Accountability, emergency and liberty during COVID-19 in the UK 2020–22

Purpose: The study explains why Parliamentarians in the United Kingdom (UK) focused on accountability through data during the COVID-19 pandemic, as well as on how data could be used to improve the government's response to the pandemic. Design/methodology/approach: Understanding the implications of accountability for COVID-19 is crucial to understanding how governments should respond to future pandemics. This article provides an account of what a select committee in the UK thought were the essential elements of these accountability relationships. To do so, the authors use a neo-Roman concept of liberty to show how Parliamentary oversight of the pandemic for accountability was crucial to maintaining the liberty of citizens during the crisis and to identify what lessons need to be learnt for future crises. Findings: The study shows that Parliamentarians were concerned that the UK government was not meeting its obligations to report openly about the COVID-19 pandemic to them. It shows that the government did make progress in reporting during the pandemic but further advancements need to be made in future for restrictions to be compatible with the protection of liberty. Research limitations/implications: The study extends the concept of neo-Roman liberty showing how it is relevant in an emergency situation and provides an account of why accountability is necessary for the preservation of liberty when the government uses emergency powers. Practical implications: Governments and Parliaments need to think about how they preserve liberty during crises through enhanced accountability mechanisms and the publication of data. Originality/value: The study extends previous work on liberty and calculation, providing a theorisation of the role of numbers in the protection of liberty. © 2023, Emerald Publishing Limited.

Answering the Call: Inpatient Vaccination for SARS-CoV2 Infection in an Academic Hospital

Background. While the available SARS-CoV2 vaccines are up to 94% effective at preventing COVID-19-related death or invasive mechanical ventilation, only 76% of the United States population aged >=18 years have received a primary series and 49% have received a booster. Vaccine administration has been complicated by changing schedule recommendations, packaging in multi-dose vials, and federal reporting requirements that may have limited the locations offering vaccines. We therefore implemented a pharmacy-based initiative to provide SARS-CoV2 vaccination to patients admitted to an academic health center, in order to encourage vaccination when patients had presented for other care. Methods. A pharmacy committee developed a protocol for administering the three authorized SARS-CoV2 vaccines to interested inpatients while minimizing vaccine waste, monitoring for safety events, and providing next dose education. Associated training included multidisciplinary education on requirements related to vaccine Emergency Use Authorization (EUA) status. While developing the protocol, the vaccine committee utilized a temporary procedure to administer vaccines once weekly through review by antimicrobial stewardship pharmacists during August 2021. The protocol went live in September 2021 for inpatient and emergency department sites, with subsequent tracking of the number of doses ordered (stratified by vaccine type and dose number) and number administered. Results. From August 3 2021 to March 25 2022, a total of 389 vaccine orders were placed with 302 doses (78%) administered, including 126 Moderna (48 first, 20 second, 15 third, 42 booster, and 1 undesignated), 165 Pfizer/BioNTech (80 first, 24 second, 41 third, 14 booster, and 6 undesignated), and 11 Janssen COVID-19 vaccine doses. Only 18 vaccine orders were placed on patients in the ED, with 14 (78%) of those doses administered. Of the 87 vaccine orders not administered, 6 were placed but not given, and 81 were placed and then discontinued. Conclusion. With multidisciplinary collaboration, SARS-CoV2 vaccination can be performed in inpatient and ED settings. However, orders should be monitored for protocol compliance and order discontinuation, as these may increase potential for waste.

AGILE: ADRESSING VUCA AND AFFECTIVE FACTORS IN DESIGN & DESIGN ENGINEERING PROJECT BASED LEARNING

The volatile, uncertain, complex and ambiguous (VUCA) global context, amplified by two years of COVID has a profound effect on the predominant project based learning approach within design and design engineering curricula. Project management and affective or emotional factors are evidenced as significant but often overlooked within this context. Linking literature on the topics with data from n=200 participants from 3 HEIs, three aspects of popular industry Agile project management approaches are shown to correlate directly with addressing the VUCA context together with a model as a basis for considering the alignment of the topics. © Proceedings of the 24th International Conference on Engineering and Product Design Education: Disrupt, Innovate, Regenerate and Transform, E and PDE 2022. All rights reserved.

Did it hurt? COVID-19 vaccination experience in people with multiple sclerosis.

BACKGROUND: Current guidelines recommend vaccination against SARS-CoV2 for people with multiple sclerosis (pwMS). The long-term review of the safety and effectiveness of COVID-19 vaccines in pwMS is limited. METHODS: Service re-evaluation. PwMS using the MS service at Barts Health National Health Service Trust were sent questionnaires via email to report symptoms following first and second COVID-19 vaccinations (n = 570). A retrospective review of electronic health records was conducted for clinical and safety data post-vaccination(s); cut-off was end of September 2021. Separate logistic regressions were carried out for symptoms experienced at each vaccination. Two sets of regressions were fitted with covariates: (i) Disease-modifying therapy type and (ii) patient characteristics for symptoms experienced. RESULTS: 193/570 pwMS responded. 184 pwMS had both vaccinations. 144 received the AZD1222 and 49 the BNT162b2 vaccine. 87% and 75% of pwMS experienced any symptoms at first and second vaccinations, respectively. The majority of symptoms resolved within a short timeframe. No severe adverse effects were reported. Two pwMS subsequently died; one due to COVID-19 and one due to aspiration pneumonia. Males were at a reduced risk of reporting symptoms at first vaccination. There was evidence that pwMS in certain treatment groups were at reduced risk of reporting symptoms at second vaccination only. CONCLUSIONS: Findings are consistent with our preliminary data. Symptoms post-vaccination were similar to the non-MS population and were mostly temporary. It is important to inform the MS community of vaccine safety data.

Dilated Cardiomyopathy with Congestive Hepatopathy in Post COVID-19 Patient-A Case Report

In the current situation of pandemic, Coronavirus Disease 2019 (COVID-19), main organ involvement is of respiratory system ranging from mild symptoms to acute severe respiratory distress syndrome. Some studies are showing an increasing number of patients being hospitalised for COVID-19 with acute heart failure and multi-system inflammatory state. A 17-year-old boy, with no known co-morbidities, presented with breathlessness and jaundice. He was diagnosed as a case of Dilated Cardiomyopathy (DCM) with congestive hepatopathy. He was treated with diuretics and supportive medications for which he showed symptomatic improvement, and there was a significant improvement in his ejection fraction during the course of treatment. The patient had Coronavirus Disease 2019 (COVID-19) infection 15 days prior to the onset of the above symptoms. The progression of COVID-19 complications seems potentially life-threatening, if associated with cardiac and hepatic manifestations. This case illustrates the probable course of the ailment that has led to DCM. There was liver involvement too which was monitored and treated meticulously. These patients have high chances of deterioration even in simple situations of fever or pain, due to an increase in metabolic demands. It is a unique case which shows a strong association between COVID-19, acute heart failure, and congestive hepatopathy.

Into the pandemic and out of the fire?

Aim: The Covid-19 pandemic has seen various government restrictions on all aspects of daily life. We assessed whether these lifestyle alterations have affected the number, severity and presentation of burns seen at a Paediatric Burns Unit. Methods: We looked at Paediatric Burns admissions to Plastic Surgery during the Covid-19 pandemic of March 2020 to Jan 2021 (DC), as well as comparison data prior to Covid-19 from April 2019 to February 2020 (PC). We also looked at specific periods of national lockdown. Using data from our electronic records we looked at varying aspects of a patient's journey. Results: In total 788 cases were admitted to the Burn's team from April19 -January21. The mean age of patients both DC and PC were 4.7 years with the mean during the first lockdown of 5. The time to presentation PC was 2.6 days, DC was 1.79 days and 2.4 days during the first lockdown. This was not significant (p=0.2). The median total body surface area (TBSA) was <1% in both PC and DC patients. Scalds made up 53% of the first lockdown injuries, this had no statistically significant difference as compared to PC and DC injuries (48% and 46% respectively). Conclusions: Overall burns admissions during the Covid-19 pandemic did not significantly change as compared to the previous year. This contrasts published adult results, which demonstrates reduced burns admissions during Covid-19. We suggest this may be due to unchanged causative factors in paediatric burns which are predominantly found in domestic lockdown environments.

Lessons learnt from managing orthopaedic trauma during the first wave of the CIVID-19 pandemic at a uk district general hospital

Background: The Coronavirus disease (COVID-19) pandemic has contributed to over 900,000 deaths worldwide. Hospitals responded by expanding services to accommodate the forecasted rise in COVID-19- related admissions. We describe the effects these changes had on management of orthopaedic trauma and patient outcomes at a district general hospital in Southern England. Method: Data were extrapolated retrospectively from two separate sixweek periods in 2019 and 2020 (1st April - 13th May) using electronic records of patients referred to the orthopaedic team. Soft tissue injuries were included where a confirmed diagnosis was made with radiological evidence. Patients were excluded if no orthopaedic intervention was required. Data were compared between the two time periods. Results: There were fewer attendances to hospital in 2020 compared with 2019 (178 vs 328), but time from presentation to surgery significantly increased in 2020 (2.94 days vs 4.91 days, p=0.009). There were fewer operative complications in 2020 (36/145 vs 11/88, p<0.001). However, ordinal logistic regression analysis found a significantly greater complication severity in 2020 including death (p=0.039). Complication severity was unrelated to COVID-19 status. Conclusions: Restructuring of orthopaedic services in response to the COVID-19 pandemic has been associated with significant delays to surgery and higher post-operative complication severity. Our results demonstrate the need for fast-track emergency operative orthopaedic services in UK district general hospitals whilst the COVID-19 pandemic continues.

Unilateral optic neuritis in post covid-19: A case report

Optic Neuritis had been an unusual manifestation, reported in patients affected with coronavirus disease-2019(COVID-19). Here the authors report a case of 67 years old male patient, who got manifested with optic neuritis as post COVID sequelae. He was treated for COVID-19. Later on, after 21 days of treatment, he presented with blurring of vision and diplopia and was further evaluated and diagnosed as a case of optic neuritis with axial Time(T)2 Magnetic Resonance Imaging (MRI) scan showing mild thickening and T2 hyperintensity of intracanalicular part of the optic nerve of the right eye. The patient was started on intravenous methylprednisolone followed by oral prednisolone. He had a good visual outcome. Post COVID-19, optic neuritis has become one of the possible neurological complications that may either present with unilateral or bilateral loss of vision. Hence, the clinicians should be aware of Neuro-ophthalmic involvement and treatment should be initiated promptly for improved outcomes.

Initial Single-Center ST-Segment Elevation Myocardial Infarction Experience in New York Before and During the COVID-19 Pandemic

Background: Following a period of stability, the coronavirus disease 2019 (COVID-19) pandemic appears to be re-intensifying globally. As the pandemic continues to evolve, so does our understanding of its implications on ST-segment elevation myocardial infarction (STEMI). We sought to describe a single center STEMI experience at one of the epicenters of the COVID-19 pandemic. Methods: This was a retrospective observational study which included consecutive suspected STEMI patients from March 1 through August 31, 2019, (Cohort 1) compared to the same time period in 2020 (Cohort 2), at a tertiary referral center in Nassau County, New York. Results: Cohort 2 (n=93) saw a similar number of acute myocardial infarction (AMI) team activations compared to cohort 1 (n=90) (Figure 1). Infection control measures and additional investigation were required to clarify the diagnosis in cohort 2, resulting in longer door-to-balloon times (95.9 minutes vs. 74.4 minutes, p=0.0587). We observed similar inpatient length of stay (LOS) (3.6 days vs. 5.0 days, p=0.0901) and mortality (13.2% vs. 9.2%, p=0.5876). Conclusions: Our single-center study, located at one of the epicenters of the pandemic, demonstrated a similar number of AMI team activations, mimicking the seasonal variability seen in 2019, but with longer door-to-balloon times. Despite this, inpatient LOS and mortality remained unchanged. [Formula presented]

ReIMAGINE: A prostate cancer research consortium with impact due to its patient and public involvement and engagement

Introduction: ReIMAGINE aims to improve current PSA/biopsy risk stratification for prostate cancer (PCa) and develop a new image-based method for diagnosing high/low risk PCa. Here, we describe how active involvement/ engagement with patients and the general public from study inception led to impactful evidence-based clinical research outputs for ReIMAGINE. Patients & Methods: We began with a series of discussion groups, whereby patients and their family members, as well as men without PCa (i.e. the general public) provided insight into participant preferences with respect to study design and management, data collection and analysis, and dissemination of findings. Results: Our consultation phase confirmed research need for less invasive PCa diagnostic strategies and generated study design recommendations. In addition to various outreach activities, our Twitter account (@reimagine-pca) is at the heart of our engagement strategy as it allows us to participate in many other relevant PPI activities. Most recently, our PPI-Subcommittee has worked collaboratively with our Trials team to reopen consortium studies following a pause in recruitment because of COVID-19. They developed information videos in which members played the parts of patients providing a "walk-through" of COVIDsecure clinical pathways encountered by study participants. Conclusion: ReIMAGINE has incorporated structures and funding for inclusion and engagement of the patient and public voice in the study design, monitoring and ongoing processes. The appointment of a funded PPI co-ordinator and a patient chair of the PPI sub-committee has led to further work outside the study remit, particularly in the establishment of a BAME PPI committee for prostate cancer.

Fit-testing of respiratory protective equipment in the UK during the initial response to the COVID-19 pandemic.

BACKGROUND: Public Health England guidance stipulates the use of filtering facepiece (FFP3) masks for healthcare workers engaged in aerosol-generating procedures. Mask fit-testing of respiratory protective equipment is essential to protect healthcare workers from aerosolized particles. AIM: To analyse the outcome of mask fit-testing across National Health Service (NHS) hospitals in the UK during the first wave of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Using the Freedom of Information Act, 137 NHS hospitals were approached on May 26th, 2020 by an independent researcher to provide data on the outcome of fit-testing at each site. FINDINGS: Ninety-six hospitals responded to the request between May 26th, 2020 to October 29th, 2020. There was a total of 86 mask types used across 56 hospitals, 13 of which were used in at least 10% of these hospitals; the most frequently used was the FFP3M1863, used by 92.86% of hospitals. Overall fit-testing pass rates were provided by 32 hospitals with mean pass rate of 80.74%. The most successful masks, in terms of fit-test failure rates, were the Alpha Solway 3030V and the Alpha Solway S-3V (both reporting mean fit-test failures of 2%). Male- and female-specific pass and failure rates were provided by seven hospitals. Across the seven hospitals, 20.1% of men tested failed the fit-test for all masks used, whereas 19.9% of women tested failed the fit-test for all masks used. Failure rates were significantly higher in staff from Black, Asian, and Minority Ethnic (BAME) backgrounds 644/2507 (25.69%) across four hospitals. CONCLUSION: Twenty percent of healthcare workers tested during the first response to the pandemic failed fit-testing for masks. A small sample revealed that this was most prominent in staff from BAME backgrounds.

Development of the 'care and inform' information and support hub

Introduction: When COVID-19 reached Ireland, there was a need for clear, concise, and compassionate palliative and end-of-life information. The 'Care&Inform' information and advice hub was developed and launched. Aim: To inform and support the Irish public and health care professionals about matters relating to end-of-life and bereavement care during COVID-19. Design and Approach: The need for up-todate, grounded, comprehensible, and audiencespecific information was identified early in the pandemic through work with different sectors: health care, bereavement services, and the general public. Each resource was developed in collaboration with subject specialists, and underwent a plain English review. Consultation with those the resources were aimed at also took place. The Care&Inform hub contains 6 sections: Resources for Healthcare Professionals;Caring for Others;Grief and Loss;Planning Ahead;Latest Research and Information and Bereavement Support Line information. Resources are available via PDF, videos, and webinar. Results: To date (July 2020) there have been more than 200,000 views of the Care&Inform hub. Qualitative feedback: Hospital Group DON: 'I was assured that I was assisting the staff at the front line to ensure that their patients were receiving a high standard of care in difficult times'. Conclusion: The need for clear, evidence-based information quickly became apparent at the onset of COVID-19. Working with partners, it was possible to identify areas where support was required, and as a result respond rapidly. Through co-ordination with other national agencies, dissemination has taken place and continues to be progressed.

Performance and dynamic change in SARS-CoV-2 antibody responses

Background: Although reports suggest that most individuals with COVID-19 infection develop detectable antibodies post infection, the kinetics, durability, and relative differences between IgM and IgG responses remain poorly understood beyond the first few weeks after symptom onset. Methods: Within a large, well-phenotyped, diverse, prospective cohort of subjects with and without SARS-CoV-2 PCR-confirmed infection and historical controls derived from cohorts with high prevalence of viral coinfections and samples taken during prior flu seasons, we measured SARS-CoV-2 serological responses (both IgG and IgM) using three commercially available assays. We calculated sensitivity and specificity, relationship with disease severity and mapped the kinetics of antibody seropositivity and antibody levels over time using generalised additive models. Results: We analysed 1,001 samples (327 confirmed SARS-CoV-2, of whom 30% developed severe disease) from 752 subjects spanning a period of 90 days from symptom onset. Overall sensitivity was lower (44.1-47.1%) early (<10 days) after symptom onset but increased to >80% after 10 days. IgM positivity increased earlier than IgG-targeted assay but positivity peaked between day 32 and 38 post onset of symptoms and declined thereafter, a dynamic that was confirmed when antibody levels were analysed and was more rapid with IgM. Early (<10 days) IgM but not IgG levels were significantly higher in those who subsequently developed severe disease (signal / cut-off 4.20 (0.75-17.93) versus 1.07 (0.21-5.46), P=0.048). Conclusion: This study suggests that post-infectious antibody responses in those with confirmed COVID-19 infection begin to decline relatively early post infection and suggests a potential role for higher IgM levels early in infection predicting subsequent disease severity.

Lessons Learnt from Managing Orthopaedic Trauma During the First Wave of the COVID-19 Pandemic at a UK District General Hospital.

Background: The Coronavirus disease (COVID-19) pandemic has contributed to over 1,000,000 deaths worldwide. Hospitals responded by expanding services to accommodate the forecasted rise in COVID-19-related admissions. We describe the effects these changes had on management of orthopaedic trauma and patient outcomes at a district general hospital in Southern England. Methods: Data were extrapolated retrospectively from two separate 6-week periods in 2019 and 2020 (1st April-13th May) using electronic records of patients referred to the orthopaedic team. Soft tissue injuries were included where a confirmed diagnosis was made with radiological evidence. Patients were excluded if no orthopaedic intervention was required. Data were compared between the two time periods. Results: There were fewer attendances to hospital in 2020 compared with 2019 (178 vs. 328), but time from presentation to surgery significantly increased in 2020 (2.94 days vs. 4.91 days, p = 0.009). There were fewer operative complications in 2020 (36/145 vs. 11/88, p < 0.001). However, ordinal logistic regression analysis found a significantly greater complication severity in 2020 including death (p = 0.039). Complication severity was unrelated to COVID-19 status. Conclusions: Restructuring of orthopaedic services in response to the COVID-19 pandemic has been associated with significant delays to surgery and higher post-operative complication severity. Our results demonstrate the need for fast-track emergency operative orthopaedic services in UK district general hospitals whilst the COVID-19 pandemic continues.

International Collaboration in the Time of COVID-19: The World Hospice and Palliative Care Social Work Network.

In the context of widespread loss, isolation, and grief due to COVID-19, palliative social workers came together in the fall of 2020 to form an international group named the World Hospice and Palliative Care Social Work Network (WHPCSW). This emerging global network is committed to amplifying the innovative work, nuanced skills, research, and education and training provided by palliative social workers across different settings around the world. This article highlights some of the novel interventions developed by social workers in response to the pandemic and describes this coalescing WHPCSW network along with information about its mission and membership.

C-CRES: COVID-19 and cancer research engagement study

Background: Emerging reports suggest that continuation of clinical trials is feasible and safe even in hospitals admitting COVID-19 patients-given the appropriate safety procedures. However, to our knowledge no studies have yet addressed how to again engage patients in cancer research. C-CRES was developed to identify factors that may be affecting participation in cancer research during the COVID-19 pandemic. We aimed to examine patientspecific concerns around research participation. This information will help inform future strategies for mitigating the impact of COVID-19 on cancer research. Methods: Between 5-13 June 2020, we advertised an anonymous survey using our research group's Twitter account and tagged a variety of cancer patient organisations/charities. Patients aged 18 with a current cancer diagnosis were eligible to participate and asked about their diagnosis/treatment, experience in cancer research, and beliefs about future cancer research participation given the COVID-19 pandemic. We specifically asked about potential concerns relating to research engagement. Results: A total of 75 patients filled out our questionnaire, of whom 89% were UK-based. 65% of respondents were male and the majority was of a white background (89%). The median age category was 60-69 years. 47% of patients had prostate cancer, 15% breast, 12% bladder, and 9% kidney cancer-a reflection of the cancer types our research team focuses on. Interestingly, 49% of participants had never participated previously in research. We therefore set out to make comparisons of patient concerns with regards to research participation during the COVID-19 outbreak between those with and without research experience. Those who had never taken part in research before were more likely to have concerns about currently being on cancer treatment (p=0.02) and about the type of cancer they had been diagnosed with (p≤0.05), with regards to taking part in cancer research during the current COVID-19 outbreak. Conclusions:Those with no prior experience of taking part in cancer research may be more likely to have concerns related to their cancer type and current treatment, in terms of participation during COVID-19. Efforts should be made to reassure potential cancer research participants about safety of participating during the COVID-19 pandemic.

Changes implemented by U.S. oncologypractices in response to COVID-19 pandemic: Initialreport from the ASCO Registry on COVID-19 and cancer

Background: In April 2020, ASCO initiated a registry to capture and analyze status and outcomes of patients withcancer and COVID-19, and to describe effects of the pandemic on U.S. cancer practices. Initial findings of changesto care delivery are included. Methods: Practices provide data on changes to care delivery due to COVID-19 and longitudinal data on patients with cancer and confirmed COVID-19. At present, 26 cancer practices have enrolled in the Registry-5 academic,15 hospital/health-system (H/HS) owned, and 6 physician-owned (P-O) located in 19 states. Enrollment of practicesand data collection is ongoing. Results: Twenty sites, from 17 practices (3 academic, 9 H/HS owned, and 5 P-O in 15 states) responded (April 20-June 4). All incorporated telemedicine visits;90% reported use of telemedicine was new. 30% reported “decliningsome but not all” new patient requests. For patients with cancer not on active therapy, 15% of sites postponed someroutine visits, 35% conducted virtually all routine visits by telemedicine, and 50% used telemedicine for some routinevisits. Most sites (95%) reported following clinical guidelines for visit postponement;90% reported following localhealth authorities on when to resume routine visits. 90% screened patients prior to in-office visits for COVID-19symptoms by phone and at clinic entrance;10% screened patients using only one method. 30% modifiedintravenous (IV) drug infusions, including halting some or all (10%), shortening some or all (20%), or switching fromIV to oral drugs (15%). While no sites conducted home-based, anticancer drug infusions, 30% are considering thisoption if COVID19 conditions change. Most sites modified laboratory specimen collection, including allowing acollection site closer to home (60%) and collection in a patient's home (1 site). Two sites only allowed patients onoral anticancer drugs to use alternate collection sites. Only 1 site reported specimen collection in patients' homes.All reported making the following changes to clinic arrangements: requiring use of masks, eliminatingaccompaniment by a support person (with exceptions), and reducing the visit numbers or increasing time betweenvisits. No sites reported shortages of anticancer or supportive care drugs. 45% experienced shortages ofnasopharyngeal swabs, 45% of medical hand sanitizer, and 75% of personal protective equipment. 40% of siteshave experienced staffing reductions or changes due to reduced patient visits (30%), transfer to other clinical areas(20%), availability (15%), and COVID-19 illness (15%). Conclusions: The COVID-19 pandemic has had a substantial impact on most aspects of cancer care delivery inU.S. oncology practices. All practices incorporated telemedicine, which is new to most. Adjustments were made topatient visits and scheduled IV drug infusions. Sites reported shortages of equipment related to COVID-19, notcancer or supportive care drug shortages. At the time of the AACR meeting we expect to have data from morepractices.

Building relational research capacity in care homes in the COVID-19 era: applying recognition theory to the research agenda

Purpose: Research can be an influential driver in raising care home standards and the well-being and human rights of residents. This paper aims to present a case for how a relational research capacity building programme could advance this agenda. Design/methodology/approach: This study uses Axel Honneth’s Recognition Theory as a lens through which to explore organisational and institutional factors (such as research capacity and investment) that can either enable or limit “recognition” in the context of research in care homes. This paper draws on recent evidence from the COVID-19 pandemic in the UK and worldwide, to argue that such a relational capacity building agenda is even more pressing in the current context, and that it resonates with evidence from existing relational capacity building initiatives. Findings: A lack of relevant research arguably contributed to the crisis experienced by the care home sector early in the pandemic, and there are only tentative signs that residents, care home providers and staff are now informing the COVID-19 research agenda. Evidence from pre COVID-19 and insights from Honneth’s Recognition Theory suggest that relational approaches to building research capacity within the care home sector can better generate evidence to inform practice. Originality/value: This is a novel application of recognition theory to research in the care home sector. Drawing on theory, as well as evidence, has enabled the authors to provide a rationale as to why relationship-based research capacity building in care homes warrants further investment. © 2020, Emerald Publishing Limited.