Medical Centre

The rollout of Covid-19 vaccination is well underway, with more than 700 million doses given worldwide as of April 2021. Vaccination is highly effective at reducing severe illness and death from Covid-19. Vaccines for Covid-19 are also safe, with extremely low risks of severe adverse events. A major threat to the impact of vaccination in preventing disease and death from Covid-19 is low uptake of vaccines. In article published in the British Medical Journal , we give on overview of vaccine hesitancy and some approaches that clinicians and policymakers can adopt at the individual and community levels to help people make informed decisions about Covid-19 vaccination. The World Health Organization defines vaccine hesitancy as a “delay in acceptance or refusal of safe vaccines despite availability of vaccine services.” It is caused by complex, context specific factors that vary across time, place, and different vaccines, and is influenced by issues such as complacency, convenience, confide...

In an editorial published in the British Medical Journal , we discuss why we must look beyond mortality to the wider burden of pandemic related harms. Over the course of the covid-19 pandemic, daily releases of national statistics on cases and deaths have been widely reported and used to support interventions and judge the success or failure of control measures around the world. However, differences in rates of testing and in reporting of deaths have led to uncertainty about whether national headline figures on deaths are directly comparable. Excess mortality is an alternative metric, which gives a measure of the number of deaths above that expected during a given time period and thus accounts for additional deaths from any cause during the pandemic, irrespective of how covid-19 deaths are defined. Measuring excess mortality alone offers only partial insights into the impact of the covid-19 pandemic on the health of nations. If we are to truly understand and intervene to mitigate the i...

  I’d rather wait to see if vaccines really are safe. What’s wrong with that? Covid-19 vaccines were tested extensively before they went into general use. The data from this research and subsequent data from their widespread use in the UK and other countries in many millions of people show that all the vaccines are very safe and that serious side effects are very rare. If you delay getting vaccinated, you are at risk of getting infected and also put at the risk the people you are in contact with.   Other people need a vaccine more than me. Isn’t it OK to let others have theirs first? People are prioritised for vaccination based on factors such as age and medical history. When you receive your invitation to be vaccinated, you are being called for vaccination at the right time for you and are not disadvantaging anyone else.   Aren’t people dying from blood clots because of the vaccine? Reports of serious blood clots are very rare, with typically only a few cas...

The Covid-19 pandemic has affected educational systems worldwide, leading to the near-total closures of educational institutions in the UK. As of 6 May 2020, schools were suspended in 177 countries affecting over 1.3 billion learners worldwide, and in many cases closures have resulted in the universal cancellation of examinations. UNICEF estimated that almost 4 months of education will be lost as a result of the first lockdown. School closures have far-reaching economic and societal consequences, including the disruption of everyday behaviours and routines. In the UK, over 2 million workers have already lost their jobs, and although the long-term impact of the pandemic on education is not yet clear, the pre-existing attainment gap between the poorest and richest children7 may widen significantly as a result of COVID-19. Children and young people make up 21% of the population of England,10 and by the time they returned to school after the summer break, some would have been out of educat...

I would like to thank the Lancet for giving me the opportunity to contribute to their Commission on the Future of the NHS. I fully support the recommendation for a strong and sustained increase in NHS funding to address the current weaknesses in the NHS. For me, the most striking data in the Lancet Commission on the Future of the NHS was this figure, taken from Securing a sustainable and fit-for-purpose UK health and care workforce , showing the changes in the number of NHS GPs and consultants per 1,000 people between 2008-18. Note the decline in GP numbers compared to the increase in consultant numbers. Although we hear a lot from NHS managers and politicians about the need to shift the focus of the NHS to the community, staffing statistics do not support this. The reality is that NHS primary care funding and workload need to reflect staff levels, not meaningless rhetoric. Figure: Numbers of GPs and hospital consultants across the UK per 1000 people, 2008–18

In an article published in the Journal of the Royal Society of Medicine , myself, Professor Marisa Papaluca and Dr Mariam Molokhia discuss how health systems can assess the long-term safety and efficacy of COVID-19 vaccines. Vaccines for COVID-19 were eagerly awaited, and their rapid development, testing, approval and implementation are a tremendous achievement by all: scientists, pharmaceutical companies, drugs regulators, politicians and healthcare professionals; and by the patients who have received them.  Because these vaccines are new, we lack long-term data on their safety and efficacy. In surveys of people who define themselves as ‘vaccine hesitant’, this lack of long-term data is one of the main reasons given for their beliefs. Hence, providing this information is a public health priority and could help reassure vaccine-hesitant people that receiving a COVID-19 vaccine is the right choice for them. Emerging data from the UK and elsewhere are confirming the benefits of ...