COVID-19 Evidence alert - 28th August 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.

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

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 our work to track emerging evidence, we have developed an evidence map on inequalities and COVID.  The map is designed to organise relevant evidence by themes, using the recently published PROGRESS framework. It is a pragmatic rather than exhaustive approach and we hope it gives a helpful overview of this important field of study. You can find the evidence map here.

We have also recently updated our evidence scan on prospective and longitudinal studies to include emerging findings.  You can find the updated scan here.

Residential facilities

Commentary from the collaboration
Understanding changes to mortality during the pandemic Non-COVID-19 excess deaths in England and Wales. Kraindler J et al., The Health Foundation. (published online 17/8/20).

Home care for patients with suspected or confirmed COVID-19 and management of their contacts. WHO Health Organization (12/08/20).

Rapid reviews
Emerging Evidence: Impact of Infection Outbreak on Long-Term Care Staff, A Rapid Review on Psychological Well-Being. Embregts P et al., Journal of Long-Term Care.

Emerging evidence
COVID-19 Outbreak Among Adolescents at an Inpatient Behavioral Health Hospital. Krass P et al., Journal of Adolescent Health.

Transmission of SARS-CoV-2 Involving Residents Receiving Dialysis in a Nursing Home — Maryland, April 2020. Bigelow BF et al., MWWR Morbidity and Mortality Weekly Report.

Coronavirus Disease 2019 Outcomes in French Nursing Homes That Implemented Staff Confinement With Residents. Belmin J et al., JAMA Netw Open.

Facility-Wide Testing for SARS-CoV-2 in Nursing Homes — Seven U.S. Jurisdictions, March–June 2020. Hatfield KM et al., MWWR Morbidity and Mortality Weekly Report.

The neglect of adult social care during covid-19. Glasby J & Needham C, BMJ.

Impacts of lifting restrictions

Commentary from the collaboration
COVID-19 policy tracker. A timeline of national policy and health system responses to COVID-19 in England. Dunn P et al., The Health Foundation. (published online 20/8/20).

Advice on the use of masks for children in the community in the context of COVID-19. UNICEF & WHO. (published online 21/8/20).

Considerations for quarantine of contacts of COVID-19 cases. Interim Guidance. WHO. (published online 19/8/20).

Rapid reviews
What is the specific role of daycares and schools in COVID-19 transmission? National Collaborating Centre for Methods and Tools. (updated 11/8/20).

Knowledge, Attitude, and Practice During the COVID-19 Pandemic: A Review. Puspitasari IM et al., J Multidiscip Healthc.

Improving the impact of non-pharmaceutical interventions during COVID-19: examining the factors that influence engagement and the impact on individuals. Seale H et al., BMC Infect Dis.

Emerging evidence
The influence of national policy characteristics on COVID-19 containment policies: a comparative analysis. Migone AR, Policy Design and Practice.

Onslaught of COVID-19: How Did Governments React and at What Point of the Crisis? Uddin S et al., Population Health Management (preprint).

Forecasting the patterns of COVID-19 and causal impacts of lockdown in top five affected countries using Bayesian Structural Time Series Models. Feroze N, Chaos, Solitons and Fractals.

The effect of social distance measures on COVID-19 epidemics in Europe: an interrupted time series analysis. Vokó Z and Pitter JG, Geroscience.

Enacting national social distancing policies corresponds with dramatic reduction in COVID19 infection rates. McGrail DJ et al. PLoS One.

Face coverings for covid-19: from medical intervention to social practice. van der Westhuizen HM et al., BMJ, 370:m3021.

Learning from Deregulation: The Asymmetric Impact of Lockdown and Reopening on Risky Behavior During COVID-19. Glaeser EL et al., NATIONAL BUREAU OF ECONOMIC RESEARCH, NBER Working Paper No. 27650.

Ageism and COVID-19: a study of social inequality through opinions and attitudes about older people in the coronavirus crisis in Spain. García-Soler A et al., International LTC Policy Network. (last updated 12/8/20).

Impact of Wearing Masks, Hand Hygiene, and Social Distancing on Influenza, Enterovirus, and All-Cause Pneumonia During the Coronavirus Pandemic: Retrospective National Epidemiological Surveillance Study. Chiu NC et al., J Med Internet Res.

Do established infection prevention and control measures prevent spread of SARS-CoV-2 to the hospital environment beyond the patient room? Jerry J et al.J Hosp Infect.

Four months into the COVID-19 pandemic, Sweden’s prized herd immunity is nowhere in sight. Orlowski EJW & Goldsmith DJA, Journal of the Royal Society of Medicine.

Why Oldham shouldn’t go into Lockdown. Heneghan C and Oke J, Oxford COVID-19 Evidence Service, Centre for Evidence-Based Medicine.

Airborne Transmission of SARS-CoV-2 Theoretical Considerations and Available Evidence. Klompas M et al., JAMA.

Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19. Neumann-Böhme S et al., Eur J Health Econ.

Long term rehabilitation needs

Rapid reviews
Why Rehabilitation must have priority during and after the COVID-19-pandemic: A position statement of the Global Rehabilitation Alliance. Gutenbrunner C et al., J Rehabil Med.

The Interrelation of Neurological and Psychological Symptoms of COVID-19: Risks and Remedies. Nami M et al., Journal of Clinical Medicine.

Considerations for Return to Exercise Following Mild-to-Moderate COVID-19 in the Recreational Athlete. Metzl jd et al., HSS Journal.

Key Aspects in Nutritional Management of COVID-19 Patients. Fernández-Quintela A et al., Journal of Clinical Medicine.

COVID-19, the heart and returning to physical exercise. Kennedy FM & Sharma S, Occupational Medicine.

Useful resources
Rehabilitation. Royal College of Occupational Therapists (RCOT).

Covid-19: the Road to Recovery. The Chartered Society of Physiotherapy (CSP).

Screening and testing

Commentary from the collaboration
Strengthening health protection: right idea, wrong time. Timmins N. The King’s Fund. (published online 20/8/20).

PHE reorganisation is highly risky and justification for the change has not been fully set out. The Health Foundation. (published online 18/8/20).

Dismantling PHE in the midst of a pandemic carries serious risks. Dixon J et al., The Health Foundation, Nuffield Trust & The King’s Fund. (published online 24/8/20).

Exploration of COVID-19 health-care worker cases: Implications for action. WHO Health Organization. (21/08/20).

Public health surveillance for COVID-19: interim guidance. WHO Health Organization (07/08/20).

What we know about the COVID-19 immune response. WHO Health Organization. (02/08/20).

Rapid reviews
Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection. Dinnes  J et al., Cochrane Database of Systematic Reviews.

Digital contact tracing technologies in epidemics: a rapid review. Anglemyer  A et al., Cochrane Database of Systematic Reviews.

Diagnostic Value of Imaging Modalities for COVID-19: Scoping Review. Aljondi R and Alghamdi S, J Med Internet Res.

Automated and partly automated contact tracing: a systematic review to inform the control of COVID-19. Braithwaite I et al., The Lancet Digital Health.

Engagement and adherence trade-offs for SARS-CoV-2 contact tracing. Lucas TCD et al., MedRxiv. (pre-print).

Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis. Hourneaux de Moura DT et al., Clinics.

A Systematic Review of Smartphone Applications Available for Corona Virus Disease 2019 (COVID19) and the Assessment of their Quality Using the Mobile Application Rating Scale (MARS). Davalbhakta S et al., Journal of Medical Systems.

Biosensors: frontiers in rapid detection of COVID‑19. Samson R et al., 3 Biotech.

A Review of the Importance of Atypical Otorhinolaryngological Symptoms in the Screening of COVID-19 Patients. Kaur G et al., Indian J Otolaryngol Head Neck Surg.

Approaches Based on Artificial Intelligence and the Internet of Intelligent Things to Prevent the Spread of COVID-19: Scoping Review. Adly AS et al., J Med Internet Res.

A Review on Deep Learning Techniques for the Diagnosis of Novel Coronavirus (COVID-19). Islam M et al. Preprint.

Emerging evidence
Standing up to the test: learning lessons for the next phase of the national Covid-19 testing strategy. NHS Providers.

Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysis. Currie J et al., BMJ Open.

COVID-19 in children: analysis of the first pandemic peak in England. Ladhani SN et al., Archives of Disease in Childhood.

COVID-19 contact tracing using sexual health services in Cumbria. Currie S, Sexually Transmitted Infections.

Self-assessment overestimates historical COVID-19 disease relative to sensitive serological assays: cross sectional study in UK key workers. Mulchandani R et al., MedRxiv. (pre-print).

Retrospective screening of routine respiratory samples revealed undetected community transmission and missed intervention opportunities for SARS-CoV-2 in the United Kingdom. Chappell JG et al., MedRxiv. (pre-print).

Population-wide testing of SARS-CoV-2: country experiences and potential approaches in the EU/EEA and the United Kingdom. European Centre for Disease Prevention and Control.

Objectives for COVID-19 testing in school settings. European Centre for Disease Prevention and Control.

SARS-CoV-2 infection and transmission in educational settings: cross-sectional analysis of clusters and outbreaks in England. Ismail SA et al., MedRxiv. (pre-print).

Transmission dynamics of COVID-19 in household and community settings in the United Kingdom. Lopez Bernal J et al., MedRxiv. (pre-print).

Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population. Krdzalic J et al.,  Br J Radiol.

Differential occupational risks to healthcare workers from SARS-CoV-2 observed during a prospective observational study. Eyre DW et al., Epidemiology and Global health.

Risk factors for positive and negative COVID-19 tests: a cautious and in-depth analysis of UK biobank data. Chadeau-Hyam M et al., Int J Epidemiol.

What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure? Huybens EM et al., World J Surg.

Perceived versus proven SARS-CoV-2-specific immune responses in health-care professionals. Behrens GMN et al., Infection.

COVID-19 clusters and outbreaks in occupational settings in the EU/EEA and the UK. European Centre for Disease Prevention and Control.

Broader impacts on health outcomes

Rapid reviews
Long-term conditions
Impact and mortality of COVID-19 on people living with dementia: cross-country report. Suárez-González A et al., LTC Covid. (updated 19/8/20).

Mental health – public
Effects of COVID-19 on Anxiety, Depression and Other Mental Health Issues: A worldwide scope review. Machado DB et al., Preprint.

Prevalence of Psychological Morbidities Among General Population, Healthcare Workers and COVID-19 patients Amidst the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Krishnamoorthy Y et al., Psychiatry Res.

Overview on Children Mental Health Status during Coronavirus Disease: Expressing How to Support. Mohammadi GH et al., Int J Pediatr.

Interpersonal Violence Against People With Disabilities: Additional Concerns and Considerations in the COVID-19 Pandemic. Lund EM, Rehabilitation Psychology.

Emerging evidence
Public health
Penetrating trauma during a global pandemic: Changing patterns in interpersonal violence, self-harm and domestic violence in the Covid-19 outbreak. Olding J et al., The Surgeon.

Child safety, protection, and safeguarding in the time of COVID-19 in Great Britain: Proposing a conceptual framework. Levine DT et al., Child Abuse & Neglect.

Behavioral Health and Service Usage During the Coronavirus Disease 2019 Pandemic Among Emerging Adults Currently or Recently Experiencing Homelessness. Tucker JS et al. J Adolesc Health.

Mental health
Impact of the COVID-19 pandemic and initial period of lockdown on the mental health and well-being of adults in the UK. White RG and Van Der Boor C, BJPsych Open.

Time and Covid-19 stress in the lockdown situation: Time free, «Dying» of boredom and sadness. Droit-Volet S et al., PLoS ONE.

The Impact of Sheltering in Place During the COVID-19 Pandemic on Older Adults’ Social and Mental Well-Being. Krendl AC and Perry BL, The Journals of Gerontology.

Mental Health During the COVID-19 Pandemic: Effects of Stay-at-Home Policies, Social Distancing Behavior, and Social Resources. Marroquín B et al., Psychiatry Research.

COVID stress syndrome: Concept, structure, and correlates. Taylor S et al., Depress Anxiety.

Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. Czeisler ME et al., Morbidity and Mortality Weekly Report.
Exacerbation of Physical Intimate Partner Violence during COVID-19 Lockdown. Gosangi B et al., Radiology (In press).

COVID-19-related fear and stress among individuals who experienced child abuse: The mediating effect of complex posttraumatic stress disorder. Tsur N and Abu-Raiya H, Child Abuse & Neglect.

Mental health
Debate: Recognising and responding to the mental health needs of young people in the era of COVID-19. Danese A & Smith P, Child and Adolescent Mental Health.

Emerging from COVID-19: prioritising the burden of loneliness in older people. Armitage R and Nellums LB, British Journal of General Practice.

"The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic. López-Pelayo H et al. BMC Med.

COVID-19 stress and substance use: Current issues and future preparations. McKay D and Asmundson GJG, J Anxiety Disord.

Psychosocial impact of COVID-19 pandemic lockdown on people living with eye diseases in the UK. Ting DSJ et al., Eye.

Substance use and abuse associated with the behavioral immune system during COVID-19: The special case of healthcare workers and essential workers. McKay D and Asmundson GJG, Addict Behav.

'Healthcare Heroes': problems with media focus on heroism from healthcare workers during the COVID-19 pandemic. Cox CL, J Med Ethics.

Impact on non-Covid care

Commentary from the collaboration
The impact of Covid-19 on the use of digital technology in the NHS. Hutchings R, Nuffield Trust (published online 27/8/20).

Chart of the week: The proportion of people waiting more than 18 weeks for planned treatment has rocketed since Covid-19.  Reed S & Scobie S. Nuffield Trust. (published online 19/8/20).

Building the evidence base on video consultations: Three priorities for further research. Jones B and Scott J, The Health Foundation. (published online 26/8/20).

A GP’s perspective on COVID-19. Q&A with Dr Becks Fisher. The Health Foundation. (published online 27/8/20).

COVID-19: Guidance for the remobilisation of services within health and care settings: Infection prevention and control recommendations. Department of Health & Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS)/National Services Scotland, Public Health England (PHE) and NHS England.

Hospital discharge service: policy and operating model. Department of Health & Social Care (21/08/20).

Rapid reviews
Covid-19 and the ‘new normal’: are remote video consultations here to stay? Bidmead E & Marshall A. British Medical bulletin, ldaa025.

Outpatient Care
Telemedicine and Orthopaedic Surgery: The COVID-19 Pandemic and Our New Normal. Lanham NS et al., JBJS Rev.

Mental health care
Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review. Mallet J et al., Progress in Neuro-Psychopharmacology and Biological Psychiatry.

End of Life Services
What enables or hinders people in the community to make or update advance care plans in the context of Covid-19, and how can those working in health and social care best support this process? Selman L et al., Oxford COVID-19 Evidence Service, Centre for Evidence-Based Medicine.

Emerging evidence
Primary care
Private video-consultation services and the future of primary care. Salisbury C et al., Journal of Medical Internet Research.

Reorganisation of primary care for older adults during COVID-19: a cross-sectional database study in the UK. Joy M et al., Br J Gen Pract.

Long Term Conditions Management
Has COVID-19 Delayed the Diagnosis and Worsened the Presentation of Type 1 Diabetes in Children? Rabbone I et al., Diabetes Care.

Outpatient Care
Following COVID-19 clinicians now overwhelmingly accept virtual clinics in Oral and Maxillofacial Surgery. Al-Izzi T et al. Br J Oral Maxillofac Surg.

Elective Care
COVID-19 and surgery: A thematic analysis of unintended consequences on performance, practice and surgical training. Whelehan DF et al., Surgeon.

Emergency Care
Environmental Factors and Hyperacute Stroke Care Activity During the COVID-19 Pandemic: An Interrupted Time-Series Analysis. Gittins M et al., Journal of Stroke & Cerebrovascular Diseases.

Creating the Moorfields' virtual eye casualty: video consultations to provide emergency teleophthalmology care during and beyond the COVID-19 pandemic. Kilduff CL et al., BMJ Health & Care Informatics.

Temporal trends in decompensated heart failure and outcomes during COVID-19: A multisite report from heart failure referral centres in London. Cannata A et al. European Journal of Heart Failure.

Cancer care
Breast Cancer Surgery During the COVID-19 Pandemic Peak in the UK: Operative Outcomes. MacInnes EG et al., Cureus.

Delivering esophago-gastric cancer care during the COVID-19 pandemic in the United Kingdom: a surgical perspective. Wahed S et al., Diseases of the Esophagus.  

Impact of COVID-19 pandemic on surgical neuro-oncology multi-disciplinary team decision making: a national survey (COVID-CNSMDT Study). Price SJ et al., BMJ Open.

Tertiary care
COVID-19 Pandemic Preparedness in a United Kingdom Tertiary and Quaternary Children`s Hospital: Tales of the Unexpected. Alders N et al., MedRxiv. (pre-print).

Trinational Study Exploring the Early Impact of the COVID-19 Pandemic on Organ Donation and Liver Transplantation at National and Unit Levels. Reddy MS et al., Transplantation.

Primary care
After the first wave: What effects did the COVID-19 measures have on regular care and how can general practitioners respond to this? van Weert H., Eur J Gen Pract.

General practice post-COVID-19: time to put equity at the heart of health systems? Ashwell G et al., British Journal of General Practice.

Outpatient Care
Telehealth for Noncritical Patients With Chronic Diseases During the COVID-19 Pandemic. Liu N et al. J Med Internet Res.

Elective Care
Surgery during COVID-19 crisis conditions: can we protect our ethical integrity against the odds? Macleod J et al. Journal of Medical Ethics.

Emergency Care
Impact of COVID-19 on cardiology services in a district hospital and adapting to the new normal. Hasan S et al., Postgrad Med J.

Maternity Services
Maternal postnatal health during the COVID-19 pandemic: Vigilance is needed. Bick D et al., Midwifery.

Tertiary care
Donation and transplantation activity in the UK during the COVID-19 lockdown. Manara AR et al., The Lancet.

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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