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Content ArticleThe emergence of the omicron variant has raised concerns that the pandemic is not yet over. In this BMJ opinion piece, William et al. outline four key lessons that governments need to learn from to protect against future pandemics
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Content ArticleA new study developed by the European Observatory on Health Systems and Policies, the WHO Regional Office for Europe and the European Commission draws out lessons for strengthening resilience to future health threats. The Health systems resilience during COVID-19: Lessons for building back better study gathers the evidence on how countries have managed (or not managed) to re-engineer how they work, the ways in which they utilise their resources and the methods they use to face and counter the pressures exerted by both COVID and non-COVID challenges.
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Content ArticleWearing face masks and maintaining social distance are familiar to many people around the world during the ongoing COVID-19 pandemic. Evidence suggests that these are effective ways to reduce the risk of COVID-19 infection. However, it is not clear how exactly the risk of infection is affected by wearing a mask during close personal encounters or by social distancing without a mask. Results from a study by Bagheri et al. show that face masks significantly reduce the risk of COVID-19 infection compared to social distancing. We find a very low risk of infection when everyone wears a face mask, even if it doesn’t fit perfectly on the face.
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News Article
NHS forecasts 230,000 extra cases of PTSD in England due to Covid
Patient Safety Learning posted a news article in News
The NHS is forecasting there will be 230,000 new cases of post-traumatic stress disorder (PTSD) in England as a result of the coronavirus pandemic, official figures show. COVID-19 has increased exposure to events that could cause PTSD, an anxiety disorder triggered by very stressful, frightening or distressing events, according to the Royal College of Psychiatrists. It says the NHS is already facing the biggest backlog of those waiting for mental health help in its history. Forecasts cited by the college from the NHS strategy unit, which carries out NHS analysis, show there could be as many as 230,000 new PTSD referrals between 2020/21 and 2022/23 in England, which suggests a rise of about 77,000 cases a year on average. Prof Neil Greenberg, expert editor of the Royal College of Psychiatrists’ new resource tool for patients with PTSD, said: “It’s a common misunderstanding that only people in the armed forces can develop PTSD – anyone exposed to a traumatic event is at risk. “It’s vital that anyone exposed to traumatic events is properly supported at work and home. Early and effective support can reduce the likelihood of PTSD and those affected should be able to access evidence-based treatment in a timely manner. Especially our NHS staff who are at increased risk as a result of this unprecedented crisis.” Read full story Source: The Guardian, 3 December 2021 -
Content ArticleThe People’s Covid Inquiry, chaired by the human rights lawyer Michael Mansfield QC, began in January 2021 to learn lessons quickly after the government rejected calls for a public inquiry. The Government was informed of the inquiry on 23 February 2021 and invited to take part. No response was received. The first session of the People’s Covid Inquiry began on 24 February and convened in live sessions fortnightly until 16 June 2021. The Inquiry took evidence over nine sessions from over 40 witnesses including international and UK experts, frontline workers, bereaved families, trade union leaders, and representatives of disabled people’s and pensioners’ organisations.
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Content ArticleCOVID-19 has highlighted the urgency of addressing violence against women and children, which reports suggest has increased during the pandemic. Often referred to as a “shadow pandemic,” the rise in violence over the past two years has been linked to lockdowns and other restrictions on movement put in place due to COVID-19, which force women and children to remain at home with their abusers. In 2016, the World Health Organization published a global plan of action to address violence against women, children, and girls. It proposed a four-pronged approach: firstly, strengthen health system leadership and governance; secondly, strengthen health service delivery and health workers’ capacity to respond; thirdly, strengthen programming to prevent interpersonal violence; and lastly, improve information and evidence. In this BMJ opinion article, Helga Fogstad discusses why, five years on, these measures are needed more than ever and why it's time to act.
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News Article
Poorly controlled asthma 'increases Covid risk for children'
Patient Safety Learning posted a news article in News
Children with poorly controlled asthma are up to six times more likely to be admitted to hospital with Covid than those without the condition, research has suggested. Scientists involved in the study said 5 to 17-year-olds in this category should be considered a priority for Covid vaccination. About 9,000 children in Scotland would benefit from the jab, researchers said. Vaccines are offered to the over-12s in Scotland, but not to younger children. In the study, poorly controlled asthma was defined as a prior hospital admission for the condition, or being prescribed at least two courses of oral steroids in the last two years. Prof Aziz Sheikh, director of the University of Edinburgh's Usher Institute and Eave II study lead, said: "Our national analysis has found that children with poorly controlled asthma are at much higher risk of Covid-19 hospitalisation. "Children with poorly controlled asthma should therefore be considered a priority for COVID-19 vaccination alongside other high-risk children." Prof Sheikh said it was important to consider both the "risks and benefits" from vaccinations. He added: "Emerging evidence from children aged five and older suggests that COVID-19 vaccines are overall well-tolerated by the vast majority of children." Read full story Source: BBC News, 1 December 2021 -
Content ArticleThe UK government and devolved administrations, along with the emergency services and other local responders, have clear responsibilities for identifying, assessing, preparing for and responding to emergencies, as well as supporting affected communities to recover. The government has risk management processes in place that aim to identify risks, to ensure that plans are drawn up to mitigate risks and prepare for shocks, and to prevent risks from being overlooked despite short-term pressures. Cabinet Office guidance states that preparedness is the preparation of plans that are flexible enough both to address known risks and to provide a starting point for handling unforeseen events. This report sets out the facts on: the government’s approach to risk management and emergency planning the actions the government took to identify the risk of a pandemic like COVID-19 the actions the government took to prepare for a pandemic like COVID-19 recent developments. The report sets out central government’s risk analysis, planning, and mitigation strategies prior to the arrival of the COVID-19 pandemic, with the aim of drawing out wider learning for the government’s overall risk management approach.
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Content ArticleThis World Health Organization (WHO) policy brief takes stock of how digital health tools have been used during the COVID-19 pandemic, in order to review what has happened, assess how uptake and use of these tools has been facilitated, identify issues that are emerging, and learn lessons for the longer term to support the sustained use of digital health tools.
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Content ArticleThis government guidance is intended to prevent transmission of seasonal respiratory viral infections focussing on influenza, SARS-CoV-2, and respiratory syncytial virus (RSV) in health and care settings while continuing to support the recovery of services.
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News Article
Is the NHS in a position to handle the Covid Omicron variant?
Patient Safety Learning posted a news article in News
How much of a threat does the emergence of Omicron pose to the NHS? Among hospital bosses there is a curious combination of apprehension that the new variant could lead to a surge in infections but also a battle-weary belief, born of negotiating the previous waves of Covid-19, that they can handle a potentially major rise in people seriously ill with the disease. “Trusts are already making contingency plans for what would happen if there were to be a significant spread of this variant and it turned out that the symptoms and disease produced as a result is as serious as with the Delta variant,” said Chris Hopson, the chief executive of NHS Providers, which represents health service trusts in England. He added: “If it turns out that this variant does evade vaccines then clearly the NHS will see a significantly higher caseload than it has at the moment.” Hopson pointed out that when the second wave was at its worst in January, hospitals in England were treating 34,000 people with Covid. On Monday, it was far, far fewer – just 6,094. He said: “The chief executive of a district general hospital told me today that they were going through plans for how they would expand critical care capacity, and their general respiratory support capacity, because that’s exactly what they needed to do last January when we had over 34,000 cases. A return to that number of hospital beds taken up with Covid patients would again force hospitals to cancel planned operations, he said. “If we get anywhere near the 34,000 cases we saw in January, then something would have to give. Elective surgery could be cancelled. As we saw last January, we would need to prioritise [care] on the basis of clinical need.” Read full story Source: The Guardian, 29 November 2021 -
News Article
Covid inquiry must look at NHS 111 ‘mishandling’, bereaved families say
Patient Safety Learning posted a news article in News
The inquiry into the government’s handling of the Covid pandemic should look at the “mishandling” of the NHS 111 service, families bereaved during the crisis have said. In a scathing report, the COVID-19 Bereaved Families for Justice group said the service was inappropriately used to “alleviate the burden on the NHS” with “horrific” consequences. The report, based on a survey of families, said many believed that the service “failed to recognise how seriously ill their relatives were and direct them to appropriate care”. They argue that the service was also quickly “swamped” during the first wave despite the addition of 700 new call handlers, many of who were making life or death decisions with just 10 weeks training. The phone line is one of a number of areas the groups want the government’s inquiry to cover. Other areas include No 10’s level of pandemic preparedness, particularly PPE shortages, as well as an investigation into the disproportionate impact on ethnic minority groups and those with disabilities. Read full story Source: The Independent, 30 November 2021 -
News Article
Covid jab clinics held for people with learning disabilities
Patient Safety Learning posted a news article in News
Two specialist Covid vaccination clinics for people with learning disabilities are to be held in Leicestershire. Local health bosses said the sessions would provide a calm environment, longer appointment times and extra support. They will take place at Loughborough Hospital later and at Leicester's Peepul Centre on 15 December. Pre-booked visitors can receive their first, second or booster jabs. Sam Screaton, learning disability vaccination clinical lead at the Leicestershire Partnership NHS Trust, said: "It is extremely important to us to ensure the Covid-19 vaccines and boosters are accessible to everyone. "All staff working at these clinics will go the extra mile to ensure patients feel comfortable, calm and able to have the vaccine." Read full story Source: BBC News, 30 November 2021 -
Event
COVID-19, foreign policy, and human rights
Sam posted an event in Community Calendar
untilAhead of the UN General Assembly’s debate on global health and foreign policy, join a distinguished line-up of speakers for a discussion about the progress - and lack thereof - on the international response to COVID-19, as well as recommendations for ensuring that this pandemic is the last one we face. With speakers: H.E. Ellen Johnson Sirleaf (Co-Chair, Independent Panel for Pandemic Preparedness and Response, member of The Elders, and former President of Liberia) H.E. Ms. María Fernanda Espinosa Garcés (Member of the Lancet Commission on COVID-19, former Ecuadorian Minister of Foreign Affairs and Defence, and former President of UN General Assembly) David Nabarro CBE (Special Envoy on Covid-19 for the World Health Organization) Register -
News Article
Government does not fully understand risks of relaxing covid infection control
Patient Safety Learning posted a news article in News
The government has been warned that changes to covid-related infection prevention and control guidance will not enable a ‘rapid’ increase in the NHS’ capacity to tackle the elective care backlog and could pose significant ‘risks’. Trust leaders have been told they no longer have to segregate patients into separate pathways according to “high”, “medium”, or “low” risk of covid-19 in updated IPC guidance issued by the Department of Health and Social Care, NHS England and UK Health Security Agency. Following this guidance means the treatment of every patient without symptoms of a respiratory illness will be subject to the same precautions – such as one, rather than two, metre physical distancing. This, in theory, could create more capacity to treat larger numbers of patients. A subsequent letter from NHS England highlighting the changes said: ”This guidance supports efficient delivery of NHS services to meet wider patient needs, via the return to pre-COVID-19 social distancing and standard IPC measures for patients who do not have infectious respiratory diseases.” However, NHS Providers chief executive Chris Hopson told HSJ that many trusts are currently losing between 10 and 20% of their capacity due to “essential” IPC measures, and would not be able to abandon this approach quickly. He said: “There is a conception in some people in central government’s minds that by having got this guidance changed, we are now going to see a rapid recovery of activity levels and we’ll be able to more successfully manage the infection risk. That’s what people need to be realistic about – there is a risk here." Read full story Source: HSJ, 29 November 2021 -
News Article
Did bad vaccine advice cost Samantha Willis her life?
Patient Safety Learning posted a news article in News
When the UK’s jab programme began, expectant mothers were told to steer clear – so Samantha decided to wait until she had had her baby. Two weeks after giving birth, she died in hospital from Covid. Samantha was unvaccinated – she had received advice against getting jabbed at an antenatal appointment. When the Covid vaccine programme began in the UK on 8 December 2020, pregnant women were told not to get vaccinated. But in October 2020, the Royal College of Obstetricians and Gynaecologists (RCOG) published guidance warning that “intensive care admission may be more common in pregnant women with Covid-19 than in non-pregnant women of the same age” and that pregnant women with Covid were three times more likely to have a preterm birth. Further evidence emerged in 2021 indicating that pregnant women were particularly vulnerable to Covid, especially in their final trimester. Research from the University of Washington, published in January, found that pregnant women were 13 times more likely to die from Covid than people of a similar age who were not pregnant. But throughout February and March, the JCVI’s scientists did not appear especially concerned about examining the case for vaccinating pregnant women. Priority in the early stages of the vaccine programme was being given to older people, so many pregnant women remained towards the back of the queue. The maternity campaign group Pregnant Then Screwed said: “If you look at who was on the Covid war cabinet and leading the daily briefing, it was nearly all men,” says Joeli Brearley, its founder. “Pregnant women were treated as if they were very similar to the general population, rather than being seen as a special cohort that needs special consideration. They were just not a priority.” Read full story Source: The Guardian, 23 November 2021 -
News Article
Covid vaccines safe in pregnancy, data shows
Patient Safety Learning posted a news article in News
The UK's Health Security Agency says its analysis of English data shows Covid vaccines are safe in pregnancy, reinforcing international evidence. The agency found similar rates of stillbirths and preterm births for vaccinated and unvaccinated mothers. Researchers say women should feel confident the jabs will help protect them and urge more to take them. Their report shows just 22% of women who gave birth in August had had at least one jab. Since mid-April, mothers-to-be have been offered the Pfizer-BioNTech or Moderna jab, with the second dose recommended eight weeks after the first. But women first eligible for vaccination were more likely to be older or have an underlying medical condition - putting them at higher risk of premature births, researchers say. Meanwhile, studies suggest about one in five women admitted to hospital with the virus have their babies delivered early and some of these babies need special intensive care. And evidence suggests the risks of stillbirths are higher if a woman has Covid in pregnancy. UKHSA immunisation head said the new information on safety was reassuring. "Every pregnant woman who has not yet been vaccinated should feel confident to go and get the jab and that this will help to prevent the serious consequences of catching Covid in pregnancy," she said. Read full story Source: BBC News, 26 November 2021 -
News Article
Change to sepsis advice after mums' herpes deaths
Patient Safety Learning posted a news article in News
Advice on how new mothers with sepsis should be treated is to change after two women died of a herpes infection. The Royal College of Obstetricians and Gynaecologists says viral sources of infections should be considered and appropriate treatment offered. This comes after the BBC revealed one surgeon might have infected the mothers while performing Caesareans on them. The East Kent Hospitals Trust said it had not been possible to identify the source of either infection. Kimberley Sampson, 29, and Samantha Mulcahy, 32, died of an infection caused by the herpes virus 44 days apart in 2018, shortly after giving birth by Caesarean section. Their families were told there was no link between the deaths but BBC News revealed on Monday that both operations had been carried out by the same surgeon. Documents we uncovered showed that the trust had been told two weeks after the second death that "it does look like surgical contamination". Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, which set standards in maternity care, said routine investigation and management of maternal sepsis "should always consider viral sources of infection, and appropriate changes should be instituted to support earlier diagnosis and treatment". Medics treating Ms Sampson and Mrs Mulcahy assumed they were suffering from a bacterial infection and didn't prescribe the anti-viral medication that may had saved their lives. The Royal College said the two deaths should be "fully investigated" as "surgical infection appears to be a significant possibility". But BBC News has learned that the East Kent Hospitals Trust, which treated both women, never told the coroner's office that the same surgeon had carried out both operations or that an investigation they had ordered had suggested the virus strains the two women had died from appeared to be "epidemiologically linked". Read full story Source: BBC News, 23 November 2021 -
News Article
Covid: UK government wasn't ready for pandemic, report finds
Patient Safety Learning posted a news article in News
The UK government was not properly prepared for a pandemic like COVID-19, a new report has found. The report by the National Audit Office (NAO) said the government lacked detailed plans on shielding, job support schemes and school disruption. The spending watchdog added that lessons needed to be learned. In response, the government said the unprecedented pandemic had challenged health systems around the world - not just the UK. The NAO said preparations for a flu pandemic or highly infectious diseases like Ebola were prioritised over diseases with similar characteristics to Covid. The watchdog said the UK government did not have specific plans to tackle a disease like COVID-19, which has a lower mortality rate than Ebola but has the ability to spread in communities with asymptomatic infected people. The report suggests the government had some mitigations in place for a pandemic, like a stockpile of personal protective equipment, but it lacked preparation for "wide-ranging impacts" coronavirus and other pandemic-inducing viruses can have on society and the economy. A government spokesperson said: "We have always said there are lessons to be learned from the pandemic and have committed to a full public inquiry in spring. "We prepare for a range of scenarios and while there were extensive arrangements in place, this is an unprecedented pandemic that has challenged health systems around the world." Labour's shadow Cabinet Office minister Fleur Anderson, said the report showed "Conservative ministers failed to prepare and they failed the public". Read full story Source: BBC News, 19 November 2021 -
Content Article
Long Covid Support: Information leaflet
Patient Safety Learning posted an article in Resources for patients
Long Covid can be difficult to diagnose, and some people might not realise their symptoms could be linked to prior COVID-19 infection. There can be more than 200 symptoms. Symptoms can affect anywhere in the body. Symptoms can come and go, and new ones can appear weeks or months later. People may not be aware they had Covid-19: some don’t have symptoms at the time of infection, and test results can be unreliable. Long Covid Support and Long Covid Kids have produced an information leaflet on the symptoms of Long Covid. -
News Article
Long-acting HIV jabs to replace daily pills in ‘great step forward’
Patient Safety Learning posted a news article in News
The NHS has been given the green light to offer people living with HIV the first "long-acting injectable" to keep the virus at bay. Charities have hailed the "incredible news" which offers an alternative to adults living with HIV who have to take daily antiretroviral drugs. Many people living with HIV can keep the virus at very low levels by taking antiretroviral tablets each day. These drugs keep the number of virus particles in the blood - also known as the viral load - so low that it cannot be detected or transmitted between people. But now an estimated 13,000 people will be eligible for the injectable treatment in England which means they no longer need daily treatment but will have two injections every two months. This means they can reduce the days they receive treatment from 365 to 6 per year. Meindert Boysen, deputy chief executive NICE, said: "Despite scientific advances HIV is still incurable, but the virus can be controlled by modern treatment. However, for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle." "We're pleased therefore to be able to recommend cabotegravir with rilpivirine as a valuable treatment option for people who already have good levels of adherence to daily tablets, but who might prefer an injectable regimen with less frequent dosing." Read full story Source: 18 November 2021 -
Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) is to help improve patient safety in relation to the management of patients with COVID-19 being treated with non-invasive respiratory support, for example continuous positive airway pressure (CPAP), in non-critical care settings. The HSIB investigation reviewed the experience of Terry, who was admitted to hospital with symptoms of COVID-19 and required support with is breathing using CPAP. On the second day after his admission to hospital, Terry was found on the floor next to his bed, having called for assistance. Terry’s CPAP tubing had become disconnected from his mask, meaning that Terry’s breathing was not supported. Staff attempted to resuscitate Terry, however they were unsuccessful, and he died.
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News ArticleResearchers have launched a major clinical trial investigating whether people on long-term immune-suppressing medicines can mount a more robust immune response to COVID-19 booster jabs by interrupting their treatment. The VROOM trial will have implications for people on immune-suppressing medicines, who are among the millions of clinically vulnerable patients advised to ‘shield’ during the pandemic. The study is funded by an NIHR and the Medical Research Council (MRC) partnership, and led by a team at the University of Nottingham. Approximately 1.3 million people in the UK are prescribed the immune-suppressing drug methotrexate for inflammatory conditions such as rheumatoid arthritis, and skin conditions such as psoriasis. Many of them were among the 2.2 million clinically extremely vulnerable people advised to shield during the first phase of the pandemic, depending on specialist advice and on their risk factors. While methotrexate is effective at controlling these conditions and has emerged as first line therapy for many illnesses, it reduces the body’s ability to generate robust responses to flu and pneumonia vaccines. Researchers will recruit 560 patients currently taking methotrexate, to investigate whether taking a two week break in this drug immediately after they receive the COVID-19 booster jab improves their immune response to vaccination, while preventing flare-ups of their long-term illness. The study will take between one to two years to complete. All participants will have had the Pfizer-BioNTech vaccine as their third jab, as part of the national vaccination programme against COVID-19. Professor Andy Ustianowski, NIHR Clinical Lead for the COVID-19 Vaccination Programme and Joint National Infection Specialty Lead, said: “Although the vaccine rollout has saved many lives and helped drive down the effects of the pandemic, there are still groups of vulnerable people who can’t always mount robust immunity against the virus. " “It’s important to establish if people can safely improve protection from their booster jabs by taking a break from their immune-supressing medicines, and this pivotal study will help develop our understanding of immune responses in people taking this widely prescribed medicine." Read full story Source: NIHR, 12 November 2021
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News ArticlePoliticians and doctors in Germany have called for urgent action to control the spread of COVID-19 after a record number of cases were reported on 11 November. Germany had 50 196 new confirmed Covid cases on 11 November, up from 39 676 cases on 10 November and 9658 on 1 November, showed figures from the Robert Koch Institute. A total of 235 Covid related deaths were reported on 11 November, up from 23 on 1 November. Speaking in the Bundestag, Germany’s lower house of parliament, the federal vice chancellor, Olaf Scholz, said that immediate steps must be taken to “winterproof” Germany against what is being described as the nation’s fourth wave of Covid-19. Scholz will meet next week with the prime ministers of Germany’s 16 states to discuss new measures to fight the pandemic. “The virus is still with us and threatens the health of citizens,” Scholz said, adding that efforts must be intensified to convince unvaccinated Germans to become fully vaccinated and encourage those already vaccinated to have the booster shot." Everything must be done, he said, to ensure “that millions of citizens get a booster—that is the task of the next weeks and months.” Read full story Source: BMJ, 12 November 2021
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Content ArticleFinding solutions to long covid will require new ways of thinking across clinical services and research, says in this BMJ Opinion article.
