COVID-19 Evidence alert - 14th August 2020
Please note we’ll be taking a short break next week – the alert will be back on 28th August.

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: (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.

Due to the time taken to compile alerts, we’re no longer providing summaries and instead present abstracts where available.

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. 

Residential facilities

Hospital discharge and preventing unnecessary hospital admissions (COVID-19). SCIE.

COVID-19: guidance for hostel services for people experiencing homelessness and rough sleeping. Public Health England (updated 7/8/20).

Supported living services during coronavirus (COVID-19). Department of Health and Social Care (published online 6/8/20).

Rapid reviews
COVID-19 in indoor environments — Air and surface disinfection measures. National Collaborating Centre for Environmental Health. (published online 29/7/20).

Emerging evidence
Experiences of Home Health Care Workers in New York City During the Coronavirus Disease 2019 Pandemic. A Qualitative Analysis. Sterling MR et al., JAMA Internal Medicine. DOI:10.1001/jamainternmed.2020.3930.

Sheltering in place and social distancing when the services provided are housing and social support: The COVID-19 health crisis and recovery housing. Mericle AA et al., Journal of Substance Abuse Treatment. DOI: 10.1016/j.jsat.2020.108094.

The devastating impact of covid-19 on social care in England.  Deeny S & Dunn P, BMJ Blogs. (published online 12/8/20).

Useful resources
Care homes and supported living: Learning and sharing following the COVID-19 lockdown. SCIE. (published online 11/8/20). 

Impacts of lifting restrictions

COVID-19 contain framework: a guide for local decision-makers. Department of Health and Social Care (published online 7/8/20).

Containing and managing local coronavirus (COVID-19) outbreaks. Department of Health and Social Care. (updated 7/8/20).

Rapid reviews
Increasing handwashing in young children: A brief review. Jess RL & Dozier CL. Journal of Applied Behavior Analysis, 53 (3), 1219-24.

Cluster infections play important roles in the rapid evolution of COVID-19 transmission: a systematic review. Liu T, International Journal of Infectious Diseases. DOI: 10.1016/j.ijid.2020.07.073.

Economic Aspects of the COVID-19 Crisis in the UK. DELVE Report No. 5. The DELVE Initiative. (published online 14/8/20).

Emerging evidence
Rapid Risk Assessment: Coronavirus disease 2019 (COVID-19) in the EU/EEA and the UK – eleventh update: resurgence of cases. European Centre for Disease Prevention and Control. (published online 10/8/20).

COVID-19 clusters and outbreaks in occupational settings in the EU/EEA and the UK. European Centre for Disease Prevention and Control. (published online 11/8/20).

Back to School Study: Interim Report 1, 11 August 2020. Lorenc A et al., University of Bristol.

Feasibility study of mitigation and suppression strategies for controlling COVID-19 outbreaks in London and WuhanYang P et al., PLoS One. DOI: 10.1371/journal.pone.0236857.

Impact of National Containment Measures on Decelerating the Increase in Daily New Cases of COVID-19 in 54 Countries and 4 Epicenters of the Pandemic: Comparative Observational Study. Wong CKH et al., J Med Internet Res, 22(7):e19904. DOI: 10.2196/19904.

Reactions to COVID-19: Differential Predictors of Distress, Avoidance, and Disregard for Social Distancing. Taylor S. Journal of Affective Disorders. (pre-proof). DOI:10.1016/j.jad.2020.08.002

Is risk compensation threatening public health in the covid-19 pandemic? Mantzari E et al., BMJ, 370. DOI:10.1136/bmj.m2913.

Public perspectives on protective measures during the COVID-19 pandemic in the Netherlands, Germany and Italy: A survey study. Meier K, PLoS One. DOI: 10.1371/journal.pone.0236917

Estimates of the ongoing need for social distancing and control measures post-"lockdown" from trajectories of COVID-19 cases and mortality. Lonergan M & Chalmers JD, Eur Respir J, 56(1):2001483. DOI: 10.1183/13993003.01483-2020

SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020. Szablewski CM et al., MMWR. (published online 7/8/20).

Social distancing laws cause only small losses of economic activity during the COVID-19 pandemic in Scandinavia. Sheridan A et al., PNAS. (published online 3/8/20). DOI:10.1073/pnas.2010068117.

COVID-19 impact on city and region: what’s next after lockdown? Kang M et al., International Journal of Urban Sciences. DOI:10.1080/12265934.2020.1803107.

Towards mental health friendly cities during and after COVID-19. Sinha M et al., Cities & Health. DOI: 10.1080/23748834.2020.1790251.

The environmental dangers of employing single-use face masks as part of a COVID-19 exit strategy. Allison AL et al., UCL Open: Environment. (Preprint).

Functional and Dysfunctional Fear of COVID-19: A Classification Scheme. Solymosi R et al., SocArXiv. (Preprint).

Leicester lockdown: could better data have prevented it? Wise J. BMJ, 370. DOI: 10.1136/bmj.m3028 

European Case-Fatality Rates beyond lockdown and the UK’s outlier status. Oke J & Heneghan C, Oxford CEBM, COVID-19 Evidence Service.

Covid-19: Was the decision to delay the UK’s lockdown over fears of “behavioural fatigue” based on evidence? Mahase E, BMJ, 370. DOI: 10.1136/bmj.m3166.

Critical Reflections on COVID-19 Communication Efforts Targeting Adolescents and Young Adults.  Abbott A et al., Journal of Adolescent Health 67, 159e160.

COVID-19 policy measures—Advocating for the inclusion of the social determinants of health in modelling and decision making.  Rangel JC et al., Journal of Evaluation in Clinical Practice. DOI: 10.1111/jep.13436.

The COVID-19 pandemic and the Swedish strategy: Epidemiology and postmodernism . Lindström M, SSM – Population Health. (In-press, pre-proof). DOI: 10.1016/j.ssmph.2020.100643.

Long term rehabilitation needs

Management of post-acute covid-19 in primary care. Greenhalgh T et al., BMJ, 370:m3026.

Why Rehabilitation must have priority during and after the COVID-19-pandemic: A position statement of the Global Rehabilitation Alliance. Gutenbrunner C et al., Journal of Rehabilitation Medicine. DOI: 10.2340/16501977-2713.

Emerging evidence
Low physical functioning and impaired performance of activities of daily life in COVID-19 patients who survived the hospitalisation. Belli S et al., European Respiratory Journal. DOI: 10.1183/13993003.02096-2020.

Multimodality cardiac evaluation in children and young adults with multisystem inflammation associated with COVID-19. Theocharis P et al., European Heart Journal: Cardiovascular Imaging, jeaa212. DOI: 10.1093/ehjci/jeaa212.

Lung Ultrasound in COVID ‐19 A Role Beyond the Acute Phase? Gaspardone C et al., Journal of Ultrasound in Medicine. DOI: 10.1002/jum.15425.

COVID-19 and functional disability: current insights and rehabilitation strategies (research letter). Ambrosino P et al., Postgrad Med J. (First published as 10.1136/postgradmedj-2020-138227 on 4/8/20).

Long term respiratory complications of covid-19. Fraser E, BMJ, 370. DOI: 10.1136/bmj.m3001.

Screening and testing

Commentary from the collaboration
New contact tracing app welcome but government must ensure app works for the hardest hit groups. Health Foundation. (published online 13/8/20).

Objectives for COVID-19 testing in school settings. European Centre for Disease Prevention and Control. (published online 10/8/20).

COVID-19 in children and the role of school settings in COVID-19 transmission. European Centre for Disease Prevention and Control. (published online 6/8/20).

Rapid reviews
Rapid Review: What is known about using wastewater surveillance to monitor the COVID-19 pandemic in the community? National Collaborating Centre for Methods and Tools (29/7/20).

Emerging evidence
Drive-Through COVID-19 Testing During the 2020 Pandemic: A Safe, Efficient, and Scalable Model for Pediatric Patients and Health Care Workers. Flynn EF et al., Academic Pediatrics, 20(6), P753-755.

Specific risk factors for SARS-CoV-2 transmission among health care workers in a university hospital. Celebi G, Americal Journal of Infection Control, DOI: 10.1016/j.ajic.2020.07.039.

Acceptability of app-based contact tracing for COVID-19: Cross-country survey evidence. Altmann S et al., JMIR mHealth and uHealth, 24/07/2020:19857 (forthcoming/in press). DOI: 10.2196/19857.

Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis. Bastos ML et al., BMJ, 370. DOI:

SARS-CoV-2 serology: Test, test, test, but interpret with caution! Bermingham WH et al., Clinical Medicine, 20(4), 365-8.

A cross‐sectional study of immune seroconversion to SARS‐CoV‐2 in frontline maternity health professionals. Bampoe S et al., Anaesthesia,

Modelling the impact of testing, contact tracing and household quarantine on second waves of COVID-19. Aleta A, Nature Human Behaviour, (2020). DOI: 10.1038/s41562-020-0931-9.

Digital technologies in the public-health response to COVID-19. Budd J, Nature Medicine, 26, 1183–1192. DOI: 10.1038/s41591-020-1011-4.

Using the COVID-19 to influenza ratio to estimate early pandemic spread in Wuhan, China and Seattle, US. Du Z et al, EClinical Medicine, DOI: 10.1016/j.eclinm.2020.100479.

Digital technology applications for contact tracing: the new promise for COVID-19 and beyond? Owusu PN, Global Health Research and Policy, 5(36).

Broader impacts on health outcomes

Rapid reviews
Mental health- general public
Health behaviour changes during COVID-19 and the potential consequences: A mini-review. Arora T & Grey I, Journal of Health Psychology, 25(9), 1155-63.

Rapid Review: What is known about the impact of the COVID-19 pandemic on families with children? National Collaborating Centre for Methods and Tools (22/7/20).

Mental health – healthcare workers
Psychological effects of the COVID 19 pandemic on healthcare workers globally: A systematic review. Sheraton M et al, Psychiatry Research, 292, DOI: 10.1016/j.psychres.2020.113360.

Mental health – pre-existing conditions
Severe mental illness and risks from COVID-19. Barber S, Oxford CEBM COVID-19 Evidence Service. (published online 5/8/20).

Emerging evidence
Public health
Caring for Bereaved Family Members During the COVID-19 Pandemic: Before and After the Death of a Patient. Morris SE et al., J Pain Symptom Management. 2020 Aug;60(2):e70-e74.

Mental health- general public
Covid-19—Beyond virology: Potentials for maintaining mental health during lockdown. Munk AJL et al., PLoS One,

The Interpersonal and Psychological Impacts of COVID-19 on Risk for Late-Life Suicide. Sheffler JL et al., The Gerontologist,

Who is lonely in lockdown? Cross-cohort analyses of predictors of loneliness before and during the COVID-19 pandemic. Bu F et al., Public Health, 186, 31-34.

Managing Psychological Distress in Children and Adolescents Following the COVID-19 Epidemic: A Cooperative Approach. Zhou X, Psychological Trauma: Theory, Research, Practice and Policy, 12(S1), S76-8.

Loneliness, physical activity and mental health during Covid-19: a longitudinal analysis of depression and anxiety between 2015 and 2020. Creese B et al., medRxiv. (Preprint), DOI: 10.1101/2020.07.30.20165415

Mental health – health care workers
Exposure to COVID-19 patients increases physician trainee stress and burnout. Kannampallil TG, PLoS One,

Symptoms of burnout in intensive care unit specialists facing the COVID-19 outbreakAzoulay E et al., Ann. Intensive Care 10, 110 (2020).

Mental Health of Medical and Non-Medical Professionals during the Peak of the COVID-19 Pandemic: A Cross-Sectional Nationwide Study. Maciaszek J et al., Journal of Clinical Medicine, 9, 2527; doi:10.3390/jcm9082527.

Pre-existing conditions
Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties. Aragona M et al., Public Health, 186, 52-6.

The Psychological Impact of COVID-19. COVID-MINDS. (updated 5/8/20).

Understanding the mental health burden of COVID-19 in the United Kingdom. Lopes BC & Jaspal R, Psychological Trauma: Theory, Research, Practice & Policy, 12 (3), 465-467.

Useful resources
Cochrane Special Collections. Coronavirus (COVID-19): support for wellbeing in the healthcare workforce. Cochrane Library. (updated 10 August 2020).

Impact on non-Covid care

Commentary from the collaboration
Supporting staff wellbeing during COVID-19: a Northumbrian experience. Laverty A, Health Foundation. (published online 5/8/20).

How did the NHS free up hospital capacity at the start of the pandemic? Elias L & Scobie S, Nuffield Trust. (published online 6/8/20).

Reflections on organisational development during Covid-19: restoring purpose and driving change. Hulks S, King’s Fund. (published online 6/8/20).

What is Covid-19 revealing about innovation in the NHS? Collins B, King’s Fund. (published online 3/8/20).

The NHS is still nowhere close to business as usual following the first outbreak of COVID-19. Health Foundation. (published online 13/8/20).

Covid-19: Guidelines for Community Palliative Care – which is the ‘Best in Show’? Jenkins L, Oxford CEBM COVID-19 Evidence Service. (published online 10/8/20).

Implementing phase 3 of the NHS response to the COVID-19 pandemic. NHS England.

Emerging evidence
Primary and community care
RAPCI Project Summary Report 4, 31 July 2020. Murphy M et al., Centre for Academic Primary Care (CAPC), University of Bristol.

The impacts of COVID-19 on Health Visiting in England: First results. Conti G & Dow A, UCL. (published online 29/7/20).

Counselling and psychotherapy post-COVID-19Vostanis P & Bell CA. Couns Psychother Res, 20:389–393.

The challenges and experiences of psychotherapists working remotely during the coronavirus* pandemic. McBeath MG et al., Couns Psychother Res. 2020;20:394–405.

Social care
Data-informed recommendations for services providers working with vulnerable children and families during the COVID-19 pandemic. Wilke NG et al., Child Abuse and Neglect,

Secondary care
Waiting for myomectomy during the COVID‐19 pandemic: The vicious cycle of psychological and physical trauma associated with increased wait times. Strong SM et al., Obstetrics and Gynaecology, DOI: 10.1002/ijgo.13340.

COVID‐19 and ENT SLT services, workforce and research in the UK: A discussion paper. Patterson JM et al., International Journal of Language and Communication Disorders,

Tertiary care
Transplantation during the COVID-19 pandemic: nothing noble is accomplished without danger. Spoletini G et al., BMC Gastroenterol 20(259). DOI: 10.1186/s12876-020-01401-0.

Patient experiences of fertility clinic closure during the COVID-19 pandemic: appraisals, coping and emotions. Boivin J et al., Human Reproduction, DOI: 10.1093/humrep/deaa218.

Cancer care
The impact of coronavirus disease 2019 on head and neck cancer services: a UK tertiary centre study. Taylor R et al., Journal of Laryngology and Otology, August 2020, 1-8.

Effects of the COVID-19 Pandemic on Cancer-Related Patient Encounters. London JW et al., JCO Clinical Cancer Informatics no. 4, 657-665. DOI: 10.1200/CCI.20.00068.

Is Elective Cancer Surgery Safe During the COVID-19 Pandemic? Ji C et al., World Journal of Surgery, DOI: 10.1007/s00268-020-05720-x.

Maternity services
Moral and Mental Health Challenges Faced by Maternity Staff During the COVID-19 Pandemic. Horsch A et al., Psychological Trauma: Theory, Practice, Research and Policy, 12(S1), S141-S142.

Outpatient services
Managing high-acuity outpatient services during the COVID-19 pandemic: lessons from the acute diabetes foot service. Deogon GS. Future Healthcare Journal, DOI: 10.7861/fhj.2020-0054.

Mental health services
COVID-19 and acute inpatient psychiatry: the shape of things to come. Boland X & Dratcu L. International Journal of Psychiatry in Clinical Practice. DOI: 10.1080/13651501.2020.1801755.

Digital or Digitally Delivered Responses to Domestic and Intimate Partner Violence During COVID-19. Emezue C. JMIR Public Health Surveill, 6(3):e19831. DOI:10.2196/19831.

Digital public health and COVID-19. Murray CJL et al., The Lancet Public Health, DOI:10.1016/S2468-2667(20)30187-0.

Useful resources
Practice Examples. Public Health England.

Understanding crisis-response measures: Collective Sense-making. Burbridge I. Royal Society of Arts, 2020.

COVID-19: Why and how organisations can learn now to shape the future. Collaborate for Social Change, 2020.

Cochrane Special Collections Coronavirus (COVID-19): remote care through telehealth. Cochrane Library. (updated 10/8/20).

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: or 
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