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Found 451 results
  1. Content Article
    Face masks for the public during the covid-19 crisis Face coverings for the public: Laying straw men to rest
  2. News Article
    Deaths resulting from COVID-19 infection account for only half of the number of excess deaths taking place in private homes, expert analysis of latest data suggests. Figures from the Office for National Statistics from the seven weeks to 15 May show that more than 40 000 COVID-19 deaths have now taken place in hospitals, care homes, and private homes in England and Wales. The figures also show 14 418 excess non-covid deaths. Although COVID-19 was mentioned on death certificates 13 500 times in care homes and private homes over the past seven weeks, some 23 500 more non-covid deaths have taken place in the community than would be expected. Discussing the data, David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, said that “as soon as the pandemic started we saw a huge immediate spike in non-covid deaths in [private] homes that occurred close to the time hospitals were minimising the service they were providing." “Over the seven weeks up to 15 May, as the NHS focused on covid, around 8800 fewer non-covid deaths than normal occurred in hospitals.” He added that these had not been “exported” to care homes, since fairly few care home residents normally died in hospitals. Instead, he said, it seemed that these deaths had contributed to the huge rise in extra deaths in private homes during this period. Read full story Source: BMJ, 27 May 2020
  3. News Article
    Problems with dispensing drugs during the COVID-19 crisis may be contributing to an “apparent increase” in deaths of patients receiving treatment for opiate addiction, the Care Quality Commission (CQC) has said. The regulator has said the increase in deaths “may be a result of some services stopping all daily dispensing of opiates” and has taken enforcement action against a “large national provider of substance misuse services” which ”stopped all daily dispensing”. The provider has not been named by the CQC as it is “entitled to an appeal period,” but the regulator told HSJ the provider had not recorded their risk assessments for their clients in relation to changes in drug dispensing. The CQC said the provider had now “assured us” individualised risk assessments were in place. The CQC is now reviewing all deaths of people which have been reported by substance misuse services since 1 March due to concerns about the apparent increase and “that some of these deaths may be related to changes in prescribing practices in response to COVID-19”. Read full story Source: HSJ, 27 May 2020
  4. News Article
    Amid warnings that BAME nursing staff may be disproportionately affected by the COVID-19 pandemic, a Royal College of Nursing (RCN) survey reveals that they are more likely to struggle to secure adequate personal protective equipment (PPE) while at work. The latest RCN member-wide survey shows that for nursing staff working in high-risk environments (including intensive and critical care units), only 43% of respondents from a BAME background said they had enough eye and face protection equipment. This is in stark contrast to 66% of white British nursing staff. There were also disparities in access to fluid-repellent gowns and in cases of nursing staff being asked to re-use single-use PPE items. The survey found similar gaps for those working in non-high-risk environments. Meanwhile, staff reported differences in PPE training, with 40% of BAME respondents saying they had not had training compared with just 31% of white British respondents. Nearly a quarter of BAME nursing staff said they had no confidence that their employer is doing enough to protect them from COVID-19, compared with only 11% of white British respondents. Dame Donna Kinnair, RCN Chief Executive & General Secretary, said: “It is simply unacceptable that we are in a situation where BAME nursing staff are less protected than other nursing staff. Read full story Source: Royal College of Nursing, 27 May 2020
  5. News Article
    A team of 25,000 contact tracers are making their first phone calls to track down people who will be told to self-isolate under a new scheme in England. Tracers will text, email or call people who test positive with coronavirus and ask who they have had contact with. Any of those contacts deemed at risk of infection will be told to isolate for 14 days, even if they are not sick. A test and trace system is also launching in Scotland, where an easing of the lockdown is expected later. The aim of England's NHS Test and Trace system is to lift national lockdown restrictions and move towards more localised, targeted measures. The team will start by contacting the 2,013 people who tested positive for the virus on Wednesday. Read full story Source: BBC News, 28 May 2020
  6. News Article
    The UK's scientists have been trying to trace COVID-19's path through the population ever since the coronavirus arrived on British shores. In what is thought to be the largest study of its kind in the world, an app developed by King's College London (KCL) and technology company Zoe, which tracks symptoms of the disease, has been downloaded more than three million times in the UK. Not to be confused with the government's contact-tracing app, the COVID-19 Symptom Study app allows users to report daily whether they feel healthy, and record any symptoms. The scientists have been using the data to estimate how the virus may have travelled through the population. Read full story Source: BBC News, 23 May 2020
  7. News Article
    "I'm not sure I want to be a nurse anymore," she tells me. "I've seen more people die in the past two months than in the whole six years." Some 70% of health workers dealing with COVID-19 in Italy's hardest-hit areas are suffering from burnout, a recent study shows. "This is actually the hardest moment for doctors and nurses," says Serena Barello, the author of the study. Read story Source: BBC News, 26 May 2020
  8. News Article
    Selected NHS coronavirus patients will soon be able to access an experimental treatment to speed up their recovery, with the health secretary Matt Hancock suggesting it is probably “the biggest step forward’’ in medication since the beginning of the COVID-19 crisis. The anti-viral drug remdesivir will be made available to patients meeting certain clinical criteria to support their recovery in hospital. The drug is currently undergoing clinical trials around the world, including in the UK, and peer-reviewed data showed it can shorten the time to recovery by about four days. Treatment will initially be prioritised for patients who have the greatest likelihood of deriving the most benefit, according to the Department of Health and Social Care (DHSC). Satisfied the drug can help boost recovery, the government’s Medicines and Healthcare products Regulatory Agency (MHRA) approved the use of remdesivir through its early access to medicines scheme. The experimental anti-viral drug was granted emergency authorisation to treat Covid-19 in the US by the Food and Drug Administration earlier this month. Read full story Source: The Independent, 26 May 2020
  9. News Article
    Facial recognition has been added as a way of logging in to an NHS app that lets people order prescriptions, book appointments and find healthcare data. Initially, it will allow faster access to the services on the app, which is separate from the contact-tracing one, but its developers say it could also be used for COVID-19 "immunity passports". The NHS facial-recognition system, built by iProov and available for both Android devices and iOS, requires users to submit a photo of themselves from an official document such as their passport or driving license. They then scan their face using their phone and, following a short sequence of flashing colours, their identification will be verified and they will have access to all the services on the NHS app. Immunity passports need to link a person's identity to their coronavirus test results, so would require a robust way of allowing people to verify themselves. Those deemed clear of the virus could then prove their status via a code generated by an app. However, the idea is controversial, not least because there is no hard scientific evidence that having had the coronavirus provides people with long-lasting immunity. The World Health Organization has warned countries against implementing such passports, saying: "There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection." Dr Tom Fisher, a senior researcher at Privacy International, said the implementation of such measures needed to be "necessary, proportionate and based on the epidemiological evidence". "For the moment, immunity passports do not meet this test," he said. "We must be concerned about the broad societal impact of such immunity passports. They are essentially about limiting the rights of those who are not deemed to be immune. This is a route to exclusion and discrimination." Read full story Source: BBC News, 27 May 2020
  10. News Article
    Weston General Hospital has stopped admitting new patients – including to the accident and emergency department – following a spike in coronavirus cases. The hospital announced yesterday it was taking this “precautionary measure” due to the “high number of coronavirus patients” on site. MP for Weston-super-Mare John Penrose tweeted that he had spoken to local health chiefs and a deep clean is being carried out at the hospital “following a spike in infections”. He added that a temporary A&E has been set up outside the hospital, while inpatients will be re-directed to hospitals in Taunton or Bristol. Out of hours GP practices, pharmacies and walk-in services at the minor treatment unit in Clevedon and Yate have also been given as alternative options for patients seeking medical treatment. Read full story Source: HSJ, 25 May 2020
  11. News Article
    NHS England has said disabled and vulnerable patients must not be denied personalised care during the coronavirus pandemic and repeated its warning that blanket do not resuscitate orders should not be happening. In a joint statement with disabled rights campaigner and member of the House of Lords, Baroness Jane Campbell, NHS England said the COVID-19 virus and its impact on the NHS did not change the position for vulnerable patients that decisions must be made on an individualised basis. It said: “This means people making active and informed judgements about their own care and treatment, at all stages of their life, and recognises people’s autonomy, as well as their preferences, aspirations, needs and abilities. This also means ensuring reasonable adjustments are supported where necessary and reinforces that the blanket application of do not attempt resuscitation orders is totally unacceptable and must not happen.” Read full story Source: The Independent, 26 May 2020
  12. News Article
    The World Health Organization has said it will temporarily drop hydroxychloroquine — the malaria drug Donald Trump said he is taking as a precaution — from its global study into experimental coronavirus treatments after safety concerns. The WHO’s director-general Tedros Adhanom Ghebreyesus said in light of a paper published last week in the Lancet that showed people taking hydroxychloroquine were at higher risk of death and heart problems than those who were not, it would pause the hydroxychloroquine arm of its solidarity global clinical trial. “The executive group has implemented a temporary pause of the hydroxychloroquine arm within the solidarity trial while the safety data is reviewed by the data safety monitoring board,” Tedros said on Monday. “The other arms of the trial are continuing,” Read full story Source: The Guardian, 25 May 2020
  13. Content Article
    Safe zones compromised COVID-19 testing is being used to inform decisions around infection control. If there are people moving into or between health and social care settings (patients or staff), who have tested negatively and are not showing typical symptoms of COVID-19, they will likely be treated accordingly. For example, they may be placed in ‘green’ areas, dedicated for those who do not have the virus. These areas are designed to protect non COVID-19 patients but there is a risk that some patients could have had a false negative test result and slipped through the net, compromising safety measures. A danger of misdiagnosis If clinicians are relying on test results being accurate, people who are experiencing symptoms but are told they are COVID-19 negative may be dismissed or misdiagnosed. In a recent blog published on the hub, patient ‘Sarah’ explains how she was discharged from A&E, following a negative test result, and diagnosed with anxiety. A few days on she deteriorated, needing to be admitted to hospital again, this time by ambulance. She was told by paramedics that, according to her observations, she should have been in a coma. Doctors later confirmed that her initial test result had been falsely negative and that she did have COVID-19. Sarah also expressed concern for the paramedics who were not wearing adequate protection to treat someone with COVID-19, because they were wrongly reassured by the test that she was negative [4]. Impact in the community If members of the public test falsely negatively for COVID-19, there is the risk that they will not isolate and will spread the infection further as they access supermarkets, pharmacies and don’t distance from members of their household. There may also be cases where patients who had a false negative were incorrectly advised they were safe to return to work. For key workers in particular, this would increase the risk of spreading the virus to their colleagues and service users. Impact on mental health and recovery There is a risk that a patient’s mental health and wellbeing could deteriorate if they receive a negative test result but are in fact suffering from COVID-19. This is of particular concern in relation to the significant number who are experiencing a slow and debilitating recovery but have not necessarily needed hospital care [5][6]. We are hearing from COVID-19 support groups that these ‘moderate’ sufferers are often left feeling lonely, depressed and frustrated that they are unable to get back on their feet as quickly as they feel they should [7]. There seems to be little support for this group, particularly where they have tested negatively and their symptoms do not align with the official list of symptoms for coronavirus infection. Some people who were sure they had the virus but received a negative test result, have ended up doubting themselves. They pushed their bodies too hard too soon, causing relapses in symptoms and they have subsequently faced further mental health challenges. In an anonymous account shared on the hub, one patient explains how a false negative caused their mental health to deteriorate. “I thought that I should be physically active if I didn't have COVID-19, so I pushed myself and berated myself when I repeatedly became unable to breath with a pounding heart upon any exertion. I couldn't cope caring for my four children and was in a 'critical' dangerous mental state many times. I self-harmed to try and cut off from feeling so awful.” [8] Concluding thoughts Patient Safety Learning are concerned that false negative test results could present several risks to patient safety and we ask the following questions: How are the number of false negative tests being monitored and is this data being publicly reported? Is adequate research being undertaken to understand the cause/s behind the false negative results? What steps are being taken to reduce the testing problems commonly encountered by healthcare professionals that lead to false negatives? Do staff taking swabs feel adequately trained and supported? Is patient feedback around the ease of the self-testing process being captured and reported on? Is the current support and guidance for people who are home-testing fit-for-purpose and endorsed by human factors experts? What is the guidance for caring for patients in hospitals and care settings when they are experiencing symptoms of COVID-19 but have tested negatively? What support is available for patients who believe they have had COVID-19 and are experiencing debilitating symptoms weeks later, but may not have been tested or may have tested negatively? A highly accurate antibody test would help to address some of the concerns raised in this blog and provide a clearer picture of the rate of false negatives. When is that likely to be widely available? References UK Parliament, House of Commons Debate: COVID-19 Response, Volume 676, 18 May 2020. https://hansard.parliament.uk/commons/2020-05-18/debates/8FA78498-C990-4246-A745-AE0F36F7B948/Covid-19Response West, Colin. P, Montori, Victor. M and Sampathkumar, P, Covid-19 Testing: The Threat of False-Negative Results, Science Direct, 11 April 2020. https://www.sciencedirect.com/science/article/pii/S0025619620303657#! Department of Health and Social Care, Coronavirus (COVID-19): scaling up testing programmes, Last Updated 6 April 2020. https://www.gov.uk/government/publications/coronavirus-covid-19-scaling-up-testing-programmes Sarah, My ‘false negative’ COVID-19 test put others at risk, Patient Safety Learning’s the hub, 19 May 2020. The Guardian, ‘Weird as hell’: the Covid-19 patients who have symptoms for months, 15 May 2020. https://www.theguardian.com/world/2020/may/15/weird-hell-professor-advent-calendar-covid-19-symptoms-paul-garner; Sky News, Prof Tim Spector: There’s no such thing as a ‘classical’ COVID-19 case, Facebook, 18 May 2020. https://www.facebook.com/skynews/videos/3470045256358345 Facebook, Covid-19 Support Group, Last Accessed 22 May 2020. https://www.facebook.com/groups/625349464716052/?multi_permalinks=636948470222818 Anonymous, ‘False negative’ and the impact on my mental health, Patient Safety Learning’s the hub, 22 May 2020. https://www.pslhub.org/learn/coronavirus-covid19/273_blogs/false-negative-and-the-impact-on-my-mental-health-r2297/
  14. Content Article
    I was experiencing symptoms of Covid-19 and when I became unable to complete a sentence or walk to the bathroom, my GP advised me to go to hospital. I have mental health difficulties and one of the staff recognised me from when I had been admitted previously, following a suicide attempt. I felt that I was treated like a 'frequent flyer' of A&E and that my symptoms were taken less seriously than they would have been otherwise. I was sent home after my tests for Covid came back negative and was told that it was just anxiety. I got much worse over the coming days. If I had tested negative, why was I feeling desperately unwell with all the published symptoms of Covid? I thought that I should be physically active if I didn't have Covid-19, so I pushed myself and berated myself when I repeatedly became unable to breath with a pounding heart upon any exertion. I couldn't cope caring for my four children and was in a 'critical' dangerous mental state many times. I self-harmed to try and cut off from feeling so awful. My physical health deteriorated. The ambulance was called by the GP who had sent a nurse to assess my oxygen levels and the paramedic said I should be in a coma according to my obs. This made me feel less like I was making it up, but it was still in my head despite my husband telling me repeatedly that the results of the test are 30% wrong. The paramedic gave me oxygen and I protested strongly against going to hospital a second time. The paramedic insisted I went, put me on oxygen and reassured me he would ask the hospital staff to relate to me as a patient who was showing clear signs of Covid and that I did struggle with my mental health but that I was doing my best to recover. I also asked the paramedics to inform the hospital staff about my eating disorder so they could gently help me to manage my low blood sugar without judgements and causing me further shame. In the hospital I saw a Dr who confirmed that I did have Covid-19 and that my test must have been a 'false negative'. I had felt judged, dismissed and had doubted myself. The first thing anyone I spoke to asked was whether or not I had had a test and whether it was positive. The negative test result isolated me from calling family and greeting neighbours as I didn't have the energy to go into the false negative answer. I found that saying my test was 'negative' sparked a surge of invalidation of everything I was experiencing. The isolation caused me further significant harm to my mental health. Among other fleeting symptoms I have had overwhelming fatigue, breathlessness, sweats or chills, no smell or taste, a rash, headaches and low mood. After nearly four weeks I am slowly recovering. I am lucky to have a social worker, family support worker and psychologist available over the phone through this period, so I do feel my family and I are supported. But I am interested to know if anyone else has found their symptoms are being quickly dismissed as anxiety when they are sure they have the virus? Or if anyone else feels like they haven't had their symptoms taken as seriously because of their mental health difficulties?
  15. News Article
    The risk of dying from coronavirus is more than twice as great in the most deprived areas of England – with the disparity largest for women, analysis shows. A study by the Health Foundation of deaths from COVID-19 showed women in the most deprived parts of the country had a risk of dying that was 133% higher than those in the least deprived neighbourhoods. Between men the difference in risk was 114% higher in worse-off areas, suggesting that while deprivation is a key factor in risk of death from coronavirus for both sexes, its effect is worse for women. Experts say the evidence shows the impact of COVID-19 is falling disproportionately on the poorest in society. Mai Stafford, principal data analyst at the Health Foundation, told The Independent: “This pandemic could and should be a watershed moment in creating the social and political will to build a society that values everyone’s health now and in the long term. Without significant action, there is a real risk that those facing the most disadvantage will eventually pay the highest price.” Read full story Source: The Independent, 21 May 2020
  16. News Article
    National leaders have said healthcare workers must do better on social distancing amid growing evidence that staff-to-staff transmission is the significant factor in the spread of coronavirus throughout hospitals. NHS England national clinical director for trauma Dr Chris Moran, said: “I’ve witnessed and I’m sure you’ve all witnessed that actually healthcare workers are not necessarily been the best at managing social distancing. We know when directly managing patients that it [social distancing] is impossible, that’s what PPE is for to protect both sides of the equation. But I think in the staff-only areas we could do quite a lot better in some of the places that I’ve visited.” National director for acute care Keith Willett added: “The evidence we’ve seen coming through suggests the infection risks from staff to patients or patients to staff seems very low but the risks to staff of infection, COVID-19 infection, within hospitals is much, much, much higher between staff and staff, and patients and patients.” The warning comes after NHS England’s patient safety director Dr Aidan Fowler said he was concerned about the rates of "nosocomial spread within our hospitals”. Following national guidance designed to facilitate an increase in elective operations and other routine work, NHS trusts have been asked to set up “covid free” green zones and blue zones with a higher COVID-19 risk. Read full story Source: HSJ, 21 May 2020