• Rapid response

    COVID-19 therapies

    This article was updated on 1 May and again on 6 July. Since its original publication on 17 April, the number of COVID-19 clinical trials has increased from 524 to 2,378. There is no cure for COVID-19. Researchers are testing existing drugs to see if they act against SARS-CoV-2 or alleviate the symptoms of the disease. New drugs are also in development, but this is at a very early stage. Results from trials on existing drugs have already been reported with some positive findings. Dexamethasone is a cheap steroid drug that reduces the risk of death of ventilated patients by 35% and by 20% for patients requiring oxygen therapy. Remdesivir is an antiviral drug; there is good evidence that it can reduce the length of time that hospitalised COVID-19 patients are ill. Negative findings are valuable because they allow researchers to focus on other drugs; there is good evidence that hydroxychloroquine does not offer any benefits to treat COVID-19 patients. Research to see if it might have a protective effect for at-risk groups, such as healthcare workers, is ongoing. There are numerous trials in progress to test a range of drugs that act on the immune system.

  • Rapid response

    Contact tracing apps for COVID-19

    Contact tracing apps could be used to control the COVID-19 outbreak. Most of them work by automatically registering another smartphone when it is too close for an extended period of time. Then if a user tests positive for Coronavirus in the future, the contact tracing app notifies these contacts. Some countries like Singapore and Australia have already adopted or rolled out their own contact tracing apps. Concerns have been raised about misuse of personal data. Initial data suggests there has been slow uptake of this new technology by users, and it's unclear if contact tracing apps have had or will have an effect on the pandemic.

  • Work programme

    Approved: Mental health impacts of COVID-19

    A POSTnote on mental health impacts of COVID-19 will summarise the latest findings from research on how COVID-19 has affected the mental health of the UK population. It will highlight which groups are vulnerable and their mental health outcomes. It will also discuss policy approaches to protect mental health and how health services can adapt to improve outcomes for those affected. Provisional start date: September 2020.

  • Work programme

    Approved: Mental health impacts of COVID-19 on healthcare workers and carers

    A POSTnote on mental health impacts of COVID-19 on healthcare workers and carers will outline the short and long-term mental health impacts of COVID-19 on this group. It will review policy approaches and support services dedicated to supporting healthcare worker mental health, with focus on special measures implemented during a pandemic. Work currently in production.

  • Rapid response

    COVID-19 and social distancing: the 2 metre advice

    An infected person produces respiratory droplets when talking, coughing and sneezing. These are responsible for the transmission of virus between people. Droplets can travel up to 2m, with finer aerosols containing smaller viral particles travelling even further. Numerous complex and interacting factors influence how they move and settle onto surfaces, and how infectious they are. The further away a person is, the fewer droplets they will be exposed to and so their risk of being infected with the virus reduces. The advice on 2 m distancing is a risk assessment based on relative not absolute risk; 2 m does not represent zero risk. Measures to mitigate the increased risk of reducing physical distancing include ventilation, physical barriers (screens and face coverings), reduced building occupancy and enhanced cleaning. These will vary according to the context. The wider range of social distancing practices will need to be maintained to contain viral transmission even if the 2 m advice changes. Social distancing and other public health measures are likely to be needed long-term, until a vaccine or more effective treatments for COVID-19 are available. There are numerous knowledge gaps about SARS-CoV-2 transmission; research to address them will inform policy-making.

  • Rapid response

    Antibody tests for COVID-19

    There is insufficient scientific evidence to know whether the presence of SARS-CoV-2 antibodies confers protection from subsequent infections, and if so at what level. Antibodies are only one part of the immune response to infection. Tests that detect SARS-CoV-2 antibodies are available. They can determine whether someone has had COVID-19. Tests can reveal those who are unaware that they had COVID-19 because they had mild or no symptoms. Test samples must be analysed in a laboratory – no home tests are authorised for use in the UK. The Government provides antibody tests for NHS and social care staff, hospital patients and care home residents. Commercial test kits are available for private use. These are of varying quality and results must be interpreted with caution. A positive test does not necessarily mean that someone will be protected from subsequent infections. There are concerns that access to private tests of variable quality will discourage the public from practising effective public health measures. Antibody tests are an important tool to understand the spread of the virus and how many people in a population have been infected. They are being used in infection surveillance surveys in the UK and elsewhere.

  • Rapid response

    Immunity to COVID-19

    Scientific understanding of the immune response to COVID-19 is incomplete but numerous research studies are underway. There is little evidence to suggest that exposure to other coronaviruses can confer protection against SARS-CoV-2. There is very good evidence that it takes at least 14 days to develop an antibody response to SARS-CoV-2. A significant proportion of people exposed to SARS-CoV-2 make very little or no detectable antibodies at all. There is insufficient scientific evidence to know whether the presence of SARS-CoV-2 antibodies confers protection from subsequent infections, and if so at what level. The duration of immunity is not clear; long-term monitoring of this in large studies will be needed to provide clarity. Antibodies are only one part of the immune response to infection, which is complex, and understanding the overall immune response to COVID-19 is very important. Additional high-quality research evidence is needed in order to indicate the likelihood of future outbreaks of disease, how often and when they are likely to occur, and to inform the development of any future immunisation programmes.

  • Horizon scanning

    COVID-19 outbreak: What data or information do experts want the UK Government to release?

    Over 1,100 experts have shared with us their concerns about COVID-19 and COVID-impacted areas in the immediate and longer term future. This report includes data or information experts would like to see the Government release in order to understand the decisions that underpin its approach to the COVID-19 outbreak. Generally, experts have highlighted five key areas of concern in the way the UK Government has released information. These include: transparency of decision making mechanisms, the quality, quantity and range of types of evidence used, the justification of the Government's decisions, the need for accessible and understandable information, and the need to publish data as soon as its available. Experts have also called for additional information to be released by the Government including: academic studies, models and Government data sets used to make decisions, all data being collected during the COVID-19 outbreak, Government guidance to departments, public bodies and public services, and Government and other public recovery strategies.

  • Rapid response

    COVID-19 in children

    There is very good evidence that children who have COVID-19 are much less likely to develop severe symptoms and much less likely to die from the disease than people in older age groups. There is good evidence that children under 13 years old are less susceptible to developing clinical disease (this means having recognisable signs and symptoms) than adults. It is not yet clear whether this is also the case for older children. There is some research indicating that children aged 13 years and under may be less susceptible to infection than adults, but the confidence in this evidence is low. There is insufficient research to say whether this is the case for older children. There is some evidence to suggest that children transmit the virus less than adults, but more research is needed to reduce uncertainty. Pregnant women are not more likely to contract the virus. Transmission of the virus from mothers to babies is low. Some babies born to COVID-19 positive mothers will develop an infection; these babies are not at increased risk of severe disease.

  • Horizon scanning

    Infrastructure and COVID-19: What are experts concerned about?

    Over 1,100 experts have shared with us their concerns about COVID-19 and COVID-impacted areas in the immediate and longer term future. This report outlines infrastructure concerns. Experts are concerned about public transport. They worry about the reduction of services and want clearer guidance on how to stay safe while traveling. They also note that after the outbreak people might not return to using public transport, which could have a range of negative impacts on infrastructure. Digital infrastructure is also an area of concern. Experts worry it will struggle to continue to cope with increased demand. In terms of energy, experts worry about volatility in the energy market and that this could affect how much energy the UK is able to import. Finally there are general concerns about the UK's ability to monitor and maintain infrastructure. Such services might have halted or reduced. On top of that, returning workers might be less familiar with the new processes and put their health and safety at risk.

  • Horizon scanning

    Environment and COVID-19: What are experts concerned about?

    This report outlines environment concerns. Greenhouse gas emissions seem to be falling during the outbreak. While experts note an opportunity to continue this reduction through policy-making, experts are concerned that the need to reinvigorate the economy will override environmental considerations. Access to green space has been important in supporting people’s well-being. Experts note that access to green space is limited in some urban areas. They have similar concerns for the equality of access to active travel such as cycling.

  • Horizon scanning

    Crime, justice, policing and COVID-19: What are experts concerned about?

    Over 1,100 experts have shared with us their concerns about COVID-19 and COVID-impacted areas in the immediate and longer term future. This report outlines crime, justice and policing concerns. On policing, experts are concerned about how the police are monitoring and enforcing adherence to Government restrictions. This includes the inadvertent criminalisation of certain communities and the risk for civil disorder. Experts are also concerned about the potential increase of certain types of crime during the outbreak, such as organised crime, corruption, domestic abuse and cybercrime. On the criminal justice system experts worry about a backlog of cases in courts which were put on hold due to the pandemic. They are also worried about a surge of news cases as a result of the pandemic. Finally there are concerns about the health of prisoners at this time and want to know about plans for early releases.

  • Horizon scanning

    Education and COVID-19: What are experts concerned about?

    Over 1,100 experts have shared with us their concerns about COVID-19 and COVID-impacted areas in the immediate and longer term future. This report outlines education concerns. Experts are concerned about home learning. They worry about the added burden on parents, the quality of home education, and the feasibility of assessment. Access to different online tools, and varying levels of digital literacy may widen achievement gaps. Experts also want to know how the Government is contributing to making education accessible from home, and how it is providing support to those who need it. Experts are also concerned about how decisions to close and open schools/nurseries are being made. Social distancing can be challenging and stressful in these setting which could negatively impact teaching staff. Finally there are several concerns on universities. Experts worry that universities may struggle to provide high-quality education. There may also be a reduction in university staff, and a drop in research projects. There might also be a drop in admissions which would have a knock-on effect on universities' main source of income.

  • Horizon scanning

    Society, community and COVID-19: What are experts concerned about?

    Over 1,100 experts have shared with us their concerns about COVID-19 and COVID-impacted areas in the immediate and longer term future. This report outlines social and community concerns. Experts are concerned about social inequalities beyond health. They note that in the long term groups may have different access to opportunities. This could be particularly true for those with protected characteristics such as women, members of the BAME community, and members of the LGBTQ+ community. Experts are also concerned about how changes in Government measures may lead to negative responses from the UK public. These could range from the public becoming less motivated to follow guidance, to public resistance of contact tracing for fears of increased surveillance. Experts also note risks to social cohesion; From an increase in racist or xenophobic behaviour, to an erosion of trust in democracy and democratic institutions. However they point out that COVID-19 could also present an opportunity for positive cultural change.