ABSTRACT
Loss of income and education, unemployment, uncertainty, social isolation, and domestic violence are just some of the emerging negative outcomes of the mass closure of businesses and schools, with disproportionate effect on people with fewer resources and poorer health, they say. John Appleby says the data are incomplete, too uncertain, and too fast moving to support reliable conclusions (doi:10.1136/bmj.m1607), a concern echoed by Sheila Bird, who says the UK's reporting of swab tests is "a travesty of science” (doi:10.1136/bmj.m1664). Sufficient capacity for this crucial element of communicable disease control is one of the three criteria set out in the joint European road map towards lifting restrictions (doi:10.1136/bmj.m1549), yet it doesn't feature among the UK government's five tests.
ABSTRACT
Billed as a review into ethnic disparities and covid-19, it devotes only a small proportion of its pages to ethnicity, and, while confirming what we knew—that people from ethnic minority groups are more likely to become infected and to die from covid-19—it makes no attempt to explain the disparities or make recommendations for action. Covid-19 has produced a "stress test” for structural racism in healthcare and public health, say Christine Douglass and colleagues (https://blogs.bmj.com/bmj/2020/06/08/structural-racism-in-society-and-the-covid-19-stress-test). The NHS's response in setting up a Race and Health Observatory is another (doi:10.1136/bmj.m2191).
ABSTRACT
[...]there is real and justified fear about personal safety, fuelled by a scandalous and widespread lack of personal protective equipment (PPE). Anna Sayburn's summary of PPE guidance from the World Health Organization, Public Health England, and specialist societies highlights the confusing variation (doi:10.1136/bmj.m1297), which in some cases is leading to inappropriate overuse and wastage. Lack of testing and PPE are redolent of the Ebola outbreak, say Megan Diamond and Liana Woskie on BMJ Opinion (https://bit.ly/2UOMSQS), showing that vital lessons have not been learnt.
ABSTRACT
[...]it is clear how much transmission is due to aerosol as well as droplet infection, surgical masks should not be considered effective protection, they say. [...]we must shield staff who are most at risk through age, sex, ethnic origin, and comorbidities. [...]that we can learn for the future, honour the sacrifice, and seek compensation for families, all deaths of health and social care workers should be referred to the coroner for independent review.
ABSTRACT
On its own it can't eliminate covid-19, but it buys a country time to prepare its health systems and to mount a public health response. The resulting loss to health and life will become clear, as will the impact on staff who have shouldered the covid burden. Failure to test patients transferred into the community fuelled the devastating outbreaks in care homes, and inability to test patients being admitted to hospital now makes it almost impossible to prevent hospital infection.
ABSTRACT
While we count the terrible toll of covid-19 (doi:10.1136/bmj.m1835) and continue asking hard questions of our governments (doi:10.1136/bmj.m2052), clinicians and patients are embracing new ways of doing things: virtual wards are helping to keep covid patients out of hospital (doi:10.1136/bmj.m2119), mental health services are experimenting with phone triage and virtual appointments (doi:10.1136/bmj.m2106), and doctors are supporting each other through their uniquely shared covid experience (doi:10.1136/bmj.m1499). [...]in other news the NHS has launched a race and health observatory, after The BMJ's call for action to end racial inequalities (doi:10.1136/bmj.m2191). The world is facing a scale of challenge not seen since the second world war. [...]rather than identify and empower local leadership (https://blogs.bmj.com/bmj/2020/05/27/chris-ham-test-and-trace-strategy-must-value-local-leadership-to-be-a-success), the government seems set to continue its centralised bungling and magical thinking (https://blogs.bmj.com/bmj/2020/05/28/public-trust-and-the-publics-health-two-sides-of-the-same-coin).
ABSTRACT
Few can doubt the size of the government's challenge or the good faith and expertise of its chief advisers. Yes, writes Ali Mehdi (doi:10.1136/bmj.m1919), in the same way as did the planners of the welfare state during the second world war. After describing how covid-19 disproportionately affects the poorest people in our society, Adam Briggs and Harry Rutter say the pandemic can't become an excuse for worsening population health and widening inequalities (https://bit.ly/3e4PXnS).
ABSTRACT
The change of heart seems to have been in response both to international criticism of its earlier laissez faire approach and to a new modelling study suggesting that the NHS would not cope unless more was done to curb the spread of the virus. There is an urgent need for increased capacity to test frontline healthcare workers, especially a quick serological test to show who has had the infection and is immune and therefore able to safely return to work. Healthcare is already changing as a result of covid-19 in some positive ways: the public is at last learning self-management;hand washing is in;technology is being embraced;phone and video are replacing face to face consultations;there are drive through clinics;people are working across traditional divisions of primary, secondary, and tertiary care and volunteering to be deployed from quieter specialties or retirement into areas of need.