COVID-19 resources on infection control

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Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK

Journal of Interprofessional Care

The first cases of Coronavirus (COVID-19) were reported in Wuhan, China in December 2019. Globally millions of people have been diagnosed with the virus whilst thousands have died. As the virus kept spreading health and social care frontline workers (HSCFW) were faced with difficulties when discharging their duties. This paper was set out to explore the challenges faced by different frontline workers in health and social care during the COVID-19 pandemic. The research utilized an explorative qualitative approach. A total of forty (N = 40) in-depth one-to-one semi-structured interviews were undertaken with HSCFW who included support workers (n = 15), nurses (n = 15), and managers (N = 10). Health and social care workers were drawn from domiciliary care and care homes (with and without nursing services). All the interviews were done online. The data were thematically analyzed, and the emergent themes were supported by quotes from the interviews held with participants. Following data analysis the research study found that lack of pandemic preparedness, shortage of Personal Protective Equipment (PPE), anxiety and fear amongst professionals, challenges in enforcing social distancing, challenges in fulfilling social shielding responsibility, anxiety and fear amongst residents and service users, delay in testing, evolving PPE guidance and shortage of staff were challenges faced by frontline health and social care workers during COVID-19 pandemic. The results of the current study point to a need for adequate pandemic preparedness within the health and social care sector to protect both frontline workers and the individuals they look after.

Last updated on hub: 01 November 2020

Discharges from NHSScotland hospitals to care homes between 1 March and 31 May 2020

Public Health Scotland

This publication presents management information statistics on people aged 18 and over who were discharged from an NHS Scotland hospital to a care home between 1 March and 31 May 2020. The first section of this report describes the methods used to identify the 5,204 discharges of 4,807 adults to care homes and describes their characteristics and COVID-19 testing status during their hospital admission. The second section focuses on the adult care homes that individuals were discharged to. It describes laboratory-confirmed care home outbreaks of COVID-19 across Scotland where the first positive test occurred between 1 March and 21 June. It then examines associations between care home characteristics and COVID-19 outbreaks, including examining association between hospital discharge to care homes and outbreaks. The data shows that: 843 of the 1084 care homes received 5,191 discharges between 1 March and 31 May (13 of the discharges identified were to English care homes or the care home could not be identified); using laboratory confirmed cases, 348 (32%) of care homes experienced an outbreak of COVID-19; the percentage of care homes with an outbreak increased progressively with care home size; almost all outbreaks (336/348) occurred in care homes for older people; COVID-19 associated mortality was concentrated in its impact, more than half of COVID-19 deaths were in 64 homes and a quarter of all COVID-19 deaths were in just 25 homes; 13.5% of care homes with no discharges from hospital had an outbreak, compared to 38% of care homes with one or more discharges.

Last updated on hub: 29 October 2020

An avoidable crisis: the disproportionate impact of Covid-19 on Black, Asian and minority ethnic communities

Labour Party

A report of a review into how people from Black, Asian and minority ethnic backgrounds have been impacted by Covid-19. The pandemic is having a disproportionate and devastating impact on ethnic minority communities. Not only are Black, Asian and minority ethnic people dying at a disproportionate rate, they are also overexposed to the virus and more likely to suffer the economic consequences. The report argues that, despite repeated warnings, the Government has failed to take sufficient action. Covid-19 has thrived on inequalities that have long scarred British society. Black, Asian and minority ethnic people are more likely to work in frontline or shutdown sectors which have been overexposed to Covid-19, more likely to have co-morbidities which increase the risk of serious illness and more likely to face barriers to accessing healthcare. Black, Asian and minority ethnic people have also been subject to disgraceful racism as some have sought to blame different communities for the spread of the virus. The virus has exposed the devastating impact of structural racism. The report makes both immediate and long-term recommendations to protect those most at risk and tackle structural inequalities in several key areas including the machinery of government, health, employment and in the education system.

Last updated on hub: 28 October 2020

COVID-19 and care homes: update paper, 23 September 2020

This paper reviews the latest evidence on the transmission of Covid-19 in care homes. It focuses specifically on the relative risk of each of four routes of ingress of infection to the care home (hospital discharge, staff, visitor (professional or domestic) and community admissions) as well as the route of transmission within care homes once infection has entered, for which more detailed genomic studies are critical. Key findings include: although staff-to-staff transmission has been observed to have been a contributory factor in specific outbreaks, it is important not to generalise to all outbreaks and emphasise one route over another without clear evidence – studies undertaken so far indicate that multiple introductions are common; retrospective genomic analysis and seropositive studies in care homes find evidence for multiple routes of virus ingress to care homes, but are not systematic enough to quantify the relative frequency of different routes of ingress; evidence of staff to staff transmission has emerged in the genomic analysis (high confidence); weak evidence on hospital discharge and modelling the impact of visitors does not suggest a dominant causal link to outbreaks from these sources; public health measures that reduce community incidence could be effective in reducing ingress into care homes; asymptomatic or atypically symptomatic presentation in residents and staff mean that ingress may be hidden for a number of generations of disease; sequencing community tests to understand the comparator population is critical for the future.

Last updated on hub: 27 October 2020

Rapid review for care homes in relation to Covid-19 in Wales

Welsh Government

This rapid review aimed to ensure that the lessons from best practice are learned and shared by Local Authorities and Health Boards who were involved in working with care homes during the initial period of the Covid-19 pandemic in the spring and summer of 2020. The work for the review has included reading some research studies, reading many submitted reports by Health and Social Care leaders from Wales and a series of interviews with stakeholders including a number of Care Home managers and owners. The report includes sections summarising the context for care homes, the initial impact of the virus and the response, and the best practices that were found in helping care homes to address the pandemic. The final section draws together a set of considerations that health and social care partners could use to assist them in completing their action plans for the winter. The review highlights the importance for health and care to work in partnership with care home managers to ensure that: every care home has an effective Infection Control Plan that is put into place; every care home has an effective plan for business continuity that includes ensuring that there are staff available to meet residents’ needs; every care home should be supported to ensure there are meaningful and helpful day to day activities for residents and that the wellbeing of both staff and residents are taken into account in all the decisions that are made; every care home has the right protective equipment; every care home has access to tests for residents and staff to know who may have the virus; and every care home has good access to primary health services including GPs.

Last updated on hub: 27 October 2020

What is the evidence of a relationship between socio-economic deprivation and the increased risk, if any, of infection with or death from COVID-19? Are there additional factors such as ethnicity, demography or population density which may amplify ...

HSE Library

This summary of evidence contains a comprehensive description of available research and key reference sources on the relationship between socio-economic deprivation, and additional factors such as ethnicity, demography or population density, and the increased risk of infection with or death from COVID-19.

Last updated on hub: 26 October 2020

Is visiting [in the social context] associated with increased incidence of COVID-19 in long-term residential care facilities?

HSE Library

This summary of evidence contains a comprehensive representation of available research evidence, key reference sources and collated information on the impact of visitors on the incidence of COVID-19 in long-term residential care facilities.

Last updated on hub: 26 October 2020

Testing guidelines for nursing homes: interim SARS-CoV-2 testing guidelines for nursing home residents and healthcare personnel

Centers for Disease Control and Prevention

This document provides guidance on the appropriate use of testing among nursing home residents. It covers: testing residents with signs or symptoms of COVID-19; testing asymptomatic residents with known or suspected exposure to an individual infected with; testing of asymptomatic residents without known or suspected exposure to an individual infected with; and Testing to determine resolution of infection.

Last updated on hub: 26 October 2020

Covid-19: interim guidance on the extended use of face masks and face coverings in hospitals, primary care, wider community care and adult care homes

Scottish Government

Guidance on the extended use of face masks and face coverings by staff within acute hospitals (including mental health, maternity, neonatal and paediatrics), community hospitals, primary care (GP practices, dentists, opticians and pharmacies) and wider community care (including adult social or community care and adult residential settings, care home settings and domiciliary care). The guidance also contains advice for visitors to care homes and hospitals, including those attending for an appointment.

Last updated on hub: 26 October 2020

Guidance on COVID-19 PCR testing in care homes and the management of COVID-19 PCR test positive residents and staff

Health Protection Scotland

The focus of this guide is on the application of PCR testing in care homes, primarily but not exclusively, as part of outbreak investigation and management and on managing the consequences of finding PCR test positive residents and staff. It helps NHS Boards, care home providers and others to interpret and implement this extended testing policy; and to identify what is required to achieve the greatest potential reduction in the risk of transmission of the virus within all forms of residential care home settings for the elderly, in the shortest possible time. The advice is written from a clinical perspective and reflects a consensus on which health protection measures are likely to be the most effective in achieving the maximum reduction in the risk of infection, most quickly.

Last updated on hub: 26 October 2020

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