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Found 2,337 results
  1. Content Article
    How does it feel to confront a pandemic from the inside, one patient at a time? To bridge the gulf between a perilously unwell patient in quarantine and their distraught family outside? To be uncertain whether the protective equipment you wear fits the science or the size of the government stockpile? To strive your utmost to maintain your humanity even while barricaded behind visors and masks? Rachel is a palliative care doctor who looked after some of the most gravely unwell patients on the Covid-19 wards of her hospital. Amid the tensions, fatigue and rising death toll, she witnessed the courage of patients and NHS staff alike in conditions of unprecedented adversity. For all the bleakness and fear, she found that moments that could stop you in your tracks abounded. People who rose to their best, upon facing the worst, as a microbe laid waste to the population.
  2. Content Article
    In December 2022, a newly formed group called 'Long Covid Doctors for Action' (LCD4A) conducted a survey to establish the impact of Long Covid on doctors. When the British Medical Association published the results of the survey, the findings were both astonishing and saddening in equal measure.[1] The LCD4A have now decided that enough is enough and that it is now time to stand up and take positive action. They have initiated a group litigation against those who failed to exercise the ‘duty of care’ that they owed to healthcare workers across the UK during the pandemic.  In this blog, I summarise how and why I feel our healthcare workers have been let down by our government and why, if you are one of these healthcare workers whose life has been effected by Long Covid, I urge you to join the group litigation initiative.
  3. Content Article
    This Lancet article highlights new evidence from analysis of population-based electronic health records for almost the entire population of the UK. The analysis showed that, as of 1 June 2022, a high proportion of the population had received fewer than the recommended number of Covid-19 vaccinations: 45·8% in England, 49·8% in Northern Ireland, 34·2% in Scotland and 32·8% in Wales. Combining the results across countries suggests that a substantial number of severe Covid-19 outcomes, including hospital admissions or deaths from Covid-19, might be prevented if recommended vaccination schedules were fully implemented. These findings reinforce the message that the role of vaccination in Covid-19 is to mitigate the severity of the illness, reducing the risk of complications and mortality, rather than avoiding all Covid-19 infections.
  4. Content Article
    This population-based cohort study from Sweden and Norway aimed to explore whether exposure to mRNA Covid-19 vaccination during pregnancy increases the risk of adverse events in newborn infants. The cohort included 94,303 infants exposed to Covid-19 vaccination during pregnancy and 102,167 control infants born between June 2021 and January 2023. The authors found that vaccination during pregnancy was associated with lower odds of neonatal intracranial haemorrhage, cerebral ischemia and hypoxic-ischemic encephalopathy, and neonatal mortality.
  5. Content Article
    Set up in January 2023, the Times Health Commission was a year-long projected established to consider the future of health and social care in England in the light of the pandemic, the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Its recommendations are intended to be pragmatic, practical, deliverable and able to be potentially taken up by any political party or government, present or future. 
  6. Content Article
    During the first wave of Covid-19, the drug hydroxychloroquine was used off-label despite the absence of evidence documenting its clinical benefits. Since then, a meta-analysis of randomised trials showed that the drug's use was associated with an 11% increase in the mortality rate. This study in the journal Biomedicine & Pharmacotherapy aimed to estimate the number of hydroxychloroquine-related deaths worldwide.
  7. Content Article
    With a number of large-scale clinical trials underway and researchers on the hunt for new therapies, Long Covid scientists are hopeful that this is the year patients will finally see improvements in treating their symptoms. This article in Medscape makes five research-based predictions that could happen in 2024. They provide promising signs of progress in treating a debilitating and frustrating disease. The predictions are: We'll gain a better understanding of each Long Covid phenotype Monoclonal antibodies may change the game Paxlovid could prove effective for Long Covid Anti-inflammatories like metformin could prove useful Serotonin levels may be keys to unlocking Long Covid
  8. Content Article
    Hundreds of doctors - led by campaign group Long Covid Doctors for Action - are planning to sue the NHS over claims that inadequate PPE provision has left them with Long Covid. One of those, Dr Nathalie MacDermott, joins Women's Health host Emma Barnett to discuss it. Listen from 2:40
  9. Content Article
    This Lancet article is written by two young people aged 19 and 20 years, based in the UK, who both developed Long Covid more than two years ago. They describe their wide-ranging symptoms and highlight the impact the condition has had on their lives, causing them to miss out on key milestones—such as starting university and learning to drive. They go on to look at the specific challenges facing young people with long-term conditions, arguing that many services that are meant to help young people—health services, schools and higher education facilities—are failing those dealing with a chronic illness or disability. This article is free to view, but you will need to sign up for a free Lancet account
  10. Content Article
    Undervaccination—receiving fewer than the recommended number of Covid-19 vaccine doses—could be associated with increased risk of severe Covid-19 outcomes including hospitalisation or death compared with full vaccination. This study aimed to determine the factors associated with undervaccination and to investigate the risk of severe Covid-19 outcomes in people who were undervaccinated in each UK nation, and across the UK. The authors found that rates of undervaccination against Covid-19 ranged from 32·8% to 49·8% across the four UK nations in summer 2022. They also concluded that undervaccination was associated with an elevated risk of severe Covid-19 outcomes.
  11. News Article
    More than 7,000 Covid-related hospital admissions could have been prevented in the UK in the summer of 2022 if the population had received the full number of jabs recommended, according to research in The Lancet. Some 44% of the UK population was under-vaccinated, with younger people among the most likely to skip doses. In a first, health records for everyone over five in the UK were analysed. The same approach could now be used to understand other diseases. The entire population of the UK is 67 million, and all those over the age of five had their anonymised electronic health data analysed for The Lancet study. With about 40,000 severe hospital admissions related to Covid during that summer, the research estimates that more than 7,000 - 17% - would have been avoided if everyone had taken up the offer of the vaccine and booster doses for which they were eligible. Read full story Source: BBC News, 16 January 2024
  12. Content Article
    The Covid-19 pandemic led to unprecedented healthcare disruption across the UK. In England, the number of patient referrals waiting to be treated in hospital was more than 7·2 million at the end of October, 2022. In response, the UK Government set up an elective recovery taskforce (ERT) in December, 2022, to help NHS England tackle this backlog. Ahmar Shah and colleagues estimated the extent of healthcare disruption during the Covid-19 pandemic to aid decision making regarding the necessary capacity increases that are required to address the ensuing backlog. The study, published in The Lancet, found NHS waiting list for elective treatment increased between 1 Jan 2012, and the start of the Covid-19 pandemic, suggesting a gradual service decline. The waiting list then substantially increased during the pandemic, but this substantial increase is likely to represent a substantial underestimation of the backlog because of the anticipated large numbers of people who have still not come forward for care. Even if the ambitious target of 30% increase in capacity is achieved during the next 3 years, several years (beyond the end of 2025) will be needed for the backlog to clear. This study emphasises the need to improve health-care system resilience to ensure that the effects of any future emergencies on the provision of routine care are minimised.
  13. News Article
    The NHS must treat at least 10% more non-emergency hospital cases a month if it wants to reduce the hefty backlog caused by the pandemic, according to new analysis. From February 2020 to October 2022, the waiting list for non-urgent care in England grew by 2.6m cases – a projected 1.8m more than if the pandemic had not hit. NHS England’s recovery plan aims to increase capacity by 30% by 2025 compared with pre-pandemic levels, but figures published on Thursday showed that the waiting list in England stood at 7.6m, down just 1.3% from the previous month. Researchers at the Universities of Edinburgh and Strathclyde examined the number of referrals awaiting treatment between January 2012 and October 2022. They calculated that an estimated 10.2m fewer referrals were made to elective care from the beginning of the pandemic to 31 October 2022. They then modelled how many of these missing patients might return for care to estimate the potential impact on waiting lists. NHS trusts would have to treat more than 10% to reverse the increasing trend in waiting lists, the authors conclude. “Even if the ambitious target of 30% increase in capacity is achieved during the next three years, several years (beyond the end of 2025) will be needed for the backlog to clear.” The research comes as NHS England monthly data published on Thursday revealed the health service is going backwards on some key targets. Read full story Source: The Guardian, 11 January 2024
  14. Content Article
    In this article for The Lancet, Professor Gagandeep Kang from the Bill & Melinda Gates Foundation examines what the story of rotavirus vaccine development in India can tell us about the opportunities, the necessary enabling environment and the challenges of creating products to improve global health. He highlights that although multiple successful vaccines were developed during the Covid-19 pandemic—in quantities that were inconceivable at the start of the pandemic—vaccine nationalism trumped the efforts of WHO, which established a prioritisation framework for vaccination of clinically vulnerable populations. The COVAX scheme was not successful in its aim to ensure that vaccines could be financed and distributed equitably around the world. This experience of delayed and low access to vaccines has led to calls for reparative justice and for moving away from short-term fixes of product donations to support local or regional vaccine manufacturing. Sharing intellectual property and enhancing regional capacity are now framed as moral imperatives against colonialism, and the development of the rotavirus vaccine provides lessons on how this can be achieved.
  15. Content Article
    The BMA has sent a letter to Amanda Pritchard, Chief Executive of NHS England, highlighting the increasing concerns from their members about the protection of healthcare workers and patients from Covid-19, particularly in light of the rise in cases, hospitalisations and deaths that occurred in September and October. 
  16. Content Article
    In this piece for the BMJ, David Oliver, consultant in geriatrics and acute general medicine, raises concerns about the way in which NHS England is using virtual wards. As well as pointing to the lack of solid evidence for the effectiveness and safety of virtual wards, he highlights lack of clarity in the use of the term, which is often being used interchangeably with 'Hospital at home', a different approach with a more robust evidence base. He also points out that staff working on virtual wards are taking workforce capacity from other parts of the health service and that the approach is placing additional pressure on existing primary and community care staff who are not part of the virtual ward.
  17. News Article
    Hundreds more middle-aged adults have been dying each month since the end of the pandemic, as obesity and NHS backlogs drive a surge in excess deaths. New analysis of official statistics has revealed that there were an extra 28,000 deaths in the UK during the first six months of 2023, compared with levels in the previous five years. The biggest rise in unexpected deaths has been among adults aged 50 to 64, who are increasingly dying prematurely from preventable conditions including heart disease and diabetes. The Covid inquiry is now being urged to shift its focus from “tactical decisions made by politicians” and to examine the lasting disruption that has kept deaths persistently high since the virus peaked. Experts believe that difficulties in accessing GPs since lockdown and record NHS waiting lists mean that middle-aged patients are missing out on life-saving preventative treatment such as blood pressure medication. Unhealthy lifestyles, obesity and widening health inequalities are also contributing to a rise in avoidable deaths. Professor Yvonne Doyle, who led Public Health England during the pandemic, warned that the official Covid inquiry risks “missing the point” by focusing on the drama and WhatsApps of Westminster politicians. In an article for The Times, Doyle, who gave evidence to the inquiry six weeks ago, says that the tens of thousands of excess deaths since Covid “represent an underlying pandemic of ill health” that should be addressed. Read full story (paywalled) Source: The Times, 13 December 2023
  18. Content Article
    The Covid-19 pandemic increased the sense of urgency to advance understanding and prevention of infectious respiratory disease transmission. There are extensive studies that demonstrate scientific understanding about the behaviour of larger (droplets) and smaller (aerosols) particles in disease transmission as well as the presence of particles in the respiratory track. Methods for respiratory protection against particles, such as N95 respirators, are available and known to be effective with tested standards for harm reduction. However, even though multiple studies also confirm their protective effect when N95 respirators are adopted in healthcare and public settings for infection prevention, overall, studies of protocols of their adoption over the last several decades have not provided a clear understanding. This preprint article demonstrates limitations in the methodology used to analyse the results of these studies. The authors show that existing results, when outcome measures are properly analysed, consistently point to the benefit of precautionary measures such as N95 respirators over medical masks, and masking over its absence.
  19. Content Article
    In this blog, journalist Rory Cellan-Jones reflects on some major challenges the NHS currently faces. Sharing insights from a recent meeting with medtech companies and a lecture by economist Professor Diane Coyle, he shares concerns that productivity in the health service has decreased as a result of the pandemic, and that medtech companies face barriers in selling their solutions to the NHS. He highlights a growing consensus that policymakers need to think beyond immediate firefighting and look at how to transform the NHS over the long term.
  20. News Article
    One of the biggest challenges facing clinicians who treat Long Covid is a lack of consensus when it comes to recognising and diagnosing the condition. But a new study suggests testing for certain biomarkers may identify Long Covid with accuracy approaching 80%. Effective diagnostic testing would be a game-changer in the Long Covid fight, for it’s not just the fatigue, brain fog, heart palpitations, and other persistent symptoms that affect patients. Two out of three people with Long Covid also suffer mental health challenges like depression and anxiety. Some patients say their symptoms are not taken seriously by their doctors. And as many as 12% of Long Covid patients are unemployed because of the severity of their illness and their employers may be sceptical of their condition. Researchers at Cardiff University School of Medicine in Cardiff, Wales, United Kingdom, tracked 166 patients, 79 of whom had been diagnosed with Long Covid and 87 who had not. All participants had recovered from a severe bout of acute Covid-19. In an analysis of the blood plasma of the study participants, researchers found elevated levels of certain components. Four proteins in particular—Ba, iC3b, C5a, and TCC—predicted the presence of Long Covid with 78.5% accuracy. "I was gobsmacked by the results. We’re seeing a massive dysregulation in those four biomarkers," says study author Wioleta Zelek, PhD, a research fellow at Cardiff University. "It’s a combination that we showed was predictive of Long Covid.." Read full story Source: Medscape, 29 November 2023
  21. News Article
    People with Covid-19 were discharged to care homes over fears about the NHS getting “clogged up”, the pandemic inquiry has heard. Professor Dame Jenny Harries, England’s deputy chief medical officer during the pandemic and now head of the UK Health Security Agency, told the inquiry of how an email she sent in mid-March 2020 described the “bleak picture” and “top line awful prospect” of what needed to happen if hospitals overflowed. Discharging people to care homes – where thousands of people died of Covid – has been one of the central controversies when it comes to how the Government handled the pandemic. On Wednesday, the Covid inquiry was read an email exchange between Rosamond Roughton, an official at the Department of Health, and Dame Jenny on March 16 2020. Ms Roughton asked what the approach should be around discharging symptomatic people to care homes, adding: “My working assumption was that we would have to allow discharge to happen, and have very strict infection control? Otherwise the NHS presumably gets clogged up with people who aren’t acutely ill.” Ms Roughton added that this was a “big ethical issue” for care home providers who were “understandably very concerned” and who were “already getting questions from family members”. In response, Dame Jenny emailed: “Whilst the prospect is perhaps what none of us would wish to plan for, I believe the reality will be that we will need to discharge Covid-19 positive patients into residential care settings for the reason you have noted. “This will be entirely clinically appropriate because the NHS will triage those to retain in acute settings who can benefit from that sector’s care. “The numbers of people with disease will rise sharply within a fairly short timeframe and I suspect make this fairly normal practice and more acceptable, but I do recognise that families and care homes will not welcome this in the initial phase.” Read full story Source: The Independent, 29 November 2023
  22. Content Article
    This study in BMC Health Services Research mapped healthcare workers’ experiences with patient safety incidents during the second wave of the Covid-19 pandemic in Slovakia. The authors found that healthcare workers with patient safety incident experiences reported poor hospital management of patient safety culture. This might reflect missed the opportunities to strengthen their resilience during the Covid-19 pandemic.
  23. Content Article
    Sepsis, characterised by significant morbidity and mortality, is intricately linked to socioeconomic disparities and pre-admission clinical histories. This study in eClinical Medicine looked at the association between non-COVID-19 related sepsis and health inequality risk factors amidst the pandemic in England, with a secondary focus on their association with 30-day sepsis mortality. It found that socioeconomic deprivation, comorbidity and learning disabilities were associated with an increased odds of developing non-COVID-19 related sepsis and 30-day mortality in England. This study highlights the need to improve the prevention of sepsis, including more precise targeting of antimicrobials to higher-risk patients. It also revealed that people with learning disabilities were almost four times as likely to develop the life-threatening illness. People with chronic liver disease were just over three times as likely, and chronic kidney disease stage 5 over 6 times more likely to develop non-COVID-19 sepsis. Cancer, neurological disease, immunosuppressive conditions, and having multiple prior courses of antibiotics were also associated with developing non-COVID-19 sepsis.
  24. Content Article
    The COVID-19 pandemic highlighted systemic weaknesses in the healthcare system. This survey of 3,067 registered nurses working in New Jersey used the Donabedian framework to identify challenges related to providing safe care during the pandemic. Respondents identified several organisational factors, including inadequate resources and staffing, which adversely impacted their ability to adhere to patient safety and infection prevention and control protocols during the pandemic.
  25. News Article
    Engaging the private sector in delivering health care and goods requires a sound understanding of how to align resources with the strategic priorities of a health system. The WHO Regional Office for Europe and the European Observatory on Health Systems and Policies have released a new report for policy-makers that analyses governance evidence from the COVID-19 pandemic. “The question is not whether we should do it, but what we can do to do it well,” explained Dimitra Panteli, programme manager at the Observatory, who presented the policy brief during a WHO-hosted launch session at the European Public Health (EPH) Conference in Dublin. Having played a key part in the COVID-19 pandemic, the private sector showed that it holds resources and expertise that can enhance the delivery of health goods and services and help achieve Universal Health Coverage. It also has a wider role in the maintenance of essential health services and in ensuring health system resilience. “We cannot have the illusion that we should not work with the private sector, especially as health services struggle to cope with backlogs caused by the pandemic,” pointed out Natasha Azzopardi Muscat, Director of Country Health Policies and Systems at WHO/Europe. This collaboration can however present challenges, for example around governance practices. Policy successes and failures during the pandemic provide lessons for countries on how to engage the private sector in their health systems effectively. Read full story Source: European Observatory on Health Systems and Policies, 20 November 2023
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