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Found 2,344 results
  1. Content Article
    Buildings have been associated with spread of infectious diseases, such as outbreaks of measles, influenza, and Legionella. With SARS-CoV-2, the majority of outbreaks involving three or more people have been linked with time spent indoors, and evidence confirms that far-field airborne transmission (defined as within-room but beyond 6 feet) of SARS-CoV-2 is occurring. In this paper, Allen et al. discuss how controlling concentrations of indoor respiratory aerosols to reduce airborne transmission of infectious agents is critical and can be achieved through source control (masking, physical distancing) and engineering controls (ventilation and filtration).
  2. News Article
    Sarah Spoor and her two adult sons have spent the past 14 months shielding in a one-bedroom apartment, with no garden, in west London. Her youngest sleeps in the bedroom, his brother has a pull-out bed in the kitchen, while Spoor takes the living room in another fold-out bed. All three have complex medical conditions that leave them vulnerable to Covid, and despite the strain of living in such close quarters, they don’t feel safe leaving home any time soon. “If we catch it, we die; it’s that simple. In the 14 months, I have probably been out about four times, and that’s usually in some dire emergency,” said Spoor, who provides round-the-clock care for her sons, 20 and 24, after their medical team decided it was too risky for their usual carers to continue visiting. The family has yet to be vaccinated as their medical conditions, which include type 1 diabetes, adrenal insufficiency, pernicious anemia and thyroid failure, mean they are likely to experience a severe reaction leading to hospital admission, and they are concerned about the risk of catching Covid in hospital when cases are still prevalent. Spoor is not alone in fearing a return to life after lockdown, with disability charity Scope estimating 75% of disabled people plan to continue shielding until after their second vaccine dose, and some for longer. “I think there is a potential long-term impact that groups of people become squirrelled away and it’s potentially easy for governments and local authorities to forget about them,” said James Taylor, executive director of strategy and social change at Scope. “We’re really worried that, in the long-term, lots of the rights that disabled people have fought for, the visibility, the recognition of disabled people as equal, that all falling away and going backwards.” Read full story Source: The Guardian, 19 April 2021
  3. Content Article
    This analysis, from The Health Foundation, looks at what we know about the impact of the second wave of the COVID-19 pandemic on elective care in England.Updated
  4. News Article
    Hundreds of senior NHS managers have voiced their fears for the future of the health service amid the ongoing coronavirus crisis without a significant pay rise to help retain staff on the frontline. A survey of more than 800 senior NHS managers has revealed the extreme pressure some have been working under, with many working 20 or more hours of unpaid extra hours each week. More than 90 per cent backed a significant pay rise for NHS staff to try and head off a feared exodus of nurses, doctors and other staff leaving the NHS after the pandemic. This would help shore up the service as it faces the daunting task of tackling record waiting lists now totalling 4.7 million patients. Some managers said that the government’s planned 1 per cent pay rise was an “insult” and made them feel “worthless”, in responses to the survey, run by the Managers in Partnership union. Another described NHS staff as being treated like “cannon fodder” during the crisis. Read full story Source: The Independent, 16 April 2021
  5. Content Article
    A group of royal colleges has produced guidance for doctors seeing patients who have concerns about symptoms after receiving the Oxford AstraZeneca COVID-19 vaccine. The Royal College of Emergency Medicine, the Society for Acute Medicine, and the Royal College of Physicians say that anyone who presents with symptoms suggestive of COVID-19 vaccine induced thrombosis and thrombocytopenia (VITT)1 should have a full blood count to check their platelet level. Symptoms of concern include persistent or severe headaches, seizures, or focal neurology; shortness of breath, persistent chest, or abdominal pain; and swelling, redness, pallor, or cold lower limbs.
  6. News Article
    A group of royal colleges has produced guidance for doctors seeing patients who have concerns about symptoms after receiving the Oxford AstraZeneca COVID-19 vaccine. The Royal College of Emergency Medicine, the Society for Acute Medicine, and the Royal College of Physicians say that anyone who presents with symptoms suggestive of COVID-19 vaccine induced thrombosis and thrombocytopenia (VITT)1 should have a full blood count to check their platelet level. Symptoms of concern include persistent or severe headaches, seizures, or focal neurology; shortness of breath, persistent chest, or abdominal pain; and swelling, redness, pallor, or cold lower limbs. The advice comes after the HSJ reported that emergency clinicians had raised concerns over a surge in patients attending emergency departments as a result of anxiety over the safety of the AstraZeneca vaccine. Investigations by EU and UK regulators into reports of unusual blood clots after receiving the vaccine concluded that these are a “possible” and “extremely rare” side effect. Katherine Henderson, president of the Royal College of Emergency Medicine, said that following the announcements, patients had been attending emergency departments after receiving the AstraZeneca vaccine. “I saw 21 patients with concerns in an eight hour shift, so we have to have a way of dealing with this. It was important for us to have a strategy for managing those patients that didn’t mean that they were getting over-investigated but they were getting reassurance. We also need to be aware that if somebody has significant symptoms it is always possible, given the rarity of VITT, that it is something else,” she said. Read full story Source: BMJ, 13 April 2021
  7. News Article
    Coronavirus death rates are twice as high in insecure jobs as in other professions, new research suggests. The TUC said workers on a contract that does not guarantee regular hours or income, such as zero-hours contracts or casual work, and those in low-paid self-employment, have been more at risk of infection. It’s thought that key workers such as those in social care and delivery driving, which cannot be done from home and require people to come into contact with others, are more insecure. The COVID-19 mortality rate among men in insecure occupations was 51 per 100,000 people aged 20-64, compared with 24 per 100,000 in more secure work, said the union organisation. The mortality rate among women in insecure jobs was 25 per 100,000 people, compared with 13 per 100,000 in more secure occupations. The TUC, which called the figures stark, said more research was needed to understand the links between precarious work and risk of infection and death. Read full story Source: The Independent, 16 April 2021
  8. News Article
    Senior government officials have raised “urgent” concerns about the mass expansion of rapid coronavirus testing, estimating that as few as 2% to 10% of positive results may be accurate in places with low Covid rates, such as London. Boris Johnson last week urged everyone in England to take two rapid-turnaround tests a week in the biggest expansion of the multibillion-pound testing programme to date. However, leaked emails seen by the Guardian show that senior officials are now considering scaling back the widespread testing of people without symptoms, due to a growing number of false positives. In one email, Ben Dyson, an executive director of strategy at the health department and one of health secretary Matt Hancock’s advisers, stressed the “fairly urgent need for decisions” on “the point at which we stop offering asymptomatic testing”. On 9 April, the day everyone in England was able to order twice-weekly lateral flow device (LFD) tests, Dyson wrote: “As of today, someone who gets a positive LFD result in (say) London has at best a 25% chance of it being a true positive, but if it is a self-reported test potentially as low as 10% (on an optimistic assumption about specificity) or as low as 2% (on a more pessimistic assumption).” He added that the department’s executive committee, which includes Hancock and the NHS test and trace chief, Dido Harding, would soon need to decide whether requiring people to self-isolate before a confirmatory PCR test “ceases to be reasonable” in low infection areas where there is a high likelihood of a positive result being wrong. Read full story Source: The Guardian, 15 April 2021
  9. News Article
    Around 4.7 million people were waiting for routine operations and procedures in England in February - the most since 2007, NHS England figures show. Nearly 388,000 people were waiting more than a year for non-urgent surgery compared with just 1,600 before the pandemic began. During January and February, the pressure on hospitals caused by COVID-19 was particularly acute. NHS England said two million operations took place despite the winter peak. However, surgeons said hospitals were still under huge pressure due to the second wave of Covid, which had led to "a year of uncertainty, pain and isolation" for patients waiting for planned treatment. Speaking on a visit to Dartmouth, Prime Minister Boris Johnson said the government would "make sure that we give the NHS all the funding that it needs... to beat the backlog". He said the situation had been "made worse by Covid", and added: "We do need people to take up their appointments and to get the treatment that they need." Read full story Source: BBC News, 15 April 2021
  10. Content Article
    COVID-19 placed unprecedented pressure on the health and care system. Improvement, which offers systematic approaches that can help adapt to change, would be expected to be a useful asset in the response to the pandemic. Q members, a community of over 4,000 people skilled in improvement, were asked about the role of improvement tools, methods, approaches and mindsets in supporting change during COVID-19. This paper summarises their responses and shares key findings and recommendations for action.
  11. News Article
    The NHS must think “very radically” about how it redesigns its elective pathways following the coronavirus pandemic, Sir Simon Stevens has told HSJ. Speaking at the HSJ Leadership Congress yesterday, NHS England’s chief executive said the service should ensure as much elective work is done as possible, while covid prevalence is low, while at the same time thinking about “different ways of doing things”. He declined to outline how many very long-waiters the service had or would have in coming months, explaining that some predictions have been “significantly off” in the past, and that future demand is unknown. The NHS chief stressed that other areas of the service would also face post-covid pressures, announcing a further investment in and expansion of long-covid clinics. “We want to see equivalent attention paid to the increased needs we’ve seen in mental health services, including eating disorders, and we want to make sure that the health service continues to expand its offer for long covid,” he said. “To that end we have 69 clinics identified last year, we will have 83 long covid clinics in place by the end of this month, so a significant expansion there.” There will be at least one in each integrated care system area, he said. Read full story (paywalled) Source: HSJ, 14 April 2021
  12. News Article
    A cheap drug, commonly used to treat asthma, can help people at home recover more quickly from COVID-19, a UK trial has found. Two puffs of budesonide twice a day could benefit many over-50s with early symptoms around the world, said the University of Oxford research team. There are also early signs the drug could reduce hospital admissions. The NHS says it can now be prescribed by GPs to treat Covid on a case-by-case basis from today. At present, there are few options for treating people with Covid who are not in hospital, apart from paracetamol. This widely-available asthma drug works in the lungs, where coronavirus can do serious damage, and could improve the recovery of at-risk patients who are unwell with Covid at home. Prof Stephen Powis, national medical director of NHS England, said he was "delighted" by the trial results so far and he said GPs could prescribe it after "a shared decision conversation" with patients. Read full story Source: BBC News, 12 April 2021
  13. Content Article
    In this piece for the BMJ, Partha Kar argues that in these unprecedented times, we need to be honest and clear about what’s feasible within existing staffing and funding envelopes, and that to suggest that all will be OK isn’t fair to the staff or the people.
  14. News Article
    Britain is facing a “terrifying” mental health crisis with tens of thousands more children needing specialist help since the start of the coronavirus pandemic. Experts from the Royal College of Psychiatrists have warned the problem facing the country will get worse before it gets better with new analysis revealing almost 400,000 children and 2.2 million adults sought help for mental health problems during the crisis. While the effect of lockdown and coronavirus has affected people of all ages, children appear to be particularly susceptible. Some 80,226 more children and young people were referred to specialist mental health services between April and December last year, up by 28% on the same months in 2019 to 372,438. Dr Bernadka Dubicka, chairwoman of the child and adolescent faculty at the Royal College of Psychiatrists, said: "Our children and young people are bearing the brunt of the mental health crisis caused by the pandemic and are at risk of lifelong mental illness." "As a frontline psychiatrist I've seen the devastating effect that school closures, disrupted friendships and the uncertainty caused by the pandemic have had on the mental health of our children and young people." Read full story Source: 9 April, 2021
  15. Content Article
    The Medicines and Healthcare products Regulatory Agency (MHRA) and the Joint Committee on Vaccinations and Immunisation (JCVI) has issued new advice suggesting people under the age of 30 with no underlying health conditions should receive an alternative to the AstraZeneca vaccine, where available.  Both the MHRA and JCVI have stressed that vaccination is highly effective and substantially reduces the risk of infection and severe COVID-19 disease.
  16. Content Article
    Space From Covid programme is made up of six modules, each addressing issues you may be experiencing due to the COVID-19 Pandemic. Each module provides clinically-backed support for trouble sleeping, coping with stress, developing mindfulness, financial worries and experiencing grief and loss. SilverCloud is offering this service completely free of charge and for anyone to use. The average module takes 30 minutes to complete and is accessible 24/7 from a smartphone, tablet or computer.
  17. News Article
    SilverCloud, a digital mental health platform, has launched a new COVID-19 support programme – ‘Space from COVID-19’ – which it has made free and available to everyone in the UK over the age of 18 years, indefinitely. The company hopes to improve access to digital mental health services during the pandemic and beyond, to help shoulder some of the demand that now faces health services in the UK and across the globe. SilverCloud’s new programme brings together a suite of digital resources and support that will assist users in managing and improving their mental health and wellbeing, specifically in regard to the impact of COVID-19. Crucially, it removes potential barriers by being open to all, with or without a clinical referral, and is fee-free for everyone. Dr Lloyd Humphreys, Clinical Psychologist and Head of Europe for SilverCloud, told HTN: “For us, what is really important is to support people during this difficult time. Everyone is talking about the mental health impact of COVID-19, everyone is talking about the problem, but no-one is really offering a solution." Read full story Source: Health Tech Newspaper, 8 April 2021
  18. Content Article
    Helen McKenna sits down with Suzie Bailey, Director of Leadership and Organisational Development at The King’s Fund, and Professor Michael West to explore the results of the 2020 NHS Staff Survey and discuss how the NHS can create an inclusive, compassionate, and supportive working environment for staff.
  19. Event
    As multiple SARS-CoV-2 variants appear around the world, information on detection, transmission, current vaccine efficacy, and health security is rapidly developing. Join this session to learn about emerging variant strains and what is known about the mutation of the virus. Register
  20. News Article
    Unpaid carers looking after terminally ill friends and relatives during the pandemic struggled to access pain relief, with some patients dying in unnecessary pain, a survey has found. The survey of 995 unpaid carers by Marie Curie also found people had difficulties getting personal care and respite nursing for loved ones. Figures show the number of people dying at home rose by 42% in the past year. Nearly two-thirds of carers surveyed by the charity said their loved one did not get all the pain relief they needed when they were dying. Susan Lowe, from Solihull, cared for her mother Sheila before she died with bowel cancer in April last year, aged 74. She said caring for her mum during lockdown was hard as "the system was just under so much pressure that we had to manage largely on our own". The public health worker says she struggled to get the right pain relief medication for her mother in her final weeks and spent hours travelling to different chemists. Susan, 50, told the BBC: "My biggest regret is that my mum died in pain - more pain than she needed to be. She really wanted to be comfortable at the end. She knew she was dying." "What she really wanted - and this is what she was assured would happen - was to be comfortable. She was told she would get the drugs that she needed for it to be as bearable as possible... I remember breaking down in tears a couple of times in the pharmacy when I was told the medication mum needed wasn't in stock." Read full story Source: BBC News, 8 April 2021
  21. News Article
    GPs should only give the Oxford/AstraZeneca Covid vaccine to patients with medical conditions which put them at higher risk of developing blood clots if the benefits outweigh the risks, the UK medicines regulator has said. The Medicines and Healthcare products Regulatory Agency (MHRA) has issued the advice to healthcare professionals regarding while it continues to review a link between the vaccine and rare blood clots. It has also added to previous advice regarding symptoms for patients to look out for following their Covid vaccination with the AZ vaccine. The new advice from the MHRA said: Administration of Covid-19 Vaccine AstraZeneca in people of any age who are at higher risk of blood clots because of their medical condition should be considered only if benefits from the protection from COVID-19 infection outweighs potential risks. Anyone who experienced cerebral or other major blood clots occurring with low levels of platelets after their first vaccine dose of Covid-19 Vaccine AstraZeneca should not have their second dose. Anyone who did not have these side effects should come forward for their second dose when invited. Pregnancy predisposes to thrombosis, therefore women should discuss with their healthcare professional whether the benefits of having the vaccine outweigh the risks for them. Meanwhile, ‘anyone who has symptoms four days or more after vaccination is advised to seek prompt medical advice’. These include: a new onset of severe or persistent headache, blurred vision, confusion or seizures develop shortness of breath, chest pain, leg swelling or persistent abdominal pain, unusual skin bruising or pinpoint round spots beyond the injection site. Read full story Source: Pulse, 7 April 2021
  22. News Article
    Patients could be waiting as much as two years for vital operations by the time of the next election due to a “truly frightening” backlog of care caused by the pandemic, the NHS’s former boss has said. Lengthening delays in getting treatment in England are will become a major political problem for Boris Johnson and pose a risk to patients’ health, Sir David Nicholson told the Guardian. “The backlog is truly frightening. We can very easily get to the next election with people waiting over two years. It’s easy to do that,” said Nicholson, citing an explosion in the number of people waiting at least a year since the start of the COVID-19 crisis. “The whole issue of access [to care] is a greater threat to the NHS than privatisation because poor access undermines confidence amongst those people who fund the service – taxpayers,” he added. The widespread suspension of normal NHS diagnostic tests and surgery during the pandemic as hospitals prioritised Covid care has left the service in England with a record 4.59 million people waiting for hospital treatment. That number is set to rise to what the NHS Confederation believes could be as much as 6.9m cases by the end of the year as people on a “hidden waiting list” – who put off seeking help after discovering symptoms of illness – finally visit a GP. According to the most recent figures, the number of people who have been waiting for at least a year has rocketed from 1,613 before the pandemic struck to 304,044. Under the NHS Constitution, 92% of people waiting are meant to be treated within 18 weeks. However, a third of the 4.59 million people have already waited longer than that. Read full story Source: The Guardian, 2 April 2021
  23. Content Article
    Government plan to prevent, mitigate and respond to the mental health impacts of the pandemic during 2021 to 2022.
  24. Content Article
    Abi Rimmer asks four experts whether doctors must be vaccinated against COVID-19 in this BMJ article.
  25. Content Article
    This page from NHS Wales signposts employers and employees to key information and guidance for workplaces which will assist in taking appropriate action upon returning to the workplace, to prevent transmission of COVID-19 and provide relevant sector specific guidance. Documents found on this page will also be particularly useful for employers experiencing clusters of cases that may be associated with their workplace.
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