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Found 63 results
  1. News Article
    People who recover from coronavirus have a similar level of protection against future infection as those who receive a Covid vaccine – at least for the first five months, research suggests. A Public Health England (PHE) study of more than 20,000 healthcare workers found that immunity acquired from an earlier Covid infection provided 83% protection against reinfection for at least 20 weeks. The findings show that while people are unlikely to become reinfected soon after their first infection, it is possible to catch the virus again and potentially spread it to others. “Overall I think this is good news,” said Prof Susan Hopkins, a senior medical adviser to PHE. “It allows people to feel that prior infection will protect them from future infections, but at the same time it is not complete protection, and therefore they still need to be careful when they are out and about.” Read full story Source: The Guardian, 14 January 2021 Public Health England press release
  2. Content Article
    Last Friday I took my mother-in-law, Margaret, for her vaccination at a local vaccination centre in Chiswick, London. First let me start with what is being done well. We received a call from our GP practice nurse on Thursday offering Margaret an appointment for the Pfizer vaccine the following day. Margaret is 77 and, because several over-80s had cancelled or declined appointments, GP practices had been contacted to open up the appointments to the clinically vulnerable over 75s. Once defrosted, the Pfizer vaccine has to be used; so to avoid waste, they had proactively sought to get other patients to use up the appointment slots that were free. The GP practice nurse forewarned us about the queues, so my husband and I were able to safety plan to ensure Margaret, who is wheelchair bound and has chronic obstructive pulmonary disease (COPD) and hypertrophic cardiomyopathy, would not be queuing in the cold for an hour. I am sure you have seen the news stories about non-socially distanced, long waits outside vaccination centres in the media this weekend. Patient safety concerns: Social distancing – before.* Once inside the vaccination centre, it is not physically possible to maintain one-metre plus social distancing as the centre is so busy. All staff were wearing masks. Most patients and carers were too, but some patients have exemptions. A positive in our centre is that the windows were all open and the staff were doing their level best to ventilate the room. However, we ended up in a cubicle far away from the windows, close to the door, and so there was a flow of patients, carers and staff who, even with their best efforts, could not maintain social distancing. Social distancing – after. After receiving the vaccination, patients are asked to wait 15 minutes before leaving. This is to ensure they are observed for a period of time in case they have an adverse reaction. It is best practice in vaccination administration and adheres to national and manufacturers' guidelines. However, in following best practice, patients and carers are kept in an environment where social distancing is not viable for a time period which increases the risk of COVID-19 transmission. I am wondering if there needs to be a policy-level conversation about trading off the risk of transmission versus adverse transfusion reaction? Or do we need to reflect on the side effect of the goal to vaccinate the most clinically vulnerable as soon as possible may be introducing congestion risks at vaccination centres? Is there scope to reduce the 15 minute observation period post-vaccination? I know some GP practices and community pharmacies have reduced the observation time frame for flu vaccines. Consent. As the cubicles are back to back, you can hear the conversation with the patient in the next cubicle. Next to Margaret was a lady who at first was not clear why she had been sent for the appointment and who then spent around ten minutes with both a nurse and doctor trying to decide whether she wanted to consent to have the vaccine or not. She did not come across as someone who had lacked capacity, rather just unclear about why she had been sent for and who then (understandably) had to ask the questions she needed answering. My reflection is that the consent conversation needs to start when the appointment is booked or confirmed over the telephone. This happened for Margaret, and it meant that on the day of the appointment staff were able to quickly confirm consent, check if she had had reactions to previous vaccines, taking anticoagulation medication or symptomatic, before administering the vaccine. If a patient is having surgery, good consent practice is to start the consent conversation at the outpatient appointments. Then confirm it on the morning of the procedure. Human Factors and the last task step in a sequence of tasks. It is a well documented source of human error that human beings have a tendency to omit the last task step in a sequence of tasks if the primary goal has been achieved before the last task step occurs. Think photocopying and walking away from the photocopying machine once you had done the photocopying, then realising that you have left the originals on the flatbed. In the context of vaccination centres, the last task step is getting the patient and their carer out of the building after they have been told they can leave. In our case, this meant being directed to a small lift which the over-80s were crowding into. Some had walking sticks, so the stairs are not an option. Some just were not aware of the risk of crowding in a lift with other folk. There was no-one managing the exit process from the building, so there was congestion in the lift area, stairwell and the lift itself. My point is that we need to identify vaccination centres where the environment is suited to the user (i.e. over-75s who may have mobility issues) and where over-crowding at entry and exit points are thought through/planned for. Guidelines and staff deployment/education needs to cover the omission of the last task step problem in the vaccination centre context. Otherwise the exit becomes a transmission hotspot. I am mindful one response to my reflections may be that the risk is not that great because the patients have been vaccinated by the time they leave. However, my understanding is that the vaccine is not effective for a few weeks and it is only patients who are vaccinated. The carers/relatives who accompany them are not eligible to be vaccinated yet, so are very exposed. Many of the relatives/carers I observed were in the 50s or 60s, and they, like me, were accompanying a loved-one who was frail. Regulators and Public Health England might find it useful to use the discussion threads on community websites to capture patient and carer feedback. Charles Vincent, Susan Burnett and I have written on the importance of soft safety intelligence like this in our Health Foundation-funded Measurement and Monitoring of Safety Framework. The discussion forum on Chiswick's website, for example, provides a timely feedback mechanism. Given the social distancing challenges I have mentioned, is anyone measuring how many patients get COVID-19 in the weeks between being vaccinated and the vaccine taking effect? And how many accompanying carers? We need to be measuring potential transmission in vaccination centres in the same way we trace back whether a patient has visited a restaurant, supermarket, had contact with school children etc.. What do you think? The staff at the vaccination centres are another example of our wonderful NHS teams; doing their best in an environment not best suited to the task. Let’s not forget they too may be at risk; so as well as the patient safety issues I have highlighted, we need to get the task and environmental design right to keep NHS staff safe. Going forward, we need to proactively iron out these safety issues. Otherwise, we may find in a few months time that vaccination centres have been a breeding ground for the fourth wave. *For other patient and carers' views click on the Forum tab on www.chiswickw4.com, and the thread started on 6 January referred to as 'the over-80s queuing for the vaccine.'
  3. News Article
    Deaths from COVID-19 in England in the first half of 2021 could exceed those seen in the whole of 2020 unless the vaccination programme is vastly increased and a national lockdown implemented—with educational settings closed for at least a month—researchers have warned. In a preprint released on 24 December, researchers from the London School of Hygiene and Tropical Medicine used modelling to compare the effects of varying COVID-19 restrictions on the virus spread, hospital and intensive care admissions, and deaths from 15 December 2020 to 30 June 2021. The model took account of the new variant spreading rapidly in southern England, which it estimated to be 56% more transmissible than non-variant COVID-19. The study, which has yet to be peer reviewed, said that control measures similar to the November national lockdown would be “unlikely to reduce the effective reproduction number to less than 1, unless primary schools, secondary schools, and universities are also closed.” It added that it would be necessary to “greatly accelerate vaccine rollout to have an appreciable impact in suppressing the resulting disease burden.” Read full story Source: BMJ, 29 December 2020
  4. News Article
    The number of COVID-19 infections likely to have been acquired in hospital are rising again for the first time in three weeks and their proportion of all cases has reached record levels for the second wave, HSJ can reveal. NHS England data covering the week to 6 December (the latest available) shows 1,787 COVID-19 cases were acquired in-hospital – a rise of almost 14% on the week before. The number of hospital-acquired, or “nosocomial”, infections had been falling since the week to 15 November, when 1,794 were recorded. This week, hospital acquired covid infections amounted to 21% of the 8,337 new cases which were recorded in hospitals – the highest proportion in the second wave. On 6 December alone, 24% of infections had probably been acquired in hospital rather than the community. Read full story (paywalled) Source: HSJ, 11 December 2020
  5. News Article
    Health inspectors in England have been moving between care homes with high levels of COVID-19 infection without being tested, raising fears they have put more residents at risk of catching the virus, leaks to the Guardian have revealed. In recent weeks all care home inspections carried out in the north of England have been of infected homes, including a facility where 38 of the 41 people receiving care and 30 staff – almost half of the workers – had tested positive, internal documents from the Care Quality Commission (CQC) show. Over the last two months inspectors have been checking infection control procedures and care standards in up to 600 care homes, many of which were dealing with outbreaks of COVID-19, but the Department of Health and Social Care (DHSC) has yet to provide testing. The CQC said on Friday it was expecting to start testing inspectors “in the coming weeks”. Weekly Covid deaths in care homes have been rising. In the week to 20 November, 398 people were notified to the CQC as having died from Covid, up from 138 a month earlier. The death toll remains lower than at the peak of the pandemic, when more than 2,500 people were dying a week in late April. The situation has sparked “very real anxieties about contracting the disease” and spreading it between infected homes, the leaked memos reveal. One inspector described work to his managers as like “going into the eye of the storm”. Read full story Source: The Guardian, 27 November 2020
  6. News Article
    Lifting lockdown must be handled better this time round to avoid a surge in Covid that could overwhelm the NHS, doctors say. The British Medical Association has published a blueprint for how it thinks England should proceed with any easing. It includes replacing the "rule of six" with a two-households restriction to reduce social mixing and banning travel between different local lockdown tiers. Government has yet to say if or exactly how England will exit on 2 December. It will decide next week, based on whether cases have fallen enough and how much strain hospitals are under. Read full story Source: BBC News, 18 November 2020
  7. News Article
    Coronavirus cases in the US will spike after Thanksgiving, further stressing health care systems and prompting new restrictions, an emergency physician said Saturday, as states continued to report soaring numbers of new cases, hospitalizations and deaths. Dr. James Phillips, chief of disaster medicine at George Washington University Hospital, told CNN's Erica Hill he is "terrified" about what's going to happen this holiday season. "We're going to see an unprecedented surge of cases following Thanksgiving this year, and if people don't learn from Thanksgiving, we're going to see it after Christmas as well," Phillips said. Already, grim indicators offer a glimpse of what's to come. A little more than a week after the US first topped 100,000 daily infections, it reported a record of more than 184,000 new cases Friday. Hospitalisations also hit a new high – for the fourth consecutive day – with more than 68,500 COVID-19 patients nationwide, according to the COVID Tracking Project. And the country's daily death toll has topped 1,300 at least three times this week. "Things are going to get much, much worse," said Dr. Leana Wen, a CNN medical analyst and former Baltimore Health Commissioner. She expressed concern over the impact on the already-strained health care system when the new cases added in recent days are reflected in hospitalisations. Read full story Source: CNN, 15 November 2020
  8. News Article
    People in Liverpool will be offered regular COVID-19 tests under the first trial of whole city testing in England. Everyone living or working in the city will be offered tests, whether or not they have symptoms, with follow-up tests every two weeks or so. Some will get new tests giving results within an hour which, if successful, could be rolled out to "millions" by Christmas, the government says. Liverpool has one of the highest rates of coronavirus deaths in England. The latest figures show the city recorded 1,754 cases in the week up to 30 October. The average area in England had 153. The pilot aims to limit spread of the virus by identifying as many infected people as possible, and taking action to break chains of transmission. It is thought around four-fifths of people who are infected with coronavirus show no symptoms. Read full story Source: BBC News, 3 November 2020
  9. News Article
    NHS staff and their families accounted for one in six patients in hospital with Covid, due in part to inadequate personal protective equipment (PPE), new research suggests. A study of hospitals from March to June revealed that healthcare workers in patient-facing roles were around three times more likely to be hospitalised with the virus than the general population. Writing in the BMJ, the study's authors called for an urgent focus on how COVID-19 spreads around hospitals to prevent a similar toll in future waves of the pandemic. They also call for hospitals to consider re-deploying staff with vulnerable family members away from high-risk zones. Read full story Source: The Telegraph, 29 October 2020
  10. News Article
    Hospital hotspots for COVID-19 have been highlighted in a new report by safety investigators. The report by the Healthcare Safety Investigation Branch (HSIB) makes a series of observations to help the health service reduce the spread of coronavirus in healthcare settings. Hospital hotspots for COVID-19 included the central nurses’ stations and areas where computers and medical notes were shared, the HSIB found. The investigation was initiated after a Sage report in May which found that 20% of hospital patients were reporting symptoms of Covid-19 seven days following admission – suggesting that their infection may have been acquired in hospital. In response to the report, NHS England and NHS Improvement confirmed they would publish nosocomial – another term for hospital acquired infections – transmission rates from trusts, the HSIB said. Read full story Source: Express and Star, 28 October 2020
  11. News Article
    Almost half of hospital patients have been discharged without receiving the results of their coronavirus test – including some patients who were sent to care homes, new research from Healthwatch and British Cross has revealed. Independent national patient body Healthwatch England said it had learned many patients were discharged from hospitals between March and August this year without proper assessments with many vulnerable people sent home without medication, equipment or the care they needed. At the start of the pandemic thousands of patients were discharged to care homes as NHS England instructed hospitals to free up 15,000 beds ahead of the first wave of coronavirus. Approximately 25,000 patients were sent to care homes with some not tested, sparking fears this helped seed care homes with the virus. There have been around 16,000 care home deaths linked to COVID-19. According to a survey of almost 600 discharged patients and interviews with 60 NHS staff, Healthwatch England said it had found serious flaws with the way hospitals had followed NHS England’s instructions. Read full story Source: The Independent, 24 October 2020
  12. Content Article
    Key findings 82% of respondents did not receive a follow-up visit and assessment at home and almost one in five of these reported an unmet care need. Some people felt their discharge was rushed, with around one in five (19%) feeling unprepared to leave hospital. Over a third (35%) of people were not given a contact who they could get in touch with for further advice after discharge, despite this being part of the guidance. Overall patients and families were very positive about healthcare staff, praising their efforts during such a difficult time. Around a third (30%) of people faced an issue with delayed COVID-19 test results, potentially putting family and carers at risk, or in a care home, other residents and staff. Recommendations To help hospitals manage a second wave of COVID-19 hospital admissions ahead of winter, we have made several recommendations based on the experiences of people and staff, including: Post-discharge check-ins and assessments: Services should follow policy and ensure people are offered follow-up support soon after discharge, whether by phone or in person. Discharge checklists: Patients should be asked about the support they need, including any transport home and equipment required. Communication: Patients and carers should be given a single point of contact for further support or questions, in line with national policy. Medication: Waiting for medication can often lead to delays being discharged from hospital. Linking patients to voluntary sector partners or community pharmacists who can deliver medicine could avoid delays. Boost community care capacity and recognise the value of the voluntary care sector in hospital discharge: The current discharge policy depends on follow-up assessments and care being available. Longer-term, more investment is needed to ensure this happens, including in the voluntary care sector.
  13. News Article
    Levels of protective antibodies in people wane "quite rapidly" after coronavirus infection, say researchers. Antibodies are a key part of our immune defences and stop the virus from getting inside the body's cells. The Imperial College London team found the number of people testing positive for antibodies has fallen by 26% between June and September. They say immunity appears to be fading and there is a risk of catching the virus multiple times. More than 350,000 people in England have taken an antibody test as part of the REACT-2 study so far. In the first round of testing, at the end of June and the beginning of July, about 60 in 1,000 people had detectable antibodies. But in the latest set of tests, in September, only 44 per 1,000 people were positive. "Immunity is waning quite rapidly, we're only three months after our first [round of tests] and we're already showing a 26% decline in antibodies," said Prof Helen Ward, one of the researchers. The fall was greater in those over 65, compared with younger age groups, and in those without symptoms compared with those with full-blown COVID-19. The number of healthcare workers with antibodies remained relatively high, which the researchers suggest may be due to regular exposure to the virus. There have been very few confirmed cases of people getting Covid twice. However, the researchers warn this may be due to immunity only just starting to fade since the peak infection rates of March and April. The hope is the second infection will be milder than the first, even if immunity does decline, as the body should have an "immune memory" of the first encounter and know how to fight back. The researchers say their findings do not scupper hopes of a vaccine, which may prove more effective than a real infection. One of the researchers, Prof Graham Cooke, said: "The big picture is after the first wave, the great majority of the country didn't have evidence of protective immunity. The need for a vaccine is still very large, the data doesn't change that." Read full story Source: BBC News, 27 October 2020
  14. News Article
    Women aged 50-60 are at greatest risk of developing “long Covid”, analysis suggests. Older age and experiencing five or more symptoms within the first week of illness were also associated with a heightened risk of lasting health problems. The study, led by Dr Claire Steves and Prof Tim Spector at King’s College London, analysed data from 4,182 COVID Symptom Study app users who had been consistently logging their health and had tested positive for the virus. In general, women were twice as likely to suffer from Covid symptoms that lasted longer than a month, compared with men – but only until around the age of 60, when their risk level became more similar. Covid vaccine tracker: when will a cor Increasing age was also associated with a heightened risk of long Covid, with about 22% of people aged over 70 suffering for four weeks or more, compared with 10% of people aged between 18 and 49. For women in the 50-60 age bracket, these two risk factors appeared to combine: They were eight times more likely to experience lasting symptoms of Covid-19 compared with 18- to 30-year-olds. However, the greatest difference between men and women was seen among those aged between 40 and 50, where women’s risk of developing long Covid was double that of men’s. “This is a similar pattern to what you see in autoimmune diseases,” said Spector. “Things like rheumatoid arthritis, thyroid disease and lupus are two to three times more common in women until just before menopause, and then it becomes more similar.” His guess is that gender differences in the way the immune system responds to coronavirus may account for this difference." Read full story Source: The Guardian, 21 September 2020
  15. News Article
    Ministers have denied care home inspectors access to weekly testing for coronavirus – despite fears they could contribute to the spread of COVID-19 as cases rise across the country, The Independent can reveal. The Care Quality Commission (CQC) was told by the Department of Health and Social Care last month it could not have access to regular testing for inspection teams as the watchdog prepares for 500 inspections of care homes during the next six weeks. Officials said the teams, who are assessing care conditions for the vulnerable and elderly, did not get close enough to people to present a risk. During the first wave of the virus, after Public Health England initially said there was no risk to care homes, an estimated 16,000 residents died from the virus. At the height of the crisis up to 25,000 NHS patients were discharged to care homes by the NHS, with many not having been tested for the virus. Labour MP Barbara Keeley said: “The refusal of the Department of Health and Social Care to treat CQC inspectors in the same way as other staff going into care homes puts lives at risk.” Read full story Source: The Independent, 20 October 2020
  16. News Article
    Senior doctors specialising in infectious diseases have written an open letter expressing "concern" about the rapid increase in COVID-19 cases in Northern Ireland. The letter is signed by 13 medics from hospitals across Northern Ireland. It calls for the public to stick to government guidance on reducing social interactions and also warns against "stigmatising people and areas with high levels of infection." The letter reads: "We need to support people who test positive. This pandemic requires us to work together to bring it under control urgently. We need to reduce the potential for transmission to protect our health service, and we need to fix our test and trace system to try and gain better control of this virus in our community." On Monday, 616 new cases of COVID-19 were identified in Northern Ireland, bringing the total during the pandemic to 14,690. The number of deaths recorded by the Department of Health remains at 584. Among those who have signed the letter are Dr Claire Donnelly, a consultant physician who specialises in infectious diseases; consultant virologist Dr Conall McCaughey and consultant paediatrician Dr Sharon Christie. Entitled an "appeal to people to adhere to Covid public health guidance", the letter lays bare the stark reality of the infections rates. The letter adds: "Worryingly the number of cases is increasing rapidly in many areas over the last week, indicating that we have widespread community transmission in many parts of Northern Ireland." Read full story Source: BBC News, 6 October 2020
  17. News Article
    From the moment coronavirus reached UK shores, public health advice stressed the importance of washing hands and deep-cleaning surfaces to reduce the risk of becoming infected. The advice was informed by mountains of research into the transmission of other respiratory viruses: it was the best scientists could do with such a new pathogen. But as the pandemic spread and data rolled in, some scientists began to question whether the focus on hand hygiene was as crucial as it seemed. The issue has resurfaced after Monica Gandhi, a professor of medicine at the University of California, San Francisco, told the US science magazine Nautilus that the easiest way to catch the virus was through droplets and aerosols sprayed from an infected person’s mouth or nose. “It’s not through surfaces,” she said. “We now know the root of the spread is not from touching surfaces and touching your eye. It’s from being close to someone spewing virus from their nose and mouth, without in most cases knowing they are doing so.” Gandhi’s is not a lone voice. Her comments follow a prominent paper in the Lancet from Emanuel Goldman, a professor of microbiology at Rutgers University in New Jersey. He was sceptical about the relevance of scientific studies that showed the virus could survive on surfaces for days at a time. “In my opinion,” he wrote, “the chance of transmission through inanimate surfaces is very small, and only in instances where an infected person coughs or sneezes on the surface, and someone else touches that surface soon after the cough or sneeze.” He defined soon as within one to two hours. Dr Julian Tang, an honorary associate professor of respiratory sciences at the University of Leicester, thinks hand washing should stay but agrees the risk from contaminated surfaces has been overplayed. He points to documents from the UK government’s Scientific Advisory Group for Emergencies (Sage) that estimate hand washing can reduce acute respiratory infections by only 16%. Meanwhile, he adds, the World Health Organization has warned about surfaces being a likely route of transmission while conceding there are no reports demonstrating infection this way. Tang believes that a preoccupation with contaminated surfaces distracted countries from taking airborne transmission seriously and played down the necessity of wearing masks. “What we’ve always said is that the virus transmits by all routes. There might be some transmission by hand and fomites and we’re not opposed to hand washing, but the emphasis is wrong,” he told the Guardian. Read full story Source: 5 October 2020
  18. News Article
    A technical glitch that meant nearly 16,000 cases of coronavirus went unreported has delayed efforts to trace contacts of people who tested positive. Public Health England (PHE) said 15,841 cases between 25 September and 2 October were left out of the UK daily case figures. They were then added in to reach Saturday's figure of 12,872 new cases and Sunday's 22,961 figure. PHE said all those who tested positive had been informed. But it means others in close contact with them were not. The issue has been resolved, PHE said, with outstanding cases passed on to tracers by 01:00 BST on Saturday. The technical issue also means that the daily case totals reported on the government's coronavirus dashboard over the past week have been lower than the true number. Read full story Source: BBC News, 5 October 2020
  19. News Article
    Covid infection rates among doctors, nurses, and other hospital and care home staff have risen more than fivefold over the past month in London, scientists have discovered. The figures – provided by the Francis Crick Institute – have triggered considerable concern among scientists, who fear similar increases may be occurring in other regions of the UK. Increasing numbers of infected healthcare workers raise fears that the spread of COVID-19 into wards and care homes – which triggered tens of thousands of deaths last spring – could be repeated unless urgent action is taken. “It is very, very worrying,” said Professor Charles Swanton, who helped set up the institute’s Pipeline testing service. “Keeping hospitals and care homes free of the virus is crucial but these figures suggest we are heading in the wrong direction.” The Francis Crick Institute – one of Britain’s leading biomedical research centres – decided in March to use its array of powerful laboratory devices to set up a Covid testing service for hospital and care home staff in central and north London. Many other UK academic institutions offered to start similar services but were discouraged by the Department of Health and Social Care which said it wanted to centralise testing operations. Read full story Source: The Guardian, 3 October 2020
  20. News Article
    A leading health expert has suggested ministers have “lost control of the virus”, after the UK recorded it’s largest 24-hour spike in COVID-19 cases since 23 May. Government figures showed there have been a further 2,988 lab-confirmed cases of coronavirus in the UK as of 9am on Sunday. This brings the total number of confirmed cases in the UK to 347,152. Sunday's figure is the highest since May 22 when 3,287 cases were recorded, and is also the first 24-hour period when cases passed 2,000 since the end of May. The tally was an increase on Saturday's figures of 1,813 new cases. Prof Gabriel Scally, a member of the Independent Sage group and a former NHS regional director of public health for the south-west, warned that government ministers had “lost control of the virus”. “It’s no longer small outbreaks they can stamp on,” he told The Guardian. “It’s become endemic in our poorest communities and this is the result. Shadow health secretary Jonathan Ashworth called upon the government to respond to the sharp spike. He added that it was “a stark reminder that there is no room for complacency in tackling the spread of the virus”. “This increase, combined with the ongoing testing fiasco where ill people are told to drive for miles for tests, and the poor performance of the contact tracing system, needs an explanation from ministers,” he said on Sunday. Read full story Source: The Independent, 7 September 2020
  21. News Article
    A home care worker who did not wear protective equipment may have infected a client with a fatal case of coronavirus during weeks of contradictory government guidance on whether the kit was needed or not, an official investigation has found. The government’s confusion about how much protection care workers visiting homes needed is detailed in a report into the death of an unnamed person by the Healthcare Safety Investigation Branch (HSIB), which conducts independent investigations of patient safety concerns in NHS-funded care in England. It was responding to a complaint raised by a member of the public in April. The report shows that Public Health England published two contradictory documents that month. One advised care workers making home visits to wear PPE and the other did not mention the need. The contradiction was not cleared up for six weeks. The government’s guidance had been a shambles that had placed workers and their vulnerable clients at risk, the policy director at the United Kingdom Homecare Association, Colin Angel, said on Wednesday. The association also accused the government of sidelining its expertise and publishing new guidance with little notice, sometimes late on Friday nights, meaning that it was not always noticed by the people it was intended for.
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