Understanding how COVID-19 impacted on people who use drugs

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

 

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

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 responsibilitiesHowever, 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.

Do development indicators underlie global variation in the number of young people injecting drugs?

Dr Lindsey Hines, Sir Henry Wellcome Postdoctoral Fellow in The Centre for Academic Mental Health & the Integrative Epidemiology Unit, University of Bristol

Dr Adam Trickey, Senior Research Associate in Population Health Sciences, University of Bristol

Injecting drug use is a global issue: around the world an estimated 15.6 million people inject psychoactive drugs. People who inject drugs tend to begin doing so in adolescence, and countries that have larger numbers of adolescents who inject drugs may be at risk of emerging epidemic s of blood borne viruses unless they take urgent action. We mapped the global differences in the proportion of adolescents who inject drugs, but found that we may be missing the vital data we need to protect the lives of vulnerable young people. If we want to prevent HIV, hepatitis C, and overdose from sweeping through a new generation of adolescents we urgently need many countries to scale up harm reduction interventions, and to collect accurate which can inform public health and policy. Continue reading

Baby box: child welfare experts say use of sleep boxes could potentially put infants’ lives at risk

Authors:
Debbie Watson, Professor in Child and Family Welfare, University of Bristol
Helen Ball, Professor of Anthropology and Director of the Parent-Infant Sleep Lab, Durham University
Jim Reid, Senior Lecturer, Department of Education and Community Studies, University of Huddersfield
Pete Blair, Professor of Epidemiology and Statistics, University of Bristol

The baby box in Finland is embedded as part of the maternity system. Kela

Having a baby can be expensive. So it’s maybe not surprising that many retailers around the world have cottoned on to the success of Finland’s baby boxes – a package aimed to set up new parents and their bundle of joy. The Finnish boxes include baby clothing, sleep items, hygiene products and a parenting guide –- as well as a “sleep space” for the baby.

Many retailers around the world are now offering similar boxes for expectant parents. Indeed, research conducted at the University of Tampere in Finland suggests there are variants in over 60 countries. This includes Scotland’s baby box scheme – with all newborn babies getting a free baby box from the Scottish government.

But as a group of child welfare experts, we believe imitations of the Finnish boxes could be placing babies at risk. This is because it has become common to believe that if babies sleep in these boxes, it will help protect them from sudden infant death syndrome (SIDS). Unfortunately, the research does not back this up. Continue reading

Why GPs and patients need to talk more openly about death

Hospitals have a role to play too.
Navalnyi/Shutterstock

Lucy Pocock, University of Bristol

Dealing with death is part of the job description for all doctors. For those working in general practice, this often means planning ahead, with GPs encouraged to keep a register of patients thought to be in the last year of their life. Continue reading

Institutionalising preventive health: what are the key issues for Public Health England?

By Takver from Australia [CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0)], via Wikime

Authors: Paul Cairney, John Boswell, Richard Gleave, Kathryn Oliver

The Green Paper on preventing ill health was published in July 2019, and many have criticised that proposals do not go far enough. Our guest blog explores some of the challenges that Public Health England face in providing evidence-informed advice. Read on to discover the reflections from a recent workshop on using evidence to influence local and national strategy and their implications for academic engagement with policymakers. Continue reading

Nanny states and grown-up debates on alcohol policy

Reducing arguments to simplistic – even incoherent – claims and accusations is not good for reasoned, public deliberation, says Professor John Coggon

Professor John Coggon, Professor of Law, Bristol University

27 November 2018 – Debates on alcohol policy are necessarily complex and controversial, and a complete consensus on how we should regulate this area will not be achieved. Like other lawful but regulated products, alcohol presents benefits and harms that may be understood from ranging perspectives. Continue reading

Putting algae and seaweed on the menu could help save our seafood

File 20171213 27593 sfv3nk.jpg?ixlib=rb 1.1Image: Shutterstock

If we have to feed 9.8 billion people by 2050, food from the ocean will have to play a major role. Ending hunger and malnutrition while meeting the demand for more meat and fish as the world grows richer will require 60% more food by the middle of the century.

But around 90% of the world’s fish stocks are already seriously depleted. Pollution and increasing levels of carbon dioxide (CO₂) in the atmosphere, which is making the oceans warmer and more acidic, are also a significant threat to marine life. Continue reading

Multimorbidity could cause a healthcare crisis – here’s what we can do about it

File 20170801 21062 7c1f04
Older patients often suffer from multiple conditions.
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Professor Chris Salisbury profile picture

Professor Chris Salisbury, Primary Health Care, University of Bristol

Multimorbidity is one of the biggest challenges facing healthcare. In recent years, a succession of research studies have shown that people with multiple health problems are more likely to have a worse quality of life, worse mental health and reduced life expectancy. The more health problems someone has, the more drugs they are likely to be prescribed and the more frequently they are likely to consult a GP or be admitted to hospital.

You might think this is all rather self-evident – it’s hardly a surprise that sick people get ill, take medicines and go to doctors more often than healthy people.

So why has multimorbidity become so prominent in discussions about healthcare over the last decade?

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