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Found 129 results
  1. Content Article
    My last blog, "Forgotten heroes" – the sequel, built upon a very moving BBC Panorama programme Forgotten heroes of the Covid front line. The BBC documentary told the sad story of healthcare workers (HCWs) who had bravely and knowingly put themselves in harm's way to care for their patients during the darkest days of the pandemic. Many lost their lives, while many more were rendered so severely injured by the disease (Long Covid) that they were (and remain) unable to work and have been unceremoniously sacked by their NHS Health Trusts/Boards. The way that an organisation manages its activities is known as 'governance'. Good governance will lead to high standards of ethics, morality, care and compassion for the people who work within it and those who may be affected by its acts and omissions. Hence, when applied to a whole country, it is known as 'Government', its departments and agencies. In this blog, I propose a possible hypothetical scenario that may have led to the tragic situation revealed by the BBC documentary. I hope this will lead you to consider the standards of 'governance' that apply to the 'duty of care' which a Government owes to its HCWs during a pandemic and what, morally and ethically, should be done to support those "forgotten heroes" if the Government’s governance should be found to be severely lacking. But is the scenario I am asking you to imagine hypothetical or is it real? I shall leave that to your judgement – and that of the Covid-19 Public Inquiry. 
  2. News Article
    A virus carried by ticks, which is common in many parts of the world, is now present in the UK and health officials are reminding the public how to avoid bites from the tiny bugs. They say the risk of tick-borne encephalitis is very low—only one person is confirmed to have been infected in England so far, last year. But the tick species which carries the virus is widespread in the UK. Most people do not develop symptoms but swelling to the brain is possible. The UK Health Security Agency has recommended changes to testing in hospital so that any new cases can be picked up quickly. Health officials say anyone who becomes unwell after a tick bite should see a GP. More serious symptoms to look out for include severe headache, stiff neck, unexplained seizure, sudden confusion and weakness in arms and legs. Read full story Source: BBC News, 5 April 2023
  3. Content Article
    Dr Nabarro’s recent comment made on Independent Sage 2 December, that Covid-19 is primarily a droplet-borne infection, flies in the face of overwhelming international scientific consensus that the pandemic is driven by airborne transmission of the SARS-CoV-2 virus. Despite airborne transmission being accepted as the dominant mode of spread in almost every other arena, within official infection prevention and control (IPC) bodies in the World Health Organization (WHO) and many national authorities including the UK, there is denial or minimising of airborne spread, and continuing adherence to the droplet theory of transmission. This has meant rejection of airborne mitigations within healthcare, with profound consequences for the lives and health of healthcare workers, as well as for patients in hospitals and care homes. It is now clear that the IPC authorities will not be persuaded, no matter how much evidence is presented to them that SARS-CoV-2 is primarily airborne, and that efforts by aerosol scientists, engineers and health experts to provide further evidence of this, are futile.  This statement from Doctors in Unite explores these issues in detail, and highlights the disastrous record of droplet-only precautions in our hospitals and care homes. It also asks why the critically important “precautionary principle” was not applied throughout healthcare from the outset, to keep workers and patients safe, while the mode of transmission of the virus was being fully elucidated, despite this being official WHO policy. 
  4. News Article
    The ‘optimal layout’ for an isolation room to contain the spread of Covid has been created following tests at a London hospital. The room was designed by researchers at Imperial College London to reduce the risk of infection for health care staff as far as possible. Researchers used a state-of-the-art fluid model to simulate the transmission of the virus within an isolation room at the Royal Brompton Hospital in Chelsea, west London. They found that the area of highest risk of infection is above a patient’s bed at a height of 0.7 to two metres, where the highest concentration of Covid is found. After the virus is expelled from a patient’s mouth, the research team explained that it gets driven vertically by wind forces within the room. The research, published in the journal Physics of Fluids, is based on data collected from the room during a Covid patient’s stay. The work centred on the location of the room’s air extractor and filtration rates, the location of the bed, and the health and safety of the hospital staff working within the area. Read full story Source: The Independent, 8 February 2023
  5. News Article
    Free HIV tests that can be done at home are being offered this week to people in England. It is part of a government drive to improve diagnosis, which dropped off during the Covid pandemic. The kit is small enough to fit through the letterbox and arrives in plain packaging through the post. It gives a result within 15 minutes by testing a drop of blood from a finger prick. A "reactive" result means HIV is possible and a clinic check is needed. Support and help is available to arrange this. About 4,400 people in England are living with undiagnosed HIV, which comes with serious health risks. HIV medication can keep the virus at undetectable levels, meaning you cannot pass HIV on and your health is protected. Most people get the virus from someone who is unaware they have it, according to the Terrence Higgins Trust (THT) charity which campaigns about and provides services relating to HIV and sexual health. HIV testing rates remain a fifth lower than before the Covid-19 pandemic - with heterosexual men in particular now testing far less than in 2019. Read full story Source: BBC News, 5 February 2023
  6. News Article
    Hepatitis B transmission from mothers to babies has been eliminated in England, according to the World Health Organisation (WHO). The WHO elimination target is that less than 2% of babies born to mothers with hepatitis B go on to develop the infection. And data from the UK Health Security Agency (UKHSA) shows the figure for England currently stands at 0.1% The UKHSA said progress had been made in tackling the viral infection, which can cause liver damage, cancer and death if left untreated. A six-in-one vaccine is offered to all babies on the NHS when they are eight, 12 and 16 weeks of age. Health and Social Care Secretary Steve Barclay said: “We are paving the way for the elimination of hepatitis B and C, with England set to be one of the first countries in the world to wipe out these viruses.” Read full story Source: The Independent, 2 February 2023 .
  7. Content Article
    Health workers, hailed as heroes during the pandemic, say they’re being abandoned by the NHS and the government. Some are living with Long Covid and say it’s having a devastating impact on both their personal and professional lives. For Panorama, the BBC’s health correspondent, Catherine Burns, meets staff struggling to return to work and reveals how some are now facing financial hardship and the prospect of having to retire early or, worse, being sacked.
  8. News Article
    Public health leaders were slow to act on repeated warnings over Christmas 2020 that contact tracing and isolation should be triggered immediately after a positive lateral flow test result, leaked evidence to the Covid inquiry shows. A scathing “lessons learned” document written by Dr Achim Wolf, a senior test and trace official, and submitted to the inquiry, gives his account of a trail of missed opportunities to improve the NHS test-and-trace regime in the first winter and spring of the pandemic – before vaccines were available. It suggests that people will have unnecessarily spread the virus to friends and relatives in the first Christmas of the pandemic and subsequent January lockdown period because they were not legally required to isolate and have their contacts traced as soon as they got a positive lateral flow test. Instead, for around two months, those eligible for rapid testing were told to get a confirmatory PCR test after a positive lateral flow. About a third of those who subsequently got a negative PCR result were likely to have had Covid anyway. In the “lessons learned” document seen by the Guardian, Wolf says: “Over the winter months, the prevalence in individuals who had 1) a positive lateral flow; followed by 2) a negative PCR; may have been upwards of 30%. These individuals were then allowed to return to their high-risk workplaces.” The former head of policy at NHS test and trace highlights how it took too long to get clear advice from Public Health England about policy on contact tracing and isolation rules in the face of changing scientific evidence on the accuracy of lateral flows. Read full story Source: The Guardian, 30 November 2022
  9. Content Article
    At the beginning of the pandemic, there was an important question to resolve: is coronavirus “airborne”? If it was, then this meant that the virus could transmit through the air from person to person, even over long distances, in indoor environments. We now know the answer is yes. In the 19th century diseases such as cholera and typhoid taught us the importance of water quality – coronavirus in the 21st century should provide that same realisation on the importance of air quality. Ideally, all indoor environments where people congregate should be fitted with modern, efficient ventilation systems that flush out potentially contaminated air and replace it with fresh, clean air continually. This would prevent the build-up of virus-containing aerosols and reduce the likelihood of transmission of covid-19 and other diseases such as influenza. With energy costs rising, it is vitally important to find methods of preventing virus transmission that are safe, quick to implement and affordable, writes Dr Alice Bunn in this HSJ article.
  10. News Article
    An immunologist has warned the new strain of Covid-19 could be causing different symptoms – including one that emerges during the night. Omicron BA.5 is a highly-contagious subvariant prompting concern as it contributes to a fresh wave of infections across the globe, including the UK. Scientists have been finding differences with previous strains, including the ability to reinfect people within weeks of having Covid. “One extra symptom from BA.5 I saw this morning is night sweats,” Professor Luke O’Neill from Trinity College Dublin told an Irish radio station in mid-July. Read full story Source: The Independent (24 August 2022)
  11. Content Article
    This opinion piece in The BMJ looks at the impact of the government's decision to make the wearing of masks in healthcare settings the decision of local providers, dependent on local risk assessment and prevalence. It highlights reports of patients wearing high-filtration FFP2 or FFP3 respirator—many of who are immunocompromised—being asked to remove and replace them with less effective single-use masks in order to gain entry to NHS facilities for treatment. The authors highlight that Covid-19 is an airborne pathogen and that the likelihood of contracting the virus increases with length of time spent in contaminated air. They argue that downgrading mask use in healthcare settings puts everyone at risk, but that it is a particular issue for patients who are clinically extremely vulnerable due to underlying health conditions or because they are undergoing treatment for cancer. They call on the government to upgrade masks to FFP2 or FFP3 respirators in order to protect staff and patients and reverse the worrying trend of clinically extremely vulnerable patients avoiding attending healthcare services.
  12. Content Article
    In July 2021, the UK Government lifted all Covid protections, meaning people were no longer legally obliged to take infection control measures such as wearing face masks in designated places. Twelve months on, the UK is facing high levels of infection and hospitalisations from Covid-19. In this opinion piece for The BMJ, members of Independent SAGE—a group of scientists working together to provide independent scientific advice about Covid-19 to the UK government and public—propose a series of measures to help people make informed decisions that will reduce the risk of illness and disruption to them, their families and their communities. The authors accuse the government of ignoring published scientific advice from their own advisory group, SPI-B, and call for action to give people the information they need to make responsible personal choices as part of the plan to 'live with Covid'.
  13. Content Article
    This study in the journal Infection Control & Hospital Epidemiology aimed to determine the extent to which asymptomatic individuals infected with Covid-19 transmitted the disease to other patients and staff on a hospital ward. The authors found that a comprehensive symptoms and signs assessment, in combination with adequate follow-up, allows for a more precise determination of Covid-19 symptoms. The results of the study revealed that asymptomatic infection was quite uncommon amongst adults in this setting.
  14. News Article
    Britain’s safety at work regulator refused to investigate reports from NHS trusts that 10 frontline staff had died as a result of catching Covid-19 during the pandemic. The Health and Safety Executive (HSE) declined to look into at least 89 dangerous incidents that NHS trusts said involved healthcare workers being exposed to Covid, including 10 deaths. The stance taken by the HSE, which oversees workplace health and safety and can bring prosecutions, is disclosed in freedom of information requests by the Pharmaceutical Journal. It has prompted concern that the regulator is too strict in its definition of workplace harm. It found that 173 trusts in England submitted at least 6,007 reports about employees’ exposure to Covid-19 in the course of their duties to the HSE between 30 January 2020 and 11 March 2022, under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). They included 213 “dangerous occurrences”, which are incidents that have the potential to cause significant harm; 5,753 cases where a staff member had caught Covid-19; and 41 deaths among people who had been exposed to the disease at their workplace. However, the HSE refused to look into five Covid deaths reported under the RIDDOR scheme by the Yorkshire ambulance service (YAS) because of what it considered a lack of evidence. The regulator also decided not to look into the Covid deaths of five staff at University College London hospital acute trust, despite the trust’s belief they had caught it at work. “The HSE found that there was no reasonable evidence that the infection was contracted at work,” a trust spokesperson said. Shelly Asquith, the health, safety and wellbeing officer at the Trades Union Congress, said the HSE’s decisions and claimed lack of evidence was “really concerning”. It suggested a continued “element of denial about Covid being airborne and it not being possible to necessarily pinpoint where exactly somebody was exposed once it’s in the air”, she added. Read full story Source: Guardian, 26 May 2022
  15. News Article
    Cases of monkeypox are being investigated in European countries, including the UK as well as the US, Canada and Australia. Monkeypox is caused by the monkeypox virus, a member of the same family of viruses as smallpox, although it is much less severe and experts say chances of infection are low. It occurs mostly in remote parts of central and west African countries, near tropical rainforests. There are two main strains of virus - west African and central African. Two of the infected patients in the UK travelled from Nigeria, so it is likely that they are suffering from the West African strain of the virus, which is generally mild, but this is as yet unconfirmed. Another case was a healthcare worker who picked up the virus from one of the patients. More recent cases do not have any known links with each other, or any history of travel. It appears they caught it in the UK from spread in the community. The UKHSA says anyone with concerns that they could be infected should see a health professional, but make contact with the clinic or surgery ahead of a visit. Initial symptoms include fever, headaches, swellings, back pain, aching muscles and a general listlessness. Once the fever breaks a rash can develop, often beginning on the face, then spreading to other parts of the body, most commonly the palms of the hands and soles of the feet. The infection usually clears up on its own and lasts between 14 and 21 days. Experts say we are not on the brink of a national outbreak and, according to Public Health England, the risk to the public is low. Prof Jonathan Ball, professor of molecular virology, University of Nottingham, said: "The fact that only one of the 50 contacts of the initial monkeypox-infected patient has been infected shows how poorly infectious the virus is. "It is wrong to think that we are on the brink of a nationwide outbreak." Read full story Source: BBC News, 20 May 2022
  16. Content Article
    On 28 March 2020, WHO tweeted, “FACT: #COVID19 is NOT airborne.” But aerosol scientist Lidia Morawska of the Queensland University of Technology in Australia said it was “so obvious” that airborne transmission was occurring, even in February 2020. Morawska and colleagues presented evidence of airborne transmission to the WHO in March 2020, including cases of people becoming infected when they were more than 1 meter from an infected person, and “years of mechanistic studies;” the advice was largely ignored. The World Health Organization (WHO) is supposed to be an "expert" when it comes to protecting public health, but it was clueless when it came to letting the public know how SARS-CoV-2 was transmitted, writes Dr Joseph Mercola.
  17. News Article
    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
  18. News Article
    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
  19. News Article
    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
  20. News Article
    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
  21. Content Article
    Early in the pandemic, the World Health Organization (WHO) stated that SARS-CoV-2 was not transmitted through the air. That mistake and the prolonged process of correcting it sowed confusion and raises questions about what will happen in the next pandemic. This Nature feature looks at the changing views of how Covid is spread.
  22. News Article
    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
  23. Content Article
    More and more people have been asking for a return to normal, and with omicron waning, governments are starting to act. The UK is removing its remaining public health measures, including mandatory self-isolation of COVID cases and free testing. However, the inescapable truth is that – unless the virus mutates to a milder form – the “normal” life we are returning to will be shorter and sicker on average than before. This article in The Conversation looks at how we need to live post-Covid.
  24. Content Article
    Sweden was well equipped to prevent the pandemic of COVID-19 from becoming serious. Over 280 years of collaboration between political bodies, authorities, and the scientific community had yielded many successes in preventive medicine. Sweden’s population is literate and has a high level of trust in authorities and those in power. During 2020, however, Sweden had ten times higher COVID-19 death rates compared with neighbouring Norway. In this report, Nele Brusselaers et al. try to understand why, using a narrative approach to evaluate the Swedish COVID-19 policy and the role of scientific evidence and integrity. We argue that that scientific methodology was not followed by the major figures in the acting authorities—or the responsible politicians—with alternative narratives being considered as valid, resulting in arbitrary policy decisions.
  25. Content Article
    Earlier this month The BMJ and the Nuffield Trust hosted a roundtable discussion about the workforce crisis. It took in a wide range of perspectives, but the message was clear: the workforce crisis is urgent, it is affecting staff morale and wellbeing, it is damaging patient care, and it requires immediate action. It’s not just a UK problem; it’s a global crisis, but some countries are better at recognising the relation between staff morale and wellbeing, better patient care and economic growth. Simply put, your economy won’t grow if your population is unhealthy; your population won’t be healthy if your health professionals are demoralised and unwell.
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