COVID-19 in the United Kingdom: How a Mixed Welfare Regime Has Responded to the Pandemic

The United Kingdom (UK) has been in the international spotlight from the beginning of the COVID-19 pandemic, experiencing an ostensibly high prevalence of the disease, failing to respond as quickly as other countries with respect to border controls and social distancing measures, but also rolling out one of the most successful vaccine programmes in the world. This chapter considers the British response to COVID-19 from a welfare regime perspective. Does the UK Government's initial resistance to deploying emergency powers, its preference for outsourcing contracts for key COVID services to private providers rather than relying on local and national statutory providers, and the fact that the National Health Service (NHS) and social care providers were at considerably reduced capacity following years of economic austerity reflect the fact that the UK is essentially a ‘liberal' welfare regime? Or does the remarkable increase in public expenditure (estimated to range from £315 to £410 billion), years of investment in vaccine research and development and the prosocial and solidarity-related behaviours exhibited by the British population speak to a more collective, social-democratic welfare regime? The chapter suggests that, in regime terms, the British welfare state is mixed, though the fact that COVID-19 has been experienced unequally in the UK—by socio-economic status, ethnicity, age and disability—is more suggestive of a liberal regime that is willing to tolerate high levels of inequality. © TheEditor(s) (ifapplicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021, 2022.

Social isolation and cognitive function in middle aged and older adults in the Wisconsin Alzheimer's Disease Research Center: Implications for the pandemic

Background: Social isolation and loneliness contribute to cognitive decline, and social isolation represents a key modifiable risk factor for dementia. Substantial interruptions in social engagement due to the COVID-19 pandemic have heightened awareness of this issue, but common later-life events may also reduce social connectedness. The neurocognitive impacts of such disruptions are unclear. Using the validated NIH Emotion Toolbox, we examined perceived social support and changes in perceived support as predictors of cognitive function in a sample of middle aged and older adults. Method(s): 672 participants from the Wisconsin Alzheimer's Disease Research Center (ADRC) completed cognitive tests and Emotion Toolbox questionnaires at 2+ visits between 2017 and 2021 (mean interim = 1.7 years). Predictors comprised t-scores on three perceived social support scales: Emotional Support, Instrumental Support, and Loneliness. Cross-sectional analyses examined associations between social support and cognitive outcomes including memory (RAVLT Immediate and Delayed Recall) and processing speed/executive function (Trails A&B times). Using median t scores from the first and last available visit to categorize social support as high or low (for Loneliness, low loneliness was categorized as "high" social support), support over time was classified as stable-high, stable-low, or "change" (high-low or low-high). Mixed-effects regression models examined the demographic-adjusted predictor-outcome relationships between social support and cognition across visits. Result(s): In this ADRC sample (mean age 65.2, SD = 9.2;Table 1), all three social support scores associated cross-sectionally (Table 2) with Trails A and B performance. Relative to stable-high participants, those reporting either stable-low or declines from high to low social support exhibited poorer performance on measures of processing speed/executive function. Conversely, participants in the low-high group performed comparably on cognitive tests to those in the stable-high group (Table 3;Figure 1). Conclusion(s): Social support associated with processing speed/executive function in this sample. Participants who reported a change in social support performed comparably to those with either stable high or stable low support, suggesting that processing speed/executive function associated with social support may be modifiable in the shorter term. These findings underscore the cognitive cost of social isolation and highlight the substantial benefits of maintaining - and improving - social connections among middle aged and older adults. Copyright © 2022 the Alzheimer's Association.

Role of Teleconsultation and Telerehabilitation in Cerebral Palsy Patients during COVID-19 Era in India

Recently Coronavirus Disease-2019 (COVID-19) pandemic has caused major problems throughout the world. Apart from all morbidity and deaths due to this virus many patients with other chronic illness have also suffered due to lack of follow-up. Many general and specialised hospitals were turned into COVID centres and partial or complete lockdown was enforced by Governments. Due to this, patient with Cerebral Palsy (CP) were not able to follow their scheduled physical appointments. Many CP patients who were taking calibrated medication for different complication and following individualised rehabilitation programs were in turmoil without guidance of specialist doctors. This has led to exponential rise in use of telemedicine appointments. Telemedicine has both advantages and disadvantages which are discussed in this review. This review also focuses on rehabilitation of cerebral palsy patients using telemedicine in this dire situation where it is difficult for most patients to visit hospitals for physical appointments. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

Consensus statement on organ donation from COVID-positive deceased donors-Indian Society of Organ Transplantation, Liver Transplant Society of India and Indian Society for Heart and Lung Transplantation

COVID has drastically impacted organ donation across the world, leading to untold misery for thousands of patients who have been waiting for organs. Early rules on the use of organs from COVID positive or affected donors were stringent due to the fear of spread of disease or thrombotic complications in patients who received these organs. However much has changed in the past two years. Most of our adult population has either been infected with COVID, or has received two doses of vaccine, or both. The current variant, despite being more infective, is associated with mild disease, especially in those who have been vaccinated Our armamentarium against severe COVID has improved dramatically in the past year- we have effective vaccines, monoclonal antibodies for treatment of mild COVID in high risk patients and post exposure and antiviral prophylaxis and treatment which can substantially reduce the risk of severe COVID requiring ICU admission. The risk of transmission of COVID infection has to be balanced against the risk of patients dying with end organ disease. We will have to learn to live with COVID- this also means investigating whether organs from donors who are, or have been COVID positive can be used with acceptable risk -benefit in selected patients with end stage organ failure. This document is a summary of evidence and information regarding donor screening for SARS-CoV-2 and considerations for organ acceptance from donors with a history of COVID-19.

NOTTO guidelines for vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation

From the context of organ donation, COVID-19 vaccine-induced thrombotic thrombocytopenia (VITT) is important as there is an ethical dilemma in utilizing versus discarding organs from potential donors succumbing to VITT. This consensus statement is an attempt by the National Organ and Tissue Transplant Organization (NOTTO) apex technical committees, India, to formulate the guidelines for deceased organ donation and transplantation in relation to VITT to help in appropriate decision-making. VITT is a rare entity, but a meticulous approach should be taken by the organ procurement organization's (OPO) team in screening such cases. All such cases must be strictly notified to the national authorities (NOTTO) as a resource for data collection and ensuring compliance with protocols in the management of adverse events following immunization. Organs from any patient who developed thrombotic events up to 4 weeks after adenoviral vector-based vaccination should be considered to be linked to VITT and investigated appropriately. The viability of the organs must be thoroughly checked by the OPO, and the final decision in relation to organ use should be decided by the expert committee of the OPO team consisting of a virologist, a hematologist, and a treating team. Considering the organ shortage, in case of suspected/confirmed VITT, both clinicians and patients should consider the riskbenefit equation based on limited experience. An appropriate written informed consent of potential recipients and family members should be obtained before the transplantation of organs from suspected or proven VITT donors.

Human-in-the-Loop Business Modelling for Emergent External Factors

In the face of emergent external factors (e.g., supply chain disruptions or public health crises like COVID-19), businesses must adapt their business model quickly in order to ensure service continuity. However, providing recommendations regarding changes should be made to the business model is a challenging problem. First, it requires details of interactions between different components of the business (e.g., service offerings, inventory, staffing, demand) to understand what possible courses of action will have the most business impact. Second, automated models may provide recommendations on changes required in the business operations. However, with lack of human insight, it will be hard to verify the feasibility of these recommendations. Third, a generic model may not be able to provide good recommendations for diverse set of business models. Fourth, the model may not have enough features or training data to provide good recommendations.In this paper, we propose a novel approach to provide actionable items that can be recommended to business users given their business features and recommendations given to businesses in similar domain. Here we first use clustering to find the business domain and similar feature set of the domain. Then, we build a machine-learning model with explainable insights to provide recommendations on different business actions that can be taken to ensure business operations in the face of emergent external factors. Next we augment our approach with human-in-the-loop to improve its performance. Finally, we federate the machine-learning model in a similar domain to add more explainable and trusted insights and recommendations by other businesses. We describe our method, illustrate its utility with results from our implementation, and discuss areas for future work. © 2020 IEEE.

Pandemic spread prediction and healthcare preparedness through financial and mobility data

The pandemics like Coronavirus disease 2019 (COVID-19) require Governments and health professionals to make time-sensitive, critical decisions about travel restrictions and resource allocations. This paper identifies various factors that affect the spread of the disease using transaction data and proposes a model to predict the degree of spread of the disease and thus the number of medical resources required in upcoming weeks. We perform a region-wise analysis of these factors to identify the control measures that affect the minimal set of population. Our model also helps in estimating the surges in clinical demand and identifying when the medical resources would be saturated. Using this estimate, we suggest the preventive as well as corrective measures to avoid critical situations. © 2020 IEEE.