COVID-19 resources on infection control

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Enabling safe and effective volunteering during coronavirus (COVID-19)

Department for Digital, Culture, Media and Sport

This guidance aims to help organisations and groups understand how to safely and effectively involve volunteers during the pandemic.

Last updated on hub: 23 November 2020

Ethical decision-making in the face of Covid-19

International Federation of Social Workers

The coronavirus (COVID 19) crisis is challenging social workers as they continue to carry out their professional roles. In the context of a shortage of resources and a lack of safety equipment, social workers are having to make difficult decisions about in-person contacts with their clients. This document highlights ethical principles from the International Federation of Social Workers and provides a series of questions to guide social workers through resolving the dilemma of balancing public health directives and guidelines and ethical obligations to clients.

Last updated on hub: 11 May 2020

Ethnic inequalities in Covid-19 are playing out again – how can we stop them?

Institute for Public Policy Research

This long read by IPPR and Runnymede Trust looks at how Covid-19 is set to continue to hit minority ethnic communities hardest as we enter the second wave. It proposes measures to help control the pandemic and mitigate immediate ethnic inequalities. including increasing access to treatment.

Last updated on hub: 26 October 2020

Evaluation of the CAMHS In-Reach to Schools Pilot Programme: pilot progress and the impact of Covid 19, supplementary paper to the interim report

Welsh Government

This paper supplements the evaluation of the CAMHS In-Reach to Schools pilot, a programme that aims to build capacity (including skills, knowledge and confidence) in schools to support pupils’ mental health and well-being and improve schools’ access to specialist liaison, consultancy and advice when needed. It presents the data gathered through the second round of qualitative case-study research with a sample of school clusters, services, such as Child and Adolescent Mental Health Services (CAMHS), school counselling, educational psychology and voluntary sector services, working with them, and interviews and discussions with CAMHS In-Reach Practitioners. The report aims to present the position for schools and services at the approximate midpoint of the pilot programme (early spring 2020) and provides a ‘snapshot’ of the impact of Covid-19 and the lockdown upon schools, pupils and services in late April and May 2020. These latter findings are drawn from a small sample at a period in time, when schools were responding to a fast-moving and challenging situation. The report finds that there is a clear need, and strong support, for the pilot, and the impact of Covid-19 is expected to increase this need. The pilot programme allows schools to be better prepared than they would otherwise have been for the return of pupils and, to a lesser degree, staff. Nevertheless, they still want support from the pilots to help them prepare for schools increasing their operations, and the difficulties pupils and staff may experience when they return.

Last updated on hub: 30 July 2020

Evidence summary for lateral flow devices (LFD) in relation to care homes

Department of Health and Social Care

A summary of published research papers on lateral flow device (LFD) efficacy and preliminary findings from the evaluation of the Department of Health and Social Care (DHSC) care home visitor testing pilot November 2020. The summary follows the release of visitor testing guidance that supports friends and relatives to visit care home residents and provides clarity on the available evidence to support safe visiting as part of our overall approach to promote the health and wellbeing of care home residents. Friends and relatives tested immediately before their visit can demonstrate they are likely to be free of risk of transmitting COVID-19 by having an LFD negative result. Testing must be done directly before the visit takes place and must be undertaken in combination with other infection prevention and control measures.

Last updated on hub: 11 January 2021

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

Lancet

Background: COVID-19 has affected care home residents internationally, but detailed information on outbreaks is scarce. This research aimed to describe the evolution of outbreaks of COVID-19 in all care homes in one large health region in Scotland. Methods: This study 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 this study 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), which this study 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: 09 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

Evolution and impact of COVID-19 outbreaks in care homes: population analysis in 189 care homes in one geographic region

medRxiv

This article is a preprint and has not been peer-reviewed. The lead researcher is Jennifer K Burton. Method: Analysis of testing, cases and deaths using linked care-home, testing and mortality data for 189 care-homes with 5843 beds in a large Scottish Health Board up to 15/06/20. Findings: 70 (37.0%) of care-homes experienced a COVID-19 outbreak.Interpretation: The large impact on excess deaths appears to be primarily a direct effect of COVID-19, with cases and deaths are concentrated in a minority of care homes. A key implication is that there is a large pool of susceptible residents if community COVID-19 incidence increases again. Shielding residents from potential sources of infection and rapid action into minimise outbreak size where infection is introduced will be critical in any wave 2.

Last updated on hub: 15 July 2020

Expanding frontiers of risk management: care safety in nursing home during COVID-19 pandemic

International Journal for Quality in Health Care

Background: Nursing homes provide long-term care and have residential-oriented hospitalizations characterized by medical, nursing, and social-care treatments for a typically geriatric population. In the current emergency phase, the problem of infections in residential structures for the elderly is taking on considerable importance in relation to the significant prevalence rates of COVID-19. Safety improvement strategies: Prevention and control measures for SARS-CoV-2 infection in nursing homes should be planned before a possible outbreak of COVID-19 occurs and should be intensified during any exacerbation of the same. Each facility should identify a properly trained contact person—also external—for the prevention and control of infections, who can refer to a multidisciplinary support committee and who is in close contact with the local health authorities. The contact person should collaborate with professionals in order to prepare a prevention and intervention plan that considers national provisions and scientific evidence, the requirements for reporting patients with symptoms compatible with COVID-19, the indications for the management of suspected, probable or confirmed cases of COVID-19. Discussion: Adequate risk management in residential structures implies the establishment of a coordination committee with dedicated staff, the implementation of a surveillance program for the rapid recognition of the outbreaks, the identification of suitable premises and equipment, the application of universal precautions, the adaptation of care plans to reduce the possibility of contagion among residents, the protection of operators and staff training initiatives.

Last updated on hub: 31 August 2020

Exploiting isolation: offenders and victims of online child sexual abuse during the COVID-19 pandemic

European Union Agency for Law Enforcement Cooperation

This report examines activities involving the sexual abuse and exploitation of children online and related offline crimes with a particular focus on how offenders have used their time during COVID-19 confinement to increase children’s vulnerability. The findings of this report are mainly based on contributions from Member States and Europol’s partner countries and input from a number of organisations. Key findings are: there have been significant increases in activity relating to child sexual abuse and exploitation on both the surface web and dark web during the COVID-19 lockdown period; travel restrictions and other measures during the pandemic have likely prevented offenders from travelling and so have shifted their focus to the exchange of child sexual abuse material (CSAM) online; an increase in the number of offenders exchanging CSAM online during lockdown may have an impact on and stimulate demand for this type of material online beyond the lockdown; increases in detection and reporting of CSAM on the surface web during lockdown indicate the level of re-victimisation of children through the distribution of images and videos depicting them; consistent levels of activity by offenders on the dark web during lockdown reflects the ongoing organised business model that has evolved and the level of threat that it poses to children; society, including law enforcement, needs to focus on the self-generation of CSAM to ensure that children are protected from this type of exposure to harm; the increased circulation of CSAM during the COVID-19 pandemic will also increase the need for law enforcement to identify the victims depicted in it; it is critical to continue to promote preventive and educational initiatives in a coordinated and structural manner across Europe.

Last updated on hub: 06 July 2020

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