Shaun Griffin

Bio: Shaun Griffin is an academic researcher. The author has contributed to research in topics: Medicine & Public health. The author has an hindex of 6, co-authored 45 publications receiving 159 citations.

Covid-19: Waiting times in England reach record highs.

Abstract: More than 83 000 patients in England waited more than a year for NHS treatment in July, the highest number since October 2008 and an 81-fold increase from 1032 in July last year, latest figures have shown.1 The number of people who had been on waiting lists for more than 18 weeks in July was also the highest since records began in 2007, at 2.15 million. Just 46.8% of patients were treated within 18 weeks in July, against the 92% target—the lowest since records began, data from NHS England showed. The average wait for treatment by a hospital consultant rose to 19.6 weeks in July 2020. Figures from August show that demand in emergency …

Covid-19: "Staggering number" of extra deaths in community is not explained by covid-19.

Abstract: Only a third of the excess deaths seen in the community in England and Wales can be explained by covid-19, new data have shown. The Office for National Statistics (ONS) data,1 which cover deaths in hospitals, care homes, private homes, hospices, and elsewhere, show that 6035 people died as a result of suspected or confirmed covid-19 infection in England and Wales in the week ending 1 May 2020 (where deaths were registered up to 9 May), a decline of 2202 from the previous week. Although the number of deaths in care homes has fallen for the second week in a row, more covid related deaths are being reported in care homes than in hospitals and are tailing off more slowly. However, David Spiegelhalter, chair of the Winton …

Covid-19: Lopinavir-ritonavir does not benefit hospitalised patients, UK trial finds.

Abstract: The anti-HIV drug lopinavir-ritonavir does not improve survival of patients with covid-19 in hospital, according to new findings from the UK RECOVERY trial. Announcing the results, which are yet to be formally peer reviewed, Martin Landray, deputy chief investigator, said that current guidelines in many countries recommend lopinavir-ritonavir as a treatment for covid-19. “The results from this trial [and] other large randomised trials should inform revisions to those guidelines and changes to the way individual patients are treated,” he said. The data showed that, at 28 days, the death rate was not significantly different in patients …

Covid-19: Herd immunity is "unethical and unachievable," say experts after report of 5% seroprevalence in Spain

Abstract: The results of the first nationwide population based epidemiological study of SARS-Cov-2 seroprevalence, conducted across Spain, reveal a national prevalence of only 5%, making global efforts to deliver herd immunity through natural infection both “unethical and unachievable,” according to experts. In a survey carried out between 27 April and 11 May and involving more than 61 000 participants in nearly 36 000 households, Marina Pollan, professor at Spain’s National Centre for Epidemiology in Madrid, with colleagues from the ENE-COVID study group, used two methods to detect anti-covid-19 antibodies: a point of care test and a laboratory immunoassay.1 Although they targeted IgG antibodies against …

Covid-19: Fully vaccinated people can carry as much delta virus as unvaccinated people, data indicate.

Abstract: Adults who have been fully vaccinated against SARS-CoV-2 can carry the same viral load of the delta variant as those who are unvaccinated, a preliminary analysis of UK data suggests.1 The latest results from the UK’s national covid-19 infection survey show that having two vaccine doses remains the most effective way to ensure protection against delta. But, although people who are fully vaccinated have a lower risk of becoming infected, those infected with the delta variant can carry similar virus levels as unvaccinated people, the data show. The authors said the implications for transmission were not yet clear but suggested that the potential for fully vaccinated individuals to transmit the virus to others would make achieving herd immunity more of a challenge. Sarah Walker, professor of medical statistics and epidemiology at the University of Oxford and chief investigator of the survey, said, “We don’t yet know how much transmission can happen from people …

Indirect acute effects of the COVID-19 pandemic on physical and mental health in the UK: a population-based study.

Abstract: Summary Background There are concerns that the response to the COVID-19 pandemic in the UK might have worsened physical and mental health, and reduced use of health services. However, the scale of the problem is unquantified, impeding development of effective mitigations. We aimed to ascertain what has happened to general practice contacts for acute physical and mental health outcomes during the pandemic. Methods Using de-identified electronic health records from the Clinical Research Practice Datalink (CPRD) Aurum (covering 13% of the UK population), between 2017 and 2020, we calculated weekly primary care contacts for selected acute physical and mental health conditions: anxiety, depression, self-harm (fatal and non-fatal), severe mental illness, eating disorder, obsessive-compulsive disorder, acute alcohol-related events, asthma exacerbation, chronic obstructive pulmonary disease exacerbation, acute cardiovascular events (cerebrovascular accident, heart failure, myocardial infarction, transient ischaemic attacks, unstable angina, and venous thromboembolism), and diabetic emergency. Primary care contacts included remote and face-to-face consultations, diagnoses from hospital discharge letters, and secondary care referrals, and conditions were identified through primary care records for diagnoses, symptoms, and prescribing. Our overall study population included individuals aged 11 years or older who had at least 1 year of registration with practices contributing to CPRD Aurum in the specified period, but denominator populations varied depending on the condition being analysed. We used an interrupted time-series analysis to formally quantify changes in conditions after the introduction of population-wide restrictions (defined as March 29, 2020) compared with the period before their introduction (defined as Jan 1, 2017 to March 7, 2020), with data excluded for an adjustment-to-restrictions period (March 8–28). Findings The overall population included 9 863 903 individuals on Jan 1, 2017, and increased to 10 226 939 by Jan 1, 2020. Primary care contacts for almost all conditions dropped considerably after the introduction of population-wide restrictions. The largest reductions were observed for contacts for diabetic emergencies (odds ratio 0·35 [95% CI 0·25–0·50]), depression (0·53 [0·52–0·53]), and self-harm (0·56 [0·54–0·58]). In the interrupted time-series analysis, with the exception of acute alcohol-related events (0·98 [0·89–1·10]), there was evidence of a reduction in contacts for all conditions (anxiety 0·67 [0·66–0·67], eating disorders 0·62 [0·59–0·66], obsessive-compulsive disorder [0·69 [0·64–0·74]], self-harm 0·56 [0·54–0·58], severe mental illness 0·80 [0·78–0·83], stroke 0·59 [0·56–0·62], transient ischaemic attack 0·63 [0·58–0·67], heart failure 0·62 [0·60–0·64], myocardial infarction 0·72 [0·68–0·77], unstable angina 0·72 [0·60–0·87], venous thromboembolism 0·94 [0·90–0·99], and asthma exacerbation 0·88 [0·86–0·90]). By July, 2020, except for unstable angina and acute alcohol-related events, contacts for all conditions had not recovered to pre-lockdown levels. Interpretation There were substantial reductions in primary care contacts for acute physical and mental conditions following the introduction of restrictions, with limited recovery by July, 2020. Further research is needed to ascertain whether these reductions reflect changes in disease frequency or missed opportunities for care. Maintaining health-care access should be a key priority in future public health planning, including further restrictions. The conditions we studied are sufficiently severe that any unmet need will have substantial ramifications for the people with the conditions as well as health-care provision. Funding Wellcome Trust Senior Fellowship, Health Data Research UK.

COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England

Abstract: BACKGROUND: Several countries affected by the COVID-19 pandemic have reported a substantial drop in the number of patients attending the emergency department with acute coronary syndromes and a reduced number of cardiac procedures. We aimed to understand the scale, nature, and duration of changes to admissions for different types of acute coronary syndrome in England and to evaluate whether in-hospital management of patients has been affected as a result of the COVID-19 pandemic. METHODS: We analysed data on hospital admissions in England for types of acute coronary syndrome from Jan 1, 2019, to May 24, 2020, that were recorded in the Secondary Uses Service Admitted Patient Care database. Admissions were classified as ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), myocardial infarction of unknown type, or other acute coronary syndromes (including unstable angina). We identified revascularisation procedures undertaken during these admissions (ie, coronary angiography without percutaneous coronary intervention [PCI], PCI, and coronary artery bypass graft surgery). We calculated the numbers of weekly admissions and procedures undertaken; percentage reductions in weekly admissions and across subgroups were also calculated, with 95% CIs. FINDINGS: Hospital admissions for acute coronary syndrome declined from mid-February, 2020, falling from a 2019 baseline rate of 3017 admissions per week to 1813 per week by the end of March, 2020, a reduction of 40% (95% CI 37-43). This decline was partly reversed during April and May, 2020, such that by the last week of May, 2020, there were 2522 admissions, representing a 16% (95% CI 13-20) reduction from baseline. During the period of declining admissions, there were reductions in the numbers of admissions for all types of acute coronary syndrome, including both STEMI and NSTEMI, but relative and absolute reductions were larger for NSTEMI, with 1267 admissions per week in 2019 and 733 per week by the end of March, 2020, a percent reduction of 42% (95% CI 38-46). In parallel, reductions were recorded in the number of PCI procedures for patients with both STEMI (438 PCI procedures per week in 2019 vs 346 by the end of March, 2020; percent reduction 21%, 95% CI 12-29) and NSTEMI (383 PCI procedures per week in 2019 vs 240 by the end of March, 2020; percent reduction 37%, 29-45). The median length of stay among patients with acute coronary syndrome fell from 4 days (IQR 2-9) in 2019 to 3 days (1-5) by the end of March, 2020. INTERPRETATION: Compared with the weekly average in 2019, there was a substantial reduction in the weekly numbers of patients with acute coronary syndrome who were admitted to hospital in England by the end of March, 2020, which had been partly reversed by the end of May, 2020. The reduced number of admissions during this period is likely to have resulted in increases in out-of-hospital deaths and long-term complications of myocardial infarction and missed opportunities to offer secondary prevention treatment for patients with coronary heart disease. The full extent of the effect of COVID-19 on the management of patients with acute coronary syndrome will continue to be assessed by updating these analyses. FUNDING: UK Medical Research Council, British Heart Foundation, Public Health England, Health Data Research UK, and the National Institute for Health Research Oxford Biomedical Research Centre.

Acceptance of a COVID-19 Vaccine and its Related Determinants among the General Adult Population in Kuwait.

Abstract: Objective: The objective of this study was to determine the acceptance of a coronavirus disease 2019 (COVID-19) vaccine among the general adult population in Kuwait and assess its determinants. Subjects and Methods: A web-based cross-sectional study was conducted by enrolling adults living in Kuwait (n = 2,368; aged ≥21 years). Acceptance of a COVID-19 vaccine was inferred if participants indicated that they “definitely or probably will accept vaccination against COVID-19 once a vaccine is available.” Associations were explored by applying a modified Poisson regression to estimate and infer adjusted prevalence ratios (aPR) and their 95% confidence intervals (CI). Results: In total, 53.1% (1,257/2,368) of the participants were willing to accept a COVID-19 vaccine once available. Male subjects were more willing to accept a COVID-19 vaccine than females (58.3 vs. 50.9%, p < 0.001). Subjects who viewed vaccines in general to have health-related risks were less willing to accept vaccination (aPR = 0.39, 95% CI: 0.35–0.44). Moreover, participants who previously received an influenza vaccine were more likely to accept a COVID-19 vaccine (aPR = 1.44, 95% CI: 1.31–1.58). Willingness to get vaccinated against COVID-19 increased as the self-perceived chances of contracting the infection increased (p < 0.001). Conclusion: Overall, 53.1% of the study participants demonstrated willingness to get vaccinated against COVID-19. We found several factors influencing the level of acceptance. Since vaccination appears to be an essential preventive measure that can halt the COVID-19 pandemic, factors relating to low vaccine acceptance need to be urgently addressed by public health strategies.