‘Frail’ people like me shouldn’t be denied lifesaving Covid care | Patience Owen

A frailty index is rationing treatment for older and disabled people who catch coronavirus. We are not sacrificial lambs

Lockdown was easy for me, it has become my daily state more frequently throughout my life. I have a debilitating connective tissue disorder that keeps me indoors most days. It was a relief I no longer had to go out and pretend to be normal when wracked with ill-health and hidden pain. Like thousands of others with rare conditions, I’m already in a minority within a minority, marginalised by our NHS, battling increasing disability day by day. So, while many fear a second lockdown over the winter months, I haven’t gone out more often since the first one was lifted because I risk a double jeopardy – catching Covid, then being a low priority for medical care.

Back in March, without consultation and days before the first lockdown, the Clinical Frailty Scale (CFS), a worldwide tool used to swiftly identify frailty in older patients to improve acute care, was adapted by the National Institute for Health and Care Excellence (Nice). It asked NHS staff in England to score the frailty of Covid patients. Rather than aiming to improve care, it seems the CFS – a fitness-to-frailty sheet using scores from one to nine – was used to work out which patients should be denied acute care. Nice’s new guidelines advised NHS trusts to sensitively discuss a possible ‘do not attempt cardiopulmonary resuscitation’ decision with all adults with capacity and an assessment suggestive of increased frailty”.

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Regular UK lockdowns could help control Covid, says Sage expert

Strategy of repeated ‘circuit breakers’ would reduce total number of cases, according to leading scientific adviser

One of the government’s scientific advisers has said repeated “mini lockdowns” could be effective as a tool to bring Covid-19 cases under control.

The suggestion from Professor John Edmunds, a member of the government’s Scientific Advisory Group for Emergencies (Sage), comes amid growing evidence the virus’s prevalence is growing among older, more vulnerable people.

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Frontline workers to be recognised in Queen’s birthday honours

Recipients’ ‘dedication and compassion’ amid pandemic praised by PM

Hundreds of frontline and community heroes who played a key role in the coronavirus pandemic response will be recognised in the Queen’s birthday honours next month, Boris Johnson has said.

The prime minister praised the “dedication, courage and compassion” shown by the recipients, whose contributions to national life will be honoured, alongside people recognised for a broad range of achievements, on 10 October.

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NHS sourcing PPE from company repeatedly accused of forced labour

Exclusive: Gloves from Malaysian company Top Glove found in NHS supply chain despite multiple allegations of worker exploitation

The UK government has been continuing to source medical gloves used as PPE by frontline healthcare workers from a manufacturer in Malaysia repeatedly accused of forcing its workers to endure “slave-like conditions” in its factories, the Guardian can reveal.

Top Glove, the world’s biggest producer of rubber medical gloves, has faced multiple allegations of exploitation from migrant workers mostly from Bangladesh and Nepal.

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Inside a Welsh ICU during the coronavirus pandemic – photo essay

Consultant and photographer Nick Mason shares his experience and that of colleagues at the Royal Gwent hospital in Newport, offering a unique perspective documenting the impact of Covid-19 on the NHS frontline

Humankind cannot bear very much reality.” TS Eliot, Burnt Norton

Human memory is fickle. Only a few brief months ago, many intensive care units (ICUs) across Britain came close to being overwhelmed by patients with a novel coronavirus, unknown to medicine before January of this year, and causing potentially life-threatening lung disease in up to 20% of those it infects. With the relaxation of the lockdown, however – only possible because it had been so effective – and the good summer weather in which we have been encouraged by Westminster to eat, drink and be merry, we have begun to forget. We have rapidly forgotten the fear and anxiety that rightly held Britain in their grip throughout the spring of 2020, the 40,000 people who died from a single infectious disease within a few brief months and the incalculable suffering caused to their families. We have forgotten that more than 600 health and social care workers died as a result of their work caring for others.

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BAME Britons still lack protection from Covid, says doctors’ chief

More than a third of coronavirus intensive care patients are from ethnic minorities

A third of coronavirus patients in intensive care are from black, Asian and minority ethnic backgrounds, prompting the head of the British Medical Association to warn that government inaction will be responsible for further disproportionate deaths.

Chaand Nagpaul, the BMA Council chair, was the first public figure to call for an inquiry into whether and why there was a disparity between BAME and white people in Britain in terms of how they were being affected by the pandemic, in April.

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Bugs in NHS website add to UK’s Covid-19 testing crisis

Many users report errors that prevent them booking a test or being told tests aren’t available

The NHS website used to book coronavirus tests is struggling to cope with the number of requests, adding yet more problems to the government’s troubled test-and-trace scheme.

Britons who attempt to book a test for Covid-19 online are directed – once they have passed screening questions to ensure they are entitled to the testing – to a purpose-built website where they can theoretically book either a home test kit or a walk-through or drive-through test. However, in practice, an increasing number of users are reporting errors on the site itself, which prevent them from even attempting to book a test.

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New antibody drug added to Oxford University trial of Covid-19 treatments

Regeneron’s experimental drug REGN-COV2 to be added to UK’s Recovery trial

The Oxford-based Recovery trial which proved that steroids saved the lives of some Covid patients will now take on a promising but far more expensive new antibody combination treatment, it has been announced.

A cohort of patients joining the trial in most NHS acute hospitals will be randomly allocated to Regeneron’s experimental drug, called REGN-COV2. The drug is a combination of two human neutralising antibodies against the virus. The company previously developed a similar antibody drug against Ebola.

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Coronavirus: 86% of doctors in England expect second wave in next six months

BMA survey also found 90% thought test-and-trace failures were a risk factor

Almost 86% of doctors in England say they expect a second peak of coronavirus in the next six months, according to a new survey, as concern continues to grow over a recent rise in cases.

On Friday, new results from a population-based study suggested the R number for England is now at 1.7, with infections doubling every 7.7 days. While the prevalence of the disease remains lower than it was in the spring, an R value above 1 means cases could grow exponentially.

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Coronavirus: is this the start of a second wave and is the UK prepared?

Cases are increasing here and across Europe as universities plan to reopen. What is the outlook for autumn?

Is this the start of a second wave, and if so will it be as bad as the first?
The number of Covid-19 infections has almost doubled in a week, with 3,497 cases announced yesterday. Admissions to hospital have also risen. We’ll find out soon if this is a second wave but there are some indicators of what is coming.

Cases are rising quickly…
Researchers at Imperial College London said on Friday that the number of cases had been doubling roughly every 7.7 days in England, and that the reproduction rate was as high as 1.7. If the virus continues to spread at that rate, the UK would see about 10,000 new cases a day in the next two weeks, with 300 to 400 hospital admissions a day.

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More than 1,000 UK doctors want to quit NHS over handling of pandemic

New survey finds two-thirds of respondents plan to leave within three years, citing Covid-19 burnout and frustrations over pay

Over 1,000 doctors plan to quit the NHS because they are disillusioned with the government’s handling of the Covid-19 pandemic and frustrated about their pay, a new survey has found.

The doctors either intend to move abroad, take a career break, switch to private hospitals or resign to work as locums instead, amid growing concern about mental health and stress levels in the profession.

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Mass weekly Covid-19 testing of population to be trialled in England

Jeremy Hunt says UK should embrace repeat testing as route to more ‘normal life’

The UK government is to trial routine weekly Covid testing of the population as part of preparations to head off a possible winter second wave, as the former health secretary Jeremy Hunt called for such tests to become the norm.

Matt Hancock said the government was committing an extra £500m to scale up testing capacity and launch community pilots trialling the effectiveness of repeat testing in schools and colleges, as well as in the population as a whole. It will also ramp up the trials of a new test kit that it is claimed can provide results within 20 minutes.

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‘It destroys lives’: why the razor-blade pain of vaginismus is so misunderstood

This common condition can lead to relationship breakdown and unnecessary surgery. So why is treatment still so poor and underfunded?

I was just a few weeks into a new relationship when the pain started. Whenever my boyfriend and I started to have penetrative sex, it felt as if there were razor blades inside me. At first I laughed it off, but soon I became terrified of intercourse. My body would freeze with fear as my clothes came off. By the time we said: “I love you,” even kissing made me feel anxious. I would spend entire day trips and holidays with him worrying about the pain.

When I first went to my GP, the advice I got was to “try and relax”. It was about as helpful as telling someone having a panic attack to “just chill out”. Without a real solution, I started to question whether I was imagining the pain. Or if maybe, somehow, I was to blame for it. My boyfriend was kind and supportive but I felt I was letting him down. Some days, I would feel so ashamed that it was hard to think about anything else. Other days, I’d feel an overwhelming sense of loss for the carefree woman I had been.

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‘It was an act of principle’: The Covid doctor who quit over Cummings

Dr Dominic Pimenta resigned from his cardiology post after Boris Johnson’s chief advisor made his controversial car journey. Was it the right decision?

On 24 May, a couple of days after it was revealed that Dominic Cummings had travelled to Durham during the lockdown, a British cardiologist, Dr Dominic Pimenta, published a tweet in which he threatened to resign if Cummings did not. For Pimenta, news of Cummings’s trip had landed like a blow. In March, he had been drafted on to a Covid-19 intensive care unit, where he had witnessed suffering and death, struggle and recovery: “This sheer volume of human capacity that had been devoted to trying to save lives.” His tweet came at the end of a terrible weekend of intensive care shifts, during which he had watched patients die, their loved ones absent, and he had given everything of himself and seen colleagues do the same. And now this? “If we are going to be asked to risk our lives,” he wrote later, “the least we can expect is to be treated like people.”

Pimenta’s tweet was widely shared. By the following morning he’d become a national news story, and he was invited by the media to share more of what he wanted to say: how he hoped that by making a stand he might highlight the recent sacrifices of healthcare workers while reassuring the public that their own sacrifices had not been in vain, that the lockdown was saving lives, that they must maintain faith in it. Catherine Calderwood, Scotland’s former chief medical officer, had recently resigned for a minor lockdown transgression. Pimenta wanted Cummings to do the same, or to at least acknowledge how irresponsible he’d been. “It was an act of principle,” Pimenta says. “And the principle was: this isn’t acceptable, I will not accept it. All I ever wanted was for the government to underline the importance of the lockdown.”

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Were Covid hospital admissions figures in England overreported? It’s not that simple

A Sage member and NHS England have pushed back against criticism of hospital admissions data

Claims that hospital admissions for Covid-19 in England were overreported at the peak of the outbreak may not be telling the whole story.

According to government figures, the daily hospital admissions for Covid-19 patients in hospital rose from 1,541 on 3 March to 17,172 on 12 April. On 20 August the figure was 516.

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Lockdown fears for Birmingham amid sharp rise in UK coronavirus cases

City sees ‘extremely concerning’ rise to 30 cases per 100,000 as positive tests in Britain hit highest level since mid-June

Police and officials in Birmingham have warned the public to act now to avert a city-wide lockdown as the number of people testing positive for coronavirus in England rose 27% in a week, hitting its highest level since mid-June.

The UK’s second city, which has a population of more than 1 million, has seen a rise to 30 cases per 100,000 up from 22.4 the week before and 12 at the start of the month, its director of public health said.

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Ministers criticised over plan to scrap Public Health England

Critics say PHE is being scapegoated for government’s failings during pandemic

Senior doctors, hospital bosses and public health experts have accused ministers of scapegoating Public Health England for their own failings over Covid-19 by planning to axe the agency.

The government’s decision to scrap PHE and merge it into a new body charged with preventing future outbreaks of infectious diseases produced a chorus of criticism on Sunday.

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I’m a shielder who’s been out for the first time. How do I stay safe? | Pippa Kent

Shielding rules were relaxed in England on 1 August, but I’m not rushing to the shops or beach any time soon

I am one of those people who were told that from 1 August we no longer needed to shield to protect ourselves from the coronavirus.

While you might assume that, having been trapped inside our homes for the past 18 weeks, we would embrace our newfound freedom with enthusiasm, the reality remains far from it.

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Protesters march for fair pay for nurses and other NHS staff

More than 30 marches due on Saturday in recognition of work during coronavirus pandemic

Thousands of NHS workers have protested across the UK calling for fair pay for NHS staff and true recognition of their work during the pandemic.

More than 30 marches were planned on Saturday as anger grows about an absence of action to match gestures such as weekly applause for healthcare workers.

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NHS appeals for urgent plasma donations from Covid-19 survivors

Blood plasma containing coronavirus antibodies may help patients in any second wave

People who have recovered from Covid-19 are being urged to donate their blood plasma as part of an urgent appeal to help the NHS treat those who fall ill during a potential second wave.

The call follows news that the number of appointments booked each week as part of the ongoing NHS Blood and Transplant (NHSBT) convalescent plasma collection has dropped by almost half in the past month. There are fewer eligible donors due to the fall in new infections during lockdown.

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