COVID-19 resources on Infection control

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Supporting children and young people with SEND as schools and colleges prepare for wider opening

Department for Education

Risk assessment guidance for settings managing children and young people with an education, health and care (EHC) plan or complex needs during the coronavirus (COVID-19) outbreak, including special schools, specialist colleges, local authorities and any other settings managing children and young people with SEND. [Updated 24 July 2020]

Last updated on hub: 28 July 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

Supporting wellbeing of older people when shielding / isolating

Public Health Wales Observatory

This summary outlines action that the evidence suggests may help to support the mental wellbeing of older adults at this time. It is intended for organisations involved in supporting older people. Four systematic reviews were identified from a search of the literature conducted in June 2019. Most provided data from qualitative research and captured the perceptions of older people on quality of life, meaningful occupations and experience of technology. Reflecting on the findings from these reviews, the analysis suggests a number of actions for consideration by those involved in supporting older people. These actions focus on: maintaining autonomy and control; occupation and social interaction; access to the internet; and money and resources.

Last updated on hub: 16 November 2020

Surviving COVID-19: social work issues in a global pandemic (Child protection and welfare, and social care)

University of Stirling

This briefing provides advice for social workers working with children and families during this coronavirus (COVID-19) pandemic. The briefing covers what is COVID-19 and its symptoms; what steps do World Health Organisation (WHO) and national and local health advisors advocate people follow in preparedness, mitigation and suppression strategies; how can social workers work with children and families during this pandemic; and how can social workers take care of themselves and others while performing their statutory duties. The briefing also covers how to uphold anti-oppressive practice, ethical behaviour and human rights, home visits and personal protection and protective equipment.

Last updated on hub: 15 June 2020

System approach to tackling COVID-19 in the care sector

Nottinghamshire County Council

Nottinghamshire County Council have worked rapidly to put in place a range of policies and support measures to support the Care Sector across Nottinghamshire. This includes working together to ensure a shared view of service capacity and pressures, and enabling urgent deliveries of personal protective equipment (PPE). Contact was made at an early stage to support people who receive a Direct Payment and those who work as a Personal Assistant have in place emergency plans and can access PPE. The full case study can be found in the Department for Health and Social Care action plan which is linked to this item and was published on 15 April 2020.

Last updated on hub: 31 March 2021

Taking extra care in lockdown: Ty Llwynderw Extra Care & Care and Cae’r Ysgol Independent Living bungalows, Maesteg

Housing LIN

This case study features Linc Cymru Housing Association’s development in Maesteg, Wales. It provides some context on why and how the scheme came about, reflects on its’ design and also captures how the scheme has coped under lockdown, successfully ensuring a Covid-free home to date. Flexing the design to respond to Coronavirus have in the main ensured that they functioned and adapted well for both the Maesteg and Tondu schemes. Operationally, staff were able to make changes so as to be able to use the building to best effect during the intense Covid-19 lockdown.

Last updated on hub: 17 September 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

Testing and vaccination to reduce the impact of COVID-19 in nursing homes: an agent-based approach

medRxiv

Background Efforts to protect residents in nursing homes involve non-pharmaceutical interventions, testing, and vaccine. This study sought to quantify the effect of testing and vaccine strategies on the attack rate, length of the epidemic, and hospitalization. Methods This study developed an agent-based model to simulate the dynamics of SARS-CoV-2 transmission in a nursing home with resident and staff agents. Interactions between 172 residents and 170 staff were assumed based on data from a nursing home in Los Angeles, CA. This study simulated scenarios assuming different levels of non-pharmaceutical interventions, testing frequencies, and vaccine efficacy to block transmission. Results Under the hypothetical scenario of widespread SARS-CoV-2 in the community, 3-day testing frequency minimized the attack rate and the time to eradicate an outbreak. Prioritization of vaccine among staff or staff and residents minimized the cumulative number of infections and hospitalization, particularly in the scenario of high probability of an introduction. Reducing the probability of a virus introduction reduced the demand on testing and vaccine to reduce infections and hospitalizations. Conclusions Improving frequency of testing from 7-days to 3-days minimized the number of infections and hospitalizations, despite widespread community transmission. Vaccine prioritization of staff provides the best protection strategy, despite high risk of a virus introduction.

Last updated on hub: 06 May 2021

Testing for professionals visiting care homes

Department of Health and Social Care

Health, social care and other professionals may need to visit residents within care homes to provide services. This guidance sets out the testing policy for these ‘visiting professionals’. Many visiting professionals work in a variety of different settings per day, including care homes. Given the substantial risks to care home residents if COVID-19 is introduced to the home, it is essential that professionals and all staff are tested regularly before visiting care homes to reduce the risk of transmission across different settings and to help keep residents and staff safe. The guidance covers: NHS professionals visiting care homes who are part of regular staff testing; testing for CQC inspectors visiting care homes; professionals not regularly tested through NHS or CQC staff testing; 90-day window; and void or invalid results. [Last updated: 7 July 2021]

Last updated on hub: 30 June 2021

Testing guidelines for nursing homes: interim SARS-CoV-2 testing guidelines for nursing home residents and healthcare personnel

Centers for Disease Control and Prevention

This document provides guidance on the appropriate use of testing among nursing home residents. It covers: testing residents with signs or symptoms of COVID-19; testing asymptomatic residents with known or suspected exposure to an individual infected with; testing of asymptomatic residents without known or suspected exposure to an individual infected with; and Testing to determine resolution of infection.

Last updated on hub: 26 October 2020

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