COVID-19 resources

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Supporting wellbeing of older people when shielding / isolating

Public Health Wales Observatory

This summary outlines action that the evidence suggests may help to support the mental wellbeing of older adults at this time. It is intended for organisations involved in supporting older people. Four systematic reviews were identified from a search of the literature conducted in June 2019. Most provided data from qualitative research and captured the perceptions of older people on quality of life, meaningful occupations and experience of technology. Reflecting on the findings from these reviews, the analysis suggests a number of actions for consideration by those involved in supporting older people. These actions focus on: maintaining autonomy and control; occupation and social interaction; access to the internet; and money and resources.

Last updated on hub: 16 November 2020

Coronavirus and the social impacts on disabled people in Great Britain: September 2020

The Office for National Statistics

Indicators from the Opinions and Lifestyle Survey on the social impact of the coronavirus (COVID-19) pandemic on disabled people in Great Britain. This release uses two waves of survey results covering 24 September to 4 October 2020 and includes indicators broken down by impairment type. Insights from qualitative research commissioned by the Cabinet Office Disability Unit and conducted by Policy Lab with disabled people help illustrate how the survey indicators can be experienced by disabled people in day-to-day life. The data shows that over 8 in 10 (83%) disabled people compared with around 7 in 10 (71%) non-disabled people said they were “very worried” or “somewhat worried” about the effect that the coronavirus (COVID-19) pandemic was having on their life in September 2020. Around 5 in 10 (50%) disabled people who were receiving medical care before the coronavirus pandemic began, indicated that they were either currently receiving treatment for only some of their conditions (29%), or that their treatment had been cancelled or not started (22%), compared with less than 3 in 10 (27%) of non-disabled people who had a physical or mental health condition or illness and were receiving care before the pandemic. All well-being ratings of disabled people remained poorer in September 2020 compared with a similar period prior to the coronavirus pandemic; almost half (47%) of disabled people reported high anxiety (a score of 6 out of 10 or higher) in September 2020 compared with less than a third (29%) of non-disabled people. A larger proportion of disabled people (83%) than non-disabled people (77%) supported “strict” or “very strict” enforcement by police of government rules aimed at combatting the coronavirus such as social distancing.

Last updated on hub: 16 November 2020

COVID-19: tackling inequalities for UK health and productivity

Northern Health Science Alliance

This report looks at the impact of COVID-19 on the health and economic inequalities between the Northern Powerhouse and the rest of England. It finds that the pandemic hit the North harder and more deeply, arguing that mitigating measures must be put in place to stop inequalities rising further and faster. The report conservatively estimates the economic cost of the increased mortality in the North during the pandemic at £6.86bn and the reductions in mental health in the region due to the pandemic at around £5bn a year. Key findings include: an extra 57.7 more people per 100,000 died in the Northern Powerhouse than the rest of England between March and July and this could cost the UK economy an additional £6.86bn in reduced productivity; mental and financial wellbeing was hardest hit in the Northern Powerhouse, as was loneliness; reductions in mental wellbeing in the Northern Powerhouse could cost the UK economy up to £5 billion in reduced productivity; austerity disproportionately affected the Northern Powerhouse, particularly areas of high deprivation which led to reduced productivity; reductions in the core spending power of local authorities in the Northern Powerhouse by £1 per-head cost £3.17 per-head in lost productivity, equivalent to around a £2bn loss in GDP per-year, or £16bn between 2011 and 2018; pre-pandemic child health, a key predictor of life-long health and economic productivity, was poor and deteriorating in the Northern Powerhouse - since the pandemic, adverse trends in poverty, education, employment and mental health for children and young people have been exacerbated; economic outcomes, particularly unemployment rates, were hardest hit in the Northern Powerhouse.

Last updated on hub: 16 November 2020

COVID 19 deaths of people identified as having learning disabilities: summary

Public Health England

Summarises findings of a review that looked at: deaths from COVID-19 of people with learning disabilities; factors impacting the risk of death from COVID-19 of people with learning disabilities; deaths in care settings of people with learning disabilities. The key finding of this study was that people with learning disabilities had significantly and substantially higher death rates in the first wave of COVID19 in England than the general population. Making no allowance for the younger age and different sex ratio of people with learning disabilities, the rate of deaths notified to LeDeR in this group was 2.3 times the death rate in the general population. If this figure is adjusted to allow for the likely level of under-notification to LeDeR it was 3.5 times the general population rate. After standardisation for age and sex the rate calculated just from notifications to LeDeR was 4.1 times the general population rate. Adjusting for the likely level of under-notification it was 6.3 times the general population rate. The total number of deaths in adults with learning disabilities for the 11 weeks from 21 March to 5 June was 2.2 times the average number for the corresponding period in the 2 previous years. By contrast, the number of deaths in the general population was 1.5 times the average for the 2 previous years. Deaths with COVID-19 in adults with learning disabilities were spread more widely across the age groups than those in the general population. As in the general population, the COVID-19 death rate in people with learning disabilities was higher for men than for women. The overall increase in deaths was also greater in Asian or Asian-British, and Black or Black-British people. Residential care homes providing care for people with learning disabilities do not appear to have had the very high rates of outbreaks of COVID-19 seen in homes providing care for other groups, mainly older people. This appears to be related to their smaller number of beds.

Last updated on hub: 16 November 2020

Ensuring equity for people living with disabilities in the age of COVID-19

Disability and Society

People with disabilities are at higher risk of severe illness from COVID-19. They may also suffer from lack of accessible emergency preparedness plans, communication and healthcare. Protective measures for people with disabilities should be endorsed and prioritized at a community level to adjust for social distancing. Repositories of local resources for emergency outreach in this time are also crucial. Telemedicine offers an innovative and safe way for health providers to care for people with disabilities to access many critical services without placing themselves or their caregivers at increased risk of contracting COVID-19. Communication strategies for critical information about resources for people with disabilities should be accessible. United States hospitals and government agencies should make allocation guideline proposals accessible to people with disabilities and incorporate bias training.

Last updated on hub: 16 November 2020

Can integrated care help in meeting the challenges posed on our health care systems by COVID-19? Some preliminary lessons learned from the European VIGOUR project

International Journal of Integrated Care

The COVID-19 pandemic puts health and care systems under pressure globally. This current paper highlights challenges arising in the care for older and vulnerable populations in this context and reflects upon possible perspectives for different systems making use of nested integrated care approaches adapted during the work of the EU-funded project VIGOUR (“Evidence based Guidance to Scale-up Integrated Care in Europe”, funded by the European Union’s Health Programme 2014–2020 under Grant Agreement Number 826640).

Last updated on hub: 16 November 2020

Dealing with COVID-19 outbreaks in long-term care homes: a protocol for room moving and cohorting

Article published in the journal Infection Control & Hospital Epidemiology by Kain, D. et al, October 2020. A letter to the editor that sets out some principals of room movements in long-term care homes during the COVID-19 in the context of Canadian care homes.

Last updated on hub: 13 November 2020

Evolution and effects of COVID-19 outbreaks in care homes: a population analysis in 189 care homes in one geographical region of the UK

Citation: Burton, J. K. et al. (2020). Evolution and effects of COVID-19 outbreaks in care homes: a population analysis in 189 care homes in one geographical region of the UK. The Lancet Healthy Longevity, 1(1), e21-e31.Background: COVID-19 has affected care home residents internationally, but detailed information on outbreaks is scarce. This study aimed to describe the evolution of outbreaks of COVID-19 in all care homes in one large health region in Scotland. Methods: The researchers did a population analysis of testing, cases, and deaths in care homes in the National Health Service (NHS) Lothian health region of the UK. This study obtained data for COVID-19 testing (PCR testing of nasopharyngeal swabs for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) and deaths (COVID-19-related and non-COVID-19-related), and the researchers analysed data by several variables including type of care home, number of beds, and locality. Outcome measures were timing of outbreaks, number of confirmed cases of COVID-19 in care home residents, care home characteristics associated with the presence of an outbreak, and deaths of residents in both care homes and hospitals. This study calculated excess deaths (both COVID-19-related and non-COVID-19-related), defined as the sum of deaths over and above the historical average in the same period over the past 5 years. Findings: Between March 10 and Aug 2, 2020, residents at 189 care homes (5843 beds) were tested for COVID-19 when symptomatic. A COVID-19 outbreak was confirmed at 69 (37%) care homes, of which 66 (96%) were care homes for older people. The size of care homes for older people was strongly associated with a COVID-19 outbreak (odds ratio per 20-bed increase 3·35, 95% CI 1·99–5·63). 907 confirmed cases of SARS-CoV-2 infection were recorded during the study period, and 432 COVID-19-related deaths. 229 (25%) COVID-19-related cases and 99 (24%) COVID-related deaths occurred in five (3%) of 189 care homes, and 441 (49%) cases and 207 (50%) deaths were in 13 (7%) care homes. 411 (95%) COVID-19-related deaths occurred in the 69 care homes with a confirmed COVID-19 outbreak, 19 (4%) deaths were in hospital, and two (<1%) were in one of the 120 care homes without a confirmed COVID-19 outbreak. At the 69 care homes with a confirmed COVID-19 outbreak, 74 excess non-COVID-19-related deaths were reported, whereas ten non-COVID-19-related excess deaths were observed in the 120 care homes without a confirmed COVID-19 outbreak. 32 fewer non-COVID-19-related deaths than expected were reported among care home residents in hospital. Interpretation: The effect of COVID-19 on care homes has been substantial but concentrated in care homes with known outbreaks. A key implication from the findings is that, if community incidence of COVID-19 increases again, many care home residents will be susceptible. Shielding care home residents from potential sources of SARS-CoV-2 infection, and ensuring rapid action to minimise outbreak size if infection is introduced, will be important for any second wave.

Last updated on hub: 13 November 2020

Caught off guard by covid-19: Now what?

Article published by the journal Geriatric Nursing by Gray-Miceli D. et al, October 2020. Human beings are social in nature and maintaining social interactions, relationships and intimacy are fundamental needs of older adults (OAs) living in assisted living (AL) communities. Yet, these very basic human needs have been impeded by quarantine mandates imposed by the COVID-19 pandemic. The socialization aspect offered in AL, allows for an integration of the whole person: body, mind, and spirit and is beneficial in mitigating the development of co-morbidities and negative patient outcomes. Additionally, the authenticity of home comes from the caring interactions provided by an interprofessional health care staff. Utilizing the 4 M Framework, created by The John A. Hartford Foundation and Institute of Healthcare Improvement, the authors describe simple direct bedside interventions of low cost, and high patient-centered value which front-line nursing and caregiver staff can employ to maintain social connections, interactions, mentation, function and mobility among residents they care for, and care about, in AL communities.

Last updated on hub: 13 November 2020

Maintaining resident social connections during COVID-19: considerations for long-term care

Citation: Ickert, C. et al. Maintaining Resident Social Connections During COVID-19: Considerations for Long-Term Care. Gerontology and Geriatric Medicine, 6. Worldwide, long-term care (LTC) homes have been heavily impacted by the coronavirus disease 2019 (COVID-19) pandemic. The significant risk of COVID-19 to LTC residents has resulted in major public health restrictions placed on LTC visitation. This article describes the important considerations for the facilitation of social connections between LTC residents and their loved ones during the COVID-19 pandemic, based on the experiences of 10 continuing care homes in Alberta, Canada. Important considerations include: technology, physical space, human resource requirements, scheduling and organization, and infection prevention and control. This paper describes some of the challenges encountered when implementing alternative visit approaches such as video and phone visits, window visits and outdoor in-person visits, and share several strategies and approaches to managing this new process within LTC.

Last updated on hub: 13 November 2020