COVID-19 Evidence alert - 11th September 2020

Please note this is the penultimate issue of the COVID-19 Evidence Alert. 

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.

Please note that this week’s alert excludes summaries of emerging evidence and rapid reviews and will instead present abstracts from these sources, due to the breadth and volume of evidence covered.

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

Coronavirus (COVID-19): looking after people who lack mental capacity. Department of Health and Social Care. (last updated 7/9/20).

Emerging evidence
A study of universal SARS-CoV-2 RNA testing of residents and staff in a large group of care homes in South London. Marossy A et al., Journal of Infectious Diseases, jiaa565,

Could we have done better with COVID-19 in nursing homes? Szczerbińska K et al., Eur Geriatr Med, 1–5.

Impacts of lifting restrictions

Commentary from the collaboration
Chart of the week: What effect will the return to schools and universities have on infection outbreaks this autumn? Fisher et al., Nuffield Trust. (published online 10/9/20)

Rapid reviews
School closure in response to epidemic outbreaks: Systems-based logic model of downstream impacts. Kneale D et al, F1000 Research, 2020 May 12;9:352. doi: 10.12688/f1000research.23631.1. eCollection 2020.

Making sense of the research on COVID-19 and school reopenings. Abbott BW et al., Brigham Young University.

Emerging evidence
Prospective active national surveillance of preschools and primary schools for SARS-CoV-2 infection and transmission in England, June 2020 (sKIDs COVID-19 surveillance in school KIDs)Ladhani S, Public Health England.

Apart but not Alone? A cross-sectional study of neighbour support in a major UK urban area during the COVID-19 lockdown. Jones M et al., Emerald Open Research.

Impact of lockdown on Covid-19 case fatality rate and viral mutations spread in 7 countries in Europe and North
. Pachetti M et al., J Transl Med 2020 Sep 2;18(1):338.  doi: 10.1186/s12967-020-02501-x.

A Harm Reduction Approach to the Ethical Management of the COVID-19 Pandemic. Weinstock D, Public Health Ethics. phaa026.

Decision making in a crisis. First responses to the coronavirus pandemic. Institute for Government.

The economics of the COVID-19 pandemic: an assessment. Susskind D & Vines D, Oxford Review of Economic Policy, graa036.”

Quantifying the impact of non-pharmaceutical interventions during the COVID-19 outbreak – The case of Sweden. Cho W, The Econometrics Journal, 1-25.

A COVID-19-Based Modified Epidemiological Model and Technological Approaches to Help Vulnerable Individuals Emerge from the Lockdown in the UK. Anderez DO et al., Sensors 20 (17) 4967.

An analysis of the policy responses to the COVID-19 pandemic in France, Belgium, and Canada. Desson Z et al., Health Policy and Technology, pre-proof.

Resurgence of covid-19 in Japan. Shimizu K, BMJ, 370:m3221

Covid-19: breaking the chain of household transmission. Haroon S, BMJ, 370:m3181.

Useful resources
Public Health Wales have prepared a series of rapid evidence summaries in response to the question: What evidence is there to inform the development and safe delivery of a COVID-19 mass vaccination campaign in developed countries that maximises uptake and minimises the risk of infection?

Long term rehabilitation needs

COVID-19: long-term health effects. Public Health England. (published online 7/9/20).

Rapid reviews
Clinical characteristics, cause analysis and infectivity of COVID‐19 nucleic acid re‐positive patients: A literature review. Li Y et al., Journal of Medical Virology,

Emerging evidence
Development of an integrated rehabilitation pathway for individuals recovering from covid-19 in the community. Sivan M et al., J Rehab Med, 52 (8).

Mental and behavioural disorders and COVID-19-associated death in older people. Boland B & Gale T, British Journal of Psychiatry, 6, e101, 1–3.

Why the biopsychosocial model needs to be the underpinning philosophy in rehabilitation pathways for patients recovering from COVID-19. Wainwright TW & Low M, Integrated Healthcare Journal, 2(1).

Anticipating the long-term cardiovascular effects of COVID-19. Becker RC, Journal of Thrombosis and Thrombolysis.

COVID-19 and its impact on neurological manifestations and mental health: the present scenario. Sultana S & Ananthapur V, Neurol Sci, 31, 1–6.

Neuropsychological consequences of Covid-19. Wilson BA et al., Journal of Neuropsychological Rehabilitation, 30 (9).

Effect of COVID-19 on the Organs. Jain U, Cureus, 12(8): e9540.

Screening and testing

Coronavirus (COVID-19): getting tested (updated). Department of Health and Social Care. (last updated 7/9/20).

Rapid reviews
Digital contact tracing technologies in epidemics: a rapid review. Anglemeyer A et al., Cochrane Database of Systematic Reviews (18/8/20).

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

Emerging evidence
Anosmia and Ageusia as Predictive Signs of COVID-19 in HealthcareWorkers in Italy: A Prospective Case-Control Study. La Torre G et al., Journal of Clinical Medicine.

Universal Shelter-in-Place Versus Advanced Automated Contact Tracing and Targeted Isolation: A Case for 21st-Century Technologies for SARS-CoV-2 and Future Pandemics. Nuzzo A et al., Mayo Clin Proc, 95(9):1898-1905.

An Integrated Strategy for the Prevention of SARS-CoV-2 Infection in Healthcare Workers: A Prospective Observational Study. Cattelan AM et al., Int J Environ Res Public Health, 17(16):E5785. doi: 10.3390/ijerph17165785.

Airborne transmission of covid-19. Wilson N, BMJ, 370:m3206.

Covid-19 mass testing programmes. Raffle AE, BMJ, 370:m3262.

Covid-19: Is local contact tracing the answer? Iacobucci G, BMJ, 370:m3248.

Broader impacts on health outcomes

Commentary from the collaboration
The Health Foundation COVID-19 Survey – second poll. The Health Foundation & Ipsos MORI. (published online September 2020).

Rapid reviews
Mental health
The psychosocial impact of flu influenza pandemics on healthcare workers and lessons learnt for the COVID-19 emergency: a rapid review. Barello S et al., International Journal of Public Health.

Coronavirus Disease (COVID-19) and Traumatic Stress: Probable Risk Factors and Correlates of Posttraumatic Stress Disorder.  Boyraz G & Legros DN, Journal of Loss and Trauma, 25 (6-7), 503-22.

Emerging evidence
Mental health – public
How has Covid-19 and associated lockdown measures affected loneliness in the UK? What Works Centre for Wellbeing.

Wellcome Monitor 2020 Covid-19 Study. Craig S et al., Wellcome & NatCen.

Are older adults also at higher psychological risk from COVID-19? Garcia-Portilla P et al., Aging and Mental Health. doi: 10.1080/13607863.2020.1805723.

Mental health – Pre-existing conditions
Understanding the experiences of people who inject drugs during the COVID-19 pandemic: Interim report 4. Hines LA et al., University of Bristol. (published online 4/9/20).

Exploring the impact of the COVID-19 pandemic and UK lockdown on individuals with experience of eating disorders. Branley-Bell D & Talbot CV, Journal of Eating Disorders, 8(44).  

Public health
Impact of COVID-19 lockdown on lifestyle adherence in stay-at-home patients with chronic coronary syndromes: Towards a time bomb. Cransec-Miet A et al., International Journal of Cardiology, in press.

Child and parent physical activity, sleep and screen time during COVID-19 compared to pre-pandemic nationally representative data and associations with mental health. Olive LS et al., PsyArXiv. (preprint).

Fears grow of nutritional crisis in lockdown UK. Baraniuk C, BMJ, 370:m3193

The COVID-19 pandemic and epidemiologic insights from recession-related suicide mortality.  Bastiampillai T et al., Molecular Psychiatry,

Impact on non-Covid care

How mental health care should change as a consequence of the COVID-19 pandemic. Moreno C et al., Lancet Psychiatry, 7 (9), 813-24.

Rapid reviews
Outpatient care
Delivering healthcare remotely to cardiovascular patients during COVID-19: A rapid review of the evidence. Neubeck L et al., European Journal of Cardiovascular Nursing, 19 (6), 486-94.

Cancer care
The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future. Wallis CJD et al., European Urology, in press.

Emerging evidence
The impact of the COVID-19 pandemic on noncommunicable disease resources and services: results of a rapid assessment. WHO.

Primary care
Respiratory specialists working in different ways: Development of a GP hotline and respiratory support service during the COVID-19 pandemic. Kumar K, Future Healthcare Journal.

Secondary care
Establishing a remote clinical advice service during the COVID-19 pandemic. Burrows S, Future Healthcare Journal.

Neurosurgical referral patterns during the COVID-19 pandemic: A United Kingdom experience. Jayakumar N et al., World Neurosurgery, preproof.

Outpatient care
Near Me at Home: codesigning the use of video consultations for outpatient appointments in patients' homes. Beattie M et al., BMJ Open Quality, 9(3):e001035.

Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic. Kennedy NA et al., Frontline Gastroenterology, 11(5).

Cohort study of outpatient hemodialysis management strategies for COVID-19 in North-West London. Medjeral-Thomas NR et al., Kidney International Reports,

Remote cardiac rehabilitation is a good alternative of outpatient cardiac rehabilitation in the COVID-19 era. Nakayama A, Environmental Health and Preventive Medicine, 25(48).

Emergency care
Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital. Hautz WE, Swiss Medical Weekly, 150:w20331.

Mental health services
Rapid response to crisis: Health system lessons from the active period of COVID-19. Salvador-Carulla L et al., Health Policy and Technology, preproof.

Trauma and orthopaedics
The impact of COVID-19 on trauma and orthopaedic patients requiring surgery during the peak of the pandemic. Mackay ND et al., Bone and Joint Open,

Social care
Screening for economic hardship for child welfare-involved families during the COVID-19 pandemic: A rapid partnership response. Fallon B et al., Child Abuse and Neglect, pre-proof.

Cancer care
One Piece of the Jigsaw for the Cancer Recovery Strategy: Prevalence of COVID-19 in Patients With Cancer. Moss C et al., Cancer Control, 27(3).

Managing uncertainty in the covid-19 era. Rutter H et al, BMJ, 370:m3349

Useful resources
Digital innovation in adult social care: how we’ve been supporting communities during COVID-19. Local Government Association.

Forthcoming event: Insight 2020

The Strategy Unit is hosting a 6-week festival of virtual events, called Insight 2020, exploring some of the challenges facing decision-makers in health and care in 2020 and beyond; emerging models of practice to make best use of analysis to inform decision-making; and some of the exciting work that is already happening in this area.

Insight 2020: a festival of analysis and learning for the NHS, Local Government and our partners will run from 28 Sep to 13 Nov 2020. The festival will comprise a mixture of events, workshops and panels, representing conversations at a local, national and international level. For example, our festival launch session includes Ben Goldacre talking about ‘How open approaches can revolutionise health data science in the UK’ and Andi Orlowski on “Dangerous analytics…and how local analysts can save you!”, with Q&A hosted by Professor Mohammed A Mohammed.

Who is Insight 2020 for? We’ve collaborated with inspirational people and organisations across the sector to bring together a programme which has something for everyone who is involved with decision-making in health and care.

What will Insight 2020 look like? Sessions will be varied and flexible. People can commit as little or as much time as they’d like, and most of the sessions will be recorded so you can fit them into your schedule in a way that suits you. Every session is free. 

Each week will focus on a central theme, starting with a ‘headline’ presentation on the Monday. This will be supported by targeted sessions and the week’s speakers will convene each Friday for an interactive panel discussion and Q&A to respond to the key debates raised during the week. The festival themes are:

  • Week 1: Our decision-making context in 2020
  • Week 2: The role of the Midlands Decision Support Network
  • Week 3: The analytical priorities of the Decision Support Network
  • Week 4: Building momentum around addressing health inequalities
  • Week 5: The decision-making toolbox
  • Week 6: Making the most of our decision-making resources

To register your interest please go to our Eventbrite page. The full-week programmes will be released on a staggered basis starting from week commencing 7th September where you will be invited to register for specific sessions.

Any questions regarding the festival please contact or

This alert has formed 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 inform the initial response to COVID-19.  Thank you for the very helpful feedback we have received since we published the first issue back in June.  We’ll be updating the evidence trackers on our web site to include all the links from the weekly alerts. In response to feedback, we’ll be adding sub-themes to the trackers on rehabilitation needs, impacts on health outcomes, and impacts on non-Covid care, to help you navigate evidence to date.

 For more information, visit: or 
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