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Content ArticleThe past several months have shown that most people hospitalized with COVID-19 will get better. As inspiring as it is to see these patients breathe on their own and converse with their loved ones again, we are learning that many will leave the hospital still quite ill and in need of further care. But little has been published to offer a detailed demographic picture of those being discharged from our nation’s hospitals and the types of community-based care and monitoring that will be needed to keep them on the road to recovery. Dr. Francis Collins takes a look at the current research.
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Content ArticlePatient Safety Movement's Dr Donna Prosser, CCO, and Dr Edward Kelley, Director of Integrated Health Services Department at World Health Organization (WHO) Headquarters, Geneva, give a COVID-19 update in this video. Topics discussed include the current climate of the COVID-19 pandemic broken down by region, influenza season amidst COVID-19, the reopening of schools across the globe, and Dr Kelley's speculations on how we will be able to overcome this crisis in the upcoming future.
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News ArticleParents and professionals have been devastated by the impact of the pandemic on some of the UK’s most vulnerable patients Kelly Stoor gave birth to her daughter, Kaia, 14 weeks early. On 12 March, the midwife held her up for Kelly to see before whisking Kaia off to the neonatal unit for critical care. Kaia became seriously ill and was transferred to a hospital in Southampton, 50 miles away from home, for specialist treatment just before lockdown was imposed on 23 March. While there, she teetered on the edge of life and death for weeks and underwent life-saving surgery twice. The impact on Kelly, her husband, Max, and their other three children has been enormous. Hospital restrictions in April dictated that only one parent was allowed to visit. Both parents were not able not hold their daughter for the first time until 88 days after she was born. “It was extremely difficult,” says Kelly. “I wasn’t allowed to hold her because of Covid. I had to wear gloves if I was going to touch her. We didn’t know if she was going to make it, and Max and I weren’t allowed in together to be with her. There was one time I was with her for three hours and I couldn’t cope any more. I wanted to break.” Kelly is not alone. In the UK, at least 25,000 children are living with conditions that require palliative care support and their lives, along with those of their families, have been upended by the coronavirus pandemic and accompanying restrictions. A report by Rainbow Trust found that lockdown was a distressing experience for many; 80% of those surveyed by the charity in April said their situation was worse or much worse than before lockdown. Nearly 60% of parents, meanwhile, say that their mental health is worse than before the pandemic. Families have had to take on the strain of caring full-time for a child with a life-limiting illness, such as cancer or neurological conditions, with little to no support. There has been no respite, explains Dr Jon Rabbs, a consultant paediatrician and trustee for Rainbow Trust. When lockdown was announced, many community healthcare services had to stop face to face contact and special schools which supported children were also closed. “One of my families is at breaking point, they are so exhausted and worried,” he says. In child healthcare there have been delays, he says. Urgent treatment is always available but follow-up care has been cancelled or delayed in some places. “In my practice we have not missed any significant relapses,” he adds. “But imagine the worry not knowing whether things were going to be OK or not.” Read full story Source: The Guardian, 22 October 2020
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News ArticleThe most comprehensive picture so far of how covid’s second wave has hit the NHS in the north of England is revealed in new figures obtained by HSJ. The latest data confirms that parts of the North West region now have more coronavirus patients in hospital beds than they did in the spring. It comes amid intense public debate about the best way to fight covid, and whether or not it is close to swamping the NHS. Collected from local NHS sources in a joint HSJ and Independent investigation, the information shows for example that: Lancashire and South Cumbria had 544 confirmed covid hospital patients yesterday (around 15-18% of the bed base), about 20 more than during the April peak. Liverpool University Hospitals – which remains the most severely affected trust – had 408 confirmed covid patients yesterday (20-25% of bed base), whereas it never topped 400 in the spring. The data is sent routinely by trusts to NHS England but most of it is not published – something some politicians are now calling for. As of yesterday, there were nearly 6,100 confirmed-covid patients across England, about 650 of whom were in critical care, and 560 receiving mechanical ventilation, according to information shared with HSJ. The number of “unoccupied” hospital beds is much lower now than in the spring, when they were cleared out in anticipation of a major hit. In the North West, up to 5,500 acute beds were reported as “unoccupied” in the spring, whereas the figure now is about 2,500 (around 14-18% of the bed base). However, critical care is the major pinch point in the most affected areas, with nearly half of the mechanical ventilation beds open at Liverpool’s hospitals (29 of 62) occupied by confirmed covid patients; and a third of those across the North West (178 of 556). However, hospitals in the area have opened very few extra critical care “surge” beds so far. The total numbers of mechanical ventilation (a subset of critical care) beds open in LUH and the rest of the region has not increased much in recent weeks, and falls well short of what they have declared they could open as potential surge capacity, if they cancelled large amounts of non-urgent care and reorganised staffing and wards. Read full story Source: HSJ, 23 October 2020
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News ArticleA trust is investigating after two junior doctors developed covid following an offsite event attended by 22 juniors where social distancing rules were allegedly ignored. The cases, involving doctors from the Royal Surrey Foundation Trust in Guildford, have been declared an outbreak by Public Health England and police have investigated the incident. But HSJ understands that contact tracing has concluded no patients needed to be tested because staff had worn appropriate PPE at all times and those involved had swiftly self-isolated once they realised they might have covid or had been at risk of exposure to it. It is not known whether any of the doctors had returned to work after the event before realising they might have been exposed to covid. Dr Mark Evans, deputy medical director, said: “Protecting our patients is our priority and we are committed to ensuring that all of our staff follow government guidance. This incident took place outside of work and has been reported appropriately, and there was no disruption to our services for patients.” Read full story Source: HSJ, 22 October 2020
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Content ArticleThe Patient Information Forum ran a survey on covid choices. It asked how people are balancing the need to have new or ongoing health conditions treated and managed versus the risks of contracting COVID-19. The aim of the survey was to identify the factors important to patients’ decision-making. This will help charities and the NHS produce the information patients need to make crucial decisions about health and well-being.
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Content ArticleGuy's and St Thomas' has shared a downloadable version of the 'Big 5'.
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News ArticleWith so many operations put on hold when the pandemic started in March, surgeon Douglas Hartley and a team of medical veterans got to work pioneering new types of protective equipment. When the coronavirus pandemic first hit the UK, thousands of surgical procedures were put on hold. For surgeons like Douglas, who performs operations on deaf children to restore their hearing, this created a significant moral dilemma – he wanted to get back into surgery to provide this vital care, but didn’t want to inadvertently catch or pass on COVID-19 in the process. Douglas regularly carries out cochlear implant surgery, a process in which a surgeon embeds an electronic device which stimulates the hearing nerve in the ear. The scientific evidence is clear that this surgery needs to be performed at the earliest opportunity so that these children can benefit from being able to hear at a vital stage in their development. But performing the surgery as normal would have put both children and surgical teams in danger. They needed to come up with another way of doing things. The team in Nottingham had to combine creativity and science to develop a novel and safe way to restart cochlear implant surgery in a matter of just a few weeks. The team used a systematic evidence-based approach to evaluate a variety of PPE for its usability and effectiveness. During simulated cochlear implant surgery, they evaluated each type of PPE across several parameters, including its effect on a surgeon’s ability to communicate, their field of vision, and their comfort. Many of the PPE options were found to substantially restrict the surgeon’s vision during operating. That rendered them unsafe for performing this sort of surgery. Instead, they found that the combination of “spoggles” and a half-face respirator mask had consistently superior performance across all aspects of clinical usability compared with all other options. During their studies, Douglas and his team also worked with a surgical product manufacturer to develop a novel drape, basically a tent, that was designed to be suspended from a microscope covering the patient’s head and torso to provide a physical barrier between the site of drilling and the rest of the team. They found that the operating tent significantly contained the droplets and prevented them from spreading around the theatre environment. They are the first – and are currently only – group in the world to develop an operating tent design that is marked for medical use. After completing our studies, we now had appropriate PPE and a protective operating tent to permit the safe restarting of cochlear implant surgery during the pandemic. These recommendations were rapidly disseminated internationally via webinars and journal publications and quickly adopted as standard patient care by Nottingham University NHS Foundation Trust and, subsequently, embraced in other departments in the UK and across the world. Read full story Source: The Independent, 22 October 2020
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News ArticleOld age and having a wide range of initial symptoms increase the risk of "long Covid", say scientists. The study estimates one in 20 people are sick for least eight weeks. The research at King's College London also showed being female, excess weight and asthma raised the risk. The aim is to develop an early warning signal that can identify patients who need extra care or who might benefit from early treatment. The findings come from an analysis of people entering their symptoms and test results into the COVID Symptom Study app. Scientists scoured the data for patterns that could predict who would get long-lasting illness. "Having more than five different symptoms in the first week was one of the key risk factors," Dr Claire Steves, from Kings College London, told BBC News. COVID-19 is more than just a cough - and the virus that causes it can affect organs throughout the body. Somebody who had a cough, fatigue, headache and diarrhoea, and lost their sense of smell, which are all potential symptoms,- would be at higher risk than somebody who had a cough alone. The risk also rises with age, particularly over 50, as did being female. Dr Steves said: "We've seen from the early data coming out that men were at much more risk of very severe disease and sadly of dying from Covid, it appears that women are more at risk of long Covid." No previous medical conditions were linked to long Covid except asthma and lung disease. Read full story Source: BBC News, 21 October 2020
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Content ArticleReports of 'Long-COVID' are rising but little is known about prevalence, risk factors, or whether it is possible to predict a protracted course early in the disease.
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News Article
Health Secretary warns of long-term effects of COVID-19 as new film released
Patient Safety Learning posted a news article in News
The Health Secretary is urging the public – and especially young people – to follow the rules and protect themselves and others from COVID-19, as new data and a new film released today reveal the potentially devastating long-term impact of the virus. The symptoms of ‘long COVID’, including fatigue, protracted loss of taste or smell, respiratory and cardiovascular symptoms and mental health problems, are described in a new film being released today as part of the wider national Hands, Face, Space campaign. The film calls on the public to continue to wash their hands, cover their face and make space to control the spread of the virus. The emotive film features the stories of Jade, 22, Jade, 32, Tom, 32 and John, 48, who explain how their lives have been affected – weeks and months after being diagnosed with COVID-19. They discuss symptoms such as breathlessness when walking up the stairs, intermittent fevers and chest pain. The film aims to raise awareness of the long-term impact of COVID-19 as we learn more about the virus. A new study from King’s College London, using data from the COVID Symptom Study App and ZOE, shows one in 20 people with COVID-19 are likely to have symptoms for 8 weeks or more. The study suggests long COVID affects around 10% of 18 to 49 year olds who become unwell with COVID-19. Read full story Source: Gov.uk, 21 October 2020 -
Content Article
Long COVID film: Hands. Face. Space.
PatientSafetyLearning Team posted an article in Patient recovery
This short film, produced by the Department of Health and Social Care, highlights the persisting symptoms many are experiencing following a COVID-19 infection. It includes patients of varying ages talking about the health struggles they continue to face months after contracting the virus. They urge viewers to take precautions to keep everyone safe. -
News Article
Covid: Lockdown had 'major impact' on mental health
Patient Safety Learning posted a news article in News
Lockdown had a major impact on the UK's mental health, including increased rates of suicidal thoughts, according to new research. The study, led by the University of Glasgow, examined the effects of COVID-19 during the height of the pandemic. Certain groups are said to be particularly at risk, including young people and women. This publication is the most detailed examination of how the UK's adult population coped during the first weeks of lockdown, when people were given strict orders to stay home. Researchers say public health measures, like lockdowns, are necessary to protect the general population, but warn they may have a "profound and long-lasting" effect on mental health and will extend beyond those who have been affected by the virus. The study, published in the British Journal of Psychiatry, looked at three blocks of time between March 31 and May 11. Just over 3,000 adults in the UK were surveyed and a range of mental health factors were considered, including depression, loneliness, suicide attempts and self-harm. The study found suicidal thoughts increased from 8% to 10% and they were highest among young adults (18-29 years), rising from 12.5% to 14%. The researchers say that, even though those are relatively small rises, they are significant because of the short period of time they happened over. "The majority of people did not report any suicidal thoughts, but this creeping rise over a very short period of time is a concern," says Prof Rory O'Connor, chair in health psychology at the University of Glasgow's Institute of Health and Wellbeing. Read full story Source: BBC News, 21 October 2020 -
News Article
Hospital cancels operations as Covid patient numbers soar
Patient Safety Learning posted a news article in News
A hospital in Yorkshire has said it is cancelling planned surgeries for at least two weeks as the number of coronavirus patients there hits levels not seen since May. Bradford Teaching Hospitals said it was being forced to stop non-urgent surgery and outpatient appointments for two weeks from Tuesday because of the numbers of severely ill COVID-19 patients. In statement the hospital said it had seen a spike in admissions in the last few days with 100 coronavirus patients now on the wards with 30 patients needing oxygen support – the highest number of any hospital in the northeast and Yorkshire region. It also said more patients were needing ventilators to help them breathe in intensive care. The trust is the latest to announce cancellations, joining the University Hospitals of Birmingham, Nottingham University Hospitals and Plymouth Hospitals as well as those in Liverpool and Manchester where hundreds of Covid patients are being looked after. Read full story Source: The Independent, 21 October 2020 -
News Article
New tool predicts person’s risk of hospitalisation and death from COVID-19
Patient Safety Learning posted a news article in News
UK researchers have developed a new risk prediction tool that estimates a person’s chance of hospitalisation and death from COVID-19. The algorithm, which was constructed using data from more than eight million people across England, uses key factors such as age, ethnicity and body mass index to help identify individuals in the UK at risk of developing severe illness. It’s hoped that the risk prediction tool, known as QCOVID, will be used to support public health policy throughout the rest of the pandemic, in shaping decisions over shielding, treatment or vaccine prioritisation. The research, published in The BMJ, was put together by a team of scientists across the UK, and has been praised for the depth and accuracy of its findings. “This study presents robust risk prediction models that could be used to stratify risk in populations for public health purposes in the event of a ‘second wave’ of the pandemic and support shared management of risk,” the researchers say. “We anticipate that the algorithms will be updated regularly as understanding of COVID-19 increases, as more data become available, as behaviour in the population changes, or in response to new policy interventions.” Read full story Source: The Independent, 21 October 2020 -
Content Article
CIEHF: COVID-19 human factor response
Patient Safety Learning posted an article in Guidance
The pandemic has brought human factors issues to prominence. The Chartered Institute of Ergonomics and Human Factors (CIEHF) and its members are responding rapidly to current challenges by providing expert guidance and help wherever it’s needed most. This site gives details and links to new guidance documents developed and published by us and matches human factors expertise to those needing assistance. -
Content ArticleClift et al. have developed a new risk prediction tool that estimates a person’s chance of hospitalisation and death from COVID-19. The algorithm, which was constructed using data from more than eight million people across England, uses key factors such as age, ethnicity and body mass index to help identify individuals in the UK at risk of developing severe illness.
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News Article
Long Covid: St Annes man 'never recovered' from long-term effects
Patient Safety Learning posted a news article in News
A man who was the last patient to leave Blackpool Victoria Hospital's intensive care unit after being treated for COVID-19 in July has died. Roehl Ribaya spent 60 days in intensive care in the summer but "never recovered" from the long-term effects of the virus. The Filipino aerospace engineer's family said the virus had taken a heavy toll on the 47-year-old even after he was discharged from hospital on 14 August. He had a cardiac arrest on 13 October and was in a coma until he died two days later. His wife, Mrs Ricio-Ribaya, who lives in St Annes in Lancashire, said: "He was never the same. He was so breathless all the time. "Please follow the government's advice so we can stop this virus. We don't want any more to die." Read full story Source: BBC News, 20 October 2020 -
Content ArticleSince the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the number of cases of coronavirus disease (COVID-19) in the United States has exponentially increased. Identifying and monitoring individuals with COVID-19 and individuals who have been exposed to the disease is critical to prevent transmission. Traditional contact tracing mechanisms are not structured on the scale needed to address this pandemic. As businesses reopen, institutions and agencies not traditionally engaged in disease prevention are being tasked with ensuring public safety. Systems to support organisations facing these new challenges are critically needed. Most currently available symptom trackers use a direct-to-consumer approach and use personal identifiers, which raises privacy concerns. Kassaye et al. developed a monitoring and reporting system for COVID-19 to support institutions conducting monitoring activities without compromising privacy.
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News Article
Trust in NHS ‘poor and diminishing’ among communities hit hardest by covid
Patient Safety Learning posted a news article in News
There is growing distrust for the NHS and government in communities that are of fundamental importance to the national effort to counter covid, according to research by NHSX. People in so-called “hard to reach” communities are faced with stigma and racism due to the covid pandemic but have dwindling trust in the health service, the research found. They are worried about how their personal data will be used by the NHS and other state bodies. They are particularly concerned that their details will be passed on to the police or immigration services. Read full story (paywalled) Source: HSJ, 20 October 2020 -
News Article
South East sees ‘striking’ levels of excess deaths at home
Patient Safety Learning posted a news article in News
Parts of the South East saw “striking” levels of excess deaths occurring in people’s homes between July and October. Analysis of official data by HSJ shows the region, which excludes London, had almost 900 excess deaths in the 10 weeks to 2 October (around 10 per 100,000 population), which accounted for almost three-quarters of the national total in that period. Excess deaths means the number taking place above the seasonal average of previous years. Deaths in people’s homes — as opposed to in hospitals or care homes, for example — more than accounted for the total excess. Meanwhile, only 132 of the region’s deaths in this period mentioned COVID-19 on the death certificate. Experts have described the South East numbers as “very striking”, but said it is not immediately clear what was causing it to be such a significant outlier. Possible explanations for excess mortality during the pandemic have included disruptions to normal health services, as well as anxiety among patients about attending hospital or GP surgeries. Read full story (paywalled) Source: HSJ, 20 October 2020 -
News ArticleMore than 200 people who went through hotel quarantine in Victoria, Australia, must be screened for HIV amid fears of cross-contamination from incorrect usage of blood glucose test devices. Several such devices were used on multiple people in quarantine between 29 March and 20 August, necessitating screenings for blood-borne diseases such as hepatitis B and C and HIV. These monitors, which take a small sample of blood from a fingertip, are intended for repeated use by only one person. While the needle is changed between usages, microscopic traces of blood can remain within the body of the machine, creating a low clinical risk of cross-contamination and infection. Safer Care Victoria, the state’s healthcare quality and safety agency, has assured the public there is no risk of COVID-19 spread as the disease is not transmitted by blood. These devices have since been taken out of circulation. In a statement, a spokesman for the agency said they have identified 243 people who had been tested by one of the shared machines during the timeframe in question, and will be contacted for screening. Everyone “who had conditions or episodes that may have required the test will also be contacted as a precaution”. The Victorian premier, Daniel Andrews, labelled the incident a “clinical error that was made some time ago”. “Safer Care Victoria have made some announcements in relation to a clinical error that was made some time ago, very low risk, but you can’t take any risks with these things. You have to follow them up properly and that’s exactly what has happened,” he said at a press conference on Tuesday. Read full story Source: The Guardian, 20 October 2020
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EventuntilThis virtual conference from The King's Fund will share practical ideas about transforming work and workplace cultures. It will explore how leadership and teamworking influences people’s work experiences, releasing their full potential to drive improved outcomes for patients and citizens. Discuss with other local health and care leaders how to create compassionate cultures with improved support for staff to make sure that the NHS and social care organisations are good employers and great places to work. Register
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EventuntilAre you a patient who has been waiting to receive a diagnosis or test results during the last six months? This includes, but is not limited to, CT scans, MRI scans, and endoscopy and dermatology procedures. Has the COVID-19 pandemic affected your service? Would you like to help to improve the patient experience of waiting for a diagnosis? The Patients Association is holding an online Zoom patient group discussion on this topic on Tuesday 27th October, 2.00-4.00pm, and we are seeking patients to take part. An £80 incentive payment will be offered in Amazon vouchers and places are limited. Participants will be chosen on the basis of suitability to ensure the group is representative of a wide variety of backgrounds and experiences. Please fill in the registration form https://www.surveymonkey.co.uk/r/CRNMC2T if you are interested.
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Content ArticlePatient Safety Movement's Dr Donna Prosser is joined by Dr Steven Deeks, Professor of Medicine, University of California, San Francisco, and Dr Jake Suett, Staff Grade Anaesthetist and Intensive Care Doctor, UUK, to discuss the long term implications of COVID-19 from clinical and personal perspectives. Dr Deeks shares the research around long COVID-19 symptoms and Dr Suett provides a personal anecdote of his experience with symptoms that have lasted months. Dr. Suett shares information about the COVID symptom study, which consists of an international mobile app to track COVID-19 symptoms over time.
