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Coronavirus: Ibuprofen tested as treatment for breathing difficulties in hospital patients

A trial has been launched in the UK to test whether ibuprofen can help with breathing difficulties in COVID-19 hospital patients.

Scientists hope a modified form of the anti-inflammatory drug and painkiller will help to relieve respiratory problems in people who have more serious coronavirus symptoms but do not need intensive care unit treatment.

Half the patients participating in the trial will be administered with the drug in addition to their usual care, while the other half will receive standard care to analyse the effectiveness of the treatment.

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Source: The Independent, 3 June 2020

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Coronavirus: Hundreds of thousands of vulnerable people 'could be told to shield' as cases rise

Hundreds of thousands of vulnerable people living in coronavirus hotspots could be told to "shield" this winter as infections continue to rise.

Ministers are expected to outline a three-tier local lockdown system next week, which may see those most at risk if they catch COVID-19 being told to stay at home for a month.

A decision on shielding has not been finalised and may be delayed because of fears for the mental health of those told to avoid seeing other people.

Around 2.2 million people in England deemed "clinically extremely vulnerable" were asked to shield at the height of the coronavirus pandemic before the scheme was "paused" at the end of July.

Sky News understands that the level of self-isolation required in each area will vary depending on the restrictions in place there.

It is thought the advice will be clinically led, with GPs helping guide what people should do bearing in mind possible negative effects on mental health.

This compares with the more blanket advice on shielding last time around.

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Source: Sky News, 9 October 2020

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Coronavirus: Hundreds of learning disability deaths in just eight weeks, new data shows

More than 460 people with a learning disability have died from coronavirus in just eight weeks since the start of the outbreak in England.

New data shows between the 16 March and 10 May 1,029 people with a learning disability died in England, with 45 per cent, 467, linked to coronavirus.Overall the number of deaths during the eight weeks is 550 more than would be expected when compared to the same period last year.

The charity Mencap warned people with a learning disability were “being forgotten in this crisis” and called for action to tackle what it said could be “potentially discriminatory practice.”

It highlighted the percentage of Covid-19 related deaths among learning disabled people was higher than those in care homes, where the proportion of Covid-19 deaths was 31 per cent for the same period.

The data has been published after an outcry over the lack of transparency about the impact of Covid-19 on mental health patients and people with a learning disability or autism.

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Source: The Independent, 19 May 2020

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Coronavirus: Hospitals warned problems with oxygen supply will be worse than first wave

Hospitals across England could see oxygen supplies at worse levels this winter than at the peak of the first coronavirus wave – when some sites were forced to close to new admissions.

An alert to NHS hospitals this week warned that because of the rise in admissions of COVID-19 patients, there is a risk of oxygen shortages.

Trusts have been ordered to carry out daily checks on the amount of oxygen in the air on wards to reduce the risk of catastrophic fires or explosions.

The problem is not because of a lack of oxygen but because pipes delivering the gas to wards will not be able to deliver the volume of gas needed by all patients.

This can trigger a cut-off in supply and a catastrophic drop in pressure, meaning patients would be denied the oxygen they need to breathe.

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Source: The Independent, 20 November 2020

 

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Coronavirus: Hospitals defy authorities to protect staff as 35,000 patients are infected with Covid on wards

NHS hospitals are defying official rules to give nurses and doctors masks with greater protection amid fears over the spread of coronavirus within hospital wards.

An analysis of the latest NHS data by The Independent shows more than 35,000 patients were likely to have been infected with coronavirus while already in hospital between 1 August and 31 January.

NHS England has estimated as many as 20% of infections could be due to spread within hospitals. Outbreaks at some hospitals have seen whole teams of doctors or nurses affected, in some cases leading to wards having to be closed.

The Independent has learnt several hospitals are now supplying higher grade masks to staff working in general wards, despite Public Health England saying only surgical masks are needed. Research this week suggested staff exposed to coughing were at greatest risk of infection from the virus.

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Source: The Independent, 7 February 2021

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Coronavirus: Home secretary urged to do more to relax drug rules to help ease end-of-life suffering

The government is under pressure to go further on measures to relax rules on powerful painkillers such as morphine to prevent patients suffering “unnecessary pain and distress in the last days of their lives”.

On Tuesday the health secretary, Matt Hancock, announced staff in care homes and hospices would be allowed to “re-use” controlled drugs such as morphine and midazolam, with medication prescribed for one patient used for another where there is an immediate need.

But the Home Office today confirmed to The Independent that it had no plans to extend the rules to the care of patients in their own homes – a restriction experts and charities have warned could leave people suffering at the end of their lives.

The government announced the changes following concerns over the supply of drugs. 

The Royal College of GPs (RCGP) welcomed the changes announced by Mr Hancock, calling them “a significant step forward”, but added: “This only applies to patients living in care home and hospice settings, so there is still work to be done to ensure patients living in their own homes have appropriate access to necessary medication in a timely way.”

Last week the RCGP wrote to home secretary Priti Patel warning that people were suffering unnecessarily due to problems accessing drugs.

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Source: The Independent, 30 April 2020

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Coronavirus: Home abortions approved during outbreak

Patients in England can now have home abortions during the COVID-19 outbreak, the government in England has said.

Abortion policy has changed several times during the current pandemic. Women and girls wanting to terminate an early pregnancy were first told the service would be available but that decision was then retracted.

Now, the government has decided patients can take two pills at home instead of going to a clinic to avoid exposure to coronavirus.

Charities had been worried that women who want an abortion but have underlying health conditions would put themselves at risk to have the procedure or turn to dangerous alternatives.

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Source: BBC News, 31 March 2020

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Coronavirus: High-risk health workers 'may not be protected' in Wales

Guidance to protect at-risk healthcare workers in Wales from coronavirus infection has been relaxed, the BBC has learned.

A risk assessment tool initially recommended high-risk workers should not work in the parts of a hospital where infection was most likely. But it now says their personal protective equipment (PPE) should be reviewed or duties changed.

The Welsh government says this reflects latest data and low infection rates. However, healthcare professionals say the change to the all-Wales COVID-19 workforce risk assessment tool was made without consultation, and are concerned it was done to prevent hospitals from losing frontline staff ahead of a potential second wave of the virus.

Mr Amol Pandit, a urologist who helped to design the tool, has written to the Welsh government four times seeking clarity on the basis for the changes, and why no one was made aware of them before the tool was rolled out.

"The changes could have been made in order to keep as many healthcare workers on the frontline as possible, which is why I sent a specific list of questions to the Welsh government, so that I could have assurances that it wasn't done for that reason, but for clinical, evidence-based reasons," Mr Pandit said.

Mr Pandit believes healthcare workers who fall into the high-risk category and work in environments where aerosol-generating procedures are performed - considered to carry a high risk of transmission of the virus - may not be fully protected by the current version of the tool if PPE supplies fall short and additional safeguarding measures aren't put into place.

"The government needs to be absolutely sure that there is adequate PPE and that it is going to be available to everybody - we have to trust them on that," he said

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Source: BBC News, 27 August 2020

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Coronavirus: Health checks recommended for ethnic minorities from age 25

Health checks should be offered to people from black, Asian and minority ethnic backgrounds from the age of 25, a report has recommended.

MPs examined the disproportionate impact of the Covid pandemic on people from black and Asian backgrounds. They said NHS checks, currently available to 40-70-year-olds in England, could pick up conditions which are linked to severe coronavirus.

The role of inequalities in employment and housing was also emphasised. The report, produced by the Women and Equalities Committee, said the government should act to tackle these wider causes of poor health.

The committee heard evidence during the course of its investigation that showed 63% of healthcare workers who died after contracting the virus had come from black, Asian or other ethnic minority backgrounds.

And during the first peak of the virus, data from the Intensive Care National Audit and Research Centre showed 34% of coronavirus patients in ICUs were from an ethnic minority background, whereas they made up 12% of viral pneumonia admissions.

Office for National Statistics (ONS) data has also shown that black people were almost twice as likely to die from Covid-19 as white people, with those of Bangladeshi and Pakistani ethnicity about 1.7 times as likely.

The report raised concerns the pandemic was entrenching "existing health inequalities".

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Source: BBC News, 15December 2020

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Coronavirus: Hancock admits ‘challenges’ over NHS equipment

The health secretary has acknowledged there have been "challenges" with the supply of personal protective equipment to NHS staff in England - but added he is determined to rise to them.

Last week, NHS staff said the lack of protective gear was putting them at risk during the coronavirus outbreak.

Matt Hancock said a million face masks had been bought over the weekend and he was taking the issue "very seriously".

From this week, the Army will play a part in helping to distribute supplies.

"I am determined to ensure that the right kit gets to the right hospital, the right ambulance service, the right doctors' surgery, right across the country," said Mr Hancock.

"There have been challenges and I can see that. We're on it and trying to solve all the problems."

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Source: BBC News, 23 March 2020

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Coronavirus: Half a million access suicide prevention course

More than half a million people have accessed online training that aims to prevent suicide in the last three weeks alone, a charity has said.

The Zero Suicide Alliance said 503,000 users completed its online course during lockdown. It aims to help spot the signs that a person may need help.

It comes as health leaders warned front-line workers tackling coronavirus could suffer from mental ill health.

NHS England launched a mental health hotline to support staff last month.

The alliance's Joe Rafferty said the true impact of the coronavirus on mental health will not be known until the pandemic ends, but he said "the stress and worry of the coronavirus is bound to have impacted people's mental health".

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Source: BBC News, 18 May 2020

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Coronavirus: GPs prepare for NHS's 'biggest crisis'

As coronavirus spreads widely across the UK, many of those who fall sick may seek treatment at their GP's surgery. But are family doctors ready to deal with a wave of patients, prevent the spread of the disease and protect the most vulnerable?

"This is a massive crisis, probably the biggest crisis the NHS has ever had to face," says Prof Martin Marshall, an east London GP who is also chair of the Royal College of General Practitioners' council.

He says not enough has been done yet to prepare family doctors for the epidemic, although he adds: "We need to be a little bit understanding of the pressures that the whole system is under."

As the virus circulates in the community, he says we need "urgent action" to protect healthcare workers, give them the information they need and provide technology to allow for more consultations by phone or the internet.

Given the pressures the NHS will be under, Prof Marshall says it is vital that doctors and nurses are not taken out of action for seven days of isolation unnecessarily.

"We're not saying that health professionals are more important than patients, we're saying that health professionals have a responsibility," he says.

"We therefore need to keep them as healthy as possible and we need to get them back into the workforce as quickly as possible. So we're asking that health professionals are tested early."

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Source: BBC News, 16 March 2020

 

 

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Coronavirus: GPs not told when patients removed from 'shielding lists'

Some extremely vulnerable people have been told they have been removed from shielding lists via text message, without the knowledge of their GP.

This has caused confusion, with charities demanding clearer guidance for this group as lockdown eases. GPs say they should be notified when their patients are added or removed from the lists.

Shielding has now been extended until the end of June and is under constant review, the government says.

Around 2.2 million people in the UK are staying at home to protect themselves from the virus because they were told they were at high risk of being seriously ill with COVID-19.

But 40 healthcare charities say the lack of a clear plan for their future is causing anxiety and potentially putting their health at risk.

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Source: BBC News, 30 May 2020

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Coronavirus: GPs demand 'clarity' over protective gear guidance

GPs are demanding "urgent clarification" from the government on whether they should now wear protective equipment to examine all patients.

Family doctors now wear it if they see a patient with suspected coronavirus. But the Royal College of General Practitioners (RCGP) has written to Health Secretary Matt Hancock to ask if GPs should wear it for all face-to-face consultations. It says patients with the virus but no symptoms could still infect staff.

The BBC understands GPs in some surgeries have decided to wear personal protective equipment (PPE) for all face-to-face consultations, but this is not currently recommended by Public Health England.

In the letter, Prof Martin Marshall, chairman of the RCGP, wrote: "GPs across the country have never been more concerned, not just for the safety of themselves and their teams, but for patients too. They are unsure as to whether they have enough supplies [of PPE], either now, or as the crisis deepens".

"They are not confident that the current guidance provides the necessary clarity about whether GPs are using the right type of equipment, at the right times," he said.

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Source: BBC News, 26 March 2020

 

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Coronavirus: GP surgery apology over 'do not resuscitate' form

A GP surgery has apologised after sending a letter asking patients with life-limiting illnesses to complete a "do not resuscitate" form.

A letter, from Llynfi Surgery in Maesteg, asks people to sign to ensure emergency services would not be called if their condition deteriorated due to coronavirus.

"We will not abandon you.. but we have to be frank and realistic," it said.

Cwm Taf health board issued an apology from the surgery, the Guardian reports.

The letter says in an "ideal situation" doctors would have had this conversation in person but had written to them due to fears they were carrying the virus and were asymptomatic.

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Source: BBC News, 1 April 2020

 

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Coronavirus: Government throwing ‘lit match into a haystack’ by discharging Covid patients to care homes

The government has been warned it is throwing “a lit match into a haystack” by discharging Covid-positive patients to care homes, with politicians demanding that the safety of residents and staff is guaranteed under the new policy.

During the first wave of the pandemic, approximately 25,000 hospital patients were sent to care homes – many of whom were not tested – which helped spread the virus among residents. Around 16,000 care home deaths have been linked to COVID-19 since the start of the crisis.

The strategy was one of the government’s “biggest and most devastating mistakes” of the crisis, says Amnesty International, and questions have been raised over the decision to introduce a similar policy as the UK’s second wave intensifies.

As part of the 2020 adult social care winter plan, the government has called on local authorities and care providers to establish “stand-alone units” – so-called “hot homes” – that would be able to receive and treat Covid hospital patients while they recover from the disease.

There is also an expectation that, due to housing pressures and a shortage of suitable facilities, some patients may be discharged to “zoned accommodation” within a home, before being allowed to return to normal living settings once they test negative for the virus.

Councils have been told to start identifying and notifying the Care Quality Commission of appropriate accommodation, and to ensure high infection prevention standards are met.

Under the requirements outlined by the government, discharged patients “must have a reported Covid test result". However, The Independent revealed on Monday that these rules have not been followed in some cases, with a recent British Red Cross survey finding that 26 per cent of respondents had not been tested before being discharged to a care home.

There is also concern whether care homes possess enough adequate personal protective equipment to prevent outbreaks, with the CQC revealing last month that PPE was still not being worn in some sites.

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Source: The Independent, 27 0ctober 2020

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Coronavirus: Five things a COVID-19 symptom-tracking app tells us

The UK's scientists have been trying to trace COVID-19's path through the population ever since the coronavirus arrived on British shores.

In what is thought to be the largest study of its kind in the world, an app developed by King's College London (KCL) and technology company Zoe, which tracks symptoms of the disease, has been downloaded more than three million times in the UK.

Not to be confused with the government's contact-tracing app, the COVID-19 Symptom Study app allows users to report daily whether they feel healthy, and record any symptoms. The scientists have been using the data to estimate how the virus may have travelled through the population.

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Source: BBC News, 23 May 2020

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Coronavirus: Eyes could be contagious for weeks, study finds

The coronavirus can linger in patients’ eyes for several weeks and could act as a way of spreading the COVID-19 disease, according new study from Italy.

Scientists at Italy’s National Institute for Infectious Diseases hospital in Rome studied the symptoms of an unnamed 65-year-old woman who developed the virus after travelling from the Chinese city of from Wuhan.

When the woman developed conjunctivitis – an eye infection causing redness and itchiness – doctors decided to take regular swabs from her eye. They discovered the virus remained present in “ocular samples” up to 21 days after she was admitted to hospital.

The team said the findings, published in the Annals of Internal Medicine, indicated that eye fluids from coronavirus patients “may be a potential source of infection”.

The study authors said: “These findings highlight the importance of control measures, such as avoiding touching the nose, mouth, and eyes and frequent hand washing.”

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Source: The Independent, 24 April 2020

 

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Coronavirus: Every hospital in England must create secure zones for patients

All NHS hospitals in England have been ordered to create secure areas for coronavirus testing to “avoid a surge in emergency departments”, according to a leaked NHS letter.

Hospitals have been told to create “coronavirus priority assessment pods”, where people will be checked for the virus, which will need to be decontaminated each time they are used.

The letter, seen by The Independent and dated 31 January, instructs all chief executives and medical directors to have the pods up and running no later than Friday 7 February.

It comes as the global death toll from the virus has reached 565 with around 28,000 infected.

One hospital chief executive told The Independent he believed the requirement was “an overreaction”, adding: “I think we should be sending teams out to swab in patients homes as the advice is to stay at home and self-manage as with any other flu".

In the letter, Professor Keith Willett, who is leading the NHS’s response to coronavirus, told NHS bosses: “Plans have been developed to avoid a surge in emergency departments due to coronavirus. “Although the risk level in this country remains moderate, and so far there have been only two confirmed cases, the NHS is putting in place appropriate measures to ensure business as usual services remain unaffected by any further cases or tests of coronavirus.”

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Source: 5 February 2020

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Coronavirus: Durham County Council accused of 'increasing' deaths

At least 25 people have died at a care home amid claims from an industry body that a council's actions "caused" or "increased COVID-19 deaths".

Melbury Court in Durham is thought to be the care home with the highest number of deaths in the UK. County Durham has had the highest number of care home deaths in England and Wales.

Durham County Council said it "strongly refuted" the claim by the County Durham Care Home Association (CDCHA).

Some patients went from the nearby University Hospital of North Durham to Melbury Court without being tested for coronavirus or after a positive test.

A BBC investigation has discovered that in a conference call in late March, council officials were told plans to move hospital patients into care homes without testing would be disastrous.

The CDCHA offered to find a specific home or homes where COVID-19 positive or untested people could be cared for rather than have them spread around the network, but this was never acted on and now the CDCHA has calculated there has been an outbreak of coronavirus in 81 of the county's 149 care homes.

Maria Vincent, who runs Crosshill Care Home in Stanhope, told the council in March that care homes were not set up to accept COVID-19 patients, and described it as "neglect pure and simple".

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Source: BBC News, 2 June 2020

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Coronavirus: Doctors' letter of concern about rising Covid cases

Senior doctors specialising in infectious diseases have written an open letter expressing "concern" about the rapid increase in COVID-19 cases in Northern Ireland.

The letter is signed by 13 medics from hospitals across Northern Ireland. It calls for the public to stick to government guidance on reducing social interactions and  also warns against "stigmatising people and areas with high levels of infection."

The letter reads: "We need to support people who test positive. This pandemic requires us to work together to bring it under control urgently. We need to reduce the potential for transmission to protect our health service, and we need to fix our test and trace system to try and gain better control of this virus in our community."

On Monday, 616 new cases of COVID-19 were identified in Northern Ireland, bringing the total during the pandemic to 14,690. The number of deaths recorded by the Department of Health remains at 584.

Among those who have signed the letter are Dr Claire Donnelly, a consultant physician who specialises in infectious diseases; consultant virologist Dr Conall McCaughey and consultant paediatrician Dr Sharon Christie.

Entitled an "appeal to people to adhere to Covid public health guidance", the letter lays bare the stark reality of the infections rates.

The letter adds: "Worryingly the number of cases is increasing rapidly in many areas over the last week, indicating that we have widespread community transmission in many parts of Northern Ireland."

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Source: BBC News, 6 October 2020

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Coronavirus: Doctors urge conversations about dying

Palliative care doctors are urging people to have a conversation about what they would want if they, or their loved ones, became seriously unwell with coronavirus.

We should discuss all possible scenarios - even those we are not "comfortable to talk about", they said. Medics said the virus underlined the importance of these conversations.

New guidelines are being produced for palliative care for Covid-19 patients, the BBC understands.

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Source: BBC News, 21 March 2020

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Coronavirus: Doctors spell out how to exit England's lockdown

Lifting lockdown must be handled better this time round to avoid a surge in Covid that could overwhelm the NHS, doctors say.

The British Medical Association has published a blueprint for how it thinks England should proceed with any easing. It includes replacing the "rule of six" with a two-households restriction to reduce social mixing and banning travel between different local lockdown tiers.

Government has yet to say if or exactly how England will exit on 2 December.

It will decide next week, based on whether cases have fallen enough and how much strain hospitals are under.

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Source: BBC News, 18 November 2020

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Coronavirus: Doctors given new guidelines on choosing which patients to treat in critical care

New guidelines have been published to help doctors and nurses decide how to prioritise patients during the coronavirus pandemic.

The advice from the National Institute for Health and Care Excellence (NICE) was produced amid concerns that the NHS would be overwhelmed by the demand for intensive care beds and ventilators.

The three new NICE guidelines, which have been drawn up within a week rather than the usual timescale of up to two years, cover patients needing critical care, kidney dialysis and cancer treatment.

They say all patients admitted to hospital should still be assessed as usual for frailty “irrespective of Covid-19 status”.

Decisions about admitting patients to critical care should consider how likely they are to recover, taking into account the likelihood of recovery “to an outcome that is acceptable to them”.

Doctors are advised to discuss possible “do not resuscitate” decisions with adults who are assessed as having increased frailty, such as those who need help with outside activities or are dependent for personal care.

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Source: Independent, 22 March 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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