Preliminary indications of the burden of COVID-19 among people who inject drugs in England and Northern Ireland and the impact on access to health and harm reduction services

S Croxford; E Emanuel; A Ibitoye; J Njoroge; C Edmundson; M Bardsley; E Heinsbroek; V Hope; E Phipps

doi:10.1016/j.puhe.2021.01.004

Preliminary indications of the burden of COVID-19 among people who inject drugs in England and Northern Ireland and the impact on access to health and harm reduction services

Public Health. 2021 Mar:192:8-11. doi: 10.1016/j.puhe.2021.01.004. Epub 2021 Jan 15.

Authors

S Croxford¹, E Emanuel², A Ibitoye², J Njoroge², C Edmundson², M Bardsley², E Heinsbroek³, V Hope⁴, E Phipps²

Affiliations

¹ National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom. Electronic address: sara.croxford@phe.gov.uk.
² National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom.
³ National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom; Joint Biosecurity Centre, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, United Kingdom.
⁴ National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom; Public Health Institute, Liverpool John Moores University, 3rd Floor, Exchange Station, Tithebarn Street, Liverpool, L2 2QP, United Kingdom.

Abstract

Objective: The aim of the study was to describe the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on people who inject drugs (PWID) in England, Wales and Northern Ireland.

Study design: This is a cross-sectional Unlinked Anonymous Monitoring (UAM) Survey of PWID.

Methods: People who had ever injected psychoactive drugs were recruited to the UAM Survey by specialist drug/alcohol services in England, Wales and Northern Ireland. From June 2020, in addition to providing a dried blood spot sample and completing the UAM behavioural questionnaire, participants were asked to complete an enhanced coronavirus disease 2019 (COVID-19) questionnaire. Preliminary data are presented to the end of October and were compared with data from the 2019 UAM Survey, where possible.

Results: Between June and October, 288 PWID were recruited from England and Northern Ireland. One in nine (11%; 29/260) PWID reported testing positive for SARS-CoV-2 or experiencing COVID-19 symptoms. Fifteen percent (26/169) reported injecting more frequently in 2020 than in 2019; cocaine injection in the preceding four weeks increased from 17% (242/1456) to 25% (33/130). One in five PWID (19%; 35/188) reported difficulties in accessing HIV and hepatitis testing, and one in four (26%; 47/179) reported difficulties in accessing equipment for safer injecting.

Conclusions: Our preliminary findings suggest that PWID have experienced negative impacts on health, behaviours and access to essential harm reduction, testing and treatment services owing to the COVID-19 pandemic. Continued monitoring through surveillance and research is needed to understand the subsequent impact of COVID-19 on blood-borne virus transmission in this population and on health inequalities.

Keywords: COVID-19; Infectious disease; Outbreak; People who inject drugs; SARS-CoV-2; United Kingdom.

MeSH terms

Adult
COVID-19 / psychology*
Cross-Sectional Studies
England / epidemiology
Female
Harm Reduction*
Health Services Accessibility*
Humans
Male
Middle Aged
Northern Ireland / epidemiology
Pandemics
Public Health Surveillance
SARS-CoV-2
Substance Abuse, Intravenous / complications
Substance Abuse, Intravenous / epidemiology*
Surveys and Questionnaires
Wales / epidemiology