Sorry for absence

 A combination of things - replaced my laptop, new one was then infected by a bug, sorted that out, then they updated Word, etc. and laptop did not have enough capacity. Bought new laptop with updated Word. Then lost password for this blog, and also took on being (unpaid) Secretary for a committee. Having found password again, I am not sure if I will post as often as previously, but hope the older posts still have relevance.  

How Finland Fights Fake News

It is difficult to combat fake news - with the approach of 2022 US midterm elections, there is a wave of false claims surrounding the vote. The crucial factor is the level of trust that the population has in authorities and the media.

Finland
Shortly after Vladimir Putin called up 300,000 military reservists in Sep. 2022, a video showing long queues of cars at the Finnish-Russian border started circulating on social media. This was quickly pointed out as fake by the Finnish Border Guard, who posted on Twitter that some of the videos were fake, having been filmed earlier. The tweet then made it to the top of the Ukraine live page on the website of national broadcaster Yle.

Finland is a high trust society, with the government trusted by 71% of the Finnish population. Parliament, the civil service, the police and the media all enjoy high levels of trust. The Open Society Institute annual study revealed that Finland ranks highest in a global chart measuring resilience to disinformation, while the UK ranks 8th and the US 10th. While Finns don't believe everything they read in the papers, and do look at social media for information, more of them are able to critically evaluate information.

As US midterm elections approach, fake news causes real-world consequence. Despite the increased focus (including efforts by the tech giants) on tackling false and misleading claims on social media, disinformation still gets through and people with social media accounts are still being pointed towards information that bolsters their starting viewpoints.

The Finnish solution
The Finnish school curriculum was revised in 2016 to teach children the skills they need to spot the fabricated information spread by social media. This is not taught as a separate subject but embedded into other subjects. Maths classes look at how statistics can be manipulated. An art project might be for children to create their own versions of a shampoo advertisement, that show that hair might not end up as shiny as promised on the bottle. In language classes they compare the same story written as fact-based text and as propaganda, while history lessons might compare war-time posters from Nazi Germany and the United States.

Finland's National Emergency Supply Agency
This is a comprehensive publicly-funded security model. The government works with private businesses and the media to build public resilience to threats and prepare people for all types of disruptions. Finland also has a number of NGOs (non-governmental organisations) and voluntary organisations working to combat fake news. The best known is probably fact-checking service Faktabaari.

Finland's experience is that proactive moderation in real-time can make a difference.

What can social media platforms do?
Since the Covid-19 pandemic, social media sites have all committed to doing more to fight against falsehoods. There has been some success in removing harmful content and labelling conspiracies with accurate information from independent fact-checkers.

But there are still posts that rack up likes and views before they are removed, and many that aren't identified. Some experts favour a pro-active moderation approach to tackle these posts before they spread. However, its harder to restore faith in institutions, especially when trust in them has been eroded by disinformation.

Source: BBC news item How Finland can help US fight fake news 13th October 2022

Future of the NHS

The Beveridge Report, written during WW2, identified five issues that needed to be addressed: want, disease, ignorance, squalor and idleness. Beveridge argued that when peace came, much of the population would need help to live well, but this would require a double redistribution of income, through social insurance and by family needs.

2022 Everyone in the NHS is worried about what winter 22/23 will bring as the service is already struggling to perform even its central function - to deliver care safely and effectively.

The waiting list for non-urgent treatment is high, with nearly one in eight people in England currently waiting for care. The seriously ill face dangerously long waits. Heart attack and stroke victims wait three times as long as they should for ambulance crews to reach them. Every minute's delay reduces the chances of surviving a heart attack by 10%. Accident & Emergency departments are also struggling. Long waits to be seen are increasingly common; waiting 12 hours is at a record level. And if transfer to a ward is needed, there can be long waits for beds to become available. 

The difference between 1948 and 2022 is stark. Annual budget in 1948 was equivalent of around £15 billion today, while the NHS England 2022 budget is £129.7 billion and rising. In 1948 male life expectancy was 66 years and for women 70. In 2022 men can expect to live to just under 80 and women almost 83 years. The UK population was about 50 million in 1948, and is now just under 70 million. In 2019 the NHS dealt with more than a million patients every 36 hours, with over 17 million hospital admissions and about 96 million outpatient attendances.

There is no simple solution for problems that have been caused years ago; and the pandemic has merely exacerbated them. And it is true that there is no perfect healthcare system in the world - they all have advantages and disadvantages. 

The NHS is drastically short of staff. One in ten posts is currently vacant (the highest level since records began five years ago), which limits the ability of the NHS to expand services. Current staff are experiencing burn-out. One carer in three quit in 2020, the number of full-time GPs has fallen by more than 700 since 2019, with the majority now only working part-time. We need 12,000 more doctors, and more than 50,000 nurses and midwives. By 2030, the NHS is expected to need 475,000 more workers, plus another 490,000 carer jobs. Many other countries face shortages, but the UK has fewer doctors and nurses per head of population than many other western European nations.

 
The pandemic and its impact on healthcare provision has left a record 6.6 million people on NHS waiting lists - and the number is rising.

It takes time to train more staff. While the numbers entering training are now increasing, the NHS has been hampered by political decisions and limited action to boost the workforce. From the mid 2010's bursaries for nurse training were removed; the health secretary at the time, Jeremy Hunt, is on record as saying it was probably his biggest single mistake. 

Doctors. Between four and seven years depending on the course and other medical qualifications. Followed by a two year Foundation programme where you work for a limited period in each of a number of different branches of medicine. Next comes specialty training: three years for general practice, between five and eight for other specialties. Nurses. Depending on which route you take it is (a) three years for a university degree, (b) two years at university if your first degree was in a related subject, (c) Registered Nurse degree apprenticeships (RNDA) is a flexible part-time route while employed, taking between two and four years. Nursing associates can top up their qualifications to RN.

Every year both the General Medical Council and the Nursing and Midwifery Council deal with multiple cases involving healthcare professionals who falsify qualifications. Many other such abuses may never come to light. In recent years, authorities have shut down hundreds of bogus higher education institutions selling fake degrees, but while it is now more difficult to obtain false medical training certificates, very convincing qualifications can still be obtained on the dark net.

GPs. GPs are at the heart of the NHS but for the past twenty years their numbers have failed to keep pace with the UK's soaring population. As older doctors retire, younger doctors are less willing to step up as practice partners and preferring to become well-paid locum or salaried doctor.  And fewer GPs are working full-time. This is undermining the sustainability of some practices, which then close. A rising population means the number of registered patients has increased substantially. Many people feel lucky to get an appointment, and even better if it is with a doctor they have seen before. But the pressure means that many GPs are wondering why they are still in the profession. 

Doctors enjoy an exceptionally high level of public trust and people are grateful for their care and public service. However they are in a unique and very powerful position. Yes they do make at least double the national average wage and enjoy great professional status, but they also feel they are increasingly being asked to ever more with ever less. 

While time pressure, red tape and targets have resulted in a loss of autonomy, there is also resistance to encouraging other health professionals to take over some of their workload, such as empowering pharmacists with more clinical decisions. Richard Horton (editor of The Lancet medical journal) believes it is time to change the system and make it easier for patients to access specialists direct, because the existing referral system causes unnecessary and potentially dangerous delays to patient care.

Does the NHS really need more money? A decade of austerity was caused by the health service being awarded much smaller rises than previously, though government has gone some way to rectifying this.

At the beginning of 2000, the health service received just over a quarter of public spending. Now it is approaching half but resources are not infinite.

Soaring demand for services, crippling legacy contracts with the private sector, mismanagement and waste means the NHS is always in financial trouble. In 2018/19, just under half of all NHS trusts were in deficit, of which nine were in financial special measures. Things improved in 2019/20 with 27% of trusts in deficit and seven in special measures.

There is a good case for continuing with a universal system that means no matter how rich or poor you are, you are entitled to the same treatment. At the same time, we need to rethink the NHS's purpose. Despite our health in general being better than ever, there is increasing medicalisation of everyday life and anxiety about our health. Doctors over-treat patients because of a risk-averse culture. It is easier to use ineffective medicines than to do nothing. The trend in medical science is to pour more and more money into aggressively treating seriously ill patients who are close to death with ever more expensive treatments. We need to work out what the boundaries of the health system should be.

Where should the money come from? The American system of individual health insurance policies prices out those on lower incomes. Options of (a) a specific tax for funding the NHS, (b) making pensioners who continue working after retirement age pay National Insurance, and (c) scrapping universal free prescriptions for the over-60s would be unpopular for those who have already been paying tax during their working lives. In 2022 all workers started paying the Health & Social Care levy of 1.25% in National Insurance payments to help manage the social care crisis. As with all such charges, the money is never ring-fenced and governments are always tempted to raid them for other, more immediate purposes.

Social care and the NHS The health system is struggling to discharge patients who are medically fit to leave hospital, but cannot because there is no support in the community. Summer 2022 data shows more than half of patients ready to leave, could not. Much social care is provided by the social care system which is run by councils. Unlike the NHS, social care has had increased funding over the past decade. The government plans to introduce a cap on care costs but this protects people's assets rather than putting money into the system.

What do other countries do?

Refunding fees. Some countries opt for specific healthcare costs to be paid initially, which are then reclaimed by specific patient types (e.g. elderly, retired, low income). In France there is a fee to see a GP; the fee is refunded to those less able to pay. This can discourage time-wasters with trivial complaints, reduce pressure on doctors and free up more appointments for those who are ill. Some people feel that upfront fees to see a doctor would impact on early diagnosis of conditions and therefore early treatment and more successful outcomes. But figures show cancer outcomes in France are better than in the UK, even with charging a fee to see a doctor

Fee exemptions: The UK charges for prescriptions and NHS dentistry. With prescriptions a number of categories are exempt (e.g. pregnant women, children under 16, and those over 60), such that only 10% of people need to pay for medication. 

France and Germany have a better level of acute hospital beds than we do. But Scandinavian countries don't - and their healthcare is often regarded as the best in the world. They have superb social care services which enable them to prevent many problems before the need for hospital admission is needed. But they pay far higher taxes than we do.

'Hotel' charges, where patients pay a nominal fee (about £8 per night) for a bed, to cover meals and bed-linen laundry. (France and Germany)

Old buildings, new buildings Many hospital buildings are old, and were built to different standards and for different ways of treating people. Almost a third were built before 1974, and another ten per cent dates back to the 1980s. Many trusts have both old and new buildings, but pay so much on the mortgage for new builds that they cannot afford to maintain older premises. So collapsing ceilings, leaking roofs, burst pipes, broken boilers, malfunctioning air-conditioning systems and many other issues are a challenge to hospital management and often a danger to patients. But there is no incentive for trusts to tell the truth about dilapidated buildings.

Buildings constructed and maintained via Private Finance Initiatives (PFI), were almost all set up during New Labour years. Without these deals there would be far fewer modern hospital, well-kept and looking good, nice environments in which to be treated. But PFI builds come at a crippling price in ongoing quarterly payments on contracts, whose average length is 31 years. Latest estimates suggest the final bill will exceed £80 billion for buildings which would have cost about £13 billion to construct if paid for upfront.

Healthcare management. While the image of the incompetent NHS manager persists, inspectors rate 70% of NHS Trusts as being well led. However, there are no specific qualifications or experience needed to be a hospital boss, responsible for the welfare of thousands of patients and managing huge teams of staff and vast sums of taxpayers money. And rarely any consequence for those who screw up. 

The Care Quality Commission is the independent regulator of health and social care services. Failing trusts have insufficient staff, inadequate medical care and 'dire' end of life care. Specific issues include overcrowding, breaching A&E waiting-time targets, shortage of doctors, use of agency nurses, poor staff communication and medical record keeping, inexperienced doctors, clinical staff shortages and inadequate IT systems, failing to inform the coroner of serious incident investigations before the bodies were cremated, meaning the truth about how someone died and the hospital's role in the death, could not be uncovered. Combined, these issues indicate an organisation that lacks basic systems and structures to guarantee a decent standard of care.

Those in positions of responsibility have a legal 'duty of candour'. In reality, a deeply disturbing culture permeates the health service, especially hospital trusts, meaning errors, abuses and failings are routinely covered up, and staff are fearful of speaking out, making it more difficult to improve matters. Professor Sir Brian Jarman developed a way of measuring whether hospitals have higher or lower death rates than expected in order to create a reasonable measure of quality of care. His methodology adjusts patient data such as age, gender, deprivations levels and whether it was an emergency admission. Depressingly, managers worked out that by giving more patients a 'palliative care code' (in hospital for end of life care), the hospital could not be criticised for failing to save them, thus dramatically reducing official death rates. Other hospitals reduced death rates by discharging dying patients to hospices. Jarman claims the Department of Health did not want to receive the alert system, effectively saying 'Please don't tell is what's wrong'.

Problems also occur with the split between clinicians and managers. Hospital consultants exert huge power and influence in the NHS and the vast majority are decent, hard-working and honest. But some routinely capitalise on poor management by taking money for hospital sessions they did not carry out, fiddling rotas and boosting private practice by deliberately slow productivity in NHS time. Private hospitals have efficient operating lists because they are paid per patient by an insurer, by the private hospital or are self-paid by the patient. As a business, a private hospital will ensure its resources are being used for the most profit.

Basic NHS salaries for consultants are modest relative to earnings in private practice. If consultants could earn significantly more from the NHS, it would reduce or even eliminate the tension between public and private work. Encouraging consultants to work full-time for the NHS is needed to sustain the health service. Until that happens, managers need to ensure hospitals get what they pay for.

Data systems Hospitals are still working with patchy, unreliable and outdated computer systems, leaving doctors and nurses making critical decisions in the dark. Parts of the NHS remain in the digital Dark Age, especially with patient records. 

And early 2000s efforts to modernise the patient record system ended in an expensive contracting fiasco. Today across the NHS, huge sums are still squandered procuring software that is unfit for purpose and must then be upgraded, repaired or changed, usually by the same company that failed to provide what was needed in the first place. Failure to train staff in new systems results in chaos and potentially puts patients at risk. 

However the pandemic showed that the NHS can change swiftly on occasion, when (for better or worse) online consultations became mainstream. 

Inefficiency It has been estimated that hundreds of millions of pounds are lost every year due to time-wasting and operating theatres being under-used. (a) Surgery starting so late in the morning that patients at the bottom of the list were sent home without having had their operation or were delayed until the following day. (b) Operations cancelled to suit staff, e.g. a member of staff thought the list would not finish on time, causing them to stay over their scheduled work time. NHS workers have little or no incentive to maximise output. They are paid the same amount however many patients they see and slow work is rarely reprimanded. It is a testament to the dedication of the depleted workforce that the NHS gets as much done as it does.

Acknowledging mistakes is the only way to improve a service. Datix is the most widely used patient safety database in the NHS. It relies on staff inputting information about safety incidents, so reveals the blunders and oversights, accidents and abuses, communication failures and confusions that take place every day in NHS trusts. Examples are errors with anaesthetics, late cancer diagnoses, drug dosage mistakes, medicines given to the wrong patients, botched gynaecological operations and injuries to mothers during childbirth, blunders with blood transfusions and lapses in infection control. But some adverse incidents are not recorded in the first place as there is widespread reluctance to flag up problems. Datix is there to highlight risk and learning from mistakes, but people don't like using it because they are afraid of how it will impact on themselves. 

Medical negligence lawsuits. The number of compensation claims is soaring and settling disputes takes a big chunk out of the already stretched NHS budget. NHS Resolution, the quango that handles medical negligence lawsuits, paid out £2.4 billion in damages and costs for claims in 2018/19. 

When to stop treating people. Charlie Gard, patients in long term comas, etc

Patients must use the NHS more appropriately and take more responsibility for looking after themselves. The single biggest issue is the national struggle with obesity. A third of children leaving primary school are overweight or obese, as are almost two-thirds of adults in England. The body positivity movement has been hijacked by some fashion brands and social-media influencers claiming it as an acceptable lifestyle choice. There is a growing recognition that drugs are not always the answer to patients' problems. Those who complain of loneliness, stress, depression or anxiety may get more out of group activities such as singing in a choir.

The time has come for zero-tolerance for those who fail to turn up to GP and specialist appointments. With privilege comes responsibility, and as attempts to educate patients about the cost of such behaviour has not worked, some system of sanctions is needed. Sticking-plaster solutions will only accelerate the decline, fuelling the market for private-health insurance for those who can afford it, and bringing in the two-tier systems the NHS was designed to avoid.

How to get things changed? The NHS is generally held in high regard, and people were impressed by the way the service responded to the coronavirus pandemic so any debate over how it is run and funded is sensitive. But most believe that the NHS is now in a worse state than before the crisis, which exacerbated existing problems (chiefly waiting times and differing standards of care nationwide) and that things are unlikely to improve soon.

Surgeries and hospitals are places where people receive treatment when things have already gone wrong. Globally and in the UK, the key issues are: high blood pressure, smoking, household air pollution, low fruit intake, alcohol use and high Body Mass Index. Other contributory factors are: low childhood weight, excessive salt intake, insufficient nuts and seeds, iron deficiency, sub-optimal breast feeding, high total cholesterol, low intake of whole grains, vegetables and omega-3, drug use, occupational injury, too much processed meat, intimate partner violence, low fibre intake, poor sanitation, vitamin A deficiency, zinc deficiency and dirty water. It is not lack of medical care that causes illness in the first place.

The NHS can encourage people to take part in health screening, to have vaccines, give up smoking, lower alcohol intake and eat their 'five a day' but the Dept. of Health cannot create the conditions that enable the population to make health lifestyle choices. Politicians over-estimate the impact of health spending, when attention would be better directed at addressing the factors that make people unwell in the first place. The need is to boost public spending on education, housing, welfare, and so on, to improve health outcomes. But while good healthcare does not equate to good health, poor healthcare equals worse death.

How do we reform? The founding principles of the service - available to everyone and free at the point of use - means ideas for reform are met with suspicion. Those who have identified the failings and problems do not believe there is any case for diverging from the founding principles, and no political party would do so. But change is necessary and in order to identify the right changes, we need to know where we are now.

With politicians unlikely to set aside traditional differences, the need to take on vested interests requires cross-party co-operation, so there is a case for establishing a Royal Commission to explore the most fruitful ideas for reform.

Sources

• Fixing the NHS - a near impossible job for new PM? Nick Triggle, BBC Health correspondent, 3rd Sept. 2022.
• Why we have to start thinking about the future of the NHS I love by Prof. Stephen Smith in Daily Mail 26th July 2022
• The unvarnished truth of the NHS by Lord Ashcroft and Isobel Oakeshott in Daily Mail retrieved 18 Aug. 2022
• Billions gobbled up by the NHS should be spent on making us healthier not fixing us by Lord Ashcroft and Isabel Oakeshott in Daily Mail retrieved 17th Aug. 2022

Background to Charlie's Law

Today many adults and children are helped by new medical treatments for serious conditions and accidental injuries but many are too ill or injured to be helped. Families in shock or distress about a loved person may then put their trust in experimental treatments, even where there may be no evidence as yet that these work. While initially treated with mechanical ventilation as doctors assess conditions or injuries, there comes a point when a discussion about withdrawing treatment is needed. 

A complicating factor is when other countries offer to treat the patient without seeing the medical records and test results.  

We don't hear about the many cases where the patient and/or family and doctors agree on this point but where there there is disagreement, recently families have made the issue public to put pressure on doctors to continue treatment, even when the patient will not recover. 

The parents of Charlie Gard have since set up the Charlie Gard Foundation to work a bill for Parliament on 'Charlie's Law'. They see an urgent need for changes in the law, policy and legal and health practices to support both families and medical and legal professionals involved in emotive, difficult and life-changing circumstances. They have been working with NHS medical professionals, world-leading ethicists and legal experts to develop draft legislation with the aim of preventing further long and painful conflicts between hospitals and families with sick children. 

Three key changes proposed.

• Prevent cases reaching court. Both families and medical professionals would prefer this. The new legislation would provide access to clinical ethics committees throughout NHS hospitals, access to medical mediation where there are differences of opinion, and speedy access to all medical records including raw data.
• Help parents get the support they need for better access to advice on ethics and their rights, independent second opinions, and legal aid so families do not have to face having to pay for costly legal representation, and are not forced to rely on funding from outside interest groups.
• Protect parental rights by restricting court involvement to cases where there is a risk of significant harm to the child.

Terminal genetic conditions. Some children are born with life-limiting genetic conditions. While doctors are able to use mechanical ventilation to help breathing and tube-fed nutrients, no treatments for these these conditions are currently available. Doctors will aim to keep the child comfortable initially but at some point physical deterioration means that they will suggest removing medical help in the best interests of the child.

This was the case with Charlie Gard (4 Aug, 2016 to 28 Jul. 2017) who was born with mitochondrial DNA depletion syndrome (MDDS), a rare genetic condition that causes progressive brain damage and muscle failure, for which there is no treatment and usually causes death in infancy. While being cared for at Great Ormond Street Hospital, doctors contacted New York neurologist Dr Hirano, who was working on an experimental nucleoside treatment and thought there was a "theoretical possibility" that it would help. Dr Hirano and a member of the GOSH medical team discussed the case and agreed that the experimental treatment was unlikely to help if there was irreversible brain damage and that a baseline MRI scan was needed to rule out "severe brain involvement". to rule out . The GOSH team intended to try the treatment and started work on an application to the hospital ethics committee and invited Hirano to visit and examine Charlie (the visit did not happen till July 2017).

When in January 2017 Charlie had seizures that caused brain damage, doctors were of the view that further treatment was futile and might prolong suffering and began discussions with his parents about ending life support and giving palliative care. However, his parents still wanted to take him to the US for experimental treatment and raised funds for the transfer. In February 2017 the hospital asked the High Court to override the parents' decision. The parents appealed but British Courts and the European Court of Human Rights supported the hospital position. In July 2017 Dr Hirano visited Charlie but after examining scans of Charlie's muscles, determined that it was too late for his treatment to help. On 27th July, by consent, Charlie was transferred to a hospice, mechanical ventilation was withdrawn and he died on 28 July 2017.

Brain death. This is permanent, meaning that the affected person will never regain consciousness or start breathing on their own. They are legally confirmed as dead with the time of death on their death certificate logged when they fail a set of tests. This can be confusing to many people because brain dead people can still have a beating heart and their chest will rise and fall with every breath, which is due solely to life support machines - not because they have miraculously regained the ability to do this themselves. Occasionally also the limbs and torso can move, due to reflexes triggered by nerves in the spine that are not linked to the brain - this does not indicate that the brain is working. [By contrast, the the brain stem still functions in someone in a vegetative state.

When the brain stem stops working, it cannot send messages to the body to control any functions and cannot receive messages back from the body. This damage is irreversible. Six tests are used to determine brain death, including pupils not responding to light, having no cough or gag reflex and being unresponsive to pain. MRI scans can also show areas of damage and necrosis.

On 7th April 2022 12-year old Archie Battersby was found unconscious by his mother with a cord round his neck at their home in Essex. (His mother thought he might have been trying a challenge seen on TikTok.) Taken to Southend Hospital, he had suffered severe brain injuries and needed life-sustaining support, including mechanical ventilation and drug treatment. He never regained consciousness. On 8th April he was transferred to the Royal London Hospital in Whitechapel. With no sign of improvement, the hospital was granted High Court permission on 13th May for Archie to undergo brain stem testing. On 16th May two specialists tried to administer brain stem function tests, but were unable to as Archie did not respond to a peripheral nerve stimulation test, a precursor to the brain stem test. Continued life support would only delay cessation of breathing and other body organs would also deteriorate. With the parents still opposing removal of mechanical ventilation, believing that the spinal nerve triggered movement showed consciousness, further court cases gave doctors permission to use MRI scans, which took place on 31st May. Despite medical evidence from the scans, the parents still refused permission to end life support. During June 2017 further court cases in the UK, including the Supreme Court, gave permission to the hospital. On 3rd August the European Court of Human Rights deemed it a matter for UK courts. The family wanted him to be moved to a hospice for this but the High Court, taking medical evidence into account, ruled he was too unstable to be transported by ambulance. Archie's life support was withdrawn early on 6th August and he died at 12.15 BST with members of his family by his bedside.

END

Self-sterilising Plastic Kills Viruses Like Covid

Scientists at Queen's University Belfast have developed a plastic film that is self-sterilising and could make it harder for infections, including Covid, to spread in hospitals and care homes. The plastic film is cheap to produce and can be fashioned into protective aprons and other clothing. 

The plastic film works by reacting with light to release chemicals that break viruses, killing them by the million, even in tough species that stay on clothes and surfaces.

Studies had shown that under certain conditions, the Covid virus was able to survive for up to 72 hours on some surfaces and under certain conditions. Other viruses can survive for longer - the norovirus (winter vomiting bug) can survive outside the body to two weeks while waiting for someone new to infect.

The aim of the research was to create a material that viruses could not survive on. While copper is known to kill microbes on contact, it is not very flexible. The new plastic contains nanoparticles of titanium dioxide, which react with ultraviolet light (which can be the tiny amount emitted by a fluorescent tube) to release molecules called reactive oxygen species. Theses react with the genetic material of the virus, the proteins it uses to enter the body, and the fatty sphere around it, resulting in a dead virus.

In the laboratory the material was tested against four types of virus: two influenza viruses, the Covid virus and a picornavirus, which is a very stable virus outside the body. Large amounts (far more than would start an infection) of each of these viruses were placed on the new plastic and went down down from one million viruses to nothing. The effect is seen in less than one hour and maximum death in two hours. In real conditions far fewer virus particles would be present, so it is likely there would be an effect in the first few minutes.

Prof. Andrew Mills of the university's chemistry department said "This film could replace many of the disposable plastic films used in the healthcare industry as it has the added value of being self-sterilising at no real extra cost."

Current personal protective equipment used in hospitals works well, but infections can take place when taking off or putting on PPE. The team are also investigating its use for hospital tablecloths and curtains and use in the food processing industry. Real world trials will be needed to work out how much of a difference it would make.

Source: Self-sterilising plastic kills viruses like Covid by James Gallagher, BBC News 9th Sept. 2022