Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 6 de 6
Filter
1.
JMIR Public Health Surveill ; 8(8): e32347, 2022 Aug 03.
Article in English | MEDLINE | ID: covidwho-1974480

ABSTRACT

BACKGROUND: The COVID-19 pandemic has resulted in an unprecedented impact on the day-to-day lives of people, with several features potentially adversely affecting mental health. There is growing evidence of the size of the impact of COVID-19 on mental health, but much of this is from ongoing population surveys using validated mental health scores. OBJECTIVE: This study investigated the impact of the pandemic and control measures on mental health conditions presenting to a spectrum of national health care services monitored using real-time syndromic surveillance in England. METHODS: We conducted a retrospective observational descriptive study of mental health presentations (those calling the national medical helpline, National Health Service [NHS] 111; consulting general practitioners [GPs] in and out-of-hours; calling ambulance services; and attending emergency departments) from January 1, 2019, to September 30, 2020. Estimates for the impact of lockdown measures were provided using an interrupted time series analysis. RESULTS: Mental health presentations showed a marked decrease during the early stages of the pandemic. Postlockdown, attendances for mental health conditions reached higher than prepandemic levels across most systems-a rise of 10% compared to that expected for NHS 111 and 21% for GP out-of-hours service-while the number of consultations to GP in-hours service was 13% lower compared to the same time previous year. Increases were observed in calls to NHS 111 for sleep problems. CONCLUSIONS: These analyses showed marked changes in the health care attendances and prescribing for common mental health conditions across a spectrum of health care provision, with some of these changes persisting. The reasons for such changes are likely to be complex and multifactorial. The impact of the pandemic on mental health may not be fully understood for some time, and therefore, these syndromic indicators should continue to be monitored.


Subject(s)
COVID-19 , COVID-19/epidemiology , Communicable Disease Control , Delivery of Health Care , England/epidemiology , Humans , Mental Health , Pandemics , Retrospective Studies , State Medicine
2.
Euro Surveill ; 27(15)2022 04.
Article in English | MEDLINE | ID: covidwho-1869325

ABSTRACT

BackgroundHouseholds appear to be the highest risk setting for COVID-19 transmission. Large household transmission studies in the early stages of the pandemic in Asia reported secondary attack rates ranging from 5 to 30%.AimWe aimed to investigate the transmission dynamics of COVID-19 in household and community settings in the UK.MethodsA prospective case-ascertained study design based on the World Health Organization FFX protocol was undertaken in the UK following the detection of the first case in late January 2020. Household contacts of cases were followed using enhanced surveillance forms to establish whether they developed symptoms of COVID-19, became confirmed cases and their outcomes. We estimated household secondary attack rates (SAR), serial intervals and individual and household basic reproduction numbers. The incubation period was estimated using known point source exposures that resulted in secondary cases.ResultsWe included 233 households with two or more people with 472 contacts. The overall household SAR was 37% (95% CI: 31-43%) with a mean serial interval of 4.67 days, an R0 of 1.85 and a household reproduction number of 2.33. SAR were lower in larger households and highest when the primary case was younger than 18 years. We estimated a mean incubation period of around 4.5 days.ConclusionsRates of COVID-19 household transmission were high in the UK for ages above and under 18 years, emphasising the need for preventative measures in this setting. This study highlights the importance of the FFX protocol in providing early insights on transmission dynamics.


Subject(s)
COVID-19 , Adolescent , Family Characteristics , Humans , Pandemics , SARS-CoV-2 , United Kingdom/epidemiology
3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-337001

ABSTRACT

Objective In September 2020, records of 15,861 SARS-CoV-2 cases failed to upload from the Second Generation Laboratory Surveillance System (SGSS) to the Contact Tracing Advisory Service (CTAS) tool, resulting in a delay in the contact tracing of these cases. This study used CTAS data to determine the impact of this delay on health outcomes: transmission events, hospitalisations, and mortality. Previously, a modelling study had suggested a substantial impact. Design Observational study Setting England. Population Individuals testing positive for SARS-CoV-2 and their reported contacts. Main outcome measures Secondary attack rates (SARs), hospitalisations, and deaths amongst primary and secondary contacts were calculated, compared to all other concurrent, unaffected cases. SGSS records affected by the event were matched to CTAS records and successive contacts and cases were identified. Results The initiation of contact tracing was delayed by 3 days on average in the primary cases in the delay group (6 days) compared to the control group (3 days). This was associated with lower completion of contact tracing of primary cases in the delay group: 80% (95%CI: 79-81%) in the delay group and 83% (95%CI: 83-84%) in the control group. There was some evidence to suggest an increase in transmission to non-household contacts amongst those affected by the delay. The SAR for non-household contacts was higher amongst secondary contacts in the delay group than the control group (delay group: 7.9%, 95%CI:6.4% to 9.2%;control group: 5.9%, 95%CI: 5.3% to 6.6%). There was no evidence of a difference between the delay and control groups in the odds of hospitalisation (crude odds ratio: 1.1 (95%CI: 0.9 to 1.2) or death (crude odds ratio: 0.7 (0.1 to 4.0)) amongst secondary contacts. Conclusions The delay in contact tracing had a limited impact on population health outcomes. Strengths and limitations of the study Shows empirical data on the health impact of an event leading to a delay in contact tracing so can test hypotheses generated by models of the potential impact of a delay in contact tracing Estimates the extent of further transmission and odds of increased mortality or hospitalisation in up to the third generation of cases affected by the event The event acts as a natural experiment to describe the possible impact of contact tracing, comparing a group affected by chance by delayed contact tracing to a control group who experienced no delay Contact tracing was not completed for all individuals, so the study might not capture all affected contacts or transmissions

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308159

ABSTRACT

Background: Identifying areas that pose the greatest risk for community transmission of COVID-19 is essential to direct public health action and allow safe re-opening of society. Spread of B.1.1.7 (alpha) lineage provided a unique opportunity to quantify COVID-19 transmission risk associated with community settings in England 2020/21. Methods: All cases of COVID-19 occurring between 11/2020 and 01/2021 reported through the English national contact tracing system included. Recruitment occurred when B.1.1.7 regional prevalence was between 20-80%. Case groups were defined as: >2 cases reporting the same, location and attendance date 7-3 days before onset. Genetic concordance, presence/absence of S-gene target failure (SGTF) in grouped cases, was determined. Odds ratios for concordance and 95% confidence intervals were calculated. Sensitivity analysis compared concordance in single to 2-3 day case groups. Findings: There were 41,325 case groups with SGTF data containing 115,410 exposure events. Odds ratios ranged from 1.87 (95% CI:1.76-1.98) for shops, 29.9 (95% CI:23.1-38.7), nursery/preschool and 35.6 (95% CI:19.7-64.2) for visiting friends/relatives. Odds ratios of concordance increased with larger cluster sizes in educational settings. Concordance estimates were reduced when case grouping time period was increased from 1 to 2-3 days. Interpretation: Transmission risk varies across community settings, likely due to different behavioural or environmental factors. Risk does not capture number of users which also affects impact of settings on transmission. Limited data for certain settings due to non-pharmaceutical interventions in place. We recommend data are used to guide policy and prioritise action when assessing and managing COVID-19 community case clusters. Funding: EB funded by EMBL. No additional funding.Declaration of Interest: None to declare

5.
Bull World Health Organ ; 99(3): 178-189, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1256313

ABSTRACT

OBJECTIVE: To describe the clinical presentation, course of disease and health-care seeking behaviour of the first few hundred cases of coronavirus disease 2019 (COVID-19) in the United Kingdom of Great Britain and Northern Ireland. METHODS: We implemented the World Health Organization's First Few X cases and contacts investigation protocol for COVID-19. Trained public health professionals collected information on 381 virologically confirmed COVID-19 cases from 31 January 2020 to 9 April 2020. We actively followed up cases to identify exposure to infection, symptoms and outcomes. We also collected limited data on 752 symptomatic people testing negative for COVID-19, as a control group for analyses of the sensitivity, specificity and predictive value of symptoms. FINDINGS: Approximately half of the COVID-19 cases were imported (196 cases; 51.4%), of whom the majority had recent travel to Italy (140 cases; 71.4%). Of the 94 (24.7%) secondary cases, almost all reported close contact with a confirmed case (93 cases; 98.9%), many through household contact (37 cases; 39.8%). By age, a lower proportion of children had COVID-19. Most cases presented with cough, fever and fatigue. The sensitivity and specificity of symptoms varied by age, with nonlinear relationships with age. Although the proportion of COVID-19 cases with fever increased with age, for those with other respiratory infections the occurrence of fever decreased with age. The occurrence of shortness of breath also increased with age in a greater proportion of COVID-19 cases. CONCLUSION: The study has provided useful evidence for generating case definitions and has informed modelling studies of the likely burden of COVID-19.


Subject(s)
COVID-19/epidemiology , COVID-19/physiopathology , Adolescent , Adult , Age Distribution , Aged , Child , Child, Preschool , Dyspnea/epidemiology , Female , Humans , Infant , Male , Middle Aged , Respiratory Tract Infections/epidemiology , SARS-CoV-2 , Travel , United Kingdom/epidemiology , Young Adult
6.
Epidemiol Infect ; 148: e122, 2020 06 18.
Article in English | MEDLINE | ID: covidwho-606045

ABSTRACT

The COVID-19 pandemic is exerting major pressures on society, health and social care services and science. Understanding the progression and current impact of the pandemic is fundamental to planning, management and mitigation of future impact on the population. Surveillance is the core function of any public health system, and a multi-component surveillance system for COVID-19 is essential to understand the burden across the different strata of any health system and the population. Many countries and public health bodies utilise 'syndromic surveillance' (using real-time, often non-specific symptom/preliminary diagnosis information collected during routine healthcare provision) to supplement public health surveillance programmes. The current COVID-19 pandemic has revealed a series of unprecedented challenges to syndromic surveillance including: the impact of media reporting during early stages of the pandemic; changes in healthcare-seeking behaviour resulting from government guidance on social distancing and accessing healthcare services; and changes in clinical coding and patient management systems. These have impacted on the presentation of syndromic outputs, with changes in denominators creating challenges for the interpretation of surveillance data. Monitoring changes in healthcare utilisation is key to interpreting COVID-19 surveillance data, which can then be used to better understand the impact of the pandemic on the population. Syndromic surveillance systems have had to adapt to encompass these changes, whilst also innovating by taking opportunities to work with data providers to establish new data feeds and develop new COVID-19 indicators. These developments are supporting the current public health response to COVID-19, and will also be instrumental in the continued and future fight against the disease.


Subject(s)
Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Population Surveillance/methods , COVID-19 , Coronavirus Infections/prevention & control , Health Behavior , Humans , Pandemics/prevention & control , Patient Acceptance of Health Care/statistics & numerical data , Pneumonia, Viral/prevention & control , Public Health Surveillance/methods
SELECTION OF CITATIONS
SEARCH DETAIL