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News Article
Hospital robots are helping combat a wave of nurse burnout in the US
Patient Safety Learning posted a news article in News
Since February, the nurses at Mary Washington Hospital in Fredericksburg, Virginia, USA, have had an extra assistant on their shifts: Moxi, a 4-foot-tall robot that ferries medication, supplies, lab samples, and personal items through the halls, from floor to floor. After two years of battling Covid-19 and related burnout, nurses say it’s been a welcome relief. “There's two levels of burnout: There's ‘we’re short this weekend’ burnout, and then there's pandemic burnout, which our care teams are experiencing right now,” says Abigail Hamilton, a former ICU and emergency room nurse that manages nursing staff support programmes at the hospital. Moxi is one of several specialised delivery robots that has been developed in recent years to ease the strain on healthcare workers. Even before the pandemic, nearly half of US nurses felt that their workplace lacked adequate work–life balance. The emotional toll of seeing patients die and colleagues infected at such a large scale—and fear of bringing Covid-19 home to family—has made feelings of burnout worse. Studies also found that burnout can have long-term consequences for nurses, including cognitive impacts and insomnia years after the exhaustion of their early careers. The world already had a nurse shortage going into the pandemic; now, roughly two out of three nurses in the US say they have considered leaving the profession, according to a survey from the National Nurses United union. Moxi has spent the pandemic rolling down the halls of some of the largest hospitals in the country, carrying objects like a smartphone or beloved teddy bear to patients in emergency rooms when Covid-19 protocol kept family members from bedsides. Read full story Source: Wired, 19 April 2022 -
News Article
'Utterly inhumane' hospitals still ban bedside visitors as Covid cases plunge
Patient Safety Learning posted a news article in News
Hospitals are still banning patients from having bedside visitors in ‘immoral’ Covid restrictions. Last night, MPs, patient groups and campaigners criticised the postcode lottery that means some frail patients are still denied the support of loved ones. Nine trusts continue to impose total bans on any visitors for some patients, The Mail on Sunday has found. Almost half of trusts maintain policies so strict that they flaunt NHS England’s guidance that patients should be allowed at least two visitors a day. Shrewsbury and Telford Hospital NHS Trust, Sandwell and West Birmingham Hospitals NHS Trust and Royal Papworth Hospital NHS Foundation Trust are among those continuing total bans on visiting for some of their patients. University College London Hospitals NHS Foundation Trust (UCLH) has even been imposing its draconian restrictions on disabled patients who need special help for their care – only allowing visits on three days a week for a maximum of an hour each time. Tory MP Alicia Kearns said: ‘It is utterly unforgivable and immoral. There is no scientific evidence for any remaining inhumane restrictions on visiting. Trusts are breaching the rights of families. 'Visitors save lives, they advocate and calm their loved ones. When will this madness end?’ Read full story Source: MailOnline, 1 May 2022 You may also be interested in: Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative -
News Article
Lack of Covid testing leaves researchers blind to evolution patterns, WHO warns
Patient Safety Learning posted a news article in News
A dramatic drop in testing for Covid-19 has left the world blind to the virus’s continuing rampage and its potentially dangerous mutations, the head of the World Health Organization has warned. The UN health agency said that reported Covid cases and deaths had been dropping dramatically. “Last week, just over 15,000 deaths were reported to WHO – the lowest weekly total since March 2020,” WHO chief Tedros Adhanom Ghebreyesus told reporters. While saying this was “a very welcome trend”, he warned that the declining numbers could also be a result of significant cuts in testing for the virus. “As many countries reduce testing, WHO is receiving less and less information about transmission and sequencing,” he said. “This makes us increasingly blind to patterns of transmission and evolution." “When it comes to a deadly virus, ignorance is not bliss.” William Rodriguez, who heads the global diagnostics alliance FIND, also decried that many governments in recent months simply stopped looking for Covid cases. Speaking at the press conference hosted by WHO, he pointed out that in the past four months, amid surging Covid cases from the Omicron variant, “testing rates have plummeted by 70% to 90% worldwide”. The plunging testing rates came despite the fact that there is now more access to accurate testing than ever before. “We have an unprecedented ability to know what is happening,” Rodriguez said. “And yet today, because testing has been the first casualty of a global decision to let down our guard, we’re becoming blind to what is happening with this virus.” Read full story Source: The Guardian, 26 April 2022 -
News ArticleAt least 200,000 people missed out on essential surgery as a result of the Covid-19 pandemic, with many enduring “misery and daily pain” as a result, a conference has heard. Both scheduled and emergency surgery levels dropped by 20% during the pandemic, suggesting there is now significant pent-up demand for treatment, according to the national clinical lead in surgery, Prof Deborah McNamara. Almost 343,000 people are waiting to see a surgeon for the first time, 100,000 of whom have been on a waiting list for more than 18 months, she told the conference on outcomes from the pandemic at the Royal College of Surgeons in Ireland (RCSI). This was only the start of delays for patients, she pointed out, as they have to wait again for their procedure to be carried out. Currently, more than 71,000 patients are waiting for surgery, a fifth of whom have been on the list for more than a year. Long-waiting patients needing complex surgery have been disproportionately affected, she said, as the system focused on treating “quick-win” procedures such as endoscopies. The amount of day-case work carried out by hospitals is back to 84 per cent of 2017 levels, yet complex care remains at only 67 per cent, she pointed out. Patients waiting for surgery were enduring a “huge amount of misery” that remains unquantified, according to Prof McNamara. The pandemic resulted in some positive changes, she said, including shorter hospital stays, a greater role for physician associates and a generational change in the use of IT. However, it also led to greater constriction in the capacity for scheduled surgery, and greater seasonal variations in demand. Read full story Source: The Irish Times, 26 April 2022
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News Article
Covid: Discharging hospital patients to care homes 'unlawful'
Patient Safety Learning posted a news article in News
Government policies on discharging untested patients from hospital to care homes in England at the start of the Covid pandemic have been ruled unlawful by the High Court. The ruling comes after two women took former Health Secretary Matt Hancock and Public Health England to court. Dr Cathy Gardner and Fay Harris said it had caused a "shocking death toll". Prime Minister Boris Johnson renewed his apologies for all those who lost loved ones during the pandemic. Dr Gardner and Ms Harris partially succeeded in claims against Mr Hancock and Public Health England. The women claimed key policies of discharging patients from hospitals into care homes were implemented with no testing and no suitable isolation arrangements in the homes. A barrister representing Dr Gardner and Ms Harris told the court at a hearing in March that more than 20,000 elderly or disabled care home residents died from Covid between March and June 2020 in England and Wales. Jason Coppel QC also said in a written case outline for the judicial review that the care home population was known to be "uniquely vulnerable" to Covid. "The government's failure to protect it, and positive steps taken by the government which introduced Covid-19 infection into care homes, represent one of the most egregious and devastating policy failures in the modern era," he added. Read full story Source: BBC News, 27 April 2022 -
News Article
Only 29% of UK Covid hospital patients recover within a year
Patient Safety Learning posted a news article in News
Fewer than one in three people who have been hospitalised with Covid-19 have fully recovered a year after they succumbed to infection. That is the shock finding of a survey into the impact of long Covid in the UK. The team of scientists and doctors at Leicester University also found that women had poorer recovery rates than men after hospitalisation, while obesity was also likely to hinder a person’s prospects of health improvements. Among the symptoms reported by patients a year after their initial infection were fatigue, muscle pain, poor sleep and breathlessness. “Given that more than 750,000 people have been hospitalised in the UK with Covid-19 over the past two years, it is clear from our research that the legacy of this disease is going to be huge,” said Rachael Evans, one of the study’s authors. The team stressed their results show there is now an urgent need to develop ways to tackle Long Covid. “Without effective treatments, Long Covid could become a highly prevalent long-term condition,” said Professor Chris Brightling, another author. A critical factor in these poor rates of recovery was the lack of treatments that exist for Long Covid, added Professor Louise Wain, who was also involved in the study. “No specific therapeutics exist for long Covid and our data highlights that effective interventions are urgently required.” The researchers also found that many of those reporting impairment in the wake of their hospitalisation were suffering from persistent inflammation. “That suggests these groups might respond to anti-inflammatory strategies,” added Wain. Read full story Source: The Guardian, 24 April 2022 -
News Article
Fear over high rates of diabetes foot amputations
Patient Safety Learning posted a news article in News
Major differences in the rate of foot amputations for people with diabetes in England are incredibly concerning, patient groups say. Such amputations are a sign patients have not received adequate care, as poorly controlled diabetes increases the risk of foot ulcers and infections. One in 10 areas had "significantly higher rates", government data shows. There was nearly a five-fold difference between the best and worst when taking into account risk factors such as age. The government data - published by the Office for Health Improvement and Disparities - looked at the three years leading up to the pandemic. It is believed up to 80% of foot amputations could be avoided with better care. Diabetes UK said the figures "shined a light on the scale of the crisis facing diabetes care" and it warned access to support was likely to have become worse during the pandemic. A report produced by the charity earlier this month said lives would be needlessly lost because of disruption to services over the past two years. Diabetes UK chief executive Chris Askew said the latest figures were "incredibly concerning". "The majority of these major amputations are preventable, but many people living with diabetes are struggling to access the care they need - and in areas of higher deprivation, people are experiencing worse outcomes. These inequalities must be addressed." Read full story Source: BBC News, 27 April 2022 -
News Article
Families banned from Covid wards during lockdown ‘left with PTSD’
Patient Safety Learning posted a news article in News
Relatives of intensive care Covid patients were left traumatised by being banned from visiting their seriously ill loved ones during the pandemic, a study has found. Researchers found two-thirds of family members of patients in intensive care were still suffering high levels of symptoms of post traumatic stress disorder (PTSD) three months after their relative was admitted. Symptoms of PTSD include flashbacks, nightmares and physical sensations such as pain, sweating, feeling sick or trembling. Before the Covid pandemic, symptoms of PTSD in family members of intensive care patients were between 15 and 30 per cent, depending on the condition. The team from the University of Colorado School of Medicine said visitation restrictions may have inadvertently generated a secondary public health crisis of stress-related disorders in family members of Covid patients. At the height of the pandemic, hospitals across Britain restricted access to patients, with many people forced to say goodbye to dying loved ones over Skype, or behind screens or windows. Even as late as last winter, a Telegraph investigation showed that a quarter of trusts were still imposing restrictions on visitors. The findings suggest that the rates of PTSD may be higher in relatives than in patients. A previous study by Imperial College and the University of Southampton found that only one-third of patients on ventilators suffer symptoms. Read full story (paywalled) Source: The Telegraph, 25 April 2022 -
News ArticleAn analysis of data from 50 studies looking at 1.6 million people suggests that as much as 43% of those infected with the coronavirus experienced post-Covid conditions, pointing to the need for better diagnosis and care for “long Covid” patients. Post-Covid conditions are clinically defined by the World Health Organization (WHO) as mid- and long-term symptoms – also known as Long Covid – occurring in individuals after infection with the SARS-CoV-2 virus. The research, published this week in the Journal of Infectious Disease, assessed 23 symptoms reported across 36 of the studies and found that shortness of breath, sleep problems, and joint pain was widely reported by those who had recovered from the novel coronavirus infection. Researchers say fatigue (23%) and memory problems (14%) were the most common symptoms of individuals experiencing post-Covid conditions. While about 34% of non-hospitalised coronavirus patients report lingering post-Covid symptoms, scientists say this rate jumps to over 50% for hospitalised Covid patients. “Long Covid is quite common overall and across geographic regions, sex and acute COVID-19 severity. Knowing this, providers should take proactive approaches such that their patients are well-supported when experiencing long-term health effects of Covid-19,” scientists wrote in the study. Read full story Source: The Independent, 21 April 2022
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News Article
Pandemic disrupted routine vaccinations of US kindergarteners
Patient Safety Learning posted a news article in News
Yet another hidden cost of Covid-19 was revealed on Thursday as the Centers for Disease Control and Prevention presented new data showing how the pandemic has dramatically impeded the US effort to vaccinate kids for other diseases. According to the CDC’s report, national vaccine coverage among American children in kindergarten dropped from 95% to below 94% in the past year – which may seem like a small amount but meant 350,000 fewer children were vaccinated against common diseases. “Overall, today’s findings support previous data showing a concerning decline in childhood immunizations that began in March 2020,” Shannon Stokley, the CDC’s immunization services deputy division director, said in a press conference on Thursday. Some of the reasons for the lower vaccination rates included reluctance to schedule appointments, reduced access to them, so-called “provisional” school enrollment, the easing of vaccination requirements for remote learners, fewer parents submitting documents and less time for school nurses to follow up with unvaccinated students. States and schools also told the CDC that there were fewer staff members to assess kindergarten vaccination coverage, and a lower response rate from schools, both due to Covid-19. “The CDC provides vaccines for nearly half of America’s children through the Vaccines for Children program,” Stokley said. “And over the last two years, orders for distribution of routine vaccines are down more than 10% compared to before the Covid-19 pandemic. “We are concerned that missed routine vaccinations could leave children vulnerable to preventable diseases like measles and whooping cough which are extremely dangerous and can be very serious, especially for babies and young children.” Read full story Source: The Guardian, 21 April 2022 -
News Article
Healthcare worker catches Covid twice in less than three weeks
Patient Safety Learning posted a news article in News
A healthcare worker caught Covid on two separate occasions over the course of just 20 days, a new study has shown. It is believed to be the shortest recorded time between two infections since the start of the pandemic. Since the arrival of the highly infectious Omicron variant, reinfections have become far more prominent. The 31-year-old woman from Spain first became infected with Delta in December 2021 – 12 days after she had received her Covid booster vaccine. Lab analysis showed that she had initially been infected by the Delta variant, followed by Omicron. Her case, which is being presented to the European Congress of Clinical Microbiology and Infectious Diseases in Portugal, is believed to represent the shortest recorded time between two separate infections. Dr Gemma Recio of the Institut Catala de la Salut in Spain, who is one of the study’s authors, said: “This case highlights the potential of the Omicron variant to evade the previous immunity acquired either from a natural infection with other variants or from vaccines". “In other words, people who have had Covid-19 cannot assume they are protected against reinfection, even if they have been fully vaccinated." Read full story Source: The Independent, 21 April 2022 -
News ArticleThe prevalence of sexually transmitted diseases (STDs) and deaths from drug overdoses increased in the US over the past two years, showing the pandemic’s effect on public health. “Even in the face of a pandemic, 2.4 million cases of chlamydia, gonorrhoea, and syphilis were reported,” the US Centers for Disease Control and Prevention (CDC) said. STDs declined during the early months of the pandemic in 2020 but then increased rapidly. Cases of gonorrhoea increased by 10% during 2020 compared with 2019. Cases of primary and secondary syphilis increased by 7% and congenital syphilis in newborns increased by 13%.2 New data suggest that primary and secondary syphilis—the most infectious stages of the disease—continued to increase during 2021, the CDC said. Jonathan Mermin, director of CDC’s national centre for HIV, viral hepatitis, STD, and tuberculosis prevention, said, “The unrelenting momentum of the STD epidemic continued even as prevention services were disrupted.” His colleague, Leandro Mena, director of CDC’s division of STD prevention, said, “The pandemic increased awareness of a reality we’ve long known about STDs. Social and economic factors—such as poverty and health insurance status—create barriers, increase health risks, and often result in worse health outcomes for some people.” Another disturbing trend during the pandemic has been the increase of deaths from drug overdoses, especially among teenagers. Just over 100 000 Americans died of drug overdoses during the year to April 2021, according to the CDC’s national centre for health statistics—an increase of 28.5% from the previous year. Read full story Source: BMJ, 19 August 2022
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News Article
Pregnant women 'afterthought' in Covid jab rollout
Patient Safety Learning posted a news article in News
Pregnant women have been an "afterthought" during the coronavirus pandemic and some of their deaths were "preventable", a leading scientist has told Newsnight. Data shows there have been at least 40 maternal deaths from Covid in the UK. Almost all were unvaccinated and more than half happened after pregnant women were advised to take-up the vaccine. The regulator says vaccines during pregnancy are "safe". Professor Marian Knight, who investigates every maternal death in the UK, said lifesaving messaging is still "struggling" to reach pregnant women, a year on since all of them were advised to get vaccinated. Professor Knight said: "This has perhaps been the first year where my job has made me cry because that was a preventable situation." During the first months of the vaccine rollout, only pregnant health or care workers or those in at-risk groups were advised by the Joint Committee on Vaccination and Immunisation to "consider" the jab due to a "lack of evidence". In April 2021, the advice was updated to cover all pregnant women after real-world data raised no safety concerns. By December 2021, a year after the rollout began, pregnant women were deemed to be more at risk of falling seriously ill from Covid and were put on the priority list for jabs. Professor Knight, the maternal lead for pregnancy monitoring group MBRRACE-UK, said changing initial advice wasn't helpful, but stresses the JCVI had little choice because pregnant women were not included in Covid vaccine trials. "It's a complicated message," she said. "The message 'don't get vaccinated because we haven't got any information' is very subtly different from 'don't get vaccinated because it's not safe'. You may think, 'I can't get vaccinated because I'm pregnant, it must not be safe'. Whereas actually we don't yet have enough information." Read full story Source: BBC News, 20 April 2022 -
News Article
Major scaling back of infection control measures announced
Patient Safety Learning posted a news article in News
A significant relaxation of infection control guidance has been announced in a bid to free up more capacity to tackle substantial waiting lists and demand for emergency care. New guidance issued jointly by the Department of Heath and Social Care, the UK Health Security Agency, NHS England and health bodies in the devolved nations, recommends the relaxation of isolation requirements for inpatients who either test positive for Covid-19 or are considered close contacts of people with the virus. The isolation period for inpatients with Covid-19 can now be reduced from 10 days to seven if they have two negative lateral flow tests. The tests must be taken on two consecutive days from day six of the isolation period onwards, and the patient must also “[show] clinical improvement”. A letter from NHSE released to trust chiefs, sent last Thursday, also recommends the “[return] of pre-pandemic physical distancing in all areas,” including emergency departments, ambulances and “all primary care, inpatient and outpatient settings.” It also recommends the returning to pre-pandemic cleaning procedures outside Covid-19 areas. Read full story (paywalled) Source: HSJ, 19 April 2022 -
News Article
Disruption to diabetes care during Covid threatens thousands, charity warns
Patient Safety Learning posted a news article in News
Thousands of lives are being put at risk due to delays and disruption in diabetes care, according to a damning report that warns patients have been “pushed to the back of the queue” during the Covid-19 pandemic. There are 4.9 million people living with diabetes in the UK, and almost half had difficulties managing their condition last year, according to a survey of 10,000 patients by the charity Diabetes UK. More than 60% of them attributed this partly to a lack of access to healthcare, which can prevent serious illness and early mortality from the cardiovascular complications of diabetes, rising to 71% in the most deprived areas of the country. One in three had no contact with healthcare professionals about their diabetes in 2021, while one in six have still not had contact since before the pandemic, the report by the charity said. Diabetes UK said that while ministers have focused on tackling the elective surgery backlog, diabetes patients have lost out as a result, and there is now an urgent need to get services back on track before lives are “needlessly lost”. Chris Askew, the chief executive of Diabetes UK, called for a national diabetes recovery plan. “Diabetes is serious and living with it can be relentless,” he said. “If people with diabetes cannot receive the care they need, they can risk devastating, life-altering complications and, sadly, early death. “We know the NHS has worked tirelessly to keep us safe throughout the pandemic, but the impacts on care for people living with diabetes have been vast. While the UK government has been focused on cutting waiting lists for operations and other planned care, people with diabetes have been pushed to the back of the queue.” Read full story Source: The Guardian, 20 April 2022 -
News Article
Covid disruption to NHS in England wreaks havoc with surgery backlog
Patient Safety Learning posted a news article in News
Operations are being cancelled across England as Covid causes “major disruption” inside the NHS, the country’s top surgeon has said, as doctors and health leaders say the government’s backlog targets look increasingly unachievable. Six million people are on the waiting list for NHS hospital care, including more than 23,000 who have waited more than two years. Boris Johnson said in February that he had launched “the biggest catch-up programme in the history of the health service”, but in the same month he dropped every domestic Covid restriction. Now record-high Covid rates are wreaking havoc with the ability of the NHS to catch up with surgery that was delayed or cancelled before and during the pandemic. More than 28,000 staff are off work every day due to Covid, recent figures show, while more than 20,000 patients are in hospital with Covid, which has dramatically reduced the number of beds and space available for planned surgery patients. “Unfortunately, Covid-19 continues to cause major disruption in the NHS, with high staff absences in recent weeks,” Prof Neil Mortensen, the president of the Royal College of Surgeons of England, told the Guardian. “We have heard that planned surgery is being cancelled again in different parts of the country due to staff being off sick with the virus. This is understandably frustrating for surgical teams who want to help their patients by getting planned surgery up and running again. It’s also very distressing for patients who need a planned operation.” Read full story Source: The Guardian, 14 April 2022 -
News Article
Covid threat being ignored in England for ideological reasons, say NHS leaders
Patient Safety Learning posted a news article in News
Ministers should reconsider England’s “living with Covid” plans, health leaders have said, while accusing the government of ignoring the ongoing threat for ideological reasons. The NHS Confederation, which represents organisations across the healthcare sector, has accused No 10 of having “abandoned any interest” in the pandemic, despite a new Omicron surge putting pressure on an already overstretched NHS. “The brutal reality for staff and patients is that this Easter in the NHS is as bad as any winter,” said Matthew Taylor, the chief executive of the NHS Confederation. "We do not have a living-with-Covid plan, we have a living-without-restrictions ideology. “But instead of the understanding and support NHS staff received during 2020 and 2021, we have a government that seems to want to wash its hands of responsibility for what is occurring in plain sight in local services up and down the country. No 10 has seemingly abandoned any interest in Covid whatsoever. “NHS leaders and their teams feel abandoned by the government and they deserve better.” Taylor later told BBC Breakfast: “In our view, we do not have a ‘living with Covid’ plan, we have a ‘living without restrictions’ ideology, which is different. We need to put in place the measures that are necessary to try to alleviate the pressures on our health service while this virus continues to affect [it].” Read full story Source: BBC News, 11 April 2022 -
News Article
Trusts to stop routine Covid tests for new patients amid ‘brutal’ NHS pressures
Patient Safety Learning posted a news article in News
Overstretched hospitals are stopping routine Covid tests for new patients as “brutal” pressures mount on doctors and nurses, The Independent understands. On Monday there were 1,702 new Covid admissions to hospitals in England as of 9 April – with 16,442 positive patients occupying beds – the NHS leaders warn their ability to tackle the backlog in planned care is at risk. Despite pleas from NHS chiefs to measures such as mask-wearing back into force, ministers said there were no plans to change guidance. The Independent understands at least two major hospitals, in Newcastle and York, have dropped testing of all patients without symptoms in order to alleviate pressure on beds – raising fears that Covid could spread on unchecked wards. Other hospitals are also likely to do the same as bed pressures worsen. Sources have told The Independent some trusts have begun to drop “red” Covid only wards, while some are considering not separating patients in A&E. One expert, critical care doctor Tom Lawton, who analyses hospital-acquired infection data, said that stopping patient testing in hospitals was “worrying” and that the NHS would be putting “blinkers on” just as in-hospital infections were “as high as they’ve ever been”. Read full story Source: The Independent, 11 April 2022 -
News Article
This Easter will be worse than any winter for the NHS
Patient Safety Learning posted a news article in News
Two years ago the first wave of the covid pandemic reached its peak. The NHS had reacted with impressive speed to prepare for an influx of patients with an infectious disease that few knew much about, had no cure for, and for which there was no known vaccine. However, now the NHS goes into the Easter break in a more fragile state than in any previous winter since, at least, the 1990s. This is not just the direct result of covid hospitalisation, of course – although the distracting narrative of ‘with rather than because of covid’ has obscured how hugely damaging any kind of infectious disease that is as widespread in the community as covid is now can be to effective hospital care. For someone who has just undergone an operation, for example, the greatest threat is not from catching covid itself, but from the impact the virus may have on how quickly their wound may heal. Perhaps covid’s greatest continuing impact is on growing staff absences and the pernicious impact it is having on the long-term health of those who had the disease – even in some cases where it has been relatively mild. For the tens of thousands who have been hospitalised with covid, the consequences for their long-term health look more serious every day. Much of this new workload is ending up at the doors of primary and community care – and displacing other needs and services just when they are most required after two years of coping with the pandemic. There is usually one thing you can confidently say about the NHS, which is that in any crisis it will make sure the life-saving decisions are made on time. However, in the South West, and probably other regions too, that is not happening. People are dying because the NHS cannot – despite its best efforts – save them. Read full story (paywalled) Source: HSJ, 8 April 2022 -
News Article
Families asked to take in Covid-positive loved ones as NHS faces ‘perfect storm’
Patient Safety Learning posted a news article in News
NHS chiefs have issued an extraordinary plea for families to help them discharge loved ones even if they are Covid-19 positive as the health service faces a “perfect storm” fuelled by heavy demand, severe staff shortages and soaring Covid cases. Hospitals and ambulance services across England are under “enormous strain”, health leaders have warned, after NHS trusts covering millions of patients declared critical incidents or issued stark warnings to residents. Dr Layla McCay, director of policy at the NHS Confederation, which represents the whole healthcare system, said the situation had become so serious that “all parts” of the health service were now becoming “weighed down”. This will have a “direct knock-on effect” on the ability of staff to tackle the care backlog, she added, as well as the current provision of urgent and emergency care. On Wednesday evening, the crisis became so acute in Hampshire and the Isle of Wight that its chief medical officer urged relatives of patients well enough to be discharged to collect them immediately – even if they were still testing positive for coronavirus. Dr Derek Sandeman, of the Hampshire and Isle of Wight Integrated Care System, revealed that almost every hospital in the two counties was full, and said the number of people with Covid-19 being cared for in hospitals across the area was 650 – more than 2.5 times higher than in early January. He added that 2,800 staff working for local NHS organisations were off sick, half of which absences were due to Covid-19. “With staff sickness rates well above average, rising cases of Covid-19 and very high numbers of people needing treatment, we face a perfect storm – but there are some very specific ways in which people can help the frontline NHS and care teams,” said Sandeman. Read full story Source: The Guardian, 6 April 2022 -
News Article
Public health ‘at risk’ as leading Covid surveillance programme ends
Patient Safety Learning posted a news article in News
Ministers will be left in the dark on Covid spikes just as case numbers reach unprecedented levels if a “world-beating” surveillance programme is scrapped, scientists have warned. The React-1 study, which played a crucial role in detecting and tracking the spread of the Alpha variant in December 2020 ahead of the second lockdown, has been stopped as part of the government's plan to cut its Covid costs. But in its last report, the study found 6.37% of the population was infected between 8 and 31 March – the highest figure since it began in May 2020. More worryingly, the scientists behind the research said the prevalence rate has also reached new highs for people aged 55 and over, at 8.31 per cent. The Royal Statistical Society (RSS) said dismantling the project while cases were at record levels damaged preparedness and put public health at risk. The spread of Covid within hospitals is also fuelling staff shortages, bed closures and delayed discharges in multiple regions of the country. This is coinciding with delays in ambulance handovers and response times, NHS sources say. Information seen by The Independent revealed hundreds of beds are currently out of use at Newcastle upon Tyne Hospitals trust due to Covid outbreaks. A senior clinician said the “hospital is coming apart at the seams” and that, across the northeast, even “high” performing emergency departments were “crashing” and “stacking ambulances outside of hospital”. Read full story Source: The Independent, 6 April 2022 -
News Article
Covid had devastating toll on poor and low-income communities in US
Patient Safety Learning posted a news article in News
The devastating impact of the Covid-19 pandemic on poor and low-income communities across America is laid bare in a new report that concludes that while the virus did not discriminate between rich and poor, society and government did. As the US draws close to the terrible landmark of 1 million deaths from coronavirus, the glaringly disproportionate human toll that has been exacted is exposed by the Poor People’s Pandemic Report. Based on a data analysis of more than 3,000 counties across the US, it finds that people in poorer counties have died overall at almost twice the rate of those in richer counties. Looking at the most deadly surges of the virus, the disparity in death rates grows even more pronounced. During the third pandemic wave in the US, over the winter of 2020 and 2021, death rates were four and a half times higher in the poorest counties than those with the highest median incomes. During the recent Omicron wave, that divergence in death rates stood at almost three times. Such a staggering gulf in outcomes cannot be explained by differences in vaccination rates, the authors find, with more than half of the population of the poorest counties having received two vaccine shots. A more relevant factor is likely to be that the poorest communities had twice the proportion of people who lack health insurance compared with the richer counties. “The findings of this report reveal neglect and sometimes intentional decisions to not focus on the poor,” said Bishop William Barber, co-chair of the Poor People’s Campaign which jointly prepared the research. “The neglect of poor and low-wealth people in this country during a pandemic is immoral, shocking and unjust.” Read full story Source: The Guardian, 4 April 2022 -
News Article
Clinically vulnerable Covid patients denied access to life-saving antivirals
Patient Safety Learning posted a news article in News
Clinically vulnerable people infected with Covid are being denied access to potentially life-saving antiviral medicine, patients, health officials and charities say. Around 1.3 million people with underlying health conditions in England have been identified by the NHS as at-risk and sent letters explaining they will be assessed for antiviral treatment if infected with Covid. The NHS said “tens of thousands of the most vulnerable patients” have received the medication to date, but told The Independent it was “aware of some local issues” in which clinically vulnerable people have struggled to access the antivirals. It comes at a time of record-breaking infection levels. Patients seeking the treatment, which suppresses an infection to prevent disease escalation and hospitalisation, have reported being turned away by GPs and hospital doctors, while others say they’ve been “pushed from pillar to post” in an attempt to access the medication. An NHS manager told The Independent that only 15% of eligible patients cared for by Kent and Medway Clinical Commissioning Group received antiviral medication in February. Anthony Nolan, the blood cancer charity, and Kidney Care UK both said they had received reports that Covid Medicine Delivery Units (CMDUs), which are responsible for ensuring antiviral medication reaches patients, were overwhelmed and struggling to provide treatment. “Weekends are a particular problem and it causes a lot of stress,” said Fiona Loud, a policy director a Kidney Care UK. “We have had reports from people in different parts of the country.” Paxlovid, molnupiravir and remdesivir are available via the NHS as antiviral medicine. All three have been shown to be effective in reducing the risk of hospitalisation among infected vulnerable patients. Antibody treatment, administered intravenously, is also available. Read full story Source: The Independent, 4 April 2022 -
News Article
Swamped NHS mental health services turning away children, say GPs
Patient Safety Learning posted a news article in News
Children and young people who are anxious, depressed or are self-harming are being denied help from swamped NHS child and adolescent mental health services, GPs have revealed. Even under-18s with an eating disorder or psychosis are being refused care by overstretched CAMHS services, which insist that they are not sick enough to warrant treatment. In one case, a crisis CAMHS team in Wales would not immediately assess the mental health of an actively suicidal child who had been stopped from jumping off a building earlier the same day unless the GP made a written referral. In another, a CAMHS service in eastern England declined to take on a 12-year-old boy found with a ligature in his room because the lack of any marks on his neck meant its referral criteria had not been met. The shocking state of CAMHS care is laid bare in a survey for the youth mental health charity stem4 of 1,001 GPs across the UK who have sought urgent help for under-18s who are struggling mentally. CAMHS teams, already unable to cope with the rising need for treatment before Covid struck, have become even more overloaded because of the pandemic’s impact on youth mental health. Mental health experts say young people’s widespread inability to access CAMHS care is leading to their already fragile mental health deteriorating even further and then self-harming, dropping out of school, feeling uncared for and having to seek help at A&E. “As a clinician it is particularly worrying that children and young people with psychosis, eating disorders and even those who have just tried to take their own life are condemned to such long waits”, said Dr Nihara Krause, a consultant clinical psychologist who specialises in treating children and young people and who is the founder of stem4. “It is truly shocking to learn from this survey of GPs’ experiences of dealing with CAMHS services that so many vulnerable young people in desperate need of urgent help with their mental health are being forced to wait for so long – up to two years – for care they need immediately. Read full story Source: The Guardian, 3 April 2022 -
News Article
Experts warn of racial disparities in the diagnosis and treatment of Long Covid
Patient Safety Learning posted a news article in News
It has long been clear that Black Americans have experienced high rates of coronavirus infection, hospitalisation and death throughout the pandemic. But those factors are now leading experts to sound the alarm about what will may come next: a prevalence of Long Covid in the Black community and a lack of access to treatment. Long Covid — with chronic symptoms like fatigue, cognitive problems and others that linger for months after an acute coronavirus infection has cleared up — has perplexed researchers, and many are working hard to find a treatment for people experiencing it. But health experts warn that crucial data is missing: Black Americans have not been sufficiently included in Long-Covid trials, treatment programmes and registries, according to the authors of a new report released on Tuesday. “We expect there are going to be greater barriers to access the resources and services available for Long Covid,” said one of the authors, Dr. Marcella Nunez-Smith, who is the director of Yale University’s health equity office and a former chair of President Biden’s health equity task force. “The pandemic isn’t over, it isn’t over for anyone,” Dr. Nunez-Smith said. “But the reality is, it’s certainly not over in Black America.” In the first three months of the pandemic, the average weekly case rate per 100,000 Black Americans was 36.2, compared with 12.5 for white Americans, the authors write. The Black hospitalisation rate was 12.6 per 100,000 people, compared with 4 per 100,000 for white people, and the death rate was also higher: 3.6 per 100,000 compared with 1.8 per 100,000. “The severity of Covid-19 among Black Americans was the predictable result of structural and societal realities, not differences in genetic predisposition.” "Many Black Americans who contracted the coronavirus experienced serious illness because of pre-existing conditions like obesity, hypertension and chronic kidney disease, which themselves were often the result of “differential access to high-quality care and health promoting resources,” the report says. Read full story (paywalled) Source: New York Times, 29 March 2022
