The doctors who have died from Covid-19 may have been mostly working with asymptomatic patients, according to a new analysis which will raise fresh concerns about the quality of protective equipment offered to staff.
A new study identifies 119 deaths of NHS staff, including five practice staff, based on news reports and social media. Reporting in the Health Service Journal, Tim Cook and Simon Lennane say the deaths involved five surgeons, four GPs and two emergency medicine specialists along with two working in acute medicine. There were a total of five deaths in practices and further nine in community health organisations.
Across professions they noted no cases of deaths involving those members of staff at greatest risk of exposure – working in intensive care. A separate study, published yesterday, found that infection rates among NHS staff peaked at 20% at the end of March.
Writing about the absence of the highest risk staff from the list of fatalities, Cook and Lennane write: “What is likely is that these groups of healthcare staff are rigorous about use of personal protective equipment and the associated practices known to reduce risk.
“It may be that this rigour is protecting staff better than some fear and the results can be considered cautiously reassuring. However, this finding is not a reason to slacken off on the appropriately rigorous use of PPE – but rather to wonder why others, who are likely involved in what are generally considered to be lower risk activities, are becoming infected and consider whether wider use of rigorous PPE is indicated.”
The study came as a delayed flight from Turkey arrived in the UK – but with half the 400,000 PPE items that had been promised.
The British Medical Association last night called for testing sites to be established in all major towns. It said sites were “few and far between”, contributing to poor testing rates of NHS staff and their family members.
Professor Dame Parveen Kumar, chair of the BMA’s board of science, said: “The Government says there has been a lack of demand for staff testing, but this is completely opposite to what doctors across the country are telling us on a daily basis. There is little clarity at local and regional levels for staff and their family members about how to get tested and we need to see better coordination of testing and far greater availability if we want to see any real chance of confidently and safely returning thousands of staff back to front line care.”
Dr Sarah Hallett, chair of the BMA’s junior doctors’ committee, said: “The frustration for health workers though is that if we had easier access to testing, it might get us back to working with our patients quicker. I developed a dry cough a few weeks ago, and therefore had to self-isolate. My flatmates are also doctors, working in A&E and general practice, and so they had to stay off for 14 days despite never showing any symptoms themselves. The staffing shortages are already considerable; all of us would rather be helping with this crisis than stuck at home.”
Health secretary Matt Hancock told MPs yesterday that testing numbers had been lower than expected, adding: “We are therefore ramping up the availability of this testing and expanding who is eligible for testing and making it easier to access the tests. The tests are conducted in NHS hospitals, through our drive-through centres, mobile units and home deliveries.”
* The BMA also stepped up calls for full death in service benefits for all doctors. Dr Vishal Sharma, chair of its pensions committee, said: “Losing a loved one during these horrific times will be difficult enough for families, without the added pressure of losing what may be their main source of income, leaving them unsure of what the future holds. It is only right and proper that the Government offers full and adequate protection to doctors risking their lives for their patients.
“The BMA has made clear since the start of the outbreak that the Government needs to give a simple guarantee to all healthcare workers – including those young and old who have answered the call to step up to the workforce during this time – that their families will be looked after should they die. The BMA demands that this procrastination ends now.”
* The BMJ last night called for deaths of health workers to be referred to the coroner for independent review. Writing for the journal surgeon Professor John Robertson, from Nottingham, says: “As this pandemic unfolds and we witness the deaths of our fellow healthcare professionals during active service and under controversial occupational conditions, there arises the inevitable question of whether the coroner should be involved?” He adds that there is no evidence that surgical masks are “effective protection.”
* Researchers in Newcastle claimed that to have run an effective testing programme for NHS staff in the city. The city’s testing programme has enabled some 1,400 staff to return to work from social isolation. Newcastle Hospitals NHS Foundation Trust says it has tested 3,200 staff in the last fortnight. The analysis, reported in The Lancet, found that 15.4% of patient-facing staff were infected along with 16.3% of those who do not have direct contact with patients. The proportion peaked at 20% at the end of March.