger, who is on immunosuppressants for an autoimmune complication of cancer, said. “How’s that supposed to work?”

He is an emergency doctor at Northwestern Medicine; he can neither work from home nor protect himself by avoiding public spaces. “How am I supposed to provide for my family or live my life if there’s a pandemic raging?” he said. 

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Source: The Atlantic, 16 February 2022

Further reading

Read further Covid-19 blogs and stories from staff on the frontline

 

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Surgical mesh: Proposed training pathway needs more patient input, say campaigners

A proposed new training pathway for treating complications of pelvic mesh implants needs more input from patients and more consistent supervision of surgical procedures being carried out, campaigners have urged.

The pathway proposed by the Royal College of Obstetricians and Gynaecologists (RCOG) aims to outline the skills required of doctors working in specialist mesh removal centres, which were set up after a recommendation in the Cumberlege review into avoidable harm among patients injured by implanted pelvic mesh.

But a joint blog published on 17 February by Patient Safety Learning and Sling the Mesh raised several concerns about the proposed pathway, including that the consultation for implementing it was too short and not well publicised, offering limited opportunities for patients and groups to comment.

The groups wrote, “While the development of the training pathway did involve a focus group of six women with mesh related issues, we believe that RCOG have missed an opportunity to engage much more widely."

“Patient engagement is key to improving patient safety, even more so when there has been a significant loss of trust for patients in healthcare professionals, such as in the case of surgical mesh. We believe it is vital that RCOG, further to its focus group, should be engaging directly with patient groups to hear their concerns and experiences and to genuinely co-produce this type of guidance.”

Jo Mountfield, vice president of the RCOG, said that the concerns raised by the groups would be considered as part of the review process. She acknowledged that the consultation period could have been longer.

She said, “There will be further opportunity to involve patient groups as part of our application to the General Medical Council for approval of the training pathway, and we will take the comments raised in this blog on board."

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Source: BMJ, 17 February 2022

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Woman screaming in pain waiting years for hip op

"Seeing how much pain she's in is killing me," the mother of a woman waiting four years for a hip operation has said.

It is only by screaming that Marie Morgan, from Carmarthenshire, can express her level of suffering.

The 30-year-old, who has multiple brain conditions, can speak only a few words and needs round-the-clock care. 

"Her hip is out and is rubbing against bone... there's no socket there," Marie's mother Sandra said. "She can't travel because every time I move her she's screaming in pain.

Marie has cerebral palsy, severe epilepsy and fluid on the brain and the constant agony caused by the wait has meant these conditions, including her seizures, have become "horrendous".

Sandra said: "She used to be so happy, we used to go to the pool, play music... Now she's gone downhill. I don't think she can last much longer to be honest with you."

Marie, from Penygroes, is on a waiting list to have surgery in Morriston Hospital, Swansea.

Her mother said staff have told her she is considered to be high priority, but despite her best efforts, she is still in the dark about when the operation will happen.

"They said because of Covid they weren't operating, now they say it's staff shortages so it's something all the time.

"I feel I'm knocking my head against a wall. It's not fair, she's only 30 and suffering the way she is."

Swansea Bay Health Board said it hoped to tackle the backlog by increasing capacity at one of its hospitals.

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Source: BBC News, 17 February 2022

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Man's partner 'begged' for help before his death

A man who died from a mixed medication overdose might still be alive if the help his partner was "begging" for had been provided, a coroner said.

Mental health patient Benjamin Stroud, 42, had been under the care of Essex Partnership University NHS Trust (EPUT) in the weeks before his death in March.

Essex coroner Michelle Brown said in a post-inquest report that, despite "escalating psychosis", his care co-ordinator did not flag the case.

Following an overdose of medication in February, his partner, a nurse, called for psychiatric intervention and despite "begging" for help, Mr Stroud's care co-ordinator did not make a referral to the multi-disciplinary team (MDT).

Mr Stroud died at home on 19 March and was found surrounded by empty insulin pens and pain medication.

In her prevention of future deaths report, the coroner said: "It was clear from [his partner's] account that she had been begging the care co-ordinator for Mr Stroud to have an appointment with the psychiatrist, which did not occur and, from the evidence of EPUT, it was clear that Mr Stroud's care co-ordinator did not make any referral to the MDT, despite his escalating psychosis."

The coroner added that the issue of care co-ordinators failing to document their reasons for not referring cases to the MDT had been raised at other inquests.

"If these practices continue there is a real risk of future deaths occurring," Ms Brown warned.

Paul Scott, chief executive at the trust, said: "We will continue to view all safety-related incidents as an opportunity to learn and make sure lessons are shared across the trust."

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Source: BBC News, 16 February 2022

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