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Take a look at a selection of our recent media coverage:

Calls for action as healthy life expectancy falls for men and women due to Covid pandemic

2nd April 2024

The number of years people are expected to life in good health has fallen in both men and women, likely due to the Covid-19 pandemic, according to Office of National Statistics (ONS) figures.

Between 2011-13 and 2020-22, healthy life expectancy fell by 9.3 months to 62.4 years in males and by 14 months to 62.7 years in females. However, there were minimal changes up to 2017-19. This meant it was ‘likely the coronavirus (Covid-19) pandemic contributed to this decrease’, the ONS said.

The largest drop for male healthy life expectancy in England was in the north east, with a decrease of 20.3 months. For females, the area with the greatest reduction was the east Midlands (31.8 months).

Senior fellow at The King’s Fund, Veena Raleigh, said the latest data provides ‘graphic’ evidence of the declining state of people’s health in England.

‘As there had been minimal change in healthy life expectancy up to 2017-19, it’s likely that the pandemic in 2020 will have contributed to this fall. It’s also likely that the delays in care for non-Covid conditions and an increase in long-term sickness following the pandemic will have been contributory factors,’ she said.

Earlier this year, ONS figures showed that overall life expectancy in 2020-22 had fallen for males and females, to 78.8 and 82.8 years respectively.

‘So not only has life expectancy stalled, but more years are now spent in poor health. Currently, males and females spend almost one-quarter of their lives in poor health,’ Ms Raleigh added.

Commenting on the ’extremely concerning’ data, Dr Sarah Clarke, president of the Royal College of Physicians, said: ’The fact that people in some parts of the country have six more years of healthy life than others highlights the urgent need to address health inequalities.

’To narrow this gap we need to tackle the factors that make people ill in the first place – from poor housing, air quality, and the marketing of food and alcohol, to employment (including how much money you have), racism and discrimination, and transport.’

As such, Dr Clarke called for ‘coordinated and collective efforts from all parts of Government‘.

She said: ‘The Government’s upcoming Major Conditions Strategy – which the Secretary of State for Health and Social Care said this week [26 March] would be published over the next few months – is a vital opportunity to commit to bold cross-Government action. Without concerted action from across government, ill health in the population is likely to grow.‘

Ms Raleigh echoed this, calling for ‘bolder measures’ to prevent and manage ill health to be an ‘urgent priority’ for the Government.

A version of this article was originally published by our sister publication Healthcare Leader.

Acute asthma admissions sharply declined during lockdowns as air quality improved, study reveals

9th February 2024

Reduced pollution levels and better air quality during the Covid-19 pandemic lockdowns strongly correlated with lower rates of acute asthma care provision, according to new research led by the University of Birmingham.

The retrospective time-series study, published in the BMJ Open, investigated the link between acute asthma hospital admissions and specific air pollutant levels in four Oxford postcodes during the national lockdowns of March to June and November to December 2020.

For adult residents, acute asthma admissions fell from 78 per 100,000 residents in 2015-19, to 46 per 100,000 residents in 2020 – a reduction of 41%.

This reduction in acute asthma care coincided with levels of air pollution falling significantly. Different pollutants dropped by 18-33% when compared to average values for the previous five-year period.

For example, nitrogen dioxide (NO2) reduced by 26.7% from a 2015-19 average of 14.6 μg m-3 to 10.7 μg m-3 in 2020.

Fine particulate matter (PM2.5) saw a reduction of 33.5% from 10.1 μg m-3 in 2015-19 to 6.7 μg m-3 in 2020, and PM10 reduced by 18.6% from 13.2 μg m-3 in 2015-19 to 10.8 μg m-3 in 2020.

‘Large-scale measures to improve air quality have potential to protect vulnerable people living with chronic asthma in urban areas,’ the authors concluded.

Commenting on the ‘unique situation’ of temporary air quality improvement, Dr Suzanne Bartington, clinical associate professor of environmental health at the University of Birmingham and lead author of the study, said: ‘The results of air pollution levels falling may have had an impact on the number of severe asthma cases that need acute hospital care, with 41% fewer hospital stays compared to the previous five-year average.

‘Furthermore, we also identified a 4% increase in risk of asthma hospital admissions for every 1 μg m-3 increase in mean monthly NO2, and an approximately 3% increase in risk for every 1 μg m-3 increase in mean monthly PM2.5 levels.

‘This is an important study to help us better understand how demand for NHS inpatient care may change when air quality is improved.’

The research team was supported by the University of Oxford, Oxfordshire County and City Councils and the then Oxfordshire Clinical Commissioning Group.

Commenting on the results, Councillor Nathan Ley, Oxfordshire County Council’s cabinet member for public health, inequalities and community safety, said: ‘We must now use what we have learned, thanks to this research with our partners, to improve our environment, in line with the Clean Air Strategy which we launched last year.

‘Elevated levels of NO2, PM2.5 and PM10 contribute towards heart disease, chronic lung disease, cancers, preterm births, and many other avoidable events. The vision of Oxfordshire County Council to tackle this issue remains clear. We must continue to use all the tools at our disposal to lead the country, clean up our air and save lives.’

Earlier this week, the European Respiratory Society (ERS) warned of rising respiratory diseases, such as asthma, as well as premature death without urgent action on air quality.

This followed the ERS consensus statement on climate change and respiratory health, published in September 2023, which highlighted the damaging effects of air pollution on health and global warming.

Pandemic lockdowns linked to sustained cognitive decline among older adults, study finds

8th November 2023

There was a more rapid cognitive decline in people aged over-50 during the pandemic, according to recent research, highlighting the need for public health measures to protect against dementia risk.

Covid-19 infection was found to be a risk factor, but the general more rapid decline in brain health was apparent even if people had not had the virus, the researchers found.

Published in the journal The Lancet Healthy Longevity, the online PROTECT study found a 50% change in the rate of cognitive decline in the first year of the pandemic among the 3,000 participants.

The analysis of tests of short-term memory and complex tasks also found that the rate of cognitive decline was higher in those who already had mild cognitive decline before the pandemic.

It appears to have been exacerbated by a number of factors among the 50-to-90-year-olds taking part, including an increase in loneliness and depression, a decrease in exercise and higher alcohol consumption.

In the second year of the pandemic, reduced exercise continued to affect executive function and associations were sustained between worsening working memory and increased alcohol use. This suggested a sustained impact after the initial 12-month period of lockdowns, the team from the University of Exeter and King’s College London (KCL) said.

The sustained drop in cognition highlights the need for public health interventions to mitigate the risk of dementia – particularly in people with mild cognitive impairment where diagnosis of dementia within five years is a substantial risk, they concluded.

Professor Anne Corbett, professor of dementia research and the PROTECT study lead at the University of Exeter, said: ‘Our findings suggest that lockdowns and other restrictions we experienced during the pandemic have had a real lasting impact on brain health in people aged 50 or over, even after the lockdowns ended.

‘This raises the important question of whether people are at a potentially higher risk of cognitive decline which can lead to dementia.

‘It is now more important than ever to make sure we are supporting people with early cognitive decline, especially because there are things they can do to reduce their risk of dementia later on.’

She added that the findings highlight the need for policymakers to consider the wider health impacts of restrictions like lockdowns when planning future pandemic responses.

Professor Dar Aarsland, professor of old age psychiatry at KCL, said the research adds to the knowledge of the long-standing health consequences of Covid-19, particularly for the most vulnerable people such as older people with mild memory problems.

He said: ‘We know a great deal of the risks for further decline, and now can add Covid-19 to this list. On the positive note, there is evidence that lifestyle changes and improved health management can positively influence mental functioning. The current study underlines the importance of careful monitoring of people at risk during major events such as the pandemic.’

A version of this article was first published by our sister publication Pulse.

Covid-19 global health emergency over, declares WHO

9th May 2023

The global health emergency posed by Covid-19 is over, the World Health Organization (WHO) has declared, while also stressing that the disease remains a ‘global health threat’.

For over a year, the Covid-19 pandemic had been ‘on a downward trend’, due to population immunity increasing from vaccination and infection, mortality decreasing and the pressure on health systems easing, said Dr Tedros Adhanom Ghebreyesus, director-general of the WHO.

WHO and the Emergency Committee, convened under the International Health Regulations, ‘have been analysing the data carefully and considering when the time would be right to lower the level of alarm’ over the last twelve months.

Based on their recommendations, Dr Tedros declared Covid-19 over as a global health emergency on 5 Mya 2023, making the statement ‘with great hope’ he said.

Covid-19 remains a threat

‘That does not mean Covid-19 is over as a global health threat’, he stressed. Indeed, one person dies from Covid-19 every three minutes, thousands of people around the world are currently in intensive care units with the condition and there are ‘millions more’ suffering the effects of long-Covid.

‘This virus is here to stay. It is still killing, and it’s still changing. The risk remains of new variants emerging that cause new surges in cases and deaths,’ Dr Tedros said, warning countries to be complacent. ‘The worst thing any country could do now’ would be ‘to use this news as a reason to let down its guard, to dismantle the systems it has built, or to send the message to its people that Covid-19 is nothing to worry about’.

Instead, he advised countries to transition from ’emergency mode to managing Covid-19 alongside other infectious diseases’,’ added Dr Tedros’, evidence of which has been seen recently with WHO’s recent pulse survey revealing a move towards restoring essential health services.

‘Skill and selfless dedication’

Dr Tedros also celebrated the efforts of healthcare workers in helping to control the virus.

‘We have arrived at this moment thanks to the incredible skill and selfless dedication of health and care workers,’ he said. ‘The suffering we have endured, the painful lessons we have learned, the investments we have made and the capacities we have built must not go to waste’.

‘We owe it to those we have lost to leverage those investments; to build on those capacities; to learn those lessons, and to transform that suffering into meaningful and lasting change,’ he added, urging ‘a commitment to future generations that we will not go back to the old cycle of panic and neglect that left our world vulnerable’.

A version of this story was originally published by our sister publication The Pharmacist.

Cancer diagnoses in young people fell but ICU admissions increased during first wave of pandemic

19th November 2021

Cancer diagnoses in young people fell during the first-wave of the pandemic but were associated with a higher rate of ICU admissions

The level of cancer diagnoses in young people fell during the first-wave of the COVID-19 pandemic but there was also an increased likelihood of admission to intensive for cancers diagnosed during the period. This was the finding from a study by researchers from Oxford University, UK who discussed their findings in a poster presentation at the National Cancer Research Institute conference.

The COVID-19 pandemic has had a major impact on cancer services in the majority of countries across the world. In the UK, a survey by Cancer Research UK in July 2020, found that 2 in 3 cancer patients reported that their cancer care had been impacted and that ratings of overall cancer care as ‘very good’ decreased from 75% ‘before lockdown started’ to 37% ‘after lockdown started’. Moreover, other research shows that in England, there were approximately 3.4 million fewer key diagnostic tests performed between March and August 2020 compared with the same period in 2019.

Given the likely impact of delays in diagnostics, the Oxford team were interested in determining how in England, the first wave of the pandemic affected childhood, teenager and young adult cancer incidence rates, diagnostic and treatment time-intervals and cancer-related intensive care (ICU) admissions. They used the QResearch database, which is derived from the anonymised health records of over 35 million patients. In addition, since QReseaerch is also linked to linked to hospital admission, mortality and cancer diagnoses data held with a disease register, it was possible for the researchers to make links between these three factors. For the present study, researchers focused on central nervous system (CNS) tumours, lymphomas, leukaemias, sarcomas and renal tumours in those aged up to 25 years of age. They compared the incidence of these cancer diagnoses between 1st February to the 15th August 2020 and compared their findings to the three preceding pre-pandemic years. As well as the number of diagnoses, the team also analysed the length of time before treatment started after diagnosis and whether or not these patients were diagnosed after being admitted to intensive care.

Findings

A total of 2607 cancer diagnoses were made from 1st January 2017-15th August 2020, with 380 during the pandemic. Overall, this represented a 17% reduction (95% CI -38% to – 6%) in the incidence-rate-ratio during the first wave of the pandemic. In particular there was a 38% (95% CI -52% to -21%)] decrease in CNS tumours and a 28% (95% CI -45% to -5%) reduction in lymphomas. Interestingly, the researchers observed that childhood cancers that were diagnosed during the pandemic were more than twice as likely to be associated with an ICU admissions (adjusted odd ratio, OR = 2.2, 95% CI 1.33 – 3.47).

The researchers also observed that the median time to diagnosis was not significantly different across the different time periods (+4.5 days, 95% CI -20.5 days to +29.5) and the median time to treatment was actually shorter during the pandemic (-0.7 days, 95% CI -1.1 to -0.30).

The authors concluded that the COVID-19 pandemic led to substantial reduction in the detection of cancer in young adults but was also associated with an increase in cancer-related ICU admissions. They suggested that this was probably due to more severe baseline disease at diagnosis and that overall, their findings demonstrate a clear disruption to cancer diagnostic pathways in this age group which need to be addressed urgently in the recovery phase of the pandemic.

Citation

Saatci D et al. The impact of the COVID-19 pandemic on cancer diagnostic pathways in children, teenagers and young adults: a cohort study in England. NCRI conference 2021

Study shows that colorectal cancer diagnoses dropped over 40% during pandemic

4th October 2021

The number of colorectal cancer (CRC) cases diagnosed fell dramatically by 40% in a year during the COVID-19 pandemic, research presented at UEG Week Virtual 2021 has shown.

The research, which was conducted across multiple hospitals in Spain, compared data from the first year of the COVID-19 pandemic with data from the previous year. Of 1385 cases of CRC diagnosed over the two-year period, almost two thirds (868 cases, 62.7%) were diagnosed in the pre-pandemic year from 24,860 colonoscopies. By contrast, only 517 cases (37.3%) were diagnosed during the pandemic, which also saw a 27% drop in the number of colonoscopies performed, to 17,337
 
Those who were diagnosed with CRC between 15 March 2020 and 28 February 2021 were also older than in the pre-pandemic year, had more frequent symptoms, a greater number of complications and presented at a more advanced disease stage.
 
Experts say the fall is a consequence of the suspension of screening programmes and the postponement of non-urgent colonoscopy investigations during the pandemic. Fewer cancers were identified by CRC screening in the pandemic period, with just 22 (4.3%) cases found in comparison to 182 (21%) in the pre-pandemic year. During the pandemic, more patients were diagnosed through symptoms (81.2% of diagnoses) compared with the pre-pandemic year (69%).
 
Dr María José Domper Arnal, from the Service of Digestive Diseases, University Clinic Hospital and the Aragón Health Research Institute (IIS Aragón) in Zaragoza, Spain, and lead author of the study, commented “These are very worrying findings indeedcases of colorectal cancer undoubtedly went undiagnosed during the pandemic. Not only were there fewer diagnoses, but those diagnosed tended to be at a later stage and suffering from more serious symptoms.”
 
There was a significant increase in the number of patients being diagnosed with serious complications – a sign of late-stage disease – with an increase in symptoms such as bowel perforation, abscesses, bowel obstruction and bleeding requiring hospital admission. These cases made up 10.6% pre-pandemic and 14.7% during the pandemic. The number of stage IV cancers being diagnosed rose during the pandemic year, with stage IV cases making up 19.9% of cases, in comparison to 15.9% in the previous year.
 
Although these figures are across a population of 1.3 million in Spain, it’s highly likely that the same drop in diagnoses would have happened elsewhere across the globe where screening was stopped and surgeries postponed, especially in countries that were heavily impacted by COVID-19”, explained Dr Arnal.
 
Colorectal cancer is often curable if it’s caught at an early stage. Our concern is that we’re losing the opportunity to diagnose patients at this early stage, and this will have a knock-on effect on patient outcomes and survival. We are likely to see this fall out for years to come.”

Source

Impact of the COVID-19 pandemic in the diagnosis and characteristics of colorectal cancer patients, presented at UEG Week Virtual 2021

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