UK COVID-19 Daily: PPE 'rapid' guidance review

  • Tim Locke, Medscape.com

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

PPE 'Rapid' Guidance Review

Urgent work is beginning to update UK guidance on protective equipment, after calls for clarity from doctors, including the Royal College of GPs.

In a statement, Dr Yvonne Doyle, medical director, Public Health England, said: "In response to NHS staff feedback about their Personal Protective Equipment the DHSC, PHE and NHS England and NHS Improvement have looked again at the guidance. 

"Now that COVID-19 is much more widespread, we will carry out a rapid piece of work ensuring the guidance is clearer on which PPE should be worn in different NHS settings. The Academy of Medical Royal Colleges will support this urgent work."

The Chief Medical Officer for Wales, Dr Frank Atherton, said: "The current guidelines about what PPE is needed differs by setting and procedure. It is essential those who need PPE have access to it but we should not use it unnecessarily in order to avoid wastage and to ensure we have sufficient stocks as the coronavirus pandemic progresses."

He continued: "The health and wellbeing of our health and social care staff is our prime concern. It is vital they are protected and that they feel confident when working."

Stephen Powis, national medical director of NHS England told today's Downing Street news briefing: "We are strengthening the supply chain every day to ensure that every organisation gets the equipment that they need. That is an absolute priority for us." 

Business Secretary Alok Sharma said product testing officials had been told to prioritise the testing of any new PPE supplies.

Deaths

Another milestone was passed in the daily deaths announced of UK patients who tested positive for COVID-19, passing 1000 for the first time. 

Thursday saw the first rise of more than 100 cases in a day. The last 24 hours saw 260 more deaths.

Dr Simon Clarke, associate professor in cellular microbiology, University of Reading was among experts commenting via the Science Media Centre. He said the figures were "sad" but "unsurprising".

He said: "Over the coming weeks we can expect to see the UK's toll of the disease grow substantially, with increasingly large day-on-day numbers of the deceased.  It is widely anticipated that we will reach a peak of numbers in around a fortnight, but it should be remembered that the strategy of suppressing the peak, will cause it to broaden and we will see peak mortality level off and stay high for some time before it starts to decrease."

Prof Brendan Wren, professor of microbial pathogenesis, London School of Hygiene & Tropical Medicine, said: "Sometimes it is difficult to put the daily death reports into perspective, but the report of 260 deaths in the UK today approximates to a person dying every 5 minutes in our hospitals from COVID-19. With the doubling rate of infection every 4/5 days and the epidemic expected to peak in 2/3 weeks it is possible that we may get to much higher levels in the coming weeks before we see if the social distancing interventions have an impact." 

Stephen Powis said: "If we do reduce the deaths, to a level which is below what we initially thought, I want to be absolutely clear: that won't be because we are somehow lucky. It won't be because somehow the virus is acting in this country differently from any other country. It will be because every citizen in this country, the British public, have complied with the instructions that the Government has given, based on the best scientific evidence to reduce the transmission of the disease.

"We can beat this virus, we can reduce the number of deaths, but only if we reduce the spread and the transmission. 

"Now is not the time to be complacent. Now is the time to really, really lockdown, and hone down. on what we've been asked to do."

Stephen Powis was also asked if the NHS was at capacity for ICU beds yet: "We are not at capacity yet within London. But beds are being opened all the time to produce that extra surge capacity."

Priority NHS Staff Antigen Testing 'Long Overdue'

The British Medical Association (BMA) responded to yesterday's announcement of antigen testing for key NHS staff to begin next week.

"The BMA has been calling for healthcare workers to be tested as a matter of urgency for weeks now, so this announcement is long overdue," BMA Council Chair, Dr Chaand Nagpaul, said in a statement. 

"While the Government has announced this will commence with certain categories of staff, it is crucial that these tests are rolled out to all healthcare workers and their households urgently – so that if they do test negative, they can support the health service at a time when they are needed most."

Dr Jonathan Leach, joint honorary secretary, Royal College of GPs, welcomed the move: "GPs and their teams are committed to delivering care to patients in these challenging circumstances, but they must be well enough to do so, and this new measure will help make that possible.

“As well as reducing doubt and anxiety for frontline healthcare professionals, it will provide reassurance for patients who are, understandably, extremely worried about the current situation.”

Today, Stephen Powis said: "We're working with NHS organisations, as I speak, to ensure that testing will be available over the next few days for their critical staff."

Commenting via the Science Media Centre, Dr James Gill, honorary clinical lecturer at Warwick Medical School, said: "The development of an antibody or serological test may revolutionise diagnosis and also screening for COVID-19, as it provides a rapid bedside test not that dissimilar to a pregnancy test, or a diabetic’s blood sugar test. The patient provides a drop of blood, which 15 minutes later would provide a clear - antibody present or not - result. The antibody status of a patient will also allow the identification of people who have had the infection and subsequently recovered, not something possible with PCR testing.

"Again there is the potential for false positives/ negatives with antibody tests, particularly influenced by when a person is tested in the course of their infection. Nevertheless, the release of an antibody test may have profoundly positive effects in our ability to fight coronavirus, and is an example of good news which recently we have been sorely lacking."

Alok Sharma also announced that red tape had been cut to help get more hand sanitiser to the market.

Transplant Surgeon's Death

The death of transplant surgeon Adil El Tayar after testing positive for COVID-19 was reported by the BBC.

Dr El Tayar had been self-isolating after developing symptoms in mid-March and he was admitted to hospital on 20th March.

His cousin, Dr Hisham El Khidir told the BBC: "Since his death on Wednesday I have had hundreds of text messages from his colleagues and friends. He will be sorely missed."

COVID-19 Sniffer Dogs?

The BBC reported that dogs are to be tested to see if they can be trained to help diagnose COVID-19.

Dogs have already been trained to detect the smell of malaria and some cancers, it reports.

However, a way had not yet been found to "safely catch the odour of the virus from patients".

Adapted from Medscape UK.