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Covid-19 HSE Clinical Guidance and Evidence

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About - HSE Repository for Interim Clinical Guidance intended for the Clinical Community

This site provides a national easily-accessible repository of clinical guidance to equip the clinical community in Ireland with the requisite information whilst working within the current COVID-19 environment. 

The site contains and enables access to:

  • HSE Interim Clinical Guidance to provide nationally consistent advice to the clinical community in response to the COVID-19 national health emergency, and as core services resume is inclusive of guidance for the provision of both COVID-19 care and non COVID care in a COVID environment.  Guidance is based on best available knowledge at the time of completion, written by clinical subject matter experts (SMEs) working with the HSE.  These SMEs have both expertise and experience of treating patients for the specific health conditions covered by the guidance.
  • Summaries of Evidence prepared by the HSE National Library Evidence team and other stakeholders (these are statements of emerging evidence and do not replace clinical judgement or guidance)
  • An online facility to request additional published COVID-19 evidence in relation to specific clinical questions

Interim Clinical Guidance published on this site is under the governance of CCO CAG.  This guidance takes into consideration advice provided by NPHET relating to the current COVID-19 health emergency. 

The content of the site is not meant to replace clinical judgment or specialist consultation, but rather strengthen clinical management of patients and provide up-to-date and relevant guidance.  The guidance is iterative in nature and is subject to ongoing review to ensure alignment with emerging evidence and updates to national guidelines.  This guidance must be read in conjunction with the National HSE Infection Prevention and Control (IPC) Guidance for Possible or Confirmed COVID-19 

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Latest - Summaries of Evidence

Updated page: 26/06/20
What impact is cocooning and the increased level of anxiety due to COVID-19 having on the mental health of those identified as at-risk due to a chronic disease [immunocompromised]? What interventions have been identified and deemed efficacious? (Published May 29, 2020)

Venkatesh et al point to quarantine and social isolation as contributors to frustration, boredom, low mood and potentially depression among those affected by recent pandemics. Anxiety was associated with stress and reduced sleep quality, and the combination of anxiety and stress reduced the positive effects of social capital on sleep quality. Brooks et al found that during major infectious disease outbreaks, quarantine can be a necessary preventive measure; however, quarantine is also often associated with a negative psychological effect. Mukhtar et al point to substantial evidence from past epidemics on the detrimental impact of quarantine on psychological health.  In a study carried out in the Basque community in Northern Spain, Ozamiz-Etxebarria et al found that although levels of anxiety were generally low at the start of the pandemic alert, younger individuals with chronic diseases reported more symptoms than the rest of the population.


Fischer et al found that self-guided therapeutic approaches including cognitive-behavioural therapies, mindfulness and acceptance-based interventions, selected positive psychology interventions, and multi-component and activity-based intervention showed promising evidence for effectiveness in combatting anxiety due to quarantine and self-isolation. Sofo et al investigated alternative approaches to alleviating stress during quarantine including the health, recreational and economic benefits associated with growing vegetable gardens in home spaces. Physical exercise as a de-stressor is discussed by Matias et al who argue that exercising at home in a crisis situation can be performed without self-criticism; which in turn may provide adaptive coping, problem-solving and psychological well-being. In a 2018 systematic review, Thabrew et al highlight the importance of e-health interventions in alleviating stress among children and adolescents suffering from long-term chronic conditions. 


Meinert et al describe the design of a mobile health app which will use goal setting and online communities to encourage positive nutrition, physical activity and virtual interaction during social distancing. Similarly, Viana et al discuss how exergames can be a useful method of combatting anxiety during periods of self-isolation.

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