COVID-19 resources on Infection control

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Potential impact of COVID-19: government policy on the adult social care workforce

Institute for Employment Studies

This report is the output of a research project to identify how government COVID-19 related policy may have impacted upon the adult social care workforce in England. The project had a particular focus on Test and Trace, and the ways in which policy changes may have enabled and incentivised the necessary behaviours of care workers. The working hypothesis has been that care workers’ behaviours are likely to be driven by a combination of commitment to those they care for, risks to themselves and their families from COVID-19 and impacts on incomes. Government policy changes were identified based on the assumed likelihood to impact on these factors. The key findings and observations include: the fragmented nature of the sector is likely to make it challenging to get information and support to the people that need it, and therefore ensure that the desired behaviour changes are happening; government guidance and measures appear to have been rushed, heavily focused on care homes and their workers, and impossible to find in one place on the internet; testing has been hard to access – this has been a disincentive to get tested, as is the fear of being unable to work if testing positive; a major concern for individuals is loss of income if having to rely on Statutory Sick Pay. The report makes recommendations for further research into the actual impact of policy on the workforce and suggestions for improving policy development, communication and implementation.

Last updated on hub: 29 September 2020

PPE guide for community health and social care settings: what PPE to wear and when: an illustrative guide

Public Health England

This resource outlines personal protective equipment (PPE) advice for health and social care workers in community setting to prevent the transmission of COVID-19. It shows: which PPE to wear depending on where and how staff are working; how to work safely using your PPE and safer working practices to protect staff and residents. The guide sets out five common scenarios community health and social care professionals might encounter, describing what PPE they should wear in each case. The scenarios include: personal care involving touching the person who is cared for; when professionals are within 2 metres of anyone who has a cough; when staff are within 2 metres of the individual being cared for but not touching them; when staff are caring for a person who is shielding; and when they are in the workplace and 2 metres away from people they are caring for. This guidance should be used in conjunction with local policies.

Last updated on hub: 10 August 2020

Practical steps to improve air flow in long-term care resident rooms to reduce COVID-19 infection risk

Journal of the American Medical Directors Association

The potential for spread of COVID-19 infections in skilled nursing facilities and other long-term care sites poses new challenges for nursing home administrators to protect patients and staff. It is anticipated that as acute care hospitals reach capacity, nursing homes may retain COVID-19 infected residents longer prior to transferring to an acute care hospital. This article outlines 5 pragmatic steps that long-term care facilities can take to manage airflow within resident rooms to reduce the potential for spread of infectious airborne droplets into surrounding areas, including hallways and adjacent rooms, using strategies adapted from negative-pressure isolation rooms in acute care facilities.

Last updated on hub: 13 November 2020

Preparing for a challenging winter 2020/21

Academy of Medical Sciences

This report considers a worst-case scenario for winter 2020/21 – a likely mix of COVID-19, bad seasonal influenza and cold weather; what this would mean for deaths, NHS capacity and social care; and the actions that would enable the health and social care system to better cope in the face of new winter pressures resulting from the pandemic. The need for health and social care undergoes large seasonal fluctuations, peaking in the winter, with the NHS and social care systems typically operating at maximal capacity in the winter months. The report identifies four additional challenges that have great potential to exacerbate winter 2020/21 pressures on the health and social care system, by increasing demand on usual care as well as limiting surge capacity: a large resurgence of COVID-19 nationally, with local or regional epidemics; disruption of the health and social care systems due to reconfigurations to respond to and reduce transmission of COVID-19; a backlog of non-COVID-19 care; and a possible influenza epidemic that will add pressure. The paper argues that there is a need for urgent preparation to mitigate the risks of a particularly challenging winter 2020/21, including: minimising community SARS-CoV-2 transmission and impact; organising health and social care settings to maximise infection control and ensure that COVID-19 and routine care can take place in parallel; improving public health surveillance for COVID-19, influenza and other winter diseases; and minimising influenza transmission and impact, including by maximising the uptake of influenza vaccination by health and social care workers. Includes a ‘Peoples perspective’ report in appendix, written by patients and carers, that calls for the actions to be developed through engagement with patients, carers and the public to ensure services, guidelines and communications work for people, rather than focusing plans on individual medical conditions.

Last updated on hub: 16 July 2020

Preventing and managing COVID-19 across long-term care services: policy brief

World Health Organization

This briefing provides policy objectives and key action points to prevent and manage COVID-19 across long-term care settings. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the pandemic across long-term care services including care providers. COVID-19 has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to long-term care facilities, with figures being as high as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19. Specifically, the paper argues that the following policy objectives should be pursued to mitigate the impact of COVID-19 across long-term care: include long-term care in all phases of the national response to the pandemic; mobilise adequate funding; ensure effective monitoring and evaluation of the impact of COVID-19 on long-term care; secure staff and resources, including adequate health workforce and health products; ensure the continuum and continuity of essential services for people receiving long-term care; ensure that infection prevention and control standards are implemented and adhered to in all long-term care settings; prioritise testing, contact tracing and monitoring of the spread of COVID-19 among people receiving and providing long-term care services; provide support for family and voluntary caregivers; prioritise the psychosocial well-being of people receiving and providing long-term care services; ensure a smooth transition to the recovery phase; and initiate steps for the transformation and integration of health and long-term care systems.

Last updated on hub: 27 July 2020

Preventing COVID-19 spread in closed facilities by regular testing of employees – an efficient intervention in long-term care facilities and prisons

medRxiv

This article is a preprint and has not been peer-reviewed. Background Draconic control measures were introduced to contain the global COVID-19 pandemic, many of which have been controversial, particularly the comprehensive use of diagnostic tests. Regular testing of high-risk individuals (pre-existing conditions, older than 60 years of age) has been suggested by public health authorities. The WHO suggested the use of routine screening of residents, employees, and visitors of long-term care facilities (LTCF) to protect the resident risk group. Similar suggestions have been made by the WHO for other closed facilities including incarceration facilities (e.g., prisons or jails), where in parts of the US, accelerated release of approved inmates is taken as a measure to mitigate COVID-19. Methods and findings Here, the simulation model underlying the pandemic preparedness tool CovidSim 1.1 (http://covidsim.eu/) is extended to investigate the effect of regularly testing of employees in order to protect immobile resident risk groups in closed facilities. The reduction in the number of infections and deaths within the risk group are investigated as well as the potential economic gain resulting from savings in COVID-19 related treatment costs in comparison to costs resulting from the testing interventions. Our simulations are adjusted to reflect the situation of LTCFs in the Federal Republic of Germany. The probability is nearly one that COVID-19 spreads into closed facilities due to contact with infected employees even under strict confinement of visitors in a pandemic scenario without targeted protective measures. Regular screening of all employees by PCR tests provides a significant reduction of COVID-19 cases and related deaths in LTCFs. While the frequency of testing (testing rate) and the quality of tests have noticeable effects, the waiting time for obtaining test results (ranging from 12 up to 96 hours) hardly impacts the outcome. The results suggest that testing every two weeks with low-quality tests and a processing time of up to 96 hours yields a strong reduction in the number of cases. Rough estimates suggest a significant economic gain. Conclusions The introduction of COVID-19 in closed facilities is unavoidable without thorough screening of persons that can introduce the disease into the facility. These measures provide an economically meaningful way to protect vulnerable risk groups characterized by an elevated risk of severe infections in closed facilities, in which contact-reducing measures are difficult to implement due to imminent unavoidable close human-to-human contacts.

Last updated on hub: 13 November 2020

Preventing respiratory illness in older adults aged 60 years and above living in long-term care

Centre for Evidence Based Medicine

This rapid overview of reviews identifies evidence from systematic reviews on infection protection and control measures for preventing respiratory illness (including coronavirus and influenza) in older adults aged 60 years and above living in long-term care. The results of the included systematic reviews suggest that high quality evidence supports treating residents with antiviral chemoprophylaxis with adamantine, as well as adamantine in combination with personal protective equipment. For the rest of the strategies, there was either no evidence of effectiveness (e.g., social isolation) or mixed evidence of effectiveness (e.g., rimantadine, zanamivir, hand hygiene, personal protective equipment). The mixed evidence on hand hygiene and use of personal protective equipment does not imply these should not be used in outbreaks.

Last updated on hub: 06 May 2020

Preventing the transmission of COVID-19 and other coronaviruses in older adults aged 60 years and above living in long-term care: a rapid review

Systematic reviews

Background: The objective of this review was to examine the current guidelines for infection prevention and control (IPAC) of coronavirus disease-19 (COVID-19) or other coronaviruses in adults 60 years or older living in long-term care facilities (LTCF). Methods: EMBASE, MEDLINE, Cochrane library, pre-print servers, clinical trial registries, and relevant grey literature sources were searched until July 31, 2020, using database searching and an automated method called Continuous Active Learning(CAL). All search results were processed using CAL to identify the most likely relevant citations that were then screened by a single human reviewer. Full-text screening, data abstraction, and quality appraisal were completed by a single reviewer and verified by a second. Results: Nine clinical practice guidelines (CPGs) were included. The most common recommendation in the CPGs was establishing surveillance and monitoring systems followed by mandating the use of PPE; physically distancing or cohorting residents; environmental cleaning and disinfection; promoting hand and respiratory hygiene among residents, staff, and visitors; and providing sick leave compensation for staff. Conclusions: Current evidence suggests robust surveillance and monitoring along with support for IPAC initiatives are key to preventing the spread of COVID-19 in LTCF. However, there are significant gaps in the current recommendations especially with regard to the movement of staff between LTCF and their role as possible transmission vectors.

Last updated on hub: 07 December 2020

Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI, 2 December 2020

Department of Health and Social Care

This advice is provided to facilitate the development of policy on COVID-19 vaccination in the UK. The Joint Committee on Vaccination and Immunisation (JCVI) advises that the first priorities for any COVID-19 vaccination programme should be the prevention of COVID-19 mortality and the protection of health and social care staff and systems. As the risk of mortality from COVID-19 increases with age, prioritisation is primarily based on age. Secondary priorities could include vaccination of those at increased risk of hospitalisation and at increased risk of exposure, and to maintain resilience in essential public services. This document sets out a framework for refining future advice on a national COVID-19 vaccination strategy.

Last updated on hub: 07 December 2020

Professional practice guidance for home visits during Covid-19 Pandemic

British Association of Social Workers England

This guidance has been produced to help social workers and their employers manage the risks of home visits during the coronavirus (Covid-19) pandemic. It aims to help social workers keep themselves safe and reduce risks of infection during home visits, enable social workers to fulfil their duties without undue risk, and minimise the risk of infection of others by social workers entering homes. It covers key issues to consider when planning a home visit, during a visit, and action to take immediately after a home visit. The key principles may also be helpful for social workers planning and carrying out face to face activities in other settings, such as hospitals or care homes during Covid-19. It does not cover social care workers who are providing hands-on personal care. The guidance has been developed by the British Association of Social Workers (BASW) in consultation with practitioners, managers and sector leaders and is applicable for all social workers across the UK. It will be reviewed and updated frequently.

Last updated on hub: 27 April 2020

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