UK COVID-19 Update: Doctors' Concerns Over Indirect Harm to Patients

Tim Locke

August 05, 2020

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

Doctors' Concerns Over Indirect Harm to Patients

A member survey for the Royal College of Physicians found 60% worry that patients have experienced harm or complications because of delays to treatment or diagnosis due to COVID-19. Overall, 94% were concerned about the general indirect impact on their patients.

Only 29% reported no delays for inpatients accessing endoscopy testing, falling to 8% for outpatients.

When it comes to a potential second wave, only 5% felt that their organisation was fully prepared, and 64% haven’t been involved in any preparation discussions.

The survey was completed by 1029 doctors on July 22.

RCP President, Professor Andrew Goddard, commented: "Delays to treatment are so often a major issue for the NHS but as a result of the COVID-19 pandemic, it’s fair to say we've reached crisis point. Doctors are, understandably, gravely concerned that their patients’ health will have deteriorated to the point where they will need much more extensive treatment than previously, at a time when NHS resources are already incredibly depleted.

"We also cannot underestimate the need to prepare for a second wave of COVID-19 infection, which threatens to compound the situation. Without careful and rigorous preparation, a second wave coupled with the winter flu season, could overwhelm the NHS."

The Welsh Government has announced a new £800 million 'stabilisation package' to help the NHS respond to and recover from the impact of coronavirus.   Health and Social Services Minister Vaughan Gething said in a statement: "Whilst our services rigorously prepare every year for winter pressures, 2020 may be unlike any other. This £800m package will help with many aspects as we move into the next phase of the virus such as PPE supplies, testing and an ambitious flu vaccination programme."

Delayed Dementia Diagnosis and Referrals

The Alzheimer's Society has raised concerns about a fall in dementia referrals and diagnoses in England.

NHS Digital data show a drop from 67.6% diagnosis rates in February to 63.5% in June.

The charity said monthly referrals had dropped from around 2600 a month to 84 in April, 435 in May, and 994 in June. It said the move to remote consultations could disadvantage many patients.

Fiona Carragher, Alzheimer’s Society's director of research and Influencing commented: "The recent sharp drop in both dementia diagnosis rates and referrals to memory clinics means a huge group of people will be living without an official diagnosis, unable to get financial, legal and emotional advice, as well as any support or treatment available."

Travel Quarantine Delay Criticised

Delays in implementing travel quarantine rules have been criticised by the Commons Home Affairs Select Committee.

In a report it said "critical errors” were made allowing up to 10,000 travellers with COVID-19 into the UK in March.

The inquiry covered the initial restrictions, mostly for people coming from Wuhan, as well as later decision making.

Committee Chair Yvette Cooper commented: "Many times ministers told us they were following the science, but we cannot find any science at all behind their completely inexplicable decision to lift all the self isolation guidance for travellers on 13 March, a full 10 days before lockdown, just at a time when other countries were introducing stronger border measures."

A Government spokesperson responded saying the MPs were "incorrect in their assertions" and that "All of our decisions throughout the pandemic have been guided by the science."

Shielding Data

Latest survey data from the Office for National Statistics show 6% of clinically extremely vulnerable people who normally worked are planning not to return to work in the next 4 months. The survey covered 9 to 16 July and shielding was 'paused' in England on 1 August.

A further 68% were comfortable going back to work outside the home as long as protective measures were in place.

The survey also found 65% of those shielding had no visitors except for support with personal care, down from 77% between 24 and 30 June after support bubbles were introduced.

Local Lockdowns

A spike of 54 COVID-19 cases in Aberdeen has resulted in many lockdown measures being reimposed today. First Minister Nicola Sturgeon called it a "significant outbreak".

Restrictions include the closure of pubs and restaurants, people not being allowed to visit other people's homes, and a 5 mile travel limit.

New lockdown laws for affected parts of the north of England, including Greater Manchester, came into effect at midnight.

The Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020 ban people from different households meeting in a private home or gardens.

Fines of £100 can now be levied up to £3200 for repeat offenders.

Ethnic Minorities 'Over-exposed' to COVID-19

A COVID-19 report from the think-tank the Runnymede Trust found people from ethnic minorities are "over exposed and under-protected".

Risk factors included being more likely to work outside the home, public transport use, key worker roles, less availability of PPE, and living in multigenerational households.

The findings come from a survey of 2585 adults in Great Britain, including 750 from BAME backgrounds.

Among its recommendations are work risk assessments, tailored testing and tracing services, and a better social security safety net.

Daily Deaths and Data

Another 892 positive cases were reported today taking the total UK confirmed cases to 307,184.

Public Health England (PHE) is pausing publication of daily death data after England's Health Secretary Matt Hancock ordered an investigation into its methodology.

However, data are still released on another gov.uk page. There were 65 deaths announced today taking the total to 46,364.

Welsh Vaccine Support

There's widespread support for COVID-19 vaccinations, according to Public Health Wales (PHW) ongoing assessments, Univadis , part of the Medscape Professional Network reported.

The key findings for 20-26 July 2020 (week 16) were:

  • 83% of adults were willing to be vaccinated against COVID-19 if a vaccine were to become available, 10% were not willing and 7% were unsure

  • Among individuals who had children, 78% said they were willing to have their children vaccinated, 8% were not and 13% were unsure

Professor Karen Hughes, from PHW, commented: "There is a huge amount of work underway to try and develop a vaccine against COVID-19, and it is very positive to see that more than 8 out of 10 people in Wales would want to be vaccinated if such a vaccine did become available."

Lockdown Streaming

People spent 40% of their day watching TV and online video services under lockdown in April, according to the latest survey from the media regulator OFCOM.

The rise in screen time is almost 45 hours or nearly a third higher compared to last year.

As lockdown measures were eased towards the end of June, video streaming and non-broadcast content was still 71% higher than last year.

Traditional broadcast TV peaked in early lockdown due to a demand for trusted news, OFCOM said, and viewing still remains 11% higher than the same time last year.

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

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