Last updated: 08.30, 6 April 2020
The current COVID-19 global pandemic is constantly evolving. The Center for Systems Science and Engineering (CSSE) at John Hopkins University data dashboard indicates that there are now more than 1.25 million reported cases globally, with the number of mortalities at 70,000 and with 262,000 people recovered from the virus. There is currently no vaccine available for COVID-19.
In the UK, on 23 March, the Prime Minister announced new measures to tackle the spread of COVID 19, effective immediately. The public have been told they must stay at home, apart from essential travel. The UK Government has issued full guidance on staying at home and away from others. Full UK Government resources are available here.
On 12 March, the UK Government announced that the 'delay' phase of the COVID-19 action plan had commenced. On 16 March, UK Prime Minister, Boris Johnson announced that people or those living with people with a persistent cough or fever must self-isolate for 14 days.
The number of cases in the UK continues to rise and UK nationals have been advised against all non-essential travel overseas.
Schools across the UK were closed on 20 March until further notice. Bars, restaurants, leisure centres, cafes and gyms were closed on 21 March, followed by non essential shops on 23 March.
On 17 March it was announced that new laws would be introduced in the UK through the Coronavirus Bill to protect public health, increase NHS capacity, strengthen social care and support the public. The Coronavirus Bill is now an Act of Parliament (law).
The Act sets out a wide variety of measures including some relating to NHS staff and healthcare regulation:
"The (Act) will allow recently retired NHS staff and social workers to return to work without any negative repercussions to their pensions..... It will enable regulators to emergency register suitable people as regulated healthcare professionals, such as nurses, midwives or paramedics. This might include (but will not be limited to) recently retired professionals and students who are near the end of their training. Registered staff can then be used appropriately, with decisions made on a local basis, to increase the available health and social care workforce and enable essential health and care services to function during the height of the epidemic”
The Scottish Government has an online hub for the latest news and guidance. On 17 March, the First Minister and Jeane Freeman, Cabinet Secretary for Health advised the Scottish Parliament that the NHS in Scotland has been placed on an emergency footing for at least the next three months.
The Scottish Government announced on 30 March that it will temporarily pause a number of screening programmes (Breast Screening (mammograms); Cervical Screening (smear tests); Bowel Screening (home test kits); Abdominal Aortic Aneurysm (AAA) Screening (ultrasound of abdomen) and Diabetic Retinopathy (Eye) Screening (images taken of the eye)) to enable healthcare staff to be re-allocated to support other essential services, including COVID-19 laboratory testing and covering for colleagues who are unwell or self-isolating.
On 1 April, Cabinet Secretary for Health, Jeane Freeman wrote to the Health and Sport Committee about COVID-19. The letter details further information regarding ICU capacity and ventilators, community care, care homes, and care at home, PPE distribution, testing for key workers, NHS staffing, guidance for shielded groups and mental health.
All the guidance and information on the UK Government online hub is applicable in England unless otherwise stated.
Welsh Government guidance on COVID-19 has been published and annoucements are regularly updated. All non-essential hospital procedures have been cancelled and Mark Drakeford AM, First Minister made a statement on further measures being taken on 17 March.
Guidance from the Northern Ireland Executive is available. Health Minister Robin Swann previously outlined actions that will be taken in Northern Ireland.
Action Plans to tackle COVID -19 in the UK
The UK Government has published an action plan, and the Scottish Government has published its response to date. The 4 phases of the UK's approach are:
Over recent weeks, the College has participated in teleconferences with the Chief Medical Officers (CMO) for England and Scotland regarding coronavirus. Through this process, the College has been advised that Public Health England (PHE) have published a flow chart for management of a suspected case of COVID-19 acute respiratory disease. The UK CMOs have co-signed a letter in support of UK doctors. The GMC has published information for healthcare professionals.
The CMOs for England and Scotland (Professor Chris Whitty and Dr Catherine Calderwood), have regularly updated representatives from the Royal Colleges, including the Royal College of Physicians of Edinburgh. Below are the main highlights from their most recent updates:
The College has noted reports in the UK, and around the world, of people being discriminated against and targeted with abuse because of their ethnicity. In that regard, it is vital that all health professionals, including physicians, are able to play their part in minimising the spread of false information about coronavirus. People from China, or any other “at risk” country, must have their nationality respected and be protected from harm. The College would encourage all clinicians to lead by example by communicating accurate, up to date information, and following official guidance and evidence-based advice issued by public health authorities (see below).
The WHO has published online a range of public health advice and information on COVID-19, including situation reports, technical guidance, travel advice, and advice for the public about how to protect themselves.
NICE have now issued rapid guidelines and evidence reviews on COVID - 19.
Updated figures for cases and mortalities in the UK can be found each day, from 2pm, on the UK Government website. A range of other information can be found on the UK Government website including advice for clinicians. A helpful patient flow chart is available along with a letter on COVID-19 NHS preparedness and response.
The GMC has now published information about coronavirus on their website for healthcare professionals. They announced on 19 March that for doctors due to revalidate before the end of September 2020, this will be deferred by one year. This decision was made to give responsible officers and doctors more time to reschedule and complete appraisals.
The GMC is also contacting doctors who may be granted temporary registration to help deal with the coronavirus (COVID-19) pandemic, outlining the process they would need to follow and informing them of what they should do if they want to opt out. Once the Secretary of State requests the GMC to grant temporary registration to this group, contact details for doctors granted that status would be shared with the health services in the UK nation matching their address. Those bodies would then contact these doctors to discuss if, how, where and when they might be asked to work. The Scottish Government and NHS England have published guidance on returning to registered professional practice to help with patient care.
Public Health England (PHE) and Health Protection Scotland (HPS) have each produced clinical guidance for initial management of coronavirus. The PHE guidance for clinicians is publicly available on their website, including for primary care and secondary care. The HPS guidance for primary care and secondary care is also online. A range of other information and guidance can be found on the HPS website. Information Governance Advice is also available from the Scottish Government.
In Scotland, NHS Boards must ensure that all front line healthcare professionals have access to HPS guidance and have a clear understanding of the management and investigation procedures for suspected cases. NHS Boards should also cascade the information to any non-NHS clinicians working in private healthcare settings if such establishments are located in their area. Information and updates from the Department of Health in Northern Ireland are also available.
Guidance on childcare provision for key workers has been published by the UK Government and Scottish Government.
The College continues to receive regular updates from relevant public health bodies and departments, including the CMOs for England and Scotland. At this stage, it is important that public health and health protection departments continue to keep the public and clinicians updated as much as possible during what is a fast-moving situation.
I hope that you have found this update helpful. We will continue to monitor coronavirus closely, and if you have any enquiries, please do get in touch.
Dr Conor Maguire, International Vice President
