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News Article
Misplaced tube contributed to first UK child Covid death, coroner rules
Patient Safety Learning posted a news article in News
A misplaced medical tube contributed to the death of the first child in the UK to die after contracting Covid, a coroner has found. Ismail Mohamed Abdulwahab, 13, of Brixton, south London, died of acute respiratory distress syndrome, caused by Covid-19 pneumonia, on 30 March 2020, three days after testing positive for coronavirus. He had a cardiac arrest before he died. Ismail’s death prompted widespread alarm about the potentially lethal impact of Covid on children. Hours before Ismail died, an endotracheal tube (ET) used to help patients breathe was found to be in the wrong position. A consultant in paediatric intensive care decided to leave it and monitor him. Giving his judgment on Thursday, senior coroner Andrew Harris said: “I am satisfied that he [Ismail] would not have died when he did were it not for the tube misplacement.” On Wednesday, the inquest at London Inner South London coroner’s court heard evidence from Dr Tushar Vince, a consultant in paediatric intensive care at King’s College hospital who treated Ismail on 29 March after he had been intubated. Asked by Harris if it would be reasonable to put the positioning of the ET on the death certificate as one of the causes, Dr Vince said: “I think it would be reasonable to consider it, yes.” She said: “I was so focused on the lungs I just didn’t see how high this tube was and I’m so sorry that I didn’t see it.” Read full story Source: The Guardian, 2 March 2023 -
News Article
Mental health of young adults severely impacted by pandemic
Patient Safety Learning posted a news article in News
A new study has found that the pandemic has severely affected people’s mental health and relationships all over the world, particularly for young adults. The third annual mental state of the world report (MSW) commissioned by Sapien Labs, a non-profit research organisation, conducted a global survey to better understand the state of mental health. The research compiled responses from over 400,000 participants across 64 countries, asking respondents about their family relationships, friendships and overall mental wellbeing. The survey found that there has been little recovery in declining mental health during the pandemic, which the group measures by a score called “mental health quotient”. It had found that average score had declined by 33 points – on a 300-point scale – over the past two years and still showed no signs of recovery, remaining at the same level as 2021. Read full story Source: The Guardian, 1 March 2023 -
Content ArticlePatients with Long Covid—defined by the National Institute for Health and Care Excellence (NICE) as signs and symptoms that persist for more than four weeks following acute Covid-19—may present in primary care with symptoms of palpitations (tachycardia) triggered by standing or minimal exertion. These may be accompanied by dizziness, breathlessness, chest pain, sweating, bloating, fatigue and other symptoms which may be caused by a dysfunction of the autonomic nervous system (dysautonomia). This practice pointer in the BMJ outlines: how tachycardia present in patients with Long Covid. what clinical assessment should involve. how to test for postural orthostatic tachycardia syndrome in primary care. drug and non-drug treatments that are available. what patients can do for themselves. when patients should be referred to a specialist.
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Content ArticleThe UK Covid-19 Inquiry is the independent public inquiry set up to examine the UK’s response to the Covid-19 pandemic, assess the impact of the pandemic and learn lessons for the future. The Inquiry is Chaired by Baroness Heather Hallett, a former Court of Appeal judge. This is a recording of the UK Covid-19 Inquiry's preliminary hearing for its third investigation looking at the impact of the pandemic on healthcare. The agenda includes: introductory remarks from the Chair update from Counsel to the Inquiry including designation submissions from core participants. Read the transcript of the hearing.
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News Article
Covid inquiry: Race should be at its core, say campaigners
Patient Safety Learning posted a news article in News
Race should be made a central part of the UK's independent public inquiry into the pandemic, campaigners say. A letter seen by BBC News, sent to the chairwoman of the Covid-19 inquiry, calls for it to look at "racism as a key issue" at every stage. Ethnic minorities were significantly more likely to die with Covid-19, according to official figures. An inquiry spokesperson said the unequal impacts of the pandemic would be at the forefront of its work. People from ethnic minority backgrounds who lost loved-ones during the pandemic also told BBC News they felt "sidelined" by the process so far. The letter to Baroness Hallett, who is chairing the inquiry, has been co-ordinated by the group Covid-19 Bereaved Families for Justice and race equality think tank Runnymede. It calls for ethnic minority communities to be "placed firmly at the centre" of the inquiry. Read full story Source: BBC News, 28 February 2023 -
Content ArticleThis study in Brain, Behaviour & Immunity - Health aimed to examine associations between symptomatic Covid-19 history, neurocognitive function and psychiatric symptoms. The authors used cognitive task performance, functional brain imaging and a prospective population survey to conduct the study. Converging findings from laboratory and population survey data support the conclusion that symptomatic Covid-19 infection is associated with task-related, functional imaging and self-reported indices of cognitive dysfunction as well as psychiatric symptoms. In some cases, these findings appear to be more amplified among women than men, and among older women than younger.
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Content ArticleStephanie Longe first arrived in the UK from Switzerland in 2019 to work at the High Consequence Emerging Viruses Group at what is now the UK Health Security Agency. At the time, her project was focused on Ebola virus disease survivors. But Covid quickly changed plans. Stephanie and her colleagues had to use their skills to develop Covid treatments and new antivirals. Stephanie was involved in early research to study the Sars-CoV-2 infection, and test vaccine candidates. Then in June 2022, Stephanie had Covid and she is now one of the 2 million people who experience self-reported Long Covid symptoms in the UK. She shares her experience of Long Covid and the research she is doing in this Guardian article.
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Content Article
The haunting brain science of Long Covid (Stat,16 February 2023)
Patient-Safety-Learning posted an article in Blogs
In this article for Stat, E. Wesley Ely, Professor of Medicine and Critical Care at Vanderbilt University Medical Center, looks at the impact Covid-19 and Long Covid can have on people's brains. He speaks to people with Long Covid who have experienced a sharp decline in brain function, leading to them losing their jobs, struggling to hold a conversation and in some cases developing early-onset dementia. He also highlights biomedical research that has shown changes to the brain in people with confirmed Covid-19 infections, including a reduction in grey matter, problems in the cells lining the blood vessels and impaired cellular metabolism in the frontal lobe six months following acute Covid. -
News Article
Ethnic minority Covid death gap closes
Patient Safety Learning posted a news article in News
People from ethnic minority backgrounds are no longer significantly more likely to die of Covid-19, new Office for National Statistics (ONS) data shows. Early in the pandemic, deaths involving coronavirus were higher among black and Asian people than white people, with the highest risk among Bangladeshi, Black Caribbean and Pakistani groups. Covid mortality rates for all ethnic minorities decreased last year. The latest data shows there is no significant statistical difference between the number of Covid deaths among ethnic minorities and the white population. The ONS also said that "all cause" mortality rates - measuring how likely people are to die of any cause, including Covid-19 - have returned to pre-pandemic patterns. The reasons for this change are complex, and experts say there are "various factors" to consider. Read full story Source: BBC News, 22 February 2023 -
Content ArticleCommunity hospitals are an important part of local health and care systems, yet there has been very little shared on their role and contribution during the pandemic. This project from the Community Hospitals Association sought to redress this and highlight the role of these local hospitals. This two-year project enabled staff to reflect on their experiences and innovations in their community hospitals during the pandemic in a systematic way that facilitated wider sharing and learning. It captures the experiences of staff working in UK community hospitals during the COVID-19 pandemic, with a focus on positive impact changes.
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News ArticleThe National Institute for Health and Care Excellence (NICE) has decided not to recommend Evusheld for adults who are unlikely to have an adequate immune response or cannot have the vaccine against Covid-19, citing a lack of evidence that it is effective against circulating variants. However, it is still reviewing whether the antibody drug could be used to prevent covid-19 infection in adults at the highest risk of severe illness, including people with immunodeficiency, people who have had a solid organ transplant, and people with cancer. NICE’s director of medicines evaluation, Helen Knight, acknowledged that the decision would be “disappointing for the many thousands” of vulnerable people who “continue to significantly modify their behaviour to avoid infection. Commenting on NICE’s decision, Lennard Lee, senior clinical research fellow at the University of Birmingham, said, “While it’s right for NICE to ensure that treatment options are based on the best possible evidence for their safety, efficacy, and cost effectiveness, it must be recognised that those who remain extremely vulnerable to covid need to be prioritised in trials akin to those early days of the pandemic to find treatments fit for them. “Otherwise, we run the risk of consigning half a million people to continue to live in 2020, stuck in their homes, not able to see their families and friends for fear of infection with no protection.” Read full story Source: The BMJ, 16 February 2023
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Content ArticleDr Nabarro’s recent comment made on Independent Sage 2 December, that Covid-19 is primarily a droplet-borne infection, flies in the face of overwhelming international scientific consensus that the pandemic is driven by airborne transmission of the SARS-CoV-2 virus. Despite airborne transmission being accepted as the dominant mode of spread in almost every other arena, within official infection prevention and control (IPC) bodies in the World Health Organization (WHO) and many national authorities including the UK, there is denial or minimising of airborne spread, and continuing adherence to the droplet theory of transmission. This has meant rejection of airborne mitigations within healthcare, with profound consequences for the lives and health of healthcare workers, as well as for patients in hospitals and care homes. It is now clear that the IPC authorities will not be persuaded, no matter how much evidence is presented to them that SARS-CoV-2 is primarily airborne, and that efforts by aerosol scientists, engineers and health experts to provide further evidence of this, are futile. This statement from Doctors in Unite explores these issues in detail, and highlights the disastrous record of droplet-only precautions in our hospitals and care homes. It also asks why the critically important “precautionary principle” was not applied throughout healthcare from the outset, to keep workers and patients safe, while the mode of transmission of the virus was being fully elucidated, despite this being official WHO policy.
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Content ArticleAgainst the backdrop of the Covid-19 pandemic, ensuring the safety of health and social care services remains a serious, ongoing challenge. This report examines how patient safety governance mechanisms in Organisation for Economic Co-Operation and Development (OECD) countries have withstood the test of Covid-19. It provides recommendations for further improving patient safety governance and strengthening health system resilience in OECD countries. This working paper was produced by the OECD for the 5th Global Ministerial Summit on Patient Safety, held in Montreux, Switzerland in February 2023.
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Content ArticleFor years, it has been known that pulse oximeters may present racial biases, with studies dating back as far as the late 1980s suggesting a flaw in how the device measures oxygen in people with darker skin tones. This article looks at how the Covid-19 pandemic finally brought the problem to the forefront of medicine. Ashraf Fawzy, Assistant Professor of Medicine at the Johns Hopkins University School of Medicine, talks about how he and other doctors noticed a trend in pulse oximeter readings not matching up to patient symptoms, and how they went on to research the issue, publishing their results in a study in May 2022. Their study found that Black and Hispanic patients were 29% and 23% less likely than white patients, respectively, to have pulse oximeters recognise their eligibility for more aggressive Covid-19 treatment. The resulting delay in care for patients with darker skin tones is likely to have a significant impact on patient outcomes.
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Content ArticleMany people will experience mental health problems in their lives. Around one in six adults in England have a common mental health disorder, and around half of mental health problems start by the age of 14. This report from the National Audit Office focuses on the implementation of NHS commitments as set out in the Five Year Forward View for Mental Health, Stepping forward to 2020/21: The mental health workforce plan for England and the the NHS Long Term Plan. It examines whether the government has achieved value for money in its efforts to date to expand and improve NHS-funded mental health services by evaluating whether DHSC, NHSE and other national bodies: have a clear understanding of how much their work to date has reduced the gap between mental and physical health services met ambitions to increase access, capacity, workforce and funding for mental health services are well placed to overcome the risks and challenges, including the impact from COVID-19, to achieving future ambitions.
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News Article
Covid-19: US will end public health emergency on 11 May, says Biden
Patient Safety Learning posted a news article in News
President Joe Biden has announced to the US Congress that he will end the country’s Covid-19 public health emergency on 11 May, although about 500 Americans are currently dying every day from Covid-19. He also plans to end the related national Covid-19 emergency. In contrast, the World Health Organization said on 27 January that the Covid-19 pandemic was still a public health emergency. The US administration’s statement said that extending the emergencies until May would provide time for an orderly transition. Ending the emergencies will mean that many Americans will lose the health insurance provided through the Medicaid programme, which helps people on low incomes and was extended during the pandemic. Many others will find that they no longer get free tests, treatments, or vaccines. Read full story Source: BMJ, 1 February 2023 -
Content ArticleHealth workers, hailed as heroes during the pandemic, say they’re being abandoned by the NHS and the government. Some are living with Long Covid and say it’s having a devastating impact on both their personal and professional lives. For Panorama, the BBC’s health correspondent, Catherine Burns, meets staff struggling to return to work and reveals how some are now facing financial hardship and the prospect of having to retire early or, worse, being sacked.
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Content ArticleYoung people from across the UK reflect on how the pandemic is still affecting their lives and their plans for the future, 18 months after the end of the third national lockdown.
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Content ArticleThis study in the journal Acta Neuropathologica Communications examined neuropathological findings of patients who died following hospitalisation in an intensive care unit with Covid-19. The researchers conducted brain autopsy on 20 people who had died, followed by ex-vivo imaging and dissection. They found that acute tissue injuries and microglial activation were the most common abnormalities discovered in Covid-19 brains. They also found evidence of encephalitis-like changes despite the lack of detectable virus. The majority of older subjects showed age-related brain conditions even in the absence of known neurologic disease. The findings of this study suggest that acute brain injury alongside common pre-existing brain disease may put older subjects at higher risk of post-Covid neurological issues.
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News Article
Thousands of NHS staff with long Covid risk losing their pay
Patient Safety Learning posted a news article in News
Thousands of NHS staff across the UK are facing pay cuts because of a change in Covid sickness policy. Analysis by BBC Panorama suggests that between 5,000 and 10,000 NHS workers could be off sick with Long Covid. Unions are accusing the government of failing to support health staff who worked during the coronavirus pandemic. The government says the Covid-19 public inquiry will examine these issues when it begins taking evidence in May. Changes to special sick pay rules introduced during the pandemic mean that some NHS staff unable to work due to Long Covid may soon no longer receive full pay. Enhanced provision ended last year. Many had a six-month transition, so expect their wages to go down soon. Some face losing their jobs. Professor David Strain is the chair of the Board of Science at the British Medical Association (BMA) and says this makes him "genuinely angry". He explains: "We've got a group of people that have put themselves forward to look after the population, they've been left with an illness and they're not being supported. "They're just in a no man's land." He believes that health workers with long Covid should be allowed to focus on their recovery without money worries. Read full story Source: BBC News, 30 January 2023 -
News Article
Nearly £15bn wasted on Covid PPE, says UK spending watchdog
Patient Safety Learning posted a news article in News
The UK health department was forced to write down £14.9bn worth of personal protective equipment and other medical items, according to a report by the independent public spending watchdog, which also issued a scathing criticism of the UK Health Security Agency. The National Audit Office said that the Department for Health and Social Care did not complete an “effective programme of year-end stock counts” to assess the quality and quantity of coronavirus-related items, such as lateral flow tests. During the last two financial years, the DHSC reported nearly £15bn of write down costs associated with PPE and other health items. The department estimated that the continuing cost of storage and disposal of excess and unusable equipment stands at £319mn. The watchdog found a “lack of adequate governance, oversight and control” at the UKHSA. It noted that due to a “lack of sufficient, appropriate audit evidence and significant shortcomings in financial control” the NAO was unable to provide an audit opinion on the 2021-22 accounts of the agency. Read full story (paywalled) Source: Financial Times, 27 January 2023 -
Content ArticleWhen Covid-19 first struck the UK, the disease was described as 'a great leveller'. But it soon became clear that Covid's impacts were not evenly distributed—we may have been in the same storm, but we were in different boats. In this episode of All in it together, guests Charlotte Augst, Halima Begum, Beth Kamunge-Kpodo, Professor Sir Michael Marmot and Pastor Mick Fleming discuss unequal outcomes during the Covid-19 pandemic.
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News Article
Political will to tackle health security ‘melting away’, warns Tony Blair
Patient Safety Learning posted a news article in News
The impetus to tackle health security has started to “melt away”, despite the devastation wrought by the Covid pandemic, Tony Blair has warned. In the foreword to a new book, ‘Disease X’, the former British prime minister said that while there are “concurrent crises jostling for the attention of governments”, leaders should not miss the opportunity to implement the “hard-won lessons” of the past three years. “Covid-19 was an unprecedented global crisis and should mark a turning point in global health policy and preparedness,” Mr Blair wrote. “Our governments need to demonstrate the same level of political will, ambition and international cooperation that leaders demonstrated in the wake of World War II, when they coalesced around the objective of a sustainable peace. “This must be applied to the post pandemic order because, at its heart, health security is national security,” he added. “It is clear this will not be the last pandemic threat of our lifetimes … there is no excuse to be unprepared, again.” Read full story (paywalled) Source: The Telegraph, 25 January 2023 -
News Article
Immensa Covid test lab concerns ignored by Test and Trace
Patient Safety Learning posted a news article in News
Concerns raised about dangerous discrepancies at a Covid testing lab which has since been blamed for causing an estimated 23 deaths were ignored by health officials for months. Documents show Public Health Wales flagged "significant concerns" about results from Immensa, in Wolverhampton, in letters to colleagues in England. They were told nothing was wrong and testing continued for six months. Letters were released after a Freedom of Information request by the Times. The UK Health Security Agency (UKHSA) has said as many as 39,000 positive results were wrongly reported as negative in September and October 2021, mostly originating from south-west England. Read full story Source: BBC News, 26 January 2023 -
Content ArticleThis article in The Times explains why the Times Health Commission was set up, what it aims to achieve and how it will do this. The year-long commission aims to address the most urgent challenges facing health and social care including the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Commissioners will draw up recommendations in ten areas to identify problems and find solutions. The Commission will publish its final report in January 2024.
