UK COVID-19 Daily: Scotland recommends face coverings in public

  • Tim Locke,

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

Scotland Recommends Face Coverings in Public

Scotland is now recommending the general public use cloth face coverings, not medical masks, in some circumstances as a precautionary measure. It isn't mandatory and won't be enforced. The Westminster Government is not following suit. 

First Minister Nicola Sturgeon said it is no substitute for staying at home and social distancing measures: "The guidance also makes clear that the evidence on the use of face coverings is still limited. However, it recognises that there may be some benefit in wearing a face covering if you leave the house and enter an enclosed space where you will come into contact with multiple people, and safe social distancing is difficult, for example on public transport, or in shops."

She continued: "The benefit comes mainly in cases where someone might have the virus  but isn't aware of that because they're not experiencing any symptoms, and therefore not isolating completely in line with the rules."

Ms Sturgeon added: "What I don't want are people thinking they're invincible to this virus because they're wearing face covering."

The face covering advice was "important and timely," according to Professor Trish Greenhalgh, professor of primary care health sciences, Nuffield Department of Primary Care Health Sciences, University of Oxford. She told the Science Media Centre: "Face coverings are a common-sense way of reducing the transmission of viral illnesses by droplet infection. They are as evidence-based as school closures, handwashing and lockdown (ie, none of these measures is supported by definitive randomised controlled trials but all are supported by other kinds of science)." 

She added: "The reluctance of our government’s scientific advisers to support this measure while at the same time supporting messages to 'sneeze into your elbow' is surprising: face coverings are highly unlikely to cause harm and may well save lives."

However, Professor Keith Neal, emeritus professor of the epidemiology of infectious diseases, University of Nottingham, said: "It is impossible to know why this has been suggested now given there has been no change in the evidence. The decision seems political given it is against the Scottish and other UK scientific advice that has been given."  

At the Downing Street briefing Health and Social Care Secretary for England, Matt Hancock said: "The UK government position hasn't changed. Not least because the most important thing people can do is social distancing as opposed to the weak science on facemasks."

Deputy Chief Scientific Adviser Dame Angela McLean added: "The evidence is weak and the effect is small, and we've passed that on to our colleagues in government, with which to make a decision."

Frontline Health Workers' Death Payments Criticised

The scheme announced on Monday for one-off £60,000 payments to families of health and care workers on the front line who die due to COVID-19 in England has been criticised by doctors' groups.

The BMA said the announcement was long overdue. However, while it may provide some immediate financial relief, it said it could still leave families lacking longer-term financial security.

In a statement Dr Vishal Sharma, BMA pensions committee chair, said: "Whilst this single payment may seem a sizeable sum, it comes nowhere near compensating families for the lifetime income their loved one may have earned if they hadn’t died prematurely, fighting this crisis on the front line. This is particularly true for young or recently qualified staff."

Dr Rinesh Parmar, chair of the Doctors' Association UK said in a statement: "Matt Hancock delivered a further kick in the teeth to many grieving families of NHS and social care staff who have sadly died in the line of duty. 

"He was successful in delivering a political sound bite in place of a policy that would adequately safeguard the dependents who dedicated frontline staff leave behind. NHS and social care staff have displayed their unwavering commitment to patients despite concerns about their own safety and the availability of personal protective equipment (PPE). 

"The scheme fails to appropriately recognise the dedication, selflessness and contribution of colleagues who have paid the ultimate price. As we observe a minute silence today we call on the Health Secretary to reflect on his announcement and make a commitment towards the ongoing support of families of NHS and social care workers who have died in service of us all."

Matt Hancock was confronted on radio station LBC by the son of a consultant urologist who died from COVID-19. Dr Chowdhury had written to Boris Johnson about the lack of PPE in his hospital days before he died.

Intisar Chowdhury said: "You might know my father, Dr Chowdhury. When he was unwell, he wrote an open letter to the Prime Minister, appealing for more PPE for NHS frontline workers. It was a request which was ignored and he passed away."

He went on to ask for an apology: "Openly acknowledging your mistake is not an admission of guilt, it is genuinely just making you seem more human."

Mr Hancock didn't apologise or acknowledge errors, but replied: "I think that it is very important that we're constantly learning about how to do these things better and I think listening to the voices on the front line is a very, very important part of how we improve."

At the Downing Street briefing Mr Hancock said: "We've been moving heaven and earth to get the amount of PPE that we need to the front line." 

He added: "What we do have is constant focus on the realities of getting PPE to the front line, and we take full responsibility to getting it to every single person who needs it." 

NHS Worker Deaths

A minute's silence was held this morning for health and social care workers who have died after testing positive for coronavirus.

"These are the nation's fallen heroes," Mr Hancock said. 

Among the recently reported NHS deaths was locum GP Kamlesh Masson, from Grays in Essex, who died on his 78th birthday. 

He moved to the UK in 1973 after working in East Africa following medical training in India.

Basildon and Brentwood CCG paid tribute, saying: "Dr Masson was an excellent clinician whose drive to constantly improve his clinical skills and knowledge with passion and enthusiasm will remain with us all." 

It continued: "He had practised medicine for over 5 decades and was a dedicated servant to the NHS for 47 years. He would have wanted to practice medicine for many more years to come."

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

Deaths and Data

Another 586 UK hospital COVID-19 deaths were reported on Tuesday taking the total to 21,678.

Of the 552 deaths in English hospitals, patients were aged between 31 and 99. Of these, 38 aged between 36 and 99 had no known underlying health condition.  

Aside from the daily hospital deaths, figures were released today by the Office for National Statistics showing the number of overall deaths in care homes for the week ending 17th April (week 16) stood at 7316. This was 2389 higher than the previous week – an increase of 48.5%.

The provisional number of deaths registered in England and Wales at the end of week 16 was 22,351. This was an increase of 3835 on the previous week, a rise of 20.7%.

From Wednesday, there will also be daily reporting of care home and community deaths alongside the hospital statistics.
Deputy Chief Scientific Adviser Dame Angela McLean presented Tuesday's statistics at the Downing Street briefing.
On new cases: "The number of tests is still rising overall, we're still getting about the same number of positive tests across the UK." 
On hospital bed occupancy: "Over the last week that has fallen by 14%, a particularly dramatic fall in London, where the number of people in hospital peaks early compared with the rest of the country."
On critical care bed capacity: "Across our four nations that has peaked and is beginning to fall as a percentage."
Testing Expanded

Matt Hancock said daily testing capacity had now reached 73,400 with 43,453 tests carried out on Monday. The target is 100,000 daily tests by the end of the month.

Testing is being opened up to care home residents and staff whether they have symptoms or not.
Professor John Newton, NHS testing coordinator, said: "We've done some intensive studies of infection in care homes and what that showed was that the presence of symptoms was not a very good marker in the care home setting, both along with residents and staff, for the presence of the virus.

"There were significant numbers of residents who were asymptomatic who had the virus."

He said extra testing "will really make a difference combined with intensive infection control methods".

Also now eligible are over 65s with symptoms, and workers who have to leave home for their jobs and who have symptoms.

More News in Brief
  • Ten days ago we reported on an unnamed NHS Trust being criticised for its guidance suggesting that doctors do not have to put coronavirus on death certificates. The Good Law Project wrote to the trust about it. "The trust has ordered a review into death certificates from last 3 weeks and withdrawn faulty guidance following our letter," it tweeted: "We don't know if this is part of a broader problem," and it’s calling on the Government "to get a grip of COVID-19 death toll".

  • As many workers in other sectors are furloughed or laid off, applications to work in the NHS in England increased by 13,500 last month compared with the same time last year. There were 27,700 jobs advertised in March. “The huge support NHS staff have received from the public has been a massive boost as they tackle the greatest global health challenge in the health service’s history," Prerana Issar, NHS chief people officer said. "Now it is clear that many more want to play their part by joining the largest health and care team in the world." 

Adapted from Medscape UK.