scholarly journals Occupational differences in COVID-19 incidence, severity, and mortality in the United Kingdom: Available data and framework for analyses

2021 ◽  
Vol 6 ◽  
pp. 102
Author(s):  
Neil Pearce ◽  
Sarah Rhodes ◽  
Katie Stocking ◽  
Lucy Pembrey ◽  
Karin van Veldhoven ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Careful Analysis ◽  
Mortality Data ◽  
Data Sets ◽  
The Public ◽  
Occupational Risks ◽  
The United Kingdom ◽  
Occupational Differences ◽  
Increased Risk ◽  
Key Variables

There are important differences in the risk of SARS-CoV-2 infection and death depending on occupation. Infections in healthcare workers have received the most attention, and there are clearly increased risks for intensive care unit workers who are caring for COVID-19 patients. However, a number of other occupations may also be at an increased risk, particularly those which involve social care or contact with the public. A large number of data sets are available with the potential to assess occupational risks of COVID-19 incidence, severity, or mortality. We are reviewing these data sets as part of the Partnership for Research in Occupational, Transport, Environmental COVID Transmission (PROTECT) initiative, which is part of the National COVID-19 Core Studies. In this report, we review the data sets available (including the key variables on occupation and potential confounders) for examining occupational differences in SARS-CoV-2 infection and COVID-19 incidence, severity and mortality. We also discuss the possible types of analyses of these data sets and the definitions of (occupational) exposure and outcomes. We conclude that none of these data sets are ideal, and all have various strengths and weaknesses. For example, mortality data suffer from problems of coding of COVID-19 deaths, and the deaths (in England and Wales) that have been referred to the coroner are unavailable. On the other hand, testing data is heavily biased in some periods (particularly the first wave) because some occupations (e.g. healthcare workers) were tested more often than the general population. Random population surveys are, in principle, ideal for estimating population prevalence and incidence, but are also affected by non-response. Thus, any analysis of the risks in a particular occupation or sector (e.g. transport), will require a careful analysis and triangulation of findings across the various available data sets.

The Relationship Between Government Popularity and Approval for the Government's Record in the United Kingdom

1985 ◽  
Vol 15 (2) ◽  
pp. 165-186 ◽  
Author(s):  
John Hudson
Keyword(s):  
The Public ◽  
The Past ◽  
The United Kingdom ◽  
State Of The Economy ◽  
Degree Of Stability ◽  
Key Variables ◽  
The Government ◽  
The Relationship ◽  
Opinion Polls

The past decade has seen the growth of a considerable literature on the link between government popularity, as reflected by the proportion of the public indicating their intention to vote for the government in opinion polls, and the state of the economy, as represented by certain key variables. The work began in the early 1970s with articles by Goodhart and Bhansali, Mueller, and Kramer. It continued through the decade; some of the more recent contributions can be found in a set of readings edited by Hibbs and Fassbender. However, despite the amount and quality of this work, problems remain. Principal amongst these, as Chrystal and Alt have pointed out, is the inability to estimate a relationship which exhibits any degree of stability either over time or between researchers. Nearly all the studies have been successful in finding a significant relationship for specific time periods, but when these are extended, or when the function is used to forecast outside the original estimation period, the relationship appears to break down.

Immunization and vaccination

2021 ◽  
pp. 583-596
Author(s):  
Eleonora A.M.L. Mutsaerts ◽  
Shabir A. Madhi
Keyword(s):  
Healthcare Workers ◽  
Healthcare Services ◽  
Economic Effects ◽  
Vaccine Preventable Diseases ◽  
The Public ◽  
Increased Risk ◽  
Vulnerable Patient ◽  
History Of ◽  
Patient Groups ◽  
Spreading Disease

This chapter describes the history of vaccination, challenges to immunization programmes, the public health benefits of vaccination programmes, and the notable successes in terms of elimination. The broader social and economic effects of vaccination are discussed. For example, healthcare workers have increased risk for acquisition of vaccine-preventable diseases. It is important that healthcare workers can maintain delivery of healthcare services during epidemics. They should also avoid spreading disease to vulnerable patient groups. Appropriate vaccination for BCG, hepatitis B, polio, diphtheria, measles, rubella, meningococcal, influenza, varicella, and pertussis is recommended, especially if at increased risk of exposure. The Expanded Programme on Immunization recommended vaccines is fully covered. Vaccination of special populations and the future of vaccines is also discussed.

scholarly journals Oscillations in U.S. COVID-19 Incidence and Mortality Data Reflect Diagnostic and Reporting Factors

mSystems ◽  
2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Aviv Bergman ◽  
Yehonatan Sella ◽  
Peter Agre ◽  
Arturo Casadevall
Keyword(s):  
Public Health ◽  
United States ◽  
Public Health System ◽  
Epidemiological Data ◽  
The United States ◽  
Mortality Data ◽  
Data Sets ◽  
Periodic Oscillations ◽  
The Public ◽  
Incidence And Mortality

ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic currently in process differs from other infectious disease calamities that have previously plagued humanity in the vast amount of information that is produced each day, which includes daily estimates of the disease incidence and mortality data. Apart from providing actionable information to public health authorities on the trend of the pandemic, the daily incidence reflects the process of disease in a susceptible population and thus reflects the pathogenesis of COVID-19, the public health response, and diagnosis and reporting. Both new daily cases and daily mortality data in the United States exhibit periodic oscillatory patterns. By analyzing New York City (NYC) and Los Angeles (LA) testing data, we demonstrate that this oscillation in the number of cases can be strongly explained by the daily variation in testing. This seems to rule out alternative hypotheses, such as increased infections on certain days of the week, as driving this oscillation. Similarly, we show that the apparent oscillation in mortality in the U.S. data are mostly an artifact of reporting, which disappears in data sets that record death by episode date, such as the NYC and LA data sets. Periodic oscillations in COVID-19 incidence and mortality data reflect testing and reporting practices and contingencies. Thus, these contingencies should be considered first prior to suggesting biological mechanisms. IMPORTANCE The incidence and mortality data for the COVID-19 data in the United States show periodic oscillations, giving the curve a distinctive serrated pattern. In this study, we show that these periodic highs and lows in incidence and mortality data are due to daily differences in testing for the virus and death reporting, respectively. These findings are important because they provide an explanation based on public health practices and shortcomings rather than biological explanations, such as infection dynamics. In other words, when oscillations occur in epidemiological data, a search for causes should begin with how the public health system produces and reports the information before considering other causes, such as infection cycles and higher incidences of events on certain days. Our results suggest that when oscillations occur in epidemiological data, this may be a signal that there are shortcomings in the public health system generating that information.

scholarly journals The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH): protocol for a prospective longitudinal cohort study of healthcare and ancillary workers in UK healthcare settings

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e050647
Author(s):  
Katherine Woolf ◽  
Carl Melbourne ◽  
Luke Bryant ◽  
Anna L Guyatt ◽  
I Chris McManus ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Minority Groups ◽  
Ethnic Minority Groups ◽  
Explanatory Variables ◽  
Healthcare Settings ◽  
The United Kingdom ◽  
Sensitive Topics ◽  
Increased Risk ◽  
Prospective Longitudinal

IntroductionThe COVID-19 pandemic has resulted in significant morbidity and mortality and devastated economies globally. Among groups at increased risk are healthcare workers (HCWs) and ethnic minority groups. Emerging evidence suggests that HCWs from ethnic minority groups are at increased risk of adverse COVID-19-related outcomes. To date, there has been no large-scale analysis of these risks in UK HCWs or ancillary workers in healthcare settings, stratified by ethnicity or occupation, and adjusted for confounders. This paper reports the protocol for a prospective longitudinal questionnaire study of UK HCWs, as part of the UK-REACH programme (The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers).Methods and analysisA baseline questionnaire will be administered to a national cohort of UK HCWs and ancillary workers in healthcare settings, and those registered with UK healthcare regulators, with follow-up questionnaires administered at 4 and 8 months. With consent, questionnaire data will be linked to health records with 25-year follow-up. Univariate associations between ethnicity and clinical COVID-19 outcomes, physical and mental health, and key confounders/explanatory variables will be tested. Multivariable analyses will test for associations between ethnicity and key outcomes adjusted for the confounder/explanatory variables. We will model changes over time by ethnic group, facilitating understanding of absolute and relative risks in different ethnic groups, and generalisability of findings.Ethics and disseminationThe study is approved by Health Research Authority (reference 20/HRA/4718), and carries minimal risk. We aim to manage the small risk of participant distress about questions on sensitive topics by clearly participant information that the questionnaire covers sensitive topics and there is no obligation to answer these or any other questions, and by providing support organisation links. Results will be disseminated with reports to Government and papers submitted to pre-print servers and peer reviewed journals.Trial registration numberISRCTN11811602; Pre-results.

scholarly journals Evidentiary Thresholds for Unilateral Aggression: Douma, Skripal and Media Analysis of Chemical Weapon Attacks as a Casus Belli

2019 ◽  
Vol 13 (3) ◽  
pp. 133-165
Author(s):  
Gavan Patrick Gray
Keyword(s):  
Media Coverage ◽  
Careful Analysis ◽  
The United States ◽  
Media Analysis ◽  
Chemical Weapon ◽  
Russian Government ◽  
The Public ◽  
Legal Standards ◽  
The United Kingdom ◽  
Alternative Scenarios

The initiation of military or economic punishment generally on states requires significant justification, lest it be judged an act of aggression. In 2018 two separate incidents invoked similar rationales for such acts of reprisal, specifically that they were responding to attacks using chemical weapons. The incidents were an alleged sarin gas attack by the Syrian government on political opponents, which led to military strikes from the United States, and an alleged poisoning via novichok nerve agents by the Russian government on a Russian ex-spy and his daughter, which led to economic sanctions from the United Kingdom. In both cases, however, evidence of culpability fell short of what legal standards typically require. Despite this, media coverage has failed to examine alternative scenarios or to offer effective critical assessment of the weak rationalizations offered by US and UK governments. The result, precipitate and incautious policy, driven by hasty conclusions rather than careful analysis, represents a failure on the part of both media and government institutions to present the public with an even-handed and neutral assessment of matters vital to their national interest.

Electoral Registration: Ethical Implications and the Law Librarian

2002 ◽  
Vol 2 (4) ◽  
pp. 32-36 ◽  
Author(s):  
Jonathan Gordon-Till
Keyword(s):  
United Kingdom ◽  
Third Parties ◽  
Data Sets ◽  
Raw Data ◽  
Electoral Roll ◽  
The Public ◽  
Ethical Implications ◽  
The United Kingdom ◽  
Address Data ◽  
The Law

In the United Kingdom the electoral roll or register is one of the most fundamental resources for accessing information about adult UK residents. Apart from the register itself, third parties have traditionally made use of the raw name and address data to provide members of the public or certain professions access to derived databases, data sets or re-packaged raw data.

scholarly journals Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020

2020 ◽  
Vol 25 (14) ◽  
Author(s):  
Alexander J Keeley ◽  
Cariad Evans ◽  
Hayley Colton ◽  
Michael Ankcorn ◽  
Alison Cope ◽  
...  
Keyword(s):  
United Kingdom ◽  
Severe Acute Respiratory Syndrome ◽  
Healthcare Workers ◽  
Teaching Hospitals ◽  
Risk Of Infection ◽  
Staffing Levels ◽  
The United Kingdom ◽  
Vulnerable Patients ◽  
Increased Risk ◽  
Roll Out

Healthcare workers (HCW) are potentially at increased risk of infection with coronavirus disease (COVID-19) and may transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to vulnerable patients. We present results from staff testing at Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom. Between 16 and 29 March 2020, 1,533 symptomatic HCW were tested, of whom 282 (18%) were positive for SARS-CoV-2. Testing HCW is a crucial strategy to optimise staffing levels during this outbreak.

scholarly journals Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data

2020 ◽  
Vol 5 ◽  
pp. 88 ◽  
Author(s):  
Robert W. Aldridge ◽  
Dan Lewer ◽  
Srinivasa Vittal Katikireddi ◽  
Rohini Mathur ◽  
Neha Pathak ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Geographical Region ◽  
Mortality Data ◽  
Black African ◽  
Risk Of Death ◽  
Occupational Risks ◽  
Minority Ethnic Groups ◽  
Black Caribbean ◽  
Increased Risk ◽  
Minority Ethnic

Background: International and UK data suggest that Black, Asian and Minority Ethnic (BAME) groups are at increased risk of infection and death from COVID-19. We aimed to explore the risk of death in minority ethnic groups in England using data reported by NHS England. Methods: We used NHS data on patients with a positive COVID-19 test who died in hospitals in England published on 28th April, with deaths by ethnicity available from 1st March 2020 up to 5pm on 21 April 2020. We undertook indirect standardisation of these data (using the whole population of England as the reference) to produce ethnic specific standardised mortality ratios (SMRs) adjusted for age and geographical region. Results: The largest total number of deaths in minority ethnic groups were Indian (492 deaths) and Black Caribbean (460 deaths) groups. Adjusting for region we found a lower risk of death for White Irish (SMR 0.52; 95%CIs 0.45-0.60) and White British ethnic groups (0.88; 95%CIs 0.86-0.0.89), but increased risk of death for Black African (3.24; 95%CIs 2.90-3.62), Black Caribbean (2.21; 95%CIs 2.02-2.41), Pakistani (3.29; 95%CIs 2.96-3.64), Bangladeshi (2.41; 95%CIs 1.98-2.91) and Indian (1.70; 95%CIs 1.56-1.85) minority ethnic groups. Conclusion: Our analysis adds to the evidence that BAME people are at increased risk of death from COVID-19 even after adjusting for geographical region. We believe there is an urgent need to take action to reduce the risk of death for BAME groups and better understand why some ethnic groups experience greater risk. Actions that are likely to reduce these inequities include ensuring adequate income protection (so that low paid and zero-hours contract workers can afford to follow social distancing recommendations), reducing occupational risks (such as ensuring adequate personal protective equipment), reducing barriers in accessing healthcare and providing culturally and linguistically appropriate public health communications.

scholarly journals On Nurses, Mental Health & Caring for the Carers

2020 ◽  
Vol 13 (3) ◽  
Author(s):  
Pardina Samson-Fessale
Keyword(s):  
Healthcare Workers ◽  
Healthcare Systems ◽  
Daily Basis ◽  
Allied Health Professionals ◽  
The Public ◽  
Increased Risk ◽  
Personal Experiences ◽  
The Many ◽  
The Uk

The COVID-19 pandemic has stretched the resources of healthcare systems across the world, as professionals work to treat the public with the scant evidence available. This has resulted in the loss of many essential workers' lives, with the loss of over 119 healthcare workers' lives in the UK as of April of this year. Adding the loss of colleagues to the many difficulties associated with working in healthcare, and the increased risk to their lives and the lives of their loved ones will undoubtedly compound the burnout already felt by nurses on a daily basis The author uses her own personal experiences to explore the themes brought up in current research, as well as looking at suggestions of how to support nurses and allied health professionals both in the immediacy and in the long term.

scholarly journals Differential occupational risks to healthcare workers from SARS-CoV-2: A prospective observational study

2020 ◽  
Author(s):  
David W Eyre ◽  
Sheila F Lumley ◽  
Denise O’Donnell ◽  
Mark Campbell ◽  
Elizabeth Sims ◽  
...  
Keyword(s):  
Risk Factors ◽  
Healthcare Workers ◽  
Prospective Observational Study ◽  
Contact Tracing ◽  
Acute Medicine ◽  
Case Identification ◽  
Occupational Risks ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Positive Results

AbstractBackgroundPersonal protective equipment (PPE) and social distancing are designed to mitigate risk of occupational SARS-CoV-2 infection in hospitals. Why healthcare workers nevertheless remain at increased risk is uncertain.MethodsWe conducted voluntary Covid-19 testing programmes for symptomatic and asymptomatic staff at a UK teaching hospital using nasopharyngeal PCR testing and immunoassays for IgG antibodies. A positive result by either modality determined a composite outcome. Risk-factors for Covid-19 were investigated using multivariable logistic regression.Results1083/9809(11.0%) staff had evidence of Covid-19 at some time and provided data on potential risk-factors. Staff with a confirmed household contact were at greatest risk (adjusted odds ratio [aOR] 4.63 [95%CI 3.30-6.50]). Higher rates of Covid-19 were seen in staff working in Covid-19-facing areas (21.2% vs. 8.2% elsewhere) (aOR 2.49 [2.00-3.12]). Controlling for Covid-19-facing status, risks were heterogenous across the hospital, with higher rates in acute medicine (1.50 [1.05-2.15]) and sporadic outbreaks in areas with few or no Covid-19 patients. Covid-19 intensive care unit (ICU) staff were relatively protected (0.46 [0.29-0.72]). Positive results were more likely in Black (1.61 [1.20-2.16]) and Asian (1.58 [1.34-1.86]) staff, independent of role or working location, and in porters and cleaners (1.93 [1.25-2.97]). Contact tracing around asymptomatic staff did not lead to enhanced case identification. 24% of staff/patients remained PCR-positive at ≥6 weeks post-diagnosis.ConclusionsIncreased Covid-19 risk was seen in acute medicine, among Black and Asian staff, and porters and cleaners. A bundle of PPE-related interventions protected staff in ICU.

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