Clearer guidance needed on coronavirus transmission in households – Sage

PA

Clearer and more specific guidance on coronavirus transmission for different kinds of households needs to be developed, scientists advising the Government have recommended.

The guidance also needs to be supported by tailored communication strategies, according to the Scientific Advisory Group for Emergencies (Sage).

In a document released by the group on Friday, it said households are an important contributor to the transmission of Covid-19, although how infection is transmitted into households and within households is unclear.

The consensus statement dated November 24 analyses data from five population studies – ONS, REACT-Imperial, Biobank, QResearch and OpenSAFELY.

The studies find that household composition are key factors in terms of risk of Covid-19 infection and mortality, even when controlling for deprivation and other factors.

Sage said the studies indicated there is increased risk of infection and mortality for those living in larger occupancy households.

It added that there is a correlation between large, or multigenerational households and increased risk of infection and or mortality, across all five studies.

A consensus statement published on Friday states: “Overall, it is difficult to draw firm conclusions about the mechanisms by which household composition contributes to higher infection and mortality risk among minority ethnic groups.”

The scientists add: “There is a need for increased understanding and compliance to mitigate household transmission, and more specific guidance can help provide practical pragmatic strategies for different households and situations.

“However, guidance on its own should not be viewed as a magic bullet and must be accompanied by wider strategies to assess public understanding and barriers to compliance.”

New cases per day of Covid-19 in private households in England
New cases per day of Covid-19 in private households in England

Compared with white ethnic groups, those from minority ethnic groups, particularly of south Asian origin, tend to live in larger or multigenerational households, the studies found.

The first recommendation sets out that clearer and more specific guidance for different kinds of households needs to be developed, supported by tailored communication strategies.

Experts say the guidance should be developed to be culturally-specific, available in multiple languages and reflect the diversity of family types and household compositions.

They also say that consideration should be given to including seasonal-specific details, particularly advice on reducing risks indoors including ventilation, hygiene and social distancing.

Another recommendation suggests that given the higher exposure risk for larger households, more specific guidance needs to be developed for these.

Sage scientists further recommend that the Government should issue clear guidance to housing providers, and say that non-stigmatising public health communications should raise awareness and give advice to all UK households on how to reduce household exposure.

Daily confirmed cases of Covid-19 in the UK
Daily confirmed cases of Covid-19 in the UK

Additionally the document suggests practical support should be offered to allow safe isolation of individuals living in crowded or multigenerational households.

The paper says minority ethnic groups face greater economic constraints, exacerbated by the economic impacts of the pandemic, and are more likely to live in housing in deprived communities.

Along with higher average household sizes, this means that they will benefit more from mitigations in terms of housing, the scientists say.

Such mitigation strategies should include things like the provision of emergency grants for repair and maintenance of social and private rental housing, and additional space.

The implementation of the bedroom tax should be reviewed for those in multi-person households, the document suggests.

In a separate document from a Sage meeting on July 30, the advisers said that during the application of non-pharmaceutical interventions nationally, there were substantial support packages available.

Sage advised that local areas of intervention would require similar – and probably more – support to facilitate adherence, particularly in disadvantaged communities.

It also said that there would more likely be a positive response to interventions from the public if the reasons behind changes are fully explained and understood.

“Clear communications and engagement are required to avoid interventions being seen as arbitrary or discriminatory,” the document says.

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