UK COVID-19 Daily: 'Cannon Fodder'

Tim Locke

March 22, 2020

Editor's note: This article may not reflect the latest COVID-19 information. Find the latest news, expert opinion, and guidance in Medscape UK's COVID-19 Resource Centre

Medscape UK has been sifting through today’s coronavirus news to bring you what we think you need to know about.

'Cannon Fodder'

Doctors' Association UK (DAUK) sent a letter signed by thousands of frontline NHS staff to the Prime Minister reiterating calls for adequate personal protective equipment (PPE) for health workers.

DAUK Chair Dr Rinesh Parmar, said in a statement: "NHS staff are putting their lives on the line in confronting this pandemic every day they turn up to work. No doctor will ever shirk their duty by walking away from the frontline and everyone is working themselves into the ground to keep patients safe.

"The reality is that many of us will get sick. Doctors are all too aware of the possibility that they will lose colleagues, as has happened in outbreaks around the world. It is therefore deeply upsetting to hear dedicated healthcare professionals say that they feel like 'cannon fodder'."
 

Rising Deaths

The total number of UK COVID-19 related deaths in the UK rose to 281 today, bringing more comparisons with the situation in Italy 2 weeks ago. That country is now in lockdown. 

Dr Jenny Harries, deputy chief medical officer for England, told a Downing Street News conference that comparisons are more complex. 

"I think if you calculated Italy's case fatality rate now [it] is about 10% and ours is 4%, actually we think overall, and we still think, that it should be about 1%.

"What both of these numbers demonstrate is that the numbers that you get, changed throughout the course of an epidemic, and it changes very much on how you count the cases as well.

"So as you go through a very sharp rise in numbers, which we will see going forward, you have to be careful not to be comparing too precisely, because at the moment in this country we are counting the most significant disease, and it will look as if our case rates, our death rates, are actually increasing. We know that is what will happen. So it's really just a reminder to say, we will look back in due course, sadly, and see the true number of people who have died from coronavirus. But a direct comparison with another country and against individual numbers is something that we should be very cautious of as we go through the epidemic."

She was asked about hospitals, particularly in London, becoming overwhelmed by COVID-19 patients at times. "The flexing of the system is designed to manage some of these bumps, if you like, where we get a high throughput of patients requiring ventilation.

"The data I have here says that in England, only 12% of adult critical care beds are currently occupied with COVID-19 patients, and that will change drastically as we go through the epidemic."

'Shielding'

The NHS in England is contacting 1.5 million people most at risk of COVID-19 to urge them to "shield themselves and stay at home" for at least 12 weeks starting tomorrow (Monday 22nd March).

The list includes certain cancers, respiratory conditions, and patients on immunosuppression treatments.

"We're asking them to take themselves out of society for 12 weeks and that is no small ask,"  Dr Jenny Harries said.

"We may actually slightly overestimate the number of individuals and there will be opportunity to discuss in due course their individual conditions, going forward."

She added: "There is a real balance point here. What we do not want to find is that we grow mental health problems, or we grow other physical problems because of such a strict imposition." 

Those unable to get family or friends to shop and collect medication for them will have special deliveries put in place.

Communities Secretary Robert Jenrick said: "The government, the food industry, community pharmacists, local councils, and emergency services are working round the clock to get this scheme off the ground. Members of the armed forces are already supporting this effort, including some of the finest military planners in the world." 

Dr Paul Johnstone, director at Public Health England, said in a statement: "If you receive a letter it is vitally important that you act on it for your own protection, don’t attend any gatherings of friends or families and don’t go out for shopping, leisure, or travel." 

Commenting via the Science Media centre, Paul Hunter, professor of medicine, University of East Anglia, said: "The recent guidance from PHE [Public Health England] on this topic is timely and absolutely crucial. If someone in one of these risk groups does not follow this advice, then their chances of surviving the epidemic is significantly reduced."

Mother's Day

Earlier, Prime Minister Boris Johnson issued a Mother's Day message to protect older mums, Sky News reported: "The sad news is that means staying away."

He added: "The numbers are very stark, and they are accelerating."

Social Distancing Outdoors

The good weather this week has brought thousands of people out to visit parks and seaside towns. This raised concerns that social distancing rules aren't being observed outdoors.

"Don't think that fresh air in itself automatically provides some immunity," Mr Johnson told a Downing Street news conference.

He added: "You've got to follow the social distancing rule, keep 2 m apart. Otherwise if you don't do it responsibly, if people don't exercise responsibly in the parks and green spaces," he said, "there is going to be no doubt that we will have to bring forward further measures and we are certainly keeping that under constant review." 
 

Stiff Upper Lip

David Hunter, professor of epidemiology and medicine, Nuffield Department of Population Health, University of Oxford, gave his perspective on the UK's pandemic response to the New England Journal of Medicine . He argues that 'keep calm and carry on', and the British traditional 'stiff upper lip' prevailed for too long.

"Throughout the past few weeks, the UK mantra has been 'we will act at the appropriate time according to the science',” he wrote.

"Many clinicians and scientists have been pushing the panic button, but the alarm, if heard, was not acted on publicly until the third week of March. Everyone is hoping that their gut instincts, the experience of other countries, and now the models are wrong. 

"What is not in doubt is that barring a miracle, a treatment, and ultimately a vaccine, the NHS in the United Kingdom is about to experience a challenge unlike any other in its 70 years of existence."

Unlicensed COVID-19 Products

A global operation has identified a disturbing trend in the online sale of products and medicines related to the COVID-19 pandemic, according to the Medicines and Healthcare products Regulatory Agency (MHRA).

Globally, 2000 online advertisements related to COVID-19 were found, and more than 34,000 unlicensed and fake products advertised as 'corona spray', 'coronavirus medicines' or 'coronaviruses packages' were seized, reported Univadis from Medscape.

Mark Jackson, head of enforcement at the MHRA, said in a statement: "Criminals who sell medicines and devices illegally are not only breaking the law but have no regard for your health and will take advantage of a major public health crisis to make a profit. Taking fake or unlicensed medicines and using a non-compliant medical device could put your health and safety in danger and may lead to serious health issues."
 

Back to Work

On Friday, a call went out to doctors who'd left the medical register in the past 3 years to return to work to help the NHS with coronavirus.

Health Secretary Matt Hancock tweeted last night that 500 doctors and 4000 nurses had already signed up.

https://twitter.com/MattHancock/status/1241449255648272389

 

Early Wedding

ITV News reported on the doctors who brought their wedding forward by 4 months so they can pitch in to help the NHS instead of going on honeymoon.

Dr Dominique Thompson and Dr Simon Bradley only had a few guests attending the ceremony in Bristol - standing 2 m apart. "We knew July would be the peak of the epidemic," Dr Thompson said.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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