COVID-19 Evidence alert - 31st July 2020
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.

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.

Please note that this email alert excludes section summaries due to the breadth and volume of evidence covered in the alert.

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. 

As part of the Analytical Collaboration on COVID-19 – and working with the NHSE/I Midlands region - the Strategy Unit has produced a model to support local systems working through the dynamics of elective recovery. The brief was to build a usable model that could be adopted and adapted locally, and that allowed the running of multiple scenarios to help inform local planning. We used a System Dynamics modelling approach to deliver this. The model was developed and tested with the NHSE/I Midlands region. The model is freely available for non-commercial use. Instructions on accessing the model and working with it are available here, alongside explanatory videos and supporting/related analyses on changes in activity patterns during COVID-19.

Residential facilities

COVID-19 guide for drug and alcohol residential rehab and detox services. SCIE. (published online July 2020).

Emerging evidence
Preventing and managing COVID-19 across long-term care services: Policy brief, 24 July 2020. WHO Global.

Care Homes and COVID-19: Results of an Online Survey in Germany. Rothgang H et al., International Long Term Care Policy Network.

COVID-19 and Long-Term Care Policy for Older People in Canada. Béland D & Marier P. Journal of Aging & Social Policy.

Risk Factors Associated With Mortality Among Residents With Coronavirus Disease 2019 (COVID-19) in Long-term Care Facilities in Ontario, Canada. Fisman DN et al., Infectious Diseases.

Social Distancing and Incarceration: Policy and Management Strategies to Reduce COVID-19 Transmission and Promote Health Equity Through Decarceration. Henry BF. Health Education & Behavior.

Prisons and COVID-19: A Desperate Call for Gerontological Expertise in Correctional Healthcare. Prost SG et al., The Gerontologist.

“We are Alone in This Battle”: A Framework for a Coordinated Response to COVID-19 in Nursing Homes. Behrens LL et al., Journal of Aging & Social Policy.

Mitigation of a COVID-19 Outbreak in a Nursing Home Through Serial Testing of Residents and Staff. Escobar DJ et al., Clinical Infectious Diseases.

Nursing Home Staff Networks and COVID-19. Chen MK et al., ArXiv. (pre-print).

Nursing Home Care in Crisis in the Wake of COVID-19. Davidson PM & Szanton SL. J Clin Nurs.

COVID-19-related deaths in long-term care: The moral failure to care and prepare. Faghanipour S et al., Nursing Ethics. (published 24/7/20).

COVID-19: digital equivalence of health care in English prisons. Edge C et al., Lancet Digital health. (published online 23/7/20)

Impacts of lifting restrictions

Commentary from the collaboration
As we face potential future waves of COVID-19, we must urgently understand how the UK differs from its neighbours and why. Tallack C. (published 30/7/20).

Guidance for conducting a country COVID-19 intra-action review (IAR). WHO. (published online 23/7/20).

Emerging evidence
From "Coffin Dodger" to "Boomer Remover:" Outbreaks of Ageism in Three Countries with Divergent Approaches to Coronavirus Control. Lichtenstein B. The Journals of Gerontology, gbaa102.

Willingness to receive a COVID-19 vaccine among adults at high-risk of COVID-19: a UK-wide survey. Thornelo R et al., PsyArXiv (pre-print).

Cross-country comparison of public awareness, rumours, and behavioural responses to the COVID-19 epidemic: An internet surveillance study. Hou Z et al., J Med Internet Res.

How Fear Appeal Approaches in COVID-19 Health Communication May Be Harming the Global Community. Stowlow JA et al., Health Education & Behavior.

Collectively Coping with Coronavirus: Local Community Identification Predicts Giving Support and Lockdown Adherence During the COVID-19 Pandemic. Stevenson C et al., OSF Preprints. (pre-print).

Collaborating During Coronavirus: The Impact of COVID-19 on the Nature of Work. DeFilippis E et al., Harvard Business School.

Simulating the effect of school closure during COVID-19 outbreaks in Ontario, Canada. Abdollahi E et al., BMC Medicine.

When and How to Lift the Lockdown? Global COVID-19 Scenario Analysis and Policy Assessment using Compartmental Gaussian Processes. Qian Z et al., ArXiv.

Strategies to reduce the risk of SARS-CoV-2 re-introduction from international travellers. Clifford S et al., MedRxiv (pre-print). (published online 25/7/20).

The effectiveness of eight nonpharmaceutical interventions against COVID-19 in 41 countries. Brauner JM et al., MedRxiv (pre-print). (published online 23/7/20).

Lessons from South Korea Regarding the Early Stage of the COVID-19 Outbreak. Chang MC et al., Healthcare, MDPI. (published online 24/7/20).

Comparison of Face-Touching Behaviors Before and During the Coronavirus Disease 2019 Pandemic. Chen YJ et al., JAMA Network Open.

Five principles for pandemic preparedness: lessons from the Australian COVID-19 primary care response. Kidd MR. BJGP. (published online July 2020).

Can self-imposed prevention measures mitigate the COVID-19 epidemic? Zhang L et al., PLOS Medicine. (published online 21/7/20).

Policy responses to Covid-19: what worked, what didn’t, and why? Mthiyane H et al., HSR UK. (published online July 2020).

Long term rehabilitation needs

Emerging evidence
Multi-Inflammatory Syndrome in Children related to SARS-CoV-2 in Spain. Moraleda C et al., Clinical Infectious Diseases.

Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020. CDC Morbidity and Mortality Weekly Report.

Respiratory rehabilitation for post-COVID19 patients in spa centers: first steps from theory to practice. Antonelli M & Donelli D. International Journal of Biometeorology.

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). Puntmann VO et al., JAMA Cardiology.

Patients with COVID-19 Face Prolonged Neurocognitive Recovery After Ventilation. Hurley D. Neurology Today. (published online 23/7/20).

Covid-19 Long Haulers: Meaning, Symptoms, Support Groups. Conte Jr. RL. COVID.US.ORG. (published online 12/7/20).

Cardiac rehabilitation in the time of COVID19. Babu AS. Global Heart. (published online 14/7/20).

Characteristics of ischaemic stroke associated with COVID-19. Beyrouti R et al., J Neurosurg Psychiatry.

Screening and testing

Rapid reviews
COVID-19 screening in patients without defined COVID-19 symptoms, admitted through emergency departments in three AHS hospitals: Final report of a pilot project. Ravani P et al., Alberta Health Services, COVID-19 Scientific Advisory Group.

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

Emerging evidence
What does RCGP surveillance tell us about COVID-19 in the community? Heneghan C & Jefferson T. Oxford CEBM. (updated 31/7/20).

Nosocomial spread of COVID-19: lessons learned from an audit on a stroke/neurology ward in a UK district general hospital. Jewkes SV et al., Clinical Medicine.

Effective Contact Tracing for COVID-19: A Systematic Review. Juneau CE et al., MedRxiv (pre-print). (published online 25/7/20).

Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study. Pallett SJC et al., The Lancet Respiratory Medicine.

COVID-19 screening strategies that permit the safe re-opening of college campuses. Patiel AD et al., MedRxiv (preprint).

Detection of COVID-19: A review of the current literature and future perspectives. Ji T et al., Biosens Bioelectron.

Drive-thru pharmacy services: a way forward to combat COVID-19 pandemic. Huassain R et al., Res in Soc & Admin Pharma.

Fecal Shedding of SARS-CoV-2 and its Potential Role in Person-To-Person Transmission and the Environment-Based Spread of COVID-19. Jones DL et al., (pre-print).

The atypical presentation of COVID-19 as gastrointestinal disease: key points for primary care. Ong J & Low JG. BJGP.

Universal Testing-Based Response to COVID-19 Outbreak by a Long-Term Care and Post-Acute Care Facility. Bakaev I et al., Journal of the American Geriatrics Society.

Rapid Scaling Up of Covid-19 Diagnostic Testing in the United States — The NIH RADx Initiative. Tromberg BJ et al., New England Journal of Medicine. (published online 22/7/20).

Broader impacts on health outcomes

Commentary from the collaboration
Living in poverty was bad for your health long before COVID-19. Tinson A. The Health Foundation. (published online 25/7/20).

Communicating about long-term health during the pandemic. Hawkins N. The Health Foundation. (published online 29/7/20).

Emerging evidence
Mental health- General public
Impact of COVID-19 Pandemic on Mental Health of the General Population, Students, and Health Care Workers: A Review. Sankhi S Marasine NR. ( (published online 25/7/20).

Healthcare workers
Physical and mental health impacts of COVID-19 on healthcare workers: a scoping review. Shaukat N et al., Int J Emerg Med.

Public health
Challenges posed by COVID-19 to people who inject drugs and lessons from other outbreaks. Vasylyeva T et al., J Int AIDS Soc.

A global survey on changes in the supply, price and use of illicit drugs and alcohol, and related complications during the 2020 COVID-19 pandemic. Farhoudian A et al., MedRxiv (pre-print). (published online 24/7/20).

Mistakes from the HIV pandemic should inform the COVID-19 response for maternal and newborn care. Gribble K et al., International Breastfeeding Journal.

Public health
Metabolic health and COVID-19: a call for greater medical nutrition education. Burridge J et al., The Lancet.

Family violence and COVID-19: Increased vulnerability and reduced options for support. Usher K et al., Int J Mental Health Nursing.

Sex workers must not be forgotten in the COVID-19 response. Platt L et al., The Lancet.

Covid-19: Male disadvantage highlights the importance of sex disaggregated data. Womersley K et al., BMJ, 370:2870.

Mental health
The COVID-19 pandemic and perinatal mental health. Caparros-Gonzalez RA & Alderdice F. Journal of Reproductive and Infant Psychology. (published online 2/7/20).

COVID-19 social distancing: A snippet view of the autistic social world. Simmons AL. Disability & Society.

Coping, fostering resilience, and driving care innovation for autistic people and their families during the COVID-19 pandemic and beyond. Ameis SH et al., Molecular Autism. (published online 22/7/20).

Societal pandemic burnout: A COVID legacy. Queen D & Harding K. Int Wound J.

Healthcare workers
Covid-19: Supporting nurses' psychological and mental health. Maben J et al., J Clin Nursing.

Mental health issues impacting pharmacists during COVID-19. Elbeddini A et al., Journal of Pharmaceutical Policy and Practice. (published online July 2020).

Useful resources
Techniques, Methods, and Dissemination of Community-Based Psychological Support Strategies in Times of the COVID-19 Pandemic. Bernecke AV et al., J Prim Care Community Health. (published online 19/7/20).

Coping with social anxiety as lockdown eases. Young Minds. (published online 24/7/20).

Impact on non-Covid care

Commentary from the collaboration
Adult social care and COVID-19: Assessing the policy response in England so far. Dunn P et al., The Health Foundation. (published online July 2020).

Adult social care and COVID-19: Assessing the impact on social care users and staff in England so far. Hodgson K et al., The Health Foundation. (published online July 2020).

COVID-19 rapid guideline: arranging planned care in hospitals and diagnostic services. NICE. NG179. (published online 27/7/20).

Digital adaptations to supervision and observations. British Psychological Society. Division of Clinical Psychology. (published online July 2020).

Emerging evidence      
Primary care
Relevance and paucity of evidence: a dental perspective on personal protective equipment during the COVID-19 pandemic. Gallagher JE et al., British Dental Journal.

Social care
COVID-19: Implications for the Support of People with Social Care Needs in England. Comas-Herrera A et al., Journal of Ageing and Social Policy.

Elective care
Is it safe to restart elective day-case surgery? Lessons learned from upper limb ambulatory trauma during the COVID-19 pandemic. Trowbridge S et al., J Clin Ortho & Trauma. (published online 25/7/20).

Secondary care
Disruption of paediatric orthopaedic hospital services due to the COVID-19 pandemic in a region with minimal COVID-19 illness. Wong FL et al., Journal of Children’s Orthopaedics.

The impact of the COVID-19 pandemic on orthopaedic services and training in the UK. Khan H et al., Eur J Ortho Surgery & Traumatology.

Cancer care
Effects of the COVID-19 Pandemic on Cancer-Related Patient Encounters. London JW et al., JCO Clinical Cancer Informatics.

Tertiary care
A Cohort Study of Emergency Surgery Caseload and Regional Anaesthesia Provision at a Tertiary UK Hospital During the Initial COVID-19 Pandemic. Wade S et al., Cureus.

Reflections from London’s Level1 Major Trauma Centres during the COVID crisis. Tahamassebi R et al., Eur J Ortho Surg Trauma.

The Response of the UK Clinical Oncology Community to the COVID-19 Pandemic. Lewis PJ & Roques TW. Clinical Oncology.

Implications for the future of Obstetrics and Gynaecology following the COVID-19 pandemic: A commentary. Kasaven LS et al., BJOG: an International Journal of Obstetrics & Gynaecology.

Covid-19: UK Obstetric Surveillance System (UKOSS) study in context. Magee LA et al., BMJ, 370:m2915.

A survey of UK cardiac surgeons' opinions during the coronavirus disease 2019 pandemic: A point and place in time. Andersen ND. Journal of Thoracic and Cardiovascular Surgery.

Useful resources
The NHS after COVID-19. The views of provider trust chief executives. Claridge F & Sogbetun T. NHS RESET & NHS Confederation. (published online July 2020).

Self-Care and Health: By All, For All- Learning From Covid-19. Duggan M. Victoria University & the Mitchell Institute. (published online July 2020). 

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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