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Coronavirus: NHS to offer drug that can shorten recovery time by four days

Selected NHS coronavirus patients will soon be able to access an experimental treatment to speed up their recovery, with the health secretary Matt Hancock suggesting it is probably “the biggest step forward’’ in medication since the beginning of the COVID-19 crisis.

The anti-viral drug remdesivir will be made available to patients meeting certain clinical criteria to support their recovery in hospital.

The drug is currently undergoing clinical trials around the world, including in the UK, and peer-reviewed data showed it can shorten the time to recovery by about four days.

Treatment will initially be prioritised for patients who have the greatest likelihood of deriving the most benefit, according to the Department of Health and Social Care (DHSC).

Satisfied the drug can help boost recovery, the government’s Medicines and Healthcare products Regulatory Agency (MHRA) approved the use of remdesivir through its early access to medicines scheme.

The experimental anti-viral drug was granted emergency authorisation to treat Covid-19 in the US by the Food and Drug Administration earlier this month.

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Source: The Independent, 26 May 2020

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Coronavirus: NHS staff with Covid-19 given wrong test results

Some Welsh NHS staff with Covid-19 have been given wrong test results and were told they did not have coronavirus, BBC Wales has learned.

They are among a group of ten who have been given incorrect results - including eight from Aneurin Bevan Health Board and two from elsewhere.

It is not clear how many of the ten had Covid-19 and were told they did not, or vice versa.

The Gwent-based heath board said the staff were contacted "immediately".

It happened when a small number of test samples from a batch of 96 were attributed to the wrong patients.

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Source: BBC Wales, 7 April 2020

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Coronavirus: NHS staff struggle with burnout as they warn hospital bosses about looming second wave

NHS workers are at breaking point after months of upheaval and high pressure during the coronavirus outbreak with hospital leaders warning the health service is facing a “perfect storm” of workforce shortages and a second wave of COVID-19.

In a survey of 140 NHS trust leaders almost all of them said they were worried about their staff suffering burnout ahead of winter.

They also sounded the alarm over concerns there had not been enough investment into social care before this winter.

NHS Providers, which carried out the survey ahead of its annual conference of hospital leaders, warned the first wave of COVID-19 had made a lasting impact on the health service which had yet to fully recover.

Chris Hopson, chief executive of NHS Providers, which represents NHS trusts, said there had been “no let-up in the pressure” during the pandemic, which followed a difficult winter for staff.

“And while the response to the spring surge in COVID-19 cases showed the NHS at its best, the pressures took their toll on staff who gave so much,” he said.

“The worry is that the sustained physical, psychological and emotional pressure on health staff is threatening to push them beyond their limits of endurance.”

Almost all those who responded to the survey, 99 per cent, said they were either extremely or moderately concerned about the current level of burnout across the workforce.

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Source: The Independent, 6 October 2020

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Coronavirus: NHS staff off work due to testing shortages, say bosses

A lack of coronavirus tests for NHS staff is leading to staff absences and services being put at risk, hospital bosses have warned.

NHS Providers, which represents hospital trusts in England, said staff are having to self-isolate rather than work because they cannot get tests for themselves or family members. It comes after widespread reports of people struggling to get tested.

The home secretary defended the system, saying capacity was increasing.

The government's testing system - part of its test, track and trace operation which Prime Minister Boris Johnson promised would be "world-beating" - has faced criticism in recent weeks. An increase in demand for coronavirus tests has led to local shortages - with some people being directed to test sites hundreds of miles from their homes.

One doctor working in a coronavirus hotspot said she applied for a test for herself and her partner after they developed coughs and fevers. After refreshing the website for five hours, she managed to get an appointment but on arrival was told no booking had been made.

She had taken screenshots of a confirmation code but was not sent a QR code to scan. "I showed the screenshots but I was told that the appointments weren't happening," she said.

"I have to say I burst into tears. I was meant to be seeing patients and I feel guilty."

Dr Rachel Ward, a GP in Newbury, told BBC Breakfast she was seeing a lot of patients who were struggling to get tests, saying a lot of families were "at the end of their tether" as it was "very stressful when you are faced with two weeks off work".

She said if the staff at her practice were unable to get tests and had to self-isolate it would have a "huge impact" on patients as some of their healthcare workers are booked in to administer 100 flu jabs in a day.

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Source: BBC News, 14 September 2020

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Coronavirus: NHS staff need tests 'twice a week'

A leading surgeon has said NHS staff must be routinely tested for coronavirus up to twice a week.

Prof Derek Alderson, president of the Royal College of Surgeons, said it was vital, to reassure patients staff were not unwittingly carrying the virus. 

But hospital trust bosses say they are still waiting for clarity on plans for regular testing. The Department for Health and Social Care (DHSC) said it was focusing on routine testing in care homes.

Prof Alderson was speaking at a Health Select Committee meeting about the necessary steps to get all NHS services back up and running. He said: "It's absolutely essential to regain public confidence that we are able to test our staff regularly."

It would be "pragmatic" for testing to take place "about twice weekly", he added, because it was known that the available tests were not perfect.

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Source: BBC News, 17 June 2020

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Coronavirus: NHS shielding letters miss thousands of cancer patients

Tens of thousands of cancer patients have not yet received letters advising them to “shield” themselves from the coronavirus threat, The Times has learnt.

Peter Johnson, national clinical director for cancer, has written to charities asking for their help in tracing the missing patients and alerting them to the need to take stringent self-protection measures against infection.

His appeal comes as the government increased by one million its estimate of the number of people at greatest risk of severe illness should they contract COVID-19.

Its new strategy document stated that it had identified 2.5 million people who were “clinically extremely vulnerable and advised to shield”. At the onset of the lockdown in March, ministers estimated the number at 1.5 million.

Professor Johnson’s letter, seen by The Times, states: “We are still receiving reports of cancer patients who believe that they should have received a shielding letter but have not yet received one or have not been added to the national list. It is crucial that those who are clinically extremely vulnerable receive a letter advising them to shield.

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Source: The Times, 12 May 2020

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Coronavirus: NHS patient triage hotline stops nurses handling calls over safety fears

Nurses and non-medical staff have been stopped from taking patient calls to the NHS coronavirus helpline amid concerns over the safety of their advice.

An audit of calls to the telephone assessment service found more than half were potentially unsafe for patients, according to a leaked email shared with The Independent. At least one patient may have come to harm as a result of the way their assessment was handled.

The COVID-19 Clinical Assessment Service (CCAS) is a branch of the NHS 111 phone line and is designed to assess patients showing signs of coronavirus to determine whether they need to be taken to hospital or seen by a GP.

The helpline was set up at the start of the pandemic to divert patients with symptoms to a phone-based triage to relieve pressure on GPs and prevent them from turning up at surgeries and spreading the virus.

GPs, nurses and allied health professionals (AHPs) such as paramedics and physiotherapists were recruited to speak to patients after they were flagged by NHS 111 call handlers.

The use of non-medical staff was first paused in July amid concerns about the quality of call handling. Now it has emerged much wider safety issues have surfaced.

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Source: The Independent, 18 August 2020

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Coronavirus: NHS nurses told 'lives would be made hell'

Hospital nurses were told their "lives would be made hell" if they complained over conditions on a coronavirus ward, a union has claimed.

Unison has raised a group grievance for 36 employees, most of them nurses, at Nottingham University Hospitals Trust. It said staff on the Queen's Medical Centre ward were not trained properly, faced bullying for raising concerns and denied PPE "as punishment".

The trust said the allegations were "very troubling".

The union said the staff, which included nurses, senior nurses and healthcare assistants, volunteered to work on the hospital's only ward dealing with end-of-life coronavirus patients. It claimed they were not given any specialist training or counselling for dealing with dying patients and their grieving relatives.

An anonymous member of staff described it as "incredibly stressful".

Another worker said a board with everyone's record of sickness was put on display in a break room to intimidate staff.

Dave Ratchford from Unison said: "This is absolutely shocking stuff. We're talking about a very high-performing team who fell foul of a culture that permits bullying and fails to address it"

"Staff were told their lives would be made hell for complaining."

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Source: BBC News, 21 July 2020

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Coronavirus: NHS hospitals accused of using crisis as excuse to deny women caesarean sections

Hospitals have been refusing requests for caesarean sections during the COVID-19 outbreak despite official guidance and NHS England advice that they should go ahead.

Multiple NHS trusts have told women preparing to give birth since March that requests for a caesarean section will not be granted due to the viral pandemic.

It has led to accusations from the charity Birthrights that the coronavirus outbreak is being used as an excuse to promote an ideology that more women should have a natural birth.

Maria Booker, from Birthrights, told The Independent: “We continue to be contacted by women being told they cannot have a maternal request caesarean and we are concerned that in some places coronavirus is being used as an excuse to dictate to women how they should give birth, which contravenes NICE (National Institute for Health and Care Excellence) guidance.

Official guidance from NICE says women should be offered a caesarean section where they insist it is what they want.

NHS England has warned hospitals they need to “make every effort” to avoid cancelling caesarean sections and work with neighbouring trusts to transfer women if necessary. It said surgery should only be suspended in “extreme circumstances” where there is a shortage of obstetricians or anaesthetists.

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Source: The Independent, 17 May 2020

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Coronavirus: NHS faces pandemic 'triple whammy' this winter

The NHS is facing a "triple whammy" of rising COVID-19 cases, a major backlog in treatment and reduced capacity due to infection-control measures, according to health bosses. 

The NHS Confederation report on the English NHS said more investment was desperately needed. The NHS bosses also called on ministers to be "honest and realistic" about waiting lists for treatment.

It comes despite the government promising an extra £3bn this winter. That money - announced over the summer - was intended to help hospitals cope with the extra-infection control measures required and to pay for patients to be treated privately for routine treatment, such as knee and hip replacements. 

But hospitals are still performing only half the number of routine operations they normally would. Two million patients have already waited longer than 18 weeks for treatment, the highest number since records began, in 2007.

And services in other areas, such as cancer care, are running at about three-quarters capacity. 

Of the more than 250 bosses who responded to the confederation's survey:

  • fewer than one in 10 said the current level of funding allowed them to deliver safe and effective care
  • nearly nine in 10 said a lack of funding would be a significant barrier to achieving waiting-time targets for everything from mental-health care to cancer treatment and routine operations.

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Source: BBC News, 29 September 2020

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Coronavirus: NHS England launches tool to aid long-term recovery

NHS England is launching a new service for people with ongoing health problems after having coronavirus.

The government says "tens of thousands" of people have long-term symptoms after catching COVID-19.

"Your Covid Recovery" will be an online portal for people in England to access tutorials, contact healthcare workers and track their progress.

The project will be rolled out in two phases, with the web portal launching later this month.

It will only be accessible via a personal log-in and will be available to virus patients who had to be treated in hospital, as well as to those who managed their illness at home.

Later in the summer, tailored rehabilitation will also be offered to those who qualify, following an assessment.

Each programme will last a maximum of 12 weeks, the Department of Health and Social Care said.

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Source: BBC News,  5 July 2020

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Coronavirus: NHS doctors ‘gagged’ over protective equipment shortages

Frontline doctors have told the Independent they have been gagged from speaking out about shortages of protective equipment as they treat coronavirus patients – with some claiming managers have threatened their careers.

Staff have been warned not to make any comments about shortages on social media, as well as avoiding talking to journalists, while NHS England has taken over the media operations for many NHS hospitals and staff.

The Independent has seen a series of emails and messages warning staff not to speak to the media during the coronavirus outbreak.

One GP has been barred from working in a community hospital in Ludlow after making comments about the lack of equipment, while another in London said they were told to remove protective equipment they had purchased themselves.

NHS England confirmed it was controlling media communications, which it said was part of its national emergency incident planning to ensure the public received “clear and consistent information”. 

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Source: The Independent, 1 April 2020

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Coronavirus: NHS bosses warn hospitals over intensive care demand surge

NHS hospitals have been told to expect a “several-fold” increase in demand for intensive care beds during a serious coronavirus outbreak.

Professor Keith Willett, NHS England’s incident director for the coronavirus outbreak, told a secret briefing of chief nurses from across the NHS that they needed to prepare now for the unprecedented demand which could overwhelm existing critical care services.

Sources who were in the briefing told The Independent Prof Willett warned the demand was likely to be not just double but “several fold” the existing 4,000 intensive care beds in the NHS.

Prof Willett said the NHS will also be holding large-scale simulations next week for an expected coronavirus surge in an effort to “stress test the system” ahead of rising cases of infection.

If the predictions are right the NHS will likely be forced to cancel large numbers of operations and re-deploy nurses and doctors.

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Source: The Independent, 12 March 2020

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Coronavirus: New saliva test to be piloted in Southampton

A new coronavirus test which could replace the existing a nose and throat swab is being piloted in Southampton.

People will be able to simply spit into a pot at home before the sample is sent off to check whether they have COVID-19.

If successful, the saliva test could become an alternative to the existing swab which some people find uncomfortable and can provoke coughing and spluttering.

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Source: The Independent, 22 June 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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Coronavirus: More tests promised for care homes

All care home residents and staff with COVID-19 symptoms will be tested for coronavirus as laboratory capacity increases, the government has promised.

Health Secretary Matt Hancock said he was "determined" to ensure everyone who needed a test had access to one. 

Care providers have been calling for more testing for weeks, with charities saying the virus is "running wild" amid outbreaks at more than 2,000 homes. At the moment only the first five residents who show symptoms in a care home are tested, to determine whether there is an outbreak of the virus.

Providers have also complained that deaths among residents were being "airbrushed" out of official figures and demanded greater support for the industry.

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Source: BBC News, 15 April 2020

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Coronavirus: Ministers have ‘lost control of the virus’, says health expert following spike in cases

A leading health expert has suggested ministers have “lost control of the virus”, after the UK recorded it’s largest 24-hour spike in COVID-19 cases since 23 May.

Government figures showed there have been a further 2,988 lab-confirmed cases of coronavirus in the UK as of 9am on Sunday. This brings the total number of confirmed cases in the UK to 347,152.

Sunday's figure is the highest since May 22 when 3,287 cases were recorded, and is also the first 24-hour period when cases passed 2,000 since the end of May. The tally was an increase on Saturday's figures of 1,813 new cases.

Prof Gabriel Scally, a member of the Independent Sage group and a former NHS regional director of public health for the south-west, warned that government ministers had “lost control of the virus”.

“It’s no longer small outbreaks they can stamp on,” he told The Guardian. “It’s become endemic in our poorest communities and this is the result.

Shadow health secretary Jonathan Ashworth called upon the government to respond to the sharp spike.

He added that it was “a stark reminder that there is no room for complacency in tackling the spread of the virus”.

“This increase, combined with the ongoing testing fiasco where ill people are told to drive for miles for tests, and the poor performance of the contact tracing system, needs an explanation from ministers,” he said on Sunday.

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Source: The Independent, 7 September 2020

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Coronavirus: Millions could be asked to stay at home again, reports say

Millions of people who are at risk of serious illness from COVID-19 could be asked to start shielding again if infection rates continue to rise, according to reports.

Officials are planning to send out letters telling the most vulnerable either to stay at home or to follow advice specifically tailored to their health conditions.

The Daily Telegraph  reports that the new programme will initially target those living in areas with dangerous levels of coronavirus but went on to quote an anonymous official as saying it could be applied to the whole of England if necessary.

If so, it could affect up to 4.5 million people – more than double the number who were asked to shield at the start of the lockdown in March.

The new shielding scheme is reportedly based on a "stratified risk model" which would target individuals based on factors such as their underlying health conditions, age, sex and weight. 

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Source: 13 September 2020

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Coronavirus: Mercedes F1 to make breathing aid

A breathing aid that can help keep coronavirus patients out of intensive care has been created in under a week.

University College London engineers worked with clinicians at UCLH and Mercedes Formula One to build the device, which delivers oxygen to the lungs without needing a ventilator.

Continuous Positive Airway Pressure (CPAP) devices are already used in hospitals but are in short supply. China and Italy used them to help Covid-19 patients.

Forty of the new devices have been delivered to ULCH and to three other London hospitals. If trials go well, up to 1,000 of the CPAP machines can be produced per day by Mercedes-AMG-HPP, beginning in a week's time.

The Medicines and Healthcare products Regulatory Agency (MHRA) has already given its approval for their use.

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Source: BBC News, 30 March 2020

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Coronavirus: Matt Hancock 'worried' about 'debilitating' long-term impact of COVID-19

Health Secretary Matt Hancock admits he is "worried" about the long-term impacts of coronavirus on those who have been infected.

Mr Hancock said a "significant minority" of people had suffered "quite debilitating" conditions after contracting COVID-19.

It comes after Sky News reported on how psychosis, insomnia, kidney disease, spinal infections, strokes, chronic tiredness and mobility issues are being identified in former coronavirus patients in northern Italy.

Asked about the long-term impact of the disease on patients, the health secretary told Sky News: "I am concerned there's increasing evidence a minority of people - but a significant minority - have long-term impacts and it can be quite debilitating. "So we've set up an NHS service to support those with long-term impacts of COVID-19 and, also, we've put almost £10m into research into these long-term effects."

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Source: Sky News, 15 July 2020

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Coronavirus: Mass testing begins in Liverpool amid fears rapid test technology is 'missing cases'

A mass testing pilot of the government's "operation moonshot" has begun in Liverpool.

The pilot scheme will see half a million people offered tests, including a new form of rapid testing, even if they do not have symptoms, as Botis Johnson banks on technological advances to steer the nation out of a second wave of COVID-19.

Around 2,000 members of the military are helping NHS staff to administer a combination of swab tests and new lateral flow tests which give results within an hour without the need of a lab.

Loop Mediated Isothermal Amplification (LAMP) tests, which can give results in as little as 20 minutes are being trialled for hospital and care home staff. But it comes as the Guardian reported that some of the technology at the heart of the scheme missed more than 50% of positive coronavirus cases in a Greater Manchester pilot.

The OptiGene LAMP test identified only 46.7% of infections during a trial in Manchester and Salford last month, according to a letter from Greater Manchester's mass testing group seen by the newspaper.

The Department of Health and Social Care (DHSC) said that it was "incorrect" to suggest the rapid test has a low sensitivity, adding that it had been validated in another recent pilot.

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Source: Sky News, 6 November 2020

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Coronavirus: Majority of pregnant women who died were ethnic minority background, report finds

A majority of pregnant women who died from coronavirus during the peak of the pandemic were from an ethnic minority background, it has emerged.

A new study of more than a dozen women who died between March and May this year also heavily criticised the reorganisation of NHS services which it said contributed to poor care and the deaths of some of the women.

This included one woman who was twice denied an intensive care bed because there were none available, as well as women treated by inexperienced staff who had been redeployed by hospitals and who made mistakes in their treatment of the women.

The report, by experts at the National Perinatal Epidemiology Unit, based at the University of Oxford, also criticised mental health services after four women died by suicide. The report said women were “bounced” between services which had stopped face-to-face assessments during the crisis.

The report looked at 16 women’s deaths in total. Eight women died from COVID-19, seven of whom had an ethnic minority background. Two women with Covid-19 died from unrelated causes, four died by suicide and two were victims of homicide.

In the report, published on Thursday, the authors concluded improvements in care could have been made in 13 of the deaths they examined. In six cases, improvements in care could have meant they survived.

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Source: The Independent, 21 August 2020

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Coronavirus: Lung damage in COVID-19 patients appears to improve after several months, study shows

The lungs and hearts of patients damaged by the coronavirus improve over time, a study has shown.

Researchers in Austria recruited coronavirus patients who had been admitted to hospital. The patients were scheduled to return for evaluation 6, 12 and 24 weeks after being discharged, in what is said to be the first prospective follow-up of people infected with COVID-19, which will be presented at today's European Respiratory Society International Congress.

Clinical examinations, laboratory tests, analysis of the amounts of oxygen and carbon dioxide in arterial blood, and lung function tests were carried out during these visits. 

At the time of their first visit, more than half of the patients had at least one persistent symptom, predominantly breathlessness and coughing, and CT scans still showed lung damage in 88% of patients. But by the time of their next visit, 12 weeks after discharge, the symptoms had improved, and lung damage was reduced to 56%.

Dr Sabina Sahanic, a clinical PhD student at the University Clinic in Innsbruck and part of the team that carried out the study, said: "The bad news is that people show lung impairment from COVID-19 weeks after discharge; the good news is that the impairment tends to ameliorate over time, which suggests the lungs have a mechanism for repairing themselves."

A separate presentation to the congress said that the sooner COVID-19 patients started a pulmonary rehabilitation programme after coming off ventilators, the better and faster their recovery.

Yara Al Chikhanie, a PhD student at the Dieulefit Sante clinic for pulmonary rehabilitation and the Hp2 Lab at the Grenoble Alps University in France, used a walking test to evaluate the weekly progress of 19 patients who had spent an average of three weeks in intensive care and two weeks in a pulmonary ward before being transferred to a clinic for pulmonary rehabilitation.

She said: "The most important finding was that patients who were admitted to pulmonary rehabilitation shortly after leaving intensive care progressed faster than those who spent a longer period in the pulmonary ward where they remained inactive. The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients' walking and breathing capacities and muscle gain."

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Source: The Independent, 7 September 2020

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Coronavirus: London’s Nightingale hospital recorded 144 safety incidents in 29 days

London’s Nightingale hospital recorded 144 patient safety incidents during its 29 days treating 54 patients, it has emerged.

There were two serious incidents at the field hospital, a doctor told a Royal Society of Medicine webinar.

Dr Andrew Wragg, consultant cardiologist and director of quality and safety at Barts Health NHS Trust, said a study of the long-term outcomes of the 54 patients was ongoing, as 20 of those treated at the ExCel conference centre site were still recovering in hospitals across London.

Johanna Cade, a nurse at Guy’s and St Thomas’ NHS trust and who worked at the Nightingale, said: “We had quite high incident reporting at 144 incidents reported and I think that demonstrates that Nightingale really did well at building a no blame safety culture for resolution and learning. This system manifested itself and staff were really striving to make things better continually. We knew who to report to and how to escalate things.”

She showed data revealing the largest number of safety incidents involved medical devices.

There were 25 incidents that included the ventilators used to keep patients alive. Staffing issues and medication, as well as pressure ulcer and communication incidents, were also among the highest numbers.

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Source: The Independent, 27 June 2020

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Coronavirus: Lockdown psychiatric care 'severely disrupted'

Isolation during lockdown is exacerbating psychosis in some patients, a consultant psychiatrist at a leading mental-health trust warns.

Steve Church said the South London and Maudsley NHS Trust had now had to shift its focus to crisis management.

He leads the psychosis recovery team, one of the trust's five teams helping patients struggling with their mental health during the coronavirus pandemic. Some have had to move homes to isolate and many no longer visit the clinic.

Dr Church, who has been working in the field for almost three decades, said: "In normal times, and we're not in normal times, the whole treatment is about trying to help people not self-isolate, trying to help people to re-engage with society.

"Self-isolation is one of the red flag-hallmarks of somebody becoming unwell in the first place, where they take themselves into a psychosis-induced lockdown."

One of his patients, Tracey, told Dr Church, in a phone consultation, staying at home had increased her hallucinations. "It's been quite daunting," she said. "I do hear the voices a little bit more now. They're domineering - they tell me to run across the road and they're following me and they say horrible and nasty things."

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Source: BBC News, 5 May 2020

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