COVID-19 resources on Infection control

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The experience of older people with multimorbidity during the COVID-19 pandemic

English Longitudinal Study of Ageing

The risk of severe COVID-19 disease is known to be higher in older individuals with multiple long-term health conditions (multimorbidity). In this briefing, we report the latest findings from the English Longitudinal Study of Ageing COVID-19 Substudy on the experiences of older people with multimorbidity during the pandemic. Not all people with multimorbidity would be classified as clinically vulnerable. We found that 35% of older individuals with multimorbidity were instructed by the NHS or their GP to shield (staying at home at all times and avoiding any face-to-face contact) on account of their vulnerability, and the majority were largely compliant with this advice. Relative to study members without multimorbidity, respondents with multimorbidity were more likely to report poor sleep quality, eating less, and being worried about not having enough food and other essentials. Unhealthy behaviours (sitting time, physical inactivity etc), poor mental health, and loneliness deteriorated considerably during the lockdown and in the two months following the lockdown. Access to medications among people with multimorbidity was not a problem, however, a fifth of individuals with multimorbidity did not have access to community health, social care services and support from other health professionals (e.g., dentist, podiatrist). When considering policies which advise people to shield or self-isolate because of their COVID-19 risk, it is important for policymakers to acknowledge that older people with multiple long-term health conditions are at higher risk of experiencing greater mental distress and worry, of engaging in unhealthy behaviours and are less likely to access health services when needed; all these factors together could potentially influence disease progression.

Last updated on hub: 15 October 2020

The experience of people approaching later life in lockdown: the impact of COVID-19 on 50-70-year olds in England

Ipsos MORI

Explores how people in their 50s and 60s experienced the COVID-19 pandemic; the future expectations and intentions of this age group, and how have these been shaped by the pandemic; and the implications of this for a future policy agenda. The report, which focuses on home and community, health and wellbeing and work and money, draws on a literature review exploring the latest evidence in relation to these policy areas; a survey of 1,000 people aged 50-70-years within England; and a longitudinal qualitative research with 19 purposively selected participants designed to reflect a range of different experiences. The findings highlight the correlation between age and health outcomes during the pandemic – there was a decline in physical health for one in five respondents while more than a third said their mental health got worse. Overall, the report finds that the lockdown has been tough on some – many people have seen their health deteriorate with more unhealthy behaviours, and more than two in five fear their finances will worsen in the year to come. But there have also been some positive changes, with many appreciating the time spent with family, helping their communities, a better work-life balance, and time to reflect on their careers and future. The report stresses that as the lockdown restrictions ease it will still take time for things to get back to normal – the data shows that two in five respondents think that it will take at least one to two years or longer.

Last updated on hub: 03 August 2020

The Government’s response to the Joint Committee on Human Rights report: the Government’s response to COVID-19: human rights implications

Department of Health and Social Care

The government’s formal response to the 55 recommendations made by the Joint Committee on Human Rights in its report ‘The government’s response to COVID-19: human rights implications’. The original recommendations and this response focus on: the lockdown regulations; health and care; detention; contact tracing; children and the right to education; access to justice; procedural obligations to protect the right to life; accountability and scrutiny. The document reiterates that while the Care Act easements were intended as a tool to help local authorities continue to meet the most urgent and acute needs in the face of COVID-19, public safety remains a top priority, including for those who need care and support – Local Authorities remain under a duty to meet needs where failure to do so would breach an individual’s human rights under the European Convention on Human Rights.

Last updated on hub: 15 December 2020

The Health Service and Social Care Workers (Scrutiny of Coronavirus-related Deaths) Directions 2020

Department of Health and Social Care

These directions ensure that NHS trusts and NHS foundation trusts seek and prioritise the services of medical examiners to scrutinise the deaths of health service and adult social care staff from coronavirus. Examiners are required to consider whether there is reason to suspect that the death was a result of the person being exposed to coronavirus during the course of their NHS or social care work

Last updated on hub: 13 July 2020

The impact of COVID-19 lockdown measures on the physical health of people living with severe mental illness

Rethink Mental Illness

This briefing looks at the impact of the Covid-19 pandemic on the physical health of people living with severe mental illness (SMI), based on the responses to a survey of 1,434 people. The briefing highlights key findings and outlines concerns about the implications of lockdown restrictions on people with severe mental illness, who already die on average 15 to 20 years earlier than the general population. Over half of respondents have been exercising less and eating less healthily during lockdown and said they were eating less healthily than usual. Respondents reported that they were smoking (16%) and drinking (23%) more than usual and a small proportion also said they were using more illicit drugs (3%) – these were likely used as coping strategies or to alleviate boredom. The paper recommends reinstating physical health checks for people with SMI and relevant system targets; co-producing targeted communications with people severe mental illness; gathering lessons from the implementation of the Community Mental Health Framework; addressing the needs of those with SMI in the government emerging obesity strategy linked to COVID-19.

Last updated on hub: 06 July 2020

The impact of COVID-19 on adjusted mortality risk in care homes for older adults in Wales, UK: a retrospective population-based cohort study for mortality in 2016–2020

Age and Ageing

Background: mortality in care homes has had a prominent focus during the COVID-19 outbreak. Care homes are particularly vulnerable to the spread of infectious diseases, which may lead to increased mortality risk. Multiple and interconnected challenges face the care home sector in the prevention and management of outbreaks of COVID-19, including adequate supply of personal protective equipment, staff shortages and insufficient or lack of timely COVID-19 testing. Aim: to analyse the mortality of older care home residents in Wales during COVID-19 lockdown and compare this across the population of Wales and the previous 4 years. Study Design and Setting: we used anonymised electronic health records and administrative data from the secure anonymised information linkage databank to create a cross-sectional cohort study. We anonymously linked data for Welsh residents to mortality data up to the 14th June 2020.Methodswe calculated survival curves and adjusted Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of mortality. We adjusted HRs for age, gender, social economic status and prior health conditions. Results: survival curves show an increased proportion of deaths between 23rd March and 14th June 2020 in care homes for older people, with an adjusted HR of 1.72 (1.55, 1.90) compared with 2016. Compared with the general population in 2016–2019, adjusted care home mortality HRs for older adults rose from 2.15 (2.11, 2.20) in 2016–2019 to 2.94 (2.81, 3.08) in 2020. Conclusions: the survival curves and increased HRs show a significantly increased risk of death in the 2020 study periods.

Last updated on hub: 21 January 2021

The impact of Covid-19 on community health services

NHS Confederation

This report captures the community sector’s response during the pandemic and showcases the achievements of community providers and their staff. Community health services play a key role within the health and care system, supporting integration at place and neighbourhood level through their relationships across the spectrum of local health and care organisations, including primary care, social care, local authorities and voluntary, community and social enterprise (VCSE). They keep people well at home, or in community settings as close to home as possible, and support them to live independently. The report seeks to learn from community providers’ experiences of the pandemic to secure the necessary transformation for the longer term. It suggests that the expansion and transformation of community services’ capacity during the pandemic proved critical in supporting the NHS’s response. As the health and care sector moves to recover and reset after the first peak of the outbreak, community service providers are now embedding innovative practice. They will play a critical role in providing ongoing rehabilitation for people who have been most seriously ill from the virus. The paper calls for investing in public health and place the social care system on a sustainable footing as a priority; supporting investment in home-based community pathways as well as community rehabilitation beds; boosting the community workforce with a national recruitment campaign and increased deployment of returners before winter pressures hit; and creating a digital improvement strategy, robust national dataset and national performance standards to standardise and spread best practice.

Last updated on hub: 10 August 2020

The impact of COVID-19 on kinship care: evidence from the kinship care charity Grandparents Plus

Scottish Journal of Residential Child Care

The challenges faced by children in kinship care and their families have been regularly identified in research. Kinship carers look after for some of society’s most vulnerable children, usually whilst facing many adversities themselves. The COVID-19 global pandemic had a significant impact on kinship carers, placing additional stress on their already difficult situations. This article describes the work of Grandparents Plus, the leading charity for kinship care in England and Wales, to identify the impact of COVID-19 on kinship carers and ensure they continued to receive support. Data were gathered using three surveys of kinship carers in England and Wales, and through discussions with Grandparents Plus project workers and volunteers. Kinship carers reported feeling scared about catching the virus, and what would happen to the children if they fell seriously ill. They were exhausted caring for the children twenty-four hours a day without a break and they were worried about the uncertainties of living with a ‘new normal’. Grandparents Plus used this information to develop new and existing support services to meet kinship carers’ needs in the context of COVID-19. It is concluded that kinship carers need sustained support to develop resilience to protect against future unforeseen crises.

Last updated on hub: 06 October 2020

The impact of COVID-19 on long-term care in Canada: focus on the first 6 months

Canadian Institute for Health Information

This report explores the pandemic experience in long-term care (LTC) and how it compares between provinces and territories in Canada. The first part of the report presents early comparisons between the first and second waves in both LTC and retirement homes. The second part focuses on the first 6 months of the pandemic in LTC homes specifically, where older Canadians with the most complex health care needs reside. It examines: the impact of COVID-19 on LTC residents and staff; changes in how residents received care; and key recommendations from investigations and inquiries of LTC homes to date. The report finds that: LTC and retirement homes have been disproportionately affected by COVID-19 in Canada, and the pandemic experience has not improved overall for the sector in the second wave; LTC residents received less medical care during the first wave of COVID-19 than in normal years; the number of LTC resident deaths was higher than usual during the first wave of the pandemic; recommendations from provincial and national inquiries to date on COVID-19 in LTC homes are similar and speak to structural challenges in the sector. This includes the need for increased staffing levels, stronger infection control and prevention practices, better inspection and enforcement processes, and improved building infrastructure to reduce crowding and infection spread.

Last updated on hub: 19 April 2021

The impact of Covid-19 on nursing homes in Italy

Politecnico di Milano

This brief note examines the interplay between the institutional context of care homes in Italy and the spread of the pandemic. As they faced the pandemic, care homes had both internal and external problems. On the internal side, they had to face the entry of the virus into their structures with inadequate medical staff and insufficient resources and capacity to implement distancing and other preventive actions. They were also unable to provide adequate health care to their Covid-19 patients, and very often unable to send them to hospitals. On the external side, their situation was ignored for a long time by policy makers, who were mainly focused to face the emergency in hospitals. The national lockdown of nursing homes regarding the access of relatives and external visitors – a crucial measure in order to prevent possible transmission of infection – was established only on March 4, about two weeks later the spreading of the infection. Furthermore, for many weeks not adequate attention has been paid to testing and monitoring activities among healthcare staff and patients: a priority for the implementation of such preventive activities in nursing homes was established only at the beginning of April. The paper argues that most of the criticalities came from the pre-existent difficult condition of these institutions. The more nursing homes have specialised in the intensive-health treatment of seriously non-self-sufficient elderly, the more the quality of their services had been hampered by very precarious financial and organisational conditions, co-determined by the lack of public investment in these structures. The pandemic has acted as a “focusing event”, revealing the structural weakness of this sector and the main critical problems affecting it.

Last updated on hub: 11 November 2020

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