Covid 19 daily update for geriatricians 27/04/20

 COVID-19 current figures

Today’s COVID-19 headlines

Don’t rush to try novel therapies, say Covid-19 clinicians

Intensivists caution against the use of premature novel therapies in lieu of traditional critical care principles in patients with Covid-19 in a recent correspondence letter in the American Journal of Respiratory Cell and Molecular Biology.

In “A Call for Rational Intensive Care in the Era of Covid-19”, Benjamin Singer, Assistant Professor of Medicine and Biochemistry & Molecular Genetics, Division of Pulmonary and Critical Care Medicine, Department of Medicine, at Northwestern University Feinberg School of Medicine, and co-authors write that “the intensive care unit is already optimised for the care of Covid-19 patients and that departures from standard of care require evidence…”

The Covid-19 pandemic is unprecedented, resulting in a surge of critically ill patients that have tested the resources of medical centers around the country. The overwhelming patient demand and dwindling resources combined to trigger a cascade of emotions, stress, and fatigue. As hospital staff mobilise to meet the growing demand of Covid-19 patients, some clinicians are making note of a pattern that has emerged where proven interventions are neglected or even rejected.

He added that physicians continuously learn from their patients by making observations and so far what they’ve learned is that the most effective treatment for COVID-19 patients is supportive therapy. Until there are clinical trials that offer clear direction on a different treatment approach, state-of-the-art supportive care is the best option. 

Problems with mood regulation are likely be affected by the Covid-19 lockdown and people should be trained to increase their own mood homeostasis via their choices of activities, according to new research from the University of Oxford.

The new study published in JAMA Psychiatry looked at 58,328 participants from low, middle and high income countries, comparing people with low mood or a history of depression with those of high mood. 

Mood varies from hour-to-hour, day-to-day and healthy mood regulation involves choosing activities that help settle one’s mood. However, in situations where personal choices of activities are constrained, such as during periods of social isolation and lockdown, this natural mood regulation is impaired which might result in depression.

How social service closures are impacting on older people and unpaid carers

A new national study has been launched to look at the impact of social service closures due to coronavirus, on the lives of older people, people with dementia and unpaid carers.

An expert team of NHS, voluntary and academic collaborators from across the country have been brought together to conduct this novel UK wide study.

The study includes Lancaster University, the University of Liverpool, UCLAN, University of Bradford, and UCL, and it will examine the impact of self-isolation on the wellbeing of older people, those living with dementia and unpaid carers.

Dr Siobhan Reilly, Senior Lecturer from Lancaster University, said: €œWe know certain groups are likely to be affected differently so it is important that as many people take part in this research as possible. We want to have representation from all groups and all parts of society. The more participation we have, the more relevant our results will be€.

Other news roundup

• Italy reported 260 deaths which is the smallest death toll since March 14
• Boris Johnson returns to work after Covid-19
• A minute’s silence will be given at 11am tomorrow for all NHS workers who have died in the pandemic
• Germany makes it mandatory to wear masks outside
• UK public will be allowed to submit questions to the daily Government briefing
• Prime Minister Jacinda Ardern said the coronavirus was “currently” eliminated in New Zealand
• A new NHS Nightingale hospital is to officially open in Bristol