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Found 2,339 results
  1. Content Article
    From acute delirium to long term fatigue, COVID-19 has serious neuropsychiatric effects. Viral infections of the respiratory tract can have multisystemic effects, including on the central nervous system (CNS), and thus may precipitate a spectrum of psychiatric and neurological disorders. Some patients with COVID-19 are now known to develop various CNS abnormalities with potentially serious and long term consequences, including stroke and isolated psychiatric syndromes. As COVID-19 cases rise again worldwide, Butler et al. review what we know and don’t know about the acute and chronic neuropsychiatric sequelae and their potential mechanisms.
  2. Content Article
    People aged under 60 who are hospitalised with COVID-19 are more likely than expected to experience severe psychiatric symptoms. Research found that altered mental states such as psychosis are being reported in these younger patients. It confirmed that strokes and other neurological symptoms are common in severe COVID-19. The authors are gathering and analysing more detailed clinical information about the patients reported in this study, and others reported since (540 are now included). They are seeking funding for a further study to include more clinical investigations such as analysis of spinal fluid, blood and brain imaging. Author Benedict Michael is co-chairing a World Health Organization commissioned task force which will consider how to use the information from the ongoing research project in guidance for clinicians. The task force will consider whether people with new-onset altered mental state or another acute neurological problem should be tested for COVID-19. Some patients with few respiratory signs present with this symptom. They will consider which tests and investigations people with COVID-19 and neurological symptoms should undergo. Doctors need to be sure COVID-19 is the cause of the symptoms, and to know how patients should be managed.
  3. Event
    This webinar will review the key factors in workplace well-being, and examine these through the lens of COVID-19 and new ways for working. It will discuss the emerging needs of workforces, both psychosocial and practical, before addressing strategies and approaches to support staff during these challenging times. The session will also include an overview of the Access to Work Mental Health Support Service delivered by Able Futures. It will looks at the service’s aims, eligibility criteria and referral process, plus what support and workplace adjustments are available at home, in an office, or other place of work.
  4. Content Article
    Approximately 10% of patients with COVID-19 experience symptoms beyond 3–4 weeks. Patients call this 'long covid'. Greenhalgh et al. sought to document the lived experience of such patients, their accounts of accessing and receiving healthcare, and their ideas for improving services. They held 55 individual interviews and 8 focus groups with people recruited from UK-based long Covid patient support groups, social media and snowballing. Participants were invited to tell their personal stories and comment on other stories.
  5. News Article
    ‘Systemic’ problems within mental health services in Birmingham have caused the number of people waiting for an inpatient bed to reach ‘extremely concerning’ levels, according to documents leaked to HSJ. There are currently 41 people waiting to be admitted to a bed by Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) , according to internal documents, while 36 people have already had to be sent to private sector facilities up to 150 miles away. The NHS in the area has indicated to HSJ that it is due to need for “intensive levels of care” now growing because of the impact of the COVID-19 pandemic. In an email thread, sent to 60 people in the trust including senior executives, one senior clinician wrote in response to the bed figures: “The number of patients with Mental Health Act assessments completed is extremely concerning. This needs to be escalated to commissioners. The problem is systemic.” It comes after an HSJ investigation earlier this year into the deaths of 12 patients under BSMHFT’s services. It revealed senior medics had repeatedly warned the trust about severe bed shortages and a lack of capacity within home treatment services. The trust said it was addressing the issues raised, but senior clinicians told HSJ this week the trust is still short of at least 80 adult mental health beds. Read full story (paywalled) Source: HSJ, 15 October 2020
  6. News Article
    Doctors and nurses in areas of northern England with some of the highest Covid infection rates have described being “physically and emotionally” exhausted, as the NHS braces itself for the second wave of the pandemic. Most of the north has been put into the tier 2 “high risk” category, with Merseyside in the highest – tier 3 – bracket. While politicians debate whether a nationwide circuit breaker would be a more effective instrument to curb spread of the virus, frontline staff – still scarred from the first wave – are under no illusions as to what lies in store. Carmel O’Boyle, a nurse in Liverpool, who is also chair of the Royal College of Nursing’s Greater Liverpool and Knowsley branch, said members of the public had used A&E and primary care sparingly during the first national lockdown but mixed messages and a lack of trust in the government had led to people throwing caution to the wind and attendances were rising accordingly. “The nurses across my branch are frightened and exhausted – physically and emotionally,” she said. “They’ve been dealing with this for months and now there are more people in hospitals than there were in March. Although we know a little bit more about how to treat people and the kind of path of the disease process, it’s still frightening. It’s just so demanding and so draining to be nursing people in this manner without any family involvement and with the complications that there are.” A consultant in Manchester, who did not want to be named, said her hospital coped with the first wave but “the difference this time is that we’re trying to continue all of the elective activity and that’s going to be challenging. “I do think that we will manage the Covid cases. I just now worry about whether we will be able to continue to keep the normal care for people who need their operations [and] need care for cancer." Read full story Source: The Guardian, 15 October 2020
  7. News Article
    At the age of 49, Sarah Fisher feels her life is on a knife-edge. She had a heart attack during lockdown and has subsequently been diagnosed with heart failure. In July, she was told she needed to have an implantable cardioverter defibrillator (ICD) fitted, which can shock the heart back into rhythm when it detects a potential cardiac arrest. But 12 weeks on, she is still waiting. "I could have a cardiac arrest at any point," Sarah says. "It is awful not knowing what is going to happen. "I am on the urgent list – but the infection rates are rising and the clinics are closing." "I don't know when I will get it. "There are so many people in my position – we don't have Covid but our lives are at risk too. We are the forgotten victims of this pandemic." British Heart Foundation analysis of Office for National Statistics data for England and Wales found almost 800 extra deaths from heart disease among under-65s from March to July - 15% more than would be expected. The rate of death was highest during the full lockdown - but, worryingly, the trend continued afterwards. The charity blames delays in people seeking care, as well as reduced access to routine tests and treatments. And NHS England figures show a sharp rise in the numbers waiting over six weeks for a whole range of key tests, including echocardiograms for hearts. Read full story Source: BBC News, 15 October 2020
  8. News Article
    "Long Covid" – the long-lasting impact of coronavirus infection – may be affecting people in four different ways, according to a review, and this could explain why some of those with continuing symptoms are not being believed or treated. There could be a huge psychological impact on people living with long-term COVID-19, the National Institute for Health Research report says. They need more support – and healthcare staff require better information. Most people are told they will recover from mild coronavirus infections within two weeks and from more serious disease within three. But the report says thousands could be living with "ongoing Covid". Based on interviews with 14 members of a long-Covid support group on Facebook and the most recent published research, the review found recurring symptoms affecting everything from breathing, the brain, the heart and cardiovascular system to the kidneys, the gut, the liver and the skin. These symptoms may be due to four different syndromes: permanent organ damage to the lungs and heart post-intensive-care syndrome post-viral fatigue syndrome continuing COVID-19 symptoms Some of those affected have had a long stay in hospital with severe Covid-19 - but others, who have had a mild infection, have never even been tested or diagnosed. The review says coming up with a "working diagnosis for ongoing COVID-19" would help people access support. Read full story Source: BBC News, 15 October 2020
  9. News Article
    Intensive care units in Liverpool’s hospitals are more than 90% full, according to a local health leader, as the city braces for a second wave of COVID-19 infections. Councillor Paul Brant, cabinet member for adult health and social care at Liverpool City Council, warned that hospital services were once again being forced to care for patients critically ill with coronavirus. "Our intensive, critical care beds are filling up very fast,” he told BBC Radio 4's Today programme. "The most recent figures I've seen suggest they are over 90 per cent full and our acute hospital trusts have occupancy levels of Covid-positive patients of over 250. At the current rate of increase, we would expect Liverpool to surpass the peak of the first wave probably within the next seven to 10 days." Addressing the intensive care situation, he added: "They are not all Covid patients, I should say, but they are running very full and they are running with an increasing number of people who are Covid-positive." He added: "It has become clear that the intensity of the demand on hospital services here in Liverpool is crowding out anything other than dealing with Covid." Read full story Source: The Independent, 14 October 2020
  10. Event
    until
    The 2020 MindTech Symposium (#MindTech2020) will be held online as a virtual event for the very first time. The Symposium topic is ‘Digital Mental Health in the Age of Covid-19’ The session times are as follows: Wednesday 2nd December 2020: 8.00pm - 9.00pm: The digital mental health response to COVID-19: A global Perspective Thursday 3rd December 2020: 1st Session 10.00am - 11.30am: A rapid digital response to a global pandemic 2nd Session 1.15pm - 2.30pm: Virtual PPI: the way forward? 3rd Session 3.00pm - 4.00pm: Rethinking mental health services for a brave new world post-COVID-19 Wednesday evening’s opening session will embrace a global perspective on the digital mental health response to COVID-19 and includes international expert panellists Helen Christensen (Australia), John Torous (USA) and Sally Merry (New Zealand). Thursday’s sessions will cover emerging technologies and how they can be harnessed in the ‘new normal’ of mental healthcare in the post-Covid world. Thursday will also host a dedicated session encompassing Patient & Public Involvement (PPI) and user-centred co-design in a virtual world. This session will be delivered by MindTech’s own PPI group. Register
  11. Content Article
    A study of more than a half-million people in India who were exposed to the novel coronavirus SARS-CoV-2 suggests that the virus’ continued spread is driven by only a small percentage of those who become infected. Furthermore, children and young adults were found to be potentially much more important to transmitting the virus — especially within households — than previous studies have identified, according to a paper by Laxminarayan et al. in the journal Science. Lead researcher Ramanan Laxminarayan, a senior research scholar in PEI, said that the paper is the first large study to capture the extraordinary extent to which SARS-CoV-2 hinges on “superspreading,” in which a small percentage of the infected population passes the virus on to more people. The researchers found that 71% of infected individuals did not infect any of their contacts, while a mere 8% of infected individuals accounted for 60% of new infections. “Our study presents the largest empirical demonstration of superspreading that we are aware of in any infectious disease,” Laxminarayan said. “Superspreading events are the rule rather than the exception when one is looking at the spread of COVID-19, both in India and likely in all affected places.”
  12. Content Article
    A national bespoke system, called NHS e-Review, has been developed and launched as part of the NHS Covid Incident Recovery programme. The online system has been developed to support clinicians record the clinical priority of patients on a waiting list and to identify alternative pathways for patients if required.
  13. News Article
    Covid’s second surge has begun disrupting elective care at hospitals outside the north west, HSJ has learned. At Nottingham University Hospitals Trust, the number of patients with COVID-19 is “rising fast”, causing ward closures and elective care disruption, according to an internal memo seen by HSJ. The memo, sent by the trust’s divisional director for surgery Simon Parsons, said covid admissions to the trust “are way past 100 and rising fast”. “There are also outbreaks of covid on certain wards, which have resulted in closures of beds,” Mr Parsons said. “I am afraid the elective programme is going to be disrupted and we are doing everything we can to preserve as much elective work as possible,” said the memo to staff at the major teaching hospital. Mr Parsons called on clinicians to concentrate on “getting patients discharged in a timely way” and for them to escalate instances where patients were fit for discharge but not leaving the trust. “We are not asking you to make unsafe discharges but to keep length of stay as short as possible,” Mr Parsons said. Read full story (paywalled) Source: HSJ, 14 October 2020
  14. News Article
    Increasing staff absence due to COVID-19 will have a ‘significant impact’ on the ability of the NHS to deliver critical care services and routine operations, leading intensive care doctors have said. The latest NHS England data has shown the number of COVID-19 related absences of staff, either through sickness or self-isolation, has risen from 11,952 on 1 September to 19,493 on 1 October. Staff absence has almost doubled in the North West in this time as well – from 2,664 to 5,142 during the same period. It peaked at 17,628 in the region on 11 April and means the October total accounts for nearly a third of that amount already (29%). Alison Pittard, dean of the Faculty of Intensive Care Medicine, confirmed increasing numbers of NHS critical care staff were absent from work. “I suspect this is due to having to be at home with children asked to isolate and therefore the parent needing to isolate, as was the case in the first wave," she told HSJ. “This will have an impact on our ability to deliver critical care services. We know that staff numbers are inadequate at the best of times, with a significant vacancy rate especially for critical care nurses.” Royal College of Anaesthetists council member Helgi Johannsson said the rising absence rate was “likely to have a significant impact”, particularly on routine operations. Dr Johannsson, a consultant anaesthetist at Imperial College Healthcare Trust, said: “In my hospitals, I have been aware of several doctors and nurses having to isolate due to their children being asked to self-isolate. These healthcare staff were otherwise well and would have been at work." Read full story (paywalled) Source: HSJ, 14 October 2020
  15. News Article
    A 45-year-old British man has been left with permanent hearing loss after developing COVID-19. UK doctors say it is the first such case they have seen linked to the pandemic coronavirus. Although rare, sudden hearing loss can follow other viral infections, such as flu. The ear-nose-and-throat experts told BMJ Case Reports journal steroid drugs could help avoid this damage if given early enough. The patient, who has asthma, had been admitted to a London hospital with COVID-19 symptoms and transferred to intensive care after struggling to breathe. Tests confirmed he had coronavirus and he was put on a ventilator machine. He also needed various drugs and a blood transfusion before beginning to recover and coming off the ventilator 30 days later. A week after the breathing tube was removed and he left intensive care, he noticed tinnitus (a ringing or buzzing noise) followed by sudden hearing loss in his left ear. A hearing test suggested the loss was linked to damage to the hearing nerve, the middle ear, or both, rather than inflammation or a blockage to the ear canal. Doctors could find no explanations for his hearing problem, other than his recent COVID-19 illness. They gave him steroid tablets as well as injections into the ear, which helped a little, but he has some irreversible hearing loss. Read full story Source: BBC News, 14 October 2020
  16. News Article
    The introduction of weekly covid tests for NHS staff in ‘high risk areas’ will mean other groups missing out or waiting longer, well-placed sources have told HSJ. There is also understood to be a standoff between NHS England and Test and Trace over the regular testing of asymptomatic staff, which was announced for the North of England on Monday. NHS trust labs don’t have enough capacity to test all their staff; and there is not enough spare in “pillar two” commercial labs to carry out hundreds of thousands of additional tests. National bodies are said to be in disagreement over who should do it. NHSE believes they should be provided by T&T, and T&T says NHS labs should expand their capacity to carry them out themselves, HSJ has been told. A senior source involved in the testing programme said there would have to be “trade-offs” for T&T to meet the new NHS demand, with supply having to be cut for others who want tests — mostly the general population, or care home staff. At present the NHS has agreed to carry out 100,000 daily tests by the end of the month, as part of the T&T’s overall 500,000 target. It has been encouraged to do more by T&T, but any expansions may face shortages of equipment and supplies such as reagents, as well as staff and space. Read full story (paywalled) Source: HSJ, 13 October 2020
  17. News Article
    A man in the United States has caught Covid twice, with the second infection becoming far more dangerous than the first, doctors report. The 25-year-old needed hospital treatment after his lungs could not get enough oxygen into his body. Reinfections remain rare and he has now recovered. However, the study in the Lancet Infectious Diseases raises questions about how much immunity can be built up to the virus. The man from Nevada had no known health problems or immune defects that would make him particularly vulnerable to Covid. Scientists say the patient caught coronavirus twice, rather than the original infection becoming dormant and then bouncing back. A comparison of the genetic codes of the virus taken during each bout of symptoms showed they were too distinct to be caused by the same infection. "Our findings signal that a previous infection may not necessarily protect against future infection," said Dr Mark Pandori, from the University of Nevada. "The possibility of reinfections could have significant implications for our understanding of COVID-19 immunity." Read full story Source: BBC News, 13 October 2020
  18. News Article
    All pregnant women have been urged by doctors to get a free flu vaccination this winter to ensure they and their babies are protected. People can get infected with flu and coronavirus at the same time - with Public Health England finding if you get both simultaneously you may get more seriously ill. Researchers previously said those who have been infected with both viruses face a serious increase to their risk of death and warned the public “not to be complacent” in the wake of fears flu could circulate around the country alongside COVID-19. The Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Midwives note while getting flu is not a big deal for most people, getting the virus while you are pregnant can be serious for a small proportion of women and their babies. Flu can occasionally lead to stillbirth, maternal death and raise the chances of having a miscarriage. Dr Edward Morris, president of RCOG, said: “We are keen to reassure pregnant women that flu vaccination is safe for women to have at any stage in pregnancy - from the first few weeks right up to their due date, and while breastfeeding." "Over the last 10 years, the flu vaccine has been routinely and safely offered to pregnant women in the UK. The vaccine can also pass some protection to babies, which lasts for the first months of their lives." Read full story Source: The Independent, 12 October 2020
  19. News Article
    Care homes should refuse to take coronavirus patients from hospitals if they cannot prevent the spread of the disease, the care watchdog has told The Independent. Staff should admit these patients only if care homes are equipped with the right personal protective equipment (PPE) and infection prevention measures, the Care Quality Commission (CQC) said. During the first wave of the pandemic, care homes saw widespread outbreaks of the virus with 16,000 deaths. Homes struggled to access protective clothing for staff and were forced to take 25,000 untested patients discharged from hospitals. In an in-depth interview, Kate Terroni, the CQC’s chief inspector of social care, said care homes should not be put under pressure during a second wave to take infected patients they could not properly look after. She said any home that refused to admit patients would have her support. “Care home providers should only admit a resident when they are confident they can meet their care needs, so where they are confident they’ve got good infection prevention control, they’ve got the right PPE, they’ve got the right workforce." “We will absolutely support a provider to say they cannot admit someone if those ingredients aren’t in place.” Read full story Source: The Independent, 12 October 2020,
  20. News Article
    Hospitals in Liverpool are scaling back non-urgent operations to help them cope with COVID-19 patients despite NHS bosses insisting that normal care continues during the second wave. NHS trusts elsewhere in north-west England, as well as in the north-east and Midlands, are also preparing to cancel routine surgery such as joint replacements and hernia repairs amid a rapid rise in seriously ill coronavirus patients. A potential second suspension of non-Covid care is looming despite warnings that this may lead to many thousands dying because their cancer, heart problem or other illness is not diagnosed or treated. Steve Warburton, the chief executive of Liverpool University Hospitals NHS trust, acknowledged that doing less surgery would be “distressing” for patients affected but said the city’s three main acute hospitals had reached a “critical point”. It is the first trust in England to make clear it cannot provide normal levels of non-Covid care during the second coronavirus surge, even though NHS England has told all hospitals to do so. The decision is likely to lead to other trusts doing the same. Warburton said: “We will continue to prioritise surgery based in clinical need with a view to maintaining urgent and cancer surgery where possible.” He promised that the trust would continue to provide outpatient appointments “wherever possible” and keep giving patients diagnostic tests such as CT and MRI scans. Read full story Source: The Guardian, 12 October 2020
  21. Content Article
    "Cancel everything” has trended as a hashtag during the coronavirus disease 2019 (COVID-19) pandemic, and for good reason. The pandemic has touched virtually every aspect of society, substantially altering, and at its onset halting, the very ways nearly every person in the United States works, learns, lives, and maintains health. The practice of surgery has not been immune, with emergency declarations by many states to suspend elective procedures and office visits in mid-March. While only temporary, this abrupt cessation of surgery has had far-reaching implications that can inform future approaches in the context of both crisis and uncertainty as Meredith et al. reflect on in this JAMA article.
  22. Content Article
    The Royal College of General Practitioners has put together useful resources for GPs during the coronavirus pandemic.
  23. News Article
    The social restrictions imposed upon our lives because of coronavirus have taken a toll on our emotions, finances, and our waistlines, but there may yet be a silver-lining: a reduction in cases of other infectious diseases. From the common cold to chickenpox, there has been a substantial drop in the number of infections being reported to GPs, despite children returning to school – and that looks set to continue as winter approaches and lockdown restrictions tighten across the country. According to the latest GP surveillance data for England there were 1.5 cases of common cold for every 100,000 people during the week ending 6 October – compared to 92.5 cases reported during the same week last year. The rate of other non-Covid respiratory illnesses was also lower, at 131 for every 100,000 people, compared to 303 last year. Influenza-like illness is also down, at 131 cases for every 100,000 people, versus 303 cases in 2019. Although there has been in increase since the start of the school term, for all of these illnesses, infection rates remain below expected seasonal levels for this time of year, the report by the Royal College of General Practitioners’ research and surveillance centre said. Equivalent data was not immediately accessible for Wales and Scotland. GP consultations for other infectious diseases like strep throat, tonsillitis and impetigo, as well as infectious intestinal diseases like norovirus are also well below the five-year average – and have been since late March – the report suggests. Read full story Source: The Guardian, 9 October 2020
  24. News Article
    A number of patients in a cancer ward have died in hospital after a coronavirus outbreak and more have tested positive for the virus. NHS Lothian have not confirmed how many died but said it was fewer than five and a ‘very small number’ of patients. The health board is investigating the Western General Hospital in Edinburgh which has had to put measures in place to further contain the outbreak. Another six patients have tested positive for the virus so the hospital has closed the oncology ward to new patients being admitted. The hospital has also asked patients, who would usually be allowed to go home over the weekend and return to hospital on Monday, to stay in hospital the whole week. Dr Donald Inverarity, consultant microbiologist at NHS Lothian, said: ‘Our thoughts are with the family of the deceased and I would like to express our sincere condolences." "A multidisciplinary Incident Management Team was immediately established and all necessary infection control measures are in place. The situation will continue to be reviewed and monitored very closely." The health board’s Health Protection Team and the nationwide Test and Protect teams are carrying out contact tracing of visitors and outpatients where necessary. Routine coronavirus screening of staff and patients is also taking place as part of an enhanced regime. Read full story Source: Metro, 10 October 2020
  25. News Article
    One of the largest studies of its kind suggests that most pregnant women who become infected with the coronavirus will have mild cases but suffer prolonged symptoms that may linger for two months or longer in some cases. The study, published in the journal Obstetrics and Gynecology, found that most women who participated had mild cases of COVID-19 — a finding consistent with previous studies. Among the nearly 600 women followed, only 5% were hospitalised and 2% were admitted to intensive care units. Despite the mildness of their cases, 25% of the participants continued to experience symptoms eight weeks after becoming sick. The median length of symptoms was 37 days. Although pregnancy is known to cause major changes to the immune system, the length of time for continuing symptoms was surprising, said co-principal investigator Vanessa Jacoby, vice chair of research in the obstetrics, gynecology and reproductive sciences department at the University of California at San Francisco. Read full story Source: The Washington Post, 10 October 2020
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