COVID-19 resources on infection control

Results 51 - 60 of 394

Order by    Date Title

Briefing: improving the nation’s health: the future of the public health system in England

The Health Foundation

In light of the impact of the pandemic and the government’s decision to abolish Public Health England (PHE), this briefing explores what needs to be put in place to make progress on the government’s commitments to improve the nation’s health. It begins by looking at the role government can play in improving the nation’s health before examining how England might transition to a new public health system and what the main priorities for any new system should be. The paper argues that the new system needs the right strategy, structures and resources: the strategy for creating an effective new public health system should include a cross-government commitment to level up health outcomes and enable people to live longer in good health; the structures needed include an independent body to report to parliament on the nation’s health, a national function supporting the public health system, and strengthened local and regional infrastructure; the resources needed include, as a minimum, £1bn to restore public health funding to its 2015 levels and a further £2.5bn needed to level up public health across the country. Government should also commit to ensuring that public health funding keeps pace NHS with funding increases in future. The transition to a new public health system needs to be managed carefully, to ensure that the reorganisation does not disrupt the pandemic response or lead to a weaker system in future.

Last updated on hub: 08 December 2020

COVID-19 vaccinations and care homes: programme launch

Department of Health and Social Care

A letter from the Minister for Care to local authorities, directors of adult social services and managers of care homes for older adults. outlining plans for getting the first COVID-19 vaccine (Pfizer-BioNTech) to care home staff.

Last updated on hub: 08 December 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

Implementation of an algorithm of cohort classification to prevent the spread of COVID-19 in nursing homes

Journal of the American Medical Directors Association

Older adults living in nursing homes are the most vulnerable group of the COVID-19 pandemic. There are many difficulties in isolating residents and limiting the spread in this setting. These researchers have developed a simple algorithm with a traffic light shape for resident classification and sectorization within nursing homes, based on basic diagnostic tests, surveillance of symptoms onset and close contact monitoring. The researchers have implemented the algorithm in several centers with good data on adherence. Suggestions for implementation and evaluation are discussed.

Last updated on hub: 07 December 2020

Care homes and COVID-19 in Hong Kong: how the lessons from SARS were used to good effect

Age and Ageing

In Hong Kong, about 15% of older people (aged 80 and above) live in care homes, one of the highest proportions in the world. During the spread of severe acute respiratory syndrome in 2003, the crude fatality rate for older people in care homes that were infected was 72%. After taking the advice of a team of international experts, the Hong Kong Government implemented comprehensive preventive measures to cope with the future epidemics. This commentary evaluates the effectiveness of these measures in coping with both influenza outbreaks and COVID-19 and suggests the lessons learnt are relevant to both developed and less developed countries? Lockdown in care homes is very effective under two conditions. Healthcare workers must wear surgical masks in the care home. Hospitals must adopt a strict policy to prevent virus transmission by discharged patients. Care homes situated within high-rise residential towers are particularly vulnerable to COVID-19 transmission; their residents can more easily be infected by asymptomatic carriers from the community. Airborne virus can also be transmitted more swiftly in care homes with open-plan layouts. Lockdown had been shown to significantly reduce influenza outbreaks in care homes. On the other hand, lockdown causes loneliness to residents. Care homes allow residents to move freely within the care home though with the risk of spreading the virus by resident who is an asymptomatic carrier. Finally, lockdown may cause family members to have guilty feelings. Family members can only make video call or window visit to residents.

Last updated on hub: 07 December 2020

August 2020 interim EUGMS guidance to prepare European long-term care facilities for COVID-19

European Geriatric Medicine

Aim: To guide LTCFs in preventing the entrance and spread of SARS-CoV-2. Findings: The guidance is based upon the literature available on August 17, 2020. It lists (1) measures that can be implemented to keep COVID-19 out of LTCFs, and (2) COVID-19 symptoms that require RT-PCR testing in residents, staff members and visitors. It also (3) indicates the strategy to be used when a first LCTF resident or staff member is infected, and (4) proposes measures to limit adverse effects of the quarantine of residents tested positive for COVID-19. Message: The EuGMS guidance enables LTCFs to adapt and suitably implement infection prevention and control measures, considering that the priorities are (1) early detection of symptomatic and asymptomatic COVID-19 residents, staff members and visitors who contribute to the entrance and dissemination of COVID-19 infection in LTCFs and (2) to limit the negative effects of isolation in infected residents.

Last updated on hub: 07 December 2020

Nursing home design and COVID-19: balancing infection control, quality of life, and resilience

Journal of the American Medical Directors Association

Many nursing home design models can have a negative impact on older people and these flaws have been compounded by Coronavirus Disease 2019 and related infection control failures. This article proposes that there is now an urgent need to examine these architectural design models and provide alternative and holistic models that balance infection control and quality of life at multiple spatial scales in existing and proposed settings. Moreover, this article argues that there is a convergence on many fronts between these issues and that certain design models and approaches that improve quality of life, will also benefit infection control, support greater resilience, and in turn improve overall pandemic preparedness.

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

Annex A: COVID-19 vaccine and health inequalities: considerations for prioritisation and implementation

Department of Health and Social Care

The purpose of this paper is to consider the impact on and implications for health inequalities in the prioritisation of COVID-19 vaccines when they are introduced in the context of initial supply constraints. This paper expands on the considerations informing the Joint Committee on Vaccination and Immunisation (JCVI) interim advice on priority groups for COVID-19 vaccine, which is intended to support the government in planning the vaccine programme, and it offers further considerations for its implementation. The conceptual framework adopted is one based on consideration of scientific evidence, ethics and deliverability, with a focus on the ethical principles of maximising benefit and minimising harm, promoting transparency and fairness, and mitigating inequalities in health. While age has the absolute highest risk of poor COVID-19 outcomes, many factors are associated with an increased relative risk (such as belonging to a BAME group and being male). These are mediated by a complex web of factors which are not straightforward to disentangle and can be potentially misleading, and if misinterpreted when translated to policy, can be damaging to populations and widen health inequalities. al conditions, and health and social care worker status (thus providing NHS resilience). While prioritisation alone cannot address all inequalities in health that are rooted in social determinants, planning and implementation should as a minimum not worsen health inequalities, and present a unique opportunity to mitigate them.

Last updated on hub: 07 December 2020

The vulnerability of nursing home residents to the Covid-19 pandemic

International Journal of Care Coordination

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

Last updated on hub: 03 December 2020

Order by    Date Title