While the testing data are so opaque, using them to direct local lockdowns is unhelpful, argues Heneghan. “The testing is there to drive the test and trace strategy,” he says. “But what seems to be happening is that, as soon as we see an outbreak, there tends to be panic and over-reacting. This is a huge problem because politicians are operating in a non-evidence-based way when it comes to non-drug interventions.”
The British public protected the NHS alright. Any fears that the institution might be overwhelmed were put aside when, a couple of weeks into lockdown, the hurriedly-constructed Nightingale hospitals were still empty, along with many other hospital wards, clinics and surgeries. By mid April, routine clinical activity by GPs was down 25 per cent and A&E visits down 52 per cent. Some of that was thanks to fewer drunks falling over and fewer children coming to grief in playgrounds, yet there is plenty to suggest that some very unwell people were scared into taking the instruction not to trouble the.
The NHS has a “hidden waiting list” of 15.3 million patients who need follow-up appointments for health problems, according to the first analysis of its kind.
The official waiting list, which stands at 3.9 million, shows how many patients are yet to have their first hospital appointment after a GP referral.
However, the total number who are on hospital books in England and need appointments is not collated centrally. A new calculation, based on freedom of information requests to NHS trusts and seen by The Times, puts the figure at 15.3 million.
Although the official waiting list, after initial referral by a GP, has remained at a fairly stable level throughout the pandemic, this has been mainly driven by fewer patients joining it.
Scores of MPs and former ministers have urged the prime minister to tackle a backlog in NHS cancer care that threatens to lead to thousands of early deaths over the next decade.
One senior oncologist has claimed that in a worst-case scenario the effects of the pandemic could result in 30,000 excess cancer deaths over the next decade.
Normally, our joint waiting rooms are bustling — with around 100 patients at any one time waiting to see doctors, nurses, or a phlebotomist to take blood. Now there are no patients and just a handful of staff.
There have been just a few patients with Covid in the hospital in the last few weeks, compared with 20 in intensive care and 100 on the wards at the peak of the pandemic.
But we are at a near standstill when it comes to seeing outpatients on site. Much to my frustration, only one of my six NHS rheumatology clinics is conducted face-to-face each week. It is still deemed too risky for patients to attend hospital.
There doesn’t seem to be a master plan or encouragement from the Department of Health to get clinics up and running again — this is needed urgently
Fatalities are down 99% and some hospitals have no coronavirus patients, sparking hope that ‘herd immunity’ may be near
The number of people in hospital with Covid-19 has fallen 96% since the peak of the pandemic, official data reveals.
Hospital staff are now treating just 700 coronavirus patients a day in England, compared to about 17,000 a day during the middle of April, according to NHS England.
Last week, some hospitals did not have a single coronavirus patient on their wards, with one top doctor suggesting that Britain is “almost reaching herd immunity”.
NHS hospitals have been warned they could face a fine if they are not at 90 per cent of their usual capacity levels by October.
A lot of routine care was paused due to the coronavirus pandemic and hospitals are currently thought to be running around 60 per cent of their usual capacity.
Experts fear people still unable to access medical care even though there are now relatively few coronavirus cases in hospitals
Twice as many people are now dying at home from unexplained causes rather than Covid-19, with experts calling for an urgent investigation into what is causing the excess deaths.
The ONS figures show that deaths in hospitals continue to be much lower than usual, suggesting that many of the home deaths are people who would ordinarily have received hospital care.
2:55 – Masks • Tom Jefferson: “Aside from people who are exposed on the frontlines, there is no evidence that masks make any difference, but what’s even more extraordinary is the uncertainty: we don’t know if these things make any difference…. We should have done randomised control trials in February, March and April but not anymore because viral circulation is low and we will need huge number of enrolees to show whether there was any difference”. • Carl Heneghan: “By all means people can wear masks but they can’t say it’s an evidence-based decision… there is a real separation between an evidence-based decision and the opaque term that ‘we are being led by the science’, which isn’t the evidence”.
9:26 – Pandemic life cycle • CH: “One of the keys of the infection is to look at who’s been infected, which shows a crucial difference when comparing the pandemic theory to seasonal theory. In a pandemic you’d expect to see young people disproportionately affected, but in the UK we’ve only had six child deaths, which is far less than we’d normally see in a pandemic. The high number of deaths with over-75s fits with the seasonal theory”.
14:00 – Covid seasonality • CH: “The stability of the virus is far less when the temperature goes up but humidity seems to be particularly important. The lower the humidity, the more stable the virus is in the atmosphere and on surfaces… It’s now winter in the southern hemisphere, which is why places like Australia are suddenly having outbreaks.”
20:37 – Lockdown • CH: “Many people said that we should have locked down earlier, but 50% of care homes developed outbreaks during the lockdown period so there are issues within the transmission of this virus that are not clear… Lockdown is a blunt tool and there needs to be intelligent conversations about what mitigation strategies can keep society functioning while we keep the most vulnerable shielded”.
25:20 – Nightingale hospitals • CH: “They are the wrong structure. What you need is fever hospitals which were here until around the 1980s or 90s. They were on single floors and had isolation within isolation. Theere were no lift shafts and staff were trained, which meant that everyone was protected from each other… It looks like at leats 20% of people got the infection while they were in hospital”
27:30 – Suppression strategy • CH: “The benefits of the current strategy are outweighed by the harms…When it comes to suppression, only the virus will have a determination in that. If you follow the New Zealand policy of suppressing it to zero and locking down the country forever, then you’re going to have a problem… This virus is so out there now, I cannot see a strategy that makes suppression the viable option. The strategy right now should be how we learn to live with this virus”
32:45 – Response to the virus • TJ: “I am a survivor of four pandemics and for the other three, I didn’t even realise they were going on. People died but nothing changed and none of the fabric of society was eroded like this response… Do I see steps being taken at a European level about learning from our mistakes and changing policies? The answer is no…
39:30 – Politics of the virus • CH: “We as individuals are part of the problem because sensationalism drives people to click and read the information. So it’s a big circle because we’ve created the problem — if we put the worst case scenario out there, we will go and have a look. If you want a solution, you’ve got to get people to stop clicking on this sensationalist stuff”.
43:30 – IFR • CH: “We will be down about where we were with the swine flu: around 0.1-0.3% which is much lower than what we think because at the moment we are seeing the case fatality”. • TJ: “If you look at the whole narrative, it was distorted from the very beginning by the obsession with influenza which was just one or two agents and nothing else existed. We’re no different now”.
People with treatable cancers are going to die because hospitals have been laid empty due to Government scaremongering, an NHS nurse has warned.
An NHS nurse called Holly* has said that throughout the lockdown period “hospitals were empty” beyond the ICU units and Covid wards and that people have died as a result.
The coronavirus pandemic was probably already in retreat before the full lockdown was imposed, the chief medical officer for England said as he insisted that there was no “huge delay” in government action.
Chris Whitty said that “many of the problems we had came out of lack of testing capacity”. He blamed a failure to build up public health infrastructure in previous years for leaving Britain unprepared.
As national restrictions were imposed, experts from the Department of Health, the Office of National Statistics (ONS), the government’s Actuary Department and the Home Office forecast the collateral damage from delays to healthcare and the effects of recession arising from the pandemic response.
It estimated that in a reasonable worst case scenario, around 50,000 people would die from coronavirus in the first six months of the pandemic, with mitigation measures in place.
[T]he report published in April they calculated that up to 25,000 could die from delays to treatment in the same period and a further 185,000 in the medium to long term – amounting to nearly one million years of life lost.
SARS-CoV-2 in the hospital environment and risk of COVID-19 nosocomial transmission
A document produced by SAGE states the following.
Evidence on efficacy of cloth face-coverings (non-medical masks):
There is limited evidence regarding the respiratory protection that non-medical / homemade masks can offer for the wearer, and there are no established quality standards for self-made face masks. One study reported a low filter efficiency (3-33%), and high penetration (up to 97%) of NaCl aerosol particles in homemade masks (42). A trial comparing the use of cloth and medical masks by healthcare workers also showed penetration of microorganisms by 97%, compared with a rate of 44% for medical masks (43).
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.
A new report by the National Audit Office confirms that 25,000 people moved from hospitals into care homes between mid-March and mid-April.
Jeremy Hunt, the Conservative former health secretary who now chairs the Commons Health Committee, said the findings were “extraordinary” and came “despite widespread knowledge that the virus could be carried asymptomatically”.
More than 600 of the nation’s physicians sent a letter to President Trump this week calling the coronavirus shutdowns a “mass casualty incident” with “exponentially growing negative health consequences” to millions of non COVID patients.
This is an order of magnitude error.
Suicide hotline phone calls have increased 600%.
Patients fearful of visiting hospitals and doctors’ officesare dying because COVID-phobia is keeping them from seeking care.
Restrictions are having a huge negative impact on non-COVID patients.
Zero cases of COVID-19 are prevented by new practices.
Patients still are fearful about going to hospitals for heart attacks and even for broken bones and deep lacerations.
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.
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