What the papers say – weekly digest (08/12/23)

Your weekly digest of the top healthcare stories, covering news published from 04/12/2023 – 08/12/2023.

The Daily Express

A revolutionary computer program can predict if type 2 diabetes patients are likely to have a heart attack or stroke up to a decade before one strikes. The Score2 software pinpoints those most at risk of developing serious cardiac complications by assessing blood sugar levels. In turn, doctors will be able to target patients urgently needing higher doses of medication as well as suggest lifestyle changes to ward off future heart troubles. More than four million people in the UK suffer from type 2 diabetes – when the body stops responding adequately to the hormone insulin, which is needed to turn sugar in the blood into energy. Increased  levels can, over time, cause fatty deposits to form inside blood vessels, reducing circulation and increasing the risk of heart attacks, strokes, lower limb amputation and even blindness. Type 2 diabetes can develop through poor diets and sedentary lifestyles, though it may also be inherited. Research has also shown that sufferers are twice as likely to die from heart problems compared to those without it.

A jab to protect against one of the most common winter bugs will be offered to children and older adults within a year, a top vaccine chief has revealed. The Government’s inoculation advisory group recommended in June that an immunisation programme be rolled out against respiratory syncytial virus (RSV) – best known for causing the lung infection bronchiolitis in children. Three highly effective RSV vaccines have been given the green light for use in the UK, including one developed by drug firm Pfizer that was approved last week by the Medicines and  Healthcare products Regulatory Agency. But according to Professor Adam Finn, a child vaccine expert and member of the Government’s Joint Committee on Vaccination and Immunisation (JCVI), the roll-out won’t begin until next year, due to delays by health officials in working out a deal with the vaccine manufacturers. The charity Asthma + Lung UK last week called on the Government to deliver the jabs ‘as soon as possible’ after the number of children hospitalised with the bug quadrupled within just a month. RSV hospitalises about 30,000 children and 18,000 adults each year – but until recently, no valid vaccine had been developed.

Action to tackle the scourge of child suicide is at the heart of a packagee of reforms intended to make Britain the safest place in the world to go online. Science, Innovation and Technology Secretary Michelle Donelan this week aims to change the law so social media platforms must provide coroners with details of what young people did online before taking their lives. The tech firms will be required to preserve any information which could be used in an inquest or other investigation. She hopes that by shedding light on the internet activity of children who take their lives, future deaths can be prevented  – and grief-stricken parents will discover what their child experienced online before their death. The move to get social media companies to preserve their information will be made through an amendment to the Data Protection and Digital Information Bill, which goes before MPs on Wednesday.

Covid taught us all the importance of vigorous hand-washing – but a study of office workers has found those habits have now all but disappeared. The survey found 39 per cent of Britons wash their hands only between three and five times a day – about half the amount exports recommend to keep viruses and bacteria at bay. The worst culprits are estate agents, more than a third of whom are guilty of ‘inadequate’ hand-washing, the research by cleaning firm Cleanology found.

Overindulging in Christmas treats can increase the risk of deadly heart trouble, an expert has warned. Research from Melbourne University shows heart attacks spike  during the festivities, while other studies suggest the number of people dying from cardiac complaints over Christmas and New Year is  four per cent above the winter average. Worse still, deaths often peak on Christmas Day itself. Rich foods, excess alcohol and stressful family get-togethers can be lethal, warns Dr Avinash Hari Narayanan, from cholesterol-test supplier London Medical Laboratory. He advises ‘Go easy on fatty foods and alcohol, and try exercises and deep breathing to calm the mechanism that converts stress to heart attacks and strokes.’

Nearly half of Brits have found themselves in a ‘viral spiral’ since the pandemic – falling ill repeatedly with consecutive ailments. A poll found many are finding it harder to shake off sickness bugs and, as a result, 80 per cent will skip social events to avoid becoming unwell over Christmas. The research, by supplement brand Sambucol, found that one third of people will avoid the office Christmas party and  a quarter will miss visiting family because of the fear of being poorly.

The Daily Telegraph

GP appointments over the phone or online risk harming patients, a study published in the British Medical Journal (BMJ) has found. An analysis of remote NHS doctor consultations between 2020 and 2023 found that ‘’deaths and serious harms’’ had occurred because of wrong or missed diagnoses and delayed referrals. Distracted receptionists were also found to be responsible for deaths after they failed to call patients back. The report, led by the University of Oxford, suggested doctors should stop giving phone appointments to the elderly, people who are deaf, or technophobes. As many as a third of GP appointments are now virtual after face-to-face appointments slumped to less than half during the pandemic. Restoring access to face-to-face appointments has been a priority of multiple health secretaries, with Steve Barclay last year promising to name and shame GPs who did not see patients in person. Patient groups said the study was likely to be ‘’just the tip of the iceberg’’ given the ‘’potential for tragic misdiagnoses because of the limitations of online or telephone consultations’’. Researchers said incidents involving death or serious harm were ‘’rare’’ and that the ‘’vast majority of remote clinical consultations in general practice’’ were safe. Experts from the University of Oxford examined 95 serious safety incidents in Britain since 2020 in which patients came to harm. Errors made over the phone included missed diagnoses or an underestimation of the severity of a range of serious conditions including sepsis, cancer, congenital heart disease and diabetic foot complications. They said they ‘’would likely have been readily diagnosed with an in-person examination’’, and found there was more risk of patients coming to harm if they had urgent conditions including new chest or abdominal pain, palliative care, physical injuries or diabetes, or if they were particularly young or old.

Covid-19 may be a man-made virus which made it difficult to prepare for the pandemic, Michael Gove has suggested. In the first major government intervention into the issue, Mr Gove told the Covid Inquiry there was ‘’significant body of judgement’’ that considered the virus was not natural. The Levelling-Up Secretary, who was Cabinet Office minister  and chancellor of the Duchy of Lancaster when the pandemic began in 2020, said dealing with such a ‘’novel’’ virus presented ‘’new challenges’’ which required new science. ‘’We were not well prepared as we should have been ideally,’’ he told the inquiry. ‘’A significant body of judgement that believes that the virus itself was man-made and that presents sort of challenges as well.’’ The debate over the origins of Covid-19 has proved contentious since the first cases emerged just eight miles from the Wuhan Institute of Virology (WIV) where scientists had been experimenting with Sars-like coronaviruses.

Social media firms are failing to protect children from being bombarded with thousands of harmful posts glorifying suicide despite the death of Molly Russell, a study has found. The research by the foundation set up in 14-year-old Molly’s memory by her family and friends found the most popular posts promoting or glorifying suicide had been liked by more than one million accounts, often driven to young users by ‘’engagement’’ features such as hashtags like ‘’#letmedie’’. The findings – timed to coincide with what would be her 21st birthday – come a year after an inquest verdict ruled her exposure to 16,000 ‘’destructive’’ posts on self-harm and suicide ‘’more than minimally contributed’’ to her death. It was the first time tech platforms had been held formally responsible for the death of a child. The research by the Molly Rose Foundation with the Bright data initiative collected and analysed data from 1,181 of the most ‘’engaged’’ posts on social media platforms Instagram and TikTok, using well known suicide, self-harm and depression hashtags. They were graded as ‘’harmful’’ if they promoted or glorified suicide or self harm, referenced suicide and self-harm ideation or contained relentless themes of misery, hopelessness and depression.

Transgender people are most likely to come from deprived areas, a new study has found. For the first time experts have been able to analyse trends among transgender people by examining the GP records of more than seven million people. Using the Townsend score – which looks at rates of employment, home and car ownership, income and education – they found that people living in some of the UK’s poorest areas are two-and-a-half times as likely to be transgender. The study, which was conducted by researchers at University of College London and published in the British Medical Journal, also found that the number of transgender people in Britain has risen sixfold since 2000. The number of people with gender dysphoria, a feeling not being the sex they should be, rose from one in 15,000 in 2000 to more than one in 2,500 by 2018. Researchers speculated that wealthier patients could be accessing care privately ‘’without going to the GP’’ first, or that trans people were more likely to be excluded from society and education.

The Guardian

Walking faster is linked to a significantly lower risk of developing type 2 diabetes, according to the first global study of its kind. Type 2 diabetes is one of the world’s major health threats, with its prevalence rising sharply in the last three decades, according to the World Health Organization. More than 537 million people have been diagnosed, but millions more are estimated to be in the dark about the fact they have the condition. It is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Researchers have known for some time that walking – and doing so frequently – is associated with a lower risk of type 2 diabetes, but it has remained unclear what walking speed is optimal. Now a worldwide analysis of studies shows that a brisk walk or striding is better for reducing your risk than walking at a slower pace. While physical activity is known to be associated with a lower risk of developing type 2 diabetes, researchers from Imperial College London, the University of Medical Sciences in Iran and Oslo New University College in Norway wanted to determine the optimal walking speed. The research, published online in the British Journal of Sports Medicine, found people who walked faster than 3km/h (about 1.9mph) were less likely to develop the condition, while those with a speedier stride of more than 6km/h (about 3.7mph) lowered their risk by 39%.

Tens of thousands of men struggling with urinary incontinence could be helped by a change in the law being demanded by a group of MPs. They have called on the Government to ensure that all male public toilets – as well as those in shops and restaurants – have sanitary bins installed for the hygienic disposal of incontinence pads. Current legislation requires these containers are provided for female staff in the workplace, to dispose of used tampons and pads. Most women’s public bathrooms feature them, too. But there is no such provision for men, even though one in three over 65s suffer some degree of leaks – often as a result of surgery for prostate cancer. Earlier this year the charity Prostate Cancer UK launched a campaign called Boys Need Bins. It says one in eight men get prostate cancer – rising to one in four among black men – and a significant number experience bladder problems. This is because prostate surgery may damage the nerves that control urinary function as the cancerous tissue is removed.  The charity claims more than a third of men with incontinence will leave home less often due to leaks and problems with pad disposal, increasing their risk of social isolation. Its research shows a similar number also keep wet pads on, rather than try to find somewhere to get rid of them. But there is headway being made. Earlier this year, Jersey passed a law demanding sanitary bins in all men’s public toilets on the island, and Winchester Council in Hampshire has voluntarily installed them in male toilets. Meanwhile, hygiene specialist PHS Group has fitted them in all 60 or so motorway service stations run by the Moto group.

Whether it’s a tickle of the nose or an irritation in one’s hair, itches can be excruciating. Now scientists say they have found a common type of skin bacterium can trigger the sensation. Crucially, as such bacteria are often found on the skin of patients with eczema – or atopic dermatitis – the work helps explain why such conditions can be accompanied by the urge to scratch. Prof  Isaac Chiu, the senior author of the research, said the study showed that the composition of microbes on our skin was important for our health. The study unpicks the relationship between Staphylococcus aureus – often called staph – and atopic dermatitis, which affects up to 20% of children and 10% of adults. The team discovered mice with methicillin-resistant staph (MRSA) applied to their skin were more likely to develop dermatitis than mice without, scratched far more, and were more sensitive to being touched with a small filament. The latter, said  Chiu, is similar to how people with eczema can find it excruciating to have a woolly sweater rubbing against their skin. The team then explored how the bacterium triggered itchiness. They treated mice with genetically modified forms of MRSA that were unable to produce particular chemicals. A process of elimination unmasked the protease V8  enzyme as the culprit: when this was applied to mice it caused them to scratch. Skin swabs from people with atopic dermatitis had higher levels of this enzyme. Further experiments revealed the enzyme interacted directly with nerve cells in the skin that carry itch signals to the brain, by binding to particular receptors on the neurons. When the team gave mice an anti-clotting drug known to block these receptors elsewhere in the body, the itchiness of the mice subsided. Chiu said it would be exciting to explore whether the drug could be used in a cream or ointment to treat itchiness.

Debilitating hip fractures are causing more than 1,500 deaths a year in England because the NHS is failing to detect osteoporosis in patients, a charity has claimed. Many sufferers with the bone-thinning disease are also left to deal with acute pain and mobility issues. The Royal Osteoporosis Society (ROS) claims the deaths – usually caused by heart problems triggered by the hip injury – are preventable and the result of a postcode lottery in screening service run by NHS hospital trusts. Fracture Liaison Services offer routine scans to anyone over the age of 50 who suffers a bone injury caused by a minor accident – such as tripping over and breaking a wrist – which could allude to low bone density and a danger of further breaks. If spotted, they can be offered drugs to strengthen their bones, reducing the risk of future fractures. Osteoporosis affects some 3.5 million people in the UK – women are most at risk because levels of the hormone oestrogen – which helps keep bones strong – plummet after the menopause. Patients do not die directly from the disease; it instead increases the chances of other deadly conditions, such as pneumonia or heart failure. Craig Jones, chief executive of the ROS, estimates 1,600 people in England die each year as their condition goes undetected.

Patients with a rare and  aggressive cancer affecting the biliary tract – the organs and ducts that move the digestive fluid bile into the gut – are set to benefit from a new combination of drugs given the green light last week. Around 70 percent of people with the cancer are diagnosed at a late stage and there are few treatment options. It affects 2,500 people in the UK each year and fewer than 15 per cent survive five years. But a trial found taking AstraZeneca’s immunotherapy drug Imfinzi alongside two chemotherapy drugs doubles the chance of living two years, compared with chemo medicines alone. The combination is now available on the NHS.

The Times

Long-term sickness will  drive a 75 per cent increase in the cost of disability benefits over the next five years, according to official estimates. Despite a back-to-work package estimated to create 50,000 jobs, welfare spending is set to rise by £100 billion by 2030 because of the pensions triple lock, higher inflation and more people claiming sickness benefits. Jeremy Hunt announced what he called ‘’the biggest set of welfare reforms in a decade’’ that will see £2.6 billion more spent on schemes for the long-term sick to find jobs, alongside tougher sanctions and work requirements. Benefits and state pensions have been uprated in line with inflation but Hunt’s plan includes removing benefits entirely from people who refuse to look for a job after six months, which will also see them stripped of entitlements such as free NHS prescriptions.

Taking drugs to treat attention deficit hyperactivity disorder significantly increases the risk of heart disease and high blood pressure, a study has found. Swedish scientists looked at the health effects of stimulant drugs including methylphenidate, known by its brand name Ritalin, that are used to treat ADHD. The drugs are taken by hundreds of thousands of people in the UK and work by stimulating areas of the brain that control attention and behaviour. People using ADHD drugs over the long term were found to be nearly twice as likely to have high blood pressure and were also at a greater risk of heart disease, which can lead to stroke and heart attacks. The study, by the Karolinska Institute, looked at data from 278,000 people with ADHD, aged between six and 64, including 10,400 with heart disease. They were followed for four years on average. Researchers compared the risk of cardiovascular problems in people taking the drugs with those of people the same age, gender and health background who were not taking medication. The risk of developing heart disease or high blood pressure increased the longer people took the medication, regardless of age. People who had been on ADHD drugs for between three and five years were 27 per cent more likely to develop cardiovascular disease than those who did not take the medication. These long-term users were 72 per cent more likely to develop high blood pressure, and rates of coronary artery disease were 65 per cent higher.

Using drones to deliver life-saving defibrillators can help keep cardiac arrest victims alive, a study suggests. The research, carried out in Gothenburg, Sweden, involved emergency call handlers dispatching a drone as well as an ambulance if they suspected a cardiac arrest. The drone carried an automated external defibrillator (AED), which uses a computer to analyse the heart rhythm of a patient. Where appropriate, it delivers an electrical shock to restore a normal heartbeat. During the trial, drones delivered AEDs to 55 cases of suspected cardiac arrest. In 37 of those, the drones arrived before ambulance crews. There were 18 cases of cardiac arrest and a member of the public managed to use an AED for six of them. Sofia Schierbeck, a PhD student at the Karolinska Institutet who led the study, said the drone project ‘’works throughout the year, in daylight and darkness’’. The results were published in the Lancet Digital Health.

Fears about doctors being replaced by robots or chatbots must be overcome to speed up the use of technology in the NHS, according to a report. A poll of 7,100 adults by the Health Foundation examined views towards artificial intelligence (AI) in healthcare as ministers seek to expand use of the technology to cope with workforce shortages and an ageing population. Other countries, including Japan, have introduced ‘’care robots’’ that use AI to help to look after older people. However the poll found that only one in three people in Britain would be happy for a robot to help them with tasks such as washing. People also oppose replacing doctors and nurses with AI chatbots, with only 30 per cent wanting to see greater use of automated systems to get health advice. However, most people are positive about other forms of technology, including self-monitoring devices such as blood pressure monitors that allow people to be treated at home.

Thousands of children are suffering concussive injuries from playing rugby each year, a new study has shown, despite mounting evidence of the risk from repeated blows to the head. The most detailed analysis yet of head injuries in young sportspeople reveals more than 4,000 under-18s were referred for medical intervention for suspected concussion on the playing field in the past 12 months and about 80 per cent were treated for concussion. The vast majority, 73 per cent, were playing rugby; other sports included football and hockey. The data was collected by Return2Play, a specialist head injury company that helps schools and clubs document concussions. It works with 86 schools, mostly independent, in the UK. In the past year alone almost 300 of the young people affected were referred for specialist treatment because they could not return to school or concentrate on their studies within a week, or because they had suffered multiple concussions on the pitch.