Indirect acute effects of the COVID-19 pandemic on physical and psychological morbidity in the UK

Date of Approval: 
2020-07-31 00:00:00
Lay Summary: 
The COVID-19 pandemic is an unprecedented public health crisis associated with very significant morbidity and mortality. Much of the clinical and research focus across the UK is understandably targeting pandemic management. As healthcare resources are reallocated to the COVID-19 response, there will inevitably be decreased resources for non-COVID-19 related healthcare, including activities designed to prevent people becoming ill, such as monitoring of chronic disease, potentially creating or worsening physical and mental health of patients. Mental health is also likely to be impacted by fears around the COVID-19 pandemic, as well as control measures such as mass social distancing, closures of social spaces and self-isolation. Understanding of these indirect effects will help public health planning and policy over the following months, particularly when/if the COVID-19 pandemic is under control. The outcomes will occur in several phases. This initial body of work focuses on acute presentations in the early stages of the pandemic. Our group is also planning a further large study focused on extending this to later outcomes related to the COVID-19 pandemic.
Technical Summary: 
The COVID-19 pandemic is an unprecedented public health crisis associated with very significant morbidity and mortality. Much of the clinical and research focus across the UK is understandably targeting pandemic management. As healthcare resources are reallocated to the COVID-19 response and modifications made to methods of care delivery due to social distancing requirements, there will inevitably be an impact on non-COVID-19 related healthcare provision, including activities designed to prevent people becoming ill, such as monitoring of chronic disease, potentially creating or worsening physical and mental health of patients. We plan to analyse changes in disease incidence, routine monitoring and health outcomes, during and following the COVID-19 pandemic. The initial approach will be a descriptive before and after analysis. This will be followed by an interrupted time series analysis. This initial body of work focuses on acute presentations in the early stages of the pandemic. Our group is also planning a further large study focused on extending this to later outcomes related to the COVID-19 pandemic.
Health Outcomes to be Measured: 
Diabetes mellitus emergency presentations: hyperglycaemia; hypoglycaemia, ketoacidosis; diabetic coma. Mental health outcomes: anxiety; depression; eating disorders (anorexia; bulimia; others); fatal and non-fatal self-harm; obsessive-compulsive disorder (OCD); serious mental illness (i.e. schizophrenia, bipolar disorder and other psychoses). Respiratory: asthma exacerbations; chronic obstructive pulmonary disease (COPD) exacerbations. Cardiovascular: myocardial infarction; unstable angina; cardiac failure; transient ischaemic attacks; cerebrovascular accidents; venous thromboembolism (pulmonary embolism and deep venous thrombosis). Alcohol: alcohol-related acute physical and psychological harms.
Application Number: 
20_089
Collaborators: 

Sinead Langan - Chief Investigator - London School of Hygiene & Tropical Medicine ( LSHTM )
Sinead Langan - Corresponding Applicant - London School of Hygiene & Tropical Medicine ( LSHTM )
Amy Mulick - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Charlotte Warren-Gash - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Harriet Forbes - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Helen Strongman - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Helena Carreira - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
John Tazare - Collaborator - GSK
Kathryn Mansfield - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Kevin Wing - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Liam Smeeth - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Patrick Bidulka - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Rohini Mathur - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Sharon Cadogan - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Yun "Angel" Wong - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )

Linkages: 
2011 Rural-Urban Classification at LSOA level;HES Accident and Emergency;HES Admitted Patient Care;ONS Death Registration Data;Practice Level Carstairs Index for 2011 Census (Excluding Northern Ireland)