Inside Health

In Covid, oxygen levels in the body can crash without noticeable symptoms - it’s known as “silent hypoxia”. This week we’ll be discussing whether letting people monitor their oxygen levels at home with a pulse oximeter could save lives. James talks to Chris Harris, who’s been using one, and two pioneers of the project - Dr Matt Inada-Kim, Consultant in Acute Medicine at Hampshire Hospitals NHS Trust, and Dr Caroline O'Keeffe who runs oximetry@home in North Hampshire. And the hotly debated topic of rapid, or lateral flow, testing. Local councils are rolling them out for people who can't work from home, and the hope is that they could help us keep on top of the virus by picking out people with Covid. Could it be a way out of the pandemic or could it cause more harm than good? Prof Irene Petersen and our own Dr Margaret McCartney are on the case. Dr Navjoyt Ladher answers some of the most common questions about vaccines.PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Should you take vitamin D pills to ward off coronavirus? Our own Dr Margaret McCartney has been sifting through the evidence in search of answers. Also clinical trials expert Dr David Collier of Queen Mary University London tells us about new treatments for Covid-19 that are in the pipeline. And is the mysterious “nocebo effect” causing most of the side-effects from statins? Janice Richardson from Hebden Bridge shares her experience on the pills and we chat to researcher and Dr James Howard of Imperial College and cardiologist Dr Rohin Francis. Presenter: James Gallagher Producer: Geraldine Fitzgerald

2020 was awful. So what about 2021?I chat with Prof Neil Ferguson to see how this year could play out and when life might return to normal. Cardiologist Dr Rohin Francis and cancer nurse Aly Foyle are both back to share their experiences of coping during Covid.I promise you, it’s not all bad news.And our own Dr Margaret McCartney, alongside Cancer Research UK’s Jodie Moffat, scrutinises a new blood test that promises to find cancer early.It's a good programme, James. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Saleyha Ahsan reports from Ysbyty Gwynedd, her own hospital in Bangor, North Wales about how the Intensive Care Unit is preparing for winter. Saleyha meets Val and the Critical Care team who have looked after her since the pandemic began. Val was admitted to the unit in March and has become part of the intensive care family.Producer, Erika Wright

Covid-19 damages the lungs, leaving people struggling to get enough oxygen into their body. In the early stages of the pandemic many patients needed a lot of support in intensive care - including artificial ventilation. But there are other ways of boosting oxygen levels in the body - which are being studied in the Recovery-RS trial. Professor Gavin Perkins from the University of Warwick is comparing oxygen delivered by a mask called CPAP with both regular and high-flow oxygen to see which works best. Physiotherapy is one of the hands-on therapies which has been disrupted by the lockdown. Patients who need to do bespoke exercises following a fall or a heart attack might have been offered online sessions instead. But Manchester University researcher Dr Helen Hawley-Hague says these don't suit everyone - including people who don't have access to the internet or a smartphone. We hear from Jennifer and George - both of them have taken part in Helen's studies and have accessed physiotherapy either face-to-face

Margaret McCartney on National Test and Trace and why households are receiving multiple calls. Beth tells of being contacted many times when her child tested positive and began to think all the family had been separately in contact with different cases, until the penny dropped that the calls were all about the same contact - her daughter. Professor Kate Ardern, director of Public Health in Wigan explains why these calls from the national system aren't joined up. And is there time in a pandemic to do trials for non-drug interventions like pub curfews or social distancing? Professor Paul Glaziou explains that there are currently just 8 such trials globally, while Professor Martin McKee highlights the problems involved. And Margaret hears from Professor Atle Fretheim who is trying to set up a trial in Norway into the impact of school closures on infection control.

The Radio 4 Touch Test included questions about touch in health care. Dr Natalie Bowling who's a psychologist from the University of Greenwich helped to create the test with colleagues at Goldsmith's University. Analysing the data revealed that a positive attitude towards touch in treatment settings increases as we get older. Surprisingly men reported being more likely to feel comfortable with touch in treatment settings - despite women preferring tactile treatments more than men. GPs Margaret McCartney and Ann Robinson agree on the importance of touch in their consulting rooms - both to help tell the difference between constipation and a ruptured appendix - and to place a comforting hand on the shoulder of a distressed patient.Chemotherapy cannot cure 82 year old Anne Townsend who was given a diagnosis of ovarian cancer a year ago - but it's hoped it will help to relieve her symptoms. One side effect has been a loss of her sense of touch - devastating because she loves to sew quilts. She found that reflexo

The story of one child's recovery from PIMS-TS, the rare new condition that caught doctors by surprise in April. James Gallagher visits specialists at the Evelina London Children's Hospital to hear how they coped with identifying and treating a condition they'd never seen before. Dr Jenni Handforth and Dr Sara Hanna explain how 'they had to reinvent and tweak the rule book' to manage PIMS-TS, where 'the immune system has gone a bit crazy' and treatments worked 'like a fire blanket to dampen down the immune system'. And scientists at the Francis Crick Institute have discovered that children can have Coronavirus-fighting antibodies from before the pandemic started. Dr George Kassiotis explains how kids could have them and what this might mean. And Dr Margaret McCartney unpicks the tricky issue of spotting Covid and cold symptoms in children.

Thromboses - blood clots that form in the circulation - are easily the biggest single killer of British men and women. They affects people of all ages, races and ethnicities. Most strokes and heart attacks are caused by thromboses forming in the arteries supplying the heart or brain. But clots in the veins can be just as lethal, particularly when part of the clot breaks off and travels around the circulation and lodges in the lungs. Recently, the appearance of abnormal micro-clots in the lungs of severely affected Covid patients has highlighted the huge impact even tiny clots can have on our long term health and mortality. What more should be done to protect people from this misunderstood condition?James Gallagher unravels the risks and causes for blood clots, from deep vein thrombosis to clots in the lungs. As he hears from patients, the surprise of a DVT diagnosis and debilitation can be profound. Treating clots is a delicate process with a need to get the balance right between thinning the blood but preve

How will this year's expanded flu vaccine programme be delivered? In addition to usual groups the flu vaccine will be offered to all eleven year olds, any household contacts of vulnerable people told to shield, more health and social care workers and - the biggest change - everyone over 50! Dr Margaret McCartney discusses the difficult logistics for GP practices and pharmacies trying to work out how to immunise around half the population, whilst managing PPE, social distancing and infection control. Dentistry and Covid - Eddie Crouch, Vice Chair of the British Dental Association discusses how practices open since lockdown are coping. And a good news story of how the pandemic has instigated change in the diagnosis of coeliac disease. Dr Hugo Penny, one of the authors of new interim guidance, explains while Radhika tells of her personal experience of coeliac disease. Plus NHS preparations for winter. Trevor Smith, Divisional Director of Medicine at Southampton General Hospital, and Professor Neil Mortensen, Pre

Dr Mark Porter on a new bedside test that differentiates between Covid-19 and other infectious diseases including flu in under an hour. Mark meets Dr Tristan Clark who has already been using the test as part of a trial. And the world's largest study into 'Long Covid' recruiting 10.000 people from 50 different hospitals across the UK who've been hospitalised for Covid to assess their long term recovery. Lead author Professor Chris Brightling discusses the long term symptoms seen in many people recovering from the virus and how research can answer difficult questions such as how long will these continue and what's the best way to help people. And Mark hears from Roz, still recovering from Covid after being admitted to intensive care on May 26th and from physiotherapists Matt and Gemma about how early and long term rehab can help. Plus Professor Sally Singh on the new NHS online rehab service 'Your Covid Recovery'.

As the Government announces GPs should start to prescribe cycling Margaret McCartney examines the evidence for exercise referrals with Harry Rutter, Professor of Global Health at the University of Bath. Temperature checks are popping up in bars, restaurants and receptions but do they work or are they giving false reassurance? Plus while the pandemic progresses Professor Carl Heneghan explains another type of false result, that the chance of false positive tests go up. Navjoyt Ladher, Head of Education at the BMJ, talks us through two highly topical terms - specificity and sensitivity. Amateur choirs have been closed due to Covid-19. Margaret talks to Professor Jackie Cassell who is currently researching what aspect of choirs congregating is particularly dangerous and whether the singing is actually a red herring.Producer: Erika Wright Studio Manager: John Boland

Public health doctors don't dash around hospitals wearing white coats brandishing stethoscopes. The work of this medical specialty is mainly outside of hospitals and it has a very long history. It has a local, national and global reach, an international skeleton charged with the care of populations. And in this pandemic, it is public health which is doing the heavy lifting.In this special edition of Inside Health Dr Margaret McCartney investigates the serious questions being raised about the UK's public health response to trying to stop the spread of the virus, and how tension, over the performance of the government's Test and Trace programme, has spilled out into the open.Margaret hears from Directors of Public Health who feel that their role and expertise in local communities working closely with local Public Health England teams has been overlooked. Instead a new national Test and Trace system has been set up using private companies outside the traditional public health infrastructure. The DPH for Wigan a

One of the most striking features of the coronavirus pandemic is the disproportionate toll it’s taken on some groups in society. Research by the Office for National Statistics shows black people are nearly twice as likely to have died from coronavirus than white people. And you see a similar pattern of elevated risk in other ethnicities too. Why is this? And to what extent is Covid 19 shedding light on approaches being taken in medicine more generally when assessing and treating people from Black, Asian and Minority ethnic groups?We hear from GP Dr Navjoyt Ladher who’s been navigating the language of race for the British Medical Journal; Dr Rohin Francis, cardiologist and host of the Medlife Crisis podcast, and Prof Kamlish Khunti who’s establishing a detailed Covid risk score to establish exactly who’s at most risk of infection. A major review has found women’s lives have been ruined and babies have been harmed in the womb and yet concerns were dismissed for years as simply “women’s problems”. Those ar

Coronavirus has turned the NHS upside down and inside out and by re-organising to treat people with the virus, other potentially fatal diseases like cancer have taken a backseat. At University Hospital Southampton NHS Foundation Trust, which Inside Health visited weekly as the pandemic unfolded, cancer diagnoses fell by half in March and April and of the 50% who were asked to come in for follow up, only 25% actually did. The virus was more frightening than a potential cancer diagnosis. Divisional Director for Medicine at Southampton, Dr Trevor Smith, tells James Gallagher, the BBC's health and science correspondent. that patients are coming back, but it will take a long time to tackle the backlog. For those with cancer caught up in the pandemic, they have experienced disruption, cancellations, altered treatments and they have had to cope with consultations and even surgery by themselves, without loved ones to support them. Charly from Wiltshire was diagnosed with breast cancer in February and her treatm

Tanya has rheumatoid arthritis, a compromised immune system and heart problems. Getting the virus is a risk she cannot take and this is the tenth week that she's been isolating at home with her husband and teenage daughter. But how long will this last and will she have to self isolate in her own home away from her family for the foreseeable future, if her daughter goes back to school? Tanya talks to Claudia about the impact of the pandemic on her life and says why those in the shielding group must not be forgotten.The arrival of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the human population has popularised vocabulary that was previously the preserve of scientists and medics. In just a matter of weeks, phrases like the R Number, Herd Immunity, Case Fatality Rate and All Cause Mortality have become part of everyday language. A new pandemic lexicon has emerged. Inside Health regular Dr Margaret McCartney and Professor Carl Heneghan, Director of the Centre for Evidence Based Medicine at the

Claudia Hammond on the longest known stay for a Briton with COVID-19 in intensive care. A month ago Respiratory Physiotherapist Gemma Bartlett at University Hospital Southampton highlighted the case to Inside Health. At that stage the patient was at day 28: now Erika Wright catches up with Gemma again for a good news update on the patient who is at a staggering 58 days on a ventilator and has been speaking for 3 weeks. There are many unknowns about COVID-19 but one aspect that is not disputed is how the virus has laid bare pre-existing health inequalities. It does not effect us all in the same way and those with underlying health conditions such as heart disease, obesity and diabetes are at a higher risk of poorer outcomes if they get the virus. Linda Bauld from Edinburgh University and Chair in Behavioural Research at Cancer Research UK says this is the time to reset the health inequalities clock. And Laura Bartley, who began having severe symptoms of agoraphobia five years ago, explains her experience of

There are a number of complications following infection with Covid-19 that doctors are continuing to find in hospitals. One of the most significant is an acute kidney injury or AKI which can come alongside the disease and NICE has just published rapid guidance to help healthcare staff on the Covid frontline who are not kidney specialists. Inside Health’s Erika Wright has been following staff at Southampton General Hospital during the coronavirus outbreak and meets Kirsty Armstrong, Clinical Lead for Renal Services, to discuss managing kidneys and Covid. Could injecting blood donated from a patient who has recovered from Covid 19 into someone who is ill help the recipient recover too? It’s a potentially viable treatment with a long history, known as convalescent plasma therapy, and trials of this technique against Covid are beginning around the world. We hear from Jeff Henderson, Professor of Medicine at Washington University in St Louis, on progress in the world’s largest trial of this passive immunisation a

Evidence from China, Italy, the USA and now the UK shows categorically that people with diabetes can get seriously ill if they're infected with the new coronavirus. Researchers are trying to untangle the risks for Type 1 and Type 2 but so far, diabetes isn't included in the government's high risk patient group. NHS England's National Specialty Advisor, Professor Partha Kar, tells Claudia Hammond that he believes an individual risk calculator which will enable people to work out their own risk, and so shield themselves accordingly, will be the best way forwards. In the meantime, Dr Kar says, glucose control is essential and people should check their ketone levels as soon as they start to feel unwell. BBC Radio Science Unit producer Beth and her husband Andy (who has Type 1 diabetes) describe to Claudia their experience of Andy getting very ill with Covid-19. They discovered ketone levels appeared at much lower blood glucose levels than normal, something that Dr Kar says appears to be a feature of Covid-19 inf

It's well established that the best thing smokers can do for their health is to quit. Smoking contributes to many of the underlying conditions that undermine recovery from coronavirus and it is pretty clear that a coronavirus patient who smokes will likely have a worse outcome than one who doesn't. The FDA in the US recently went so far as to suggest smoking might increase the risk of contracting the virus at all. Nevertheless, existing data coming from various studies of patients around the world appear to show smaller numbers of smokers amongst the hospitalized cases than might be expected from local smoking populations. There are fewer smokers than there should be in the data. But why?As the University of Edinburgh and CRUK's Prof Linda Bauld tells Claudia, there may be several simple reasons for this, such as data gathering - that patients' smoking status is going unrecorded or unverified. But a study last week from France goes so far as to suggest that nicotine itself, know to disrupt some of the recepto