Assessment of how older adults have been affected by COVID-19: A look at the Hertfordshire Cohort Study
By Elaine Dennison, University of Southampton
December 16, 2020
In our final COVID-19: Perspectives blog series this year, Professor Elaine Dennison, Deputy Director of the Hertfordshire Cohort Study, takes a look at the lockdown experiences of the participants of the study, all born in Hertfordshire during 1931-9.
I am writing this shortly after the announcement that several vaccines are showing promise in the fight against COVID-19, and the news is full of talk of mass vaccination before Christmas, and the world returning to normal next year. My head has a number of questions, and like others I have some reservations, but there is no doubt that the news has lifted the public mood in what has been a remarkably challenging year.
What has struck me over the last few months is the collaborative, ‘can do’ way scientists have worked this year. Based at the University of Southampton, I have been amazed by the number of COVID-19 related projects, including the CLOSER partner studies like our own that have pivoted at speed to include COVID-19 sub-studies. As the First Wave of COVID-19 struck, we were coming to the end of baseline data collection of a randomised controlled trial of healthy conversation skills in some 180 of our study participants, all born in Hertfordshire during 1931-9, and still living there in their own homes (the Healthy Conversation Skills technique uses open questioning by a trained researcher or health professional to help individuals identify something that they would like to change in their lifestyle, supporting them to achieve these changes, a technique used more commonly in younger populations). When we decided to add a COVID-19 extension to our study, our main aims were to find out how older adults within the Hertfordshire cohort have been practically and emotionally affected by the COVID-19 pandemic, and to report their experience of the First Wave, achieved via a phone administered quantitative survey.
As a consequence of being asked to write this blog, we have taken the opportunity to review the first 70 responses from an approximately equal balance of men and women. Of 70 initial respondents, all born in Hertfordshire during the period 1931-9 and still living there, 37% lived alone; of the remainder, 86% lived with a spouse and the remaining 14% lived with family. Importantly, 20% of participants had felt they needed to go out even though they didn’t want to; if participants went shopping or collected their shop, 69% went themselves, whilst 31% had the shop done by someone else in their household. We were particularly interested to know whether participants found the government COVID-19 guidance easy to understand and how they rated their own knowledge of it. Figure 1 below shows how easy our study participants found the COVID-19 guidance to follow and to rate their knowledge; as seen, this was variable, perhaps reflecting the study team’s experiences as well…
Figure 1: Was the UK government guidance on COVID-19 easy to understand?
30 (42%) participants said they had received help during the pandemic that they wouldn’t normally receive, 36 (51%) had not received help, and 5 (7%) didn’t comment. A key concern for many people in the First Wave was getting supplies of food and medication while home delivery services struggled to upscale. Almost half of our participants had heard of the NHS volunteer responders programme, launched during the first lockdown, and 53% hadn’t; only 4% had made use of support services, such as Age UK Hertfordshire. Many participants said they would be open to use such services but hadn’t previously because they felt they didn’t need it or hadn’t thought of it. Some would only use these services if they didn’t have any other means of help, or in case of emergency. Most participants however said they didn’t need the services because they have family, friends or neighbours available to help if required. Those who said they wouldn’t use the services felt able to manage.
Figure 2: Delivery of food and prescriptions
Much discussion recently has focused on the displacement of other medical care as a consequence of the pandemic; 40% of our respondents had had a medical appointment cancelled because of lockdown due to COVID-19, of which 80% were follow up appointments.
The impact of the pandemic on daily life in what one might consider to be a relatively homogenous groups with regard to age, ethnicity and geographic location has been broad ranging; in one question we asked participants to compare how their life had been in the week prior to their telephone interview, in comparison to before COVID-19, and their responses are shown in Figure 3 below. Further questions asked about specific activities and in general, time spent watching TV was unchanged, as were smoking habits and dietary patterns, although about a quarter of participants reported eating less than usual. While we have yet to analyse the loneliness data, 80% of respondents said they had less social contact than usual.
Figure 3: How different has life been in the past week compared to before COVID-19?
Finally, respondents were also asked what internet accessible devices they possessed. While 60% had access to a basic mobile phone, only 31% had a smart phone compatible with the NHS App. Two thirds had internet access, and some means of accessing information (computer or iPad).
Clearly these are preliminary findings, and we look forward to the next set of results with interest. However, they provide a fascinating snapshot of experience of the First Wave of the COVID-19 pandemic in older adults in the UK.