Published:
00:25 GMT, 1 December 2015
| Updated:
00:31 GMT, 1 December 2015
Organs will be transplanted from the dead without consent for the first time in Britain from today.
A landmark law change in Wales gives doctors the right to assume that all adults consent to be organ donors after their death.
The
new system means that adults have to ‘opt out’ from the register if
they do not want to be donors - a dramatic change from the current ‘opt
in’ system.
If they have not opted out, they will be treated as if they had given their approval, a principle known as ‘deemed consent’.
A landmark law change in Wales means
that doctors have the right to assume that all adults consent to be
organ donors after their deaths, and people will have to opt out of the
register (file image)
Officials in England are carefully monitoring whether the new system is successful.
Some religious groups have criticised the move, but health officials argue that it will save hundreds of lives.
The Welsh Government predicts the new law could increase the number of organ donors by as much as a quarter.
Under
the new system, relatives will still have the right to object to a
family member’s organs being removed - but if they cannot be contacted a
transplant will go ahead.
Share
According to the latest figures, 1,000 people in the UK die every year while waiting for a transplant.
Organ transplants dropped in number last year for the first time in a decade, NHS figures show.
The number of transplants fell from 4,655 in 2013/14 to 4,431 in 2014/15.
The 5 per cent decrease is the first drop in 11 years, meaning that 224 fewer people received an organ transplant.
The British Heart Foundation last night called for England to follow the Welsh lead.
Simon
Gillespie, chief executive at the charity, said organ donation rates in
the UK are 40 per cent lower than in other countries in Europe, such as
Spain and Croatia, that already use the opt-out system.
According to the latest figures, 1,000 people in the UK die every year while waiting for a transplant (file image)
‘Sadly
hundreds of people die every year waiting for a transplant because
there is a desperate shortage of organ donors,’ he said.
‘Other European countries that already use an opt-out system have much higher donor rates than the UK.
‘We campaigned strongly in Wales to introduce soft opt-out and now it’s time for the rest of the UK to follow their lead.’
Wales’
health minister Mark Drakeford said: ‘The change to a soft opt-out
system for organ donation will deliver a revolution in consent.
‘Organ
donation saves lives; increasing the rate of organ donation allows us
to save more lives. That’s the key motivation for this significant
change.’
Under
the new system, those over 18 will become potential donors either by
registering their decision to opt in - as they do currently - or by
doing nothing at all.
It will apply to adults who have lived in the country for more than 12 months.
Organs
available will be the same as the ‘opt-in’ method - including kidneys,
heart, liver, lungs and pancreas - and would go anywhere in the UK.
Some 8 per cent of eligible adults in Wales have decided to opt out ahead of the new law today.
Ahead
of the new law coming into effect leading Welsh Christian, Jewish and
Muslim clerics signed an open letter expressing their unease about the
plan.
‘We remain opposed to any weakening of the principle the donation of organs should be free and voluntary,’ they said.
The Archbishop of Wales, Dr Barry Morgan, has warned that the scheme could turn ‘volunteers into conscripts’.
But
in an open letter published today, Church of Wales bishops called on
people to make a positive decision one way or the other.
It said: ‘As Bishops we are wholeheartedly in favour of organ donation.
‘It
is love in action and a wonderful example of what it can mean to love
our neighbours, especially those in need. Such generosity is a response
to God’s generosity towards us.
‘We
urge and encourage you to sign the Organ Donor Register, and tell your
families, so that there can be no doubt about your wishes in the event
of your death.’
A
spokesman for the Department of Health said England had no plans to
follow the lead set by Wales - but admitted officials would be watching
closely.
He
said: ‘Our opt-in system is working well. In 2008 independent experts
advised against an opt-out system and recommended more specialist
nurses, clinical leads and donation committees. This has seen organ
donation rates increase by 60 per cent.
‘We
are watching how the change in Wales impacts on donations and continue
to work hard to build on the significant increase in organ donations
achieved in recent years.’
A
sexually transmitted diseases epidemic is sweeping the US, with cases on
the rise as chlamydia infections reaches 'record levels', experts have
warned.
Cases
of chlamydia, gonorrhea and syphilis have all increased for the first
time since 2006, according to the Centers for Disease Control and
Prevention (CDC).
Chlamydia
cases had dipped in 2013, but last year's total of more than 1.4
million — or 456 cases per 100,000 — was the highest number of annual
cases of any condition ever reported to the CDC.
The chlamydia rate was up almost three per cent from 2013, new figures revealed.
'America's
worsening STD epidemic is a clear call for better diagnosis, treatment,
and prevention,' said the CDC's Dr Jonathan Mermin.
Scroll down for videos
+6
A sexually transmitted diseases
epidemic is sweeping the US, with rising rates of chlamydia, gonorrhea
and syphilis. The map shows the rate of cases of chlamydia in each state
in 2014, per 100,000 of the population, with Alabama, Mississippi,
Louisiana and Alaska among those with the highest number of cases
+6
Chlamydia cases reached their highest
ever levels recorded, for both men and women in 2014, with 1.4 million
cases in total across the US
Experts
have pointed the finger at dating apps, including Tinder, Happn and
Grindr, warning they could trigger an 'explosion' in rates of sexually
transmitted diseases.
In
May this year, The Rhode Island Department of Health revealed from 2013
to 2014, cases of syphilis rose by 79 per cent, gonorrhea by 30 per
cent and HIV by almost 33 per cent.
And
in September this year, The AIDS Healthcare Foundation launched a new
billboard campaign in Los Angeles, drawing users' attention to the risk
of catching chlamydia and gonorrhea during casual sex among young
adults.
The charity said a rise in STDs corresponds with the growing popularity of dating or 'hookup' mobile phone apps.
Whitney
Engeran-Cordova, senior director, Public Health Division for AHF: said:
'Mobile dating apps are rapidly altering the sexual landscape by making
casual sex as easily available as ordering a pizza.'
However, a CDC spokesman told Daily Mail Online: 'There is no single answer to explain why STDs are increasing this year.
These are complex diseases that can be impacted by a number of factors.'
He
said increased STD screening, including more extragenital screening,
may be increasing detection of chlamydia and gonorrhea infections,
especially in men.
The spokesman added: 'We don't have any evidence showing a link between STDs and dating apps.
'Having
anonymous partners though, can make it difficult to offer partner
services, like expediated partner therapy, or conduct contact tracing
for syphilis to interrupt the cycle of transmission.'
The
CDC report revealed gonorrhea cases totaled 350,062, up five per cent
from 2013, and the most contagious forms of syphilis jumped 15 per cent
to 20,000 cases.
As in previous years, the increase in syphilis was largely among gay and bisexual men.
Syphilis among these groups has been increasing since at least 2000.
In
2014, rates of syphilis increased among men who have sex with men, who
account for 83 per cent of reported cases among men when the sex of the
partner is known.
Also
concerning is that more than half of men who have sex with men (51 per
cent) diagnosed with syphilis in 2014 were also HIV-positive.
Infection with syphilis can cause sores on the genitals, which make it easier to transmit and acquire HIV.
+6
The CDC report revealed gonorrhea
cases totaled 350,062, up five per cent from 2013, and the most
contagious forms of syphilis jumped 15 per cent to 20,000 cases. The map
reveals the rate of gonorrhea per 100,000 of the population in each
state, revealing Louisiana and Mississippi had the highest rates of the
STD
+6
The majority of gonorrhea (pictured
under the microscope) cases were in young people, aged 15 to 24. The
infection can cause infertility in women, but can be treated with
antibiotics, the CDC said
Most gonorrhea and chlamydia infections were in 15- to 24-year-olds, an ongoing trend.
Both can cause infertility in women but can be treated with antibiotics.
They
often have no symptoms, and while yearly screening is recommended for
sexually active women younger than 25, many don't get tested and
infections go untreated, the CDC said.
America's worsening STD epidemic is a clear call for better diagnosis, treatment, and prevention
Dr Jonathan Mermin, CDC
Dr
Mermin said: 'STDs affect people in all walks of life, particularly
young women and men, but these data suggest an increasing burden among
gay and bisexual men.'
The 2014 data also reveals young people are still at the highest risk of acquiring an STD, especially chlamydia and gonorrhea.
Despite
being a relatively small portion of the sexually active population,
young people between the ages of 15 and 24 accounted for the highest
rates of chlamydia and gonorrhea in 2014 and almost two thirds of all
reported cases.
Additionally,
previous estimates suggest that young people in this age group acquire
half of the estimated 20 million new STDs diagnosed each year.
Despite
recommendations from the CDC and the United States Preventive Services
Task Force (USPSTF) for annual chlamydia and gonorrhea screening for
sexually active women younger than 25, experts believe far too many
young people are not tested, and therefore do not know they are
infected.
Gail
Bolan, director of the CDC's division of STD prevention, said: 'The
consequences of STDs are especially severe for young people.
+6
The most contagious forms of syphilis
jumped 15 per cent to 20,000 cases. The map reveals the rates of cases
of syphilis by state, with Washington DC, Louisiana, Georgia and Nevada
reporting the most cases
+6
The CDC said gay, bisexual and other
men who have sex with men, are at greatest risk of contracting syphilis.
The graph reveals how, since 2007, while the rates of syphilis among
women and men who have sex with women, have remained relatively low,
rates for men who have sex with men, the red line, have soared
'Because
chlamydia and gonorrhea often have no symptoms, many infections go
undiagnosed and this can lead to lifelong repercussions for a woman's
reproductive health, including pelvic inflammatory disease and
infertility.'
Preventing STDs in young people is a key priority, the CDC said.
Among
their efforts, the CDC encourage the use of expediated partner therapy,
where the sexual partners of anyone diagnosed with chlamydia or
gonorrhea are offered treatment without medical exam, where legally
permissible.
However, the CDC said key to reducing STDs is Americans taking steps to protect themselves.
Sexually active individuals are encouraged to undergo regular testing and treatment where necessary.
The
CDC also advises 'using condoms consistently and correctly, and
limiting the number of sex partners' as effective strategies for
reducing the risk of infection.
Sexually
transmitted diseases are among more than 70 diseases that are
reportable to the CDC, including measles, chickenpox and tuberculosis.
Flu is reported differently, by hospitalizations.
The Chair of St George’s NHS Trust warns that the NHS needs at least
£4bn more a year between now and 2020 to avoid disaster, according to a
Guardian article.
Christopher Smallwood, Chairman of St George's
University Hospitals NHS Foundation Trust in London, has described ‘an
accelerating financial disaster’ for hospitals, stating that ‘hardened
professionals who have worked in the service for decades have never seen
anything like it.’
Writing for the Guardian, he said: ‘Two years
ago a quarter of hospitals recorded deficits. Last year, this rose to
half. This year, three–quarters of hospitals are running deficits, some
of them extremely large – and 90%...expect to be in deficit by the end
of the year.’
Mr Smallwood also warns of eroding standards of
care, writing: ‘Waiting times for cancer treatment, and in A&E
departments, are now missed routinely, as is the minimum wait for
diagnostic tests. And the waiting target for elective procedures has
been abandoned.’ He added: ‘Missed targets trigger fines of many
millions of pounds, intensifying financial pressures. The queues will go
on lengthening.’
Claiming that ‘Ministers are in denial about
what is happening’, Mr Smallwood continued: ‘The past five years have
seen the smallest increase in health spending over any parliament since
the second world war – 0.8% a year. This compares with an annual
increase in demand and cost pressures of between 4% and 5%.’
Mr
Smallwood concluded that ‘Those drawing up the autumn statement need to
be aware of these realities,’ explaining: ‘Even if the efficiency gains
achieved in the next five years matched those of the past five, the
government would need to increase annual budgets by £2bn-£3bn a year
between now and 2020 to preserve standards. But since the NHS cannot
continue to raise productivity at this rate, at least £4bn a year extra
will be necessary, starting in April.
Cleaning up: Korean workers disinfecting a subway trainBill Gates says there could be one benefit from the Ebola epidemic
that has killed more than 11,000 people in west Africa since 2014. “It
may serve as a wake-up call,” says the Microsoft founder. “We must
prepare for future epidemics of diseases that may spread more
effectively than Ebola.”
His charitable foundation, the Bill & Melinda Gates Foundation,
has been at the heart of the global fight against slower-burning health
scourges such as HIV and malaria. However, few things worry him as much
as the risk of a sudden global infectious disease outbreak.
“There is a significant chance that an epidemic of a substantially
more infectious disease [than Ebola] will occur sometime in the next 20
years,” he wrote in a paper in the New England Journal of Medicine
earlier this year. “Of all the things that could kill more than 10m
people around the world, the most likely is an epidemic stemming from
either natural causes or bioterrorism.”
His paper went on to set out proposals for a “global warning and
response system” for pandemics and warned that Ebola had exposed glaring
deficiencies in preparedness. His recommendations were aimed primarily
at policymakers. But his broader point on the need for readiness should
also resonate in boardrooms and human resources departments across the
corporate sector.
In the event of a pandemic,
private sector employers would be on the front line of the battle to
contain its spread and their businesses would be highly exposed to
disruption.
The economic case for preparedness is clear. According to the World
Bank, a severe pandemic could reduce global wealth by $4tn, or 5 per
cent of gross domestic product. But the importance of ensuring business
continuity goes beyond the need to minimise lost revenues. It would also
be crucial to broader efforts to keep the economy and society
functioning.
Some 85 per cent of critical US infrastructure resides in the private sector, according to the Department for Homeland Security.
The danger of business paralysis during a pandemic became clear at
the height of the Ebola outbreak when some iron ore mines — an important
part of the west African economy — ceased production, and farming and
trade were disrupted.
Mr Gates warns that future pandemics could spread much more quickly
and widely than Ebola. “Other disease agents — measles and influenza,
for example — are far more infectious because they can be spread through
the air, rather than requiring direct contact,” he says. “People may
not even be aware that they are infected or infectious. Since a person
carrying one of these pathogens can infect many strangers in a
marketplace or on an airplane, the number of cases can escalate very
quickly.”
Public awareness of the risk has increased in recent years. Between
1997 and 2009, six major outbreaks of highly fatal zoonoses —
animal-borne diseases that can be transmitted to humans, such as Ebola,
Sars, avian and H1N1 flu — caused an estimated $80bn in economic losses,
according to the World Bank.
A clear plan should be in place before an epidemic erupts — and exercises carried out to test it for flaws
Yet
none of these was anywhere close in scale to the 1918 Spanish flu
pandemic, which infected 500m people and killed between 50m and 100m, or
3-5 per cent of the world’s population. Today, according to the World
Bank, a similarly infectious and deadly virus would kill 33m people in
250 days.
So what measures should companies have in place to protect their businesses and employees? Recommendations issued by the US Centers for Disease Control and Prevention during the 2009 H1N1 swine flu outbreak provide some pointers.
To begin with, businesses should start with a good understanding of
their normal seasonal absenteeism. Every winter, nearly 111m workdays in
the US are lost due to flu, according to the CDC. Identifying when the
usual level of infection and illness becomes something more unusual is
an important first step.
Much of the CDC’s advice involves commonsense measures little
different to best practice during the regular flu season. Sick employees
must stay at home, with plentiful supplies of soap, water and hand rubs
provided in the workplace to promote good hygiene.
Other recommendations are more specific to a severe pandemic. These
include “social distancing” strategies, such as banning non-essential
travel and meetings, increasing physical space between employees in the
workplace and allowing people to work from home. IT systems should be
checked to make sure they are robust enough to support large numbers of
remote users.
Screening of employees when they arrive for work should also be considered and people with symptoms of flu sent back home.
Close communication with employees, business partners and local
authorities would be crucial. A clear plan should be in place before an
epidemic erupts and exercises carried out to test it for flaws.
Mr Gates says the world’s readiness for an epidemic compares
unfavourably with its preparedness for other strategic threats such as
war. “NATO countries participate in joint exercises in which they work
out logistics such as how fuel and food will be provided, what language
they will speak and what radio frequencies will be used. Few, if any,
such measures are in place for response to an epidemic.”
The absence of this kind of planning caused delays in the world’s
response to Ebola, says Mr Gates. “In the next epidemic, such delays
could result in a global disaster.”
