COVID-19 resources on Infection control

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Lonely and left behind: tackling loneliness at a time of crisis

British Red Cross

Findings from an in-depth qualitative research, exploring the experience of loneliness among people who had been isolating or shielding as a result of the pandemic. The research took a longitudinal, case study approach, engaging 16 participants from a range of backgrounds through a series of in-depth telephone interviews and written diary tasks between July and September 2020. Each of the participants had been, at the time of the research, isolating or shielding, with some starting to reintegrate throughout the period. The study reveals that: many participants were feeling lonely or isolated before the pandemic, often due to experiencing a degree of turbulence in their lives, and this has been compounded by the impacts of the pandemic and being less able to utilise previous coping strategies during lockdown; all participants reported experiencing loneliness more often as a result of the pandemic and lockdown; for participants who continue to shield as lockdown restrictions eased, feelings of loneliness either stayed the same or worsened as they watched others resume their social lives, and they reported feeling ‘left behind’; participants pointed to the heightened importance of technology and entertainment to try to cope with loneliness, rather than the physical social interactions that they would have been able to turn to prior to the pandemic; of the policy and practice solutions tested with participants, the most popular solution was investing in remote mental health and emotional support. It was felt any type of support would need to be delivered remotely, due to fear of COVID-19 and reluctance to access options that would require physical travel or mixing with others in person.

Last updated on hub: 17 December 2020

Long-stay mental health care institutions and the COVID-19 crisis: identifying and addressing the challenges for better response and preparedness

World Health Organization

This report presents the results of a survey with 169 long-stay institutions to assess the impact of the COVID-19 pandemic on services, staff, service users and residents with psychosocial and intellectual disabilities. Specific themes explored in this report are how well the institutions were prepared for the crisis by authorities, the quality of communications, the availability of personal protective equipment, and the impact of the risk of infection and protective measures on staff and residents. The report finds that there were significant differences between the types of institution reporting, which included psychiatric hospitals; care homes; and other settings for mental health care. Responses from psychiatric, intellectual disability and autism services were broadly consistent with those from social care homes, except for the following significant areas of difference: social care homes were happier with information from the authorities and the information they provided for residents in accessible formats; care home staff reported challenges with more workload, stress, frustration and burnout; care homes were less likely to use discharge to reduce numbers and manage the virus; and more likely to report an increase in the use of restrictive measures. The analysis highlights the need to put in place comprehensive and practical plans to facilitate management and day-to-day operations under crisis conditions. The keys to this are: having clear guidelines and tested systems in place; ensuring clarity of communication; implementing a comprehensive and facility-based infection prevention and control plan; establishing clear procedures and protocols to ensure safe environments; being able to increase staff capacities according to need; and having a clear focus on ensuring person-centred and human rights-based care in all decision-making.

Last updated on hub: 05 October 2020

Long-term care facilities and the coronavirus epidemic: practical guidelines for a population at highest risk

Journal of the American Medical Directors Association

Editorial. Considers why long-term care preparedness for COVID-19 is important. Comments on the practical considerations for reducing the risk of transmission in the workplace; ensuring protection of healthcare workers; maintaining health care infrastructure; the assisted living experience; the blame game and what next? Suggests that appropriate preparedness includes five key elements: 1) reduce morbidity and mortality among those infected; 2) minimize transmission; 3) ensure protection of health care workers; 4) maintain health care system functioning; and 5) maintain communication with worried residents and family members

Last updated on hub: 13 November 2020

Making evidence and policy in public health emergencies: lessons from COVID-19 for adaptive evidence-making and intervention

Evidence and Policy

Background: In public health emergencies, evidence, intervention, decisions and translation proceed simultaneously, in greatly compressed timeframes, with knowledge and advice constantly in flux. Idealised approaches to evidence-based policy and practice are ill equipped to deal with the uncertainties arising in evolving situations of need. Key points for discussion: There is much to learn from rapid assessment and outbreak science approaches. These emphasise methodological pluralism, adaptive knowledge generation, intervention pragmatism, and an understanding of health and intervention as situated in their practices of implementation. The unprecedented challenges of novel viral outbreaks like COVID-19 do not simply require us to speed up existing evidence-based approaches, but necessitate new ways of thinking about how a more emergent and adaptive evidence-making might be done. The COVID-19 pandemic requires us to appraise critically what constitutes ‘evidence-enough’ for iterative rapid decisions in-the-now. There are important lessons for how evidence and intervention co-emerge in social practices, and for how evidence-making and intervening proceeds through dialogue incorporating multiple forms of evidence and expertise. Conclusions and implications: Rather than treating adaptive evidence-making and decision making as a break from the routine, we argue that this should be a defining feature of an ‘evidence-making intervention’ approach to health.

Last updated on hub: 09 September 2020

Making vaccination a condition of deployment in older adult care homes: open consultation

Department of Health and Social Care

This consultation is seeking views on a proposal to make COVID-19 vaccination a condition of deployment in older adult care homes. Older adults living in care homes have been significantly affected by the COVID-19 pandemic because of their heightened risk to COVID-19 infection, often with devastating consequences, as well as the risk of outbreaks in these closed settings. While vaccination uptake rates are increasing slowly week on week, there are still a high number of older adult care homes which do not have the level of protection needed to reduce the risk of outbreak. To increase vaccine take up, the government is considering amending the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This would mean older adult care home providers could only use those staff who have received the COVID-19 vaccination (or those with a legitimate medical exemption) in line with government guidance. The deadline for responding to the consultation is Friday 21 May 2021

Last updated on hub: 19 April 2021

Managing older adults’ fear of coronavirus disease: a new role for social work practice

Qualitative Social Work

As the number of patients infected with the 2019 novel coronavirus disease (nCOVID-19) increases, the number of deaths has also been increasing. According to World Health Organization (WHO), as of 4 October 2020, 34,804,348 cases had tested positive for nCOVID-19 globally, which among them, 1,030,738 confirmed deaths had occurred, equivalent to a case-fatality rate of 2.96%. However, in comparison with global statistics, the incidence and mortality of the nCOVID-19 infection are higher in Iran. As reported by the National Committee on COVID-19 Epidemiology of Ministry of Health of Iran, the total number of patients with confirmed COVID-19 infection has reached 468,119, of which 26,746 have died, equivalent to a case-fatality rate of 5.71%. Currently, there is solid evidence that older adults are at a higher risk of severe disease following infection from COVID-19.

Last updated on hub: 17 March 2021

Managing through COVID-19: the experiences of children’s social care in 15 English local authorities

King's College London

This study examines the arrangements put in place in children’s social care services during the period of the COVID-19 lockdown and considers what their impact and legacy might be. A modified Delphi methodology was adopted, gathering expert opinion from 15 representatives of English local authorities to through a series of iterative questionnaires, with a goal of coming to a group consensus. Findings cover a whole range of issues, including home and office working; referrals; working with families in a pandemic; foster care; care leavers and unaccompanied young people seeking asylum; residential homes; multi-agency working; recruitment; planning for the end of lockdown; and lessons for the future. The study found that the local authorities have responded to three interrelated imperatives: to keep social workers safe while promoting their health and wellbeing, to work with extremely vulnerable families and to use technology to undertake work with these families who may be technology poor. All authorities were conscious that soon they could be facing additional challenges as they dealt not only with the practicalities of social distancing and technology, but the increased number of referrals that they expected once other services returned to ‘more business as usual’ operations. There was concern about those families who had been exposed to the risks arising within their homes such as domestic abuse, coercive control, alcohol and substance misuse, with consequences for their mental and physical health. COVID-19 has also offered opportunities, leading children’s social care services to think afresh about how things work and speed up changes that would have taken years to introduce. Previous notions of how to conduct an assessment, engage in direct practice and offer student placements are amongst the many activities that have been tested and reshaped, at least temporarily. Similarly, virtual visits to families were reported to be effective in certain circumstances and be less intrusive for some families, although establishing face-to-face contact in the home will continue to be necessary.

Last updated on hub: 07 July 2020

Managing youth sector activities and spaces during COVID-19

National Youth Agency

This guidance is intended to support councils, local voluntary providers, leaders, volunteers and young people to remain safe when engaging in youth sector activities. Youth sector organisations typically work with young people aged 8 to 25 years, although other age groups are recognised. This guidance takes into consideration the safety and support needed for young people, staff and volunteers and wider public health considerations for youth services and activities. It is recognised that the level of lockdown will vary over time and by location if local restrictions are applied. To support youth sector organisations when reacting to these changes a readiness framework and level is provided. Alongside adhering to the framework’s guidance, all proposed activities and changes must be subject to a risk assessment, which should be enhanced when physical spaces/buildings /land are to be used.

Last updated on hub: 09 March 2021

Mapping young London: a view into young Londoners after a year in lockdown

Partnership for Young London

This report looks at a range of issues the impact that Covid-19 has had on young people in London and the support or change they want to see. Partnership for Young London conducted a survey of 1623 young people aged 16-25, that was conducted between November 2020 and February 2021. Key findings include: Priorities – Housing, employment, and mental health are the most important issues for young Londoners now, with Covid-19 and lockdown having a huge impact on these issues; Covid-19 and lockdown – Young people are overwhelming unhappy with the Government’s response to the pandemic, with three in four (76.2%) believing the response was bad or very bad; Housing – Young Londoners are worried about not having a stable or safe space to stay (40.3%), with one in three having their housing situation impacted by Covid-19 and lockdown (31%); Employment – Two thirds (66.6%) said that Covid-19 and lockdown has impacted their, or someone in their household’s employment, and half (51.4%) had said that their future employment plans had changed; Mental and physical health – Young Londoners are facing a mental health crisis, with a third (34.4%) reporting wellbeing scores indicating depression, and a majority (75.5%) indicating poor wellbeing; Safety and the police – A majority (83.8%) of those surveyed said that they believed that there is systematic racism in the police, with even more (88%) saying that they supported Black Lives Matter; Discrimination – Just less than half (45.2%) of those surveyed said that they had experienced discrimination in London, while two thirds (74.4%) said they thought discrimination was common in London; Fairness and finance – One in five (20.2%) of those surveyed said that their financial situation meant that they have to go without essentials; Youth services – Nine out of ten (88%) of those surveyed said that they do not feel that they have a say in how youth services are set up and run.

Last updated on hub: 05 May 2021

Mass testing after a single suspected or confirmed case of COVID-19 in London care homes, April-May 2020: implications for policy and practice

Age and Ageing

Introduction: Previous investigations have identified high rates of SARS-CoV-2 infection among residents and staff in care homes reporting an outbreak of COVID-19. This study investigated care homes reporting a single suspected or confirmed case to assess whether early mass testing might reduce risk of transmission during the peak of the pandemic in London. Methods: Between 18-27 April 2020, residents and staff in care homes reporting a single case of COVID-19 to Public Health England had a nasal swab to test for SARS-CoV-2 infection by RT-PCR and subsequent whole genome sequencing. Residents and staff in two care homes were re-tested eight days later. Results: Four care homes were investigated. SARS-CoV-2 positivity was 20% (65/333) overall, ranging between 3-59%. Among residents, positivity ranged between 3-76% compared to 3-40% in staff. Half of the SARS-CoV-2 positive residents (23/46, 50%) and 63% of staff (12/19) reported symptoms within 14 days before or after testing. Repeat testing 8 days later in two care homes with the highest infection rates identified only two new cases. Genomic analysis demonstrated a small number of introductions of the virus into care homes, and distinct clusters within three of the care homes. Conclusions: This study found extensive but variable rates of SARS-CoV-2 infection among residents and staff in care homes reporting a single case of COVID-19. While routine whole home testing has now been adopted into practice, care homes must remain vigilant and should be encouraged to report a single suspected case, which should trigger appropriate outbreak control measures.

Last updated on hub: 25 March 2021

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