Medicine and Science from The BMJ

Stephen Thomas - Behind the scenes in the Pfizer vaccine trial

Never has the spotlight been as strong on a clinical trial as that on the Pfizer BioNTech vaccine, the first approved for covid-19.
In this interview, Joanne Silberner spoke to its lead principal investigator, Stephen Thomas chief of infectious diseases at SUNY Upstate Medical University, New York, became the lead principal investigator for one of the most closely watched clinical trials in history.
They discuss the moment the positive results came through, what will happen to the people who are still enrolled in the trial, but got a placebo dose, and why the trial was designed in the way it was.
www.bmj.com/coronavirus

Coronavirus second wave - cancelled surgery, increasing waiting lists

Many surgeries have been cancelled during the pandemic, with good reason, as early data showed the increase in mortality associated with a coronavirus infection, but now waiting lists grow, and there are questions about how the NHS will pick up the slack.
In this podcast, Fiona Godlee, editor in chief of The BMJ, talks to the full panel; 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.
They are joined by Mary Venn, research fellow, and honorary surgical registrar in London, who's been looking into the pandemic's effect on surgery. For more on that research:
http://nihrglobalsurgery.org/surgeryduringcovid
To register for our covid known unknowns webinar - https://www.bmj.com/covid-19-webinars

Wellbeing - speaking out about mental health in the NHS

Ashling Lillis is a now consultant in acute medicine at Whittington Health NHS Trust, but she was almost a consultant in intensive care medicine - but a mental health crisis just 6 months before she qualified made her reassess her career, and choose a different path.
In this podcast, Ash talks to Abi and Cat about the difficulty many doctors have when discussing their mental health - and how speaking out about her own experiences, has encouraged others to talk to her privately - and opened her eyes to the extent of the problem in the NHS.
www.bmj.com/wellbeing

The BMJ Interview - Jeremy Farrar; sharing the vaccine is enlightened self interest

Jeremy Farrar, is director of the Wellcome Trust, as well as advisor to the government on SAGE. Trained as a medic and with a PhD in neuro-immunology, he was a professor of Tropical Medicine and Global health at the University of Oxford.
In this podcast, he tells us why he thinks that vaccine nationalism is a very short-termist response the pandemic, and why he's bullish about new variants of the SARS-CoV-2 virus.
www.bmj.com/coronavirus

Corona virus second wave - Palliative care, and online abuse

In this podcast, Fiona Godlee, editor in chief of The BMJ, talks to; Partha Kar, consultant in diabetes and endocrinology in Portsmouth, Helen Salisbury, GP in Oxfordshire, and Nisreen Alwan, public health consultant in Southampton. This week our special guest is Rachel Clarke, author and palliative care specialist.
The panel discuss how end of life care has changed in the pandemic, and how clinicians have become targets of abuse on social media, for speaking out about things like masks and hospital capacity.

Wellbeing special - A post vaccination mindfullness moment

The observation period, after receiving a covid-19 vaccination may be the only 15 minutes someone in the NHS might get all day.
In this podcast, we're joined again by Chris Bu, psychiatry trainee who has previously spoken to us about how Burmese Buddhism helped him in his training.
He takes us through a guided mindfullness meditation, tailored to that post-vaccination period, to help you make the most of your observation time.
www.bmj.com/wellbeing

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