COVID-19 resources

Results 1 - 10 of 2219

Order by    Date Title

Health inequalities, the Covid vaccination programme and community-centred approaches

Coalition for Personalised Care

A report of the Coalition for Personalised Care (C4PC) roundtable held on 23 February 2021. The aims of the roundtable were to improve understanding within the NHS, the Government and LGA of how best to influence vaccine take-up; and further the Partnership’s ongoing commitment to assisting the work and activities of the NHSE’s Inequalities Team, the Vaccinations Team, and the Community Champions for the vaccine roll-out, as well as the Personalised Care Team. Participants agreed that addressing vaccine hesitancy requires a range of specific responses and more tailored engagement to overcome different motivations, insecurities, and reasonable fears. A clear consensus also emerged about the main barriers to health equality and how more robust, granular data is needed to better understand people’s experience of multiple disadvantages; how targeted local approaches, actively supported by the NHS, could overcome the barriers; and how effective community engagement and empowerment can overcome mistrust and foster greater co-production of local solutions. A key message is that it is time to move from a national hospital service to a National Health and Wellbeing Service able to tackle all aspects of good health and wellbeing.

Last updated on hub: 27 July 2021

Loneliness beyond Covid-19: learning the lessons of the pandemic for a less lonely future

Campaign to End Loneliness

A review of the impact of Covid-19 on UK loneliness and what we can expect in future. The report finds that although restrictions on social contact during lockdown were universal, people had very different experiences of loneliness. Covid-19 exacerbated existing inequalities, meaning that groups already at risk of loneliness – such as those who were poorer, in worse health or from ethnic minorities or LGBTQ+ communities – were at greater risk during the pandemic. Those who were already lonely before the pandemic were likely to become even more lonely. The report finds that organisations responsible for addressing loneliness experienced more demand for their services because: the co-ordinated response to loneliness during the pandemic identified many people who were already lonely, but not previously known to services; the impact of Covid-19 meant that more people were likely to be at risk of chronic loneliness, perhaps because they had lost their job or been ill; people who were already lonely, experienced deep isolation, and many experienced changes in their circumstances as a result of the pandemic which meant they became even more lonely. The report calls on the Government to provide enough funding to maintain services and support for people experiencing chronic loneliness in the wake of the pandemic; ensure that support is particularly targeted at the most disadvantaged communities where loneliness is a particular risk; take action and invest to ensure a ‘connected recovery’, strengthening community capacity, with funding for green spaces, high streets and meeting places as well as transport and digital connectivity.

Last updated on hub: 27 July 2021

The youth justice system’s response to the COVID-19 pandemic: literature review

Alliance for Youth Justice

This literature review has been produced to map and draw together the available literature to capture and analyse the significant impacts of COVID-19 on the youth justice system. The review aims to document this exceptional period for youth justice, exploring the policy and practice responses, and the available evidence about the impacts on children. The review finds that the devastating impact of the pandemic on children and families, and the heightened levels of safeguarding concerns, are major concerns for children involved with the youth justice system as well as those in the general population facing new and increased challenges. The literature identifies a consistent theme about the lack of information, understanding and focus on children during the pandemic. Throughout the various stages of the youth justice system, digital models of communication and service provision have been adapted – a clear ‘digital divide’ has emerged between those who have access to digital technologies and those who do not. From decisions to arrest, divert or prosecute children in the community, to remand and sentencing, there was a clear need identified to work to reduce the number of children passing through a system that is struggling to cope. The full impacts of delays on the courts and broader criminal justice system in the longer-term are yet to be fully understood but should be seen in the context of a system already under severe strain. Custody numbers fell overall, but the proportion of children on remand has increased. The majority of children in penal establishments have been subjected to awful conditions for months on end, deprived of education, visits and contact, and amounting to solitary confinement. The harms experienced by children in custody, and the impacts on their longer-term health and wellbeing must be fully assessed and supported effectively.

Last updated on hub: 27 July 2021

Vulnerable children and young people survey: summary of returns waves 1 to 25

Department for Education

Findings of a survey of local authorities in England to help understand the impact of the coronavirus (COVID-19) outbreak on children’s social care. Local authorities were asked to report on the following areas: contact with children supported by the local authority children’s social care; children’s social care workforce; and system pressures. Headline figures for Wave 25 of the survey are as follow. The total number of children looked after (CLA) was 2% higher than the same time in 2019-20 and the total number of children on a child protection plan (CPP) was 6% lower. A large proportion of CLA, children on a CPP and other children in need (CIN) have been in contact with a social worker in the last four weeks (67%, 93% and 61% respectively). The proportion of social workers not working due to coronavirus (COVID-19) has remained low with 3% of local authorities reporting over 10% of social workers unavailable due to coronavirus (COVID-19). The proportion of local authorities reporting over 10% of their residential care staff unable to work due to coronavirus (COVID19) has also remained low at 5%. Note that some local authorities have small residential care workforces and therefore a small change in the number of staff available may result in a large change in the proportion unavailable. The total number of referrals during Wave 25 was 17% lower than the usual number at that time of year. However, as Wave 25 fell during half term for most schools and the timing of the holidays differs from year to year, this comparison should be treated with caution. The total number of children who started to be looked after reported in waves 1 to 25 of the survey was 10,020. This is around 29% lower than the same period in 2017-20.

Last updated on hub: 27 July 2021

The association of nursing home quality ratings and spread of COVID-19

Journal of the American Geriatrics Society

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has severely affected nursing home residents. Given the continued high incidence of COVID-19, and the likelihood that new variants and other infectious agents may cause future outbreaks, we sought to understand the relationship of nursing home quality ratings and measures of COVID-19 outbreak severity and persistence. Design: This study analyzed nursing home facility-level data on COVID-19 cases and deaths, county-level COVID-19 rates, and nursing home data from the Centers for Medicare & Medicaid Services (CMS), including ratings from the CMS Nursing Home Five-Star Quality Rating System. We used regression analysis to examine the association between star ratings and cumulative COVID-19 incidence and mortality as well as persistent high resident incidence. Setting: All nursing homes in the CMS COVID-19 Nursing Home Dataset reporting data that passed quality assurance checks for at least 20 weeks and that were included in the January 2021 Nursing Home Care Compare update. Participants: Residents of the included nursing homes. Measurements: Cumulative resident COVID-19 incidence and mortality through January 10, 2021; number of weeks with weekly resident incidence of COVID-19 in the top decile nationally. Results: As of January 10, 2021, nearly all nursing homes (93.6%) had reported at least one case of COVID-19 among their residents, more than three-quarters (76.9%) had reported at least one resident death, and most (83.5%) had experienced at least 1 week in the top decile of weekly incidence. In analyses adjusted for facility and county-level characteristics, we found generally consistent relationships between higher nursing home quality ratings and lower COVID-19 incidence and mortality, as well as with fewer high-incidence weeks. Conclusion: Nursing home quality ratings are associated with COVID-19 incidence, mortality, and persistence. Nursing homes receiving five-star ratings, for overall quality as well as for each domain, had lower COVID-19 rates among their residents.

Last updated on hub: 26 July 2021

“Somebody like me”: understanding COVID-19 vaccine hesitancy among staff in skilled nursing facilities

Journal of the American Medical Directors Association

Objective: The vaccination of skilled nursing facility (SNF) staff is a critical component in the battle against COVID-19. Together, residents and staff constitute the single most vulnerable population in the pandemic. The health of these workers is completely entangled with the health of those they care for. Vaccination of SNF staff is key to increasing uptake of the vaccine, reducing health disparities, and reopening SNFs to visitors. Yet, as the vaccine rollout begins, some SNF staff are declining to be vaccinated. The purpose of this article is to describe reasons for COVID-19 vaccine hesitancy reported by staff of skilled nursing facilities and understand factors that could potentially reduce hesitancy. Design: Five virtual focus groups were conducted with staff of SNFs as part of a larger project to improve vaccine uptake. Setting and Participants: Focus groups with 58 staff members were conducted virtually using Zoom. Measures: Focus groups sought to elicit concerns, perspectives, and experiences related to COVID-19 testing and vaccination. Results: Our findings indicate that some SNF staff are hesitant to receive the COVID-19 vaccine. Reasons for this hesitancy include beliefs that the vaccine has been developed too fast and without sufficient testing; personal fears about pre-existing medical conditions, and more general distrust of the government. Conclusions and Implications: SNF staff indicate that seeing people like themselves receive the vaccination is more important than seeing public figures. This paper discusses the vaccination effort as a social enterprise and the need to develop long-term care provider-academic-community partnerships in response to COVID-19 and in expectation of future pandemics.

Last updated on hub: 26 July 2021

Proceedings from an international virtual townhall: reflecting on the COVID-19 pandemic: themes from long-term care

Journal of the American Medical Directors Association

Residents of long-term care (LTC) homes have suffered disproportionately during the COVID-19 pandemic, from the virus itself and often from the imposition of lockdown measures. Provincial Geriatrics Leadership Ontario, in collaboration with interRAI and the International Federation on Aging, hosted a virtual Town Hall on September 25, 2020. The purpose of this event was to bring together international perspectives from researchers, clinicians, and policy experts to address important themes potentially amenable to timely policy interventions. This article summarizes these themes and the ensuing discussions among 130 attendees from 5 continents. The disproportionate impact of the COVID-19 pandemic on frail residents of LTC homes reflects a systematic lack of equitable prioritization by health system decision makers around the world. The primary risk factors for an outbreak in an LTC home were outbreaks in the surrounding community, high staff and visitor traffic in large facilities, and crowding of residents in ageing buildings. Infection control measures must be prioritized in LTC homes, though care must be taken to protect frail and vulnerable residents from their overly blunt application that deprives residents from appropriate physical and psychosocial support. Staffing, in terms of overall numbers, training, and leadership skills, was inadequate. The built environment of LTC homes can be configured for both optimal resident well-being and infection control. Infection control and resident wellness need not be mutually exclusive. Improving outcomes for LTC residents requires more staffing with proper training and interprofessional leadership. All these initiatives must be underpinned by an effective quality assurance system based on standardized, comprehensive, accessible, and clinically relevant data, and which can support broad communities of practice capable of effecting real and meaningful change for frail older persons, wherever they chose to reside.

Last updated on hub: 26 July 2021

COVID-19 cases and death in nursing homes: the role of racial/ethnic composition of facilities and their communities

Journal of the American Medical Directors Association

Objectives: To examine the extent to which the racial and ethnic composition of nursing homes (NHs) and their communities affects the likelihood of COVID-19 cases and death in NHs, and whether and how the relationship between NH characteristics and COVID-19 cases and death varies with the racial and ethnic composition of the community in which an NH is located. Methods and Design: Centers for Medicare & Medicare Services Nursing Home COVID-19 data were linked with other NH- or community-level data (eg, Certification and Survey Provider Enhanced Reporting, Minimum Data Set, Nursing Home Compare, and the American Community Survey). Setting and Participants: NHs with more than 30 occupied beds (N=13,123) with weekly reported NH COVID-19 records between the weeks of June 7, 2020, and August 23, 2020. Measurements and model: Weekly indicators of any new COVID-19 cases and any new deaths (outcome variables) were regressed on the percentage of black and Hispanic residents in an NH, stratified by the percentage of blacks and Hispanics in the community in which the NH was located. A set of linear probability models with NH random effects and robust standard errors were estimated, accounting for other covariates. Results: The racial and ethnic composition of NHs and their communities were both associated with the likelihood of having COVID-19 cases and death in NHs. The racial and ethnic composition of the community played an independent role in the likelihood of COVID-19 cases and death in NHs, even after accounting for the COVID-19 infection rate in the community (ie, daily cases per 1000 people in the county). Moreover, the racial and ethnic composition of a community modified the relationship between NH characteristics (eg, staffing) and the likelihoods of COVID-19 cases and death. Conclusions and Implications: To curb the COVID-19 outbreaks in NHs and protect vulnerable populations, efforts may be especially needed in communities with a higher concentration of racial and ethnic minorities. Efforts may also be needed to reduce structural racism and address social risk factors to improve quality of care and population health in communities of color.

Last updated on hub: 26 July 2021

Emerging evidence on effectiveness of COVID-19 vaccines among residents of long-term care facilities

Journal of the American Medical Directors Association

The development and deployment of several COVID-19 vaccines within a little over a year after the pandemic started is seen as a success story in high-income countries. However, evidence on the effectiveness of the various vaccine candidates among users of long-term care (LTC) services was missing at the time of market entry. Given the disproportionate mortality burden carried by this population throughout the pandemic, it is important to understand whether vaccines protect the often frail and vulnerable users of LTC from infection and severe outcomes. This study aimed to monitor and summarize emerging evidence on the effects of COVID-19 vaccines in LTC users. Methods: The researchers conducted weekly searches of one academic literature database (MEDLINE via PubMed) between February 22 and May 11, 2021, to identify any original research articles reporting on the effect of COVID-19 vaccines in users of LTC. Eligible studies either focused solely on LTC or reported data separately for LTC users. This study also searched 2 additional databases on May 11, 2021 (Web of Science; CINAHL Plus). The researchers extracted key findings from included studies and summarized them narratively. This was a pragmatic and rapid review to monitor emerging evidence. The researchers did not register a protocol for this work. Results: The researchers identified 17 studies reporting on effects of COVID-19 vaccines in LTC users (including 5 preprints). All studies were conducted in institutional care facilities and none reported on community- or home-based care. Studies reporting estimates of vaccine effectiveness are summarized in Table 1. Large cohort studies from England and Denmark (not yet peer-reviewed) estimated vaccine effectiveness against infection at 60% or higher 4 weeks or more after the first dose,1 or 1 week after the second dose.2 These results are not directly comparable because of different intervals between first and second doses in the 2 countries. Two smaller studies found similar levels of protection against infection, and 1 also showed protection from severe outcomes (Table 1)

Last updated on hub: 26 July 2021

Closing the UK care home data gap - methodological challenges and solutions

International Journal of Population Data Science

UK care home residents are invisible in national datasets. The COVID-19 pandemic has exposed data failings that have hindered service development and research for years. Fundamental gaps, in terms of population and service demographics coupled with difficulties identifying the population in routine data are a significant limitation. These challenges are a key factor underpinning the failure to provide timely and responsive policy decisions to support care homes. This commentary proposes changes that could address this data gap, priorities include: (1) Reliable identification of care home residents and their tenure; (2) Common identifiers to facilitate linkage between data sources from different sectors; (3) Individual-level, anonymised data inclusive of mortality irrespective of where death occurs; (4) Investment in capacity for large-scale, anonymised linked data analysis within social care working in partnership with academics; (5) Recognition of the need for collaborative working to use novel data sources, working to understand their meaning and ensure correct interpretation; (6) Better integration of information governance, enabling safe access for legitimate analyses from all relevant sectors; (7) A core national dataset for care homes developed in collaboration with key stakeholders to support integrated care delivery, service planning, commissioning, policy and research. The authors suggestions are immediately actionable with political will and investment. We should seize this opportunity to capitalise on the spotlight the pandemic has thrown on the vulnerable populations living in care homes to invest in data-informed approaches to support care, evidence-based policy making and research.

Last updated on hub: 26 July 2021

Order by    Date Title