Exploring the Need of Social Change Leadership Concerning Health Communication and Health Disparities During the COVID-19 Pandemic

In March of 2020, the United States activated nationwide pandemic response protocols due to the swift spread of Novel Coronavirus Disease 2019, also known as COVID-19. Amidst the domestic response, urgency surrounded the need to build collective awareness of the signs, symptoms, and preventive measures of the virus. As the virus spread and historically marginalized communities were disproportionately impacted with rates of infection, the need to explore the presence of disparities in health communication, health education, and personal health literacy surfaced. The research contained within this study examines the root cause of the gap in health literacy for communities of color and presents actionable next steps to increase positive healthcare outcomes for all.

Design of a University Pandemic Response Decision Support System

The global effort to combat the COVID-19 pandemic has changed how people conduct their daily lives. Institutions of higher education have been greatly impacted by these changes and must find ways to adapt to this new environment. Universities are a unique case because they must control disease spread, while maintaining the same or similar quality of education. The University Pandemic Response Decision Support System (UPRDSS) is a system designed to help universities pick the most suitable method for instruction delivery when faced with any pandemic. Using George Mason University as a case study, the goal was to design a system that allows university administrations to make an educated operations decision. The UPRDSS achieves this by simulating the spread of disease, analyzing learning outcome data, and using a multi-attribute utility function to determine the most appropriate method of instruction that enables positive learning and health outcomes.

Implementation of SARS-CoV-2 monoclonal antibody infusion sites at three medical centers in the United States: Strengths and challenges assessment to inform COVID-19 pandemic and future public health emergency use

Monoclonal antibody therapeutics to treat COVID-19 have been authorized by the U.S. Food and Drug Administration under Emergency Use Authorization (EUA). Many barriers exist when deploying a novel therapeutic during an ongoing pandemic, and it is critical to assess the needs of incorporating monoclonal antibody infusions into pandemic response activities. We examined the monoclonal antibody infusion site process during the COVID-19 pandemic and conducted a descriptive analysis using data from three sites at medical centers in the U.S. supported by the National Disaster Medical System. Monoclonal antibody implementation success factors included engagement with local medical providers, therapy batch preparation, placing the infusion center in proximity to emergency services, and creating procedures resilient to EUA changes. Infusion process challenges included confirming patient SARS-CoV-2 positivity, strained staff, scheduling, and pharmacy coordination. Infusion sites are effective when integrated into pre-existing pandemic response ecosystems and can be implemented with limited staff and physical resources.

Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center

The SARS-CoV-2 pandemic has resulted in a surge of critically ill patients. Hospitals have had to adapt to the demand by repurposing areas as intensive care units. This has resulted in high workload and disruption of usual hospital workflows. Surge capacity guidelines and pandemic response plans do not contemplate how to limit collateral damage from issues like hospital-acquired infections. It is vital to ensure quality of care in surge scenarios.

Analyzing natural herd immunity media discourse in the United Kingdom and the United States

Natural herd immunity, where community-acquired infections in low-risk populations are used to protect high risk populations from infection–has seen high profile support in some quarters, including through the Great Barrington Declaration. However, this approach has been widely criticized as ineffective and misinformed. In this study, we examine media discourse around natural herd immunity in the United States (US) and United Kingdom (UK) to better understand how this approach was promoted. Country-specific news media publications between March 11, 2020 and January 31, 2021 were searched for references to herd immunity. News articles focused on herd immunity and including a stakeholder quote about herd immunity were collected, resulting in 400 UK and 144 US articles. Stakeholder comments were then coded by name, organization, organization type, and concept agreement or disagreement. Government figures and a small but vocal coalition of academics played a central role in promoting natural herd immunity in the news media whereas critics were largely drawn from academia and public health. These groups clashed on whether: natural herd immunity is an appropriate and effective pandemic response; the consequences of a lockdown are worse than those of promoting herd immunity; high-risk populations could be adequately protected; and if healthcare resources would be adequate under a herd immunity strategy. False balance in news media coverage of natural herd immunity as a pandemic response legitimized this approach and potentially undermined more widely accepted mitigation approaches. The ability to protect high risk populations while building herd immunity was a central but poorly supported pillar of this approach. The presentation of herd immunity in news media underscores the need for greater appreciation of potential harm of media representations that contain false balance.

Sidelined during COVID-19: a narrative inquiry into how simulationists experienced the pandemic

Background In the simulation community, colleagues who are no longer clinically practicing were often proximal to the COVID-19 response, not working in the frontlines of patient care. At the same time, their work as simulationists changed dramatically or was halted. This research explored the experiences of those simulationists who have clinical backgrounds but did not provide direct patient care during the initial pandemic response. The aim of this study was to allow those simulationists to share and have their stories heard. Methods This qualitative research used a narrative approach to answer the research question: What were the experiences of those in the simulation community who did not contribute to the frontline patient care response during the early stages of the pandemic? A semi-structured questionnaire aimed at eliciting a story was disseminated through online simulation discussion boards. Data was collected through PHONIC with options to type or speak responses. Responses were analyzed using an inductive analytical process to identify themes or patterns in the narratives. Results Thirty-six respondents completed the survey between August 1, 2020 and November 30, 2020. Narrative arcs were identified that illustrated the events, actions, thoughts and feelings representative of experiences shared by many simulationists. Two major themes emerged: Challenges and Opportunities. Challenges included feelings of guilt; frustration; overwhelmed, stressed and exhausted; being away from the action, being unused and underappreciated. Opportunities included leadership (evolution and innovation), personal development, and being a part of something. Conclusions The findings reflect a snapshot in time of how simulation was viewed and used in the world during a pandemic through the personal stories of simulationists with clinical backgrounds who did not provide direct patient care. Sharing these narratives may inform future simulation development; however, it is vitally important that the emotions are recognized and acknowledged. Managers should ensure mental health resources and support are available to all staff, including those not deployed to the frontline.

How did UK policymaking in the COVID-19 response use science? Evidence from scientific advisers

Background: Responses to COVID-19 have invested heavily in science. How this science was used is therefore important. Our work extends existing knowledge on the use of science in the pandemic by capturing scientific advisers’ experiences in real time.Aims and objectives: Our aim was to present generalisable messages on key qualifications or difficulties involved in speaking of ‘following the science’.Methods: Ninety-three interviews with UK scientific advisors and government officials captured their activities and perceptions during the pandemic in real time. We also examined Parliamentary Select Committee transcripts and government documents. This material was analysed for thematic content.Findings and discussion: (1) Many scientists sought guidance from policymakers about their goals, yet the COVID-19 response demonstrated the absence of a clear steer, and a tendency to change course quickly; (2) many scientists did not want to offer policy advice, but rather to provide evidence; and (3) a range of knowledge informed the UK’s pandemic response: we examine which kinds were privileged, and demonstrate the absence of clarity on how government synthesised the different forms of evidence being used.Conclusions: Understanding the reasons for a lack of clarity about policy goals would help us better understand the use of science in policy. Realisation that policy goals sometimes alter rapidly would help us better understand the logistics of scientific advice. Many scientists want their evidence to inform policy rather than determine the options selected. Since the process by which evidence leads to decisions is obscure, policy cannot be said to be evidence-based.<br />Key messages<br /><ul><li>Scientific advisors need to know policy goals, but these can be obscure and changeable.</li><br /><li>Many scientists want their evidence to inform policy rather than determine the policy selected.</li><br /><li>Evidence feeds into decisions in obscure ways, so policy cannot be said to be evidence-based.</li><br /><li>‘Evidence-informed’ policy is a more feasible aim than ‘evidence-based’ policy.</li></ul>