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Omicron peak could come in ‘the next 10 to 14 days’ in Wales

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THE FIRST MINISTER Mark Drakeford has said he is ‘hopeful’ figures in Wales could start to reduce from around two weeks’ time.

The comments came during the live briefing held yesterday lunchtime in Cardiff, with the First Minister referring to modelling several times and comparing it to what has been recorded in firm figures.

The First Minister said of the above slide, “It shows you how the modelling that we’ve had done for us here in Wales shows how the Omicron wave wave is expected to behave. The blue line shows how cases are predicted to grow over the coming weeks. The black line shows the actual confirmed cases.

“As you can see, the actual cases are following very closely the predicted wave, and what the wave shows is the speed at which the Omicron wave will break over us and then how cases decline at a relatively rapid rate as well.

“Now we haven’t reached the peak of that wave yet, it could be within the next 10 to 14 days. But we will get to the top of the wave and then hopefully we will see the numbers reducing again here in Wales.

“The latest figures show that there are more than 2300 cases per 100,000 people across Wales. Cases are highest amongst 20- to 39-year-olds but we are also now seeing rises in older age groups. As community transmission increases rapidly, while the figures are clearly concerning, they are in line with what the modelling forecasts told us.”

“Every close contact is an opportunity for it to spread.”

Data was also released on the number of people to being admitted to hospital with coronavirus, “The latest figures show that there are now a total of 994, just under 1000, COVID-19 patients in our hospitals in Wales and that is a 43% increase on a single week and that number is the highest we have seen in Welsh hospitals since March of last year”.

“There are now around 40 people are so ill in hospital that they have to receive critical care and the majority of those people are people who have not been vaccinated. Very sadly since just the start of this year, public health Wales has reported 38 New deaths from coronavirus.”

When asked about reversing restrictions, and what timeframes could be involved, the First Minister said, “As people will have seen from the model that we showed earlier, the position over the next 10 days to two weeks is not going to be one that is easing.

“The numbers are likely to continue to rise. So it will not be until we have past the peak of infections and we are sure that we can see the pressures on the spread of this virus in the community are beginning to reduce, and will then take a while as it always does to feed through into reducing pressure on health services, hospital services, critical care services.

“So I don’t anticipate that over the next fortnight we will be in a position to move away from the level of restrictions we currently have in place. But, we will track it every day. We will review it every week. And when we see that corner being turned and we can see the number as we hope coming down reasonably rapidly. That will be the point at which we will be able to assess when it is safe to begin to lift the extra restrictions and protections we put in place so far.”

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Health

Public Health Wales apology over lack of clarity on smear test changes

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PUBLIC HEALTH WALES has apologised and admitted it hasn’t “done enough” to explain the reasons for increasing the length of time between cervical screening tests.

The change, which was announced on Tuesday, means people aged between 25 and 50 with a cervix will now wait five years until another test, rather than three, providing no human papillomavirus (HPV) cells are detected.

HPV is a very common virus that most people will come into contact with at some time during their lives. One or more high-risk types of HPV are present in over 99.8% of cervical cancers.

HPV testing was successfully introduced in Wales in 2018 and almost nine out of 10 results show no high-risk HPV.

There are about 160 cases of cervical cancer diagnosed every year in Wales and it is the most common cancer in women under the age of 35.

But Public Health Wales has admitted it has failed to give clear information over the change, leading to concerns cancers could be missed.

In a tweet this weekend PHW said: “We are sorry. We haven’t done enough to explain the changes to cervical screening and have caused concern. We are working to make this clearer and more information will be available as soon as we can today and in the coming days.”

Cancer charities have sought to reassure women concerned by the change. Cancer Research UK has said people should be aware increasing the gap between screenings is “safe” and the new form of testing means people are invited for further based on their risk of developing cancer rather than their age.

An online petition, calling for the reintroduction of the three year gap between routine smear tests, has now attracted more than 680,000 signatures.

Alice Davies, Cancer Research UK’s health information manager, said people should be aware the decision to increase the time between screenings was made on scientific advice and due to a new way of testing samples which detects human papilloma virus (HPV) and means doctors are better able to identify those at risk of developing cervical cancer.Ms Davies said: “As the new test is more accurate at finding those at risk of cervical cancer, screening intervals can be safely extended from three to five years.

“If someone is HPV positive then their next screening interval will be shorter than five years. The new test allows women to be invited back for screening based on their risk of developing cervical cancer, rather than just their age.

“Overall this makes the programme more accurate, and means people don’t have extra rounds of screening that wouldn’t give them any benefit, while offering more screening to people at higher risk.”On Wednesday Public Health Wales said it accepted it has to do more to explain the reasons for the change.

Charity Jo’s Cervical Cancer Trust, described as the UK’s leading cervical cancer charity, has sought to reassure people concerned about the changes.

It has said the change has been introduced following advice from the UK National Screening Committee which recommended the five year gap between tests due to the use of HPV tests which are more sensitive and effective.

It said this means the advice is most women aged 25 to 49 can, as those aged 50 to 64 are, can be tested every five years rather than three.

The charity says the improved testing will likely mean more lives saved by identifying those at greater risk of cancer earlier.

According to Jo’s Cervical Cancer Trust women in Wales, and Scotland, are invited back based on the result of the screening.

If those show high-risk HPV and cell changes you will be invited to colposcopy.

If it identified high-risk HPV but no cell changes you will be invited for cervical screening in one year.

If there is no HPV you will be invited for cervical screening in five years.

Public Health Wales says HPV testing was introduced in Wales in 2018 and almost nine out of 10 results show no high-risk HPV.

Heather Lewis, consultant in public health for Cervical Screening Wales said: “The HPV test we now use in Wales is more effective at identifying people at higher risk of developing cell changes which can cause cervical cancer.

“The evidence shows that it is therefore safe to extend the time between cervical screening tests for people who do not have HPV identified.”

HPV is a very common virus that most people will come into contact with at some time during their lives. One or more high-risk types of HPV are present in over 99.8% of cervical cancers.

Increasing the time between smear tests will also reduce risks from screening.

Head of Programme for Cervical Screening Wales at Public Health Wales, Louise Dunk said: “Testing everyone who attends for cervical screening using a test for high risk HPV will identify those at risk and prevent more cancers than just examining the cells alone.

“It is a really positive development that this more effective test will mean that women and people with a cervix, who test negative for HPV, now only need to attend their testing every five years, rather than three.”

There are around 160 cases of cervical cancer diagnosed every year in Wales and it is the most common cancer in women under the age of 35.

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Health

Most stupid and inappropriate calls to the Welsh Ambulance Service revealed

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THE WELSH AMBULANCE SERVICE has revealed the most inappropriate calls made to 999 in the past year.

Among them was someone who had eaten a mouldy tomato and someone who had got their plaster cast wet.

One person with an earring lodged inside their ear asked for a “lift” to the Emergency Department, while another dialled 999 for a papercut.

Of the 470,653 incidents recorded by the service in the last 12 months, nearly a quarter were non-essential, including someone with diarrhoea and someone enquiring about their medication.

In the face of unprecedented demand, the ambulance service is reminding people only to call 999 in a serious or life-threatening emergency.

Chief Executive Jason Killens said: “Our ambulance service exists to help people who are seriously ill or injured, or where there is an immediate threat to their life.

“That’s people who’ve stopped breathing, people with chest pain or breathing difficulties, loss of consciousness, choking, severe allergic reactions, catastrophic bleeding or someone who is having a stroke.

“People with something stuck in their ear still have a clinical need, but calling 999 for that is ill-judged when there are so many other ways to access more appropriate help.

“Non-essential calls represent nearly a quarter of our total 999 calls, and time spent dealing with these could be time spent helping someone in a life or death situation.”

As Covid-19 tightens is grip, the Trust is asking the public to think about the many alternatives to 999.

Director of Operations Lee Brooks said: “Winter is traditionally our busiest period, and we also have a global pandemic to contend with.

“It’s easy to make fun of the people who call 999 foolishly, but actually, these people do have a legitimate clinical need – they just don’t know where to turn for it.

“We’re asking the public to educate themselves on the NHS services available in their area, of which there are many.

“The symptom checkers on the NHS 111 Wales website are a good place to start for advice and information, or you could phone 111 to speak to a nurse or health information advisor.

“Also think about your local pharmacist, dentist and optician, as well as your minor injuries unit and GP.

“Also ensure you have a well-stocked medicine cabinet for things which can be treated at home, like coughs and colds, sore throats and grazed knees.

“Every single one of us has a responsibility to use NHS services wisely and protect them for those who need them most.

“Help us to help you, and think twice before you call 999.”

Examples

The following are real 999 calls made to the Welsh Ambulance Service in the past year –

Call 1

Caller: Basically, I had a piercing a few weeks ago in my ear. Everything’s been fine but last night I woke up and the piercing had gone. I can’t find the piercing and it feels like it might be in my ear drum.

Operator: Right, OK.

Caller: Normally I would go to A&E myself but I don’t actually have any money. A lift to A&E would be amazing.

Call 2

Caller: My neighbour came here and she gave me a sandwich, cheese and tomato. Anyway, I feel quite sick now. I looked at the tomatoes and there’s mildew on them.

Operator: OK, is that why you’re requiring an ambulance?

Call 3

Caller: I was mucking about with my plaster cast and it’s coming apart. I don’t know whether to get a taxi or an ambulance.

Operator: From the information you’ve given, you require a more detailed assessment by a nurse. An ambulance will not be sent at this time.

Caller: Oh, you’re joking. Are you being serious?

Operator: We’re extremely busy at the moment.

Caller: I’ll get a taxi.

Call 4

Caller: I cut my arm, my arm’s cut.

Operator: How did you do that?

Caller: I sliced it on a piece of paper.

Operator: When did this happen?

Caller: About half an hour ago.

Operator: Is there any serious bleeding?

Caller: No.

Call 5

Operator: Tell me exactly what’s happened.

Caller: Basically, my mum drank apple vinegar but mixed it with water and lemon. Now she has diarrhoea.

Call 6

Caller: Oh, hi there. Basically, I’ve got my hand in a cast. It’s been in there for three weeks and I’ve got it wet.

Operator: OK.

Caller: It’s not an actual emergency, I just need to get to hospital.

Call 7

Caller: What it is, right, I’ve got different medication and I don’t know whether I can take these or not now.

Operator: What’s your telephone number?

Caller: I don’t want an ambulance, I just don’t know if I can take my meds or not.

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Health

Health Board takes actions to protect healthcare for the most critically ill

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HEALTH and care services across West Wales are responding to the impacts of the Omicron variant of COVID-19 in order to provide emergency and urgent care for patients in the safest way possible during the coming weeks.

Hywel Dda University Health Board is taking a number of actions today, and appealing for the continued support of our staff and communities to keep Hywel Dda safe as we face this new phase of the pandemic.

Actions are being taken in a planned way due to the high demand we are seeing for non-COVID care during this time of the year, together with high incidence of COVID-19 in our area, like the rest of the UK.

This is starting to result in higher numbers of COVID admissions and incidences in our hospitals and communities.  

It is also having a direct impact on our staffing levels across primary care, community and hospital services.  We currently estimate that at least 10 per cent of our workforce is absent for both COVID and non-COVID related reasons.  This figure is higher in some teams and we expect it to rise in the coming weeks. We need to plan how we deliver the most critical clinical services with the staff we have available. 

Actions being taken include:

  • The health board is providing and reminding staff of the services available to them internally to support them at this difficult time. It is standing down some less urgent work in order to redeploy staff where possible.
  • To maintain delivery of the most urgent cancer surgery in the short term, this will be undertaken for the Hywel Dda population from Prince Philip Hospital, in Llanelli, with the exception of Head and Neck urgent cancer surgery, which will continue at Glangwili General Hospital, in Carmarthen.. Our clinicians believe that concentrating the majority of our urgent care resources onto one site during the next few weeks is the best way to protect the delivery of this potentially life-saving surgery. This position will be continually reviewed and we will seek to re-establish urgent cancer surgery at our other main hospitals as soon as we can do so safely. We ask patients and families to support us and travel for their surgery. If you have no means to travel for your surgery, then please contact us on our COVID enquiries line on  0300 303 8322 or email COVIDEnquiries.hdd@wales.nhs.uk 
  • Outpatient & therapy appointments and clinics will be prioritised for the most urgent patients over the next few weeks. With the exception of a small number of emergency cases and some children’s appointments, we will reschedule outpatient appointments next week.  Patients will be re-booked according to clinical urgency in subsequent weeks. Unless you are contacted directly by the health board, please attend any appointment as scheduled. If anyone has concerns about the delay in their outpatient appointment, as a result of this short term measure, they can contact the health board on 0300 303 8322 or email COVIDEnquiries.hdd@wales.nhs.uk 

Director of Operations Andrew Carruthers said: “The whole of the UK is facing challenge from Omicron and the indirect impact on staffing. This is affecting us in Hywel Dda UHB across all our services whether in the community, primary care or hospitals, but to different degrees and is a very fluid situation. To ensure the delivery of care for the most critically unwell, and to ensure we protect the ability of our staff to provide this care, we have put in place actions that will provide some extra capacity. We apologise to anyone affected adversely by these actions and it remains our ambition, always, to re-establish our planned care services as soon as we are able to, knowing the impact this has on people’s lives.”

Director of Nursing, Quality and Patient Experience Mandy Rayani added: “We are so grateful to our staff who continue to work in difficult circumstances, always driven by the desire to provide the best care possible to our population. We are asking our staff to be vigilant about the behaviours we know reduce transmission of COVID-19 at work and at home; and our public can also play a significant role in supporting the NHS and each other by also adhering to these principles. Unfortunately we are seeing more abuse targeted at our staff and we will not tolerate this. Health and care staff – from the clinicians to the support teams and call handlers in primary, community and hospital teams – provide a service to help our patients and communities and they should never be the victims of abuse, physical or verbal. Please help us to help you.”

Steps you can take to protect more lives, our NHS and each other include:

  • Get your full course of vaccination https://hduhb.nhs.wales/healthcare/covid-19-information/covid-19-vaccination-programme/
  • Follow Welsh Government guidance on self-isolation and testing, including carrying out regular LFDs (health and care staff have specific and different guidance internally)
  • Wear face coverings, or if asked in a health setting, a surgical face mask
  • Keep a 2meter distance from others when you can
  • Wash hands regularly and be ready to be asked by a healthcare professional to wash hands or sanitise whether in hospital or your own home
  • Do not accompany people to hospital, GP surgery, or another setting unless they are vulnerable and need your assistance
  • Please be aware that your GP surgery may offer you appointments in different ways where appropriate, such as over the telephone or online. Please allow extra time when ordering prescriptions during this busy time. Community pharmacies are also extremely busy so you may need to wait longer than usual.
  • Pre-arrange hospital visiting with the ward sister and be understanding if it is not possible at this time due to safety

The health board continues to work closely with others including the Welsh Ambulance Service NHS Trust, local authorities and other partners to work together in these challenging times.

If you or a loved one is unwell, remember:

If you have a relative or loved one in hospital who is medically fit but is waiting to be discharged, you may be able to help us by providing short term care or considering interim placements in care homes.

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