Respiratory infections place a significant burden on individuals, healthcare systems and society. This short report discusses early findings from an ongoing longitudinal survey study as part of the wider Community Action on Respiratory Infections Cymru (CARI) study. An initial baseline survey was sent to a large sample of predominately older adults in Wales in December 2022 and January 2023 (n=3476) (f = 63%; white = 98%; age, M=62.94 (SD=12.83)). Follow-up ‘symptom surveys’ are being sent to random sub-samples of the overall sample at regular intervals throughout winter 2022/3. Results find that intentions to get future COVID-19 vaccinations are high, but that prevalence of infection-reducing behaviours was generally low. Additionally, although overall worry about respiratory infections was relatively low, there was greater worry about COVID-19 relative to flu and other viruses. Amongst those experiencing symptoms, flu was perceived as the most common cause, and a high temperature, continuous cough and fever were most likely to lead people to take specific precautions like taking a COVID-19 test or seeking medical advice. Findings have implications for public health, including the need to provide nuanced but clear public health information and guidance on what actions to take when people are experiencing symptoms of a respiratory illness.

Objective To explore UK public decisions around whether or not to get COVID-19 vaccines, and the facilitators and barriers behind participants’ decisions. Design This qualitative study consisted of six online focus groups conducted between 15 th March and 22 nd April 2021. Data were analysed using a framework approach. Setting Focus groups took place via online videoconferencing (Zoom). Participants Participants (n = 29) were a diverse group (by ethnicity, age and gender) UK residents aged 18 years and older. Results We used the World Health Organization’s vaccine hesitancy continuum model to look for, and explore, three main types of decisions related to COVID-19 vaccines: vaccine acceptance, vaccine refusal and vaccine hesitancy (or vaccine delay). Two reasons for vaccine delay were identified: delay due to a perceived need for more information and delay until vaccine was “required” in the future. Nine themes were identified: three main facilitators (Vaccination as a social norm; Vaccination as a necessity; Trust in science) and six main barriers (Preference for “natural immunity”; Concerns over possible side effects; Perceived lack of information; Distrust in government;; Conspiracy theories; “Covid echo chambers”) to vaccine uptake. Conclusion In order to address vaccine uptake and vaccine hesitancy, it is useful to understand the reasons behind people’s decisions to accept or refuse an offer of a vaccine, and to listen to them and engage with, rather than dismiss, these reasons. Those working in public health or health communication around vaccines, including COVID-19 vaccines, in and beyond the UK, might benefit from incorporating the facilitators and barriers found in this study.

Health communication has relevance for virtually every aspect of health and well-being, including disease prevention. This review explored the effectiveness of communications in enhancing the adoption of or adherence to behavioural interventions (non-pharmaceutical interventions (NPIs)) related to COVID-19. The review takes the UK as a case study and focuses on self-reported behaviours (e.g. social distancing). It also reviews the psychosocial determinants of adherence. Searches were conducted using PubMed, Scopus, CINAL, ASSIA and iCite databases. Eleven thousand five hundred records were identified and 13 were included in the final sample. Included studies suggest that NPI adoption or adherence was generally high, and communication had significant impacts, with key themes including clarity and consistency, trust and control. Based on the evidence in this review, features of effective communication in the context of NPI adoption or adherence are (i) information should be conveyed clearly and conflicting (mixed) messages should be avoided; (ii) information should be conveyed by trusted sources (e.g. health authorities) and (iii) communication should strike a balance between being authoritative but avoiding language seen as controlling (e.g. 'you must'). Future research should prioritize quantitative, experimental and longitudinal study designs, that focus specifically on communication as an intervention, and which measure behaviour. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.

This report summarises the findings of the public views during the Covid pandemic (PVCOVID) study, conducted between March 2020 and November 2022. PVCOVID included a longitudinal qualitative study of a cohort of members of the UK public, documenting in real-time their attitudes and experiences of the pandemic. The report documents people's experiences of, and compliance with, non- pharmaceutical interventions (NPIs) including lockdowns and social distancing, testing, contact tracing and self-isolation, facemask use, as well as their attitudes towards vaccines. Key lessons for the future include: Build trust in government and use trusted messengers; Tackle misinformation; Ensure rules and guidance are clear and consistent; Balance providing too much with too little information; and Provide greater support for social distancing and isolation, including emotional and mental health support.

Recent declines in the overall rates of covid-19 in the UK have masked the rapid and steep rise in cases among children.As of 26 January 2022, Office for National Statistics data suggest that nearly 12% of children in primary school and below (ages 2 to 11), and 6.5% of children in secondary school (ages 11 to 16), tested positive for covid-19.

If we are to successfully live with covid, we need to draw on past lessons, say Simon Williams and Susan Michie

Congenital heart disease (CHD) is the most common birth defect, affecting approximately 1% of live births globally. The genetic aetiology of CHD is poorly understood: many genetic loci have already been identified which cause CHD either as part of a defined genetic syndrome or as non syndromic CHD, but the majority of cases remain unexplained. The 100,000 Genomes Project conducted whole genome sequencing for patients with a range of rare diseases and cancers, including a number recruited for CHD. We analysed clinical, phenotypic and genetic data from the 100,000 Genomes Project to identify potentially pathogenic variants in 2638 participants with CHD, including 536 recruited for CHD and 2102 recruited for other conditions who also have cardiac defects. This cohort are primarily composed of individuals with CHD accompanied by additional extra-cardiac abnormalities but without a diagnosis of a recognised syndrome. We estimate that the set of known non syndromic CHD-causative genes which are routinely screened by Genomics England account for a maximum of 5.6% CHD cases in this cohort. In contrast, expanding screening to include a number of genes associated with CHD as part of a defined genetic syndrome (eg. Noonan, CHARGE or Kabuki syndromes) could increase the diagnostic yield for this cohort by more than two-fold. Analysis of de novo variants in non-familial CHD cases also identified a significant burden of variants in syndromic CHD genes. Copy number variants (CNVs) are known to play a significant role in CHD, especially in cases of CHD with additional abnormalities. Participants with CHD in this cohort have a significantly higher burden of both deletions and duplications than a matched control cohort. However, very few CNVs overlap known CHD-causative regions such as the 22q11.2 or Williams-Beuren syndrome regions indicating novel CNVs are likely to explain a significant number of cases in this cohort. Wider screening of syndromic CHD genes and novel copy number variants could significantly increase the yield of the 100,000 Genomes Project for participants with CHD. Further investigation of rare variants in this cohort, particularly structural variants, will yield additional novel CHD-associated genes and genomic regions to help explain the ‘missing heritability’ of CHD. This research was made possible through access to the data and findings generated by the 100,000 Genomes Project. Conflict of Interest None