News Category 3
You are breathing my air; New insights on respiratory pathogens - Dr Mark Burgin
12/05/20. Dr. Mark Burgin BM BCh (oxon) MRCGP discusses whether continuing to tolerate high levels of deaths from respiratory infections will be acceptable in a post COVID world.
Public health measures reduced the rate of death from pneumonia in 1900 (200 per 100k population) to 1950 (about 40/100k equivalent to 30k deaths a year).
Since then there was little progress until introduction of the Pneumonia vaccine (Strep Pn bacteria) about 20 years ago (now 40/100k), surprisingly there was little impact from antibiotics.
Viruses are found in most community acquired pneumonia (rhinovirus, influenza, RSV, parainfluenza, coronaviruses, adenoviruses) suggesting person to person spread is key.
Immunisation against all these viruses is difficult but we could prevent the spread of respiratory viruses through the application of known public health measures.
Living and working in groups
Until COVID 19 it was culturally acceptable to attend school and work and even social gatherings with clinically obvious upper respiratory tract infections (viral URTI).
There has been no attempt to isolate people with a viral URTI or to take reasonable health and safety steps to reduce the exposure to infected people.
Simple and obvious steps such as remote working, increasing ventilation, wearing masks and providing sinks close to the desk (hand washing) have not been considered.
Social distancing could dramatically reduce respiratory infections but is disruptive and there are other Public health techniques that could be used.
Superinfectors
One of the key issues in transmission of respiratory viruses is the superinfector who passes the infection to tens or hundreds of others.
They may not have symptoms but they shed viruses at a much higher rate than other people so like Typhoid Mary they cause local outbreaks.
Genetic analysis of those who become superinfected may provide an explanation as to why they are vulnerable but developing a general test for superinfection is likely to be easier.
Making reasonable adjustments for those recognised to have this disability of their immune system so that they do not become infected in the first place could be crucial to control.
Contact tracing
Ethically contact tracing causes problems with confidentiality, in South Korea where they sent texts telling the person when they were close to an infected person.
It is the only technique that detects a possible infection before the person shows symptoms and therefore is essential when trying to break the chain of infection.
For serious respiratory infections like COVID 19 this can assist the eradication of the infection once herd immunity has been established as an exit strategy from lockdown.
In legal cases where a vulnerable person has become infected due to poor Health and Safety at work it is possible to take viral swabs and arrange a genotype to identify the infection.
Conclusions
Public health has been many times more effective than technology and simple steps such as changing airflow patterns in offices, public transport and schools do not require new technology.
There has been a historic reluctance to address the burden of respiratory disease in the UK partly due to waiting for a high-tech solution and partly a feeling that death is inevitable.
We have the means to defeat respiratory infections, the average loss of life in the COVID outbreak was estimated at 13 years and despite antibiotics pneumonia causes significant mortality.
Solicitors can assist claims where a claimant who develops pneumonia is known to be vulnerable by instructing an infection control expert witness to gather evidence.
Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.
Dr. Burgin can be contacted on This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website drmarkburgin.co.uk
Wunderink Causes and management of community acquired pneumonia in adults The BMJ 2017;358:j3546 state of the art review
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Credit Hire and Fundamental Dishonesty - Aidan Ellis, Temple Garden Chambers
29/04/20. For many years, the claimants in credit hire cases were habitually described by Judges as honest witnesses, perhaps confused about the detail of the contractual arrangements but always trying their best to assist the court. However, the growing judicial awareness of the problem of fraudulent claims in soft tissue injury cases and the increasing reliance on section 57 of the Criminal Justice and Courts Act 2015 means that findings of fundamental dishonesty are increasingly being seen in a credit hire context. Two recent appellate decisions, summarised below, illustrate this trend.
In Roberts v Kesson and Tesco Underwriting Ltd [2020] EWCA Civ 521, the unsuccessful Defendant appealed against the first instance decision on section 57. In a claim for personal injury and special damages including credit hire, storage and the pre-accident value of the vehicle, whilst acknowledging that aspects of the claim were “curious”, the trial Judge had dismissed those aspects of the claim which he found were not proven but entered judgment for the claimant on the remainder. On appeal, the High Court held that the decision had failed to address the issue of fundamental dishonesty properly and systematically and went on to find that the only possible conclusion from the evidence was that there had been dishonesty in relation to the claim for the pre-accident value of the vehicle, that the dishonesty was fundamental and therefore that the whole claim should be dismissed pursuant to section 57.
In order to explain the decision, it is necessary to set out...
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Summary of Recent Cases, April 2020
15/04/20. Here is a summary of the recent notable court cases over the past month. You can also receive these for free by registering for our PI Brief Update newsletter. Just select "Free Newsletter" from the menu at the top of this page and fill in your email address.
Summary of Recent Cases - Substantive Law
Brian John Morrow v Shrewsbury Rugby Union Football Club Ltd [2020] EWHC 379 (QB)
The Claimant and his wife had been watching their son play rugby on the Defendant's field. During the match, the Claimant was struck over the head by a rugby post, which fell over and knocked him unconscious. The Claimant was treated by paramedics and taken to hospital, where he remained for three days. The Defendant accepted liability for the accident.
The Claimant's Case
Prior to the accident the Claimant worked as an independent financial adviser at the Manchester branch of a financial services company. He became a Senior Adviser in 2004 and was made Branch Head in 2015. But for the accident, the Claimant contended that he would have continued to work within the company until his retirement at the age of 65 years. It was his case that the accident left him with hearing problems, tinnitus, balance problems and cognitive complaints. The accident had also caused a resurgence of previous epilepsy, as well as a new somatoform disorder which caused him to give up work. He would never be able to resume his work as a financial advisor and would only be capable of achieving minimum wage going forward. The Claimant's main...
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Andrea Brown v Comissioner of Police of the Metropolis & Others [2019] EWCA Civ 1724: The Court of Appeal addressed the application of QOCS in 'mixed' claims - Ian Meikle, Civitas Law
07/04/20. AB had brought actions relating to allegedly wrongful use of personal data, claiming damages for personal injury, for breach of the Data Protection Act 1998 (“DPA”) and the Human Rights Act 1998 (“HRA”) and for breach of contract, misfeasance in public office and the misuse of private information. Her claim was therefore “mixed” (i.e. included claims for personal and injury and otherwise) for the purposes of CPR 44.13-44.16.
The court ruled that claims not for personal injury damages, even when brought alongside and arising out of the same facts as a personal injury claim, were not protected by QOCS. However, the QOCS position should be the starting point even when 44.16(2)(b) applied and the judge had a wide discretion as to the extent of any costs awarded.
Discussion:
In this case it suffices to elaborate only the nature of the claims brought by AB, namely that some were for personal injury, some were for general damages for breaches of other rights, some were for exemplary damages and some were for directions to destroy information.
The DPA and HRA claims were admitted by the police and the breach of contract claim was abandoned. The claims for aggravated damages, exemplary damages and directions to destroy information were rejected. The claim for personal injury was also rejected...
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Summary of Recent Cases, March 2020
15/03/20. Here is a summary of the recent notable court cases over the past month. You can also receive these for free by registering for our PI Brief Update newsletter. Just select "Free Newsletter" from the menu at the top of this page and fill in your email address.
Summary of Recent Cases - Substantive Law
Carroll (A Protected Party Suing By His Mother And Litigation Friend) v (1) Taylor (2) Doyle (3) EMMS Taxis Ltd (4) QBE Insurance (Europe) Ltd [2020] EWHC 153 (QB)
After a night out with friends, the Claimant, who had been drinking, hailed the First Defendant's black cab to take him home. However, the First Defendant did not take the Claimant home, but stole the Claimant's debit card and PIN code and left the Claimant some three miles from his home. The Claimant was in contact with his girlfriend, who offered to come and collect him in her car if he stayed put. The Claimant, however, decided to...
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![Appeal judge rules that credit hire company has no costs liability following a finding of fundamental dishonesty in personal injury case: RSA v. Fastrack Solutions Limited [2023] 4 WLUK 92 - David Bowden, Erimus Chambers](/content/images/resized/images/stories/carkeys_72_72.jpg)
