UK COVID-19 Daily: International Fame for PM's Nurses

Tim Locke

April 13, 2020

These are the UK coronavirus stories you need to know about today.

International Fame for PM's Nurses

Two nurses from St Thomas' Hospital singled out for praise by Prime Minister Boris Johnson have become famous overnight.

Luis Pitarma from Portugal was contacted by his country's President Marcelo Rebelo de Sousa to congratulate him. A statement said: "The President of the Republic underlines the special recognition presented today by the British Prime Minister Boris Johnson, to the Portuguese nurse Luis Pitarma for his work and vigilance during hospitalisation in intensive care."

Jenny McGee from New Zealand was "blown away" by the PM's praise, her brother told the NZ Herald.

Her mum, Caroline McGee, told Television New Zealand she was "exceptionally proud" and that "It doesn't matter what patient she is looking after, this is what she does."

The mayor of her home town, Sir Tim Shadbolt, told stuff.co.nz: "It's not very often a nurse from Invercargill saves the life of the British Prime Minister."

Chief Executive at Guy's and St Thomas' Dr Ian Abbs said in a statement: "I am incredibly proud of the staff who have cared for the Prime Minister and pleased that he is now able to continue his recovery at home. I want to pay tribute to the teams whose dedication, skill and compassion made this possible.

"It is a great credit to the exceptional professionalism of clinical teams, as well as everyone in the wider organisation, that we have been able to care for the Prime Minister so effectively, whilst continuing to deliver equally high standards of care to all of our patients."

Deaths

UK COVID-19 hospital deaths rose by 717 today taking the total to 11,329. The rise is thought to be lower than recent days due to reporting delays over the bank holiday weekend.

Foreign Secretary Dominic Raab told the daily Downing Street briefing these were "grisly figures". 

Of the 667 deaths in English hospitals reported today patients were aged between 17 and 101. Of these, 40 patients aged between 37 and 98 had no known underlying health conditions.  

The number of people in hospital with COVID-19 is "beginning to flatten off in many parts of the country, not absolutely everywhere," Government Chief Scientific Adviser Sir Patrick Vallance said.

Mr Raab said there were "some positive signs from the data that we are starting to win this struggle". 

An interesting question on the data was raised today by experts: Are COVID-19 patients in hospital or admitted to hospital? Prof Carl Heneghan and colleagues at the Centre for Evidence-Based Medicine and the Nuffield Department of Primary Care Health Sciences at the University of Oxford, said: "The April 1st briefing definition 'COVID-19 hospital admissions' can be interpreted in different ways. Does the definition include only those who tested positive, or people already in hospital for other reasons? Does it include people who had COVID-19 prior to admission and were admitted for other reasons than COVID-19? We do not know the answers to these questions."

Tomorrow, weekly out-of-hospital deaths for England and Wales will be released by the Office for National Statistics. They're expected to include some of the deaths of 13 residents at the Stanley Park Care Home in County Durham. It is run by Care UK. The company tried to reassure families that staff are doing everything they can to keep residents safe.

Government Chief Medical Adviser Professor Chris Whitty said around 13.5% of care homes had reported COVID-19 cases: "In the last 24 hours there have been 92 care homes where an outbreak has been detected."

He said care homes are a future priority for testing: "One of the things we want to do is to extend the amount of testing of people in care homes as the ability to test ramps up over the next few weeks. Because clearly care homes are one of the areas where there are large numbers of vulnerable people. 

"And that is an area of risk and therefore we would very much like to have much more extensive testing in that setting."

Prof Whitty said non-COVID-19 deaths were also being monitored: "The most important number in my view actually, over the epidemic as a whole, is going to be all-cause mortality." 

This he said includes “things like people not being able to get into hospital," adding, "but also things that might be postponed, and also the long-term effects of the economic and other effects on people's long-term health". 

Among recently reported NHS deaths was nurse Amor Gatinao, 50, who worked at St Charles hospital in London. Tributes described her as "a warrior".

Daminic Raab was the latest minister to be asked to apologise to NHS staff for PPE shortages. He didn't do that but instead said: "We're trying to give not just the staff on the frontline the equipment but the reassurance they need."

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

Lockdown Extension

The Cabinet decision on extending the lockdown will be taken this week. Scotland and Wales have already said their lockdowns will be extended..

Ministers will make the decision after hearing the latest scientific advice from the SAGE expert group.

Mr Raab said: "We don't expect to make any changes to the measures currently in place… and we won’t until we're confident, as confident as we realistically can be that any such changes can be safely made." 

He added: "If we eased up too early we'd risk a second wave."

Sir Patrick said: "We'll look and see where the peak is and when we are firmly the other side of it in terms of numbers coming down, only at that stage do you start looking at what measures might be released, and how they might be released." 

He continued: "It'd be a waste if we were to rapidly reverse that and lead to a re-emergence of this."

Mr Raab was asked if fewer lives would have been lost if, like other countries,  the UK enforced a lockdown sooner: "I don't think it is clear. I don't think those comparisons are like-for-like."

The World Health Organisation is issuing criteria tomorrow for countries considering lifting lockdowns. Today its Director General Dr Tedros Adhanom Ghebreyesus warned: "While COVID-19 accelerates very fast, it decelerates much more slowly. 

"In other words, the way down is much slower than the way up. 

"That means control measures must be lifted slowly, and with control. It cannot happen all at once. Control measures can only be lifted if the right public health measures are in place, including significant capacity for contact tracing." 

Sir Patrick said widespread facemask use in the community is still being assessed: "We have a review ongoing at the moment at the evidence around masks. And if that review concludes that the position should change we will of course make that recommendation, and if it stays the same, we will make that clear as well." 

More News in Brief

  • New data on the investigational antiviral drug remdesivir (Gilead) for COVID-19 suggest some clinical improvement. However, one UK expert told Medscape Medical News the data published online in the New England Journal of Medicine are "almost uninterpretable". Stephen Griffin, PhD, associate professor at the University of Leeds School of Medicine, was not involved in the study. "It is impossible to know the outcome for this relatively small group of patients had they not received remdesivir," he said.

  • Yesterday we reported on NHS England plans for a contract tracing smartphone app using anonymised data derived from short range Bluetooth signals. Today the Guardian reports on a leaked NHS memo from last month saying that "more controversially" device IDs could be used to "to enable de-anonymisation if ministers judge that to be proportionate at some stage". The paper said NHSX denied there had been such plans. Apple and Google are also working on contact tracing apps and systems.

  • Cabinet Office minister Michael Gove is out of self-isolation. A family member had suspected COVID-19 symptoms. Sky News reported that special permission was given by England's CMO Professor Chris Whitty for the family member to be tested.

  • Patients unable to have visitors are being given access to video calling devices to connect with relatives thanks to donations from tech companies. NHSX Digital Transformation Director Iain O’Neil said: "Technology has never been so important to providing one of life’s most essential things – the ability to communicate with the people we love regardless of where they are."

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

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