COVID-19 resources on Infection control

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Under reconstruction: the impact of COVID-19 policies on the lives and support networks of older people living alone

International Journal of Care and Caring

In the spring of 2020, the Austrian government introduced COVID-19 containment policies that had various impacts on older people living alone and their care arrangements. Seven qualitative telephone interviews with older people living alone were conducted to explore how they were affected by these policies. The findings show that the management of everyday life and support was challenging for older people living alone, even though they did not perceive the pandemic as a threat. To better address the needs of older people living alone, it would be important to actively negotiate single measures in the area of conflict between protection, safety and assurance of autonomy.

Last updated on hub: 31 March 2022

Understanding the impact of COVID-19 responses on citizens

Social Care Institute for Excellence

A guide that discusses the impact of COVID-19 and responses on people who use or interact with social care services.

Last updated on hub: 29 June 2020

Understanding vaccine hesitancy through communities of place: abridged report

Institute for Community Studies

This report presents a summary of the longer study ‘Vaccine Hesitancy and Communities of Place’. The study looked at the issue of vaccine engagement with historical and sociological lenses. It has delved into the health, social, economic, and political consequences of COVID-19 for different groups in each of the case study areas and also examined the historic and current dynamics of the relationship between different communities and a) health authorities; b) local authorities and State authorities; c) organisations and groups. The study has found how the interaction of place with the social determinants of health has created antecedent conditions for vaccine hesitancy in certain communities. Some critical lessons can be learnt from this report, namely: addressing vaccine hesitancy requires the engagement of national, State and local institutions with local communities in an authentic manner over time to build trusting relationships; messaging about COVID-19 should be straightforward and transparent, and grounded in pull - not push - reasons for accepting the vaccine, that may be locally specific; messages should be delivered in conversations between trusted “messengers” and local residents, and should consider their rationales, concerns and fears about vaccination, recognising that they are real regardless of the source; vaccine delivery should be associated with activities and materials that people want and need, including access to dialogue about their health, and health education; local organisations and convening efforts in communities as well as public health authorities should have reliable and accessible local and hyperlocal data able to be disaggregated by demographics and vaccine variables on an ongoing basis, that provide for agile planning in emergency and ‘peace-time’ public health approaches for different local communities.

Last updated on hub: 24 November 2021

Unequal impact? Coronavirus and BAME people: Government response to the Committee’s third report

Her Majesty's Government

Government response to the Women and Equalities Committee’s inquiry into the impact of Covid-19 pandemic on BAME people. Having considered its findings alongside other reports and evidence, the Government is committed to reduce Covid-19 disparities for ethnic minority groups. On 22 October 2020 the Minister for Equalities published her first quarterly report on progress to tackle the disparities in Covid-19 risks and outcomes highlighted by the Public Health England review. The second quarterly report was published on 26 February. The first report included a comprehensive overview of the actions the Department of Health and Social Care (DHSC) is taking in relation to the recommendations made in PHE’s ‘Beyond the Data’ report. Both quarterly reports also summarise the measures that other government departments and their agencies have, to date, put in place to mitigate the impacts of COVID-19. The government response to each of the Committee’s recommendations is set out in this response. Some of these have already been actioned. For example, the Race Disparity Unit already has a section on Covid-19 by ethnicity on the Ethnicity Facts and Figures website. Others will be picked up under existing streams of work. The new Equality Hub, in the Cabinet Office, brings together the Disability Unit, Government Equalities Office, Race Disparity Unit and, from 1 April, the sponsorship of the Social Mobility Commission. The Government Equalities Office’s remit relates to gender equality, LGBT rights and the overall framework of equality legislation for Great Britain, and the other units’ areas of focus are on cross-government disability policy and ethnic disparities respectively.

Last updated on hub: 09 March 2021

Unequal impact? Coronavirus and BAME people: third report of session 2019-21

House of Commons

Findings from an inquiry exploring the extent to which, throughout the coronavirus pandemic, Black, Asian, and minority ethnic (BAME) people have been affected by pre-existing inequalities across a huge range of areas, including health, employment, accessing Universal Credit, housing and the no recourse to public funds policy. The report considers the health factors that have exacerbated the impact of the coronavirus pandemic for BAME people, including the role played by comorbidities, health inequalities, and other wider determinants of health. It examines the interplay between an individual’s occupation and their exposure to the virus; the relationship between pre-existing occupational inequality and how this was heightened by the economic consequences of the pandemic; and how BAME people have been particularly affected by zero-hour contracts during the pandemic. The report also looks at some of the challenges faced by BAME people when applying for Universal Credit (UC), as more people are turning to the UC system to access necessary support; and examines how pre-existing housing inequalities amplified the impact of coronavirus for BAME communities, focusing on the health impacts of overcrowding and housing conditions. Finally, the report highlights early evidence suggesting that there are severe impacts of the no recourse to public funds policy that need to be addressed.

Last updated on hub: 15 December 2020

Unequal pandemic, fairer recovery: the COVID-19 impact inquiry report

The Health Foundation

This report sets out the findings of the Covid-19 impact inquiry, exploring how the same factors contributing to this widening of health inequalities exposed the UK to a high death toll and reduced people’s ability to deal with the subsequent economic shock. Drawing on an extensive body of evidence, this report identifies what has driven such outcomes during the pandemic. The factors shaping the UK’s overall experience of the pandemic are complex and multifaceted, and the pandemic is still ongoing. The Covid-19 impact inquiry provides an initial assessment of the effects of the pandemic using evidence available up to May 2021. The report highlights that poor health and existing inequalities left parts of the UK vulnerable to the virus and defined the contours of its devastating impact. The pandemic has revealed stark differences in the health of the working age population – those younger than 65 in the poorest 10% of areas in England were almost four times more likely to die from Covid-19 than those in wealthiest. Recovery needs to prioritise creating opportunities for good health – a vital asset needed to 'level up' and rebuild the UK economy. Government restrictions, although needed to limit Covid-19’s spread, have had wide-ranging consequences: from unmet health needs and mental health problems to education gaps, lost employment and financial insecurity. Some groups – young people, disabled people, ethnic minority communities and care home residents – have been more affected than others. Prisoners, homeless people and people experiencing sexual exploitation have also faced particular challenges. Type and quality of work, housing conditions, and access to financial support to self-isolate all contributed to increased exposure to the virus among working age adults. The legacy of the financial crisis has had a direct bearing on our experience of the pandemic. Deep-rooted issues – poor health, increased financial insecurity and strained public services – left the UK more vulnerable to Covid-19’s health and economic impacts.

Last updated on hub: 06 July 2021

Updating ethnic contrasts in deaths involving the coronavirus (COVID-19), England and Wales: deaths occurring 2 March to 28 July 2020

The Office for National Statistics

Updated estimates of mortality involving the Covid-19 by ethnic group and investigation of the explanatory power of hospital-based comorbidity on ethnic differences, building on previous models published by the Office for National Statistics. Considering deaths up to 28 July 2020, males and females of Black and South Asian ethnic background were shown to have increased risks of death involving the Covid-19 compared with those of White ethnic background. In England and Wales, males of Black African ethnic background had the highest rate of death involving COVID-19, 2.7 times higher than males of White ethnic background; females of Black Caribbean ethnic background had the highest rate, 2.0 times higher than females of White ethnic background. All ethnic minority groups other than Chinese had a higher rate than the White ethnic population for both males and females. Looking separately at the care home population, males of Asian ethnic background and females of Black and Asian ethnic backgrounds (using broader ethnic groupings) also had a raised rate of death involving COVID-19 compared with people of White ethnic background after taking account of geography and health measures. These findings show that ethnic differences in mortality involving COVID-19 are most strongly associated with demographic and socio-economic factors, such as place of residence and occupational exposures, and cannot be explained by pre-existing health conditions using hospital data or self-reported health status.

Last updated on hub: 21 October 2020

Using non-pharmaceutical interventions and high isolation of asymptomatic carriers to contain the spread of SARS-CoV-2 in nursing homes

medRxiv

Objective Using a pandemic influenza model modified for COVID-19, this study investigated the degree of control over pre-symptomatic transmission that common non-pharmaceutical interventions (NPIs) would require to reduce the spread in long-term care facilities. Methods This study created a stochastic compartmental SEIR model with Poisson-distributed transition states that compared the effect of R0, common NPIs, and isolation rates of pre-symptomatic carriers primarily on attack rate, peak cases, and timing in a 200-resident nursing home. Model sensitivity was assessed with 1st order Sobol’ indices. Results The most rigorous NPIs decreased the peak number of infections by 4.3 and delayed the peak by 9.7 days in the absence of pre-symptomatic controls. Reductions in attack rate were not likely, even with rigorous application of all defined NPIs, unless pre-symptomatic carriers were identified and isolated at rates exceeding 76%. Attack rate was most sensitive to the pre-symptomatic isolation rate (Sobol’ index > 0.7) and secondarily to R0. Conclusions Common NPIs delayed and reduced epidemic peaks. Reducing attack rates ultimately required efficient isolation of pre-symptomatic cases, including rapid antigen tests on a nearly daily basis. This must be accounted for in testing and contact tracing plans for group living settings.

Last updated on hub: 20 February 2021

Using technology to support the people you care for

Skills for Care

For many vulnerable people who receive care, COVID-19 and the lockdown mean a dramatic reduction in activities and family contact. Staff may also have less free time to spend with the people they support as things change. It is critical to minimise the impact for users of services and their families. This webinar – co-delivered with Digital Social Care – explores how technology can offer some help to connect people and to bring ‘outside experiences’ in.

Last updated on hub: 29 June 2020

VacciNation: exploring vaccine confidence with people from African, Bangladeshi, Caribbean and Pakistani backgrounds living in England: insight report

Healthwatch England

Findings from a study to better understand current trends in vaccine barriers among Black and Asian people. The report is based on in-depth conversations and online exercises with 95 participants from African, Bangladeshi, Caribbean, and Pakistani ethnicity over a period of five weeks during March and April. Attitudes to the vaccine are incredibly personal and we cannot make any broad conclusions about whole communities from our findings. We have drawn out some key themes to support improvement in the way the NHS and other public health professionals communicate with the public. These are: individual agency and an ability for a person to act on their own behalf is important in relation to the COVID-19 vaccine; independence of institutions and those who speak for them; participants associated levels of trust with the level of real-world experience an individual had; participants linked the notions of transparency and trust together; targeted messaging can have the opposite to the intended impact; conscious and unconscious trust needs to be considered.

Last updated on hub: 08 June 2021

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