ABSTRACT
BackgroundThe COVID-19 pandemic generated a surge of critically ill patients greater than the NHS capacity. Additionally, there have been multiple well-documented impacts associated with the national COVID-19 pandemic surge on ICU workers, including an increased prevalence of mental health disorders on a scale potentially sufficient to impair high-quality care delivery. AimTo identify prevalence of probable mental health disorders and functional impairment. As well as establish demographic and professional predictors of probable mental health disorders and functional impairment in ICU staff between November 2020 to April 2021. MethodsEnglish ICU staff were surveyed before, during and after the winter 2020/2021 surge using a survey which comprised of validated measures of mental health. Results6080 surveys were completed, by nurses (57.5%), doctors (27.9%), and other healthcare staff (14.5%). Reporting probable mental health disorders increased from 51% (prior to), to 64% (during) and then dropped to 46% (after). Younger, less experienced and nursing staff were most likely to report probable mental health disorders. Additionally, during and after the winter, over 50% of participants met threshold criteria for functional impairment. Staff who reported probable post-traumatic stress disorder, anxiety or depression were more likely to meet threshold criteria for functional impairment. ConclusionsThe winter of 2020/2021 was associated with an increase in poor mental health outcomes and functional impairment during a period of peak caseload. These effects are likely to impact on patient care outcomes and the longer-term resilience of the healthcare workforce.
ABSTRACT
Objectives: To investigate rates of adherence to the UKs test, trace and isolate system over time. Design: Time series of cross-sectional online surveys. Setting: Data were collected between 2 March and 5 August 2020. Participants: 42,127 responses from 31,787 people living in the UK, aged 16 years or over, are presented (21 survey waves, n{approx}2,000 per wave). Main outcome measures: Identification of the key symptoms of COVID-19 (cough, high temperature / fever, and loss of sense of smell or taste), self-reported adherence to self-isolation if symptomatic, requesting an antigen test if symptomatic, intention to share details of close contacts, self-reported adherence to quarantine if alerted that you had been in contact with a confirmed COVID-19 case. Results: Only 48.9% of participants (95% CI 48.2% to 49.7%) identified key symptoms of COVID-19. Self-reported adherence to test, trace and isolate behaviours was low (self-isolation 18.2%, 95% CI 16.4% to 19.9%; requesting an antigen test 11.9%, 95% CI 10.1% to 13.8%; intention to share details of close contacts 76.1%, 95% CI 75.4% to 76.8%; quarantining 10.9%, 95% CI 7.8% to 13.9%) and largely stable over time. By contrast, intention to adhere to protective measures was much higher. Non-adherence was associated with: men, younger age groups, having a dependent child in the household, lower socio-economic grade, greater hardship during the pandemic, and working in a key sector. Conclusions: Practical support and financial reimbursement is likely to improve adherence. Targeting messaging and policies to men, younger age groups, and key workers may also be necessary.
ABSTRACT
WHAT IS ALREADY KNOWN ON THIS TOPICO_LITest results indicating the presence of antibodies to SARS-CoV-2 are often referred to as Immunity Passports or Certificates. C_LIO_LIDue to the limitations of such tests, including uncertainty about the duration of immunity conferred by detected antibodies, those receiving results indicating the presence of antibodies retain a risk of becoming infected by SARS-CoV-2. C_LIO_LIIt is unknown whether the use of the terms Immunity Passports or Certificates reduces awareness of the residual risk inherent in an antibody-positive test result and adherence to protective behaviours, thereby increasing risk of transmission. C_LI WHAT THIS STUDY ADDSO_LIUsing the term Immunity - as opposed to Antibody - to describe antibody tests for SARS-CoV-2 more than doubled the proportion who erroneously perceived they would have no risk of catching coronavirus in the future given an antibody-positive test result, from 9.8% for Antibody to 19.1% for Immunity. C_LIO_LIPerceiving no risk of infection with coronavirus given an antibody-positive test result was associated with an intention to wash hands less frequently. C_LIO_LIUsing the terms Passport, Certificate or Test had no significant effect. C_LI ObjectiveTo assess the impact of describing an antibody-positive test result using the terms Immunity and Passport or Certificate, alone or in combination, on perceived risk of becoming infected with SARS-CoV-2 and intention to continue protective behaviours. Design2 x 3 experimental design. SettingOnline with data collected between 28th April and 1st May 2020. Participants1,204 adults registered with a UK research panel. InterventionParticipants were randomised to receive one of six descriptions of an antibody test and results showing SARS-CoV-2 antibodies, differing in the terms used to describe the type of test (Immunity vs Antibody) and the test result (Passport vs Certificate vs Test). Main outcome measuresThe primary outcome was the proportion of participants perceiving no risk of becoming infected with SARS-CoV-2 given an antibody positive test result. Other outcomes include intended changes to frequency of handwashing and physical distancing. ResultsWhen using the term Immunity (vs Antibody), 19.1% of participants [95% CI: 16.1 to 22.5] (vs 9.8% [95% CI: 7.5 to 12.4]) perceived no risk of catching coronavirus at some point in the future given an antibody-positive test result (AOR: 2.91 [95% CI: 1.52 to 5.55]). Using the terms Passport or Certificate - as opposed to Test - had no significant effect (AOR: 1.24 [95% CI: 0.62 to 2.48] and AOR: 0.96 [95% CI: 0.47 to 1.99] respectively). There was no significant interaction between the effects of the test and result terminology. Across groups, perceiving no risk of infection was associated with an intention to wash hands less frequently (AOR: 2.32 [95% CI: 1.25 to 4.28]) but there was no significant association with intended avoidance of physical contact with others outside of the home (AOR: 1.37 [95% CI: 0.93-2.03]). ConclusionsUsing the term Immunity (vs Antibody) to describe antibody tests for SARS-CoV-2 increases the proportion of people believing that an antibody-positive result means they have no risk of catching coronavirus in the future, a perception that may be associated with less frequent handwashing. The way antibody testing is described may have implications for the likely impact of testing on transmission rates. Study registrationOpen Science Framework: https://osf.io/tjw78/files/
