UK COVID-19 Update: Doctors' Training Disrupted, Ethnicity Inequalities Report

Tim Locke

October 22, 2020

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

Doctors' Training Disrupted

Training was disrupted for 8 in 10 doctors due to COVID-19, according to a GMC survey of more than 38,000 doctors.

Opportunities were reduced significantly for 38% and reduced slightly for 43%.

GMC Chief Executive Charlie Massey commented: "The disruption the pandemic has had on doctors in training and trainers cannot be underestimated. Our survey shows us that trainees and trainers alike believe important training has been missed.

"This is no surprise, but it is important now that we work hard, with training providers, postgraduate deans and others, to protect training as we cope with this significant and ongoing challenge."

Meanwhile the BMA has criticised Health Education England plans that could mean junior doctors having to sit unexpected exams or complete unverified self-assessments to access next year's specialty training posts.

BMA Junior Doctors Committee Deputy Chair,  Lucie Cocker commented: "Extra exams and changes in selection procedures and requirements, without truly knowing their impact on selection in specialties or the individuals taking those assessments, will damage junior doctor wellbeing, in a profession that is already approaching breaking point as a result of COVID-19 and historical NHS pressures."

Ethnicity Inequalities Report

The first quarterly report on ethnic minority inequalities with COVID-19 has been published by the Government's Equalities Office. It follows Public Health England's initial risk report in June.

The report said 95% of frontline NHS staff from Ethnic Minorities have now had a risk assessment and agreed actions afterwards.

In future, ethnicity will be recorded on death certificates.

Changes will also be made to the Shielded Patients List to take account of ethnicity risks.

In a news release, Sir Mark Caulfield, professor of clinical pharmacology, Queen Mary University of London and chief scientist for Genomics England, said: "This important report into health inequalities and COVID-19 draws together important strands of evidence to highlight the disproportionate impact on ethnic minorities by identifying the key factors that contribute to their increased risk of infection and adverse outcomes. These include household size, deprivation, co-morbidities and particularly occupation which highlights the vital contribution our diverse communities have made as key workers on the front line during the pandemic."

BMA Council Chair Dr Chaand Nagpaul said the report was "long overdue".

He commented: "While the report makes recommendations for the future and describes work in several areas that the BMA had long been calling for – such as some community initiatives and improving the way deaths are recorded – the key question remains: are BAME people any better protected today from the impact of this virus?"

He continued: "There needs to be more tangible action right now to protect BAME people. This could include providing resources to support individuals and businesses to ensure they have the right protective equipment and to ensure their workplaces are COVID secure. With higher numbers of BAME people in low-paid employment or living in deprived areas, it is vital to offer adequate funding that encourages individuals to be tested and to self-isolate if infected, given evidence that many feel that financial loss acts as a deterrent to do so."

Latest Data

The latest weekly performance data from England's Test and Trace system show 80.7% of people testing positive and transferred to the system were reached and asked to provide information about their contacts.

However, 40.4% of close contacts were not reached to be told to self-isolate. That's the worst performance since the service began.

Chief Scientific Adviser Sir Patrick Vallance told a Downing Street briefing: "It's very clear there's room for improvement." He also said testing and tracing has more of an impact when numbers are low.

In today's daily data another 21,242 UK positive tests were reported and 189 deaths.

There are 7433 COVID-19 patients in hospital and 711 ventilator beds are in use.

Public Health England's Weekly Surveillance Report showed:

  • Highest case rates continue to be seen among those aged 10 to 29

  • Positivity rates were highest in those aged between 10 and 29

  • The COVID-19 hospitalisation rate was 7.74 per 100,000 in week 42 compared to 5.55 per 100,000 in the previous week

  • 39.9% of new critical care admissions have involved people from BAME backgrounds over the course of the pandemic

Hospital Pressures

England's Health Secretary Matt Hancock announced the Manchester Nightingale Hospital is reopening today.

One hospital medical director took to twitter to appeal to people to stick to social distancing measures.

Dr Tristan Cope, who is also an ICU consultant at  Liverpool University Hospitals NHS Foundation Trust, said: "Sadly we are now treating more patients in hospital with COVID-19 @LivHospitals than we did in April at the peak of the first wave and numbers continue to rise."

Stoke, Slough, and Coventry are the latest parts of England that will move into the high alert Tier 2 restrictions at the weekend.

Vaccine Trials

Oxford University said a Brazilian trial of its coronavirus vaccine will continue despite the death of a participant.

It said the case had been investigated and no vaccine safety concerns had been found.

The person appeared to be in the placebo arm with Bloomberg reporting they had not received the vaccine, quoting "a person familiar with the matter".

Meanwhile, today in the BMJ is an article by Associate Editor Peter Doshi pointing out that current trials are not designed to tell us if vaccines will save lives.

He wrote: "None of the trials currently underway are designed to detect a reduction in any serious outcome such as hospitalisations, intensive care use, or deaths. Nor are the vaccines being studied to determine whether they can interrupt transmission of the virus."

Social Care Reform

A Commons Health and Social Care Committee report says a £7bn annual increase in social care funding in England is needed as "a starting point" for reform, and warns "doing nothing is no longer an option".

Anita Charlesworth from the Health Foundation commented: "COVID-19 has exposed the fault lines in the social care system and laid bare years of chronic underfunding. Sadly, care home residents and those receiving care in their own homes have paid a huge price for years of failure in political leadership."  

Kids' Lockdown Mental Health

There are new insights into the mental health of children and young people in England in new data compiled by NHS Digital, the Office for National Statistics (ONS), NatCen Social Research, University of Cambridge, and University of Exeter.

In July 2020, 1 in 6 children aged 5 to 16 years were identified as having a probable mental disorder, up from 1 in 9 in 2017.

In a blog post, Tim Vizard from ONS said: "Whilst it’s not possible to say this increase is wholly due to the pandemic, our research also found four in ten 11 to 16 year olds felt that lockdown had made their life worse, whilst 3 in 10 reported no change, and almost 3 in 10 reported the lockdown had made their life better."

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

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