Medicine and Science from The BMJ

Talk evidence covid-19 update - natural history of covid, include patients in guidelines

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing.
We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you some insight into these issues.
This week:
(1.20) Carl gives us an update on the England and Wales admission data.
(3.00) Helen talks about ways in which spread and severity of infection amongst household contacts.
(8.20) We talk natural history of covid-19, and Harlan Krumholz, cardiologist at Yale, tells us what we know, and why it's difficult to have a full picture at the moment.
(15.10) Helen picks up on a study from Tim Spectre and colleagues using an app to track cases.
(20.00) Henry Scowcroft, one of The BMJ's patient editor, who also works for Cancer Research UK, joins us to talk about patients who are taking part in clinical trials, and how this is affecting them. He also touches on the thin patient participation in the design of covid treatment guidelines.
(24.10) Carl talks rapidity of publishing, and where researchers should most target their evidence outreach.
Reading list:
Reducing risks from coronavirus transmission in the home
https://www.bmj.com/content/369/bmj.m1728
Rapid implementation of mobile technology for real-time
epidemiology of COVID-19
https://science.sciencemag.org/content/sci/early/2020/05/04/science.abc0473.full.pdf
The BMJ Public and Patient participation twitter chat
https://twitter.com/hashtag/BMJdebate

Wellbeing – coping with Covid fatigue

We are more than six weeks into the lockdown and if you were to gauge the mood of the nation, it would be one of fatigue. It started as an all-hands-on-deck emergency situation, but it now transpires that the current work situation for healthcare professionals is not going to change any time soon.
This is a marathon rather than a sprint. So how can we better look after ourselves to cope with this new realisation? In this podcast we speak to Dr Caroline Walker, an NHS-based psychiatrist and therapist.
Wait til the end for Caroline's simple technique she uses to help when feeling overwhelmed.
Read Caroline and Clare Gerada's opinion piece
https://blogs.bmj.com/bmj/2020/03/31/extraordinary-times-coping-psychologically-through-the-impact-of-covid-19/

Coping with Covid with Monica Schoch-Spana and Jud Brewer

In this week’s episode, we discuss bystander guilt, convergence, brain hacks and “how you can sneeze on someone’s brain from anywhere in the world”. How can GPs cope with the myriad worries around treating patients during the current pandemic, both on the frontline and in general practice? How do we recognise and break unhelpful anxious behaviour habits and stop fixating on the news?
Our guests:

Monica Schoch-Spana is a medical anthropologist and a Senior Scholar at Johns Hopkins Center for Public Health. She specialises in crisis and risk communication, community resilience to disaster, public engagement in policy-making and public health emergency preparedness.
Jud Brewer is an addiction psychiatrist and neuroscientist, specialising in anxiety and habit change. He is the Director of Research and Innovation at Brown University’s Mindfulness Center, an associate professor of behavioural and social sciences at the School of Public Health at Brown, as well as of psychiatry at the university’s medical school.
Reading list:

Monica's blog on the psychological impacts of covid-19
 https://blogs.scientificamerican.com/observations/covid-19s-psychosocial-impacts/
Jud's article in the New York Times
https://www.nytimes.com/2020/03/13/well/mind/a-brain-hack-to-break-the-coronavirus-anxiety-cycle.html
GP course: https://drjud.com/health-care-provider-course/
Youtube animation of the NYTimes article: https://www.youtube.com/watch?v=900cOKCADIk&feature=youtu.be
Youtube coronavirus daily videos: https://www.youtube.com/watch?v=w4NwsyXRbNw&list=PL6sRqjtLfiTTni7oXKpSj2cQ9290lkpKH

Frontline stories - caring for non-covid patients

As the pandemic plays out - hospitals are reconfigured to increase critical care capacity, outpatient clinics become virtual, and elective procedures delayed.
How are these affecting care for those who are in hospital but don't have covid-19?
In this podcast, Matt Morgan,honorary senior research fellow at Cardiff University, consultant in intensive care medicine and Partha Kar, consultant in diabetes and endocrinology in Portsmouth, join us to discuss how their working week is changing.
Read the BMJ's columns
https://www.bmj.com/uk/news/views%20%26amp%3B%20reviews

Talk Evidence covid-19 update - lack of testing transparency, how to give good debate

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing.
We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you some insight into these issues.
This week:
(1.10) Carl gives us an update on the UK's figures, and how deaths outside are now being counted.
(2.10) When the pandemic slows down, and normal services resume - what should we start doing first? Helen picks up some evidence on what they might be.
(6.05) There's a signal that covid-19 may be causing coagulopathies in some patients, and Helen picks up on a listeners request for more information.
(11.22) John Deeks, professor of Biostatistics at the University of Birmingham, is leading a Cochrane initiative into examining the evidence around testing, and rivals Carl's rant when he explains how some research is being done behind a veil of confidentiality.
(35.27) When there's a lot of uncertainty, and the stakes are very high, then tempers can flare. Vinay Prasad, hematologist-oncologist in the US, and host of Plenary Sessions podcast, joins us to talk about having a good, respectful, scientific debate.

Wellbeing – how one junior doctor found a way to support frontline staff

How can we help frontline clinicians? Sometimes medics may feel uneasy or even guilty and that they could be doing more. That was what a junior doctor in Abergavenny in Wales felt and she did something about it.
In this podcast, we speak to Josie Cheetham about how she started her initiative to provide support boxes in hospitals for her colleagues working at the frontline, and how that initiative inspired others and mushroomed across the UK.

Public Health Vs The Economy

Around the world, as the covid pandemic plays out, and some countries are starting to ease their restrictions, this narrative of the economy and public health being opposing weights on a set of scales keeps returning - they need to be balanced.
But before this, a healthy population is very much seen as being supportive of the economy. So is a pandemic different, or is that dichotomy false.
Joining us to discuss are;
Martin Mckee, professor of european health at LSHTM
Kathleen Bachynski, assistant professor of public health at Muhlenberg College
Sridhar Venkatapuram, associate professor global Health & philosophy at King's College London

Frontline stories - working as a GP during covid

As the pandemic plays out - the way in which doctors in the UK practice is changing, hospitals are reconfigured to increase critical care capacity, GPs are working from home and doing their day to day work remotely.
Some of the changes have come at the detriment of staff and patient wellbeing but covid-19 has also helped cut through some of the inertia to get welcome changes done.
In this podcast, Helen Salisbury, GP in Oxfordshire, and Clare Gerada, GP in south London, join us to talk about the way in which general practice has changed, and how they and their teams are experiencing that.

Talk Evidence covid-19 update - covid ethics, waste and a minimum RCT size

For the next few months Talk Evidence is going to focus on the new corona virus pandemic.
There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing.
We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you some insight into these issues.
This week:
(1.00) Carl gives us an update on the UK’s covid-19 related mortality
(7.40) When the evidence is uncertain, and the outcomes so massive, then the ethical dimensions of decisions become even more apparent. Helen talks ethics in guidelines with Julian Sheather, advisor on ethics and human rights to the BMA and MSF.
(25.37) Update on covid-19 research, looking at viral particle shedding.
(29.24) We’ve mentioned the potential wasted effort in covid-19 research, and Helen speaks to Paul Glaziou, director of the Institute for Evidence Based Research at Bond University, about the waste he’s already seen, and ways in which it could be avoided.

Teleconsulting with Trish Greenhalgh and Fiona Stevenson

A new podcast from The BMJ, to help GP's feel more connected, heard, and supported.
Subscribe on;
Apple podcasts - https://bit.ly/applepodsDBI
Spotify - https://bit.ly/spotifyDBI
Google podcasts - https://bit.ly/googlepodsDBI
In our first episode, we discuss the highs and lows of video consultations, and how coronavirus has altered the landscape of business as usual for GPs. How will this change affect our relationships with our patients? How do we cope with frustrating technical issues? Are we more likely to miss a crucial diagnosis if we can’t rely on physical examinations? And, finally, are teleconsultations the future of GP practice?
Our guests:
Trish Greenhalgh is a former GP of 30 years who is now Professor of Primary Care Health Sciences at the University of Oxford. Trish is a leading researcher on video consultations.
Fiona Stevenson is a medical sociologist and researcher based at UCL. She is the co-director of their e-health unit.
Deep Breath Out - the Rob Auton Daily Podcast https://play.acast.com/s/robautonpodcast
https://www.bmj.com/podcasts/deepbreathin