- ACEIs and ARBs not linked to severity of COVID-19, researchers find
- Almost a third of temporary pharmacy registrants intend to return to work, regulator finds
- More detail on delayed registration exam will be provided by the end of May says GPhC
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Tuesday 19 May
- MPs have called on the government to build capacity for large-scale COVID-19 vaccine manufacturing before clinical trials are completed or risk “losing valuable time” in their distribution. In a letter to the Prime Minister published on 18 May 2020, the House of Commons Science and Technology Committee said the “development and deployment of vaccines could be critical to halting the COVID-19 pandemic” and cited evidence from witnesses which “made clear the need to start the manufacture of potential vaccines before their effectiveness is proven” to ensure they are available as soon as possible. Andrew Pollard, professor of paediatric infection and immunity at University of Oxford was quoted in the letter as saying that if investment in manufacturing was withheld until trials are complete “then the UK would be ‘years and years away’ from having a vaccine that could be ready for mass use”.
- Community pharmacy’s bid for extra funding to cover costs associated with COVID-19 has been submitted to the Treasury, the Pharmaceutical Services Negotiating Committee (PSNC) has said. Speaking in a video to contractors on 15 May 2020, Simon Dukes, chief executive of the PSNC, said community pharmacies “need more money, simple as that,” adding that the PSNC’s “bid for more money is with Treasury… being scrutinised and as soon as we get a response from them we will let you know”. The PSNC would not disclose to The Pharmaceutical Journal how much funding it has requested from the government.
- In a statement published on 19 May 2020, the PSNC said the government plans to increase medicine reimbursement prices by £15m in June 2020 as part its annual adjustments to ensure community pharmacy receives a margin payment of £800m. Dukes said he was “pleased to have agreed these increases” but added that “this is not enough – all pharmacies are facing significant and wide-ranging financial issues as a result of the COVID-19 pandemic, and we are continuing to press for urgent additional investment in the sector”.
Monday 18 May
- Multiple Mini Interviews (MMIs) — part of the Oriel recruitment process for pharmacy pre-registration places in England and Wales — will be scrapped this year because of the COVID-19 pandemic. In Scotland, the national assessment centre, part of the Pre-Registration Pharmacist Scheme (PRPS), will also not take place. In another change, applicants in Scotland will go through the same situational judgement test (SJT) and numeracy assessment as those in England and Wales, via the Oriel platform.
- A letter from Health Education England (HEE), NHS Education for Scotland, and Health Education and Improvement Wales, seen by The Pharmaceutical Journal, sets out the changes, and says that the decisions will “benefit any candidates planning to apply to both [England and Wales, and Scotland] vacancies, as they will only be required to sit the assessment once”. The letter adds that a new applicant handbook reflecting the changes will be published in the week beginning 25 May 2020. A webinar, co-hosted with the national health education bodies and the British Pharmaceutical Students’ Association (BPSA), will be held at a later date to discuss the changes.
- Some 20,000 people are to be asked to participate in a government-funded COVID-19 antibody testing study led by the UK Biobank. The study will measure blood antibodies to help determine what proportion of the population has already had the virus, the duration of immunity after being infected, and why the virus affects people differently. Participants will be chosen from existing UK Biobank volunteers, as well as their adult children and grandchildren, and they will be asked to provide a blood sample using a finger-prick device sent to them each month for at least six months. According to a statement from the Department of Health and Social Care (DHSC), the blood samples will then be returned to the UK Biobank for processing before being sent for validated antibody testing at the University of Oxford. This is the third antibody testing programme launched by the DHSC after programmes run by the Office for National Statistics and Imperial College were announced in April 2020.
- Pharmacists should be able to make changes to prescriptions, to minimise unnecessary delays in getting medicines to patients during the COVID-19 pandemic, the Royal Pharmaceutical Society (RPS) has said. The call was made as part of an evidence submission to the House of Commons Health Select Committee inquiry into delivering NHS services during the pandemic. The Society said that if a medicine was unavailable, a pharmacist should be able to amend the strength and formulation dispensed, or supply an equivalent generic medicine, without going back to the prescriber. Unlike serious shortage protocols (SSPs), which are used for specific drugs, the RPS would like to see a more wide-ranging system, which could be used for any medicine.
- The Society said its proposals would improve access to treatment and reduce the workload of GPs, noting that the practice is already used in hospital settings, and in community pharmacies in Scotland. “All pharmacists should be allowed to minimise the impact of medicine shortages on patient care” said Sandra Gidley, president of the RPS. “We want the UK Government to introduce greater flexibility and improve access to medicines by enabling community pharmacists across Great Britain to make these simple changes”.
- Research to find a COVID-19 vaccine will be boosted by £84 million of new government funding, business secretary, Alok Sharma, announced on 17 May 2020. Just over £65 million will be allocated for the vaccine being developed by researchers at the University of Oxford and a further £18.5 million will be awarded to researchers at Imperial College London. The announcement comes as Oxford University finalises a global licensing agreement with UK-based pharmaceutical company, AstraZeneca, to manufacture their potential vaccine. The agreement will mean that, if the vaccine is found to be safe and effective against COVID-19, AstraZeneca will work to make up to 30 million doses available by September 2020 for people in the UK, as part of an agreement to deliver 100 million doses in total.
- The government has also announced that the opening of the UK’s first not-for-profit vaccine development centre will be brought forward by a year to summer 2021. The Vaccines Manufacturing and Innovation Centre, is being built in Oxfordshire, and a temporary version is to open in the summer of 2020.
- From today, anyone who develops a loss or change in their normal sense of smell, or associated taste, known as anosmia, should self-isolate, the chief medical officers (CMOs) for Wales, Northern Ireland, Scotland and England have warned. In a statement published on the 18 May 2020, the CMOs said they had been “closely monitoring” the emerging data and evidence on COVID-19 and after thorough consideration, were now “confident enough” to recommend this new measure. “The individual’s household should also self-isolate for 14 days as per the current guidelines and the individual should stay at home for 7 days, or longer if they still have symptoms other than cough or loss of sense of smell or taste,” the guidance states.
Friday 15 May
- More than 70 million face masks for use by front line health and care workers will be manufactured in the UK over the next 18 months, the government has announced. The masks will be produced at a rate of 4.5 million per month at Honeywell’s plant in Newhouse, Scotland, after the UK government struck a deal with the manufacturer. The government’s order of FFP2 and FFP3 Honeywell SuperOne disposable respirator masks will be delivered to frontline workers through the NHS supply chain from July 2020. Honeywell’s Newhouse plant had previously specialised in electronic systems assembly. Lord Deighton, the government’s adviser on personal protective equipment (PPE) said the contract marked a “significant step along the way” in increasing UK provision of PPE.
Thursday 14 May
- Public Health England (PHE) has approved a coronavirus antibody test developed by Roche. John Newton, PHE’s director of health improvement and national coordinator of the UK Coronavirus Testing Programme, said that “scientific experts at PHE Porton Down carried out an independent evaluation of the new Roche SARS-CoV-2 serology assay in record time, concluding that it is a highly specific assay with specificity of 100%”. Newton added that the antibody test is “a very reliable marker of past infection”, but said that while the test results may indicate some immunity to future infection, “the extent to which the presence of antibodies indicates immunity remains unclear”.
- Roche said they aim to roll out the test across the UK from mid-May but it is not yet clear whether pharmacies will be called upon to assist with the tests. Gino Martini, chief scientist at the Royal Pharmaceutical Society (RPS), said that although pharmacists have the skills to support antibody testing services, “current demands on pharmacies mean that taking on the additional workload when teams are already working flat out would be very tough”.
- The pharmacy sector needs assurances about the ongoing supply of personal protective equipment (PPE) — and clear guidance on its use — as lockdown restrictions lift, the Royal Pharmaceutical Society (RPS) director for Wales has said. Speaking during an evidence session held by the Welsh Health, Social Care and Sport committee on 14 May 2020, Elen Jones said the RPS would also like to be assured that pharmacy teams will have continued access to wellbeing support after the pandemic. Pharmacy teams were given access to wellbeing support services for the first time on 16 April 2020. Angela Burns, shadow cabinet secretary for health and well-being, said she had received emails from pharmacists who “feel that they’re at the end of the food chain, in that they’ve been the neglected front line”. Suzanne Scott-Thomas, chair of the RPS Welsh Pharmacy Board, added that the RPS always strove to raise the sector’s profile, “but it sometimes takes a crisis like COVID for it to come to the fore”.
- The Department of Health and Social Care (DHSC) is considering expanding its eligibility criteria for the NHS-funded flu vaccination programme in 2020/2021, it has said. In a government letter sent to pharmacies on 14 May 2020, the DHSC warned that this year could see “co-circulation of COVID-19 and flu”, making it “more important than ever to make every effort” to deliver flu vaccines in primary care. “Further guidance will be issued about how to manage the immunisation programme to reflect circumstances nearer the planned start of the programme in September 2020,” it said, adding that “discussions to consider expansion of the flu programme for this autumn are underway” and include potential changes to the eligibility criteria.
- In the meantime, pharmacies are advised “to urgently review your vaccine orders now to make sure the number of vaccines ordered meet at least national ambitions and previous uptakes rates, whichever is highest”. “We anticipate that concerns about COVID-19 may increase demand for flu vaccination in all groups this year,” the letter said, adding that those who are eligible “should be given flu vaccination as soon as possible so that individuals are protected when flu begins to circulate”.
- The Queen has paid tribute on social media to the work pharmacy teams are doing during the COVID-19 pandemic. The official Twitter account of the royal family, which has 4.2m followers, carried a message on 14 May 2020 which read: “We are paying tribute to pharmacists and pharmacies everywhere, who are working tirelessly to keep people healthy and safe, whilst under huge pressure. To all the pharmacies that are relied on by their local communities – thank you!” The Queen is patron of the Royal Pharmaceutical Society and the royal family’s twitter account thanked the work both they and the Commonwealth Pharmacists Association had been carrying out in recent weeks.
This #ThankfulThursday, we are paying tribute to pharmacists and pharmacies everywhere, who are working tirelessly to keep people healthy and safe, whilst under huge pressure.
— The Royal Family (@RoyalFamily) May 14, 2020
- NHS employers have been asked to risk assess their staff for their vulnerability to COVID-19 using a framework published by the Faculty of Occupational Medicine. The ‘Risk Reduction Framework’, which has been backed by NHS England, advises managers to conduct a workplace assessment of “hygiene measures, safe systems of work” and correct use of personal protective equipment, as well as a workforce assessment “to identify those individuals with potentially increased vulnerability to infection”. The assessment should consider individuals’ underlying health conditions, sex, age, ethnicity and whether they are pregnant. Following a risk assessment, employers are expected to consider “redeployment of those deemed at highest risk of adverse outcomes such as redeployment to lower risk environments”. The framework comes after NHS England advised pharmacies to risk assess staff from a black, Asian or minority ethnic background.
Wednesday 13 May
- A training resource for pharmacists redeployed to critical care during the COVID-19 has been published by the Royal Pharmaceutical Society (RPS). The COVID-19 Critical Care Training Resource includes tools for self-assessment of current knowledge and skills; self-directed learning tools to address gaps in knowledge; clinical case studies, and model questions and answers. The RPS recommended that the learning package be completed with the support of an experienced critical care pharmacist, who can act as a tutor or clinical supervisor during the training.
- The resource has been developed by RPS alongside a group of expert stakeholders including the UK Clinical Pharmacy Association (UKCPA). The content “distils the experiences of pharmacists working in critical care units, such as the NHS Nightingale in London, to enable those new to the field to step into critical care with confidence”, the RPS said. As with all COVID-19-related content, the learning package has been made freely available to the whole pharmacy profession.
- Pregnant women are no more likely to become ill with severe COVID-19 than non-pregnant women, research carried out at the University of Oxford has found. However, more pregnant women from black and minority ethnic (BAME) backgrounds are admitted to hospital with COVID-19. The study looked at 427 pregnant women who were admitted to UK hospitals with confirmed COVID-19 between 1 March 2020 and the 14 April 2020. The researchers estimated that the incidence of hospitalisation with confirmed COVID-19 in pregnancy was 4.9 per 1000 pregnancies. The majority of women were in the late second or third trimester, which, the researchers said, supported guidance for continued social distancing, however most of the women had good outcomes and transmission of the virus to infants was “uncommon”.
- “It is concerning that more pregnant women from black and minority ethnic groups are admitted with COVID-19 in pregnancy and this needs urgent investigation,” said lead researcher Marian Knight, professor of maternal and child population health at the Nuffield Department of Population Health at the University of Oxford.
- Thousands of patients with COVID-19 will have their genomes sequenced as part of a project to understand how a person’s genetic make-up could influence their susceptibility to the virus. Genomics England and the University of Edinburgh will carry out the major human whole genome sequence study across the NHS. The study will involve up to 20,000 people currently or previously in an intensive care unit with COVID-19, as well as 15,000 people with mild or moderate symptoms of the virus. DNA samples have been collected from almost 2,000 patients so far. The study will aim to help identify treatments which have the best chance of success in clinical trials, and potentially identify people at extreme risk if they develop COVID-19. The project’s £28 million funding comes from Genomics England, UK Research and Innovation, the Department of Health and Social Care and the National Institute for Health Research.
Tuesday 12 May
- Community pharmacists across Wales have come together as part of a digital choir. Organised by Community Pharmacy Wales (CPW), they performed a rousing rendition of Calon LÃ¢n, well known to Welsh rugby union fans. The performance was, CPW said, inspired by a similar performance by their colleagues at Community Pharmacy Northern Ireland.
— CommunityPharmWales (@CPWales) May 12, 2020
- Community pharmacies in England may not be required to open on the forthcoming spring bank holiday if enough pharmacies are already intending to open, the Pharmaceutical Services Negotiating Committee (PSNC) has said. In its daily COVID-19 update, published on 11 May 2020, the PSNC reported that NHS England and NHS Improvement (NHSE&I) had said in a recent webinar that they were hoping to revert to locally determined opening arrangements for the holiday, which falls on 25 May 2020. The PSNC said NHSE&I would need enough data on the number and whereabouts of which pharmacies were planning to open on the bank holiday before it could make a decision, and it urged contractors to contact their local NHSE&I team if they were intending to open on 25 May.
Monday 11 May
- The government has said it plans to “invest in preventative and personalised solutions to ill-health” to curb risk-factors related to COVID-19, such as obesity, as part of its phased approach to reopening the UK after lockdown. In documents published on 11 May 2020, following a speech by Prime Minister Boris Johnson the previous evening, the government said the move towards preventative care will involve “expanding health screening services, especially through the NHS Health Check programme, which is currently under review”. In January 2020, the National Institute for Health and Care Excellence suggested pharmacies are “well placed” to encourage patients to stop smoking, cut down on drinking and/or lose weight.
- The government papers also said that it has set up a new global sourcing unit for personal protective equipment (PPE), which is staffed by 400 people who are “working urgently to identify new sources of critical PPE from overseas markets” to meet demand. The document added that 50 million items of PPE have been sent to local resilience forums to respond to demand from pharmacies, GPs and social care providers.
- Current and anticipated shortages of medicines during the COVID-19 pandemic are being driven mainly by unexpected surges in demand and changes in prescribing behaviours, the European Medicines Agency (EMA) has said. These conclusions came from data collected through the industry single point of contact (i-SPOC) system which was launched on the 17 April 2020 to enable pharmaceutical companies to report directly to the EMA on shortages of critical medicines used in the context of COVID-19.
- In a previous update the EMA said that the information received via the i-SPOC system had concerned nationally authorised medicines, particularly antibiotics and anaesthetics. The EMA said that it would continue providing updates as more data was gathered via i-SPOC to allow the EU to consider ways to deal with reported medicines shortages.
- Over 15 million pairs of goggles supplied to the NHS do not meet splash protection requirements and should not be used in a COVID-19 setting, an alert from the Department of Health and Social Care (DHSC) has said. A DHSC spokesperson told The Pharmaceutical Journal that 25 million pairs of Tiger Eye protective goggles were bought by the government in 2009, as part of its Pandemic Influenza Preparedness Programme, and were in boxes with the Europe-wide CE mark. Over 15 million pairs of these goggles have since been distributed to healthcare workers.
- However, an alert sent on 10 May 2020 said that tests, carried out following concerns about the fit of the eye protectors, had found that the product did not meet “the current requirement for splash protection” and was being removed from the supply chain. The alert advises that staff who have used the product when performing aerosol generating procedures (APGs) should inform the Health and Safety Executive. The DHSC spokesperson said that, based on current stock assessments, hospital trusts should have enough visors and goggles to immediately stop using ‘Tiger Eye’ protection. But emergency supply can be arranged, they added.
- Healthcare workers have been found to have similar death rates from COVID-19 compared with the general working population, according to data from the Office for National Statistics (ONS). The ONS analysed the 2,494 COVID-19-related deaths in England and Wales amongst the working population up to and including 20 April 2020. In the healthcare workforce, this included 43 males and 63 females — equating to 10.2 deaths per 100,000 males and 4.8 deaths per 100,000 females. This, the ONS said, was not statistically significant compared with rates in the general working population: 9.9 male deaths per 100,000 (1,612 deaths), and 5.2 deaths per 100,000 females (882 deaths).
- The data was not broken down by healthcare sector, with the exception of nurses: the only profession for whom, the ONS said, a reliable rate could be calculated. The ONS added that some healthcare workers — for example, dentists and opticians — may have had reduced exposure to COVID-19 during lockdown because of a lack of routine appointments. However, those working in social care — including care workers and home carers — had “significantly raised” rates of death. For this group, there were 23.4 deaths per 100,000 males (45 deaths) and 9.6 deaths per 100,000 females (86 deaths).
Thursday 7 May
- The Good Life Pharmacy in Hatton, Derbyshire, have been celebrated in an unusual tribute. Emma Bailey, a nurse at The Royal Derby Hospital, created a display thanking the pharmacy team — with a large teddy bear, named Bradley, acting as locum pharmacist for the day. According to
, Bailey and Bradley put on a new display each day to honour local community workers. So far, more than 30 different key workers have been the star of the show.
Thanks for the work Goodlife Pharmacy are doing has hit the local press
— Derbyshire LPC (@DerbyshireLPC) May 7, 2020
- Annual reviews for patients on valproate should not be delayed because of the COVID-19 pandemic, the Medicines and Healthcare products Regulatory Agency (MHRA) has advised. In guidance published on 6 May 2020, the MHRA said specialist prescribers should preferably conduct video or telephone consultations with girls of any age and women of childbearing potential who are on valproate. During the consultation the prescriber should go through the Annual Risk Acknowledgement Form (ARAF) and ensure that the patient understands the requirements of the Pregnancy Prevention Programme, before sending a copy of the completed ARAF to the patient and their GP. The clinician is also expected to ensure the patient has access to effective contraception. The guidance added that prescribers should still carry out face-to-face consultations – with appropriate social distancing – for patients initiating valproate. However, remote consultations should be considered if the patient is shielding.
- Black people are around four times more likely to die from COVID-19 than white people, according to data published by the Office for National Statistics (ONS). The statistics showed that people of Bangladeshi, Pakistani and Indian ethnicity also had a significant increased risk compared to white people. Amongst people of Chinese ethnicity, the risk was increased for males but not for females. Commenting on the data, Tim Elwell-Sutton, assistant director of strategic partnerships at the Health Foundation, said that “the exact reasons why black and minority ethnic groups are being disproportionately impacted by the virus are still unknown but existing social inequalities and structural discrimination in British society are likely to be playing a significant role”.
- When the data was adjusted to take into account socioeconomic determinants of health, the risk of death compared to people of white ethnicity was reduced — but still remained comparatively high. According to the adjusted figures, black people were 1.9 times more likely to die from COVID-19 than white people, and men and women of Bangladeshi and Pakistani ethnicity were 1.8 and 1.6 times likely to die, respectively. The adjusted data, the ONS said in its report, showed that “differences in risk between ethnic groups that are specific to those ethnic groups”, and not caused by socioeconomic factors.
- A new biological reagent has been made freely available to researchers in the UK and around the world to aid the development of an accurate diagnostic test for COVID-19. The reagent is comprised of non-infectious genetic material isolated from SARS-CoV-2, the virus that causes COVID-19. As a result, the reagent can be used as a positive control for tests being developed to detect the presence of the virus. This means it can act as a confirmatory sample to assure researchers of the accuracy of their test. The development of the reagent has been fast-tracked by the National Institute for Biological Standards and Control (NIBSC), an expert centre of the Medicines and Healthcare products Regulatory Agency.
- “This reagent is a great example of the NIBSC rapidly responding to public health needs in the response to COVID-19,” said Nicola Rose, head of the division of virology at the NIBSC. “The development of the research material is a prelude to the production of established standards and reference materials that laboratories can use in their own work on COVID-19, and we will continue to make producing this material an absolute priority.”
Wednesday 6 May
- Pharmacy employers must notify the Health & Safety Executive (HSE) if a member of the pharmacy team contracts COVID-19 and was likely to have contracted the infection at work, even if symptoms are mild, the Pharmacists’ Defence Association (PDA) has advised in a statement. It added that any death that occurs as a result of COVID-19 contracted at work must be reported as a workplace fatality within 10 days of the incident. Following the government announcement that pharmacists are eligible for the state-backed COVID-19 related death-in-service compensation payments, the PDA has told pharmacists that reporting work acquired COVID-19 infections to the HSE would be an important component in any subsequent claim put to the government scheme on behalf of the deceased. “Even if contracting COVID-19 does not cause death, there may be the possibility of a claim for compensation being made against the employer in the event that it could be shown that appropriate risk management measures were not put in place by the employer,” the statement said.
- Pharmacy teams must be arranged by primary care networks (PCN) and GP practices to support care home residents and staff “within a fortnight at the latest” NHS England and NHS Improvement (NHSE&I) has said. In a letter sent on 1 May 2020, PCNs, practices, and clinical commissioning groups, were told that pharmacy teams that can help care hopes with medication supply, medicines reviews, and medication queries should be “established as soon as possible”. The letter, signed by the directors of primary care, community health, and primary care strategy at NHSE&I says that COVID-19 is posing a “significant challenge” for care homes.
- On 24 April 2020, Graham Stretch, chief pharmacist at the Argyle Health Group across London and clinical director of Brentworth PCN, told The Pharmaceutical Journal that “multiple contacts” had reported cases of medicines optimisation in care homes (MOCH) pharmacy teams being moved to carry out other work. “These vulnerable patients need all the support we can give them,” Stretch said at the time, adding that “vital to this effort is the pharmacy team”.
- If recruitment for the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial is kept above 1,000 patients per week, results on some of the treatments being tested could be available within 5-7 weeks, the UK’s chief medical officers (CMO) have revealed in a letter to NHS staff. The letter, which was signed by the CMOs for Wales, Scotland, Northern Ireland and England, and the national medical director for NHS England and NHS Improvement, Stephen Powis, highlighted that over 9,000 participants had enrolled in the RECOVERY trial so far. However, the signatories said that in order to obtain strong evidence large numbers were required; around 2,000 participants per arm of the trial. Current enrolment to the trial is at 13% of all hospital admissions but the CMOs and Powis said that this proportion needed to be increased. “We appreciate that the operational pressure from Covid-19 makes research hard, and local situations will lead to variability in ability to recruit, but increasing this proportion is important,” the letter said.
- The Medicines and Healthcare products Regulatory Agency has authorised seven batches of Chiesi’s Clenil 100 microgram inhaler (beclomethasone) to be dispensed within the UK to cope with increased demand. The inhalers were reported to be in short supply in early April 2020 following a surge in demand caused by the COVID-19 pandemic. The batches required authorisation due to a variation in their appearance from those usually dispensed in the UK. However, Chiesi said in a statement, published on 5 May 2020, that the inhalers “will contain the same medication and therefore requires no differences to the way prescriptions are written or how patients manage their asthma”. The additional inhalers are expected to come into circulation from 11 May 2020, Chiesi said, with further batches “being released into the supply chain over the coming months”.
Tuesday 5 May
- Details of a phase II/III study to determine the efficacy, safety and immunogenicity of the COVID-19 vaccine candidate ChAdOx1 nCoV-19 have been revealed. The new study, carried out by researchers at the University of Oxford, will assess how well people of all ages can be protected from COVID-19 with the new vaccine as well as provide information on safety and its ability to generate good immune responses against the virus. The researchers have said that they will enrol 5,260 volunteers in total starting with a small number of older adults (56-70 years, then 70+ years) before expanding to large numbers of adults across all ages (18+ years). Following this they will assess the vaccine in a small cohort of children (5-12 years).
- The vaccine is currently being tested in a phase I/II trial, which began on 23 April 2020, whereby researchers are randomly allocating 510 healthy participants, aged 18-55 years old, to receive either the vaccine or a placebo injection in addition to doing blood tests and collecting information about any symptoms that occur after vaccination. The next phase of the trial is still awaiting approval from the Health Research Authority.
- A Yellow Card website dedicated to reporting side-effects or incidents from medicines being used to treat COVID-19 has been set up by the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA said the aim of the site was to ensure that there was “rapid identification of new or emerging risks” which might not have been previously known about that would allow it to take appropriate regulatory action, where needed. “While our aim is to ensure that potentiallyâ€¯lifesavingâ€¯COVID-19â€¯treatmentsâ€¯andâ€¯medicalâ€¯equipment reach patients as quickly as possible, patient safety is our highest priority,” said June Raine, chief executive of the MHRA. The site also contains information about fake medicines and devices, ventilatory and respiratory support, and the latest news on COVID-19.
- Community pharmacies in Wales are working with the Royal Mail to ensure patients who are shielding or self-isolating receive their medicines during the COVID-19 pandemic. Using the Royal Mail’s ‘Tracked 24’ delivery service, postal workers will collect prescriptions from pharmacies and deliver them the next day. Pharmacists will be given access to the Royal Mail’s ‘Click and Drop’ system so that they can track the deliveries. The Royal Mail link-up supports Wales’ volunteer prescription delivery scheme, in which over 400 volunteers will be linked up with more than 650 community pharmacies to deliver medicines to patients who have no-one else to collect their prescriptions.
- With support from the National Pharmacy Association (NPA), a web-based tracking system called Pro Delivery Manager will also be made available to pharmacies and volunteer drivers. Raj Aggarwal, NPA board member for Wales, said the system was “a tried-and-tested product”. Vaughan Gething, Welsh Minister for Health and Social Services, said he was “pleased to see how the skills and expertise of organisations from the private, public and third sector have been brought together to make this a success.”
Monday 4 May
- Scottish prisoners who are currently prescribed opiate substitution therapy (OST) will be switched to buvidal, a longer-lasting form of medicine, as part of Scottish government support for drug users during the COVID-19 pandemic. This programme will cost £1.9 million as part of a budget of more than £2 million set aside by the Scottish government. Buvidal is a prolonged-release injection form of buprenorphine, which is administered weekly or monthly, rather than daily. Joe FitzPatrick, Scottish minister for public health, sport and wellbeing, said that “by making this available to people in prisons, we will support continuity of care, while reducing the need for daily contact and reducing pressure on our frontline prison officers and NHS staff”.
- The funding will also support additional residential rehabilitation places for those leaving prison who need help to recover from drug or alcohol misuse. And naloxone will also be made more widely available.
- Pharmacists feature in a new COVID-19 version of the classic children’s game Top Trumps. The new “Britain at its Best: Key Workers” version of the ever-popular card game includes a card that covers both pharmacists and pharmaceutical scientists. They are given an “unsung hero” rating of 7 out of 10, but score only 2 out of 10 in the “gadgets and gizmos” category. According to the pharmacist card in the game, pharmacy originated in 1752, and pharmacists have been credited with a “street style” score of 6 out of 10. Other groups of workers in the pack include refuse collectors, teachers, NHS volunteers, and even journalists.
- The Scottish NHS death in service provision for the families of frontline NHS staff who die as a result of COVID-19 will include community pharmacy, Harry McQuillan, chief executive of Community Pharmacy Scotland (CPS) has said. In a video update published on 1 May 2020, McQuillan said CPS had received confirmation that “community pharmacy colleagues will be included in proposals to provide a COVID-19-related death-in-service benefit scheme”. CPS was, he continued, working with the Scottish government on the terms of the benefit. McQuillan added that “I very much hope we never have to implement it”, but that it was nonetheless “reassuring to know that you are valued along with all other members of the health and social care team in Scotland”.
- The Scottish scheme will provide a lump sum of twice the staff member’s annual earnings and continued survivor entitlements. In England and Wales, the families of frontline health and social care workers — including community pharmacists — will receive £60,000 under the scheme. When asked by The Pharmaceutical Journal if the scheme covered other members of the community pharmacy team, a spokesperson for the Welsh government said that “details of the operation of the scheme in Wales are still being considered” but that final confirmation would be available soon. The Pharmaceutical Journal has asked the Department of Health and Social Care for similar clarification in England.
- Police forces in Wales will be providing extra reassurance and advice to community pharmacists on the protection of staff and pharmacy premises during the COVID-19 pandemic. The move follows concerns raised by the Royal Pharmaceutical Society (RPS) about aggression and even violence towards community pharmacy teams, based on reports from members. Assistant chief constable Nigel Harrison, chair of the All Wales Police Gold Command Group for COVID-19, said that the police “recognise the key role of pharmacies in our communities and as such we are more than happy to offer assistance”. The police will, Harrison added, “robustly deal with those who feel it is acceptable to act in an aggressive way to our pharmacy teams doing such great work at this time”.
- Elen Jones, RPS director for Wales, said that the majority of people had been “hugely supportive and understanding of the current pressures on pharmacy teams”, but added that “given the nature of the reports from our members, we felt that it was appropriate for us to highlight these concerns to police forces in Wales”.
Friday 1 May
- Nearly 40% of anaesthetists surveyed by the Royal College of Anaesthetists have said they are not confident that they will have sufficient supplies of anaesthetic drugs for COVID-19 patients over the next month. The survey of 2,174 anaesthetists added that 14% currently “do not have access to all the usual drugs”. This comes after the government warned on 16 April 2020 that supplies of atracurium and cisatracurium were expected to run out “over the coming days” due to increased demand from COVID-19 patients. The survey, published on 23 April 2020, said: “Departments of anaesthesia and intensive care are currently collaborating with each other and with pharmacists to ensure drugs are prioritised appropriately across the two areas.”
- Researchers have linked severe COVID-19 infections with a unique blood clotting disorder in the lungs that could be contributing to mortality levels. The research published in the
British Journal of Haematology
on 30 April 2020 looked at 83 COVID-19 patients, 81% of whom were Caucasian, 12% were Asian, 6% were African and 1% was of Latino/Hispanic ethnicity. They found that those with a higher level of coagulopathy – blood clotting activity – primarily focused within the lungs, had a significantly worse prognosis and were more likely to require admission to intensive care.
- “In addition to pneumonia affecting the small air sacs within the lungs, we are also finding hundreds of small blood clots throughout the lungs,” explained James O’Donnell, consultant haematologist in the National Coagulation Centre in St James’s Hospital. “This scenario is not seen with other types of lung infection, and explains why blood oxygen levels fall dramatically in severe COVID-19 infection … understanding how these micro-clots are being formed within the lung is critical so that we can develop more effective treatments for our patients, particularly those in high risk groups.”
- Preliminary results from trials assessing the use of chloroquine and hydroxychloroquine (CQ/HCQ) for treating COVID-19 should be “treated with care” to avoid misinterpretation by the non-scientific community, pharmacy experts from the University of Huddersfield have warned. “Care should be taken to avoid exaggerating the preliminary safety/efficacy evidence of CQ/HCQ treatment in prevention and treatment of COVID-19 as it can lead to potential self-harm,” Syed Shahzad Hasan and Hamid Merchant wrote in the British Journal of Pharmacy
on 30 April 2020, in collaboration with Chia Siang Kow, a pharmacist at the International Medical University in Kuala Lumpur.
- The authors highlighted how publicity around the antimalarial drugs had led to “unnecessary hoarding” and called for pharmacists across the world to dispense them responsibly, discouraging the over-the-counter supply of CQ/HCQ in pharmacies. “It is the duty of pharmacists and other healthcare professionals to monitor the proper usage of these antimalarial drugs…its use should be restricted for the treatment of COVID-19 associated pneumonia in severely ill patients only under clinical supervision of a licensed practitioner and close cardiac monitoring.”
- Consultation rooms in Boots pharmacies are being designated safe spaces for people experiencing domestic violence during the COVID-19 lockdown. Working in partnership with the charity Hestia Crisis Support as part of its “UK says no more” campaign, information about 24-hour UK domestic abuse helplines will be available in the consulting rooms from 1 May 2020. Marc Donovan, chief pharmacist at Boots UK, said he hopes the initiative “can help people find the support they need at this difficult time, when many other options are temporarily unavailable”.
- The move is backed by the Royal Pharmaceutical Society (RPS) and the General Pharmaceutical Council (GPhC) which urged other pharmacies to follow the multiple’s lead. “The trust that the public have in pharmacies make them an ideal place to access help and take a step away from harm towards a better future,” said Sandra Gidley, president of the RPS. “It’s as simple as making your consultation room available for a phone call to the relevant agency who can help.” On 27 April 2020, the Parliamentary home affairs committee said the government should consider making pharmacies and supermarkets safe spaces for victims of domestic abuse.
The antibiotic, azithromycin, has replaced interferon beta, a protein that is produced by the body as a defensive response to viruses, in the UK-based Randomised evaluation of COVID-19 therapy (RECOVERY) trial.
According to the trial protocol, azithromycin is preferred over other macrolides because data suggest it has stronger immunomodulatory effects.
Patients in the azithromycin arm of the trial will be given 500mg doses by mouth (or nasogastric tube) or intravenously once daily for 10 days.
The trial is now also open to patients with a suspected SARS-Co-2 infection, having previously only been open to those with a proven infection. Patients who lack capacity to give consent, because of a medical condition, can now also be recruited using a legal representative.
Other changes to the RECOVERY trial protocol include an adjustment to the recommended corticosteroid for pregnant women to prednisolone 40 mg administered by mouth, instead of dexamethasone.