full article by Alicia Clegg in the FT

At the start of the pandemic, trainee GP Kaveri Jalundhwala was working on a hospital placement. By the end of March, she had become infected with Covid-19, which then developed into long Covid and forced her to pause her training. With stories emerging of how healthcare workers in makeshift masks and gowns — and sometimes no protection at all — were paying for failures to provide adequate personal protective equipment (PPE) with their health, Jalundhwala looked for a way to support her colleagues.  She joined Doctors’ Association UK (DAUK), a grassroots lobbying group. And rather than “just get angry at home”, Jalundhwala got involved with their “Protect the frontline” campaign. Its aims include to inform the public about conditions in the fight against Covid and press the government to give healthcare workers appropriate PPE and support.

The DAUK grew from doctors joining together to support a junior paediatrician, Hadiza Bawa-Garba. In 2015, Bawa-Garba was convicted of manslaughter by gross negligence after the death of six-year-old patient and was then struck off by the General Medical Council. But many medical professionals did not see a doctor who had failed, rather an overstretched colleague who was put in an unsafe situation and scapegoated. “Any one of us could be Bawa-Garba,” says Jalundhwala. It often feels that doctors are “a faceless number on a rota where [our] individual voice does not matter to the people who make decisions,” she adds. Bawa-Garba has since returned to medical practice, while the DAUK developed its “Learn not blame” campaign to improve the culture of the NHS so it can learn from mistakes “in a constructive and fair manner”.

When the pandemic hit, DAUK started its “Protect the frontline” campaign. As part of this, it broke the story of NHS staff being warned not to discuss PPE problems on social media or speak to the press. It also created an app that enables doctors and GPs to report on PPE supplies. In April 2020, DAUK also led calls for an independent public inquiry into healthcare worker deaths and PPE supplies, with its petition gathering more than 100,000 signatures. When this received no formal response from government, DAUK started legal proceedings with the Good Law Project.

“When something needs doing, we do not sit on it,” says Pushpo Hossain, who joined DAUK to amplify the voice of doctors working in the UK who qualified abroad.

In May, when a DAUK member heard about a plan to upload all NHS patients’ medical records to a central database that could be shared with third parties, the organisation joined forces with Foxglove, a digital rights campaign group, to help force a delay. “In less than a week we had decided to take legal action [later paused],” says Rosie Shire, a GP who led DAUK’s response to the plans. The scheme has now been postponed to allow time for more consultation with no new date for implementation.

Read the full piece by following the above link

“The fact that politicians stood on the doorsteps of No 10 clapping while treating NHS staff with such contempt has angered even the most mild-mannered of my colleagues.
And it is this deep, impassible feeling of betrayal which has made people feel they have no option but to leave. A mass exodus from the NHS is no longer a case of if, it’s a case of when.
Staff morale will probably never recover fully. But there is a small window of opportunity now that, if lost, will never be regained. If we don’t start caring about our staff now, there will be no one left to care for our patients.”

– Dr Samantha Batt-Rawden, DAUK founder

Read the full article in The Guardian

The NHS has been urged to rethink safety for thousands of frontline staff after new research suggested that Covid patients’ coughing is putting them at far greater risk of catching the virus than previously thought.

The study found that coughing generated at least 10 times more infectious “aerosol” particles than speaking or breathing – which could explain why so many NHS staff have fallen ill during the pandemic.

The research has led to fresh demands that anyone caring for someone with Covid-19, or suspected Covid-19, should be provided with the most protective equipment – including FFP3 respirator masks – and that hospital ventilation should be improved.

Health workers are up to four times more likely to contract coronavirus than the general population, with infection rates among those on general hospital wards approximately double those of intensive care unit (ICU) staff – who do have access to the most protective PPE.

This access to higher-level PPE was based on the assumption thatICU wards are more dangerous because treatments such as continuous positive airway pressure (CPAP), used to support patients’ breathing, generated large amounts of aerosols – which linger in the air and can be breathed into the lungs.

Staff working in other hospital areas, GP surgeries and care homes are issued with looser-fitting surgical masks, which afford little protection against these tiny particles, but block larger virus-carrying droplets.

The new research, which has not yet been peer-reviewed, turns these assumptions on their head.

The research may also boost efforts to force a public inquiry into Covid-19 deaths among NHS staff and care workers. In December, Doctors’ Association UK (DAUK), which represents frontline medics, escalated its threat of judicial review against the government. “Inquiries must be initiated to investigate any factors that may have led to healthcare workers’ deaths,” a spokesperson said.

“We feel that there would be fewer infections among healthcare workers, and fewer deaths, if people had proper masks,” said Dr Katie Sanderson, a junior doctor and committee member of DAUK. “Acute medical wards and A&E, which is where most Covid patients are being cared for, have much lower standards of ventilation than intensive care units, and generally people are coughing all the time.

“This issue affects GPs as well, because most GP commissioners have refused to let GPs have access to proper masks.”

Read the article in full here: https://www.theguardian.com/world/2021/feb/03/covid-coughing-study-suggests-nhs-staff-at-far-greater-risk-than-thought

Matt Hancock has been criticised for a “disgustingly disrespectful” claim that there was never a national shortage of personal protective equipment during the pandemic.

Doctors and MPs condemned the UK health secretary as “deeply insulting” on Tuesday after he insisted that his team had delivered protective equipment for frontline NHS staff in the “teeth of a pandemic”.

Doctors groups said they had helped deliver 45,000 masks to hospitals that lacked adequate supply at the start of the crisis and that the families of healthcare workers who lost their lives to Covid had raised concerns about the protection they received.

Amid the first wave of coronavirus, NHS staff were photographed with poorly fitting PPE, with some having to make gowns themselves from bin bags.

Hancock said that while there were “individual challenges in access to PPE”, they “never had a national shortage, because of my team”.

He was addressing a high court ruling over failings in publishing details of coronavirus-related contracts. He told BBC Radio 4’s Today programme: “This has all been looked into in great detail. It’s only because of the transparency that I support that we can ask questions about these contracts.

“And what’s more, it’s easy to ask these questions, but what is hard is to deliver PPE in the teeth of a pandemic.”

Dolin Bhagawati, from the medical campaign group Doctors’ Association UK (DAUK), said Hancock’s comment that the NHS did not face a national shortage of PPE during the first wave of the pandemic “is disgustingly disrespectful to the memory of frontline colleagues who died from Covid-19 while raising concerns about inadequate PPE”.

He said frontline staff did not imagine having to provide their own makeshift protective equipment, “raising our concerns for weeks only for them to be ignored”.

DAUK delivered 45,000 masks to hospitals that lacked adequate supply. “We are not imagining mourning the colleagues that treated Covid-19 patients with inadequate PPE,” Bhagawati said.

He added: “This callous disregard for the experience of shell-shocked NHS staff in order to save political face is beneath contemptible.”

Read the full article here: https://www.theguardian.com/world/2021/feb/23/hancock-criticised-for-claim-there-was-no-national-covid-ppe-shortage

Pregnant women should be included in coronavirus vaccine trials, experts have urged, as those in priority groups wrestle with whether or not to have the jab.

Doctors are considering emerging evidence that pregnant women may face greater risks from Covid-19, although they are not at present a priority group.

Professor Lucy Chappell, spokeswoman for the Royal College of Obstetricians and Gynaecologists (RCOG), said that it was not asking for this status to change but that it would discuss any risk with the Joint Committee on Vaccination and Immunisation.

DAUK’s Dr Ellen Welch said:

This is a very personal decision, for me it was important to have the vaccine in pregnancy
In pregnancy there is very little safety data for any medications&for something this new,there is clearly no long term data.However there is no current evidence of harm. Whereas there is plenty of evidence of the harm covid can do in pregnancy
for me the risks of either ending up on icu while pregnant, or having long covid with 2 small children clearly outweighed the minimal risks of having a new vaccine.
Pregnant women safely have the flu vaccine every year

Find out more- watch the MacDonald Obstetric Medicine Webinar on the topic https://www.obstetricmedic.org.uk/moms-webinar-archive/
Read the RCOG leaflet https://www.rcog.org.uk/globalassets/documents/guidelines/2021-01-12-covid-19-vaccine-info-sheet.pdf

The full article can be accessed here: https://www.thetimes.co.uk/article/pregnant-women-should-be-included-in-covid-19-vaccine-trials-n23ndqjv6

Doctors have written to ministers expressing severe concerns about the coronavirus vaccine schedule, warning that patients are at risk if they do not receive a timely second dose.

In a letter sent to the health secretary, the minister in charge of vaccines and the head of the NHS, doctors criticised the lack of guidance around the decision to change the period between doses of the Pfizer-Biontech vaccine from three weeks to 12 weeks.

Heads of the Doctors’ Association UK (DAUK), which represents frontline medics, have demanded immediate explanations of what steps are being taken to keep track of patients who have had the first dose because of fears that the follow-up could be missed.

“We must be clear that it is completely unacceptable to ignore the need for a second vaccination,” they said. “All studies confirm the need for this to provide reliable and lasting immunity. It must be noted that there is currently no data around the reliability of the immune response if vaccines are interchanged.”

The letter was sent on Monday to Matt Hancock, Nadhim Zahawi, Sir Simon Stevens, Chris Whitty, the chief medical officer for England, and other figures responsible for the UK’s mass vaccination programme. DAUK has not yet received a reply.

“We understand the rationale for the delay in scheduling the Pfizer-Biontech second dosing from three to 12 weeks. The concerns arise from decisions being made without acknowledging the consequences of enacting them on the front line,” the doctors wrote.

“We are concerned that there are no clear plans to follow up and monitor the immunity of these patients, to ensure the 12-week booster will be adequate, given that this schedule goes against the advice of both the manufacturer and WHO.”

They called for a government guarantee that all patients will be given their second immunisations by 12 weeks “at the absolute latest” with the same brand of vaccine they initially received.

Both the Pfizer and Oxford vaccines require two jabs, which the manufacturers say should be had three or four weeks apart. Britain has increased the gap to up to 12 weeks to ensure that more vulnerable people get at least some protection over the winter, despite warnings from the companies that there is little data to justify the change.

Ministers followed guidance from the Joint Committee on Vaccination and Immunisation that the Pfizer vaccine is 89 per cent effective after one dose, from a study of people who received their second dose within three to four weeks. Analysis from Israel suggests that the effectiveness of a single dose may be as low as 33 per cent.

Doubt was cast on whether everyone would be given a second dose when Dominic Raab, the foreign secretary, refused this week to guarantee that all people who had received a first dose would get a second within 12 weeks. He instead said the government was “aiming for” everyone to get a second jab.

Read the full article here: https://www.thetimes.co.uk/article/delaying-second-covid-vaccine-dose-puts-patients-at-risk-insist-doctors-m53jjg7bx

The Doctors’ Association UK featured in BBC Panorama’s documentary “The Virus vs The Vaccine” last week. Our Vice-chair Dr Jenny Vaughan and committee member Dr Pushpo Babel Hossain spoke about conditions within the NHS during our third lockdown.

With the country locked down again in the battle against coronavirus, Panorama reporter Clive Myrie asks what it will take to get through this latest, deadly stage of the pandemic. Hospitals are under pressure, with many said to be at breaking point. Once again, we’re being told to ‘stay at home, protect the NHS and save lives’. With schools shut and most exams cancelled, Panorama assesses the impact on young people’s mental health. The arrival of a vaccine offers hope, but its rollout is now in a race with a new, highly contagious strain of the virus

The full programme is available to watch on BBC iplayer for 11 months: https://www.bbc.co.uk/iplayer/episode/m000rggf/panorama-the-virus-vs-the-vaccine

Dr Samantha Batt-Rawden, an intensive care registrar, says NHS staff are facing “devastating” abuse online and at protests.

She thinks it’s driven by coronavirus sceptics and anti-lockdown activists.

In response Dr Batt-Rawden, who is president of the Doctors’ Association UK, started her own campaign for people to post blue hearts on social media to show their support for health workers.

Watch the video on the BBC News site: https://www.bbc.co.uk/news/av/uk-england-london-55616041

London‘s NHS Nightingale hospital will have just 300 beds for treating patients, a fraction of the 4,000 available in March, when it re-opens next week, MailOnline can reveal. 

The flagship hospital at the ExCeL centre will start admitting recovering emergency care patients who have tested negative for coronavirus in the coming days, but it will not have all its beds available for patients until next month. 

A spokesman for NHS England did not deny they had significantly cut the number of beds, and said the number would be determined ‘by the demand and availability of staff’.

The seven Nightingales were left largely unused during the first wave despite £220million of taxpayers’ money being pumped into them, as hospitals struggled to spare the needed doctors and nurses to man their wards. Just 57 Covid-19 patients were admitted to London’s Nightingale, Department of Health figures show.

The NHS also admitted the emergency facility would be used for non-Covid patients, despite millions being poured into equipping it with ventilators during the first wave for those suffering the worst effects of the virus. 

‘It will provide rehabilitation for people who are recovering after an emergency hospital stay and who are not Covid positive, freeing up other beds in hospital for Covid-19 patients,’ they said.

The Nightingale in the capital’s ExCeL Centre is currently ‘on standby’. 

The hospital was built to much fan-fare during the first wave of the pandemic, with Health Secretary Matt Hancock heralding it a ‘remarkable feat in these challenging times’.

But it was left idling for months after barely a month in use, before the order to start stripping the hospital was given – as clearly shown by shocking photos from inside it last month revealing empty wards.

Frantic efforts were then launched to re-construct a ‘scaled-down’ version of the mothballed hospital, sources said, at further expense to the public purse. 

It comes as London’s hospitals are treating more Covid-19 patients than they did during the first wave of the crisis, official figures reveal.

There was an average of 5,061 patients suffering from the disease in hospital beds on April 8, but this was exceeded on December 29, when as many as 5,130 were in the capital’s beds.

Britain has recorded more than 50,000 Covid-19 infections for the sixth day in a row, in an alarming sign the second wave of the pandemic is gathering speed. As many as 54,990 cases and 454 deaths from the virus have been recorded in the last 24 hours.

Boris Johnson warned this morning tougher restrictions were on the horizon for England after plunging four-fifths of the country into Tier 4 – forcing the closure of non-essential shops and gyms.

NHS London Nightingale was hurriedly put up in less than two weeks in March, amid fears the capital’s hospitals could be overwhelmed by spiralling Covid-19 admissions.

It was opened to patients on April 3 by Prince Charles, and welcomed its first patient four days later.

Professor Richard Schilling, a consultant cardiologist, tweeted a photo to mark the event as the first team came on duty.

But within six weeks the hospital had been moved to ‘standby’ and ordered to close its doors.

Department of Health figures reveal only 57 patients were admitted to the emergency hospital, with the final patients being received on April 27.

By May 6, shortly before it was due to close, the Government dashboard shows only five patients remained at the facility.

The emergency facility has been left dormant for months, before hospital chiefs decided the extra capacity would again be needed in the new year.

Shocking photos reveal that in this time the Nightingale – put up at huge expense to taxpayers – had been stripped of its beds and wards while it was officially mothballed.

They revealed it was virtually deserted, with empty conference rooms stripped of vital beds and ventilators, while the corridors lay eerily silent. Outside, signs directing ambulances to wards had also been removed.

Doctors had warned when they were first constructed there were not enough medics available to staff the London Nightingale, or others in the country.

Dr Samantha Batt-Rawden, an intensive care medic and president of Doctors’ Association UK, held ministers feet to the fire last week when she said they had failed to listen to warnings there were too few medics to keep the facilities open.

‘As a doctor who volunteered for the Nightingale I can’t tell you how much effort went into it,’ she said, ‘but (intensive care) staff are wafer thin on the ground’.

‘We had warned of a staffing crisis in (intensive care) before the pandemic. The Government didn’t listen.’

Read the full article here: https://www.dailymail.co.uk/news/article-9108133/Londons-Nightingale-hospital-just-300-4-000-beds-use-reopens-week.html

Available here: https://www.telegraph.co.uk/global-health/science-and-disease/coronavirus-news-covid-vaccine-oxford-lockdown-tiers-deaths/