Wednesday 13 May
- Thousands of patients with COVID-19 will have their genomes sequenced as part of a project to understand how a person’s genetic make-up could influence their susceptibility to the virus. Genomics England and the University of Edinburgh will carry out the major human whole genome sequence study across the NHS. The study will involve up to 20,000 people currently or previously in an intensive care unit with COVID-19, as well as 15,000 people with mild or moderate symptoms of the virus. DNA samples have been collected from almost 2,000 patients so far. The study will aim to help identify treatments which have the best chance of success in clinical trials, and potentially identify people at extreme risk if they develop COVID-19. The project’s £28 million funding comes from Genomics England, UK Research and Innovation, the Department of Health and Social Care and the National Institute for Health Research.
Tuesday 12 May
- Community pharmacists across Wales have come together as part of a digital choir. Organised by Community Pharmacy Wales (CPW), they performed a rousing rendition of Calon Lân, well known to Welsh rugby union fans. The performance was, CPW said, inspired by a similar performance by their colleagues at Community Pharmacy Northern Ireland.
— CommunityPharmWales (@CPWales) May 12, 2020
- Community pharmacies in England may not be required to open on the forthcoming spring bank holiday if enough pharmacies are already intending to open, the Pharmaceutical Services Negotiating Committee (PSNC) has said. In its daily COVID-19 update, published on 11 May 2020, the PSNC reported that NHS England and NHS Improvement (NHSE&I) had said in a recent webinar that they were hoping to revert to locally determined opening arrangements for the holiday, which falls on 25 May 2020. The PSNC said NHSE&I would need enough data on the number and whereabouts of which pharmacies were planning to open on the bank holiday before it could make a decision, and it urged contractors to contact their local NHSE&I team if they were intending to open on 25 May.
Monday 11 May
- The government has said it plans to “invest in preventative and personalised solutions to ill-health” to curb risk-factors related to COVID-19, such as obesity, as part of its phased approach to reopening the UK after lockdown. In documents published on 11 May 2020, following a speech by Prime Minister Boris Johnson the previous evening, the government said the move towards preventative care will involve “expanding health screening services, especially through the NHS Health Check programme, which is currently under review”. In January 2020, the National Institute for Health and Care Excellence suggested pharmacies are “well placed” to encourage patients to stop smoking, cut down on drinking and/or lose weight.
- The government papers also said that it has set up a new global sourcing unit for personal protective equipment (PPE), which is staffed by 400 people who are “working urgently to identify new sources of critical PPE from overseas markets” to meet demand. The document added that 50 million items of PPE have been sent to local resilience forums to respond to demand from pharmacies, GPs and social care providers.
- Current and anticipated shortages of medicines during the COVID-19 pandemic are being driven mainly by unexpected surges in demand and changes in prescribing behaviours, the European Medicines Agency (EMA) has said. These conclusions came from data collected through the industry single point of contact (i-SPOC) system which was launched on the 17 April 2020 to enable pharmaceutical companies to report directly to the EMA on shortages of critical medicines used in the context of COVID-19.
- In a previous update the EMA said that the information received via the i-SPOC system had concerned nationally authorised medicines, particularly antibiotics and anaesthetics. The EMA said that it would continue providing updates as more data was gathered via i-SPOC to allow the EU to consider ways to deal with reported medicines shortages.
- Over 15 million pairs of goggles supplied to the NHS do not meet splash protection requirements and should not be used in a COVID-19 setting, an alert from the Department of Health and Social Care (DHSC) has said. A DHSC spokesperson told The Pharmaceutical Journal that 25 million pairs of Tiger Eye protective goggles were bought by the government in 2009, as part of its Pandemic Influenza Preparedness Programme, and were in boxes with the Europe-wide CE mark. Over 15 million pairs of these goggles have since been distributed to healthcare workers.
- However, an alert sent on 10 May 2020 said that tests, carried out following concerns about the fit of the eye protectors, had found that the product did not meet “the current requirement for splash protection” and was being removed from the supply chain. The alert advises that staff who have used the product when performing aerosol generating procedures (APGs) should inform the Health and Safety Executive. The DHSC spokesperson said that, based on current stock assessments, hospital trusts should have enough visors and goggles to immediately stop using ‘Tiger Eye’ protection. But emergency supply can be arranged, they added.
- Healthcare workers have been found to have similar death rates from COVID-19 compared with the general working population, according to data from the Office for National Statistics (ONS). The ONS analysed the 2,494 COVID-19-related deaths in England and Wales amongst the working population up to and including 20 April 2020. In the healthcare workforce, this included 43 males and 63 females — equating to 10.2 deaths per 100,000 males and 4.8 deaths per 100,000 females. This, the ONS said, was not statistically significant compared with rates in the general working population: 9.9 male deaths per 100,000 (1,612 deaths), and 5.2 deaths per 100,000 females (882 deaths).
- The data was not broken down by healthcare sector, with the exception of nurses: the only profession for whom, the ONS said, a reliable rate could be calculated. The ONS added that some healthcare workers — for example, dentists and opticians — may have had reduced exposure to COVID-19 during lockdown because of a lack of routine appointments. However, those working in social care — including care workers and home carers — had “significantly raised” rates of death. For this group, there were 23.4 deaths per 100,000 males (45 deaths) and 9.6 deaths per 100,000 females (86 deaths).
Thursday 7 May
- The Good Life Pharmacy in Hatton, Derbyshire, have been celebrated in an unusual tribute. Emma Bailey, a nurse at The Royal Derby Hospital, created a display thanking the pharmacy team — with a large teddy bear, named Bradley, acting as locum pharmacist for the day. According to Derbyshire Live, Bailey and Bradley put on a new display each day to honour local community workers. So far, more than 30 different key workers have been the star of the show.
Thanks for the work Goodlife Pharmacy are doing has hit the local press 😃
— Derbyshire LPC (@DerbyshireLPC) May 7, 2020
- Annual reviews for patients on valproate should not be delayed because of the COVID-19 pandemic, the Medicines and Healthcare products Regulatory Agency (MHRA) has advised. In guidance published on 6 May 2020, the MHRA said specialist prescribers should preferably conduct video or telephone consultations with girls of any age and women of childbearing potential who are on valproate. During the consultation the prescriber should go through the Annual Risk Acknowledgement Form (ARAF) and ensure that the patient understands the requirements of the Pregnancy Prevention Programme, before sending a copy of the completed ARAF to the patient and their GP. The clinician is also expected to ensure the patient has access to effective contraception. The guidance added that prescribers should still carry out face-to-face consultations – with appropriate social distancing – for patients initiating valproate. However, remote consultations should be considered if the patient is shielding.
- Black people are around four times more likely to die from COVID-19 than white people, according to data published by the Office for National Statistics (ONS). The statistics showed that people of Bangladeshi, Pakistani and Indian ethnicity also had a significant increased risk compared to white people. Amongst people of Chinese ethnicity, the risk was increased for males but not for females. Commenting on the data, Tim Elwell-Sutton, assistant director of strategic partnerships at the Health Foundation, said that “the exact reasons why black and minority ethnic groups are being disproportionately impacted by the virus are still unknown but existing social inequalities and structural discrimination in British society are likely to be playing a significant role”.
- When the data was adjusted to take into account socioeconomic determinants of health, the risk of death compared to people of white ethnicity was reduced — but still remained comparatively high. According to the adjusted figures, black people were 1.9 times more likely to die from COVID-19 than white people, and men and women of Bangladeshi and Pakistani ethnicity were 1.8 and 1.6 times likely to die, respectively. The adjusted data, the ONS said in its report, showed that “differences in risk between ethnic groups that are specific to those ethnic groups”, and not caused by socioeconomic factors.
- A new biological reagent has been made freely available to researchers in the UK and around the world to aid the development of an accurate diagnostic test for COVID-19. The reagent is comprised of non-infectious genetic material isolated from SARS-CoV-2, the virus that causes COVID-19. As a result, the reagent can be used as a positive control for tests being developed to detect the presence of the virus. This means it can act as a confirmatory sample to assure researchers of the accuracy of their test. The development of the reagent has been fast-tracked by the National Institute for Biological Standards and Control (NIBSC), an expert centre of the Medicines and Healthcare products Regulatory Agency.
- “This reagent is a great example of the NIBSC rapidly responding to public health needs in the response to COVID-19,” said Nicola Rose, head of the division of virology at the NIBSC. “The development of the research material is a prelude to the production of established standards and reference materials that laboratories can use in their own work on COVID-19, and we will continue to make producing this material an absolute priority.”
Wednesday 6 May
- Pharmacy employers must notify the Health & Safety Executive (HSE) if a member of the pharmacy team contracts COVID-19 and was likely to have contracted the infection at work, even if symptoms are mild, the Pharmacists’ Defence Association (PDA) has advised in a statement. It added that any death that occurs as a result of COVID-19 contracted at work must be reported as a workplace fatality within 10 days of the incident. Following the government announcement that pharmacists are eligible for the state-backed COVID-19 related death-in-service compensation payments, the PDA has told pharmacists that reporting work acquired COVID-19 infections to the HSE would be an important component in any subsequent claim put to the government scheme on behalf of the deceased. “Even if contracting COVID-19 does not cause death, there may be the possibility of a claim for compensation being made against the employer in the event that it could be shown that appropriate risk management measures were not put in place by the employer,” the statement said.
- Pharmacy teams must be arranged by primary care networks (PCN) and GP practices to support care home residents and staff “within a fortnight at the latest” NHS England and NHS Improvement (NHSE&I) has said. In a letter sent on 1 May 2020, PCNs, practices, and clinical commissioning groups, were told that pharmacy teams that can help care hopes with medication supply, medicines reviews, and medication queries should be “established as soon as possible”. The letter, signed by the directors of primary care, community health, and primary care strategy at NHSE&I says that COVID-19 is posing a “significant challenge” for care homes.
- On 24 April 2020, Graham Stretch, chief pharmacist at the Argyle Health Group across London and clinical director of Brentworth PCN, told The Pharmaceutical Journal that “multiple contacts” had reported cases of medicines optimisation in care homes (MOCH) pharmacy teams being moved to carry out other work. “These vulnerable patients need all the support we can give them,” Stretch said at the time, adding that “vital to this effort is the pharmacy team”.
- If recruitment for the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial is kept above 1,000 patients per week, results on some of the treatments being tested could be available within 5-7 weeks, the UK’s chief medical officers (CMO) have revealed in a letter to NHS staff. The letter, which was signed by the CMOs for Wales, Scotland, Northern Ireland and England, and the national medical director for NHS England and NHS Improvement, Stephen Powis, highlighted that over 9,000 participants had enrolled in the RECOVERY trial so far. However, the signatories said that in order to obtain strong evidence large numbers were required; around 2,000 participants per arm of the trial. Current enrolment to the trial is at 13% of all hospital admissions but the CMOs and Powis said that this proportion needed to be increased. “We appreciate that the operational pressure from Covid-19 makes research hard, and local situations will lead to variability in ability to recruit, but increasing this proportion is important,” the letter said.
- The Medicines and Healthcare products Regulatory Agency has authorised seven batches of Chiesi’s Clenil 100 microgram inhaler (beclomethasone) to be dispensed within the UK to cope with increased demand. The inhalers were reported to be in short supply in early April 2020 following a surge in demand caused by the COVID-19 pandemic. The batches required authorisation due to a variation in their appearance from those usually dispensed in the UK. However, Chiesi said in a statement, published on 5 May 2020, that the inhalers “will contain the same medication and therefore requires no differences to the way prescriptions are written or how patients manage their asthma”. The additional inhalers are expected to come into circulation from 11 May 2020, Chiesi said, with further batches “being released into the supply chain over the coming months”.
Tuesday 5 May
- Details of a phase II/III study to determine the efficacy, safety and immunogenicity of the COVID-19 vaccine candidate ChAdOx1 nCoV-19 have been revealed. The new study, carried out by researchers at the University of Oxford, will assess how well people of all ages can be protected from COVID-19 with the new vaccine as well as provide information on safety and its ability to generate good immune responses against the virus. The researchers have said that they will enrol 5,260 volunteers in total starting with a small number of older adults (56-70 years, then 70+ years) before expanding to large numbers of adults across all ages (18+ years). Following this they will assess the vaccine in a small cohort of children (5-12 years).
- The vaccine is currently being tested in a phase I/II trial, which began on 23 April 2020, whereby researchers are randomly allocating 510 healthy participants, aged 18-55 years old, to receive either the vaccine or a placebo injection in addition to doing blood tests and collecting information about any symptoms that occur after vaccination. The next phase of the trial is still awaiting approval from the Health Research Authority.
- A Yellow Card website dedicated to reporting side-effects or incidents from medicines being used to treat COVID-19 has been set up by the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA said the aim of the site was to ensure that there was “rapid identification of new or emerging risks” which might not have been previously known about that would allow it to take appropriate regulatory action, where needed. “While our aim is to ensure that potentially lifesaving COVID-19 treatments and medical equipment reach patients as quickly as possible, patient safety is our highest priority,” said June Raine, chief executive of the MHRA. The site also contains information about fake medicines and devices, ventilatory and respiratory support, and the latest news on COVID-19.
- Community pharmacies in Wales are working with the Royal Mail to ensure patients who are shielding or self-isolating receive their medicines during the COVID-19 pandemic. Using the Royal Mail’s ‘Tracked 24’ delivery service, postal workers will collect prescriptions from pharmacies and deliver them the next day. Pharmacists will be given access to the Royal Mail’s ‘Click and Drop’ system so that they can track the deliveries. The Royal Mail link-up supports Wales’ volunteer prescription delivery scheme, in which over 400 volunteers will be linked up with more than 650 community pharmacies to deliver medicines to patients who have no-one else to collect their prescriptions.
- With support from the National Pharmacy Association (NPA), a web-based tracking system called Pro Delivery Manager will also be made available to pharmacies and volunteer drivers. Raj Aggarwal, NPA board member for Wales, said the system was “a tried-and-tested product”. Vaughan Gething, Welsh Minister for Health and Social Services, said he was “pleased to see how the skills and expertise of organisations from the private, public and third sector have been brought together to make this a success.”
Monday 4 May
- Scottish prisoners who are currently prescribed opiate substitution therapy (OST) will be switched to buvidal, a longer-lasting form of medicine, as part of Scottish government support for drug users during the COVID-19 pandemic. This programme will cost £1.9 million as part of a budget of more than £2 million set aside by the Scottish government. Buvidal is a prolonged-release injection form of buprenorphine, which is administered weekly or monthly, rather than daily. Joe FitzPatrick, Scottish minister for public health, sport and wellbeing, said that “by making this available to people in prisons, we will support continuity of care, while reducing the need for daily contact and reducing pressure on our frontline prison officers and NHS staff”.
- The funding will also support additional residential rehabilitation places for those leaving prison who need help to recover from drug or alcohol misuse. And naloxone will also be made more widely available.
- Pharmacists feature in a new COVID-19 version of the classic children’s game Top Trumps. The new “Britain at its Best: Key Workers” version of the ever-popular card game includes a card that covers both pharmacists and pharmaceutical scientists. They are given an “unsung hero” rating of 7 out of 10, but score only 2 out of 10 in the “gadgets and gizmos” category. According to the pharmacist card in the game, pharmacy originated in 1752, and pharmacists have been credited with a “street style” score of 6 out of 10. Other groups of workers in the pack include refuse collectors, teachers, NHS volunteers, and even journalists.
- The Scottish NHS death in service provision for the families of frontline NHS staff who die as a result of COVID-19 will include community pharmacy, Harry McQuillan, chief executive of Community Pharmacy Scotland (CPS) has said. In a video update published on 1 May 2020, McQuillan said CPS had received confirmation that “community pharmacy colleagues will be included in proposals to provide a COVID-19-related death-in-service benefit scheme”. CPS was, he continued, working with the Scottish government on the terms of the benefit. McQuillan added that “I very much hope we never have to implement it”, but that it was nonetheless “reassuring to know that you are valued along with all other members of the health and social care team in Scotland”.
- The Scottish scheme will provide a lump sum of twice the staff member’s annual earnings and continued survivor entitlements. In England and Wales, the families of frontline health and social care workers — including community pharmacists — will receive £60,000 under the scheme. When asked by The Pharmaceutical Journal if the scheme covered other members of the community pharmacy team, a spokesperson for the Welsh government said that “details of the operation of the scheme in Wales are still being considered” but that final confirmation would be available soon. The Pharmaceutical Journal has asked the Department of Health and Social Care for similar clarification in England.
- Police forces in Wales will be providing extra reassurance and advice to community pharmacists on the protection of staff and pharmacy premises during the COVID-19 pandemic. The move follows concerns raised by the Royal Pharmaceutical Society (RPS) about aggression and even violence towards community pharmacy teams, based on reports from members. Assistant chief constable Nigel Harrison, chair of the All Wales Police Gold Command Group for COVID-19, said that the police “recognise the key role of pharmacies in our communities and as such we are more than happy to offer assistance”. The police will, Harrison added, “robustly deal with those who feel it is acceptable to act in an aggressive way to our pharmacy teams doing such great work at this time”.
- Elen Jones, RPS director for Wales, said that the majority of people had been “hugely supportive and understanding of the current pressures on pharmacy teams”, but added that “given the nature of the reports from our members, we felt that it was appropriate for us to highlight these concerns to police forces in Wales”.
Friday 1 May
- Nearly 40% of anaesthetists surveyed by the Royal College of Anaesthetists have said they are not confident that they will have sufficient supplies of anaesthetic drugs for COVID-19 patients over the next month. The survey of 2,174 anaesthetists added that 14% currently “do not have access to all the usual drugs”. This comes after the government warned on 16 April 2020 that supplies of atracurium and cisatracurium were expected to run out “over the coming days” due to increased demand from COVID-19 patients. The survey, published on 23 April 2020, said: “Departments of anaesthesia and intensive care are currently collaborating with each other and with pharmacists to ensure drugs are prioritised appropriately across the two areas.”
- Researchers have linked severe COVID-19 infections with a unique blood clotting disorder in the lungs that could be contributing to mortality levels. The research published in the British Journal of Haematology on 30 April 2020 looked at 83 COVID-19 patients, 81% of whom were Caucasian, 12% were Asian, 6% were African and 1% was of Latino/Hispanic ethnicity. They found that those with a higher level of coagulopathy – blood clotting activity – primarily focused within the lungs, had a significantly worse prognosis and were more likely to require admission to intensive care.
- “In addition to pneumonia affecting the small air sacs within the lungs, we are also finding hundreds of small blood clots throughout the lungs,” explained James O’Donnell, consultant haematologist in the National Coagulation Centre in St James’s Hospital. “This scenario is not seen with other types of lung infection, and explains why blood oxygen levels fall dramatically in severe COVID-19 infection … understanding how these micro-clots are being formed within the lung is critical so that we can develop more effective treatments for our patients, particularly those in high risk groups.”
- Preliminary results from trials assessing the use of chloroquine and hydroxychloroquine (CQ/HCQ) for treating COVID-19 should be “treated with care” to avoid misinterpretation by the non-scientific community, pharmacy experts from the University of Huddersfield have warned. “Care should be taken to avoid exaggerating the preliminary safety/efficacy evidence of CQ/HCQ treatment in prevention and treatment of COVID-19 as it can lead to potential self-harm,” Syed Shahzad Hasan and Hamid Merchant wrote in the British Journal of Pharmacy on 30 April 2020, in collaboration with Chia Siang Kow, a pharmacist at the International Medical University in Kuala Lumpur.
- The authors highlighted how publicity around the antimalarial drugs had led to “unnecessary hoarding” and called for pharmacists across the world to dispense them responsibly, discouraging the over-the-counter supply of CQ/HCQ in pharmacies. “It is the duty of pharmacists and other healthcare professionals to monitor the proper usage of these antimalarial drugs…its use should be restricted for the treatment of COVID-19 associated pneumonia in severely ill patients only under clinical supervision of a licensed practitioner and close cardiac monitoring.”
- Consultation rooms in Boots pharmacies are being designated safe spaces for people experiencing domestic violence during the COVID-19 lockdown. Working in partnership with the charity Hestia Crisis Support as part of its “UK says no more” campaign, information about 24-hour UK domestic abuse helplines will be available in the consulting rooms from 1 May 2020. Marc Donovan, chief pharmacist at Boots UK, said he hopes the initiative “can help people find the support they need at this difficult time, when many other options are temporarily unavailable”.
- The move is backed by the Royal Pharmaceutical Society (RPS) and the General Pharmaceutical Council (GPhC) which urged other pharmacies to follow the multiple’s lead. “The trust that the public have in pharmacies make them an ideal place to access help and take a step away from harm towards a better future,” said Sandra Gidley, president of the RPS. “It’s as simple as making your consultation room available for a phone call to the relevant agency who can help.” On 27 April 2020, the Parliamentary home affairs committee said the government should consider making pharmacies and supermarkets safe spaces for victims of domestic abuse.
Citation: The Pharmaceutical Journal