Inequalities in psychological distress before and during the COVID-19 pandemic among UK adults : Kishan Patel

Background Evidence about how population mental health has evolved from before and over the COVID-19 pandemic remains mixed, with impacts on mental health inequalities being unclear. We investigated changes in mental health and sociodemographic inequalities from before and across the first year of the pandemic. Methods Data from 11 UK longitudinal population-based studies with pre-pandemic measures of psychological distress were analysed, estimates pooled, and stratified by age, sex, ethnicity, country and lone household status. Trends in the prevalence of poor mental health were assessed before the pandemic (TP0) and across the pandemic at three time periods (initial lockdown (TP1), easing of restrictions (TP2), and a subsequent lockdown (TP3)). Results In total, 49,993 adult participants were analysed across the 11 cohort studies. There was an overall worsening in mental health from pre-pandemic scores across all three pandemic timepoints, (TP1 Standardised Mean Difference: 0.15 (95% CI: 0.06 - 0.25);TP2 SMD: 0.18 (0.09 - 0.27);TP3 SMD: 0.21 (0.10 - 0.32)) with no evidence of improvement during the period of eased lockdown restrictions in summer 2020. Changes from pre-pandemic psychological distress were higher in females during the pandemic (TP3 SMD: 0.23 (0.11 - 0.35)), amongst those with degree-level education (TP3 SMD: 0.26 (0.14 - 0.38)), and adults aged 25-44 years. We did not find evidence of changes in distress differing by ethnicity, lone household status or UK nation. Conclusions The substantial deterioration in mental health seen in the UK during the first lockdown did not reverse when lockdown lifted and a sustained worsening was observed across the pandemic. Mental health declines have been unequal across the population and these results have implications for policy, including the need for specific investment for support for those most affected to mitigate the effects of the pandemic and measures to reduce inequalities within these specific groups. Key messages • A sustained deterioration in mental health was observed from before the start of the COVID-19 pandemic, and did not recover when social restrictions were eased. • Deterioration in mental health varied by sociodemographic factors, namely age, sex, and education, and highlights a need for improved mental health care provision to minimise widening inequalities.

Fashioning Masks. July 20, 2020

Since April 2020, the U.S. Center for Disease Control (CDC) has asked for people to wear face masks in public to curb the spread of COVID-19. This shift has given rise to a mass movement of cloth mask making. Artists have leapt into action to produce masks for healthcare and frontline workers or as an alternative economy for lost income, while others customize masks to communicate identity, beliefs, or concerns. Mask making has also raised questions about the future of fashion with regards to health and sustainability. Through a series of conversations, experts from the arts, fashion, sustainability, and medical fields were invited to talk about the variety of issues, and questions this moment of mask making and wearing have produced. Boston-based creative Erin Robertson has been putting her talents to good use during the COVID-19 crisis. Robertson has been sewing cotton face masks for healthcare workers, as well as selling some chic options on her website to raise money towards her frontline PPE efforts. In addition, Robertson has leveraged her celebrity in order to share tutorials and materials to aid others in their mask making. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

A sense of coherence: Drawing for the mind

As part of the award-winning Big Anxiety Festival in Australia, an exhibition of mixed-media drawings of plants and seeds was displayed at the University of Sydney, at the same time as two public drawing workshops in the Royal Botanic Garden Sydney. This paper describes and summarizes the various drawing techniques used in these workshops, and discusses the feedback from participants, who self-identified as having anxiety. Drawing using different types of approaches allowed workshop participants to mediate their tacit knowledge of the symptoms and solutions of living with anxiety, and to transition to a lived experience of proactively using drawings to improve their individual cognition, mindsets and mental health. Utilizing the platform afforded by the promotion of Mental Health Month in New South Wales, allowed the drawing exhibitions and workshops to be understood more broadly within an interdisciplinary context, which embedded their impact on other fields of research, including ecopsychology and biophilia, in a salutogenic model of practice. Specific to this approach, a 'sense of coherence' was deliberately embedded in both of the workshops' sequential drawing exercises, which were observational and objective in intent. The exhibitions in 2017 and 2019 also consciously deployed a 'sense of coherence' in their design. Documentation drawings have recently been used as a tool to alleviate anxiety and promote wellness in medical staff working in a UK Emergency Department during the COVID-19 pandemic. This demonstrated the widespread potential applications for drawings to provide an antidote and a method of communication to proactively and positively assist mental health. Further research and exploration of the role that drawing plants and nature can play in the construction of learning in the context of individuals struggling with anxiety may offer routes to new knowledge and better understanding and potentially enhance connections between art and health researchers and institutions globally. © 2020 Intellect Ltd Project Reports. English language.

COVID-19: smoke testing of surgical mask and respirators.

BACKGROUND: Fluid Resistant Surgical Masks have been implemented in UK personal protective equipment (PPE) guidelines for COVID-19 for all care sites that do not include aerosol-generating procedures (AGPs). FFP3 masks are used in AGP areas. Concerns from the ENT and plastic surgery communities out with intensive care units have questioned this policy. Emerging evidence on cough clouds and health care worker deaths has suggested that a review is required. AIMS: To test the efficacy of Fluid Resistant Surgical Mask with and without adaptions for respiratory protection. To test the efficacy of FFP and FFP3 regarding fit testing and usage. METHODS: A smoke chamber test of 5 min to model an 8-h working shift of exposure while wearing UK guideline PPE using an inspiratory breathing mouthpiece under the mask. Photographic data were used for comparison. RESULTS: The Fluid Resistant Surgical Mask gave no protection to inhaled smoke particles. Modifications with tape and three mask layers gave slight benefit but were not considered practical. FFP3 gave complete protection to inhaled smoke but strap tension needs to be 'just right' to prevent facial trauma. Facial barrier creams are an infection risk. CONCLUSIONS: Surgical masks give no protection to respirable particles. Emerging evidence on cough clouds and health care worker deaths suggests the implementation of a precautionary policy of FFP3 for all locations exposed to symptomatic or diagnosed COVID-19 patients. PPE fit testing and usage policy need to improve to include daily buddy checks for FFP3 users.