Talk Evidence
Talk evidence covid-19 update - natural history of covid, include patients in guidelines
09 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: (1.20) Carl gives us an update on the England and Wales admission data. (3.00) Helen talks about ways in which spread and severity of infection amongst household contacts. (8.20) We talk natural history of covid-19, and Harlan Krumholz, cardiologist at Yale, tells us what we know, and why it's difficult to have a full picture at the moment. (15.10) Helen picks up on a study from Tim Spectre and colleagues using an app to track cases. (20.00) Henry Scowcroft, one of The BMJ's patient editor, who also works for Cancer Research UK, joins us to talk about patients who are taking part in clinical trials, and how this is affecting them. He also touches on the thin patient participation in the design of covid treatment guidelines. (24.10) Carl talks rapidity of publishing, and where researchers should most target their evidence outreach. Reading list: Reducing risks from coronavirus transmission in the home https://www.bmj.com/content/369/bmj.m1728 Rapid implementation of mobile technology for real-time epidemiology of COVID-19 https://science.sciencemag.org/content/sci/early/2020/05/04/science.abc0473.full.pdf The BMJ Public and Patient participation twitter chat https://twitter.com/hashtag/BMJdebate
Full Episode
Welcome back to this week's Talk Evidence that we're recording on the 6th of May. As always, we're trying to give you an update on what's happening with coronavirus, the evidence that's building all the time, even though that might be quite murky sometimes. This week we are going to be looking at the natural history of the disease and a little bit about how patients are involved.
To do that, I'm joined, as always, by our two favourite EBM nerds. First of all, Helen MacDonald, who's a resting GP and UK research editor for the BMJ. Welcome back to the podcast, Helen.
Hi, Duncan.
And Carl Hennigan, who is Director for Oxford Centre for Evidence-Based Medicine. You forgot who I am already! You've got lockdown fever. I'm trying to rationalise all the things that you're doing and making it into a soundbite and it's just not happening. EBM nerd. There we go. EBM nerd. Chief EBM nerd. So, that's Carl.
Carl, in your EBM Nerdery, each week you've been talking to us a little bit about the death data. So what's going on this week? Boris Johnson says we've passed the peak. Is he right? Can we tell?
Yeah, it's pretty much more of the same this week with the Office for National Statistics data comes out. But remember, that's about going back about 10 days ago. So it comes out on Tuesday and looks back in time. But when we say we're looking at the peak, I think there's a multitude of bits of data that allow us now to say we're well past the peak. If you look at the hospital data on deaths,
The peak of the death there was the 8th of April. We can also look at the admission data which we've got access to and that peaked on about the 2nd of April. All the other measures show that they're now trending down and particularly the admission data is really helpful.
because we've now come down from a peak, as I said, on the 2nd of April, they've come down by about 70%, and we've been low 1,000 admissions a day. All of that information is reassuring, and that's going to help us when we come out of lockdown.
And hopefully that's what we can talk about next week, what this means, and maybe what the fears of coming out of lockdown too early mean as well. Great. Well, thanks for that update, Carl. So each week in Talk Evidence, we try and give you something to start or to stop doing. And Helen, you've been looking this week at severity of infection amongst households.
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