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COVID-19 - IN DEVELOPMENT


What has the virus done to our world?

Covid-19 has changed the world we live in.

This 'Information is beautiful infographic datapack' provides a full and detailed overview of the impact the virus has had across the globe.

How can this information help?

To help us and you understand more about the virus, its impact and the future then we have collated, and will continue to, a range of data sources, literature and information that helps us all to respond in the most appropriate way possible.

We will endeavour to keep the information up to date and adding new and relevant content.

 

World Health Organisation (WHO) describes 'Coronavirus disease' (COVID-19) as an infectious disease caused by a newly discovered coronavirus.

Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment.  Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.

The best way to prevent and slow down transmission is be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face. 

The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, so it’s important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).

At this time, there are no specific vaccines or treatments for COVID-19. However, there are many ongoing clinical trials evaluating potential treatments. WHO will continue to provide updated information as soon as clinical findings become available.

Prevention

Symptoms

COVID-19 symptoms include:

  • Cough

  • Fever or chills

  • Shortness of breath or difficulty breathing

  • Muscle or body aches

  • Sore throat

  • New loss of taste or smell

  • Diarrhoea

  • Headache

  • Fatigue

  • Nausea or vomiting

Coronaviruses are a large family of viruses that usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. However, three new coronaviruses have emerged from animal reservoirs over the past two decades to cause serious and widespread illness and death.

There are hundreds of coronaviruses, most of which circulate among such animals as pigs, camels, bats and cats. Sometimes those viruses jump to humans—called a spillover event—and can cause disease.

Four of the seven known coronaviruses that sicken people cause only mild to moderate disease.

Three can cause more serious, even fatal, disease.

  • SARS coronavirus (SARS-CoV) emerged in November 2002 and caused severe acute respiratory syndrome (SARS). That virus disappeared by 2004.

  • Middle East respiratory syndrome (MERS) is caused by the MERS coronavirus (MERS-CoV). Transmitted from an animal reservoir in camels, MERS was identified in September 2012 and continues to cause sporadic and localized outbreaks.

  • The third novel coronavirus to emerge in this century is called SARS-CoV-2. It causes coronavirus disease 2019 (COVID-19), which emerged from China in December 2019 and was declared a global pandemic by the World Health Organization on March 11, 2020.

What is the Epidemiology of Coronavirus?

On 31 December 2019, the World Health Organization (WHO) was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China.

On 12 January 2020, it was announced that a novel coronavirus had been identified in samples obtained from cases and that initial analysis of virus genetic sequences suggested that this was the cause of the outbreak. This virus is referred to as SARS-CoV-2, and the associated disease as COVID-19.

As of 29 June 2020, over 10.1 million cases have been diagnosed globally with more than 501,000 fatalities. In the 14 days to 29 June, more than 2.2 million cases were reported (European Centre for Disease Prevention and Control, situation update worldwide).

The WHO coronavirus dashboard has country by country information. WHO also publishes a daily international situation report.

The total number of confirmed cases in the UK is published by the Department of Health and Social Care, and is available in a visual dashboard.

 

Where do coronaviruses come from?

European Centre for Disease Prevention and Control suggests that Coronaviruses are viruses that circulate among animals with some of them also known to infect humans.

Bats are considered natural hosts of these viruses yet several other species of animals are also known to act as sources. For instance, Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is transmitted to humans from camels, and Severe Acute Respiratory Syndrome Coronavirus-1 (SARS-CoV-1) is transmitted to humans from civet cats. More information on coronaviruses can be found in the disease background of COVID-19.

The source of the outbreak has yet to be determined. A zoonotic source to the outbreak has not been identified yet, but investigations are ongoing.

According to current evidence, SARS-CoV-2 is primarily transmitted between people through respiratory droplets and contact routes. Airborne transmission is possible in specific settings in which procedures or support treatments that generate aerosols are performed.

At the moment, human-to-human transmission is occurring extensively. Hence, precautions to prevent human-to-human transmission are appropriate for both suspected and confirmed cases (see infection prevention and control guidance).

In addition to respiratory secretions, SARS-CoV-2 has been detected in blood, faeces and urine.

In the UK

COVID-19 epidemic result of 1,356 virus imports

In June, a study by the COVID-19 Genomics UK consortium (Cog-UK), revealed that the COVID-19 epidemic in the UK is the result of at least 1,356 separate virus importations from abroad, followed by local transmission within the UK. Chaired by the Director of PHE’s National Infection Service and Chief Scientific Adviser Professor Sharon Peacock, the findings of Cog-UK invalidate the idea that a single ‘patient zero’ started the outbreak in the UK. Instead, the preliminary analysis confirms that transmission was largely initiated by travel from European countries including Italy in late February, Spain in early-to-mid-March, and then France in mid-to-late March.

Who's at higher risk from coronavirus?

Coronavirus (COVID-19) can make anyone seriously ill. But for some people, the risk is higher.

There are 2 levels of higher risk:

  • high risk (clinically extremely vulnerable)

  • moderate risk (clinically vulnerable)

People at high risk (clinically extremely vulnerable)

People at high risk from coronavirus include people who:

  • have had an organ transplant

  • are having chemotherapy or antibody treatment for cancer, including immunotherapy

  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer

  • are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)

  • have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)

  • have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine

  • have been told by a doctor they have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)

  • have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)

  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)

  • have a serious heart condition and are pregnant

For more advice if you are deemed higher risk - go to NHS website


We discuss later on this web page, who, or what, has been affected by the virus.

Coronavirus (COVID-19): guidance

Visit .GOV.UK for the most recent updates on guidance about coronavirus (COVID-19) for health professionals and other organisations.

 

Public Health England - Coronavirus (COVID-19) - what you need to know


What the data tells us?

TEXT TO INTRODUCE CONTENT


The WHO coronavirus dashboard has country by country information. 

WHO also publishes a daily international situation report.

 

The total number of confirmed cases in the UK is published by the Department of Health and Social Care, and is available in a visual dashboard.

Regional and local data to Local Authority level is available on the GOV.UK website and is updated daily

Local Authority COVID-19 dashboard produced by ODI Leeds on github that provides confirmed cases, per capita comparisons and timeline for infections


Who, or what, has been affected by the virus?

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PHE published a rapid review into how different factors have affected COVID-19 risk and outcomes. This work confirmed that COVID-19 has replicated existing health inequalities and in some cases exacerbated them. 

Impacts we have seen so far...

 

National/regional - Graphic to highlight age distribution of those affected by virus

National/regional - Percentages of deaths by age

Local similarity to national or regional outcomes

 

 

 

National/regional - Graphic to highlight age distribution of those affected by virus

National/regional - Percentages of deaths by age

Local similarity to national or regional outcomes

Disparities in the impact of Covid-19 in black and minority ethnic populations: review of the evidence and recommendations for action (The Independent Scientific Advisory Group for Emergencies (SAGE)) (July 2020)
The question of why more people from black and minority ethnic (BME) backgrounds appear to be at greater risk of hospitalisation and deaths with Covid-19 – and the need for urgent action in order to address this – has become one of the most urgent issues in this pandemic in the UK. This review of the evidence suggests that the reasons why some BME groups appear to be at greater risk of dying with Covid-19 are complex, with interplay between socio-economic disadvantage in BME populations, high prevalence of chronic diseases and the impact of longstanding racial inequalities being key explanations.

Understanding the impact of Covid-19 on Black Asian Minority Ethnic (BAME) communities

PHE (June 2020) published a rapid review into how different factors have affected COVID-19 risk and outcomes. This work confirmed that COVID-19 has replicated existing health inequalities and in some cases exacerbated them.

In relation to Black, Asian Minority Ethnic  (BAME) communities, then specific work was undertaken to learn more about factors that may be influencing the impact of COVID-19. PHE has published a summary of this work,  which includes recommendations based upon stakeholder’s requests for action for strategies addressing inequalities. These insights will form the basis of the next steps being taken forward by the Equalities Minister. 

House of Commons Library briefing Covid-19 and Black, Asian and minority ethnic communities (17 June 2020).

House of Commons Library Briefing: Sources of statistics on inequalities between ethnic groups (June 2020)
This briefing paper provides a list of links to statistical and other related resources on differences by ethnic group in a range of topics including health, justice, employment and income. Material is listed by type of resource (eg, House of Commons Library publications, government publications and independent reviews). 


The mental health emergency: how has the coronavirus pandemic impacted our mental health? 
A survey of more than 16,000 people during lockdown by the charity Mind has revealed the scale of the impact of the pandemic on people with mental health problems. Two out of three (65 per cent) adults over 25 and three-quarters (75 per cent) of young people aged 13-24 with an existing mental health problem reported worse mental health.

The mental health effects of the first two months of lockdown and social distancing during the Covid-19 pandemic in the UK. IFS Working Paper IFS Working Paper W20/16 (Institute of Fiscal Studies (IFS) (June 2020) 

This report finds that the COVID-19 episode has had substantial negative impacts on mental health across the population. The biggest impacts have been on the gender and age groups – broadly women and the young – that already had relatively low levels of mental health. Pre-existing inequalities in mental health have therefore been exacerbated by the crisis.

COVID-19: guidance on supporting children and young people’s mental health and wellbeing (Public Health England)
Advice for parents and carers on looking after the mental health and wellbeing of children or young people during the coronavirus (COVID-19) outbreak. Updated with guidance on 'support bubbles'.

New Emerging Evidence series explores the impact of coronavirus on young people’s mental health (Anna Freud National Centre for Children and Families) (June 2020) 
In collaboration with the Child Outcomes Research Consortium, the Evidence Based Practice Unit at the Anna Freud Centre and UCL has launched Emerging Evidence, a series of rapid reviews to search for evidence from around the world during the current coronavirus pandemic. The series aims to help us understand the impact of the pandemic on children and young people’s mental health, by exploring some key questions: What are the key mental health challenges for children and young people during the coronavirus pandemic? Are there any particularly vulnerable groups? What might help children and young people to manage these challenges?
You can read Issue 2 and Issue 1 of the Emerging Evidence series, and find more research-focused resources about children and young people’s mental health and the coronavirus pandemic on the Anna Freud Centre website.  

 

Coronavirus (COVID-19): guidance for educational settings (Department for Education) (June 2020)
Guidance for schools and other educational settings about the novel coronavirus, COVID-19.

Supporting your children's education during coronavirus (COVID-19) (Department for Education) (June 2020) 
Information, guidance and support for parents and carers of children who are learning at home. Updated with guidance for secondary school children.

Supporting vulnerable children and young people during the coronavirus (COVID-19) outbreak (Department for Education) (June 2020) 
Guidance for education settings and local authorities about children and young people supported through social care, with education, health and care (EHC) plans or identified as vulnerable by their school or local authority.

Loneliness, social isolation and COVID-19: practical advice (Local Government Association (LGA))

The LGA and Association of Directors of Public Health (ADPH) have jointly produced this practical advice for Directors of Public Health and others leading the response to the loneliness and social isolation issues arising from the COVID-19 pandemic.

 

Tackling loneliness (House of Commons Library) (June 2020)

The Government's Loneliness Strategy was published in October 2018. It set out a wide variety of cross-departmental measures that the Government would take to provide 'national leadership' to tackle loneliness in England. As well as explaining the Strategy and the steps taken so far by the Government, this briefing also looks at research into the causes and impact of loneliness and possible interventions. The impact of the Covid-19 pandemic on loneliness is also considered, alongside the measures introduced by the Government in response.

 

 

Learning Disability (House of Commons Library) (June 2020)

House of Commons Library briefing on policies and services for people with a learning disability in England. Section 1 provides a summary of the impact of coronavirus on people with learning disabilities in England. The briefing also looks at recent policy changes in the areas of employment, welfare and education.

The cost of learning in lockdown: family experiences of school closures (Child Poverty Action Group) (June 2020) 
The Cost of the School Day project helps schools identify and reduce the financial barriers that prevent children in poverty from fully participating in school life. To understand how the Covid-19 pandemic has impacted children’s experience of learning, research was conducted through surveys and interviews. The project gathered the experiences of 3,600 parents and carers, along with 1,300 children and young people, with an emphasis on the experiences of low-income households. The research has found that the cost burdens of school closures have fallen most heavily on families already living on a low income.

Children in lockdown: the consequences of the coronavirus for children living in poverty (The Childhood Trust) (June 2020) 
This report documents the impact of the Coronavirus crisis on disadvantaged and vulnerable children.


What the literature tells us?


Text to introduce

Describes what we know now... 

 

 

GP referrals: what has happened since lockdown began? 

Nuffield Trust (NT) suggest that there was an alarming drop in referrals from GPs to hospital services from the  start of the Covid-19 outbreak. NT used weekly data from NHS Digital to investigate how the number of GP referrals to these kinds of services has changed since last autumn.

View Nuffield Trust Chart

The chart shows a sharp drop in GP referrals over the Christmas and New Year period, which is generally the case, and then a rapid recovery to a peak of 380,503 referrals in the week beginning 20th January.

Following the Covid-19 outbreak, partly in anticipation of the scaling back of hospital care, but also possibly due to fewer people presenting at GP surgeries, the number of GP referrals started to fall dramatically from the beginning of March. 

By mid-April, all referrals had fallen significantly, with routine referrals decreasing by 90%.  Urgent referrals and two-week referrals for suspected cancer had fallen by 78% and 67% respectively. Although these services have been protected to some extent, these falls are especially worrying given the higher risk of harm to patients from treatment being delayed.  

Referrals have started to increase again at a much slower rate than which they fell. Unfortunately, the lack of ability to bounce back to the normal level of GP referrals is likely to create a large backlog of cases that will cause waiting lists to soar, and suggests to NT that the NHS may not be returning to normal any time soon.

Author: Jessica Morris, Nuffield Trust

 

Covid-19's impact on public finances and government borrowing (Nuffield Trust, July 2020)
This Nuffield Trust briefing highlights the immense changes to government finances in recent months precipitated by the coronavirus, and considers what this might mean for health services in future.

The impact of the coronavirus pandemic on public finances around the world has been immediate and massive. In the UK, a combination of lockdown measures and the need for huge boosts in public spending has, in just a few months, outweighed the impact wrought by the 2008 global financial crisis. 

In order to finance its activities, in May this year the government borrowed £55.2 billion compared to just £5.7 billion in May 2019. Increases in day-to-day borrowing – the deficit – has added to the stock of national debt, pushing it from just over 80% of GDP in May last year to nearly 101% this May. This is the first time debt has exceeded total GDP since 1963.

Covid-19 and public finances


Coronavirus and the then latest indicators for the UK economy and society (28 May 2020)
This ONS report uses early experimental data on the impact of the coronavirus (COVID-19) on the UK economy and society, including online price changes data. These faster indicators are created using rapid response surveys, novel data sources and experimental methods.

 

ADD DATES TO REPORTS IN JUNE THEN LATER MONTHS

 

 

What is the evidence to support the 2-metre social distancing rule to reduce COVID-19 transmission? Qureshi Z, Jones N, Temple R et al. Centre for Evidence Based Medicine. This rapid review assesses available evidence for the 2-metre social distancing rule and reduction in COVID-19 transmission. https://www.cebm.net/covid-19/what-is-the-evidence-to-support-the-2-metre-social-distancing-rule-to-reduce-covid-19-transmission/
Key findings include that the 2-metre rule is based on an outdated model assuming that viral transmission occurs in either large droplets or small airborne particles. Transmission is more complex, with a continuum of droplets sizes and exhaled air influencing transmission range. It is recommended that distancing rules should account for viral load, ventilation, type of activity, transmission in outdoor vs indoor settings, and use of face masks.


What the future holds?


TEXT TO INTRODUCE

explanations of how world could change - new technologies, continued social distancing, telehealth, GP ONLINE, shopping, events, 

What next for the NHS? NHS Providers (June 2020)
report by NHS Providers, based on the first full survey of NHS trust leaders since COVID-19 started, highlights the scale of the challenge ahead as the NHS recovers from the first peak of the virus. 

Capturing beneficial change from the Covid-19 pandemic: response from the British Geriatrics Society (July 2020)
This report is a response to a request from NHS England and NHS Improvement for examples of beneficial innovations across the NHS that have been implemented during the Covid-19 pandemic and should be retained as the NHS starts to resume business as usual. BGS members contributed examples of innovations that have been implemented in their areas.


General practice in the post Covid world: challenges and opportunities for general practice (Royal College of General Practitioners (RCGP) July 2020)
This report calls on the four governments of the UK to each produce a comprehensive plan to support GPs in managing the longer-term effects of Covid-19 in the community. The RCGP says the plans should contain: costed proposals for additional funding for general practice; solutions for how the current GP workforce capacity can manage new and pre-existing pressures; commitments to continue the reduction in regulatory burdens and ‘red tape’, which has enabled GPs to spend more time on frontline patient care during the pandemic; a systematic approach for identifying those patients who are likely to require primary care support; and proposals for how health inequalities will be minimised to ensure all patients have access to the necessary post-Covid-19 care.

 

 

Shopping may never be the same again
Office for National Statistics (June 2020)

The coronavirus (COVID-19) pandemic has changed many elements of our everyday lives, including how we shop. The introduction of movement restrictions meant the closure of most physical shops, so many consumers have been doing their shopping from home instead. In May 2020, over a third of retail spending was online – the highest ever share. In this ONS blog they take a closer look at the online retail sales data to understand this trend.

Coronavirus and the economic value of human life or ... Is the lockdown worth it?

Institute of Economic Affairs (June 2020)
This IEA briefing examines the ongoing argument about easing or ending the lockdown restrictions and considers numerous factors that will affect government decisions. It emphasises the importance of putting a monetary value on life as a tool to make cost-benefit analyses about the effectiveness of lockdown and makes clear that while people may feel squeamish about looking at human life in financial terms, such calculations are necessary to make the most of limited resources in the fairest and most effective way.

Following the government implementation of NHS Test and Trace, PHE and partners in local government are working to investigate and control outbreaks and to support the community to ensure safe and effective self isolation.

The new system seeks to help identify, contain and control COVID-19, and reduce the spread of the virus, and since its creation, more than one-hundred thousand close contacts have been identified.

More information on NHS Test and Trace here. 


Resources and links

There are numerous and many providers offering links to their COVID-19 information - we have listed many below - and will continue to update but please feel free to send any options or opportunities we can add that you are aware of. 

 

General LGA COVID-19 website

The LGA’s website is being regularly updated with information/signposting regarding the outbreak, including new guidance for councillors on COVID-19, and sections on various topics of interest. We are also regularly pushing information on the outbreak out to councils via Twitter @LGAComms and @LGANews.

 

Information is beautiful
https://informationisbeautiful.net/visualizations/covid-19-coronavirus-infographic-datapack/