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COVID-19 in the UK has had a profound impact on population health and other socially important outcomes, including on education and the economy. Although a range of evidence has guided policy, epidemiological models have been central. It is less clear whether models to support decision making have sought to integrate COVID-19 epidemiology with a consideration of broader health, wellbeing and economic implications. We report on a rapid review of studies seeking to integrate epidemiological and economic modelling to assess the impacts of alternative policies. Overall, our results suggest that few studies have explored broader impacts of different COVID-19 policies in the UK. Three studies looked only at health, capturing impacts on individuals with and without COVID-19, with various methods used to model the latter. Four models considered health and wider impacts on individuals' economic outcomes, such as wages. However, these models made no attempt to consider the dynamic impacts on economic outcomes of others and the wider economy. The most complex analyses sought to link epidemiological and dynamic economic models. Studies compared a wide range of policies, although most were defined in general terms with minimal consideration of their granular specifications. There was minimal exploration of uncertainty, with no consideration in half the studies. Selecting appropriate models to inform decisions requires careful thought of factors relevant to the decision options under consideration such as the outcomes of interest, sectors likely to be impacted and causal pathways. In summary, better linking epidemiological and economic modelling would help to inform COVID-19 policy., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Government policies on abortion are a longstanding topic of heated political debates. The COVID-19 pandemic shook health systems to the core adding further to the complexity of this topic, as imposed national lockdowns and movement restrictions affected access to timely abortion for millions of women across the globe. In this paper, we examine how countries within the European Union and the United Kingdom responded to challenges brought by the COVID-19 crisis in terms of access to abortion. By combining information from various sources, we have explored different responses according to two dimensions: changes in policy and protocols, and reported difficulties in access. Our analysis shows significant differences across the observed regions and salient debates around abortion. While some countries made efforts to maintain and facilitate abortion care during the pandemic through the introduction or expansion of use of telemedicine and early medical abortion, others attempted to restrict it further. The situation was also diverse in the countries where governments did not change policies or protocols. Based on our data analysis, we provide a framework that can help policy makers improve abortion access., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The health and care sector plays a valuable role in improving population health and societal wellbeing, protecting people from the financial consequences of illness, reducing health and income inequalities, and supporting economic growth. However, there is much debate regarding the appropriate level of funding for health and care in the UK. In this Health Policy paper, we look at the economic impact of the COVID-19 pandemic and historical spending in the UK and comparable countries, assess the role of private spending, and review spending projections to estimate future needs. Public spending on health has increased by 3·7% a year on average since the National Health Service (NHS) was founded in 1948 and, since then, has continued to assume a larger share of both the economy and government expenditure. In the decade before the ongoing pandemic started, the rate of growth of government spending for the health and care sector slowed. We argue that without average growth in public spending on health of at least 4% per year in real terms, there is a real risk of degradation of the NHS, reductions in coverage of benefits, increased inequalities, and increased reliance on private financing. A similar, if not higher, level of growth in public spending on social care is needed to provide high standards of care and decent terms and conditions for social care staff, alongside an immediate uplift in public spending to implement long-overdue reforms recommended by the Dilnot Commission to improve financial protection. COVID-19 has highlighted major issues in the capacity and resilience of the health and care system. We recommend an independent review to examine the precise amount of additional funds that are required to better equip the UK to withstand further acute shocks and major threats to health., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

In response to the heightened risk that coronavirus disease 2019 (COVID-19) poses to the health and lives of people with obesity, in 2020 the U.K. government launched a new package of policies intended to stimulate weight loss among the country's population. In this article, I present a critical discourse analysis of the policy paper which announced these new measures. I identify the discourses that are used to represent things, people, and processes in this policy text. These discourses are interpreted in terms of broadly neoliberal ideologies of public health management. Taken together, the discourses identified contribute to a broadly neoliberal ideology of public health management. It is argued that the policy paper represents an instance of "lifestyle drift," as it initially appears to engage with social and economic determinants of health but ultimately neglects these in favor of focusing on individual lifestyle factors, particularly in the shape of individuals' "choices." [ABSTRACT FROM AUTHOR]

This paper critically comments on the state of affairs in the UK relating to the pandemic and explores how a focus on inequities experienced by marginalized and vulnerable groups is necessary for exposing the material realties of everyday life, but also how such a focus has been hijacked by center right politics to distract us from collective responsibilities and building alliances for systemic change. The paper critically reviews the impact of the COVID‐19 pandemic on the most marginalized and vulnerable in UK society and highlights the interconnected risk factors of COVID‐19 and its secondary impacts to demonstrate how these are linked to political ideology, policy, and practice. We conclude with recommendations informed through a looking back at the key tenants and purposes of universal healthcare to apprise what is needed in this moment of crisis and beyond. [ABSTRACT FROM AUTHOR]

Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic. Arksey and O′Malley's scoping review framework. A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach. Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner. An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of ' leaving no one behind' in post-pandemic and future responses. [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]

Aim: The aim of this paper is to reflect upon the experiences of a senior nurse in a patient‐facing role, who led a tea providing direct care to those with coronavirus disease 2019 (covid‐19). This would establish what those experiences meant to nurses during the initial outbreak to enable their coping mechanisms to face subsequent waves in the United Kingdom. Background: The worst infectious disease outbreak of a generation rapidly made its impact known to the medical profession and its support infrastructure across the globe. It imparted unprecedented challenges, not only for managing the care of the most critically ill but for minimising its spread and protecting the workforce. Sources of evidence: Reflections of working on the covid‐19 frontline during the initial stages of the pandemic, the challenges faced, and lessons learned enabled the development of a strategy to better support nurses in the ongoing pandemic. Discussion: Visible, invested and consistent leadership was key in forming a strong foundation to support clear communication, peer support and increasing confidence. Consequently, strong bonds were forged to enable the team to face further challenges as they felt 'in it together'. Summary and implications for nursing and health policy: The experiences described in this paper are those of a senior nurse leader within a particular care context. However, the lessons learned are likely to resonate with many nurses who are facing the same challenges in very similar care contexts and who are urged to reflect upon their own experiences. Furthermore, the associated lessons may help support others and inform their strategy for coping throughout potential future admission surges of this pandemic. [ABSTRACT FROM AUTHOR]

Public health policy analysis lacks theoretical foundations and tends not to be evidence-based. This is apparent in the areas of dietary health needs assessment, the problematization of issues, and subsequently, conceptual policy generation. However, this paper will demonstrate that theory utilised in process engineering can lend itself to dietary health policy analysis; it will show that a scheme which addressed a UK food issue during the COVID-19 pandemic was based upon apparent public needs, rather than being based on public actual needs, and so rather than safeguarding health, the scheme may have resulted in the unintended, reverse consequence of being injurious to health. Using such theory, this paper then presents a proposal which could help to meet global governance drivers which address food and nutrition insecurity. [ABSTRACT FROM AUTHOR]

This paper offers a five‐part framework for assessing why the United Kingdom has coped poorly compared with peer countries with the medical, social and economic challenges brought by the COVID‐19 pandemic – a surprising failure, given the strength of its scientific community and the internationally attested quality of its civil service. The paper also offers a proposal for how to shape an independent inquiry, one promised by the UK Prime Minister, of the kind that has the primary motivation to better prepare the country for future crises. The paper begins by providing various metrics that set out how the UK has, as of late 2020, been particularly adversely affected by the pandemic. It then details the five‐part framework, which is presented as a series of propositions with initial supporting evidence that require more thorough investigation, supported by a fuller record of evidence. First, we suggest that there have been problems as to how evidence about the pandemic and its anticipated effects was collected, processed and circulated, weakening policymakers' ability to evaluate the risk calculus. Second, particular structures and processes of government decision‐making appear to have been inadequate and ill‐suited to the multidimensional challenges brought by the pandemic. Third, the role of political leadership and decision‐making in the public health and broader policy responses needs thorough evaluation. Fourth, we assess some aspects of economic policymaking during the pandemic. Fifth, features of the UK's institutional make‐up may have been a driver of the suboptimal outcomes. Overall, we argue that UK policymakers may have over‐relied on the medical sciences at the expense of other (social) scientific evidence. [ABSTRACT FROM AUTHOR]

This paper analyses the costs and benefits of lockdown policies in the face of COVID-19. What matters for people is the quality and length of lives and one should measure costs and benefits in terms of those things. That raises difficulties in measurement, particularly in valuing potential lives saved. We draw upon guidelines used in the UK for public health decisions, as well as other measures, which allow a comparison between health effects and other economic effects. We look at evidence on the effectiveness of past severe restrictions applied in European countries, focusing on the evidence from the UK. The paper considers policy options for the degree to which restrictions are eased. There is a need to normalise how we view COVID because its costs and risks are comparable to other health problems (such as cancer, heart problems, diabetes) where governments have made resource decisions for decades. The lockdown is a public health policy and we have valued its impact using the tools that guide health care decisions in the UK public health system. The evidence suggests that the costs of continuing severe restrictions in the UK are large relative to likely benefits so that a substantial easing in general restrictions in favour of more targeted measures is warranted. [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]

While the COVID-19 pandemic now affects the entire world, countries have had diverse responses. Some responded faster than others, with considerable variations in strategy. After securing border control, primary health care approaches (public health and primary care) attempt to mitigate spread through public education to reduce person-to-person contact (hygiene and physical distancing measures, lockdown procedures), triaging of cases by severity, COVID-19 testing, and contact-tracing. An international survey of primary care experts' perspectives about their country's national responseswas conducted April to early May 2020. This mixed method paper reports on whether they perceived that their country's decision-making and pandemic response was primarily driven by medical facts, economic models, or political ideals; initially intended to develop herd immunity or flatten the curve, and the level of decision-making authority (federal, state, regional). Correlations with country-level death rates and implications of political forces and processes in shaping a country's pandemic response are presented and discussed, informed by our data and by the literature. The intersection of political decision-making, public health/primary care policies and economic strategies is analysed to explore implications of COVID-19's impact on countries with different levels of social and economic development. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has tremendously caused significant health impacts leading to high load of ICU critical patients. Multiple Intensive Care Unit (ICU) admission framework and triaging score have been adapted worldwide for admission of COVID-19 patients. The aim of this article is to review the COVID-19 ICU admission policy in five (5) countries, identify challenges and provide recommendations. Materials and Methods: Literature review was carried out through searching available literature from online databases such as EBSCO, PubMed, Research Gate, Google Scholar and Google search engine. The selected information used in this review is taken from any journal, article, report, thesis, national report, news update regarding the topic. Result: The ICU admission policy in 5 countries, namely South Africa, USA, UK, Hong Kong and Malaysia were reviewed. Different countries apply different guidelines to triage, prioritize and admit severe COVID-19 patients to ICU such as Color-coded Priority Scale in South Africa, Critical Care Triage Tool in USA, COVID-19 Critical Care Guideline in UK, COVID- 19 Critical Care Triage Tool in Hong Kong and ICU Admission Prioritization Criteria in Malaysia. The ICU admission decision-making is supported with multiple ICU scorings such as Sequential Organ Failure Assessment (SOFA), Clinical Frailty score and National Early Warning score 2 (NEWS2). Conclusion: The COVID-19 ICU admission policies in these countries are well established and have been practised appropriately despite challenges faced by the ICU practitioners. All five selected national guidelines in this paper correspond to the WHO framework on the ICU admission policy. Ethical issues and legal supports on the ICU practitioners in ICU admission decision-making requires great attention form government and relevant policy stakeholders. [ABSTRACT FROM AUTHOR]

Purpose: In this work, the authors present some of the key results found during early efforts to model the COVID-19 outbreak inside a UK prison. In particular, this study describes outputs from an idealised disease model that simulates the dynamics of a COVID-19 outbreak in a prison setting when varying levels of social interventions are in place, and a Monte Carlo-based model that assesses the reduction in risk of case importation, resulting from a process that requires incoming prisoners to undergo a period of self-isolation prior to admission into the general prison population.Design/methodology/approach: Prisons, typically containing large populations confined in a small space with high degrees of mixing, have long been known to be especially susceptible to disease outbreaks. In an attempt to meet rising pressures from the emerging COVID-19 situation in early 2020, modellers for Public Health England's Joint Modelling Cell were asked to produce some rapid response work that sought to inform the approaches that Her Majesty's Prison and Probation Service (HMPPS) might take to reduce the risk of case importation and sustained transmission in prison environments.Findings: Key results show that deploying social interventions has the potential to considerably reduce the total number of infections, while such actions could also reduce the probability that an initial infection will propagate into a prison-wide outbreak. For example, modelling showed that a 50% reduction in the risk of transmission (compared to an unmitigated outbreak) could deliver a 98% decrease in total number of cases, while this reduction could also result in 86.8% of outbreaks subsiding before more than five persons have become infected. Furthermore, this study also found that requiring new arrivals to self-isolate for 10 and 14 days prior to admission could detect up to 98% and 99% of incoming infections, respectively.Research Limitations/implications: In this paper we have presented models which allow for the studying of COVID-19 in a prison scenario, while also allowing for the assessment of proposed social interventions. By publishing these works, the authors hope these methods might aid in the management of prisoners across additional scenarios and even during subsequent disease outbreaks. Such methods as described may also be readily applied use in other closed community settings.Originality/value: These works went towards informing HMPPS on the impacts that the described strategies might have during COVID-19 outbreaks inside UK prisons. The works described herein are readily amendable to the study of a range of addition outbreak scenarios. There is also room for these methods to be further developed and built upon which the timeliness of the original project did not permit. [ABSTRACT FROM AUTHOR]

In this paper, we reflect on 'scientific' governmental and media responses to Covid-19 in the UK, illuminating their negative impacts on complex and emergent touch forms/practices and people's related emotions. The scientisation of the pandemic led to the government initially placing the country in lockdown and enforcing social distancing. It thereby regulated and proscribed routine and normative touch practices in order to save lives. However, such strategies were not accompanied by an awareness that increased touch deprivation could be emotionally harmful, that lockdown could exacerbate abusive touch in the privatised familial domestic sphere, and that paid care-giver touch in other contexts, such as care homes for the elderly, could also be potentially lethal. These negative consequences are important for social workers to understand and appropriately respond to, as they disproportionately impact vulnerable and marginalised groups and are heightened for service users, who are frequently members of many disadvantaged groups simultaneously. [ABSTRACT FROM AUTHOR]

In this brief paper, I argue that the coronavirus pandemic is functioning like an ethnomethodological 'breaching experiment'. In short, it is putting a gigantic spanner in the works of neoliberal governance, in the process exposing the widening cracks and fissures of what I have called the 'fractured society'. I begin by recalling Garfinkel's notion of the breaching experiment and by listing the principal attributes of the fractured society. I then explore the response to the coronavirus in the UK, from the government's initial commitment to 'herd immunity' to its present policy of 'muddling through'. The bulk of the remainder of this contribution addresses precisely how this global health crisis shines a harsh and unforgiving searchlight on the strategies and policies pursued by governments in the UK since 2010, and most especially after the passing of the Health and Social Care Act of 2012. In the closing paragraphs, I examine possible scenarios for a post-fractured society, making particular use of Fraser's concepts on 'reactionary' versus 'progressive populism', and conclude with a comment on sociology and engagement. [ABSTRACT FROM AUTHOR]

In this paper, we analyse the conditions under which the COVID‐19 pandemic will lead either to social order (adherence to measures put in place by authorities to control the pandemic) or to social disorder (resistance to such measures and the emergence of open conflict). Using examples from different countries (principally the United Kingdom, the United States, and France), we first isolate three factors which determine whether people accept or reject control measures. These are the historical context of state‐public relations, the nature of leadership during the pandemic and procedural justice in the development and operation of these measures. Second, we analyse the way the crisis is policed and how forms of policing determine whether dissent will escalate into open conflict. We conclude by considering the prospects for order/disorder as the pandemic unfolds. [ABSTRACT FROM AUTHOR]

Key epidemiological parameters, including the effective reproduction number, RðtÞ, and the instantaneous growth rate, rðtÞ, generated from an ensemble of models, have been informing public health policy throughout the COVID-19 pandemic in the four nations of the United Kingdom of Great Britain and Northern Ireland (UK). However, estimation of these quantities became challenging with the scaling down of surveillance systems as part of the transition from the "emergency" to "endemic" phase of the pandemic. The Office for National Statistics (ONS) COVID-19 Infection Survey (CIS) provided an opportunity to continue estimating these parameters in the absence of other data streams. We used a penalised spline model fitted to the publicly-available ONS CIS test positivity estimates to produce a smoothed estimate of the prevalence of SARS-CoV-2 positivity over time. The resulting fitted curve was used to estimate the "ONS-based" RðtÞ and rðtÞ across the four nations of the UK. Estimates produced under this model are compared to government-published estimates with particular consideration given to the contribution that this single data stream can offer in the estimation of these parameters. Depending on the nation and parameter, we found that up to 77% of the variance in the government-published estimates can be explained by the ONS-based estimates, demonstrating the value of this singular data stream to track the epidemic in each of the four nations. We additionally find that the ONS-based estimates uncover epidemic trends earlier than the corresponding government-published estimates. Our work shows that the ONS CIS can be used to generate key COVID-19 epidemiological parameters across the four UK nations, further underlining the enormous value of such population-level studies of infection. This is not intended as an alternative to ensemble modelling, rather it is intended as a potential solution to the aforementioned challenge faced by public health officials in the UK in early 2022. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to uncover perspectives on the COVID‐19 pandemic and the responses implemented by the UK and Scottish Governments to help control the spread of infection. Such understanding could help to inform future responses to pandemics at individual, community and national levels. Method: Q methodology was used to elicit perspectives from people in England and Scotland with different experiences of the pandemic including public health officials, key workers, those on furlough, those who were unvaccinated or vaccinated to different levels, those who were 'shielding' because they were at higher risk and people with different scientific expertise. Participants rank‐ordered phrases about different aspects of COVID‐19 according to their viewpoint. Factor analysis was then conducted in conjunction with interview material from the same respondents. Results: A four‐factor solution was statistically supported and was interpretable alongside the qualitative accounts of participants loading on these factors. These four perspectives are titled Dangerous and Unaccountable Leadership, Fear and Anger at Policy and Public responses, Governing Through a Crisis and Injustices Exposed. Conclusion: The four perspectives demonstrate plurality and nuance in views on COVID‐19 and the associated policies and restrictions, going beyond a binary narrative that has been apparent in popular and social media. The four perspectives include some areas of common ground, as well as disagreement. We argue that understanding the detail of different perspectives might be used to build cohesion around policy initiatives in future. Patient or Public Contribution: The development of the statement set, which is rank‐ordered by participants in a Q study, and factor interpretations were informed by views of the general public. The statement set was initially developed using existing publicly available material based on members of the general public experiencing the pandemic first hand. It was then piloted with members of the public experiencing different challenges as a result of COVID‐19 and the subsequent lockdown and updated based on feedback. Finally, interpretations of the identified factors were presented publicly and edited according to their feedback. [ABSTRACT FROM AUTHOR]

Background : Governments have relied on their citizens to adhere to a variety of transmission-reducing behaviours (TRBs) to suppress the Covid-19 pandemic. Understanding the psychological and sociodemographic predictors of adherence to TRBs will be heavily influenced by the particular theories used by researchers. This review aims to identify the theories and theoretical constructs used to understand adherence to TRBs during the pandemic within the UK social and legislative context. Methods: A systematic review identified studies to understand TRBs of adults in the UK during the pandemic. Identified theoretical constructs were coded to the Theoretical Domains Framework. Data are presented as a narrative summary. Results: Thirty-five studies (n = 211,209) investigated 123 TRBs, applied 13 theoretical frameworks and reported 50 sociodemographic characteristics and 129 psychological constructs. Most studies used social cognition theories to understand TRBs and employed cross-sectional designs. Risk of sampling bias was high. Relationships between constructs and TRBs varied, but in general, beliefs about the disease (e.g. severity and risk perception) and about TRBs (e.g. behavioural norms) influenced behavioural intentions and self-reported adherence. More studies than not found that older people and females were more adherent. Conclusions: Behavioural scientists in the UK generated a significant and varied body of work to understand TRBs during the pandemic. However, more use of theories that do not rely on deliberative processes to effect behaviour change and study designs better able to support causal inferences should be used in future to inform public health policy and practice. Prospero Registration: CRD42021282699. [ABSTRACT FROM AUTHOR]

Although the health care systems in Europe are considered the global benchmark, European nations were severely affected by the coronavirus disease 2019 (COVID-19) pandemic. This manuscript aimed to examine the strategies implemented to combat the COVID-19 pandemic by France, the United Kingdom, Spain, Italy, Germany, and Russia and their outcomes in terms of the number of cases, testing, and deaths. This is the first review of its kind that extensively analyzes the preparedness, mitigation, and response strategies against the COVID-19 pandemic adopted by these nations. This paper further suggests a strategic preparedness model for future pandemics. From the analysis, we found that a decentralized approach, prompt decision-making and timely execution, coordination between local health authorities, and public participation in the implementation of strategies could substantially reduce the case fatality rate. Nations with a high percentage of gross domestic product invested in the health sector, as well as more nurses, physicians, hospital beds, intensive care unit beds, and ventilators, better managed the pandemic. Instead, nations that postponed their pandemic response by delaying tracking, tracing, testing, quarantine, and lockdown were badly affected. The lessons learned from the present pandemic could be used as a guide to prepare for further pandemics. [ABSTRACT FROM AUTHOR]

Two studies tested a distrustful complacency hypothesis, according to which either concern or political trust would be enough to sustain law‐abiding attitudes and compliance with health‐protective policies during the COVID‐19 pandemic; but the absence of both concern and trust would result in markedly lower support and compliance. Study 1 supported this hypothesis with NatCen nationally representative sample of Great Britain (N = 2413; weighted regression analyses), focussing on law‐abiding attitudes. Study 2 (preregistered) replicated these findings with a representative sample (N = 1523) investigating support for COVID‐19 policies and compliant behaviour. Participants who were less concerned about the consequences of the pandemic (for themselves and for others) and simultaneously less trustful of the government expressed weaker law‐abiding attitudes and reported less compliance with COVID‐19 restrictions. These findings have implications for policy and public health strategies in time of crisis. [ABSTRACT FROM AUTHOR]

Vaccination rates against SARS-CoV-2 in children aged five to eleven years remain low in many countries. The current benefit of vaccination in this age group has been questioned given that the large majority of children have now experienced at least one SARS-CoV-2 infection. However, protection from infection, vaccination or both wanes over time. National decisions on offering vaccines to this age group have tended to be made without considering time since infection. There is an urgent need to evaluate the additional benefits of vaccination in previously infected children and under what circumstances those benefits accrue. We present a novel methodological framework for estimating the potential benefits of COVID-19 vaccination in previously infected children aged five to eleven, accounting for waning. We apply this framework to the UK context and for two adverse outcomes: hospitalisation related to SARS-CoV-2 infection and Long Covid. We show that the most important drivers of benefit are: the degree of protection provided by previous infection; the protection provided by vaccination; the time since previous infection; and future attack rates. Vaccination can be very beneficial for previously infected children if future attack rates are high and several months have elapsed since the previous major wave in this group. Benefits are generally larger for Long Covid than hospitalisation, because Long Covid is both more common than hospitalisation and previous infection offers less protection against it. Our framework provides a structure for policy makers to explore the additional benefit of vaccination across a range of adverse outcomes and different parameter assumptions. It can be easily updated as new evidence emerges. [ABSTRACT FROM AUTHOR]

This article examines the way numbers, often concerning risk, were communicated by politicians, covered by the news media and interpreted by the public during the early stages of the COVID-19 crisis in the United Kingdom. To explore this topic, we adopted a mixed-methods approach that included content analysis, comparative thematic analysis and a series of focus groups. Whilst coherency and consistency are touted as essentials in public health messaging, our textual analysis highlighted the disconnect between political communication and news media coverage. Whereas the UK government relied on vague references to curves and peaks to underpin a narrative of consistency and certainty in public health policy, the UK news media referred to specific numbers from within and outside the UK to criticise the government's approach as haphazard and lacking. This disconnect gained even more significance during our focus groups. When discussing numbers, participants referred to news media coverage rather than political messaging, using these figures to challenge the timing and nature of the UK lockdown. These findings present a significant critique of the UK government's communication during this health crisis. Instead of putting forward a coherent, homogenous and clear message to the public, the discourse around numbers and risk was diffracted, disconnected and opaque. This was largely due to the competing narratives presented by the news media. [ABSTRACT FROM AUTHOR]

Objective: This study aims to compare the differences in COVID-19 prevention and control policies adopted by the United Kingdom (UK) during the first wave (31 January 2020 to 6 September 2020) and the second wave (7 September 2020 to 12 April 2021), and analyze the effectiveness of the policies, so as to provide empirical experience for the prevention and control of COVID-19. Methods We systematically summarized the pandemic prevention and control policies of the UK from official websites and government documents, collated the epidemiological data from 31 January 2020 to 12 April 2021, and analyzed the effectiveness of the two waves of pandemic prevention and control policies. Results: The main pandemic prevention and control policies adopted by the UK include surveillance and testing measures, border control measures, community and social measures, blockade measures, health care measures, COVID-19 vaccination measure, and relaxed pandemic prevention measures. The new cases per day curve showed only one peak in the first wave and two peaks in the second wave. The number of new cases per million in the second wave was much higher than that in the first wave, and the curve fluctuated less. The difference between mortality per million was small, and the curve fluctuated widely. Conclusion: During the first and second waves of COVID-19, the UK implemented three lockdowns and managed to slow the spread of the pandemic. The UK's experience in mitigating the second wave proves that advancing COVID-19 vaccination needs to be accompanied by ongoing implementation of non-pharmacological interventions to reduce the transmission rate of infection. And a stricter lockdown ensures that the containment effect is maximized during the lockdown period. In addition, these three lockdowns featured distinct mitigation strategies and the UK's response to COVID-19 is mitigation strategy that reduce new cases in the short term, but with the risk of the pandemic rebound. [ABSTRACT FROM AUTHOR]

In this paper, we trace how mathematical models are made 'evidence enough' and 'useful for policy'. Working with the interview accounts of mathematical modellers and other scientists engaged in the UK Covid-19 response, we focus on two weeks in March 2020 prior to the announcement of an unprecedented national lockdown. A key thread in our analysis is how pandemics are made 'big'. We follow the work of one particular device, that of modelled 'doubling-time'. By following how modelled doubling-time entangles in its assemblage of evidence-making, we draw attention to multiple actors, including beyond models and metrics, which affect how evidence is performed in relation to the scale of epidemic and its policy response. We draw attention to: policy; Government scientific advice infrastructure; time; uncertainty; and leaps of faith. The 'bigness' of the pandemic, and its evidencing, is situated in social and affective practices, in which uncertainty and dis-ease are inseparable from calculus. This materialises modelling in policy as an 'uncomfortable science'. We argue that situational fit in-the-moment is at least as important as empirical fit when attending to what models perform in policy. • Pandemics are performed as crises of uncertain yet catastrophic potential. • Mathematical models are forms of scalar narrative affording epidemics their scale. • Models and projections are made useful as evidence in their situated policy events. • Calculations are given agency as affects in the evidencing of pandemics. • Modelling pandemics is a site of 'uncomfortable science' and 'dis-ease'. [ABSTRACT FROM AUTHOR]

This article presents a thematic analysis of 100 articles which appeared in 'SW2020 under COVID-19' online magazine, authored by people with lived experience, practitioners, students and academics. The magazine was founded by an editorial collective of the authors of this article and ran as a free online magazine during the period of the first UK COVID-19 lockdown period (March–July 2020). It contained a far higher proportion of submissions from the first three groups of contributors, above, than traditional journals. The analysis is organised under four analytic themes: 'Hidden populations; Life, loss and hope; Practising differently and Policy and system change'. The article concludes by describing the apparent divergence between accounts that primarily suggest evidence of improved working relationships between social workers and those they serve via digital practices, and accounts suggesting that an increasingly authoritarian social work practice has emerged under COVID-19. We argue that, notwithstanding this divergence, an upsurge in activism within social work internationally during the pandemic provides a basis for believing that the emergence of a community-situated, socially engaged social work is possible post-pandemic. [ABSTRACT FROM AUTHOR]

In this brief communication, we discuss the confusion of mortality with fatality in the interpretation of evidence in the coronavirus disease 2019 (COVID-19) pandemic, and how this confusion affects the translation of science into policy and practice. We discuss how this confusion has influenced COVID-19 policy in France, Sweden, and the United Kingdom and discuss the implications for decision-making about COVID-19 vaccine distribution. We also discuss how this confusion is an example of a more general statistical fallacy we term the "Missing Link Fallacy." [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a global pandemic. Measures to reduce transmission of the virus have altered usual activities, routines, and livelihoods, and have had a significant impact on mental health. The current study aims to examine the potential alterations in psychological wellbeing, mental health, sleep and diurnal preference due to the COVID-19 pandemic. A cross sectional online questionnaire-based study with n = 200 participants (aged 18–62; 7.86.0% female, 93.0% white, 92.5% UK-based, 73.5% students). Data were collected between 15th April and 8 June 2020. Participants answered questions on lifestyle changes and their concerns and worries about COVID-19, and completed the SCI, PHQ9, GAD7, PWB18, UCLA3 and MEQ. Results showed self-isolation was linked to lower psychological well-being, and increased loneliness, anxiety and depression. Home-working was related to a shift in diurnal preference. Reduced work/income was related to decreased psychological well-being and sleep quality and increased anxiety, depression, loneliness and. Intensity of worried thoughts and concerns about COVID-19 were positively correlated with anxiety, depression and negatively with sleep quality. In conclusion, the social, occupational and economic disruption due to COVID19 has had a negative impact on psychological well-being. However, the transition to home-working may have been somewhat beneficial for some individuals in terms of sleep. These findings should be taken into account by policy makers during the transition to the 'new normal' post-pandemic. [ABSTRACT FROM AUTHOR]

The UK Government has produced an array of televised information adverts or ‘campaigns’ to increase public awareness of COVID-19 and promote compliance with its subsequent policy. Research has shown that compliance with public health policy is influenced by fearful visual-verbal campaign messaging strategies, and that emotive representations of ‘risk’ are generally perceived to be more effective than non-emotive discourse. However, how the Government has semiotically constructed and utilised fear within their COVID-19 campaigns to nudge public compliance remains unexplored. Preliminary analysis of seventeen COVID-19 adverts revealed four sequential phases to the Government’s pandemic response: responsibility, management, mitigation, and reflection. An in-depth Multimodal Critical Discourse Analysis of four selected adverts (one screenshot per advert, per phase), revealed that fear was constructed using less conventional meaning potentials in favour of more implicit multimodal semiotic interactions. By portraying a ‘good’ pandemic subject as one who makes ‘moral’ and ‘rational’ decisions to comply with COVID-19 policy, pre-existing societal inequalities which might hinder compliance, particularly for the socioeconomically disadvantaged groups of society, were reduced and problematised. This raises ethical concerns over notions of ‘expertise’ and the ‘rationalising’ of ‘irrational’ lifestyles. Future research should further explore multimodal nudges in public health campaigns to hold producers accountable. The UK Government has produced an array of televised information adverts or ‘campaigns’ to increase public awareness of COVID-19 and promote compliance with its subsequent policy. Research has shown that compliance with public health policy is influenced by fearful visual-verbal campaign messaging strategies, and that emotive representations of ‘risk’ are generally perceived to be more effective than non-emotive discourse. However, how the Government has semiotically constructed and utilised fear within their COVID-19 campaigns to nudge public compliance remains unexplored. Preliminary analysis of seventeen COVID-19 adverts revealed four sequential phases to the Government’s pandemic response: responsibility, management, mitigation, and reflection. An in-depth Multimodal Critical Discourse Analysis of four selected adverts (one screenshot per advert, per phase), revealed that fear was constructed using less conventional meaning potentials in favour of more implicit multimodal semiotic interactions. By portraying a ‘good’ pandemic subject as one who makes ‘moral’ and ‘rational’ decisions to comply with COVID-19 policy, pre-existing societal inequalities which might hinder compliance, particularly for the socioeconomically disadvantaged groups of society, were reduced and problematised. This raises ethical concerns over notions of ‘expertise’ and the ‘rationalising’ of ‘irrational’ lifestyles. Future research should further explore multimodal nudges in public health campaigns to hold producers accountable. [ABSTRACT FROM AUTHOR]

Proposals for SARS‐CoV‐2 virus vaccination priorities in the UK and in many other countries are heavily influenced by epidemiological models, which use outcome measures such as deaths or hospitalisation. Limiting the values under consideration to those attributable to the direct effects of infection has the advantage of simplifying the models and the process of decision‐making. However, the consequences of the pandemic extend beyond outcomes directly attributable to SARS‐CoV‐2 infection, and include restrictions on educational and work opportunities, access to services, recreational activities, affiliations and relationships with others, freedom of movement (including escaping abusive relationships), and other determinants of human experience. Capability theory gives emphasis to the freedoms that individuals have to express themselves (in doings and beings). Restrictions on freedoms restrict our capabilities. Capability theory has been used to provide a framework for the evaluation and comparison of international development approaches and in the evaluation of public health policy. There is a clustering of disadvantages associated with this pandemic that adds to pre‐existing inequalities. Much of the disadvantage engendered in the SARS‐CoV‐2 pandemic is left out when public health policy is based on a limited range of metrics. Acknowledging the impact of policy across the range of human freedoms at both a national and international level has the potential to improve policy, facilitate the mitigation of direct and indirect adverse consequences, and improve public confidence and the effectiveness of vaccine deployment strategies. [ABSTRACT FROM AUTHOR]

Context: The precarious work arrangements experienced by many long-term care workers have led to the creation of a "shared" workforce across residential, home, and community aging care sectors. This shared workforce was identified as a contributor to the spread of COVID-19 early in the pandemic. Objective: This analysis sought to review policy measures targeting the long-term care workforce across seven high income jurisdictions during the first year of the COVID-19 pandemic. The focus was on financial supports introduced to recognize long-term care workers for the increased risks they faced, including both (1) health risks posed by direct care provision during the pandemic and (2) economic risks associated with restrictions to multi-site work. Method: Environmental scan of publicly available policy documents and government news releases published between March 1, 2020 and March 31, 2021, across seven high income jurisdictions. Findings: While there was limited use of financial measures in the United States to compensate long-term care workers for the increased health risks they faced, these measures were widely used across Canada, as well as in Wales, Scotland, and Australia. Moreover, there was a corresponding use of financial measures to protect workers from income loss in parts of Canada, Australia and the UK. Limitations: Our analysis did not include additional policy measures such as sick pay or recruitment incentives. We also relied primarily on publicly available policy documentation. In some cases, documents had been archived or revised, making it difficult to ascertain and clarify original information and amendments. Implications: While these financial measures are temporary, they brought to light long-standing issues related to the supply of and support for workers providing care to older adults in long-term care homes. [ABSTRACT FROM AUTHOR]

Gastrointestinal infections are an important global public health issue. In the UK, one in four people experience a gastrointestinal infection each year and epidemiological research highlights inequalities in the burden of disease. Specifically, poorer children are at greater risk of infection and the consequences of illness, such as symptom severity and time off work/school, are greater for less privileged groups of all ages. Gastrointestinal infections are, however, largely 'hidden' within the home and little is known about the lived experience and practices surrounding these illnesses, how they vary across contrasting socioeconomic contexts, or how inequalities in the disease burden across socioeconomic groups might come about. This paper presents data from an ethnographic study which illuminate how socioeconomic inequalities in the physical and material management and consequences of gastrointestinal infections are generated in families with young children. The study shows how the 'work' needed to manage gastrointestinal infections is more laborious for people living in more 'disadvantaged' conditions, exacerbated by: more overcrowded homes with fewer washing and toilet facilities; inflexible employment; low household incomes; and higher likelihood of co-morbidities which can be made worse by having a gastrointestinal infection. Our findings call into question the current approach to prevention of gastrointestinal infections which tend to focus almost exclusively on individual behaviours, which are not adapted to reflect differences in socioeconomic context. Public health agencies should also consider how wider social, economic and policy contexts shape inequalities in the management and consequences of illness. Our findings are also pertinent to the COVID-19 pandemic response in the UK. They highlight how research and policy approaches to acute infectious diseases need to take into consideration the differing lived experiences of contrasting households if they wish to address (and avoid exacerbating) inequalities in the future. • First ethnographic study to examine UK socioeconomic inequalities in GI infections. • GI infections create a huge amount of labour for all families with young children. • Co-morbidities, poorer living conditions and low income increase GI infection labour. • Low paid, insecure, inflexible work exacerbates material consequences of infection. • GI infection policy should look beyond behavioural advice to address inequalities. [ABSTRACT FROM AUTHOR]

The role of shared identity in predicting both ingroup helping behaviour and adherence to protective norms during COVID‐19 has been extensively theorized, but remains largely under‐investigated. We build upon previous Social Identity research into community resilience by testing the role of pre‐existing local community (or 'neighbourhood') identity as a predictor of these outcomes, via the mediator of perceived social support. Community residents in the UK completed a longitudinal online survey four months before lockdown (T1; N = 253), one month before lockdown (T2; N = 217), and two months into lockdown (T3; N = 149). The cross‐lagged panel analysis shows that T1 community identification predicts T3 giving and receiving of pandemic‐related support, and that these effects occur via the perception of community support at the second time point (while the alternative pathway from T1 support via T2 identification is non‐significant). Moreover, we show that T1 community identification also directly predicts lockdown adherence at T3. Our findings point to the pivotal role played by community identity in effective behavioural responses to the pandemic, and the need to support and foster community development to facilitate local community resilience as the crisis continues to unfold. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has had a major impact globally, with older people living in aged care homes suffering high death rates.Objectives: We aimed to compare the impact of initial government policies on this vulnerable older population between the UK and Australia during the first wave of attack.Methods: We searched websites of governments in the UK and Australia and media outlets. We examined the key policies including the national lockdown dates and the distribution of some important resources (personal protective equipment and testing) and the effects of these initial policies on the mortality rates in the aged care homes during the first wave of attack of COVID-19.Results: We found that both countries had prioritized resources to hospitals over aged care homes during the first wave of attack. Both countries had lower priority for aged care residents in hospitals (e.g. discharging without testing for COVID-19 or discouraging admissions). However, deaths in aged care homes were 270 times higher in the UK than in Australia as on 7 May 2020 (despite UK having a population only 2.5 times larger than Australia). The lower fatality rate in Australia may have been due to the earlier lockdown strategy when the total daily cases were low in Australia (118) compared to the UK (over 1000), as well as the better community viral testing regime in Australia.Conclusion: In conclusion, the public health policy in Australia aimed towards earlier intervention with earlier national lockdown and more viral testing to prevent new cases. This primary prevention could have resulted in more lives being saved. In contrast, the initial policy in the UK focussed mainly on protecting resources for hospitals, and there was a delay in national lockdown intervention and lower viral testing rate, resulting in more lives lost in the aged care sector. [ABSTRACT FROM AUTHOR]

In times of the coronavirus, complying with public health policies is essential to save lives. Understanding the factors that influence compliance with social distancing measures is therefore an urgent issue. The present research investigated the role of political and social trust for social distancing using a variety of methods. In Study 1 (N = 301), conducted with a sample from the United Kingdom in the midst of the virus outbreak (i.e., the first wave), neither political nor social trust had main associations with self-reported social distancing tendencies. However, both factors interacted such that social trust was associated with lower social distancing tendencies among participants with low levels of political trust. In Study 2, using an experimental longitudinal design and again conducted with a sample collected from the UK (N = 268) during the first wave of the pandemic, social distancing practices increased over time, independent of an experimental manipulation of political trust. Moreover, while the interaction between political and social trust from the first study could not be conceptually replicated, social trust was positively related to social distancing intentions. Moving from the individual to the country level and assessing actual behavior at both the first and second wave of the pandemic, in Study 3 (N = 65 countries), country-level political trust was related to less social distancing during the first wave. Social trust was related to a higher growth rate of infections. Against the background of these inconsistent findings, we discuss the potential positive and unexpected negative effects of social trust for social distancing. [ABSTRACT FROM AUTHOR]

Background: To mitigate and slow the spread of COVID-19, many countries have adopted unprecedented physical distancing policies, including the UK. We evaluate whether these measures might be sufficient to control the epidemic by estimating their impact on the reproduction number (R0, the average number of secondary cases generated per case).Methods: We asked a representative sample of UK adults about their contact patterns on the previous day. The questionnaire was conducted online via email recruitment and documents the age and location of contacts and a measure of their intimacy (whether physical contact was made or not). In addition, we asked about adherence to different physical distancing measures. The first surveys were sent on Tuesday, 24 March, 1 day after a "lockdown" was implemented across the UK. We compared measured contact patterns during the "lockdown" to patterns of social contact made during a non-epidemic period. By comparing these, we estimated the change in reproduction number as a consequence of the physical distancing measures imposed. We used a meta-analysis of published estimates to inform our estimates of the reproduction number before interventions were put in place.Results: We found a 74% reduction in the average daily number of contacts observed per participant (from 10.8 to 2.8). This would be sufficient to reduce R0 from 2.6 prior to lockdown to 0.62 (95% confidence interval [CI] 0.37-0.89) after the lockdown, based on all types of contact and 0.37 (95% CI = 0.22-0.53) for physical (skin to skin) contacts only.Conclusions: The physical distancing measures adopted by the UK public have substantially reduced contact levels and will likely lead to a substantial impact and a decline in cases in the coming weeks. However, this projected decline in incidence will not occur immediately as there are significant delays between infection, the onset of symptomatic disease, and hospitalisation, as well as further delays to these events being reported. Tracking behavioural change can give a more rapid assessment of the impact of physical distancing measures than routine epidemiological surveillance. [ABSTRACT FROM AUTHOR]