- Coronavirus disease (COVID-19) outbreak Up to date health advice from the World Health Organisation
- 6 Demands from NHS staff to help us tackle Coronavirus Sign the health workers' petition
- Coronavirus: where we stand Statement from Keep Our NHS Public
- Government seeks urgent PPE audit amid widespread shortages HSJ reports in an exclusive (April 1) that despite constantly claiming in daily press conferences that supplies of PPE are adequate, “The government has ordered an urgent national audit of personal protective equipment, body bags, swabs and infection control products”.
“Local resilience forum planners were earlier this week asked to share stock levels and daily consumption rates of the items at ambulance, acute trusts and in primary care and other services by 9pm on Tuesday.
“… The email added the data collection was “authorised” by Number 10. Yet on Tuesday afternoon — just hours before the audit results were due — a Downing Street spokesperson played down supply issues, telling reporters he had “not seen anything to suggest we don’t have enough [PPE].”
“The news comes days after a new national PPE supply channel was announced in response to weeks of major shortages at trusts, GPs and community partners. HSJ revealed on Tuesday that retail logistics firm Clipper would manage the new coronavirus-related channel.
“The audit request came from a Ministry of Defence planner at the resilience and emergencies division of the Ministry of Housing, Communities and Local Government. As well as trusts, resilience forum staff were asked to share stock levels among adult social care services, numbers of mortuary staff, other local authority staff, police, prisons, fire and rescue services and funeral directors.”
- PHE publishes updated guidance on use of PPE Pulse reports on the new PPE guidance, and notes, in context of primary care, BMA comments and warnings that supplies are vital -- and have not been getting through to many NHS hospitals or GPs:
"BMA chair of council Dr Chaand Nagpaul said: 'Although PHE has produced updated guidance, what fundamentally matters is that doctors and healthcare workers get the adequate and appropriate supplies of PPE on the frontline. Without these supplies there is continued unacceptable danger to the health and lives of healthcare workers and their patients.'
"The BMA has warned that without adequate protection, GPs and hospital doctors 'will die' from Covid-19.
"Dr Nagpaul said: 'It is four days since the minister Robert Jenrick gave the assurance that no frontline staff should be working without the right protective equipment. Yet this week the BMA has received concerns from doctors in over 30 hospital trusts about inadequate PPE supplies and GPs across England who are yet to receive eye protection.'"
- COVID-19 personal protective equipment (PPE) The long awaited revised guidance on personal protective equipment (PPE) from Public Health England. It notes:
"This guidance …seeks to set out clear and actionable recommendations on the use of PPE, as part of safe systems of working, for health and social care workers relative to their day-to-day work. Incidence of COVID-19 varies across the UK and risk is not uniform and so elements of the updated guidance are intended for interpretation and application dependant on local assessment of risk."
- Delay and dithering mean targets for coronavirus testing are way off (£) Times report April 1: "Boris Johnson says that he hopes to reach 250,000 daily tests for coronavirus infections, but the country is still testing fewer than 10,000 patients a day. At the heart of the problem are two key decisions taken by the prime minister, his advisers and public health officials."
- Doctors kept away from front line BMA (27 March) again challenging government's failure to test healthcare workers for Covid-19, and its implications:
"BMA council chair Chaand Nagpaul (pictured above) has written to health secretary Matt Hancock urging priority testing for healthcare workers at the NHS’s time of ‘greatest need’.
"The Government has pledged to keep NHS staff safe and give ‘everything’ frontline workers need, with Mr Hancock promising to ramp up testing, but Dr Nagpaul has demanded clarity.
"He said: ‘I am writing to ask you when specifically will priority testing for healthcare workers and their symptomatic household members become available? Each day that goes by is illogically perpetuating further reductions of doctors from the workforce who could be treating patients instead.’
"Dr Nagpaul added: ‘Put simply, this failure to test is resulting in significant numbers of doctors off work, many unnecessarily, adding further pressure to an already stretched service. This is ironic at time when the NHS is actively recruiting retired doctors and medical student to support doctor shortages.’"
- COVID-19 Bonanza: Stimulus Hands Health Industry Billions Not Directly Related To Pandemic Kaiser Health News (March 31) reports on the emergency measures adopted by US Congress:
"The coronavirus stimulus package Congress rushed out last week to help the nation’s hospitals and health care networks hands the industry billions of dollars in windfall subsidies and other spending that has little to do with defeating the COVID-19 pandemic.
"The $2 trillion legislation, which President Donald Trump signed Friday, includes more than $100 billion in emergency funds to compensate hospitals and other health care providers for lost revenue and other costs associated with COVID-19. The measure also calls for spending up to $16 billion to replenish the nation’s depleted stockpile of medical gear, such as ventilators, medicines and personal protective equipment, or PPE.
"But health care businesses will get billions of dollars in additional funding not directly related to the pandemic, in some cases because Congress agreed to reverse scheduled cuts in the rates paid by Medicaid and Medicare, which the federal government had tried for years to impose."
- For the sixteenth consecutive day, the government has refused to answer one very simple question about coronavirus Brilliant and funny Independent March 31 take on the government's continued failure to implement WHO policy of mass testing (or carry out its own promises):
"For the sixteenth consecutive day, we go live to 10 Downing Street for the daily coronavirus press conference.
“Good afternoon prime minister/health secretary/foreign secretary/chief medical officer/senior NHS management bod/dog/cat/off-duty police officer/inanimate lectern-based object. My question is the same as it has been for the last two weeks. Why is Germany doing more than a half a million coronavirus tests a week and we still haven’t managed to reach our target of 10,000 a day?”
“Well thank you, Mr or Mrs Blurry Head from the BBC/ITV/Guardian/Beano/Dandy/Razzle/Nuts magazine. May I just say how nice your kitchen is?"
- The Covid-19 outbreak will lead to untold misery & death in besieged Gaza Grim 27 March warning from Labour & Palestine: "Last weekend, the devastating news broke for the people of Palestine of confirmed Covid-19 cases in the densely populated Gaza strip.
"It is important for everyone in the labour and solidarity movements to understand why this is truly a nightmare situation for the people of the besieged Gaza strip, and why these 1.8 million people are particularly vulnerable.
"The UN has previously warned that Gaza would be uninhabitable by 2020, and now 13 years of an illegal blockade mean that Gaza’s fragile healthcare system is already stretched to a point that it is hard for us to imagine. Covid-19 means it will now be placed under a simply unbearable strain.
"Alongside this, the situation in Gaza is one of malnutrition on the rise, poorly controlled non-communicable diseases, dense living and housing conditions.
"There are deep levels of poverty, the power supply is sporadic and sources of drinking water are largely contaminated.
"Older people are without access to proper nursing and healthcare.
"At the current time, Israel has restricted testing kits to the strip, where there are only 60 working ventilators and 2,800 hospital beds. Stocks of essential drugs are already chronically low."
- Hospitals Tell Doctors They’ll Be Fired If They Speak Out About Lack of Gear Bloomberg report March 31 reveals that the lack of adequate protective equipment and the efforts to gag staff who speak out are similar in Trump's USA and Johnson's NHS:
"Hospitals are threatening to fire health-care workers who publicize their working conditions during the coronavirus pandemic -- and have in some cases followed through.
"Ming Lin, an emergency room physician in Washington state, said he was told Friday he was out of a job because he’d given an interview to a newspaper about a Facebook post detailing what he believed to be inadequate protective equipment and testing.
"In Chicago, a nurse was fired after emailing colleagues that she wanted to wear a more protective mask while on duty.
"In New York, the NYU Langone Health system has warned employees they could be terminated if they talk to the media without authorization."
- Royal College of Nursing says lack of PPE puts nurses and their families at risk RCN CEO Dame Donna Kinnair, March 30 says:
"“The government is finally prioritising Covid-19 testing for NHS staff, including social care, but it is completely unacceptable that weeks into this crisis, there are colleagues in all settings – hospitals, community or care homes – who have not been provided with personal protective equipment.
"I am hearing from nurses who are treating patients in Covid-19 wards without any protection at all. This cannot continue. They are putting themselves, their families, and their patients at risk.
“As the professional trade union representing potentially the largest group of affected workers, the RCN has said repeatedly that we will not accept anything less than aprons, gloves and masks for all staff, in all settings. But this is a minimum – and that is why we are so disappointed even that level of protection has yet to be provided."
- UK insurers tighten terms to explicitly exclude coronavirus FT report March 31, shows hoe British health insurers are proving they are as anti-social and as profit-obsessed as their bigger US equivalents, making sure they carry no risk at all on the major health issue of the day:
“Insurers are tightening the terms of their business coverage to make sure anything related to the coronavirus pandemic is explicitly excluded. The industry has been criticised for sticking to a tough line since the crisis began that the outbreak is already excluded from many policies.
“According to brokers and other advisers, insurers have been closing any remaining loopholes on contracts that are up for renewal to try to reduce their exposure to any future costs.
“They are rushing out a whole series of exclusions in all kinds of different contracts,” said Bruce Hepburn, chief executive of Mactavish, a claims specialist. “The big worry is that these are very broad exclusions.” “They are making sure not only that they were not on the hook when [the outbreak] happened, but that they won’t be on the hook at all. It really doesn’t feel like they are sharing the pain,” he added."
- UNISON writes to PM over lack of PPE for front line staff Text of a letter from the largest public sector union to Boris Johnson demanding action on the continued lack of adequate personal protection equipment in NHS and social care.
- Why Did Government Downgrade COVID-19? Can We Trust Numbers & Why Little Testing? Blog by prominent public health expert Prof John Ashton on the latest twists and turns of government policy and the failures to deal scientifically with the Covid-19 epidemic.
- Chronicle of a “national scandal” – blunders and deception Detailed account in The Lowdown (March 31) of the ways ministerial statements day by day have bluffed waffled and lied to journalists:
"However the attempts to palm off journalists and the public with superficial claims and statements have proved increasingly ineffective, while the frustrations of the NHS staff whose own lives are potentially being put at risk have been voiced more loudly and effectively.
"Time and again Matt Hancock, whose department assured us in February that the NHS was “extremely well prepared for coronavirus,” has been seen to have lied and dissembled when asked about the extension of testing, supplies of personal protective equipment (PPE) for hospital staff, and delivery of ventilators to supplement the inadequate stocks.
"Hancock’s claim – made on BBC Question TIme, that he was working with supermarkets to secure deliveries of food to vulnerable patients was denied by retail insiders and described as “totally made up”. Even the Daily Mail cast doubt on the assertion that new ventilators could be in hospitals ‘within days’ when manufacturers were warning that it would take a month to start large scale production."
- PPE delays – the Unipart way March 30 from the Lowdown: "NHS Supply Chain is the organisation which should be coordinating the distribution of the vital PPE gear, ventilators, supplies of sanitiser and other basics to hospital trusts, GPs and community health providers. But it is manifestly failing in its task.
"Who, then are NHS Supply Chain? Technically it is a holding company owned by the Secretary of State for Health and Social Care. But in practice it is an immensely complex and dysfunctional web of contracts at the centre of which is Unipart, the one-time supplier of components to the motor industry, which won the £730m contract to take over the logistical contract from DHL back in 2018.
"Since March last year Unipart Logistics has been tasked with delivering medical devices and hospital consumables (other than medicine) to NHS trusts, warehousing, inventory management, order processing and delivery, and a subcontracted home delivery service, which makes up 10% of the contract. So if they are not being delivered, it’s down to them."
- Urgent: PPE provision for the adult social care sector: Letter to Secretary of State Matt Hancock from the LGA and ADASS Letter from local government and social care bosses again flags up the glaring gap between ministerial claims and the harsh reality on the ground:
"As the Government recognises, social care is at the frontline of responding to the unique challenges posed by Covid-19 and the workforce is doing an incredible job in extremely testing circumstances. It is also doing a dangerous job, with colleagues putting themselves, their families and their communities at risk. Ensuring their safety must be the number one priority alongside the safety of those they are supporting.
"Despite welcome recognition from Government of the importance of PPE, we continue to receive daily reports from colleagues that essential supplies are not getting through to the social care frontline.
"Furthermore, national reporting that equipment has been delivered to providers on the CQC registered list does not tally with colleagues’ experience on the ground.
"Of equal concern, there is a notable lack of confidence in national planning for, and provision of, PPE for the thousands of people who work in non-regulated services, such as personal assistants. The advice they are being given is to contact their local council. To be absolutely clear, councils do not have stocks of PPE equipment to distribute."
- https://www.union-news.co.uk/social-care-workers-at-breaking-point-over-lack-of-ppe-warns-unison/ Union News reports: "Social care workers across the country are at breaking point with many being given just plastic aprons and gloves to protect against coronavirus as they support the vulnerable and elderly, UNISON has said.
"Care workers say some managers are either refusing to issue face masks or not providing training in how to use them, and not supplying hand sanitiser. This has triggered widespread anxiety among staff that they and their families may become infected or they may spread the virus among the people they care for, says UNISON.
"The news comes as the government cracks down on whistleblowers, threatening to discipline health workers who speak to the media.
"The union has also received reports of some employees being asked to work even if they have underlying health issues, and to bring their children in if they cannot get childcare."
- A WORLD AT RISK September 2019 report of Global Preparedness Monitoring Board supported by WHO and World Bank:
"In this first annual report, the Board explores and identifies the most urgent needs and actions required to accelerate preparedness for health emergencies, focusing in particular on biological risks manifesting as epidemics and pandemics.
The Board analysed evidence and commissioned seven review papers that explore the challenges of preparedness through various lenses: governance and coordination; country preparedness capacities; research and development; financing; enhancing community engagement and trust; preparing for and managing the fallout of a high-impact respiratory pathogen pandemics; and, lessons learned and persistent gaps revealed by recent outbreaks of Ebola virus disease in Africa. The Board has drawn on these papers and other data to identify areas where preparedness efforts are working
and where they are faltering (1)."
It warns (page 8): "A rapidly spreading pandemic due to a lethal respiratory pathogen
(whether naturally emergent or accidentally or deliberately released) poses additional preparedness requirements. Donors and multilateral institutions must ensure adequate investment in developing innovative vaccines and therapeutics, surge
manufacturing capacity, broad-spectrum antivirals and appropriate non-pharmaceutical interventions. All countries must develop a system for immediately sharing genome sequences of any new pathogen for public health purposes along with the means to share limited medical countermeasures across countries."
- Counting deaths involving the coronavirus (COVID-19) ONS blog March 31:
"Knowing the exact number of people whose death involved coronavirus (COVID-19) is of great importance, but it’s not a simple question. Sarah Caul introduces the provisional new figures published on 31 March and explains why the different ways of counting used across the government give different answers."
- Italian doctors warn protective equipment vital to prevent healthcare system collapse Independent report March 31: "Shortages in protective equipment could cause whole healthcare systems to collapse, doctors at the forefront of efforts to fight the coronavirus pandemic in Italy have warned.
"In a new paper, more than a dozen Italian anaesthetists and intensive care doctors warn other countries to make sure nurses, doctors and other staff are protected from the virus after large numbers of Italian staff became sick themselves.
"The UK government continues to face criticism from doctors and hospital staff over the lack of equipment and shortages across the country. Ministers have called in the army to help deliver 170 million masks, gloves and other items in recent days.
"The Italian experts warn: “The ramifications of losing significant proportions of frontline healthcare workers remain uncertain, but this may contribute to the collapse of healthcare systems affected by Covid-19”."
- COVID-19 TRACKING AND TESTING MUST RESUME Doctors for the NHS: "DFNHS member Allyson Pollock has co-written an editorial in the BMJ calling for the resumption of widespread tracking and testing for Covid-19.
"The editorial, written with NHS Reinstatement Bill co-author Peter Roderick and others, suggests the lack of testing means the cited number of cases nationally is an underestimate, and also points out the shortcomings of regarding the pandemic in the UK as one large infection instead of more accurately gauging it as many local ones at different stages. It lays the blame for this firmly at the feet of years of neglect of public-health provision, especially in England."
The BMA editorial concludes: "‘So what now? WHO’s mantra of “trace, test, and treat” must be followed. It is not too late to adopt WHO Guidance.2122 A second and third wave of the epidemic is likely. Contact tracing must recommence. This means immediately instituting a massive, centrally coordinated, locally based programme of case finding, tracing, clinical observation, and testing. It requires large teams of people, including volunteers, using tried and tested methods updated with social media and mobile phones and adapting the manuals and guidance published by China."
- England's ravaged public health system just can't cope with the coronavirus Guardian Comment is Free report March 30: "The NHS has also had 10 years of significant underfunding – and England, in particular, has an operational and management system that is fragmented and lacks an effective command and control structure. The public health function in England has been removed from the NHS and incorporated into local government, where its budgets have been systematically raided to prop up local councils that have suffered catastrophic cuts in the name of austerity.
"Local authority functions closely aligned with public health, such as environmental health and social services, have been notable casualties. Within the local government world, the once powerful directors of public health have seen their influence decline, along with their staffing and resources."
- Coronavirus: Questions over true death toll as hospital records almost three times more deaths than official figures show Telegraph report, March 30: "The official death toll for coronavirus is lower than the true number of casualties reported by hospitals, it was claimed on Sunday night.
"Channel 4 News reported that an email sent to staff at one of London's biggest hospitals suggested the daily tally, made public by the Government, did not tally with the actual number killed by Covid-19.
"The message, sent to staff at King's College Hospital Trust, said: "The number of deaths reported at King's in national figures is below what they are experiencing. It is not just King's but a number of other trusts, and the centre has been made aware."
- ‘I’m losing the will to live, god help us all’: despair of NHS procurement chief HSJ reports March 30: "Gowns for front-line staff were not included in the national pandemic stockpile of personal protective equipment, procurement chiefs have been told.
"Trust procurement leads have raised concerns over dwindling gown supplies. Health Care Supply Association chief officer Alan Hoskins tweeted he could not order the products through NHS Supply Chain, even after escalating the matter to NHS England.
"Mr Hoskins’ tweet on Sunday, which has since been deleted, said: “What a day, no gowns NHS Supply Chain. Rang every number escalated to NHS England, just got message back — no stock, can’t help, can send you a PPE pack. Losing the will to live, god help us all.”
"Senior procurement leads told HSJ that major trusts, including Barts Health in London, ran out of gowns at the end of last week. Calling the supplies situation “extremely bad,” one source said there were “virtually no gowns left in the system” and no communication from NHS Supply Chain as to when more would be available."
- Coronavirus: NHS doctors ‘gagged’ over protective equipment shortages Independent report from March 31 raising real doubts on the extent to which supply problems of PPE and other vital kit have really been resolved as ministers claim:
"Frontline doctors have told The Independent they have been gagged from speaking out about shortages of protective equipment as they treat coronavirus patients – with some claiming managers have threatened their careers.
"Staff have been warned not to make any comments about shortages on social media, as well as avoiding talking to journalists, while NHS England has taken over the media operations for many NHS hospitals and staff.
"The Independent has seen a series of emails and messages warning staff not to speak to the media during the coronavirus outbreak."
…"One intensive care doctor, who asked to remain anonymous, raised concerns with their managers about a shortage of protective masks after being told they would have to use less safe surgical masks. They claimed they were later warned in a meeting with trust bosses that their social media profiles would be watched.
"The doctor said they were told: “If we hear of these concerns going outside these four walls, your career and your position here will not be tenable going forward.”
- How South Korea Flattened the Curve New York Times (March 23) on the success in containing Covid-19 in South Korea:
"At the peak, medical workers identified 909 new cases in a single day, Feb. 29, and the country of 50 million people appeared on the verge of being overwhelmed. But less than a week later, the number of new cases halved. Within four days, it halved again — and again the next day.
"On Sunday, South Korea reported only 64 new cases, the fewest in nearly a month, even as infections in other countries continue to soar by the thousands daily, devastating health care systems and economies. Italy records several hundred deaths daily; South Korea has not had more than eight in a day.
"South Korea is one of only two countries with large outbreaks, alongside China, to flatten the curve of new infections. And it has done so without China’s draconian restrictions on speech and movement, or economically damaging lockdowns like those in Europe and the United States."
- UK ministers accused of overstating scale of coronavirus testing Guardian report March 30: "Ministers have been accused of overstating the scale of coronavirus testing in the UK as figures for the number of daily tests fell to 8,278 on Saturday – far short of the 10,000 target it was meant to have met last week.
"Michael Gove, the Cabinet Office minister, claimed over the weekend that the 10,000 target had been reached.
"However, it turned out only 9,114 tests had been carried out on about 6,900 people on Friday – falling to 8,278 tests on 4,908 patients on Saturday.
"The figures are well below the 10,000 daily tests promised by the government on 11 March and cast doubt on whether it would hit the next target of 25,000 daily tests within a fortnight.
"It shows the UK is lagging behind other countries such as Germany, which is testing 70,000 people daily, despite the World Health Organization’s advice for countries to “test, test, test”."
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