UK COVID-19 Daily: Coronavirus concerns for single-handed GP Practices

  • Peter Russell, Medscape.com

  • UK Medical News
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These are the latest UK coronavirus stories you need to know.

GPs' Risk from COVID-19 'Threatens Patient Health'

A report by the Health Foundation said that 32.7% of general practitioners in England who singlehandedly manage a GP practice are at high risk of death or serious illness from COVID-19.

The research revealed that this could potentially leave 710,043 patients without face-to-face appointments with their GPs if those at high risk decided to limit direct contact.

The independent health charity said that across England, at least 8% of GPs (3632) are believed to be in the 'high risk' category, with factors including age, sex, and ethnicity contributing to greater risk.

The impact was likely to be most severely felt in deprived areas of the country since GPs at very high risk of death from COVID-19 are more than three times as likely to be working in those regions. Also, single-handed GP practices are more likely to be in areas of high deprivation.

The analysis suggested that London could be among areas hardest hit, as the capital has the highest proportion of GPs at very high risk from COVID-19, as well as single-handed practices run by a GP at very high risk.

Locum GPs, who might be employed to cover GP absences, were also disproportionately at risk from COVID-19, the report found. While less than 10% of the GP workforce are locums, they make up 17% of GPs at very high risk from COVID-19.

The Health Foundation called for national and regional decision-makers to provide additional support to keep GPs at high risk from COVID-19 and their patients safe and healthy.

Dr Rebecca Fisher, senior policy fellow at the Health Foundation, and practising GP, said: "It's particularly worrying that GPs at higher risk from COVID-19 are far more likely to be working in areas of high deprivation. Those are precisely the areas with the greatest health need, the biggest burden from COVID-19, and an existing under-supply of GPs relative to need.

"Unless urgent action is taken this could become another way in which poorer communities become further disadvantaged, and risks further widening health inequalities."

Dr Richard Vautrey, GP committee chair at the British Medical Association, BMA GP committee chair, said: "As this data shows, some GPs working alone are at a higher risk of becoming ill from COVID-19 and therefore, potentially not able to see patients face-to-face. If needed, locum GPs can be recruited to help these practices, but surgeries need financial support to do so, as well as adequate space in their practices to accommodate another practitioner.

"This research therefore not only highlights the need for more GPs in the system, especially in deprived areas, as well as the continued provision of effective PPE, but also free access to comprehensive occupational health services to support clinicians with risk assessments."

Coronavirus Infection Rates

A pre-print of new research suggested that the prevalence of infection from the SARS-CoV-2 virus in England decreased to 0.077% (95% confidence rate 0.065% to 0.092%) in late June and July compared to 0.13% (95% confidence rate 0.11% to 0.15%) in May.

A programme of infection tracking led by Imperial College London (ICL) found a reduction in cases from an earlier report, despite some lockdown restrictions being eased at the start of June.

A second report in a series found that for every 10,000 people tested, approximately 8 had the virus. The first report showed a higher average, with 13 cases for every 10,000 people tested.

People from Asian backgrounds continued to have high rates of infection at 1.0% compared to those from white backgrounds where 0.07% were affected. Individuals from black and other ethnicities were also disproportionately affected with 0.15% of these groups having the infection.

Researchers also calculated the overall 'R' reproduction number for June 19 to July 8 at 0.58, similar to May's level of 0.57.

The findings were based on the REal-time Assessment of Community Transmission (REACT 1).

Prof Paul Elliott, director of the programme at ICL, said: "Through our community testing programme, we're beginning to build a more informed picture of COVID-19 across England.

"This surveillance programme is showing us the prevalence of infection between different demographics, age groups and ethnicities as well as giving us insight into how easing lockdown restrictions are affecting the infection rate."

Paul Hunter, professor in medicine at the University of East Anglia, said although the report largely confirmed what was already known about the trajectory of the epidemic in England, it was "important to realise that the fact that the early relaxations in June did not cause an increase in cases does not mean that further relaxations will have done so already or will do so in the future".

NHS Face Mask Legal Review

Fifty million face masks bought by the government in April will not be used in the NHS because of safety concerns, the BBC reported on Thursday.

It is understood that the FFP2 masks, bought from supplier Ayanda Capital, which use ear-loop fastenings rather than head loops, might not fit tightly enough.

The Good Law Project, which has issued a judicial review on the issue, said it estimated that the Government had spent between £156 million and £177 million on the masks.

The Government said it could not comment on the specific case because of ongoing legal proceedings. In a statement sent to Medscape News UK, a spokesperson for the Department of Health and Social Care said: "Throughout this global pandemic, we have been working tirelessly to deliver PPE to protect people on the frontline.

"Over 2.4 billion items have been delivered, and more than 30 billion have been ordered from UK-based manufacturers and international partners to provide a continuous supply, which meets the needs of health and social care staff both now and in the future.

"There is a robust process in place to ensure orders are of high quality and meet strict safety standards, with the necessary due diligence undertaken on all government contracts."

Hospitalised Patients 'A Priority for Convalescent Plasma Donations'

People hospitalised by COVID-19 produced more antibodies than those who did not need hospital treatment, new data released by NHS Blood and Transplant (NHSBT) showed.

It said the results confirmed that they should be made priority plasma donors.

An analysis of donations found that 76% of people testing positive for COVID-19 who received hospital care had high enough antibody levels for their donation to be used in two ongoing randomised control trials.

In comparison, only 30% of positive tested people who did not need hospital treatment had high enough antibody levels.

Dr Lise Estcourt, head of NHSBT's Clinical Trials Unit, said: "These figures demonstrate how important it is for people who were hospitalised with coronavirus to donate – they are most likely to be able to save the lives of other[s] seriously ill people.

"These donors have higher antibody levels because while initially your immune system will try and fight off a virus with white blood cells, if you become more ill, your immune system needs to produce more antibodies that neutralise or kill the virus."

NHS Blood and Transplant is currently appealing for donors, especially men, ahead of any second wave of the coronavirus.

COVID-19 convalescent plasma is being collected at NHSBT's 23 donor centres around the country, and several pop-up donor centres. London, Greater Manchester, and Birmingham are priority areas for donation.

More than 13,000 donations have been taken so far, including more than 800 donations from people who were hospitalised, NHSBT said.

Adapted from Medscape UK.