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COVID Fears Keeping Americans From Vital Doctor Visits

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COVID Fears Keeping Americans From Vital Doctor Visits

Latest Prevention & Wellness News

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, June 17, 2020 (HealthDay News) — A ruptured appendix is one medical emergency that a general surgeon colleague of Dr. Jacqueline Fincher hadn’t treated for more than 15 years in their small town of Thomson, Ga.

That’s because the signs and symptoms of appendicitis are so well-known that nearly everyone gets to the hospital well before an inflamed appendix has a chance to burst.

But then came COVID-19.

“In the month of March he had two,” said Fincher, president of the American College of Physicians. “It’s because people were afraid to go to the doctor or go to the emergency room. They sat at home and got really, really sick, and ended up going to the emergency room and having a much more difficult course.”

Even though the United States is emerging from lockdown, Americans worry that many folks remain too fearful of contracting COVID-19 to get the medical care they need to prevent a serious illness from becoming a medical emergency.

More than half the participants in a recent poll (54%) said they are concerned that their health or the health of a loved one is at risk because they’ve delayed treatment for medical problems, researchers at Fairleigh Dickinson University in New Jersey found.

Further, more than a quarter (27%) said they will not go to a doctor’s office except for emergencies, until either a vaccine or a treatment for COVID-19 is available.

“If individuals are not seeking medical care when they should, it may mean that they’re missing vaccinations. It means that perhaps they have a condition that’s going untreated, or perhaps they need an adjustment to their medications,” said Julie Kalabalik-Hoganson, chair of pharmacy practice with Fairleigh Dickinson’s School of Pharmacy and Health Sciences in Florham Park, N.J. “It has a lot of implications that we’re worried about.”

There’s no doubt the pandemic caused a serious financial hit to doctors’ offices.

In April, use of health care services declined by 68%, with a 48% reduction in revenue compared to the same time the previous year, according to a new report from FAIR Health, a nonprofit group that examines health sector economics.

For many doctors, telehealth provided a much-needed financial lifeline, the FAIR Health report says.

Fincher agreed, noting the pandemic response caused a loosening of regulatory restrictions around telemedicine and prompted many insurers to pay the same rates for a telehealth visit as they would for a regular office visit.

“It was an absolute lifesaver,” Fincher said. “Wow, it opened up. Everybody was on telehealth really fast.”

About a quarter of people in the Fairleigh Dickinson poll said they’d used online video conferencing to see a doctor or health professional since the pandemic began, and nearly three-quarters said the experience was the same or better than an in-person medical visit.

Telehealth likely helped the wellness of many locked-down people dealing with chronic medical conditions like high blood pressure, emphysema and diabetes, Fincher said.

Doctors have kept tabs on people’s health by having them regularly check their own markers, using home versions of the devices used by medical experts, Fincher said.

Folks these days use glucometers to check their blood sugar, thermometers, pulse oximeters to measure the oxygen in their body and other devices on a regular basis at home, then transmit their numbers to their doc.

“A blood pressure monitor and a scale go a long way in helping us to monitor your health and follow you outside of the office,” Fincher said. “Those devices are very helpful for us as physicians to monitor key things that keep you out of the hospital, keep you out of the emergency room. We can delay to some degree your chronic medical visit during this strange time of pandemic.”

However, it’s hard for telemedicine to capture everything a doctor can observe in person, said Dr. Gary LeRoy, president of the American Academy of Family Physicians.

“I start my examination and my assessment of my patients from the moment I see them walk into my office,” watching how they move, how they sit, how they’re dressed and how alert they appear to be, said LeRoy, a family physician in Dayton, Ohio. “Sometimes that’s my first tip that something just isn’t right with their situation.”

The reopening of America has led to a bit of a rush to the doctor’s office, he said.

“Our patients are anxiously wanting to come back in person versus on a video screen or by telephone,” LeRoy said. “My personal practice has totally flipped, in the sense that the overwhelming majority of my patient visits now are in person.”

But there remain many who are simply too fearful of COVID-19 to go have their health concerns addressed. The new poll jibes with a Kaiser Family Foundation health poll from May, in which about half of adults said either they or a family member had postponed or skipped medical care due to the pandemic.

Doctors need to keep promoting the precautions they’ve taken to prevent COVID-19 transmission in their offices, Fincher said.

For example, Fincher’s practice holds an acute respiratory illness clinic every afternoon, out of a tent behind the office. People with COVID-19 symptoms can be treated without setting foot inside the office.

“We do all the history-taking over the phone with them while they’re sitting in our parking lot, then we bring them out under the tent and examine them,” Fincher said.

Masks are required in offices, and every exam room is thoroughly cleaned between patients.

Some patients are reluctant. “I’ll ask them, ‘Well, are you going to the grocery store?'” Fincher said. “Most of the time they say yes and I tell them, ‘Well, I can promise you my office is way safer than the grocery store.'”

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.

References


SOURCES: Jacqueline Fincher, M.D., president, American College of Physicians; Julie Kalabalik-Hoganson, Pharm.D., chair, pharmacy practice, Fairleigh Dickinson University School of Pharmacy and Health Sciences, Florham Park, N.J.; Gary LeRoy, M.D., president, American Academy of Family Physicians

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Mom’s Depression Can Lead to Behavior Problems in Kids

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Mom’s Depression Can Lead to Behavior Problems in Kids

WEDNESDAY, June 17, 2020 (HealthDay News) — Children of mothers with long-term depression have an increased risk of behavioral problems and poor development, researchers say.

The new study included nearly 900 Australian mothers and 978 of their children. Levels of depression were examined in the mothers before, during and after pregnancy. The investigators also analyzed their children’s development and behavior.

One in five of the women experienced depression once, while 11% experienced it more than once. The length of a mother’s depression had a greater impact on her child than when depression occurred, according to the researchers at the University of Queensland, Australia.

“The longer a mother suffered maternal depression, the worse the outcomes for the child,” study author Katrina Moss said in a university news release. She’s a research officer in the School of Public Health.

“Mothers may worry that if they’ve been depressed during pregnancy then it’s too late to do anything about it, but reducing depressive symptoms at any stage is better for them and their children,” she explained.

“The earlier we can effectively detect and treat maternal depression, the better our chances of improving outcomes,” Moss said.

Screening for depression could start when couples begin planning a pregnancy and continue through early childhood, she suggested.

“Maternal depression is a significant challenge for women, families and communities, and we need to look after women better at key times in their lives,” Moss said.

Women who develop depression should visit their family doctor and find supportive parent resources, she advised.

The study was published recently in the journal Paediatric and Perinatal Epidemiology.

— Robert Preidt

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.





QUESTION


Depression is a(n) __________ .
See Answer

References


SOURCE: University of Queensland, news release, June 14, 2020

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Answering the Call: How COVID-19 Hotline Staffers Helped Panicked New Yorkers

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Answering the Call: How COVID-19 Hotline Staffers Helped Panicked New Yorkers

By Alan Mozes
HealthDay Reporter

THURSDAY, June 18, 2020 (HealthDay News) — “I live in Washington state,” said the caller, “but my husband is on a plane to New York City, and I just got a call from my doctor telling me that he’s positive for COVID! What should I do?”

“I take care of my grandmother,” said another, “and she goes to this temple whose Rabbi was recently diagnosed with COVID. And she was recently sitting right next to him! What should I do?”

Those were two of the more than 90,000 calls, many anxious and tearful, that have flooded one New York City health care system’s COVID-19 hotline since the crisis first emerged in mid-March. The NYC Health + Hospitals (NYC H+H) COVID-19 hotline has been a lifeline for New Yorkers faced by tough decisions with little expert advice on hand.

It’s been a tough and evolving process running the hotline, said Dr. Ross Kristal. He’s co-medical director of the NYC H+H Contact Center at NYC Health + Hospital’s Office of Ambulatory Care.

When the first New York City case was diagnosed back on March 2, “COVID was new and scary,” he said. But no one could foresee just how bad things would get.

But NYC H+H is one of the largest public health care systems in the United States, with over 70 inpatient and outpatient locations across the five boroughs of New York City. So calls to the center started rolling in.

Some callers were concerned about future risk, for themselves and their family. Others already had symptoms and were seeking care.

‘Scared and worried’

Curbing the virus’ spread was a priority.

“We didn’t want patients with symptoms coming to our clinics and possibly infecting our patients and staff,” Kristal explained. So, H+H call center agents followed U.S. Centers for Disease Control and Prevention guidelines, answering callers’ questions while drawing out info on factors such as prior travel histories and signs of COVID-19.

“If they screened positive we then made sure callers would talk to a doctor on the phone,” Kristal explained. In the early days of the hotline there were two doctors at the ready, Kristal being one of them.

Callers were often confused, he said, and the calls themselves were often tense.

“People were definitely scared, they were worried. Even people who didn’t have symptoms themselves, not knowing if someone around them had symptoms,” Kristal said.

One man struggling with a cough called in out of concern that he might expose a vulnerable roommate who was undergoing chemotherapy.

Another, a business owner, called wondering if he should instruct his staff to telework after he’d been potentially exposed to the new coronavirus.

Still another reached out to say he felt “lost,” scared and helpless after his elderly dad came down with a high fever, cough and crippling fatigue.

“We saw everything across the spectrum,” Kristal added, including patients of all ages. On the one hand, “we would get calls from young people who were short of breath and anxious. Clearly anxious. And, in fact, after talking to them and finding out more about their respiratory status we would realize that their issue was really anxiety, not COVID. And they didn’t need to go to the ER.”

An evolving crisis

On the other hand, Kristal said, “we would also get callers who really had difficulty breathing and it was determined they really did need emergency care.”

People who Kristal and his colleague deemed truly “high risk” were not given an appointment to come to the hospital, but rather were referred to the NYC Department of Health and Mental Hygiene. The department would then arrange for an in-person diagnostic test.

The system worked well, Kristal said, but almost immediately “call volume exponentially grew. And at a very quick rate. A lot of New Yorkers started calling in to 311 saying they didn’t have a doctor but wanted to speak to one, so we were [also] getting those calls.”

So, beginning March 11, Kristal and colleagues set up an expanded, doctor-helmed COVID-19 hotline, manned primarily by physicians, advanced practice providers and physician assistants.

The goals were clear. “We wanted to make sure that every New Yorker had access to a health care provider that was free and available to anyone who needs it, no matter what language you speak or whether you have insurance or not,” Kristal said. “And we wanted a system that could connect to people who are at home, because we wanted people to stay at home. Because this was when ERs were getting overwhelmed, we wanted to do triage so those who did not need to go to an ER didn’t.”

Information on isolation, quarantine and testing was also provided, based on New York City health department guidelines. Callers were asked about symptoms and critical high-risk factors, such as age or proximity to elderly or immunocompromised household members.

Based solely on word of mouth — though it would later be promoted by Mayor Bill de Blasio and City Hall — calls continued to flood in, either directly to the H+H call center or via 311. By mid-March, call volume hit north of 2,500 a day, and on March 20, over 5,000 calls were logged in a single day, Kristal said.

At that point, with hospital cases skyrocketing, both the city and the hotline had to switch tactics. With New York City hospitals under increasing strain, both physicians and tests were becoming scarce.

So the hotline turned to a pool of registered nurses as the first point of caller contact, and callers were told that, per new city guidelines, COVID-19 testing was reserved only for hospitalized patients.

Peak passed — for now

At the same time, the types of crises H+H hotline staffers responded to grew. For example, callers fearful of housing eviction and dwindling food supplies, or in need of space in “isolation hotels,” were directed to social service resources, Kristal said.

ER referrals continued to be given to those with serious symptoms and/or those at high risk for COVID-19 complications, such as the elderly with pre-existing conditions.

“We also implemented callbacks,” said Kristal. “So, if we got a call from an elderly patient, we would actually put him on a list to call back and check in on him.”

The team also launched a new tracking system that now allows patients to text in their symptoms to physicians twice a day for routine monitoring.

By May, New York City had “flattened the curve” of new coronavirus cases, and by June the city has begun to cautiously reopen for business.

But Kristal said the hotline is still very much open and active as a reliable source for information, guidance and reassurance.

“The call volume is not at its peak anymore,” said Kristal. “But we’re still getting phone calls, and there’s no end date. We are here to service New Yorkers.”

Kristal and his colleagues chronicled their COVID-19 hotline experience in the August issue of Health Affairs.

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.

References


SOURCES: Ross Kristal, MD, co-medical director, NYC Health + Hospitals Contact Center, Office of Ambulatory Care, NYC Health + Hospitals, New York City; Health Affairs, August 2020

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How Easily Does Coronavirus Spread at Home?

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How Easily Does Coronavirus Spread at Home?

WEDNESDAY, June 17, 2020 (HealthDay News) — COVID-19 spreads easily among people who live together and other family members, even before an infected person shows any symptoms, new research shows.

The study — published June 17 in The Lancet Infectious Diseases journal — also said that the new coronavirus spreads among household members more easily than severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS).

Those conclusions emerged from an analysis of contract-tracing data from 349 COVID-19 patients and 1,964 of their close contacts in Guangzhou, China. The analysis found that people with COVID-19 were as infectious before they developed symptoms as during their actual illness.

Close contacts included people in the same household and family members who don’t live together, as well as friends and coworkers.

Another key finding: People age 60 and older were most susceptible to COVID-19 infection.

“Our analyses suggest that the infectiousness of individuals with COVID-19 before they have symptoms is high and could substantially increase the difficulty of curbing the ongoing pandemic,” said study co-leader Yang Yang, an associate professor in the College of Public Health and Health Professions at the University of Florida.

Researchers said their estimates are the first to quantify symptomless transmission of the new coronavirus.

The findings suggest that halting the chain of transmission within households and families could significantly reduce the number of COVID-19 cases. Doing so will require identifying and isolating infected people and then tracing and quarantining their close contacts, researchers said.

“Active case finding and isolation in conjunction with comprehensive contact tracing and quarantine will be key to preventing infected contacts from spreading the virus during their incubation periods, which will be crucial when easing lockdown restrictions on movement and mixing,” Yang said in a journal news release.

Household transmission was believed to be a major factor in COVID-19 infections in China after lockdowns were imposed, but research into spread of the disease in households has been limited.

This study estimated that the secondary attack rate (the probability that an infected person will transmit the disease to someone else) was 2.4% among contacts not in the same household. However, the researchers estimated the rate as 1 in 6 (17%) for people in the same household, and 1 in 8 (12.4%) among family members not living together.

“Family members such as parents and older children may not be living at the same address, which might explain why they appear at less risk of secondary infections than those living in the same household as the COVID-19 case,” said study co-author Natalie Dean, an assistant professor of biostatistics at UF.

“While the likelihood of transmitting COVID-19 in households may seem quite low, it is around twice what has been estimated for SARS [4.6%-8%] and three times higher than for MERS [4%-5%], although these data are only based on a small number of studies,” Dean said in the release.

The study also found that the risk of household infection is highest among adults 60 and older — an attack rate of 28% (more than 1 in 4) of those living together, and 18.4% (1 in 5) of other family members.

The risk is lowest in those 20 and younger, according to the study. Of those living together, the attack rate is 6.4% (1 in 15), and it’s 5.2% (1 in 20) for other family members.

Virginia Pitzer, an associate professor of epidemiology at Yale School of Public Health, wrote an editorial that accompanied the findings.

“This study demonstrates the value of carefully collected contact tracing data to understand risk factors for transmission and susceptibility,” she wrote. “The findings confirm the relative importance of pre-symptomatic transmission and the relationship between older age and susceptibility, key insights which should inform design of intervention strategies.”

— Robert Preidt

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.

References


SOURCE: The Lancet Infectious Diseases, news release, June 17, 2020

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How Many Coronavirus Infections Are Asymptomatic? – MedicineNet Health News

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How Many Coronavirus Infections Are Asymptomatic? – MedicineNet Health News

THURSDAY, June 18, 2020 — As many as 45% of people infected with COVID-19 have no symptoms, and they may play a major role in the spread of the virus, a new study says.

The findings show the need for large-scale testing and contact tracing to combat the pandemic, according to the Scripps Research investigators.

“The silent spread of the virus makes it all the more challenging to control,” said study author Dr. Eric Topol, founder and director of the Scripps Research Translational Institute in La Jolla, Calif., and professor of molecular medicine at Scripps Research.

“Our review really highlights the importance of testing. It’s clear that with such a high asymptomatic rate, we need to cast a very wide net, otherwise the virus will continue to evade us,” he added in a Scripps news release.

The researchers analyzed data from studies on coronavirus infection in people worldwide and in various groups, including nursing home residents, cruise ship passengers and prison inmates.

“What virtually all of them had in common was that a very large proportion of infected individuals had no symptoms,” said study co-author Daniel Oran, a behavioral scientist at Scripps.

“Among more than 3,000 prison inmates in four states who tested positive for the coronavirus, the figure was astronomical: 96% asymptomatic,” Oran said in the release.

Another finding was that asymptomatic people may be able to transmit the new coronavirus for a long time, perhaps longer than 14 days.

The researchers also said that even if they don’t have symptoms, infected people may still be at risk for harm. For example, CT scans showed that 54% of infected but asymptomatic people on a cruise ship had minor lung abnormalities, which suggests that coronavirus infection could affect lung function in a way that’s not immediately apparent.

With so many asymptomatic cases around, the researchers stressed the importance of not spreading infection.

“Our estimate of 40-45% asymptomatic means that, if you’re unlucky enough to get infected, the probability is almost a flip of a coin on whether you’re going to have symptoms. So to protect others, we think that wearing a mask makes a lot of sense,” Oran concluded.

The study was published recently in the journal Annals of Internal Medicine.

— Robert Preidt

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.

References


SOURCE: Scripps Research, news release, June 9, 2020

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Hundreds of Melbourne hotel staff in quarantine

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Hundreds of Melbourne hotel staff in quarantine

A coronavirus outbreak at a Melbourne hotel may have been exacerbated by breaches in social-distancing guidelines as the state’s deputy chief health officer reveals hundreds of hotel workers are in quarantine.

Dr Annaliese van Diemen today told reporters health authorities were bracing for more virus cases at the Stamford Plaza Hotel after five security contractors tested positive overnight.

The five employees had worked shifts over a similar period at the hotel.

The Stamford Plaza in Melbourne. (Google)

“We have a couple of hundred workers in quarantine at this point in time,” she said.

“There’s a large cohort of security guards and other workers and unfortunately it does appear that quite a few of them have worked for single or multiple days whilst infectious.

“We do expect that there will quite possibly be further cases linked to that outbreak and that won’t be a huge surprise unfortunately.”

Dr van Diemen said it did appear the hotel employees had reportedly flouted social-distancing requirements.

Stamford Plaza Melbourne. (Nine)

“It does appear there have been some breaches in those guidelines,” she said.

“There has been some closer mingling with these guards in the workplace. We are increasing the auditing, we are increasing the supervision.”

The Department of Health today said investigations into potential sources of transmission, testing of staff and follow up discussions with close contacts were ongoing.

Victoria has recorded an increase of 13 new cases, with a net increase of 12 due to one infection being reclassified, bringing the state’s total to 1792.

Among the other new cases, two were linked to a family in Keilor Downs which were close contacts of a known case. The new outbreak has not been linked to the previously reported family outbreak in Keilor Downs.

Victorian Deputy Chief Health Officer Annaliese van Diemen. (AAP)

One new case was a close contact related to the Rydges hotel, bringing the cluster’s total to 17.

Three new cases were identified through routine testing, one case was linked to a returned overseas traveller and another case was still under investigation.

Community transmission has increased by one infection in the state. There are 91 active cases in Victoria.

“This is a deadly and dangerous virus,” Transport Minister Jacinta Allen said today.

“We do have to keep up our own personal efforts to stay safe as restrictions are eased.

“We will continue to take the advice of the chief health officer.”

Rydges hotel in Melbourne. (Nine)

There are five people in Victorian hospitals, including two patients in intensive care.

Dr van Diemen yesterday said authorities still planned to relax restrictions on Monday, despite the surge in cases but the state would remain “vigilant”.

Gyms, cinemas, indoor sports centres and concert venues are scheduled to reopen, while cafes, restaurants and pubs are set to increase capacity from 20 people to 50.

“We are hoping this is a blip,” she said.

“Monday’s restrictions will go ahead as planned.”

In NSW, there were seven new coronavirus cases confirmed overnight.

All new cases were returned travellers in hotel quarantine, NSW Health said.

The state also recorded its second-highest test numbers, with 17,363 tests carried out in the reporting period, after the record-high of 17,392 tests in the previous 24 hours.

Almost 700,000 COVID-19 tests have now been carried out in NSW.

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Rockets hit Baghdad’s Green Zone again

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Rockets hit Baghdad’s Green Zone again

Jun 19, 2020

Rockets hit Baghdad’s Green Zone where the US Embassy is located Wednesday night. It was the latest in a string of such attacks by unknown groups as the United States and Iraq discuss the status of the American military in the country.

Iraq’s Security Media Cell, a part of the prime minister’s office that reports on security developments, reported that four rockets fell in the fortified Green Zone, where several embassies are located, late Wednesday night. The incident was “without human or material losses,” the cell said in a tweet. Security forces determined the rockets were fired from south Baghdad.

The attack followed several other recent rocket attacks in the Green Zone and on US and Iraqi military positions in the country. On Monday, rockets hit Baghdad International Airport, where both US and Iraqi forces are. On Sunday, Iraqi forces thwarted a rocket attack on their positions and near a base hosting US troops north of Baghdad. A rocket also landed near the Baghdad airport last week.

In a more deadly incident, two American troops and one British soldier died during a rocket attack at Camp Taji in March. The Iraqi military base hosts foreign troops who are part of the global coalition fighting the Islamic State (IS).

The US and Iraq are currently in talks on the status of US forces in the country, who are there to help Iraq fight IS. The latest talks ended last week with the United States pledging to continue removing troops from Iraq and Iraq committing to protecting US forces there.

Political pressure against the US presence increased when the United States killed Iranian commander Qasem Soleimani via an airstrike in Baghdad in January, which followed an attack by pro-Iran militia supporters on the US Embassy in Baghdad.

Several of the recent rocket attacks have gone unclaimed. The United States suspects Iran-backed Popular Mobilization Units (PMU) are behind the attacks.

Iranian state media reported yesterday that League of the Revolutionaries, a mysterious new Iraqi group that has claimed attacks on the United States before, took credit for a US military plane crash at Camp Taji last week. The US military said the incident was not the result of an attack, however. The group also claimed credit for one of the recent missile strikes on the Baghdad airport, according to Iran’s Al-Alam News Network.

Muhammad al-Waeli, an Iraq-based analyst, said the recent rocket attacks aim to drive the US military out of Iraq as negotiations continue.

“The rocket attacks sort of provide pressure on both the Iraqi government and also the Americans in Iraq in regards to the negotiation process,” Waeli told Al-Monitor. “The ones doing the attacks aim at making the Americans pull out or at least have a very limited presence.”

Waeli said the recent attacks are likely the result of Iraqi groups who are not part of the main PMU factions. He said it is possible the groups have relations with Iran but are not directly controlled by Tehran, similar to the Hamas-Iran relationship.

Several new militias claimed responsiblity for the attacks on their telegram channels. The Joint Operations Command has formed a special committee to investigate the recent attacks.

“We shouldn’t think of it as a centralized process in which Iran is supporting and controlling them and telling them when to hit and what. These groups are very likely Iraqi and they have their own agenda,” Waeli said. “For them, it’s actually safer to not have a strong, centralized connection with Iran.”



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UK coronavirus live: £1bn tutoring fund to help England’s students catch up on learning

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UK coronavirus live: £1bn tutoring fund to help England’s students catch up on learning










Asked this morning about the government’s abandonment of its own contact tracing app in favour of a design by Apple and Google, schools minister Nick Gibb said that there was no point rolling out a system that then fails.

“We want to have ambitious plans to track and trace, and that’s what the app is about, but it has to be properly tested,” he added.

“There’s no point in rolling out a system that then fails because what you’re asking people to do when they’re contacted by the tracers is to self-isolate and you have to be able to trust the information.”

No mention of the system by a government figure would be the same without that familiar baking mantra and, sure enough, Gibb added: “The app was almost like the cherry on the cake.

“It’s a sort of more sophisticated extra layer on top of the track and trace, but it has to be able to operate properly.”

Work started in March as the pandemic unfolded, but despite weeks of work, officials admitted on Thursday that the NHS app only recognised 4% of Apple phones and 75% of Google Android devices during testing on the Isle of Wight.

That was because the design of Apple’s iPhone operating system is such that apps quickly go to sleep when they are not being used and cannot be activated by Bluetooth – a point raised by experts and reported by the Guardian in early May.










An estimated 4.5 million people – three times the size of the NHS workforce – have been forced to become unpaid carers for sick, older or disabled relatives by the Covid-19 pandemic, according to research.

Charities say the huge increase – a result of support services being withdrawn – has happened behind closed doors.

There were already an estimated 9.1 million unpaid carers before the outbreak. The research comes after it was revealed that more than 100,000 people doing unpaid caring for older, disabled or seriously ill relatives had been
forced to use food banks since start of the pandemic.

The increase, say experts, has profound implications for society. More than 70% of the new, unpaid carers, the majority of whom are women, many already living in poverty, said the responsibility was the source of significant stress and that they were deeply concerned about how they would cope as the lockdown eased.




Carers UK has said it wants to see an urgent rise in carer’s allowance.

Carers UK has said it wants to see an urgent rise in carer’s allowance. Photograph: Jennie Hart/Alamy Stock Photo

Updated










Local authority officials and teachers have been calling this morning for more detail on the government’s £650m tutoring programme.

A bit more has been coming from schools standards minister, Nick Gibb, who said schools in England will be able access the fund “at their discretion” to help children catch up on missed work.

Speaking on Sky News, he added that the government wants to ensure no pupils face any long-term detriment to their education as a result of the coronavirus pandemic.

He said: “Schools have done a brilliant job in providing online lessons for children, providing them work while they’re at home.

“But nothing beats children being back in the classroom in terms of the quality of the education and we want to make sure that no child loses out, or has any long-term detriment to their education as a consequence of this crisis.

“So that’s why we’re allocating this huge sum of money, £650m to schools to use at their discretion, to ensure that every child can catch up over the course of the next academic year.”

Updated










The chancellor, Rishi Sunak, has said that the figures confirm the “severe impact” which coronavirus is having on the UK’s public finances.

“The best way to restore our public finances to a more sustainable footing is to safely reopen our economy so people can return to work.”

Updated










Government borrowing to hit £55.2bn – ONS

Government borrowing in May is predicted to have hit £55.2bn – nearly nine-times higher than in the same month a year ago, according to figures released this morning by the Office for National Statistics (ONS).

The figure is slightly lower than the £62.1bn of borrowing in April, according to the ONS, although the organisation also revised down that figure by £13.6bn to £48.5bn on Friday.

Debt levels at the end of May were 100.9% of gross domestic product (GDP), the first time that debt as a percentage of GDP has exceeded 100% since the financial year ending March 1963, the ONS added, standing at £1.95 trillion – up £173.2bn in May 2019.

The BBC’s economic’s editor has more:

Faisal Islam
(@faisalislam)

May UK public finances – £55.2 billion borrowed – 9x last year, highest monthly borrowing on record (since 1993)

Public Sector Net Debt is at 100.9% of GDP – first time since the early 1960s

April’s deficit revised down £14bn to £48.5bn pic.twitter.com/j2dxLZxj1o


June 19, 2020

Updated










English schools to get £1bn to help pupils catch up

Richard Adams

Subsidised tutoring being offered through a new government programme from September is likely to cost state schools £12-an-hour in the scheme’s first year, compared with the £50-an-hour usually charged by the private providers involved.

The programme will come via an extra £650m provided to schools in England to help pupils catch up on teaching missed during the coronavirus lockdown since March, as part of a £1bn package.

Gavin Williamson, the education secretary, will announce the funding on Friday, which will also include a separate £350m in subsidies for a one-year national tutoring programme – as revealed by the Guardian – to help the most disadvantaged children in their education by offering low-cost tuition for schools to purchase.

“This package will make sure that every young person, no matter their age or where they live, gets the education, opportunities and outcomes they deserve, by spending it on measures proven to be effective, particularly for those who are most disadvantaged,” Williamson said

“The plan will be delivered throughout the next academic year, bringing long-term reform to the educational sector that will protect a generation of children from the effects of this pandemic.”




Year six pupils in a literacy lesson at Manchester Grammar School being taught in small bubbles in line with the government imposed restrictions during the Covid-19 pandemic. Christopher Thomond for The Guardian.

Year six pupils in a literacy lesson at Manchester Grammar School being taught in small bubbles in line with the government imposed restrictions during the Covid-19 pandemic. Christopher Thomond for The Guardian. Photograph: Christopher Thomond/The Guardian

Updated










Ben Quinn

Good morning and welcome to the Guardian’s live blog coverage of the coronavirus pandemic in the UK.

Education and the question of how to get children back to school once again takes centre stage today as the government steps up its efforts to convince the public that it has a plan to get on top of one of the most concerning societal impacts of the lockdownt.

Overnight, the government said it would give an extra £650m to schools in England to help pupils catch up on teaching missed during the coronavirus lockdown since March, as part of a £1bn package.

Meanwhile this morning, the Office for National Statistics is due to release its latest picture of how the British economy has been battered by the pandemic. New borrowing data for last month was also expected to show how the national debt is being loaded up

At noon, a view of the state of public sector finances will be published by the Office for Budget Responsibility (OBR). I’ll be covering that along with a range of other developments with colleagues. You can reach me on Twitter at @BenQuinn75.

Updated



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76 Soldiers Injured in Galwan Valley Clash with China Now in Stable Condition, Say Army Officials

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76 Soldiers Injured in Galwan Valley Clash with China Now in Stable Condition, Say Army Officials

An Indian Army convoy moves along a highway leading to Ladakh, at Gagangeer in Kashmir’s Ganderbal district on Thursday. (Reuters)

The Army had earlier clarified that all soldiers are accounted for after the violent clashes with the Chinese army.

  • News18.com

  • Last Updated: June 19, 2020, 12:05 AM IST

The Indian Army on Thursday said 18 soldiers undergoing treatment at a hospital in Leh are no more critical and are stable, while 58 soldiers at other hospitals should be back on duty within a week. At least 20 Indian soldiers were killed in the confrontation with the Chinese Army in Ladakh’s Galwan Valley earlier this week.

“No one is critical as of now, all are stable. Eighteen soldiers are at our hospital in Leh, they will be out on duty in about 15 days. 58 soldiers are at other hospitals, they should be back on duty within a week,” news agency ANI quoted the sources as saying. They added that the health status of the status is as of Thursday afternoon.

The 58 personnel that are at other hospitals have minor injuries, which is why “an optimistic time-frame of one week has been given for their recovery”, added the sources.

The Army had earlier clarified that all soldiers are accounted for after the violent clashes with the Chinese army.

Referring to a news report claiming that soldiers are missing in action, the Army said all Indian troops are accounted for. “It is clarified that there are no Indian troops missing in action,” the Army said in a statement.

There have been reports that several Indian Army soldiers were held captive by the Chinese Army following the Galwan Valley clashes in which 20 Indian Army personnel including a Colonel were killed. China has not yet released any casualty figures.

At a media briefing, External Affairs Ministry Spokesperson Anurag Srivastava also said no Indian soldiers were missing since the clashes on Monday evening.

Indian and Chinese militaries held a Major General-level dialogue on Thursday for the third consecutive day on disengagement of troops as well as restoring normalcy in areas around the Galwan Valley.

On Wednesday also, top Indian and Chinese military commanders talked at Galwan Valley over the violent clash but the three-hour dialogue remained inconclusive at the end of the day. The dialogue was to ensure that Chinese People’s Liberation Army pulls back all its troops from the Galwan Valley and removed all the military-grade tents which house them.

Both the forces have redeployed troops at the site of the clash. Sources said that India Army officials have made clear to Chinese counterparts that they have to move back.

Major General Abhijit Bapat, who is the Commander of the Indian Army’s 3 Division, raised several points with the Chinese officers with regards to the incident on the intervening night of June 15-16.

The clashes were the biggest military confrontation in over five decades that has significantly escalated the already volatile border standoff in the region.


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PTI government committed to agreement with BNP-M: Qureshi

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PTI government committed to agreement with BNP-M: Qureshi

Foreign Minister Shah Mahmood Qureshi. AFP

ISLAMABAD: The PTI government is still committed to its agreement with the Balochistan National Party-Mengal (BNP-M) said Foreign Minister Shah Mahmood Qureshi on Friday, reported Geo News. 

Speaking to Geo Pakistan, the foreign minister said that the government was not concerned about any developments regarding its allies as “ups and downs are part of politics”.

He said that Akhtar Mengal was a respected politician and that the PTI was bound by the agreement it had signed with the BNP-M. “He mentioned an agreement with us [PTI], we are still bound by it,” said the foreign minister. “We are not rejecting it,” added, stating that talks can be held to discuss the pace of the progress at which it needs to be implemented.

FM Qureshi said that the PTI will establish contact with Mengal to persuade him to review his decision. “He is an MNA, a lawmaker and the leader of his party,” said FM Qureshi. “We listened to what he had to say. We will try to satisfy his demands.”

However, the foreign minister said that Mengal was “independent in making his own decisions” about the coalition government.

In response to a question about whether the PTI was missing Jahangir Tareen — who has recently become estranged with the party leadership due to his alleged role in the sugar price hike — when it came to allaying allies’ concerns, Qureshi said that there were lots of senior members of the party who were “playing their roles”.

“There are lots of senior members in the PTI such as Pervaiz Khattak, Asad Umar, Shafqat Mahmood, and many others,” he said. “There is no such issue that things won’t be able to move forward [in Tareen’s absence].”

The foreign minister said that he could not comment on the implementation of the points of the agreement between the PTI and the BNP-M as he had been traveling. He said that the COVID-19 had reduced his travels and forced the foreign minister to communicate via virtual meetings hence now he had more time to pay attention to such matters.

Qureshi commented on India’s election as a non-permanent member of the UN Security Council, saying that it was a wrong perception that Pakistan had abstained from voting.

“Pakistan did not abstain from voting, we voted against India,” he said. “We expressed our reservations of India’s August 5 actions, which were against the Security Council regulations and in contravention to international law, by principally voting against India,” the foreign minister stressed.

He said that people should understand the election process of the Security Council membership election. The foreign minister noted that Pakistan had won the election as a non-permanent member of the Council seven times and that India had won an equal number of times in the past.

FM Qureshi said that India had started lobbying for the election since 2013. “It was not the PTI that was in government in 2013. We must check the record as to who was in government then,” he stated.

BNP-M announces leaving govt coalition

His statement comes in response to the BNP-M’s announcement on Wednesday that the party was breaking its alliance with the ruling coalition.

“Today, I announce in Parliament [the BNP-M’s] separation from PTI’s [ruling] alliance,” Mengal had said while addressing the National Assembly.

However, the lawmaker had clarified that his party will continue to be part of the National Assembly and keep talking about Balochistan’s issues.

In his speech, Mengal reminded the House that his party had two agreements with the ruling party, adding that it was the Imran Khan-led party which had come to him for an alliance, not the BNP-M which went to Bani Gala — the personal residence of PM Imran Khan.

“The first agreement was done on August 8, 2018 and signed by Shah Mahmood Qureshi, Jahangir Tareen and Yar Muhammad Rind,” recalled Mengal.

He added that his party had demanded that the missing persons issue be resolved and the National Action Plan be implemented in letter and spirit in the agreement.

“Can someone tell us if there was anything unconstitutional in both these demands? Why were they not implemented?” the lawmaker from Balochistan had asked. 

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