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COVID-19 Evidence alert - 26th June 2020
 
Welcome
COVID-19 Evidence alert is a weekly update highlighting emerging evidence on the following key topics identified as useful in supporting Covid recovery planning:
  1. Residential settings
  2. Impacts of lifting restrictions
  3. Long term rehabilitation needs
  4. Screening and testing
  5. Broader impacts on health outcomes
  6. Impact on non-Covid care
This update follows on from a series of rapid evidence scans on these key topics, with corresponding evidence trackers providing details of relevant papers. 

The evidence scans and corresponding evidence trackers can be found here: https://www.strategyunitwm.nhs.uk/covid19-and-coronavirus (see ‘Evidence - Helping you to keep up to date’).

Here you will also find details of the evidence that has been used to inform this weekly update

We are also working on other key areas of interest such as impacts on inequalities and marginalised groups, which will be added to the alert once completed.

Analytical Collaboration for COVID-19  

As previously described the collaboration are supporting ad hoc immediate questions raised by national bodies but are also using their expertise to focus on questions that the NHS may lack the immediate resources to look at, which may be more medium-term, cut across sectors, or benefit from independent analysis.  This week the Strategy Unit published analyses on changes in healthcare activity since lockdown, these include:   

Residential facilities

Earlier searches identified a wave of papers on the impact of the pandemic in care homes.  There have been fewer papers on the impact in other residential facilities, however a new blog from the Nuffield looks at what life might be like in prisons while the virus remains a threat, and what it might mean for access to health care. Research is starting to explore lessons learned from the first wave of COVID-19 that can help prepare in case of a second wave. 

Impacts of lifting restrictions

New rapid reviews from the Oxford Centre for Evidence Based Medicine explore the evidence to support the 2-metre social distancing rule to reduce COVID-19 transmission, and transmission dynamics of COVID-19. Community engagement to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures is also explored.     

Long term rehabilitation needs

Emerging evidence explores increased concerns regarding potential neurological complications of COVID-19. A BMJ editorial highlights the need to shift the research focus to studies on living with this disease. Other commentaries cover cognitive rehabilitation, cardiac rehabilitation, and paediatric inflammatory syndrome temporally related to Covid-19. 

Screening and testing

A Cochrane review explores antibody tests for identification of current and past infection with Covid 19. Emerging evidence explores the late diagnosis of COVID-19 in patients admitted to hospital, as well as approaches to testing patients in psychiatric units and protocols to restore surgical services. Research on criteria for COVID-19 testing of heath care workers is also considered. 

Broader impacts on health outcomes

There is continued concern of the impact of the pandemic and restrictions on mental health, both in the general public and for those with pre-existing conditions.  There are also concerns that the pandemic may lead to a widening of pre-existing health inequalities. A new rapid review explores the effect of the COVID19 pandemic on alcohol use and alcohol-related harms. Emerging research covers concerns regarding maternal and child health and nutrition, and elder mistreatment. 

Impact on non-Covid care

The Royal College of Surgeons of England and the Royal College of Emergency Medicine have issued a joint memorandum to MPs calling for urgent action to help the NHS recover from Covid-19. A rapid review shows the COVID-19 pandemic has highlighted the importance of unpaid carers. Ethical dilemmas due to the Covid-19 pandemic are also considered in a rapid review. The role of community health workers in the COVID-19 response is emerging. 

This update forms part of a national evidence update service, provided by the Strategy Unit, as part of a collaboration to provide analytical support to the health and care system to help in the fight against COVID-19. For more information, visit: https://www.strategyunitwm.nhs.uk/covid19-and-coronavirus or 
contact our Covid Evidence team on: mlcsu.covidevidence@nhs.net.
Click here to visit the Strategy Unit website
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