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Found 2,345 results
  1. News Article
    The number of people who have died from Covid in Britain during the pandemic is impossible to determine because of the inconsistent definitions of what is meant by a coronavirus death, researchers have concluded. Experts from Oxford University discovered that public health and statistics organisations across the UK are operating under 14 different definitions to classify a death from Covid. Freedom of Information (FOI) requests show that many people who died in the first wave never tested positive for the virus, particularly older people who died in care homes. Instead, their deaths were registered as Covid simply based on a statement of the care home provider, and because coronavirus was rife at the time. The authors also point out that it is unlikely that a Covid infection on its own could cause death in the absence of contributing factors, such as other illness, or the infection leading to a more deadly condition such as pneumonia. The report also found that in some trusts, up to 95% of Covid deaths were in people with Do Not Resuscitate (DNR) orders. The team said the confusion meant they were unable to separate deaths caused by Covid from those triggered by the pandemic response, and called for a proportion of deaths to be verified by post-mortem in future pandemics to determine the true reason. Read full story (paywalled) Source: The Telegraph, 19 March 2022
  2. News Article
    A vaccine has been used to free a man who was trapped at home by a Covid infection that lasted for more than seven months. It is the first time that a vaccine has been used to "treat" Covid rather than "prevent" it. Ian Lester, 37, has a weakened immune system due to Wiskott-Aldrich syndrome, and was unable to defeat the virus on its own. He says he became a prisoner in his home in Caerphilly, Wales, as he isolated for months on end. He shielded during the first wave of Covid, but coronavirus eventually found him in December 2020. He had one of the classic symptoms - a slight loss of sense of taste and smell - which cleared up within a month. For most of us that would be the end of it, but Ian's Covid journey was only just beginning. His doctors wanted him to keep on testing because his weakened immune system meant there was a risk he could be contagious for longer than normal. But month after month, test after test came back positive. Ian had to give up work. Scientists and doctors were monitoring the battle between the virus and Ian's immune system at Cardiff University and at the Immunodeficiency Centre for Wales in the University Hospital of Wales. The analysis showed Ian had a long-term infection, it was not just "dead virus" being detected, and his symptoms were not long-Covid. Prof Stephen Jolles, clinical lead at the Immunodeficiency Centre, said: "This infection was burbling along, but with his [weakened] immune system it was just not enough to kick off a response sufficient to clear it. "So the vaccine really made a huge difference, in antibodies and T-cells, and utilised and squeezed every last drop out of what his immune system could do." Read full story Source: BBC News, 21 March 2022
  3. News Article
    A hospital in Devon has declared a second critical incident following extreme pressures, as Covid-19 admissions in the region double, The Independent has learnt. North Devon Healthcare Trust declared a critical incident on Monday, after it declared another earlier this month it has confirmed. The news comes as the number of people with Covid-19 across two hospitals in Devon has doubled in just two weeks. As of Thursday, there were 292 Covid positive patients in across hospitals in Devon, with a further 37 awaiting test results. According to a statement from healthcare leaders in Devon, Plymouth and Torbay, as of Thursday there were almost 1,200 NHS staff off work due to Covid. Meanwhile 183 care services, such as care homes and other social care providers, in the area have reported Covid outbreaks, making it harder to discharge patients, the leaders said. NHS data published on Thursday showed there were 213 patients across three hospitals in Devon, waiting to be discharged. Covid-19 infections are also continuing to rise across most of the UK, with levels in Scotland hitting another record high, new figures show. Read full story Source: The Independent, 19 March 2022
  4. News Article
    Infection control rules in hospitals are ‘now disproportionate to the risks’ posed by covid and should be relaxed, some of the NHS’s most senior leaders have warned. The government rules – such as not allowing covid-positive staff to work, and separating out services for covid, non-covid and covid-contact patients – make a big dent in hospital capacity and slows down services. Glen Burley, who is chief executive of three Midlands trusts and involved in national-level discussions on elective matters, told HSJ: “Pretty much every pathway has a covid and non-covid route, which slows down flow and staff productivity. “There is a growing argument that these rules are now disproportionate to the risks. With covid cases in the community also rising now, we may have to question again the relative risks of continuing to isolate staff.” NHS Confederation director of policy Layla McCay told HSJ: “Healthcare leaders are concerned the current [IPC] measures are having a serious knock-on effect on capacity and that the measures in their current form are reducing efficiency and capacity within healthcare settings. “We need more clarity on if and how current measures can be safely adjusted so [the NHS] can further increase bed capacity and patient throughput, as well as the ability to transport patients more quickly and efficiently.” But NHS Providers, which has previously said relaxing the IPC guidance would not enable a “rapid” increase in the NHS’ capacity to tackle the elective care backlog and could pose significant “risks”, remains more cautious. Read full story (paywalled) Source: HSJ, 21 March 2022
  5. Content Article
    People with COVID-19 often have symptoms in the long term (ie, long COVID), including fatigue, breathlessness, and neurocognitive difficulties. The disease mechanisms causing long COVID are unknown, and there are no evidence-based treatment options. Clinical guidelines focus on symptom management, and various treatment options are being evaluated. The scarcity of advice has often left people with long COVID feeling isolated and frustrated in their search for therapies. Research is needed to understand the self-management practices that are being used to manage long COVID symptoms; factors influencing their uptake; and the benefits, harms, and costs. There is also a need to assess the potential harmful effects of polypharmacy and drug–drug interactions in these individuals. The Therapies for Long COVID (TLC) Study (ISRCTN15674970) will begin to explore self-management practices through a survey of people with long COVID. This study aims to be a first step towards understanding this important and under-researched public health issue. 
  6. Content Article
    Last month, Boris Johnson argued that the downward trends in Covid cases and hospitalisations meant that it was time to scrap restrictions. Now both are rising. But the government is ending testing and most surveillance studies. Sajid Javid, the health secretary, said that the rise was “to be expected” – though this foresight did not extend to having a plan to deal with the increase in infections. Instead, he dismissed the concern about the new Deltacron variant. The health secretary seemed nonchalant about the threat the virus now posed. Sajid Javid may be right that the country has weathered the worst of the pandemic, but Covid is not yet in retreat. It makes no sense to withdraw funding from a series of studies that allow the spread of the virus to be mapped in detail. Without the data, experts won’t be able to effectively monitor the disease. The country will be less effective in responding and adjusting to future waves of infection. Individuals will be less able to make informed choices about the risks involved. The clinically vulnerable face being cut off from everyday life. “It is like turning off the headlights at the first sign of dawn,” Stephen Reicher, a psychologist at the University of St Andrews, told the Guardian. “You can’t see what’s coming and you don’t know when it makes sense to turn them on again.”
  7. News Article
    US health officials are monitoring an unusual situation in the UK, where COVID-19 cases and hospitalisations are simultaneously climbing due to the BA.2 subvariant, CNN reports. COVID-19 cases were up 52% in the UK last week compared with the week prior, and hospitalisations were up 18%t over the same period, according to the UK Coronavirus Dashboard. The seemingly in-tandem ascent of cases and hospitalisations is unusual, given that increases in COVID-19 cases preceded increases in hospitalisations by about 10 days to two weeks in previous waves. "So we're obviously keenly interested in what's going on with that," Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN. Dr Fauci said in conversation with his U.K. counterparts, they attribute the rising cases and hospitalisations to three things, listed in order of contribution: the BA.2 variant, which is more transmissible than the original omicron; the opening of society, with people socializing indoors without masks; and waning immunity from vaccination or prior infection. Hospitalisations in the U.K. raise questions, given that BA.2 doesn't appear to cause more severe disease. "The issue with hospitalization is a little bit more puzzling, because although the hospitalizations are going up, it is very clear their use of ICU beds has not increased," Dr. Fauci said. "So are the numbers of hospitalizations a real reflection of COVID cases, or is there a difficulty deciphering between people coming into the hospital with COVID or because of COVID?" Read full story Source: Becker Hospital Review, 16 March 2022
  8. Content Article
    COVID-19 has meant activity in general practice has changed dramatically over the last 2 years. Practices have moved rapidly towards remote triage and care delivery to reduce risk of infection. Many have also delivered a large proportion of the COVID-19 vaccination programme as part of Primary Care Networks (PCNs), alongside their usual patient care. Understanding the total workload of general practice is vital for planning, research and supporting practices under pressure. However, the data we have on activity in general practice are limited, especially compared with hospital data. This has made it challenging to accurately track the ongoing impact of COVID-19 on general practice. This short analysis from The Health Foundation uses data from different sources, some publicly available and some not, to explore recent trends in general practice activity in England. We also present data on the general practice workforce, to help contextualise activity levels. It highlights what the data can tell us – and importantly, what it can’t.
  9. News Article
    Some care homes have "no choice" but to allow workers who have Covid to deliver care, a public health official said. According to Public Health England cases are rising the fastest in Somerset. As a result, care homes in the county are struggling to safely staff their services and schools are seeing a rise in staff sickness. Somerset Council said ensuring vulnerable residents received care was "lower risk" than them being infected. Health officials advised care workers to continue working only if they wore PPE and felt well enough. Council public health consultant Alison Bell said: "In some cases, we have no choice but to have people who are testing positive delivering care to people in Somerset. "That risk is actually less than that person not receiving care." She said the Omicron variant was more transmissible and people were getting re-infected with it, some within a matter of weeks. Read full story Source: BBC News, 16 March 2022
  10. News Article
    Admissions of covid positive patients to English hospitals are once again rising steadily across England. The seven day total of new confirmed covid cases in hospitals on 12 March (the latest data available) stood at 9,642. This is 46% higher than the seven day total of 6,612 recorded on 25 February, the day before the current rise began. Asked on Radio 4’s Today programme yesterday about the rise in Covid infections, health and social care secretary Sajid Javid said there was “nothing in the [covid] data that gives us any cause for concern”. The Covid admissions figures used include patients who are already covid-positive when admitted, are diagnosed on admission, or are diagnosed while in hospital, so in some cases have caught Covid while in hospital. Read full story (paywalled) Source: HSJ, 15 May 2022
  11. News Article
    People who suffer from severe Covid-19 symptoms are more likely to have long-term mental health problems, a new study suggests. Higher rates of depression and anxiety have been found in people who were “bedridden” with Covid-19 for more than seven days last year, according to a study published in the Lancet. Scientists, drawing on data from 247,249 people across the UK, Denmark, Estonia, Iceland, Norway and Sweden, found that people with coronavirus who were not admitted to hospital were more likely to experience symptoms of depression up to 16 months after diagnosis, compared to those never infected. However, over 16 months, patients who were bedridden for seven days or more were between 50 and 60% more likely to experience higher levels of depression and anxiety compared to people never infected during the study period, the researchers found. Overall, people diagnosed with Covid-19 had a higher prevalence of depression and poorer sleep quality compared with individuals who were never diagnosed – 20% of those in the former group experienced symptoms of depression, versus 11% in the latter group. Researchers suggested patients who spent longer in bed or had higher depression or anxiety rates could be suffering from ill health due to a combination of worrying about long-term health effects and Covid symptoms persisting. Patients with severe Covid often experience inflammation, which has previously been linked to chronic mental illness, particularly depression. Read full story Source: The Independent, 15 March 2022
  12. News Article
    Covid-19 is on the retreat across the American continents but it is too early for the region to let its guard down, warned the Pan American Health Organisation, the World Health Organization’s regional office for the Americas, on 9 March. Reported cases of Covid-19 fell by 26% in the past week and deaths by nearly 19%, as the omicron wave of infections tailed off. But ongoing transmission and future variants could expose the region’s public health priorities once more, said PAHO’s director, Carissa Etienne. A total of 2.6 million people have died from Covid-19 in the Americas, the highest number of any region of the world and almost half of the global total, despite being home to only 13% of its population. “This is a tragedy of enormous proportions, and its effects will be felt for years to come,” said Etienne on the second anniversary of the pandemic. Patchy vaccination coverage has left countries vulnerable to current and future variants of SARS-CoV-2. Around 248 million people in Latin America and the Caribbean are yet to receive a single dose of a covid vaccine, with vaccination rates particularly low in hard-to-reach rural areas. In the first two months of 2022 the Americas accounted for 63% of the world’s new cases. Despite a general fall in incidence across the region, new cases rose by 2.2% in the Caribbean, while Bolivia and Puerto Rico reported an increase in deaths in the past week. Michael Touchton, head of the University of Miami’s Covid-19 policy observatory for Latin America, said, “Latin America is perhaps the most vulnerable region in the world to the emergence of a new variant. Vaccine delays have a greater impact in Latin America due to concentrated urban populations, chronic disease burden, and low capacity health systems. Taken together, Latin America is likelier to fare worse than other similarly low and middle income regions.” Read full story Source: BMJ, 14 March 2022
  13. News Article
    A newly-discovered Covid variant that combines mutations from both Omicron and Delta is “the real thing,” scientists have said. Earlier in the year, concern was raised after a lab in Cyprus claimed to have found evidence of a Delta-Omicron recombination event – when the two variants co-infect a patient and exchange genetic material to produce a new viral offspring – but experts said the findings were false. Now, however, virologists from L’Institut Pasteur in Paris have sequenced the genome of a genuine “Deltacron” variant, which has been detected in several regions of France and appears to have been circulating since early January. “This one is legit,” said Aris Katzourakis, a professor of evolution and genomics at the University of Oxford. “[It is] one to keep an eye on.” “The French cluster appears to be a validated occurrence where a recombination event has given rise to a virus fit enough to circulate,” said Dr Stephen Griffin, a virologist at the University of Leeds. In deriving its spike from Omicron, the Deltacron variant could similarly target the upper respiratory pathway, rather than the lungs, Dr Griffin said. “At the same time, there are some parts of Omicron thought to lessen severity that are missing from the recombinant,” he said. Dr Griffin said: "This is another clear demonstration that we remain in a dynamic situation with respect to Sars-2, and that the maintenance of genetic surveillance and testing is both relevant and prudent." Read full story Source: The Independent, 11 March 2022
  14. Content Article
    Catherine Villanueva Gardner, Professor of Women’s and Gender Studies and Philosophy at the University of Massachusetts Dartmouth, looks at the material effects on women with Long Covid.
  15. News Article
    Nearly one in five items of personal protective equipment (PPE) the government bought during the pandemic are not fit for purpose and cannot be used by the NHS, it has been revealed – including 1.2 billion items that cannot be used at all. As of December, almost 7 billion items of personal protective equipment bought for frontline services – 19.1% of the 36.4 billion items bought since February 2020 – had been marked “do not supply” to the NHS by the Department of Health and Social Care. The number is more than three times the figure quoted last September, when health minister Lord Bethell admitted 1.9 billion items worth £2.8bn were in the “do not supply” category – 6.2% of the PPE bought up to that point. The not-fit-for-purpose stock includes 1.2 billion units of PPE that cannot be used in any setting. This "wastage" – which accounts for 3.3% of pandemic PPE – includes around 800m aprons that DHSC is now looking to recycle, permanent secretary Sir Chris Wormald said in a letter to the Public Accounts Committee. The revelation comes as a consultation opens on the terms of reference for the public inquiry into the government's response to Covid. The inquiry will look at pandemic preparedness and the healthcare response, among other things. Read full story Source: Civil Service World, 11 March 2022
  16. News Article
    A leading figure in the World Health Organisation Foundation has criticised the UK’s move to dismantle its Covid testing programme as the disease surges in other parts of the world. Mr Anil Soni, chief executive of the WHO Foundation, said in an interview with The Independent that maintaining surveillance over Covid-19 was “incredibly important” and the “dismantling of the testing infrastructure here strikes me as very worrying.” The WHO Foundation chief warned people were “looking the other way” from counties where there is low vaccine coverage to maintain the hope that Covid is over. He warned low vaccine coverage is a “petri dish” for future variants to breed and that the acute phase of the pandemic could not be over until this is addressed. When asked about the UK’s plans to end its NHS Test and Trace programme Mr Soni said: “I’m very concerned about it. “What we’ve seen is, it’s incredibly important to maintain surveillance, and countries in southern Africa should be applauded for detecting Omicron as quickly as they did. Those surveillance systems need to be in place around the world. “We also want to make sure that testing is widely available so that people, when they become infectious, can be aware of their status and keep others safe. For testing not to be available and for us to be moving too quickly to normalcy creates risk.” Mr Soni said the world’s position with Covid was “precarious” and highlighted the surge being seen in Hong Kong, where “health centres are at the verge of collapse, because of how many people are sick”. Read full story Source: The Independent, 10 March 2022
  17. News Article
    The draft terms of reference for the UK public inquiry into the government's handling of the Covid-19 pandemic have been published. The inquiry, due to start in the spring, will play a key role in "learning lessons" from the pandemic and for the future, it said. The terms of reference were published after a consultation with inquiry chairwoman and former High Court judge Baroness Hallett, and with ministers in the devolved nations. The Scottish government has already published the terms of reference for its own Covid-19 inquiry, to be led by Judge Lady Poole. The UK-wide inquiry proposes examining a broad range of issues including: the UK's preparedness for the pandemic the use of lockdowns and other 'non-pharmaceutical' interventions such as social distancing and the use of face coverings the management of the pandemic in hospitals and care homes the procurement and provision of equipment like personal protective equipment and ventilators support for businesses and jobs, including the furlough scheme, as well as benefits and sick pay. The inquiry aims to produce "a factual, narrative account" covering decision-making at all levels of government and the response of the health and care sector as well as identifying the "lessons to be learned". Becky Kummer, spokesperson for Covid-19 Bereaved Families for Justice, said the publication was a "huge step forward" and the organisation looked forward to contributing to the consultation on the terms. Chris Hopson, chief executive of NHS Providers, which represents hospital trusts, said there was much the NHS did well during the pandemic but: "It is right the inquiry looks at areas where there were major challenges - such as infection prevention and control, access to PPE, testing, and robust epidemiological modelling." Read full story Source: BBC News, 11 March 2022
  18. Content Article
    The introduction of remote triage and assessment early in the pandemic raised questions about patient safety. Wieringa et al. sought to capture patients and clinicians’ experiences of the management of suspected acute COVID-19 and generate wider lessons to inform safer care. Lessons from the pandemic suggest three key strategies are needed to prevent avoidable deaths and inequalities in the next crisis: (1) strengthen system resilience (including improved resourcing and staffing; support of new tools and processes; and recognising primary care’s role as the ‘risk sink’ of the healthcare system); (2) develop evidence-based triage and scoring systems; and (3) address social vulnerability.
  19. Content Article
    This is the independent public inquiry to examine the UK’s preparedness and response to the Covid-19 pandemic, and to learn lessons for the future. The Inquiry has been established under the Inquiries Act 2005. This means that the Chair will have the power to compel the production of documents and call witnesses to give evidence on oath. The Chair has been appointed and will set out her vision for the Inquiry’s work in the coming months. The Inquiry has received the draft Terms of Reference from the Cabinet Office, and will open a public consultation tomorrow, Friday 11 March. The consultation will remain open for four weeks, and will be available online. See the UK COVID-19 Inquiry: draft terms of reference.
  20. News Article
    Deepa Singh, 30, of Louisville, USA, has been seriously ill for two years, racked with extreme fatigue, racing heartbeat and memory problems from Long covid that she says prevent her from working. Adding to her distress, she says, has been a grueling — and so far unsuccessful — battle for disability payments. Singh, who worked as a project manager, is among a cohort of Long Covid patients who have been denied disability benefits, either by private insurance companies, which operate benefit plans offered by employers, or by the Social Security Administration, which manages government disability benefits. Tasked with sorting legitimate health claims from fraudulent or marginal ones, these gatekeepers now face a novel challenge as the coronavirus pandemic drags on: a flood of claims citing a post-infection syndrome that is poorly understood by the medical community and difficult to measure. Patients cite a litany of symptoms that defy verification through basic medical tests. They become exhausted at the merest exertion. They can’t remember simple words. Their hearts feel like they are fluttering. Yet neurological exams, ECGs and chest X-rays come back clean. Doctors said in interviews they are treating Long Covid patients who are clearly too sick to work but who have difficulty meeting the evidence threshold insurers demand: objective medical test results showing an inability to perform work. Specialized tests can measure a few Long Covid-related problems, such as a central nervous system disorder called dysautonomia, which affects the body’s ability to regulate itself. But there are months-long waiting lists for the tests, doctors and patients said. The challenges are similar to those faced for years by people claiming disabilities based on chronic fatigue syndrome. But the pandemic has given rise to such claims on a far greater scale. Read full story (paywalled) Source: The Washington Post, 8 March 2022
  21. News Article
    Catching Covid may cause changes to the brain, a study suggests. Scientists found significant differences in MRI (magnetic resonance imaging) scans before and after infection. Even after a mild infection, the overall size of the brain had shrunk slightly, with less grey matter in the parts related to smell and memory. The researchers do not know whether the changes are permanent but stressed the brain could heal. Lead author Prof Gwenaelle Douaud, from the Wellcome Centre for Integrative Neuroimaging, at the University of Oxford, said: "We were looking at essentially mild infection, so to see that we could really see some differences in their brain and how much their brain had changed compared with those who had not been infected was quite a surprise." But the researchers do not know whether the changes are reversible or truly matter for health and wellbeing. "We need to bear in mind that the brain is really plastic - by that we mean it can heal itself - so there is a really good chance that, over time, the harmful effects of infection will ease," Prof Douaud said. The most significant loss of grey matter was in the olfactory areas - but it is unclear whether the virus directly attacks this region or cells simply die off through lack of use after people with Covid lose their sense of smell. UK Biobank chief scientist Prof Naomi Allen said: "It opens up all sorts of questions that other researchers can follow up about the effect of coronavirus infection on cognitive function, on brain fog and on other areas of the brain - and to really focus research on how best to mitigate that." Read full story Source: BBC News, 8 March 2022
  22. News Article
    Sasha Mallett, Sue Taylor and Kimberly Cooley all have immune deficiencies that make them especially vulnerable to Covid-19, and all have tried to get the same thing: a new treatment that can prevent the disease in people who either cannot produce antibodies after receiving a coronavirus vaccine or cannot get vaccinated at all. Ms. Cooley, a liver transplant recipient in Duck Hill, Mississippi, got the antibody drug, called Evusheld, from her transplant team at the University of Mississippi Medical Center with no trouble. But Ms. Taylor, of Cincinnati, was denied the treatment by two hospitals near her home. And Dr. Mallett, a physician in Portland, Ore., had to drive five hours to a hospital willing to give her a dose. As much of the USA unmasks amid plummeting caseloads and fresh hope that the pandemic is fading, the Biden administration has insisted it will continue protecting the more than seven million Americans with weakened immune systems who remain vulnerable to Covid. Evusheld, which was developed by AstraZeneca with financial support from the federal government, is essential to its strategy. But there is so much confusion about the drug among healthcare providers that roughly 80% of the available doses are sitting unused in warehouses and on pharmacy and hospital shelves. Interviews with doctors, patients and government officials suggest the reasons the drug is going unused are varied. Some patients and doctors do not know Evusheld exists. Some do not know where to get it. Government guidelines on who should be prioritised for the drug are scant. In some hospitals and medical centres, supplies are being reserved for patients at the highest risk, such as recent transplant recipients and cancer patients, while doses in other areas of the country are being given out through a lottery or on a first-come, first-served basis. Hesitance is also an issue. Some doctors and other providers do not know how to use Evusheld and are thus loath to prescribe it. Read full story (paywalled) Source: New York Times, 6 March 2022
  23. Content Article
    Influenza, polio and more have shown that infections can change lives even decades later. So why the complacency over possible long-term effects of COVID-19 writes Laura Spinney in this Nature article.
  24. Content Article
    Government must take a cautious and evidence-based approach to exiting the pandemic, factoring in six key elements for a fail-safe exit strategy.
  25. Content Article
    What have we learned about the symptoms of Long COVID or Post COVID-19 condition so far? How long does it last, when should you worry, and what treatments are recommended? WHO’s Dr Janet Diaz explains in this video. Part of WHO's Science in 5 series.
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