Health Matters – April 2023

• Covid Update & Boosters
• Covid & Child Asthma
• Cancer & mRNA Vaccines
• NHS at the Moment
• The Waiting List

1. Covid & Flu  –  Here’s the latest summary

• The case rate remains low at 24 per 100,000, and that’s down on last week’s 35 last week – for comparison, it’s 28 in Watford!
• Verulam Park is the highest area in St Albans with 104 cases per 100,000
• The numbers in hospital are similar to last month – Lister is down from 66 to 55 but Watford is static at 64.
• Covid Vaccinations – the Spring Booster vaccinations in Care Homes have been done and people over 75 and people with a weakened immune system have been contacted to book their jabs. If you haven’t been contacted yet you can book an appointment online at www.nhs.uk/nhs – services/covid-19-services/covid-19-vaccination-services/book-covid-19-vaccination. If you prefer the phone, then ring 119 to book an appointment instead.
• So – please follow my example and book yours as soon as you can. There is evidence that some people are developing vaccine hesitancy thinking
  • “I’ve got away with it so far so why bother?” Remember you got away with it so far because you had your injections!!!! Or
  • “I’ve had Covid so I have the antibodies” – yes but they don’t provide immunity for long and it may well be an old variant!

2. Covid & Asthma – one of the consequences of Covid was that the rates of asthma in children fell by 52% during the Covid epidemic. This was found by comparing the rate of diagnosis in children under 18 with no previous asthma diagnosis with the 2019 rate.

The theory is that there are two considerations – the drop in colds during Covid plus mask wearing; by keeping ourselves isolated and wearing masks in enclosed spaces led to less infections and children’s colds are the main trigger for the onset of asthma. So Covid did some good after all!

3. Cancer & mRNA Vaccines – Let’s start with a reminder:

• Traditionally, vaccines inject part or all of a weakened virus into the body to provoke an immune response. For ages, this is the way that our flu vaccines work, for example.
• But mRNA works by injecting only the genetic instructions and allowing the body’s cells to make part of the cancer protein (antigen) itself. This trains the immune system to develop antibodies against the protein. This process has been defined by prescribing a template to generate the specific range of antibodies needed to treat the patient.

Currently cancer is treated with surgery (cutting out cancerous cells), by radiotherapy (akin to burning cancer cells), and chemotherapy (stopping cancer cells from dividing by directly killing them). But the point is, our immune system already knows how to fight cancer; the problem is that cancer cells learn how to turn the immune system off. By blocking these receptors, the immune system can recognise cancer as an enemy and kill it – like removing the cloak on an intruder.

The mRNA Cancer vaccine is in advanced trials but the big problem at the moment is cost; but further research will be able to bring that cost down significantly

4. The NHS at the Moment – there’s no getting away from the fact that the NHS, at the moment, can certainly be described as stretched; probably dysfunctional if we were being less kind!

The issues causing this are probably obvious, but let’s re-cap them:

• Workforce – and specifically vacancies! This is especially hurting Primary Care (i.e., Doctors’ Surgeries)
• Burn-out following Covid and morale issues
• Demand, the Waiting List, and the impact of Long Covid
• Strikes – especially Junior Doctors and Nurses

So, I thought a series of ideas you can follow to minimise your health issues would be helpful if you’re feeling unwell:

• The NHS website has lots of advice to help you to look after yourself when you have minor symptoms. There is also information about what is a serious medical emergency: When to call 999 – NHS www.nhs.uk
• Pick up a few medicines while you’re shopping so that you can look after very minor illnesses or injuries yourself.
• Your Pharmacy will be able to help in many cases – and they are very effective in providing guidance and signposting.
• If you have a computer or smartphone, you can use your GP practice’s e-consultation service, which directs your query quickly to the right member of practice staff and helps free up the telephone lines for those who aren’t online.
• If you need urgent health help, use NHS 111 online (www.111.nhs.uk) or call 111. Your symptoms will be assessed, and you will be provided with healthcare advice or an appointment to see a doctor or nurse if this is needed. NHS 111 can also send an ambulance and can book an appointment for you in some services like urgent treatment centres.
• If you are in a mental health crisis, call NHS 111 and get straight through to mental health help by selecting option 2.
• Accident and Emergency (A&E) departments at our hospitals only have the capacity to treat people who have serious or life-threatening conditions. If you use emergency services with a minor issue you are risking the lives of others and may not get the treatment for your symptoms as quickly as you will elsewhere.
• Do not visit anyone in a hospital or care home if you have recently had diarrhoea or vomiting. Stomach bugs are easily spread, make already ill people very seriously unwell, and can lead to whole hospital wards being closed. Please wait 48 hours after your last bout of sickness or diarrhoea before visiting anyone who is vulnerable.

5. The Waiting List – guess what – it’s coming down at Watford Hospital!!!!!

• There should be no-one waiting over 18 months by the end of this month; that’s from a high of 156 in May last year.
• People waiting 15 months have fallen from a high of over 830 in December to under 600.
• And 12 months waits are down from over 4,300 in November to 2,300.
• In addition, Cancer metrics have improved, with two week wait performance above 90% for the first time since the summer of 2021

Alan Bellinger
19^th  April 2023