Preventing within household transmission of COVID-19: Is the provision of accommodation feasible and acceptable?

Abstract

Background Within-household transmission of COVID-19 is responsible for a significant number of infections. The risk of within-household infection is greatly increased among those from Black Asian and minority ethnic (BAME) and low income communities. Efforts to protect these communities are urgently needed. The aim of this study is to explore the acceptability of provision of accommodation to support isolation outside the home among at risk populations. Methods Our study used a mixed methods design structured in two phases. In phase 1, we conducted a survey study of a sample of volunteers from our existing database of 300 individuals who had provided consent to be contacted about ongoing research projects into reducing infection transmission. In phase 2, we conducted semi-structured interviews with 19 participants from BAME communities and low income communities recruited through social media. Results Many participants from both the survey and interview phase of the study viewed the provision of accommodation to support isolation as both important and necessary to protect the household and control the virus. Factors influencing likely uptake of accommodation included perceived 1) vulnerability of household 2) exposure to the virus and 3) options for isolation within the home. Barriers to isolation outside the home included 1) being able to isolate at home 2) not wanting to be apart from family 3) caring for others 4) concerns about the implications of isolation for mental wellbeing 5) upheaval of moving when ill and 6) perceived risk to and from others in the building. Participants raised a series of issues surrounding the provision of accommodation outside the home that should be addressed before it could be offered. These included questions regarding who should use temporary accommodation and at what stage to effectively reduce transmission in the home, and how infection control in temporary accommodation would be managed. Concerns were also raised among those with caring duties and responsibilities. Conclusion This research provides evidence that the provision of accommodation to support isolation outside the home is viewed as acceptable, feasible and necessary by many people who are concerned about infection transmission in the home. We explore ways in which isolation outside the home might be offered to suit the needs of people in different circumstances. In particular, vulnerable members of the household could be protected if accommodation is offered to individuals who are informed through test trace and isolate that they have been in contact with the virus.

Experiences of supported isolation in returning travellers during the early COVID-19 response: a qualitative interview study

“…15 Furthermore, with the COVID-19 pandemic ongoing, it is possible that supported isolation will be required in other contexts, such as to assist those with difficulty isolating at home 16 or to reduce household transmission. 17 It is therefore important to understand more about the way in which people experience supported isolation, so that this process can be optimised to increase adherence and mitigate any negative effects on well-being. We carried out a rapid mixed-methods study in which we: (1) interviewed individuals who underwent supported isolation at Arrowe Park Hospital and Kents Hill Park Conference Centre (findings reported here); (2) surveyed those who underwent supported isolation at two time points (immediately after supported isolation and 3 months after supported isolation) (findings to be reported elsewhere).…”

Experiences of supported isolation in returning travellers during the early COVID-19 response: an interview study

“…This paper represents the first in-depth analysis of the experiences of those who underwent supported isolation in the UK during the first wave of the COVID-19 pandemic. Given that supported isolation is once again required in the management of COVID-19 [8,10,11], our findings should help facilitate optimised management.…”

“…Policy around this isolation is focused on identifying the best ways to maximise compliance, with an increasing emphasis on enforcement [9]. Furthermore, with the COVID-19 pandemic ongoing, it is possible that supported isolation will be required in other contexts, such as to assist those with difficulty isolating at home [10] and to reduce household transmission [11]. It is therefore important to understand more about the way in which people experience supported isolation, so that this process can be optimised to increase adherence and mitigate any negative effects on wellbeing.…”

Environmental health practitioners and the COVID-19 pandemic

“…Within-household transmission is said to be responsible for a significant number of infections. 5,6 eHps have advised landlords and tenants on how to reduce risks and meet regulatory requirements in the pandemic. Yet, addressing crowded housing or lack of space is difficult when there is a lack of alternative accommodation.…”