COVID-19 resources on infection control

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COVID-19 and Coronavirus evidence alerting. Rapid scan 1: effects on people in care/nursing homes (and other residential facilities) including approaches to protecting workers and residents

NHS Midlands and Lancashire Commissioning Support Unit

This rapid scan collates new and emerging evidence on implications for care homes and residential facilities and transferable lessons from previous pandemics and major incidents. It highlights key papers to inform decisions, policy and planning, and is intended to be pragmatic rather than exhaustive in its coverage. The resource summarises key messages and recurring themes emerging from the evidence – around PPE, reducing the spread, surge planning, staffing, communication, isolation and distancing, and technology – and signposts to expert commentary, key guidance, rapid reviews, lessons from previous pandemics, ongoing studies and other useful resources.

Last updated on hub: 24 June 2020

Covid-19 and early intervention: understanding the impact, preparing for recovery

The Early Intervention Foundation

This report explores the impact of COVID-19 on early help – the range of services that would ordinarily be supporting vulnerable children and families below the threshold for statutory local authority support, including targeted support provided by universal services. It considers the response of local services across England to the immediate challenges presented by COVID-19, and the challenges on the horizon. This work was undertaken by EIF and Action for Children between March and May 2020 and is based on 28 semi-structured qualitative interviews with heads of early help services, lead practitioners, and head teachers. Areas of focus include: risk assessment and referral in a virtual environment; virtual delivery of services; maintaining essential face-to-face delivery; closure of school and early years provision; and longer-term issues. The findings indicate that the pandemic has necessitated rapid adaptation of the way that services support vulnerable children and families, characterised by an almost wholesale transition to virtual or online contact while retaining some element of face-to-face provision when needed. There is a unique opportunity to improve the evidence base on virtual delivery of early intervention for children and families through seizing the opportunity for testing and evaluation. Conversely, the professionals recognise that there is a risk that some children and families who became vulnerable or became more vulnerable during the lockdown period could be missed without home visits. The research also identified a clear sense of apprehension among professionals about the longer-term impact of the pandemic and particularly the lockdown period on vulnerable children and families, and about the ability of services to cope with the demand that this will create.

Last updated on hub: 30 June 2020

COVID-19 and health inequality

Independent Scientific Advisory Group for Emergencies

This report examines Covid-19 mortality rates in the most deprived neighbourhoods in England and in the lowest income households – contextualising them within the wider issue of health inequalities. Firstly, the report provides an overview of socio-economic health inequalities in the UK. It then summarises epidemiological evidence of socio-economic inequalities in relation to Covid-19 (both in the UK and internationally) and examines the pathways linking Covid-19 and inequality. In part three, it examines inequalities and the impact of the emergency policy response to Covid-19, including the lockdown, the emerging parallel pandemic of restricting non-COVID NHS services, mental health impacts, rising homelessness and school closures. Part four examines the emerging evidence of an unequal Covid-19 economic crisis and the impact that it could have on future health inequalities. The report concludes by outlining some key recommendations whereby local government and devolved authorities, the NHS and national government can act to reduce these inequalities. Key messages include: Covid-19 has magnified and exacerbated health inequalities with higher rates of illness and death from Covid-19 in more deprived communities; Covid-19 has highlighted the importance of the social determinants of health namely – housing, income, nutrition, employment sickness benefits and financial support, social security and social care and health care; people in lower paid jobs or living in more deprived neighbourhoods are more likely to experience adverse outcomes from the virus because of co-morbidities and reduced immune response associated with poverty and stress, occupational exposures and inability to shield at home, overcrowding and homelessness, lack of sickness benefits and lack of access to and adequacy of health and social care services. While the UK government has taken steps to mitigate some of the distributional impacts of Covid-19, there is an urgent need for additional action to reinvest and rebuild capacity in all public services linked to a strategy for full employment and resource redistribution.

Last updated on hub: 24 November 2020

COVID-19 and the female health and care workforce: survey of health and care staff for the Health and Care Women Leaders Network, August 2020

NHS Confederation

This report sets out the findings of a survey to understand the impact the Covid-19 pandemic has had on women working across health and care services. A total of 1,308 women responded to the survey. While the overwhelming majority of respondents to the survey were white, there were some key differences in the findings in relation to participants from black and minority ethnic (BME) backgrounds. The survey found that most respondents – almost three-quarters – had reported that their job had a greater negative impact than usual on their emotional wellbeing as a result of the pandemic, and more than half had suffered a negative impact on their physical health. Staff from BME backgrounds also reported feeling traumatised by the disproportionate impact of the virus, compounded by concerns over risk assessments not being performed in a timely manner, if at all. In addition, the analysis shows that PPE availability and training have been broadly adequate, but could be stronger; managerial support has been strong, but some issues emerge over sharing concerns; struggles with work-life balance since lockdown started; some respondents had safety concerns when working from home. The report also draws out some of the positive experiences, such as opportunities for learning and the strength of support many have received from their managers. Recommendations to improve the working conditions for women in health and care services are included.

Last updated on hub: 27 August 2020

COVID-19 and the MCA 2005

Mental Capacity Law and Policy

This page includes resources relating to COVID-19 and the Mental Capacity Act 2005. It offers an overview of DHSC, NHS England and NHS Improvement, and CQC guidance. It also signposts to additional guidance from the Social Care Institute for Excellence, NICE and ADASS. The key message is that the MCA 2005 is not, itself, changed by the current circumstances. Nothing in the Coronavirus Act 2020 (for instance) changes the obligations imposed under it. However, the Act is having to be applied in a different context, which will require all those involved to think creatively about how to secure its core principles, as well as to be clear as to when a particular option is simply not available so that it does not fall for consideration as part of any best interests decision-making process.

Last updated on hub: 21 September 2020

COVID-19 checklist for choosing a care home: 5 questions for residents, families, friends and carers to ask

National Care Forum

This short guide helps think about what individuals need to know and the questions they might ask when thinking about a choice of home during COVID-19. The pandemic means that care homes have had to learn to do things differently while continuing to provide high quality care. The questions focus on the quality of the home; the extent to which residents are able to maintain contacts with friends and family in a safe way; the testing programme; the use of personal protective equipment; and the health and hygiene measures that are in place to stop the spread of COVID-19.

Last updated on hub: 24 September 2020

COVID-19 guide for drug and alcohol residential rehab and detox services

Social Care Institute for Excellence

This guide aims to provide specific and useful information for all drug and alcohol residential detox and rehab services dealing with COVID-19.

Last updated on hub: 22 July 2020

COVID-19 in long-term care facilities: An upcoming threat that cannot be ignored

Perspective published in the Journal of Microbiology, Immunology and Infection in June 2020. The perspective considers the the spread of COVID-19 in long-term care facilities in the United States up to the time of publication. Concludes that infection prevention and control (IPC) polices should be established in long-term care facilities and strictly adhered to in order to prevent this disease from entering these facilities and spreading within and outside of them. Citation: Lai, C. C., et al. (2020). COVID-19 in long-term care facilities: An upcoming threat that cannot be ignored. Journal of Microbiology, Immunology, and Infection, 53(3), 444.

Last updated on hub: 19 October 2020

Covid-19 infection and attributable mortality in UK long term care facilities: cohort study using active surveillance and electronic records (March-June 2020)

medRxiv

This article is a preprint and has not been peer-reviewed. The lead researcher was Peter F Dutey-Magni. Background: Rates of Covid-19 infection have declined in many countries, but outbreaks persist in residents of long-term care facilities (LTCFs) who are at high risk of severe outcomes. Epidemiological data from LTCFs are scarce. This study used population-level active surveillance to estimate incidence of, and risk factors for Covid-19, and attributable mortality in elderly residents of LTCFs. Methods: Cohort study using individual-level electronic health records from 8,713 residents and daily counts of infection for 9,339 residents and 11,604 staff across 179 UK LTCFs. This study modelled risk factors for infection and mortality using Cox proportional hazards and estimated attributable fractions. Findings: 2,075/9,339 residents developed Covid-19 symptoms (22.2% [95% confidence interval: 21.4%; 23.1%]), while 951 residents (10.2% [9.6%; 10.8%]) and 585 staff (5.0% [4.7%; 5.5%]) had laboratory confirmed infections. Confirmed infection incidence in residents and staff respectively was 152.6 [143.1; 162.6] and 62.3 [57.3; 67.5] per 100,000 person-days. 121/179 (67.6%) LTCFs had at least one Covid-19 infection or death. Lower staffing ratios and higher occupancy rates were independent risk factors for infection. 1,694 all-cause deaths occurred in 8,713 (19.4% [18.6%; 20.3%]) residents. 217 deaths occurred in 607 residents with confirmed infection (case-fatality rate: 35.7% [31.9%; 39.7%]). 567/1694 (33.5%) of all-cause deaths were attributable to Covid-19, 28.0% of which occurred in residents with laboratory-confirmed infection. The remainder of excess deaths occurred in asymptomatic or symptomatic residents in the context of limited testing for infection, suggesting substantial under-ascertainment. Interpretation: 1 in 5 residents had symptoms of infection during the pandemic, but many cases were not tested. Higher occupancy and lower staffing levels increase infection risk. Disease control measures should integrate active surveillance and testing with fundamental changes in staffing and care home occupancy to protect staff and residents from infection.

Last updated on hub: 31 August 2020

COVID-19 infection prevention and control guidance for family and friends (informal carers) who support people in their own homes

Health Service Executive

This guidance has been developed to help carers and people who are cared for on how to protect each other from COVID-19. It is also intended to help healthcare workers who advise people who provide care about how to keep safe from infection. It sets out the steps that carers need to take before and during their visit to the person they care for.

Last updated on hub: 22 December 2020

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