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Top Royal Free consultant warns second Covid surge ‘inevitable’

Vitamin D could defeat virus but vaccine not ready 'until after winter'

18 September, 2020 — By Tom Foot

One in six patients admitted to the Hampstead hospital died

A SECOND major wave of Covid-19 infections is “inevitable”, according to the top infectious disease consultant at the Royal Free.

Sanjay Bhagani, who is based in the Pond Street hospital in Hampstead, spoke in detail about the NHS trust’s response to the pandemic at an online annual members meeting on Wednesday.

He said: “As we move now to the next phase – and I’m afraid it is inevitable – we are going to see an upsurge in infections in the next few weeks to few months.

“It is important we have a better handle on how we offer supportive care to our patients. We haven’t quite got the panacea of treatments yet. We need to do more research and studies.”

Mr Bhagani told the meeting how the Royal Free, which is one of two national centres in the country specialising in infectious diseases like Covid-19, had “started to hear about reports of this new pneumonia from China” in early December 2019.

Between Christmas and New Year, it was understood to be spreading as a coronavirus.

The first patient was admitted to the Hampstead hospital on February 9 at a time when the virus had started to spread with “people going on skiing holidays and coming back”, he said.

“By March, we were into the pandemic and all our medical staff came together to concentrate on Covid-19. The whole hospital became a Covid hospital. We knew this virus wasn’t as benign as we thought when reports came out of China around December.”

More than 1,000 patients were admitted, with more than 100 patients gong into intensive care. “We did lose patients. One in six of the people we admitted died,” he said.

Despite this, Mr Bhagani said that the “vast majority” of Covid patients “get through that first phase and recover”, adding: “A small minority go onto the next phase of illness, where it travels down into the lungs. Then there is a smaller minority of those when it goes down into the kidneys, heart, blood vessels – and these require intensive care support, often with mechanical ventilation.  The older you were, more likely to have progressive infection. If you were of BAME ethnic origin, there is an increased risk.”

“While we can predict who is likely to get to the second and third stage of infection, what would be ideal is to try and offer people treatment at that stage to stop them progressing on to the next phase.”

He added: “There were many treatments being bandied around as being effective. Some of which were proclaimed by world leaders as being the right thing to do. But the best way to assess patients was through clinical trials. We set up trials very quickly. We learnt that Remdesivir has a positive effect – and it is now licensed.”

He added that “Vitamin D is a very crucial in function of immune system” and there “are a number of studies looking at relationship between vitamin D and risk of progressive Covid 19”.

He said he did not expect a vaccine to be available “before the end of this winter”.

Royal Free London chief executive Caroline Clarke spoke about how the board had done “everything to take pebbles out of shoes of staff” working on the frontline in April and May. Donations to the hospital’s charity were used to support staff, with 350,000 free meals served up to NHS workers and psychological help.

Speaking on what the public could do to help, chairman Dominic Dodd said: “I would say simply: Volunteer. Contact the Royal Free Charity – work with them on volunteering.”

He added: “I want to personally thank our 10,000 staff for the expertise, energy and devotion to patients that they’ve shown during this period.”

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