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Found 2,345 results
  1. Content Article
    An author turned junior doctor’s account of the chaos at work and anguish at home as Covid-19 arrived in the UK.
  2. News Article
    When the coronavirus pandemic began, Emily Landon thought about her own risk only in rare quiet moments. An infectious-disease doctor at the University of Chicago Medicine, she was cramming months of work into days, preparing her institution for the virus’s arrival in the United States. But Landon had also recently developed rheumatoid arthritis—a disease in which a person’s immune system attacks their own joints—and was taking two drugs that, by suppressing said immune system, made her more vulnerable to pathogens. Normally, she’d be confident about avoiding infections, even in a hospital setting. This felt different. “We didn’t have enough tests, it was probably around us everywhere, and I’m walking around every day with insufficient antibodies and hamstrung T-cells,” she said. Two years later, Covid-19 is still all around us, everywhere, and millions of people like Landon are walking around with a compromised immune system. A significant proportion of them don’t respond to Covid vaccines, so despite being vaccinated, many are still unsure whether they’re actually protected—and some know that they aren’t. Much of the United States dropped COVID restrictions long ago; many more cities and states are now following. That means policies that protected Landon and other immunocompromised people, including mask mandates and vaccination requirements, are disappearing, while accommodations that benefited them, such as flexible working options, are being rolled back. This isn’t a small group. Close to 3% of US adults take immunosuppressive drugs, either to treat cancers or autoimmune disorders or to stop their body from rejecting transplanted organs or stem cells. That makes at least 7 million immunocompromised people. In the past, immunocompromised people lived with their higher risk of infection, but COVID represents a new threat that, for many, has further jeopardised their ability to be part of the world. From the very start of the pandemic, some commentators have floated the idea “that we can protect the vulnerable and everyone else can go on with their lives.” Seth Trueger, who is on immunosuppressants for an autoimmune complication of cancer, said. “How’s that supposed to work?” He is an emergency doctor at Northwestern Medicine; he can neither work from home nor protect himself by avoiding public spaces. “How am I supposed to provide for my family or live my life if there’s a pandemic raging?” he said. Read full story Source: The Atlantic, 16 February 2022 Further reading Read further Covid-19 blogs and stories from staff on the frontline
  3. Content Article
    Persistent Covid-19 illness following an acute infection with SARS-CoV-2 can have both a physical and psychological impact. Pharmacists in community and primary care should be able to provide patients with appropriate advice and support to manage their symptoms.
  4. News Article
    Children aged between five and 11 in England will be offered a low-dose Covid vaccine, the government says. Official scientific advice concludes the move would help protect the "very small" number of children who become seriously ill with Covid. Health Secretary Sajid Javid says the rollout will be "non-urgent", with an emphasis on parental choice. Northern Ireland also said on Wednesday it will be following Wales and Scotland in offering young children the vaccine. Children are at a much lower risk of becoming severely ill from a Covid infection, so the health benefits of vaccinating them are smaller than in other age-groups. Also, many will have some protection from already having caught the virus. So the scientists on the Joint Committee on Vaccination and Immunisation (JCVI), which advises governments across the UK, have been weighing up the evidence for immunising five to 11-year-olds. It concluded vaccination should go ahead to prevent a "very small number of children from serious illness and hospitalisation" in a future wave of Covid. Prof Wei Shen Lim, from the JCVI, said: "We're offering this to five to 11-year-olds now in order to future-proof their defences against a future wave of infection." He suggested parents consider getting their children vaccinated during school holidays to minimise disruption to their education from any flu-like side effects of the jab. Read full story Source: BBC News, 16 February 2022
  5. News Article
    As surges of COVID-19 cases driven by the highly infectious Omicron variant recede, parts of the United States, Canada, and Europe are moving swiftly to lift constraints on a pandemic-fatigued public. Sweden, Denmark, and Norway have abolished nearly all ­COVID-19–related restrictions in recent weeks, and the United Kingdom announced it would do the same this month, dropping even the legal requirement that people quarantine after testing positive for SARS-CoV-2. In the United States, despite persistently high numbers of COVID-19–related deaths and busy hospitals, 10 governors, many known for being cautious in their pandemic response, last week announced immediate or impending ends to their states’ indoor or school mask mandates. Some of those moves came with assertions that it’s time to “live with the disease” and treat the coronavirus as endemic—a stable, enduring figure in the panoply of human pathogens, alongside cold viruses and influenza. That suggestion troubles many scientists, who warn it is eroding governments’ commitment to tracking and responding to the pandemic—which could leave countries flying blind and unprepared for any new variant. “Endemic delusion is probably what captures it the best,” says Kristian Andersen, an infectious disease researcher at Scripps Research who has been especially critical of recent moves by his home country of Denmark, which include an announcement that as of this month COVID-19 would no longer be categorised as a “socially critical disease” even though related death and hospitalisation rates were still climbing there. In the United States, governors cited various metrics to justify recent decisions to lift or let expire indoor mask mandates. California Governor Gavin Newsom noted stable hospitalisation rates and a 65% reduction in cases since Omicron’s peak in announcing the state’s mandate would end this week. But leaders also face political and economic pressures. States’ moves may be driven largely by the public’s impatience with restrictions, says epidemiologist Dustin Duncan of Columbia University. “Even people who recognize the importance of masking, social distancing, all that stuff, may be more amenable to take more risk,” he says. “At the same time, to me, going maskless just seems egregious.” Read full story Source: Science, 15 February 2022
  6. Content Article
    In this blog, Patient Safety Learning’s Chief Executive, Helen Hughes, reflects on participating in a recent Health Service Journal (HSJ) Patient Safety Congress webinar, held in association with BD, which considered some of the key emerging patient safety issues for 2022. 
  7. Content Article
    The UK Health Security Agency (UKHSA) has undertaken a rapid evidence review looking at the effects of vaccination against Long COVID or post-COVID symptoms. The review includes 15 UK and international studies that were undertaken up until January 2022. An estimated 2% of the UK population have reported symptoms of long COVID or post-COVID syndrome, which can last for more than 4 weeks after their initial infection. The three most common symptoms are fatigue, shortness of breath and muscle or joint pain. Eight of the studies in the review looked at the effect of vaccinations administered before infection. Most of these studies suggest that vaccinated people (1 or 2 doses) were less likely to develop symptoms of long COVID following infection compared with unvaccinated people – in the short term and long term (4 weeks up until 6 months after infection).
  8. News Article
    Two years of the pandemic have meant drops in essential screening and detection in Australia, while cancer patients undergo treatments alone and isolate to avoid Covid risks. When Claire Simpson turned 50 in early 2020, she received a letter telling her to get a mammogram. Then the pandemic hit, and Victoria went into lockdown. “Like many people, I put it off until we were coming out of that lockdown, but by then it was September and I couldn’t get an appointment until December,” she says. In February 2021 she was diagnosed with breast cancer and had a mastectomy. Tests showed she was positive for the aggressive HER2 receptor, so she began 12 weeks of chemotherapy as well as a treatment called Herceptin, which she received an IV infusion of every three weeks. Simpson says the delay in screening “really, really delayed diagnosis for me, by a good six months”. “I can’t help but feel that [an earlier screening] could have probably saved me from having to have chemotherapy and this Herceptin infusion therapy that I’m having,” she says. Her last Herceptin treatment was last Wednesday. She has been living in self-imposed lockdown, terrified as the Omicron wave built that she would have to isolate due to Covid and disrupt her treatment. That self-imposed isolation will continue until her final surgery, an elective operation scheduled for mid-year. Cancer screening dropped by 10% in Victoria alone in the first year of the pandemic. In 2021, referrals to the Peter MacCallum Cancer Centre, a leading treatment and research facility in Melbourne, were down 40%. “That is certainly going to bounce back at some point,” says Prof Sherene Loi, an oncologist and researcher at Peter MacCallum. “It is potentially going to be a real problem in a few years’ time. At the moment we have a lot of very young cancer diagnoses, a lot of breast cancer … we are just flat chat.” Read full Source: The Guardian, 13 February 2022
  9. Content Article
    This report from CIPD examines the latest evidence and the experiences of employees experiencing long COVID, and offers recommendations for organisations on how to effectively support those with long COVID to return to, and stay in, work.
  10. Content Article
    This is a video recording of a Health Service Journal (HSJ) Patient Safety Congress webinar, in association with BD, considering some of the key emerging patient safety issues for 2022. The panel discuss the legacy of the Covid-19 pandemic patient and staff safety, what needs to be done to ensure that patient safety is designed into elective care recovery plans and the important role for co-production as part of this.
  11. News Article
    A lack of beds in Welsh hospitals meant it was "inevitable" Covid patients would come into contact with others, a doctor has said. "Seeing patients in bed at the time of admission is becoming a rarity," Dr Nicky Leopold said. Some patients, including those with Covid, have had to spend nights on chairs in A&E due to a lack of beds. The Welsh government said it aimed to deliver 12,000 more staff by 2024-25. Health Minister Eluned Morgan and the chief executive of the Welsh NHS are due to give evidence to the Senedd's health committee on winter pressures.. Dr Leopold, a consultant geriatrician, who is a member of the BMA union in Wales, said there had been recent improvements since the number of NHS staff testing positive for Covid fell, but the flow of patients through hospital was still a problem. She said: "So many patients are stranded in hospital and that's very difficult and frustrating. There just aren't the staff in the community to support the increased level of need." Outpatient appointments had also been affected by shortages, she added. A lot of patients were in "dire need" and staff were "desperately" trying to keep clinics running. Read full story Source: BBC News, 10 February 2022
  12. News Article
    The government plans to end all remaining covid restrictions in England—including the legal obligation to self-isolate—ahead of schedule later this month, the prime minister, Boris Johnson, has said. The current restrictions, including the requirement that anyone who tests positive for Covid-19 must self-isolate for at least five days, are due to expire on 24 March. But Johnson, addressing MPs during prime minister’s questions on 9 February, said that the remaining rules could end early if recent trends in the data continued. In response to the prime minister’s statement healthcare leaders said that they understood the importance of wanting to return to normal but called for a cautious approach. Chris Hopson, chief executive of NHS Providers, said, “It is important to remember that Covid-19 has not gone away. Though cases have fallen significantly in recent weeks and the NHS’s very successful booster campaign has made a massive difference to the numbers of seriously ill patients, the number of people testing positive for Covid-19 remains high by previous standards." “Any steps to de-escalate our precautionary approach—including ending requirements for self-isolation for positive tests—must be proportionate to the risks.” Matthew Taylor, chief executive of the NHS Confederation, said, “Around 40% of NHS staff absences are due to covid currently, and so removing the self-isolation requirements could bolster capacity significantly at a time when the service is committed to tackling its waiting lists—but we have to be mindful that it could also lead to higher rates of transmission, which could then lead to more admissions into hospital alongside more ill health in the community." “The government must take a cautious approach as we move onto the endemic stage of covid, be guided by the evidence, engage the NHS appropriately, and be prepared to review its decision if new threats emerge.” Read full story Source: BMJ, 9 February 2022
  13. News Article
    People with dementia, particularly care home residents early in the pandemic, were “disproportionately” vulnerable to fatal Covid infections, according to a new report. The analysis, commissioned by the Scottish Government, also found that excess deaths involving dementia during 2020 were “almost wholly” attributable to Covid. Of the 2,154 deaths where both dementia and Covid were listed on the death certificate, 95 per cent had Covid as the main underlying cause. This contradicts previous suggestions that a rise in dementia deaths early in the pandemic may have been linked indirectly to the virus as a result of “lockdown distress” or an increased use of potentially harmful sedation in elderly people confused by restrictions. The report also found that 73% (1,577) of those who died with both Covid and dementia mentioned on their death certificates had passed away in care homes. Henry Simmons, chief executive of Alzheimer’s Scotland, said their loved ones had been “torn apart by grief and loss” and that the report “raises many more questions as to why so many people with dementia living in care homes quickly became victims of Covid-19”. Read full story Source: The Herald, 10 February 2022
  14. News Article
    A formal complaint accuses the British Government of facilitating ‘the largest single health and safety disaster to befall the United Kingdom workforce since the introduction of asbestos products’. An expert letter to the UK Government’s Health & Safety Executive (HSE) from one of its own advisors accuses the agency of failing to use its statutory authority to correct “seriously flawed” guidance on infection protection and control (IPC), imperilling “the health and safety of healthcare workers by failing to provide for suitable respiratory protection”. The continued failure to protect healthcare workers by ensuring they are wearing the appropriate form of PPE (personal protective equipment) to minimise the risk of infection from COVID-19 airborne transmission, the letter says, has led to thousands of avoidable deaths. The failures amount both to “gross negligence” and serious “criminal offences”, claims the letter seen by Byline Times. The letter addressed to HSE chief executive Sarah Albon is authored by 27-year chartered health and safety consultant David Osborn, who is a ‘consultee member’ of the HSE’s COSHH (Control of Substances Hazardous to Health) Essentials Working Group, where he has helped HSE to prepare guidance for employers and employees. Written in his own personal capacity, the letter is a formal complaint accusing the members of the Government’s “IPC Cell” – a group of experts behind official guidance on infection protection and control – along with other senior Government officials of committing a “criminal offence… ultimately punishable by fine and/or imprisonment” by breaching Section 36 of the Health and Safety at Work Act. The letter argues that a police investigation is needed. The guidance, Osborn writes in his letter, has failed to ensure that healthcare workers understand that they should wear and have access to respiratory protection equipment (RPE) designed to protect from COVID-19 airborne transmission. “There is sufficient prima-facie evidence to suggest that the offence has led to the potentially avoidable deaths of hundreds of healthcare workers and the debilitating disease known as Long COVID in thousands of other healthcare workers,” the letter says. “I firmly believe that the primary source of infection was the inhalation of aerosols whilst caring for infected patients at close quarter,” says Osborn in his letter. Read full story Source: Byline Times, 10 February 2022
  15. Content Article
    Richard Murray, Chief Executive of The King’s Fund, comments on the NHS elective recovery plan.
  16. News Article
    Scientists and politicians “probably killed hundreds of thousands of people” by damaging the reputation of the AstraZeneca vaccine, according to an Oxford scientist who worked on the jab. Prof John Bell said: “They have damaged the reputation of the vaccine in a way that echoes around the rest of the world.” “I think bad behaviour from scientists and from politicians has probably killed hundreds of thousands of people – and that they cannot be proud of that,” he told a BBC Two documentary When the Oxford/AstraZeneca jab was rolled out in the UK government advisers recommended under-40s should be offered an alternative due to a link to very rare blood clots. Fears over the links to blood clots also led other countries, including Germany, France, Spain, Italy, the Netherlands, the Republic of Ireland, Denmark, Norway, Bulgaria, Iceland and Thailand, to pause their use of the vaccine. The AstraZeneca vaccine has also not played a significant role in the booster programme. The BBC reported it accounted for only 48,000 of the more than 37m booster doses given in the UK. Read full story Source: Guardian, 7 February 2022
  17. Content Article
    The Covid-19 vaccination programme has been one of the few almost unqualified successes of the UK’s response to the pandemic. System-working, joining up the NHS, local government and the voluntary sector was a hallmark of the vaccine roll-out. Local knowledge and delivery were crucial. Volunteers also played a vital role, not just in acting as stewards at vaccination sites, but also in terms of community outreach, for example with faith communities and others offering sites for vaccination which in turn built trust in the vaccine and in the NHS. The NHS has never used so much data so quickly and so powerfully, supporting the delivery of vaccine doses, recording any adverse reactions and, most importantly, allowing NHS staff to map who had the vaccine. This data in turn supported outreach work to support gaps in service provision and overcome vaccine hesitancy. These factors which helped make the roll out a success should be ‘bottled and re-used’ for other NHS services, from childhood immunisations to screening for cancer, diabetes, high blood pressure and other conditions, improving the service’s ability to reach the harder to reach Based on interviews with a wide range of people involved in the programme, this King's Fund report sets out what the roll-out in England has achieved as well as its trials and tribulations.
  18. Event
    until
    As the health service continues to absorb Covid-19 pressures , and with Omicron adding further strain to an already debilitated workforce, we will look into the core issues and gaps around staff safety and wellbeing and the subsequent risk to patients. Join this HSJ webinar to engage in an open and honest discussion with valuable perspectives from frontline clinicians on some of the key emerging challenges around workforce safety and contingency options and innovation solutions that will help ensure essential services can be maintained safely. Hear from expert panellists on: The realities of dealing with continued service disruption and uncertainty: A perspective from frontline clinicians on the impact on patient safety Is enough being done around staff wellbeing? Find out what kind of support staff really need to ensure they can maintain high standards of care Safety education: How to bring organisational safety standards to the forefront with sections on People, Processes and Performance and discuss the impact of multidisciplinary team training on patient outcomes Speakers: Annie Hunningher, Consultant in Anaesthesia at Barts Health NHS Trust Jono Broad, Senior Manager for Co-Production and Patient Experience Lead for the Integrated Personalised Care Team, South West Regional Team, NHS England and NHS Improvement Chaired by Helen Hughes, Chief Executive, Patient Safety Learning. Register
  19. News Article
    The Nightingale surge hubs cost more than £10.6 million to set up but have admitted roughly seven patients, it has emerged. Eight temporary sites were built at hospitals across the country during the height of the omicron wave, with the capacity to house about 100 patients each. However, it has now been revealed that the hubs cost £10,672,088 to build and only one has admitted a handful of patients. Announcing the hubs in December, NHS England said they would be used if “the record number of Covid-19 infections leads to a surge in admissions and outstrips existing capacity”. However, as of Jan 30, there were 1,285 daily admissions, an eight per cent decrease on the previous week. The chief executive of the William Harvey Hospital, in Ashford, Kent – the location of one of the eight omicron hubs – has expressed concerns that the structure “may adversely impact” other services and never be used. The cost of the hubs was revealed in response to a written question submitted by Damian Green, the Conservative MP Mr Green said that the temporary sites were an “insurance policy” and added “it looks like they won’t be needed”. He called on ministers to assess if they could be repurposed to help clear the backlog of patients waiting for treatment. Read full story (paywalled) Source: The Telegraph, 2 February 2022
  20. Content Article
    This study in the BMJ Open examines the links between between adverse childhood events and trust in Covid-19 health information, attitudes towards and compliance with Covid-19 restrictions and vaccine hesitancy. The study found correlations between adverse childhood events and: low trust in NHS Covid-19 information feeling unfairly restricted by government supporting removal of social distancing and ending of mandatory face coverings breaking Covid-19 restrictions vaccine hesitancy. The authors concluded that as adverse childhood events are common across many populations, there is a need to understand how they impact trust in health advice and uptake of medical interventions. This could play a critical role in the continuing response to Covid-19 and approaches to controlling future pandemics. In addition, as individuals with adverse childhood events suffer greater health risks throughout life, better compliance with public health advice is another reason to invest in safe, secure childhoods for all children.
  21. Content Article
    Covid-19 has infected more than 278 million people globally, with at least 5.4 million deaths recorded by the World Health Organization as of 26 December 2021. The omicron (B.1.1.529) variant of concern is spreading rapidly. Some countries view infection as a net harm and pursue strategies ranging from suppression to elimination. They seek to sustain low infection rates through a combination of vaccination, public health measures, and financial support measures (vaccines-plus). Other countries implemented mitigation strategies that aim to prevent health systems from being overwhelmed by building population immunity through a combination of infection and vaccination. These countries rely on a vaccines-only approach and seem willing to tolerate high levels of infection provided their healthcare systems can cope. In an open letter by a group of public health experts, clinicians, scientists, they suggest a vaccines-plus approach should be adopted globally. 
  22. News Article
    It is one of many mysteries about Long Covid: Who is more prone to developing it? Are some people more likely than others to experience physical, neurological or cognitive symptoms that can emerge, or linger for, months after their coronavirus infections have cleared? Now, a team of researchers who followed more than 200 patients for two to three months after their Covid diagnoses report that they have identified biological factors that might help predict if a person will develop long Covid. The study, published by the journal Cell, found four factors that could be identified early in a person’s coronavirus infection that appeared to correlate with increased risk of having lasting symptoms weeks later: The level of coronavirus RNA in the blood early in the infection, an indicator of viral load. The presence of certain autoantibodies — antibodies that mistakenly attack tissues in the body as they do in conditions like lupus and rheumatoid arthritis. The reactivation of Epstein-Barr virus, a virus that infects most people, often when they are young, and then usually becomes dormant. Having Type 2 diabetes, although the researchers and other experts said that in studies involving larger numbers of patients, it might turn out that diabetes is only one of several medical conditions that increase the risk of Long Covid. The researchers said they had found that there was an association between these factors and Long Covid whether the initial infection was serious or mild. They said that the findings might suggest ways to prevent or treat some cases of Long Covid, including the possibility of giving people antiviral medications soon after an infection has been diagnosed. “I think this research stresses the importance of doing measurements early in the disease course to figure out how to treat patients, even if we don’t really know how we’re going to use all that information yet,” said Jim Heath, the principal investigator of the study. However, the study authors and other experts cautioned that the findings were exploratory and would need to be verified by considerably more research. Read full story (paywalled) Source: The New York Times, 25 January 2022
  23. Content Article
    The resilience of health systems and cooperation between Member States have become particularly important during the COVID-19 pandemic. On the occasion of the French Presidency of the European Union (FPEU) 2022, the European Observatory on Health Systems and Policies and the General Directorate for HealthCare Services of the French Ministry of Health have worked together to produce this special issue of Eurohealth to better understand how health systems have responded to the health crisis and to draw lessons for improving resilience of health systems. (Available in both English and French.)
  24. News Article
    Trust were tonight told to cease plans for dismissing unvaccinated staff, as the government announced it would consult on dropping its mandatory covid vaccine policy. An email to local NHS leaders said: “Today the Secretary of State has announced that [the vaccination as a condition of deployment policy] is being reconsidered. The government’s decision is subject to Parliamentary process and will require further consultation and a vote to be passed into legislation. “We are aware that, based on the guidance already issued to the service, you will have begun to prepare for formal meetings with staff on their deployment if they remain unvaccinated. This change in government policy means we request that employers do not serve notice of termination to employees affected by the [vaccination as a condition of deployment] regulations.” Previous guidance had required that, after 3 February – the deadline to have a first vaccination in order to have two vaccines by the 1 April legal cut-off – trusts begin formal meetings and issue dismissal warnings to unvaccinated patient-facing staff. Huge efforts have been put into encouraging staff to be vaccinated and to preparing for the next steps in recent weeks. However, tens of thousands across England are still believed to have had no vaccine, or to have an “unknown” vaccine status. The brief NHSE letter gave no further guidance on whether trusts should continue to press staff to be vaccinated by that date, or continue to have discussions about redeployment. Sajid Javid, who introduced the legal requirements last year, told the Commons: “I am announcing that we will launch a consultation on ending [VCOD] in health and all social care settings. “Subject to the responses – and the will of this House – the Government will revoke the regulations. I have always been clear that our rules must remain proportionate and balanced – and of course, should we see another dramatic change in the virus, it would be responsible to review this policy again.” Read full story (paywalled) Source: HSJ, 1 February 2022
  25. News Article
    More than 1 in 10 school entry-age children in England are at risk of measles because they have not had their vaccine jabs, data reveals. Coverage for the two doses of MMR that helps protect five-year-olds against measles, mumps and rubella is currently at 85.5%. That is the lowest for a decade, and well below the 95% target recommended to stop a resurgence of measles. Measles is highly contagious, more than Covid, and can cause serious illness. Nine in every 10 people can catch it if they are unjabbed and exposed. As well as a distinctive rash, measles can lead to severe complications, such as pneumonia and brain inflammation, and sometimes can be fatal. Vaccination can remove almost all of these risks. Two doses of the MMR vaccine give 99% protection against measles and rubella and about 88% protection against mumps. When a high percentage of the population is protected through vaccination, it becomes harder for the disease to pass between people. But since the start of the Covid pandemic, there has been a concerning drop in the number of children receiving these vaccines on time. Experts say some parents may not have realised doctors were still offering appointments, or did not want to burden the NHS. Coverage of the first dose of the MMR vaccine in two-year-olds has now fallen below 90%. This means that more than one in 10 children under the age of five are not fully protected from measles and are at risk of catching it. Among all five-year-olds in England, 93.7% have had one dose and 85.5% have had the recommended two doses. Read full story Source: BBC News, 1 February 2022
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