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Found 30 results
  1. News Article
    I fell sick on 25 March. Four months later, I’m still dealing with fever, cognitive dysfunction, memory issues and much more I just passed the four-month mark of being sick with Covid. I am young, and I had considered myself healthy. My first symptom was that I couldn’t read a text message. It wasn’t about anything complex – just trying to arrange a video call – but it was a few sentences longer than normal, and I couldn’t wrap my head around it. It was the end of the night so I thought I was tired, but an hour later I took my temperature and realized I had a fever. I had been isolating for 11 days at that point; the only place I had been was the grocery store. My Day 1 – a term people with Long Covid use to mark the first day of symptoms – was 25 March. Four months later, I’m still dealing with a near-daily fever, cognitive dysfunction and memory issues, GI issues, severe headaches, a heart rate of 150+ from minimal activity, severe muscle and joint pain, and a feeling like my body has forgotten how to breathe. Over the past 131 days, I’ve intermittently lost all feeling in my arms and hands, had essential tremors, extreme back, kidney and rib pain, phantom smells (like someone BBQing bad meat), tinnitus, difficulty reading text, difficulty understanding people in conversations, difficulty following movie and TV plots, sensitivity to noise and light, bruising, and petechiae – a rash that shows up with Covid. These on top of the CDC-listed symptoms of cough, chills and difficulty breathing. Read the full article here.
  2. News Article
    Plans for a mass expansion of rehabilitation beds in new “Seacole centres” have been scrapped, with local leaders now told there is no capital funding to build them. In late May, NHS England announced the “first” Seacole Centre in Surrey, for patients recovering from coronavirus, and asked other local systems to draw up proposals for similar units ahead of a possible second peak of the virus over winter. The policy was designed to provide significant extra bed capacity to help get covid and other respiratory patients out of hospital more quickly, while offering effective rehab care. But multiple well-placed sources have now told HSJ that capital bids for new Seacole units have been rejected. In a statement, NHSE said: “Work with local NHS and social care providers suggests that these expanded rehab services can largely be provided in existing physical facilities as well as people’s own homes, so government has not allocated extra capital in year for this purpose.” However, local leaders told HSJ that some of the plans to use “existing physical facilities” still required some capital funding to make them suitable for rehab care. One trust executive in the North West said: “If there’s no capital it means we can’t go ahead.” Read full story (paywalled) Source: HSJ, 5 August 2020
  3. Content Article
    There is a lot to be uncertain about these days: school, work, health, family. However, in July one thing was certain: the streaming release of “Hamilton” in the US was going to be epic. The acclaimed musical production tells the story of a U.S. founding father Alexander Hamilton, intensely American, exploring themes of love, anger, arrogance, heroism, betrayal, mistakes, politics, policy, devotion, family, sacrifice and death. In some ways, it sounds like healthcare in the era of COVID-19. While months of the coronavirus pandemic are behind us, the uncertainties caused by the pace of change and the expected surge of further infection spread bring continued stress, fear and frustration. Disruptions to services, processes and relationships are rampant. They demand continued experimentation across healthcare to address concerns to keep patients, communities and healthcare workers safe. And the lack of a coordinated collective policy response to the crisis only perpetuates discomfort about the unreliability of actions to improve safety and the substantial costs the future holds in store. Ambiguities and dread due to the pandemic are problematic and will be for some time. Continued patient avoidance of care is evident and could be contributing to lack of timely care and diagnosis. An ImproveDx article summarises how fear is keeping patients from getting the care they need, and highlights the importance of recognising that rebuilding trust will take time. To anchor this effort, leaders must view risk as individuals see it rather than just an academic exercise to inform reentry strategies in the months to come. The unsettled nature of care and access to loved ones during COVID can make end-of-life planning particularly fraught with uncertainty. Stanford University School of Medicine has developed the GOOD framework for clarifying steps forward when working with patients and families facing palliative care decisions during the pandemic. Its four elements – Goals, Options, Opinions and Documentation – provide an effective structure for clinicians to have conversations with patients and families to address care management when the path forward is unclear. Prolonged uncertainty can degrade healthcare staff mental and physical health. In Hawaii, one health system sought to make antibody testing available to staff as a strategy to decrease anxiety and improve sensemaking around the crisis. Hawai`i Pacific Health in NEJM Catalyst explores the reasons why those who were tested opted into the programme. The authors found “curiosity” to be a primary motivator. Knowing something – whether positive or not – can reduce one aspect of uncertainty, which the article posits will help clinicians and their community think beyond the doubt to achieve a modicum of control. This single piece of stability will enable a willingness to gather information, to plan and to act. Despite the challenge uncertainty brings, there are individuals who consistently believe the future holds promise. People who are able to act and make a difference despite uncertainty. Much has been said about those in the midst of the COVID-19 crisis, but others continue to address persistent uncertainties and unreliableness of care – beyond the pressures of the pandemic. There are many whose tenacity shores up the foundations of the healthcare system to improve its safety. One such leader from the US, John Eisenberg MD, is celebrated every year through an award programme in his name. John was a founding father of patient safety in the US. Through his leadership, national research and improvement programmes were developed and funded to lead government efforts to improve quality and safety. In July for the first time, the John Eisenberg Patient Safety and Quality Awards were bestowed virtually. These awards recognise individuals, local efforts and national programmes whose work provides evidence of the value and commitment to engage in work to improve safety. This year’s recipients demonstrated values core to improvement and perseverance in their work toward achieving healthcare that is safe. The awardees have accomplishments that focused on diagnostic error and sepsis reduction. Each of these stories started in tests and trials motivated by commitment to getting healthcare to a better place. For example, Tennessee-headquartered HCA Healthcare was recognised for its SPOT (Sepsis Prediction and Optimization of Therapy) algorithm as a mechanism to identify sepsis quickly to enhance quality and patient safety. Through this enhanced use of technology, SPOT uses basic laboratory and clinical data in real time to provide teams with the information they needed to reduce sepsis mortality across their 173-hospital system. Data triggered alerts that initiated actions to decrease response times by approximately 6 hours rather than relying on shift change as the information sharing mechanism. The SPOT algorithm enhancement to the electronic medical record partnered well with existing sepsis management processes to arrive at improvements. In the climax of Hamilton’s first act, the battle of Yorktown culminates in a chorus of “the world turned upside down”, with the hope that the cacophony will ultimately result in a new country with new freedoms only imagined prior to crisis. It is certain that COVID disruptions will continue to test us all worldwide. Can we challenge ourselves, our peers and our leaders to experiment as necessary to confront COVID-19 while guaranteeing that what was learned will be used to create something better?
  4. News Article
    Trusts have been set a series of “very stretching” targets to recover non-covid services to nearly normal levels in the next few months, in new guidance from NHS England. NHS England and Improvement set out the system’s priorities for the remainder of 2020-21 in a “phase three letter” sent to local leaders. It said the NHS must “return to near-normal levels of non-covid health services, making full use of the capacity available in the ‘window of opportunity’ between now and winter”, when further emergency and covid pressures are anticipated. In recent weeks providers have found it very difficult to resume many services, with many running at well below normal capacity, due to infection prevention measures, staffing gaps, and other covid-related barriers. The targets in the new guidance for phase three of the NHS’s covid response include: In September trusts must deliver “at least 80 per cent of their last year’s activity for both overnight electives and for outpatient/daycase procedures, rising to 90% in October (while aiming for 70% in August)”; “This means that systems need to very swiftly return to at least 90 per cent of their last year’s levels of MRI/CT and endoscopy procedures, with an ambition to reach 100 per cent by October.” “Trusts must hit 100 per cent of their last year’s activity for first outpatient attendances and follow-ups (face to face or virtually) from September through the balance of the year (and aiming for 90 per cent in August).” Read full story (paywalled) Source: HSJ, 31 July 2020
  5. Content Article
    Following discussion with patients’ groups, national clinical and stakeholder organisations, and feedback from seven regional ‘virtual’ frontline leadership meetings, NHS England and Improvement have set out NHS priorities for this third phase. Their shared focus is on: Accelerating the return to near-normal levels of non-Covid health services, making full use of the capacity available in the ‘window of opportunity’ between now and winter. Preparation for winter demand pressures, alongside continuing vigilance in the light of further probable Covid spikes locally and possibly nationally. Doing the above in a way that takes account of lessons learned during the first Covid peak; locks in beneficial changes; and explicitly tackles fundamental challenges including: support for our staff, and action on inequalities and prevention. As part of this Phase Three work, and following engagement and discussion, NHS Engagement and Improvement have published a more detailed 2020/21 People Plan,
  6. News Article
    The list of lingering maladies from COVID-19 is longer and more varied than most doctors could have imagined. Ongoing problems include fatigue, a racing heartbeat, shortness of breath, achy joints, foggy thinking, a persistent loss of sense of smell, and damage to the heart, lungs, kidneys and brain. The likelihood of a patient developing persistent symptoms is hard to pin down because different studies track different outcomes and follow survivors for different lengths of time. One group in Italy found that 87% of a patient cohort hospitalized for acute COVID-19 was still struggling 2 months later. Data from the COVID Symptom Study, which uses an app into which millions of people in the United States, United Kingdom, and Sweden have tapped their symptoms, suggest 10% to 15% of people—including some “mild” cases—don’t quickly recover. But with the crisis just months old, no one knows how far into the future symptoms will endure, and whether COVID-19 will prompt the onset of chronic diseases. One such patient is Athena Akrami. Her early symptoms were textbook for COVID-19: a fever and cough, followed by shortness of breath, chest pain, and extreme fatigue. For weeks, she struggled to heal at home. But rather than ebb with time, Akrami’s symptoms waxed and waned without ever going away. She’s had just 3 weeks since March when her body temperature was normal. “Everybody talks about a binary situation, you either get it mild and recover quickly, or you get really sick and wind up in the ICU,” says Akrami, who falls into neither category. Thousands echo her story in online COVID-19 support groups. Outpatient clinics for survivors are springing up, and some are already overburdened. Akrami has been waiting more than 4 weeks to be seen at one of them, despite a referral from her general practitioner. Read full story Source: Science, 31 July 2020
  7. Community Post
    Why do we need GP referrals to this service for assessment? Early patients untested cannot get access to GPs, not being believed, dismissed, told they are delusional. se have been sat for months unable to get referrals ...today someone got a referral and the NHS denied them that too. So we are getting no support. We are having a host of around 200 effects (Ive documented them), most of us are weeks 12 to 33 and having lung cognitive and heart problems. We needs mri and ct scans now and we cant be joining the back of already lengthy outpatient appointments. theresa huge backlog. When is someone going to help us? #longtailgoing viral @postcovidsynd Post Covid 19 Syndrome Support Group International (facebook). Sir Simon Stevens from NHS England doesn't have time to answer our letter, he said the Seacole Centre has been set up...but it only takes tested positive patietns and the phone numbers don't work. He told us to watch himself on the Andrew Marr show..which was about this app. As you can see we still cant get referrals here either as we need GP referrals adn we cant get them/..did no one raise this? I think they did...as I did with Senior Government Advisors. Nothing has been offered to untested patients. The medical community are very much aware that we were sent home so to deny we are sick and label it as anxiety is a scandal. Likewise, graded therapy (I note exercise is on here) is not recommended as we have heart problems and some of us have done it and had heart attacks...dangerous information to share with people suffering 200 symptoms thatt the medical community have not followed us on .... health-problems (1).pdf
  8. News Article
    People are being warned to familiarise themselves with the symptoms of sepsis after a study found that as many as 20,000 COVID-19 survivors could be diagnosed with the condition within a year. One in five people who receive hospital treatment for the coronavirus are at risk, according to the UK Sepsis Trust. Sepsis is triggered when the body overreacts to an infection, causing the immune system to turn on itself - leading to tissue damage, organ failure and potentially death. If spotted quickly, it can be treated with antibiotics before it turns into septic shock and damages vital organs. Read the full article here.
  9. Event
    Our ICUsteps trustees and invited guests answer questions about recovery from critical illness and what patients and relatives can do to help support their recovery. Book here
  10. News Article
    The Centers for Disease Control and Prevention acknowledged last week that a significant number of COVID-19 patients do not recover quickly, and instead experience ongoing symptoms, such as fatigue and cough. As many as a third of patients who were never sick enough to be hospitalized are not back to their usual health up to three weeks after their diagnosis, the report found. Read the full article here
  11. Community Post
    A video has been produced featuring @Ron Daniels that gives some useful information based on the joined up working between these two organisations. Watch the video on Youtube (1:34 mins) here
  12. Content Article
    HSJ revealed this month that the ’call before you walk’ model is being trialed in London, Portsmouth and Cornwall, with system leaders keen for a wider roll-out ahead of winter. In these trials, which have received the backing of the Royal College of Emergency Medicine, NHS 111 is being used as a “triage point” enabling patients needing urgent treatment, but not facing medical emergencies, to book access to primary care, urgent treatment centres or same-day emergency “hot clinics” staffed by specialists. Emergency patients just walking in, or those arriving via ambulance, will be treated, in theory, as per the current system. Similar models are used in Denmark, Norway and the Netherlands where they have high approval ratings. But these are vastly different healthcare systems with better resourced out of hospital services. So, can the model work in the English NHS? It is critical to view efforts to introduce ‘call before you walk’ in the wider policy context. The move is part of a far wider radical overhaul of emergency care pathways broadly designed to address the dangerous overcrowding seen in EDs in recent years.
  13. Content Article
    You may also like to watch: 2-minute Tuesdays: Guidance in a time of flux 2-minute Tuesdays: Safer apps for safer patients
  14. News Article
    Health Secretary Matt Hancock admits he is "worried" about the long-term impacts of coronavirus on those who have been infected. Mr Hancock said a "significant minority" of people had suffered "quite debilitating" conditions after contracting COVID-19. It comes after Sky News reported on how psychosis, insomnia, kidney disease, spinal infections, strokes, chronic tiredness and mobility issues are being identified in former coronavirus patients in northern Italy. Asked about the long-term impact of the disease on patients, the health secretary told Sky News: "I am concerned there's increasing evidence a minority of people - but a significant minority - have long-term impacts and it can be quite debilitating. "So we've set up an NHS service to support those with long-term impacts of COVID-19 and, also, we've put almost £10m into research into these long-term effects." Read full story Source: Sky News, 15 July 2020
  15. News Article
    Coronavirus patients have continued to suffer from fatigue, breathlessness and forgetfulness more than 100 days after contracting the bug. Many COVID-19 survivors have found that they are not back to normal months after they tested positive. Louise Nicholls, from Litherland in Liverpool, is one of those people who found themselves suffering from curious symptoms long after she should have been back to normal. She was told she had coronavirus by her doctor on 1 April having gone in search of medical help after suffering from a number of respiratory symptoms. "I was trying to do my workouts and I was getting really short of breath," Louise said. "I couldn't put my finger on what was going on but it got worse every day. My chest started getting tighter and my lungs were burning. I didn't have a cough or a fever but I had shortness of breath and I was waking up with night sweats." Louise said her symptoms were dismissed as anxiety by those around her at first, but when her symptoms got worse she phoned the doctor who said it sounded like coronavirus. Louise said: "My doctor said it sounds like covid. She said 'you're young and fit, you'll be over it in a few weeks' and sent me on my way." Louise's breathing continued to get worse and she was given a steroid inhaler, which she is still taking today. Although Louise feels much better than she did at one time, she is still struggling with her breathing today and is continuing to use her inhaler. She said: "I feel much better than I was but I can't push myself too much... My chest feels tight if I don't take my inhaler every day." Read full story Source: Mirror, 12 July 2020
  16. Content Article
    RCGP says the plans should contain: costed proposals for additional funding for general practice solutions for how the current GP workforce capacity can manage new and pre-existing pressures commitments to continue the reduction in regulatory burdens and ‘red tape’, which has enabled GPs to spend more time on frontline patient care during the pandemic a systematic approach for identifying those patients who are likely to require primary care support; and proposals for how health inequalities will be minimised to ensure all patients have access to the necessary post-COVID-19 care.