COVID-19 resources on Infection control

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Adult secure service user, family and carer feedback survey during the Coronavirus (COVID-19) pandemic

Rethink Mental Illness

Findings from a survey to gather the views and experiences of people in adult secure services, in all service categories including mental illness, personality disorder, learning disability and autism (both in the hospital and the community), and their families and carers, to find out the impact of COVID-19 on them from March to June 2020. The most striking finding was the considerable variation in responses – both between services and within the same service. This report sets out 9 key areas where people identified examples of what is working well, as well as where lessons could be learnt and improvements made, not only for a potential second wave of the pandemic but also to ensure long lasting improvements for services as a consequence of this experience. The key areas are: activities; outdoor access; leave and progress; communication; digital access; family and friends contact; infection control; physical health; and staff. Leave was the most common theme in all of the responses to the survey and overwhelmingly people found the restrictions difficult. People cited a range of reasons for this – not being able to continue with community activities, feeling ‘cooped up’ and the impact on seeing friends and family. Some people linked these restrictions to the effect this was having on their progress and were frustrated that this was holding them up. There was also frustration for people that lockdown easing in the community was not always reflected in the lifting of restrictions in their hospital. Overall, people said they were very understanding of the measures that needed to be in place to limit the impact of COVID-19 and keep them safe.

Last updated on hub: 19 November 2020

Recasting social workers as frontline in a socially accountable COVID-19 response

International Social Work

The COVID-19 pandemic has seen the engagement of a wide range of professionals in responding to clinical, social and economic issues. While the clinical expression of the pandemic has generated strong media portrayal of physicians and nurses as frontline workers, social workers – who play a key role in helping individuals and families in crisis – have not been similarly highlighted. The pandemic within a social accountability framework highlights important roles of both public officials and civic society in containment efforts. This article recognizes social workers as important actors in their representative and supportive role for civil society during COVID-19.

Last updated on hub: 19 November 2020

Social work and COVID-19 pandemic: an action call

International Social Work

The social work profession, more than any other, is most hurt by the rampaging coronavirus (aka, COVID-19) pandemic given the scourge’s pernicious impact on society’s underserved and undervalued populations. More so, the pandemic has undermined the profession’s historical value commitment to social justice and human rights while overturning our insistence on the importance of human relationships. The purpose of this essay is to explicate the nexus between social work and COVID-19 pandemic. While noting the deafening silence of the profession in the global discourse of the pandemic, it advocates for the urgency of our response if our profession is to attain significant public value amid the current loss of lives and threats to human rights. Strategies for our professional action, in flattening the curve of the contagion, are laid out.

Last updated on hub: 19 November 2020

A rapid systematic review of measures to protect older people in long term care facilities from COVID-19

medRxiv

The global COVID-19 pandemic produced large-scale health and economic complications. Older people and those with comorbidities are particularly vulnerable to this virus, with nursing homes and long term care facilities experiencing significant morbidity and mortality associated with COVID-19 outbreaks. The aim of this rapid systematic review was to investigate measures implemented in long term care facilities to reduce transmission of COVID-19 and their effect on morbidity and mortality of residents, staff, and visitors. Databases (including MedRXiv pre-published repository) were systematically searched to identify studies reporting assessment of interventions to reduce transmission of COVID-19 in nursing homes among residents, staff, or visitors. Outcome measures include facility characteristics, morbidity data, case fatalities, and transmission rates. Due to study quality and heterogeneity, no meta-analysis was conducted. The search yielded 1414 articles, with 38 studies included. Reported interventions include mass testing, use of personal protective equipment, symptom screening, visitor restrictions, hand hygiene and droplet/contact precautions, and resident cohorting. Prevalence rates ranged from 1.2-85.4% in residents and 0.6-62.6% in staff. Mortality rates ranged from 5.3-55.3% in residents. Novel evidence in this review details the impact of facility size, availability of staff and practices of operating between multiple facilities, and for-profit status of facilities as factors contributing to the size and number of COVID-19 outbreaks. No causative relationships can be determined; however, this review provides evidence of interventions that reduce transmission of COVID-19 in long term care facilities.

Last updated on hub: 17 November 2020

Deaths of people identified as having learning disabilities with COVID-19 in England in the spring of 2020

Public Health England

This review analyses the available data on the deaths from COVID-19 of people identified as having learning disabilities. The review looked at: deaths from COVID-19 of people with learning disabilities; factors impacting the risk of death from COVID-19 of people with learning disabilities; deaths in care settings of people with learning disabilities. The key finding of this study was that people with learning disabilities had significantly and substantially higher death rates in the first wave of COVID19 in England than the general population. Making no allowance for the younger age and different sex ratio of people with learning disabilities, the rate of deaths notified to LeDeR in this group was 2.3 times the death rate in the general population. If this figure is adjusted to allow for the likely level of under-notification to LeDeR it was 3.5 times the general population rate. After standardisation for age and sex the rate calculated just from notifications to LeDeR was 4.1 times the general population rate. Adjusting for the likely level of under-notification it was 6.3 times the general population rate. The total number of deaths in adults with learning disabilities for the 11 weeks from 21 March to 5 June was 2.2 times the average number for the corresponding period in the 2 previous years. By contrast, the number of deaths in the general population was 1.5 times the average for the 2 previous years. Deaths with COVID-19 in adults with learning disabilities were spread more widely across the age groups than those in the general population. As in the general population, the COVID-19 death rate in people with learning disabilities was higher for men than for women. The overall increase in deaths was also greater in Asian or Asian-British, and Black or Black-British people. Residential care homes providing care for people with learning disabilities do not appear to have had the very high rates of outbreaks of COVID-19 seen in homes providing care for other groups, mainly older people. This appears to be related to their smaller number of beds.

Last updated on hub: 16 November 2020

Deaths of people with learning disabilities from COVID-19

University of Bristol

This report describes the circumstances leading to death for a representative sample of 206 adults with learning disabilities. The majority of the 206 deaths (79%, n=163) were attributable to COVID-19: 27% of the total number of COVID-19 deaths notified to the LeDeR programme from 2nd March 2020 – 9th June 2020. Forty-three (21%) of the 206 deaths were attributed to other causes and are included as a comparator group – 6% of the total deaths from other causes occurring during this period. The study finds that there is a striking difference in age at death between COVID-19 deaths in the general population compared with people with learning disabilities. In the general population of England and Wales, 47% of deaths from COVID-19 were in people aged 85 years and over. Of all deaths of people with learning disabilities from COVID-19 notified to the LeDeR programme, just 4% were aged 85 years and over. A third (35%) of those who died from COVID-19 lived in residential care homes, rising to almost half of those with Down’s syndrome. A quarter (25%) lived in supported living settings. Priority must be given to supporting measures to prevent the spread of COVID-19 in these settings. People who died from COVID-19 were more frequently reported to have respiratory conditions (72%), compared to those who died from other conditions (60%). Access to healthcare that was problematic for some people who died from COVID-19 included: the responsiveness of NHS111; access to COVID-19 tests; and access to specialist learning disability nurses. Ensuring that these services are fully accessible to people with learning disabilities, their families and paid carers would improve service provision.

Last updated on hub: 16 November 2020

Supporting wellbeing of older people when shielding / isolating

Public Health Wales Observatory

This summary outlines action that the evidence suggests may help to support the mental wellbeing of older adults at this time. It is intended for organisations involved in supporting older people. Four systematic reviews were identified from a search of the literature conducted in June 2019. Most provided data from qualitative research and captured the perceptions of older people on quality of life, meaningful occupations and experience of technology. Reflecting on the findings from these reviews, the analysis suggests a number of actions for consideration by those involved in supporting older people. These actions focus on: maintaining autonomy and control; occupation and social interaction; access to the internet; and money and resources.

Last updated on hub: 16 November 2020

Coronavirus and the social impacts on disabled people in Great Britain: September 2020

The Office for National Statistics

Indicators from the Opinions and Lifestyle Survey on the social impact of the coronavirus (COVID-19) pandemic on disabled people in Great Britain. This release uses two waves of survey results covering 24 September to 4 October 2020 and includes indicators broken down by impairment type. Insights from qualitative research commissioned by the Cabinet Office Disability Unit and conducted by Policy Lab with disabled people help illustrate how the survey indicators can be experienced by disabled people in day-to-day life. The data shows that over 8 in 10 (83%) disabled people compared with around 7 in 10 (71%) non-disabled people said they were “very worried” or “somewhat worried” about the effect that the coronavirus (COVID-19) pandemic was having on their life in September 2020. Around 5 in 10 (50%) disabled people who were receiving medical care before the coronavirus pandemic began, indicated that they were either currently receiving treatment for only some of their conditions (29%), or that their treatment had been cancelled or not started (22%), compared with less than 3 in 10 (27%) of non-disabled people who had a physical or mental health condition or illness and were receiving care before the pandemic. All well-being ratings of disabled people remained poorer in September 2020 compared with a similar period prior to the coronavirus pandemic; almost half (47%) of disabled people reported high anxiety (a score of 6 out of 10 or higher) in September 2020 compared with less than a third (29%) of non-disabled people. A larger proportion of disabled people (83%) than non-disabled people (77%) supported “strict” or “very strict” enforcement by police of government rules aimed at combatting the coronavirus such as social distancing.

Last updated on hub: 16 November 2020

COVID 19 deaths of people identified as having learning disabilities: summary

Public Health England

Summarises findings of a review that looked at: deaths from COVID-19 of people with learning disabilities; factors impacting the risk of death from COVID-19 of people with learning disabilities; deaths in care settings of people with learning disabilities. The key finding of this study was that people with learning disabilities had significantly and substantially higher death rates in the first wave of COVID19 in England than the general population. Making no allowance for the younger age and different sex ratio of people with learning disabilities, the rate of deaths notified to LeDeR in this group was 2.3 times the death rate in the general population. If this figure is adjusted to allow for the likely level of under-notification to LeDeR it was 3.5 times the general population rate. After standardisation for age and sex the rate calculated just from notifications to LeDeR was 4.1 times the general population rate. Adjusting for the likely level of under-notification it was 6.3 times the general population rate. The total number of deaths in adults with learning disabilities for the 11 weeks from 21 March to 5 June was 2.2 times the average number for the corresponding period in the 2 previous years. By contrast, the number of deaths in the general population was 1.5 times the average for the 2 previous years. Deaths with COVID-19 in adults with learning disabilities were spread more widely across the age groups than those in the general population. As in the general population, the COVID-19 death rate in people with learning disabilities was higher for men than for women. The overall increase in deaths was also greater in Asian or Asian-British, and Black or Black-British people. Residential care homes providing care for people with learning disabilities do not appear to have had the very high rates of outbreaks of COVID-19 seen in homes providing care for other groups, mainly older people. This appears to be related to their smaller number of beds.

Last updated on hub: 16 November 2020

Dealing with COVID-19 outbreaks in long-term care homes: a protocol for room moving and cohorting

Article published in the journal Infection Control & Hospital Epidemiology by Kain, D. et al, October 2020. A letter to the editor that sets out some principals of room movements in long-term care homes during the COVID-19 in the context of Canadian care homes.

Last updated on hub: 13 November 2020

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