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Found 2,339 results
  1. Content Article
    "To healthcare workers in the COVID era, holidays mean death, and we knew Omicron was coming before it had a name. The wave caused by this variant has barely begun, rapidly gathering steam, and we are exhausted, attempting to pull from reserves badly drained by earlier surges." Kathryn Ivey, a critical care nurse at a medical center in Nashville, Tennessee, confronts the Omicron surge filling her hospital.
  2. Content Article
    Omicron is inundating a healthcare system that was already buckling under the cumulative toll of every previous surge, writes Ed Yong in an article for the Atlantic. When a healthcare system crumbles, this is what it looks like. Much of what’s wrong happens invisibly. At first, there’s just a lot of waiting. Emergency rooms get so full that “you’ll wait hours and hours, and you may not be able to get surgery when you need it,” says Megan Ranney, an emergency physician in Rhode Island. When patients are seen, they might not get the tests they need, because technicians or necessary chemicals are in short supply. Then delay becomes absence. The little acts of compassion that make hospital stays tolerable disappear. Next go the acts of necessity that make stays survivable. Nurses might be so swamped that they can’t check whether a patient has their pain medications or if a ventilator is working correctly. People who would’ve been fine will get sicker. Eventually, people who would have lived will die. This is not conjecture; it is happening now, across the United States. 
  3. Content Article
    "Patients wait up to 12 hours. Some die waiting. How long must we wait for this dire situation to improve?" The NHS is overwhelmed. Although Covid has shone a bright light on this, it alone did not create these problems. There are multiple reasons for failure writes the'Secret Paramedic' in this Guardian article.
  4. News Article
    The debilitating disease multiple sclerosis could be caused by the common virus behind "kissing disease", scientists claim. A new study from Harvard University suggests the chronic disease could be from an infection of Epstein-Barr, a herpes virus that causes infectious mononucleosis. Mono or glandular fever, as it’s otherwise known, is colloquially known as "the kissing disease" for being highly contagious through saliva. While causing fatigue, fever, rash, and swollen glands, researchers propose that the Epstein-Barr virus could also establish a latent, lifelong infection that may be a leading cause of multiple sclerosis. Affecting 2.8 million people, there is no known cure for the chronic inflammatory disease of the central nervous system. “The hypothesis that EBV causes MS has been investigated by our group and others for several years, but this is the first study providing compelling evidence of causality,” the study’s senior author Alberto Ascherio, a professor of epidemiology and nutrition at Harvard Chan School, said in a press release. “This is a big step because it suggests that most MS cases could be prevented by stopping EBV infection, and that targeting EBV could lead to the discovery of a cure for MS.” Read full story Source: The Independent, 13 January 2022
  5. Content Article
    Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system of unknown etiology. Bjornevik et al. tested the hypothesis that MS is caused by Epstein-Barr virus (EBV) in a cohort comprising more than 10 million young adults on active duty in the US military, 955 of whom were diagnosed with MS during their period of service. Risk of MS increased 32-fold after infection with EBV but was not increased after infection with other viruses. These findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS.
  6. News Article
    NHS England is urging health systems to ramp up physical health checks for people with severe mental illnesses to address a widening life expectancy gap caused by covid, according to a letter seen by HSJ. In a letter circulated to integrated care system leads, chairs, mental health and community trust executives on Wednesday, national commissioners warn the impact of the pandemic may widen current gaps in life expectancy for people with SMI and learning disabilities even further, without “decisive and proactive action”. The letter, circulated by national mental health director Claire Murdoch, learning disability and autism director Tom Cahill and inequalities director Bola Owolabi, quotes NHS data suggesting people with SMI are five-and-a-half times more likely to die prematurely and those with learning disabilities three times more likely to die from an avoidable cause of death. It says: ”The health inequalities faced by people living with SMI and people with a learning disability are stark… The impacts of the pandemic will widen this gap further unless we take decisive and proactive action to address inequalities… These checks are a key lever to address the reduced life expectancy for both groups.” It calls on primary care teams, already delivering thousands of covid vaccinations as part of the booster programme, to prioritise annual physical health checks alongside the rollout, “even as we continue with a level 4 national incident” caused by the omicron variant. Read full story (paywalled) Source: HSJ, 14 January 2022
  7. News Article
    Just under 6 million people in England are now waiting for hospital treatment – a record high – as latest performance figures show how the NHS was struggling even before the Omicron Covid variant emerged. A total of 5,995,156 patients were on the waiting list for an operation in November, of whom more than 2 million had already waited longer than the maximum standard of 18 weeks for routine treatment. Figures published by the NHS underlined its growing inability to provide timely care. They also showed that more than 300,000 people have been waiting more than a year for surgery and that performance against the crucial four-hour A&E target is the worst ever. The figures led to warnings from the Health Foundation thinktank that the NHS was “being stretched to its limits” and from the Liberal Democrat health spokesperson Daisy Cooper that “patients are being catastrophically let down by this government’s woeful neglect of the NHS”. “With the NHS now in the thick of one of the most uniquely challenging periods in its history, unacceptably long waits for hospital care are becoming increasingly commonplace,” said Siva Anandaciva, the chief analyst at the King’s Fund. Read full story Source: The Guardian, 13 January 2022
  8. News Article
    A new study has linked COVID-19 to complications during pregnancy. Scottish researchers found that women who catch the virus near the end of pregnancy were more vulnerable to birth-related complications. They are more likely to suffer them than women who catch Covid in early pregnancy or not at all. The researchers say getting vaccinated is crucial to protect pregnant women and their babies from life-threatening complications. The latest findings come from the Covid in Pregnancy Study (Cops), which carried out research across Scotland to learn about the incidence and outcomes of Covid-19 infection and vaccination in pregnancy. It is one of the first national studies of pregnancy and Covid. They found that preterm births, stillbirths and newborn deaths were more common among women who had the virus 28 days, or less, before their delivery date. The majority of complications occurred in unvaccinated women. The results, which have been published in Nature Medicine, come after recent data showed 98% of pregnant women admitted to UK intensive care units with coronavirus symptoms were unvaccinated. Researchers are now calling for measures to increase vaccine uptake in pregnant women. Read full story Source: BBC News, 13 January 2022
  9. Content Article
    Population-level data on COVID-19 vaccine uptake in pregnancy and SARS-CoV-2 infection outcomes are lacking. Stock et al. describe COVID-19 vaccine uptake and SARS-CoV-2 infection in pregnant women in Scotland, using whole-population data from a national, prospective cohort. They found that vaccine coverage was substantially lower in pregnant women than in the general female population of 18−44 years. Overall, 77.4% of SARS-CoV-2 infections, 90.9% of SARS-CoV-2 associated with hospital admission and 98% SARS-CoV-2 associated with critical care admission, as well as all baby deaths, occurred in pregnant women who were unvaccinated at the time of COVID-19 diagnosis. Addressing low vaccine uptake rates in pregnant women is imperative to protect the health of women and babies in the ongoing pandemic.
  10. News Article
    Many supposedly “incidental” infections aren’t really incidental, and cannot be dismissed, writes Ed Yong. More Americans are now hospitalised with COVID-19 than at any previous point in the pandemic. The current count—147,062—has doubled since Christmas, and is set to rise even more steeply, all while Omicron takes record numbers of healthcare workers off the front lines with breakthrough infections. For hospitals, the math of this surge is simple: Fewer staff and more patients mean worse care. Around the United States, people with all kinds of medical emergencies are now waiting hours, if not days, for help. Some reporters and pundits have claimed that this picture is overly pessimistic because the hospitalisation numbers include people who are simply hospitalised with COVID, rather than for COVID—“incidental” patients who just happen to test positive while being treated for something else. In some places, the proportion of such cases seems high. UC San Francisco recently said a third of its COVID patients “are admitted for other reasons,” while the Jackson Health System in Florida put that proportion at half. In New York State, COVID “was not included as one of the reasons for admission” for 43% of the hospitalised people who have tested positive. But the “with COVID” hospitalisation numbers are more complicated than they first seem. Many people on that side of the ledger are still in the hospital because of the coronavirus, which has both caused and exacerbated chronic conditions. And more important, these nuances don’t alter the real, urgent, and enormous crisis unfolding in American hospitals. Whether patients are admitted with or for COVID, they’re still being admitted in record volumes that hospitals are struggling to care for. “The truth is, we’re still in the emergency phase of the pandemic, and everyone who is downplaying that should probably take a tour of a hospital before they do,” says Jeremy Faust, an emergency physician at Brigham and Women’s Hospital, in Massachusetts. Read full story Source: The Atlantic, 12 January 2022
  11. News Article
    Parents are being warned to look out for signs of a non-Covid virus that is “rife” in the UK amid a surge in reports of children struggling to breathe. The British Lung Foundation (BLF) said Respiratory Syncytial Virus (RSV) is staging a comeback this winter after lockdown last year meant there were fewer infections than would normally occur. It is concerned that this year children will have “much lower immunity” at a time when the NHS is already under extreme pressure. “In the last few weeks, we have noticed a surge in calls from parents who are worried about their child’s breathing,” said Caroline Fredericks, a respiratory nurse who supports the BLF’s helpline. “Most of these parents have never heard of RSV which is worrying.” RSV is common in babies and children. Almost all will have had it by the time they are two. It may cause a cough or cold but for some it can lead to bronchiolitis, an inflammatory infection of the lower airways which can make it hard to breathe. The early symptoms of bronchiolitis are similar to those of a common cold but can develop over a few days into a high temperature, a dry and persistent cough, difficulty feeding, and wheezing. While many cases clear up in two to three weeks, some children will end up being hospitalised. “There are steps parents can take to make their child more comfortable at home if their RSV develops into bronchiolitis, such as keeping their fluid intake up, helping them to breathe more easily by holding them upright when feeding and giving them paracetamol or ibuprofen suitable for infants,” said Fredericks. Read full story Source: The Guardian, 12 January 2022
  12. Content Article
    In this article for The Conversation, the authors discuss their latest research findings regarding Covid-19 transmission, outlining the likelihood of catching Covid-19 in different indoor and outdoor scenarios. They demonstrate that speaking, shouting, singing and heavy exercise all increase the likelihood of transmission, and illustrate the impact of ventilation, face coverings and number of people on the risk of catching the virus. The article includes an table summarising their findings and a link to the Covid-19 Aerosol Transmission Estimator developed by the authors. View the full research paper
  13. Content Article
    People who have already been infected by some common cold viruses are less likely to get COVID, according to new results from a study by Kundu et al. funded by the NIHR.
  14. News Article
    Hospitals across Kent, Sussex and Surrey are being asked to discharge hundreds of patients who are well enough to leave by Friday. The head of NHS South East, Anne Eden, said the beds are needed to deal with an expected surge in admissions of people ill with the Omicron variant. The NHS nationally has agreed to a reduction of 30% of such patients based on the baseline figure of 13 December. South East hospitals are being asked to make a 50% reduction by 31 January. In a letter seen by the BBC, Ms Eden said: "This is in order to create the headroom to manage any further Covid pressures, with current modelling indicating a peak in Covid activity in mid-January." She wrote: "It is now critical that we redouble our efforts to discharge those patients who no longer require bedded care, to create capacity, improve flow and reduce the pressure on staff." Ms Eden said staff absences and the need to maintain delivery of critical care for patients mean the NHS "must continue to focus on creating the necessary capacity to meet demand". "Failure to do this will significantly increase the risk of a further rise in patient harm," she said. She said hospitals must work with partners, including social care providers, to achieve the reduction in the number of patients in hospital who were well enough to be discharged. Read full story Source: BBC News, 10 January 2022
  15. News Article
    NHS leaders have been accused of downplaying the impact of the Covid crisis and putting hospitals under scrutiny for declaring critical incidents and postponing surgeries. A leaked email urges hospitals to use the “correct terminology” and make NHS leaders aware when declaring their status. Sources said the message was a “thinly veiled threat” and that there was “subtle pressure” amid rapid spread of Omicron. At least 24 trusts have declared critical incidents this week, including one in Northamptonshire on Friday afternoon, while new figures show a 59% rise in staff absences in just seven days. Trusts in London were told hospitals will be scrutinised for declaring a critical incident if there is “doubt” over the decision, according to an internal email sent from NHS England on Wednesday. In light of media coverage, it would be “valuable” to “raise awareness of the key terminology and encourage you to ensure that you are clear ... when considering a declaration,” it said. “National scrutiny on the declaration on incidents has heightened ... and [senior managers] will need to make additional enquiries where there is doubt as to the status of an organisation’s incident.” Shadow health secretary Wes Streeting said: “We know that the NHS is under enormous pressure and it is important that local trusts are able to be honest and open with parliament and the public about the challenges they’re facing. We are increasingly concerned that ministers are more interested in covering up problems than solving them.” Daisy Cooper, the Lib Dem Health spokesperson, said: “This is an insult to every health worker who has given their all, and every patient with cancelled appointments and delayed surgeries. Read full story Source: The Independent, 9 January 2022
  16. News Article
    Occupational health professionals should avoid employment and management matters related to unvaccinated NHS staff, new guidance has warned. The Faculty of Occupational Medicine guidance comes as trusts are considering their options of how to approach patient-facing staff who remain unvaccinated, including their potential redeployment or dismissal. However, HSJ understands some occupational health practitioners are concerned they may become entangled in difficult ethical issues, such as the vaccination status of individual employees, or disciplinary processes. Today’s FOM guidance said: “There is no scope for occupational health practitioners to provide an opinion on medical exemptions, whether to confirm or refute them… “Redeployment, dismissal and other employment consequences of vaccine refusal by a worker, within the scope of the proposed regulations, are entirely employment and management matters, and not an area in which occupational health should be involved.” FOM president Steve Nimmo said: “When the programme is implemented, occupational health professionals should be mindful of ethical and consent issues, and be careful not to be associated with any disciplinary process.” Read full story (paywalled) Source: HSJ, 7 January 2022
  17. News Article
    Pregnant women are being urged not to delay getting their Covid jab or booster in a government campaign. More than 96% of pregnant women admitted to hospital with Covid symptoms between May and October last year were unvaccinated, according to the UK Obstetric Surveillance System. The campaign will share testimonies of pregnant women who have had the jab on radio and social media. The government said the vaccine was safe and had no impact on fertility. In December, the Joint Committee on Vaccination and Immunisation added pregnant women to the priority list for the vaccine, saying they were at heightened risk from Covid. Around one in five pregnant women admitted to hospital with the virus needed to be delivered pre-term to help them recover, and one in five of their babies needed care in the neonatal unit, the Department of Health and Social Care (DHSC) said. Prof Lucy Chappell, chief scientific adviser to the DHSC, told BBC Radio 4's Today programme that a third of unvaccinated pregnant women with COVID-19 needed help with breathing and one in six were admitted to intensive care. "We've also seen stillbirths and neonatal deaths in the latest wave," she said. Prof Chappell said the vaccine causes pregnant women to produce antibodies against the virus, which cross over to their babies and give them protection too. Dr Jen Jardine, from the Royal College of Obstetricians and Gynaecologists, who is seven months pregnant and has had her booster jab, said: "Both as a doctor and pregnant mother myself, we can now be very confident that the Covid-19 vaccinations provide the best possible protection for you and your unborn child against this virus." Read full story Source: BBC News, 10 January 2022
  18. News Article
    The Covid-19 pandemic has entered its third year, with no end in sight, and the world is fed up to the gills. A new and even more highly transmissible variant, Omicron, has been scorching through holiday gatherings over the past couple of weeks. People who are thrice vaccinated are among the infected. STAT asks Mike Ryan, head of the health emergencies programme at the World Health Organization, if he expected the pandemic to last as long as it has, who should make the call on whether to update Covid vaccines, and what he thinks are the main mistakes the world has made. “What’s shocked me most in this pandemic has been that absence or loss of trust,” he said of people’s unwillingness to follow the advice of public health leaders and the containment policies set out by governments," says Ryan. Read full interview Source: STAT, 3 January 2022
  19. Content Article
    The COVID-19 pandemic has led to changes in health service utilisation patterns and a rapid rise in care being delivered remotely. However, there has been little published research examining patients’ experiences of accessing remote consultations since COVID-19. Such research is important as remote methods for delivering some care may be maintained in the future.
  20. News Article
    The government has announced 200 military personnel are being deployed to “support the NHS in London amid staff shortages due to COVID-19”. The 200 figure is equivalent to about 1.8% of the covid-related absences in acute trusts in the capital on Wednesday, and 0.2% of the national all-trust total of 120,000. The Ministry of Defence will provide 40 defence medics and 160 general duty personnel, it said. The first were deployed this week, including in Whipps Cross in east London. According to the minutes of an internal meeting held by senior leadership at the hospital, 10 general duty military personnel have been deployed. They do not have clinical training so cannot take blood, but will undertake general duties, such as feeding patients and communication with teams and relatives. Staff absences from NHS trusts hit nearly 120,000 on Wednesday after another increase, HSJ has learned. Figures due to be published by NHS England are expected to show there were total absences across acute trusts of just over 80,000 on 2 January, down from more than 85,000 on 30 December. However, figures seen by HSJ show that, after the end of the new year bank holiday period, this acute trusts figure leapt to more than 92,000 by Wednesday (5 January). Read full story (paywalled) Source: HSJ, 7 January 2022
  21. Event
    until
    The importance of housing for delivering better outcomes for population health is being increasingly understood by health and care services. Throughout the pandemic, the benefit of a healthy home for a healthy life has become central to the nation’s fight against Covid-19. For most people, homes are no longer just a personal space but now serve as workplaces, socialising hubs and more, encapsulating all the functions of human life. The King’s Fund is organising a four-day conference, 21–24 February to explore, in-depth, how health care and housing are coming closer together and the implications of good quality housing (or lack of) for health outcomes across the country. Register
  22. News Article
    Trusts will be told next week how they should go about dismissing potentially thousands of NHS staff who have decided not to be vaccinated against covid, HSJ has learned. Last year, the government decided all patient-facing NHS staff would need to have received their first dose of the covid vaccine by 3 February, and two doses by April 2022. The stipulation covers non-clinical staff who may have face-to-face contact with patients, such as receptionists, porters and cleaners. NHS England published the first part of its guidance for employers in December last year, which warned staff who have to be redeployed because of a refusal to have the covid vaccination could be forced to compete for their job and also have their pay and pension affected. HSJ understands NHSE will issue its ‘phase two’ guidance’ next week. To date, government and NHSE announcements or guidance have not mentioned what will happen to patient-facing staff who refuse to be redeployed or are exempt from the requirement. However, HSJ understands the new guidance will make it clear that — while redeployment remains the preferred outcome — some staff are likely to be dismissed and trusts should be prepared for taking that action next month. Read full story Source: HSJ, 6 January 2022
  23. News Article
    The World Health Organization (WHO) has warned against describing the Omicron variant as mild, saying it is killing people across the world. Recent studies suggest that Omicron is less likely to make people seriously ill than previous Covid variants. But the record number of people catching it has left health systems under severe pressure, said WHO chief Dr Tedros Adhanom Ghebreyesus. On Monday, the US recorded more than one million Covid cases in 24 hours. The WHO - the UN's health agency - said the number of global cases has increased by 71% in the last week, and in the Americas by 100%. It said that among severe cases worldwide, 90% were unvaccinated. "While Omicron does appear to be less severe compared to Delta, especially in those vaccinated, it does not mean it should be categorised as mild," Dr Tedros told a press conference on Thursday. "Just like previous variants, Omicron is hospitalising people and it is killing people. "In fact, the tsunami of cases is so huge and quick, that it is overwhelming health systems around the world." Read full story Source: BBC News, 6 January 2022
  24. News Article
    Thousands of overseas-qualified doctors wanting to work in the UK will be delayed after the General Medical Council cancelled exams due to the surge in Covid cases. The regulator said its decision to pause professional and linguistic assessment board tests, scheduled for January and February, was made “in direct response” to the current omicron wave. Up to 54 doctors would have been needed each per day as examiners, it said, alongside a “large number of role players and staff”. It comes as overseas recruitment is seen by government and national officials as a crucial way to boost NHS staffing, including GPs. Director of registration Una Lane said: “We are deeply disappointed to have to cancel exams at this time, but given the pressures on the NHS and the impact on examiner availability, it was the only viable option.” Read full story (paywalled) Source: HSJ, 6 January 2022
  25. News Article
    More than one in four inpatients at one of England’s largest mental health trusts were reported as covid-positive this week, according to data seen by HSJ. Around 160 inpatients across South London and Maudsley (SLAM) Foundation Trust’s sites, or 28% of its total open beds, were reported as positive at the beginning of the week. Several other London mental health trusts have seen high rates of covid cases in recent weeks, as there has been enormous spread of the omicron variant in the capital, although rates have not been as high as at SLAM. SLAM told HSJ that infection rates rose and fell in a reflection of community transmission, with covid-positive people being admitted, and there being spread within inpatient units. While no wards have been closed and all of the trust’s services are open, visiting was suspended in mid-December due to what the organisation described on its website as a “high number of [covid] outbreaks”. Several sources in the sector told HSJ there had been widespread omicron outbreaks in mental health units across England. They said the nature of psychiatric wards and use of restraints meant adhering to stringent social distancing measures, in the face of a highly infectious variant, was more difficult than in other settings. Read full story (paywalled) Source: HSJ, 6 January 2022
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