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A week in the COVID 19 crisis from a UK perspactive.

COVID-19 in the UK. A Week in an Underprepared Nation

A week in the COVID 19 crisis from a UK perspactive.
A week in the COVID 19 crisis from a UK perspective.

New research from the University of Huddersfield has starkly warned that the local authorities of the UK are unprepared for the sheer numbers of deaths likely to be caused by the spread of the COVID-19 novel strain of the coronavirus.

In a paper published in the journal Emergency Management Review, the authors warn that major increase in mortality rates and staff absences will mean a struggle to issue death certificates, leading to a bottleneck in burials and cremations, with mortuaries filled beyond capacity, adding that even if fatality rates are at the lower end of expectations — one per cent of virus victims — it is highly likely that death and bereavement services will be overwhelmed.

The UK Prime Minister Boris Johnson has tested positive for Coronavirus. Credit: Wikimedia Commons.

As well as analyzing the readiness of local authorities, the authors including Dr Julia Meaton, Dr Anna Williams and researcher Helen-Marie Kruger, drew on data from previous pandemics. Their findings are based on research conducted in 2019 which aimed to assess how well prepared the UK was to handle a potential flu pandemic.

This is by far from the first time that medical professionals have warned the UK authorities that their response to the coronavirus pandemic sweeping that the globe is insufficient. Much of this criticism has focused on the UK authorities failing to secure sufficient medical equipment to handle the growing crisis.

When future generations look back at the handling of this crisis by Boris Johnston’s government they will likely be forced to navigate a litany of lousy excuses, u-turns, bluffs, under the table deals, incompetence and the collapse of the NHS after a decade of neglect. An NHS already at breaking point before the onset of a global pandemic and the health crisis it has wrought.

What follows are revelations of mishandling and blunders that have unfolded during just one week of this crisis. 

Missed emails and missing ventilators

Even as the aforementioned paper was being published, the Government was facing accusations of failing to secure 25,000 ventilators — a potentially life-saving piece of equipment — from UK manufacturer Direct Access. 

The Cheshire based company claim that it informed the UK Department of Health that it could secure the 25,000 ventilators and 50 million coronavirus testing kits, yet its e-mail went unanswered for two weeks. During this intervening period, Direct Access says that the equipment was purchased by other countries. Cabinet Minister, Michael Gove, has apologised for the error and promised to investigate the situation.

“No one seemed to be taking us seriously,” says Andy Faulkner, the manager of Topland, a Dubai firm helping Direct Access obtain ventilators, adding that the two companies offered the government 5,000 units a week over five weeks — but initially received no response. “They asked us to register on the ventilation website, which we did, and then waited another five days for any response.”

Faulkner concluded by saying that it could be as late as July before the companies could offer the NHS any further equipment, even were it to be ordered immediately. 

“Brexit over breathing”

The error comes on the heels of the revelation that Johnson’s government had failed to enroll in the EU scheme to jointly obtain ventilators to avert the predicted shortfall over the following critical weeks. 

The official line from Downing Street was initially that as they were no longer part of the European Union then it had been believed they could not be part of the scheme, an excuse so flimsy that the Independent referred to it as “Brexit over breathing.” Downing Street later clarified that the failure to register in the programme was a result of a communications mix-up. A claim that has been dismissed by Brussels.

On Friday a spokesperson for the EU made it clear that the 11-month transition period during which Britain makes its exit includes an allowance for the country to join in any “joint procurement” programmes. They continue: “The member states’ needs for personal protective equipment have been discussed several times in the meetings of the health security committee where the UK participated.

“At these meetings, the commission stressed its readiness to further support countries with the procurement of medical countermeasures if needed, so member states and the UK had the opportunity to signal their interest to participate in any joint procurements.”

Number Ten did state that they would take part in any future measurements to procure ventilators undertaken by the EU.

To many, this may be seen as an assurance that is both too little and too late. It is estimated that the UK will need 30,000 ventilators to deal adequately with the deepening COVID-19 situation. The NHS currently has an estimated 8,000 machines, with a further 8,000 expected to be ready for the end of April. A deeply worrying shortfall. 

What has come as a shock to some, is that the Government has approached a manufacturer to produce ventilators, albeit one with no prior history in building medical devices and equipment. 

Help from unusual sources

The company Dyson unveiled a prototype ventilator — the Co Vent — just last week, immediately garnering an initial order for 10,000 units from Westminister. The deal will be based upon the device passing tests from expert clinicians and health regulators, according to a spokesperson for Boris Johnson. 

The involvement of the company, founded by billionaire Brexit-supporter and Tory-part donor James Dyson, has garnered a great deal of scepticism, with a representative from Penlon-part of the ventilator Challenge UK consortium — stating that it is deeply unrealistic to design a new ventilator and rapidly begin producing tens of thousands of the device. 

Why have a ventilator by a leading manufacturer in the field when you can buy 10,000 unbuilt prototypes from a Tory donor? Credit: Dyson.

There is, of course, some crossover between the ventilator and the machine that made Dyson a household name, the vacuum cleaner. Both machines are designed to pump air efficiently, and some of the parts are similar. If this doesn’t inspire much Dyson have employed the Technology Partnership — a company that employs some scientists with experience in designing medical interventions — to assist them. Dyson has also pledged to donate 4,000 Co Vent units globally to help fight against COVID-19, as well as promising to donate a further 1,000 devices to the UK.

Fortunately, the NHS is receiving help from a somewhat unexpected source to help tackle other shortages. A medical fetish website — MedFet Uk has donated its entire stock of disposable scrubs to the NHS after it was approached by procurement representatives. 

“Today we donated our entire stock of disposable scrubs to an NHS hospital. It was just a few sets, because we don’t carry large stocks, but they were desperate, so we sent them free of charge,” the company said in a statement posted on their Twitter account. 

The scrubs donated by medical fetish website MedFetUK

Whilst the company has received rightful praise, it seems utterly terrifying that so many years of abuse, neglect, and cost-cutting measures by the Tory Government has left NHS is such dire need of essentials they have to appeal for help from a fetish website. 

The MedFetUK Twitter statement went on to reflect this sentiment, concluding: “So when it’s all over…and the doctors, nurses and other staff have done an amazing job (as they undoubtedly will despite the circumstances)… let’s not forget, or forgive, the ones who sent the NHS into this battle with inadequate armour and one hand tied behind its back.”

The microbes join to cre­ate slimy rib­bons that tan­gle and trap other pass­ing bac­te­ria, cre­at­ing a full block­age in a star­tlingly short period of time. (c) Princeton University

Bacteria clogging of medical devices is more serious than previously thought

A team of researchers at Princeton University have devised an experimental set-up that closely mimics the flow of bacteria through working medical devices. Their findings show that bacteria clog medical devices extremely fast – much faster than previously thought – and warrant new strategies and designs in order to counter machine failure.

The researchers used time lapse cameras to monitor fluid flow in narrow tubes or pores sim­i­lar to those used in water fil­ters and med­ical devices. What’s important to note is that the scientists used pressure driven fluid and rough tube surface, instead of stationary liquid and smooth surface, in order to mirror as closely as possible natural occurring conditions.

The microbes join to cre­ate slimy rib­bons that tan­gle and trap other pass­ing bac­te­ria, cre­at­ing a full block­age in a star­tlingly short period of time. (c) Princeton University

The microbes join to cre­ate slimy rib­bons that tan­gle and trap other pass­ing bac­te­ria, cre­at­ing a full block­age in a star­tlingly short period of time. (c) Princeton University

A number of bacteria commonly found in clogged devices were introduced in the experiment, and were observed over a period of 40 hours. The researchers dyed the microbes green in order to better monitor them. What they found, however, took them by surprise. The microbes steadily attached themselves to the walls of the narrow tube and began to multiply, eventually forming a slimy layer of coating called a biofilm.

Additional microbes, this time dyed red, were introduced and, naturally, these too adhered to the walls surface, where they stuck to the biofilm. During this time, however, fluid flow wasn’t considerably disrupted. Some 55 hours in the experiment,  the biofilm stream­ers tan­gled with each other and formed a sort of net-like structure that progressively trapped more and more bacteria as the snare became larger. Within an hour, the entire tube became blocked and the fluid flow stopped.

“For me the sur­prise was how quickly the biofilm stream­ers caused com­plete clog­ging,” said  Howard Stone, Princeton’s Don­ald R. Dixon ’69 and Eliz­a­beth W. Dixon Pro­fes­sor of Mechan­i­cal and Aero­space Engineering.. “There was no warn­ing that some­thing bad was about to happen.”

So in less than 60 hours of operation, their set-up had become clogged, much sooner and more devastating then anyone would have ever thought. The Princeton scientists’ work, published in the journal  Pro­ceed­ings of the National Acad­emy of Sci­ences, shows how easily susceptible water and soil filter or, most importantly, medical devices are to clogging in the face of flowing bacteria.

 

A tiny, self-propelled medical device that would be wirelessly powered from outside the body, enabling devices small enough to move through the bloodstream. (c) Stanford University

Cyber-crime turns frightening real: hacking pacemakers and other medical devices

It seems like a scenario from a bad spy movie: someone hacking a medical device like an insulin pump or pacemaker and control it at his will. Unfortunately, this is all but possible.

There are currently millions of people fitted with various electronic devices, some of which we’ve featured here on ZME Science. These range from smart regulatory devices that adjust things like heart beats or deliver drugs to simple tiny monitoring devices, that feedback data in real time and can provide valuable info otherwise unavailable.

A tiny, self-propelled medical device that would be wirelessly powered from outside the body, enabling devices small enough to move through the bloodstream. (c) Stanford University

A tiny, self-propelled medical device that would be wirelessly powered from outside the body, enabling devices small enough to move through the bloodstream. (c) Stanford University

However, scientists and government offices paid little attention to cyber attacks on such devices, either because they couldn’t believe something like this would be possible or simply because the technology employed today doesn’t allow for fitting cyber protection. Energy consumption is one of the biggest concern  when designing such tiny medical implants, and factor of the matter is battery life can only allow for so few processes. On top of that, it’s not like you can update your firmware on your pacemaker. An update signifies surgery.

The first signs that hinted towards the idea of cyber threats to medical implants as a genuine possibility came in 2008 when academic researchers demonstrated an attack that allowed them to intercept medical information from implantable cardiac devices and pacemakers and to cause them to turn off or issue life-threatening electrical shocks. Back then it would’ve cost thousands of dollars for a hacker to afford the necessary equipment to intercept a transmitter, but today you can do it just as well with only $20 using an Arduino module.

A McAfee security analyst demonstrated in July that he could scan and identify insulin pumps that communicate wirelessly and have any such pump immediately dump all its contents within a range of 300 feet. The same security analyst showed at a conference how he reverse engineered a pacemaker and could deliver an 830-volt shock to a person’s device from 50 feet away. Now that’s an assassination.

Indeed many companies took notice of this and haven’t taken the issue lightly. Noise shields or biometric heartbeat sensors to allow devices within a body to communicate with each other, keeping out intruding devices and signals. Governments are looking to staple regulations designed to protect patients from cyber attacks, and have future implants meet a certain anti-malware criteria. Still, it seems like the enforcing bodies are trailing behind the fast expanding branch of medical cyber-crime. I recommend you read more on the subject at these editorials from Fast Company and Singularity Hub.

If you have an electronic medical implant currently in your body or are considering one, please don’t be startled. There has been no reported actual attack on a person so far, so no one was injured let alone killed by hacking his medical device, despite being possible.

The sea lamprey, a very simple organism which dwells in the Atlantic waters, which scientists will use as inspiration for a bio-mechanical device capable of traveling through your body. Not that much of looker, but he's on our side. (c) U.S. Fish and Wildlife Service.

Bio-mechanical hybrid robot might detect diseases from inside your body

Scientists at Newcastle University are currently developing a tiny bio-inspired robot, just one centimeter in length, which in less than five years might be used to diagnose and pinpoint diseases from inside the human body.

The sea lamprey, a very simple organism which dwells in the Atlantic waters, which scientists will use as inspiration for a bio-mechanical device capable of traveling through your body. Not that much of looker, but he's on our side. (c)  U.S. Fish and Wildlife Service.

The sea lamprey, a very simple organism which dwells in the Atlantic waters, which scientists will use as inspiration for a bio-mechanical device capable of traveling through your body. Not that much of looker, but he's on our side. (c) U.S. Fish and Wildlife Service.

The researchers, backed-up by the American National Science Foundation and the UK’s Engineering and Physical Sciences Research Council,  are hoping to succeed where other scientists at nano labs across the world have been painstakingly trying to achieve as well – a working, safe tiny device which can swim through the blood stream and collect critical information, irretrievable otherwise.

Called the “Cyberplasm”, the Newcastle scientists’ take involvesa  biomimicking robot that functions like a living creature loaded with sensors derived from animal cells, inspired by the  sea lamprey, a creature found mainly in the Atlantic Ocean. The animal has an extremely nervous system, making it perfect for bio-mechanical mimicking.

“Nothing matches a living creature’s natural ability to see and smell its environment and therefore to collect data on what’s going on around it,” Dr Frankel noted.

Cyberplasm will have an electronic nervous system, ‘eye’ and ‘nose’ sensors derived from mammalian cells, and artificial muscles that use glucose as an energy source. Its sensors are being developed to respond to external stimuli, like chemical signals or light, much in the same way organisms do in nature by converting them into electronic impulses that are sent to an electronic ‘brain’ equipped with sophisticated microchips. This information will be then used by the brain to send electronic messages to artificial muscles, telling them to contract or relax, resulting in an undulating motion which propels the Cyberplasm and allows it to navigate through the human body. Data on the chemical make-up of the robot’s surroundings can be collected and stored for later recovery, information later used for diagnosis.

Besides disease diagnosis, the researchers believe the Cyberplasm might have some immediate applications in the prosthetics sector, where the tiny bio-robot might be used to stimulate  living muscle tissue to contract and relax.  The researchers are currently developing the components of Cyberplasm individually, and while the initial prototype will be one centimeter long, they’re confident they can scale it down to nano-size in time – a working device should be ready within five years.

“We’re currently developing and testing Cyberplasm’s individual components,” Frankel concluded. “We hope to get to the assembly stage within a couple of years. We believe Cyberplasm could start being used in real world situations within five years”.

University of Newcastle  / Eureka Alert

The self-propelled wirelessly powered prototype developed by Stanford scientists, 3mm wide and 4mm long, showed resting upon one of the researcher's hand. (c) Stanford University

Revolutionary wireless powered tiny device can swim through blood streams

Implantable medical devices, capable of delivering drugs or performing micro-surgery from inside the body, have been the subject of scientific research for decades now. A number of exciting prototypes have been developed in the past few years, as miniaturization allowed it, however reliability flaws rendered them unpractical. A new tiny device developed by Stanford electrical engineers, was presented this week at the International Solid-State Circuits Conference by lead researcher Ada Poon, which is powered without wires or batteries and is small enough to travel through human blood streams.

“Such devices could revolutionize medical technology,” said Poon, an Electrical Engineering Assistant Professor. “Applications include everything from diagnostics to minimally invasive surgeries.”

The self-propelled wirelessly powered prototype developed by Stanford scientists, 3mm wide and 4mm long, showed resting upon one of the researcher's hand. (c) Stanford University

The self-propelled wirelessly powered prototype developed by Stanford scientists, 3mm wide and 4mm long, showed resting upon one of the researcher's hand. (c) Stanford University

In front of the conference audience, Poon demonstrated the working device, just a few millimeters in size and wirelessly powered, capable of controlled motion through a fluid, including blood. This could be the first of a new class of working medical implants, which could deliver drugs, perform analyses, and perhaps even zap blood clots or remove plaque from sclerotic arteries all from inside the human body. Since its power is derived wirelessly using electromagnetic radio waves, the device escapes all the reliability issues other implants meant for similar applications encountered. No batteries or wires means that the device can travel through the blood stream without risk of power failure and a dramatic scale down in size (batteries amount to most of the volume of such devices).

“While we have gotten very good at shrinking electronic and mechanical components of implants, energy storage has lagged in the move to miniaturize,” said co-author Teresa Meng, a professor of electrical engineering and computer science. “This hinders us in where we can place implants within the body and also creates the risk of corrosion or broken wires, not to mention replacing aging batteries.”

A tiny surgeon inside your blood vessels

Scientists have been trying to devise such medical wirelessly powered implants for 50 years now, but it seems the approach taken in the past was wrong, all because of one flawed assumption – that the human tissue is a good electrical conductor. Couldn’t been farther from the truth. With this inaccurate model in mind, high-frequency waves dissipate in the human tissue, dissipating as the device travels further.

Poon took a different approach, and considered the human tissue as a dielectric, a type of insulator – quite the opposite of previous assumptions! In a dielectric, the signal is conveyed as waves of shifting polarization of atoms within cells, which renders radio waves propagation possible. Moreover, the human tissue has been found to be “low-loss” dielectric, which means signal loss is minimal. Again, the opposite of past assumptions. These have all been demonstrate experimentally and mathematically.

“When we extended things to higher frequencies using a simple model of tissue, we realized that the optimal frequency for wireless powering is actually around one gigahertz,” said Poon, “about 100 times higher than previously thought.”

This revelation was instrumental to the researchers’ development, since it allowed them to build the device 100 times smaller and yet deliver the power needed by the medical device. This is why the antenna is just 2mm in size – small enough to travel through blood streams.

[RELATED] Nanotech powered by your breath

Two types of self-propelled devices were developed and demoed. One generates direction force to push itself forward by driving electrical current directly through the blood stream, allowing for velocity of around half a centimeter per second. The other, moves similar to the way a kayaker paddles upstream, switching current back and forth through a wire loop.

“There is considerable room for improvement and much work remains before such devices are ready for medical applications,” said Poon. “But for the first time in decades the possibility seems closer than ever.”

source

Amplify, a product used in spinal surgery, that act as carriers for bone morphogenetic protein-2 as well as a scaffold for new bone formation.

Spinal implant causes cancer, medical company tries to cover it up

Medtronics is a medical tech behemoth worth $15 billion. Among other cutting edge medical tech and R&D SciFi prototypes, the company is responsible for manufacturing a wide range of pacemakers, anti-seizure gadgets along with a number of surgery machinery. One of their most successful products in the last decade is a spinal implant that alleviates people suffering of serious back pain, at a hefty cost it seems – cancer.

Amplify, a product used in spinal surgery, that act as carriers for bone morphogenetic protein-2 as well as a scaffold for new bone formation.

Amplify, a product used in spinal surgery, that act as carriers for bone morphogenetic protein-2 as well as a scaffold for new bone formation.

The tiny device is implanted via surgery between vertebrates to correct irregularities in the spine including scoliosis, kyphosis, disc herniation or vertebral fracture. The implant held much promise, since before it came into practice a similar procedure required  an extra surgery to get replacement bone from the patient’s hip or rely on a donor bone for it to be effective. Instead, the products Infuse (in production since 2002) and Amplify (unapproved), get the same results or better by use of a bone growth stimulating biological agent known as bone morphogenetic protein-2, or BMP-2.

In 2009, Medtronics paid millions of dollars for an investigation by surgeons whose purpose was to assess whether the product was safe or not. No safety hazards were found as a result of this extensive medical trial. An independent research however, sparked by various frightening stories in journals, showed that after two or three years from the implant with the genetically engineered protein, the number of patients diagnosed with cancer dramatically increased. The original 2009 paper authors, which were funded with millions by Medtronics, defended themselves by stating that at the time they published the report there were no signs that would allow them to correlate the implants with cancer.

Revenue from Infuse has been about $700 million annually since coming on the market in 2002. Amplify has yet to be approved, but Medtronics is constantly appealing the decision. Clearly there’s a serious conflict of interest at hand.

“There is no question that BMP has biological effects that we don’t fully understand,” said Raj Rao, a professor of orthopedic surgery at the Medical College of Wisconsin and a member of the 2010 FDA advisory panel on Amplify.

Much of these finds have been exposed by the extraordinary display of investigative journalism of the Milwaukee Journal-Sentinel, which published an exhaustive piece on the controversial subject, after digging in through more 1,000 pages of FDA document and recruiting qualified physicians to aid.