Cross-border handshakes: what’s next for digital contact tracing?

As we enter a new year, and a new phase of the Covid-19 pandemic, we are reminded of the need to follow public health advice to stop the spread of the virus. The emergence of new variants of Covid-19, which appear to be more transmissible, has resulted in tougher restrictions across the world. Although the emergence of new variants of Covid-19 can seem frightening, we are not powerless in preventing the spread of the virus; face coverings, social distancing, regular handwashing and self-isolating remain effective.

Additionally, the development and subsequent roll-out of numerous vaccines should provide us all with hope that there is light at the end of the tunnel. However, although vaccines appear to protect people from becoming seriously ill with the virus, there is still uncertainty regarding the impact vaccines will have on viral transmission of Covid-19.

Therefore, the need for those with symptoms to self-isolate, get tested and undergo contact tracing when a positive case is detected is likely to remain. This will become even more important in the months ahead, as we see the gradual re-opening of hospitality, leisure and tourism sectors.

Effectiveness of contact tracing

Contact tracing is a tried-and-tested public health intervention intended to identify individuals who may have been in contact with an infected person and advise them to take action that will disrupt chains of transmission. Prior to Covid-19, contact tracing was often used to prevent the spread of sexually transmitted infections, and has been heralded as vital to the eradication of smallpox in the UK.

According to modelling, published by the Lancet Infectious Diseases, a combination of self-isolation, effective contact tracing and social distancing measures, may be the most effective and efficient way to control the spread of Covid-19.

However, for contact tracing to be at its most effective, the modelling estimates that for every 1,000 new symptomatic cases, 15,000 to 41,000 contacts would have to be asked to self-isolate. Clearly, the logistical burden of operating a manual contract tracing system is high. As a result, governments have chosen to augment existing systems through the deployment of digital contract tracing apps, which are predominantly built using software developed by Apple and Google.

Digital contact tracing

As we go about our day-to-day lives, especially as restrictions are eased, it may not be possible to name everyone you have encountered over the previous 14 days if you later contract Covid-19. Digital contact tracing provides a solution to this issue by harnessing the Bluetooth technology within our phones to help identify and remember potential close contacts. Research by the University of Glasgow has found that contact tracing apps can contribute substantially to reducing infection rates when accompanied by a sufficient testing capability.

Most countries have opted to utilise a system developed by Apple and Google, known as Exposure Notifications, as the basis for digital contact tracing. Public health authorities have the option to either provide Apple and Google with the criteria which defines when an alert should be generated or develop their own app, such as the Scottish Government’s Protect Scotland.

Exposure notification system

In order to protect privacy, the exposure notification system can only be activated by a user after they have agreed to the terms; the system cannot be unilaterally activated by public health authorities or Apple and Google. 

Once activated, the system utilises Bluetooth technology to swap anonymised IDs with other users’ devices when they come into close contact. This has been described as an anonymous handshake. Public health authorities set what is considered as a close contact (usually contact at less than a 2-metre distance for over 15 minutes), and the app calculates proximity measurements over a 24-hour period.

Anonymised IDs are not associated with a user’s identity, change every 10-20 minutes and collected anonymised IDs are securely stored locally on user devices for a 14-day period (incubation period of Covid-19) before being deleted.

If a user tests positive for Covid-19, the public health authority will provide them with a code that confirms their positive diagnosis. This will then provide users with an option to upload collected anonymous IDs to a secure public health authority server. At least once a day, the user’s phone will check-in with this server to check if any of the anonymised IDs collected in the previous 14-days match up with a positive case. If there is a match, and the proximity criteria has been met, a user may receive a notification informing them of the need to self-isolate.

Analysis conducted by the National Institute for Health Research highlights that the use of contact tracing apps, in combination with manual contact tracing, could lead to a reduction in the number of secondary Covid-19 infections. Additionally, the analysis revealed that contact tracing apps identified more possible close contacts and reduced the amount of time it took to complete contact tracing. The analysis concluded that the benefits of digital contact tracing include the ability to trace contacts who may not be known to the infected individual and the overall reliability and security of digitally stored data, rather than an individual’s memory or diary.

Therefore, it could be said that digital contract tracing apps will be most effective when restrictions ease and we are more likely to be in settings where we may be in close contact with people we may not know, for example, when we’re on holiday or in a restaurant.

Cross-border handshakes

Covid-19 naturally does not respect any form of border, and as restrictions on domestic and international travel are relaxed, opportunities will arise for Coivd-19 to spread. In order to facilitate the reopening of the tourism sector, there have been calls for countries which have utilised the Exposure Notification system to enable these systems to interact.

Examples of interoperability already exist internally within the UK, as an agreement exists between Scotland, England and Wales, Northern Ireland, (plus Jersey, Guernsey and Gibraltar), that enables users to continue to receive exposure notifications when they visit an area they do not live in, without the need to download the local public health authority app.

EU Exposure Notification system interoperability, European Commission, 2020

Additionally, the European Union has also developed interoperability of the Exposure Notification system between member states, with a commitment to link 18 national contact tracing apps, establishing the world’s largest bloc of digital contact tracing. The EU views the deployment of linked apps as vital to re-establishing safe free movement of people between member states, for work as well as tourism.

Over the next few months, it is likely that links will be created across jurisdictions. For example, the Scottish Government has committed to investigating how interoperability can be achieved between the Scottish and EU systems. The interoperability of Northern Ireland and Ireland’s contact tracing app highlights that on a technical level there appears to be no barrier for this form of cross-jurisdiction interaction.  

Therefore, as restrictions ease, the interoperability of digital contact tracing apps may become a vital way in which to ensure safe travel, as we learn to live with the ongoing threat of Covid-19.

Final thoughts

Covid-19 has proven itself to be a persistent threat to our everyday lives. However, the deployment of effective vaccines provides us with hope that the threat will be minimized soon. Until then, the need to utilise contact tracing is likely to remain.

As the roll-out of mass-vaccination programmes accelerates, and restrictions are relaxed, we are likely to be in more situations where we will be in contact with more people, not all of whom we may necessarily know. This will be especially true as domestic and international tourism begins to re-open. In these scenarios, the Exposure Notification system, and interoperability between public health authority apps, will become increasingly vital to the operation of an effective contact tracing system.

In short, digital contact tracing may prove to be key to the safe re-opening of the tourism sector and enable users to easily and securely be contact traced across borders.


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Further reading: articles on COVID-19 and digital from The Knowledge Exchange blog

Why are we still talking about healthy places?

In recent years, there has been a wide ranging debate across the housing, planning, health and infrastructure sectors about the development of healthy places in both regeneration and newly approved projects.

In 2016, Town and Country Planning Journal published an article on building health and wellbeing into the built environment (Town and Country Planning, Vol 85 No 11 Nov 2016, Knowledge Exchange customers can login to view the article here) In 2017 and 2018 the talk was all about healthy towns initiatives, and a Design Council report in 2018 looked at the relationship between healthy placemaking and the impact on our communities. In 2019 the Town & Country Planning Association (TCPA) called on members to “reunite” health and planning

It is clear that everyone involved in placemaking agrees building places that promote health and wellbeing for all is of vital importance to our communities, The Covid-19 pandemic brought this into sharp focus, and the idea remains at the forefront of design policy, particularly in urban city contexts. But, over four years after the initial conversations and thought pieces, why are we still talking about it, and what actions still need to be taken to integrate the idea of a healthy place into planning to the extent that it just becomes the norm in the planning and design of our places?

Preventing avoidable disease

The phrase ‘healthy placemaking’ has been defined by Design Council as: “Tackling preventable disease by shaping the built environment so that healthy activities and experiences are integral to people’s everyday lives”.

Public Health England defined healthy placemaking as: “Placemaking that takes into consideration neighbourhood design (such as increasing walking and cycling), improved quality of housing, access to healthier food, conservation of, and access to natural and sustainable environments, and improved transport and connectivity”

Research has shown preventable diseases linked to lifestyle and environment are among the most significant threats to public health. Lifestyle-related conditions like heart disease and cancer, as well as being health problems in their own right, can also contribute to the development of other chronic conditions, exacerbate symptoms and create complications with care which are costly to the NHS.

Creating healthy spaces is not just about encouraging people to live more active lifestyles by facilitating active travel and improving the environment around buildings, although this is a significant part of it. “Healthy places” include approaches to improve air quality, reduce loneliness, allow people to age well in place, promote mental as well as physical wellbeing, reduce deprivation and inequality through projects like housing, infrastructure development, and high street regeneration.

Healthy places also have a preventative role to play in public health management, not just a health improvement role; such interventions are essential to help avert the onset of disease, improve people’s quality of life and reduce health inequalities. And evidence shows the return on investment from public health interventions is high and creates value of different kinds – economic, social and personal.

In short people who live in healthy places, tend to live healthier lives, place less strain on services and “contribute” more to society, both economically through work or spending and socially through community engagement.

Victoria Park, Belfast. Image: Fiona Ann Paterson

Enabling planning practitioners to think about creating healthy places

Research published in 2020 by the Royal Town Planning Institute (RTPI) explored local, national and international planning practices that enable the creation and delivery of healthy places. While a lot of research draws attention to the barriers to building healthy places – including a lack of funding, different requirements from developers and conflicting policy priorities – the RTPI report instead sought to identify important challenges faced by planners who try to integrate healthy placemaking principles in their decisions and then offer potential solutions to these in practice. Key themes emerging from the report include a need to improve collaboration, knowledge sharing and the skills of planners.

The report provides case studies looking at: the place standard tool; the livewell development accreditation; connecting communities in Tower Hamlets; health planning in South Worcestershire; and train station district rejuvenation in Grasse, France. It also identifies seven steps to plan for healthier environments

Across the sector there have been calls for planners to be allowed to be innovative, creative and take a “visionary” approach to planning to help make places healthier in order to address the convergence of challenges around public health, the climate emergency, and economic recovery from Covid-19.

How has the coronavirus pandemic changed how we think about healthy spaces?

The lockdowns  imposed as a result of the coronavirus pandemic have thrown the importance of quality space into sharp focus. Places that facilitate health and wellbeing among the people who live there, and places where the indoor living quality is as important as the outdoor space have become incredibly important.

The pandemic has highlighted what it really means to have a healthy space. It has also demonstrated how wider socioeconomic deprivation and inequality – linked to living conditions as well as other factors – is having an impact on infection and hospital admission rates, with those groups who live in more deprived areas being found to be at a higher risk of becoming seriously ill or being admitted to hospital with Covid-19. 

The 2018 Design council report found in its survey of practitioners that focus was given far more to outdoor space than to indoors, as it was easier and more cost effective to make changes that could produce demonstrable impacts (an increase in cycling, for example). But the pandemic and the increased time we have been forced to spend indoors has encouraged designers and urban planners to think even more creatively about quality space in their developments.

Where now?

Public Health England (PHE) which for many years was a strong voice in the conversations around healthy placemaking has been disbanded and will be replaced by a National Institute of Health Protection. It remains to be seen how, or if this new organisation will fit into the conversation going forward. But reflecting on recent reports on the significant public health crisis facing the UK in the long term, it is clear that the work must continue, driven collectively by those in planning, urban design and public health.


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‘Bending the Curve’ of biodiversity loss – could Covid-19 be the catalyst for change?

dead forest pic

“The evidence is unequivocal – nature is being changed and destroyed by us at a rate unprecedented in history” (WWF)

The latest Living Planet report from the Worldwide Fund for Nature (WWF) finds that 68% of the world’s wildlife populations have been lost since 1970 – more than two thirds in less than 50 years – with the most striking result a 94% decline in tropical subregions of the Americas. The report says this ‘catastrophic’ decline shows no signs of slowing. The cause – human activity.

Until 1970, the ecological footprint of the human population was less than the rate of the Earth’s regeneration. Explosive growth in global trade, consumption, population growth and urbanisation means we are now using more of the world’s resources than can be replenished:

“To feed and fuel our 21st century lifestyles, we are overusing the Earth’s biocapacity by at least 56%.” (WWF)

The environmental impact of human activity is hardly a new topic but the numerous warnings over the years haven’t had the desired effect of changing society’s trajectory. The stark warnings from recent reports including the 2018 IPCC (Intergovernmental Panel on Climate Change) special report on the impacts of global warming, and popular programmes such as the Blue Planet II series which highlighted the devastating impact of pollution on the world’s oceans, have certainly helped heighten awareness and action has been taken across the world to address the climate emergency. Unfortunately, the progress made so far is not enough to reverse the current declining trends.

But the new report raises hope in that times of crisis new ideas and opportunities for transformation can arise and that the current Coronavirus (COVID-19) pandemic could perhaps be the catalyst for such change.

‘People and nature are intertwined’

COVID-19 has undoubtedly injected a new sense of urgency, emphasising again the interconnectedness of humans and nature. It has provided a stark reminder how unparalleled biodiversity loss threatens the health of both people and the planet.

Factors believed to lead to the emergence of pandemics – including global travel, urbanisation, changes in land use and greater exploitation of the natural environment – are also some of the drivers behind the decline in wildlife.

The report emphasises that biodiversity loss is not just an environmental issue, but also a development, economic, global security, ethical and moral one. And it is also about self-preservation as “biodiversity plays a critical role in providing food, fibre, water, energy, medicines and other genetic materials; and is key to the regulation of our climate, water quality, pollution, pollination services, flood control and storm surges.”

As well the pandemic, a series of recent catastrophic events are used to underline the intrinsic links between human health and environmental health, including: Africa’s plague of locusts in 2019 which threatened food supplies, caused by the unusually high number of cyclones; extreme droughts in India and Pakistan in 2019, leading to an unknown death toll; and Australia’s most intense bushfire season ever recorded, made worse by unusually low rainfall and record high temperatures, as well as excessive logging.

Alongside this, the “extraordinary gains in human health and wellbeing” over the past century, including reduced child mortality and increased life expectancy, are highlighted as a cause for celebration but the study warns that the exploitation and alteration of the natural environment that has occurred in tandem threatens to undo these successes.

Biggest threats to biodiversity

Clearly, biodiversity is fundamental to human life and it is vital that the drivers of its destruction are addressed; and quickly.

Drawing on the Living Planet Index (LPI), which tracks the abundance of mammals, birds, fish, reptiles, and amphibians across the globe, using data from over 4,000 different species, the report identifies the major threat categories to biodiversity:

  • Changes in land and sea use
  • Invasive species and disease
  • Species overexploitation
  • Pollution
  • Climate change

It may be surprising to learn that climate change has not yet been the main driver of biodiversity loss. In fact, globally, climate change features lower on the scale of threats than the other drivers in almost all regions. Changes in land and sea use is the biggest proportional threat, averaged across all regions, at 50%. This is followed by species exploitation at 24% with invasive species taking third place at 13%. Climate change accounts for 6% on average.

However, the report warns projections suggest the tables are set to turn with climate change overtaking all other drivers in the coming years.

But all is not lost yet. The report argues that it is possible to reverse these trends and calls for action to do so by 2030.

Bending the Curve’

This year’s report highlights findings from significant new research, the Bending the Curve initiative, which uses pioneering modelling of different human behaviour scenarios aimed at restoring biodiversity. It argues that this has provided ‘proof of concept’ for the first time that we can halt, and reverse, the loss of nature while feeding a growing population:

“Bending the curve of biodiversity loss is technologically and economically possible, but it will require truly transformational change in the way we produce and consume food and in how we sustainably manage and conserve nature.”

2020 has certainly made the whole world stop and think. And it has provided an opportunity to reset humanity’s relationship with nature. Encouragingly, there has been widespread talk of a ‘green recovery’ from the pandemic and the British public have recently backed a “fairer, greener Britain” amid concerns the government might be rushing the country back to a ‘business-as-usual’ model.

Achieving a balance with nature will clearly require systemic change, as the Living Planet report shows. In the words of Sir David Attenborough, above all it will require a change in perspective”.


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The Covid-19 knock-on: public health and the impact of delays in non-urgent treatment and diagnosis

Since the beginning of the pandemic, concerns have been raised about the wider public health impacts of coronavirus. In addition to strains on acute NHS care services on the frontline, there are warnings about the additional public health impacts of delays to preventative healthcare measures like screening and routine medical care in the form of pre-planned operations for long-term chronic and non-urgent conditions.

At the outbreak of the pandemic many hospitals took the decision to delay or stop entirely routine pre-planned surgeries and preventative screening and diagnostics. Some even suspended treatment for more urgent care like cancer treatment on a short term basis. While many of these services have resumed since the beginning of the pandemic, albeit with a backlog of patients now to be seen, significant strain on the NHS as we come into the winter months because of  coronavirus is still anticipated. As a result, many hospitals are not working at full capacity in order to prepare for potential increases in admissions due to coronavirus or staff shortages over the winter.

In many areas this has led to a backlog of care, both for those patients already in the system awaiting routine surgeries, as well as those who are yet to be diagnosed but would have been through preventative screening programmes run by the NHS.

Delays in healthcare and routine screening programmes 

Even before the coronavirus pandemic took hold, many NHS hospital trusts were under criticism because of the significant length of waiting times for people who required routine operations, which in some parts of the UK can be as long as three years. Doctors across the UK are now warning that these delays could be increased further unless the NHS receives additional support to increase capacity across all areas of care  not just urgent care in the coming months.

Data released by NHS England in October 2020 showed the numbers waiting over a year for hospital treatment have hit a 12-year high, with almost 2 million patients waiting more than the target time of 18 weeks for routine care.

It has been suggested that delays in diagnosis and routine treatments could lead to an increased number of hospitalisations further down the line, requiring higher levels of care, longer lengths of stay, and increased hospital readmissions.

A reluctance to visit hospitals and use primary care services

Government messages to ‘protect the NHS’ may have had the unintended consequence of discouraging people from seeking urgent medical care when it was required for fear of using services unnecessarily or for fear of contracting the virus when attending hospital or primary care settings.

Research from the Health Foundation found that there had been a significant reduction in the number of GP consultations since the start of the pandemic which has led to concerns about the care of non-covid patients, patients with long term health conditions and also the potential for delayed diagnosis. Primary care consultations also reduced and have remained low consistently since the beginning of lockdown.

Figures have also shown a reduction in the number of referrals, medical tests, new prescriptions and immunisations. While some of these reductions are the result of advice to delay routine referrals to free up capacity for hospitals to deal with the potentially large number of cases of Covid-19, routine referrals have still not recovered to pre-lockdown levels.

 

A potential future crisis for the NHS and a ticking time bomb for public health

Doctors are now warning that the treatment backlog which has been caused by the coronavirus pandemic, in addition to diagnostic delays and screening programmes, may lead to a future crisis of care or significant delays in care for people waiting to receive more routine treatment.

Delays in care have not only been reported in cases of physical health. There have also been significant delays in referrals for those seeking treatment for a mental health condition, an area of the NHS which was already facing significant delays in referral and transfer of care even before the pandemic. Research suggests that incidence of mental illness during the coronavirus pandemic increased. However, the numbers of people accessing services and being referred for treatment have not increased proportionate to this. People with mental health conditions may have been unable to access appropriate support through primary care pathways, which could potentially impact on their long term health and care.

Finally, concerns have been raised about the wider social determinants of health such as employment and poverty. Public Health England (PHE) published a monitoring tool which looks at the wider impacts of the Covid-19 pandemic on population health, and it is likely that the knock-on impact of the virus could have far reaching consequences for public health in the future as the health implications of lockdown, lack of social interaction and rising unemployment could be significant. 

Where next?

While the challenges of the coronavirus pandemic for the NHS will not be going away anytime soon, it is clear that it will be necessary for the NHS and other supporting services to act now to prevent a longer term public health crisis. It is critical that we not only focus on the acute care of Covid-19 patients, but also proactively manage patients without Covid-19, particularly those with time-sensitive, complex and long term conditions who are postponing their care. We must also consider the knock-on impacts of delayed diagnosis for those people who missed out on routine screening or who were unable or too afraid to visit their GP or hospital. This is important not only to sustain health and life, but to preserve hospital and NHS capacity in the future.


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How the COVID-19 homelessness response shows opportunities for future progress

Before the UK entered lockdown in March 2020, there were already discussions around how the spread of COVID-19 would impact some of the most vulnerable people in our society. There was an acute awareness not only of the significant levels of homelessness in our towns and cities but that the number of people who needed support was growing at an alarming rate. Strategies for prevention and outreach programmes to help break the cycle of homelessness through a network of support systems for homeless people were helping to a certain extent in some areas, but the problem was (is) chronic and the concern among people who worked in, and had experience of, the sector in relation to the potential impact of COVID-19 was growing.

Homelessness during the COVID-19 pandemic

Surprisingly though, in many areas the response to support the UK’s homeless populations was swift, definitive and all encompassing. Partnerships were formed with local hotel chains – the GLA partnership with multiple hotel groups as part of the Pan London Placement scheme is probably the best publicised but individual arrangements have sprung up across the country and people were moved from the street into accommodation which was self-contained and would allow them to effectively isolate if they showed any symptoms of COVID-19.

In March, minister Robert Jennick announced £3.2 million of funding for councils to help them protect local rough sleepers from the pandemic and MHCLG, councils, the voluntary sector and those who work within homelessness outreach specifically have all mobilised to form an effective network of support for many people who had previously been sleeping on the streets.

The response to moving those who were sleeping rough off the streets has been unprecedented, as is the volume of people who have been helped. Many people have been accommodated regardless of their “local connection” or their “recourse to public funds”, something which previously was a significant barrier to many people being housed in temporary accommodation by their local authority.

A new wave of homelessness?

However despite the significant progress made, there are growing concerns about a “second wave of homelessness”- people who become homeless off the back of the stagnation and collapse of some areas of the economy, particularly those in low paid and precarious work i.e. hospitality and retail sector. Additionally, there are signs that some especially vulnerable groups have not engaged with the process or that some people have became homeless after the initial offer of support was rolled out. These include people from migrant backgrounds, and people with acute and severe mental ill health.

Things can’t go back to the way they were

One thing is clear, according to professionals, things can’t be allowed to return to the way they were. In some instances this is for practical reasons, and in other instances because we have been able to see what it is possible to achieve when people co-operate and there is a collective will to progress.

The use of communal shelters, one of the main ways of delivering emergency accommodation for many years may have to stop, or at least be re-organised to avoid multiple people sharing facilities like bathrooms or sleeping in rooms with multiple beds. A move towards more “pod style” contained living may be a way forward, but it will take a shift in design to accommodate people safely in the future.

The response has shown that it is vital to develop links between housing and health, and that the integration of services with public health to create wrap-around care (which is something which is currently being co-ordinated in response to the pandemic) should be maintained going forward.

The pandemic response has also shown that multiple organisations can work well effectively together and that the red tape, perceived layers of bureaucracy and challenges of different ways of working can be overcome if there is collective understanding and will. These barriers can be overcome to create really effective and much needed services and support for some of our most vulnerable citizens.

Concerns have been raised around future funding, and in particular the risks of funding being stopped abruptly or the supply being removed at short notice, for example if hotels re-open and councils then struggle to identify appropriate accommodation for people to transition into. The sector has stressed that councils should be planning for this transition phase to prevent people returning to the streets and dis-engaging with services.

Opportunities to learn lessons

At an online event hosted by the Centre for London, which brought together professionals from within the sector in London to reflect on the response to COVID-19, somewhat surprisingly, the atmosphere was one of optimism that this could be the start of a new way of working. There is hope that a “can do” and “get things done attitude” which had been catalysed by the need for urgency because of the spread of COVID-19 can be harnessed and that this mindset should be embedded into practice going forward.

One of the main questions that appears to be raised is, if we can do it now, with such urgency, why couldn’t we do it before, and what steps need to be taken to ensure that the collective will and the government support doesn’t disappear post COVID-19? This is something local authorities, homeless outreach groups and other partners will have to grapple with over the coming weeks and months.

The response to the pandemic has been unprecedented. It has shown that with understanding, flexibility and effective partnership working to deliver coordinated services (as well as appropriate supply and funding) that tackling homelessness, or at least offering more to our homeless communities in terms of effective long term support, can be achieved.

There is a collective sense within the sector that the steps forward taken as a result of this pandemic should not be allowed to regress in the future, but should be strengthened and built upon to provide more effective support going forward for homeless communities across the UK.


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“Same storm, different boats”: addressing covid-19 inequalities and the ‘long term challenge’

MS Queen Elizabeth in Stornoway

The coronavirus pandemic has impacted upon almost every aspect of life.  However, this impact has not been felt by everyone equally. Some groups of people have been particularly badly affected – both by the virus itself and by the negative social and economic consequences of social distancing measures.  The phrase ‘same storm, different boats’ has been used widely to emphasise this.

The pandemic has exposed and deepened many of the deep-rooted inequalities in our society, including gender, ethnicity and income.  It has also shone a light on more recent inequalities too, such as the growth of precarious employment among sections of the population.

As we move out of lockdown, the long term consequences of the pandemic will continue to be felt unevenly across different sections of society, with those on the lowest incomes being most vulnerable.

As thoughts turn to recovery, there is a growing sense that now is the time to consider how we can create a more equitable society that benefits those most in need.

 

The long-term challenge

During a recent Poverty Alliance webinar, ‘Build Back Better: Poverty, Health and Covid-19: emerging lessons from Scotland’, Dr Gerry McCartney, Head of the Public Health Observatory at Public Health Scotland noted that the coronavirus pandemic was causing three concurrent public health crises:

  • the direct impact of the virus (through ill health and/or death);
  • the indirect impacts on health and social care services (e.g. reduced hospital admissions/referrals, delayed diagnoses); and
  • the long term unintended consequences of physical distancing measures

Dr McCartney’s recent research sets out the different groups at particular risk from covid-19 and outlines a number of ways in which the unintended consequences of physical distancing measures may negatively impact upon health via a complex set of pathways – including reduced physical activity, fear, anxiety, stress, boredom and loneliness, economic stresses related to reduced income and unemployment, the impact of the loss of education, as well as the risk of abuse and exploitation of children not in school, substance abuse, and domestic abuse and violence.

Dr McCartney has also been involved in a project that sought to quantify the direct impact of the pandemic in terms of years of life lost.  The results showed that, over 10 years, the impact of inequality on life expectancy is actually at least six times greater than the direct impact of the pandemic itself.

Dr McCartney referred to this as the “long-term challenge” and argues that in order to address these inequalities, it is crucial that society aims to ‘build back better’ following the pandemic.

Build Back Better

But what does this mean?  Put simply, Build back better argues that pandemic offers an unprecedented opportunity to refocus society on the principles of equity and sustainability.

A recent paper by the Wellbeing Economy Alliance (WEAll) sets out 10 key principles for ‘building back better’, covering a range of environmental, social and governance issues:

It highlights international examples of each of these principles in action, for example, speeding up the adoption of the doughnut economics framework in Amsterdam in response to the pandemic, and through the wellbeing principles implemented by the Wellbeing Economy Governments (WEGo) group, consisting of Iceland, New Zealand and Scotland (and recently joined Wales).

Indeed, in Scotland, the independent Advisory Group on Economic Recovery, established by the Scottish Government, have recently published their findings on how to support Scotland’s economy to recover from the pandemic.  It states that “establishing a robust, wellbeing economy matters more than ever”.

Unequal employment impact

One of the guiding principles set out by the Advisory Group on Economic Recovery is to “tackle inequality by mitigating the risks of unemployment, especially among groups hit hard by the crisis”.

Indeed, unemployment following the pandemic is unlikely to affect everyone equally – women, young people, BAME individuals and the low-paid are predicted to suffer the brunt.

In a subsequent Poverty Alliance webinar, ‘Addressing unemployment after Covid-19’, Tony Wilson from the Institute for Employment Studies (IES) highlights the scale of the problem.  He states that unemployment is rising faster than at any point in our lifetimes (barring a blip in 1947), and is likely to increase by 3 million as a result of the pandemic.

Again, the impact of this will be uneven.  Anna Ritchie Allan, director of Close the Gap, discusses the impact upon women in particular.  As well as being more likely to work in a sector that has been shut down, women are also more likely to have lost their job, had their hours cut, or been furloughed. As women are also usually the primary carers of their children, they have disproportionately affected by the closure of schools and home learning.

A recent report by Close the Gap highlights how the impending post-covid downturn is different than previous recessions, as the restrictions imposed to tackle the virus have impacted most heavily upon sectors that employ large numbers of female (e.g. hospitality, retail, care), as well as services that enable women’s participation in the labour market (e.g. nurseries, schools, and social care). Young and Black and minority ethnic (BME) women have been particularly affected.

For example, Kathleen Henehan, Research and Policy Analyst at the Resolution Foundation, considers how young people’s employment prospects have been affected by the pandemic. She notes that young people leaving education are likely to be worst affected.  However, again, inequalities exist – with those with lower levels of qualifications being particularly affected, and women and BME individuals within those groups affected most of all.

According to Anna Allan, policy to address unemployment as a result of the pandemic needs to be both gender-sensitive and intersectional – taking account of the fact that women are not one homogenous group, and ensuring that any job creation is not just providing more ‘jobs for the boys’.  For example, recent research by the Women’s Budget Group shows that investing in care would create 7 times as many jobs as the same investment in construction: 6.3 as many for women and 10% more for men.

Building forwards

In a third webinar, ‘Disability, rights and covid-19: learning for the future’, Dr Sally Witcher, CEO of Inclusion Scotland, suggests that as well as exposing and deepening existing inequalities, the coronavirus pandemic has created the scope for new inequalities to be created – ‘faultlines’ created by the differing impacts of the virus.

Dr Witcher questions the term ‘build back better’ – she asks whether indeed we should want to build back, when the old normal didn’t work for a large proportion of people, particularly those with disabilities. Dr Witcher also questions ‘who’ is doing the building, and whether the people designing this new future will have the knowledge and lived experience of what really needs to change.

Dr Witcher suggests that for any attempt to ‘build back better’ to be meaningful, it needs to reach out to the people that don’t currently have a voice – the people who have been most heavily affected by the virus.  Not only do these groups need to be involved, but they need to be leading the discussion about what a post-covid future looks like.

A post-covid future

Whilst the coronavirus pandemic has had a massive, devastating impact on people and economies around the world, it has created an opportunity to reflect on what is important to us as individuals and as a society.

There is strong public demand for change. According to a new YouGov poll, only 6% of the public want to return to the same type of economy as before the coronavirus pandemic.

Building back better recognises that addressing the causes of the deep-rooted and long-standing inequalities in our society is critical to a successful post-covid recovery.

There is also a need to protect and enhance public services, address issues of low-pay and insecure work, and prioritise wellbeing and the environment through a ‘green recovery’.

As Tressa Burke, of the Glasgow Disability Alliance, states:

History will recount how we all responded to the coronavirus outbreak.  We need to ensure that the story told demonstrates our commitment, as a society, to protecting everyone from harm, particularly those most at risk of the worst impacts of covid.”


For further discussion of the wellbeing economy, you may be interested in our blog post ‘How well is your economy? Moving beyond GDP as an indicator of success

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Knowledge from a distance: recent webinars on public and social policy

During the national lockdown, it’s been impossible for most of us to attend conferences and seminars. But many organisations have been harnessing the power of technology to help people share their knowledge, ideas and experience in virtual seminars.

In the past few weeks, the research officers at The Knowledge Exchange have joined some of these webinars, and in today’s blog post we’d like to share with you some of the public and social policy issues that have been highlighted in these online events.

The liveable city

Organised by the Danish Embassy in the UK, this webinar brought together a range of speakers from Denmark and the UK to consider how our cities may change post COVID-19, including questions around green space, high street recovery, active travel and density and types of residential living accommodation in our towns and cities.

Speakers came from two London boroughs, architectural design and urban planning backgrounds and gave examples of experiences in Newham, Ealing and Copenhagen as well as other more general examples from across the UK and Denmark. The seminar’s website also includes links to presentations on previous Liveable City events in Manchester, Edinburgh, Bristol and Glasgow.


What next for public health?

“Healthcare just had its 2008 banking crisis… COVID-19 has generated a real seismic shift within the sector and I don’t think we will ever go back”

This webinar brought together commentators and thought leaders from across the digital health and tech sectors to think about how public health may be transformed by our experiences of the COVID-19 pandemic and the significant shift to digital and online platforms to deliver care.

The speakers discussed data, privacy and trust and the need to recognise different levels of engagement with digital platforms to ensure that specific groups like older people don’t feel unable to access services. They also discussed the importance of not being driven by data, but using data to help us to make better decisions. The webinar was organised by BIMA, a community of businesses, charities and academia across the UK.


Green cities

This project, organised by the Town and Country Planning Association (TCPA), included 3 webinars each looking at different elements of green infrastructure within cities, including designing and planning, assessing the quality of different types of green infrastructure and highlighting the positive impacts of incorporating more good quality green spaces for mental and physical health, as well as for environmental purposes.


Rough sleeping and homelessness during and after the coronavirus

Organised by the Centre for London, this webinar brought together speakers from across the homelessness sector within London, including St Mungos, the Greater London Authority (GLA) and Croydon Council to explore how the COVID-19 pandemic was impacting people who are homeless or sleeping rough in the city.

Each speaker brought insights from their own experiences supporting homeless people in the capital (so far) during the COVID 19-pandemic. They highlighted some of the challenges, as well as some of the more positive steps forward, particularly in relation to co-operation and partnership working across different levels of government and with other sectors such as health.

They also commended everyone involved for the speed at which they acted to support homeless people, particularly those who were vulnerable or at risk. However, concerns were also raised around future planning and the importance of not regressing back into old ways of working once the pandemic response tails off.


Poverty, health and Covid-19: emerging lessons in Scotland

This webinar was hosted by the Poverty Alliance as part of a wider series that they are hosting.  It looked at how to ‘build back better’ following the pandemic, with a particular focus upon addressing the long-standing inequalities that exist throughout society.

The event included presentations from Dr Gerry McCartney, Head of the Public Health Observatory at Public Health Scotland, Dr Anne Mullin, Chair of the Deep End GPs, and Professor Linda Bauld, Professor of Public Health at University of Edinburgh.

A key message throughout was that while the immediate health impacts of the pandemic have been huge, there is an urgent need to acknowledge and address the “long-term challenge” – the impact on health caused by the economic and social inequalities associated with the pandemic.

It is estimated that over 10 years, the impact of inequalities will be six times greater than that of an unmitigated pandemic. Therefore, ‘building back better’ is essential in order to ensure long-term population health.


Returning to work: addressing unemployment after Covid-19

This webinar was also hosted by the Poverty Alliance as part of their wider webinar series on the pandemic.

The focus here was how to address the inevitable rise in unemployment following the pandemic – the anticipated increase in jobless numbers is currently estimated to be over three million.

The event included presentations from Kathleen Henehan, Research and Policy Analyst at Resolution Foundation, Anna Ritchie Allan, Executive Director at Close the Gap, and Tony Wilson, Director of the Institute for Employment Studies.

The webinar highlighted the unprecedented scale of the problem – noting that more than half of the working population are currently not working due to the pandemic, being either unemployed, furloughed or in receipt of self-employment support.

A key theme of the presentation was that certain groups are likely to be disproportionately affected by unemployment as the support provided by the government’s support schemes draw to a close later this year.  This includes women – particularly those from BAME groups, the lower paid and migrants – and young people.  So it’s essential that the support provided by the government in the form of skills, training, job creation schemes etc addresses this, and is both gender-sensitive and intersectional.


Supporting the return to educational settings of autistic children and young people

The aim of this webinar, provided by the National Autism Implementation Team (NAIT), was to offer a useful overview of how to support autistic children and young people, and those with additional support needs, back into educational settings following the pandemic.

Currently around 25% of learners in mainstream schools have additional support needs, and it is generally accepted that good autism practice is beneficial for all children.

The webinar set out eight key messages for supporting a successful return, which included making anticipatory adjustments rather than ‘waiting and seeing’, using visual supports, providing predictability, planning for movement breaks and provision of a ‘safe space’ for each child.  The importance of listening to parents was also emphasised.


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Ellisland Farm, Dumfries. “P1050381.JPG” by ejbluefolds is licensed under CC BY-NC 2.0

Burns at Ellisland

Our Research Officer, Donna Gardiner has also been following some cultural webinars, including one that focused on the links between Scotland’s national poet and the Ellisland Farm site. The webinar was led by Professor Gerard Carruthers, Francis Hutcheson Chair of Scottish Literature at the University of Glasgow and co-director of the Centre for Robert Burns Studies.

Robert Burns lived at Ellisland Farm in Dumfriesshire between May 1788 and November 1791, and is where he produced a significant proportion of his work – 23% of his letters and 28% of his songs and poems, including the famous Tam O’Shanter and Auld Lang Syne.

The presentation looked at how Robert Burns was influenced by the farm itself and its location on the banks of the River Nith.  It also touched on his involvement with local politics and friends in the area, which too influenced his work.

It was suggested that the Ellisland farm site could be considered in many ways to be the birthplace of wider European Romanticism. The webinar also included contributions from Joan McAlpine MSP, who is chair of the newly formed Robert Burns Ellisland Trust. She discussed how to help promote and conserve this historic site, particularly given the impact of the coronavirus on tourism.


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Digital infrastructure supporting health care during the COVID-19 pandemic

Healthcare is a key frontline service in the response to the COVID-19 outbreak. The NHS has had to react at pace to plan and deliver services in new and innovative ways.

Digital healthcare solutions are at the fore of ensuring not only the delivery of acute care for those patients suffering from COVID-19 but are also supporting the successful continuity of care and the day to day running of a health service which still needs to maintain “normal service” as well as its pandemic response. Digital infrastructure is helping the NHS and other partners to adapt and to meet the demand for health and care in a number of ways.

Supporting the delivery of care

In many ways, the NHS and frontline care in particular were already making inroads towards transitioning to digital and online platforms before the pandemic emerged. Many GP surgeries allow online appointment booking, and where appropriate, monitoring of those with long term conditions can be done remotely through at-home testing facilities, such as home heart monitors or monitors to help people monitor their diabetes.

Many care providers also already offer telehealth solutions for clients, and patient records are now stored online. However, in many ways the COVID-19 pandemic has catalysed uptake of digital solutions to healthcare diagnosis and delivery, with an increase in online consultations, greater use of the NHS Digital and NHS24 online and app platforms and a rise in the development of digital solutions to better support care in the community.

Support and training for frontline staff

In addition to supporting the direct delivery of care to patients, digital health infrastructure is also being adapted and used to deliver training and support to staff on the frontline. Blogs and online forums, including social media groups are enabling people to share experiences and best practice, and to create a sense of community among healthcare workers. In addition, virtual and e-learning opportunities are being developed to enable staff to access educational activities remotely. These include supporting the rapid education of the healthcare workforce in how best to manage the respiratory conditions encountered, as well as providing education to staff who may have been redeployed to other departments or settings as a result of the pandemic response. Online learning has also been used to help train volunteers and help the public to keep up to date with the latest developments across the health service.

Beyond healthcare to support the response to the pandemic

Artificial intelligence and data analytics also have a vital role to play in helping prevent the spread of coronavirus and other infectious diseases as digital solutions look to be developed to help beyond acute healthcare responses.

Predictive analytics and scenario modelling can be used to help identify those populations who are at risk of spreading the virus and of falling most severely ill to help support shielding campaigns and protect vulnerable groups as lockdown measures ease.

A project run by UK firm Biobank is looking to use samples collected by volunteers to map genetic sequencing in order to identify whether certain genetic characteristics make people more predisposed to become seriously ill, or more likely to contract the virus in the first place. This may help in the development of a vaccine and can also help identify those groups who will be most vulnerable when lockdown conditions are lifted so that they can be monitored more effectively.

Modelling and analytics can also be used to try and project any potential “second waves”. It is hoped that AI, analytics and machine learning will be able to help organisations learn from events such as the SARS epidemic, as well as quickly creating new knowledge from the millions of data points being generated in this outbreak.

Final thoughts

The significant humanitarian response to this global pandemic is being underpinned by a digital infrastructure, the extent of which we have never had at our disposal before. This digital support, of care delivery, communication, analytics, and modelling is being used in conjunction with insight from health and scientific specialists to try and help us find a path through this pandemic, deliver care, aid recovery and prevent re-emergence.

Making best use of the data and digital capacity we have throughout our health and care infrastructure will be a key part in preparing and meeting the needs and challenges that communities are facing.


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Further reading: articles on COVID-19 from The Knowledge Exchange blog

Coping with covid: supporting autistic children through and beyond lockdown

The measures put in place to reduce the spread of coronavirus (COVID-19) have impacted almost every aspect of our lives – from our contact with family, friends and loved ones, to how we work, eat, shop, relax and learn.

Adapting to and living with these new measures has been universally challenging.  For autistic people, the changes to daily life associated with the COVID-19 outbreak present a number of additional challenges.  In this blog, we are going to discuss some of these additional challenges, with a particular focus on autistic children and young people.  We also highlight some available supports.

Change of routines

A key feature of autism is the desire to follow certain routines and/or avoid unexpected or unpredictable events. Thus, adjusting to the changes caused by COVID-19 poses particular difficulty for many autistic people, for whom changes to routine may cause additional anxiety, distress and in some cases, emotional overload.

Other autistic people may be distressed because of the lack of structure their day now has – being unable to tell one day from the next, when there are no defining characteristics, can feel particularly disorientating.

Scottish Autism have produced guidance for autistic people and their parents/carers on helping to maintain a routine and the reasons why this is important.  They explain that not only does maintaining a routine provide a sense of security and stability, it can also help to provide a sense of calmness, support emotional self-regulation and encourage health and positive habits.

Many autistic children already use visual schedules and/or calendars to let them know what is happening and what to expect next.  These can be helpful in the current circumstances to help children adapt to new routines at home, and bring some sense of predictability and control to their changed lives.

 Being at home

Another change that COVID-19 has brought about is that more people within the household are at home than is typical – for example, one or both parents/carers may be working from home, along with any siblings/other householders who are usually in education or work.

This may be present challenges for autistic people both in terms of the change to routine and also in terms of sensory issues (e.g. noise).  For example, the household being busier than usual may be more challenging for autistic people as they will subsequently have less time and/or space to themselves, which may be needed in order to self-regulate and/or avoid sensory overload.

Special interests

Many autistic people have special interests that form a large part of their daily routines, and may play a key role in enabling them to relax, self-regulate and recover from sensory overload.

The coronavirus ‘lockdown’ has prevented most outdoors activities from taking place.  Thus many autistic people may have found that their special interest is no longer open to them – from train spotting to bird watching.  The removal of this activity from their life may be experienced as particularly distressing, and make self-regulation more difficult.

School closures

The widespread closure of schools means that many parents of autistic children have found themselves responsible for educating their child at home.

Educating children at home under these new circumstances is challenging for all parents.  However, for parents of autistic children, it presents additional challenges.

Many autistic children require additional support with their learning, and may experience difficulties sustaining concentration.  Autistic children may also have additional support needs such as dyslexia or dyscalculia, which may require the use of specific approaches and/or learning aids.  This presents additional challenges for learning in the home environment for parents that are unaccustomed to providing a full time education for their child.

In school, many autistic children receive additional support in class either in a 1-2-1 or in a small group lesson from practitioners skilled in addressing these additional needs. Replicating this level of support at home is of course challenging for parents who may not be familiar with the techniques used, or skilled in their use.  They may also struggle to provide the necessary 1-2-1 support if they are also expected to work from home themselves, or have other children to care for.

Concern about their child being disproportionately affected by school closures without the skilled support that they receive in schools may also add considerable stress.  For example, the United Nations has recently noted in a briefing paper that children with disabilities and special needs are among those most dependent on face-to-face services and are least likely to benefit from distance learning solutions.

As well as adequately supporting special educational needs, there are also challenges in relation to an autistic child’s ability and/or willingness to undertake schoolwork at home.  Some autistic people have difficulties with what is termed ‘flexible thinking’. This may include, for example, the ability to see something in a new way. Autistic children may be more likely to have a fixed perception of home as distinct from school.  Thus, it may be more difficult for autistic children to accept and adapt to schoolwork being done at home.  Similarly, they may not readily accept the notion that their parent or carer is now also their ‘teacher’, particularly if this person is usually relied upon as being their primary source of comfort and safety when distressed.

Accessible home learning

While this is without a doubt a difficult situation for both autistic people and their parents/carers, the good news is that there is an increasing amount of support and sources of advice available to help support autistic people to adapt and respond to the ‘new normal’ that the coronavirus pandemic has created.

On Twitter, the #accessiblehomelearning hashtag has been trending, with people sharing lots of home learning ideas and support for parents and carers, including tools to support individuals with dyslexia and/or reading and writing difficulties.

Lucy Chetty, Head Teacher at New Struan School has also shared her top tips on education at home.  She notes that different young people will experience the changes to life differently – some will enjoy having more control over their day outside of school, whereas others will miss the routines that they are used to.

According to Lucy, happiness and fun is a key aspect of learning. Thus parents and carers should try to find something that interests and motivates their individual child special interests may be of particular help in this regard.

On a practical level, ensuring clarity is hugely important.  This includes providing clear instructions, and setting out a clear beginning, middle and end to the activity.  Also recommended is ‘chunking down’ activities into smaller pieces so that there are regular breaks, and the use of visual strips and/or timers to help illustrate how long an activity will last.

 Re-opening schools

As we look ahead to the future, there are a number of critical issues that need to be considered to support autistic children and/or adults to transition back out of lockdown.

Transitioning back into the school environment will be challenging for many autistic children, particularly those that have previously found it difficult to attend school, and/or have experience of ‘school refusal’.  For many autistic children, successful school attendance has required a great deal of input from teaching and support staff, parents and the child themselves. This is because the school environment is often experienced as being particularly challenging for a number of different reasons – for example, sensory issues (e.g. noises, smells, lighting), difficulties with processing information, and/or social communication challenges (social skills, etiquette, etc).  Many autistic children also experience heightened levels of anxiety, which is exacerbated by the school environment.

Many autistic children will need additional support with the change of routine back to school days and hours, and also with their anxiety levels – particularly if they have concerns about catching and/or spreading the virus, or if other people within the school are perceived to be ‘not following the rules’.

Additional support for transitioning back into school will be particularly important if the new school environment looks significantly different to that which the child is used to as a result of social distancing measures – for example, by attending different hours or days at school, or having different classroom set ups to allow for social distancing – both of which are options currently being considered by the Scottish Government.

Transitioning out of lockdown

In recognition of the difficulties facing many autistic people and their parents and/or carers, the Scottish Government recently announced new funding to help provide additional support in the form of an extended helpline run by Scottish Autism, and the creation of online social support groups by the National Autistic Society Scotland. 

Researchers at UCL Institute of Education are also currently conducting research into the experiences and needs of parents and carers of autistic children during the pandemic, which will hopefully help inform how they can best be supported as we transition out of lockdown and into the future, where we learn to live alongside coronavirus.

In Scotland, the Education Recovery Group is currently exploring options for stabilising the education of pupils with additional support needs as “an early priority”.

While there is still a degree of uncertainty about how and when lockdown will be eased across the UK, what is certain is that the easing of lockdown – whenever it happens – will present additional challenges for many autistic people and their parents/carers. Listening to the voices of autistic people and their parents and carers will be hugely important if they are to be successfully supported in this transition.


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Guest Post: Will coronavirus be the catalyst for lasting air quality improvements?

By Freddie Talberg

‘Unprecedented’ has been the word of the moment as we find ourselves living through a health pandemic, the likes of which most of us have never seen before.

Who would have thought, even last month, that we would be faced with school closures, panic buying and huge bailouts of the economy that make Boris Johnson’s government look like Clement Attlee’s?

We will not know the long-term impact of this pandemic for months, maybe even years, but in the short-term as business braces for a bumpy ride ahead and our health system prepares for its most pressurised moment since the founding of the welfare state, we can look for some glimmers of light in the darkness.

In both China and Italy, there have been significant and immediate reductions in levels of air pollution in response to government lockdowns to tackle the virus outbreak. Research suggests a 25% drop in energy usage in the former that could see a 1% decline in its carbon emissions by the end of the year. In Italy, the vision of Venice’s canals running clear puts into perspective how quickly a reduction in human activity can positively improve air quality.

Looking around London, you can see the impact of full-scale lockdown just days in. Almost no traffic on the streets, and the number of people entering the city centre significantly down. This is reducing the public’s exposure to harmful particulates and other sources of air pollution, as it is in New York, where lockdown measures were implemented last week; early research shows carbon monoxide emissions down 50% on this time last year.

We should be careful about the conclusions that can be made from this. These positive environmental effects are down a significant government intervention that has essentially shut down all economic activity in response to a major public health emergency. These measures are going to take a toll on our wellbeing and can in no way be considered a sustainable solution.

But it makes me wonder. Can we possibly balance economic and social wellbeing whilst having a meaningful impact upon pollution levels in our cities? We will not be able to see the long-term legacy of this pandemic for years, but we should think about what we want it to be.

In my opinion, if one thing emerges above all else as the one thing we learn from COVID-19 and the lockdown measures it has enforced, is that we must reconsider certain aspects of our lives that we deem necessary and the long-term impact that our actions have on air quality. Seeing how much more vulnerable those with underlying health issues, including chronic lung conditions, are to the coronavirus says so much about the importance of good air quality.

We have to emerge from this crisis with a completely different attitude on how we tackle air quality issues and how we protect lung health.

The excellent quality open source data, such as that provided by the European Space Agency showing Italy and by NASA showing China, allows us to monitor the impacts of lockdown measures and track air pollution in real-time. This sort of tracking has to continue  once restrictions are lifted and include specific remediations, in order to prevent a spike in pollutive activity.

Families are going to travel to visit loved ones not seen for months across the country and the world, or they will take that holiday they had to cancel. Businesses meanwhile will look to make up for lost time and industrial production will ramp up. ‘Flatten the curve’ has been the government’s motto around coronavirus, and should be the world’s motto regarding emissions after this is over.

We therefore must have practical solutions in place. Taking control of emissions is difficult at the best of times, but technology can be used to help companies track their emissions levels and act on air quality, on a scale that works for them – it is not just a job for the world’s largest space agencies.

EMSOL for example, provides businesses with real-time, specific, actionable evidence about emission breaches delivered straight to their mobile. So, they can pinpoint the problem the moment it becomes a problem, and take specific steps every day to improve air quality.

It may not seem the priority right now but this pandemic does not change that we are in an ongoing climate crisis. COVID-19 is forcing us to ask fundamental questions about how we live our lives, and it is a wake-up call for London and big cities around the world about the importance of good lung health.

When all this is over, I hope to see our political and business leaders make the legislative changes necessary that mean we can track and reduce our pollution levels for the long-term.

Freddie Talberg, CEO and co-founder of Emsol

Our thanks to Air Quality News for permission to republish this article.


Idox Transport solutions enable traffic managers to model, monitor and control the environmental effects of travel as well as reducing congestion to maximise the use of a limited road network, all using UTMC, RTIG, SIRI and other recognised industry protocols. Idox Transport was also funded through the UK Government’s Low Emission Freight and Logistics Trial to explore the use of real-time data tools to change driver behaviour, reduce carbon emissions and improve air quality.


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