Biodiversity 2020: climate change evaluation report

In 2011, the government published Biodiversity 2020: A strategy for England’s wildlife and ecosystem services [1]. This strategy for England builds on the 2011 Natural Environment White Paper - NEWP [2] and provides a comprehensive picture of how we are implementing our international and EU commitments. It sets out the strategic direction for biodiversity policy between 2011-2020 on land (including rivers and lakes) and at sea, and forms part of the UK’s commitments under the ‘the Aichi targets’ agreed in 2010 under the United Nations Convention of Biological Diversity’s Strategic Plan for Biodiversity 2011-2020 [3]. Defra is committed to evaluating the Biodiversity 2020 strategy and has a public commitment to assess climate change adaptation measures. This document sets out the information on assessing how action under Biodiversity 2020 has helped our wildlife and ecosystems to adapt to climate change. Biodiversity 2020 aims to halt the loss of biodiversity and restore functioning ecosystems for wildlife and for people. The outcomes and actions in Biodiversity 2020, although wider in scope, aimed to increase resilience of our wildlife and ecosystems in the face of a changing climate. In order to inform the assessment, we have defined which of the measurable outputs under Biodiversity 2020 contribute to resilience. Biodiversity 2020 included plans to develop and publish a dedicated set of indicators to assess progress towards the delivery of the strategy. The latest list (at the time of writing), published in 2017, contains 24 biodiversity indicators [4] that would help inform progress towards achieving specific outcomes, they are also highly relevant to the outputs (detailed below) that form the basis for this evaluation. The Adaptation Sub-Committee’s 2017 UK Climate Change Risk Assessment Evidence Report [5] sets out the priority climate change risks and opportunities for the UK. The ASC also produced a review of progress in the National Adaptation Programme - “Progress in preparing for climate change” [6], which highlights adaptation priorities and progress being made towards achieving them. The UK Government’s response to the ASC [7] review includes a set of recommendations, of which Recommendation 6 states that “Action should be taken to enhance the condition of priority habitats and the abundance and range of priority species”. The recommendation further iterated that “This action should maintain or extend the level of ambition that was included in Biodiversity 2020” and that “An evaluation should be undertaken of Biodiversity 2020 including the extent to which goals have been met and of the implications for resilience to climate change.” To this, end an evaluation process has been put in place to define: a. What worked and why? Which actions or activities have had the greatest benefit in terms of delivering the desired outcomes? And, conversely, what prevented progress? b. Where are the opportunities? What are the financial, political, scientific and social opportunities for furthering the desired outcomes in the future? These objectives underpin the evaluation process for actions to date, and will also inform future actions and the iteration of a new nature strategy for England

Resolving issues with environmental impact assessment of marine renewable energy installations

Growing concerns about climate change and energy security have fueled a rapid increase in the development of marine renewable energy installations (MREIs). The potential ecological consequences of increased use of these devices emphasizes the need for high quality environmental impact assessment (EIA). We demonstrate that these processes are hampered severely, primarily because ambiguities in the legislation and lack of clear implementation guidance are such that they do not ensure robust assessment of the significance of impacts and cumulative effects. We highlight why the regulatory framework leads to conceptual ambiguities and propose changes which, for the most part, do not require major adjustments to standard practice. We emphasize the importance of determining the degree of confidence in impacts to permit the likelihood as well as magnitude of impacts to be quantified and propose ways in which assessment of population-level impacts could be incorporated into the EIA process. Overall, however, we argue that, instead of trying to ascertain which particular developments are responsible for tipping an already heavily degraded marine environment into an undesirable state, emphasis should be placed on better strategic assessment.Publisher PDFPeer reviewe

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

Abstract Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).</jats:p

Implementation of corticosteroids in treating COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK:prospective observational cohort study

BACKGROUND: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. METHODS: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. FINDINGS: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. INTERPRETATION: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. FUNDING: UK National Institute for Health Research and UK Medical Research Council