UK COVID-19 Update: Thousands of Lives Lost to Cancer Delays

Tim Locke

July 21, 2020

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

Thousands of Lives Lost to Cancer Delays

Modelling published in The Lancet Oncology journal predicts 3291 to 3621 excess cancer deaths in England over 5 years due to disruption of NHS oncology services because of COVID-19.

A second paper in the same journal predicts 181 to 542 additional cancer deaths due to delay in patient presentation and referral under lockdown, and a further 401 to 1231 deaths due to delayed diagnosis with a backlog of cases.

Michelle Mitchell, Cancer Research UK’s chief executive, said: "COVID-19 has caused huge disruption to cancer care and has allowed an enormous backlog to build up over the last few months. Diagnosing and treating people swiftly is vital to give people with cancer the greatest chances of survival. The Government must work closely with the NHS to ensure it has sufficient staff and equipment to clear the backlog while giving patients the care that they need, quickly and safely."

'COVID-Related' Pay Rise

Many doctors and dentists across the UK are getting an above-inflation 2.8% pay rise this year to recognise work on the COVID-19 front line.

It follows full acceptance of the latest recommendations from the Review Body on Doctors' and Dentists' Remuneration (DDRB). The rise is backdated to April.

However, the BMA has described the increase as "a metaphorical slap in the face".

Phone Ahead for A&E

The NHS in Wales has confirmed a trial to ask patients to call ahead before going to A&E. They'll then be directed to the most appropriate service, which may not be the emergency department.

The triage service at Cardiff and Vale University Health Board is based on a Scandinavian system and is designed to help avoid overcrowding in A&E.

Dr Jo Mower, national clinical director for unscheduled care, and vice president of the Royal College of Emergency Medicine , commented: "We recognise the efforts made by the public to use emergency care services sensibly during the pandemic and thank them for this.

However, we must learn to live alongside coronavirus and we never want to see overcrowding and long waits for a bed return to our emergency departments.

"We are working with the Welsh Government to ensure patients are seen in the right place, which may be in the community, and by the right clinician, first time."

Hancock's 'Big, Hairy, Audacious Goal'

England's Health Secretary has appeared before a Commons committee looking into the COVID-19 response. He was asked how he decided on his 100,000 daily test target.

"I wanted to galvanise the system to get up to a mass scale of testing and rapidly accelerate the ramp up," he said. 

"When you're handling a pandemic response, and the response you need is to scale up at a speed that is almost unprecedented within government at a national scale, the tools that I found worked were to set demanding goals. In fact the Chancellor told me afterwards that I'd set a 'big, hairy, audacious goal'. Apparently this is a classic business school doctrine that I didn't know that I was following."

Earlier in the day, Chief Medical Adviser Professor Chris Whitty had a heated exchange with former Health Secretary and Health and Social Care Committee Chair Jeremy Hunt over testing.

Prof Whitty said widespread testing in the community in the early stages of the outbreak needed "an infrastructure we did not have".

He blamed "incredibly limited testing capacity", and a failure to have testing infrastructure in place ahead of the pandemic.

Also giving evidence was SAGE Advisory Group member and Wellcome Trust Director Professor Sir Jeremy Farrar. He said the UK was slow to increase testing and put PPE in place.

"The response to a pandemic has to be faster than the pandemic itself, otherwise you get behind the curve," he said.
 

Daily Deaths and Data

On Friday Public Health England (PHE) said it was pausing publication of death data after England's Health Secretary Matt Hancock ordered an investigation into its methodology.

However, data are still published on another gov.uk page with 110 UK COVID-19 deaths announced today, taking the total to 45,422.

Another 445 positive cases were reported today taking the total UK confirmed cases to 295,817.

ONS Data

In Week 28 (ending 10 July), the Office for National Statistics (ONS) said the number of deaths registered in England and Wales was 6.1% below the 5-year average.

That's the fourth consecutive week that deaths have been below the 5-year average.

Although deaths in care homes, hospitals, and other communal settings were lower than the 5-year average, deaths in private homes were higher than the 5-year average.

Chief Nurse 'Was Dropped'

On June 12 at a Downing Street briefing, Transport Secretary Grant Shapps denied reports the Chief Nursing Officer Ruth May was no longer attending Downing Street briefings because she wouldn't support the PM's adviser Dominic Cummings over his lockdown journey. "I don't think it's true," he said. "I'm sure she'll be back here again."

Yesterday, she appeared before the Commons Public Accounts Committee and confirmed she'd attended preparations for a briefing but was told she was no longer needed - without explanation: "It is indeed true I was dropped from the briefing but that happened to many of my colleagues as well."

The Committee asked her whether she thought Mr Cummings’ behaviour breached lockdown rules. "In my opinion the rules were clear. They were there for everyone's safety and they applied to us all," Ruth May said.

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

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