ABSTRACT
There is still much unknown about the long-term consequences of COVID-19, otherwise known as post-acute sequelae of COVID (PASC). The challenge of defining the manifestation of Long COVID in children and young people (CYP) was specifically identified as a research subject by the National Institute for Health and care Research (NIHR). The lack of data relating to this age group and the impact the symptoms of PASC may have on the well-being and development of children have made research on this topic especially pressing. This healthcare policy study focuses on the applicability of Thompson et al.'s and Campbell and Carnevale’s frameworks in understanding the formulation and implementation of Long COVID healthcare policies. The analysis uses the ‘LISTEN’ method, applying a mixed method analysis of policy data and social media discourse analysis. Overall, the findings of this review of Long COVID policy guidelines for CYP and adults between 2020 and 2022, highlight increased public concern around the ethical aspects of policy-making, with high focus on Accountability and Responsiveness. The review concludes with several policy recommendations such as enhancing accountability through regular audits, promoting inclusiveness by incorporating CYP perspectives, ensuring transparency via regular updates, and maintaining equity in policy impact. Clinical policies should provide clear guidelines for healthcare providers, support mental health services for CYP and healthcare workers, and clarify school policies regarding Long COVID. Policymakers should also consider a health equity perspective in their Long COVID recovery policies.
Subject(s)
COVID-19ABSTRACT
People from Black and Asian backgrounds are more likely to die from Covid-19 but less likely to be vaccinated, threatening to exacerbate health inequalities already experienced by ethnic minority groups. Literature suggests that mistrust rooted in structural inequality may be a key barrier to Covid-19 vaccine uptake. We need to better understand how structural inequalities influence vaccine confidence. Understanding and addressing these processes is likely to lead to longer-term impacts than information alone. We draw on health and sociological theories of structure and agency to inform our understanding of structural factors. We conducted qualitative interviews and focus groups with 22 people from London and surrounding areas in December 2021 to March 2022. Fifteen participants were members of the public from ethnic minority backgrounds and 7 were professionals working with the public to address concerns and encourage vaccine uptake. Our findings suggest that people from ethnic minority backgrounds make decisions regarding Covid-19 vaccination based on a combination of how they experience external social structures (including political authority, social positioning and racial inequality) and internal processes (what they believe and understand about Covid-19 vaccines). We may be able to support knowledge accumulation through the provision of reliable and accessible information, particularly through primary and community care. But we recommend a number of changes to research, policy and practice which address structural inequalities. These include working with communities to improve ethnicity data collection, increasing funding allocation to health conditions where ethnic minority communities experience poorer outcomes, greater transparency and public engagement in the vaccine development process, and culturally adapted research recruitment processes.
Subject(s)
COVID-19ABSTRACT
ABSTRACT Aims With a social media analysis of the discourse surrounding the prevalence of Long COVID in children and young people (CYP), this study aims to explore healthcare workers’ perceptions concerning Long COVID in CYP in the UK between January 2021 and January 2022. This will allow to contribute to the emerging knowledge on Long COVID and identify critical areas and future directions for researchers and policymakers. Design A mixed methods approach with a discourse, keywords, sentiment, and image analysis, using Pulsar™ and Infranodus. Setting A discussion of the experience of Long COVID in CYP in the UK shared on Twitter between 1 January 2021 and 31 January 2022. Participants A sample of health workers with Twitter accounts whose bio has them identifying themselves as HCWs. Results We obtained 2588 tweets. HCW were responsive to announcements issued by authorities regarding the management of COVID-19 in the UK. The most frequent feelings were negative. The main themes were uncertainty about the future, policies and regulations, managing and addressing COVID-19 and Long COVID in CYP, vaccination, using Twitter to share scientific literature and management strategies, and clinical and personal experiences. Conclusions The perceptions described on Twitter by HCW concerning the presence of Long COVID in CYP appear to be a relevant and timely issue and responsive to the declarations and guidelines issued by health authorities over time. We recommend further support and training strategies for health workers and school staff regarding the manifestations and treatment of Long COVID in CYP. Strengths and limitations of this study – Our online analysis of Long COVID contributes towards an emerging understanding of reported experiential, emotional and practical dimensions of Long COVID in CYP specifically, as well as questions of vaccine hesitancy in CYP with Long COVID. – We identify key policy areas that need considered attention and focus, such as: a) the provision of psychosocial support with access to quality mental health resources to alleviate the impact that Long COVID can have on the mental health of CYP; and b) the development of clear Long COVID pandemic recovery policies that are informed from a health equity perspective and how this affects CYP living with Long COVID. – This is one of few studies to collect healthcare workers’ perceptions regarding Long COVID in CYP in the UK, using information from Twitter. – This study is limited to the perception of those who identified as healthcare workers via their online biographies, and so is not representative of the general UK or the global population.
Subject(s)
COVID-19 , Delayed Emergence from Anesthesia , Intellectual DisabilityABSTRACT
The COVID-19 pandemic has shed light on the fractures of healthcare systems around the world, particularly in relation to the healthcare workforce. Frontline staff, in particular, have been exposed to unprecedented strain and delivering care during the pandemic has impacted their safety, mental health and wellbeing. The aim of this paper was to explore the experiences of HCWs delivering care in the UK during the COVID-19 pandemic to understand their wellbeing needs, experiences and strategies used to maintain wellbeing (at individual and organizational levels). We analysed 94 telephone interviews with HCWs and 2000 tweets about HCWs mental health taking place during the first year of the COVID-19 pandemic. Results were grouped under six themes: redeployment; wellbeing support and coping strategies; mental health effects; organisational support; social network and public support. These findings demonstrate a need for open conversations, where staffs wellbeing needs and strategies can be shared and encouraged, rather than implementing solely top-down psychological interventions. At the macro level, findings also highlighted the impact on HCWs wellbeing of public and government support, as well as the need for ensuring protection through PPE, testing, and/or vaccines for frontline workers.
Subject(s)
COVID-19 , Fractures, BoneABSTRACT
Objectives: To explore healthcare workers' (HCWs) perceptions and attitudes towards the COVID-19 vaccination programme in the UK, including their expectations, concerns and views on whether to promote vaccination to others. To understand the key factors shaping HCWs' attitudes towards COVID-19 vaccination in the UK. Design: This study was designed as a rapid qualitative appraisal integrating data from a review of UK policies and guidance on COVID-19 vaccination with data from in-depth semi-structured telephone interviews with frontline HCWs in the UK. Data were analysed using framework analysis. Participants: Interviews were carried out with a purposive sample of HCWs from two large London-based hospital Trusts (n=24) and 24 government policies and guidelines on the vaccination programme were reviewed. Results: The level of uncertainty about the vaccines' long-term safety and efficacy against mutant strains made it difficult for HCWs to balance the benefits against the risks of vaccination. HCWs felt that government decisions on vaccine rollout had not been supported by evidence-based science and this impacted their level of trust and confidence in the programme. The spread of misinformation online also impacted HCWs' attitudes towards vaccination, particularly among junior level and Black, Asian and Minority Ethnic (BAME) HCWs. Most HCWs felt encouraged to promote vaccination to their patients and the majority said they would advocate vaccination or engage in conversations about vaccination with others when relevant. Conclusion: In order to improve HCWs' trust and confidence in the UK's COVID-19 vaccination programme, there needs to be clarity about what is known and not known about the vaccines and transparency around the evidence-base supporting government decisions on vaccine rollout. Effort is also needed to dispel the spread of vaccine-related misinformation online and to address specific concerns, particularly among BAME and junior level HCWs.
Subject(s)
COVID-19ABSTRACT
ObjectivesTo report frontline healthcare workers (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in the UK. To understand HCWs fears and concerns surrounding PPE, their experiences following its guidance and how these affected their perceived ability to deliver care during the COVID-19 pandemic. MethodsA rapid qualitative appraisal study combining three sources of data: semi-structured in-depth telephone interviews with frontline HCWs (n=46), media reports (n=39 newspaper articles and 145,000 social media posts) and government PPE policies (n=25). HCWs interviewed were from secondary care, primary care and specialist community clinics. Media and policy data were from across the UK. ResultsA major concern was running out of PPE, putting HCWs and patients at risk of infection. Following national-level guidance was often not feasible when there were shortages, leading to re-use and improvisation of PPE. Frequently changing guidelines generated confusion and distrust. PPE was reserved for high-risk secondary care settings and this translated into HCWs outside these settings feeling inadequately protected. Participants were concerned about inequitable access to PPE for community, lower seniority, female and ethnic minority HCWs. Participants continued delivering care despite the physical discomfort, practical problems and communication barriers associated with PPE use. ConclusionThis study found that frontline HCWs persisted in caring for their patients despite multiple challenges including inappropriate provision of PPE, inadequate training and inconsistent guidance. In order to effectively care for patients during the COVID-19 pandemic, frontline HCWs need appropriate provision of PPE, training in its use, as well as comprehensive and consistent guidance. These needs must be addressed in order to protect the health and well-being of the most valuable healthcare resource in the COVID-19 pandemic: our HCWs. O_TEXTBOXWhat is already known?- PPE is an important component of infection prevention and control to protect HCWs delivering care on the frontline of an infectious disease outbreak. - Frontline HCWs have reported challenges delivering care in PPE during the COVID-19 pandemic. - Research understanding how HCWs responded to these challenges are lacking. What are the new findings?- HCWs faced multiple challenges delivering care including inadequate provision of PPE, inconsistent guidance and lack of training in its use. - HCWs persisted delivering care despite the negative physical effects, practical problems, lack of protected time for breaks and communication barriers associated with wearing PPE. - In the face of training, guidance and procurement gaps, HCWs improvised by developing their own informal communication channels to share information, they trained each other and bought their own PPE. - HCWs reported inequalities accessing PPE based on the healthcare sector, gender, level of seniority and ethnicity. What do the new findings imply?- To feel safe and confident caring for patients, frontline HCWs need to be provided with appropriate size, quality and level of PPE, as well as training in its use. - PPE guidance should be consistent, clearly communicated, and reflect the most up-to-date evidence-base for the safest level of PPE. - Regular breaks for staff working in full PPE should be prioritised even in contexts of understaffing and PPE shortages as these are key aspects of well-being. C_TEXTBOX
Subject(s)
COVID-19ABSTRACT
WITHDRAWAL/DISCLAIMER STATEMENT The authors have withdrawn this manuscript because of issues that have been raised regarding the process of data collection. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.