Talk Evidence
Talk Evidence covid-19 update - lack of testing transparency, how to give good debate
04 May 2020
For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you some insight into these issues. This week: (1.10) Carl gives us an update on the UK's figures, and how deaths outside are now being counted. (2.10) When the pandemic slows down, and normal services resume - what should we start doing first? Helen picks up some evidence on what they might be. (6.05) There's a signal that covid-19 may be causing coagulopathies in some patients, and Helen picks up on a listeners request for more information. (11.22) John Deeks, professor of Biostatistics at the University of Birmingham, is leading a Cochrane initiative into examining the evidence around testing, and rivals Carl's rant when he explains how some research is being done behind a veil of confidentiality. (35.27) When there's a lot of uncertainty, and the stakes are very high, then tempers can flare. Vinay Prasad, hematologist-oncologist in the US, and host of Plenary Sessions podcast, joins us to talk about having a good, respectful, scientific debate.
Full Episode
Welcome back to your Now Weekly Talk Evidence, the show where we bring you a roundup of what's going on in the world of COVID and our understanding of it. Today we're going to be looking at diagnostic tests again and the fact that there are so many of them out there, the way in which we're debating the evidence on COVID and how we do some decision making.
As always, joining us are Helen MacDonald, resting GP and UK research editor for the BMJ. Hi, Helen.
Hi, Duncan.
And Carl Hennigan, professor of epidemiological medicine at Oxford, editor of BMJ's EBM journal, and also a GP. Hi, Carl.
Hi, Duncan.
Carl, last week we got you to give us a very quick update on data from England and Wales about the mortality rate at the moment. And this week there has been yet another update on that. Could you give us a very quick summary of what's been going on?
Yes, what we've seen is hospital deaths trending down, but actually in the home and in the care home setting, there are actually more deaths now than there are in hospitals. And importantly, in the home setting, 90% of the deaths were non-COVID. And this was pretty similar in care homes, a bit less, but about 70% of the excess deaths potentially in care homes were actually not COVID.
So there are two reasons this could occur. One is it's a reporting issue. We just people are dying. They weren't seen and they died very suddenly and they didn't put Covid. Or second is actually there's something else going on. There's an issue about people are not seeking care or actually other conditions are increasing and increasing dramatically. I think it's a little bit of both.
That's really interesting you mentioned that, Carl, because one of the first things I wanted to come to in the podcast this week was around how can we better support people with non-COVID related problems to come forward when they need to. And I think we've seen some increasing national awareness and campaigns building around this this week.
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