ASH Daily News for 11 May 2020



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UK

  • Brits with severe asthma and diabetes at higher risk of dying from COVID-19 says recent study
  • Royal College of Physicians research update on relationship between smoking status and COVID-19
  • MP writes to Health Secretary in call for new smoking restrictions for beer gardens
  • Bradford health professionals urge smokers to quit for Covid-19
  • Salford: More people are dying from Coronavirus in the most deprived communities

International

  • India states ban smokeless tobacco products and spitting

UK

Brits with severe asthma and diabetes at higher risk of dying from COVID-19 says recent study

Findings from a new study shows that British people suffering from severe asthma and uncontrolled diabetes are among those at highest risk of dying from coronavirus.

The team at Oxford and London School of Hygiene and Tropical Medicine (LSHTM) reviewed the
medical records of 17.4 million adults in the UK – from 1st February to 25th April. It is said to be the
“largest study of Covid-19 carried out in any country to date and it provides the strongest evidence to date” on risk factors associated to death from coronavirus.

Key findings from the recent study, also show that men are at higher risk of contracting coronavirus and dying from complications. People from a deprived background were found to be at greater risk of death – even after other factors like underlying health conditions had been taken into account. Brits from Asian and Black ethnic origin are more likely to die compared to white people.

Emma Rubach, Head of Health Advice at Asthma UK, said: “Asthma can affect people of all ages, genders, social backgrounds and ethnicities but, like many respiratory conditions including COVID-19, we are seeing that it hits people on lower incomes hardest.”

Editorial note:

“[The researchers] found some evidence of increased risks in former smokers. In current smokers there was a slight protective effect, which was removed when fully adjusted for ethnicity. The risks associated with smoking have been disputed, with increased risks initially reported, but some more recent reports finding that smokers are under-represented in those with more severe disease, and a potential protective mechanism for nicotine has been suggested.

Even if smoking does have a small protective effect against COVID-19, this would still be massively outweighed by the well-established adverse health effects of smoking.”

Source: The Sun 08 May 2020

See also: Factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients.
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Royal College of Physicians research update on relationship between smoking status and COVID-19

Researchers from the Royal College of Physicians have published a third update to a living rapid evidence review which aims to estimate the rate of infection, hospitalisation, disease severity and mortality from SARS-CoV -2 /COVID-19 stratified by smoking status: The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review Preprint V3.

In the previous review, 28 observational studies were included, and findings suggested that there is substantial uncertainty arising from the recording of smoking status on whether current and/or former smoking status is associated with SARS-CoV-2 infection, hospitalisation or mortality.

The new updated study included 41 observational studies, and findings continue to suggest that there is substantial uncertainty about the associations between smoking and COVID-19 outcomes arising from the recording of smoking status. The recorded smoking prevalence in hospitalised patients across multiple settings was lower than national estimates but that observation is inconsistent with there being no evidence of increased admission to hospital from three ‘fair’ quality studies among people who tested positive in the community. There was limited evidence from ‘fair’ quality studies that current compared with never smoking is associated with greater disease severity in those hospitalised for COVID-19.

Implications: Unrelated to COVID-19, smokers are at a greater risk of a range of serious health problems requiring them to be admitted to hospital. Given uncertainty around the association of smoking with COVID-19, smoking cessation remains a public health priority and high-quality smoking cessation advice should form part of public health efforts during this pandemic.

Source: Qeios, 07 May 2020
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MP writes to Health Secretary in call for new smoking restrictions for beer gardens

Mark Pritchard, MP for The Wrekin, has written to Matt Hancock after calling for new regulations to protect non-smokers, should outdoor seating areas at pubs, cafes and restaurants be allowed to reopen.

Mr Pritchard said: “This is about non-smoking customers being able to sit outside cafes and pubs without having to run the gauntlet of secondary smoke from smokers, especially the elderly and families with young children. … There should be smoke-free areas where people can eat and drink.”

Source: Shropshire Star, 08 May 2020
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Bradford health professionals urge smokers to quit for Covid-19

Bradford Council’s Public Health team are joining calls from Public Health England and the Chief Medical Officer encouraging smokers to try and quit to protect themselves and others during the COVID-19 outbreak.

Public Health Bradford is also supporting the #QuitforCovid campaign which was developed by Bristol-based GP Dr Charlie Kenward and is being led by members of the Smokefree Action Coalition (SFAC) including Action on Smoking and Health (ASH).

Councillor Sarah Ferriby, Executive Member for Healthy People and Places in Bradford said: “we are supporting the #QuitforCovid campaign as there has never been a more important time to quit smoking than right now. It is never too late to see health benefits of quitting smoking and you’re never too old to quit”

Ruth Tennant, Tobacco lead for the Association of Directors of Public Health, said: “There are so many reasons to quit smoking, but it is never been a more important time than right now during the coronavirus pandemic. Emerging evidence suggests that smoking puts people more at risk from severe complications from COVID-19, and the Association of Directors of Public Health is supporting efforts to encourage smokers to quit for COVID.”

Source: Telegraph & Argus 10 May 2020

See also: Today is the Day

Quit for Covid resources for health professionals

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Salford: More people are dying from Coronavirus in the most deprived communities

Coronavirus has taken a huge toll on Salford, a metropolitan borough in Manchester which has recorded the worst mortality rate outside of London. The borough’s rate – 93 deaths per 100,000 people – is 50% higher than Manchester and roughly double that of neighbouring Bolton and Bury, according to figures published by the Office for National Statistics (ONS).

Data has shown that poorer people are more likely to die from the virus. Consequently, Salford’s deprivation makes it particularly vulnerable to Covid-19.

Barbara Keeley, Labour MP for Worsley and Eccles South, is calling on government to take action.
She said: “Areas like Salford face a number of challenges managing the Covid-19 crisis, from large numbers of people unable to work from home so still travelling into work and higher prevalence of underlying health problems, like heart and lung disease, which can make people more susceptible to Covid-19. … We must learn the lessons from this pandemic and ensure that we are able to take action to prevent Covid-19 leading to deeper health inequalities between communities.

“Over the last five years Government cuts to budgets mean that vital public health services, like support to stop smoking, have had to be cut back. By restoring public health budgets, we could ensure that people are able to access the services they need to live a healthier life.”

Source: Manchester Evening News, 08 May 2020
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International

India states ban smokeless tobacco products and spitting

In light of COVID-19, 22 states and six Union Territories (UTs) have banned the use of smokeless tobacco products and spitting in public places says official sources in the Union health ministry.

“Chewing smokeless tobacco products, paan masala and areca nut (supari) increases the production of saliva followed by a very strong urge to spit. Spitting in public places could enhance the spread of the COVID-19 virus,” the ministry said in a letter to states.

Professor Pratima Murthy, Professor and Head, Department of Psychiatry, National Institute of Mental Health and Neurosciences said: “Smokers who develop COVID-19 infection have more complications and greater risk of fatality. Even if a person is not affected by coronavirus infection it is a good time to stop smoking. This improves immunity and can improve lung function within a few months”.

Source: Deccan Herald, 10 May 2020
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