COVID-19 resources on infection control

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Caught between two fronts: successful aging in the time of COVID-19

Working with Older People

Purpose: The COVID-19 pandemic poses a great challenge for older people both in terms of the severity of the disease and the negative consequences of social distancing. Assumptions about negative effects on the lives of the elderly, affecting dimensions of successful aging (such as the preservation of social relationships), have thus far been hypothetical and have lacked empirical evidence. The aim of this paper is to shed empirical light on the effects of COVID-19 on the everyday life of older people against the background of the concept of successful aging. Design/methodology/approach: Data of a standardized, representative telephone survey with residents of Lower Austria, a county of Austria, were used for this secondary analysis. The sample included 521 persons of 60 years of age and older. For this paper, contingency analyses (χ² coefficients, z-tests using Bonferroni correction) and unidimensional correlational analyses were calculated. Findings: The empirical data show that successful aging along the three dimensions of successful aging is a challenge in the time of the COVID-19 pandemic – leaving the elderly caught between two fronts. Originality/value: The present work focusses on a unique moment in time, describing the changes to the lives of Austrian elderly because of the social distancing measures imposed to protect against the spread of COVID-19. These changes are discussed in the theoretical framework of successful aging.

Last updated on hub: 29 December 2020

Discharge into care homes: designated settings

Department of Health and Social Care

This guidance is for local authorities, clinical commissioning groups, care providers and people who use these services. It sets out: advice on setting up designated settings, and information for local authorities and providers; information on discharge arrangements, and supporting individuals to ensure that their care needs and preferences are accounted for; additional advice on data collection, funding, visiting, and infection prevention and control (IPC) requirements. A designation scheme has been introduced to ensure that everyone being discharged from hospitals to care homes who is COVID-19 positive, is discharged to premises that meet a set of agreed control standards to complete the recommended 14-day isolation period. Local authorities must have access to at least one designated setting or suitable alternative premises (for example, NHS community hospital beds). [First published 16 December 2020. Last updated 13 January 2021]

Last updated on hub: 22 December 2020

The impact of the Covid-19 pandemic on Approved Mental Health Professional (AMHP) services in England

British Association of Social Workers

Based on responses to a survey from 100 Approved Mental Health Professional (AMHP) services across England, which account for 75% of the local authorities across the country, this report explores the impact of the Covid-19 pandemic on mental health professionals and services. The survey questions focused on changes in demand for Mental Health Act (MHA) assessments both during the first lockdown and following the easing of restrictions, the possible reasons for the changes and the impact of the pandemic and the resulting restrictions on staff. Most respondents reported an increase in assessments overall, particularly during the lockdown period and into the post-lockdown period in summer. This amounts to a higher level of demand than prior to the pandemic. Many services identified a significant increase in ‘first-time presentations’ of people who had not been previously known to mental health services. Concern was expressed from many respondents that withdrawal of face-to-face visits and monitoring by community services, and reduction of contact to telephone only, led to requests for MHA assessments which would not otherwise have been made and which did not warrant consideration of detention in hospital. During the lockdown many professionals moved to working from home, raising a number of issues in relation to support, supervision and management, particularly in the context of MHA assessment referrals, which by definition entail high risk with a need for rapid information gathering and assessment. Many respondents reported greater difficulty in accessing admission beds, possibly due to the need to isolate patients who were COVID-positive or at risk of being. Many areas found section 12 approved doctors less available, due to shielding, isolation or redeployment to COVID duties. Some ambulance services reduced or stopped providing transportation for mental health patients, leading to some services starting or increasing their use of private ambulance services.

Last updated on hub: 22 December 2020

Covid-19 Insight: issue 6

Care Quality Commission

This report shares regional data on the designated settings that allow people with a COVID-positive test result to be discharged safely from hospital, and the latest data on registered care home provision. It also looks at how providers have collaborated to provide urgent and emergency care during the pandemic. In addition, the report updates data on outbreaks and staff absences in homecare services; numbers of deaths of people detained under the Mental Health Act; numbers of deaths of people with a learning disability; breakdown of deaths in adult social care settings by ethnicity.

Last updated on hub: 22 December 2020

Technical Advisory Group: updated consensus statement on recommended testing criteria for discharge of asymptomatic patients to care homes

Welsh Government

Currently a negative RT-PCR test for SARS-CoV-2 is required before a patient can be discharged from hospital to a care home. This paper examines, in the light of emerging knowledge of infectivity, whether an alternative testing strategy may be more appropriate. It recommends that patients that have had COVID-19 during admission but who have had resolution of fever for at least three days and clinical improvement of symptoms other than fever, and are to be discharged from hospital to a care home or other step down care can be assumed to be non-infectious if 20 days have elapsed since onset of symptoms, or first positive SARS-CoV-2 test; or 14 days have elapsed since onset of symptoms, or first positive SARS-CoV-2 test and an RT-PCR test is negative or ‘low positive’ with a Ct value ≥35. For patients with severe immunocompromised, there should be individualised discussion and assessment between clinical and microbiology teams. If these criteria are fulfilled, residents who have had COVID-19 during hospital admission would not require isolation when discharged to a care home or other stepdown facility. Residents who had not had evidence of COVID-19 infection during admission to hospital would still need to self-isolate for 14 days following discharge.

Last updated on hub: 22 December 2020

Rapid review update 1: what risk factors are associated with COVID-19 outbreaks and mortality in long-term care facilities and what strategies mitigate risk?

McMaster University

This rapid review was produced to support public health decision makers’ response to the COVID-19 pandemic. It seeks to identify, appraise, and summarise emerging research evidence to support evidence-informed decision making. The review is based on the most recent research evidence available at the time of release. A previous version was completed on October 16, 2020. This updated version includes evidence available up to November 30, 2020 to answer the question: What risk factors are associated with COVID-19 outbreaks and mortality in LTC facilities and what strategies mitigate risk? Across studies, incidence in the surrounding community was found to have the strongest association with COVID-19 infections and/or outbreaks in LTC settings. Several resident-level factors including, racial/ethnic minority status, older age, male sex, receipt of Medicaid or Medicare were associated with risk of COVID-19 infections, outbreaks and mortality; severity of impairment was associated with infections and outbreaks, but not mortality. At the organisational level, increased staffing, particularly Registered Nurse (RN) staffing was consistently associated with reduced risk of COVID-19 infections, outbreaks and mortality while for-profit status, facility size/density and movement of staff between facilities was consistently associated with increased risk of COVID-19 infections, outbreaks and mortality. Most guideline recommendations include surveillance, monitoring and evaluation of staff and resident symptoms, and use of personal protective equipment (PPE). Other interventions demonstrating some effect on decreased infection rates within syntheses and a small number of single studies include promotion of hand hygiene, enhanced cleaning measures, social distancing, and cohorting. Technological platforms and tools (e.g., digital contact tracing, apps, heat maps) are being developed and show potential for decreased transmission through efficient case and/or contact identification that further informs infection control planning strategies.

Last updated on hub: 22 December 2020

Rapid review: what risk factors are associated with COVID-19 outbreaks and mortality in long-term care facilities and what strategies mitigate risk?

McMaster University

This rapid review was produced to support public health decision makers’ response to the COVID-19 pandemic. It seeks to identify, appraise, and summarise emerging research evidence to support evidence-informed decision making. The review includes evidence available up to October 5, 2020 to answer the question: What risk factors are associated with COVID-19 outbreaks and mortality in LTC facilities and what strategies mitigate risk? Across studies, incidence in the surrounding community was found to have the strongest association with COVID-19 infections and/or outbreaks in LTC settings. Several resident-level factors including, racial/ethnic minority status, older age, male sex, receipt of Medicaid or Medicare were associated with risk of COVID-19 infections, outbreaks and mortality; severity of impairment was associated with infections and outbreaks, but not mortality. Most guideline recommendations include surveillance, monitoring and evaluation of staff and resident symptoms, and use of personal protective equipment (PPE). Other interventions demonstrating some effect on decreased infection rates within syntheses and a small number of single studies include promotion of hand hygiene, enhanced cleaning measures, social distancing, and cohorting. Technological platforms and tools (e.g., digital contact tracing, apps, heat maps) are being developed and show potential for decreased transmission through efficient case and/or contact identification that further informs infection control planning strategies.

Last updated on hub: 22 December 2020

Homeless and forgotten: surviving lockdown in temporary accommodation

Shelter England.

This research reveals the total number of people who spent lockdown in temporary accommodation, and shares the experiences of over 20 households who told us what it was like to be homeless in a pandemic. Temporary accommodation (TA) is the name given to the accommodation that is often offered to people who seek help from their council as they are homeless, eligible for help and owed ‘a rehousing duty’. The report starts by setting out new findings on the number of people who were living in temporary accommodation during lockdown. It then describes what it is like to live in temporary accommodation, before moving on to people’s experience of lockdown and the impact it had on them. It then sets out the changes needed to ensure that, as life gets back to normal, everybody has the right to a safe home. There were over a quarter of a million (253,620) homeless people living in temporary accommodation in England during the first national lockdown This works out as an estimated 1 in 222 people were homeless and living in temporary accommodation. Families, especially single parent households, are overrepresented among homeless people in temporary accommodation. During the lockdown, people in TA found it difficult to keep safe due to physical proximity; to meet lockdown rules and stay safe; and to meet basic needs. Almost all (20 out of 21) of the interviewees said that their or their partner’s mental health had been negatively affected by living in TA. Most people (20 out of 21) also reported that their or their partner’s physical health had also been negatively affected by living in the accommodation. Children experienced a negative impact on education and development; lack of safe space to play; impact on mental health and behaviour; impact on physical health.

Last updated on hub: 22 December 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

Coronavirus (COVID-19): adult care home visitor testing guidance

Scottish Government

Coronavirus (COVID-19) adult care home visitor testing guidance which forms part of the Test and Protect Pathways Programme. The Scottish Government’s COVID-19 Test and Protect Pathways Programme has expanded testing to include care home visitors. Currently this is aimed at designated visitors, i.e. a family member or friend chosen by the resident to visit them indoors. This webpage contains guidance and materials to support care homes to implement visitor testing.

Last updated on hub: 22 December 2020

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