'Like an unbridled horse that runs away with you': a study of older and disabled people during the COVID-19 pandemic and their use of digital technologies

POINTS OF INTERESTThis study explored the experiences of using digital technology by older and disabled people who were social distancing and shielding during the first period of lockdown over the Covid 19 Pandemic.The pandemic saw a greater need for support to use digital technologies as face-to-face social activities were limited.The biggest change in the use of digital technology and support requested from older and disabled people over the lockdown was the growth of video calling.Digital technologies were also used for entertainment like watching online videos, playing computer games, and listening to audiobooks and music.The study found older and disabled people used digital technologies to help them, but the increased use could be challenging and stressful.Both initial and ongoing digital support must be available to older and disabled people, and digital technology support workers need knowledge and experience of digital technology and disability to offer good support. This study explored the uses of digital technologies by older and disabled people who were social distancing and shielding during the early Covid-19 pandemic lockdowns. The study considers the benefits, difficulties, and technical support needs of these groups of people during this time. Using a case study methodology, in-depth interviews were undertaken with 11 older and disabled people recruited from a local digital support service, and their support workers. Five main themes were identified by the research team. These were: technology was a mixed blessing and caused frustration;technology use increased during lockdown;technology supported resilience and contributed to identity through 'stimulation, knowledge and friendship';technology needs to be accessible, and support was required to facilitate technology use. Understanding these experiences will enable policymakers, commissioners, and providers to develop better and more responsive digital support for older and disabled people in the future.

A time for adaptation and reflection: the experience of Admiral Nurses during COVID-19

COVID-19 has meant that, globally, people, organisations and governments have had to make huge changes in life and work. The aim of this study is to explore the impact of working during the first wave of COVID-19 on Admiral Nurse practice (specialists in dementia care who support families affected by dementia). Semi-structured interviews were used to gather data from 19 Admiral Nurses. Themes drawn from the data show that Admiral Nurses experienced an immediate sense of impotence and helplessness, and, from there, moved through a process of adaptation to reach a new level of competence. This research provides insight into the experiences of Admiral Nurses and their adaptability in extraordinary circumstances.

A Needle in a Haystack? Human Rights Framing at the World Trade Organization for Access to COVID-19 Vaccines

How and why is implicit and explicit human rights language used by World Trade Organization (WTO) negotiators in debates about intellectual property, know-how, and technology needed to manufacture COVID-19 vaccines, and how do these findings compare with negotiators' human rights framing in 2001? Sampling 26 WTO members and two groups of members, this study uses document analysis and six key informant interviews with WTO negotiators, a representative of the WTO Secretariat, and a nonstate actor. In WTO debates about COVID-19 medicines, negotiators scarcely used human rights frames (e.g., "human rights" or "right to health"). Supporters used both human rights frames and implicit language (e.g., "equity," "affordability," and "solidarity") to garner support for the TRIPS waiver proposal, while opponents and WTO members with undetermined positions on the waiver used only implicit language to advocate for alternative proposals. WTO negotiators use human rights frames to appeal to previously agreed language about state obligations;for coherence between their domestic values and policy on one hand, and their global policy positions on the other;and to catalyze public support for the waiver proposal beyond the WTO. This mixed-methods design yields a rich contextual understanding of the modern role of human rights language in trade negotiations relevant for public health.

The story of an emerging crisis: the impact of COVID-19 on care home residents with dementia in the UK

The impact of COVID-19 in UK care homes has been significant - for staff, residents and people with dementia. Given the rapidly changing circumstances, the media (limitations notwithstanding) have reported vital insights from the front line. A qualitative analysis of news articles across three time points reveals the story of an emerging crisis in UK care homes, beginning with a sole focus on hospital care and resulting in tragically high death rates. This public-facing narrative has potential to: advocate for increased resources in care homes;drive government accountability;highlight improvements for care practices;and bear witness to the experiences of a vulnerable population.

COVID-19 and ethical care at the end of life: Using qualitative media analysis to understand experiences of care home residents with dementia

Background: A palliative care approach for people with dementia is imperative for care quality and ethical practice. COVID-19 has affected health outcomes for care home residents with dementia. Therefore, it is important to explore whether residents received end of life care consistent with ethical standards during the pandemic. Aims: This study sought to understand the experiences of care home residents with dementia during the pandemic. Methods: A review was conducted using approaches from qualitative media analysis, mapping news articles that reported care experiences from the frontline. Searches for articles took place at three time points within a specific time frame. Forty-seven articles were thematically analysed and coded. Following this, salient ethical values for care delivery were identified by synthesising relevant UK ethical standards and codes of practice. These values were used to analyse real life experiences reported in the literature, and the extent to which ethical end of life care was evident during the pandemic. Results: Findings identified experiences for care home residents with dementia relating to: caring;non-maleficence;beneficence;procedural justice;dignity in death and dying;wellbeing, safety;personhood. The analysis showed positive experiences resulting from ethical practice displayed by care home staff, care organisations and the third sector. However, negative experiences for residents and staff were also evident, demonstrating the failings of negligent government strategy. Delayed guidance, lack of personal protective equipment, unclear data and inconsistent testing combined to undermine ethical care during the pandemic. Conclusion: These findings have implications for other countries, highlighting ethical values to uphold at the end of life for people with dementia, and areas to be prioritised to maintain care quality.

Productivity and the pandemic: short-term disruptions and long-term implications: The impact of the COVID-19 pandemic on productivity dynamics by industry

This paper analyses quarterly estimates of productivity growth at industry level for three advanced economies, France, the UK and the US, for 2020. We use detailed industry-level data to distinguish reallocations of working hours between industries from pure within-industry productivity gains or losses. We find that all three countries showed positive growth rates of aggregate output per hour in 2020 over 2019. However, after removing the effects from the reallocation of hours between low and high productivity industries, only the US still performed positively in terms of within-industry productivity growth. In contrast, the two European economies showed negative within-industry productivity growth rates in 2020. While above-average digital-intensive industries outperformed below-average ones in both France and the UK, the US showed higher productivity growth in both groups compared to the European countries. Industries with medium-intensive levels of shares of employees working from home prior to the pandemic made larger productivity gains in 2020 than industries with the highest pre-pandemic work-from-home shares. Overall, after taking into account the productivity collapse in the hospitality and culture sector during 2020, productivity growth shows no clear deviation from the slowing pre-pandemic productivity trend. Future trends in productivity growth will depend on whether the favourable productivity gains (or smaller losses) in industries with above-average digital intensity will outweigh negative effects from the pandemic, in particular scarring effects on labour markets and business dynamics. © 2021, The Author(s).