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Babylon apology after GP app lets patients see other people's consultations

Babylon Health is investigating whether NHS patients were among those affected by a 'software error' that allowed people registered with its private GP service to view recordings of other people's consultations earlier this month.

Babylon Health has confirmed that a small number of patients were able to view recordings of other patients' consultations earlier this week. The issue came to light after a patient in Leeds who had access to the Babylon app through a private health insurance plan with Bupa reported that he had been able to view around 50 consultations that were not his own.

The patient told the BBC he was 'shocked' to discover the data breach. "You don't expect to see anything like that when you're using a trusted app," he said. "It's shocking to see such a monumental error has been made."

Babylon told GPonline that the app used by private and NHS patients is the same, but it had yet to confirm whether the roughly 80,000 patients registered with the company's digital first NHS service GP at Hand were among those affected.

The problem is understood to have cropped up when a new feature was introduced for patients who switched from audio to video mid-way through a consultation.

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Source: GPOnline, 10 June 2020

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NHS blood unit is “systemically racist” and “psychologically unsafe,” investigation finds

An independent investigation into working conditions at a unit of the NHS’s blood and organ transplant service has concluded that it is “systemically racist” and “psychologically unsafe.”

The internal investigation was commissioned in response to numerous complaints from ethnic minority staff working in a unit of NHS Blood and Transplant (NHSBT) in Colindale, north London. The report, carried out by the workplace relations company Globis Mediation Group, concluded that the environment was “toxic” and “dysfunctional.”

The report found evidence that ethnic minority employees had faced discrimination when applying for jobs and that white candidates had been selected for posts ahead of black applicants who were better qualified. “Recruitment is haphazard, based on race and class and whether a person’s ‘face fits,’” it said.

“Being ignored, being viewed as ineligible for promotion and enduring low levels of empathy all seem to be normal,” the report noted. “These behaviours have created an environment which is now psychologically unsafe and systemically racist.”

Chaand Nagpaul, BMA council chair, commented, “This report highlights all too painfully the racial prejudices and discrimination we are seeing across healthcare. We must renew efforts to challenge these behaviours and bring an end to the enduring injustices faced by black people and BAME healthcare workers here in the UK.”

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Source: BMJ, 10 June 2020

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Two hospitals see 60 percent of new covid cases caught on the wards

More than 60% of new covid cases diagnosed at two hospitals in the Midlands in recent days were caught at least two weeks after the patient was admitted — suggesting there may be particular problems with the virus spreading on their wards.

Northamptonshire is also still grappling with larger numbers of covid cases in hospital, in contrast to most of England. Its NHS organisations have said they do not know the cause of its ongoing problems.

But the large share of cases diagnosed among patients who have been in hospital for at least 15 days – classed by NHS England as definitely “healthcare associated” – indicate that problems controlling the spread within the hospitals may be playing a significant part, rather than the outbreaks in the community.

There has been major national concern about in-hospital spread of the virus in recent weeks, with the government introducing new mandatory controls on Friday.

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Source: HSJ, 11 June 2020

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Recovering COVID-19 patients given devices to spot dips in oxygen levels

Those recovering from Covid-19 are to be given devices which can help spot dips in their blood oxygen-levels while they recover at home.

The NHS is trialling the use of oximeters, combined with an app, which will make it easier to spot whether people need to be re-admitted to hospital.

The new oximeter service is being tested with more than 150 patients in sites on Watford, Hertfordshire and north London.

Clinicians in ‘virtual wards’ are able to track patients’ vital signs – including temperature, heart rate and blood oxygen saturation – in near real-time, receiving alerts if they suggest a patient is deteriorating so that further assessments and care can be arranged.

Health and Social Care Secretary, Matt Hancock, said: “While we restore face to face NHS services too, new innovations will ensure patients can benefit from the comfort of home, with the reassurance that they can be fast tracked to support from the NHS should they need. NHS at Home will help keep people safe and out of hospital while providing the best possible care.”

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Source: Digital Health, 5 June 2020

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Doctors fear 'tsunami' of investigations over delayed care in COVID-19 pandemic

A poll of members by the Medical Protection Society (MPS) found that 43% of doctors fear investigation if patients come to harm because of delays to referrals and reduced NHS services during the pandemic.

Treatment has been delayed for millions of patients while the NHS has focused on managing the pandemic - with GPs in many areas still unable to refer as normal and even urgent referrals delayed while the UK has been in lockdown. The NHS Confederation has warned that 10 million people could be on NHS waiting lists by Christmas.

Reduced NHS services during the pandemic have left even patients who need urgent treatment or scans for cancer waiting longer. GPonline reported in April that patients had been waiting more than a month for urgent cancer checks - and Cancer Research UK warned in May that 2.4 million patients were waiting longer for scans or treatment because of disruption to services during the pandemic.

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Source: GPonline, 11 June 2020

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Covid aftercare piles pressure on ‘understaffed’ community services

The aftercare of COVID-19 patients will have significant financial implications for ‘understaffed’ community services, NHS England has been warned.

This month the national commissioner released guidance for the care of patients once they have recovered from an immediate covid infection and been discharged from hospital.

It said community health services will need to provide “ongoing health support that rehabilitates [covid patients] both physically and mentally”. The document said this would result in increased demand for home oxygen services, pulmonary rehabilitation, diagnostics and for many therapies such as speech and language, occupational, physio, dieticians and mental health support.

One GP heavily involved in community rehab told HSJ: “There is a lot detailed information about what people might experience in recovery, but it doesn’t say what should actually happen.

“We have seen people discharged from hospital that don’t know anything about their follow-up and the community [health sector] hasn’t got any instructions of what they should be doing or what services have even reopened. This guidance needs to go a step further and rapidly say what is expected so local commissioners can put that in place.”

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Source: HSJ, 10 June 2020

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UK ministers face legal challenge for refusal to order PPE inquiry

Ministers are facing a high court legal challenge after they refused to order an urgent investigation into the shortages of personal protective equipment faced by NHS staff during the coronavirus pandemic.

Doctors, lawyers and campaigners for older people’s welfare issued proceedings on Monday which they hope will lead to a judicial review of the government’s efforts to ensure that health professionals and social care staff had enough personal protective equipment (PPE) to keep them safe.

They want to compel ministers to hold an independent inquiry into PPE and ensure staff in settings looking after Covid-19 patients will be able to obtain the gowns, masks, eye protection and gloves they need if, as many doctors fear, there is a second wave of the disease.

About 300 UK health workers have so far died of COVID-19, and many NHS staff groups and families claim inadequate PPE played a key role in exposing them.

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Source: The Guardian, 8 June 2020

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Swann reveals future of Northern Ireland health service post COVID-19

Northern Ireland faces a massive challenge rebuilding health and social care in the wake of the first COVID-19 wave, Health Minister Robin Swann has said.

Speaking at the Northern Ireland Assembly on Tuesday, Mr Swann said that the rebuilding process can secure better ways of delivering services but will require innovation, sustained investment and society-wide support.

He said that services will not be able to resume as before and that rebuilding will be significantly constrained by the continuing threat from COVID-19 and the need to protect the public and staff from the virus.

“Our health and social care system was in very serious difficulties long before Coronavirus reached these shores. The virus has taken the situation to a whole new level. The Health and Social Care system has had its own lockdown – services were scaled back substantially to keep people safe and to focus resources on caring for those with COVID-19."

The Health Minister said that despite the pressures, there are opportunities to make improvements.

“I have seen so many examples of excellence, innovation and commitment as our health and social care staff rose to the challenges created by COVID-19. Decisions were taken at pace, services were re-configured, mountains were moved. Staff have worked across traditional boundaries time and time again. I cannot thank them enough. We must build on that spirit in the months and years ahead. Innovations like telephone triage and video consultations will be embedded in primary and secondary care.”

Mr Swann added that the health system can't go back to the way it was and that it must be improved.

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Source: Belfast Telegraph, 9 June 2020

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Coronavirus: 'Structural racism' must be taken into account when dealing with BAME deaths

"Structural racism and social inequality" should be taken into account when looking at the impact of COVID-19 on Britain's black, Asian and minority ethnic, according to an expert involved in a recent review.

Professor Kevin Fenton was a major part of a Public Health England (PHE) report ordered by the government into why the BAME community has been disproportionately affected by coronavirus. It found people from BAME groups were up to twice as likely to die with COVID-19 than those from a white British background.

The review was also meant to offer recommendations, but sources have told Sky News that these were "held back" by the government.

Health Secretary Matt Hancock said coming from a non-white background was a

Speaking at a public meeting for Hackney Council, Prof Fenton said: "Over the last six weeks I've worked with over 4,000 individuals to understand what are some of the contextual issues that are driving the excess risk amongst, black, Asian and minority ethnic groups."

"Some of the structural issues, like racism, discrimination, stigma, distrust, fair, these are real issues that are challenging for the communities and are seen as underpinning some of the disparities we see for COVID. Any conversation about what we need to do, should take into consideration these things."

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Source: Sky News, 9 June 2020

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'I am very angry at the way I have been treated due to COVID-19': Horrendous toll on non-virus patients is emerging

As the death toll from the virus soars above 40,000, slowly the horrendous toll on non-Covid patients is emerging.

These are patients who are not afflicted by coronavirus, but who have had their treatment or diagnosis for other potentially deadly conditions postponed or cancelled, as hospitals scrambled to make way for an overwhelming burden of COVID-19 patients.

Sherwin Hall, a 27-year-old from Leeds, had tried 13 times in one month during the lockdown to get a proper diagnosis for the crippling pain in his groin. He was initially told it might be a sexually transmitted disease. Eventually he was given the all clear of any STD after multiple blood tests and begged for an MRI scan. But he claims he was told no scans would be available because of the COVID-19 emergency.

Finally he got a scan which confirmed a 14 cm tumour near his pelvis. He clams his consultant confirmed the delay in diagnosis and therefore cancer treatment may have serious consequences on his chances of survival.

He told ITV news "I am very angry at the way I have been treated due to COVID-19 and the delay on my cancer treatment and now I am fighting for my life."

His lawyer, Mary Smith, who specialises in medical negligence at Novum Law in Bristol, says she is worried there will be a spike in cases involving delayed diagnosis or treatment coming across her desk.

She wants an urgent overhaul of the management of this crisis, now its peak appears to have passed. 

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Source: ITV News, 9 June 2020

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Three in four GP partners fear for staff safety as practice workload floods back

Almost three quarters of GP partners are concerned about how to keep colleagues safe as numbers of patients attending practices return to pre-pandemic levels - with access to PPE a major worry, a GPonline poll has found.

Half of the 185 GP partners responding to the poll said that they were either 'very worried' or 'slightly worried' about the government's ability to supply the PPE that GPs and practice staff needed to keep them as safe as possible through the rest of the pandemic.

Only 9% said they were 'very confident' that the government would be able to supply adequate PPE, with a further 20% saying they were 'slightly confident'.

Some 73% of GP partners said that they were concerned about how to ensure the safety of practice staff as the number of patients attending the surgery begins to rise.

BMA GP committee chair Dr Richard Vautrey said keeping staff safe was 'a challenge for everyone in the NHS'.

He told GPonline: 'Even months now into this crisis the government still hasn’t sorted out PPE in a way that means people have absolute confidence that they will have enough to meet their needs, and the growing needs of practices as they will need to be seeing more patients face-to-face for important procedures that can’t be done remotely.

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Source: GPonline, 8 June 2020

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Senior doctors warned of service failings before 12 deaths

Senior doctors repeatedly raised concerns over safety and staffing problems at a mental health trust before a cluster of 12 deaths, an HSJ investigation has found.

The deaths all happened over the course of a year, starting in June 2018, involving patients under the care of the crisis home treatment services at Birmingham and Solihull Mental Health Trust. The causes of the deaths included suicides, drug overdoses, and hanging.

Coroners found several common failings surrounding the deaths and have previously warned of a lack of resources for mental health services in the city.

HSJ has now seen internal documents which reveal senior clinicians had raised repeated internal concerns about the trust’s crisis home treatment teams during 2017 and early 2018. The clinicians warned of inadequate staffing levels, long waiting lists, and a lack of inpatient bed capacity.

In the minutes of one meeting in February 2018, just two months before the first of the 12 deaths, a consultant is recorded as saying he had “grave concerns over safety in [the home treatment teams]”.

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Source: HSJ, 9 June 2020

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Coronavirus: Risk higher for pregnant BAME women

The high proportion of pregnant women from black and ethnic minority (BAME) groups admitted to hospital with COVID-19 "needs urgent investigation", says a study in the British Medical Journal.

Out of 427 pregnant women studied between March and April, more than half were from these backgrounds - nearly three times the expected number. Most were admitted late in pregnancy and did not become seriously ill. Although babies can be infected, the researchers said this was "uncommon".

When other factors such as obesity and age were taken into account, there was still a much higher proportion from ethnic minority groups than expected, the authors said.

But the explanation for why BAME pregnant women are disproportionately affected by coronavirus is not simple "or easily solved," says Professor Knight, lead author.

"We have to talk to women themselves, as well as health professionals, to give us more of a clue."

Gill Walton from the Royal College of Midwives says, "Even before the pandemic, women from black, Asian or ethnic minority backgrounds were more likely to die in and around their pregnancy,"

She said they were "still at unacceptable risk" and getting help and support to affected communities was crucial. 

Ms Walton added: "The system is failing them and that has got to change quickly, because they matter, their lives matter and they deserve the best and safest care."

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Source: BBC News, 8 June 2020

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Coronavirus: NHS trust bosses not consulted over new face mask rules

NHS trusts were not consulted before the government announced changes to the use of face coverings and visitor policy in English hospitals, the chief executive of NHS Providers has said.

Chris Hopson said trust leaders felt "completely in the dark" about the "significant and complex" changes.

From 15 June, hospital visitors and outpatients must wear face coverings and staff must use surgical masks.

A spokeswoman said that, while the public were "strongly urged" to wear a face covering while inside hospitals, no-one would be denied care.

Separately, NHS England has lifted the national suspension on hospital visiting with new guidance for NHS trusts.

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Source: BBC News, 6 June 2020

 

 

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More than half of England’s coronavirus-related deaths will be people from care homes

Care home residents are on course to make up more than half the deaths caused directly or indirectly by the coronavirus crisis in England, according to a new analysis.

The study warns that the death toll by the end of June from OVID-19 infections and other excess deaths is “likely to approach 59,000 across the entire English population, of which about 34,000 (57%) will have been care home residents”.

The estimate, produced by the major healthcare business consultancy LaingBuisson, includes people who list a care home as their primary residence, wherever they died – including those who died in hospital.

It is based on data from the Office for National Statistics, as well as the analyst’s own modelling of the number of care home resident deaths likely to have occurred in the absence of the pandemic.

The new study coincides with mounting concerns over the failure to protect care homes earlier in the pandemic. Senior care industry figures point to the decision to move some hospital patients back to care homes in mid-March. There have also been complaints that non-Covid-related healthcare became less accessible to homes during the height of the pandemic, leading to extra deaths.

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Source: The Guardian, 7 June 2020

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After coronavirus, we may not recognise changed NHS

In many ways it is wrong to talk about the NHS restarting non-coronavirus care. A lot of it never stopped — births, for instance, cannot be delayed because of a pandemic.

However, exactly what that care looks like is likely to be very different from what came before. There are more video and telephone consultations and staff treat patients from behind masks and visors.

That is likely to be the case for some time, experts have told The Times.

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Source: The Times, 6 June 2020

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Contact tracing system rolled-out across Wales

A contact tracing system has this week been launched in Wales, initially a telephone based process, followed by an online system next week.

Anyone who has a positive coronavirus test result will be contacted by a team of contact tracers and asked for details of everyone they have had close contact with while they have had symptoms.

From Monday 8th June, a new online system will be used to support the process. People will have the option to use the system to provide details of their close contacts electronically.

The system has been trialled in four health board areas over the last two weeks and more than 600 contact tracers have so far been employed, with more to be employed.

Health Minister,  Vaughan Gething said “Today’s roll-out of the contact tracing element of our Test, Trace, Protect strategy is a significant step forward in the gradual move out of lockdown.”

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Source: HTN, 2 June 2020

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Respiratory patients still avoiding A&E

Emergency attendances for several conditions are still well below their normal levels, despite a steady increase in overall activity since the peak of the coronavirus outbreak.

Weekly data from Public Health England suggests overall A&E attendances increased to around 105,000 in the last week of May, which was an increase from 98,813 over the previous seven days.

Data from the 77 A&E departments included in the research suggests that overall attendances are up to an average of 15,000 day, compared to around 10,000 at the peak of the pandemic and the long-term trend of just under 20,000. However, attendances for bronchitis, acute respiratory infections, respiratory, pneumonia, asthma, gastroenteritis are still far below their normal levels.

It did not offer an explanation for why attendances for these conditions have remained low, while those for cardiac, influenza, myocardial Ischaemia, and gastrointestinal problems have returned to normal levels or above.

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Source: HSJ, 5 June 2020

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Michael Seres, an influential patient who hacked together a ‘smart’ ostomy bag, dies at 51

Michael Seres, an entrepreneur, patient advocate, husband and father of three, died on Saturday in Orange County, California, of a sepsis infection. He was 51. 

Seres was widely considered to be one of the first and most prominent “e-patients,” a term which has become popular to denote patients who are informed and engaged in their health, often sharing their experiences online. He is also one of a small number of patient inventors who helped design and build a medical device – a digitally enhanced ostomy bag – that got FDA clearance in 2014. His invention eased the suffering of millions of people with bowel injuries, chronic gut illnesses and cancer.

Source: CNBC, 2 June 2020

Read more about Michael and his innovative patient work in our hub blog

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BMA urges plan to tackle backlog of patients awaiting non-covid treatment

The government urgently needs to set out a plan to reduce the huge backlog of patients waiting for NHS treatments unrelated to COVID-19 in the wake of the pandemic, the BMA has said.

The call came as the BMA released the results of its latest survey of over 8000 doctors. It found that more than half (3754 of 7238) were either not very confident or not confident at all that their department would be able to manage patient demand as NHS services resumed.

“The government must be honest with the public about the surge to come and start meaningful conversations with frontline clinicians about how we can, together, begin to tackle the backlog,” said the BMA’s chair of council, Chaand Nagpaul. “Covid-19 has brought with it the worst health crisis in a century. The NHS must not return to its previous perilous state.”

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Source: BMJ, 4 June 2020

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Extra 10,000 dementia deaths in England and Wales in April

There were almost 10,000 unexplained extra deaths among people with dementia in England and Wales in April, according to official figures that have prompted alarm about the severe impact of social isolation on people with the condition.

The data, from the Office for National Statistics, reveals that, beyond deaths directly linked to COVID-19, there were 83% more deaths from dementia than usual in April, with charities warning that a reduction in essential medical care and family visits were taking a devastating toll.

“It’s horrendous that people with dementia have been dying in their thousands,” said Kate Lee, chief executive officer at Alzheimer’s Society. “We’ve already seen the devastating effect of coronavirus on people with dementia who catch it, but our [research] reveals that the threat of the virus extends far beyond that.”

The charity thinks the increased numbers of deaths from dementia are resulting partly from increased cognitive impairment caused by isolation, the reduction in essential care as family carers cannot visit, and the onset of depression as people with dementia do not understand why loved ones are no longer visiting, causing them to lose skills and independence, such as the ability to speak or even stopping eating and drinking.

Another factor may be interruptions to usual health services, with more than three-quarters of care homes reporting that GPs have been reluctant to visit residents.

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Source: The Guardian, 5 June 2020

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Patient restraint spikes as covid measures spark ‘frustration’

Several mental health trusts have reported spikes in incidents of physical restraint or seclusion on patients, driven by COVID-19 restrictions, HSJ has learned.

Concerns have been raised nationally about the potential for incidents to increase during the pandemic, due to temporary measures which have had to be introduced such as visiting restrictions and communication difficulties due to personal protective equipment.

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Source: HSJ, 5 June 2020

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'Tens of thousands' of heart procedures delayed by pandemic

The postponement of tens of thousands of hospital procedures is putting the lives of people with long-term heart conditions at risk, according to the British Heart Foundation.

The coronavirus pandemic has created a backlog which would only get larger as patients waited for care, it said.

People with heart disease are at increased risk of serious illness with COVID-19, and some are shielding.

The BHF estimates that 28,000 procedures have been delayed in England since the outbreak of coronavirus in the UK. These are planned hospital procedures, including the implanting of pacemakers or stents, widening blocked arteries to the heart, and tests to diagnose heart problems.

People now waiting for new appointments would already have been waiting for treatment when the lockdown started, the charity said, as it urged the NHS to support people with heart conditions "in a safe way".

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Source: 5 June 2020

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NASA and other innovators work to redesign ventilators for COVID-19 patients

NASA scientists as well as other innovators are busy developing alternatives to the traditional ventilator being used worldwide to treat severe cases of COVID-19.  The movement is in response to growing evidence that in some cases ventilators can cause more harm than good in some patients with low oxygen levels. Statistics tell the story: 80% of patients with the coronavirus die on such machines.

Its VITAL machine is tailored for COVID-19 patients and is focused on providing air delicately to stiff lungs — a hallmark symptom of the virus.

Eight U.S. manufacturers have been selected to make the ventilator that was made in 37 days by engineers at NASA’s Jet Propulsion Laboratory.

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Source: CNBC, 30 May 2020

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