COVID-19 Timeline British Foreign Policy Group

COVID-19 Timeline British Foreign Policy Group

During the first 4 months of 2021 there was a large wave of deaths from COVID-19. However, an analysis of the death registration data by occupation has not yet become available for 2021. The age-adjusted mortality data published by ONS for 2020 highlighted high death rates found in food processing, care work, transport, security, nursing, local, national and local government administration and retail work. These findings are also reflected in an analysis of the same dataset of excess mortality, a measure considered by some as one the most objective indicators of the impact of a pandemic (Karlinsky and, Kobak 2021). The highest excess mortality was found for Health care workers followed by transport workers, social care workers and police and protective service workers (Matz et al., 2022).

  • They are particularly interested in large good quality studies of workers and workplaces and also community-based studies regarding both death and long term effects of infection with SARS-CoV-2.
  • In high-risk jobs, particularly where there is close contact with potentially infected persons, such as in healthcare, public transport and retail, the level of intervention will need to be proportionally higher to achieve optimal control.
  • The study by Martin et al, found that South Asian and Black participants were significantly younger, more likely to have diabetes and live in a larger household than those of white ethnicity and were more likely to live in a deprived area.
  • There is also an increasing literature reporting one or more of a wide range of persisting symptoms following COVID-19 (described as Post-COVID syndrome or Long Covid), which may impact on daily activities including ability to work.

If necessary, immediate release fentanyl should be discontinued from primary care prescribing (deprescribed) with support from specialist services. Commissioned by NHSEvia specialist centres for treating 5q spinal muscular atrophy (SMA) in patients with a clinical diagnosis of SMA types 1, 2 or 3 or with pre-symptomatic SMA and 1 to 4 SMN2 copies, in line with NICE TA755. Not available in Dorset, all patients should be referred for treatment at Southampton (UHS).

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Alternatively this is also offered by North Bristol (NBT) and Plymouth (UHP) in the south west region. Only for patients with genuine swallowing difficulties who don’t require a daily morphine dose exceeding 60mg. Solution, concentrated solution, immediate release tablets, modified release tablets and capsules. Until the supplies of atomoxetine return to normal, no new patients will be started on this as a treatment. Haloperidol 500mcg tablets are more expensive than other formulations. Consider liquid formulations for low doses.

Should they occur, treatment should be discontinued. The concomitant use of diazepam with alcohol and/or CNS depressants should be avoided. Such concomitant use has the potential to increase the clinical effects of diazepam possibly including severe sedation, clinically relevant respiratory and/or cardio-vascular depression (see section 4.5). The patients should be followed closely for signs and symptoms of respiratory depression and sedation.

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The complex patterns of occupational and non-occupational infection and control measures that occurred during the pandemic in the UK has made it challenging to evaluate the health consequences that can be attributed to work exposure. Also, the quality and quantity of available evidence relating to occupation is very variable. Development of COVID-19 requires human-to-human transmission of the virus, SARS-CoV-2, so the only way to prevent the disease is to stop the virus being transferred from an infectious person to the nose or mouth of an uninfected individual. However, because transmission may occur by multiple routes, i.e. by inhaling aerosol, intercepting large droplets or hand contact with contaminated surfaces, complete prevention for workers is not feasible. While exposure levels vary in different workplaces, exposure is difficult to quantify and people can be infective even when asymptomatic. So, it is prudent to apply as much control as is practicable for the workplace concerned, with a variety of control measures likely being required.

  • The syndrome is recognised by worsened mobility and or cognitive or psychological symptoms following a period of critical illness.
  • There has been increasing evidence from several countries that workers in some occupational sectors are at increased risk of both being infected with SARS-CoV-2 and dying from it.
  • These sectors include health and community social care, security, transportation, retail, food production and construction.
  • Post-COVID syndrome was the most commonly used COVID-19-related diagnostic code (23,273 cases or 64% of all codings).

It is widely acknowledged that the pandemic is ongoing and it can be expected that more and better evidence on the long-term adverse health consequences of COVID-19, and on the association with occupational exposure, will emerge. The Council will thus continue to monitor the scientific literature and reported data. Indeed, the Council is aware of several ongoing studies, including analyses of death and infection data for 2021 and 2022, along with data on workplace infection outbreaks in the UK that should be published in the near future.

So, to try and manage the risk in the workplace employers need to consider all transmission routes and apply a variety of control measures. Myers et al., (2021) examined the healthcare data for 55 million US patients up to June 2020 and quantified the risk of myocardial infarction in those with a diagnosis of COVID-19. There were 634,000 COVID infections and approximately 4,000 myocardial infarctions. The time to the occurrence of the myocardial infarction is not stated but those with COVID-19 had approximately 7 times the risk compared with the control population. A history of familial hypercholesterolaemia appeared to double the risk.

Changes in usual work patterns may have impacted on the estimation of risks of COVID-19 due to occupational exposure. For example, there may have been misclassification of occupation e.g., those notifying a death may have used the usual occupation rather than the one that was actually being done at the time of getting COVID-19. Many industrial sectors introduced remote working from home where possible for jobs such as administrators, Gene Science Pharmaceuticals managers and clerical work but, clearly, some jobs cannot be done from home. In addition, because of changing Government restrictions, the number working from home has varied over time during the pandemic. Furthermore, there was some redeployment of staff to jobs that were different from their pre-pandemic jobs so that their official job titles may not reflect the actual work carried out during the pandemic.

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There were no longer statistically significant differences in infection rates by the time of the second survey carried out between June 19 and July 8, 2021, but by that stage the rates of infection in the general population had fallen substantially. The relative rates of infection in health and care home workers (aORs) rose again as infection rates in the community increased in the latter months of 2020 and fell again in 2021 in line with the early immunisation programme for health and social care workers (Appendix Table 3). The pattern is similar to that of the ONS data. They highlight international studies that show there has been a clear intersection of COVID-19 transmission networks and socioeconomic inequities, reflecting the amplifying effects of working in public facing jobs, crowded housing, job insecurity, and poverty (EMG 2021a).

Peripheral nerve damage probably has several causes including abnormalities of the microcirculation, mitochondrial dysfunction, and disordered cell membrane function (Kress and Hall, 2014). The combined effects of muscle weakness and nerve damage result in global limb weakness, most pronounced around the shoulders and hips. For the purposes of IIAC it is important that the sequalae of infection that can explain symptoms and resultant disability are considered; these are considered first followed by a section on Post-COVID-19 syndrome. PHE studied concordance of the S-Gene Target Failure (SGTF) marker in pairs of infected individuals in various settings, mostly around December 2020 (EMG 2021b). SGTF was a pattern seen in a proportion of SARS-CoV-2 PCR tests. Two individuals with SGTF were more likely to have a common source of infection than individuals with discordant results.

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