COVID-19 resources on infection control

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Lockdown loneliness and anxiety across the generations

The Nuffield Trust

An examination of the impact of lockdown on emotional wellbeing and mental health, by age group, finding that young people tended to fare worse.

Last updated on hub: 19 October 2020

Lockdown. Rundown. Breakdown. The COVID-19 lockdown and the impact of poor-quality housing on occupants in the North of England

Northern Housing Consortium

This report has been produced to document the experiences of households living in poor-quality, ‘non-decent’ accommodation in the UK – with a specific focus on households in the North of England – during the height of the UK lockdown. It draws on rapidly produced primary research undertaken between May and July 2020. It involved semi-structured interviews with 40 residents from privately rented housing, ten residents from owner-occupied housing and eight key actors/professionals. The study also used a short survey to capture the views and experiences of people who preferred not to be interviewed. The findings reveal that: households were living with longstanding repair and quality issues – lockdown had ultimately worsened such conditions and impaired people’s ability to live with those conditions; many longstanding repair and quality issues were described as worsening throughout lockdown because social distancing measures prohibited contractors from entering the home; renters were having to draw on their own incomes, savings and credit to cope with the costs associated with their poor conditions, which further entrenched people in the private rented sector; the vast majority of renters had not considered the possibility of asking landlords for rent reductions when questioned during interviews; private renters were under-reporting the repairs that were needed to their homes; overcrowding was an issue most households were experiencing, with entire households living, working and spending time in the same housing space; conversely, people who lived by themselves discussed feeling isolated and lonely in the weeks when contact with family and friends was restricted to online video call facilities. There is an opportunity to learn from the first few months of the COVID-19 lockdown and take urgent action for the short, medium and long term to ensure that the housing crisis, which has been so frequently identified, does not lead to systemic or personal breakdown.

Last updated on hub: 10 November 2020

Lockdown’s side effect: mental health deterioration of people affected by dementia, with third ‘giving up’

Alzheimer's Society

Sets out findings from a survey of around 2,000 people affected by dementia revealing the devastating impact coronavirus has had on their mental health, with a third living with dementia reporting apathy or a sense of ‘giving up’. Nearly half of respondents said that lockdown has had a ‘negative impact’ on their mental health. Around half of unpaid carers also reported that loved ones with the condition have experienced stress, anxiety or depression.

Last updated on hub: 21 July 2020

Lonely and left behind: tackling loneliness at a time of crisis

British Red Cross

Findings from an in-depth qualitative research, exploring the experience of loneliness among people who had been isolating or shielding as a result of the pandemic. The research took a longitudinal, case study approach, engaging 16 participants from a range of backgrounds through a series of in-depth telephone interviews and written diary tasks between July and September 2020. Each of the participants had been, at the time of the research, isolating or shielding, with some starting to reintegrate throughout the period. The study reveals that: many participants were feeling lonely or isolated before the pandemic, often due to experiencing a degree of turbulence in their lives, and this has been compounded by the impacts of the pandemic and being less able to utilise previous coping strategies during lockdown; all participants reported experiencing loneliness more often as a result of the pandemic and lockdown; for participants who continue to shield as lockdown restrictions eased, feelings of loneliness either stayed the same or worsened as they watched others resume their social lives, and they reported feeling ‘left behind’; participants pointed to the heightened importance of technology and entertainment to try to cope with loneliness, rather than the physical social interactions that they would have been able to turn to prior to the pandemic; of the policy and practice solutions tested with participants, the most popular solution was investing in remote mental health and emotional support. It was felt any type of support would need to be delivered remotely, due to fear of COVID-19 and reluctance to access options that would require physical travel or mixing with others in person.

Last updated on hub: 17 December 2020

Long-stay mental health care institutions and the COVID-19 crisis: identifying and addressing the challenges for better response and preparedness

World Health Organization

This report presents the results of a survey with 169 long-stay institutions to assess the impact of the COVID-19 pandemic on services, staff, service users and residents with psychosocial and intellectual disabilities. Specific themes explored in this report are how well the institutions were prepared for the crisis by authorities, the quality of communications, the availability of personal protective equipment, and the impact of the risk of infection and protective measures on staff and residents. The report finds that there were significant differences between the types of institution reporting, which included psychiatric hospitals; care homes; and other settings for mental health care. Responses from psychiatric, intellectual disability and autism services were broadly consistent with those from social care homes, except for the following significant areas of difference: social care homes were happier with information from the authorities and the information they provided for residents in accessible formats; care home staff reported challenges with more workload, stress, frustration and burnout; care homes were less likely to use discharge to reduce numbers and manage the virus; and more likely to report an increase in the use of restrictive measures. The analysis highlights the need to put in place comprehensive and practical plans to facilitate management and day-to-day operations under crisis conditions. The keys to this are: having clear guidelines and tested systems in place; ensuring clarity of communication; implementing a comprehensive and facility-based infection prevention and control plan; establishing clear procedures and protocols to ensure safe environments; being able to increase staff capacities according to need; and having a clear focus on ensuring person-centred and human rights-based care in all decision-making.

Last updated on hub: 05 October 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

Making evidence and policy in public health emergencies: lessons from COVID-19 for adaptive evidence-making and intervention

Evidence and Policy

Background: In public health emergencies, evidence, intervention, decisions and translation proceed simultaneously, in greatly compressed timeframes, with knowledge and advice constantly in flux. Idealised approaches to evidence-based policy and practice are ill equipped to deal with the uncertainties arising in evolving situations of need. Key points for discussion: There is much to learn from rapid assessment and outbreak science approaches. These emphasise methodological pluralism, adaptive knowledge generation, intervention pragmatism, and an understanding of health and intervention as situated in their practices of implementation. The unprecedented challenges of novel viral outbreaks like COVID-19 do not simply require us to speed up existing evidence-based approaches, but necessitate new ways of thinking about how a more emergent and adaptive evidence-making might be done. The COVID-19 pandemic requires us to appraise critically what constitutes ‘evidence-enough’ for iterative rapid decisions in-the-now. There are important lessons for how evidence and intervention co-emerge in social practices, and for how evidence-making and intervening proceeds through dialogue incorporating multiple forms of evidence and expertise. Conclusions and implications: Rather than treating adaptive evidence-making and decision making as a break from the routine, we argue that this should be a defining feature of an ‘evidence-making intervention’ approach to health.

Last updated on hub: 09 September 2020

Managing through COVID-19: the experiences of children’s social care in 15 English local authorities

King's College London

This study examines the arrangements put in place in children’s social care services during the period of the COVID-19 lockdown and considers what their impact and legacy might be. A modified Delphi methodology was adopted, gathering expert opinion from 15 representatives of English local authorities to through a series of iterative questionnaires, with a goal of coming to a group consensus. Findings cover a whole range of issues, including home and office working; referrals; working with families in a pandemic; foster care; care leavers and unaccompanied young people seeking asylum; residential homes; multi-agency working; recruitment; planning for the end of lockdown; and lessons for the future. The study found that the local authorities have responded to three interrelated imperatives: to keep social workers safe while promoting their health and wellbeing, to work with extremely vulnerable families and to use technology to undertake work with these families who may be technology poor. All authorities were conscious that soon they could be facing additional challenges as they dealt not only with the practicalities of social distancing and technology, but the increased number of referrals that they expected once other services returned to ‘more business as usual’ operations. There was concern about those families who had been exposed to the risks arising within their homes such as domestic abuse, coercive control, alcohol and substance misuse, with consequences for their mental and physical health. COVID-19 has also offered opportunities, leading children’s social care services to think afresh about how things work and speed up changes that would have taken years to introduce. Previous notions of how to conduct an assessment, engage in direct practice and offer student placements are amongst the many activities that have been tested and reshaped, at least temporarily. Similarly, virtual visits to families were reported to be effective in certain circumstances and be less intrusive for some families, although establishing face-to-face contact in the home will continue to be necessary.

Last updated on hub: 07 July 2020

Medicine is a social science: COVID-19 and the tragedy of residential care facilities in high-income countries

Commentary published in BMJ Global Health, 5(8) 2020. Comments on the pandemic spread of COVID-19 in high-income countries that have witnessed an extraordinary high death toll of people living in residential care facilities. Provides insights from a social sciences and public health perspective about infections. Citation: Krones, T., Meyer, G., & Monteverde, S. (2020). Medicine is a social science: COVID-19 and the tragedy of residential care facilities in high-income countries. BMJ Global Health, 5(8), e003172.

Last updated on hub: 13 November 2020

Mitigating the impact of the COVID-19 outbreak: a review of international measures to support community-based care

International Long-term Care Policy Network

This report provides a brief overview of the policy responses and practice measures used internationally to respond to the impact of COVID-19 on the provision of community-based care. The data provided is largely collected from the country reports on the COVID-19 long-term care situation, including Australia, Austria, Brazil, China, England, Germany, Hong Kong, Ireland, Israel, Italy, Netherlands, Slovenia, South Korea, and the United States. Key findings include: community-based care faces unique challenges during the COVID-19 pandemic compared to other parts of the long-term care continuum; several countries have taken steps to prevent the spread of COVID-19 infections in community-based care including the closure of adult day centres and other service providers; continuity of care is of upmost importance – a disruption of care and support could have serious negative impacts on individual health and well-being due to increased risk of loneliness and social isolation; the dispersed nature of community based care suggests that direct governmental action and oversight may be more difficult to provide than for residential care settings such as care homes or nursing facilities; efforts to maintain continuity of care in community-based care include government financial support to home care workers; recruitment of volunteers and family members to act as paid carers; and the provision of remote psychological supports to home care workers; some countries have taken steps to move patients and home care workers to residential care settings; few countries are specifically reporting data on infections and deaths among users of home care – an exception to this is Australia; overall evidence of national measures to support community-based care is still lacking for most countries.

Last updated on hub: 04 November 2020

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