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26 PCPH-Emagazine-Spring-2021.Pdf Spring 2021 Department of Primary Care & Public Health touch mattersCOVID-19, physical examination, and 21st century general practice Image by jcomp via freepik.com Spring 2021 Many of the articles in this edition of our newsletter discuss Covid-19 vaccination. This is now being rolled out nationally and offers the best way for the United Kingdom to bring the Covid-19 pandemic under control, and allow a return to a more normal way of living. We are very proud that many members of the department, and also many of our medical students, have contributed to the vaccination programme; including working as vaccinators and addressing vaccine hesitancy in marginalised groups. There is also a reminder in the newsletter that Covid-19 is a global pandemic and we won’t be truly safe in the United Kingdom until vaccination programmes have targeted the rest of the world’s population, in Professor Azeem Majeed Head of Department of Primary Care and particular, people in low income countries. Public Health Imperial College London Follow Prof Majeed on Twitter PRIVACY NOTICE PRIVACY We welcome feedback on the newsletter and are taking submissions for future issues. ARCHIVE Email your news, events, achievements and stories to us. [email protected] PCPH eMagazine Team Subscribe Unsubscribe Javier Gallego Candida Vasconcelos Copyright © 2021 Department of Primary Care & Public Health, Imperial College London RETURNING TO PHYSICAL ACTIVITY AFTER A COVID -19 INFECTION Image: rawpixel.com In an article published in the British Medical Journal, we discuss returning to physical activity after a Covid-19 infection. A risk-stratification approach can help maximise safety and mitigate risks, and several factors need to be taken into account. First, is the person physically ready to return to activity? In the natural course of Covid-19, deterioration signifying severe infection often occurs at around a week from symptom onset. Therefore, consensus agreement is that a return to exercise or sporting activity should only occur after an asymptomatic period of at least seven days, and it would be pragmatic to apply this to any strenuous physical activity. English and Scottish Institute of Sport guidance suggests that, before re-initiation of sport for athletes, activities of daily living should be easily achievable and the person able to walk 500 metres on the flat without feeling excessive fatigue or breathlessness. However, we recommend considering the person’s pre-illness baseline, and tailoring guidance accordingly. PROFESSOR MAJEED AWARDED LEADING HEALTH HONOURS Six Imperial researchers, including Professor Azeem Majeed, have been appointed to prestigious research positions by the National Institute of Health Research (NIHR). They have been named as NIHR Senior Investigators – positions given to those who are deemed to be the most outstanding leaders of patient and people-based research within the NIHR faculty. They provide research leadership to the NIHR faculty, promoting clinical and applied research in health and social care. They also act as a key source of advice to the Department of Health and Social Care’s Chief Scientific Adviser. FULL STORY CONGRATULATIONS PROFESSOR KOSH RAY, YOU'RE A HIGHLY CITED RESEARCHER ─ 2020 Each year, Clarivate™ identifies the world’s most influential researchers ─ the select few who have been most frequently cited by their peers over the last decade. In 2020, fewer than 6,200, or about 0.1%, of the world's researchers, in 21 research fields and across multiple fields, have earned this exclusive distinction. Prof Ray is among this elite group recognized for his exceptional research influence, demonstrated by the production of multiple highly cited papers that rank in the top 1% by citations for field and year in the Web of Science™. AWARD FOR BEST PREMATURITY AND NEONATAL RESEARCH - INTERNATIONAL CONFERENCE 2020 Dr Enitan Ogundipe was selected as the ‘Best Neonatal and Prematurity Research with educational grant’ award. The work was on improving the brain outcomes of babies by optimising their mothers’ nutrition in a double blinded placebo- controlled trial. The study was based on work published in Prog Lipid Res 2018 which gave the first ever evidence of effect of maternal ‘Brain Specific’ fatty acid supplementation on their new-born babies’ Brain volumes measured using MRI scan. ALERT TO SEPSIS WHOCC AND ROYAL COLLEGE OF PHYSICIANS, EDINBURGH Researchers have been awarded JOINT FELLOWSHIP over £800,000 to review the impact of a digital alert system to monitor WHO CC and Royal College of Physicians, patients with sepsis at NHS Edinburgh, have been working on a joint hospitals Quality Governance Fellowship, which will be launched in the latter part of the year. Dr Kate Honeyford (Global Digital Health The fellowship will be based in London, Unit) joined a group of national leaders on and applications will be open in spring. 26 Feb to provide a comprehensive seps More information to be announced on the training day for nurses, paramedics, Centre’s website. doctors and other healthcare professionals. CHILD HEALTH UNIT CHRISTMAS SOCIAL Kate described the impact of digital sepsis alerts at ICHT, how using data as part of a Child Heath Unit PhD Student, Tishya learning healthcare system can improve Venkatraman, organised a Christmas patient care and described the future Social Bingo for the Child Health Unit work of the DiAlS NIHR project. before the college closure. We saw ugly Christmas jumpers, learnt about each Kate was keen to link robust statistical other’s strange food choices, heard a methodology with improving patient clinician and lecturer sing his favourite outcomes – which meant describing Karaoke song, and guessed each other’s propensity score matching on a Friday and spirit animals. It was a lovely way to afternoon! Although challenging, Kate end a trying year with some fun and gave a clear and erudite description of the laughs. approach. In addition, Kate spoke about the need to appreciate the role, both observational studies and natural experiments, have in our understanding of healthcare provision. Conference delegates described the talk as ‘interesting but very complex and blew my mind a little’, additional comments included ‘so interesting to see how data can be used to benefit quality improvement’ and ‘pertinent to my digital transformation role’. The positive VIVA SUCCESSES response of delegates clearly demonstrates that clear, relevant Congratulations to Shirin Aliabadi and explanations of data and statistics are Federica Amati on passing their vivas. received well by a range of audiences. My gran has had both her jabs. It’s unlikely that employers could Once lockdown has ended, can I go force you to get vaccinated, but and see her? they could recommend vaccination for staff who have public-facing Once lockdown ends and the roles that place them at increased prohibition on people from different risk of infection. households mixing indoors stops, including for the clinically extremely Everyone in my mum’s care home vulnerable, you would be able to has had the vaccine. Should they visit your grandmother. However, it allow relatives to visit without a may be some time before this screen? happens. Relatives will continue to need to be I’ve been shielding on my own. screened for now because the Once I’ve had the vaccine will I be Covid-19 vaccines are not 100% able to form a bubble with other effective even after two doses and family members? some vaccinated people can still get infected. The risk of serious illness, You would need to continue to complications and death is very high follow any lockdown rules that are in people living in care homes and in place in your local area even after we must be particularly cautious you have had two doses of the with this group. vaccine. Can I still be fined for breaking the I’ve had my first vaccine – can I hug rules if I show my vaccine card? my grandchildren? A vaccine card does not exempt you One vaccination offers only partial from following any local or national protection. Two vaccinations are rules that are in place; so yes, you needed for maximum protection. can be fined for breaking lockdown Even after receiving two doses of rules even if you have proof of vaccine, you would still need to vaccination. follow any lockdown rules that were in place in your local area. Once everyone has been vaccinated, might there be places Can my employer force me to get those who have refused the vaccinated? vaccine aren’t allowed? It’s possible that some places might It will take some time for research implement this policy. For example, to establish this. We may find out some cruise companies have said later in 2021. they will require proof of If one of my employees has been vaccination from customers. vaccinated, should I consider Will I need to show proof of my him/her for a role that has a higher vaccine to travel abroad? risk of infection? It’s possible that some countries will Employers should risk assess staff require proof of vaccination before before placing them in a specific allowing you to travel there but this role. My view is that vaccination will vary from country to country. should not be used as a reason for placing potentially clinically If I’ve had my vaccine will I still vulnerable staff in high-risk roles have to self-isolate if I’ve been in that expose them to a greater risk contact with someone who tested of infection. positive? I’m a piano teacher. Can I advertise If you have been in recent contact for students using my proof of with someone who has tested vaccination to show I’m Covid free? positive, you would still need to self-isolate for 10 days because at Vaccination does not guarantee that this point, we don’t know if you will be “Covid-free”.
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