Rapid response

There is emerging evidence that the COVID-19 outbreak is negatively affecting the mental health and well-being of NHS staff. A greater understanding of these impacts can inform the development of effective interventions to support staff during the current outbreak and beyond.

Testing people to see if they are currently infected or previously infected with SARS-CoV-2, the virus that causes COVID-19, is a key component of medical management, public health monitoring and research. Diagnosing people as having active infections is a fundamental part of any test and contact tracing system. Improving the speed and accuracy of tests that detect current infections is a research priority and the focus of recent UK Government investment and policy decisions. Antibody tests are also an important tool to understand how many people in the population have been infected and how their immune system responded.

Contact tracing apps could be used to control the COVID-19 outbreak. Most of them work by automatically registering another smartphone when it is close by for a set period of time. If the user then tests positive for COVID-19 in the future, the contact tracing app notifies these contacts. 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 affect the pandemic. Northern Ireland, Scotland, and now England and Wales have recently launched contact tracing apps.

There is emerging evidence that COVID-19 affects many systems of the body, with patients reporting a wide range of symptoms. ‘Long-haulers’ are patients who experience ongoing COVID-19 symptoms for several months after infection. These include fatigue, difficulties in thinking, shortness of breath, chest pain, irregular or abnormal heart rhythm, and joint pain. 

Disadvantaged pupils tend to have lower educational attainment compared with their peers; this is often called the disadvantage gap. School closures, as a result of the COVID-19 pandemic, are likely to have widened the disadvantage gap. This is because disadvantaged pupils tend to have less access to technology, spend less time learning and have reduced support from parents/carers compared with their peers.

The UK Government secured early access to 340 million doses of six different COVID-19 vaccine candidates. It is still unknown whether any of them will be able to protect from SARS-CoV-2. In case of a successful vaccine candidate, supply may be initially constrained and therefore priority groups need to be defined.

Seasonal influenza occurs every year, is a key driver for winter pressure on the NHS and a leading cause of excess deaths every winter. The influenza season, together with other respiratory infections, is likely to coincide with COVID-19 this winter. Those most at risk from influenza are also most vulnerable to COVID-19.

The latest research suggests that antibodies can be detected in recovered patients for up to 2 to 3 months after symptoms. There's also emerging evidence for the role of T cells in the immune response. A better understanding of the immune response is vital if there is going to be a successful vaccine.

While there is some evidence for the use of face masks and face coverings, it is weak and highly situational. Face masks are no substitute for social distancing. Hand hygiene and good respiratory etiquette, remain the best ways to limit the spread of coronavirus.

Children who have COVID-19 are not likely to develop severe symptoms. They are also much less likely to die from the disease than people in older age groups. there is some evidence on infection risk for under 13s and for BAME children but more data from well-designed studies is needed to draw conclusions.

Charities and academics have expressed concerns that children’s mental health is disproportionately affected by the intervention measures used during the pandemic. Child and adolescent mental health may be compromised by factors such as strained family relationships, academic stress and reduced social contact with friends. Child and adolescent mental health services (CAMHS) have been reduced during the pandemic. They are likely to be under strain to meet increased demand. The UK Government has announced funding to ensure that charities can continue supporting those in need.

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. Children are more likely to catch an infection from adult(s) in their household. There is evidence that schools are a low-risk environment for transmission. There are some limited data suggesting that children from a black, Asian or minority ethnic background may be at higher risk of severe disease, consistent with evidence for adults. Large and well-designed studies are needed in order to draw firm conclusions. 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.