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Found 2,337 results
  1. News Article
    Inspectors have demanded improvements from a hospital after a report highlighted a number of failings over COVID-19 precautions. The Care Quality Commission (CQC) inspected the emergency department and medical wards at the William Harvey Hospital in Ashford, Kent, on 11 August. Inspection teams visited a ward where patients showed symptoms and were awaiting test results as well as a ward caring for patients who had COVID-19. A ward for patients without the virus and a fourth ward where there had been an outbreak of COVID-19 were also inspected. The CQC said it took urgent enforcement action, telling the trust to ensure there was an "effective system to manage the health and safety of people using the hospital". The report revealed staff did not always wear PPE or face coverings correctly in medical wards. One member of the nursing team was seen to be wearing a mask incorrectly in the ward where there had been an outbreak of the coronavirus. At least seven members of staff were seen entering and leaving the ward caring for people who were suspected of having COVID-19 without adhering to hand hygiene practices. Staff did not always remove PPE upon entering a new clinical area of the emergency department. Nor did they always put on or take off their PPE when entering and leaving patient bays. While equipment was said to have been cleaned on the day, inspectors found this was not always recorded. The report also detailed that five members of staff were seen in one room that was too small to enable the practised social distancing in that space. East Kent Hospitals Trust chief executive Susan Acott said: "In August, a CQC inspection team visited the William Harvey Hospital and saw examples of practice which falls short of the high standard we all want to provide for our patients." "Keeping our patients and staff safe is our priority. We have responded to the CQC with the actions we are taking and we are committed to the care and safety of every patient in our hospitals." Read full story Source: BBC News, 7 October 2020
  2. News Article
    For most people, COVID-19 is a brief and mild disease but some are left struggling with symptoms including lasting fatigue, persistent pain and breathlessness for months. The condition known as "long Covid" is having a debilitating effect on people's lives, and stories of being left exhausted after even a short walk are now common. There is no medical definition or list of symptoms shared by all patients - two people with long Covid can have very different experiences. However, the most common feature is crippling fatigue. Others symptoms include: breathlessness, a cough that won't go away, joint pain, muscle aches, hearing and eyesight problems, headaches, loss of smell and taste as well as damage to the heart, lungs, kidneys and gut. Mental health problems have been reported including depression, anxiety and struggling to think clearly. Long Covid is not just people taking time to recover from a stay in intensive care. Even people with relatively mild infections can be left with lasting and severe health problems. "We've got no doubt long Covid exists," Prof David Strain, from the University of Exeter, who is already seeing long-Covid patients at his Chronic Fatigue Syndrome clinic, told the BBC. A study of 143 people in Rome's biggest hospital, published in the Journal of the American Medical Association, followed hospital patients after they were discharged. It showed 87% had at least one symptom nearly two months later and more than half still had fatigue. The Covid Symptom Tracker App - used by around four million people in the UK - found 12% of people still had symptoms after 30 days. Its latest, unpublished data, suggests as many as one in 50 (2%) of all people infected have long-Covid symptoms after 90 days. The number of people with long-Covid appears to be falling with time. However, the virus emerged only at the end of 2019 before going global earlier this year so there is a lack of long-term data. "We've asked, deliberately, to follow people for 25 years, I certainly hope only a very small number will have problems going beyond a year, but I could be wrong," said Prof Brightling. However, there are concerns that even if people appear to recover now, they could face lifelong risks. People who have had chronic fatigue syndrome are more likely to have it again and the concern is that future infections may cause more flare-ups. "If long Covid follows the same pattern I'd expect some recovery, but if it takes just another coronavirus infection to react then this could be every winter," said Prof Strain. It is still possible more problems could emerge in the future. Read full story Source: BBC News, 6 October 2020
  3. News Article
    Much has been said about the delays to patient care during the first wave of COVID-19, but the full picture has been hard to pin down as statistics come in different forms and are released gradually. However, one recently-published poll performed by Ipsos Mori, with more than 2,000 UK adults aged between 18-75, revealed two-thirds of people who needed treatment for new or recently changed conditions had their care cancelled or delayed during March and July. The poll also revealed three-quarters of people missed out on routine treatment in the same timeframe. It is believed to be the hitherto largest patient-focused survey exploring the impact of the pandemic on non-COVID-19 care during its first peak. It found that – of the people who needed treatment for a new or changed condition – 23% chose to cancel their treatment while 42% had their treatment cancelled or delayed by their healthcare provider. Within the group of people requiring care for an ongoing problem, 31% of patients delayed or cancelled their treatment. Mark Davies, chief medical officer at IBM – which commissioned the poll – told HSJ the number of people with new or recently changed conditions choosing to cancel or delay their care was “really worrying”. “This survey backs up the anecdotal evidence we hear about people being worried about going into hospital during the pandemic,” he said. “It is striking that the proportion of this group of patients who did not get treatment is roughly similar to the proportion of patients requiring treatment for an ongoing health problem who cancelled or delayed their care." He said he would have expected the former group – those with new or changed conditions – to be more anxious to get treated, and warned of a “backlog of unmet need that is only going to emerge in the next few months”. Read full story (paywalled) Source: HSJ, 6 October 2020
  4. News Article
    NHS workers are at breaking point after months of upheaval and high pressure during the coronavirus outbreak with hospital leaders warning the health service is facing a “perfect storm” of workforce shortages and a second wave of COVID-19. In a survey of 140 NHS trust leaders almost all of them said they were worried about their staff suffering burnout ahead of winter. They also sounded the alarm over concerns there had not been enough investment into social care before this winter. NHS Providers, which carried out the survey ahead of its annual conference of hospital leaders, warned the first wave of COVID-19 had made a lasting impact on the health service which had yet to fully recover. Chris Hopson, chief executive of NHS Providers, which represents NHS trusts, said there had been “no let-up in the pressure” during the pandemic, which followed a difficult winter for staff. “And while the response to the spring surge in COVID-19 cases showed the NHS at its best, the pressures took their toll on staff who gave so much,” he said. “The worry is that the sustained physical, psychological and emotional pressure on health staff is threatening to push them beyond their limits of endurance.” Almost all those who responded to the survey, 99 per cent, said they were either extremely or moderately concerned about the current level of burnout across the workforce. Read full story Source: The Independent, 6 October 2020
  5. News Article
    Melissa Vanier, a 52-year-old postal worker from Vancouver, had just returned from holiday in Cuba when she fell seriously ill with COVID-19. “For the entire month of March I felt like I had broken glass in my throat,” she says, describing a range of symptoms that included fever, migraines, extreme fatigue, memory loss and brain fog. “I had to sleep on my stomach because otherwise it felt like someone was strangling me.” By the third week of March, Vanier had tested negative for Sars-CoV-2 – the virus that causes Covid-19. But although the virus had left her body, this would prove to be just the beginning of her problems. In May, she noticed from her Fitbit that her heart rate appeared to be highly abnormal. When cardiologists conducted a nuclear stress test – a diagnostic tool that measures the blood flow to the heart – it showed she had ischaemic heart disease, meaning that the heart was not getting sufficient blood and oxygen. Similar stories illustrate a wider trend – that the coronavirus can leave patients with lasting heart damage long after the initial symptoms have dissipated. Cardiologists are still trying to find out exactly why some people are left with enduring heart problems despite having had an apparently mild bout of COVID-19. The underlying mechanisms are thought to be slow and subtle changes that are quite different to those that put strain on the heart during the acute illness, especially in patients who have been hospitalised with the disease. Some cardiologists have suggested that treatments such as cholesterol-lowering drugs, aspirin or beta blockers may help patients with lingering cardiovascular effects many weeks or months after the initial infection, but the evidence remains limited. “It is too early to share data on this,” says Mitrani. “But these therapies have proven efficacy in other inflammatory heart muscle diseases. They have anti-inflammatory effects and we believe may help counter some of the lingering pro-inflammatory effects from Covid-19.” But for patients such as Vanier, there remains a long and uncertain road to see whether her heart does fully recover from the impact of the virus. “Psychologically this has been brutal,” she says. “I haven’t been back to work since I went on holiday in February. The heart hasn’t improved, and I now have to wait for more tests to see if they can find out more.” Read full story Source: The Guardian, 4 October 2020
  6. News Article
    Senior doctors specialising in infectious diseases have written an open letter expressing "concern" about the rapid increase in COVID-19 cases in Northern Ireland. The letter is signed by 13 medics from hospitals across Northern Ireland. It calls for the public to stick to government guidance on reducing social interactions and also warns against "stigmatising people and areas with high levels of infection." The letter reads: "We need to support people who test positive. This pandemic requires us to work together to bring it under control urgently. We need to reduce the potential for transmission to protect our health service, and we need to fix our test and trace system to try and gain better control of this virus in our community." On Monday, 616 new cases of COVID-19 were identified in Northern Ireland, bringing the total during the pandemic to 14,690. The number of deaths recorded by the Department of Health remains at 584. Among those who have signed the letter are Dr Claire Donnelly, a consultant physician who specialises in infectious diseases; consultant virologist Dr Conall McCaughey and consultant paediatrician Dr Sharon Christie. Entitled an "appeal to people to adhere to Covid public health guidance", the letter lays bare the stark reality of the infections rates. The letter adds: "Worryingly the number of cases is increasing rapidly in many areas over the last week, indicating that we have widespread community transmission in many parts of Northern Ireland." Read full story Source: BBC News, 6 October 2020
  7. News Article
    There could be a "tsunami" of cancelled operations this winter as the NHS copes with rising numbers of coronavirus patients, leading surgeons are warning. Members of the Royal College of Surgeons of England say they doubt the NHS can meet targets to restore surgery back to near pre-pandemic levels. Planned procedures such as hip replacements were paused to free up beds during lockdown in the spring. And hospitals have since been dealing with a backlog. In July, NHS England boss Sir Simon Stevens told trusts hospitals should by September 2020 be performing at least 80% of their September 2019 rates of: overnight planned procedures outpatient or day-case procedures And by October, this proportion should rise to 90%. But data suggests more than two million people have been waiting longer than 18 weeks for routine operations, with 83,000 waiting more than a year - up from 2,000 before the pandemic. Read full story Source: BBC News, 6 October 2020
  8. News Article
    Omnicell UK & Ireland, a leading provider of automated healthcare and medication adherence solutions, hosted a health summit on the eve of World Patient Safety Day, to discuss the impact of medication errors on patients and the NHS. The session focussed on the role technology can play in preventing such issues. The summit, this year held via webinar, comes off the backdrop of the Department of Health and Social Care disclosing that in England 237 million mistakes occur every year at some point in the medication process. These errors cause serious issues for patient safety, but also place a significant cost burden on an already stretched NHS. The 2019 Patient Safety Strategy published by NHS England and NHS Improvement also found the NHS failed to save 11,000 lives a year due to safety concerns with the cost of extra treatment needed following incidents being over £1bn. A number of high-profile panel members answered a series of questions from the audience on solutions and best practice to improve patient safety with the aim of debating and sharing ideas on how to meet challenges and the impact of COVID-19. One of the panelists, Patient Safety Learning's Chief Digital Office Clive Flashman, agreed with the other panel members that the NHS had become more collaborative and familiar with technology since Covid: “We’ve seen a definite increase in telehealth and telemeds. Covid has forced cultural blockers that were there before to be removed out of necessity. There has been a growth in robotic pharmacy automation to free up staff time from high volume administration tasks to do more complex work that adds value for patients.” But with the second-wave of COVID-19 still a very real threat he advised: “We don’t want to wait until the next wave to learn a lesson – we need to learn lessons now. Quality Improvement Leads should be focussed on what went right and what went wrong over that period between March and May. They need to be looking at what we can learn from that now and what we can do differently next time. If we don’t do that, we won’t succeed in the second wave where we might fail.” Ed Platt, Automation Director, Omnicell UK & Ireland, added: “Challenges within the NHS throughout Covid has forced them to embrace technology and drive innovation." "It’s important that when things go back to normal, we don’t go back to the same status quo. We need to invest in the right infrastructure in hospitals so unnecessary demands and stress are not put on pharmacy, supply managers and nurses so they are free to focus on patient care not administration tasks." Read full story Source: NHE, 17 September 2020 You can watch the webinar on demand here
  9. News Article
    A 33-year-old woman says she's been suffering awful coronavirus symptoms for six months and says it's "ruined her life". Stephanie, from London, says her symptoms began in mid-March when she started experiencing loss of taste and smell, body aches, headaches, a fever, shivering, hot and cold sweats, and sickness. But six months later she still has had no sense of taste and smell, she suffers brain fog and chronic fatigue and says just walking across her flat leaves her chest feeling tight. The photographer, who lives alone, says she sleeps for 10-12 hours but is still always tired. "I'm only 33," she said. Stephanie wants to raise awareness of 'long Covid' and says more research needs to be done on how to treat the long-term effects of the disease. She said she's scared she'll 'never be the same again'. Stephanie says she has a hospital appointment on Friday to have tests on her lungs and heart as doctors are concerned she has lung damage. She added: "I think some people don't believe in long Covid, so I want to raise awareness of what people are going through. We need more research of how to treat people with long Covid because there isn't much available, it's so awful." Read full story Source: Mirror, 1 October 2020
  10. News Article
    From the moment coronavirus reached UK shores, public health advice stressed the importance of washing hands and deep-cleaning surfaces to reduce the risk of becoming infected. The advice was informed by mountains of research into the transmission of other respiratory viruses: it was the best scientists could do with such a new pathogen. But as the pandemic spread and data rolled in, some scientists began to question whether the focus on hand hygiene was as crucial as it seemed. The issue has resurfaced after Monica Gandhi, a professor of medicine at the University of California, San Francisco, told the US science magazine Nautilus that the easiest way to catch the virus was through droplets and aerosols sprayed from an infected person’s mouth or nose. “It’s not through surfaces,” she said. “We now know the root of the spread is not from touching surfaces and touching your eye. It’s from being close to someone spewing virus from their nose and mouth, without in most cases knowing they are doing so.” Gandhi’s is not a lone voice. Her comments follow a prominent paper in the Lancet from Emanuel Goldman, a professor of microbiology at Rutgers University in New Jersey. He was sceptical about the relevance of scientific studies that showed the virus could survive on surfaces for days at a time. “In my opinion,” he wrote, “the chance of transmission through inanimate surfaces is very small, and only in instances where an infected person coughs or sneezes on the surface, and someone else touches that surface soon after the cough or sneeze.” He defined soon as within one to two hours. Dr Julian Tang, an honorary associate professor of respiratory sciences at the University of Leicester, thinks hand washing should stay but agrees the risk from contaminated surfaces has been overplayed. He points to documents from the UK government’s Scientific Advisory Group for Emergencies (Sage) that estimate hand washing can reduce acute respiratory infections by only 16%. Meanwhile, he adds, the World Health Organization has warned about surfaces being a likely route of transmission while conceding there are no reports demonstrating infection this way. Tang believes that a preoccupation with contaminated surfaces distracted countries from taking airborne transmission seriously and played down the necessity of wearing masks. “What we’ve always said is that the virus transmits by all routes. There might be some transmission by hand and fomites and we’re not opposed to hand washing, but the emphasis is wrong,” he told the Guardian. Read full story Source: 5 October 2020
  11. News Article
    Sending thousands of older untested patients into care homes in England at the start of the coronavirus lockdown was a violation of their human rights, Amnesty International has said. A report says government decisions were "inexplicable" and "disastrous", affecting mental and physical health. More than 18,000 people living in care homes died with COVID-19 and Amnesty says the public inquiry promised by the government must begin immediately. According to Amnesty's report, a "number of poor decisions at both the national and local levels had serious negative consequences for the health and lives of older people in care homes and resulted in the infringement of their human rights" as enshrined in law. Researchers for the organisation interviewed relatives of older people who either died in care homes or are currently living in one; care home owners and staff, and legal and medical professionals. Amnesty said it received reports of residents being denied GP and hospital NHS services during the pandemic, "violating their right to health and potentially their right to life, as well as their right to non-discrimination". It adds that care home managers reported to its researchers that they were "pressured in different ways" to accept patients discharged from hospital who had not been tested or had COVID-19. Amnesty says the public inquiry into the pandemic should begin with an "interim phase". "The pandemic is not over," it added. "Lessons must be learned; remedial action must be taken without delay to ensure that mistakes are not repeated." Read full story Source: BBC News, 4 October 2020
  12. News Article
    A technical glitch that meant nearly 16,000 cases of coronavirus went unreported has delayed efforts to trace contacts of people who tested positive. Public Health England (PHE) said 15,841 cases between 25 September and 2 October were left out of the UK daily case figures. They were then added in to reach Saturday's figure of 12,872 new cases and Sunday's 22,961 figure. PHE said all those who tested positive had been informed. But it means others in close contact with them were not. The issue has been resolved, PHE said, with outstanding cases passed on to tracers by 01:00 BST on Saturday. The technical issue also means that the daily case totals reported on the government's coronavirus dashboard over the past week have been lower than the true number. Read full story Source: BBC News, 5 October 2020
  13. News Article
    Covid infection rates among doctors, nurses, and other hospital and care home staff have risen more than fivefold over the past month in London, scientists have discovered. The figures – provided by the Francis Crick Institute – have triggered considerable concern among scientists, who fear similar increases may be occurring in other regions of the UK. Increasing numbers of infected healthcare workers raise fears that the spread of COVID-19 into wards and care homes – which triggered tens of thousands of deaths last spring – could be repeated unless urgent action is taken. “It is very, very worrying,” said Professor Charles Swanton, who helped set up the institute’s Pipeline testing service. “Keeping hospitals and care homes free of the virus is crucial but these figures suggest we are heading in the wrong direction.” The Francis Crick Institute – one of Britain’s leading biomedical research centres – decided in March to use its array of powerful laboratory devices to set up a Covid testing service for hospital and care home staff in central and north London. Many other UK academic institutions offered to start similar services but were discouraged by the Department of Health and Social Care which said it wanted to centralise testing operations. Read full story Source: The Guardian, 3 October 2020
  14. News Article
    A Dublin teenager has told of his harrowing battle with COVID-19 and is urging other young people to take the disease seriously. Jack Edge, 17, from Rathfarnham, had no underlying health conditions when he contracted the virus in April. Five months on and three hospital admissions later, the Leaving Cert student is still suffering from the "destruction" the virus wreaked on his body. Jack first displayed symptoms of COVID-19 on 15 April and five days later was admitted to Tallaght University Hospital. Within hours of being hospitalised, he was fighting for his life. Jack had to be put on a ventilator to help him breathe for 12 days. As his condition stabilised, he was transferred to a high dependency unit. Jack said: "I couldn't sleep for three days. Every time I closed my eyes, there was just dizziness and loads of colours. "I literally stayed in the bed for 72 hours, just staring at the wall. I had a lot of dark times in the hospital, since I do struggle with anxiety too." "But the care I received was absolutely amazing. They came in and talked to me if I needed to talk, as I would often get lonely, as it was mainly just me in an isolation room." However, surviving COVID-19 was just the first step for Jack. On 28 May, he was readmitted to hospital in excruciating pain. Doctors told him he may have suffered nerve damage associated with the virus. "I’m currently taking 18-20 tablets a day. Tablets for the nerve damage, for pain and for my anxiety. " "I basically have to learn to walk again. I do two to two-and-a-half hours of physio every day, depending on how much energy I have. I wake up some days and I get really upset. I still don’t know why this happened to me or how I got it." Jack hopes that by sharing his story he can raise awareness of the dangers and debilitating long-term effects of COVID-19 for young people. Read full story Source: RTE News, 2 October 2020
  15. News Article
    General practices will struggle to cope with a second wave of COVID-19 unless urgent measures are put in place to support them, the BMA has warned. It said that practices in England were reporting that they did not have the capacity to carry out all of the work required of them while managing ongoing patient care, dealing with the backlog of care put on hold during the first wave of the pandemic, and reconfiguring services. Richard Vautrey, chair of the BMA’s General Practitioners Committee England, said, “GPs, like all doctors, are extremely concerned that without decisive action now services will be overwhelmed if we see another spike in the coming weeks and months.” In the report, the committee called for a package of measures to support the GP workforce, including making occupational health services available to all staff to ensure that they are properly risk assessed and to provide free supplies of personal protective equipment. It also called for the suspension of routine inspections by the Care Quality Commission and of the Quality and Outcomes Framework, as part of efforts to reduce bureaucracy. NHS England’s covid support fund for practices should be rolled over until March 2021 and expanded to ensure that all additional costs such as additional telephony and cleaning are included, it added. Vautrey said, “The measures we’ve outlined are aimed at supporting practices and their staff to deliver high quality care while managing the increased pressures of doing so during a pandemic, and it is vital that the government and NHS England listen and implement these urgently, to ensure that primary care can continue to operate safely through what looks to be an incredibly difficult winter.” Read full story Source: BMJ, 1 October 2020
  16. News Article
    Almost nine in ten maternity services experienced a decline in emergency pregnancy appointments during the pandemic due to women avoiding healthcare providers amid coronavirus chaos, a study has found. The Royal College of Obstetricians and Gynaecologists, who carried out the research, said women refrained from attending appointments due to anxiety around going into a hospital and fears of overwhelming the NHS, as well as not being clear if the appointments were essential. Researchers found 70% of maternity services reported a reduction in antenatal appointments, while 60% of units stopped the option of giving birth at home or in a midwife-led unit. Over half of services said postnatal appointments after childbirth had been reduced. The findings come as maternity services warn staff must not be sent to work in other parts of the hospital in the wake of a second wave of coronavirus. Royal College of Obstetricians & Gynaecologists and the Royal College of Midwives, who together represent the overwhelming bulk of maternity staff, say there must not be a repeat of the acute and widespread maternity staff shortages which played out during the health emergency’s peak. Read full story Source: The Independent, 30 September 2020
  17. News Article
    The stress and anxiety caused to patients by "poor communication" from NHS bodies in England during the covid pandemic has been criticised by MPs. While recognising the huge burden placed on the NHS, their report said cancelled treatments and surgery had left some "in limbo" and others "too scared" to seek medical help. The report also questioned why weekly testing of NHS staff had not yet begun. And it called for their mental and physical wellbeing to be supported. Jeremy Hunt, who chairs the Health and Social Care Committee, which compiled the report, praised the "heroic contribution" made by front-line NHS staff during the pandemic, which had saved many lives. But he said the pandemic had "massively impacted normal NHS services" and this situation could have been improved with clearer communication to patients and better infection control measures in hospitals. The report, based on evidence from doctors, nurses, patient groups and NHS leaders, said the case for routine testing for all NHS staff in all parts of the country was "compelling" and it should be introduced as soon as possible before winter to help reduce the spread of the virus. The government and NHS England told the committee they wanted to bring in routine testing of staff but any plans depended on the capacity available. Read full story Source: BBC News, 1 October 2020
  18. News Article
    Most operations have been cancelled at a hospital in a COVID-19 hotspot in south Wales after an outbreak of the virus involving more than 80 people. Hospital chiefs said transmission had taken place within the Royal Glamorgan hospital at Llantrisant and some wards where patients and staff had been infected were closed. The hospital, which is within Rhondda Cynon Taf, one of the areas under local lockdown restrictions, said it was trying to speed up the testing of patients and staff. In a statement, it said: “Significant temporary service restrictions will be put in place at Royal Glamorgan hospital from 2pm Wednesday 30 September as increased action is taken to contain a COVID-19 outbreak within the hospital. Teams have been working at pace to implement robust measures to manage the outbreak. However, additional cases linked to transmission within the hospital have been confirmed in recent days with the number of cases currently standing at 82." Andrew RT Davies, shadow health minister for the Welsh Conservatives, called on the Welsh government to explore using field hospitals and other health facilities to alleviate pressure on the Royal Glamorgan. He added: “This is very concerning, particularly as many of the additional cases are linked to transmission within the hospital, and so questions over processes and protocols must be asked.” Read full story Source: The Guardian, 30 September 2020
  19. News Article
    Clarence Troutman survived a two-month hospital stay with COVID-19, and then went home in early June. But he's far from over the disease, still suffering from limited endurance, shortness of breath and hands that can be stiff and swollen. "Before Covid, I was a 59-year-old, relatively healthy man," said the broadband technician from Denver. "If I had to say where I'm at now, I'd say about 50% of where I was, but when I first went home, I was at 20%." He credits much of his progress to the "motivation and education" gleaned from a new programme for post-covid patients at the University of Colorado, one of a small but growing number of clinics aimed at treating and studying those who have had the unpredictable disease caused by this coronavirus. As the US general election nears, much attention is focused on daily infection numbers or the climbing death toll, but another measure matters: Patients who survive but continue to wrestle with a range of physical or mental effects, including lung damage, heart or neurological concerns, anxiety and depression. "We need to think about how we're going to provide care for patients who may be recovering for years after the virus," said Dr Sarah Jolley, a pulmonologist with UCHealth University of Colorado Hospital and director of UCHealth's Post-Covid Clinic, where Troutman is seen. That need has jump-started post-covid clinics in the US, which bring together a range of specialists into a one-stop shop. One of the first and largest such clinics is at Mount Sinai in New York City, but programmes have also launched at the University of California-San Francisco, Stanford University Medical Center and the University of Pennsylvania. The Cleveland Clinic plans to open one early next year. And it's not just academic medical centres: St. John's Well Child and Family Center, part of a network of community clinics in South Central Los Angeles, said this month it aims to test thousands of its patients who were diagnosed with covid since March for long-term effects. The general idea is to bring together medical professionals across a broad spectrum, including physicians who specialize in lung disorders, heart issues and brain and spinal cord problems. Mental health specialists are also involved, along with social workers and pharmacists. Read full story Source: CNN Health, 28 September 2020
  20. News Article
    A frailty index is rationing treatment for older and disabled people who catch coronavirus, says Patience Owen. Patience has has a debilitating connective tissue disorder and, like thousands of others with rare conditions, is already in a minority within a minority, marginalised by our NHS, battling increasing disability day by day. Back in March, without consultation and days before the first lockdown, the Clinical Frailty Scale (CFS), a worldwide tool used to swiftly identify frailty in older patients to improve acute care, was adapted by the National Institute for Health and Care Excellence (NICE). It asked NHS staff in England to score the frailty of Covid patients. Rather than aiming to improve care, it seems the CFS – a fitness-to-frailty sheet using scores from one to nine – was used to work out which patients should be denied acute care. Nice’s new guidelines advised NHS trusts to “sensitively discuss a possible ‘do not attempt cardiopulmonary resuscitation’ decision with all adults with capacity and an assessment suggestive of increased frailty”. "Checking the scale, I found I would score five, the 'mildly frail' category, and therefore should I get Covid I could be steered towards end-of-life care. Bluntly, if I catch the virus, the NHS may help me to die, not live," says Patience. By early April, there was a proliferation of illegal “do not resuscitate” (DNR) notices in care homes for people with learning disabilities, and for older people in care homes and in hospitals. Many acutely ill patients stayed at home with Covid symptoms in the belief that they risked being denied care in hospital. Following warnings by the healthcare regulator, the Care Quality Commission, and other medical bodies, that the blanket application of the notices must stop, and legal challenges by charities, exclusions were made to the NICE guidelines. These included “younger people, people with stable long-term disabilities, learning disabilities or autism”. Yet the guidelines remain in place, in spite of the fact that they appear to contravene the Human Rights Act (including the right to life, article 2, and the right to non-discrimination, article 14). A spokeswoman for NICE says it is “very aware of the concerns of some patient groups about access to critical care, and we understand how difficult this feels. Our COVID-19 rapid guideline on critical care was developed to support critical care teams in their management of patients during a very difficult period of intense pressure." “'Difficult' is a hollow word for the feeling of being selected to die," says Patience. "It’s difficult not to conclude that those with long-term conditions and disabilities, like myself, have become viewed as a sacrificial herd." Read full story Source: The Guardian, 29 September 2020
  21. News Article
    Experts say robust legal protections are needed to inspire public confidence. The UK government has set out plans to amend drug regulations in case it decides that COVID-19 vaccines should be used before they are licensed, in a bid to roll them out more quickly. In a consultation on the proposals that ran from 28 August to 18 September the Department of Health and Social Care for England explained that if a suitable vaccine emerged with strong evidence of safety, quality, and efficacy the government would seek to license it through the usual route but could supply it in the meantime. The document added, “A COVID-19 vaccine would only be authorised in this way if the UK’s licensing authority was satisfied that there is sufficient evidence to demonstrate the safety, quality, and efficacy of the vaccine. ‘Unlicensed’ does not mean ‘untested.” The consultation, and the timeframe in which it was conducted, prompted some people to post their concerns on social media. However, the Human Medicine Regulations 2012 already allow the licensing authority to temporarily authorise the supply of an unlicensed product in response to certain public health threats, including the suspected spread of pathogens. The proposed change would allow conditions to be attached “to ensure product safety, quality, and efficacy” The 2012 regulations also give healthcare professionals and manufacturers immunity from being sued in the civil courts for the use of some unlicensed products recommended by the licensing authority in response to a public health threat. The new regulations would extend the immunity to drug companies that have not manufactured the product but placed it on the market with the approval of the licensing authority, and they clarify the consequences for a breach of conditions imposed by the authority. Social media posts play into existing concerns that many people might not accept the vaccine, as surveys indicate. Lawyers have told the Department for Health and Social Care that to inspire public confidence it must provide redress for the few people who might experience adverse effects. Bozena Michalowska, a partner specialising in product liability at the law firm Leigh Day, said, “I do not believe that people will want to play Russian roulette with their health by taking a vaccine which they know nothing about, especially when they know that the risks they take are just taken by them and not a shared risk and they will not have sufficient protection should things go wrong.” Read full story Source: The BMJ, 28 September 2020
  22. News Article
    Covid survivor Tam McCue is one of the lucky ones. Earlier in the year he was in intensive care in the Royal Alexandra Hospital in Paisley where he had been on a ventilator for nearly two weeks. At one point Mr McCue, who could barely speak, didn't think he would live. Fast forward five months and Mr McCue, of Barrhead, East Renfrewshire, is back from the brink. He became desperately ill but, thankfully, it only went as far as his lungs. With coronavirus some patients have have suffered multiple organ failure which also affected their heart, kidneys, brain and gut. Mr McCue describes his recovery as a "rollercoaster". He added: "It's a slow process. You think you can do things then the tiredness and fatigue sets in." He said: "It lies in the back of your mind. As years go on, how are you going to be? Is it going to get you again? It does play on you. It definitely does." As part of his recovery Mr McCue is attending the Ins:pire clinic online. It is normally a face-to-face rehabilitation clinic which involves multiple specialties, including pharmacists, physiotherapists and psychologists. Mr McCue is one of the first Covid survivors to take part in the five-week programme, which started earlier this month. Read full story Source: BBC Scotland News, 29 September 2020
  23. News Article
    Official data from mid-September shows that nearly 6,400 people had waited more than 100 days following a referral to cancer services. The leaked data reveals for the first time the length of the cancer waiting list in the wake of the first pandemic peak, during which much diagnostic and elective cancer care was paused. The list consists of those waiting for a test, the outcome of a test, or for treatment. NHS England and Improvement only publish waiting times for patients who have been treated – not the number still waiting – so this information has been secret. The data, obtained from official emails seen by HSJ, showed the total number of people on the cancer waiting list grew substantially, from 50,000 to around 58,000, between the start of August and the middle of September. Of the 6,400 people recorded to be waiting more than 104 days on 13 September, 472 had a “decision to treat classification”, meaning they have cancer and are awaiting treatment. NHS England has said reducing the cancer waiting list would be overseen by a national “taskforce”, which is being chaired by national director for cancer Peter Johnson. Experts have warned the delays already stored up in the system could cost tens of thousands of lives as patients go undiagnosed or have their diagnosis and treatment later than they otherwise would. HSJ asked NHS England if harm reviews had been carried out for those on the waiting list and whether it had discovered if those waiting longer than104 days had been harmed, but did not receive an answer. Read full story (paywalled) Source: HSJ, 29 September 2020
  24. News Article
    The NHS is facing a "triple whammy" of rising COVID-19 cases, a major backlog in treatment and reduced capacity due to infection-control measures, according to health bosses. The NHS Confederation report on the English NHS said more investment was desperately needed. The NHS bosses also called on ministers to be "honest and realistic" about waiting lists for treatment. It comes despite the government promising an extra £3bn this winter. That money - announced over the summer - was intended to help hospitals cope with the extra-infection control measures required and to pay for patients to be treated privately for routine treatment, such as knee and hip replacements. But hospitals are still performing only half the number of routine operations they normally would. Two million patients have already waited longer than 18 weeks for treatment, the highest number since records began, in 2007. And services in other areas, such as cancer care, are running at about three-quarters capacity. Of the more than 250 bosses who responded to the confederation's survey: fewer than one in 10 said the current level of funding allowed them to deliver safe and effective care nearly nine in 10 said a lack of funding would be a significant barrier to achieving waiting-time targets for everything from mental-health care to cancer treatment and routine operations. Read full story Source: BBC News, 29 September 2020
  25. News Article
    When Sarah found herself suffering sudden bouts of breathlessness in May, she took herself to hospital. But after her COVID-19 swab test came back negative, doctors said she was probably anxious, and sent her home. Despite this, Sarah’s symptoms continued to worsen. A week later, she was rushed to hospital in an ambulance. Paramedics told her that based on her clinic observations, she should be in a coma. Then came more surprising news: She had tested positive for coronavirus Sarah’s story – given to a patient safety charity under a pseudonym – is one that resonates with Dr Claudia Paoloni, president of the Hospital Consultants and Specialists Association. She detailed another case in which a patient tested negative twice: once when she was first admitted to hospital and once later in her hospital stay. She finally tested positive on her third test – by which time she was on a ventilator in intensive care. Paolini believes COVID-19 swab tests produce a troublingly high rate of false negative results, and the problem lies in the reliance on a single test. “To use as a one-off test in any capacity to exclude someone from having COVID-19 is a folly.” If you want to exclude someone from having the virus, Paoloni said, you must do multiple tests and collect multiple negative results. “If the test and tracing system is not working, which is the case here, transmission will continue unabated in the community.” The most recent data published by the Office for National Statistics says the test’s sensitivity - which it says can tell us how likely it is to return a false-negative result, may be somewhere between 85% and 98%. Dr Deenan Pillay, Professor of Virology at University College London and member of Independent Sage, a group of scientists providing transparent advice during the crisis, said a significant number of self-administered tests could be coming back negative for people who do in fact have the virus. “The single biggest reason why a swab from someone who has COVID-19 comes up as negative is the quality of the swab that is taken,” Dr Pillay said. “Swabbing your nose and throat in a way that will pick up the virus means really scraping down the side of the wall of the nose or back of the throat to get cells from the lining of the throat. That’s not a pleasant thing to do.” This is of course true for at-home testing, which relies on the patient or a family member to collect the swab. But it could be true at testing centres, too. Tom, a 29-year-old from London whose name has been changed for this story, said there were no medical staff on site when he visited a Covid testing centre in London. The only people he interacted with were staff from a third-party contractor paid to carry out testing. “The man simply handed me a test, read out the instructions to self-administer the test, and asked me to do it myself,” he said. Pillay agrees that testing methods are likely to have an impact on false negative results. “I have seen the documentation given out at testing centres and it is very confusing,” he said. “Centres often expect you to administer the test yourself or get someone else in your car to administer it for you, all of which creates difficulties.” Pillay believes the solution lies in having medically trained staff at testing centres. “The way the system is developed at the moment, outsourced to private companies like Deloitte and Lighthouse Labs, is just woeful,” he said. “The whole system is failing at the moment. And it’s happening just as the numbers of infections are starting to rise,” Dr Pillay said. Read full story Source: Huffpost, 27 September 2020
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