UK COVID-19 Update: 'cancel Xmas' journals urge, scrapping 4 hour wait target

  • Tim Locke, Medscape.com

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

'Cancel Xmas Lockdown Easing' Medical Journals Urge

A joint editorial from The BMJ and Health Service Journal urges the Government to scrap the planned 5 day Christmas relaxation of lockdown measures across the UK.

It is only their second joint editorial in more than 100 years.

"We believe the Government is about to blunder into another major error that will cost many lives," the editorial says.

It criticises ministers for being slow to react in the past, and "squandering money on failure", referring to England's Test and Trace system.

"It should now reverse its rash decision to allow household mixing and instead extend the tiers over the 5 day Christmas period. In order to bring numbers down in advance of a likely third wave, it should also review and strengthen the tier structure, which has failed to suppress rates of infection and hospital admission," it concludes.

Labour called on Prime Minister Boris Johnson to convene the emergency COBRA group to review whether the planned relaxation of restrictions is appropriate.

Germany, the Netherlands, and the Czech Republic have ordered Christmas lockdowns due to rising cases.

Scrapping 4 Hour Wait Target

NHS England has launched a consultation on 'Transformation of urgent and emergency care', which could signal the end of 4 hour A&E waiting time targets.

The review began in 2018 and the latest document acknowledges that the pandemic has further reduced bed capacity.

Dr Samantha Batt-Rawden, president of the Doctors’ Association UK and a senior registrar in emergency and intensive care medicine, commented: "The 4-hour target is considered by many frontline doctors as not fit for purpose, with patients continuing to wait hours in Emergency Departments this winter as in many recent winters.

"We are pleased that NHS England is launching this consultation in partnership with frontline staff to develop alternative patient-focused targets; going forward we must ensure that these are backed up with the staff and resources to achieve them."

NHS Providers said the ambitions in the plan "will require significant investment".

Chief Executive Chris Hopson said: "Changing the way we measure performance will not, by itself, deliver the improvements to urgent and emergency care that patients need."

Tributes to Emergency Department Nurse

Tributes have been paid to emergency department nurse Barclay Mason, 56, who died after testing positive for COVID-19 at the Princess Alexandra Hospital, Harlow, Essex.

Chief Executive Lance McCarthy said he'll be remembered "for his commitment to patient care, his kindness and as a valued friend and colleague to many at the Princess Alexandra Hospital".

He was originally from New Zealand. His family said: "The sadness we feel is more than words can express."

 
Excess Deaths

Latest figures from the Office for National Statistics (ONS) for week 49 show the number of registered deaths in England and Wales was 15% above the 5-year average.

COVID-19 accounted for 23% of all deaths.

Commenting, Veena Raleigh, senior fellow at The King’s Fund said: "With over 71,000 excess deaths in England and Wales since the COVID-19 pandemic began, the death statistics for this year are truly sobering. If current trends continue, the total excess death toll for 2020 could exceed 80,000, very likely leading to a significant fall in life expectancy in 2020."

A separate ONS report looks at the higher death toll from COVID-19 for some ethnic minority communities.

It points to socio-economic factors, such as occupational exposure, overcrowded housing, and living in urban areas as being major contributors.

REACT Study Latest

Imperial's continuing REACT study latest preprint findings suggest coronavirus infections are not falling but are levelling off in England.

Swab tests from more than 160,000 people taken between 13 November to 3rd December show around 1 in 110 was infected, or 0.94% of the population.

Imperial's Professor Paul Elliott said: "During the first half of lockdown our study showed that infections were on a clear downward trajectory, but we’re now seeing a levelling off, driven by clusters of infections in certain regions and age groups. Behaviours and public health measures need to be guided by this fast-changing situation to prevent it from worsening, and everyone has a part to play in keeping this virus at bay, especially as we approach a relaxing of rules over Christmas."

Kids' Inequality

A generation of children and young people risk worsening health and shorter lives after the pandemic, according to a report called Build Back Fairer from UCL's Professor Sir Michael Marmot.

The report points out that England's COVID-19 excess death rate is higher than anywhere else in Europe, and lockdown measures have harmed children and young people’s well-being and long-term health.

Sir Michael said in a news release: "There is an urgent need to do things differently, to build a society that functions to meet the needs of its members; to build a well-being economy that puts achievement of health and well-being at the heart of government strategy, rather than narrow economic goals; to build a society that responds to the climate crisis at the same time as achieving greater health equity."

BMA board of science Chair Professor Dame Parveen Kumar said the country needs to move beyond the "damaging status-quo", and: "It is absolutely unacceptable that in a country of such means there is such a strong divide between the richest and poorest in society. This report should serve as an important call to action for the Government to invest in the health of this nation in the long term as, in these challenging uncertain times, closing the gap has never been more important."

Schools Row

London goes into Tier 3 from Wednesday, and Greenwich Council had pre-empted the move by telling parents it would be shifting to online learning to help stop transmission ahead of the Christmas break.

However, on Monday, England's Education Secretary threatened court action to keep schools open.

Council leader Danny Thorpe issued a statement on Tuesday: "I cannot agree that this is the correct choice for our schools. However, I also cannot justify the use of public funds to fight the decision in the courts. Consequently, I have no choice but to ask our schools to keep their doors open to all students rather than just continuing with online learning."

Oxford-Sputnik Combo Vaccine Trial

Trials are being planned for a combined approach to vaccination using Russia's Sputnik V product with the Oxford/AstraZeneca jab.

Vaccine task force Chair, Kate Bingham, already signalled trials next year using combinations of different kinds of vaccine for initial and booster jabs to maximise the immune response with a "mix-and-match" approach.

Meanwhile, the European Medicines Agency has booked an 'exceptional meeting' for 21 December ahead of possible approval of the Pfizer/BioNTech jab.

Telemedicine Getting Bad Press

An article in The British Journal of General Practice finds media coverage of GPs' shift to telemedicine is getting negative media coverage after initially positive comments.

Later coverage following a 'remote-by-default' policy in England is raising quality and safety questions, issues of digital inequalities, and missed diagnoses.

The authors conclude: "To restore public trust in general practice, public communication should emphasise the wide menu of consulting options now available to patients and measures being taken to assure safety and avoid inequity."

Xmas Hit?

The latest talented NHS singing group to release a Christmas song is the Midwifery Ambassadors choir.

'Caroll Of Hope' is a coronavirus-inspired take on 'Somewhere Over The Rainbow'.

The group is aiming to raise £500,000 to help fund a pregnancy and parenting app. That's £1 for every baby born under lockdown.

Adapted from Medscape UK.