Medicine and Science from The BMJ

Talk Evidence - re-hospitalistion for covid-19, remote hypertension intervention

The evidence geekery continues, and this week Helen Macdonald and Duncan Jarvies are joined by Joe Ross, The BMJ's US research editor, and professor of medicine and public health at Yale.
This week we pick up on a preprint in medRxiv, which has been attracting attention on social media - it tries to look at the longer term effects of covid hospitalisation.
Joe explains why he thinks propensity matching can be summarised as "doing your best".
Finally, as more and more care moves remotely, we discuss a trial on a digital intervention to help manage poorly controlled hypertension remotely.
Reading list:
Epidemiology of post-COVID syndrome following hospitalisation with
coronavirus: a retrospective cohort study
https://www.medrxiv.org/content/10.1101/2021.01.15.21249885v1.full.pdf
Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial
https://www.bmj.com/content/372/bmj.m4858

Neil Greenberg on tackling PTSD in the NHS

Neil Greenberg is a psychiatrist, and professor of Defence Mental Health at King's College London. He spent 23 in the military, and now continues to work with them on things like peer led traumatic stress support packages.
A recent survey of NHS staff showed disturbing signs that covid-19 has caused a widespread trauma in staff, so in this podcast we talked to Neil about trauma and moral injury, what some of the warning signs are, and what individuals and organisations can do to help their colleagues.
www.bmj.com/wellbeing

The BMJ interview - Jeremy Hunt MP

Jeremy Hunt probably needs no introduction to our audience - the UK's longest serving health minister, he now chairs Westminster's Health and Social Care Committee - the powerful committee that holds the government to account for its policy choices.
In this interview Gareth Iacobucci asks Hunt if he regrets his decision to impose the contract on junior doctors which lead to their industrial action, how workforce issues have left the NHS in a poor state to deal with a health emergency. They also talk about the potential for a public enquiry into the government's handling of the pandemic, and what an upcoming committee report into the same issue might find.

Coronavirus second wave - The NHS one year on

The "public health emergency of international concern" was issued by the WHO a year and a lifetime ago. As the UK ramps up testing for the South African virus variant, and is full steam ahead on vaccination, we look back at what we've learned in that time.
In this podcast, Fiona Godlee, editor in chief of The BMJ, talks to; Partha Kar, consultant in diabetes and endocrinology in Portsmouth, Matt Morgan, a consultant in a intensive care medicine in Cardiff, and Helen Salisbury, GP in Oxfordshire.
They talk about working in the NHS at the moment, the utility of international comparisons, and their remaining questions about vaccination regimes.
www.bmj.com/coronavirus

The BMJ interview - Tom Frieden, former CDC director on why we thought we were prepared

It’s been just over a year since the WHO declared the pandemic a “Public Health Emergency of International Concern” - if you cast your mind back to then, the news was full of reassurances about how prepared the UK and the USA were for a pandemic.
Now a year later, with the benefit of hindsight, that confidence was wildly overstated - but why was that, what is the gap between that theoretical readiness, and reality.
In this podcast we're joined by talking to Tom Frieden - former director of the Centres for Disease Control and Prevention, under President Obama, and who has a long history of public health leadership.
He talks about the gap between the apparatus to do something, the the political will to do that. Why data have been lacking, and the interaction between a infectious and non-infectious diseases.
www.bmj.com/coronavirus

Coronavirus second wave - 100,000 deaths

Recorded on the 26th January 2021
The UK has become, officially, the worst performing country in terms of Covid-19 deaths, per head of population - and the number of people in hospital is still higher than at any point in the pandemic.
In this podcast, Fiona Godlee, editor in chief of The BMJ, talks to; Partha Kar, consultant in diabetes and endocrinology in Portsmouth, Matt Morgan, a consultant in a intensive care medicine in Cardiff, and Helen Salisbury, GP in Oxfordshire.
They talk about working in the NHS at the moment, and the challenges in things like oxygen and vaccine supplies. How the pandemic has exposed a gap in general medicine, and the importance of challenging poor responses at all levels.

Coronavirus second wave - The view from the front line

In the UK, over 37,000 people are in hospital with covid-19, and the NHS comes closer than ever to being overwhelmed - though 4 million people have received their first dose of the vaccine, we are warned that things will get worse before they get better.
In this podcast, Fiona Godlee, editor in chief of The BMJ, talks to; Partha Kar, consultant in diabetes and endocrinology in Portsmouth, Matt Morgan, a consultant in a intensive care medicine in Cardiff, Helen Salisbury, GP in Oxfordshire, and Nisreen Alwan, public health consultant in Southampton, about the pressure on hospitals, why GPs are questioning the need for max vaccination centres, and why the public health approach can't be just lockdown and vaccinations.
www.bmj.com/coronavirus

The BMJ interview: Fixing America’s covid response in the Biden era

US president elect Joe Biden wasted no time in appointing a special advisory board of experts to guide America out of its coronavirus crisis.
One of those experts is Celine Gounder, an infectious diseases epidemiologist who has worked on Ebola, tuberculosis, and HIV in Africa and South America. She’s a clinical assistant professor of medicine and infectious diseases at New York University’s School of Medicine, as well as an active writer and podcast host, including of Epidemic
In this podcast she talks to Joanne Silberner about the ways in which the taskforce is helping prepare for action immediately after the inauguration, what the big challenges they need to tackle are, and how they plan to rebuild trust in the U.S. covid response.
https://www.bmj.com/content/372/bmj.n33

Talk Evidence - Lateral flow tests update, not the best public health approach

In this episode of Talk Evidence, Jon Deeks, professor of biostatistics at the University of Birmingham, returns to the pod with an update on lateral flow tests - and why the government plan for using them in asymptomatic screening for covid-19 doesn't follow the science.
We're also joined by Allyson Pollock, clinical professor of public health at Newcastle University, and author of a recent editorial in The BMJ about asymptomatic transmission of SARS-CoV-2. She explains why she thinks supporting social isolation is the missing piece of our approach to tackling the pandemic.
Covid-19 INNOVA testing in schools: don’t just test, evaluate
https://blogs.bmj.com/bmj/2021/01/12/covid-19-innova-testing-in-schools-dont-just-test-evaluate/
Asymptomatic transmission of covid-19
https://www.bmj.com/content/371/bmj.m4851

The BMJ Interview - Andrew Pollard on the Oxford/Astra Zeneca vaccine

Andrew Pollard is Director of the Oxford Vaccines Group - who, along with Astra Zeneca, have developed an modified adenovirus vaccine for SARS-CoV-2.
In this interview we talk to him about the development of that vaccine - what he thinks about the UK government's plan to increase the interval between doses; if he worries about a mutating virus and vaccine escape; and how the university came to make a deal with a commercial company to provide cost-price vaccinations for the world.
www.bmj.com/coronavirus