Did England’s national home oxygen monitoring programme for COVID-19 work? Yes… and no

• Published in: Emergency medicine journal : EMJ Vol. 40; no. 6; pp. 394 - 395
• Main Author: Weber, Ellen J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine 01.06.2023; BMJ Publishing Group LTD
• Subjects: admission avoidance; Coronaviruses; COVID-19; Editorial; Emergency medical care; England; epidemiologic research design; Health services utilization; Hospitalization; Humans; Mortality; Observational studies; Oxygen; Pandemics; Patients; planning; Pulse oximetry; England; San Francisco California; United Kingdom > UK; United States > US; COVID-19; planning; admission avoidance; research; epidemiologic research design
• ISSN: 1472-0205; 1472-0213; 1472-0213
• DOI: 10.1136/emermed-2023-213195

Correspondence to Dr Ellen J Weber, Emergency Medicine, University of California San Francisco, San Francisco, CA 92521, USA; ellen.weber@ucsf.edu The article by Beaney and colleagues just published in the EMJ evaluates the outcomes from a national programme of home oxygen monitoring instituted by NHS England during the first waves of the COVID-19 pandemic.1 This may sound familiar; we ran a paper by this same author group on this subject in our August 2022 issue.2 At first glance, you might think we accidentally reran the same paper. Spoiler alert: in the treatment/non-treatment study published in this issue, deaths were 52% lower in those enrolled (95% CI 7% to 75%) compared with those not enrolled, while the odds of any ED attendance were higher at 37% (95% CI 16% to 63%) in the enrolled group, as were the odds for admission at 59% (95% CI 32% to 91%).1 However, we know from the population-based paper that the O2 monitoring programme only enrolled 2.5% of the eligible cohort.2 In the previously published population-based study, the authors found no association between mortality rates from COVID during the period that the monitoring programme was in effect, and there was a small increase in healthcare utilisation.2 It is not surprising that, with such a small proportion of eligible patients enrolled, an overall impact was not seen. While the programme may benefit the individuals who take part, if it cannot be deployed on a wide-scale basis, perhaps we should try another path. [...]it is worth the effort to acknowledge what happened with the O2 monitoring programme, and, going further, perform exploratory, qualitative work with physicians and patients to determine why so few individuals were offered—or enrolled—in the programme.