Bayesian Emulation and History Matching of JUNE

We analyse JO_SCPLOWUNEC_SCPLOW : a detailed model of Covid-19 transmission with high spatial and demographic resolution, developed as part of the RAMP initiative. JO_SCPLOWUNEC_SCPLOW requires substantial computational resources to evaluate, making model calibration and general uncertainty analysis extremely challenging. We describe and employ the Uncertainty Quantification approaches of Bayes linear emulation and history matching, to mimic the JO_SCPLOWUNEC_SCPLOW model and to perform a global parameter search, hence identifying regions of parameter space that produce acceptable matches to observed data.

The mental health of staff working on Intensive Care Units over the COVID-19 winter surge of 2020 in England: a cross sectional survey.

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.

The mental health of critical care and anaesthetic staff during COVID-19

BackgroundIntensive Care Unit (ICU), anaesthetic and theatres staff have faced significant challenges during the COVID-19 pandemic which have the potential to adversely affect their mental health AimsTo identify the rates of probable mental health disorder in ICU and anaesthetic staff in six English hospitals during June and July 2020 MethodsAn anonymised brief web-based survey comprising standardised questionnaires examining depression, anxiety symptoms, symptoms of Post Traumatic Stress Disorder (PTSD), wellbeing and alcohol use was administered to staff. Results709 participants completed the surveys comprising 291 (41%) doctors, 344 (48.5%) nurses, and 74 (10.4%) other healthcare staff. Over half (58.8%) reported good wellbeing, however 45.4% met the threshold for probable clinical significance on at least one of the following measures: severe depression (6.3%), PTSD (39.5%), severe anxiety (11.3%) or problem drinking (7.2%). 13.4% of respondents reported frequent thoughts of being better off dead, or of hurting themselves in the past two weeks. We found that doctors consistently reported better mental health than nurses. ConclusionsWe found substantial rates of probable mental health disorders, and thoughts of self-harm, amongst ICU staff; these difficulties were especially prevalent in nurses. These results indicate the need for a national strategy to protect the mental health, and decrease the risk of functional impairment, of ICU staff whilst they carry out their essential work during COVID-19. Occ Med Statements: article should contain 3 statements (each max of 3 bullets of max 50 words each)O_ST_ABSWhat is already known about this subjectC_ST_ABSO_LIIntensive care unit (ICU) staff are regularly exposed to traumatic situations as part of their job C_LIO_LIPrevious studies have shown them to be at risk of psychological and moral distress C_LIO_LILittle is known about the mental health of ICU staff during the current pandemic C_LI What this study addsO_LIAlmost half of ICU staff report symptoms consistent with a probable diagnosis of post traumatic stress disorder, severe depression or anxiety or problem drinking C_LIO_LIAround 1 in 7 ICU staff report recent thoughts of self-harm or of wanting to be better off dead C_LIO_LINursing staff are more likely to report higher levels of distress than doctors or other clinical staff C_LI What impact this may have on practice or policyO_LIHealthcare managers need to prioritise staff mental health support and timely access to evidence based treatments for ICU staff C_LIO_LISupervisors and managers should be aware that a substantial proportion of ICU staff may perform less well because of their current poor state of mental health C_LIO_LIMore work is needed to understand whether the high levels of mental health symptoms identified in this study are truly indicative of high levels of clinical need for mental healthcare C_LI