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Found 2,339 results
  1. News Article
    Doctors are less likely to resuscitate the most seriously ill patients in the wake of the pandemic, a survey suggests. Covid-19 may have changed doctors’ decision-making regarding end of life, making them more willing not to resuscitate very sick or frail patients and raising the threshold for referral to intensive care, according to the results of the research published in the Journal of Medical Ethics. However, the pandemic has not changed their views on euthanasia and doctor-assisted dying, with about a third of respondents still strongly opposed to these policies, the survey responses reveal. The Covid-19 pandemic transformed many aspects of clinical medicine, including end-of-life care, prompted by millions more patients than usual requiring it around the world, say the researchers. In respect of DNACPR, the decision not to attempt to restart a patient’s heart when it or breathing stops, more than half the respondents were more willing to do this than they had been previously. Asked about the contributory factors, the most frequently cited were: “likely futility of CPR” (88% pre-pandemic, 91% now); coexisting conditions (89% both pre-pandemic and now); and patient wishes (83.5% pre-pandemic, 80.5% now). Advance care plans and “quality of life” after resuscitation were also commonly cited. Read full story Source: The Guardian, 25 July 2022
  2. News Article
    Women have spoken to the BBC about the "nightmare" of giving birth during the restrictions imposed because of Covid. The London Assembly was told a de facto maternity ward ban on partners meant new mums often got very little support. Campaign group Pregnant Then Screwed said elective Caesareans spiked, as women tried to find a way to have their partner by their side. Patient care also suffered as maternity units struggled with what a midwifery group said was a 40% staff absence. A London Assembly health committee review of Covid pandemic pregnancy care has heard that more than three-quarters of the some 110,000 women who gave birth in the capital in 2020 were believed to have done so without their partner's support. Joeli Brearley, director of Pregnant then Screwed, said elective Caesarean rates increased from 15% to 24%: "Women were requesting severe surgery simply so their partner could be there." Suzanne Tyler, from the Royal College of Midwives, agreed that London hospitals were badly affected by staff shortages. "At its worst, staffing was 40% down," she said. "The babies didn't stop coming during Covid but services did have to be rationalised." Dr Tyler, who said the pandemic "ended up pitting midwives against women", criticised "confusing... contradictory" advice from the government and NHS England that "kept changing". Read full story Source: BBC News, 26 July 2022
  3. News Article
    The monkeypox outbreak has been declared a global health emergency by the World Health Organization. According to the UK Health Security Agency, early symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes and chills, as well as other features such as exhaustion. Monkeypox does not spread easily between humans, and requires close contact. According to the US Centers for Disease Control and Prevention, it is thought that human-to-human transmission primarily occurs through large respiratory droplets. Globally, there have so far been 16,016 monkeypox cases – 4,132 of which were in the past week, according to WHO data. It is now in 75 countries and territories and there have been five deaths. The European region has the highest number of total cases, at 11,865, and the highest increase in the past seven days, with 2,705. The west African strain of monkeypox is generally a mild infection for most people, but it is important those infected and their contacts are identified. The virus is more of a concern among vulnerable people such as those with weakened immune systems or who are pregnant. Read full story Source: The Guardian, 23 July 2022
  4. Content Article
    The science behind the symptoms of Long Covid are explained in this infographic from docdroid.
  5. Content Article
    This article in the Nursing Times Long Covid series discusses how nurses are at high occupational risk of Long Covid and how best to support them.
  6. News Article
    Patients who contract Covid-19 are at increased risk of being diagnosed with cardiovascular disorders and diabetes in the three months following infection, although the risk then declines back to baseline levels, a large UK study has found. Researchers from King’s College London say patients recovering from Covid-19 should be advised to consider measures to reduce diabetes risk including adopting a healthy diet and taking exercise. The GP medical records from more than 428,650 Covid-19 patients were matched with the same number of controls and followed up to January 2022. All patients with pre-existing diabetes or cardiovascular disease were excluded from the study, published in the open access journal PLOS Medicine. According to the analysis, diabetes mellitus diagnoses were increased by 81% in acute covid-19 and remained elevated by 27% from 4 to 12 weeks after infection. Lead study author Emma Rezel-Potts said, “While it is in the first four weeks that covid-19 patients are most at risk of these outcomes, the risk of diabetes mellitus remains increased for at least 12 weeks. Clinical and public health interventions focusing on reducing diabetes risk among those recovering from covid-19 over the longer term may be beneficial.” The researchers said that people without pre-existing cardiovascular disease or diabetes who become infected with covid-19 do not appear to have a long term increase in incidence of these conditions. Read full story Source: BMJ, 22 July 2022
  7. Content Article
    COVID-19 has been associated with new-onset cardiovascular disease (CVD) and diabetes mellitus (DM), but it is not known whether COVID-19 has long-term impacts on cardiometabolic outcomes. This study from Rezell-Potts et al. aimed to determine whether the incidence of new DM and CVDs are increased over 12 months after COVID-19 compared with matched controls. The study found that CVD was increased early after COVID-19 mainly from pulmonary embolism, atrial arrhythmias, and venous thromboses. DM incidence remained elevated for at least 12 weeks following COVID-19 before declining. People without preexisting CVD or DM who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions.
  8. Content Article
    In her opening statement, Baroness Heather Hallett, Chair of the UK Covid-19 Inquiry, has set out her approach to running it. The Inquiry will consider and report on the preparations and the response to the pandemic in England, Wales, Scotland and Northern Ireland. The Terms of Reference provide the broad outline of the issues the Inquiry will investigate.
  9. Content Article
    Two years into the COVID-19 pandemic, it is clear that gender differences exist, and that women, men, and gender minorities are differentially impacted by the pandemic.
  10. News Article
    NHS leaders have sometimes been “shouting into the void” about their fears of the health service being overwhelmed by Covid because of the absence of a single national command centre for the pandemic response, a new report argues. The Tony Blair Institute for Global Change has published a report which recommends short and long term actions for dealing with Covid and future health emergencies. It says the government should have previously, and should now, set up “a national centre for response” to have overriding national responsibility for managing Covid and future crises. The government should also shift away from traditional methods of communication, to instead listen to “communities… beliefs and fears” about Covid, and adjust messages to respond to these. The report has been authored by the institute’s head of health Henry Dowlen, who was seconded to work on several pandemic projects such as a setting up a Nightingale Hospital and coordinating regional and national response work. He said that if government did not change course then the NHS, along with other services and parts of society, would remain in a “vicious cycle” of operational problems. Read full story (paywalled) Source: HSJ, 20 July 2022
  11. Content Article
    The UK’s current strategy is outlined in its “Living with Covid-19” plan, which has three key pillars: vaccines, testing and treatment. In April 2022, the Tony Blair Institute for Global Change undertook a critical analysis of this plan: what worked well, what didn’t, and what needed to change to manage Covid more effectively, and to protect society and the economy. The recommendations were incremental steps amounting to a responsible and proactive strategy. Unfortunately, as we see from the recent rapid rise in cases – most involving people who are being infected for the first time – as well as from the increasing hospitalisations and the rise in deaths, the strategy shows what living with Covid means in reality. To support the government, this paper sets out immediate and practical measures to safely guide the country through the latest Covid wave and to outline the longer-term shifts that will better prepare it for public-health emergency management in the future – including by restoring trust with the public. 
  12. Content Article
    Today may be the most difficult day the NHS has ever experienced. The headlines will focus on the pressures created by the heatwave and that most visible sign of healthcare failure – ambulances queuing outside hospitals. But, as we know all too well, this brutal situation is the culmination of many factors, which include but are not limited to prolonged periods of underfunding in the past decade, lack of an adequate workforce plan, and a cowardly and short-sighted failure to undertake social care reform, writes Dr Kamran Abbasi, editor of the BMJ, and HSJ editor, Alastair McLellan, in this joint editorial.
  13. Content Article
    Despite under-reporting, health workers (HWs) accounted for 2-30% of the reported COVID-19 cases worldwide. In line with data from other countries, Jordan recorded multiple case surges among HWs. This study from Tarif et al. looked at infection prevention and control risk factors in HWs infected with Covid-19. Study findings confirmed the role of hand hygiene as one of the most cost-effective measures to combat the spreading of viral infections.
  14. Content Article
    COVID-19 is more likely to lead to Long COVID among persons of working age. In this paper, Darja Reuschke  and Donald Houston outline the first estimates of the impact of Long Covid on employment in the UK. Using estimates of cumulative prevalence of Long Covid, activity-limiting Long COVID in the working-age population and of economic inactivity and job loss resulting from Long COVID, they provide evidence of the profound impact of Long COVID on national labour supply. Since the start of the pandemic, cumulatively 2.9 million people of working age (7% of the total) in the UK have had, or still have, Long ovid. This figure will continue to rise due to very high infection rates in the Omicron wave. Since the beginning of the pandemic, economic inactivity due to long-term sickness has risen by 120,900 among the working-age population, fuelling the UK’s current labour shortage. An estimated 80,000 people have left employment due to Long COVID. The authors argue that governments need to tackle the twin challenges to public health and labour supply and provide employment protection and financial support for individuals and firms affected by Long COVID.
  15. Content Article
    An analysis of data from nearly 154 000 US veterans with SARS-CoV-2 infection provides a grim preliminary answer to the question: What are COVID-19’s long-term cardiovascular outcomes? The study, published in Nature Medicine by researchers at the Veterans Affairs (VA) St Louis Health Care System, found that in the year after recovering from the illness’s acute phase, patients had increased risks of an array of cardiovascular problems, including abnormal heart rhythms, heart muscle inflammation, blood clots, strokes, myocardial infarction, and heart failure. What’s more, the heightened risks were evident even among those who weren’t hospitalised with acute COVID-19.
  16. Content Article
    Our health services face an unprecedented challenge in recovering from the pandemic and coping with ongoing waves of covid. With such demand for healthcare services from the general population and covid cases rising once more, some customers are bound to be angry or unhappy. But, as we recover from the pandemic, our handling of complaints must surely change, writes David Oliver in this BMJ article.
  17. News Article
    Monkeypox is continuing to spread in the UK, with current efforts insufficient to curb the outbreak, experts have warned as a whistleblower claimed there were serious flaws in the support given to those who think they have been exposed. According to the UK Health Security Agency (UKHSA), there have been 1,552 confirmed cases of monkeypox in the UK related to the outbreak as of 7 July. “[There is] no evidence that current strategies are likely to bring this to an end anytime soon,” said Paul Hunter, a professor in medicine at the University of East Anglia, although he noted that while total case numbers were continuing to rise, the rate of new infections may have plateaued. The concerns came as a whistleblower working on a UKHSA monkeypox inquiries line said it had numerous issues, including offering little support for people who are not confirmed contacts of cases – i.e. somebody whose name has been provided to contact tracers by a person with monkeypox. The Guardian has seen scripts that show even if someone calls because they are worried they may have had a contact with a confirmed case, they are told their risk is very low if they have not been formally identified as a contact. The whistleblower said that made little sense when a caller has said a sexual partner has monkeypox symptoms. In addition, the whistleblower said call handlers were not allowed to suggest callers contact a sexual health clinic unless sexual health was brought up by the caller, They added that some clinics had turned off their phone lines. The UKHSA has rejected the claims, saying the phone line is an additional service to provide non-clinical advice to members of the public. Read full story Source: The Guardian, 11 July 2022
  18. News Article
    When Susan Sullivan died from Covid-19, her parents’ world fell quiet. But as John and Ida Sullivan battled the pain of losing their eldest, they were comforted by doctors’ assurance that they had done all they could. It was not until more than a year later, when they received her medical records, that the family made a crushing discovery. These suggested that, despite Susan being in good health and responding well to initial treatments, doctors at Barnet hospital had concluded she wouldn’t pull through. When Susan was first admitted on 27 March 2020, a doctor had written in her treatment plan: “ITU (Intensive therapy unit) review if not improving”, indicating he believed she might benefit from a higher level of care. But as her oxygen levels fell and her condition deteriorated, the 56-year-old was not admitted to the intensive unit. Instead she died in her bed on the ward without access to potentially life-saving treatment others received. In the hospital records, seen by the Observer, the reason Susan was excluded is spelled out: “ITU declined in view of Down’s syndrome and cardiac comorbidities.” A treatment plan stating she was not to be resuscitated also cites her disability. For John, 79, a retired builder, that realisation was “like Susan dying all over again”. “The reality is that doctors gave her a bed to die in because she had Down’s syndrome,” he said. “To me it couldn’t be clearer: they didn’t even try.” Susan is one of thousands of disabled people in Britain killed by Covid-19. Last year, a report by the Learning Disabilities Mortality Review Programme found that almost half those who died from Covid-19 did not receive good enough treatment, including problems accessing care. Of those who died from Covid-19, 81% had a do-not-resuscitate decision, compared with 72% of those who died from other causes. Read full story Source: The Guardian, 10 July 2022
  19. News Article
    The UK must urgently procure stocks of a drug that can boost vulnerable people’s protection against Covid, experts have urged in a letter to The Times. Evusheld, made by AstraZeneca, was licensed by the UK regulator the Medicines and Healthcare products Regulatory Agency in March. Some people with immune system problems, such as blood cancer patients or organ transplant patients do not get sufficient protection from vaccinations and many are continuing to shield. Campaigners believe that offering Evusheld to those people could allow them to resume normal life. Evusheld is being used in countries including the United States and Israel but the UK government has yet to ask AstraZeneca for supplies. In a letter published in The Times, Gemma Peters, chief executive of Blood Cancer UK, and Lord Mendelsohn, co-chairman of the All-Party Parliamentary Group on Vulnerable Groups to Pandemics, say that this represents a failure of a promise made at the start of the pandemic that the government would “do everything in its power to protect the vulnerable”. They write: “People who are immunocompromised are still dying from Covid at much higher rates than the rest of the population. They cannot afford to wait. They deserve better.” Read full story (paywalled) Source: The Times, 6 July 2022
  20. News Article
    It would be “sensible” for hospitals to reintroduce mandatory mask-wearing, the chair of the Joint Committee on Vaccination and Immunisation has said, as several trusts in England and Wales announced the move. When NHS rules on wearing masks in England were dropped on 10 June, local health bodies were given the power to draft their own policies. Their guidance, however, is no longer legally enforceable. Figures from NHS England show there were about 10,658 patients hospitalised with coronavirus on Monday. Infections have doubled in a fortnight across England – with about 1,000 patients being admitted with the virus each day. Prof Andrew Pollard, who is also the director of the Oxford Vaccine Group, which developed the AstraZeneca jab, said there were an “extraordinary” number of cases at the moment. “I certainly know more people now who have had Covid than at any time in the past,” he told the BBC Radio 4’s Today programme. “Because there’s so much in the community, anything we can do in our hospitals to reduce the potential outbreaks make sense and so the mandatory mask wearing in hospitals is very sensible policy,” he added. Read full story Source: The Guardian, 5 July 2022
  21. News Article
    NHS Blood and Transplant (NHSBT) which supplies blood to hospitals is reporting severe supply shortages for the first time since 2018, HSJ has learned. Well-placed senior sources said it is close to issuing a formal “amber alert”, which would mean it could not guarantee blood supplies to hospitals, they said. NHSBT acknowledged to HSJ that it was “expecting a difficult few months”. NHS trusts would have to start cancelling elective operations if they cannot ensure that necessary bloods are available. NHSBT has already written to trusts asking them not to over-order supplies, and to ensure management plans are in place should the situation escalate. Supplies of the common O blood types are thought to be down to less than three days’ worth. If they were to drop to two days, this would trigger an amber alert. Read full story (paywalled) Source: HSJ, 5 July 2022
  22. News Article
    The government is to cut special sick pay for NHS staff off work with Covid from next week – even as cases soar – The Independent has learnt. The Department of Health and Social Care is set to announce an end to the enhanced pay arrangements provided during the pandemic, meaning that staff who go off sick with either Covid or Long Covid will be subject to normal sick-pay rules. In response to the pandemic, the government announced special arrangements for staff to be paid if they were isolating because of Covid, and to receive a full 12 months’ pay if they were suffering from Long Covid. Arrangements will now revert to the normal NHS sick-pay rules, which give workers six months’ full pay and six months’ half pay. A senior healthcare source said: “They have agreed to end the arrangement for new people from next week, and then have an implementation period where people who are currently off on this sort of scheme revert back to normal sick-pay entitlement from September.” The Royal College of Nursing’s director for England, Patricia Marquis, speaking about the cut in sick pay, said: “This decision is hugely disappointing, given that Covid-19 clearly hasn’t gone away, and nursing staff continue to be disproportionately affected by the virus as they face a higher risk of exposure." Read full story Source: The Independent, 2 July 2022
  23. Content Article
    There was a national roll out of ‘COVID Virtual Wards’ (CVW) during England's second COVID-19 wave (Autumn 2020 – Spring 2021). These services used remote pulse oximetry monitoring for COVID-19 patients following discharge from hospital. A key aim was to enable rapid detection of patient deterioration. It was anticipated that the services would support early discharge, reducing pressure on beds. This study from Georghiou et al. evaluated the impact of the CVW services on hospital activity. The study found no evidence of early discharges or changes in readmissions associated with the roll out of COVID Virtual Wards across England.
  24. News Article
    Patients with long-lasting symptoms from Covid will have access to more convenient tests and checks closer to home, under new NHS measures announced. Specialist clinics, dedicated to Long Covid, will now be able to send people for tests at local one stop shops and mobile clinics, rather than people going back to their GP practice for multiple different tests. Backed by an additional £90 million investment, the updated Long Covid plan includes ambitions for all patients to have an initial assessment within six weeks to ensure they are diagnosed and treated quickly. Latest estimates from the ONS show that around 1.6 million people in England are experiencing ongoing COVID symptoms lasting more than four weeks, with around one in five saying it has a significant impact on their daily life. The plan, which has been developed with expert insights from patients, clinicians and partners across the health and care system, shows the NHS has already made significant progress on delivering the 10 commitments it set out for Long Covid services just over one year ago. This includes establishing a nationwide network of 90 specialist long COVID clinics, 14 hubs for children and young people and investment in training and guidance to support GP teams in managing the condition. Dr Kiren Collison, GP and chair of the NHS long COVID taskforce said: “Long COVID can be devastating for those living with it, and while we continue to learn more about this new condition, it’s important people know they’re not alone, and that the NHS is here for them. “In just under two years, the NHS has invested £224m to support people experiencing long term effects from COVID – from setting up specialist clinics, hubs for children, and an online recovery platform, to providing training for GP teams. “Today’s plan builds on this world-leading care, to ensure support is there for everyone who needs it, and that patients requiring specialist support can access care in a timely and more convenient way.” Read full story Source: NHS England, 28 July 2022
  25. Content Article
    As a clinician, Abraar Karan rarely sees a patient die from Covid-19 anymore. Those who end up in the hospital these days have benefited from the immense advances in clinical science that have brought us vaccines, monoclonal antibodies, and antivirals, and taught us how best to use these and other existing medications, such as steroids, to save patients’ lives. Collectively, this is an enormous accomplishment. It’s not, however, the end of the pandemic. The end of covid-19 will not be a clinical feat, but a public health one. We need public health innovation from our governments, writes Abraar in this BMJ opinion article.
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