UK COVID-19 Update: Heart Attacks Down, Independent Inquiry 

Tim Locke

July 15, 2020

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

Big Drop in Heart Attack Admissions Under Lockdown

Around 5000 heart attack patients in England may have missed out on life saving hospital treatment due to the COVID-19 pandemic, according to new research published in The Lancet.

According to the study led by the University of Oxford, only two thirds of the expected number of patients with heart attacks were admitted to hospital between mid February and the end of March this year.

One of the authors, Chris Gale, professor of cardiovascular medicine at Leeds' School of Medicine, commented: "One of the unintended consequences of the 'stay at home' message during the peak of the pandemic is that fewer people were seeking help for medical emergencies such as a heart attack."

Prof Gale added: "People will have died or developed heart failure as a result of not seeking treatment for their heart attack."

However, Prof John Martin, professor of cardiovascular medicine, University College London, suggested via the Science Media Centre: "There may be another explanation for these findings: there may have been a real reduction in heart attacks. There is some evidence that heart attacks might be precipitated by inflammatory illnesses which cause increase in blood coagulation which may lead to clots in the coronary artery. It has been observed that the isolation of lockdown has led to a decrease in non-COVID respiratory infections (data must be checked). Therefore, the decrease in heart attack presentation in hospital may be due to a real reduction in heart attacks due to the beneficial effects of lockdown."

PM Promises COVID-19 Independent Inquiry 

Boris Johnson has previously said lessons will be learned from the pandemic but today committed to an independent inquiry for the first time, although not specifically a public inquiry.

At Prime Minister's Questions he was tackled by Liberal Democrat acting leader Sir Ed Davey: "Under this PM we’ve suffered one of the worst death rates in the world and Europe's worst death rate for health and care workers.

"Previously he's refused my demand for an immediate independent inquiry, saying it's too soon."

In his reply Mr Johnson said: "Certainly we will have an independent inquiry into what happened."

There'd been speculation there would be an announcement on making face coverings mandatory in offices in England. However, Health Secretary Matt Hancock said that was unnecessary.

He told the BBC: "When you're in close proximity with somebody that you have to work closely to, if you're there for a long time with them, then a mask doesn't offer that protection."

He added the same logic applied to schools.

Meanwhile, Doctors' Association UK Medical Student Representative Julia Simons spotted a problem with images used by Downing Street to promote face coverings in shops.

"How can the Government video not get this right?” she tweeted. "Please do wear a cloth face covering. Don’t wear a facemask with a valve. The valves means your face mask is no use for protecting others."

https://twitter.com/DrJulia_Simons/status/1283090786960236545

 

NHS Sued Over Delayed Cancer Surgery

A former NHS hospital manager and PCT Chief Executive, Rob McMahon, 68, is taking the NHS to court over having to pay £20,000 for private cancer treatment because of COVID-19 delays, The Guardian reported.

He was diagnosed with prostate cancer after an MRI 4 days before lockdown began.

Worcestershire Acute Hospitals NHS Trust delayed follow up appointments and told him there'd be a delay for a biopsy, so he went private.

Hi solicitor, Mary Smith of Novum Law, told the paper: "Unfortunately, Rob’s story is one of many we are hearing about from cancer patients who have been seriously affected by the disruption to oncology services as a result of COVID-19."

She added: "He’s one of the lucky ones. As a retired NHS chief executive, he knew how to navigate the complex healthcare system and he is extremely fortunate he had the money to pay for a second opinion privately."

A Million Quit Smoking Under COVID-19

A million people in the UK have quit smoking since the COVID pandemic started according to UCL and Action on Smoking and Health (ASH) research. However, ASH cautions that this is the rate for short-term quit success "and it remains to be seen if this translates into longer term quit success".

The findings come from a YouGov survey between 15 April and 20 June 2020 with 10,251 respondents and additional analysis of Office for National Statistics data.

The data were released ahead of a public health radio campaign to encourage people to stop smoking featuring Respiratory Consultant Dr Ruth Sharrock saying: "Smoking damages the lungs and the immune system, making it harder to fight off infections."

Prof Linda Bauld, professor of public health, University of Edinburgh, commented: "Short term quit rates in this survey are higher for younger rather than older smokers and this is promising because if smokers can quit before the age of 35, their life expectancy returns to that of a non-smoker. More research will be needed to determine if these short-term results affect population-level smoking rates in the UK. But the signs may be promising."

Blackburn Works to Avoid Return to Lockdown

Blackburn with Darwen council is working to try to avoid a Leicester-style lockdown.

It is asking residents to follow new local guidance, including wearing face coverings in shops and work places, and a limit of two people from the same household visiting another household. Footpaths are also being widened in places to improve physical distancing.

Director of Public Health Dominic Harrison said: "In another 2 weeks, if the rates are continuing to rise, we will have to consider reversing some of the national lockdown lifting measures locally one by one until we see a reversal in the current rising trend. It’s up to everyone to make sure we don’t have to do that."

Meanwhile, the BMA has written to MPs in the North East of England asking for "concerted action" to tackle the "entrenched problem" of health inequalities in the region.

North East Regional Council Chair Dr George Rae wrote: "Action must be taken to address social determinants of health, including ensuring a high standard education for all, providing high-quality housing and delivering good employment opportunities."

Was R Lower Than Thought Before England's Lockdown Loosened?

England's R number was significantly reduced before many lockdown measures were lifted in May, according to Imperial College research commissioned by the Department of Health and Social Care (DHSC).

R was 0.57, Imperial found, rather than the official 0.7-1.0 published at the time.

The findings come from the REal-time Assessment of Community Transmission (REACT 1) programme in a preprint ahead of peer review.

The study also found:

  • 69% of individuals who tested positive reported that they were symptom-free on the day of the test or in the previous 7 days

  • 18 to 24 year olds were more likely to test positive than other age groups

  • People with Asian ethnicity were more likely to test positive than those of White ethnicity

Imperial's Professor Paul Elliott commented: "Community testing is a vital step in ongoing efforts to mitigate the pandemic, but to be successful this must be based on robust scientific evidence and sound statistics. Through this surveillance programme with DHSC and Ipsos MORI we’re gathering the critical knowledge base necessary to underpin community testing and facilitate a greater understanding of the prevalence of COVID-19 in every corner of England."

BAME COVID-19 Risk Tool

A University of Exeter developed COVID-19 risk tool for health workers has been adopted by the BMA.

A points-based calculation is carried out taking into account known risks, such as being male, BAME background, and pre-existing health conditions. 

The score is designed to be used  to help conversations over appropriate duties at work.

Senior Lecturer Dr David Strain commented: "Evidence shows that people from BAME backgrounds are among those at higher risk, and our tool aims to facilitate conversations to keep people safer, such as thinking about how roles are allocated. The tool could also be useful in other workplaces to help reduce risk."
 

Daily Deaths and Data

Another 85 UK COVID-19 deaths were announced today, taking the total over a new milestone to 45,053.

Another 538 positive cases were reported today taking the total UK confirmed cases to 291,911.
 

Heathrow Deploys UV Robots

Heathrow Airport now has UV cleaning robots patrolling terminals at night killing viruses and bacteria as part of its COVID-19 response.

https://twitter.com/PA/status/1283272833649356800

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

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