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Sam

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  1. Sam
    One of the mysteries of COVID-19 is why oxygen levels in the blood can drop to dangerously low levels without the patient noticing.
    It is known as "silent hypoxia" and as a result, patients have been arriving in hospital in far worse health than they realised and, in some cases, too late to treat effectively.
    But a potentially life-saving solution, in the form of a pulse oximeter, allows patients to monitor their oxygen levels at home, and costs about £20.
    They are being rolled out for high-risk Covid patients in the UK, and the doctor leading the scheme thinks everyone should consider buying one.
    A normal oxygen level in the blood is between 95% and 100%.
    "With Covid, we were admitting patients with oxygen levels in the 70s or low-or-middle 80s," said Dr Matt Inada-Kim, a consultant in acute medicine at Hampshire Hospitals.
    He told BBC Radio 4's Inside Health: "It was a really curious and scary presentation and really made us rethink what we were doing."
    Read full story
    Source: BBC News, 21 January 2021
    See hub resource on the 'Covid Oximetry @home' project
  2. Sam
    The second wave of COVID-19 has put doctors under huge pressure, the Royal College of Physicians has warned, as two thirds of physicians report feeling tired or exhausted.
    A survey of 25 500 members of the college from across the UK, conducted on 2 November, received 1890 responses. It found that two thirds (64%, 931) felt tired or exhausted, 48% (687) felt worried, and just under a third (29%, 424) felt demoralised. Almost a fifth (19%, 280) said they have sought informal mental health support, such as speaking to colleagues or friends, during the pandemic. Just 10% (155) said they had sought formal mental health support from either their employer, GP, or external services.
    College president Andrew Goddard said he was concerned about the mental health of doctors, “There is no way to dress it up—it is pretty awful at the moment in the world of medicine. Hospital admissions are at the highest ever level, staff are exhausted, and although there is light at the end of the tunnel, it seems a long way away.”
    He said that before the pandemic, few physicians would have expected to need formal mental health support during their career.
    After the pandemic, staff will be in desperate need of a break, Goddard said, and will need specific time away if they’re to be at their best. “Doctors have demonstrated remarkable resilience throughout the pandemic, working under the most challenging conditions the NHS has ever faced, but they can’t continue working this way forever,” he said.
    Read full story
    Source: The BMJ, 21 January 2021
  3. Sam
    Just a third of people aged 80 and over have received the covid vaccine in one part of England, compared to four out of five in the area with the highest rate, new NHS England figures have revealed. 
    Gloucestershire delivered at least one dose of the vaccine to 85% of its over 80s population between 8 December and 17 January. Three other STPs — Northamptonshire, Herefordshire and Worcestershire, and Lancashire and South Cumbria — have all delivered at least one dose to at least three-quarters of over 80s in the area.
    By contrast, Suffolk and North East Essex has vaccinated just 36% of its over 80s population. A further seven of England’s 42 STP/Integrated Care Systems had vaccinated under half of their over 80s population.
    The mixture of reasons for the differences are not known — it may be due to supply, delivery issues, the nature of the area, or the size of the over-80s population. NHS England has maintained that the vaccine is being used nearly as quickly as it is available each week, with supply the main constraint. NHSE decides when sites are able to open and when they have supply. 
    Read full story (paywalled)
    Source: HSJ, 21 January 2021
  4. Sam
    At least seven so-called NHS “never events” should be reclassified because the health service has failed to put in place effective measures to stop them from repeatedly happening, safety experts have said.
    The independent Healthcare Safety Investigation Branch (HSIB) said NHS England should remove the never event incidents from the list of 15 it requires hospitals to report, because they are not “wholly preventable” and the NHS has not adequately recognised the systemic risks that mean they keep happening.
    The errors include examples such as a 62-year-old man having the wrong hip replaced during surgery and a nine-year-old girl who was given a drug by injection that should have been given by mouth.
    Other incidents included a woman who had a vaginal swab left inside her following the birth of her first child and a 26-year-old man who had a feeding tube accidentally inserted into his lung rather than his stomach.
    In a new report, investigators from HSIB carried out a detailed analysis of seven incidents it has investigated which account for the majority of never events recorded by NHS hospitals in 2018-19.
    NHS England claims there are steps hospitals can take that mean the errors should never happen but HSIB says many of the steps are administrative, such as a checklist, and do not fully take into account the environment staff work in, the nature of the errors or how they happen.
    Read full story
    Source: The Independent, 21 January 2021
  5. Sam
    Only a little over half of British Indians say they would get a coronavirus vaccine, according to research. 
    Some 56% of British Indians said they would take up a vaccine when asked by the 1928 Institute, a new think tank led by academics from the University of Oxford. However, 31% per cent were unsure, while 13% said they would decline a jab, the online poll of 510 respondents found.
    The think tank said much of this stemmed from people feeling they were not informed enough about the vaccines, while a significant proportion felt other people deserved to receive a vaccine more.
    The researchers are calling for an urgent public health campaign and funding, with messaging in different languages and co-produced with community leaders to assuage doubts.
    The government should also widely share information on how it is helping poorer countries distribute vaccines, given that several participants said vulnerable people and those in poorer countries should take priority, they said in their report.
    Read full story
    Source: The Independent, 21 January 2021
  6. Sam
    ‘Surge’ clauses allowing the NHS to again take over private hospitals — as it did in the spring — have been triggered in some areas, HSJ has learned.
    An email from NHS England to private hospitals in London, seen by HSJ, was sent last week, triggered a seven-day notice period under NHSE’ covid contracts with the providers.
    The letter said the London region had requested the move after taking into account “critical care capacity, the doubling rate [and the] forecast acute admission rate related to local prevalence.”
    The letter refers to the north central London health system, but HSJ understands similar arrangements have been triggered for north east London. The two areas have a combined population of 3.9m people and have been some of the hardest hit by covid admissions. The clause is also thought to have been triggered in other parts of south east England, but it is not known which ones.
    The letter listed six hospitals, five owned by BMI Healthcare and one by Aspen Healthcare, which would, from Friday, commit “100 per cent” of their capacity to NHS use.
    Read full story (paywalled)
    Source: HSJ, 20 January 2021
  7. Sam
    Smear-test delays during lockdown have prompted calls for home-screening kits.
    Cervical cancer screening has restarted across the UK - but some women say they will not attend their appointments for fear of catching Covid.
    Jo's Cervical Cancer Trust is urging "faster action" on home tests for HPV, which causes 99% of cervical cancers.
    An NHS official said GP practices should continue screening throughout lockdown, and "anyone invited for a cervical smear test should attend".
    Cancer Research UK said it was not yet known how effective and accurate self-sampling could be in cervical screening.
    A survey by gynaecological cancer charity the Eve Appeal indicates nearly one in three missed smear tests are the result of people being "put off" by coronavirus. And a Jo's Cervical Cancer Trust survey during the pandemic suggests the same proportion would prefer to take their own human-papillomavirus (HPV) test rather than go to a GP.
    Acting chief executive Rebecca Shoosmith said coronavirus had added "more barriers" to going for a smear test. "Sadly those who found it difficult before are likely to be no closer to getting tested," she said. "Self-sampling would be a game-changer."
    Both charities emphasise smear tests are for "women and anyone with a cervix" and transgender and non-binary people may have additional barriers to going.
    Jo's Cervical Cancer Trust said DIY tests could also help people who had been sexually assaulted and those with disabilities or from backgrounds where smear tests were taboo.
    Read full story
    Source: BBC News, 21 January 2021
  8. Sam
    Nearly a third of people who were discharged from hospitals in England after being treated for COVID-19 were readmitted within five months – and almost one in eight died, a study suggests.
    The research, which is still to be peer-reviewed, also found a higher risk of problems developing in a range of organs after hospital discharge in those younger than 70 and ethnic minority individuals.
    “There’s been so much talk about all these people dying from Covid … but death is not the only outcome that matters,” said Dr Charlotte Summers, a lecturer in intensive care medicine at the University of Cambridge who was not involved in this study.
    “The idea that we have that level of increased risk in people – particularly young people – it means we’ve got a lot of work to do.”
    There is no consensus on the scale and impact of “long Covid”, but scientists have described emerging evidence as concerning. According to recent figures provided by the Office for National Statistics (ONS), a fifth of people in England still have coronavirus symptoms five weeks after being infected, half of whom continue to experience problems for at least 12 weeks.
    Read full story
    Source: The Guardian, 18 January 2021
  9. Sam
    For the last 10 months, everyone in healthcare has lived their lives as if they were trapped in a burning building without a fire escape. 
    No matter how much water we throw on the fire or how many firefighters (healthcare providers in this instance) we send in, we cannot gain control of the flames. The catastrophic loss of life has been insurmountable, and we often haven’t had enough physicians to take care of everyone. 
    This is not new for a healthcare system. For years prior to this pandemic, there has been a physician shortage in the United States that is expected to worsen over the coming years. The Association of Medical Colleges (AAMC) predicts that the US could see a shortage between 54,000 and 139,000 physicians in both primary and specialty care by 2033. Although the total physician supply is expected to grow, it won’t be at a fast enough rate to outpace demand. 
    This is where physician assistants (PAs) and advanced practice nurses (APRNs) come in. Many people don’t realise that PAs and APRNs have been around for over 50 years. 
    For 50 years, a plethora of research has shown that PAs and APRNs are safe, reliable, high quality healthcare providers and essential members of the healthcare team. But too often critics claim that because they have not gone through physician training, they cannot provide exceptional medical and surgical care. In fact, they already do. A recent comprehensive review of PA and APRN outcomes from 2008 to 2018 found that PAs and APRNs had similar outcomes compared to physicians including hospital length of stay, readmission rates, quality and safety and patient and staff satisfaction. 
    Read full story
    Source: The Hill, 16 January 2021
  10. Sam
    People in high-risk minority ethnic groups must be prioritised for Covid immunisations, alongside a targeted publicity campaign, experts and politicians have said amid growing concerns over vaccine scepticism.
    With figures on Monday recording more than 4m Covid vaccine doses now administered across the UK, and the rollout being expanded to all over-70s, public health experts and MPs called for black, Asian and minority ethnic (BAME) communities to be better protected.
    The Scientific Advisory Group for Emergencies (Sage) has also raised concerns after research showed up to 72% of black people said they were unlikely or very unlikely to have the jab.
    Prof Martin Marshall, chair of the Royal College of GPs, urged Whitehall to begin a public health campaign. “We are concerned that recent reports show that people within BAME communities are not only more likely to be adversely affected by the virus but also less likely to accept the Covid vaccine, when offered it,” he said.
    “As such, where appropriate, we’re calling for public health communications to be tailored to patients in BAME communities, to reassure them about the efficacy and safety of the vaccine and ultimately encourage them to come forward for their vaccination when they are invited for it.”
    His remarks came as the vaccines minister, Nadhim Zahawi, admitted he feared some BAME communities could remain exposed to coronavirus despite high expected uptake of the jabs.
    Read full story
    Source: The Guardian, 18 January 2021
  11. Sam
    NHS bosses have instructed hospitals to keep performing urgent cancer surgery despite Covid pressures, after a growing number cancelled procedures because they did not have enough intensive care beds or available staff.
    They have told England’s regional directors of cancer to ensure treatment of people who need cancer surgery within four weeks gets the same priority as care of patients who have Covid.
    The move was unveiled in a letter, obtained by HSJ, sent last Friday by Amanda Pritchard, the chief operating officer at NHS England and NHS Improvement. It was also signed by Cally Palmer, the NHS’s national cancer director, and Prof Peter Johnson, a highly respected specialist who is the NHS’s national clinical director for cancer.
    They have acted after unease among cancer specialists that growing numbers of hospitals, including all those in London, had cancelled urgent operations. Hospitals have felt obliged to do so either because they did not have enough intensive care beds for patients who might need one after their cancer procedure or because surgical staff had been repurposed to help care for Covid patients.
    Doctors voiced alarm at the scale of recent postponements of what the NHS classes as “priority two” operations. That means they should be done within 28 days to ensure that someone with cancer does not see their disease spread or become inoperable because it was delayed.
    More than 1,000 cancer patients in London are now waiting to have “priority two” or “P2” urgent surgery, but none have been given a new date for when it will happen, HSJ reported last week.
    Read full story
    Source: The Guardian, 18 January 2021
  12. Sam
    Covid outbreaks in care homes have more than trebled in a month. Figures show that infection levels are now similar to the peak of the first wave, with last week having the second highest weekly total since records began in April.
    Senior figures said the numbers were "shocking" and warned: "Care homes cannot be neglected again".
    Ministers have pledged that all care home residents would be vaccinated by the end of this month. But The Telegraph has been told the care home rollout was taking longer than officials had anticipated.
    The new figures come after The Telegraph revealed the Government is proposing to send hospital patients into care homes without tests, despite being warned that was responsible for driving up cases in the first wave.
    Read full story
    Source: The Telegraph, 14 January 2021
  13. Sam
    The Healthcare Safety Investigation Branch (HSIB) have launched a national investigation into the provision of piped oxygen gas supplies to hospitals.
    During the COVID-19 pandemic there has been an increased demand for oxygen gas on hospital wards, with more patients needing oxygen therapy. Insufficient oxygen supply to seriously ill patients can have very severe consequences, including death.
    The investigation is examining a major incident that took place at an acute hospital. Demands on their oxygen supply led to patients being diverted to other hospitals. In addition, patients were also transferred between clinical environments.
    As part of HSIB's final investigation report, they will make safety recommendations to the appropriate national bodies in order to improve patient safety.
    Read full story
    Source: HSIB, 15 January 2021
  14. Sam
    Fake news is likely to be causing some people from the UK's South Asian communities to reject the Covid vaccine, a doctor has warned.
    Dr Harpreet Sood, who is leading an NHS anti-disinformation drive, said it was "a big concern" and officials were working "to correct so much fake news". He said language and cultural barriers played a part in the false information.
    Dr Sood, from NHS England, said officials were working with South Asian role models, influencers, community leaders and religious leaders to help debunk myths about the vaccine.
    Much of the disinformation surrounds the contents of the vaccine.
    He said: "We need to be clear and make people realise there is no meat in the vaccine, there is no pork in the vaccine, it has been accepted and endorsed by all the religious leaders and councils and faith communities."
    "We're trying to find role models and influencers and also thinking about ordinary citizens who need to be quick with this information so that they can all support one another because ultimately everyone is a role model to everyone", he added.
    Dr Samara Afzal has been vaccinating people in Dudley, West Midlands. She said: "We've been calling all patients and booking them in for vaccines but the admin staff say when they call a lot of the South Asian patients they decline and refuse to have the vaccination.
    "Also talking to friends and family have found the same. I've had friends calling me telling me to convince their parents or their grandparents to have the vaccination because other family members have convinced them not to have it".
    Read full story
    Source: BBC News, 15 January 2021
  15. Sam
    Boris Johnson’s plans to test millions of schoolchildren for coronavirus every week appear to be in disarray after the UK regulator refused to formally approve the daily testing of pupils in England, the Guardian has learned.
    The Medicines and Healthcare products Regulatory Agency (MHRA) told the government on Tuesday it had not authorised the daily use of 30-minute tests due to concerns that they give people false reassurance if they test negative. This could lead to pupils staying in school and potentially spreading the virus when they should be self-isolating.
    The regulator’s decision undermines a key element of the government’s strategy to bring the pandemic under control – and is bound to raise fresh questions about the tests, and the safety of the schools that have been asked to use them.
    Prof Jon Deeks, a biostatistician of the University of Birmingham and Royal Statistical Society, described the use of rapid tests in this context as “ridiculous and dangerous” and welcomed the MHRA’s stance.
    He said: “It is really important that we have confidence in the safety and effectiveness of tests for Covid-19 and all other diseases - this is the responsibility of our regulator.
    “This clarification of the unsuitability of lateral flow tests for saying people are not infected with SARS-CoV-2 from the MHRA demonstrates that they are taking their responsibility seriously to ensure that tests are used in a safe way."
    Read full story
    Source: The Guardian, 14 January 2021
  16. Sam
    A nurse who was threatened by colleagues for speaking out about care failings at Mid Staffordshire Foundation Trust has said bullying remains a “real problem” in the NHS.
    Helene Donnelly has told MPs that more than 10 years on from the scandal – commonly known as Mid Staffs – she was still seeing “echoes” of what she experienced happening across the country.
    “Although it is in the minority, as we saw at Mid Staffs the results can be absolutely catastrophic”
    She called for the development of a national body to improve workplace cultures in the NHS and “stamp out bullying once and for all”.
    The inquiry into poor standards of care and deaths at Mid Staffordshire indentified issues around staff behaviour, inadequate staffing levels and skills, and lack of effective leadership and support.
    Ms Donnelly told a Health and Social Care Committee hearing today that there were “real negative behaviours” at the trust that created a “real bullying culture of fear and intimidation”.
    “There was not a culture that encouraged and enabled staff to speak up and if they did as I did, we were bullied and threatened,” said Ms Donnelly, who now holds the roles of ambassador for cultural change and lead Freedom to Speak Up Guardian at the organisation where she works.
    Read full story (paywalled)
    Source: The Nursing Times
  17. Sam
    When pharmacist Ifeoma Onwuka, known to her friends as Laura, went into hospital to have her daughter, she and her husband hoped the delivery would go smoothly, and that they would soon be able to take their new arrival home  to meet her siblings. 
    Onwuka's labor was induced at James Paget University Hospital in Great Yarmouth in late April 2018. Things progressed quickly and there were soon signs that her baby was in distress, causing staff to begin preparations for an emergency Caesarian section, but Onwuka's daughter was born in the recovery room.
    Shortly after the birth, Onwuka's condition began to deteriorate. According to the family's lawyer, Tim Deeming, she began to bleed heavily, and was taken into surgery where attempts were made to stem the loss of blood. Hours later, and only after a second consultant had been called in, she was given an emergency hysterectomy. The mother-of-three died three days later.
    The coroner, Yvonne Blake, said an expert had told Onwuka's inquest that the delay to surgery contributed to her death, since acting early could have controlled the bleeding. 
    Black mothers have worse outcomes during pregnancy or childbirth than any other ethnic group in England. According to the latest confidential inquiry into maternal deaths (MBRRACE-UK). Black people in England are four times more likely to die in pregnancy or within the first six weeks of childbirth than their White counterparts. 
    Read full story
    Source: CNN. 14 January 2021
  18. Sam
    Nearly a quarter of a million people have been waiting more than a year for operations and other hospital procedures, HSJ has learned. 
    Official NHS England data for November, released on Thursday, showed 192,000 patients had been waiting for treatment for more than a year.
    However, figures leaked to HSJ of weekly data up to 3 January showed a steep increase to 223,000 patients — the highest reported so far throughout the COVID-19 pandemic and before.
    According to the leak, just under 4.2 million people are waiting for treatment, of which year-long waiters comprise 5.4%. The data also showed 175 patients across England had waited more than two years for treatment.
    In February, before the pandemic, 1,613 patients were waiting more than a year — meaning there has been a 138-fold increase.
    Read full story (paywalled)
    Source: HSJ, 15 January 2021
  19. Sam
    More than one in 10 hospital nurses are now off work in areas hard-hit by covid, according to internal data leaked to HSJ.
    The data shows the toal absence rate among acute trust nurses has risen steadily over the last month.
    Nationally the total absence rate among acute trust nurses was 9.7% as of Monday, up from around 7% at the start of December, pushed up by rapidly rising absences due to covid. These make up more than half of total absences, and have now hit rates last seen in early May.
    Senior NHS sources said staff absences are severely compounding operational pressures in the hardest hit regions, limiting hospitals’ capacity to operate more than is suggested in official bed capacity figures.
    The highest rate was in the East of England where 11.4% of nurses off work, with coronavirus accounting for 7.5%. This is likely to mask even higher rates in particular hospitals, services and wards.
    Read full story
    Source: HSJ, 14 January 2021
  20. Sam
    Younger people who think they are “invincible” need to be aware of the shocking life-changing reality of long Covid, according to health professionals who are living with the condition.
    Long Covid, also known as post-Covid syndrome, is used to describe the effects of COVID-19 that continue for weeks or months beyond the initial illness.
    Speaking at the All-Party Parliamentary Group (APPG) on Coronavirus, Dr Nathalie MacDermott, 38, said neurologists believe Covid has damaged her spinal cord and she can only walk about 200 metres without some form of assistance.
    She said the damage has affected her bladder and bowel too, causing urinary tract infections, and she gets pain in her arms and has weakness in her grip.
    Dr MacDermott, a clinical doctor sub-specialising in paediatric infectious diseases in the NHS, told MPs there needs to be “better recognition” from employers that long Covid is a “genuine condition” and that people may need to be off work for a significant period of time.
    She added: “And I think we need better recognition in the public, particularly the younger public who think that they’re invincible.
    “I’m 38 and I wonder if I’ll ever be able to walk properly without crutches again. Will this continue to get worse? Will I end up in a wheelchair?”
    Read full story
    Source: 12 January 2021, Lancashire Post
  21. Sam
    People who recover from coronavirus have a similar level of protection against future infection as those who receive a Covid vaccine – at least for the first five months, research suggests.
    A Public Health England (PHE) study of more than 20,000 healthcare workers found that immunity acquired from an earlier Covid infection provided 83% protection against reinfection for at least 20 weeks.
    The findings show that while people are unlikely to become reinfected soon after their first infection, it is possible to catch the virus again and potentially spread it to others.
    “Overall I think this is good news,” said Prof Susan Hopkins, a senior medical adviser to PHE. “It allows people to feel that prior infection will protect them from future infections, but at the same time it is not complete protection, and therefore they still need to be careful when they are out and about.”
    Read full story
    Source: The Guardian, 14 January 2021
    Public Health England press release
  22. Sam
    Patients are missing out on potentially life-saving organ transplant surgery because hospital intensive care beds are filled by coronavirus patients, The Independent has learnt.
    Major organ transplant centres in London, as well as the Queen Elizabeth Hospital in Birmingham and Addenbrooke’s Hospital in Cambridge, have been forced to close their doors to transplant cases because of a lack of beds, the increased risk to patients, and the need to redeploy doctors and nurses to the coronavirus front line.
    The impact on organ transplant services follows hundreds of urgent cancer operations being delayed in London and across the country, as NHS trusts run out of spare beds to treat non-Covid patients. Most routine operations have also been stopped in the hardest-hit areas.
    Teacher Shona McFadyen was diagnosed with liver cancer in December 2018 and needs an urgent liver transplant at the Queen Elizabeth Hospital in Birmingham. She has already waited 22 months for her surgery.
    She told The Independent: “It’s not the hospital’s fault. I get that. But it just adds to the feeling of hopelessness and it feels like as patients we have been forgotten about. It is life and death for us.”
    Read full story
    Source: The Independent, 13 January 2021
  23. Sam
    Some High Street pharmacies in England will start vaccinating people from priority groups on Thursday, with 200 providing jabs in the next two weeks.
    Six chemists in Halifax, Macclesfield, Widnes, Guildford, Edgware and Telford are the first to offer appointments to those invited by letter. But pharmacists say many more sites should be allowed to give the jab, not just the largest ones.
    More than 2.6 million people in the UK have now received their first dose.
    Across the UK, the target is to vaccinate 15 million people in the top four priority groups - care home residents and workers, NHS frontline staff, the over-70s and the extremely clinically vulnerable - by mid-February.
    The vaccines – made by either Oxford-AstraZeneca or Pfizer-BioNTech – are being administered at hospitals, care homes, GP surgeries and vaccination centres.
    It comes as the UK saw its highest number of daily reported coronavirus deaths since the pandemic began, with the government announcing a further 1,564 deaths of people within 28 days of a positive Covid test.
    On Wednesday evening, the Scottish government published its detailed 16-page plan for rolling out the vaccine, including details of how many vaccines it expects to receive every week until the end of May.
    Read full story
    Source: BBC News, 14 January 2021
  24. Sam
    NHS England has asked hospitals across the country to open hundreds more intensive care beds so they can take in patients from the hardest hit areas, to prevent those patches having to ration access.
    A letter sent to dozens of acute trusts today by NHS England asks them to enact their “maximum surge” for critical care from tomorrow, opening up hundreds of beds, which will rely on them redeploying staff and cancelling more planned care.
    The letter is to trusts in the Midlands but HSJ understands a similar approach is being taken in the other regions where critical care is not currently under as much pressure as London, the East of England and the South East.
    The message to surge capacity to support a “national critical care service” was reinforced to trusts nationwide in a call with Keith Willett, NHS England covid incident director, also on Wednesday.
    The letter, from the NHSE Midlands regional team, said there had been a national request for the region to surge beyond its own needs to support London and the East of England. “Significant” numbers are likely to be transferred, HSJ was told.
    Read full story (paywalled)
    Source: HSJ, 13 January 2021
  25. Sam
    COVID-19 patients in England's busiest intensive care units (ICUs) in 2020 were 20% more likely to die, University College London research has found.
    The increased risk was equivalent to gaining a decade in age.
    By the end of 2020, one in three hospital trusts in England was running at higher than 85% capacity. Eleven trusts were completely full on 30 December, and the total number of people in intensive care with Covid has continued to rise since then.
    The link between full ICUs and higher death rates was already known, but this study is the first to measure its effect during the pandemic.
    Tighter lockdown restrictions are needed to prevent hospitals from being overwhelmed, says study author Dr Bilal Mateen.
    Researchers looked at more than 4,000 patients who were admitted to intensive care units in 114 hospital trusts in England between April and June last year. They found the risk of dying was almost a fifth higher in ICUs where more than 85% of beds were occupied, than in those running at between 45% and 85% capacity. That meant a 60-year-old being treated in one of these units had the same risk of dying as a 70-year-old on a quieter ward.
    The Royal College of Emergency Medicine sets 85% as the maximum safe level of bed occupancy. However, the team found there was no tipping point after which deaths rose - instead, survival rates fell consistently as bed-occupancy increased.
    This suggests "a lot of harm is occurring before you get to 85%".
    Read full story
    Source: BBC News, 14 January 2021

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