Covid-19: news update for geriatrics 15/05/20

 COVID-19 current figures

Today’s COVID-19 headlines

UK’s response is “too little, too late, too flawed”

The UK’s response to Covid-19 so far has neither been well prepared nor remotely adequate, argue experts in The BMJ today.

Public health experts, Gabriel Scally at the University of Bristol and Bobbie Jacobson at Johns Hopkins University, together with The BMJ’s Executive Editor, Kamran Abbasi, say the UK was €œforewarned but not forearmed€ and call for a clear, locally led strategy of case finding, testing, and contact tracing to minimise further harm.

They discuss some of the UK government’s decisions since the World Health Organization (WHO) declared a public health emergency on 30 January, and ask how did a country with an international reputation for public health get it so wrong?

These included rejecting lockdown measures, abandoning contact tracing, and downgrading the covid-19 threat level, so that a lower level of PPE was required to treat patients.

New guidance has been published to help ensure that frail older people, including those in care homes and prison settings, receive the care they want and deserve at the end of life.

The guidelines from the British Geriatrics Society were produced over 18 months involving more than 30 contributors with expertise in a wide range of issues which affect older people towards the end of life.

It is the first set of guidance to cover the unique considerations applicable in specific settings, such as urgent care, care homes and prisons. They explore issues such as cultural and spiritual needs, and the importance of social and psychological support.

Covid-19: hospital response risks worsening health inequalities

Disadvantaged and marginalised people face worsening health inequalities as a result of the difficult choices made by NHS hospitals in response to the Covid-19 pandemic. Public health doctors, writing in the Journal of the Royal Society of Medicine, say that the restriction of non-urgent clinical services, such as gynaecology, sexual health and paediatrics, and the precipitous decline in emergency department attendances, will affect marginalised groups, disproportionately.

Emergency departments, which in March 2020 saw a 44% decline in attendances, are often used for routine care by vulnerable people, such as homeless people and migrants, who can find it difficult to access general practice and other community services.

The authors conclude: “The NHS has taken swift action to expand capacity and reorganise services to help ensure that health services can help with an influx of seriously ill Covid-19 patients. Difficult choices have been made, and some unintended consequences are inevitable. Policymakers, managers and clinicians should take pause during this phase to protect the most vulnerable groups in our society from negative unintended consequences and avoid worsening health inequalities.”

Importance of care homes must be recognised by policy makers

The coronavirus pandemic highlights the vital role care homes play in the long-term care of older people and must be recognised by policy makers, a new paper co-written by the Centre for Research in Public Health and Community Care (CRIPACC) claims. 

The Covid-19 pandemic has disproportionately affected care home residents, with anywhere from 19 to 72% of deaths occurring in care homes worldwide. Published in Age and Ageing, the paper addresses a lack of personal protective equipment (PPE), personnel and skills, and ambiguity around testing and diagnosis processes that have contributed to Covid-19 deaths. It also calls for psychological support to €˜avoid significant mental health issues for care home staff at the end of the pandemic’.

The paper argues that the losses and difficulties faced by the care home sector have emphasised system-wide issues, such as endemic underfunding, lack of integration between the public and private sectors, and a lack of recognition and regard €“ because care homes are too often represented as problems and not partners in delivering care.

Other news roundup

• Official figures show that 12,256 residents of care homes in England and Wales died with Covid-19 mentioned on their death certificates
• Any vaccine to fight the new coronavirus will not be ready for use for at least two years, said the chief executive of Swiss pharmaceutical company Novartis (Reuters)
• Denmark reports no deaths from coronavirus for the first time since March 13
• Slovenia becomes first European country to declare an end to its virus epidemic
• New York City’s lockdown has been extended until 28 May at the earliest