What does COVID-19 mean for hepatitis C elimination plans in London? Dee Cunniffe gives an update.
Two months ago, on 2 March, senior leaders from across the NHS, addictions sector and public health in London came together at City Hall to kick start work on a new routemap to eliminate hepatitis C in the capital. The World Hepatitis Alliance hailed the partnership as ‘an example of best practice that could be replicated in cities across the world’ and support for this initiative from every connected sector in London has been impressive.
However, just days after our ‘kick start’ event, the enormity of the impact of COVID-19 started to unfold. That seems like a lifetime ago now, and since then the NHS has completely reconfigured to create capacity for coronavirus patients, and all outreach and addictions support services have had to adapt to supporting people remotely.
So, where does that leave our plans for eliminating hepatitis C? While people who had started treatment are being supported to complete it and become hepatitis C free, outreach testing and treatment initiations have paused in most places, and some hepatologists have been redeployed to COVID wards.
We know this is not forever and Matt Hancock has already started talking about the restoration of other NHS services. This will require substantial service reconfiguration in many places and will take several weeks, maybe months for some areas.
Creativity and fresh thinking will be required to ensure that healthcare challenges, such as finding the undiagnosed people who are living with hepatitis C, are not worsened in the long term due to this crisis. For example, we will need to think more creatively about how we raise awareness and provide information and support online, and whether self-testing could be used, as it has for HIV.
The steering group for the routemap brings together senior representatives from Public Health England, local government, NHS England, addictions service providers, homeless services, CCGs and The Hepatitis C Trust. While many of these people and their organisations are completely focused on combatting COVID-19 at the moment, they are all also deeply committed to the goal of eliminating hepatitis C. No one wants progress made in addressing hepatitis C to be another victim of COVID-19.
There is one thing that has been constant in my experience of working in the hepatitis C field for the last ten years: progress has always been built on the passion and dedication of an army of incredible people, from people with experience of living with hepatitis C to nurses, consultants, addictions support workers, and many more. I know that we will all rise to the new challenges and, as a ‘new normal’ develops, ensure we continue to make progress to our goal of eliminating hepatitis C.
Key Areas for Action
Five Key Areas for Action
The routemap to eliminating hepatitis C in London has five key areas for action – raising awareness, engaging with people who are under-served by traditional health systems, working with GPs to find the undiagnosed, making pathways as quick and easy as possible, and aligning hepatitis C and HIV Fast Track Cities Initiatives.