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NHS England 'on its knees' as performance figures hit new lows

Via The Guardian: NHS England 'on its knees' as performance figures hit new lows.

The NHS was “on its knees” even before winter had begun, health service bosses have said as figures showed it missed key waiting-time targets for A&E care, operations and cancer treatment.  

The performance of the NHS in England in November was yet again its worst ever, prompting concern that it cannot keep up with a relentless rise in the number of people needing care. 

Doctors’ leaders called for Boris Johnson’s government to take urgent action to boost staffing, hospital bed numbers and GP services.  

“These figures show an NHS on its knees and it is no wonder that most leaders predict that this winter will be the worst on record,” said Niall Dickson, the chief executive of the NHS Confederation. “More and more patients are turning up at emergency departments and there is a limit as to how many they can cope with.”  

The latest set of monthly performance figures published by NHS England show:  

• 71% of patients who attended a hospital-based A&E unit in November were seen and discharged, admitted or transferred within four hours – a record low. 

• Hospitals were 95% full, far beyond the 85% that doctors consider safe, even before the surge in demand that winter always brings. 

• The highest number of patients ever were forced to spend at least four hours on a hospital trolley waiting for a bed. 

• Thousands of hospital beds are being lost each week due to norovirus, the winter vomiting bug. 

• Flu is already putting serious strain on the NHS, sparking fears of a major outbreak this winter. 

The number of people waiting for a non-urgent operation has risen to 4.45 million. The numbers of people seeking help at A&E and being admitted as an emergency case were each at record highs last month. And hospitals managed to meet only three of the eight NHS-wide targets for cancer treatment. 

“What we are seeing is a health service that is on a downward spiral as this month we see yet another set of shambolic figures,” said Dr Chaand Nagpaul, the chair of the British Medical Association. 

He blamed the Conservatives for creating the dire situation. “Day one of the new government and another set of stark NHS performance figures. They are not inheriting a problem, they created this problem, and the responsibility ultimately lies with them to fix it.”  

In recent weeks growing numbers of hospitals have had to declare a black alert – an admission that they cannot cope – as they have been overwhelmed by the number of patients seeking care. 

“We’ve seen an early spike in flu, while others have been battling norovirus cases, which are already double the levels we saw last year,” said Miriam Deakin, the director of policy and strategy at NHS Providers, which represents NHS trusts.

US: Virus outbreak closes Colorado schools for more than 20,000 students

Via The New York Times: Virus Outbreak Closes Colorado Schools for More Than 20,000 Students. This does sound like norovirus. Excerpt:

When a virus appeared last week, a Colorado school district closed one high school in an attempt to stymie an outbreak. A few days later, a nearby middle school was closed. By Thursday, administrators were forced to close an entire school district that serves more than 22,000 students.  

More than 40 schools in the Mesa County Valley School District 51 will remain closed until after Thanksgiving break, Dr. Diana Sirko, the district’s superintendent, said in a statement on Wednesday. 

Public health officials have not officially identified the illness, but it is acting like norovirus, according to Jeff Kuhr, the executive director of Mesa County Public Health. He said symptoms included vomiting and diarrhea, and usually lasted between 12 and 24 hours.  

This is the first time the school district has closed all of its schools because of an illness, Emily Shockley, a spokeswoman for the district, said. Normally, schools are closed one at a time, and the last time a school was closed over norovirus was in 2014, she added.

“We are taking this highly unusual action because this virus is extremely contagious and spreading quickly across our schools,” Tanya Marvin, the district’s nursing coordinator, said in the superintendent’s statement. 

The school district, stretching from the Utah border to Palisade, Colo., is the 14th largest in the state. It has 24 elementary schools, eight middle schools, four high schools, three charter schools, two K-12 schools, one middle/high school and one alternative high school, according to the district’s website. The district employs about 3,000 people. 

The first school to close was a high school last Thursday, Ms. Shockley said. On Monday, a middle school was forced to close, and by Wednesday, two more middle schools, a charter school and an elementary school were closed.  

By then, more than 5,000 students were absent from class — though officials could not be sure how many of these students were sick and how many were avoiding contagion. 

“It was pretty out of control,” Mr. Kuhr said. “If all the stars align, norovirus could really wreak havoc on a community. It just feels like that right now.”

Canada: More on the Richmond hotel norovirus outbreak

Via CBC News: 80 fall ill in norovirus outbreak at Richmond hotel. Excerpt:

A Sheraton Hotel in Richmond, B.C., and two associated restaurants have been shut down after 80 people became sick with norovirus over the weekend.  

According to Vancouver Coastal Health (VCH), about 40 staff members and 40 guests have been affected by the illness. Cavu Kitchen Bar at the Hilton Vancouver Airport Hotel has also been closed in connection with the outbreak.  

Currently, no one is allowed to stay at the Sheraton Vancouver Airport Hotel on Westminster Highway until the facility has been thoroughly cleaned. 

"It's quite significant to shut down an entire hotel and especially at that size," said Claudia Kurzac, VCH's manager for environmental health.  

"Given the numbers of people potentially exposed and that were ill, I think that was probably the best course of action to take."  

A large conference of 500 people that began last Friday was being held at the Sheraton Hotel, according to Kurzac. VCH received a call during its off hours the next day about a problem at the hotel.  

An inspector was sent out that afternoon.

Until the facility has been thoroughly cleaned, the hotel is now closed, along with two restaurants inside, a Starbucks and Harold's Bistro,  

All rooms, public areas and food and beverage facilities must be sanitized before the hotel is safe to reopen. 

"Norovirus is a very hardy virus that can survive on surfaces … so you need a higher level of disinfectant," said Kurzac. 

In an email, Steve Veinot, the hotel manager, said that they are not able to trace the source of the outbreak. 

2nd hotel affected 

The Sheraton Hotel was not the only hotel that was affected.  

On Saturday, a chef at the Cavu Kitchen Bar in the Hilton Vancouver Airport Hotel started to notice symptoms of norovirus, according to Kurzac. The hotel immediately closed down its food and beverage facilities, but the hotel remains open to guests. 

The hotels are operated by the same company — Larco Hospitality — and staff members occasionally move between hotels to help out when a hotel is hosting a large function.  

"It's unfortunate that so many people are ill, but I'm very impressed with the response from both hotels," Kurzac said.

Canada: Norovirus closes down two Richmond restaurants on Mother's Day

Via the Richmond News here in Metro Vancouver: Norovirus closes down two Richmond restaurants on Mother's Day. Excerpt:

Hundreds of Mother’s Day diners were scrambling to find last-minute places to eat – after a Norovirus outbreak closed restaurants in two neighbouring Richmond hotels.  

Harold’s Bistro in the Sheraton on Westminster Highway and Cavu Kitchen in the Hilton, around the corner on Minoru Boulevard, both closed their kitchens on the weekend.

According to Vancouver Coastal Health (VCH), a number of the Sheraton’s food handling and cleaning staff, as well as hotel guests, did appear to be suffering on Saturday and Sunday from a Norovirus outbreak.  

Whereas Sanjeet Sadana, general manager at the Hilton, said there was “no reported guest sickness.” 

“They closed down all food and beverage facilities in the hotel. A VCH environmental health officer inspected Saturday,” added the VCH spokesperson. 

“Also, on Saturday a kitchen staffer at the Hilton hotel went home ill. The staffer had assisted at the Sheraton on Friday. They also closed down their kitchen as a precaution.”  

Both hotels, said the spokesperson, are deep-cleaning the food and beverage areas today (Monday), so those areas of the hotel are still closed.  

VCH was sending health inspectors to both hotels today and Wednesday to follow up on what has been done.

Canada: Surgeries postponed due to gastrointestinal illness outbreak at Kamloops medical facilities

Via CBC News: Surgeries postponed due to gastrointestinal illness outbreak at Kamloops medical facilities. Excerpt:

A gastrointestinal illness outbreak has hit the Royal Inland Hospital in Kamloops, as well as several other local health facilities, postponing 20 surgeries so far and halting patient admissions to three medical units. 

Thirteen surgeries were cancelled Thursday and seven have already been cancelled for Friday to ensure there are beds available for emergencies.  

Interior Health said the hospital normally conducts 35 to 40 operations per day.  

"It's not unexpected that we would see something like this in the hospital because these outbreaks happen all the time in the community," said Susan Duncan with Interior Health.  

"Of course when you've got people coming into the hospital from the community, they're bringing bugs with them." 

Possibly norovirus ​

Duncan said that a number of specimens have tested positive for norovirus.  

Symptoms include vomiting, diarrhea and sometimes a fever.  

"[This] is not a flu. Influenza is something completely different. A gastrointestinal illness is a virus that upsets your stomach," she told Daybreak Kamloops host Shelley Joyce.  

Virus spreading 

Currently, 30 patients and 24 staff have been affected at the hospital and at the Hillside Psychiatric Centre next door said Duncan. 

Since the stomach bug first broke out at the hospital on Sunday, two other medical facilities in Kamloops have also posted outbreak alerts for a gastrointestinal illness.   

"I advise people to call before visiting and not go in with any symptoms," said Duncan.

Camp Fire Friday update: Toll rises, evacuees face hardships

Via the Chico Enterprise-Record: Camp Fire Friday update: Toll rises, evacuees face hardships – Chico Enterprise-Record. Click or tap through for links to more reports, photos, and videos. 

More than a week after the Camp Fire swept through Paradise, Concow and other areas, the startling numbers continue to rise as officials get a better handle on the devastation. 

The latest: 63 dead, 630 listed as missing, 142,000 acres burned, 9,700 homes gone, 230 commercial buildings destroyed and just 45 percent containment. 

All of those numbers have been rising, though the Butte County Sheriff’s Office hopes the number of missing will decrease after releasing a list of people that family and friends cannot find. 

Meanwhile, a norovirus outbreak at shelters is making evacuees sick, and an unofficial evacuation camp that grew in the parking lot at the Chico Walmart is expected to close by Sunday.  

The only shelter still accepting evacuees is at Bidwell Junior High School in Chico. Evacuation centers at Neighborhood Church in Chico, Oroville Nazarene Church and fairgrounds in Gridley, Orland, Quincy and Yuba City are all full, according to Butte County.

Norovirus at several Camp Fire shelters

Via the Chico Enterprise-Record: Norovirus at several Camp Fire shelters. Excerpt:

CHICO — Close quarters make for the easy spread of sickness, which explains a norovirus outbreak at the Camp Fire evacuation centers.  

Lisa Almaguer of Butte County Public Health said as of Thursday morning there were 21 individuals at the Neighborhood Church confirmed with norovirus out of the 179 evacuees at the center. 

Symptoms included fever, vomiting, diarrhea and stomach pain. She said that symptoms have been seen at the other evacuation centers, but the center managers have isolated the individuals, who are being cared for separately by other public nurses.  

Those ill have separate areas for washing hands and using the restroom, with “limited” in and out access. 

“Other shelters have people who are ill. We didn’t wait to confirm through lab tests (what they had). They are in separate parts of the shelters,” she said.  

Thursday morning there were 10 sick of the 352 at the Oroville Nazarene Church; nine of the 142 at the Butte County Fairgrounds; and one of 200 at the East Avenue Church.  

Spreading illness 

Norovirus spreads through touching contaminated surfaces like door handles, food, objects or other people or their body fluids. Just being close to someone physically can spread the virus too, Almaguer said. 

The sickness lasts one to three days, and Almaguer said people are still contagious for two days after symptoms disappear.  

“They should go home, stay home, not run errands, don’t go to work.” 

The virus had been reported in the community before the fire, she said, and this is the time of year normally when it pops up. 

Last year, evacuees from the Oroville Dam spillway crisis wrestled with the condition as well at the fairgrounds.  

Almaguer said there is no medication or treatment to cure the virus. It just has to run its course. Prevention is important. Wash hands with soap and water, and use bleach-based products to clean all areas touched by persons with nausea, vomiting and diarrhea.  

Almaguer said additional medical staff is being assigned to the shelters, and evacuees are being instructed in how to prevent norovirus.

100 fall ill in suspected norovirus contamination at Finnish lake

Via Yle Uutiset: 100 fall ill in suspected norovirus contamination at Finnish lake.

A hundred people have fallen ill after contracting the norovirus at a beach in Kajaani, eastern Finland, according to local newspaper Kaleva.  

City health officials say the patients were hit with intestinal ailments after swimming at the Kesäniemi beach in late July and early August. The beach is on Lake Sipinen, not far from the city centre.  

Norovirus was not detected at the lakeshore in water tests carried out by local public safety officials, but has been found in stool samples from those affected. 

City authorities shut down the beach when reports of people with stomach complaints began to surface. The virus causes symptoms including nausea, diarrhoea, and sometimes fever. 

Local officials have advised people to avoid Kesäniemi beach until 23 August.  

Health officials have issued a warning that the warm summer weather could increase the likelihood of contamination on beaches in general, according to the paper.

Raw oysters from BC tied to norovirus outbreaks in Canada, US

Via CIDRAP, Lisa Schnirring writes: Raw oysters from BC tied to norovirus outbreaks in Canada, US. Excerpt:

The US Food and Drug Administration (FDA) yesterday said federal and state health authorities, along with Canadian public health officials, are investigating multistate and multi-province norovirus outbreaks linked to raw oysters from British Columbia. 

So far, there's no word on how many illnesses and states are involved in the US part of the outbreak, but the California Depaprtment of Public Health (CDPH) said today that about 100 people have reported getting sick after eating raw oysters from British Columbia, and the Public Health Agency of Canada (PHAC) said on Apr 27 that 172 cases so far have been reported in three provinces—British Columbia, Alberta, and Ontario. 

Outbreak involves uncommon strain 

The US Centers for Disease Control and Prevention (CDC) said yesterday that multiple states are currently affected by outbreaks related to raw oysters from British Columbia. It added that lab analysis has identified that an uncommon type of norovirus is involved.  

The CDC said contaminated oysters and other shellfish are common causes of norovirus outbreaks. It recommends cooking oysters and other shellfish thoroughly (to 145°F or higher) before eating. 

Norovirus is the leading cause of illness and outbreaks from contaminated food in the United States, with about 50% of foodborne illnesses caused by the virus. Foods commonly linked to outbreaks include leafy greens, fresh fruits, and shellfish, including oysters. 

Most people infected with norovirus experience diarrhea, fever, and abdominal cramps 12 to 48 hours after exposure. Children younger than 5, seniors, and those with weakened immune systems are at greater risk for severe illness. 

Oysters went to at least 5 states 

The FDA said the potentially contaminated raw oysters were harvested in the south and central parts of Baynes Sound in British Columbia and were distributed to California, Illinois, Massachusetts, New York, and Washington state. It said other states may have received the oysters directly from Canada or from other distributors in the United States.  

The FDA and state partners are tracking where the raw oysters were distributed to make sure they're removed from the food supply. The agency urged retailers not to serve raw oysters harvested from the following locations (landfiles) within Baynes Sound: #1402060, #1411206, #1400483, and #278757.

Canada: Two BC oyster farms closed after norovirus outbreak

Via CBC News: 2 B.C. oyster farms closed after norovirus outbreak. Excerpt:

Two B.C. Vancouver Island oyster farms have been closed following an outbreak of norovirus associated with eating the raw shellfish.  

The B.C. Centre for Disease Control says about 40 cases of acute gastrointestinal illness have been connected to the consumption of raw oysters since March. Testing has confirmed some of the cases were norovirus. 

Federal officials with Fisheries and Oceans Canada (DFO) confirmed the affected farms are located on the east coast of Vancouver Island at Deep Bay and Denman Island. 

While the two farms are no longer harvesting oysters for consumption, no recall of oysters has been issued by the Canadian Food Inspection Agency. 

Human sewage suspected 

While the precise sources of contamination have not been identified, human sewage in the marine environment is currently believed to be the most plausible cause of shellfish contamination, according to BCCDC epidemiologist Marsha Taylor.  

Anyone who falls ill with diarrhea and vomiting after eating shellfish should call B.C. HealthLink at 811, said Taylor. Most people recover from norovirus on their own with proper hydration and rest, but in some cases dehydration can be severe and require medical attention. 

In order to kill norovirus and other pathogens, the BCCDC recommends consumers cook oysters thoroughly, to an internal temperature of 90 C for 90 seconds. Consumption of raw oysters is not encouraged.