COVID-19 Evidence alert - 16th 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.  

Residential facilities

Preventing and controlling outbreaks of COVID-19 in prisons and places of detention. Public Health England & Ministry of Justice. (updated 14/7/20).

COVID-19 guide for care staff supporting adults with learning disabilities or autistic adults. SCIE, Department of Health & Social Care. (updated July 2020).

Emerging evidence
Why, in almost all countries, was residential care for older people so badly affected
by COVID-19?
 Declerq A et al., Observatoire Social Européen paper series. (published online July 2020).

Hospital affiliated long term care facility COVID-19 containment strategy by using prevalence testing and infection control best practices. Eckardt P et al., American Journal of Infection Control (pre-proof).

Evolution and impact of COVID-19 outbreaks in care homes: population analysis in 189 care homes in one geographic region. Burton JK et al., MedRXiv (pre-print).

Atypical Presentations of COVID-19 in Care Home Residents presenting to Secondary Care: A UK Single Centre Study. Rawle MJ et al., MedRXiv (pre-print). Doi: 10.1101/2020.07.07.20148148.

Leaving the most vulnerable behind: Reflection on the Covid-19 pandemic and Direct Provision in Ireland. Gusciute E. Irish Journal of Sociology. Doi: 10.1177/0791603520940145.

The COVID-19 Epidemic and the Prison System in Italy. Cingolani M et al., Journal of Correctional Health Care. Doi: 10.1177/1078345820929733.

Detrimental effects of confinement and isolation on the cognitive and psychological health of people living with dementia during COVID-19: emerging evidence. Suárez-González A. International Long Term Care Policy Network. (published online 23/6/20- last updated 1/7/20).

Nurse Staffing and Coronavirus Infections in California Nursing Homes. Harrington C et al., Policy, Politics, & Nursing Practice. Doi: 10.1177/1527154420938707.

Improving the care of older patients during the COVID-19 pandemic. Bianchetti A et al., Aging Clinical and Experimental Research.

COVID-19 pandemic: urgent need for action in care homes and senior citizens’ homes from a medical-ethics perspective. Schone-Seifert B & Van Aken HK. Current Opinion in Anaesthesiology. (published online 7/7/20).

Impacts of lifting restrictions

Commentary from the collaboration
Lessons from the last hospital building programme, and recommendations for the next. Edwards N. Nuffield Trust. (published online 16/7/20).

Covid-19: lessons for hospital building programmes. Edwards N. Nuffield Trust. (published online 16/7/20).

Impact of easing COVID-19 lockdown restrictions on domestic violence and abuse. Social Care Institute for Excellence. (SCIE). (published online July 2020).

Emerging evidence
Economic interventions to ameliorate the impact of COVID-19 on the economy and health: an international comparison. Danielli S et al., Journal of Public Health. Doi: 10.1093/pubmed/fdaa104. 

Reopening Schools in the Context of COVID-19: Health and Safety Guidelines From Other Countries. Melnick H & Darliing-Hammond et al., Learning Policy Institute. Policy Brief.

Social distancing, population density, and spread of COVID-19 in England: a longitudinal study. Tammes P. BJGP, bjgpopen20X101116.

Is Lockdown Bad for Social Anxiety in COVID-19 Regions?: A National Study in The SOR Perspective. Zheng L et al., Int J Environ Res Public Health, 17(12).

12 Lessons learned from the management of the coronavirus pandemic. Forman R et al., Health Policy, 124(6).

Policing Social Distancing: Gaining and Maintaining Compliance in the Age of Coronavirus. Grace S. Policing: A Journal of Policy and Practice, paaa029.

Sports medicine leaders working with government and public health to plan a ‘return-to-sport’ during the COVID-19 pandemic: the UK’s collaborative five-stage model for elite sport. Kemp S et al., Br J Sports Med. (published online 14/7/20).

There will be no 'back to normal'. Haley C et al., NESTA (updated July 2020).

We don’t want ‘normal’ – we want better. Marmot M, NESTA. (published online July 2020).

Pandemic peak SARS-CoV-2 infection and seroconversion rates in London frontline health-care workers. Houlihan et al., The Lancet. (published online 9/7/20).

Harnessing behavioural science in public health campaigns to maintain ‘social distancing’ in response to the COVID-19 pandemic: key principles. Bonnell C et al., Epidemiology & Community Health, 74(8). (published online 8/5/20).

Why Scotland’s slow and steady approach to covid-19 is working. Sridhar A & Chen A. BMJ, 370:m266. (published online 6/7/20).

We must rapidly learn lessons from Leicester’s local lockdown to prevent further outbreaks. Nazareth J et al., BMJ Opinion. (published online 10/7/20).

Covid-19: How does local lockdown work, and is it effective? Mahase E. BMJ, 370:m2679. (published online 3/7/30).

Long term rehabilitation needs

Expert consensus on protocol of rehabilitation for COVID-19 patients using framework and approaches of WHO International Family Classifications. Zeng B et al., Aging Medicine. Doi: 10.1002/agm2.12120. (published online 6/7/30).

Emerging evidence
Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery. Zhao YM et al., The Lancet. Doi: 10.1016/j.eclinm.2020.100463.

Intensive care admissions of children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the UK: a multicentre observational study. Davies P et al., Lancet Child Adolesc Health.

Guillain-Barré syndrome associated with COVID-19 infection: a case from the UK. Tiet MY & AlShaikh, BMJ Case Reports, 13(7).

Meeting the Transitional Care Needs of Older Adults with COVID-19. Naylor MD et al., Journal of Aging & Social Policy, 32(4).

A Proposal for Multidisciplinary Tele-rehabilitation in the Assessment and Rehabilitation of COVID-19 survivors. Green SA et al., Environmental Research and Public Health, 17(13).

Persistent Symptoms in Patients After Acute COVID-19. Carfi A et al., JAMA, doi: 10.1001/jama.2020.12603.

Frailty and COVID-19: A Systematic Scoping Review. Maltese G et al., J Clin Med.

Global evaluation of echocardiography in patients with COVID-19. Dweck MR et al., European Heart Journal- Cardiovascular imaging,jeaa178.

Severe refractory Kawasaki disease in seven infants in the COVID-19 era. Vergnano S et al., Lancet Rheumatol. Doi: 10.1016/S2665-9913(20)30231-9. (published online 10/7/20).

Behavioral interventions in acute COVID-19 recovery: A new opportunity for integrated care. Jaywant A et al., Gen Hosp Psychiatry.

Patients’ experiences of “longcovid” are missing from the NHS narrative. Rayner C et al., BMJ Opinion. (published online 23/6/20).

Covid-10:What do we know about “long covid”? Mahase E. BMJ. (published online 14/7/20)

An adult with Kawasaki-like multisystem inflammatory syndrome associated with COVID-19. Shaigany S et al., The Lancet. (published online 10/7/20).

Screening and testing

Commentary from the collaboration
‘Leaky’ test and trace system has long way to go to reach ‘world-beating’. Palmer B. Nuffield Trust. (published online 9/7/20).

Transmission of SARS-CoV-2: implications for infection prevention precautions. WHO Scientific Brief. (published online 9/7/20).

Emerging evidence
Clinical utility of targeted SARS-CoV-2 serology testing to aid the diagnosis and management of suspected missed, late or post-COVID-19 infection syndromes: results from a pilot service. Sweeny N et al., MedRXiv (pre-print).

Rapid Large-Scale COVID-19 Testing during Shortages. Beetz C et al., Diagnostics, MDPI.

Fighting the COVID-19 pandemic: onsite mass workplace testing for COVID-19 in the Republic of Korea. Seo E et al., Ann Occup Environ Med, 32,e22.

Suitability and Sufficiency of Telehealth Clinician-Observed, Participant-Collected Samples for SARS-CoV-2 Testing: The iCollect Cohort Pilot Study. Guest JL et al., JMIR Public Health Surveill, 6(2), e19731.

Taking a covid-19 test at home: the fragile base on which track-and-trace is built. Smith R, BMJ Opinion. (published online 3/7/20).

Useful resources
COVID-19 Second Wave Public Health Policy Recommendations. Chavkin W et al., Columbia Mailman School of Public Health. (published online June 2020).

What do countries need to do to implement effective ‘find, test, trace, isolate and support’ systems? Rajan S et al., J Royal Soc Med. (published online 14/7/20).

Broader impacts on health outcomes

Commentary from the collaboration
Obesity: time for action. Buck D. The King’s Fund. (published online 14/7/20).

Safeguarding children and families during the COVID-19 crisis. Social Care Institute for Excellence. (published online July 2020)

Rapid reviews
Pre-existing conditions
Impacts of COVID-19 Mitigation on People with Pre-Existing Substance Use and Addictions Issues. Bornstein S. Newfoundland and Labrador Centre for Applied Health Research.

Impacts of COVID-19 Mitigation on People with Pre-existing Mental Health Conditions. Bornstein S. Newfoundland and Labrador Centre for Applied Health Research. 

Emerging Evidence
Public health
Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic. Khalil A et al., JAMA, doi: 10.1001/jama.2020.12746

How the COVID-19 Pandemic Is Focusing Attention on Loneliness and Social Isolation. Smith BJ & Lim MH. Public Health Res Pract, 30(2).

Prevalence and correlates of physical activity in a sample of UK adults observing social distancing during the COVID-19 pandemic. Smith L et al., BMJ Open Sport & Exercise Medicine, 6, e000850.

Mental health - General public
The mental health impact of COVID-19 and pandemic related stressors among adults in the UK. Chandola T et al., MedRxiv (pre-print).

Abuse, self-harm and suicidal ideation in the UK during the COVID-19 pandemic. Iob E et al., British Journal of Psychiatry, 1-4.

How do Funeral Practices impact Bereaved Relatives' Mental Health, Grief and Bereavement? A Mixed Methods Review with Implications for COVID-19. Burrell A & Selman LE et al., Journal of Death and Dying. Doi: 10.1177/0030222820941296. 

Healthcare workers
The Impact of the COVID-19 Pandemic on Final Year Medical Students in the United Kingdom: A National Survey. Choi B et al., BMC Med Educ, 20(1).

Pre-existing conditions
Child Suicide Rates during the COVID-19 Pandemic in England: Real-time Surveillance. Odd D et al., National Child Mortality Database.

Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Hao F et al., Brain Behav Immun, 87.

Substance Use Disorder in the COVID-19 Pandemic: A Systematic Review of Vulnerabilities and Complications. Wei Y & Shah R (pre-print).

Long term conditions
Detrimental effects of confinement and isolation on the cognitive and psychological health of people living with dementia during COVID-19: emerging evidence. Suárez-González A. International Long Term Care Policy Network. (published online 23/6/20- last updated 1/7/20).

Social isolation due to the COVID-19 pandemic has led to worse outcomes in females with inflammatory arthritis. Maguire S & O’Shea F. Irish Journal of Medical Science.

The Lancet COVID-19 Commission. Sachs JD et al., The Lancet. (published online 9/7/20).

Public health
Obesity and COVID-19: a call for action from people living with obesity. Le Brocq S et al., Lancet Diabetes Endocrinol. Doi: /10.1016/S2213-8587(20)30236-9. (published online 9/7/20).

Coronavirus and Quarantine: Catalysts of Domestic Violence. Bouillon-Minoi JB et al., Violence Against Women. (published online 6/7/20).

A crisis of accountability for women's, children's, and adolescents' health. Phumaphi J et al., The Lancet. (published online 12/7/20).

Structural racism remains a primary public health risk amidst COVID and beyond in the United Kingdom. Clementi R. Journal of Public Health, fdaa102. Doi: 10.1093/pubmed/fdaa102. (published online 10/7/20).

Combating physical inactivity during the COVID-19 pandemic. Pinto AJ et al., Nat Rev Rheumatol.

Mental health
Trauma-informed responses in addressing public mental health consequences of the COVID-19 pandemic: position paper of the European Society for Traumatic Stress Studies (ESTSS). Javakhishvili JD et al., European Journal of Psychotraumatology. 11, 1780782.

The Mental Health Impact of the COVID-19 Pandemic Across Different Cohorts. Khan KS et al., International Journal of Mental Health and Addiction. Doi: 10.1007/s11469-020-00367-0

Healthcare workers
Impact of COVID-19 on ophthalmic specialist training in the United Kingdom—the trainees’ perspective. Hussain R et al., Eye.

Useful resources
Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians. Selman LE et al., Journal of Pain and Symptom Management (jn press).

Wider Impacts of COVID-19 on Health (WICH) monitoring tool. Public Health England. (updated 16/7/20).

Impact on non-Covid care

Commentary from the collaboration
The NHS will not be able to restart all of its services at once and difficult decisions will have to be made. Gardner T. The Health Foundation. (published online 9/7/20).

Story of two halves as NHS struggles to shake off effects of coronavirus. Edwards N. Nuffield Trust. (published online 9/7/20).

Despite gains, Covid-19 will intensify the challenge of keeping nurses and midwives within the NHS. Dayan M. Nuffield Trust. (published online 9/7/20).

The road to renewal: five priorities for health and care. Charles A & Ewbank L. The King’s Fund. (published online 16/7/20).

Chart of the week: Number of people waiting over a year for treatment has rocketed in months since onset of pandemic. Scobie S. Nuffield Trust. (published online 15/7/20).

COVID-19: guidance for commissioners and providers of services for people who use drugs or alcohol. Department of Health and Social Care & Public Health England. (updated 14/7/30).

Preparing for a challenging winter 2020/21. The Academy of Medical Sciences. (published online 14/7/20).

Rebuilding the NHS. Improving medical pathways for acute care. Royal Colleges of General Practitioners, Emergency Medicine and Physicians & Society for Acute Medicine. (published online 10/7/20).

ARCS and BFS U.K. best practice guidelines for reintroduction of routine fertility treatments during the COVID-19 pandemic. Association of Reproductive and Clinical Scientists (ARCS) & British Fertility Society (BFS). (published online May 2020, updated June 2020).

Rapid reviews
Primary care
Recommendations for the re-opening of dental services: a rapid review of international sources. COVID-19 Dental Services Evidence Review (CoDER) Working Group.

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.

Emerging evidence
The load and capacity model of healthcare delivery: considerations for the crisis management of the COVID-19 pandemic. Steiger J & Moxham J. J Thorac Dis, 12(6).

Social care
COVID-19: Implications for the Support of People with Social Care Needs in England. Comas-Herrera A et al., Journal of Aging & Social Policy, 32(4).

Primary care
Setting up and maximising the usage of an Urgent Dental Care Centre in Blackpool. Sharing our experiences. Hammond D et al., British Journal of Oral & Maxillofacial Surgery.

The Oxford Royal College of General Practitioners Clinical Informatics Digital Hub: Protocol to Develop Extended COVID-19 Surveillance and Trial Platforms. De Lusignan S et al., JMIR Public Health Surveill, 6(3), e19773.

Secondary care
Impact of the 2020 COVID-19 pandemic on the workload of the orthopaedic service in a busy UK district general hospital. Murphy T & Mutimer AJ., Injury.  

COVID-19 preparedness and response at a large UK major trauma operating theatres department. Britton CR et al., Journal of Perioperative Practice, 30(7).

COVID-19 pandemic and its impact on service provision: A cardiology prospect. Adam S et al., Acta Cardiologica. Doi: 10.1080/00015385.2020.1787636.

COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Mafham M et al., The Lancet.

Elective care
Remodelling elective hospital services in the COVID-19 era – designing the new normal. King AL & Hothi SS. Future Healthcare Journal, 7(3).  

Cancer services
Considerations for the treatment of pancreatic cancer during the COVID-19 pandemic: the UK consensus position. Jones CM et al., British Journal of Cancer.

Covid-19: an opportunity to reduce unnecessary healthcare. Moynihan R et al., BMJ, 370:m2752.

Primary care
Children’s oral health. Barraclough O et al., BDJ in Practice, 33(7). (pubslihed online 6/7/20).

General practice in the post Covid world. Challenges and opportunities for general practice. Royal College of General Practitioners.

Cancer services
Cancer has not gone away: A primary care perspective to support a balanced approach for timely cancer diagnosis during COVID-19. Helsper CW et al., Eur J Cancer Care. (published online 7/7/20).

Secondary care
COVID-19 scenario modelling for the mitigation of capacity-dependent deaths in intensive care. Wood RM et al., Health Care Manag Sci.

Outpatient care
Rebuilding the NHS - Resetting outpatient services for the 21st century in the context of COVID-19. Royal College of General Practitioners & Royal College of Physicians.

Useful resources
Reimagining the future of health and social care. How to learn the lessons from the Covid-19 crisis for a next generation health and care system. Webster H & Hannan R. Royal Society for the encouragement of Arts, Manufactures and Commerce & Accenture.

10 Leaps Forward – Innovation in the Pandemic. London South Bank University.

A Framework for Aging-Friendly Services and Supports in the Age of COVID-19. Hoffman GJ et al., Journal of Aging and Social Policy, 34(4).

COVID-19 and telepsychiatry: an evidence-based guidance for clinicians. Smith K et al., (accepted pre-print), JMIR.

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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