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Content ArticleThe second annual Safety For All conference was held at the Royal College of Physicians in London on Tuesday 5th December 2023. Over 100 members of the healthcare community attended this event, including occupational health professionals, patient safety experts, frontline staff, patients and academics. The conference was hosted by the Safer Healthcare and Biosafety Network and Patient Safety Learning as part of the Safety For All campaign, supported by B. Braun, BD, Boston Scientific and Stryker. Attendees had the opportunity to hear from two keynote speakers: Lynn Woolsey, UK Deputy Chief Nurse at the Royal College of Nursing and Dr Henrietta Hughes, Patient Safety Commissioner for England. The conference was chaired and facilitated by Dr Rob Galloway, A&E Consultant at Brighton and Sussex Hospital NHS Trust, with a welcome introduction from Dr Ian Bullock, CEO of the Royal College of Physicians. There were a number of panel sessions and presentations throughout the day which are summarised in the attachment below, including on sustainability, antimicrobial resistance and antibiotic underdosing, violence at work, clinical communications, human factors, implementing the Patient Safety Incident Response Framework (PSIRF), and women's health and the menopause.
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Content ArticleIn this episode of the Medicine and the Machine podcast, Scottish GP Gavin Francis talks about the need to reconsider the importance of convalescence. He discusses the role of GPs in supporting patients through recovery after a hospital admission or period of illness and talks about a lack of awareness of the principles of convalescence amongst patients.
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News Article
New tests may finally diagnose Long Covid
Patient-Safety-Learning posted a news article in News
One of the biggest challenges facing clinicians who treat Long Covid is a lack of consensus when it comes to recognising and diagnosing the condition. But a new study suggests testing for certain biomarkers may identify Long Covid with accuracy approaching 80%. Effective diagnostic testing would be a game-changer in the Long Covid fight, for it’s not just the fatigue, brain fog, heart palpitations, and other persistent symptoms that affect patients. Two out of three people with Long Covid also suffer mental health challenges like depression and anxiety. Some patients say their symptoms are not taken seriously by their doctors. And as many as 12% of Long Covid patients are unemployed because of the severity of their illness and their employers may be sceptical of their condition. Researchers at Cardiff University School of Medicine in Cardiff, Wales, United Kingdom, tracked 166 patients, 79 of whom had been diagnosed with Long Covid and 87 who had not. All participants had recovered from a severe bout of acute Covid-19. In an analysis of the blood plasma of the study participants, researchers found elevated levels of certain components. Four proteins in particular—Ba, iC3b, C5a, and TCC—predicted the presence of Long Covid with 78.5% accuracy. "I was gobsmacked by the results. We’re seeing a massive dysregulation in those four biomarkers," says study author Wioleta Zelek, PhD, a research fellow at Cardiff University. "It’s a combination that we showed was predictive of Long Covid.." Read full story Source: Medscape, 29 November 2023 -
News ArticleFormer Prime Minister Boris Johnson is scheduled to provide evidence at the Covid Inquiry on the 6 and 7 of December. Long Covid is one of the most catastrophic consequences of the pandemic and it deserves a prominent place in the discussions during this critical phase of the inquiry. The Long Covid Groups will be delivering a letter to No.10 Downing Street today, urging attention to the unique challenges faced by those with Long Covid. Read the letter and sign the petition
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Content ArticleA NIHR-funded study has reached an agreement amongst researchers and patients on how best to measure improvement in Long Covid. Researchers have identified a Core Outcome Measure Set (COMS). This is designed to help researchers and clinicians measure the severity and impact of Long COVID. COMS specify key things that should be measured in all patients. This improves how data can be compared and summarised. Researchers say this will speed up the development of treatments for Long Covid.
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News Article
The ‘wrecked’ lives of forgotten Long Covid sufferers
Patient Safety Learning posted a news article in News
Nearly four years since the start of the coronavirus outbreak, you could be forgiven for believing the pandemic is behind us. But for many, it feels far from over. Close to two million people face a daily battle with debilitating symptoms of Long Covid – the lasting symptoms of the virus that remain after the infection is gone – with some now housebound, unable to walk and even partially blind. Alan Chambers, 49, is among those who have been grappling with the illness for years, having caught coronavirus in March 2020. Mr Chambers went from being “a fit, healthy, working member of the community who would do anything to help anyone” to being “ill and isolated in our bedroom”, blind in one eye and no longer able to walk unaided, his wife Vicki said. As of March, an estimated 1.9 million people in the UK have experienced coronavirus symptoms for more than four weeks, according to the latest figures from the Office for National Statistics. Of those, 1.5 million reported the condition had adversely affected their day-to-day activities. It comes as coronavirus case rates have shown an overall increase since July, with fears the approaching winter will bring a further surge in infections. Yet in May, the World Health Organisation (WHO) declared that coronavirus no longer represents a global health emergency, which was seen as a symbolic step towards the end of the pandemic. Dr Jo House, founding member and health advocacy lead at Long Covid Support, said the advocacy group now has 62,000 members, with about 250 more people joining every month. “In their words, they feel ‘forgotten, unheard, disbelieved, isolated, unemployed, disabled, immobile’. NHS England admitted to The Independent that access to necessary support, treatment and care for Long Covid patients is still lacking. It said there was “still more to do to ensure support is there for everyone who needs it”, so that patients requiring specialist assessment and treatment for Long Covid can access care in a timely way. Read full story Source: The Independent, 29 November 2023 -
Content ArticleIn this video, the Long Covid Groups' KC Anthony Metzer questions Professor Kamlesh Khunti to find out if he agrees that Long Covid should be cited as a reason not to allow Covid-19 to spread unchecked via non-pharmaceutical interventions (NPIs). Professor Khunti is a member of SAGE and former Chair of the National Long Covid Research Working Group.
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News Article
Long Covid: MRI scans reveal new clues to symptoms
Patient Safety Learning posted a news article in News
People living with long Covid after being admitted to hospital are more likely to show some damage to major organs, according to a new study. MRI scans revealed patients were three times more likely to have some abnormalities in multiple organs such as the lungs, brain and kidneys. Researchers believe there is a link with the severity of the illness. It is hoped the UK study will help in the development of more effective treatments for Long Covid. The study, published in Lancet Respiratory Medicine, looked at 259 patients who fell so ill with the virus that they were admitted to hospital. Five months after they were discharged, MRI scans of their major organs showed some significant differences when compared to a group of 52 people who had never had Covid. The biggest impact was seen on the lungs, where the scans were 14 times more likely to show abnormalities. MRI scans were also three times more likely to show some abnormalities in the brain - and twice as likely in the kidneys - among people who had had severe Covid. Dr Betty Raman, from the University of Oxford and one of the lead investigators on the study, says it is clear that those living with long Covid symptoms are more likely to have experienced some organ damage. She said: "The patient's age, how severely ill they were with Covid, as well as if they had other illnesses at the same time, were all significant factors in whether or not we found damage to these important organs in the body." Read full story Source: BBC News, 23 September 2023 -
Content ArticleThe only masking that’s going on is that of the government’s continued failure to get to grips with the virus, writes George Monbiot in this Guardian opinion piece. For some people, going to hospital may now be more dangerous than staying at home untreated. Many clinically vulnerable people fear, sometimes with good reason, that a visit to hospital or the doctors’ surgery could be the end of them. Of course, there have always been dangers where sick people gather. But, until now, health services have sought to minimise them. Astonishingly, this is often no longer the case. Across the UK, over the past two years, the NHS has been standing down even the most basic precautions against Covid-19. For example, staff in many surgeries and hospitals are no longer required to wear face masks in most clinical settings. Reassuring posters have appeared even in cancer wards, where patients might be severely immunocompromised. A notice, photographed and posted on social media last week, tells people that while they are “no longer required to wear a mask in this area”, they should use hand sanitiser “to protect our vulnerable patients, visitors and our staff”. Sanitising is good practice. But Covid-19 is an airborne virus, which spreads further and faster by exhalation than by touch.
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Content ArticleFull opening statement of the Long Covid groups (Long Covid Support, Long Covid SOS and Long Covid Kids) to Module 2 of the Covid-19 Inquiry as representative organisations for nearly 2 million adults and children who have suffered from Long Covid.
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News ArticleThe U.S. Department of Health and Human Services (HHS), through the Agency for Healthcare Research and Quality (AHRQ), announced nine grant awards of $1 million each for up to 5 years to support existing multidisciplinary Long COVID clinics across the country to expand access to comprehensive, coordinated, and person-centered care for people with Long COVID, particularly underserved, rural, vulnerable, and minority populations that are disproportionately impacted by the effects of Long COVID. The grants are a first of their kind. They are designed to expand access and care, develop, and implement new or improved care delivery models, foster best practices for Long COVID management, and support the primary care community in Long COVID education. This initiative is part of the Biden-Harris Administration's whole-government effort to accelerate scientific progress and provide individuals with Long COVID the support and services they need. “The Biden-Harris Administration is supporting patients, doctors and caregivers by providing science-based best practices for treating long COVID, maintaining access to insurance coverage, and protecting the rights of workers as they return to jobs while coping with the uncertainties of their illness,” said Secretary Xavier Becerra. “Treatment of Long COVID is a major focus for HHS, and AHRQ is helping lead the way through grants to investigate best practices and get useful guidance to doctors, hospitals, and patients.” Read full story Source: AHRQ, 20 September 2023
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Content ArticleThis review, published in Nature Reviews Immunology, looks at the research and data relating to long-Covid. Subsections include: Symptoms Possible mechanisms of long COVID Long-term disease risk following COVID-19 Therapeutics and outlook
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Content ArticleUnable to work or to play with their children, forced to sell their homes or facing insolvency—doctors with Long Covid deserve more support from the government and the NHS, writes Adele Waters in this BMJ article.
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News Article
Brain fog after Covid linked to blood clots - study
Patient Safety Learning posted a news article in News
Blood clots in the brain or the lungs might explain some common symptoms of "Long Covid", including brain fog and fatigue, a UK study suggests. In the study, of 1,837 people admitted to hospital because of Covid, researchers say two blood proteins point to clots being one cause. It is thought 16% of such patients have trouble thinking, concentrating or remembering for at least six months. But the research team, from the universities of Oxford and Leicester, stress: Their findings are relevant only to patients admitted to hospital. They are "the first piece of the jigsaw" but further research is needed before they can propose or test any potential treatments. They tracked cognitive problems at six and 12 months only and through tests and questionnaires, which may "lack sensitivity". Identifying predictors and possible mechanisms was "a key step" in understanding post-Covid brain fog, study author Prof Paul Harrison, from the University of Oxford, said. Leicester's professor of respiratory medicine, Chris Brightling, said: "It's a combination of someone's health before, the acute event itself and what happens afterwards that lead on to physical and mental health consequences." Read full story Source: BBC News, 31 August 2023 -
Content ArticleThis study in the Journal of Medical Virology aimed to assess the extent and the disparity in excess acute myocardial infarction (AMI)-associated mortality during the pandemic, focusing on the outbreak of the Omicron strain. Using data from the US Centers for Disease Control and Prevention's (CDC's) National Vital Statistics System, the authors found that excess death, defined as the difference between the observed and the predicted mortality rates, was most pronounced for the 25–44 years age group. Excess deaths ranged from 23%–34% for the youngest compared to 13%–18% for the oldest age groups. The trend of mortality suggests that age and sex disparities have persisted even through the Omicron surge, with excess AMI-associated mortality being most pronounced in younger-aged adults.
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Content ArticleThe aim of the Long Covid webinar held on 5 July 2023 was to discuss where we are now with Long Covid clinics and research. The presentation videos from the webinar can be accessed from the link below.
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Content Article
My last blog, "Forgotten heroes" – the sequel, built upon a very moving BBC Panorama programme Forgotten heroes of the Covid front line. The BBC documentary told the sad story of healthcare workers (HCWs) who had bravely and knowingly put themselves in harm's way to care for their patients during the darkest days of the pandemic. Many lost their lives, while many more were rendered so severely injured by the disease (Long Covid) that they were (and remain) unable to work and have been unceremoniously sacked by their NHS Health Trusts/Boards. The way that an organisation manages its activities is known as 'governance'. Good governance will lead to high standards of ethics, morality, care and compassion for the people who work within it and those who may be affected by its acts and omissions. Hence, when applied to a whole country, it is known as 'Government', its departments and agencies. In this blog, I propose a possible hypothetical scenario that may have led to the tragic situation revealed by the BBC documentary. I hope this will lead you to consider the standards of 'governance' that apply to the 'duty of care' which a Government owes to its HCWs during a pandemic and what, morally and ethically, should be done to support those "forgotten heroes" if the Government’s governance should be found to be severely lacking. But is the scenario I am asking you to imagine hypothetical or is it real? I shall leave that to your judgement – and that of the Covid-19 Public Inquiry. -
Event
Spotlight on Long Covid: Part 3
Patient Safety Learning posted an event in Community Calendar
At least 65 million individuals worldwide are estimated to have Long Covid, and more than 200 symptoms have been identified and attached to this often-debilitating illness*. Three years on from the start of the pandemic we continue to navigate and build our understanding of Long Covid’s impact, its best treatment pathways and question what the future holds. Following on from their first two episodes in this series, The Royal Society of Medicine return to the topic with ‘Spotlight on Long Covid, part 3’. This extended webinar programme will present the most up-to-date knowledge of the condition, highlight findings from ongoing research and share key insights from clinicians, researchers and patients. Joining the webinar will be researchers from the LOCOMOTION study**, a £3.4 million project identifying the best ways to treat and support Long Covid, alongside clinicians who lead on the treatment, service development and our understanding of the long-term effects of COVID-19. By attending this webinar, you will: Receive an update on the latest statistics and research surrounding Long Covid Receive advice on how to manage and support patients with Long Covid Understand the treatment pathways currently available for those with Long Covid and how these pathways are resourced within the NHS Dive deeper into the key health topics within Long Covid, looking at symptoms, treatment, research and patient experience Register -
News Article
Mysterious new long Covid symptom identified by scientists
Patient-Safety-Learning posted a news article in News
A new symptom of long Covid has been revealed by scientists at the University of Leeds. Though most people who contract Covid recover within a few days or weeks of experiencing initial symptoms, some people can experience longer, more persistent symptoms – termed Long Covid or post Covid-19 syndrome by the NHS. Until now, the most commonly identified symptoms have included extreme tiredness, loss of smell, muscle aches and shortness of breath. Others include memory problems, chest pain, insomnia, heart palpitations, dizziness, joint pain, tinnitus and depression and anxiety. Now, a new study has revealed a previously unidentified symptom of long Covid. Published in The Lancet medical journal, the research detailed a new symptom of the condition after a 33-year-old man was referred to the specialists’ clinic. The patient had a six-month history of what the authors describe as a “rapid purple discolouration” on his legs. When standing, he remarked that they would feel progressively heavier and become “tingly, itchy and dusky” in colour. He added that a rash would occasionally appear on his feet, but that the mysterious symptoms would disappear when laying down. The disorder is known as acrocyanosis or persistent and extreme blue or cyanotic discolouration. It typically occurs in the hands and feet but can also appear across the nose and ears. “This was a striking case of acrocyanosis in a patient who had not experienced it before his Covid-19 infection”, said co-author Dr Manoj Sivan, associate clinical professor and honorary consultant in rehabilitation medicine at the University of Leeds. “Patients experiencing this may not be aware that it can be a symptom of Long Covid and dysautonomia, and may feel concerned about what they are seeing. Similarly, clinicians may not be aware of the link between acrocyanosis and Long Covid. We need to ensure that there is more awareness of dysautonomia [malfunctioning of the nervous system] in Long Covid so that clinicians have the tools they need to manage patients appropriately.” Read full story Source: The Independent, 15 August 2023 -
Content ArticleIn a new Lancet Respiratory Medicine Series about Long Covid, Sally J Singh and colleagues discuss the origins of respiratory sequelae and consider the promise of adapted pulmonary rehabilitation programmes and physiotherapy techniques for breathing management. Pratik Pandharipande and colleagues review the epidemiology and pathophysiology of neuropsychological sequelae of COVID-19-related critical illness, highlighting the combined threat of long COVID and post-intensive care syndrome (PICS), and outline potential mitigation strategies. Finally, Matteo Parotto and colleagues discuss pathophysiological mechanisms of diverse, multisystem sequelae in adult survivors of critical illness, including longitudinal effects of endothelial and immune system dysfunction, and consider the challenges of providing appropriate care and support for patients.
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Content Article
As reported recently, the Scottish Healthcare Workers Coalition called upon the Scottish Government to reinstate 'universal masking' in health and social care settings. In this statement written in support of their campaign, an occupational safety and health practitioner, David Osborn, explains the legal requirements for risk assessments that the Government ought to have undertaken before reaching such a decision that exposes healthcare staff to the life-changing consequences associated with repeat Covid-19 infections. He also explains the legal duty of the Government to consult with workers before implementing changes that may affect their health and safety. Neither duty (risk assessment nor prior consultation with workers) appears to have been well met, putting the Scottish Government and Health Boards in breach of UK-wide health and safety law. -
Content Article
The UK Covid-19 Inquiry is the independent public inquiry set up to examine the UK’s response to and impact of the Covid-19 pandemic, and learn lessons for the future. In order to fully understand the impact of the pandemic on the UK population, the Inquiry is inviting the public to share their experiences of the pandemic by launching Every Story Matters. It will inform the Inquiry’s work by gathering pandemic experiences which can be brought together and represent the whole of the UK, including those seldom heard. The output of Every Story Matters will be a unique, comprehensive account of the UK population’s experiences of the pandemic, to be submitted to the Inquiry’s legal process as evidence. This toolkit contains information and creative assets that can be used to encourage participation in Every Story Matters. Every Story Matters aims to provide inclusive methods for people to talk about their experience of the pandemic, so anyone that wants to share their story feels heard, valued, and can contribute to the Inquiry. -
News Article
Doctors call for return of face mask guidance
Patient Safety Learning posted a news article in News
Doctors have warned the decision to remove face mask guidance in healthcare settings is "playing Russian roulette" with staff and patients' welfare. It was withdrawn in May in hospitals, dentists and GP surgeries having been in place since June 2020. Doctors from the British Medical Association (BMA) Scotland condemned the decision at the time. Now, the Scottish Healthcare Workers Coalition has written to ministers to highlight the "very serious flaws" in changing the guidance. The group is made up of Scottish healthcare workers who worked throughout the pandemic and are now living with long Covid or another chronic post-viral illness or disability. In the letter, the coalition states the updated guidance is not based on the science of coronavirus transmission and "represents a flawed and dangerous decision which will result in more infection in health and social care settings". Dr Shaun Peter Qureshi, of the Scottish Healthcare Workers Coalition, said: "At-risk patients have entirely legitimate concerns that they may endanger their health by visiting their GP or hospital. "With at least 4% of NHS staff now living with chronic post-Covid complications, the Scottish government must follow the evidence and improve protections from the airborne spread (of the virus) in healthcare settings, not reduce them." Read full story Source: BBC News, 17 July 2023 -
News Article
Long Covid causing 'debilitating impact' on doctors
Patient Safety Learning posted a news article in News
A "significant" number of doctors are still suffering with the "debilitating effects" of Long Covid, according to a new report. Many are left in financial limbo as they have been forced to quit work or reduce their hours, the British Medical Association (BMA) report warns. Some 600 doctors with long COVID were quizzed about the impact on their day-to-day lives. One in five told the BMA and the Long COVID Doctors for Action group they had been forced to stop work or significantly cut back on their hours. Carrying out essential daily activities such as getting dressed, household activities, and childcare have become difficult or not possible for 60% of the medics who took part in the survey. Nearly half (49%) said they have experienced loss of earnings as a result of Long Covid symptoms of which include: fatigue, headaches, muscular pain, nerve damage, joint pain, ongoing respiratory problems. The BMA has made a series of calls to support doctors with Long Covid, including: Financial support for doctors and other health workers with Long Covid. Long Covid to be recognised as an "occupational disease". Better access to physical and mental health services for those affected after the report said that access to NHS long COVID clinics is "patchy". Greater "workplace protection" for staff. More support to help healthcare workers return to work "safely". Read full story Source: Medscape, 3 July 2023 -
Content ArticleA significant number of doctors and other healthcare workers have developed post-acute COVID, including a large number who developed it as a result of workplace exposure to Covid-19. This paper examines the impact post-acute Covid symptoms have had on the medical workforce, personally and professionally. It provides a unique and valuable insight into the experience of UK doctors suffering from post-acute Covid. It has been informed by a UK survey of over 600 doctors suffering from the continuing effects of an infection with Covid-19, as well as wider research of the issues. The survey was undertaken by the British Medical Association (BMA) in partnership with Long COVID Doctors for Action. This is the first comprehensive survey of doctors with post-acute Covid health complications. This paper should inform the support needed by current sufferers of post-acute COVID in the NHS workforce, and help protect services and patients now and in the future.
