The NHS could be forced to waste coronavirus vaccines if it does not offer leeway for medics to vaccinate beyond the designated at-risk groups.

The current cohort is group seven of the Joint Committee on Vaccination and Immunisation’s priority list, which takes in 60- to 64-year-olds. Over-65s, health workers, the clinically vulnerable, and care home residents should already have been offered the jab.

But the success and speed of the vaccination programme has seen some of those delivering it left with empty clinics and spare doses after reaching the end of the list for their eligible cohorts, and now medics are asking for permission to continue vaccinating into the next group should that occur.

Dr Rosie Shire, who works as a GP in Cheshire, has also been running a pop-up vaccination clinic. The uptake has been so successful that a few weeks ago, she finished vaccinating cohort 4 and asked if she could progress to cohort 5.

Dr Shire says this was refused and her clinic was informed it must help other local practices by diverting any leftover vaccines.

Diverting supplies to places in need, as the guidance states, sounds sensible but in practice it can be difficult to arrange at short notice given the vaccine’s short shelf life and the sub-zero temperatures that the Pfizer vials must be kept at.

Dr Shire, who has transported the Oxford/Astra Zeneca vaccine for home visits, said: “I believe there has been a list of limitations on moving it between vaccine sites.”

Dr Shire has been careful not to risk any wastage, but says she has heard rumours of places that have had to throw away doses because of these rules.

Dr Shire says there were also unconfirmed rumours earlier in the programme that anyone who reached the end of their cohort would not be paid for delivering second vaccinations ahead of the official go-ahead, and even risked losing their licences.

She said: “If you could say: ‘Well, you know what, let’s use some second vaccines in this case because there’s three people in the clinic next door who can just have it,’ then it would be done.”

She says the issue is creating bottlenecks each time a new cohort is sanctioned, before once again trickling to a halt while the rest of the country catches up.

Speaking on behalf of the Doctors’ Association, she told HuffPost UK: “We had a backup plan, we had it from early on. When you are actually holding a vial, it feels like gold. You’re so scared of dropping it because you know they are so precious. We just do not want them to go to waste – they definitely need to be used.”

Dr Shire’s clinic recently reached the end of its quota for the day and found itself in possession of a spare dose.  

She said: “The vaccine clinic I’ve worked in is in a big community building which has a library and leisure services. I had one dose left and I knew it needed to be used. I rushed around and found the manager of that building and we gave it to him. We reasoned he is going to be public-facing and he’s in a community role. I was trying to think creatively.

“It’s going to be hard for someone who finds themselves with three doses left at the end of the day. I was determined not to waste it but that was my choice. Someone else might have to go straight home at the end of the day, so what do you do?”

Read the article in full here

“Less than an hour before it emerged that some students would be able to resit their SJT, the Doctor’s Association UK (DAUK) released an open letter urging the UKFPO to urgently address how grades would be allocated for students who had been interrupted and to arrange resits where necessary.

Anna Sigston, who sits on the DAUK medical student committee told HuffPost UK: “We have received concerns from a number of students whose SJT exam’s were cut short due to technical difficulties and unclear guidance. Ultimately the communication from the UKFPO to these students was poor at best.

“Graduating medical school is a stressful time, especially during a global pandemic, let alone when a major exam was cut short due to errors with the system. The delayed and dismissive communication from the UKFPO has only made this experience more taxing, negatively impacting many student’s mental health.

“Not only this, but we believe it will negatively impact students applications for an error that was not their fault. Pearson VUE and the UKFPO should take responsibility for their technical faults and unclear guidance, rather than punishing students for their failures.”

Read the full article here: https://www.huffingtonpost.co.uk/entry/nhs-u-turn-final-year-exam-students-inhumane_uk_600ac50cc5b6d64153ab15ca?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cubGlua2VkaW4uY29tL2NvbXBhbnkvdGhlZG9jdG9yc2Fzc29jaWF0aW9udWsvcG9zdHMvP2ZlZWRWaWV3PWFsbA&guce_referrer_sig=AQAAABltF_lIcEmfG0w2GXjRzpbscRnUHP_Z6_MFyn9GiE-BCJpwRl_jE0vZgUY2c92wIGdVziqoF9niDApaeeeOTpAvPRH5EWfkMXVoipSlN_ZD6uROLY9ShiVnV4dQj68N_X_Gwaod0qfkr5ykIpb34aLxaKO7B9pAXcKZKBb7kSFM

The article points out that this delay in vaccinating frontline staff echoes the “shambles” of PPE provision during the first wave, which proved devastating to staff safety.

“My personal experience would be that a nearby trust have patchily offered vaccines out to hospital staff. GP staff haven’t been told at all what’s going on. We may or may not be being sent slots in the new year.”

Dr Zainab Najim, DAUK

“At present there is no central government guidance on this issue and the vaccination of staff has been carried out sporadically, often on an ad hoc basis, without appropriate prioritisation.”

“Frontline staff are the greatest asset the NHS has and we should ensure we are protecting them. The impact of staff sickness is already taking its toll across the country. We can prevent further staff shortages by vaccinating our front line.”

Dr Ellen Welch, DAUK

Read the full article here.

Going into work last Monday, we were greeted by the ward clerk waiting with a pile of death certificates from the weekend. A pile. 

For our local population, the level of harm done by this virus has been immeasurable. It has not been uncommon to be treating numerous members of the same family, coming in one after another or sometimes as a unit.

One elderly couple shared a hospital room in their last days of life, holding hands between the bed rails before one and then the other died. Spread of Covid-19 among family members is common, and deadly. 

Relaxing measures appears foolhardy and risks an explosion of cases when we are on the cusp of a mass vaccine roll-out.

After seeing such tragedy, the suggestion of relaxing Covid rules for Christmas is a difficult pill to swallow.

Typically, winter is the most brutal time of year for the NHS. Social care can be patchy or non-existent, families who provide care are often away and the cold weather exacerbates the medical condition of our patients with lung and heart disease.

One of our local hospitals recorded their busiest ever day on January 2 – eight days after Christmas. Obviously, any relaxation of the rules that might allow infection rates to bloom over Christmas would spell disaster.  

Christmas is typically a difficult time for many staff members who are missing time with their loved ones. What gets us through is usually the boost in spirits from being together and knowing we are all doing our best under the circumstances.

With low morale, high staff sickness rates and many clinicians facing burnout, this year feels like it will be difficult one. The NHS relies on the goodwill of staff.

In a system with an exhausted workforce, having to cope with a spike in Covid-19 infections, that goodwill will vanish and the patients who need us at this time will suffer.

In times of adversity, necessity dictates the need for rationality over sentiment. NHS staff are in desperate need of a scientific approach to the management of this pandemic. Announcing Christmas-specific measures, although understandably well meaning, can only be detrimental for the health service.

Many of those staff members who will be dealing with the consequences of a relaxation would have been working over the Christmas period and unable to see their loved ones anyway.

Other festival celebrations have been curtailed in the name of Covid protection – very notably the restriction on gatherings that was communicated three hours before Eid earlier in the year. In light of Public Health England reporting that racism may have exacerbated disproportionate BAME deaths, it feels culturally insensitive that special rules for Christmas are made when this consideration was not forthcoming for the festivities of other faiths.

Relaxing measures appears foolhardy and risks an explosion of cases when we are on the cusp of a mass vaccine roll-out.

With a large and loud family, loving in-laws, and friends across the country, I feel the pain at not being able to catch up and be together over Christmas, but it feels like we have come so far and suffered so much to cause unnecessary harm in the name of seeing loved ones on this special day.

So I have a suggestion – why not postpone Christmas this year? Arrange a day once we have a working vaccine and infection rates are under control to ensure that there are fewer empty chairs at Christmas dinner in 2021.

Dr Richard Gilpin is a junior doctor who specialises in the care of older people. He is on the editorial team for Doctors’ Association UK, a professional organisation for UK doctors.

Full article from the Huffington Post as seen here: https://www.huffingtonpost.co.uk/entry/boris-johnson-christmas_uk_5fbe748bc5b68ca87f809bfc

“Trust and honest planned communication is vital for a successful vaccine rollout. Without it, any vaccine programme will fail. We are therefore imploring the government to listen to primary care staff. We can tell you the potential pitfalls and their solutions, we can provide the resources needed to do this locally and, for goodness sake, vaccinate the vaccinators first.”

Read the rest of the article here.

Earlier this year, pregnant nurse Mary Agyeiwaa Agyapong died of Covid-19 soon after giving birth, after reporting similar fears. 

Her husband, Ernest Boateng is campaigning for all pregnant women who are more than 20 weeks gestation to be legally entitled to work from home, or suspended on full pay. 

Pregnant women remain in the clinically vulnerable category, which according to the most up to date government guidance, means they should strictly social distance. 

During the summer, when the shielding restrictions were lifted, the Royal College of Obstetricians and Gynaecologists (RCOG) archived its Covid-19 occupational health guidance for pregnant women, leading to many NHS trusts relaxing their approach towards expecting healthcare workers – despite the risks being unchanged.

The Doctors’ Association UK has heard from a number of worried pregnant NHS workers who have been on the frontline. 

“I don’t feel safe,” one surgical junior doctor from the South-East told us, speaking of her discomfort at being asked to continue working night shifts during her second trimester. 

“I have been told that I should continue to work beyond 28 weeks in “green” areas (ie free of coronavirus), as there is no evidence of increased risk to pregnant women. However, we have had multiple patients admitted to our supposed “green” ward who have turned out to test positive for coronavirus.” 

Another trainee from London was also desperately worried. She was informed that all pregnant staff should continue to work on site, including on-calls, with the advice to call in the consultant if a high-risk patient presented. 

“It is quite unnerving to hear so many doctors sent home from 28 weeks, when you have been told to continue as normal,” she said. “The differing advice being given across the country is a worry. I generally toe-the-line and feel very uncomfortable challenging managers. I assume that I will catch covid at some point and I just have to hope that it is not severe.” 

The pandemic has made us refocus on what is important and shown that it is possible to adapt our working practices to ensure staff can still be productive yet safe.

A medic based in Scotland told us of similar fears following outbreaks of coronavirus amongst her colleagues, who were sharing small office spaces and unable to adequately social distance. 

“I became so anxious at work, that I eventually approached my supervisors to request I was no longer patient facing. Fortunately, they were sympathetic and arranged for me to do telephone clinics and admin, but I really don’t think I would have been able to avoid catching the virus without doing this.”

Recent studies by the Centers for Disease Control and Prevention in the States have provided further evidence that pregnant women may be at more risk of severe disease if they contract coronavirus, including an increased risk of preterm labour and stillbirth. Among the 703 cases described in the two reports, three of the women died, and between 16-30% required support on intensive care. 

As a pregnant doctor myself, I chose to avoid a return to face-to-face work when I found out I was pregnant earlier this year, and feel my family is safer for me doing so. 

I am in the incredibly fortunate position of being able to work entirely from home, as the service I work for was set up for remote working even before the virus hit. I wrestle with feelings of guilt for not being “on the frontlines” alongside my colleagues, but have come to realise I am still doing my job and helping people every day. 

The Doctors’ Association UK advocate for medical professionals and are concerned that many pregnant healthcare workers are being exposed to covid-19 through their frontline work. We have a duty to protect these women and their unborn children and there is an urgent need for clear occupational health guidance from the government.

The pandemic has made us refocus on what is important and shown that it is possible to adapt our working practices to ensure staff can still be productive yet safe. 

I feel strongly that my colleagues should be extended the same protection as myself.

“Going into work last Monday, we were greeted by the ward clerk waiting with a pile of death certificates from the weekend. A pile.“

When the government announced a relaxation in the restrictions for Christmas, DAUK’s Richard Gilpin shared his views about the announcement. He was concerned having seen so much tansmission of the virus between family members.

“For our local population, the level of harm done by this virus has been immeasurable. It has not been uncommon to be treating numerous members of the same family, coming in one after another or sometimes as a unit.

One elderly couple shared a hospital room in their last days of life, holding hands between the bed rails before one and then the other died. Spread of Covid-19 among family members is common, and deadly.”

You can read the complete article here:

Dr Lizzie Toberty is a GP in Sunderland and a member of the Doctors’ Association UK, a doctor-led grassroots lobbying and campaigning group advocating for the medical profession and the wider NHS.

She said:

“We can do it, I believe that we can, but we need to be given the right support, we need to be given the right information and we need to be given the right resources and right now we’re lacking on all three.

“The way it’s been negotiated with NHS England and between the GP committee (GPC) at the British Medical Association (BMA) has been rushed.”

Read the full article here: