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UK COVID-19 Update: NHS 'COVID-only', Exhausted Nurses

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

NHS 'COVID-only'

NHS Providers has taken issue with part of Boris Johnson's TV address last night in which he said: "If we let this virus get out of control now, it would mean that our NHS had no space – once again – to deal with cancer patients and millions of other non-COVID medical needs."

Chief Executive Chris Hopson commented: "While the Prime Minister wanted to stress the importance of protecting the NHS, the words he used, implying that the NHS was providing a COVID-only service during the first peak, were untrue, unfair, and potentially dangerous."

He said the PM's comments "give the impression that there is little point in non-COVID patients presenting themselves for diagnosis or treatment because the NHS would be unable to care for them".

The BMA issued a statement supporting the wider use of face coverings in England but said other measures didn't go far enough.

Dr Chaand Nagpaul, BMA council chair, said: "The Prime Minister missed an opportunity...to revise the ‘rule of six’ which, as currently interpreted, allows members of six different households to meet indoors whereas previously members of only two households could do so. Data suggests that transmission between households is by far the biggest driver of infection, and this should therefore be rectified at the earliest possible opportunity."

Today's Data

UK daily reported cases rose to 6178 today from 4926 yesterday. That's the third highest during the pandemic.

Another 37 deaths were reported, 1469 COVID-19 patients are in hospital, and 211 ventilator beds are in use.

Scotland reported its highest number of daily COVID-19 cases since the pandemic began, though the figure of 486 may reflect increased testing.

Yvonne Doyle, medical director at Public Health England commented: "We are testing much more than we were earlier on in the outbreak and our local Health Protection teams are working with local councils and Directors of Public Health to manage the increase."

Prof James Naismith, Director of the Rosalind Franklin Institute, and Professor of Structural Biology, University of Oxford, commented via the Science Media Centre: "Today’s spike in positive COVID-19 cases is very unwelcome news. It is part of a trend and there is no doubt the virus is taking off again."

However, he added: "The sudden jump is likely to reflect issues in the testing system reporting. It seems very unlikely we are back to a doubling of cases every 3 to 4 days. We will need to see a few more days of data to judge how fast case numbers are doubling."

UK Daily Cases By Date Reported Source: DHSC

Exhausted Nurses & Midwives

A new report calls for new minimum standards to improve working conditions and a review of 12-hour shifts to help reduce exhaustion and burnout among nurses and midwives.

The King’s Fund analysis was commissioned by the RCN Foundation and finds staff stress, absenteeism, and turnover have reached alarmingly high levels, which have been compounded by the pandemic.

"The current system is not sustainable," said the King's Fund's Suzie Bailey. "An urgent review is needed to investigate alternative shift patterns and look at mitigating the impact of 12-hour shifts on staff wellbeing, care quality, and safety. This may include providing rest areas for staff to decompress during shifts or to sleep after a night shift before driving home."

Susan Masters, RCN's director of nursing, policy and public affairs, commented: "Safe staffing and appropriate pay are key priorities related to wellbeing that we are campaigning on. Today, there are approximately 50,000 registered nurse vacancies in the NHS in the UK, impacting patient safety, and morale and wellbeing in the profession – and at a time when these are crucial."

A second report from the Commons Public Accounts Committee also highlights high vacancy levels in nursing but says the Department for Health & Social Care doesn't understand the nursing needs of the NHS and does not know how many nurses are needed, or where and in what specialism.

Committee Chair Meg Hillier said in a statement: "We fully recognise that the NHS is reeling under the strain of COVID-19, with staff unsure how they will cope with the second wave that it seems clear [is] already upon us. But it must not take its eye off the ball and allow a slide back into short-term, crisis mode. It must press on with coherent plans to get the nursing workforce back to capacity, under the kind of working conditions that can encourage hard-won, hard-working nurses to stay in our NHS and care homes."

Missing App Evidence

England and Wales' widely anticipated contact tracing app is due to launch tomorrow. However, the Health Foundation points out results of pilots of the app which took place last month on the Isle of Wight and in Newham in London have not yet been published.

Senior fellow Josh Keith commented: "For any major, nationwide public health intervention it is important the Government publishes evidence that it is effective and ready for mass roll-out in advance of its launch. This is key for building confidence in the app as people will want to know that it will benefit them and their communities. But any data on the pilots that took place in August have been notably absent, leaving major questions over the app’s effectiveness unanswered."

Welsh Support for Local Lockdowns

Yesterday the Welsh Government joined the rest of the UK in announcing pubs and restaurants will be closing at 10pm. Wales also urged people not to make unnecessary journeys.

Public Health Wales has been conducting weekly surveys since April 2020 to highlight the effect of COVID-19 on the physical, mental and social well-being of Welsh people and how they are coping with the pandemic.

Univadis from Medscape reported the key findings for the period from 7 September 2020 to 13 September 2020, before the latest announcements, are as follows:

  • 91% of respondents said they supported local lockdowns in areas where cases of COVID-19 are on the rise
  • 66% of respondents believed the national restrictions were about right, 29% believed they were not adequate and 5% believed they were too much
  • 31% of respondents reported gaining weight during the COVID-19 restrictions, whereas 23% said they had lost weight
  • 43% of respondents reported not having left their home to exercise in the last 7 days, and 30% reported not exercising at all during the last 7 days

Life Under Lockdown

The Office for National Statistics has been tracking attitudes to lockdown in Great Britain.

In March more than half of adults surveyed thought life would be back to normal within 6 months. By late August, the most common response was 'more than a year’.

By the end of August, more than half of working adults reported travelling into work, compared with just 36% in late May. Yesterday they were told to work from home again if they can in England.

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

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