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NHS trusts in England declare critical incidents amid Covid staff crisis | NHS

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Multiple NHS trusts across England have declared “critical incidents” amid soaring staff absences caused by Covid-19, with health leaders saying many parts of the service are now “in a state of crisis”.

Boris Johnson on Monday ruled out the introduction of new curbs “for now” but said he recognised that the pressure on the NHS and its hospitals, was “going to be considerable in the course of the next couple of weeks, and maybe more”.

More than half a dozen trusts have issued alerts over “internal critical incidents” in recent days, it is understood, as concerns mount that some may be unable to deliver vital care to patients.

Health leaders said the “rapidly increasing” number of absent NHS staff was piling “very serious” pressure on hospitals already struggling to cope with increasing Covid admissions and “huge wider pressure” on urgent and emergency services.

They said pressure was increasingly spreading to hospitals outside London, with those in the north-east and Yorkshire reporting the most rapid growth in Covid patient numbers in recent days.

Johnson said there was no question Omicron continued “to surge through the country”, adding it would be folly to think the pandemic was over. A further 157,758 lab-confirmed Covid-19 cases have been recorded in England and Scotland as of 9am on Monday, the government said.

However, speaking publicly for the first time this year during a visit to a vaccination centre in Aylesbury, Johnson said the UK remained in a much better position than this time last year thanks to vaccines and stressed Omicron was “plainly milder” than previous variants.

NHS chiefs also expressed cautious optimism that after weeks of rising hospitalisations in London – the centre of the Omicron outbreak – the increases may have peaked and are starting to level off.

Chris Hopson, the chief executive of NHS Providers, which represents NHS hospital, mental health, community and ambulance services, said: “We were seeing increases in the number of Covid-19 patients in London hospitals go up by 9% a day, 15% a day …  in terms of 27, 28 and 29 December.

“Interestingly, in the last two days the increases have only been 1% and 2%, so they’ve dropped pretty significantly, so there’s a hope we might have seen a possible peak and plateau.”

Another piece of positive news, he added, was that hospitals were still not admitting large numbers of seriously ill older people with Covid. Hopson said it was striking that hospital bosses were “pointing to the fact” that outbreaks in care homes were not translating into hospital admissions.

One of the UK’s biggest care home operators called on the government to lift visiting restrictions after it recorded one Covid death in the last fortnight. Four Seasons Healthcare, which operates 165 care homes, said close to 4,000 residents were living under strict lockdowns because of outbreaks, but Omicron was proving so mild in a well-vaccinated population that limits on seeing family and friends were in “total imbalance” with the risk.

Hopson cautioned that the biggest challenge facing many NHS trusts – like many workplaces across the country in the first week of the new year – was mounting staff absences. Covid-related staff shortages are causing havoc in many sectors, with bins in some areas “overflowing” with waste from the festive period and schools scrambling to hire substitute teachers for the start of the new term.

Hopson said a number of trusts across the country had declared “internal critical incidents” over the past few days. United Lincolnshire hospitals NHS trust declared a critical incident with “extreme and unprecedented” staff shortages resulting in “compromised care”.

Critical incidents are declared by NHS trusts when they believe they may no longer be able to provide a range of critical services. Declaring an incident enables local health chiefs to call for help from staff and other organisations, and creates a formal interim emergency governance structure to make prioritisation decisions at speed, for example redeploying staff or reprioritising services.

Joe Harrison, the chief executive of Milton Keynes University hospital, said while his trust was not yet declaring a critical incident, he expected the “very pressured” situation to get worse before it got better. Meanwhile, in Yorkshire, the ambulance service said: “The added challenge of Covid-19-related absence among staff … is having a significant impact on our frontline operations.”

In a blog published on Monday, Matthew Taylor, the chief executive of the NHS Confederation, which represents the healthcare system in England, Wales and Northern Ireland, issued a stark warning that many parts of the health service were “currently in a state of crisis”.

“In the face of high levels of demand and staff absence some hospitals are having to declare a critical incident,” he wrote. “Some hospitals are making urgent calls to exhausted staff to give up rest days and leave to enable them to sustain core services. Many more hospitals are having to ban visitors to try to reduce the spread of infection.”

Taylor also urged politicians “making optimism and complacency a kind of political virility symbol” not to turn Covid policy “into a new terrain for the culture wars”, but instead to focus on the facts and “listen to those trying to cope on the frontline”.

Meanwhile, the Royal College of Nursing (RCN) has written to ministers calling for further measures in England amid “confusing and concerning” differences in restrictions across the UK.

“Nursing professionals are questioning the level and nature of the variation between governments,” wrote the RCN’s council chair, Carol Popplestone, and its general secretary and chief executive, Pat Cullen. “We therefore ask that, as secretary of state for health and social care, you work with counterparts across government on a more cautious approach for England without further delay.”

Parliament will return from its Christmas recess on Wednesday, when the cabinet is set to meet to review the plan B rules. Ministers are expected to keep restrictions – including mask wearing, Covid passports and home working – as they are.

On Monday, Johnson rejected the idea that England’s relatively limited Covid restrictions amounted to a gamble. “The way forward for the country as a whole is to continue with the path that we’re on,” he said. “We’ll keep everything under review. But the mixture of things that we’re doing at the moment is, I think, the right one.”

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Solar storms may cause up to 5500 heart-related deaths in a given year

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In an approximate 11-year cycle, the sun blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field, which may disrupt our body clock and ultimately affect our heart



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17 June 2022

A solar storm

Jurik Peter/Shutterstock

Solar storms that disrupt Earth’s magnetic field may cause up to 5500 heart-related deaths in the US in a given year.

The sun goes through cycles of high and low activity that repeat approximately every 11 years. During periods of high activity, it blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field.

These so-called solar storms can cause glitches in our power grids and bring down Earth-orbiting satellites. A handful of studies have also hinted that they increase the risk of …

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UK Covid infection rate rising, with more than a million cases in England | Coronavirus

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Coronavirus infections are rising in the UK, figures have revealed, with experts noting the increase is probably down to the more transmissible BA.4 and BA.5 Omicron variants.

The figures from the Office for National Statistics (ONS), based on swabs collected from randomly selected households, reveal that in the week ending 11 June an estimated one in 50 people in the community in England are thought to have had Covid – around 1.13 million people.

The figure is even higher, at one in 45, in both Wales and Northern Ireland, while it was highest in Scotland where, in the week ending 10 June, one in 30 people are thought to have been infected.

While the figures remain below the peak levels of infection seen earlier this year, when around one in 13 people in England had Covid, the findings are a rise on the previous week where one in 70 people in England were thought to be infected. Furthermore, the data reveals increases in all regions of England, except the north-east, and across all age groups.

Experts say that a key factor in the increase is probably the rise of the Covid variants of concern BA.4 and BA.5.

“Infections have increased across all four UK nations, driven by rising numbers of people infected with the BA.4 and BA.5 Omicron variants,” said Kara Steel, senior statistician for the Covid-19 Infection Survey.

While Steel said it remained too early to say if this was the start of another wave, others have warned it may already have begun, with increased mixing and travelling among other factors fuelling a rise in cases.

Among concerns scientists have raised are that BA.4, BA.5 and another variant on the rise, BA.2.12.1, replicate more efficiently in human lung cells than BA.2.

Prof Azra Ghani, an epidemiologist at Imperial College London, said the latest figures were not surprising, and might rise further.

“This increase in infection prevalence is likely due to the growth of the BA.4 and BA.5 Omicron subvariants, which as we have seen elsewhere in Europe, appear to be able to escape immunity generated from previous Omicron subvariants,” she said.

“It is therefore possible that we will continue to see some growth in infection prevalence in the coming weeks and consequently an increase in hospitalisations, although these subvariants do not currently appear to result in any significantly changed severity profile. This does however serve as a reminder that the Covid-19 pandemic is not over.”

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NHS to offer women in England drug that cuts recurrence of breast cancer | Breast cancer

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Thousands of women in England with breast cancer are to benefit from a new pill on the NHS which reduces the risk of the disease coming back.

The National Institute for Health and Care Excellence (Nice) has given the green light to abemaciclib, which cuts the chance of breast cancer returning after a patient has had surgery to remove a tumour.

Trials showed that patients who had the drug with hormone therapy had a more than 30% improved chance of their cancer not coming back after surgery, compared with hormone therapy alone.

“It’s fantastic thousands of women with this type of primary breast cancer will now have an additional treatment option available on the NHS to help further reduce the risk of the disease coming back,” said Delyth Morgan, the chief executive of charity Breast Cancer Now.

“The fear of breast cancer returning or spreading to other parts of their body and becoming incurable can cause considerable anxiety for so many women and their loved ones.

“New effective treatments such as abemaciclib, which can offer more women the chance to further reduce the risk of the disease recurring, are therefore extremely welcome and this is an important step change in the drug options available for this group of patients.”

The twice-a-day pill is suitable for women with hormone receptor-positive, HER2-negative, node-positive early breast cancer at high risk of recurrence who have had surgery. About 4,000 women will benefit initially, Nice said.

Helen Knight, the interim director of medicines evaluation at Nice, said the draft recommendation came less than a month after abemaciclib received its licence.

“The fact that we have been able to produce draft recommendations so quickly is testament to the success of our ambition to support patient access to clinically and cost effective treatments as early as possible,” said Knight. “Until now there have been no targeted treatments for people with this type of breast cancer.

“Abemaciclib with hormone therapy represents a significant improvement in how it is treated because being able to have a targeted treatment earlier after surgery will increase the chance of curing the disease and reduce the likelihood of developing incurable advanced disease.”

Abemaciclib works by targeting and inhibiting proteins in cancer cells which allow the cancer to divide and grow. It normally costs £2,950 for a packet of 56 150mg-tablets, but the manufacturer, Eli Lilly, has agreed an undisclosed discounted price for NHS England.

“Thanks in part to this latest deal struck by NHS England, NHS patients will be able to access another new targeted drug for a common and aggressive form of breast cancer,” said Prof Peter Johnson, the cancer director of NHS England.

“Abemaciclib, when used alongside a hormone therapy, offers a new, doubly targeted, treatment option, helping to increase the chances of beating the cancer for good, as well as meeting the NHS’s commitment to delivering improved cancer care under our long-term plan.”

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