Doctors have told The BMJ they are deeply concerned at the number of patients becoming infected with covid-19 in NHS hospitals in England and have called for more stringent infection control measures to combat its spread.
Only a third of the excess deaths seen in the community in England and Wales can be explained by covid-19, new data have shown.
Of those 30 000, only 10 000 have had covid-19 specified on the death certificate. While Spiegelhalter acknowledged that some of these “excess deaths” might be the result of underdiagnosis, “the huge number of unexplained extra deaths in homes and care homes is extraordinary. When we look back . . . this rise in non-covid extra deaths outside the hospital is something I hope will be given really severe attention.”
At the current time, children do not appear to be super spreaders. Sero-surveillance data will not be available to confirm or refute these findings prior to the urgent policy decisions that need to be taken in the next few weeks such as how and when to re-open schools. Policies for non-pharmacological interventions involving children are going to have to be made on a risk–benefit basis with current evidence available.
This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.
In conclusion, as opposed to Greenhalgh et al., we believe that the context of the current covid-19 pandemic is very different from that of the “parachutes for jumping out of aeroplanes”, in which the dynamics of harm and prevention are easy to define and even to quantify without the need of research studies. It is necessary to quantify the complex interactions that may well be operating between positive and negative effects of wearing surgical masks at population level. It is not time to act without evidence.
There needs to be a more effective and sustainable strategy to manage Covid-19 than the current economically ruinous policy, argue vets Dick Sibley and Joe Brownlie.