Inside Health

Can you take hormone replacement therapy - HRT - for forever? Three women talk about their different experiences of how they managed the menopause. We balance the risks and the benefits of HRT to see who might be able to take it for the long-term.And do you know how much water should you drink? If you said 2 litres or six-to-eight glasses a day then you may be in for a surprise.PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Can “one helluva pig” be the solution to a worldwide shortage of organ donors. People die waiting for replacement hearts, lungs and kidneys. So I meet the teams that have started transplanting pig organs into people. We’ll explore the huge leaps of genetic engineering that are making "xenotransplantation” possible and ask if it’s even ethical to try. Presenter: James Gallagher Producer: Andrew Luck-Baker

Will we need boosters forever? It’s the question you wanted us to tackle so we’re joined by Prof Beate Kampmann, the Director of The Vaccine Centre at the London School of Hygiene and Tropical Medicine, in the search for answers. Then we explore why so few pregnant women are taking up the Covid vaccine even though it is the best option for mother and baby.And can we stop another infection in babies - Group B Strep - which can have devastating consequences.PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Jimi Olaghere feels like he’s been reborn after a pioneering new treatment for sickle cell disease. Scientists have engineered his blood to overcome the disease that left him in constant pain. I speak to Jimi about his experience and to his doctors about what this could mean for people with sickle cell around the world. Then we explore the headlines around women being worse off with male surgeons and get quite excited about a study suggesting a bedtime read helps sleep.Presenter: James Gallagher Producer: Andrew Luck-Baker Image Credit: Getty Images

Are you one of the five million people with asthma in the UK? If so, could you be on a different inhaler - one that could control your asthma better while also being kinder to the planet? “Puffers” - or aerosol spray inhalers - contain potent greenhouse gases and can be tricky to use correctly, so not everyone can control their asthma. We speak to Caroline from Cornwall, who has switched inhalers and it’s transformed her life. James talks to the doctors who think far more people could benefit from making the change. We also speak to Nerys from North Wales who has started antiviral treatment for her Covid infection. We explore the new drugs with virologist Dr Elisabetta Groppelli and Prof Chris Butler who is running the clinical trial designed to pinpoint who is likely to benefit from antivirals the most. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Is an Omicron infection inevitable? Which drugs still work? Is this the last hurrah of the pandemic? This week we have three of the country’s greatest scientific minds teasing apart what Omicron means for our lives now and in the future. Prof Eleanor Riley, Prof Azra Ghani and Prof Sir Martin Landray also tackle your, at times controversial questions! And our regular Dr Rohin Francis gives us a first-hand account of the pressures on NHS staff?

Happy New Year. I hope you’re sticking to your New Year’s resolutions! Our resident GP Margaret McCartney has dragged me out for a wintery run to discuss how to stick to a healthier lifestyle. And we’re joined by Dr Giles Yeo, Dr Ian Hamiliton and Prof Russel Foster as we tackle the best diets, giving up booze for Dry January and getting a better night’s sleep. PRESENTER: James Gallagher PRODUCER: Beth Eastwood & Geraldine Fitzgerald

Beat pre-diabetes and get your love life back? We hear from two people who are trying to avoid getting type 2 diabetes. But not everyone thinks the term is helpful so our resident GP Margaret McCartney and Dr Samuel Seidu, from the Leicester Diabetes Centre, join us to discuss. And our cardiologist Rohin Francis gets one step closer to his dream of being an astronaut. Presenter: James Gallagher Producer: Geraldine Fitzgerald

Flying London to New York and back. 244 times every day. For half a year. That’s the size of the carbon footprint of all the personal protective equipment used in health and social care in England during the first six months of the pandemic. So I take a look at how the NHS is going green including efforts to make a reusable facemask. Also, a shortage of vials for blood tests has GP Navjoyt Ladher asking whether we were testing too much anyway.PRESENTER: James Gallagher PRODUCER: Beth Eastwood

The future is here. Gene silencing medicines - which can fine tune how our DNA works - have held promise for decades. Now hundreds of thousands of people will get them in the UK. James speaks to a surgeon whose life and career have been saved by gene-silencing drugs and to researchers who think the field could lead to drugs for diseases we think of as untreatable. Presenter: James Gallagher Producer: Geraldine Fitzgerald

The pandemic has strapped rocket boosters onto vaccine science. So where is it taking us next? What other diseases are we about to take on? Prof Dame Sarah Gilbert, architect of the Oxford vaccine, gives me her view. Also, given teenagers and parents agree about everything and never have any arguments.... we should be able to rapidly resolve any questions about whose decision it is when it comes to the Covid jab in teens. Dr Navjoyt Ladher and Dr Vanessa Apea join some very honest teenagers to help find the answer. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Anyone need a hug? I’m taking a look at this year’s Nobel Prize for Medicine. It helps explain how we experience the physical sensations of touch, heat and cold. Yes it’s the hugs, tea and ice cream Nobel! But it could also have implications for treating pain, so Prof Irene Tracey is here to discuss. And you wait decades for fortification and two come along at once. I explore why the government wants to tweak our flour and water.

We’re going meat-free for this podcast! The supermarket shelves are heaving with faux meats and vegan ultra-processed foods. And if you don’t want to put milk in your coffee or on your cereals there’s a load of plant-based alternatives. So we take a look at how healthy these foods are and what you need to know when you’re doing the weekly shop. Sorry you will have to listen to me eating a sausage roll. PRESENTER: James Gallagher PRODUCERS: Beth Eastwood & Lorna Stewart

Do you know your mons pubis from your labia majora? Few of us can identify the parts of the vulva - that’s the external female genitals. So I go exploring with Dr Fiona Reid from St Mary’s Hospital in Manchester and find out why we all need to be better informed. Also, who should be able to look at your medical records? There are grand plans afoot to collect the data your GP holds on you and make it available to researchers. We discuss the pros and the cons with Prof Martin Landray from Oxford University and GP Dr Margaret McCartney. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

My blood pressure is perfectly normal, but could I benefit from medication to lower it even further? We discuss with Oxford University’s Prof Kazem Rahimi and our resident GP Margaret McCartney. How do you diagnose a new disease that could have 200 symptoms? We explore long Covid in children with our reporter Carolyn Atkinson and Professor Sir Terence Stephenson from the UCL Great Ormond Street Institute for Child Health.PRESENTER: James Gallagher PRODUCER: Beth Eastwood

It’s time to talk about periods and contraception. Different birth control options alter the menstrual cycle. Journalist Nicola Davis tells me about her decade without periods and our resident GP Margaret McCartney and sexual health doctor Julia Bailey discuss the evidence and what you need to know. We’ve also got vaccination expert Adam Finn to discuss the slowdown in young people getting the Covid-19 jab and cardiologist Rohin Francis explores the link between erectile dysfunction and the heart.PRESENTER: James Gallagher PRODUCER: Geraldine Fitzgerald & Beth Eastwood

Time for a sprinkling of happiness with a new exhibition at the Wellcome Collection.Last time we heard how children's A&E is under huge pressure as infections, that disappeared during Covid, make a comeback. But doctors also warn that many of those children shouldn’t actually be there. Damian Roland a paediatrician in emergency medicine at University Hospitals of Leicester NHS Trust busts the myths about fever and gives tips on when to take your child to A&E. And the wonders of ear wax, until it builds up, that is, as it does for me. But it's not just ear wax that nurse Andrew Hill has found in people's ears - cocaine and spiders too. You get it all here on Inside Health.PRESENTER: James Gallagher PRODUCERS: Beth Eastwood & Geraldine Fitzgerald

Here at Team Inside Health we’ve noticed our children are constantly ill. So we find out why. Are all those bugs that were dormant for the pandemic suddenly having a resurgence? Or has a year and a half of being squeaky clean left a lingering impact on our immune system? Plus Medlife Crisis - Rohin Frances asks can you be too fit?

The Inside Health podcast is back with a bang! Find out how having a couple of mates round for the football trapped scientist Alex Crozier inside a Covid experiment. Laura talks us through her remarkable journey, from a fear of needles to having her Covid jab, and Oxford University’s Daniel Freeman has some tips for you too. We’ve unleashed our cardiologist, Rohin Francis, for the first of his “Roving Rohin” (trademark pending) reports on hospital staff who don’t get the vaccine. And GP Navjoyt Ladher shares her insight on where we’re at with the pandemic. Happy listening.PRESENTER: James Gallagher PRODUCERS: Beth Eastwood & Geraldine Fitzgerald

This is the remarkable story of how the UK’s Recovery Trial saved the lives of hundreds of thousands of Covid patients. It was set up in nine days, after a conversation on the number 18 bus. Within 100 days it had found the first life-saving drug. This trial has united thousands of doctors, the NHS and 40,000 patients, at the scariest moments of their lives, changing the pandemic, and possibly medicine, forever. We speak to Oxford professors Martin Landray and Peter Horby who devised the Recovery Trial, and to some of the doctors and patients who helped make it happen.PRESENTER: James Gallagher PRODUCERS: Geraldine Fitzgerald & Beth Eastwood

I was floored for three days with side-effects after having my first Covid jab and many of you have been in touch about your side-effects too. Why do some of us feel awful after the vaccine, while others barely notice anything? What does this say about our immune systems and how protected we will be against covid? We put your questions to Eleanor Riley, a professor of immunology and infectious disease at Edinburgh University. Our resident GP Margaret McCartney has been taking a look at the reports of blood clots after vaccination, and we speak to Victoria Male, a lecturer in reproductive immunology at Imperial College London, about the rules for vaccination in pregnant women.PRESENTER: James Gallagher PRODUCERS: Beth Eastwood & Geraldine Fitzgerald

I have become hooked on playing online chess during this lockdown and after watching the Queen’s Gambit. So we’ll find out if it is actually doing my brain any good and whether it and similar games can ward off dementia. Margaret McCartney takes us on a fascinating tour through the history of deliberately infecting people with diseases, as the first “challenge trials” with coronavirus are about to start. Listeners David and Barbara tell us about a treatable condition called normal pressure hydrocephalus that is often mistaken for dementia. PRESENTER: James Gallagher PRODUCER: Beth EastwoodClip from the Netflix series 'The Queen's Gambit', directed by Scott Frank. Music copyright: ‘Training with Mr Schaibel’ by Carolos Rafael Rivera from the official soundtrack of The Queens Gambit

What has the pandemic done to our sex lives? We’ll hear if there’s been a baby boom with Dr Margaret McCartney and Dr Rebecca Thomson-Glover has the lowdown on sexually transmitted infections. We’ll also explore changes to contraception and sexual health services. Meanwhile it feels like we’re on the march to normality, but what about the backlog of patients whose treatment has been cancelled. We speak to Charmayne whose surgery has been held up by the pandemic and Nick Arresti from the British Orthopaedic Association to see how such waiting lists can be tackled.

Most people recover rapidly after catching coronavirus. But I chat to three people who were infected almost a year ago and are still feeling the impact, both on their bodies and their minds. Doctors are having to rapidly grapple with how to treat patients with long Covid. We speak to one of them, Dr Manoj Sivan, the Research Lead for the Long Covid Service in Leeds, who warns that long Covid could be a “second pandemic”. We also have GP Dr Navjoyt Ladher answering your questions on the Covid vaccines.PRESENTER: James Gallagher PRODUCER: Beth Eastwood

A fever, cough or loss of smell and taste are criteria for a Covid-19 test, but what if you have different symptoms? James Gallagher discusses whether more symptoms should be added to the UK government's list with resident GP, Margaret McCartney and Dr Thomas Struyf of KU Leuven.Cardiologist Dr Rohin Francis explains what symptoms he sees when patients with coronavirus arrive in hospital. One of the most common symptoms of Covid-19 is the loss of the sense of smell. It returns after a few weeks in most people but a significant minority still can’t smell anything many months later. James Gallagher talks to Prof Carl Philpott of Norwich Medical School who has led an international panel of nose doctors, assessing the evidence for the best therapies to restore the olfactory sense to people who have lost it following respiratory infections. So-called smell training comes out top as the most evidence-based approach. Carl explains how it works and we hear from two people who are trying to regain their sense of smell.And Dr Carly Welch from the British Geriatric Society says that delirium has emerged as another symptom of Covid-19, particularly in the elderly.

One or our listeners, Katharine, asks whether mouthwash can help stop the spread of coronavirus. We hunt down the answer with the help of biochemist Valerie O’Donnell, from the University of Cardiff, and our own Dr Margaret McCartney. Then it’s our turn in the dentist’s chair. Dentistry is up close and personal with a fair amount of splatter, the perfect place for coronavirus to spread. So dentist Paul Woodhouse and University of Newcastle dentist and researcher, Richard Holliday, are on to explain how to make it safe. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

It’s an exercise special on Inside Health. This week Amanda wants to know how quickly she can get back to exercising after Covid. Dr David Salman has drawn up some advice and Dr Navjoyt Ladher explains why this virus means we should be taking it easy, as well as having a shocking confession of her own. We check in on George, Jen and Dr Helen Hawley-Hague to see how they are getting on with their physiotherapy in the height of lockdown. And we explore with Sport England’s Tim Hollingsworth what the pandemic can teach us about improving exercise levels. Oh and I think I nearly broke our resident GP Margaret McCartney talking about 'adaptogens'.

In Covid, oxygen levels in the body can crash without noticeable symptoms - it’s known as “silent hypoxia”. This week we’ll be discussing whether letting people monitor their oxygen levels at home with a pulse oximeter could save lives. James talks to Chris Harris, who’s been using one, and two pioneers of the project - Dr Matt Inada-Kim, Consultant in Acute Medicine at Hampshire Hospitals NHS Trust, and Dr Caroline O'Keeffe who runs oximetry@home in North Hampshire. And the hotly debated topic of rapid, or lateral flow, testing. Local councils are rolling them out for people who can't work from home, and the hope is that they could help us keep on top of the virus by picking out people with Covid. Could it be a way out of the pandemic or could it cause more harm than good? Prof Irene Petersen and our own Dr Margaret McCartney are on the case. Dr Navjoyt Ladher answers some of the most common questions about vaccines.PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Should you take vitamin D pills to ward off coronavirus? Our own Dr Margaret McCartney has been sifting through the evidence in search of answers. Also clinical trials expert Dr David Collier of Queen Mary University London tells us about new treatments for Covid-19 that are in the pipeline. And is the mysterious “nocebo effect” causing most of the side-effects from statins? Janice Richardson from Hebden Bridge shares her experience on the pills and we chat to researcher and Dr James Howard of Imperial College and cardiologist Dr Rohin Francis. Presenter: James Gallagher Producer: Geraldine Fitzgerald

2020 was awful. So what about 2021?I chat with Prof Neil Ferguson to see how this year could play out and when life might return to normal. Cardiologist Dr Rohin Francis and cancer nurse Aly Foyle are both back to share their experiences of coping during Covid.I promise you, it’s not all bad news.And our own Dr Margaret McCartney, alongside Cancer Research UK’s Jodie Moffat, scrutinises a new blood test that promises to find cancer early.It's a good programme, James. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Saleyha Ahsan reports from Ysbyty Gwynedd, her own hospital in Bangor, North Wales about how the Intensive Care Unit is preparing for winter. Saleyha meets Val and the Critical Care team who have looked after her since the pandemic began. Val was admitted to the unit in March and has become part of the intensive care family.Producer, Erika Wright

Covid-19 damages the lungs, leaving people struggling to get enough oxygen into their body. In the early stages of the pandemic many patients needed a lot of support in intensive care - including artificial ventilation. But there are other ways of boosting oxygen levels in the body - which are being studied in the Recovery-RS trial. Professor Gavin Perkins from the University of Warwick is comparing oxygen delivered by a mask called CPAP with both regular and high-flow oxygen to see which works best. Physiotherapy is one of the hands-on therapies which has been disrupted by the lockdown. Patients who need to do bespoke exercises following a fall or a heart attack might have been offered online sessions instead. But Manchester University researcher Dr Helen Hawley-Hague says these don't suit everyone - including people who don't have access to the internet or a smartphone. We hear from Jennifer and George - both of them have taken part in Helen's studies and have accessed physiotherapy either face-to-face or via a phone app. An Inside Health listener wanted to know if live vaccines like the polio vaccine could protect us against Covid. Oxford University's Andy Pollard explains about the theory behind this idea and how it might help. Dr Margaret McCartney looks at whether it makes a difference if you do a Covid throat and nose yourself - or if it's carried out by a healthcare professional.

Margaret McCartney on National Test and Trace and why households are receiving multiple calls. Beth tells of being contacted many times when her child tested positive and began to think all the family had been separately in contact with different cases, until the penny dropped that the calls were all about the same contact - her daughter. Professor Kate Ardern, director of Public Health in Wigan explains why these calls from the national system aren't joined up. And is there time in a pandemic to do trials for non-drug interventions like pub curfews or social distancing? Professor Paul Glaziou explains that there are currently just 8 such trials globally, while Professor Martin McKee highlights the problems involved. And Margaret hears from Professor Atle Fretheim who is trying to set up a trial in Norway into the impact of school closures on infection control.

The Radio 4 Touch Test included questions about touch in health care. Dr Natalie Bowling who's a psychologist from the University of Greenwich helped to create the test with colleagues at Goldsmith's University. Analysing the data revealed that a positive attitude towards touch in treatment settings increases as we get older. Surprisingly men reported being more likely to feel comfortable with touch in treatment settings - despite women preferring tactile treatments more than men. GPs Margaret McCartney and Ann Robinson agree on the importance of touch in their consulting rooms - both to help tell the difference between constipation and a ruptured appendix - and to place a comforting hand on the shoulder of a distressed patient.Chemotherapy cannot cure 82 year old Anne Townsend who was given a diagnosis of ovarian cancer a year ago - but it's hoped it will help to relieve her symptoms. One side effect has been a loss of her sense of touch - devastating because she loves to sew quilts. She found that reflexology sessions helped - though they stopped because of lockdown and she now uses acupressure techniques which she was taught online by therapists at St Christopher's hospice. Deborah Bowman, Professor of Bioethics at St George's University, also felt calmer and better-prepared for medical procedures when she was having cancer treatment. She explains how she trains medical students to approach their patients in a sensitive way and use touch with care.

The story of one child's recovery from PIMS-TS, the rare new condition that caught doctors by surprise in April. James Gallagher visits specialists at the Evelina London Children's Hospital to hear how they coped with identifying and treating a condition they'd never seen before. Dr Jenni Handforth and Dr Sara Hanna explain how 'they had to reinvent and tweak the rule book' to manage PIMS-TS, where 'the immune system has gone a bit crazy' and treatments worked 'like a fire blanket to dampen down the immune system'. And scientists at the Francis Crick Institute have discovered that children can have Coronavirus-fighting antibodies from before the pandemic started. Dr George Kassiotis explains how kids could have them and what this might mean. And Dr Margaret McCartney unpicks the tricky issue of spotting Covid and cold symptoms in children.

Thromboses - blood clots that form in the circulation - are easily the biggest single killer of British men and women. They affects people of all ages, races and ethnicities. Most strokes and heart attacks are caused by thromboses forming in the arteries supplying the heart or brain. But clots in the veins can be just as lethal, particularly when part of the clot breaks off and travels around the circulation and lodges in the lungs. Recently, the appearance of abnormal micro-clots in the lungs of severely affected Covid patients has highlighted the huge impact even tiny clots can have on our long term health and mortality. What more should be done to protect people from this misunderstood condition?James Gallagher unravels the risks and causes for blood clots, from deep vein thrombosis to clots in the lungs. As he hears from patients, the surprise of a DVT diagnosis and debilitation can be profound. Treating clots is a delicate process with a need to get the balance right between thinning the blood but preventing bleeding. James examines the effectiveness of the latest range of anticoagulants that have a more predictable blood thinning effect, without the need for regular checks to make sure the blood’s not too thick or too thin.The psychological effects of being diagnosed with thrombosis are often under reported. but in up to half the cases severe anxiety, depression and PTSD can arise. We hear of a major new study following the experiences of patients from their diagnosis to follow ups after treatment that explores how effectively they overcame the impact on their mental health of knowing they carried a blood clot.And James Gallagher reports on the newly emerging relationship between Covid and clotting. It was back in April when the alarm was first sounded about abnormal blood clots in severe Covid cases. Research is shedding new light on the causes of the problem - sticky blood. In turn, this knowledge is offering up new ways to treat some of the major complications thrown up by the virus. Presenter: James Gallagher Producer Adrian Washbourne

How will this year's expanded flu vaccine programme be delivered? In addition to usual groups the flu vaccine will be offered to all eleven year olds, any household contacts of vulnerable people told to shield, more health and social care workers and - the biggest change - everyone over 50! Dr Margaret McCartney discusses the difficult logistics for GP practices and pharmacies trying to work out how to immunise around half the population, whilst managing PPE, social distancing and infection control. Dentistry and Covid - Eddie Crouch, Vice Chair of the British Dental Association discusses how practices open since lockdown are coping. And a good news story of how the pandemic has instigated change in the diagnosis of coeliac disease. Dr Hugo Penny, one of the authors of new interim guidance, explains while Radhika tells of her personal experience of coeliac disease. Plus NHS preparations for winter. Trevor Smith, Divisional Director of Medicine at Southampton General Hospital, and Professor Neil Mortensen, President of the Royal College of Surgeons in England, both share their forecasts..

Dr Mark Porter on a new bedside test that differentiates between Covid-19 and other infectious diseases including flu in under an hour. Mark meets Dr Tristan Clark who has already been using the test as part of a trial. And the world's largest study into 'Long Covid' recruiting 10.000 people from 50 different hospitals across the UK who've been hospitalised for Covid to assess their long term recovery. Lead author Professor Chris Brightling discusses the long term symptoms seen in many people recovering from the virus and how research can answer difficult questions such as how long will these continue and what's the best way to help people. And Mark hears from Roz, still recovering from Covid after being admitted to intensive care on May 26th and from physiotherapists Matt and Gemma about how early and long term rehab can help. Plus Professor Sally Singh on the new NHS online rehab service 'Your Covid Recovery'.

As the Government announces GPs should start to prescribe cycling Margaret McCartney examines the evidence for exercise referrals with Harry Rutter, Professor of Global Health at the University of Bath. Temperature checks are popping up in bars, restaurants and receptions but do they work or are they giving false reassurance? Plus while the pandemic progresses Professor Carl Heneghan explains another type of false result, that the chance of false positive tests go up. Navjoyt Ladher, Head of Education at the BMJ, talks us through two highly topical terms - specificity and sensitivity. Amateur choirs have been closed due to Covid-19. Margaret talks to Professor Jackie Cassell who is currently researching what aspect of choirs congregating is particularly dangerous and whether the singing is actually a red herring.Producer: Erika Wright Studio Manager: John Boland

Public health doctors don't dash around hospitals wearing white coats brandishing stethoscopes. The work of this medical specialty is mainly outside of hospitals and it has a very long history. It has a local, national and global reach, an international skeleton charged with the care of populations. And in this pandemic, it is public health which is doing the heavy lifting.In this special edition of Inside Health Dr Margaret McCartney investigates the serious questions being raised about the UK's public health response to trying to stop the spread of the virus, and how tension, over the performance of the government's Test and Trace programme, has spilled out into the open.Margaret hears from Directors of Public Health who feel that their role and expertise in local communities working closely with local Public Health England teams has been overlooked. Instead a new national Test and Trace system has been set up using private companies outside the traditional public health infrastructure. The DPH for Wigan and lead director of public health for the Greater Manchester Combined Authority, Professor Kate Ardern, tells Margaret she believes government didn't understand the role and the experience of local public health teams and so instead of empowering them to oversee test, trace and isolate services, set up a new national system, from scratch, using private companies without public health experience. And the data needed locally to identify and deal with Covid cases, she tells Margaret, just hasn't come through. This is despite the fact that the law is clear; Covid is a notifiable disease and local directors of public health should receive the information.Margaret explores the history of public health with Professor Martin Gorsky from the London School of Hygiene and Tropical Medicine and hears from Professor of Global Health at Queen Mary, University of London, David McCoy, who believes the very structure of public health institutions after the 2012 Health and Social Care fragmented the service, leaving the country vulnerable (as he and 400 other experts warned at the time) to a pandemic. Public Health England's Medical Director, Professor Yvonne Doyle, rejects suggestions that PHE is insufficiently independent from government and insists that both national and local public health teams have pulled together in these unprecedented times.Producer: Fiona Hill

One of the most striking features of the coronavirus pandemic is the disproportionate toll it’s taken on some groups in society. Research by the Office for National Statistics shows black people are nearly twice as likely to have died from coronavirus than white people. And you see a similar pattern of elevated risk in other ethnicities too. Why is this? And to what extent is Covid 19 shedding light on approaches being taken in medicine more generally when assessing and treating people from Black, Asian and Minority ethnic groups?We hear from GP Dr Navjoyt Ladher who’s been navigating the language of race for the British Medical Journal; Dr Rohin Francis, cardiologist and host of the Medlife Crisis podcast, and Prof Kamlish Khunti who’s establishing a detailed Covid risk score to establish exactly who’s at most risk of infection. A major review has found women’s lives have been ruined and babies have been harmed in the womb and yet concerns were dismissed for years as simply “women’s problems”. Those are the findings of the Independent Medicines and Medical Devices Safety Review. It looked at the hormonal pregnancy test Primodos, the epilepsy drug sodium valproate and vaginal mesh implants which are used to treat prolapse and incontinence. Inside Health’s resident GP Margaret McCartney. discusses what needs to change.Presenter: James Gallagher Producer: Adrian Washbourne

Coronavirus has turned the NHS upside down and inside out and by re-organising to treat people with the virus, other potentially fatal diseases like cancer have taken a backseat. At University Hospital Southampton NHS Foundation Trust, which Inside Health visited weekly as the pandemic unfolded, cancer diagnoses fell by half in March and April and of the 50% who were asked to come in for follow up, only 25% actually did. The virus was more frightening than a potential cancer diagnosis. Divisional Director for Medicine at Southampton, Dr Trevor Smith, tells James Gallagher, the BBC's health and science correspondent. that patients are coming back, but it will take a long time to tackle the backlog. For those with cancer caught up in the pandemic, they have experienced disruption, cancellations, altered treatments and they have had to cope with consultations and even surgery by themselves, without loved ones to support them. Charly from Wiltshire was diagnosed with breast cancer in February and her treatment was changed as lockdown happened. Instead of chemotherapy then surgery, she had surgery first. And a mastectomy instead of a lumpectomy. But despite the disruption to her care, she still considers herself one of the lucky ones because she did get treatment.Others weren't so lucky and across the country, lives have been lost. The focus now is on Covid-proofing cancer care and tackling the backlog in screening, diagnosis and treatment. And it's an enormous backlog. Professor Charlie Swanton, chief clinician of Cancer Research UK tells James Gallagher, the BBC's health and science correspondent, that 2.7 million people have missed out on cervical, breast and colorectal screening and 300,000 fewer people than normal have been referred under the urgent 2 week cancer pathway. The creation of Covid-free cancer hubs, he says, safe zones for cancer treatment, are vital, but it will still take a long time to recover and of course there's the spectre of a second wave of coronavirus which would disrupt services all over again.Confidence building includes rapid Covid-19 testing for staff and Dr Trevor Smith from Southampton tells James about the saliva test pilot for key workers in the city. The new test just involves putting saliva in a sample pot, much easier than the normal "have you got it" swab test which involves wiping the back of the throat and deep inside the nose. Dr Navjoyt Ladher, GP and Head of Education at the British Medical Journal gives a simple guide to the "have you got it" tests: PCR, antigen and perhaps if the trial is a success, the new saliva test as well as the "have you had it tests"; the antibody tests. And finally in the week that in England at least, guidance for those who are "clinically vulnerable" and shielding on the advice of the government changes, Inside Health's Dr Margaret McCartney reviews the new advice for those in all four nations of the UK. Producer: Fiona Hill

Tanya has rheumatoid arthritis, a compromised immune system and heart problems. Getting the virus is a risk she cannot take and this is the tenth week that she's been isolating at home with her husband and teenage daughter. But how long will this last and will she have to self isolate in her own home away from her family for the foreseeable future, if her daughter goes back to school? Tanya talks to Claudia about the impact of the pandemic on her life and says why those in the shielding group must not be forgotten.The arrival of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the human population has popularised vocabulary that was previously the preserve of scientists and medics. In just a matter of weeks, phrases like the R Number, Herd Immunity, Case Fatality Rate and All Cause Mortality have become part of everyday language. A new pandemic lexicon has emerged. Inside Health regular Dr Margaret McCartney and Professor Carl Heneghan, Director of the Centre for Evidence Based Medicine at the University of Oxford, discuss the meanings of these very precise descriptions and reveal their personal bugbears, the misuse of such terms.And in her final visit for this series to University Hospital Southampton, Inside Health's Erika Wright, talks again to Trevor Smith, Divisional Director for Medicine, about the enormous challenges ahead as the hospital adapts to living with Covid-19. And she talks about the Banksy art work currently hanging at the hospital which reveals a Super Nurse displacing the traditional comic book superheroes, Batman and Spiderman.Healthcare workers have been lionised as heroes, putting themselves on the front line, risking their own lives, to save others. It's a sentiment which troubles some. Dr Michael FitzPatrick, a gastroenterologist in Oxford and Co-chair of the Royal College of Physicians Trainees Committee, describes why heroes are almost entirely the wrong comparators for healthcare workers. Producer: Fiona HillClips used in programme: Batman theme by Danny Elfman (composer) from Batman (1989) Copyright Warner Bros. Avengers Theme by Alan Sivestri (composer) from The Avengers copyright Disney Clip from Infinity War , Joe Russo, Anthony Russo (Directors) Copyright Disney Clip from Justice League by Zac Snyder and Joss Whedon (Directors) Copyright Warner Bros Clip from Iron Man by Jon Favreau (director) copyright Disney Clip from Avengers Endgame by Joe Russo, Anthony Russo (directors). Copyright Disney

Claudia Hammond on the longest known stay for a Briton with COVID-19 in intensive care. A month ago Respiratory Physiotherapist Gemma Bartlett at University Hospital Southampton highlighted the case to Inside Health. At that stage the patient was at day 28: now Erika Wright catches up with Gemma again for a good news update on the patient who is at a staggering 58 days on a ventilator and has been speaking for 3 weeks. There are many unknowns about COVID-19 but one aspect that is not disputed is how the virus has laid bare pre-existing health inequalities. It does not effect us all in the same way and those with underlying health conditions such as heart disease, obesity and diabetes are at a higher risk of poorer outcomes if they get the virus. Linda Bauld from Edinburgh University and Chair in Behavioural Research at Cancer Research UK says this is the time to reset the health inequalities clock. And Laura Bartley, who began having severe symptoms of agoraphobia five years ago, explains her experience of lockdown. Plus resident sceptic GP Margaret McCartney explains her concerns about the current Covid-19 testing strategy.

There are a number of complications following infection with Covid-19 that doctors are continuing to find in hospitals. One of the most significant is an acute kidney injury or AKI which can come alongside the disease and NICE has just published rapid guidance to help healthcare staff on the Covid frontline who are not kidney specialists. Inside Health’s Erika Wright has been following staff at Southampton General Hospital during the coronavirus outbreak and meets Kirsty Armstrong, Clinical Lead for Renal Services, to discuss managing kidneys and Covid. Could injecting blood donated from a patient who has recovered from Covid 19 into someone who is ill help the recipient recover too? It’s a potentially viable treatment with a long history, known as convalescent plasma therapy, and trials of this technique against Covid are beginning around the world. We hear from Jeff Henderson, Professor of Medicine at Washington University in St Louis, on progress in the world’s largest trial of this passive immunisation against the virus in the US, and from James Gill, Honorary Clinical Lecturer at Warwick Medical School, who’s been following the latest game-changing refinement of this therapy.Just as the rest of us have been getting better at zoom meetings and remembering to unmute ourselves when we want to speak, so have GPs who are now getting rather good at having online consultations. Will this change the way we “go to the doctor” forever or is there sometimes no substitute for face to face contact? Dr Margaret McCartney gives a GP’s insights.As more people begin to wear face masks what kind of impact does it have on communication when a person’s mouth is covered up and it’s hard to tell whether someone is happy or cross? Claudia discusses this question with George Hu, a clinical psychologist in Shanghai where masks have now become ubiquitous, and Alexander Todorov, Professor of Psychology at Princeton University and author of the book “Face Value : The Irresistible Influence of First Impressions”. Are we more versatile in interpreting a masked person’s mood or intentions than we think?Producer: Adrian Washbourne

Evidence from China, Italy, the USA and now the UK shows categorically that people with diabetes can get seriously ill if they're infected with the new coronavirus. Researchers are trying to untangle the risks for Type 1 and Type 2 but so far, diabetes isn't included in the government's high risk patient group. NHS England's National Specialty Advisor, Professor Partha Kar, tells Claudia Hammond that he believes an individual risk calculator which will enable people to work out their own risk, and so shield themselves accordingly, will be the best way forwards. In the meantime, Dr Kar says, glucose control is essential and people should check their ketone levels as soon as they start to feel unwell. BBC Radio Science Unit producer Beth and her husband Andy (who has Type 1 diabetes) describe to Claudia their experience of Andy getting very ill with Covid-19. They discovered ketone levels appeared at much lower blood glucose levels than normal, something that Dr Kar says appears to be a feature of Covid-19 infection.Erika Wright is back at University Hospital Southampton NHS Foundation Trust. Clinical lead and consultant in critical care, Dr Sanjay Gupta, talks about success giving critically ill patients oxygen using non-invasive ventilation: CPAP - continuous positive airway pressure. He also describes reorganising the hospital's critical care into four sections: patients positive for Covid, negative for Covid, those waiting for test results and those who test negative but are symptoms positive. Nationally, he tells Erika, those who falsely test negative, is between 5-10%.And Inside Health contributor Dr Margaret McCartney delves into the accuracy of antigen swab tests (the test that tells you whether you have the virus or not). False negatives, test results that report the person doesn't have the virus when in fact they do, have serious implications for health care professionals, who might return to work on the basis of a mistaken result. Caution is advised, Dr McCartney advises, when symptoms contradict the test result. A cytokine storm is a variant on a hyperactive immune reaction, where the body thinks its own tissues are invaders. Cytokines are small proteins that trigger more immune activity or less. In a cytokine storm the cytokines rage through the bloodstream, throwing our immune system out of balance and leading to severe illness and even death. This hyper inflammation has been seen in Covid-19 patients and Dr Jessica Manson, consultant rheumatologist at University College London Hospitals and co-chair of the national group of hyper inflammation doctors, tells Claudia what is and isn't known about how to treat cytokine storms in patients with coronavirus.Producer: Fiona Hill

It's well established that the best thing smokers can do for their health is to quit. Smoking contributes to many of the underlying conditions that undermine recovery from coronavirus and it is pretty clear that a coronavirus patient who smokes will likely have a worse outcome than one who doesn't. The FDA in the US recently went so far as to suggest smoking might increase the risk of contracting the virus at all. Nevertheless, existing data coming from various studies of patients around the world appear to show smaller numbers of smokers amongst the hospitalized cases than might be expected from local smoking populations. There are fewer smokers than there should be in the data. But why?As the University of Edinburgh and CRUK's Prof Linda Bauld tells Claudia, there may be several simple reasons for this, such as data gathering - that patients' smoking status is going unrecorded or unverified. But a study last week from France goes so far as to suggest that nicotine itself, know to disrupt some of the receptors viruses use to enter cells, may be conferring some kind of a protection. It is just a hypothesis, but while the dangers of smoking tobacco still stand, studies on Covid-19 patients using nicotine patches might be worthwhile. And if you are trying to quit, nicotine replacement therapy might be an even better idea just now than was thought.Inside Health's resident GP Dr Margaret McCartney talks of her concerns for NHS non-urgent treatments being side-lined under the current virus squeeze, and some of her hopes for the future. Professor Pamela Qualter and Dr Margarita Panayioutou describe why lockdown is an important time to do more psychological research into the effects of loneliness and other responses while we have the chance.And in this week's update from Southampton General, where Inside Science's Erika Wright has been speaking to frontline health workers every week, Mr Robert Wheeler, a surgeon and clinical law expert muses on some of the legal aspects of our coronavirus response.

Every week we’re heading to Southampton General Hospital, where we’ve heard a lot about the doctors and nurses doing amazing work. But this week Erika Wright has been talking to Gemma Blanchett who does a job you might not even associate with the virus or with intensive care – and that’s physiotherapy. Gemma is a respiratory physiotherapist who has the joy of watching some recover with her extraordinary help.Recovery is going to be a long haul for some and can even take time for those who’ve had the virus with mild symptoms at home. So what do we know about how long a complete recovery takes? James Gill GP and Honorary Clinical Lecturer at Warwick Medical School discusses the latest insights.For people who have already found themselves worrying excessively about their health or who have an obsessive compulsive disorder related to hand washing, this is a particularly difficult time. With all of us now on the look-out for symptoms, Claudia Hammond speaks to Jo Daniels, a Senior Lecturer in Clinical Psychology at Bath University who specialises in health anxiety, and David Adam, author of the Man Who Couldn’t Stop – an intimate account of the power of obsessional thoughts.There’s been a lot of discussion about how to get accurate numbers for the people who have died from the virus outside hospital and one issue that’s been raised is whether doctors are wary of putting Covid-19 on a death certificate, when there’s been so little testing in the community. GP Margaret McCartney examines the current dilemmas.Amidst a host of trials to find effective treatments against Covid19, are there existing drugs which no one has thought of yet? We hear from Dr Lindsay Broadbent whose team at Queens University are testing more than a thousand drugs on human lung cells infected with Covid19 in the lab, to see what might work for both mild and more severe infection.Producer Adrian Washbourne

A range of potential treatments have been suggested for Covid-19 but nobody knows if any of them will turn out to be more effective in helping people recover than the usual standard hospital care which all patients will receive. Inside Health regular Dr Margaret McCartney talks to Claudia about how the first randomised trials are now setting out to test some of these suggested treatments with unprecedented speed and adaptability as potential new drug candidates emerge.During lockdown some find their mental health is put at higher risk. Katie Connebear is a mental health campaigner and blogger who was diagnosed with bipolar disorder eight years ago. She has experienced psychotic episodes and has coping strategies in place for when she feels her mental health deteriorating. She offers her thoughts on how to make small progressive steps in the absence of family and friends who she normally relies on when times are difficult.We’ve the latest in Inside Health’s regular visits to test the temperature at Southampton General Hospital. During the current pandemic maternity wards have to make sure that the birth of babies happens in a way that keeps expectant mothers, their birth partners and staff safe from the virus. Government advice includes pregnant women in the “vulnerable group" who need to take extra steps to socially distance, with extra attention after 28 weeks. Consultant obstetrician Jo Mountfield is keen to allay pregnant women’s concerns.And with isolation set to continue, we can also learn from people who have lived in a different kind of lockdown – and one that was in many ways more extreme. Beth Healey is an intensive care doctor currently working in Switzerland who spent 14 months at Concordia research station in the Antarctic, investigating how the team coped with living in such an isolated environment She reveals the similarities in life there and life under lockdown here.Producer Adrian Washbourne

Claudia Hammond reports on Covid-19 and "moral injury" - when the virus peaks, some healthcare staff will find themselves in a situation never faced before, forced to make decisions they would never normally have to make. This puts them at risk of a so-called “moral injury” which might harm their mental health. It’s more often associated with life in the armed services and Neil Greenberg, Professor of Defence Mental Health at Kings College London, explains how he's applying lessons from research in the military to support staff starting work at the new Nightingale Hospital in London. And some of the million recipients of letters saying they should shield themselves by not going out at all for 12 weeks are people who have asthma. Margaret McCartney examines the evidence for how those with asthma receiving letters were selected. Plus the latest dispatch from University Hospital Southampton: consultant Chris Hill explains that the emergency department has been split into Red and Blue areas based on the probability of arrivals having Covid-19. And what’s happening to mental health services during this time of crisis when seeing someone face-to-face needs to be avoided as much as possible? Claudia finds out from psychiatrist Dr Sri Kalidindi. Producer: Erika Wright