Coronavirus: how accurate are coronavirus tests?

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by Dr Jessica Watson, GP and NIHR Doctoral Senior Clinical Research Fellow, Centre for Academic Primary Care, University of Bristol and Dr Penny Whiting, Associate Professor in Clinical Epidemiology, NIHR ARC West and University of Bristol

Coronavirus testing has been the subject of huge interest, frustration and confusion. The UK has come under worldwide criticism for its lack of mass testing, despite the director general of WHO encouraging countries to “test, test, test”. Health Secretary Matt Hancock announced that the UK now aims to test 100,000 people a dayfor COVID-19 by the end of April.

There are two main types of COVID-19 tests. Swab tests, which usually take a sample from the throat or nose, to detect viral RNA. These determine if you currently have COVID-19. Blood tests, which detect antibodies, can determine if you have had COVID-19, and are therefore immune.

No test … Read more

How coronavirus has transformed the grieving process

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Dr Lucy Selman, Senior Research Fellow, Centre for Academic Primary Care, University of Bristol

As I write this, the UK government has just announced that 13,729 people have died in hospitals from COVID-19. Care England estimates more than 1,400 people have now died in care homes. As you read this, those appalling figures will have grown. The national medical director, Stephen Powis, has said that if the UK death tally comes in below 20,000, “we will have done very well”.

As a result, a wave of grief will swell in the coming months, with more and more people experiencing a close bereavement related to COVID-19. The disease brings new challenges in caring for patients and supporting their family and friends. A particularly cruel one is that patients must be isolated to control the spread of infection.

Since a patient’s loved ones are often unable to accompany … Read more

A GP reads ‘The Plague’ during the COVID-19 pandemic

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Prof Gene Feder

 

 

by Gene Feder, GP and Professor of Primary Care, Centre for Academic Primary Care, University of Bristol

The Plague, a novel by Albert Camus, published in 1947, tells the story of Oran, a city struck by bubonic plague. It was an extended metaphor for living under fascism and the way society and individuals behave under occupation.

I found an English translation at the back of a book shelf, having first read it as a teenager over half a century ago. On the title page there is a stamp: ‘Rainbow Library Salzburg THIS BOOK IS A [sic] PROPERTY OF THE UNITED STATES’. My father – working with Holocaust* survivors in Germany and Austria – must have forgotten to return it.

In 2020, it turns out that the book – partially – exemplifies our response to the pandemic du jour: COVID-19.

Everybody knows that pestilences have

… Read more

What we know about ACE inhibitors, high blood pressure and COVID-19

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by Dr Rupert Payne, Consultant Senior Lecturer in Primary Health Care, Centre for Academic Primary Care, University of Bristol

The COVID-19 pandemic has unsurprisingly been associated with a similar epidemic of social media misinformation. But there are also some genuine clinical issues of relevance to people with existing health conditions, who are known to be more vulnerable to the disease. One particular topic that has left patients and health professionals alike confused and alarmed is the suggestion that ACE inhibitor drugs may increase the dangers of COVID-19.

First introduced in the early 1980s, ACE (angiotensin-converting enzyme) inhibitors were initially used for the treatment of high blood pressure, but their role has grown over the years to include the management of heart failure, heart attacks, diabetes and kidney disease. Given that roughly one-fifth of the adult population in the UK has diagnosed hypertension, and other … Read more

Vaccinating children – why peace of mind should not be forgotten when it comes to funding

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Gemma Lasseter

 

by Gemma Lasseter, Research Fellow, Centre for Academic Primary Care and NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol

In the UK, government policy on whether to fund new vaccines, or modify their availability, is based on advice from an independent scientific advisory group. This involves weighing up the benefits and costs, and then deciding whether a vaccine is value for money.

The idea is to find a balance between the cost of doing something (such as routinely vaccinating all children against a particular disease) and how much benefit you get from doing it (such as health gains by preventing disease and the associated economic savings).

Yet the current approach does not take into account many of the benefits that vaccinations offer and which set them apart from other health interventions. The fact that vaccinations are preventative rather than curative, for … Read more

What are the causes of unnecessary antibiotic prescribing?

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By Christie Cabral, Research Fellow, Centre for Academic Primary Care, University of Bristol

Why do parents seeking evaluation, reassurance and information about their child’s cough end up with antibiotics from their GP? Research fellow Christie Cabral looks at the evidence.

GPs see a lot of children with respiratory tract infections (RTIs), usually presenting with a cough, high temperature or both. RTIs can be distressing and disruptive for children and parents but are mostly viral illnesses that will get better on their own: there is little that a GP can do to treat them.

However, many are prescribed unnecessary antibiotics that can lead to resistant bacteria. From our previous research, we know that parents often feel uncertain about the severity of an RTI and feel that it’s safer to consult a doctor.

They are usually seeking a medical evaluation, reassurance and information to help them understand and … Read more

SafeTea: An online intervention to prevent hot drink scalds in small children and improve burn first aid

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Professor Alan Emond

 

 

Guest blog by Professor Alan Emond, Emeritus Professor of Child Health, Bristol Medical School, University of Bristol

SafeTea is a national campaign which aims to reduce hot drink scalds to young children and promote burns first aid. The launch of the intervention will be on 16 October 2019, National Burn Awareness Day. The target audience is parents, grandparents and carers of children under 5 across the UK.

Primary care centres can participate in the campaign by:

  • displaying posters, flyers or videos that are freely available on the SafeTea website. 
  • by following us on social media @SafeTeaCampaign on Twitter, Facebook, Instagram and YouTube
  • by taking the SafeTea pledge.

The key messages of the campaign are to:

  • Keep hot drinks away from young children
  • Never carry a hot drink whilst carrying a baby
  • Never pass a hot drink over the heads of young children
  • Make a
… Read more

Prescribing and the environment

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by Dr Rupert Payne, Consultant Senior Lecturer in Primary Health Care, Centre for Academic Primary Care, University of Bristol

Boots pharmacies made the mainstream news headlines in May this year when it became apparent that some prescriptions which were being prepared using an automated centralised system were being distributed using plastic bags. Lloyds pharmacies have a similar process in place.

The argument is that the centralised assembly process is more efficient and safer than the old-fashioned local approach which used paper bags. The bags can be recycled but, as many of us know, that isn’t necessarily straightforward. Given the backlash against plastic that has been seen recently, and particularly given the fact that pharmacies have always been well known for using paper bags, it is unsurprising that this change has been received negatively by consumers.

But the impact of prescribing on the environment is not just … Read more

Health Data Science: the next key development in patient-centred research will be data-led

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by Dr Yvette Pyne, Academic Clinical Fellow, Centre for Academic Primary Care, University of Bristol

The breadth of conditions doctors are expected to manage continues to grow as people and society become ever more complex and it is in GP surgeries up and down the country where this is most starkly seen. The volume of work expected of GPs is taking its toll on individual doctors and the service as a whole.

My previous career designing and developing information technology (IT) systems gives me insight into the huge potential computers and machine learning have to help us in this increasingly challenging environment. Artificial Intelligence (AI) can enable us to provide the best evidence-based medicine to our patients while also freeing us from mundane administration to spend more time connecting with the human beings in front of us.

In the UK, Primary Care is already leading … Read more

Wanted: GPs who understand that evidence alone does not create policy

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by Dr Jason Sarfo-Annin, Honorary Research Fellow, Centre for Academic Primary Care, University of Bristol

Debate surrounding the future of general practice is usually rooted in the context of the primary care workforce, the introduction of new roles and developing practitioners with a new skill-mix.
Such solutions are rooted in the medical model of health. I share the Marmotian view that health care is just one dimension of improving individual and population health.

As GPs, we often consult with patients who cannot be helped by our services. We are also often unable to effectively signpost patients or help navigate them to services that can support them. Consequently, I believe the future involves working as part of a collaboration of services – delivered optimally by co-location. Provision of these services would be based on the geographical location of patients and include amenities already provided by local authorities … Read more