COVID-19 resources on infection control

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Build back fairer: the COVID-19 Marmot review. The pandemic, socioeconomic and health inequalities in England

The aim of this report is three-fold: to examine inequalities in COVID-19 mortality, focusing on mortality among members of BAME groups and among certain occupations, alongside continued attention to the socioeconomic gradient in health; to show the effects that the pandemic, and the societal response to contain the pandemic, have had on social and economic inequalities, their effects on mental and physical health, and their likely effects on health inequalities in the future; and to make recommendations on what needs to be done. The report sets out the proposition that England’s comparatively poor management of the pandemic is of a piece with England’s health improvement falling behind that of other rich countries in the decade since 2010. It offers four likely reasons why: the quality of governance and political culture which did not give priority to the conditions for good health; continuing increases in inequalities in economic and social conditions, including a rise in poverty among families with children; a policy of austerity and consequent cuts to funding of public services; and a poor state of the nation’s health that would increase the lethality of COVID-19. The high mortality rate of members of Black, Asian and minority ethnic groups can be attributed to living in more deprived areas, working in high-risk occupations, living in overcrowded conditions. Structural racism means that some ethnic groups are more likely to be exposed to adverse social and economic conditions. The report argues that the pandemic must be taken as an opportunity to build a fairer society, acknowledging that economic growth is a limited measure of societal success. It suggests that to build back fairer there needs to be a commitment at two levels. First is the commitment to social justice and putting equity of health and wellbeing at the heart of all policy-making, nationally, regionally and locally. The second level is to take the specific actions needed, as laid out in this report, to create healthier lives for all.

Last updated on hub: 15 December 2020

Build back fairer: the COVID-19 Marmot review. The pandemic, socioeconomic and health inequalities in England. Executive summary

The aim of this report is three-fold: to examine inequalities in COVID-19 mortality, focusing on mortality among members of BAME groups and among certain occupations, alongside continued attention to the socioeconomic gradient in health; to show the effects that the pandemic, and the societal response to contain the pandemic, have had on social and economic inequalities, their effects on mental and physical health, and their likely effects on health inequalities in the future; and to make recommendations on what needs to be done. The report sets out the proposition that England’s comparatively poor management of the pandemic is of a piece with England’s health improvement falling behind that of other rich countries in the decade since 2010. It offers four likely reasons why: the quality of governance and political culture which did not give priority to the conditions for good health; continuing increases in inequalities in economic and social conditions, including a rise in poverty among families with children; a policy of austerity and consequent cuts to funding of public services; and a poor state of the nation’s health that would increase the lethality of COVID-19. The high mortality rate of members of Black, Asian and minority ethnic groups can be attributed to living in more deprived areas, working in high-risk occupations, living in overcrowded conditions. Structural racism means that some ethnic groups are more likely to be exposed to adverse social and economic conditions. The report argues that the pandemic must be taken as an opportunity to build a fairer society, acknowledging that economic growth is a limited measure of societal success. It suggests that to build back fairer there needs to be a commitment at two levels. First is the commitment to social justice and putting equity of health and wellbeing at the heart of all policy-making, nationally, regionally and locally. The second level is to take the specific actions needed, as laid out in this report, to create healthier lives for all.

Last updated on hub: 15 December 2020

Building a country that works for all children post COVID-19

The Association of Directors of Children's Services

This discussion paper looks at the impacts of Covid-19 on children and their families. Its purpose is three-fold: to put children, young people and their lived experiences of the pandemic front and centre in national recovery planning; to articulate what is needed to restore the public support services they rely on; and to capture the positives and gains made during a very complex national, and indeed, global emergency. The paper reveals that the directors of children’s services in England share concerns about increased exposure of children to ‘hidden harms’ such as domestic violence and the impact of social distancing on children and young people’s development and on their mental and emotional health and wellbeing. The vulnerability of specific cohorts, including care leavers, young carers, children and young people in conflict with the law and families with no recourse to public funds, has been heightened during this period. Covid-19 has disrupted professionals’ relationships with children and families and weakened the sustainability of both the voluntary and charitable sector and the early years and childcare sector. Both families and the workforce have shown great levels of resilience, flexibility and creativity. The paper calls for a rapid review of the response to the first phase of the pandemic to improve preparedness for future waves and spikes of infection, arguing that the experiences of practitioners and of children and families must be part of this process. It also suggests that the recovery phase offers the government an opportunity to further its ‘levelling up’ agenda, and the initiation of an ambitious, world leading health inequalities strategy, making wellbeing rather than straightforward economic performance the central goal of policy.

Last updated on hub: 20 July 2020

Can social prescribing support the COVID-19 pandemic?

Centre for Evidence Based Medicine

This document looks at how social prescribing can be implemented within the current coronavirus (COVID-19) pandemic. It finds that although there is limited evidence on how social prescribing can be best implemented within the current COVID-19 pandemic, there are an increasing array of anecdotal accounts that suggest the importance of maintaining community connectedness during this time.

Last updated on hub: 29 April 2020

Care and support workers’ perceptions of health and safety issues in social care during the COVID-19 pandemic: initial findings, 15 April 2020

University of Kent

This paper provides initial findings from legal and survey data about the role of care and support providers in the pandemic as employers with legal responsibilities for preventing harm to staff and people who use their services. The evidence suggests that care and supports workers, care home residents and other users of care and support services are exposed to the risk of SARS-CoV-2 virus without the protections to which they are legally entitled. The research team worked with UNISON in the North West of England to analyse findings from a survey of 2,600 care workers in approximately 1,200 different settings across residential care, home care, and support services for people with learning disabilities. The analysis of results is split into three sections, covering concerns about the need for Personal Protective Equipment (PPE); pay problems; and other COVID-19 related health and safety concerns. The findings reveal that: a large majority of respondents believe too little is being done by employers to keep staff safe from the risks SARS-CoV-2 infection; a large majority of respondents believe too little is being done by employers to keep people using care and support safe; 8 in 10 care workers think that they would not be paid their wages as normal if they had to self-isolate; care workers who are ill with COVID-19 are not all self-isolating; care workers believe that lack of attention to minimising the risk of infection in care and support settings has directly contributed to outbreaks of COVID-19 in social care settings.

Last updated on hub: 14 December 2020

Care home infection control top tips

North West Association of Directors of Adult Social Services

The purpose of this guide is to highlight some of the ways in which residential and nursing homes have responded to the Covid-19 pandemic in order to ensure that residents are safe, needs continue to be met and wellbeing is promoted, in what are very challenging and difficult circumstances. This guide has been compiled from desktop review of policy and best practice guidance, together with interviews with a selection of providers and commissioners from across the North West region. It aims to stimulate ideas on how providers and commissioners can develop and enhance services in the context of Covid-19, whilst simultaneously building future resilience into providers existing infection control plans. Topics covered include: the physical environment; staff; wellbeing; processes; and technology.

Last updated on hub: 17 September 2020

Care home LFD testing of visitors guidance

Department of Health and Social Care

This guidance is for all care homes who are receiving lateral flow device (LFD) test kits and explains how to prepare and manage lateral flow testing for visitors. Testing visitors can reduce the risk of COVID-19 transmission but it does not completely remove the risk of infection. When used alongside robust infection prevention and control (IPC) measures such as personal protective equipment (PPE) it can support care homes to safely maintain a balance between infection control and the vital benefits of visiting to the health and wellbeing of residents.

Last updated on hub: 09 December 2020

Care home review: a rapid review of factors relevant to the management of Covid-19 in the care home environment in Scotland

Scottish Government

Findings of the rapid review of COVID-19 outbreaks in four care homes, including a list of recommendations based on risk factors that were found to be common in at least two of the homes. The review aimed to collate and evaluate local level experiences and responses to the resurgence of COVID-19 outbreaks within care homes and to support learning and practice across the sector through the sharing of learning identified and approaches to improvement. High community prevalence and slow confirmation of an outbreak after the first case was detected was a common cause of the high attack rate identified. Many of the positive cases were not identified quickly because they were asymptomatic or there was a lack of awareness in those interviewed of the wider spectrum of symptom presentation in older people. This resulted in testing not done in a timely manner. As a result additional control measures were put in place too late to stop the widespread transmission. Key to this is timely testing and reporting of results, in order that control measures can be put in place. The challenges with high community prevalence in the local areas, testing availability and turnaround times, combined with high occupant density, staff shortage indicators and the built environment risks re isolation or cohorting capability, placed care home residents at risk of the swift spread of COVID-19. Once COVID-19 has been introduced into a care home, it has the potential to result in high attack rates among residents, staff members, and visitors, and this occurred in each of the homes within this review. It is therefore critical that all long-term care facilities (care homes, residential settings and community hospitals) implement active measures to prevent introduction of COVID19, and are supported to do so.

Last updated on hub: 11 November 2020

Care homes action plan: summary of progress

Welsh Government

This document summarises the progress that has been made – and is being made – against the high-level actions in the Care Homes Action Plan. The Plan sets out high-level actions under six themes to ensure the care home sector in Wales is well supported ahead of winter pressures, learning lessons from the Covid-19 pandemic. The six themes are: infection prevention and control; personal Protective Equipment (PPE); general and clinical support for care homes; residents’ wellbeing; social care workers’ wellbeing; and financial sustainability.

Last updated on hub: 26 October 2020

Care homes analysis

Department of Health and Social Care

This paper provides an assessment of evidence on care homes, including optimal approaches to testing, and the potential value of other protection approaches. It reveals that some local authorities (i.e. Liverpool, Oxfordshire) have suffered higher numbers of outbreaks than might have been expected given the number of care homes locally. Nursing home have consistently higher rates of reporting outbreaks than care homes. Both residential and nursing homes show an increase as home size increases. Examining the effectiveness of approaches to reducing rates of infection, the paper stresses that testing can only support reduction of infection rates if coupled with actions to reduce contacts with positive cases and infection control more generally. It acknowledges that despite the potential reduction in risk of the non-rotation of care workers, there may be multiple operational challenges to achieving this. Cohorting of residents to receive care from a small number of carers has the potential to reduce transmission through limiting contacts. If this can be implemented easily, without creating other risks, it has the potential to reduce risk of infection. As the picture is developing rapidly and, as new evidence or data emerges, some of the information in this paper may have been superseded.

Last updated on hub: 14 July 2020

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