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UK COVID-19 Daily: Death of Doctor Who Warned PM Over PPE

Editor's note 1920 BST, 9th April 2020: This article was updated with the news that Prime Minister Boris Johnson has been moved out of intensive care.

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

Death of Doctor Who Warned PM Over PPE

A doctor who warned the Prime Minister about PPE shortages has died after testing positive for the virus.

Urologist Dr Abdul Mabud Chowdhury was 53.

His message to Boris Johnson 3 weeks ago urged him to "urgently" ensure personal protective equipment was available for "each and every NHS worker in the UK".

He worked at Homerton Hospital in East London and died on Wednesday at Queen's Hospital in Romford.

The Mayor of  Hackney, Philip Glanville, said Dr Chowdhury was a "hero".

He tweeted: "I hope his death wasn’t as a result of continuing issues around testing & PPE, but it raises Qs. A sobering reminder of the lives being lost to keep us safe & the contribution BAME staff make."

In Scotland, Janice Graham, a health care support worker and district nurse, died at Inverclyde Royal Hospital with COVID-19.

In a statement, Louise Long, chief officer of Inverclyde Health and Social Care Partnership, said: "Janice was a valued team member in our District Nursing and Evening Services team and brought kindness and compassion to patients and colleagues.

"Her bright and engaging personality and razor sharp wit will be sorely missed."

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

Another 881 UK hospital COVID-19 deaths were announced today taking the total to 7978.

PPE and Duty of Care

With concerns continuing about availability of correct PPE, Medscape UK asked the Health and Safety Executive (HSE) about the need for employers to protect doctors and healthcare staff, and whether rules on their duty of care had changed. An HSE spokesperson said: "We are all concerned about the safety and wellbeing of all frontline NHS staff responding to this pandemic. 

"We accept their role means they will take on a higher degree of risk, and we absolutely expect those risks to be appropriately managed.

"Any concerns about the health, wellbeing or safety of workers would be a concern to us. Although these are extraordinary times the principle of employers needing to assess the risks in the workplace and act accordingly, on a case by case basis, has not changed."

HSE said NHS employers are required to follow the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR). However, diagnosed cases of COVID-19 are not reportable under RIDDOR unless there is reasonable evidence suggesting that a work-related exposure was the likely cause of the disease. 

Incidents may be reportable as a Dangerous Occurrence, such as a vial containing coronavirus breaking in a laboratory leading to exposure.

Scotland issued a statement after a meeting with health unions over PPE clarifying that alongside recent UK-wide guidance, professional judgement plays a part. First Minister Nicola Sturgeon said: "Whenever a healthcare worker on the front line feels that they should be wearing a mask, they should do so, it is their professional judgement, and that should be the guiding factor."

At the daily Downing Street briefing, Foreign Secretary Dominic Raab said: "We're obviously doing everything we can to provide the equipment, the PPE that they need, we're rolling that out at pace.

"I recognise that there have been challenges with the distribution."

Lockdown Continues

Yesterday Wales said the lockdown would continue there beyond next week. Today, Scotland's First Minister Nicola Sturgeon said: "There is no likelihood or prospect of these measures being lifted after the Easter weekend."

Dominic Raab said: "As we look forward to the long bank holiday Easter weekend I know some people are going to start wondering, is it time to ease up on the rules? So I say thank you for your sacrifice but also, we're not done yet. We must keep going." 

He continued: "We haven't yet reached the peak of the virus. So it's still too early to lift the measures that we've put in place." 

He also confirmed lockdown decisions didn't need to wait for the PM to be back at work: "I've got all the authority I need to make the relevant decisions," he said.

Government Chief Medical Adviser Professor Chris Whitty was asked about the pace of the spread of the virus. "When I was first talking about this, the doubling time, how fast we were doubling in terms of numbers, particularly in intensive care, was around about 3 days. It varied a bit.

"This has got steadily longer in time over the last 2 weeks thanks to what people have done.

"This is really now becoming not quite flat, but doubling time is now 6 or more days almost everywhere in the country, and extending in time."

NHS Capacity

"We had a number of patients die - I can't remember ever losing this many in a week," the words of intensive care unit registrar Jenny Abthorpe in her diary for Sky News. "The handover is quick and efficient. The night team of two doctors look exhausted," she wrote. "We give them a round of applause to send them on their way home. Heroes."

Today, Government Chief Scientific Adviser Sir Patrick Vallance, said: "People are working heroically in intensive care units to look after the very sick patients who are there."

He showed data showing cases still rising, "But again, this is not the sharp upstroke of big increases in numbers, it's a steady increase in numbers, which might, just might, be beginning to flatten off. But it's certainly not accelerating. 

"That means that the NHS can cope. It's got the right numbers of beds, with the new expansion, in order to be able to cope with it."

PM's Condition Check

Tonight Downing Street said Boris Johnson has been moved out of intensive care at London's St Thomas' Hospital.

"What would Boris do?" The Telegraph asked in a headline earlier today, saying that's the only question that matters to the Cabinet now. "It is imperative," the paper said, "that Dominic Raab, who is deputising for Johnson, begins every meeting with a simple question to the rest of the Cabinet: What would the boss be doing in our place? How would he be imposing his will on Whitehall? How can we try to do as he would?"

Dominic Raab gave an earlier update, saying: "He continues to make positive steps forwards, and he's in good spirits."

However, he said he has still not spoken to the PM since starting to deputise for him: "Not yet. I think it's important," he said, "to let him focus on the recovery. We in the government have got this covered." 

More News in Brief

  • There's been a 29% drop in A&E visits in England, latest data show. "This suggests that many of those who might have attended A&E previously could be seeking clinical advice elsewhere, and that 111 is playing a critical role in advising people on how to access care," Tim Gardner, senior policy fellow at the Health Foundation, commented. "Further work is needed to understand who is not coming to A&E and whether unmet needs are being stored up for the future." 
  • The charity BPAS (British Pregnancy Advisory Service) is launching a telemedicine home abortion pill service for women in Northern Ireland up to 10 weeks of pregnancy. Although abortion was decriminalised in NI last October services have yet to be introduced and travel to England is the only option. In a statement, Ann Furedi, BPAS chief executive, said: "We can no longer stand back and watch this shameful political gameplay with women’s health at a time of national crisis. We will no longer be complicit in Government policy of booking bleeding, vomiting women on interminable ferry journeys, putting their health at serious risk, nor will we abandon women with serious health conditions, when we can ensure they are cared for in the safety of their own home."
  • Charities have welcomed yesterday's announcement of £750m of Government financial support. Cancer Research UK has already announced £44m cuts in research funding. Its Chief Executive, Michelle Mitchell, said: "This package is a significant first step which will help many charities continue their vital work through these challenging times. But this pandemic is having a profound impact on our life-saving work, so we are joining other charities in asking Government to review the level of this support as the crisis continues." St John Ambulance Chief Executive, Martin Houghton-Brown, hoped it would be "the lifeline that we need".
  • Ferrets may play a part in future COVID-19 vaccine development, a team of researchers in China reported in Science. The virus, they said, replicates poorly in dogs, pigs, chickens, and ducks but efficiently in ferrets and cats. "The fact that SARS-CoV-2 replicates efficiently in the upper respiratory tract of ferrets makes them a candidate animal model for evaluating antiviral drugs or vaccine candidates against COVID-19," the researchers wrote.
  • There's another Clap for Carers tonight at 8pm. Mr Raab said he'd be taking part, but wouldn't be drawn when asked if there'd be financial rewards for frontline NHS workers in future.

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

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