Health Care Workers

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Publications

4th Dose COVID mRNA Vaccines’ Immunogenicity & Efficacy Against Omicron VOC – medRxiv

RESULTS Of 1050 eligible HCW, 154 and 120 were enrolled to receive BNT162b2 and mRNA1273, respectively, and compared to 426 age-matched controls. Recipients of both vaccine types had a ∼9-10-fold increase in IgG and neutralizing titers within 2 weeks of vaccination and an 8-fold increase in live Omicron VOC neutralization, restoring titers to those measured after the third vaccine dose. Breakthrough infections were common, mostly very mild, yet, with high viral loads. Vaccine efficacy against infection was 30% (95%CI:-9% to 55%) and 11% (95%CI:-43% to +43%) for BNT162b2 and mRNA1273, respectively. Local and systemic adverse reactions were reported in 80% and 40%, respectively.

CONCLUSIONS The fourth COVID-19 mRNA dose restores antibody titers to peak post-third dose titers. Low efficacy in preventing mild or asymptomatic Omicron infections and the infectious potential of breakthrough cases raise the urgency of next generation vaccine development.

https://www.medrxiv.org/content/10.1101/2022.02.15.22270948v1.full-text

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News

Sajid Javid tells medical regulators to insist staff get jabs – The Times

Medical regulators must crack down on unvaccinated staff, the health secretary has said as he tries to deal with the fallout from abandoning compulsory jabs.

Sajid Javid has rebuked regulators and demanded that they send a “clear message” to healthcare workers that they must get a coronavirus vaccine.

http://archive.today/2022.02.08-001721/https://www.thetimes.co.uk/article/sajid-javid-tells-medical-regulators-to-insist-staff-get-jabs-q5z6wzv2f

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News

Doctors join waiters in turning down Covid jabs – The Times

Doctors are among the health workers least likely to be vaccinated against Covid-19, while fitness instructors, artists and waiters have some of the highest unjabbed rates overall.

New figures from the Office for National Statistics (ONS) show vaccination rates by profession at the end of last year. The data provides an early indication of which parts of the NHS and social care workforce could be hardest hit by the compulsory vaccination rule that comes into force in April.

http://archive.today/2022.01.21-103524/https://www.thetimes.co.uk/article/doctors-join-waiters-in-turning-down-covid-jabs-rf79t7ktf

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News

The NHS is hiding a guilty little secret – The Telegraph

Plan B is a go. And just like that, more mask mandates, working from home guidance and, most controversially, vaccine passports have been rushed in. While we wait, of one thing we can be certain: Covid decisions this winter are once again being determined by one institution. While we wait to find out more about the omicron variant, there is one thing we can say with certainty: our future rests once again on the ability of the National Health Service to handle an uptick in cases.

…Yet the NHS has a guilty little secret, rarely talked about given its status as the national religion. On many metrics, capacity has not been rising – it’s actually been falling.

http://archive.today/2021.12.10-111316/https://www.telegraph.co.uk/news/2021/12/09/nhs-hiding-guilty-little-secret/

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Publications

Hospital-acquired COVID-19 tends to be picked up from other patients, not from healthcare workers – University of Cambridge

The majority of patients who contracted COVID-19 while in hospital did so from other patients rather than from healthcare workers, concludes a new study from researchers at the University of Cambridge and Addenbrooke’s Hospital.

The researchers analysed data from the first wave of the pandemic, between March and June 2020.  While a great deal of effort is made to prevent the spread of viruses within hospital by keeping infected and non-infected individuals apart, this task is made more difficult during times when the number of infections is high. The high level of transmissibility of the virus and the potential for infected individuals to be asymptomatic both make this task particularly challenging.

https://www.cam.ac.uk/research/news/hospital-acquired-covid-19-tends-to-be-picked-up-from-other-patients-not-from-healthcare-workers

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Videos

Dr. Peter McCullough interview by John Leake

Dr. Peter McCullough has been the world’s most prominent and vocal advocate for early outpatient treatment of SARS-CoV-2 (COVID-19) infection in order to prevent hospitalization and death. On May 19, 2021, I interviewed him about his efforts as a treating physician and researcher. From his unique vantage point, he has observed and documented a profoundly disturbing policy response to the pandemic—a policy response that may prove to be the greatest malpractice and malfeasance in the history of medicine and public health.”

Link to interview audio format released by Julian Charles of The Mind Renewed podcast.

Backup mirror:

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Publications

COVID-19 vaccine refusal is higher among health and social care workers who feel pressured by their employers – London School of Hygiene and Tropical Medicine

Health and social care workers who felt under greater pressure from their employers to receive COVID-19 vaccination were more likely to decline it, according to preliminary new research highlighting factors influencing uptake.

https://www.lshtm.ac.uk/newsevents/news/2021/covid-19-vaccine-refusal-higher-among-health-and-social-care-workers-who-feel

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News

Hancock begs BAME health workers to get Covid-19 jab as study shows only 37% of black NHS staff have come forward for vaccine – RT

While 71 percent of white staff had received at least their first dose, a mere 37 percent of black workers had come forward for the jab. Rates among South Asians were also low, around 60 percent.

https://www.rt.com/uk/515601-hancock-bame-covid19-black-nhs/

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Publications

COVID-19: management of staff and exposed patients or residents in health and social care settings – GOV.uk

Immunocompetent staff, patients and residents who have tested positive for SARS-CoV-2 by PCR should be exempt from routine re-testing by PCR or LFD antigen tests (for example, repeated whole setting screening or screening prior to hospital discharge) within a period of 90 days from their initial illness onset or test (if asymptomatic) unless they develop new COVID-19 symptoms. This is because fragments of inactive virus can be persistently detected by PCR in respiratory tract samples following infection – long after a person has completed their isolation period and is no longer infectious.

https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings#section6

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News

Nearly half of care home staff WON’T take Covid vaccine as bosses call on ministers to make jabs compulsory among healthcare workers – Daily Mail

Nearly half of care home staff won’t take the coronavirus vaccine, with bosses desperately calling on ministers to make jabs compulsory among healthcare workers.

Nadra Ahmed, chairman of the National Care Association, said as many as 40% of carers could choose not to take up the option as it is rolled out over the coming days.

Ms Ahmed told BBC Radio 4’s Today programme: ‘We know that between 50-60%, depending on individual services, the staff are actually saying they will definitely have the vaccine and are very keen.

‘We understand between about 17-20% of staff in services are saying they definitely won’t have it, and then you have the rest who are waiting to see.

‘So we are looking at potentially 40% who decide not to have it.’

https://web.archive.org/web/20201212102821/https://www.dailymail.co.uk/news/article-9045937/Nearly-half-care-home-staff-WONT-Covid-vaccine-bosses-call-make-jabs-compulsory.html?ito=social-twitter_dailymailUK

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Opinion

The Covid Physician’s true coronavirus timeline – The Critic

Our mission: save the NHS by neglecting ourselves and the NHS. I received numerous CCG advice and flow-charts on the coronavirus-centric mass processing of patients. Most of it was about whom not to see, and who could pass the pearly gates of the hospitals. Then there was the advice on the parallel IT and video-consultation medical industrial revolution: our new NHS normal.

…For clarity, the “D” in coronavirus means “disease”, the second “S” in SARS-CoV-2 means “syndrome”. In a sense, the WHO had already decided Covid-19 was a distinct disease entity caused by a novel coronavirus before characterising it as a syndrome called SARS-2, and before the naming of the virus as SARS-CoV-2. The importance of scientific syntax and semantics cannot be overemphasised. Such cognitive slip-ups trickle unnoticed into general parlance and may have fatal consequences for us as a species.

Without a definite cause, one cannot definitively conclude to treat anything in particular. Is Covid-19 a syndrome, a mixed bag of symptoms and signs that has been negligently and politically globally fast-tracked to a scientifically wrong conclusion? Is it, in practice, a conflation of different, distinct disease entities including influenzae, rhinoviruses, pneumoniae and other coronaviruses, not to mention other non-infectious phenomena?

https://thecritic.co.uk/the-covid-physicians-true-coronavirus-timeline/

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Publications

Fask Facts -The Association of American Physicians and Surgeons

A curated list of mask facts and medical publications.

COVID-19 is as politically-charged as it is infectious. Early in the COVID-19 pandemic, the WHO, the CDC and NIH’s Dr. Anthony Fauci discouraged wearing masks as not useful for non-health care workers. Now they recommend wearing cloth face coverings in public settings where other social distancing measures are hard to do (e.g., grocery stores and pharmacies). The recommendation was published without a single scientific paper or other information provided to support that cloth masks actually provide any respiratory protection. Let’s look at the data.

  • Surgical masks are loose fitting. They are designed to protect the patient from the doctors’ respiratory droplets.  There wearer is not protected from others’ airborne particles.
  • People do not wear masks properly. Many people have the mask under the nose. The wearer does not have glasses on and the eyes are a portal of entry.  If the virus lands on the conjunctiva, tears will wash it into the nasopharynx.
  • Most studies cannot separate out hand hygiene.
  • The designer masks and scarves offer minimal protection. They give a false sense of security to both the wearer and those around the wearer.
    **Not to mention they add a perverse lightheartedness to the situation.
  • If you are walking alone, no need for a mask. Avoid other folks; use common sense.
  • Remember: children under 2 years should not wear masks because of accidental suffocation and difficulty breathing in some.
  • Even if a universal mask mandate were imposed, several studies noted that folks do not use the mask properly and over-report their wearing.  Additionally, how would the mandate be enforced??
  • The positive studies are models that assume universality and full compliance.
  • If wearing a mask makes people go out and get Vitamin D – go for it. In the 1918 flu pandemic people who went outside did better.  Early reports are showing people with COVID-19 with low Vitamin D do worse than those with normal levels. Perhaps that is why shut-ins do so poorly.

https://aapsonline.org/mask-facts/

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Publications

Community and Close Contact Exposures Associated with COVID-19 Among Symptomatic Adults ≥18 Years in 11 Outpatient Health Care Facilities — United States, July 2020 – CDC

“In the 14 days before illness onset, 71% of case-patients and 74% of control participants reported always using cloth face coverings or other mask types when in public.” 

https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a5-H.pdf

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Videos

Denis Rancourt on the effectiveness of masks

https://youtube.com/watch?v=CtJcB_MrAkM
  • Science has already proved that masks don’t work.
  • Many large Randomised Control Trials (RCT) and meta-analyses over the past decade show masks offer no reduction in risk from respiratory viruses.
  • We understand the mechanism of transmission of respiratory disease and the science is clear that masks can’t work.
  • It can’t help others when you’re breathing out and it can’t help you when you’re breathing in.
  • The mechanism of transmission is through very small aerosol particles.
  • Any opening in the mask will allow enough of the minimal dose to infect you.
  • One of the effects shown in studies with healthcare workers is that they had an increase in headaches.
  • Many articles in support of masks are not relevant e.g. masks stop droplets but transmission is not via droplets.
  • Diseases are seasonal because droplets are carried for a long time when the air is dry like in the winter.
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News

A third of NHS staff in two hospital units were infected with coronavirus without showing symptoms, study finds – Independent

Almost 60 per cent of staff infected with coronavirus continued to work and commute

https://www.independent.co.uk/news/health/coronavirus-nhs-staff-symptoms-antibodies-covid-maternity-test-a9664841.html

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Publications

Preliminary report on surgical mask induced deoxygenation during major surgery – PubMed (2008)

Abstract
Objectives: This study was undertaken to evaluate whether the surgeons’ oxygen saturation of hemoglobin was affected by the surgical mask or not during major operations.

Methods: Repeated measures, longitudinal and prospective observational study was performed on 53 surgeons using a pulse oximeter pre and postoperatively.

Results: Our study revealed a decrease in the oxygen saturation of arterial pulsations (SpO2) and a slight increase in pulse rates compared to preoperative values in all surgeon groups. The decrease was more prominent in the surgeons aged over 35.

Conclusions: Considering our findings, pulse rates of the surgeon’s increase and SpO2 decrease after the first hour. This early change in SpO2 may be either due to the facial mask or the operational stress. Since a very small decrease in saturation at this level, reflects a large decrease in PaO2, our findings may have a clinical value for the health workers and the surgeons.

https://pubmed.ncbi.nlm.nih.gov/18500410/

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News

Autopsy shows Wellington nurse died of kidney infection, not COVID-19

A report from the Palm Beach County Medical examiner obtained by CBS12 News shows that a young Wellington nurse believed to have passed from COVID-19, was never infected with the virus at all.

The report shows that 33-year-old Danielle DiCenso died from “complications of acute pyelonephritis,” otherwise known as a kidney infection.

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Publications

A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes – The Lancet

Lockdowns may reduce the peak of transmission and recovery rates but not the number of critical cases or overall mortality.

Lastly, government actions such as border closures, full lockdowns, and a high rate of COVID-19 testing were not associated with statistically significant reductions in the number of critical cases or overall mortality.

…full lockdowns and early border closures may lessen the peak of transmission, and thus prevent health system overcapacity, which would facilitate increased recovery rates.

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30208-X/fulltext

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Publications

Particle sizes of infectious aerosols: implications for infection control – The Lancet

Note: Coughing and large droplets are note the issue beause breathing exhales more virus in fine aerosols than coughing. Finer aerosols bypass masks and nose to the lungs. Since masks nebulise particles, the solution is ventilation, not face masks.

The global pandemic of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) has been associated with infections and deaths among health-care workers. There have been conflicting recommendations from health authorities on the use of masks or respirators to protect health-care workers. When I first reviewed personal respiratory protection against tuberculosis for health-care workers more than 20 years ago, there was very little information on infectious aerosols. Since then, colleagues in various disciplines have provided a wealth of data. The purpose of this Viewpoint is to review the scientific literature on the aerosols generated by individuals with respiratory infections, and to discuss how these data inform the optimal use of masks, respirators, and other infection-control measures to protect health-care workers from those aerosols. This is not a review of the literature on the use of surgical masks or respirators, as several have been done already.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30323-4/fulltext

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Publications

Contamination by respiratory viruses on outer surface of medical masks used by hospital healthcare workers – BMC Infectious Diseases

Background
Medical masks are commonly used in health care settings to protect healthcare workers (HCWs) from respiratory and other infections. Airborne respiratory pathogens may settle on the surface of used masks layers, resulting in contamination. The main aim of this study was to study the presence of viruses on the surface of medical masks.

Methods
Two pilot studies in laboratory and clinical settings were carried out to determine the areas of masks likely to contain maximum viral particles. A laboratory study using a mannequin and fluorescent spray showed maximum particles concentrated on upper right, middle and left sections of the medical masks. These findings were confirmed through a small clinical study. The main study was then conducted in high-risk wards of three selected hospitals in Beijing China. Participants (n = 148) were asked to wear medical masks for a shift (6–8 h) or as long as they could tolerate. Used samples of medical masks were tested for presence of respiratory viruses in upper sections of the medical masks, in line with the pilot studies.

Results
Overall virus positivity rate was 10.1% (15/148). Commonly isolated viruses from masks samples were adenovirus (n = 7), bocavirus (n = 2), respiratory syncytial virus (n = 2) and influenza virus (n = 2). Virus positivity was significantly higher in masks samples worn for > 6 h (14.1%, 14/99 versus 1.2%, 1/49, OR 7.9, 95% CI 1.01–61.99) and in samples used by participants who examined > 25 patients per day (16.9%, 12/71 versus 3.9%, 3/77, OR 5.02, 95% CI 1.35–18.60). Most of the participants (83.8%, 124/148) reported at least one problem associated with mask use. Commonly reported problems were pressure on face (16.9%, 25/148), breathing difficulty (12.2%, 18/148), discomfort (9.5% 14/148), trouble communicating with the patient (7.4%, 11/148) and headache (6.1%, 9/148).

Conclusion
Respiratory pathogens on the outer surface of the used medical masks may result in self-contamination. The risk is higher with longer duration of mask use (> 6 h) and with higher rates of clinical contact. Protocols on duration of mask use should specify a maximum time of continuous use, and should consider guidance in high contact settings. Viruses were isolated from the upper sections of around 10% samples, but other sections of masks may also be contaminated. HCWs should be aware of these risks in order to protect themselves and people around them.

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4109-x