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Covid-19 today’s headlines for geriatrics 23/04/20

An overview of today’s Covid-19 news and current trial information relevant for physicians caring for older patients on 23rd April 2020.

 COVID-19 current figures

 

Current UK cases: 138,078 are confirmed as positive

Numbers tested: 425,821 people have been tested in the UK

18,738 (616) patients in the UK who tested positive for coronavirus (Covid-19) have died

(Source: DHSC: As of 9am on 23 April 2020/death figures of 5pm on 22 April 2020)

 

Global situation report:  2,471,136 confirmed (73,920) 169,006 deaths (6058)

European Region: 1,219,486 confirmed (32,302) 109,952 deaths (3,618)

Regions of the Americas: 925,291 confirmed (32,172) 44,775 deaths (2,089)

Eastern Mediterranean Region: 139,349 confirmed (4,879) 6,326 deaths (141)

Western Pacific Region: 136,271 confirmed (1,765) 5,793 deaths (108) 

South-East Asia: 33,912 confirmed (2,242) 1,427 deaths (86)

African Region: 16,115 confirmed (560) 720 deaths (16)

(Source: World Health Organization situation report 93)

 

 

Today’s COVID-19 headlines

 

Coronavirus tracking and antibody test study launched

The government has launched a large-scale virus infection and antibody test study of 20,000 households in England to track the spread of Covid-19 in the general population.

It will include antibody testing to help improve understanding around the current rate of infection and how many people are likely to have developed antibodies to the virus. 

Participants in the study will form a representative sample of the entire UK population by age and geography. The results will help scientists and the government in the ongoing response to the coronavirus outbreak, with initial findings expected to be available in early May.

Led by the Department for Health and Social Care and the Office for National Statistics (ONS), the study draws on the expertise of the University of Oxford, backed by data science company IQVIA UK and the National Biosample Centre in Milton Keynes.  

It will add to the population data already being collected through the national surveillance programme operated by Public Health England, which has been enhanced since the end of February.

 

New NICE guidance on acute myocardial injury and digestive disorders

NICE has published two new rapid Covid-19 guidelines on the care of patients with suspected and confirmed Covid-19 that cover the management of disorders of the digestive system and the care of people in hospital who develop heart problems as a consequence of Covid-19 infection.

The guidance on gastrointestinal and liver conditions provides clinicians with advice on how to adjust care to reduce patients’ exposure to Covid-19 and how to balance the risks and benefits of taking drugs that affect the immune response during the pandemic. It recommends that patients who are not known to have Covid-19 continue to take existing courses of drugs that affect the immune response to minimise the risk of a flare-up.

The guideline on acute myocardial injury aims to help healthcare professionals who are not cardiology specialists to identify, monitor and treat heart problems in adults with known or suspected Covid-19 but without known pre-existing heart disease.

It highlights that acute myocardial injury was observed in 9.5% of all hospitalised patients dying in Italy with Covid-19 and that some of the symptoms are similar to the respiratory complications of Covid-19.

 

BMA demands ‘proper’ death in service cover for doctors

The British Medical Association is demanding the Government give all NHS staff full death in service benefits regardless of whether they are a member of the NHS Pension Scheme or not.

The Scottish Government has already announced a commitment to providing a comprehensive death in service package for all NHS workers imminently, and the BMA is demanding that full protections are put in place in the other UK nations.

Under current rules, the families of returning doctors, medical students and newly-qualified doctors, locum doctors and those who have opted out of the pension scheme all receive no €“ or a considerably reduced €“ benefit should they die while trying to save the lives of others. For locums specifically, this means if they die on a day they are not scheduled to work, even though they may have contracted Covid-19 while treating Covid-positive patients, their families are not entitled to full benefits.

 

COVID-19 screening of healthcare workers offers reassurance and faster return to work

The rate of infection among NHS staff treating patients is no higher than for those in non-clinical roles, according to new research published in The Lancet.

The findings from Newcastle Hospitals and University has shown that the delivering staff testing during the pandemic is feasible and the rates of positive tests in patient-facing staff were no higher than in those staff in clerical or administrative roles who have no patient contact.

Dr Christopher Duncan, Research Fellow at Newcastle University and Honorary Consultant in Infectious Diseases within Newcastle Hospitals, said: “An efficient and robust system of testing has enabled 1,414 health care workers to return more rapidly to NHS service in Newcastle in the last three weeks, the vast majority returning directly into patient care.”

  

RCP guidance on managing tracheostomised patients

New supplementary guidance from the Royal College of Physicians will help clinicians manage patients in prolonged disorders of consciousness (PDOC) and minimally conscious state who have had a tracheostomy.

A significant number of patients in PDOC need to have a tracheostomy that can be connected to an oxygen supply and ventilator, and/or to remove any fluid that’s built up in the throat and windpipe. Some patients have the tracheostomy for a short time and can be weaned off, and for some it is for a longer period or permanently.

Tracheostomy procedures (insertion, removal, changing or open suctioning) are aerosol generating procedures (AGP), which pose a very significantly higher risk of transmission – both droplet- and air-borne.

 

All health and social care deaths should be referred to the coroner

All deaths of health and social care workers during the Covid-19 pandemic should be referred to the coroner for independent review, says Dr Fiona Godlee, Editor in Chief of The BMJ.

Her call echoes that of Professor John Robertson, Consultant Surgeon at the University of Nottingham and colleagues, who say “as this pandemic unfolds and we witness the deaths of our fellow healthcare professionals during active service and under controversial occupational conditions, there arises the inevitable question of whether the coroner should be involved?”

Writing in this week’s journal, they say it is imperative that there is no further delay in providing every healthcare worker with effective PPE, and argue that, “until it is clear how much transmission is due to aerosol as well as droplet infection, surgical masks should not be considered effective protection.”

  

Other news roundup

  • The CEO of Campaign Against Living Miserably (Calm) says he has seen an increase in calls from NHS workers during the lockdown
  • China reports no new Covid-19 deaths for the eighth day in a row
  • The northern Italian region of Lombardy began an antibody testing programme today
  • China said  it would donate a further $30 million to the World Health Organization
  • Two cats in New York have become the first pets in the US to test positive for the new coronavirus
  • Nicola Sturgeon has outlined Scotland’s exit plan

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