COVID-19 transmission and infection: linkage of COVID-19 Infection Survey, Test and Trace, and Patient Demographics Survey.

Objectives Data linkage was conducted between the Office for National Statistics’ Covid Infection Survey (CIS), the Department of Health and Social Care’s Test and Trace (T&T) and NHS’ Personal Demographics Service (PDS) datasets. Linked data was required to provide reliable estimates of rates of COVID-19 transmission and infection used to inform policy regarding the ongoing pandemic. Approach The CIS was created to track infection rates in the UK population. Linking CIS participants to positive tests in T&T helped improve these estimates. Linkage to PDS was required to attach NHS number to these datasets to facilitate further linkages that could also be used to inform Government about the spread of the virus. Multiple approaches were used to link the data. Initially, T&T was linked to itself via a series of strict matchkeys to cluster records belonging to the same individual, to create a person level identifier. Subsequent linkage of CIS-PDS, T&T-PDS and CIS-T&T involved deterministic linkages with matchkeys designed and applied independently. A probabilistic (Fellegi-Sunter scoring) method was used to link CIS-PDS and CIS-T&T. Additional, associative links were created between CIS and T&T records that had matched to the same PDS record but had not matched to each other. Results The accuracy of CIS-PDS and CIS-T&T linkages was high (recall and precision >98%; all 95% lower confidence intervals >93%). A quality assessment of T&T-PDS is underway, as are relevant bias analyses. Conclusion As a result of this linkage, COVID-19 analysts have access to enriched datasets linked to compare previously separated variables, with confidence that the linkage method used was to required quality standards. The linked data has been used to provide crucial evidence to Government on infection and re-infection rates. Subsequent linkages have enabled analysts to explore risk factors associated with different variants of the virus, vaccination status and hospital episodes. Improvements continue to be made

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Integrating Care for Individuals with FASD: Results from a Multi-Stakeholder Symposium

BACKGROUND: Fetal Alcohol Spectrum Disorder (FASD) has a significant impact on communities and systems such as health, education, justice and social services. FASD is a complex neurodevelopmental disorder that results in permanent disabilities and associated service needs that change across affected individuals’ lifespans. There is a degree of interdependency among medical and non-medical providers across these systems that do not frequently meet or plan a coordinated continuum of care. Improving overall care integration will increase provider-specific and system capacity, satisfaction, quality of life and outcomes. METHODS: We conducted a consensus generating symposium comprised of 60 experts from different stakeholder groups: Allied & Mental Health, Education, First Nations & Métis Health, Advocates, Primary Care, Government Health Policy, Regional FASD Coordinators, Social Services, and Youth Justice. Research questions addressed barriers and solutions to integration across systems and group-specific and system-wide research priorities. Solutions and consensus on prioritized lists were generated by combining the Electronic Meeting System approach with a modified ‘Nominal Group Technique’. RESULTS: FASD capacity (e.g., training, education, awareness) needs to be increased in both medical and non-medical providers. Outcomes and integration will be improved by implementing: multidisciplinary primary care group practice models, FASD system navigators/advocates, and patient centred medical homes. Electronic medical records that are accessible to multiple medical and non-medical providers are a key tool to enhancing integration and quality. Eligibility criteria for services are a main barrier to integration across systems. There is a need for culturally and community-specific approaches for First Nations communities. CONCLUSIONS: There is a need to better integrate care for individuals and families living with FASD. Primary Care is well positioned to play a central and important role in facilitating and supporting increased integration. Research is needed to better address best practices (e.g., interventions, supports and programs) and long-term individual and family outcomes following a diagnosis of FASD