COVID-19 resources on infection control

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Infection prevention and control in care homes

Care Quality Commission

A set of questions and prompts used by CQC inspectors to assess how well staff and residents of care homes are protected by infection prevention and control, including checks for COVID-19 mitigation.

Last updated on hub: 20 October 2020

Face-to-face DoLS assessments strongly discouraged in high-risk Covid areas

Community Care

A brief overview of current guidance relating to face-to-face Deprivation of Liberty Safeguards (DoLS) assessments, highlighting that practitioners should only carry out face-to-face assessments “in exceptional circumstances” in areas covered by tier 2 and 3 Covid-19 restrictions. Updated guidance also says that people without relevant capacity are unlikely to be committing offence if they breach self-isolation regulations.

Last updated on hub: 20 October 2020

Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes

Journal of Infection

Background: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England. Methods: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. Results: In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9–4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes. Conclusions: SARS-CoV-2 positivity was significantly higher among staff working across different care homes than those who were working in the same care home. We found local clusters of SARS-CoV-2 infection between staff only, including those with minimal resident contact. Infection control should be extended for all contact, including those between staff, whilst on care home premises.

Last updated on hub: 19 October 2020

Supporting individuals with intellectual and developmental disability during the first 100 days of the COVID‐19 outbreak in the USA

Journal of Intellectual Disability Research

Background: It is unknown how the novel Coronavirus SARS‐CoV‐2, the cause of the current acute respiratory illness COVID‐19 pandemic that has infected millions of people, affects people with intellectual and developmental disability (IDD). The aim of this study is to describe how individuals with IDD have been affected in the first 100 days of the COVID‐19 pandemic. Methods: Shortly after the first COVID‐19 case was reported in the USA, the organisation in this study, which provides continuous support for over 11 000 individuals with IDD, assembled an outbreak committee composed of senior leaders from across the health care organisation. The committee led the development and deployment of a comprehensive COVID‐19 prevention and suppression strategy, utilising current evidence‐based practice, while surveilling the global and local situation daily. This study implemented enhanced infection control procedures across 2400 homes, which were communicated to employees using multi‐faceted channels including an electronic resource library, mobile and web applications, paper postings in locations, live webinars and direct mail. Custom‐built software applications were used to track patient, client and employee cases and exposures, and this study leveraged current public health recommendations to identify cases and to suppress transmission, which included the use of personal protective equipment. A COVID‐19 case was defined as a positive nucleic acid test for SARS‐CoV‐2 RNA. Results: In the 100‐day period between 20 January 2020 and 30 April 2020, this study provided continuous support for 11 540 individuals with IDD. Sixty‐four per cent of the individuals were in residential, community settings, and 36% were in intermediate care facilities. The average age of the cohort was 46 ± 12 years, and 60% were male. One hundred twenty‐two individuals with IDD were placed in quarantine for exhibiting symptoms and signs of acute infection such as fever or cough. Sixty‐six individuals tested positive for SARS‐CoV‐2, and their average age was 50. The positive individuals were located in 30 different homes (1.3% of total) across 14 states. Fifteen homes have had single cases, and 15 have had more than one case. Fifteen COVID‐19‐positive individuals were hospitalised. As of 30 April, seven of the individuals hospitalised have been discharged back to home and are recovering. Five remain hospitalised, with three improving and two remaining in intensive care and on mechanical ventilation. There have been three deaths. This study found that among COVID‐19‐positive individuals with IDD, a higher number of chronic medical conditions and male sex were characteristics associated with a greater likelihood of hospitalisation. Conclusions: In the first 100 days of the COVID‐19 outbreak in the USA, this study observed that people with IDD living in congregate care settings can benefit from a coordinated approach to infection control, case identification and cohorting, as evidenced by the low relative case rate reported. Male individuals with higher numbers of chronic medical conditions were more likely to be hospitalised, while most younger, less chronically ill individuals recovered spontaneously at home.

Last updated on hub: 19 October 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

Recommendations in covid-19 times: a view for home care

Brazilian Journal of Nursing (Revista Brasileira de Enfermagem)

Objective: To suggest recommendations for the practice of Home Nursing in the context of COVID-19. Method: Reflective study, originated from readings associated with the theme, available in current guidelines from the Pan American Health Organization, World Health Organization and the Ministry of Health. Results: Recommendations were developed from current scientific evidence for prevention of infections, control of epidemics and pandemics in the Brazilian home scenario. Final considerations: the reflections achieved contribute to guiding actions for better assistance to the patient, family caregivers and the community in the perspective of safe home care with COVID-19, and it is characterized as an introductory discussion on the theme, encouraging new studies to be carried out from the unfolding of the current scenario.

Last updated on hub: 19 October 2020

How will Brexit affect the UK’s response to coronavirus?

The Nuffield Trust

This briefing looks at how leaving the single market might affect UK health and social care services in the short term as they try to deal with coronavirus while maintaining normal services. It will also look at what difference a deal might make, and the options that the UK and the EU have. The paper makes the following key points: leaving the single market will create new and wide-ranging problems for the majority of NHS medicines and medical devices which come from or via the EU – the coronavirus wave and Brexit stockpiling both created spikes in imported supplies, and filling both requirements at once may be very difficult; export blocks on medically vital supplies by the EU were used during the first wave of coronavirus and could cover the UK after 31 December; the UK will no longer have access to the European Centre for Disease Prevention and Control (ECDC), which collects and shares intelligence on pandemics and other infectious disease outbreaks; based on negotiating documents, draft treaties, and briefing to date, the majority of the crucial issues for health which could have been secured in an agreement are not agreed upon by the two sides, or the outcome is uncertain – these should be given a higher priority in the context of the ongoing pandemic; several important areas for responding to coronavirus depend on cooperative practices and favourable decisions across the EU and UK, beyond simply the presence or absence of a deal; poor funding for public health and social care contributed to limitations in the UK’s capacity to address coronavirus during the first wave – leaving the single market will mean slower growth, making addressing these more difficult though the case to do so remains very strong.

Last updated on hub: 19 October 2020

How Coronavirus has affected people with learning disabilities and autistic people: easy read

Department of Health and Social Care

This report comes from the Social Care Taskforce National Advisory Group: People with Learning Disabilities and Autistic People. The group gives the Government advice about services for people with learning disabilities or autistic people. The report explains how Coronavirus is affecting people with learning disabilities and autistic people; and what the Government should do to keep people safe. This includes new ways of working; accessible information; continuing to support people; helping lonely people and those who are often are left out.

Last updated on hub: 19 October 2020

Right2visit

bemix

This website is for families or close friends having problems visiting a loved one who is autistic and/or has learning disabilities. Visits are being limited or stopped because of COVID-19.

Last updated on hub: 19 October 2020

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

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