COVID-19 resources

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Using a rapid assessment methodology to identify and address immediate needs among low-income households with children during COVID-19

PLoS ONE

Objective: Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and families. Due to COVID-19-related school closures, states were under “shelter in place” orders, and Brighter Bites administered a rapid assessment survey to identify social needs among their families. The purpose of this study is to demonstrate the methodology used to identify those with greatest social needs during this time (“high risk”), and to describe the response of Brighter Bites to these “high risk” families. Methods: The rapid assessment survey was collected in April 2020 across Houston, Dallas, Washington DC, and Southwest Florida. The survey consisted of items on disruption of employment status, financial hardship, food insecurity, perceived health status and sociodemographics. The open-ended question “Please share your greatest concern at this time, or any other thoughts you would like to share with us.” was asked at the end of each survey to triage “high risk” families. Responses were then used to articulate a response to meet the needs of these high risk families. Results: A total of 1048 families completed the COVID-19 rapid response survey, of which 71 families were triaged and classified as “high risk” (6.8% of survey respondents). During this time, 100% of the “high risk” participants reported being food insecure, 85% were concerned about their financial stability, 82% concerned about the availability of food, and 65% concerned about the affordability of food. A qualitative analysis of the high-risk group revealed four major themes: fear of contracting COVID19, disruption of employment status, financial hardship, and exacerbated food insecurity. In response, Brighter Bites pivoted, created, and deployed a framework to immediately address a variety of social needs among those in the “high risk” category. Administering a rapid response survey to identify the immediate needs of their families can help social service providers tailor their services to meet the needs of the most vulnerable.

Last updated on hub: 07 December 2020

Nursing home design and COVID-19: balancing infection control, quality of life, and resilience

Journal of the American Medical Directors Association

Many nursing home design models can have a negative impact on older people and these flaws have been compounded by Coronavirus Disease 2019 and related infection control failures. This article proposes that there is now an urgent need to examine these architectural design models and provide alternative and holistic models that balance infection control and quality of life at multiple spatial scales in existing and proposed settings. Moreover, this article argues that there is a convergence on many fronts between these issues and that certain design models and approaches that improve quality of life, will also benefit infection control, support greater resilience, and in turn improve overall pandemic preparedness.

Last updated on hub: 07 December 2020

The impact of COVID-19 measures on well-being of older long-term care facility residents in the Netherlands

Journal of the American Medical Directors Association

The fear of the new Coronavirus Disease 2019 (COVID-19) globally forced health authorities to take drastic actions to prevent spreading of infections among citizens. Long-term care facility (LTCF) residents are especially susceptible for fatal or severe outcomes of COVID-19 infection because of high prevalence of frailty and comorbidity, sometimes atypical COVID-19 symptoms, and circumstances such as insufficient personal protective equipment and testing capacity, and staff working while having mild symptoms.1,2 On March 20, 2020, the Dutch government implemented a visitor ban in all LTCFs. In many instances physical visits were replaced by social contact via telephone and video calls, or through windows. Many LTCFs closed social facilities and stopped daytime programs. Although the LTCF's policy prioritized safety, scarce attention was paid to well-being and autonomy. The study aims to gain insight into the consequences of COVID-19 measures on loneliness, mood, and behavioural problems in residents in Dutch LTCFs.

Last updated on hub: 07 December 2020

The COVID-19 pandemic: a pandemic of lockdown loneliness and the role of digital technology

Journal of Medical Internet Research

The focus of this perspective is on lockdown loneliness, which this study defines as loneliness resulting from social disconnection as a result of enforced social distancing and lockdowns during the COVID-19 pandemic. This study also explores the role of digital technology in tackling lockdown loneliness amid the pandemic. In this regard, this study highlights and discusses a number of the key relevant issues: a description of lockdown loneliness, the burden of lockdown loneliness during the COVID-19 pandemic, characteristics of people who are more likely to be affected by lockdown loneliness, factors that could increase the risk of loneliness, lockdown loneliness as an important public health issue, tackling loneliness during the pandemic, digital technology tools for social connection and networking during the pandemic, assessment of digital technology tools from the end users’ perspectives, and access to and use of digital technology for tackling lockdown loneliness during the COVID-19 pandemic. This study suggests that the most disadvantaged and vulnerable people who are more prone to lockdown loneliness are provided with access to digital technology so that they can connect socially with their loved ones and others; this could reduce loneliness resulting from social distancing and lockdowns during the COVID-19 crisis. Nonetheless, some key issues such as access to and knowledge of digital technology tools must be considered. In addition, the involvement of all key stakeholders (family and friends, social care providers, and clinicians and health allied professionals) should be ensured.

Last updated on hub: 07 December 2020

Effect of COVID-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK

BMJ Open

Objectives To determine any change in referral patterns and outcomes in children (0–18) referred for child protection medical examination (CPME) during the COVID-19 pandemic compared with previous years. Design Retrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown. Setting Birmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288 000 children. Participants Children aged under 18 years attending CPME during an 18-week period from late February to late June during the years 2018–2020. Main outcome measures Numbers of referrals, source of disclosure and outcomes from CPME. Results There were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95% CI 12.4% to 59.0%) reduction in referrals from 2018 to 2020, and a 37.3% (95% CI 8.6% to 57.4%) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12 (26%) compared with 36 (47%) and 38 (52%) in 2018 and 2019, respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns. Conclusions School closure due to COVID-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully reopen as children disclose the abuse they have experienced at home.

Last updated on hub: 07 December 2020

Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI, 2 December 2020

Department of Health and Social Care

This advice is provided to facilitate the development of policy on COVID-19 vaccination in the UK. The Joint Committee on Vaccination and Immunisation (JCVI) advises that the first priorities for any COVID-19 vaccination programme should be the prevention of COVID-19 mortality and the protection of health and social care staff and systems. As the risk of mortality from COVID-19 increases with age, prioritisation is primarily based on age. Secondary priorities could include vaccination of those at increased risk of hospitalisation and at increased risk of exposure, and to maintain resilience in essential public services. This document sets out a framework for refining future advice on a national COVID-19 vaccination strategy.

Last updated on hub: 07 December 2020

Annex A: COVID-19 vaccine and health inequalities: considerations for prioritisation and implementation

Department of Health and Social Care

The purpose of this paper is to consider the impact on and implications for health inequalities in the prioritisation of COVID-19 vaccines when they are introduced in the context of initial supply constraints. This paper expands on the considerations informing the Joint Committee on Vaccination and Immunisation (JCVI) interim advice on priority groups for COVID-19 vaccine, which is intended to support the government in planning the vaccine programme, and it offers further considerations for its implementation. The conceptual framework adopted is one based on consideration of scientific evidence, ethics and deliverability, with a focus on the ethical principles of maximising benefit and minimising harm, promoting transparency and fairness, and mitigating inequalities in health. While age has the absolute highest risk of poor COVID-19 outcomes, many factors are associated with an increased relative risk (such as belonging to a BAME group and being male). These are mediated by a complex web of factors which are not straightforward to disentangle and can be potentially misleading, and if misinterpreted when translated to policy, can be damaging to populations and widen health inequalities. al conditions, and health and social care worker status (thus providing NHS resilience). While prioritisation alone cannot address all inequalities in health that are rooted in social determinants, planning and implementation should as a minimum not worsen health inequalities, and present a unique opportunity to mitigate them.

Last updated on hub: 07 December 2020

One size does not fit all: moving towards delivering culturally competent services

Healthwatch Enfield

Findings of a survey to understand the impact of Coronavirus on local Black, Asian and Minority Ethnic communities across Enfield. A key lesson from this report is that specific community groups used different services in different ways and as a result had different views about the support they need. It is also clear that the existing methods of cascade with a strong reliance on online communication do not work for everybody in BAME groups. A common issue is the lack of trust in the system, based on people’s previous experiences of giving feedback, only to see no action resulting from their efforts. The report finds that: 54% of respondents said that they have not received the help and support they need; a significant proportion of respondents prefer to access information through television or radio in their own language; 1 in 10 people said that accessing services online had stopped them from getting the help they need; 40% said that English is not their first language; 30% said that they need a translator to communicate during health appointments, so using a telephone to do this was a problem for them; 53% of people reported that they would not be having the flu vaccine this year, and their comments provides clear reasons for this decision. The report makes six recommendations to ensure that individuals from BAME communities in Enfield are able to access the care and support they need in the future, including developing and investing in culturally competent research which is informed by communities and address areas of concern to them.

Last updated on hub: 07 December 2020

Rural Wisdom evaluation: the value of connection

National Development Team for Inclusion

This short report shares the experiences and reflections of the Volunteering Matters Cymru team leading the Rural Wisdom project in Wales on the impact the COVID-19 pandemic has had upon their work. Rural Wisdom is a five-year National Lottery funded project exploring the impact of community-based activities that are led by older people living in rural areas in Scotland and Wales. In sharing these reflections, the report aims to provide others living and working in rural areas to apply and benefit from what works, in fast-paced and challenging times. For older people, the impact of the coronavirus pandemic has been incredibly detrimental. The issues identified, around loneliness, isolation and vulnerability, have been exacerbated by the measures to shield and isolate from family, friends and the wider community over a prolonged period of time. Building and maintaining connections with people, even remotely, has never been so important. Despite restrictions older people are still willing and able to contribute to their communities. Development Workers are working with people over the age of 70 who still volunteer but have adapted what they do based on their circumstances and restrictions, for example being a telephone befriender. Through engagement events, local community councils and steering groups, older people are still having a voice and influencing change; the difference is that they now meet online. Where groups or events have been sustained and taken on by the community the pandemic has only put a pause on their activity, although it is hard to tell how long for. However, other activities such as the school lunch club that had not been running long enough for it to be embedded or sustained, may need support to get re-started.

Last updated on hub: 07 December 2020

COVID-19 and the wellbeing of the adult social care workforce: evidence from the UK

Personal Social Services Research Unit

The coronavirus pandemic has badly hit the social care sector in Britain. The impact on the health of care recipients, and the operation of care settings has been well documented. However, the experience of the social care workforce has been less fully explored. This report presents and discusses the findings from a ‘pulse’ survey of care workers undertaken in July/August 2020. We show that many care workers experienced increased workloads, reduced feelings of safety at work, and increased levels of stress, some of which significantly differed by care setting. However, many remained committed to the sector, despite the challenges. The results highlight the need for the development of tailored practical strategies and guidance to support care workers' wellbeing at work. An adequate level of supply of relevant equipment and testing along with relevant training remain crucial for both the workforce and service quality. While the COVID-19 pandemic has exacerbated the effect of long-standing cracks in the social care sector, an urgent response is required to maintain the ability of the sector and its workforce to meet the escalating demands for social care.

Last updated on hub: 07 December 2020