COVID-19 resources

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How to do ‘learning’ in practice

King's Fund

As the government and health and care organisations are starting to reflect on what can be learned from their experiences of dealing with Covid-19, this article draws on insights from the literature on organisational learning to outline the key features of a productive ‘learning’ environment and process. These include: bearing witness to people’s experiences; paying attention to who you should be learning from and with, and how; capitalising on the learning that is already happening in practice; and being seriously curious about the positives.

Last updated on hub: 20 August 2020

Children of COVID-19: pawns, pathfinders or partners?

British Medical Association

Opinion piece published in the Journal of Medical Ethics, 46(8) 2020. Countries throughout the world are counting the health and socioeconomic costs of the COVID-19 pandemic, including the strategies necessary to contain it. Profound consequences from social isolation are beginning to emerge, and there is an urgency about charting a path to recovery, albeit to a ‘new normal’ that mitigates them. Children have not suffered as much from the direct effects of COVID-19 infection as older adults. Still, there is mounting evidence that their health and welfare are being adversely affected. Closure of schools has been a critical component of social isolation but has a far broader impact than the diminution of educational opportunities, as important as these are. Reopening of schools is therefore essential to recovery, with some countries already tentatively implementing it. Children’s interests are vital considerations in any recovery plan, but the question remains as to how to address them within the context of how society views children; should they be regarded as pawns, pathfinders or partners in this enterprise?

Last updated on hub: 20 August 2020

Care homes innovate to reunite residents and families during lockdown

Care Home Professional

From drive-throughs to visitor pods, garden and window visits to cuddle curtains, this article looks at the innovative ways care home providers have been going about bringing care residents and relatives back together during Covid-19 lockdown.

Last updated on hub: 20 August 2020

Care Provider Alliance Coronavirus (COVID-19) directory

Care Provider Alliance

The Care Provider Alliance (CPA) are collating and signposting to the latest guidance and advice from reliable sources on their website. The resource includes news, guidance and information. The site is updated frequently.

Last updated on hub: 20 August 2020

National Care Forum COVID-19 guidance and resources

National Care Forum

The COVID-19 section of the National Care Forum (NCF) website is a good source for government guidance and information relevant to the care sector. The resource includes links to information about: infection control, CPA Visitors’ Protocol, clinical guidance, regulation, information governance, workforce, supported housing and homeless, volunteering wellbeing and other practical resources.

Last updated on hub: 20 August 2020

Coronavirus disease 2019: achieving good mental health during social isolation

British Journal of Psychiatry

The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence-based ways that people can maintain or even strengthen their mental health during this crisis.

Last updated on hub: 19 August 2020

Mental health and COVID-19: is the virus racist?

British Journal of Psychiatry

COVID-19 has changed our lives and it appears to be especially harmful for some groups more than others. Black and Asian ethnic minorities are at particular risk and have reported greater mortality and intensive care needs. Mental illnesses are more common among Black and ethnic minorities, as are crisis care pathways including compulsory admission. This editorial sets out what might underlie these two phenomena, explaining how societal structures and disadvantage generate and can escalate inequalities in crises.

Last updated on hub: 19 August 2020

COVID-19 outbreak: organisation of a geriatric assessment and coordination unit. A French example

Age and Ageing

Older people are particularly affected by the COVID-19 outbreak because of their vulnerability as well as the complexity of health organisations, particularly in the often-compartmentalised interactions between community, hospital and nursing home actors. In this endemic situation, with massive flows of patients requiring holistic management including specific and intensive care, the appropriate assessment of each patient’s level of care and the organisation of specific networks is essential. To that end, we propose here a territorial organisation of health care, favouring communication between all actors. This organisation of care is based on three key points: 1) To use the basis of territorial organisation of health by facilitating the link between hospital settings and geriatric sectors at the regional level; 2) To connect private, medico-social and hospital actors through a dedicated centralised unit for evaluation, geriatric coordination of care and decision support. A geriatrician coordinates this multidisciplinary unit. It includes an emergency room doctor, a supervisor from the medical regulation centre (Centre 15), an infectious disease physician, a medical hygienist and a palliative care specialist. 3) To organise an ad hoc follow-up channel, including the necessary resources for the different levels of care required, according to the resources of the territorial network, and the creation of a specific COVID geriatric palliative care service. This organisation meets the urgent health needs of all stakeholders, facilitating its deployment and allows the sustainable implementation of a coordinated geriatric management dynamic between the stakeholders on the territory.

Last updated on hub: 18 August 2020

COVID-19 in older people: a rapid clinical review

Age and Ageing

Introduction: the COVID-19 pandemic poses a high risk to older people. The aim of this article is to provide a rapid overview of the COVID-19 literature, with a specific focus on older adults. We frame our findings within an overview of the disease and have also evaluated the inclusion of older people within forthcoming clinical trials. Methods: we searched PubMed and bioRxiv/medRxiv to identify English language papers describing the testing, treatment and prognosis of COVID-19. PubMed and bioRxiv/medRxiv searches took place on 20 and 24 March 2020, respectively. Results: screening of over 1,100 peer-reviewed and pre-print papers yielded n = 22 on COVID-19 testing, n = 15 on treatment and n = 13 on prognosis. Viral polymerase chain reaction (PCR) and serology are the mainstays of testing, but a positive diagnosis may be increasingly supported by radiological findings. The current evidence for the effectiveness of antiviral, corticosteroid and immunotherapies is inconclusive, although trial data are largely based on younger people. In addition to age, male gender and comorbidities, specific laboratory and radiology findings are important prognostic factors. Evidence suggests that social distancing policies could have important negative consequences, particularly if in place for an extended period. Conclusion: given the established association between increasing age and poor prognosis in COVID-19, we anticipate that this rapid review of the current and emergent evidence might form a basis on which future work can be established. Exclusion of older people, particularly those with comorbidities, from clinical trials is well recognised and is potentially being perpetuated in the field of current COVID-19 research.

Last updated on hub: 18 August 2020

Frailty in the face of COVID-19

Age and Ageing

Rapidly increasing healthcare demand due to COVID-19 requires clinicians to make difficult medical and ethical decisions about the treatment of older people, models of care and triage systems. Algorithms and scoring systems are being developed to predict risks of mortality in relation to the most limited resources such as mechanical ventilation. Screening of frailty is being proposed as a key tool to assist in this triage process. This commentary argues against the use of screening tools (including the Clinical Frailty Scale (CFS) when used as such) as the sole component to ration access of older people to health care. Instead it recommends that frailty screening tools are implemented as a rapid component of a person-centred approach to assessment that takes account of three key biomedical factors: severity of the presenting acute illness, the likelihood of medical interventions being successful and the degree of frailty. Key points raised in this paper include: the Clinical Frailty Scale is a quick and reliable screening tool for frailty; while the CFS has value in allocation of scarce health resources, it also has limitations; frailty is a continuum rather than a dichotomous variable; the type and severity of the presenting illness are important variables independently associated with the clinical outcome; a person-centred approach should consider the severity of illness and likelihood of success as well as the degree of frailty.

Last updated on hub: 18 August 2020

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