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An inquest into the death of a London bus driver at London’s Nightingale Hospital during the first wave of coronavirus has heard evidence about equipment mistakes which may have harmed patients. Kishorkumar Patel, aged 58, was one of the first patients to be admitted to the field hospital at London’s Excel Conference Centre in April last year. An inquest at East London Coroner’s Court was told doctors and nurses were forced to work “leanly” because of limited staff and ventilators to help patients breathe. Mr Patel is one of 10 patients who had the wrong filter used on the ventilator machines which it is thought triggered a cardiac arrest in Mr Patel, a father of six. A serious incident report identified 10 patients were affected by the use of the wrong filter, with three said to have been harmed as a result. Read coroner's report Read full story Source: The Independent, 6 October 2021

The country’s largest clinical study is being launched in Greater Manchester to investigate the best gap between first and second Covid-19 vaccine doses for pregnant women. Led by St George’s, University of London, the Preg-CoV study will provide vital clinical trial data on the immune response to vaccination at different dose intervals – either four to six weeks or eight to 12 weeks. This data will help determine the best dosage interval and reveal more about how the vaccine works to protect pregnant mothers and their babies against Covid-19. Pregnant women are more likely to develop severe Covid-19 or die from the disease but are excluded from clinical trials with new vaccines. This means there are currently very limited clinical trial data on the immune response and side effects caused by the vaccines for these women. Read the full story here Source: National Health Executive

The co-founder of a coronavirus bereaved families group has said he hopes Boris Johnson will "at long last... take us seriously" when he meets them at Number 10 today. Matt Fowler said it is vital the prime minister understand the need to start a public inquiry as soon as possible. Mr Johnson will meet members of the Covid-19 Bereaved Families for Justice group today - more than a year after promising to meet people whose loved ones had died. They will share how their family members caught the disease and died, and repeat calls for a public inquiry to get priority. The group plans to raise issues with the PM such as the disproportionate effect of COVID on some ethnic groups, transmission of the disease on public transport and in the workplace, the impact of late lockdowns, and failures to learn from the first wave. Boris Johnson previously said the inquiry would start in spring 2022. Read full story Source: Sky News, 28 September 2021

Hospitals in England have been given the green light to ease some of the Covid infection-control measures that have been in place during the pandemic. The changes, recommended by the UK Health Security Agency (UKHSA), are aimed at easing pressure on the NHS. It says testing and isolating patients before planned operations can be dropped and hospitals can return to normal cleaning procedures. Social distancing can also be reduced from 2m (6ft) to 1m in some areas. UKHSA chief executive Dr Jenny Harries said the new recommendations would help local hospitals plan more elective care. "This is a first step to help the NHS treat more patients more quickly, while ensuring their safety and balancing their different needs for care," she said. Health and Social Care Secretary Sajid Javid said: "As ever more people benefit from the protection of our phenomenal vaccination campaign, we can now safely begin to relieve some of the most stringent infection controls where they are no longer necessary, to benefit patients and ease the burden on hardworking NHS staff." Read full story Source: BBC News, 28 September 2021

Anti-vaccine Facebook groups in the United States have a new message for their community members: Don’t go to the emergency room, and get your loved ones out of intensive care units. Consumed by conspiracy theories claiming that doctors are preventing unvaccinated patients from receiving miracle cures or are even killing them on purpose, some people in anti-vaccine and pro-ivermectin Facebook groups are telling those with COVID-19 to stay away from hospitals and instead try increasingly dangerous at-home treatments, according to posts seen by NBC News over the past few weeks. Some people in groups that formed recently to promote the false cure ivermectin, an anti-parasite treatment, have claimed extracting Covid patients from hospitals is pivotal so that they can self-medicate at home with ivermectin. But as the patients begin to realize that ivermectin by itself is not effective, the groups have begun recommending a series of increasingly hazardous at-home treatments, such as gargling with iodine, and nebulizing and inhaling hydrogen peroxide, calling it part of a “protocol.” The messages represent an escalation in the mistrust of medical professionals in groups that have sprung up in recent months on social media platforms, which have tried to crack down on Covid misinformation. And it’s something that some doctors say they’re seeing manifest in their hospitals as they have filled up because of the most recent delta variant wave. Those concerns echo various local reports about growing threats and violence directed toward medical professionals in the US. In Branson, Missouri, a medical center recently introduced panic buttons on employee badges because of a spike in assaults. Violence and threats against medical professionals have recently been reported in Massachusetts, Texas, Georgia and Idaho. Read full story Source: NBC News, 24 September 2021

The return of schools and the arrival of autumn means common colds and other respiratory infections are firmly on the rise, spreading coughs and sneezes, more severe illnesses, and prompting some to report their worst colds ever. According to Public Health England, there is no particularly nasty new virus doing the rounds, but as cases rise, experts warn that people can expect more frequent infections and more serious symptoms now the UK is emerging from lockdown. Common colds and other respiratory tract infections tend to ramp up in September when the schools go back and autumn arrives, but after 18 months of social distancing and mask wearing, many people are thought to have weaker immune defences to protect themselves against the onslaught of respiratory viruses. With reduced immunity across the board, people may fall ill with viruses they would normally have fended off with little trouble, or develop co-infections that make them feel more poorly. This is particularly likely if the viruses that have been kept at bay by anti-Covid measures all bounce back at once. “We don’t know what we’re going to see with common colds this season,” said Prof Ronald Eccles, former director of the Common Cold Centre at Cardiff University. “We’re seeing this increase now, but the whole system has been knocked out of kilter by the fact that we’ve been socially distancing and wearing masks, and children have not had that immunity over the past year or so.” Read full story Source: The Guardian, 24 September 2021

The Government’s out-of-date advice on Covid symptoms that should trigger a PCR test could be causing around 20,000 cases a day and needs to be changed urgently, a leading researcher has warned. Speaking with Pulse, Professor Tim Spector, who heads the ZOE Covid study at King’s College London said the picture is ‘now fairly clear’ that the most common symptoms among those now testing positive are nothing like when the pandemic began. ‘It’s the wrong message and it’s not a joke, it’s killing people,’ he told Pulse. The ZOE Covid study was first launched in March 2020 and tracks infections using an app with millions of users. According to the app, the traditional symptoms of cough, shortness of breath, and fever rank way down the list in vaccinated adults and unvaccinated children. Instead the virus is presenting more like a regular cold with runny nose, headache, sneezing and sore throat leading the way. ‘One in two people with a positive PCR test across the country lack any of the three government approved symptoms,’ he said. ‘We’re missing lots of cases.’ Read full story Source: Pulse, 17 September 2021

The entire Covid shielding programme has been “closed” for good in an announcement slipped out at night during a Cabinet reshuffle. Clinically extremely vulnerable people will “not be advised to shield again” in future despite fears of a huge winter wave, said the statement uploaded to the government website last week. Furious charities today raised fears disabled and immunosuppressed people will be “cast adrift” - while others will feel “yet again forgotten by the government”. Some 3.8million vulnerable people were advised to shield during England’s third lockdown, going outside only for exercise or health appointments. That guidance was paused on 1 April and on July 19 people were told they could follow the same rules as the rest of the population. But the ‘Shielded Patient List’ was retained for future use and ex-shielders were given special tips, such as only meeting vaccinated people. Last night, however, the government announced there will no longer be “centralised guidance” for clinically extremely vulnerable people. Read full story Source: Mirror, 16 September 2021

At a certain point, it was no longer a matter of if the United States would reach the gruesome milestone of 1 in 500 people dying of COVID-19, but a matter of when. A year? Maybe 15 months? The answer: 19 months. The burden of death in the prime of life has been disproportionately borne by Black, Latino, and American Indian and Alaska Native people in their 30s, 40s and 50s. “So often when we think about the majority of the country who have lost people to covid-19, we think about the elders that have been lost, not necessarily younger people,” said Abigail Echo-Hawk, executive vice president at the Seattle Indian Health Board and director of the Urban Indian Health Institute. “Unfortunately, this is not my reality nor that of the Native community. I lost cousins and fathers and tribal leaders." The pandemic has brought into stark relief centuries of entwining social, environmental, economic and political factors that erode the health and shorten the lives of people of colour, putting them at higher risk of the chronic conditions that leave immune systems vulnerable to the coronavirus. Many of those same factors fuel the misinformation, mistrust and fear that leave too many unprotected. Many people don’t have a physician they see regularly due in part to significant provider shortages in communities of colour. If they do have a doctor, it can cost too much money for a visit even if insured. There are language barriers for those who don’t speak English fluently and fear of deportation among undocumented immigrants. “Some of the issues at hand are structural issues, things that are built into the fabric of society,” says Enrique W. Neblett Jr., a University of Michigan professor who studies racism and health. Read full story (paywalled) Source: The Washington Post, 15 September 2021

Changes to periods and unexpected vaginal bleeding after having a Covid vaccine should be investigated to reassure women, says a leading immunologist specialising in fertility. Writing in the BMJ, Dr Victoria Male, from Imperial College London, said the body's immune response was the likely cause, not something in the vaccines. There is no evidence they have any impact on pregnancy or fertility. The UK's regulator has received more than 30,000 reports of period problems. These include heavier than usual periods, delayed periods and unexpected bleeding after all three Covid vaccines, out of more than 47 million doses given to women in the UK to date. After reviewing the reports, the Medicines and Healthcare products Regulatory Agency (MHRA) says it "does not support a link" between Covid vaccines and the symptoms. However, writing in an opinion piece in the BMJ, Dr Male says "robust research" into reports of period problems would help to counter misinformation around the vaccines. "Vaccine hesitancy among young women is largely driven by false claims that COVID-19 vaccines could harm their chances of future pregnancy. Failing to thoroughly investigate reports of menstrual changes after vaccination is likely to fuel these fears." "If a link between vaccination and menstrual changes is confirmed, this information will allow people to plan for potentially altered cycles," she said. Read full story Source: BBC News, 16 September 2021

Surgical hubs, new technology and innovative ways of working will help tackle waiting lists and treat around 30% more elective care patients by 2023 to 2024. Backed by a new £36 billion investment in health and social care over the next 3 years, ‘doing things differently’ and embracing innovation will be the driving force to get the NHS back on track. The funding will see the NHS deliver an extra 9 million checks, scans and operations for patients across the country, but it’s not enough to simply plug the elective gaps. The NHS will push forward with faster and more streamlined methods of treatments. Surgical hubs already being piloted in a number of locations, including London, are helping fast-track the number of planned operations, including cataract removal, hysterectomies and hip and knee replacements, and will be expanded across the country. Located on existing hospital sites, surgical hubs bring together the skills and resource under one roof while limiting infection risk and providing a COVID-secure environment, with more planned to open in the coming year. The NHS has been trialling a range of new ways of working in 12 areas, backed by £160 million, to accelerate the recovery of services. This includes setting up pop-up clinics so patients can be treated quickly, in person, and discharged closer to home, as well as virtual wards and home assessments to allow patients to receive medical support from the comfort of their home, freeing up beds in hospitals. GP surgeries are using artificial intelligence to help prioritise patients most in need and identify the right level of care and support needed for patients on waiting lists. The latest cancer tests being deployed across the NHS are also helping speed up diagnosis and spot cancer early on. Thanks to the hard work of staff, a quarter of a million people were checked for cancer in June – the second highest number on record – and more than 27,000 people started treatment for cancer in the same period. Professor Steve Powis, NHS England medical director, said: "Although the pandemic is still with us and we will have to live with the impact of COVID for some time, the NHS has already made effective use of additional resources to recover services. From adopting the latest technologies to more evening and weekend working, NHS staff are going to great lengths to increase the number of operations carried out. The further funding announced this week will support staff to deliver millions more vital checks, tests and operations, so if you have a health concern, please do come forward to receive the care and treatment you may need." Read full story Source: 8 September, Department of Health and Social Care

Fully vaccinated people are much less likely to die with COVID-19 than those who aren't, or have had only one dose, figures from the Office for National Statistics (ONS) show. Out of more than 51,000 Covid deaths in England between January and July 2021, only 256 occurred after two doses. They were mostly people at very high risk from illness from COVID-19. The figures show the high degree of protection from the vaccines against illness and death, the ONS said. Some deaths after vaccination were always expected because vaccines are not 100% effective, and it takes a couple of weeks after your second dose to build the fullest protection. Breakthrough" deaths - occurring at least two weeks after the second jab along with a first positive PCR Covid test - tend to happen in the most vulnerable, men and those with weakened immune systems, with the average age being 84. But overall numbers were very small - they accounted for only 0.5% of all deaths from COVID-19 over the first six months of the year. Read full story Source: BBC News, 14 September 2021

A care home owner has said she was "forced" to ask two staff with Covid-19 to work because of a staff shortage. The Caledonia home in Holyhead, Anglesey, said 11 of its 12 residents had Covid and the two staff only cared for residents who were also positive. Ann Bedford said Anglesey council and an agency had both been unable to provide emergency cover for staff who were sick or isolating. After speaking to social services, it was agreed the staff could work. "I have never known a situation as bad as we faced over the last weekend. As a matter of course we have contingency plans in place to cope in emergencies but even these buckled under the strain," she said. "My heart sinks when I think about the weeks and months ahead. We felt abandoned and alone. I called on social services for help but they were facing their own emergencies." "The shortage of carers on Anglesey is at dangerous levels and is being intensified by the pandemic." Read full story Source: BBC News, 8 September 2021

More than one in five ‘covid deaths’ were both probably hospital-acquired, and caused at least in part by the virus, at several trusts, according to analysis released to HSJ. HSJ obtained figures from more than 30 trusts which have looked in detail at cases where patients died after definitely, or probably, catching covid in hospital. Thirty-two acute trusts provided HSJ with robust data, out of the total 120 in England. Across all 32, they had recorded 3,223 covid hospital deaths which were either “definitely” or ‘probably’ nosocomial — making up around 17% of their total reported 19,020 hospital deaths. The trusts said 2,776 of the 3,223 deaths also had covid listed on their death certificate, either as an “immediate cause” or as a contributory factor. That constitutes about 15% of all the hospitals’ covid deaths, and 86% of the nosocomial deaths. When approached by HSJ, these trusts said they followed robust infection control practices, and that high community covid prevalence, and covid admissions, were the main cause of hospital-acquired infection. Some trusts also cited their ageing infrastructure. Read full story (paywalled) Source: HSJ, 6 September 2021

Public Health England's medical director has said schools are not "drivers" or "hubs" of Covid infection. "We understand, and I understand fully, that parents may be nervous but I would stress again that schools are not the drivers and not the hubs of infection." Said Dr Yvonne Doyle. However, Prof Calum Semple, a government scientific adviser, said with most adults vaccinated, schools were likely to be a "greater part of the problem" Read full story. Source: BBC News, 02 September 2021

Gavin Williamson, despite the risk of Covid, has insisted children must return to a "normal pre-pandemic" experience in schools. The education secretary said testing could be the key to guarding against infection rates, but refused to rule out a potential rise after experts have warned surges in Covid-19 are linked to classrooms. "This is why we're doing the testing programme and we're encouraging children to take part in it, parents, and of course teachers and support staff as well. This is a way of rooting out Covid. We're trying to strike that constant, sensible balance of actually giving children as normal experience in the classroom as possible, but also recognising we're still dealing with a global pandemic." He told Niall Paterson. Read full story. Source: Sky News, 02 September 2021

Experts have said the risk of "long Covid" in children is much lower than many had feared, with research suggesting somewhere between 2% and 14% still had symptoms caused by Covid 15 weeks later. However, while the research team found little evidence to showing huge number seeking help for symptoms that had left them bedridden or unable to attend school, it was still important that they received support if they had any persistent symptoms such as headaches, tiredness and breathing difficulties. Prof Sir Terence Stephenson, from UCL's Great Ormond Street Institute of Child Health, said of the development of Long Covid in children, "It is nowhere near what people thought in the worst-case scenario". Read full story. Source: BBC News, 01 September 2021

Groups representing the NHS have warned services may have to be cut unless NHS England receives an extra £10bn in funding next year, which may put patients at risk. The NHS Confederation and NHS Providers said the money was needed to cover pandemic-related costs and reduce the backlog in operations and treatments, but the government said it had already provided additional money to tackle backlogs. "We are committed to making sure the NHS has everything it needs to continue providing excellent care to the public as we tackle the backlogs that have built up during the pandemic. This year alone we have already provided a further £29bn to support health and care services, including an extra £1bn to tackle the backlog. This is on top of our historic settlement for the NHS in 2018, which will see its budget rise by £33.9bn by 2023-24." Said a government statement. Read full story. Source: BBC News, 02 August 2021

New data has revealed the number of people in hospital with Covid-19 is climbing rapidly, even before the latest surge in infections. These figures highlight the immense pressure the NHS is currently facing, and according to this data, there are now 585 people in hospital with the virus, up from 312 just eleven days ago, showing it to be the highest figure since early March. Health Secretary Huma Yousaf said the situation in A&E is being closely monitored. "Hospitals are reporting increased levels of people attending A&E who are much sicker and require higher levels of care. Weekly performance is impacted due to a range of challenges including high attendances, staffing pressures due to isolation and annual leave and the continued requirement for infection control precautions that is affecting the time people need to spend in A&E." Read full story. Source: The Herald, 01 September 2021

Government experts have said the reopening of schools next month will likely trigger an exponential rise in Covid infections among children. According to members of SPI-M-O, the governments committee on on pandemic modelling, the removal of certain measures such as face masks, and the lack of vaccinations, may mean children will be susceptible to the virus. “Vaccines have amazingly weakened the link between infections and illness and hospitalisations, but not broken it. No one wants to reimpose restrictions but we face a challenging winter. I do believe we need an informed public debate on the options through 2021 and 2022. The infection is not going away, we have incredible tools (tests, treatment, vaccines). No one wants restrictions reimposed but we will have to accept some illness, hospitalisations and deaths.” Said Sage member and director of the Wellcome Trust, Sir Jeremy Farrar Read full story. Source: The Independent, 28 August 2021

The number of Covid-19 cases reported in Scotland has now reached 7,113, previously recorded as 6,835 on Friday. Health Secretary Humza Yousaf has warned the NHS was facing a "perfect storm" of pressure, with latest government figures showing a total of 507 people are in hospital with Covid and 52 are in intensive care. "We are seeing a rising curve of cases in Scotland. It's reassuring that vaccines are preventing the levels of serious health harms that case numbers like this would once have caused. However, we can't be complacent and are monitoring carefully. In the meantime, please take care." Tweeted First Minister Nicola Sturgeon. Read full story. Source: BBC News, 30 August 2021 (Scotland)

A new study focused largely on unvaccinated or partially vaccinated people has found the Delta variant is more likely to cause hospitalisation than the Alpha variant. The Delta variant, first identified in India, is already understood to be far more infectious than the previously dominant Alpha variant that was initially detected in Kent. Dr Gavin Dabrera, one of the study’s lead authors and a consultant epidemiologist for Public Health England has said, “This study confirms previous findings that people infected with Delta are significantly more likely to require hospitalisation than those with Alpha, although most cases included in the analysis were unvaccinated.” Read full story. Source: The Guardian, 27 August 2021

Following a number of serious infections, hospitals have warned about the risks of wearing the wrong kind of face mask during surgery. This comes after a patient safety alert was issued by NHS England where it was reported that respirator masks have been acquired by the millions during the coronavirus pandemic but sometimes have been deployed in inappropriate settings. “These incident reports and feedback from services suggest that the risks of valved respirators and PAPRs for surgical and invasive procedures is not well recognised, and that their use may have become routine in some theatre environments.” NHS England said in the document. Read full story. Source: The Independent, 26 August 2021

A major review of vaccines suggests the AstraZeneca jab does raise the risk of blood clots and another serious condition that can cause bleeding. However, the study also found the complications following coronavirus infection to be much higher. The University of Oxford-led team also found an increased risk of stroke after the Pfizer jab but also found it at a much lower rate than after infection. This comes after a coroner ruled that BBC Radio Newcastle presenter Lisa Shaw died due of complications from the AstraZeneca jab. Lead author Professor Julia Hippisley-Cox said it was "important people were aware of the risks, but that they were kept in context given the higher risk from being infected". Read full story. Source: BBC News, 26 August 2021

A spike in hospital acquired Covid-19 has been observed in two acute trusts, The Royal Wolverhampton Trust and Yeovil District Hospital Foundation Trust. According to NHS England, it is can be considered hospital acquired if covid infections are diagnosed eight days or more after admission. Data suggests The Royal Wolverhampton Trust had a weekly average of 25 probable hospital-acquired covid infections in mid-August and a spike at the start of August for Yeovil District Hospital Foundation Trust. Infection Prevention Society president Jennie Wilson said "Infection prevention and control teams are totally aware it’s a problem and they strive to do their best to keep it under control. It’s hugely challenging but [staff] are doing their best." Read full story. Source: HSJ, 25 August 2021