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 update is intended to provide a brief update on the evidence base since the scan e.g. new areas of focus; changes in recommendations; consistency with earlier evidence.
Following the publication of this weekly alert the evidence trackers are updated with the new evidence meaning the evidence trackers provide an up-to-date resource on these key topics. 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.
Since our initial rapid scan on 7 May, there has been increased scrutiny regarding the impact of Covid-19 in care homes and what lessons may be learned and applied to minimise further spread and harm, as indicated by additional guidance and several commentaries. Analysis from the Health Foundation explores the uneven spread of infection in care homes across the country. There is also evidence emerging on the impact in other residential facilities, including prisons. Strategies to limit spread include: use of standard PPE, disinfection, physical distancing and universal testing, including asymptomatic individuals. There are also concerns for the protection and wellbeing of staff and carers in residential facilities.
Since our initial rapid scan on 14th May, there has been more emerging evidence around medical/surgical facemasks and other coverings (e.g. cloth /homemade masks) and whether these are an effective means of reducing viral transmission. Most recently, a Lancet article supports the use of face-coverings in public. Further studies on lockdown restrictions have emerged with consideration for mitigating adverse economic impacts of lockdown in the long-term. Modelling studies and commentary on the impact of lifting restrictions are largely consistent with earlier evidence, indicating that a second epidemic wave is likely if restrictions are lifted prematurely or without adequate mitigation- the risk of long-term economic and public health repercussions of additional lockdowns are also highlighted. Further studies have been identified comparing the response of different countries and healthcare systems to the COVID-19 outbreak.
Since our initial rapid scan on 13 May, there has been an increase in published evidence regarding the rehabilitation needs of COVID 19 patients (see resource section for more research papers). There has been increased scrutiny regarding Kawasaki-like multisystem inflammatory syndrome in children, the symptoms and complications of COVID-19 in the nervous system and the musculoskeletal consequences of COVID-19. One rapid review analysed the functional impacts of COVID-19 that went beyond infected patients, to influence the wellbeing of healthcare workers and the entire community. There have also been additional studies that reviewed the Rehabilitation needs of older people specifically.
Since we published our initial rapid scan on 20 May, there has been more evidence emerging on contact tracing including ethical implications and the use of technology. There is also evidence emerging on testing asymptomatic patients and population groups to limit spread, including implications for continuity of care (e.g. testing prior to procedures) and the potential impact on health inequalities. There are some studies emerging on seroprevalence but the implications are still unclear.