NEWS
Government advice on masks ‘confusing’ warns BMA
The BMA has warned that Government measures and public guidance on face covering rules in England are unclear, inconsistent and are causing widespread confusion. Official Government communications have also used images of people wearing inappropriate masks with valves, while some businesses, including hairdressers, are being advised to use visors or face shields in the place of an effective face covering.
It is vital, the BMA says, to emphasise that the primary purpose of wearing a face covering is to prevent droplets leaving the mouth or nose of someone who may be carrying and therefore potentially transmitting the virus to others, but who has
no or minimal symptoms. It is therefore not a protective strategy for the individual, but one for the population as a whole. The BMA believes: For the general public a cotton mask, covering the nose, mouth and chin, is suitable. This can then be washed and reused. Ideally these should be three layers thick and of tightly woven fabric. l Masks with exhalation valves should not be used, as they allow potentially infected air to be channelled out through the valve and are thus less effective.
l Visors are likely to offer much less protection against viral transmission from the wearer to others and should not be worn in place of an effective face covering.
l People who are clinically extremely vulnerable should consider wearing a fluid-resistant surgical mask, as these are likely to offer greater protection to the wearer.
l The public should not wear medical grade respirators – these should be reserved for frontline healthcare workers.
The BMA says that face coverings should be mandatory in all scenarios where two-metre physical distancing cannot be maintained between people from different households or “bubbles”, and there are no other mitigating measures in place, such as plastic screens.
Urgent cancer referrals being turned down
The charity, Cancer Research UK, has reported that around a quarter of GPs surveyed said that urgent referrals for suspected cancer have been inappropriately turned down by hospitals ‘more often than before the pandemic’. Over 1,000 GPs across the UK were
surveyed in June and asked to compare how the past month had differed to before the COVID-19 pandemic. Experts believe the change is likely to be because of a lack of capacity and reduced access to diagnostic tests within hospitals. It is also possible hospitals could have been trying to reduce exposure to COVID-19 that could occur if patients came to a hospital. Worryingly, nearly 40% of all the GPs did not feel that adequate safety-netting had been put in place, leaving patients in limbo between the GP practice and secondary care when referrals were rejected.
In some areas, cancer referrals dropped by 75% at the peak of the pandemic, mainly because people weren’t coming forward with
symptoms and staying home to protect the NHS.
The survey showed that referrals being rejected was also a problem, with the impact varying in different regions of the UK. Up to 40% of GPs in some regions, like the West Midlands, said they felt this was happening more regularly than before the pandemic. On average, around 233,000 people with suspected cancer symptoms are urgently referred for further investigation each month across the UK, and an estimated 16,300 of these people would turn out to have cancer. However, since the start of the lockdown, it’s estimated that there have been 300,000 fewer urgent suspected cancer referrals than normal.
“It’s deeply concerning that suspected cancer patients are being refused hospital appointments despite being referred by their doctor. And even more worrying that they may be slipping through the net,” commented Michelle Mitchell, Cancer Research UK’s chief executive.
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WWW.CLINICALSERVICESJOURNAL.COM
HIV drug does not reduce mortality in
COVID patients The ‘RECOVERY’ trial has released preliminary results showing lopinavir/ ritonavir, an antiviral drug commonly used to treat HIV, had no significant mortality benefit in hospitalised COVID-19 patients.
The RECOVERY trial has also recently announced preliminary results showing: low-cost dexamethasone reduced death by up to one third in hospitalised patients with severe respiratory complications of COVID-19; and no effect on mortality from the use of hydroxychloroquine in patients admitted to hospital with COVID-19.
NICE recommends steam treatment for enlarged prostate
Up to 10,000 men with an enlarged prostate could receive a new treatment which improves their quality of life and preserves their sexual function, under new guidance from NICE.
NICE has recommended the use of
Rezum, a minimally invasive procedure that involves injecting steam to destroy excess prostate tissue. Some current treatments use heat to destroy excess prostate tissue and this can have considerable side effects. Benign prostatic hyperplasia (BPH) is the medical term used to describe a noncancerous enlargement of the prostate. Symptoms like needing to pass urine more frequently, trouble starting to urinate and loss of bladder control affect more than a third of men over the age of 50.
Clinical evidence analysed by NICE’s medical technology advisory committee shows that using the Rezum procedure relieves lower urinary tract symptoms (LUTS) caused by BPH in men with moderate to severe symptoms who have a moderately enlarged prostate.
Evidence also shows that using Rezum is associated with improved quality of life and a low risk of sexual dysfunction. Rezum is cost saving compared with standard treatments such as transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) by more than £550 per person over four years.
AUGUST 2020
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