The Covid-19 Airborne Transmission Alliance (CATA), of which DAUK is a member, is set to give testimony of how UK healthcare officials have systematically denied overwhelming scientific evidence that COVID-19 is airborne.

CATA, which is a core participant in the inquiry, includes professional associations representing 65,000 healthcare workers as well as individual experts.

It’s chair, Dr Barry Jones, is due to take the stand on Thursday 12 September.

Since 2020, CATA’s membership has been seeking to persuade UK Health Officials to align national guidance to the scientific facts about how the disease is transmitted and how healthcare workers need to be protected from infection.

Kamini Gadhok, former CEO of the Royal College of Speech and Language Therapists and Vice Chair of CATA, said: “The way in which healthcare workers were abandoned to their fates and their professional knowledge was disregarded has left a scar on the UK’s healthcare system.

“The mental health crisis in the NHS and staff shortages all have their roots in the disregard for life and expertise that professionals experienced through the pandemic.”

Click here for more information on the hearing.

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The money lost to profiteering from the pandemic should be recovered for the NHS, the Doctors’ Association UK (DAUK) told national radio listeners.

Dr Steve Taylor, DAUK spokesperson, said doctors were angry that people made excessive profit at a time of national emergency through the sale of PPE at inflated prices and that did not meet medical requirements.

Dr Taylor, a GP based in Manchester, was speaking to LBC News over the developing PPE scandal.

He said: “I can’t believe the mess we’re in. We’ve lost so much money as a result of all of this.

“I think back to 2020, when I was busy trying to rescue patients from Covid with very limited PPE at the time, the thought that anyone would actually make a profit out of it – it was a national emergency.”

He added: “Companies went out of the way to provide PPE and actually that PPE was inadequate, and that’s a big issue.

“As doctors, we’re all a bit angry.

“We’re angry at the amount of money that’s currently needed in the NHS and has been lost. This was the NHS budget fundamentally.”

Dr Taylor told LBC News listeners that following the ongoing Covid Inquiry changes should be made that prevent profiteering from national emergencies.

And he said that the money “lost” to profiteering should be recovered for the NHS.

“Fundamentally we haven’t got enough money to run the NHS at the moment and that money is in the hands of some very wealthy people,” he said.

“They made a profit at a time of emergency when we were all fighting for the health of the nation.

“It hasn’t disappeared. Most of the money that very wealthy people have isn’t suddenly spent – most of them struggle to spend it because they’ve got too much.”

Listen again to Dr Taylor talking to LBC News. The interview starts at around two hours and 32 minutes.

DAUK’s Dr Katie Sanderson spoke to BBC Radio 4 about her concerns as a frontline hospital doctor for the weeks ahead:

“I found it much scarier this time because we’re very well set up. We are much better at looking after these patients. I think we know how to treat them much better. But the volume of people turning up who are really unwell is just unremitting, and I think that’s already the case now. And the concern is how are we going to manage over the next few weeks. Looking after people well takes time, and there’s a finite number of staff available. And so I suppose every new admission just means less time for everybody else.”

Dr Katie Sanderson, DAUK

Listen in below to Dr Sanderson,

“We asked for an inquiry back in April and May so that we could learn the lessons of the first wave, unfortunately, that has not happened. And I’m sorry to say that some of those same mistakes are being made again. We have paid doctors and nurses on the front line who are concerned about PPE guidance, who are not being listened to.”

“If it is a choice between the virus and food, that is a very difficult choice to make. And so there needs to be an increase in the support for lockdown in terms of financial and social support that will improve the engagement with it.”

“We’re losing over a large hospital worth of people per day. If these were terrorist attacks, there would be outrage. These are individual tragedies.”

“The point at this point is that every single person can help in fighting this. And that involves as much as possible engaging in the lockdown measures, keeping or distance, washing your hands, wearing a face mask. And we have to adapt or there is more tragedy to come.”

The link is available here

Thursday’s relaunched “Clap for Heroes” faced a damp reception this week, as frontline workers took to Twitter to request more practical action instead of ritualistic applause. 

On my street, 8pm passed without a single pot, pan or firework disturbing the silence (in Spring, my street was particularly animated during the “Clap for Carers”), as demoralised NHS staff asked for basic provisions such as fairer pay and free parking.

“The clap” played a central role during the first lockdown, continuing for 10 weeks, as millions took to their doorsteps to show their appreciation for NHS staff and keyworkers. Enthusiasm for this gesture has now well and truly waned after a year of hardship, and sadly, there are many reports of NHS staff facing abuse and contempt, rather than appreciation.

The Twitter storm that replaced Thursday’s clap provided some much-needed encouragement that NHS staff are still very much supported by thousands. Campaigner and chef Jack Monroe led the way with the hashtag “thunderclapforcarers”, inviting followers to write to MPs en masse every Thursday to ensure essential workers are paid a liveable wage. 

Intensive care registrar and president of the Doctors’ Association UK, Dr Samantha Batt-Rawden, appealed for Twitter users to follow the hashtag “NHSblueheart” instead of clapping, in an effort to amplify the voices on the frontline, requesting that people press for concrete alternatives that will make a real-life difference to NHS Staff.

Britain’s official death toll from coronavirus hit nearly 80,000 on Friday and 1,325 daily deaths were recorded – the highest number since the pandemic began. London mayor Sadiq Khan declared a major incident across the capital, announcing: “One in 30 Londoners now has Covid. If we do not take immediate action now, our NHS could be overwhelmed and more people will die.”

So instead of clapping – these are the actions that will make a difference. Respect the lockdown and stay at home. Covid-19 thrives on human contact and the more complacent we become, the more the virus will spread to our loved ones. If you are young and fit and feel unconcerned, consider this – as hospital beds fill up with coronavirus patients, where will you be treated if you find yourself in a road traffic accident, or if your appendix bursts?

Be mindful of the main symptoms of the disease – cough, fever and loss of taste and smell – and isolate yourself and your household if you have any of these. Please don’t argue that your cough is not continuous enough to be coronavirus. If it is a new cough then you need a test. In reality, any “cold-like” symptoms could be Covid-19. 

Countries like Australia have tested and isolated patients since March with sore throats and runny noses and have fared considerably better than we have in the UK. Speak out against the coronavirus deniers and those who would spit in the face of key workers striving to get the country through such a dark time – show them the voices from the frontline who are living through this inferno.

The Doctors’ Association UK advocates for a better NHS for everyone, instead of clapping it calls for adequate protection of the frontline. We urge supporters to ask MPs for an urgent review of the PPE provided, alongside a centralised plan to prioritise vaccination of NHS staff.

The UK has recorded some of the highest numbers of Covid-related healthcare worker deaths in the world, with higher rates among black, Asian and minority ethnic staff. Despite this, our PPE remains inadequate compared to our overseas colleagues. Provision of FFP3 masks to all healthcare workers in patient-facing roles is both achievable and lifesaving. 

Finally, we call for indefinite leave to remain for NHS workers and their families. Around 170,000 healthcare staff working in England are migrants, who have risked their lives for this country during this pandemic – caring for patients irrespective of the colour of their passport. These workers have shown their commitment to the country and it is time the government recognises their contribution and allows them to call the UK home.

Ellen Welch is a GP adviser for DAUK.

The article can be found here

Morale among ICU staff is tumbling and concerns have been expressed about a “mass exodus” as the second wave of Covid infections escalates rapidly in London and elsewhere in England.

Some doctors and nurses have already quit.

DAUK’s Rebecca Lewis reported that the government had done little to look after doctors and nurses, and that many had in effect been forced to work for 10 months without a break as a result of cancelled leave and staff shortages.

“NHS staff repeatedly warned the government against relaxing guidelines over Christmas but unfortunately these warnings were not heeded, and we are now seeing the grave consequences,”

“We are now seeing the grave consequences’ of the government relaxing restrictions”

“It is becoming more and more difficult to see how we will avoid a mass exodus of doctors and nurses after all this is over, due to the impossible mental strain working through this pandemic has put them under. Little has been done to look after and protect those who are tasked with looking after us, and we will continue to see the consequences of this even beyond the pandemic.”

The full article can be found here

What is the ChAdOx1 nCoV-19 vaccine?

Developed by Oxford University in partnership with AstraZeneca, the ChAdOx1 nCoV-19 vaccine is a replication-deficient chimpanzee adenovirus that has been engineered to express the coronavirus spike glycoprotein gene. This method of vaccine delivery makes use of our lack of pre-existing immunity to chimpanzee adenoviruses, conferring immunogenic properties that stimulate the immune system to mount a response against both the adenovirus and the coronavirus spike protein it carries.

Efficacy of ChAdOx1 nCOV-19

Phase 2 trials, the results of which were published in November, demonstrated the ability of ChAdOx1 nCoV-19 to stimulate spike-specific humoral and cellular immune responses in trial participants. In comparison, this latest paper published in the Lancet describes the interim results of phase 3 trials for the vaccine, representing the first peer-reviewed publication of SARS-Cov-2 vaccine efficacy to date. The purpose of these phase 3 trials is to assess the safety of the vaccine, and to determine whether the ChAdOx1 nCOV-19 vaccine protects against symptomatic, virologically confirmed COVID-19.

11,636 people in total participated in the phase 3 trials in Brazil and the UK; participants in each trial were randomly allocated to receive either a prime-boost regimen of the ChAdOx1 nCOV-19 vaccine, or a control product (two doses of the meningitis MenACWY vaccine, or MenACWY followed by saline). Across both studies, 5807 people received the vaccine, of which 0.5% went on to develop symptomatic COVID-19 at least 14 days after receiving the second dose of vaccine. In comparison, 5829 people were allocated to the control group, of which 1.7% developed symptomatic COVID-19. Vaccine efficacy was calculated to be 70.4% from these results.

Though all participants in the vaccine arm of the trials received an initial dose followed by a booster dose, this initial dose varied between cohorts. In the Brazil trial, all subjects in the vaccine arm received two standard doses, whilst in the UK trial, the vaccine arm comprised two cohorts with different dosage regimens: low-dose followed by standard dose (LD/SD), and standard dose followed by standard dose (SD/SD). Though it was originally planned that all subjects in the vaccine group would receive two standard doses, the batch of vaccines administered to the initial cohort was retrospectively found to contain a lower dose of ChAdOx1 nCOV-19 viral particles than intended. The reason for this was unexpected interference between a non-active ingredient of the vaccine and the spectrophotometry assay used to measure the viral dose being used. This was amended for subsequent cohorts, who received the standard dose for both initial and booster doses.

When participants in the vaccine arm are split into subgroups according to dose regimen, the analysis shows a significant increase in vaccine efficacy in the LD/SD group within the UK trial (reported as 90.0%), compared to the SD/SD group taken as a whole across both trials (62.1%). Age was considered as a possible confounding factor in these results, given that LD/SD participants were all 18-55 years, in comparison to the SD/SD group which included participants in the 18-55, 56-69, and ≥70 age groups. The interval between doses also varied between the LD/SD and SD/SD groups: in the LD/SD group, only 0.8% had a second dose within 8 weeks of the first dose – this was because the LD/SD group had already received the priming dose when, on the basis of antibody response findings in the UK phase 1/2 trial, the phase 3 trial protocol was modified to a two-dose regimen. Subgroup analysis restricting the UK SD/SD group to participants aged 18-55 with less than 8 weeks’ interval between vaccine doses did not substantially alter the finding: vaccine efficacy in the restricted UK SD/SD group did increase slightly (from 60.3% to 65.6%), but with a higher p-value and wider confidence intervals implying more uncertainty about the result. In the discussion section of the paper, the study authors suggest several possible mechanisms that could explain this unexpected finding.

In addition to symptomatic COVID-19 infection, the study looked at whether there was a difference in the number of COVID-19 cases occurring more than 21 days after the first dose of vaccine, compared to controls. This analysis was restricted to participants that received two standard doses of the vaccine. Overall, ten cases requiring hospitalisation occurred >21 days after the first dose, notably all of which were in the control group. Of these participants, two had severe COVID-19 (WHO score ≥6), and one case was fatal.

Preliminary results as to whether the vaccine reduces incidence of asymptomatic infection, which was detected in the UK trial through weekly NAAT testing of participants, are also published in this paper. In the UK trial, the incidence rate of asymptomatic infection was slightly reduced in the vaccine group compared to the control group, with vaccine efficacy calculated as 27.3%. As the study authors note however, the wide confidence interval for this result suggests a need for a greater sample size in order to draw reliable conclusions.

One limitation of this study is the lack of efficacy data for older adults, with only 8.3% of participants aged 56-69 years, and 3.8% of participants aged ≥70 years. The study did not perform subgroup analysis for vaccine efficacy stratified by age group due to the limited data, however this has been identified as a priority once further data becomes available.

Safety profile of ChAdOx1 nCOV-19

Safety analysis for the vaccine included data from 23,848 participants enrolled in four trials. This included participants from the earlier phase 1/2 studies (which evaluated safety and immunogenicity of the vaccine) in the UK and South Africa, in addition to participants in the vaccine arm of phase 3 trials. A similar number of adverse events were recorded in trial participants that received the vaccine and those who did not: 84 adverse events classified as either serious or of special interest occurred in vaccine recipients, versus 91 adverse events in participants who received MenACWY or saline. Of the adverse events in the vaccinated participants, only two were considered to be possibly related to the vaccine, including one case of transverse myelitis, and one case of fever >40°C.

Conclusions:

Overall, these interim results suggest that the Oxford-AstraZeneca vaccine has an acceptable safety profile and is effective at reducing symptomatic COVID-19 infection. The authors also identify several unanswered questions that additional data and subgroup analysis will help to resolve as the study continues, including the duration of protection offered by the vaccine, whether vaccine efficacy is affected by age, ethnicity, and dose regimen, and the ability of the vaccine to prevent asymptomatic spread of the virus.

DAUK’s Samantha Batt-Rawden, who works as a NHS critical care doctor, is quoted ‘hitting back’ at anyone suggesting health-care workers were exaggerating:

“We are incredibly thin on the ground. NHS staff have not been prioritised for the vaccine and are going off sick in droves with the new strain. Trusts are so desperate they are tweeting out for medical students to help in ICU. This was confirmed by a consultant on the ground.”

“When staff have spoken up on Twitter they have been told this is all a hoax. It’s not. Try holding an iPad for a patient to say goodbye to their family. Or having to a ventilate a colleague. This is real & happening right now. Staff are broken and need support now more than ever.”

It highlighted that health-care workers are not being prioritized for vaccines, which are largely going to the elderly and those with underlying health problems at this stage of the British government’s rollout.

Samantha wrote that many medical workers are getting sick from the new variant and that some hospitals are tweeting out messages asking for medical students to work in intensive care units.

“This is not a drill. Please believe us,”

You can read the full article here.

The article reports that member polling by Doctors’ Association UK (DAUK) found 70% of more than 1000 frontline staff did not know when they’d receive the jab.

DAUK has also written to England’s Health Secretary Matt Hancock over concerns that PPE guidance has not been updated to match the increased transmissibility of the new virus variant.

DAUK’s Dr Zainab Najim:

“Without a universal policy to vaccinate frontline patient-facing staff as a priority, and no review of current PPE guidance, we could be facing avoidable staff sickness and absence over the already difficult winter months. We are also concerned that, without escalating the current PPE guidelines, staff themselves will be at risk of not only contracting the virus but passing it onto the vulnerable patient population.”

The article can be found here (registration required).