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New guidance published for COVID-19 frontline staff
The Royal College of Physicians has published ethical guidance for frontline staff dealing with the COVID-19 pandemic, supported by more than a dozen other health organisations.
It provides guidance for the difficult ethical issues that front-line staff will face while caring for their patients during the pandemic and takes into consideration recent joint statements from the General Medical Council (GMC), the NHS and the UK’s four Chief Medical Officers.
Members of the RCP’s Committee on Ethical Issues in Medicine, chaired by Dr Alexis Paton, developed the guidance and said that while so much has changed during the pandemic, staff still need to ensure that care is provided in a fair and equitable way.
BMA calls for enhanced death in service cover
The BMA is calling on the Chancellor of the Exchequer to ensure that financial protection is in place for the families of retired doctors returning to the NHS to help tackle the Covid-19 pandemic should the worst happen.
The doctors’ trade union has called for an automatic extension to enhanced death in service cover for all frontline NHS staff who will be asked to go above and beyond over the coming weeks and months as the NHS faces unprecedented challenges.
Writing to Rishi Sunak, Dr Chaand Nagpaul, BMA council chair, explained that the NHS Pension Scheme offers important benefits on death, but that these can vary depending on which scheme a healthcare professional is on.
Those who have opted out entirely therefore, are now faced with significantly reduced benefits compared to those who are active members – all at a time when healthcare workers are being exposed to a potentially lethal disease.
Significant numbers will continue to die in Italy until at least mid-April
A new report on Covid-19 data from Italy, prepared by an Italian expert for the European Society of Anaesthesiology (ESA), says that the number of daily deaths in Italian hospitals is still accelerating at the maximum rate, and significant numbers of deaths in hospital are likely to continue until at least mid-April and could go on until early June.
The report is by Davide Manca, Professor of Process Systems Engineering at Politecnico di Milano, Milan, Italy.
The data suggest that the increase in numbers of patients in intensive care (ICU) in both the Lombardy region and Italy as a whole are likely to have peaked, but that numbers of deaths in hospital will continue to increase at the maximum rate for several days to come.
March 31, 2020, is classed as day 39 of the pandemic in Italy, with day 1 classed as February 22. For deaths, the report said it is important to note that patients dying now and during the days to come were mostly infected around two weeks ago.
Adapted Penlon ventilator devices will be ready next week
The first batch of the Penlon ventilator device, which has been rapidly adapted from other existing ventilator designs, will be ready for dispatch next week, following approval from the MHRA that it meets the necessary safety requirements.
The device is being manufactured by a consortium including Formula 1 teams McLaren and Mercedes, Ford, Siemens and Meggitt. The Government said that initial delivery will be ready this weekend, with potentially hundreds more of that device to follow, alongside thousands more of other new devices in the coming weeks.
Other existing ventilator devices are also being scaled up, in collaboration with British and international industry, including products from Diamedica, Breas Medical and Smiths Group.
GPs banned from speaking out about PPE
GPs in parts of the UK have been banned from speaking out publicly over concerns about personal protective equipment (PPE) and asked to remove face visors to avoid 'frightening patients', according to GP Magazine.
They report being told by CCGs not to give interviews to the press, and to avoid posting comments on social media about PPE concerns.
GPs working in community hospitals who have chosen to wear PPE they have purchased themselves - such as face visors to protect their eyes - have been asked to remove it. Hospital doctors also report threats over their future careers if they speak out over PPE concerns.
Individuals taking class of steroid medications at high risk for COVID-19
Individuals taking a class of steroid hormones called glucocorticoids for conditions such as asthma, allergies and arthritis on a routine basis may be unable to mount a normal stress response and are at high risk if they are infected with the virus causing COVID-19, according to a new editorial published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.
Patients taking these medications may be more susceptible to COVID-19 as a result of the medication suppressing the immune system. They may also experience more severe disease once infected because these medications suppress their own steroid response to infection. Injectable supplemental glucocorticoid therapy in this setting can reverse the risk of potentially fatal adrenal failure and should be considered in every case.
Individuals with known primary adrenal insufficiency, also known as Addison's disease, and secondary adrenal insufficiency occurring in hypopituitarism should also take extra precautions. If patients develop symptoms such as a dry continuous cough and fever, they should double their oral glucocorticoid dose immediately and continue doing so until the fever has subsided. They, too, will require injectable glucocorticoid therapy should their condition worsen.
Other news roundup
- Edinburgh's cultural festivals have been postponed
- US death toll hits 4000
- Spain records a death toll of 864
- HIV scientist and research leader Gita Ramjee dies in South Africa
- Eurovision will hold an online audience-free show in May