Real time surveillance on the impact of restrictions on harm reduction services to improve responsiveness and reduce harms in unprecedented times
The Harm Reduction Database Wales (HRD) provides real-time web-based surveillance at person-based level in all harm reduction services across Wales including all Needle and Syringe Programmes (NSP), Take Home Naloxone (THN) providers and suspected fatal-drug poisoning ‘hot’ reviews. Over the period 2020 to 2021 and ongoing, data from the HRD provide timely information for action to service providers, planners and policy makers for the adaptation of harm reduction service provision in response to COVID-19 pandemic restrictions. From 2020, an extract was drawn from the HRD on the first of each month, and data collated and analysed by site, health board and unique individual level profiling demographics, activity and outcomes for each of the harm reduction service elements: NSP, THN and suspected fatal drug poisoning reviews. The data and recommendations report was presented to health and social care leads within one week of data extract using 2019 monthly activity data from each of the harm reduction service elements as a baseline.
Compared to 2019, the mean number of clients attending monthly at NSP services decreased by 22% in 2020 and 33% to end of 2021. This decrease was more evident amongst PWID aged 15- 29 years compared to those aged 30 or over with decreases of 31% and 46% in 2020 and 2021 respectively.
Overall, THN provision remained stable, however, suspected drug poisonings increased by 50% in 2020 compared to the previous year. Additional analysis is ongoing and will be presented. Real-time surveillance of individual and harm reduction service-level activity is vital to provide evidence on the ongoing impact and recommendations for action for groups already at risk of poorer health outcomes, risk of bacterial infections, transmission of blood borne virus infection and premature death.