Quantifying the impact of physical distance measures on the transmission of COVID-19 in the UK.

BACKGROUND: To mitigate and slow the spread of COVID-19, many countries have adopted unprecedented physical distancing policies, including the UK. We evaluate whether these measures might be sufficient to control the epidemic by estimating their impact on the reproduction number (R0, the average number of secondary cases generated per case). METHODS: We asked a representative sample of UK adults about their contact patterns on the previous day. The questionnaire was conducted online via email recruitment and documents the age and location of contacts and a measure of their intimacy (whether physical contact was made or not). In addition, we asked about adherence to different physical distancing measures. The first surveys were sent on Tuesday, 24 March, 1 day after a "lockdown" was implemented across the UK. We compared measured contact patterns during the "lockdown" to patterns of social contact made during a non-epidemic period. By comparing these, we estimated the change in reproduction number as a consequence of the physical distancing measures imposed. We used a meta-analysis of published estimates to inform our estimates of the reproduction number before interventions were put in place. RESULTS: We found a 74% reduction in the average daily number of contacts observed per participant (from 10.8 to 2.8). This would be sufficient to reduce R0 from 2.6 prior to lockdown to 0.62 (95% confidence interval [CI] 0.37-0.89) after the lockdown, based on all types of contact and 0.37 (95% CI = 0.22-0.53) for physical (skin to skin) contacts only. CONCLUSIONS: The physical distancing measures adopted by the UK public have substantially reduced contact levels and will likely lead to a substantial impact and a decline in cases in the coming weeks. However, this projected decline in incidence will not occur immediately as there are significant delays between infection, the onset of symptomatic disease, and hospitalisation, as well as further delays to these events being reported. Tracking behavioural change can give a more rapid assessment of the impact of physical distancing measures than routine epidemiological surveillance.

Social and occupational factors associated with psychological wellbeing among occupational groups affected by disaster: a systematic review.

BACKGROUND: The psychological impact of disasters has been well-documented; less attention has been paid to factors affecting the wellbeing of those exposed to disasters as occupational groups. AIMS: To conduct a systematic literature review identifying social and occupational factors affecting the wellbeing of disaster-exposed employees; to use these factors to identify recommendations for potential interventions. METHOD: Four electronic literature databases were searched; reference lists of relevant papers were hand-searched. RESULTS: A total of 18 005 papers were found, 571 full texts were read and 36 included in the review. The psychological impact of disasters on employees was associated with pre-disaster factors (experience/training; income; life events/health; job satisfaction), peri-disaster factors (exposure; peri-traumatic experiences; perceptions of safety; injury), social factors (organisational support; social support generally) and post-disaster factors (impact on life). CONCLUSIONS: It is important to build a resilient workforce outside of a crisis. Pre-disaster training in recognising signs of distress, understanding vulnerability factors such as those described above, which may put certain employees at greater risk of distress and how to support colleagues may be useful. Further research into the effectiveness of post-disaster interventions is needed.

Psychological and Physical Impacts of Extreme Events on Older Adults: Implications for Communications.

In recent years, a series of large-scale, high-profile natural disasters and terrorist attacks have demonstrated the need for thorough and effective disaster preparedness. While these extreme events affect communities and societies as a whole, they also carry specific risks for particular population groups. Crises such as Hurricane Katrina and the 2011 earthquake and tsunami disaster in Japan have illustrated the risk of significant and disproportionate morbidity and mortality among older adults during disasters. Age does not necessarily equate to vulnerability, but many physical and psychological consequences of the aging process can increase the risk of adverse outcomes. As the older population grows, so too does the need to ensure that adequate, practical, and appropriate measures exist to offset the specific risks from extreme events associated with this subpopulation. Effective risk and crisis communication plays a key role in mitigating the extent to which older adults are differentially affected during extreme events. By identifying the specific issues affecting older adults, this review highlights important areas for action for practitioners and policy-makers, particularly in the realm of crisis communication. (Disaster Med Public Health Preparedness. 2017;11:127-134).

The psychological and psychiatric effects of terrorism: lessons from London.

The 7 July 2005 bombings in London caused heightened levels of distress among some in the general community. This distress was most notable in Muslims and members of ethnic minority groups. These effects were transient for most. An estimated 30% of those who were more affected by the attacks, including victims and witnesses, developed psychiatric disorders as a result. An outreach program was set up to screen those who were exposed to potentially traumatic events and to offer them evidence-based treatment. This article discusses what lessons might be learned from studies of the general community and the screen-and-treat approach.

The London polonium incident: lessons in risk communications.

Public responses to large-scale radiological incidents are often thought to be disproportionate to the objective risk and can involve widespread societal disruption. Recent experiences of the (200)Po incident in central London suggest that public responses depend heavily on the nature of the incident and the effectiveness of risk communication efforts. This paper describes the outcome of several studies done in the aftermath of the (200)Po incident that suggest the reaction of the public on this occasion was muted, even for those directly affected. However, the desire for accurate, up-to-date and individually-tailored information was strong, and satisfaction with the efforts of the responding agencies was mediated by this information provision. A small minority of individuals was difficult to reassure effectively. This group may confer a particular drain on resources. Lessons for the risk communication efforts of public health responders are identified, in particular the importance of helping individuals to identify their risk of exposure, understand the difference between acute and chronic effects of exposure, and appreciate the meaning of any test results. Attempts at providing reassurance in the absence of specific information are likely to be counterproductive in any future radiological incident.

Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: cross sectional telephone survey and qualitative analysis.

OBJECTIVES: To identify public perceptions of the risk to health after the poisoning of Alexander Litvinenko with polonium-210 (210Po) in London and to assess the impact of public health communications. DESIGN: Cross sectional telephone survey and qualitative interviews. SETTING: London, United Kingdom. PARTICIPANTS: 1000 people completed the cross sectional survey and 86 potentially exposed people completed the qualitative interviews. MAIN OUTCOME MEASURES: Perception of risk to personal health after the 210Po incident. Qualitative interviews were analysed with an emphasis on information needs. RESULTS: 11.7% of the survey sample (n=117) perceived their health to be at risk. Aside from personal variables the main predictors of perceived risk to health were believing that the incident was related to terrorism (odds ratio 2.7, 95% confidence interval 1.5 to 4.6) rather than to espionage, that it was targeted at the wider public rather than one person (5.9, 3.2 to 10.9), and that it could affect people who had not been in the contaminated area (3.2, 2.1 to 5.1). Participants in the qualitative interviews were generally satisfied with the information they had received, although they would have preferred more information about their individual risk of exposure, the results of their urine tests, and the health implications of the incident. CONCLUSIONS: Perceptions of the public that the 210Po incident in London in 2006 was related to espionage helped to reassure them that the risks to personal health were low. In the event of future incidents it is important to ensure that detailed, comprehensible information about the risks of any exposure is available.