Data sources on COVID-19 infection and vaccination in pregnancy on the island of Ireland: strengths, weaknesses, and recommendations for future pandemic preparedness

Background

Monitoring coronavirus disease (COVID-19) infection and vaccination during pregnancy is vital because of the increased susceptibility to severe disease. This article outlines the available data sources on COVID-19 infection and vaccination rates during pregnancy in Northern Ireland (NI) and the Republic of Ireland (ROI) and describes the processes, strengths, and weaknesses of available data.

Methods

Three data sources on COVID-19 vaccination and infection were identified in the ROI: the national computerized infectious disease reporting (CIDR) system used for reporting notifiable infectious diseases, the national dataset of all COVID-19 vaccinations for all residents (COVAX), and a regional Maternal and Newborn Clinical Management System (MN-CMS), which includes data on COVID-19 vaccination and infection. Four data sources were identified in NI: the NI maternity system (NIMATS) records maternity data, including COVID-19 infection and vaccination during pregnancy; datasets of COVID-19 antigen testing performed in hospitals (Pillar 1) and in the community (Pillar 2); and the NI Vaccine Management System dataset of COVID-19 Vaccinations.

Results

In the ROI, the CIDR database allows for the calculation of COVID-19 infection rates in women of reproductive age; however, pregnancy status remains largely unreported. The COVAX dataset includes pregnancy status, although the accuracy depends on whether the pregnancy is known at the time of vaccination. The MN-CMS tracks COVID-19 infection and vaccination during pregnancy. However, there are uncertainties regarding its reliability. In NI, COVID-19 data are available for all pregnant women using Health and Care numbers to link the NIMATS data to testing and vaccination databases.

Conclusions

Both countries track COVID-19 infection and vaccination rates, but the strength of the NI system is the use of unique identification numbers that allow linkage of maternal records to infection and vaccination databases. Both countries face delays in data access, underscoring the need for real-time systems to support future pandemic preparedness.

"We're seen as part of the supply chain of medicines rather than as the professionals that we are": The wellbeing of community pharmacists during the COVID response

INTRODUCTION

Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future.

AIM(S)

To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response.

METHOD

11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis.

RESULTS

Work experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives.

CONCLUSIONS

The post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.

Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis

BACKGROUND

Research has begun to draw attention to the challenges mental health professionals faced in delivering services during the COVID-19 pandemic response. However, few studies have examined the specific experiences of consultant psychiatrists.

AIMS

To examine the work-related experiences and psychosocial needs of consultant psychiatrists situated in the Republic of Ireland arising from the COVID-19 response.

METHOD

We interviewed 18 consultant psychiatrists and analysed data using inductive thematic analysis.

RESULTS

Work-related experience of participants was characterised by increased workload associated with assumption of guardianship of physical and mental health of vulnerable patients. Unintended consequences of public health restrictions increased case complexity, limited availability of alternative supports and hindered the practice of psychiatry, including inhibiting peer support systems for psychiatrists. Participants perceived available psychological supports as generally unsuitable for their needs given their specialty. Long-standing under-resourcing, mistrust in management and high levels of burnout exacerbated the psychological burden of the COVID-19 response.

CONCLUSIONS

The challenges of leading mental health services were evident in the increased complexity involved in caring for vulnerable patients during the pandemic, contributing to uncertainty, loss of control and moral distress among participants. These dynamics worked synergistically with pre-existing system-level failures, eroding capacity to mount an effective response. The longer-term psychological well-being of consultant psychiatrists - as well as the pandemic preparedness of healthcare systems - is contingent on implementation of policies addressing long-standing under-investment in the services vulnerable populations rely on, not least community mental health services.