UK COVID-19 Update: Doctors' Burnout, Scotland's Latest Lockdown

Tim Locke

November 17, 2020

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

Doctors' Burnout 'A Serious Situation'

BMA Council Chair Dr Chaand Nagpaul has briefed MPs on the Commons Health Committee about burnout risks facing doctors in the pandemic's second wave: "Forty percent of doctors say their stress levels and their levels of burnout are now higher...59% say they're really fatigued, and 40% haven't been able to take adequate leave from work since March," he said.

He continued: "About 50% say that once the pandemic is over, they plan to reduce working hours, a fifth plan to retire early, a fifth plan to do another job other than being a doctor. So this is a serious situation."

A recent Medscape UK survey found a 68% increase in doctor's burnout levels since 2018.

Scotland's Latest Lockdown Announcement

Scotland is moving 11 local authority areas, including Glasgow, into its highest level 4 lockdown for a limited period of time from 6pm on Friday. Non-essential shops close, household mixing is restricted, but schools stay open.

First Minister Nicola Sturgeon said cases were at a "stubbornly high level".

She told the Scottish Parliament the measures "are necessary to ensure that the National Health Service can cope with the range of pressures it will face over the winter. We must ensure that hospital and intensive care services are there, not just for those with COVID, but for everyone who needs them."

Ms Sturgeon also told the Scottish TUC that she's working on a "better, fairer" pay deal for NHS workers in recognition of their "incredible efforts" during the pandemic.

Earlier, England's Health Secretary Matt Hancock told the Commons that after England's national lockdown ends on December 2, it will be replaced with a tiered system "similar to what we had before".

Testing Moonshot Questioned

A group of experts from the universities of Birmingham, Newcastle, Warwick, and Bristol is raising questions about the Government's mass testing 'Moonshot' which has begun in Liverpool.

Points raised include:

  • Current evidence doesn't indicate whether population screening will increase or decrease disease transmission, hospitalisation, and death

  • The initiative will cost more than any other healthcare intervention contemplated, and could cause harm by diverting resources

  • Population screening for SARS-CoV-2 is not endorsed by WHO, SAGE, or the UK National Screening Committee

Moderna Vaccine Order

The UK Government reacted to Moderna's reporting of its vaccine's protection against COVID-19 being almost 95% effective by announcing an order last night.

Five million doses could be ready to deliver from Spring 2021 if it gets MHRA approval.

The order means the UK has now ordered  355 million vaccine doses from a range of manufacturers.

Chair of the Government’s Vaccine Taskforce Kate Bingham said: "We will continue to monitor the field of promising vaccines, and are very encouraged by the effectiveness shown by these early frontrunners, but we must remain vigilant to the fact that no vaccine is yet approved for use by regulators."

The Daily Mail reported on leaked plans for volunteers with no previous medical experience to receive training to help deliver a vaccination programme.

Latest Data

The latest weekly data from the Office for National Statistics show the number of deaths registered in England and Wales was 14.3% above the 5-year average.

'Novel coronavirus (COVID-19)' was cited in 16.4% of all deaths, up from 12.7% the previous week.

Hospital deaths were above the 5-year average for the third week in a row.

Deaths in private homes and care homes were also above the 5-year average.

Commenting via the Science Media Centre, Professor Sir David Spiegelhalter, chair, Winton Centre for Risk and Evidence Communication, University of Cambridge, said: "Usually around 2500 people die at home each week at this time of year - now it is 3500. That is 1000 more, an extra 40%. These extra home deaths, very few of which are from COVID, have continued since March.  it would be very good to know the quality of end of life care being received, and how many of these deaths might have been delayed through, for example, more rapid treatment of heart attacks and strokes."

Mouthwash

More preliminary research suggests widely-used mouthwash products containing cetylpyridinium chloride could help inactivate coronavirus in 30 seconds.

The Cardiff University preprint research was carried out in a laboratory rather than in people. The mouthwash manufacturer Venture Life Group is now funding human trials.

Last month, US research published in the Journal of Medical Virology found several mouthwash products were effective against the SARS-CoV-2 virus.

Obesity and COVID-19

BMI should be taken into account in COVID-19 risk assessments, according to Queen Mary University of London led research published in Frontiers in Genetics.

Mendelian randomisation was used with individual genetic information to investigate the effects of cardiovascular risk factors on COVID-19 infection risks.

Lead author Dr Nay Aung commented: "Our findings support the use of BMI and LDL cholesterol as important metrics alongside other known characteristics (such as age and ethnicity) in the risk assessment of vulnerability to COVID-19 infection."

AKI Risks

Patients with COVID-19 presenting with acute kidney injury (AKI) are likely to have worse outcomes in terms of mortality and the need for critical care, a new study published in PLoS One suggests.

Univadis from Medscape reported that researchers retrospectively analysed data from adults admitted with a diagnosis of COVID-19 to the four Manchester University Foundation Trust Hospitals between 10 March 2020 and 30 April 2020.

The authors call for close monitoring of patients with suspected COVID-19 presenting with AKI and those at risk of AKI.

Eating Disorders

The COVID-19 crisis has created "a dangerous bottleneck" of children and young people (<19 years) with eating disorders needing help and not receiving it, according to the alcohol and drug rehabilitation provider UK Addiction Treatment.

Univadis from Medscape reported that the group was responding to new figures from NHS England which revealed that the number of children and young people waiting to start treatment for eating disorders almost doubled between the end of March 2020 and the end of June 2020.

Genomics Funding

The COVID-19 Genomics UK Consortium has received £12.2M funding from the Department for Health and Social Care Testing Innovation Fund to expand whole genome sequencing of positive SARS-CoV-2 virus samples to map how COVID-19 spreads and evolves.

The funding will facilitate the genome sequencing capacity needed to meet the increasing numbers of COVID-19 cases expected this winter, Univadis from Medscape reported.

PHE Leader's BAME Recognition

Public Health England's Regional Director for London Professor Kevin Fenton has been named the second most influential black person in the UK by Powerlist 2021.

He tweeted: "I am delighted, honoured and humbled to be named among so many incredible and inspiring black individuals. The news is still only just sinking in!"

He was recognised for his work engaging with BAME communities on the disproportionate impact of COVID-19.

Prof Fenton was beaten to the top spot by F1 champion Lewis Hamilton.

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

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