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Found 287 results
  1. Content Article
    This blog looks at evidence around the impact of universal masking in healthcare settings on infection rates. Highlighting a recent study carried out at St. George’s Hospital in London that showed universal to have a negligible benefit on infection control amongst patients, the author argues that it is time to move away from universal masking to masks being worn really carefully as part of PPE for dealing with respiratory symptoms.
  2. Content Article
    The theme of this year’s International Long Covid Awareness Day is ‘Confront Long Covid: Recognise, prevent, act’. In this interview, we speak to retired occupational physician Dr Clare Rayner about her work in understanding Long Covid and its impact on individuals, the health service and the wider economy. She talks about recent guidance she has developed on people with Long Covid returning to work and outlines the impact Long Covid has on the workforce. She calls on healthcare leaders and the Government to invest in treatment-related research as well as highlighting the significant health risks associated with Covid reinfection.
  3. Content Article
    In this blog, I discuss the limitations associated with FFP3 (Filtering Face Piece) tight-fitting masks as respiratory protective equipment (RPE) for the healthcare sector during the ongoing Covid pandemic. I highlight inequalities in the distribution of effective RPE among healthcare workers (HCWs) and also draw attention to the underlying reasons for the shortage of RPE that has beset our healthcare services since the start of the pandemic.
  4. News Article
    Nearly 70 healthcare workers with Long Covid will take their fight to the High Court later to sue the NHS and other employers for compensation. The staff, from England and Wales, believe they first caught Covid at work during the pandemic and say they were not properly protected from the virus. Many of them say they are left with life-changing disabilities and are likely to lose income as a result. The Department of Health said "there are lessons to be learnt" from Covid. The group believe they were not provided with adequate personal protective equipment (PPE) at work, which includes eye protection, gloves, gowns and aprons. In particular, they say they should have had access to high-grade masks, which help block droplets in the air from patient's coughs and sneezes which can contain the Covid virus. But the masks they were given tended to be in line with national guidance. Rachel Hext, who is 36, has always insisted that she caught Covid in her job as a nurse in a small community hospital in Devon. "It's devastating. I live an existence rather than a life. It prevents me doing so much of what I want to do. And it's been four years." Her list of long Covid symptoms includes everything from brain fog and extreme fatigue to nerve damage, and deafness in one ear. Solicitor Kevin Digby, who represents more than 60 members of the group, describes their case as "very important". He says: "It's quite harrowing. These people really have been abandoned, and they are really struggling to fight to get anything. "Now, they can take it to court and hope that they can get some compensation for the injuries that they've suffered." Read full story Source: BBC News, 6 March 2024 Related reading on the hub: Healthcare workers with Long Covid: Group litigation – a blog from David Osborn The pandemic – questions around Government governance: a blog from David Osborn
  5. Content Article
    This descriptive and cross-sectional study in the Journal of Patient Safety aimed to examine the impact of nurses’ fear of Covid-19 on their nursing care behaviour during the pandemic. 450 nurses providing one-on-one care to Covid-19 patients between January and March 2021 took part in the study. The results showed that nurses providing care to patients during the pandemic feared Covid-19, that their care behaviours were generally at a good level, and that the care behaviours of nurses with a high degree of fear were negatively and significantly impacted.
  6. Content Article
    Extracts of a letter from David Osborn to the UK Covid-19 Public Inquiry Legal Team regarding misleading evidence by Professor Yvonne Doyle, which: Highlights errors in Prof Yvonne Doyle’s evidence to the Inquiry relating to the declassification of Covid‑19 as a high consequence infectious disease. Calls into question Professor Sir Jonathan Van Tam’s evidence to the Inquiry in which he sought to attribute responsibility for the downgrade from FFP3 to FRSM to Public Health England. The letter sets out his involvement in the issue of the 4-Nations IPC guidance version 1.0 which implemented that downgrade. Further reading on the hub: Healthcare workers with Long Covid: Group litigation – a blog from David Osborn
  7. Content Article
    A forthcoming three-part ITV drama Breathtaking, set in a fictionalised London hospital, tells the devastating impact of the Covid-19 pandemic through the eyes of Acute Medical Consultant Dr Abbey Henderson. The series is based on Dr Rachel Clarke’s book of the same name. She worked on Covid wards and is also one of the writers on the series. Rachel joins Women's Health host Emma Barnett to discuss it. Listen from 1:40
  8. Content Article
    How does it feel to confront a pandemic from the inside, one patient at a time? To bridge the gulf between a perilously unwell patient in quarantine and their distraught family outside? To be uncertain whether the protective equipment you wear fits the science or the size of the government stockpile? To strive your utmost to maintain your humanity even while barricaded behind visors and masks? Rachel is a palliative care doctor who looked after some of the most gravely unwell patients on the Covid-19 wards of her hospital. Amid the tensions, fatigue and rising death toll, she witnessed the courage of patients and NHS staff alike in conditions of unprecedented adversity. For all the bleakness and fear, she found that moments that could stop you in your tracks abounded. People who rose to their best, upon facing the worst, as a microbe laid waste to the population.
  9. Content Article
    In December 2022, a newly formed group called 'Long Covid Doctors for Action' (LCD4A) conducted a survey to establish the impact of Long Covid on doctors. When the British Medical Association published the results of the survey, the findings were both astonishing and saddening in equal measure.[1] The LCD4A have now decided that enough is enough and that it is now time to stand up and take positive action. They have initiated a group litigation against those who failed to exercise the ‘duty of care’ that they owed to healthcare workers across the UK during the pandemic.  In this blog, I summarise how and why I feel our healthcare workers have been let down by our government and why, if you are one of these healthcare workers whose life has been effected by Long Covid, I urge you to join the group litigation initiative.
  10. Content Article
    Katie Hurst is a general surgery registrar based in the Thames Valley Deanery and chair of the Trainees’ Committee for the Royal College of Surgeons of Edinburgh. In our interview, Katie speaks about the work she is doing with the Royal College of Surgeons of Edinburgh on raising awareness and protecting staff from ionising radiation.
  11. Content Article
    Hundreds of doctors - led by campaign group Long Covid Doctors for Action - are planning to sue the NHS over claims that inadequate PPE provision has left them with Long Covid. One of those, Dr Nathalie MacDermott, joins Women's Health host Emma Barnett to discuss it. Listen from 2:40
  12. Content Article
    The BMA has sent a letter to Amanda Pritchard, Chief Executive of NHS England, highlighting the increasing concerns from their members about the protection of healthcare workers and patients from Covid-19, particularly in light of the rise in cases, hospitalisations and deaths that occurred in September and October. 
  13. News Article
    The Royal College of Nursing has warned of an increase risk of Covid among hospital staff and patients due to the NHS’s failure to follow World Health Organization advice about infection control during a current spike in cases. The most recent figures showed one in 24 people in England and Scotland had Covid on 13 December, up from one in 55 two weeks before. Last week WHO expressed concern about a new subvariant of Omicron, labelled JN.1, after its rapid spread in the Americas, western Pacific and European regions. To tackle the increase, the WHO advised that all health facilities “implement universal masking” and give health workers “respirators and other PPE”. Now the RCN has written to the four chief nursing officers in England, Wales, Scotland and Northern Ireland asking why this guidance has not been introduced across the NHS. The letter, seen by the Guardian, points out that existing guidance in the national infection prevention and control manual (NIPCM) does not mandate hospital staff to use masks. It also leaves decisions about respirators to local risk assessors. The RCN says this guidance to UK hospitals is “inconsistent” with WHO advice. The letter by Patricia Marquis, the RCN’s director for England, calls for urgent revision to the NIPCM guidance to ensure the “universal implementation” of masks and respirators for health workers. Read full story Source: The Guardian, 22 December 2023
  14. Content Article
    The Covid-19 pandemic increased the sense of urgency to advance understanding and prevention of infectious respiratory disease transmission. There are extensive studies that demonstrate scientific understanding about the behaviour of larger (droplets) and smaller (aerosols) particles in disease transmission as well as the presence of particles in the respiratory track. Methods for respiratory protection against particles, such as N95 respirators, are available and known to be effective with tested standards for harm reduction. However, even though multiple studies also confirm their protective effect when N95 respirators are adopted in healthcare and public settings for infection prevention, overall, studies of protocols of their adoption over the last several decades have not provided a clear understanding. This preprint article demonstrates limitations in the methodology used to analyse the results of these studies. The authors show that existing results, when outcome measures are properly analysed, consistently point to the benefit of precautionary measures such as N95 respirators over medical masks, and masking over its absence.
  15. Content Article
    During the bleak early years of the Covid pandemic, if there was one thing we were all doing, it was “following the science”. This, we were repeatedly assured, was what was driving all the government’s tough decisions. We might not like all its policies but we shouldn’t, it was implied, argue. After all, it was – always – just “following the science”. But was it really? In her evidence to the Covid inquiry, former civil servant Helen MacNamara revealed that in April 2020, the then prime minister, Boris Johnson, asked the former chief executive of the NHS in England, Simon Stevens, about reports that female frontline healthcare workers were struggling with PPE that had been designed for men. Stevens is said to have “reassured” the prime minister that there was “no problem”. However, as Caroline Criado Perez highlights, report after report over decades has found that while PPE is usually marketed as gender-neutral, the vast majority has in fact been designed around a male body, and therefore neither fits nor protects women. In fact, more often than not, it’s a hindrance.
  16. Content Article
    The 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.
  17. Content Article
    Unable 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.
  18. 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. 
  19. News Article
    The UK government failed in its duty of care to protect doctors and other healthcare staff from avoidable harm and suffering in its management of the covid-19 pandemic, a major review by the BMA has concluded. Two reports published on 19 May document the experiences of thousands of UK doctors throughout the pandemic, drawing on real time surveys carried out over the past two years, formal testimonies, data, and evidence sessions. The reports will form part of a wider review by the BMA into the government’s handling of the pandemic, with three further instalments to come. The evidence lays bare the devastating impact of the pandemic on doctors and the NHS, with repeated mistakes, errors of judgment, and failures of government policy amounting to a failure of a duty of care to the workforce, the BMA said. Chaand Nagpaul, BMA chair of council, said, “A moral duty of government is to protect its own healthcare workers from harm in the course of duty, as they serve and protect the nation’s health. Yet, in reality, doctors were desperately let down by the UK government’s failure to adequately prepare for the pandemic, and their subsequent flawed decision making, with tragic consequences. “The evidence presented in our reports demonstrates, unequivocally, that the UK government failed in its duty of care to the medical profession.” Read full story Source: BMJ, 19 May 2022
  20. News Article
    The national supply chain agency will bring management of significant areas of NHS spend in-house on a permanent basis in a major overhaul of its operating model, HSJ has been told. NHS Supply Chain’s current operating model, which has existed since 2018, has outsourced day-to-day management of the procurement of most of the goods and services bought by trusts as part of the “category towers” structure. Under this structure, 11 category towers each cover a different spend area with a service provider to manage the available products and services. But, in an exclusive interview, NHSSC chief Andrew New said the 11 categories would be reduced to eight. Three of the new categories — personal protective equipment, “medical capital” (which combines large capital diagnostics equipment with smaller scale diagnostics, pathology and point of care testing categories) and “medical clinically complex” surgical products and services — would be managed in-house. The new model will come into effect in 2023-24 following a procurement process to find new suppliers for the revamped category structure, which starts on 11 April 2022 with the publication of the contract notice. Read full story (paywalled) Source: HSJ, 4 April 2022
  21. News Article
    NHS staff face unacceptable health risks as a result of “retrograde” changes to the government’s guidance on preventing spread of Covid-19, doctors’ leaders have warned. The BMA said on 16 March it was concerned over updated guidance issued by the UK Health Security Agency covering use of personal protective equipment. It said the guidance failed to properly acknowledge that SARS-CoV-2 infection can spread in the air during the routine care of patients as they cough or sneeze and not just when specific processes known as aerosol generating procedures (AGPs) are being undertaken. “This is a retrograde step as it once again means that healthcare workers will not be routinely provided the right level of protective masks and equipment they need to be safe at work when looking after covid patients,” said Chaand Nagpaul, the BMA’s chair of council. The BMA said it was crucial that any staff looking after patients with confirmed or suspected Covid-19, or in other situations where a local risk assessment required it, had access to respiratory protective equipment such as filtering face piece (FFP3) masks. Nagpaul said, “All healthcare workers who are caring for Covid-19 patients are putting themselves at risk, each and every day, and the very least the government should do is to provide surety that staff will be given the best protection possible.” Respirators such as FFP3 masks are designed to protect the wearer from ingress of contaminated air and are fitted to ensure no gaps. They offer higher protection than surgical masks, which block the outward escape of droplets from the wearer. The BMA’s concern follows a supposed clarification of the main messages regarding airborne transmission in the latest infection and prevention and control guidance issued on 15 March 2022. The guidance said that respiratory protective equipment (FFP3 masks) are recommended when caring for patients with a suspected or confirmed infection spread “predominantly” by the airborne route (during the infectious period). The word “predominantly” has been added to the previous guidance update, which was issued on 17 January 2022, and is the crux of doctors’ concern, one leading scientist said. Read full story Source: BMJ, 18 March 2022
  22. News Article
    Nearly one in five items of personal protective equipment (PPE) the government bought during the pandemic are not fit for purpose and cannot be used by the NHS, it has been revealed – including 1.2 billion items that cannot be used at all. As of December, almost 7 billion items of personal protective equipment bought for frontline services – 19.1% of the 36.4 billion items bought since February 2020 – had been marked “do not supply” to the NHS by the Department of Health and Social Care. The number is more than three times the figure quoted last September, when health minister Lord Bethell admitted 1.9 billion items worth £2.8bn were in the “do not supply” category – 6.2% of the PPE bought up to that point. The not-fit-for-purpose stock includes 1.2 billion units of PPE that cannot be used in any setting. This "wastage" – which accounts for 3.3% of pandemic PPE – includes around 800m aprons that DHSC is now looking to recycle, permanent secretary Sir Chris Wormald said in a letter to the Public Accounts Committee. The revelation comes as a consultation opens on the terms of reference for the public inquiry into the government's response to Covid. The inquiry will look at pandemic preparedness and the healthcare response, among other things. Read full story Source: Civil Service World, 11 March 2022
  23. News Article
    The draft terms of reference for the UK public inquiry into the government's handling of the Covid-19 pandemic have been published. The inquiry, due to start in the spring, will play a key role in "learning lessons" from the pandemic and for the future, it said. The terms of reference were published after a consultation with inquiry chairwoman and former High Court judge Baroness Hallett, and with ministers in the devolved nations. The Scottish government has already published the terms of reference for its own Covid-19 inquiry, to be led by Judge Lady Poole. The UK-wide inquiry proposes examining a broad range of issues including: the UK's preparedness for the pandemic the use of lockdowns and other 'non-pharmaceutical' interventions such as social distancing and the use of face coverings the management of the pandemic in hospitals and care homes the procurement and provision of equipment like personal protective equipment and ventilators support for businesses and jobs, including the furlough scheme, as well as benefits and sick pay. The inquiry aims to produce "a factual, narrative account" covering decision-making at all levels of government and the response of the health and care sector as well as identifying the "lessons to be learned". Becky Kummer, spokesperson for Covid-19 Bereaved Families for Justice, said the publication was a "huge step forward" and the organisation looked forward to contributing to the consultation on the terms. Chris Hopson, chief executive of NHS Providers, which represents hospital trusts, said there was much the NHS did well during the pandemic but: "It is right the inquiry looks at areas where there were major challenges - such as infection prevention and control, access to PPE, testing, and robust epidemiological modelling." Read full story Source: BBC News, 11 March 2022
  24. News Article
    Up-to-date registers of clinically vulnerable patients must be created to ensure that those who are most at risk during Covid-19 and any future pandemics are protected and can access the support they need, a report from the All-Party Parliamentary Group (APPG) on Vulnerable Groups to Pandemics has recommended. The report considered vulnerable people’s experiences during the pandemic and makes 16 recommendations on what the government and the health service can do better to plan and prioritise extremely vulnerable patients during further Covid-19 outbreaks and future pandemics. These tackle the format and content of information and guidance; access to medical services such as mental health support to help people deal with anxiety, fear, and isolation; provision of practical support such as food and finance when isolating; and the need for more research into how medical conditions make people more vulnerable to a threat and vaccines less protective. At the launch of the report representatives of charities and patient groups described how the pandemic had left clinically vulnerable people feeling anxious, afraid, lonely, trapped, and desperate. They also described the “not on the list” scenario many had had to contend with, meaning they could not access priority services such as testing or support to isolate. There were still patients whose doctors recognised that they should be on the list fighting to get their condition recognised, said Susan Walsh, chief executive of Immunodeficiency UK. This means that, under the government’s Living with Covid plans, they will no longer be able to access free testing. Lord Mendelsohn, co-chair of the APPG on Vulnerable Groups to Pandemics, said, “We should be more willing to allow the medical practitioners responsible for these patients to be able to overhaul computerised systems and find ways to make that happen.” Read full story Source: BMJ, 28 February 2022
  25. News Article
    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
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