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The coronavirus (COVID-19) pandemic disrupted all surgical specialties significantly and exerted additional pressures on the overburdened United Kingdom (UK) National Health Service. Healthcare professionals in the UK have had to adapt their practice. In particular, surgeons have faced organisational and technical challenges treating patients who carried higher risks, were more urgent and could not wait for prehabilitation or optimisation before their intervention. Furthermore, there were implications for blood transfusion with uncertain patterns of demand, reductions in donations and loss of crucial staff because of sickness and public health restrictions. Previous guidelines have attempted to address the control of bleeding and its consequences after cardiothoracic surgery, but there have been no targeted recommendations in light of the recent COVID-19 challenges. In this context, and with a focus on the perioperative period, an expert multidisciplinary Task Force reviewed the impact of bleeding in cardiothoracic surgery, explored different aspects of patient blood management with a focus on the use of haemostats as adjuncts to conventional surgical techniques and proposed best practice recommendations in the UK. [ABSTRACT FROM AUTHOR]

Introduction: Disparities in the uptake of routine and COVID‐19 vaccinations have been observed in migrant populations, and attributed to issues of mistrust, access and low vaccine confidence. Participatory research approaches and behaviour change theory hold the potential for developing tailored vaccination interventions that address these complex barriers in partnership with communities and should be explored further. Methods: This study used a theory‐informed, community‐based participatory research approach to co‐design a culturally tailored behaviour change intervention aimed at increasing COVID‐19 vaccine uptake among Congolese migrants in London, United Kingdom (2021–2022). It was designed and led by a community‐academic partnership in response to unmet needs in the Congolese community as the COVID‐19 pandemic started. Barriers and facilitators to COVID‐19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in‐depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the capability, opportunity, motivation, behaviour model to identify target behaviours and strategies to include in interventions. Interventions were co‐designed and tailored in workshops involving Congolese migrants. Results: Thirty‐two Congolese adult migrants (24 (75%) women, mean 14.3 (SD: 7.5) years in the United Kingdom, mean age 52.6 (SD: 11.0) years) took part in in‐depth interviews and 16 (same sample) took part in co‐design workshops. Fourteen barriers and 10 facilitators to COVID‐19 vaccination were identified; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences and environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations and social opportunities. Strategies included culturally tailored behaviour change techniques based on education, persuasion, modelling, enablement and environmental restructuring, which resulted in a co‐designed intervention comprising community‐led workshops, plays and posters. Findings and interventions were disseminated through a community celebration event. Conclusions: Our study demonstrates how behavioural theory can be applied to co‐designing tailored interventions with underserved migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities' unique cultural needs and realities. Patient or Public Contribution: Patient and public involvement (PPI) were embedded in the participatory study design and approach, with community members co‐producing all stages of the study and co‐authoring this paper. An independent PPI board (St George's Migrant Health Research Group Patient and Public Involvement Advisory Board) comprising five adult migrants with lived experience of accessing healthcare in the United Kingdom were also consulted at significant points over the course of the study. [ABSTRACT FROM AUTHOR]

As a UK-based group of female postgraduate researchers, the authors explored their experiences during COVID-19 pandemic through multivocal inquiry via a feminist collaborative autoethnographic project. In this paper, we use the Listening Guide as a tool to revisit and (re)analyse data from the aforementioned project, displaying findings in the form of voice poems. In utilising the Listening Guide, we discovered that listening is less of an exercise and more an art form. While the structured approach of the LG helped to enhance our understandings of wider individual experiences of disability and womanhood, identities that all authors inhabit, we were surprised to find that despite our established mutual trust and superficially similar experiences, we were unable to find emotional resonance through data that wasn't our own voice. We also found that the traditional stepped process of the LG that incorporates four listens to the data left our interpretations feeling flat. Through reflexivity and the novel collaborative approach we undertook in this analysis, we identified and implemented an augmentation of the Listening Guide process. In this paper, we propose an additional fifth listen, focusing on emotion, to facilitate a more holistic analysis of voice data. We explore how the fifth listen assisted the (re)construction of individual and collective identities, helping us to reshape our understandings. Finally, we elucidate the positives and pitfalls we experienced in the Listening Guide as a data analysis tool, recommending to other researchers the adoption of an iterative, flexible and reflexive approach in using it during collaborative research. [ABSTRACT FROM AUTHOR]

Objectives: Established in March 2020, the C19PRC Study monitors the psychological and socio‐economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 6 (August–September 2021). Methods: The survey assessed: COVID‐19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adult participants from any previous wave (N = 3170) were re‐invited, and sample replenishment procedures helped manage attrition. Weights were calculated using a survey raking algorithm to ensure the on‐going original panel (from baseline) was nationally representative in terms of gender, age, and household income, amongst other factors. Results: 1643 adults were re‐interviewed at Wave 6 (51.8% retention rate). Non‐participation was higher younger adults, those born outside UK, and adults living in cities. Of the adults recruited at baseline, 54.3% (N = 1100) participated in Wave 6. New respondent (N = 415) entered the panel at this wave, resulting in cross‐sectional sample for Wave 6 of 2058 adults. The raking procedure re‐balanced the longitudinal panel to within 1.3% of population estimates for selected socio‐demographic characteristics. Conclusions: This paper outlines the growing strength of the publicly available C19PRC Study data for COVID‐19‐related interdisciplinary research. [ABSTRACT FROM AUTHOR]

Background: In early 2021, the Department of Health and Social Care in the UK called for research on the safety and immunogenicity of concomitant administration of COVID-19 and influenza vaccines. Co-administration of these vaccines would facilitate uptake and reduce the number of healthcare visits required. The ComFluCOV trial was designed to deliver the necessary evidence in time to inform the autumn (September–November) 2021 vaccination policy. This paper presents the statistical methodology applied to help successfully deliver the trial results in 6 months. Methods: ComFluCOV was a parallel-group multicentre randomised controlled trial managed by the Bristol Trials Centre. Two study statisticians, supported by a senior statistician, worked together on all statistical tasks. Tools were developed to aid the pre-screening process. Automated data monitoring reports of clinic data and electronic diaries were produced daily and reviewed by the trial team and feedback provided to sites. Analyses were performed independently in parallel, and derivations and results of all outcomes were compared. Results: Set-up was achieved in less than a month, and 679 participants were recruited over 8 weeks. A total of 537 [at least] daily reports outlining recruitment, protocol adherence, and data quality, and 695 daily reports of participant electronic diaries identifying any missed diary entries and adverse events were produced over a period of 16 weeks. A preliminary primary outcome analysis of validated data was reported to the Department of Health and Social Care in May 2021. The database was locked 6 weeks after the final participant follow-up and final analyses completed 3 weeks later. A pre-print publication was submitted within 14 days of the results being made available. The results were reported 6 months after first discussions about the trial. Conclusion: The statistical methodologies implemented in ComFluCOV helped to deliver the study in the timescale set. Working in a new clinical area to tight timescales was challenging. Having two statisticians working together on the study provided a quality assurance process that enabled analyses to be completed efficiently and ensured data were interpreted correctly. Processes developed could be applied to other studies to maximise quality, reduce the risk of errors, and overall provide enhanced validation methods. Trial registration: ISRCTN14391248, registered on 30 March 2021 [ABSTRACT FROM AUTHOR]

Background: Community-based volunteering supports outbreak management by extending reach into at-risk communities. This paper examines the application of a 'community champions' model in England, UK, during the COVID-19 pandemic. Evidence pre-pandemic shows that community champion interventions tap into social networks to strengthen connections with disadvantaged communities. During the pandemic, the UK government set up a COVID community champions funding award scheme for local authorities to develop local programmes that addressed emerging inequalities. The study aim was to identify transferable learning on community engagement in the pandemic by undertaking a secondary qualitative synthesis of practice-based case studies of local COVID community champion programmes. Methods: A systematic staged approach for synthesis of practice-based case studies was used. In total, 16 COVID community champion case studies, which were written by practitioners involved in local programme implementation and published by the Local Government Association, were included. Case studies covered aims, programme development and delivery, examples of activities and a discussion of learning. Framework qualitative analysis methods were used to code and organise data prior to cross case analysis. The final stage produced an overarching thematic framework that best represented descriptive and interpretive themes. Results: The results provide an overview of common features of COVID community champion programmes and emergent learning. All local programmes aimed to reduce health inequalities by involving at-risk communities in local prevention efforts, adapting the approach to local priorities. Two levels of community engagement were volunteer mobilisation and subsequent community-based outreach activities. Elements of capacity building, such as training and creation of networks, were common. The synthesis of practice-based learning found that stronger relationships with communities were regarded as a key mechanism to support more equitable prevention strategies. Other learning themes related to champion roles, community engagement strategies and programme implementation. Conclusions: By focusing on how community champion approaches were applied by local authorities in England during the COVID-19 pandemic, this study contributes to knowledge on volunteer mobilisation as a mechanism to improve public health communication and outreach. Notwithstanding the limitations of experiential evidence, the synthesis of practice-based learning highlights potentially transferable community engagement strategies for health protection and health improvement. [ABSTRACT FROM AUTHOR]

Long COVID, a long-lasting disorder following an acute infection of COVID-19, represents a significant public health burden at present. In this paper, we propose a new mechanistic model based on differential equations to investigate the population dynamics of long COVID. By connecting long COVID with acute infection at the population level, our modeling framework emphasizes the interplay between COVID-19 transmission, vaccination, and long COVID dynamics. We conducted a detailed mathematical analysis of the model. We also validated the model using numerical simulation with real data from the US state of Tennessee and the UK. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic had a significant impact on the operations and functionality of the public transport sector in the UK. This paper reflects on the experience of this sector through the pandemic period, and considers recommendations for any future mitigations required for either new COVID-19 waves or a different public health emergency. Methods: Semi-structured interviews were carried out with public transport experts, organisational leaders, workers and passengers in two phases: Phase 1 from January to May 2021, and Phase 2 from December 2021 to February 2022. Interviews were analysed thematically. Results: Using the 'What? So What? Now What?' reflective model, ideas are drawn out to describe (a) what changes occurred, (b) what effects these changes had on service provision as well as perceptions of risk and mitigation and (c) what lessons have been learned and how these findings can feed into pandemic preparedness for the future. Respondent reflections focussed on the importance of communication, leadership, and maintaining compliance. Conclusions: The wealth of experience gained through the COVID-19 pandemic in the public transport sector is extremely valuable. Through reflection on this experience, specific recommendations are made relating to these factors, covering: maintaining links across industry, access to information and data, understanding of mitigation effectiveness, improving messaging, challenges of behavioural mitigations, and clear lines of accountability. The recommendations made on the basis of this reflective process will help to improve public health strategy within the public transport sector. [ABSTRACT FROM AUTHOR]

As a UK-based group of female postgraduate researchers, the authors explored their experiences during COVID-19 pandemic through multivocal inquiry via a feminist collaborative autoethnographic project. In this paper, we use the Listening Guide as a tool to revisit and (re)analyse data from the aforementioned project, displaying findings in the form of voice poems. In utilising the Listening Guide, we discovered that listening is less of an exercise and more an art form. While the structured approach of the LG helped to enhance our understandings of wider individual experiences of disability and womanhood, identities that all authors inhabit, we were surprised to find that despite our established mutual trust and superficially similar experiences, we were unable to find emotional resonance through data that wasn't our own voice. We also found that the traditional stepped process of the LG that incorporates four listens to the data left our interpretations feeling flat. Through reflexivity and the novel collaborative approach we undertook in this analysis, we identified and implemented an augmentation of the Listening Guide process. In this paper, we propose an additional fifth listen, focusing on emotion, to facilitate a more holistic analysis of voice data. We explore how the fifth listen assisted the (re)construction of individual and collective identities, helping us to reshape our understandings. Finally, we elucidate the positives and pitfalls we experienced in the Listening Guide as a data analysis tool, recommending to other researchers the adoption of an iterative, flexible and reflexive approach in using it during collaborative research. [ABSTRACT FROM AUTHOR]

Objectives: The COVID‐19 Psychological Research Consortium (C19PRC) Study was established in March 2020 to monitor the psychological and socio‐economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 5 (March–April 2021). Methods: The survey assessed: COVID‐19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adults who participated in any previous wave (N = 4949) were re‐invited to participate. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was nationally representative in terms of gender, age, and household income, amongst other factors. Results: Overall, 2520 adults participated. A total of 2377 adults who participated in the previous survey wave (November–December 2020) were re‐interviewed at Wave 5 (61.5% retention rate). Attrition between these two waves was predicted by younger age, lower household income, children living in the household, and treatment for mental health difficulties. Of the adults recruited into the C19PRC study at baseline, 57.4% (N = 1162) participated in Wave 5. The raking procedure re‐balanced the longitudinal panel to within 1.5% of population estimates for selected socio‐demographic characteristics. Conclusion: This paper outlines the growing strength of the publicly available C19PRC Study data for COVID‐19‐related interdisciplinary research. [ABSTRACT FROM AUTHOR]

• Systematic mass testing in closed settings provides information on infection rates. • Test positivity was 11.6%, with only one-quarter reporting symptoms. • The prison wing handling new admissions reported the second-lowest positivity rate. • Testing uptake was higher in residents than in staff members. • Mass testing is a valuable tool to bring outbreaks under control quickly. The aim of this paper was to describe the results of mass asymptomatic testing for COVID-19 in a male prison in England following the declaration of an outbreak. It provides novel data on the implementation of a mass testing regime within a prison during the pandemic. The paper is an observational evaluation of the mass testing conducted for 6 months following the declaration of a COVID-19 outbreak within a prison. It investigated the incidence of positive cases in both staff and residents using polymerase chain reaction testing. Data from October 2020 until March 2021 was included. A total of 2170 tests were performed by 851 residents and 182 staff members; uptake was 48.3% for people living in prison and 30.4% for staff. Overall test positivity was 11.6% (14.3% for residents, 3.0% for staff), with around one-quarter of these reporting symptoms. The prison wing handling new admissions reported the second-lowest positivity rate (9.4%) of the eight wings. Mass testing for COVID-19 over a short space of time can lead to rapid identification of additional cases, particularly asymptomatic cases. Testing that relies on residents and staff reporting symptoms will underestimate the true extent of transmission and will likely lead to a prolonged outbreak. [ABSTRACT FROM AUTHOR]

During the last three years, numerous research papers have been reported which use social media data to explore several issues related to the COVID-19 pandemic. Bibliometric methods in this work are used to analyze 1427 peer-reviewed documents from the last three years extracted from the Web of Science database. The results of this study show that there was high growth in publications in open access journals with an annual rate reaching 19.3% and they also identify the top cited journals and research papers. The thematic analysis of papers shows that research topics related to social media for surveillance and monitoring of public attitudes and perceptions, mental health, misinformation, and fake news are important and well-developed, whereas topics related to distance-learning education with social media are emerging. The results also show that the USA, China, and the UK have published many papers and received a high number of citations because of their strong international collaboration. [ABSTRACT FROM AUTHOR]

Simple Summary: The COVID-19 pandemic resulted in widescale changes to how UK puppy buyers purchased their puppies. Many of these changes threatened canine welfare by increasing the likelihood of buyers purchasing a puppy from a low-welfare source, e.g., collecting a puppy away from its place of birth or without seeing their mother, both of which are currently illegal in the UK. However, whether these puppy-purchasing changes were limited only to the 2020 'peak pandemic' phase and had returned to their pre-pandemic baseline afterwards or had persisted into the later phases of the pandemic in 2021 was not known. This study explored how and why puppies were purchased in 2021 and then compared this to the same date-periods in 2020 and 2019. Valid responses were analysed from the owners of 1148 "2019 puppies", 4369 "2020 Pandemic Puppies", and 2080 "2021 puppies". Although some of the peak pandemic changes had returned to pre-pandemic levels in 2021, some worrying trends still persisted, including 2021 puppies being less likely to be viewed in-person pre-purchase or to be collected from inside their breeders' property, compared to 2019 puppies. Furthermore, concerning year-on-year increases were documented between 2019 and 2021 in the number of puppies being sold with a passport indicating importation to the UK, often under the minimum legal age for import. The issues identified in this paper require further monitoring and intervention to protect canine welfare in the future. The COVID-19 pandemic led to a surge in acquisitions of puppies in the UK, dubbed the "Pandemic Puppy" phenomenon. In addition to an increased demand for puppies, widespread changes to both why and how puppies were purchased during this period compared to pre-pandemic 2019 purchases were documented, many of which threatened canine welfare (e.g., puppies being collected away from their place of birth, without seeing their mother). This study aimed to explore which changes to the pre-purchase and purchase motivations and behaviours of UK owners who purchased a puppy aged <16 weeks in the 2020 phase of the COVID-19 pandemic had persisted into 2021 or had returned to pre-pandemic 2019 levels. An online survey was conducted during February to April 2022 from which 2080 valid responses were analysed ("2021 puppies") and compared with previously collected data from comparable cohorts in 2019 (n = 1148, "2019 puppies") and 2020 (n = 4369, "Pandemic Puppies"). While the majority of the peak pandemic changes documented in 2020 had returned to their 2019 pre-pandemic baseline, others persisted into 2021. Multinomial logistic regression models revealed that the shifts during 2020 towards owners viewing their puppy pre-purchase over video calls or via video recordings/photos rather than in-person and towards collecting their puppy from outside of their breeders' property rather than inside had persisted into 2021 and had not returned to pre-pandemic levels. Year-on-year significant rises in the number of puppies sold with a passport were documented between 2019 and 2021, with over 1 in 10 2021 puppies having been sold with a passport, the figure more than doubling since 2019. An increasing number of these puppies sold with a passport were under the minimum legal age for import at sale. Going forward, these concerning changes require further monitoring and human behaviour change interventions to tackle, including increased buyer awareness but also legislative approaches to prevent the greatest harm. [ABSTRACT FROM AUTHOR]

Previous research has suggested that older trans and gender non-conforming (TGNC) people may face particular challenges related to stigma, social exclusion and discrimination in later life. However, direct data on social support and needs in older TGNC population both internationally and within the UK is limited due to the small, dispersed nature of this population, and the absence of specific data collection on aging TGNC populations. During the UK COVID-19 lockdown in summer 2020, older people and those with long-term health conditions were advised to adopt particular precautions. This study aimed to explore older TGNC people's social support networks, key concerns and unmet needs during the COVID-19 'lockdown'. A UK cross-sectional survey of LGBT + people aged 60+ (n = 375) was undertaken during the lockdown. This paper analyses responses from the subset (n = 38) of TGNC participants. The majority of TGNC respondents described diverse social networks, often centered around friends and non-kin social networks, although partners and adult children were also significant for some. In most cases, those with existing strong networks continued to maintain social connections during lockdown, albeit with some regrets about loss of activities and face-to-face connection. However, a minority of respondents had experienced greater challenges prior to lockdown, and may have been at increased vulnerability during the pandemic, for example indicating that they had no-one to call on for practical support in an emergency. When asked about unmet needs and challenges, social isolation was repeatedly raised as the most frequent concern. Several respondents also mentioned issues specifically affecting TGNC communities, including access to gender affirming care and a perceived rise in social intolerance. Health and social care providers should be aware of the diversity of support networks within TGNC communities. There may also be benefits in community sector interventions to help older TGNC build and maintain strong social networks. [ABSTRACT FROM AUTHOR]

Introduction: A range of nonpharmaceutical public health interventions has been introduced in many countries following the rapid spread of Covid‐19 since 2020, including recommendations or mandates for the use of face masks or coverings in the community. While the effectiveness of face masks in reducing Covid‐19 transmission has been extensively discussed, scant attention has been paid to the lived experience of those wearing face masks. Method: Drawing on 40 narrative interviews with a purposive sample of people in the United Kingdom, with a particular focus on marginalised and minoritized groups, our paper explores experiences of face mask use during the pandemic. Results: We find that face masks have a range of societal, health and safety impacts, and prompted positive and negative emotional responses for users. We map our findings onto Lorenc and Oliver's framework for intervention risks. We suggest that qualitative data offer particular insights into the experiences of public health interventions, allowing the potential downsides and risks of interventions to be more fully considered and informing public health policies that might avoid inadvertent harm, particularly towards marginalised groups. Patient or Public Contribution: The study primarily involved members of the public in the conduct of the research, namely through participation in interviews (email and telephone). The conception for the study involved extensive discussions on social media with a range of people, and we received input and ideas from presentations we delivered on the preliminary analysis. [ABSTRACT FROM AUTHOR]

The mathematical interpretation of interventions for the mitigation of epidemics in the literature often involves finding the optimal time to initiate an intervention and/or the use of the number of infections to manage impact. Whilst these methods may work in theory, in order to implement effectively they may require information which is not likely to be available in the midst of an epidemic, or they may require impeccable data about infection levels in the community. In reality, testing and cases data can only be as good as the policy of implementation and the compliance of the individuals, which implies that accurately estimating the levels of infections becomes difficult or complicated from the data that is provided. In this paper, we demonstrate a different approach to the mathematical modelling of interventions, not based on optimality or cases, but based on demand and capacity of hospitals who have to deal with the epidemic on a day to day basis. In particular, we use data-driven modelling to calibrate a susceptible-exposed-infectious-recovered-died type model to infer parameters that depict the dynamics of the epidemic in several regions of the UK. We use the calibrated parameters for forecasting scenarios and understand, given a maximum capacity of hospital healthcare services, how the timing of interventions, severity of interventions, and conditions for the releasing of interventions affect the overall epidemic-picture. We provide an optimisation method to capture when, in terms of healthcare demand, an intervention should be put into place given a maximum capacity on the service. By using an equivalent agent-based approach, we demonstrate uncertainty quantification on the likelihood that capacity is not breached, by how much if it does, and the limit on demand that almost guarantees capacity is not breached. [ABSTRACT FROM AUTHOR]

This paper aims at modeling the COVID-19 spread in the United Kingdom and United States of America, by specifying an optimal statistical univarite model. A new lifetime distribution with three-parameters is introduced by a combination of inverse Rayleigh distribution and oddWeibull family of distributions to formulate the odd Weibull inverse Rayleigh (OWIR) distribution. Some of the mathematical properties of the OWIR distribution are discussed as linear representation, quantile, moments, function of moment production, hazard rate, stress-strength reliability, and order statistics. Maximum likelihood, maximum product spacing, and Bayesian estimation method are applied to estimate the unknown parameters of OWIR distribution. The parameters of the OWIR distribution are estimated under progressive type-II censoring scheme with random removal. A numerical results of a Monte Carlo simulation is obtained to assess the use of estimation methods. [ABSTRACT FROM AUTHOR]

Public health policy often involves a trade-off between promoting population health and protecting the interests of identifiable individuals. This paper analyses this tradeoff as it arises in the context of decisions about the vaccination of children against Covid-19, where vaccination may be in the interests of society as a whole, as a means to stopping transmission, but not in the interests of individual children. The paper argues that the UK's Joint Committee on Vaccination and Immunisation resolved this tension by appeal to a version of a non-maleficence principle. It argues that, while this principle can be a useful guide to some public health policy decision-making, it is inappropriate in the case of vaccination. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has presented unique challenges for rapidly designing, initiating, and delivering therapeutic clinical trials. PRINCIPLE (Platform Randomised Trial of Treatments in the Community for Epidemic and Pandemic Illnesses) is the UK national platform investigating repurposed therapies for COVID-19 treatment of older people in the community at high risk of complications. Standard methods of patient recruitment were failing to meet the required pace and scale of enrolment. This paper describes the development and appraisal of a near real-time, data-driven, ethical approach for enhancing recruitment in community care by contacting people with a recent COVID-19 positive test result from the central NHS Test and Trace service within approximately 24-48 h of their test result.Methods: A multi-disciplinary team was formed to solve the technical, ethical, public perception, logistical and information governance issues required to provide a near-real time (approximately within 24-48 h of receiving a positive test) feed of potential trial participants from test result data to the research team. PRINCIPLE was also given unique access to the Summary Care Record (SCR) to ensure safe prescribing, and to enable the trial team to quickly and safely bring consented patients into the trial. A survey of the public was used to understand public perceptions of the use of test data for this proposed methodology.Results: Prior to establishing the data service, PRINCIPLE registered on average 87 participants per week. This increased by up to 87 additional people registered per week from the test data, contributing to an increase from 1013 recruits to PRINCIPLE at the start of October 2020 to 2802 recruits by 20 December 2020. Whilst procedural caveats were identified by the public consultation, out of 2639 people contacted by PRINCIPLE following a positive test result, no one raised a concern about being approached.Conclusions: This paper describes a novel approach to using near-real time NHS operational data to recruit community-based patients within a few days of presentation with acute illness. This approach increased recruitment and reduced time between positive test and randomisation, allowing more rapid evaluation of treatments and increased safety for participants. End-to-end public and patient involvement in the design of the approach provided evidence to inform information governance decisions.Trial Registration: PRINCIPLE is funded by UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research. EudraCT number: 2020-001209-22 . 26/03/2020 ISRCTN registry: ISRCTN86534580 . 20/03/2020 REC number: 20/SC/058 IRAS number: 281958. [ABSTRACT FROM AUTHOR]

The COVID‐19 health crisis has imposed extensive shocks to many global systems, particularly the UK food production chains, further challenging Eurocentric development discourses and stereotypes. Thus, this paper investigates how the pandemic has challenged the UK's development status by analysing how the pandemic has impacted the country's food industry. A literature review was conducted and used to identify, select and critically appraise publications between 2000 and 2021 discussing the challenges in the UK food system. The findings reveal that the UK's food industry is unsustainable as there are significant flaws in the system, that is food insecurity and food waste that go unaddressed. The impact of the pandemic has exacerbated the social and economic impacts of operating with such a system. Compounded with the geopolitical adjustments caused by Brexit, the UK is faced with the challenge of restructuring and developing new frameworks such as policies, regulations, schemes and partnerships to support the food industry's sustainability. Lastly, the findings reinforce that 'developed' and 'developing' nations encounter similar food challenges, which manifest differently in various landscapes and contexts. Therefore, the world (not just the UK) needs to shift away from Eurocentrism, moving towards a universal but equally personalised development outlook. This review provides an outline of the major problem areas in the UK food system and presents potential solutions aimed at helping guide the government's decision‐making process. [ABSTRACT FROM AUTHOR]

Objectives: The COVID‐19 Psychological Research Consortium (C19PRC) Study aims to assess the impact of the COVID‐19 pandemic in the adult population in multiple countries. This paper describes the third wave of the UK survey (the 'parent' strand of the Consortium) during July‐August 2020. Methods: Adults (N = 2025) who participated in the baseline and/or first follow‐up surveys were reinvited to participate in this survey, which assessed: (1) COVID‐19 related knowledge, attitudes, and behaviours; (2) the occurrence of common mental disorders; as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public's response to the pandemic. Weights were calculated using a survey raking algorithm to ensure that the cross‐sectional sample is nationally representative in terms of gender, age, and household income, and representative of the baseline sample characteristics for household composition, ethnicity, urbanicity and born/raised in UK. Results: 1166 adults (57.6% of baseline participants) provided full interviews at Wave 3. The raking procedure successfully re‐balanced the cross‐sectional sample to within 1% of population estimates across selected socio‐demographic characteristics. Conclusion: This paper demonstrates the strength of the C19PRC Study data to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Clinical research infrastructure is one of the unsung heroes of the scientific response to the current COVID-19 pandemic. The extensive, long-term funding into research support structures, skilled people, and technology allowed the United Kingdom research response to move off the starting blocks at pace by utilizing pre-existing platforms. The increasing focus from funders on evaluating the outcomes and impact of research infrastructure investment requires both a reframing and progression of the current models in order to address the contribution of the underlying support infrastructure. The majority of current evaluation/outcome models focus on a "pipeline" approach using a methodology which follows the traditional research funding route with the addition of quantitative metrics. These models fail to embrace the complexity caused by the interplay of previous investment, the coalescing of project outputs from different funders, the underlying infrastructure investment, and the parallel development across different parts of the system. Research infrastructure is the underpinning foundation of a project-driven research system and requires long-term, sustained funding and capital investment to maintain scientific and technological expertise. Therefore, the short-term focus on quantitative metrics that are easy to collect and interpret and that can be assessed in a roughly 5-year funding cycle needs to be addressed. The significant level of investment in research infrastructure necessitates investment to develop bespoke methodologies that develop fit-for-purpose, longer-term/continual approach(es) to evaluation. Real-world research should reflect real-world evaluation and allow for the accrual of a narrative of value indicators that build a picture of the contribution of infrastructure to research outcomes. The linear approach is not fit for purpose, the research endeavour is a complex, twisted road, and the evaluation approach needs to embrace this complexity through the development of realist approaches and the rapidly evolving data ecosystem. This paper sets out methodological challenges and considers the need to develop bespoke methodological approaches to allow a richer assessment of impact, contribution, attribution, and evaluation of research infrastructure. This paper is the beginning of a conversation that invites the community to "take up the mantle" and tackle the complexity of real-world research translation and evaluation. [ABSTRACT FROM AUTHOR]

Nurse, Midwives and Allied Health Professionals (AHPs), along with other health and social care colleagues are the backbone of healthcare services. They have played a key role in responding to the increased demands on healthcare during the COVID-19 pandemic. This paper compares cross-sectional data on quality of working life, wellbeing, coping and burnout of nurses, midwives and AHPs in the United Kingdom (UK) at two time points during the COVID-19 pandemic. An anonymous online repeated cross-sectional survey was conducted at two timepoints, Phase 1 (7th May 2020-3rd July 2020); Phase 2 (17th November 2020-1st February 2021). The survey consisted of the Short Warwick-Edinburgh Mental Wellbeing Scale, the Work-Related Quality of Life Scale, and the Copenhagen Burnout Inventory (Phase 2 only) to measure wellbeing, quality of working life and burnout. The Brief COPE scale and Strategies for Coping with Work and Family Stressors scale assessed coping strategies. Descriptive statistics and multiple linear regressions examined the effects of coping strategies and demographic and work-related variables on wellbeing and quality of working life. A total of 1839 nurses, midwives and AHPs responded to the first or second survey, with a final sample of 1410 respondents -586 from Phase 1; 824 from Phase 2, (422 nurses, 192 midwives and 796 AHPs). Wellbeing and quality of working life scores were significantly lower in the Phase 2 sample compared to respondents in Phase 1 (p<0.001). The COVID-19 pandemic had a significant effect on psychological wellbeing and quality of working life which decreased while the use of negative coping and burnout of these healthcare professionals increased. Health services are now trying to respond to the needs of patients with COVID-19 variants while rebuilding services and tackling the backlog of normal care provision. This workforce would benefit from additional support/services to prevent further deterioration in mental health and wellbeing and optimise workforce retention. [ABSTRACT FROM AUTHOR]

Background: Researchers conducting cohort studies may wish to investigate the effect of episodes of COVID-19 illness on participants. A definitive diagnosis of COVID-19 is not always available, so studies have to rely on proxy indicators. This paper seeks to contribute evidence that may assist the use and interpretation of these COVID-indicators.Methods: We described five potential COVID-indicators: self-reported core symptoms, a symptom algorithm; self-reported suspicion of COVID-19; self-reported external results; and home antibody testing based on a 'lateral flow' antibody (IgG/IgM) test cassette. Included were staff and postgraduate research students at a large London university who volunteered for the study and were living in the UK in June 2020. Excluded were those who did not return a valid antibody test result. We provide descriptive statistics of prevalence and overlap of the five indicators.Results: Core symptoms were the most common COVID-indicator (770/1882 participants positive, 41%), followed by suspicion of COVID-19 (n = 509/1882, 27%), a positive symptom algorithm (n = 298/1882, 16%), study antibody lateral flow positive (n = 124/1882, 7%) and a positive external test result (n = 39/1882, 2%), thus a 20-fold difference between least and most common. Meeting any one indicator increased the likelihood of all others, with concordance between 65 and 94%. Report of a low suspicion of having had COVID-19 predicted a negative antibody test in 98%, but positive suspicion predicted a positive antibody test in only 20%. Those who reported previous external antibody tests were more likely to have received a positive result from the external test (24%) than the study test (15%).Conclusions: Our results support the use of proxy indicators of past COVID-19, with the caveat that none is perfect. Differences from previous antibody studies, most significantly in lower proportions of participants positive for antibodies, may be partly due to a decline in antibody detection over time. Subsequent to our study, vaccination may have further complicated the interpretation of COVID-indicators, only strengthening the need to critically evaluate what criteria should be used to define COVID-19 cases when designing studies and interpreting study results. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has affected how clinical trials are managed, both within existing portfolios and for the rapidly developed COVID-19 trials. Sponsors or delegated organisations responsible for monitoring trials have needed to consider and implement alternative ways of working due to the national infection risk necessitating restricted movement of staff and public, reduced clinical staff resource as research staff moved to clinical areas, and amended working arrangements for sponsor and sponsor delegates as staff moved to working from home.Organisations have often worked in isolation to fast track mitigations required for the conduct of clinical trials during the pandemic; this paper describes many of the learnings from a group of monitoring leads based in United Kingdom Clinical Research Collaboration (UKCRC) Clinical Trials Unit (CTUs) within the UK.The UKCRC Monitoring Task and Finish Group, comprising monitoring leads from 9 CTUs, met repeatedly to identify how COVID-19 had affected clinical trial monitoring. Informed consent is included as a specific issue within this paper, as review of completed consent documentation is often required within trial monitoring plans (TMPs). Monitoring is defined as involving on-site monitoring, central monitoring or/and remote monitoring.Monitoring, required to protect the safety of the patients and the integrity of the trial and ensure the protocol is followed, is often best done by a combination of central, remote and on-site monitoring. However, if on-site monitoring is not possible, workable solutions can be found using only central or central and remote monitoring. eConsent, consent by a third person, or via remote means is plausible. Minimising datasets to the critical data reduces workload for sites and CTU staff. Home working caused by COVID-19 has made electronic trial master files (TMFs) more inviting. Allowing sites to book and attend protocol training at a time convenient to them has been successful and worth pursuing for trials with many sites in the future.The arrival of COVID-19 in the UK has forced consideration of and changes to how clinical trials are conducted in relation to monitoring. Some developed practices will be useful in other pandemics and others should be incorporated into regular use. [ABSTRACT FROM AUTHOR]

The current paper describes an adaptation of a daypatient programme for adults with anorexia nervosa in the UK in response to the COVID-19 pandemic and consequent government guidelines. The paper details how the programme, which is normally delivered face-to-face, became a 'virtual' clinic, providing support to a group of patients via the Internet and conducting its core activities almost exclusively via videoconferencing. Anxiety around the pandemic influenced patients' feelings about recovery, and there were concerns about the programme moving online, which necessitated careful management. It has been possible to continue an intensive level of care given wider organisational backing and the support of the patients involved. Some of the patients' reflections on the experience are included in the article. As well as the adaptations, the article also discusses some of the challenges and opportunities encountered, in the hope of guiding similar services. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has been characterized by a social media "infodemic": an overabundance of information whose authenticity may not always be guaranteed. With the potential to lead individuals to harmful decisions for the society, this infodemic represents a severe threat to information security, public health and democracy. In this paper, we assess the interplay between the infodemic and specific aspects of the pandemic, such as the number of cases, the strictness of containment measures, and the news media coverage. We perform a comparative study on three countries that employed different managements of the COVID-19 pandemic in 2020—namely Italy, the United Kingdom, and New Zealand. We first analyze the three countries from an epidemiological perspective to characterize the impact of the pandemic and the strictness of the restrictions adopted. Then, we collect a total of 6 million posts from Facebook to describe user news consumption behaviors with respect to the reliability of such posts. Finally, we quantify the relationship between the number of posts published in each of the three countries and the number of confirmed cases, the strictness of the restrictions adopted, and the online news media coverage about the pandemic. Our results show that posts referring to reliable sources are consistently predominant in the news circulation, and that users engage more with reliable posts rather than with posts referring to questionable sources. Furthermore, our modelling results suggest that factors related to the epidemiological and informational ecosystems can serve as proxies to assess the evolution of the infodemic. [ABSTRACT FROM AUTHOR]

This paper shows how existing methods of time series analysis and modeling can be exploited in novel ways to monitor and forecast the COVID-19 epidemic. In the past, epidemics have been monitored by various statistical and model metrics, such as evaluation of the effective reproduction number, R (t). However, R (t) can be difficult and time consuming to compute. This paper suggests two relatively simple data-based metrics that could be used in conjunction with R (t) estimation and provide rapid indicators of how the epidemic's dynamic behavior is progressing. The new metrics are the epidemic rate of change (RC) and a related state-dependent response rate parameter (RP), recursive estimates of which are obtained from dynamic harmonic and dynamic linear regression (DHR and DLR) algorithms. Their effectiveness is illustrated by the analysis of COVID-19 data in the UK and Italy. The paper also shows how similar methodology, combined with the refined instrumental variable method for estimating hybrid Box–Jenkins models of linear dynamic systems (RIVC), can be used to relate the daily death numbers in the Italian and UK epidemics and then provide 15-day-ahead forecasts of the UK daily death numbers. The same approach can be used to model and forecast the UK epidemic based on the daily number of COVID-19 patients in UK hospitals. Finally, the paper speculates on how the state-dependent parameter (SDP) modeling procedures may provide data-based insight into a nonlinear differential equation model for epidemics such as COVID-19. [ABSTRACT FROM AUTHOR]

Background The dissemination of scientific data on coronavirus disease 2019 (COVID-19) continually builds but, in April 2020, could not keep up with the spread of the disease. Through technology, surgeons in Italy and the UK, representing both peak and pre-peak infective time zones, were able to communicate so that the urgent lessons on the huge expected demands of care learned in Italy could be brought to the UK in advance. This paper specifically discusses the issues related to paediatric surgery, currently under-reported in the literature. Methods The aim of this paper is to conjoin experience from the field to provide a framework for a safe assessment and treatment of paediatric patients by adopting a systemic approach aimed at reducing the risk of contamination. We reviewed the processes and good practices that were undertaken in contexts of emergency such as in Italy and the UK and then adapted them within the Systems Engineering Initiative for Patient Safety (SEIPS) framework to provide an assessment of how to reorganize the services in order to cope with an unexpected situation. The SEIPS model is the adopted theoretical framework, which allows to analyse the system in its main components with a human factors and ergonomics (HFE) perspective. Results The results introduce some of the good practices and recommendations developed during the emergency in the surgical scenario with a focus on the paediatric patients. They represent the lessons learned from the combination of the little existing evidence of literature and the experience from surgical teams who responded in an impromptu and unrehearsed way. Conclusions Lessons learned from the frontline 'on the fly' during COVID-19 emergency should be consolidated and taken into the future. In order to prepare proactively for the next phases and get ahead of the curve of these hospital accesses, there is a need for a risk assessment of the new clinical pathways with a multidisciplinary approach centred on HFE with the adoption of the SEIPS model and an involvement of all the surgical teams. [ABSTRACT FROM AUTHOR]

This paper describes and analyses the response of UK civil society in the early months of the Covid-19 crisis, roughly the period March to July 2020. While focussing primarily on civil society actors, the paper includes an exploration of how civil society and the national government interacted with each other. It considers the extent to which responses to the Covid-19 crisis reflect familiar patterns of behaviour by civil society in the UK, and in the relationship between the government and 'third sector'. The paper concludes by pointing to emergent issues for civil society as the UK looked towards recovery from the initial wave of crisis. [ABSTRACT FROM AUTHOR]

In early 2020 a wide range of social and economic restrictions were implemented in most countries in response to the global coronavirus pandemic (Covid-19). This paper uses national electricity generation data to examine the extent to which overall British electricity consumption deviated from 'normal' consumption patterns during the UK's spring lockdown period, and how the combination of consumption reduction and variation in carbon intensity affected greenhouse gas emissions (GHG) associated with electricity consumption. The paper shows that ongoing trends in the reduction of electricity demand and generation carbon intensity mean that lower year-on-year demand and lower emissions would have been expected even in the absence of Covid-19. Controlling for this, the paper estimates lockdowndriven below-trend electricity reductions of up to 20% in the morning peak period, 11% in the daytime and 9% in the evening peak period in April, declining to 6%, 4% and 4%, respectively, by June. These correspond to marked reductions in morning (06:00-08:00 hours) and daytime demand during all restriction periods studied, but relatively smaller reductions in evening demand, and some evidence of a relative increase on Friday and Saturday evenings. [ABSTRACT FROM AUTHOR]

Effective and culturally appropriate hand-hygiene education is essential to promote health-related practices to control and prevent diseases such as Diarrhoea, Ebola and COVID-19. In this paper we outline and evaluate the Co-Creation processes underpinning a handwashing intervention for young children (A Germ's Journey) developed and delivered in India, Sierra Leone and the UK, and consider the implications surrounding Imperialist/Colonial discourse and the White Saviour Complex. The paper focuses both on the ways Co-Creation was conceptualised by our collaborators in all three countries and the catalysts and challenges encountered. Qualitative data have been drawn from in-depth interviews with five key stakeholders, focus group data from 37 teachers in Sierra Leone and responses to open-ended questionnaires completed by teachers in India (N = 66) and UK (N = 63). Data were analysed using thematic analysis and three themes, each with three constituent subthemes are presented. In the theme 'Representations of and Unique Approaches to Co-Creation' we explore the ways in which Co-Creation was constructed in relation to teamwork, innovative practice and more continuous models of evaluation. In 'Advantages of Co-Creation' we consider issues around shared ownership, improved outcomes and more meaningful insights alongside the mitigation of risks and short-circuiting of problems. In 'Challenges of Co-Creation' we discuss issues around timing and organisation, attracting and working with appropriate partners and understanding the importance of local context with inherent social, economic and structural barriers, especially in low-and-middle-income countries. We consider how theoretical elements of Co-Creation can inform effective international public health interventions; crucial during a global pandemic in which handwashing is the most effective method to control the transmission of COVID-19. Finally we reflect on some of the methodological challenges of our own work and in managing the potentially conflicting goals of the ethical and participatory values of Co-Creation with pragmatic considerations about ensuring an effective final 'product'. [ABSTRACT FROM AUTHOR]

In this paper, we take up the call to further examine structural injustice in health, and racial inequalities in particular. We examine the many facets of racism: structural, interpersonal and institutional as they appeared in the COVID‐19 pandemic in the UK, and emphasize the relevance of their systemic character. We suggest that such inequalities were entirely foreseeable, for their causal mechanisms are deeply ingrained in our social structures. It is by recognizing the conventional, un‐extraordinary nature of racism within social systems that we can begin to address socially mediated health inequalities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused huge and disruptive technological changes in the healthcare sector, transforming the way businesses and societies function. To respond to the global health crisis, there have been numerous innovation projects in the healthcare sector, including the fast design and manufacturing of personal protective equipment (PPE) and medical devices, and testing, treatment, and vaccine technologies. Many of these innovative activities happen beyond organizational boundaries with collaboration and open innovation. In this paper, we review the current literature on open innovation strategy during the pandemic and adopt the co-evolution view of business ecosystems to address the context of change. Based on a detailed exploration of the COVID-19-related technologies in the UK and global healthcare sectors, we identify the key emerging themes of open innovation in crisis. Further discussions are conducted in relation to each theme. Our results and analysis can help provide policy recommendations for the healthcare sector, businesses, and society to recover from the crisis. [ABSTRACT FROM AUTHOR]

Background vaccination uptake in the UK and increased care home testing are likely affecting care home visitation. With scant scientific evidence to date, the aim of this longitudinal qualitative study was to explore the impact of both (vaccination and testing) on the conduct and experiences of care home visits. Methods family carers of care home residents with dementia and care home staff from across the UK took part in baseline (October/November 2020) and follow-up interviews (March 2021). Public advisers were involved in all elements of the research. Data were analysed using thematic analysis. Results across 62 baseline and follow-up interviews with family carers (n  = 26; 11) and care home staff (n  = 16; 9), five core themes were developed: delayed and inconsistent offers of face-to-face visits; procedures and facilitation of visits; variable uptake of the COVID-19 vaccine; misinformation, education and free choice; frustration and anger among family carers. The variable uptake in staff, compared to family carers, was a key factor seemingly influencing visitation, with a lack of clear guidance leading care homes to implement infection control measures and visitation rights differently. Conclusions we make five recommendations in this paper to enable improved care home visitation in the ongoing, and in future, pandemics. Visits need to be enabled and any changes to visiting rights must be used as a last resort, reviewed regularly in consultation with residents and carers and restored as soon as possible as a top priority, whilst more education needs to be provided surrounding vaccination for care home staff. [ABSTRACT FROM AUTHOR]

The objective of this paper is to model lost Quality Adjusted Life Years (QALYs) from symptoms arising from COVID-19 disease in the UK population, including symptoms of 'long-COVID'. The scope includes QALYs lost to symptoms, but not deaths, due to acute COVID-19 and long-COVID. The prevalence of symptomatic COVID-19, encompassing acute symptoms and long-COVID symptoms, was modelled using a decay function. Permanent injury as a result of COVID-19 infection, was modelled as a fixed prevalence. Both parts were combined to calculate QALY loss due to COVID-19 symptoms. Assuming a 60% final attack rate for SARS-CoV-2 infection in the population, we modelled 299,730 QALYs lost within 1 year of infection (90% due to symptomatic COVID-19 and 10% permanent injury) and 557,764 QALYs lost within 10 years of infection (49% due to symptomatic COVID-19 and 51% due to permanent injury). The UK Government willingness-to-pay to avoid these QALY losses would be £17.9 billion and £32.2 billion, respectively. Additionally, 90,143 people were subject to permanent injury from COVID-19 (0.14% of the population). Given the ongoing development in information in this area, we present a model framework for calculating the health economic impacts of symptoms following SARS-CoV-2 infection. This model framework can aid in quantifying the adverse health impact of COVID-19, long-COVID and permanent injury following COVID-19 in society and assist the proactive management of risk posed to health. Further research is needed using standardised measures of patient reported outcomes relevant to long-COVID and applied at a population level. [ABSTRACT FROM AUTHOR]

Understanding and monitoring the epidemiological time delay dynamics of SARS-CoV-2 infection provides insights that are key to discerning changes in the phenotype of the virus, the demographics impacted, the efficacy of treatment, and the ability of the health service to manage large volumes of patients. This paper analyses how the pandemic has evolved in the United Kingdom through the temporal changes to the epidemiological time delay distributions for clinical outcomes. Using the most complete clinical data presently available, we have analysed, through a doubly interval censored Bayesian modelling approach, the time from infection to a clinical outcome. Across the pandemic, for the periods that were defined as epidemiologically distinct, the modelled mean ranges from 8.0 to 9.7 days for infection to hospitalisation, 10.3 to 15.0 days for hospitalisation to death, and 17.4 to 24.7 days for infection to death. The time delay from infection to hospitalisation has increased since the first wave of the pandemic. A marked decrease was observed in the time from hospitalisation to death and infection to death at times of high incidence when hospitals and ICUs were under the most pressure. There is a clear relationship between age groups that is indicative of the youngest and oldest demographics having the shortest time delay distributions before a clinical outcome. A statistically significant difference was found between genders for the time delay from infection to hospitalisation, which was not found for hospitalisation to death. The results by age group indicate that younger demographics that require clinical intervention for SARS-CoV-2 infection are more likely to require earlier hospitalisation that leads to a shorter time to death, which is suggestive of the largely more vulnerable nature of these individuals that succumb to infection. The distinction found between genders for exposure to hospitalisation is revealing of gender healthcare seeking behaviours. [ABSTRACT FROM AUTHOR]

Emerging voices of patients in the form of opinions and expectations about the quality of care can improve healthcare service quality. A large volume of patients’ opinions as online doctor reviews (ODRs) are available online to access, analyze, and improve patients’ perceptions. This paper aims to explore COVID-19-related conversations, complaints, and sentiments using ODRs posted by users of the physician rating website. We analyzed 96,234 ODRs of 5,621 physicians from a prominent health rating website in the United Kingdom (Iwantgreatcare.org) in threetime slices (i.e., from February 01 to October 31, 2020). We employed machine learning approach, dynamic topic modeling, to identify prominent bigrams, salient topics and labels, sentiments embedded in reviews and topics, and patient-perceived root cause and strengths, weaknesses, opportunities, and threats (SWOT) analyses to examine SWOT for healthcare organizations. This method finds a total of 30 latent topics with 10 topics across each time slice. The current study identified new discussion topics about COVID-19 occurring from time slice 1 to time slice 3, such as news about the COVID-19 pandemic, violence against the lockdown, quarantine process and quarantine centers at different locations, and vaccine development/treatment to stop virus spread. Sentiment analysis reveals that fear for novel pathogen prevails across all topics. Based on the SWOT analysis, our findings provide a clue for doctors, hospitals, and government officials to enhance patients’ satisfaction and minimize dissatisfaction by satisfying their needs and improve the quality of care during the COVID-19 crisis. [ABSTRACT FROM AUTHOR]

Background: Occupational musculoskeletal injuries are prevalent in healthcare workers and are reported to be profession-specific. There is, however, a paucity of information around the injuries sustained from working as a podiatrist. This paper looks at the incidence of injury from working as a podiatrist, the aggravating factors to sustain these injuries and whether the changes in workload due to the COVID-19 pandemic altered the incidence. Methods: A modified work based musculoskeletal injury questionnaire was distributed in the UK via podiatry led social media platforms. Open and Closed questions explored the demographics of the sample, perceived injury 12 months prior to the COVID-19 pandemic and then 6 months into the lockdown. Pre and post COVID-19 data were analysed for differences and thematic analysis was included to categorise reported experiences. Results: 148 podiatrists representing 3 % of HCPC registered practitioners responded to the questionnaire. Employment status altered as a result of the COVID-19 pandemic with a 13 % reduction in those working full time. Environments also changed with domiciliary and telehealth significantly increasing (p > 0.00) and non-clinical roles being extended (p > 0.002). Pain frequency and intensity significantly (p > 0.04) increased as a result of the pandemic with shoulder pain being most frequent before lockdown altering to the neck during the lockdown. Two main themes were identified that were attributed to the causes of pain including physical demands and working in awkward spaces. Conclusions: Work-related musculoskeletal pain in podiatrists is common with the shoulder and neck being the most frequently affected. Changes in work practices due to the restrictions enforced from the COVID-19 pandemic increased the frequency and intensity of pain mostly associated with increased domiciliary and telehealth working environments. [ABSTRACT FROM AUTHOR]

Background: Clinical research has been central to the global response to COVID-19, and the United Kingdom (UK), with its research system embedded within the National Health Service (NHS), has been singled out globally for the scale and speed of its COVID-19 research response. This paper explores the impacts of COVID-19 on clinical research in an NHS Trust and how the embedded research system was adapted and repurposed to support the COVID-19 response. Methods and findings: Using a multi-method qualitative case study of a research-intensive NHS Trust in London UK, we collected data through a questionnaire (n = 170) and semi-structured interviews (n = 24) with research staff working in four areas: research governance; research leadership; research delivery; and patient and public involvement. We also observed key NHS Trust research prioritisation meetings (40 hours) and PPI activity (4.5 hours) and analysed documents produced by the Trust and national organisation relating to COVID-19 research. Data were analysed for a descriptive account of the Trust's COVID-19 research response and research staff's experiences. Data were then analysed thematically. Our analysis identifies three core themes: centralisation; pace of work; and new (temporary) work practices. By centralising research prioritisation at both national and Trust levels, halting non-COVID-19 research and redeploying research staff, an increased pace in the setup and delivery of COVID-19-related research was possible. National and Trust-level responses also led to widescale changes in working practices by adapting protocols and developing local processes to maintain and deliver research. These were effective practical solutions borne out of necessity and point to how the research system was able to adapt to the requirements of the pandemic. Conclusion: The Trust and national COVID-19 response entailed a rapid large-scale reorganisation of research staff, research infrastructures and research priorities. The Trust's local processes that enabled them to enact national policy prioritising COVID-19 research worked well, especially in managing finite resources, and also demonstrate the importance and adaptability of the research workforce. Such findings are useful as we consider how to adapt our healthcare delivery and research practices both at the national and global level for the future. However, as the pandemic continues, research leaders and policymakers must also take into account the short and long term impact of COVID-19 prioritisation on non-COVID-19 health research and the toll of the emergency response on research staff. [ABSTRACT FROM AUTHOR]

Notable cross-country differences exist in the diffusion of the Covid-19 and in its lethality. Contact patterns in populations, and in particular intergenerational contacts, have been argued to be responsible for the most vulnerable, the elderly, getting infected more often and thus driving up mortality in some context, like in the southern European one. This paper asks a simple question: is it between whom contacts occur that matters or is it simply how many contacts people have? Due to the high number of confounding factors, it is extremely difficult to empirically assess the impact of single network features separately. This is why we rely on a simulation exercise in which we counterfactually manipulate single aspects of countries' age distribution and network structures. We disentangle the contributions of the kind and of the number of contacts while holding constant the age structure. More precisely, we isolate the respective effects of inter-age contact patterns, degree distribution and clustering on the virus propagation across age groups. We use survey data on face-to-face contacts for Great Britain, Italy, and Germany, to reconstruct networks that mirror empirical contact patterns in these three countries. It turns out that the number of social contacts (degree distribution) largely accounts for the higher infection rates of the elderly in the Italian context, while differences in inter-age contacts patterns are only responsible for minor differences. This suggests that policies specifically targeting inter-age contacts would be little effective. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reproduction number has become an essential parameter for monitoring disease transmission across settings and guiding interventions. The UK published weekly estimates of the reproduction number in the UK starting in May 2020 which are formed from multiple independent estimates. In this paper, we describe methods used to estimate the time-varying SARSCoV-2 reproduction number for the UK. We used multiple data sources and estimated a serial interval distribution from published studies. We describe regional variability and how estimates evolved during the early phases of the outbreak, until the relaxing of social distancing measures began to be introduced in early July. Our analysis is able to guide localized control and provides a longitudinal example of applying these methods over long timescales. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak is of great concern due to the high rates of infection and the large number of deaths worldwide. In this paper, we considered a Bayesian inference and failure mode and effects analysis of the modified susceptible-exposed-infectious-removed model for the transmission dynamics of COVID-19 with an exponentially distributed infectious period. We estimated the effective reproduction number based on laboratory-confirmed cases and death data using Bayesian inference and analyse the impact of the community spread of COVID-19 across the United Kingdom. We used the failure mode and effects analysis tool to evaluate the effectiveness of the action measures taken to manage the COVID-19 pandemic. We focused on COVID-19 infections and therefore the failure mode is taken as positive cases. The model is applied to COVID-19 data showing the effectiveness of interventions adopted to control the epidemic by reducing the reproduction number of COVID-19. Results have shown that the combination of Bayesian inference, compartmental modelling and failure mode and effects analysis is effective in modelling and studying the risks of COVID-19 transmissions, leading to the quantitative evaluation of the action measures and the identification of the lessons learned from the governmental measures and actions taken in response to COVID-19 in the United Kingdom. Analytical and numerical methods are used to highlight the practical implications of our findings. The proposed methodology will find applications in current and future COVID-19 like pandemics and wide quality engineering. [ABSTRACT FROM AUTHOR]

LINKED CONTENT This article is linked to Taxonera et al paper. To view this article, visit https://doi.org/10.1111/apt.15804 [ABSTRACT FROM AUTHOR]

Background: During the 2020 COVID‐19 pandemic, one of the key components of many countries' strategies to reduce the spread of the virus is contact tracing. Objective: To explore public attitudes to a COVID‐19 contact tracing app in the United Kingdom. Setting: Online video‐conferencing. Participants: 27 participants, UK residents aged 18 years and older. Methods: Qualitative study consisting of six focus groups carried out between 1st‐12th May, 2020 (39‐50 days into the UK 'lockdown'). Results: Participants were divided as to whether or not they felt they would use the app. Analysis revealed five themes: (1) lack of information and misconceptions surrounding COVID‐19 contact tracing apps; (2) concerns over privacy; (3) concerns over stigma; (4)concerns over uptake; and (5) contact tracing as the 'greater good'. Concerns over privacy, uptake and stigma were particularly significant amongst those stated they will not be using the app, and the view that the app is for the 'greater good' was particularly significant amongst those who stated they will be using the app. One of the most common misconceptions about the app was that it could allow users to specifically identify and map COVID‐19 cases amongst their contacts and in their vicinity. Conclusions: Our participants were torn over whether digital contact tracing is a good idea or not, and views were heavily influenced by moral reasoning. Patient or Public Contribution: No patients were involved in this study. The public were not involved in the development of the research questions, research design or outcome measures. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Summary results were disseminated via email to participants prior to publication for feedback and comment. [ABSTRACT FROM AUTHOR]

Objectives: The C19PRC study aims to assess the impact of the COVID‐19 pandemic in the adult population of the UK, Republic of Ireland, and Spain. This paper describes the conduct of the first two waves of the UK survey (the "parent" strand of the Consortium) during March–April 2020. Methods: A longitudinal, internet panel survey was designed to assess: (1) COVID‐19 related knowledge, attitudes, and behaviors; (2) the occurrence of common mental health disorders as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public's response to the pandemic. Quota sampling (age, sex, and household income) was used to recruit a nationally representative sample of adults. Results: Two thousand and twenty five adults were recruited at baseline, and 1406 were followed‐up one‐month later (69.4% retention rate). The baseline sample was representative of the UK population in relation to economic activity, ethnicity, and household composition. Attrition was predicted by key socio‐demographic characteristics, and an inverse probability weighting procedure was employed to ensure the follow‐up sample was representative of the baseline sample. Conclusion: The C19PRC study data has strong generalizability to facilitate and stimulate interdisciplinary research on important public health questions relating to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak is of great concern due to the high rates of infection and the large number of deaths worldwide. In this paper, we considered a Bayesian inference and failure mode and effects analysis of the modified susceptible-exposed-infectious-removed model for the transmission dynamics of COVID-19 with an exponentially distributed infectious period. We estimated the effective reproduction number based on laboratory-confirmed cases and death data using Bayesian inference and analyse the impact of the community spread of COVID-19 across the United Kingdom. We used the failure mode and effects analysis tool to evaluate the effectiveness of the action measures taken to manage the COVID-19 pandemic. We focused on COVID-19 infections and therefore the failure mode is taken as positive cases. The model is applied to COVID-19 data showing the effectiveness of interventions adopted to control the epidemic by reducing the reproduction number of COVID-19. Results have shown that the combination of Bayesian inference, compartmental modelling and failure mode and effects analysis is effective in modelling and studying the risks of COVID-19 transmissions, leading to the quantitative evaluation of the action measures and the identification of the lessons learned from the governmental measures and actions taken in response to COVID-19 in the United Kingdom. Analytical and numerical methods are used to highlight the practical implications of our findings. The proposed methodology will find applications in current and future COVID-19 like pandemics and wide quality engineering. [ABSTRACT FROM AUTHOR]

Objective: The Covid-19 pandemic has wrought disruption to everyday life and services, and emerging evidence suggests that those with eating disorders (EDs) are likely to experience marked distress and exacerbation of their symptoms. However, little is known around the most relevant factors to symptom change; whether certain emotion regulation and coping strategies are linked to better outcomes; and how people with EDs are adjusting to psychological interventions moving online. Method: In a mixed-method design, we collected qualitative and quantitative data from 207 (76 males) self-selected UK residents with self-reported ED, who described and ranked impacts of the pandemic on their symptoms. Regression analysis examined whether emotion regulation strategies were associated with self-reported symptom change, ED symptomatology, and negative emotional states. Thematic analysis explored participants' experiences of the pandemic, particularly factors affecting their ED, coping strategies used, and experiences of psychological intervention. Results: Most participants (83.1%) reported worsening of ED symptomatology, though factors affecting symptom change differed between specific EDs. Emotion regulation, such as having fewer strategies, poorer emotional clarity, and non-acceptance of emotions, explained nearly half of the variance in emotional distress during the pandemic. Qualitative findings indicated that difficult emotions (such as fear and uncertainty), changes to routine, and unhelpful social messages were triggering for participants during the pandemic. While some participants described employing positive coping strategies (such as limiting social media exposure), many reported using ED behaviours (among other maladaptive strategies, like alcohol use) to cope with the pandemic. Finally, loss of treatment support, feeling underserving of support and experiencing a 'detached connection' online were further exacerbating factors for these participants. Discussion: While our sample was self-selected and may not represent all people with EDs, our results suggest that people with EDs have been strongly affected by the pandemic. Some aspects of online treatment were found to be beneficial but our findings suggest it also needs some improvement. Our paper discusses implications for online treatment such as taking into account personal circumstances and, in a time where people have limited control over the antecedents of negative emotion, the need to develop skills to manage emotions when they arise. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak is of great concern due to the high rates of infection and the large number of deaths worldwide. In this paper, we considered a Bayesian inference and failure mode and effects analysis of the modified susceptible-exposed-infectious-removed model for the transmission dynamics of COVID-19 with an exponentially distributed infectious period. We estimated the effective reproduction number based on laboratory-confirmed cases and death data using Bayesian inference and analyse the impact of the community spread of COVID-19 across the United Kingdom. We used the failure mode and effects analysis tool to evaluate the effectiveness of the action measures taken to manage the COVID-19 pandemic. We focused on COVID-19 infections and therefore the failure mode is taken as positive cases. The model is applied to COVID-19 data showing the effectiveness of interventions adopted to control the epidemic by reducing the reproduction number of COVID-19. Results have shown that the combination of Bayesian inference, compartmental modelling and failure mode and effects analysis is effective in modelling and studying the risks of COVID-19 transmissions, leading to the quantitative evaluation of the action measures and the identification of the lessons learned from the governmental measures and actions taken in response to COVID-19 in the United Kingdom. Analytical and numerical methods are used to highlight the practical implications of our findings. The proposed methodology will find applications in current and future COVID-19 like pandemics and wide quality engineering. [ABSTRACT FROM AUTHOR]

This paper aims to analyse the coordination and cooperation in Primary Health Care (PHC) measures adopted by the British government against the spread of the COVID-19. PHC is clearly part of the solution founded by governments across the world to fight against the spread of the virus. Data analysis was performed based on coordination, cooperation, and PHC literature crossed with documentary analysis of the situation reports released by the World Health Organisation and documents, guides, speeches and action plans on the official UK government website. The measures adopted by the United Kingdom were analysed in four periods, which helps to explain the courses of action during the pandemic: pre-first case (January 22- January 31, 2020), developing prevention measures (February 1 -February 29, 2020), first Action Plan (March 1- March 23, 2020) and lockdown (March 24-May 6, 2020). Despite the lack of consensus in essential matters such as Brexit, the nations in the United Kingdom are working together with a high level of cooperation and coordination in decision-making during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]