COVID-19 resources

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Risk factors associated with SARS-CoV-2 infection and outbreaks in long term care facilities in England: a national survey

medRxiv

This article is a preprint and has not been peer-reviewed. This study aimed to identify risk factors for SARS-CoV-2 infection and outbreaks in Long Term Care Facilities (LTCFs). It was a cross-sectional survey of all LTCFs providing dementia care or care to adults >65 years in England with linkage to SARS-CoV-2 test results. Findings: 5126/9081 (56%) LTCFs participated in the survey, with 160,033 residents and 248,594 staff. The weighted period prevalence of infection in residents and staff respectively was 10.5% (95% CI: 9.9-11.1%) and 3.8% (95%: 3.4-4.2%) and 2724 LTCFs (53.1%) had ≥1 infection. Odds of infection and/or outbreaks were reduced in LTCFs that paid sickness pay, cohorted staff, did not employ agency staff and had higher staff to resident ratios. Higher odds of infection and outbreaks were identified in facilities with more admissions, lower cleaning frequency, poor compliance with isolation and “for profit” status. Interpretation: Half of LTCFs had no cases suggesting they remain vulnerable to outbreaks. Reducing transmission from staff requires adequate sick pay, minimal use of temporary staff, improved staffing ratios and staff cohorting. Transmission from residents is associated with the number of admissions to the facility and poor compliance with isolation.

Last updated on hub: 13 November 2020

Contact tracing: an opportunity for social work to lead

Citation: Ross A. M. et al. (2020). Contact Tracing: An Opportunity for Social Work to Lead. Social work in public health, 35(7), 533-545. Since the novel coronavirus disease (COVID-19) first emerged in December 2019, there have been unprecedented efforts worldwide to contain and mitigate the rapid spread of the virus through evidence-based public health measures. As a component of pandemic response in the United States, efforts to develop, launch, and scale-up contact tracing initiatives are rapidly expanding, yet the presence of social work is noticeably absent. This paper identifies the specialized skill set necessary for high quality contact tracing in the COVID-19 era and explore its alignment with social work competencies and skills. Described are current examples of contact tracing efforts, and an argument for greater social work leadership, based on the profession’s ethics, competencies and person-in-environment orientation is offered. In light of the dire need for widespread high-quality contact tracing, social work is well-positioned to participate in interprofessional efforts to design, oversee and manage highly effective front-line contact tracing efforts.

Last updated on hub: 13 November 2020

How the COVID-19 pandemic is focusing attention on loneliness and social isolation

Public Health Research and Practice

The effects of the coronavirus disease 2019 (COVID-19) pandemic upon human health, economic activity and social engagement have been swift and far reaching. Emerging evidence shows that the pandemic has had dramatic mental health impacts, bringing about increased anxiety and greater social isolation due to the physical distancing policies introduced to control the disease. In this context, it is possible to more deeply appreciate the health consequences of loneliness and social isolation, which researchers have argued are enduring experiences for many people and under-recognised contributors to public health. This paper examines the social and psychological consequences of the COVID-19 pandemic, with a focus on what this has revealed about the need to better understand and respond to social isolation and loneliness as public health priorities. Social isolation and loneliness are understood to be distinct conditions, yet each has been found to predict premature mortality, depression, cardiovascular disease and cognitive decline. Estimates of the prevalence and distribution of social isolation and loneliness vary, possibly ranging from one-in-six to one-in-four people, and the lack of knowledge about the extent of these conditions indicates the need for population monitoring using standardised methods and validated measures. Reviews of the evidence relating to social isolation and loneliness interventions have found that befriending schemes, individual and group therapies, various shared activity programs, social prescription by healthcare providers, and diverse strategies using information and communication technologies have been tried. There remains uncertainty about what is effective for different population groups, particularly for prevention and for addressing the more complex condition of loneliness. In Australia, a national coalition – Ending Loneliness Together – has been established to bring together researchers and service providers to facilitate evidence gathering and the mobilisation of knowledge into practice. Research–practice partnerships and cross-disciplinary collaborations of this sort are essential for overcoming the public health problems of loneliness and social isolation that have pre-existed and will endure beyond the COVID-19 pandemic.

Last updated on hub: 13 November 2020

A balanced approach to decision-making in supporting people with IDD in extraordinarily challenging times

Research in Developmental Disabilities

A balanced approach to decision-making during challenging times is necessary in order to avoid risks that jeopardize the lives and wellbeing of people with intellectual and developmental disabilities (IDD). The COVID-19 pandemic is the recent example of a crisis that places people with IDD at risk for lopsided societal reactions and threats to them or their wellbeing. Attention to decision-making is required to safeguard hard-earned achievements, including public policies and organization practices that emphasize human and legal rights, self-advocacy, individualized supports, inclusive environments, choices, and community inclusion. This paper suggests maintaining a holistic approach to understanding the lives and human functioning of people with IDD, a balanced approach to accountability and performance management, an understanding of the multidimensional properties of context, and a heightened vigilance in professional responsibility. A balanced approach will strengthen the likelihood of a return to high quality services and supports to people after the crisis, reduce loss of critical progress, and enhance stability across future social, political, and financial changes and challenges.

Last updated on hub: 13 November 2020

Long-term care facilities and the coronavirus epidemic: practical guidelines for a population at highest risk

Journal of the American Medical Directors Association

Editorial. Considers why long-term care preparedness for COVID-19 is important. Comments on the practical considerations for reducing the risk of transmission in the workplace; ensuring protection of healthcare workers; maintaining health care infrastructure; the assisted living experience; the blame game and what next? Suggests that appropriate preparedness includes five key elements: 1) reduce morbidity and mortality among those infected; 2) minimize transmission; 3) ensure protection of health care workers; 4) maintain health care system functioning; and 5) maintain communication with worried residents and family members

Last updated on hub: 13 November 2020

Rapid return of children in residential care to family as a result of COVID-19: Scope, challenges, and recommendations

Child Abuse and Neglect

Background: As a result of the COVID-19 pandemic, some governments have mandated that residential care providers rapidly return children and youth to family. Objective: The goal of the present study was to better understand the scope and characteristics of rapid return, and to provide data-informed recommendations for service providers working with this population. Participants and setting: Representatives from 67 non-government organizations (NGOs) providing residential care that were government-mandated to rapidly return children and youth to family completed a brief online survey. They collectively serve 12,494 children in 14 nations. Methods: Using a mixed methods design, results examined 1) characteristics of the rapid return mandate, 2) preparation received by children and families, 3) support services provided since the return, and 4) primary concerns for children and families. Results: Data revealed that rapid return was characterized by compressed timelines that did not allow for adequate child and family assessment and preparation. However, all respondents indicated they believed at least some families would be able to remain intact safely with appropriate support. Primary concerns for children and families related to unresolved antecedents to separation, lack of economic capacity, limited monitoring, and lack of access to education. Conclusions: Based on the findings, 9 recommendations were made for service providers working with children and families that have been rapidly reunified as a result of the COVID-19 pandemic.

Last updated on hub: 13 November 2020

Seeking Answers for Care Homes during the COVID-19 pandemic (COVID SEARCH)

Age and Ageing

The care and support of older people residing in long-term care facilities during the COVID-19 pandemic has created new and unanticipated uncertainties for staff. This short report presents analyses of the uncertainties of care home managers and staff expressed in a self-formed closed WhatsApp discussion group during the first stages of the pandemic in the UK. This study categorised their wide-ranging questions to understand what information would address these uncertainties and provide support. This study has been able to demonstrate that almost one-third of these uncertainties could have been tackled immediately through timely, responsive and unambiguous fact-based guidance. The other uncertainties require appraisal, synthesis and summary of existing evidence, commissioning or provision of a sector- informed research agenda for medium to long term. The questions represent wider internationally relevant care home pandemic-related uncertainties.

Last updated on hub: 13 November 2020

Real-time digital contact tracing: development of a system to control COVID-19 outbreaks in nursing homes and long-term care facilities

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can spread rapidly in nursing homes and long-term care (LTC) facilities. Symptoms-based screening and manual contact tracing have limitations that render them ineffective for containing the viral spread in LTC facilities. Symptoms-based screening alone cannot identify asymptomatic people who are infected, and the viral spread is too fast in confined living quarters to be contained by slow manual contact tracing processes. Objective: We describe the development of a digital contact tracing system that LTC facilities can use to rapidly identify and contain asymptomatic and symptomatic SARS-CoV-2 infected contacts. A compartmental model was also developed to simulate disease transmission dynamics and to assess system performance versus conventional methods. Methods: We developed a compartmental model parameterized specifically to assess the coronavirus disease (COVID-19) transmission in LTC facilities. The model was used to quantify the impact of asymptomatic transmission and to assess the performance of several intervention groups to control outbreaks: no intervention, symptom mapping, polymerase chain reaction testing, and manual and digital contact tracing. Results: Our digital contact tracing system allows users to rapidly identify and then isolate close contacts, store and track infection data in a respiratory line listing tool, and identify contaminated rooms. Our simulation results indicate that the speed and efficiency of digital contact tracing contributed to superior control performance, yielding up to 52% fewer cases than conventional methods. Conclusions: Digital contact tracing systems show promise as an effective tool to control COVID-19 outbreaks in LTC facilities. As facilities prepare to relax restrictions and reopen to outside visitors, such tools will allow them to do so in a surgical, cost-effective manner that controls outbreaks while safely giving residents back the life they once had before this pandemic hit. Citation: Wilmink G et al. (2020) Real-Time Digital Contact Tracing: Development of a System to Control COVID-19 Outbreaks in Nursing Homes and Long-Term Care Facilities. JMIR Public Health Surveill 2020;6(3):e20828

Last updated on hub: 13 November 2020

COVID-19 and nursing home residents' rights

Journal of the American Medical Directors Association

Letter to the editor. Makes the point that restriction of resident rights is concerning, even in the face of a global pandemic. In the United States, nursing homes are required by federal regulations to provide maximal quality of life. Considers the question: How can we keep residents safe while protecting their right to self-determination and choice Makes recommendations for safer reopening of visitors to nursing homes.

Last updated on hub: 13 November 2020

Outcomes in French nursing homes that implemented staff confinement with residents

Question: Was self-confinement of staff members with residents in French nursing homes during the coronavirus disease 2019 (COVID-19) pandemic associated with better outcomes related to COVID-19 compared with overall national outcomes? Findings: This cohort study including 17 nursing homes with staff self-confinement and 9513 nursing homes in a national survey found that nursing homes with staff self-confinement experienced lower mortality related to COVID-19 among residents and lower incidence of COVID-19 among residents and staff members than rates recorded in a national survey. Meaning: These findings suggest that self-confinement of nursing home staff members with residents may help protect residents from mortality related to COVID-19 and residents and staff from COVID-19 infection. Citation: Belmin J. et al. (2020). Coronavirus disease 2019 outcomes in French nursing homes that implemented staff confinement with residents. JAMA network open, 3(8), e2017533-e2017533.

Last updated on hub: 13 November 2020