Category Archives: Covid-19

Understanding how COVID-19 impacted on people who use drugs

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Authors

Dr Joanna Kesten, Research Fellow, Bristol Medical School, Bristol Population Health Science Institute, Health Protection Research Unit. 

Professor Catriona Matheson, Professor at the University of Stirling, and Chair of the Ministerial Drug Death Task Force for Scotland.

When the COVID-19 pandemic hit the UK in early 2020, there was concern about its impact on vulnerable groups in society. In this blog, Jo Kesten, Research Fellow at the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol and Catriona Matheson, Professor at the University of Stirling and Chair of the Ministerial Drug Death Task Force for Scotland, discuss the findings and wider policy implications of two independent research projects to investigate how people who inject drugs were affected. Both studies interviewed people who use drugs in the first national lockdown in 2020 to understand how the pandemic impacted on them. In Scotland, data from online forums, surveys and the police were also used to examine changes in the drugs market.

 Key points

  • Service innovation can happen quickly in a crisis
  • Digital inclusion is important if services are to continue with remote contact
  • Many people struggled with the loss of connection with others
  • There were fewer infections among interviewees than may have been predicted
  • Drug markets were more resilient than we had thought
  • More research needs to be carried out on changes to drug treatment medication policies as our studies recorded slightly different experiences

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To address ethnic inequalities in COVID-19, we must acknowledge the multifaceted influence of racism

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This blog post was written by Dr Saffron Karlsen, (Associate Professor in Sociology, University of Bristol). 

The evidence of ethnic inequalities in the number of COVID-related infections and deaths in the UK is compelling – yet discussions about how to address them remain somewhat simplistic. Dr Saffron Karlsen discusses five key issues that must be acknowledged if we are to establish a more complete picture of these inequalities and their drivers.

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Management consultants in healthcare do more harm than good, but keep getting rehired – new research

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This blog post was written by Andrew Sturdy, Chair in Organisation and Management, University of Bristol and Ian Kirkpatrick, Chair in Management, University of York. This article is republished from The Conversation under a Creative Commons license, read the original article here.

The use of management consultants has grown enormously in recent years. In the UK, consultancy brings in around £10 billion a year in fees across the public and private sectors. And while not totally recession-proof, the numbers grew in the run-up to Brexit and then COVID-19. (Remember test and trace? Consultants played a major role.)

Consulting firms can provide advice and extra resources at short notice and can be very effective for the right task and client. But their use often brings controversy, especially when public money is at stake, over the value of outsourcing, for instance. This raises a number of questions. Does consultancy bring improvements such as increased efficiency? If not, how can we explain its huge growth?

In the NHS, there is a remarkable lack of clarity and transparency over how much consultancy is used and with what effects. This falls within broader concerns noted in a recent National Audit Office report on procurement across public services.

In our ongoing research on management consultancy in the NHS, we have started to address these issues.

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COVID-19 school closures are threatening children’s oral language skills: but whole-school based interventions could help.

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Oral language skills are critical for learning, and they matter now more than ever

Dr Ioanna, Bakopoulou, Lecturer in Psychology in Education, School of Education, University of Bristol

Capabilities such as vocabulary knowledge, narrative skills and active listening are foundational for young children’s learning. Developed both at home and in school, these capabilities are known as oral language. Oral language is essential for young children’s learning, in particularly their literacy development and their ability to access the curriculum.

Oral language skills have always mattered, but they matter now more than ever.

The Covid-19 pandemic has widened the already stubborn ‘language gap’, that is the difference between the language levels of children from poorer backgrounds vs their more affluent peers. Ofsted have raised concerns that children hit hardest are ‘regressing in basic skills and learning, including language, communication and oral fluency’1. Recent research found that 92 per cent of teachers think school closures due to the Covid-19 pandemic have contributed to a widening of the ‘word gap’ and that 94 per cent found it challenging to support pupils’ vocabulary development while teaching remotely during the first national lockdown2.

This suggests that the inequalities facing children in our school system are being exacerbated by the Covid-19 pandemic. Pupils from poorer backgrounds have suffered the most and face a greater loss of learning as a result of school closures3.

The likely increase in the disadvantage gap highlights the importance of school-based, early language interventions. Support for oral language offers an important means by which we can address the injustices worsened by the pandemic.

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Learning loss: the National Tutoring Programme for England is a valuable step – but may not go far enough

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Authors:
Simon Burgess, Professor of Economics, University of Bristol
Hans Sievertsen, Senior Lecturer in Economics, University of Bristol

UNESCO estimates that around 1.5 billion children were unable to attend school in the spring of 2020. Closed schools mean lost learning, lower skills and reduced life chances and wellbeing.

A strategy for closing this learning gap needs to be rapid, school-based rather than online, and provided in addition to regular school. Given the size of the learning gap, it requires significant investment. Most importantly, there must be evidence of its effectiveness.

The policy that best fits these criteria is small-group tutoring, based in schools. This is the focus of the UK government’s new flagship catch-up programme, available to state schools in England.

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Coronavirus: have we already missed the opportunity to build a better world?

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Martin Parker Professor of Organisation Studies University of Bristol

Many people like to say that the coronavirus is teaching us a lesson, as if the pandemic were a kind of morality play that should lead to a change in our behaviour. It shows us that we can make big shifts quickly if we want to. That we can build back better. That social inequality is starkly revealed at times of crisis. That there is a “magic money tree”. The idea that crisis leads to change was also common during the financial crunch over a decade ago, but that didn’t produce any lasting transformations. So will post-COVID life be any different?

At the start of lockdown, in the middle of the anxiety and confusion, I started to notice that I was enjoying myself. I was cooking and gardening more; the air was cleaner, my city was quieter and I was spending more time with my partner. Lots of people started to write about the idea that there should be #NoGoingBack. It seemed that we had taken a deep collective breath, and then started to think about coronavirus as a stimulus to encourage us to think how we might address other big issues – climate, inequality, racism and so on.

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The ties that bind: what the killing of George Floyd can tell us about ethnic inequalities in COVID-19 (and why we should listen)

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This blog post was written by Dr Saffron Karlsen, (Senior Lecturer in Social Research, University of Bristol) 

On the last weekend of May 2020, much of the world watched with horror scenes of US urban disturbances in response to the death of George Floyd – another Black person killed in police custody. On the other side of the pond, many in the UK also awaited the release of an official report into the higher rates of infection and death of Black and other ethnic minority people from COVID-19.

Photo by Thomas de LUZE on Unsplash

Delays and disappointment

This Public Health England (PHE) report was heralded as an opportunity to finally provide answers to questions we’d had since evidence of these inequalities first emerged. The inquiry’s lead, Professor Kevin Fenton, described the pressing need for open discussion, to listen to the views of people from Black communities and those who worked with them to find out what was producing these inequalities.

Unfortunately, the report which was finally released is very far from fulfilling these ambitions. It does not provide a detailed investigation of the drivers of these ethnic inequalities and includes very little new information from which to make sense of these patterns.

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PolicyBristol and Covid-19

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Written by Lindsey Pike

These are uncertain times. Both research and policymaking has been thrown into unknown territory, and anxiety is running high. The coronavirus situation is dynamic and is likely to change how we live and work for the foreseeable future. At PolicyBristol we are looking at how we can reprioritise how we work and what we do, to ensure we’re making the most of the resources we have within the team.  

The team are working from home, but are available to discuss policy engagement and related issues – related to COVID, or any other topic – over the phone or videoconferencing.  

We understand that both researchers and policy colleagues that we work with are under pressure to adapt to working from home, often while coordinating and managing childcare and other responsibilities. However, we’ll continue to signpost you to relevant opportunities and information to make sure that, especially in times such as these, policy decisions are informed by a robust evidence base.  

We’re also aware that other policy priorities, while currently overshadowed, have not gone away. We’d like to reiterate that regardless of your area of research or policy, we’re here to support you. 

Many colleagues in our research community are already forging links with public health, clinical, social and third sector services to offer the resources we have. If you are a researcher whose work is relevant to Covid-19, we have listed some relevant engagement opportunities below: please get in touch with one of the team (emails below) if we can support you in any way; for example with support to edit or structure scientific summaries into policy/ lay friendly ones, horizon scanning, or any other task related to getting findings out there and used.   

Contact your faculty’s PolicyBristol Associate 

Meet the team and contact us here. 

We hope you stay safe and well during this time. 

Resources from the University of Bristol 

Guidance for researchers during the COVID-19 outbreak (internal). 

The University is keen to hear about the circumstances our partners and communities are facing, how they are responding and how we might work together to meet these unparalleled new challenges. Please contact us if you have suggestions for how the University, our staff and students can support your organisational or community activities in response to COVID-19. 

The University of Bristol’s researchers, staff and students are working together and with partners from across society to understand coronavirus (COVID-19) and its far-reaching impact on our lives. Find out more here. 

National consultations and inquiries related to COVID19 

Online harms (Home Affairs Committee) The inquiry seeks evidence on Online Harms arising from the Covid-19 lockdown period and the adequacy of the Government’s proposals to counter them. Deadline 21 May 2020

Covid-19 and the food supply (Environment, Food and Rural Affairs Committee)
This inquiry examines issues related to the food supply chain and access to healthy foods. Deadline: 22 May 2020

Economic impact of coronavirus (Treasury Committee) In this stage, the Committee will examine the operational effectiveness, cost and sustainability of the Government’s and Bank of England’s support packages. The Committee will also examine the impact on the economy and different sectors, the implications for public finances, and how the Government can work towards a sustained recovery. Deadline 27 May 2020

The impact of coronavirus on business and workers (Business, Energy and Industrial Strategy Committee)
The BEIS Select Committee has launched an inquiry into the impact of coronavirus on businesses and workers. Deadline: 29 May 2020

The impact of Covid-19 on education and children’s services (Education Committee) The inquiry will examine both short term impacts, such as the effects of school closures and exam cancellations, as well as longer-term implications particularly for the most vulnerable children.
Deadline: 31 May 2020 

Left behind white pupils from disadvantaged backgrounds (Education Committee) This inquiry will investigate the issues faced by disadvantaged groups, with an initial inquiry into the educational underachievement of white pupils from disadvantaged backgrounds including white working class pupils. This inquiry will examine the extent of the achievement gap between this group and their peers and how it is measured, alongside a consideration of the effects of the COVID-19 outbreak. It will also look at what the priorities should be for tackling this issue. Deadline 5 June 2020

Defence contribution to the UK’s pandemic response (Defence Committee) This inquiry will focus on the Ministry of Defence’s and the Armed Forces’ contribution to the United Kingdom’s response to the Covid-19 pandemic. The scope will include: assessing the MoD’s planning and preparedness for a pandemic; understanding how the Armed Forces have supported the civilian authorities during the pandemic; evaluating the effectiveness of the specific actions and activities undertaken by military and civilian personnel, and; exploring how the MoD has ensured that potential adversaries have not taken advantage of the need to focus on the pandemic response. Deadline: 15 June 2020

Impact of COVID-19 on DCMS sectors: (Digital Culture Media and Sport Committee) The DCMS Committee has launched an inquiry into the ‘Impact of Covid-19 on DCMS sectors’. It will consider both the immediate and long-term impact that Covid-19 and the related social and financial measures are having on the wide range of industries and organisations under the Committee’s remit. The Committee expects to hold a number of evidence sessions from late April onwards to hear directly from stakeholders, arms-length bodies and Government about what is being done and what further support is needed. Deadline 19 June 2020

Coronavirus and Scotland (Scottish Affairs Committee). Deadline 23 June 2020

Coronavirus: implications for transport: (Transport committee). The Transport Committee is asking transport workers, stakeholders and members of the public to write to them about the transport issues they face during the coronavirus outbreak. MPs will explore the impact felt by the industry, its workers and passengers in a rolling programme of work to monitor the impact of coronavirus on UK transport, sector by sector. Deadline: 29 June 2020

The science of COVID-19: (Science and Technology Committee (Lords) This inquiry will investigate the scientific and technological aspects of the COVID-19 pandemic, including the nature of the SARS-CoV-2 virus, its transmission and spread, the development of vaccines and treatments, and how digital technologies can be used for tracking and modelling. The inquiry aims to help Government and society learn from the pandemic and better prepare for future epidemics.Deadline: 30 June 2020

The Government’s response to Covid-19: human rights implications
(Human Rights Joint Committee)
The Committee is seeking evidence on how the Government is ensuring measures are human-rights compliant, the impact of these measures on human rights in the UK, and the groups who will be disproportionately affected. Deadline: 22 July 2020

UK Science, Research and Technology Capability and Influence in Global Disease Outbreaks (Science and Technology Committee)
Once the COVID-19 pandemic has passed its peak, the Committee will inquire formally into the place of UK research, science and technology in the national and global response, and what lessons should be learned for the future. Deadline: 31 July 2020 

Past COVID inquiries

Impact of Covid-19 on the charity sector
(Digital, Culture, Media and Sport Committee)
Deadline: 16th April 2020 

  • This is a short inquiry into the impact on the charity sector. Find out more here. 

Home Office preparedness for Covid-19
(Home Affairs Committee)
Deadline: 21 April 2020 

  • The Home Affairs Committee is undertaking a short inquiry into the Home Office’s preparations for and response to Covid-19 (Coronavirus). Find out more here. 

The Covid-19 pandemic and international trade
(International Trade Committee)
Deadline: 24th April 2020 

  • This wide-ranging inquiry seeks views on impact on UK businesses, supply chains, and access to essential goods. Find out more here 

Unequal impact: Covid-19 & people with protected characteristics
(Women and Equalities Committee)
Deadline: 30th April 2020 

  • The committee wants to hear about the different and disproportionate impact that the Coronavirus – and measures to tackle it – is having on people with protected characteristics under the Equality Act. Find out more here.  

Humanitarian crises monitoring: impact of coronavirus
(International Development Committee)
Deadline: 17 April/ 8th May 2020 

  • This inquiry is seeking evidence in two waves; current situation and immediate risks (17 April) and longer-term issues and implications (8 May). Find out more here.

Life of Breath – The perspective of the humanities on COVID-19

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This post was written by Professor  Havi Carel (University of Bristol) and Professor Jane Macnaughton (Durham University)

Editor Note: COVID-19, with its wide ranging impacts, has opened up an opportunity to demonstrate the value of scholarly analysis from a wide range of perspectives.  The use of an Arts and Humanities lens helps reveal unexamined areas of interest and importance that would otherwise remain blindspots in our understanding of the health, disease and societal impacts. This piece not only highlights beneficial arts and science collaborations (Singing for Lung Health) but also shows the power of reframing concepts in new ways, which can affect how we approach them.

For the last five years (2015-2020) we have been leading a Wellcome-funded project, the Life of Breath  https://lifeofbreath.org/.  Our aim has been to explore the experience of breathing and breathlessness from an interdisciplinary medical humanities perspective, including insights and knowledge from the humanities, social science and the arts.  It is astonishing that just as we submitted our end of project report, the whole world has been taken over by the COVID-19 pandemic and, with it, the fear of breathlessness. This is all the more strange because a major theme of our project was the invisibility of breath: how as healthy individuals we take breathing for granted; how hidden are those who live with the daily fear of death that accompanies severe breathlessness; and how trustingly we rely on the air around us.

Although breathlessness is central to the diagnosis of COVID-19, and also a sign of disease progression, it is still not highly visible in the media, despite being a pervasive symptom of severe disease.  Many of our pressing current concerns are more tangential: we are concerned about the curbs on personal freedom, about accessing food, and most of all about the health and wellbeing of our loved ones. Why are we not trying to understand the experience of breathlessness better?

Our research sheds light on this strange avoidance.  Breath is essential to life and any threat to it is too frightening to be able to comprehend, let alone express.  Our deepest and most atavistic fears relate to suffocation, drowning, or being unable to breathe.  Breathlessness itself, we have found, is a complex experience that is difficult to articulate, and clinical language can obstruct understanding and prevent the update of suitable management. https://lifeofbreath.org/2019/07/the-meaning-of-the-name-pulmonary-rehabilitation-oxley-et-al-2019/

Much of our work explored how arts and humanities approaches can be used to support and alleviate the suffering associated with chronic breathlessness.  Our research showed that encouraging expression of what breathlessness feels like can be aided by involvement with the arts, for example, through the ‘letter to my breath’ workshops our project designed and ran (https://lifeofbreath.org/2019/01/dear-breath-using-story-structure-to-understand-the-value-of-letter-writing-for-those-living-with-breathlessness-penny-malpass-2019/)

Outreach work from our Catch your Breath exhibition showed that poetry unleashes ideas and metaphors that enable the experience of breathlessness to be not only expressed to others but also understood by the breathless person themselves.  Our ‘Singing for Lung Health’ groups provided important evidence that learning basic diaphragm control and simple singing exercises can increase confidence and sense of control.

Philosophy has also been used in our work to develop a framework for understanding breathlessness more broadly, as a lived experience, rather than as a medical symptom.

See: https://lifeofbreath.org/2016/10/phenomenology-of-illness-by-havi-carel/

We have also published policy recommendations on how breathlessness could be better managed, especially in end of life care:

http://www.bristol.ac.uk/policybristol/policy-briefings/life-of-breath/

Approaches to management can be enhanced if we take a step away from clinical contexts and instead step onto the dance floor to improve exercise capacity.

http://www.bristol.ac.uk/policybristol/policy-briefings/life-of-breath/

The Life of Breath website provides resources based on our research to support people with breathlessness or who are feeling anxious during this difficult time.  We hope you find them useful.

https://lifeofbreath.org/2020/03/breathing-in-isolation-support-with-anxiety-breathlessness-during-lockdown/

https://lifeofbreath.org/2020/03/dance-easy-breathe-better-and-feel-good/

This post was originally published by the International Science Council. You can read the original article here.

Covid-19 in South Africa: The Long Walk to Freedom Continues

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Angelique Retief (PhD student, School of Policy Studies, University of Bristol)

The large number of deaths of BAME people due to the coronavirus has quickly disproved the claim that the pandemic is a ‘great equaliser’ and has instead brought to the fore the many social ills in society. As most determinants of health are socially created, it logically follows then that the fact that socioeconomic deprivation disproportionately affects BAME people will be a precursor to the impact of the virus on those communities. With living space, gardens, and local areas (or the lack thereof) dictating our wellbeing, the gap between the rich and the poor has never been more obvious. The coronavirus will therefore not be felt equally and – compounded by the already profound challenges to wellbeing in non-OECD countries – will only serve to further entrench existing racial and economic disparities.

Racial disparities have a history. The product of centuries of colonialism, apartheid and racial exclusion, South Africa’s welfare system has struggled to provide the freedoms promised in 1994. It has been 26 years since South Africa’s first democratic election, and it is still one of the world’s most unequal societies. With unemployment levels at a decade high of 30% (reaching 40% in some areas), poor levels of basic service provision (StatsSA, 2018), over 2 million AIDS orphans, and the highest level of people with HIV of any country (UNAIDS, 2018), the impacts of Covid-19 will be acutely felt in this part of the world.

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