There was some much needed good news last week for pre-registration (aka trainee) optometrists. The lockdown and subsequent restrictions meant many trainees were forced to cease activities at a time when a considerable number were very close to completion of the required stage 1 competencies. Overall impact has varied and, sadly, a few have been laid off while the rest have had a significant break from the ‘gaining experience’ phase that is now to resume in a somewhat different form.
The GOC-approved plans for resumption of stage 1 are now widely known and, unsurprisingly, direct observation and the discussion of patient records have been replaced with Zoom-led, remote assessment, case scenario discussion and an increased use of witness testimonies, mainly from supervisors, and reflective statements from the trainees. To combat any accusations of dumbing down, I look to Dad’s Army for the paraphrase ‘there is a pandemic on you know’, and am confident that the good will of all will help these mostly excellent people achieve the required experience and standards to support the eye health of the public in the future. Plans for stage 2 and the OSCEs to be released soon.
Obesity
Images of a jolly, portly Covid-recoverer have graced many a news page this week. These were alongside news of a new campaign, called Better Health, to be launched this week. As yet, there do not appear to be plans for changed taxation nor any new investment, but look out for altered signage on some food and drink packaging and a barrage of upbeat ads on TV. The government have also announced that the campaign will have a particular focus on people of black, Asian and minority ethnic backgrounds; those who have suffered disproportionately high death rates during the pandemic.
Evidence for the impact of obesity upon Covid-19 severity has been accruing for weeks. In Covid Update 9 (Optician 05.06.2020), we reported a French study showing how ‘of the 340 patients with severe Covid-19, 25% had obesity compared with 15.3 % of the general population.’ So, obesity was 1.35 times higher in severe Covid-19 patients. Last week, a new study reported that ‘younger patients (age <50 years) hospitalized with Covid-19 have a higher BMI than older patients (age ≥50 years) hospitalized with Covid-19, and this remains true in subgroups of patients without diabetes and hypertension.’ Importantly, the new study concludes that there is ‘a negative correlation of BMI and age for patients hospitalized with Covid-19, suggesting degree of obesity matters relative to age.’ In other words, obese younger people are at greater risk of severe Covid illness with the infection than those with lower BMI.1
A survey commissioned by the Health Foundation last month found that, in light of the Covid‑19 pandemic, close to nine out of 10 people believe that national government has either a ‘great deal’ or a ‘fair amount’ of responsibility for ensuring that people stay healthy.
Last year, we ran an interactive exercise looking at attitudes to eye care professionals raising the subject of obesity with patients (Optician 01.11.2020). The overall majority of participants were wholly in support of eye care professionals (ECPs) addressing the issue of obesity, whether prompted by the patient or not. With good evidence that the public trusts information on health given out by ECPs, and eyesight threat is a good persuader of compliance, ECP ‘lifestyle prescriptions’ would be a useful way of supporting any campaign. Whether they are recognised by a Prime Minister who, prior to contracting Covid, thought of a levy on sugary drinks as a ‘sin stealth tax’ is another matter.
Lockdown Impact
The impact of lockdown upon eye health, especially ocular surface disorders, is become apparent. I recommend an online survey from Professor Shahina Pardhan (Anglia Ruskin) which aims to ‘understand whether the coronavirus pandemic has had an impact on the management of your eye disorders, and whether it has caused undue stress and anxiety.’ To complete the survey, you should be above 18 years of age and have eye or sight problems (which includes the use of spectacles). Go to; https://angliaruskin.onlinesurveys.ac.uk/eye-disea...
Pooling Resources
As mentioned last week, the UK’s Recovery trial is garnering praise worldwide. I also reported that completion of future trials would be hampered by reducing numbers of active Covid-19 cases. Already this week, major trials have been terminated for this reason.2
An argument for better pooling of trial resources, and trial design standardisation to allow such pooling, has been raised. Worth a look.3 •