UK COVID-19 Daily: £60,000 death payments for health workers' families

  • Tim Locke, Medscape.com

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

£60,000 Death Payments for Frontline Health Workers' Families

Health unions, including the BMA, have been lobbying for death in service benefits for NHS workers, including those who are not members of the pension scheme.

On Monday, Health and Social Care Secretary for England, Matt Hancock told the Downing Street briefing: "Today I'm able to announce that the government is setting up a life insurance scheme for NHS and social care frontline colleagues. Families of staff who die from coronavirus in the course of their essential frontline work will receive a £60,000 payment. 

"Of course, nothing replaces the loss of a loved one. But we want to do everything that we can to support families who are dealing with this grief."

The scheme would also apply to overseas NHS staff and those who have returned to the medical profession, Mr Hancock said.

He also confirmed that accepting the payments would not mean waiving the right of families to take legal action against the NHS if they felt their relative had not been properly protected.

Among recently announced NHS worker deaths was Dr Vishna Rasiah, a consultant neonatologist at Birmingham Women’s Hospital.

Trust Chief Executive Sarah-Jane Marsh paid tribute: "Vish was an amazing doctor, leader, colleague and friend passionate about the care of babies and their families. Losing him in such a cruel and unfair way will be too much to bear for many of us, in particular anyone involved in neonatal care, and of course his beautiful wife and daughter.

"As our tears flow, we must always remember the values that Vish stood for, and hold his vision, courage and compassion in our hearts."

A minute's silence will be held tomorrow morning (Tuesday 28th April) at 11 am in a nationwide tribute to NHS and care staff who have lost their lives to the virus.

National Medical Director Professor Stephen Powis said: "This is an opportunity for us all to pay tribute to doctors, nurses, cleaners and many other NHS staff who have died in this pandemic.

"I hope the whole nation will fall silent in tribute and show how much their contribution is remembered and appreciated."

Mr Hancock said that so far 82 NHS staff and 16 social care staff are known to have died after testing positive for coronavirus.

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

Alert Over New Symptoms in Children

An alert has been issued from within NHS England over rising cases in the past 3 weeks of new symptoms in children needing ICU admission that may be linked to coronavirus.

The symptoms, seen in London and other parts of the UK, are described as a multi-system inflammatory state with overlapping features of toxic shock syndrome and atypical Kawasaki disease, with blood parameters consistent with severe COVID-19.

The symptoms have been seen in children who test positive for the virus, and those with negative tests.

Professor Powis told the Downing Street briefing: "I've asked the National Clinical Director for Children and Young People to look into this as a matter of urgency… I know Public Health England are also looking into this. 

"So it's obviously important that when clinicians see these cases and worry that there might be a cluster that they alert other clinicians so that we can make sure that they are identified if they're occurring elsewhere. 

"And then, I think, quite rightly we asked our experts to look into them and to see whether they can establish any link. 

"We're not sure at the moment, it's really too early to say whether there is a link."

Government Chief Medical Adviser Professor Chris Whitty added: "I think it is entirely plausible that this is caused by this virus, at least in some cases, because we know that in adults who of course have much more disease than children do, big problems are caused by an inflammatory process and this looks rather like an inflammatory process, a rather different one.

"Therefore, given that we've got a new presentation of this at a time with a new disease...its not definite, we need to look for other causes as well but the possibility that there is a link is certainly plausible."

PM: COVID-19 is 'Invisible Mugger'

Prime Minister Boris Johnson was back at work this morning making a live statement in Downing Street. He'd been recuperating at Chequers since leaving London's St Thomas' hospital where he'd spent time in the COVID-19 ICU ward.

He said the UK was dealing with "the biggest single challenge since the war" and "it is also true that we are making progress with fewer hospital admissions, fewer COVID patients in ICU, and real signs now that we are passing through the peak".

He thanked the public for "forbearance" saying: "Thanks to our collective national resolve we are on the brink of achieving that first clear mission to prevent our National Health Service from being overwhelmed in a way that tragically we have seen elsewhere.

"And that is how and why we are now beginning to turn the tide." 

He described the virus, "from personal experience" as being like "an unexpected and invisible mugger". 

Continuing the analogy he said, "this is the moment when we have begun together to wrestle it to the floor".

This he said "is the moment of opportunity. This is the moment when we can press home our advantage. It is also the moment of maximum risk."

The PM said he understood the "impatience" of people and businesses to loosen lockdown measures, but "we must also recognise the risk of a second spike, the risk of losing control of that virus, and letting the reproduction rate go back over 1, because that would mean not only a new wave of death and disease, but also an economic disaster".

He continued: "We defied so many predictions. We did not run out of ventilators, or ICU beds, we did not allow our NHS to collapse. And on the contrary, we have so far collectively shielded our NHS so that our incredible doctors and nurses and health care staff have been able to shield all of us from an outbreak that would have been far worse."

He confirmed the five tests needing to be met "when we're sure that this first phase is over".

They are:

  • "Deaths falling

  • NHS protected

  • Rate of infection down

  • Really sorting out the challenges of testing, and PPE

  • Avoiding a second peak."

He committed to sharing Government "working and thinking" and that "the preparations are underway, and have been for weeks, to allow us to win phase two of this fight as I believe we are now on track to prevail in phase one".

PPE Problems Persist

Before the PM said "really sorting out the challenges of testing and PPE" was a priority, the Royal College of Physicians released a survey saying doctors working in high-risk COVID-19 settings are still having trouble accessing appropriate equipment and testing.

The online survey was completed by 2129 members over 24 hours from Wednesday 22nd April 2020.

It found:

  • For aerosol-generating procedure (AGP) 31% couldn't always access long-sleeved disposable gowns and 37% couldn't always access full-face visors

  • Of the 86% of respondents working in non-AGP areas with confirmed or possible COVID-19 cases 40% are not always able to access eye protection, and 15.5% are not always able to access fluid repellent face masks

  • The situation has worsened in the 3 weeks since members were last polled with 26.5% being unable to access the PPE they need to manage COVID-19 patients compared to 22% previously

  • 23% didn't know how to raise PPE concerns in their organisation

  • Staff absences dropped from 18% to 8% over the past 3 weeks

  • 91% of those with COVID-19 symptoms are now able to access testing for themselves compared with 31% three weeks ago

  • 29% are still unable to access testing for a symptomatic household member

  • 29% have moved to work in different clinical areas from normal with 53% now working on acute medicine wards and 14% on COVID-19 wards

RCP President Professor Andrew Goddard said in a statement: "The lack of PPE remains their biggest concern and it is truly terrible that supply has worsened over the past 3 weeks rather than improved.

"Healthcare workers risking their lives couldn't care less how many a billion pieces of PPE have been ordered or supplied. If it isn't there when they need it, they are in harm's way."

The Chief Executive of NHS Providers Chris Hopson commented: "It will be important – when the time comes for a public inquiry – to examine why the pandemic stockpile was not configured for an epidemic like the one we face today and didn’t have enough gowns and visors."

Deaths and Data

Another 360 UK hospital COVID-19 deaths were reported on Monday taking the total to 21,092. 

Of the 329 deaths in English hospitals patients were aged between 29 and 100. Of these,  22 aged between 29 and 89 had no known underlying health condition.  

Prof Whitty said: "As we have said every time just after a weekend, there's an artificial drop because there's less notification over weekends."

He added: "I do actually expect there will be a bit of an uptick again later in the week as we catch up from the weekend drop. 

"Nevertheless, the trend overall... is a gradual decline. But we are definitely not consistently past the peak across the whole country at this point in time."

On new cases, Prof Whitty said: "One thing you have to bear in mind is the number of tests is going up overall, but despite that, the trend is flat or slightly down in terms of positive cases." 

On those in hospital with COVID-19: "I think the trends that demonstrate that over the country as a whole we’re going through the peak are reasonably clear to see. Obviously a bigger fall in London, but the rest of the country in different areas, either flat or decreasing over time."

On critical care bed occupancy: "Both in absolute and in relative terms, this is gradually trending down. But importantly … this is a very gradual peak we're not seeing a dramatic fall off and nor do we expect so."

He later acknowledged: "This has got a very long way to run."

He was asked about the current replication (R0) number. "I think that there's a reasonable degree of confidence that it's in that broader range 0.5 to 1 and I think it's probably in a rather narrow range in the middle of that." 

Testing

Mr Hancock was asked if he was still on target to reach 100,000 tests a day by the end of the month. "I think we are on track to the 100,000 target, we're broadly where we expected to be. You've seen a big increase over the weekend to 37,000 tests on Sunday.

"Now, we are also enhancing and making it easier to access how you get hold of tests. The home tests have been particularly popular. We delivered 5681 of those on Sunday." 

Looking forward he said: "We want testing to continue to increase. As you'll know the Prime Minister set a goal of 250,000 some time ago, especially for when the antibody tests come on stream, but so far there isn't one of those that is clinically valid."

He added: "We've already gone past the number of tests per day for instance that they carry out in South Korea, and we're approaching the levels that Germany undertakes."

More News in Brief

  • An Imperial College London study in Lancet Infectious Diseases in March credited with hardening the Government's response to COVID-19 has been corrected. The paper warned of uncontrolled spread of the disease-causing as many as 510,000 deaths. However, Retraction Watch alerted the research team to the withdrawal of a preprint it cited. Azra Ghani, co-corresponding author of the paper told Retraction Watch "the epidemic has now moved on" and they are "confident that the results would still hold".

  • The National Cancer Research Institute (NCRI) is the latest organisation to cancel a medical conference. The 2020 NCRI Cancer Conference was due to have taken place in Belfast  2nd-4th November.  It has now been postponed until 12 months later. In a statement NCRI said: "This decision was made after a thorough review and discussion of all factors impacting the annual conference, and the ability of delegates, speakers, presenters, and sponsors to take part. Whilst we believe that postponing is the right decision, we also understand that it is disappointing for all participants and would like to thank you for your patience and support at this challenging time."

  • Due to COVID-19 the storage limit for frozen eggs, sperm, and embryos has been extended by 2 years to give those undergoing IVF treatment more time. Sally Cheshire, chair of the Human Fertilisation and Embryology Authority, said in a news release: "We know this is a difficult and distressing time for all patients, so this decision brings good news for those who are reaching the 10-year storage limit.  It provides them with some much-needed reassurance and most importantly gives more time to try for their much longed for family."

  • Betting and Gaming Council members are voluntarily removing all TV and radio gaming advertising during the COVID-19 lockdown. The group's Chief Executive Michael Dugher said in a statement that it "underlines our commitment to safer betting and gaming with many people cut off and feeling anxious. We have been working closely with our member companies since this crisis began to monitor the impact of betting and gaming. There hasn’t been an explosion in people betting online as some had predicted – in fact, the opposite is true with total revenue down by up to 60%." 

Adapted from Medscape UK.