Now Is the Time to Strengthen Government-Academic Data Infrastructures to Jump-Start Future Public Health Crisis Response

During public health crises, the significance of rapid data sharing cannot be overstated. In attempts to accelerate COVID-19 pandemic responses, discussions within society and scholarly research have focused on data sharing among health care providers, across government departments at different levels, and on an international scale. A lesser-addressed yet equally important approach to sharing data during the COVID-19 pandemic and other crises involves cross-sector collaboration between government entities and academic researchers. Specifically, this refers to dedicated projects in which a government entity shares public health data with an academic research team for data analysis to receive data insights to inform policy. In this viewpoint, we identify and outline documented data sharing challenges in the context of COVID-19 and other public health crises, as well as broader crisis scenarios encompassing natural disasters and humanitarian emergencies. We then argue that government-academic data collaborations have the potential to alleviate these challenges, which should place them at the forefront of future research attention. In particular, for researchers, data collaborations with government entities should be considered part of the social infrastructure that bolsters their research efforts toward public health crisis response. Looking ahead, we propose a shift from ad hoc, intermittent collaborations to cultivating robust and enduring partnerships. Thus, we need to move beyond viewing government-academic data interactions as 1-time sharing events. Additionally, given the scarcity of scholarly exploration in this domain, we advocate for further investigation into the real-world practices and experiences related to sharing data from government sources with researchers during public health crises.

The role of the Field Epidemiology Training Program in the public health emergency response: Sudan armed conflict 2023

Background

On April 15, 2023, the armed conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) started in Khartoum state, Sudan. This conflict was complicated by the preexisting complicated epidemiological situation and fragile health system in Sudan. This study endeavors to illuminate the pivotal role essayed by the Sudan FETP (SFETP) in enhancing the nation's public health response, particularly amidst the tumultuous backdrop of armed conflicts that have left their indelible mark on the region.

Methods

Employing a blend of quantitative and qualitative methodologies, we investigated the SFETP's contributions to the public health response during the initial 4 months of the conflict (April-July 2023). Sixty-four SFETP residents and graduates were invited to participate, and data were gathered through semi-structured questionnaires.

Results

A total of 44 (69%) SFETP residents and graduates were included in this study. Out of 38 SFETPs present in the states, 32 have considerably contributed to the crisis response at state and locality levels. Three-quarters of them have played key leadership, planning, and management roles. In essence, 38% (n = 12) of them have contributed to public health surveillance, particularly in data management, reports, Early Warning Alert and Response System (EWAR) establishment, and epidemic investigation. SFETPs have made special contributions to crisis response at the community level. The involved SFETPs supported WASH interventions (n = 4), and almost one-third of them strengthened risk communication and community engagement (n = 9). Despite their physical presence at the subnational level, 27% of graduates were not deployed to the crisis emergency response. Notably, throughout this time, half of the total SFETPs were formally retained during this response.

Conclusion

The study highlighted the importance of FETP engagement and support during public health crises. SFETP residents and graduates played diverse roles in the various levels of public health emergency response to the crisis. However. Strategies to improve the deployment and retention of FETP residents are necessary to ensure their availability during crises. Overall, FETP has proven to be an asset in public health crisis management in Sudan.

Conflict, COVID-19, and crisis response: shifting from 'pivoting' to preparedness

This paper assesses the extent to which the COVID-19 (Coronavirus disease 2019) pandemic directed the attention and resources of the international community away from peacebuilding, and the potential impact of this on conflict-affected environments. It draws from a global survey, interviews, and conversations with peacebuilding practitioners, publicly available information on peacebuilding funding, and real-time data on conflict events from the Armed Conflict Location & Event Data Project. The paper argues that resources and attention have 'pivoted' away from peacebuilding to tackle the threat presented by COVID-19, and that this can-but does not always-adversely affect conflict dynamics. It contends that this pivoting belies the interconnectedness of crises, leads to 'forgotten crises' and escalating threats, and exposes deficiencies in peacebuilding funding and, more broadly, preparedness and crisis response. Crises do, however, provide opportunities for reflection and change, including how to address these deficiencies and, in so doing, advance more efficient, effective, and ethical practice.

Reducing policing in mental health crises: A vision for university campuses

University campuses could become leaders in developing alternatives to policing for managing public health and safety, yet, nearly all campuses rely on campus or local police to respond to mental health emergencies. Herein, we present the available evidence for campus mobile crisis intervention teams (MCITs) as an alternative to policing, consider what colleges and universities can learn from existing community MCIT models, and propose initial steps for the development and implementation of a campus MCIT.

First responder perceptions of the system of care and people who use drugs: Spanning boundaries

Addressing the beliefs of first responders about people who use drugs and the system of care with which they interact must be part and parcel to addressing the opioid crisis. Using a boundary spanning framework, we examine how first responders perceive community behavioral health. With qualitative methods, we asked: What are first responders' lived experiences on the frontlines of the opioid crisis? In sum, it is important to consider that there is a critical role that first responders could play in brokering services when they are not themselves behavioral health practitioners but are, importantly, boundary spanners.

The strength of a weak centre: pandemic politics in the European Union and the United States

The European Union presents a puzzle to political systems scholars: how can a developing polity, with all its attendant functional weaknesses, be rendered politically stable even through moments of a policy crisis? Building on insights from the literature on fiscal federalism, this article challenges much conventional wisdom on Europe’s incompleteness. This is based on the corollary of Jonathan Rodden’s concept of Hamilton’s Paradox : whereas a strong centre cannot resist exploitation by states because it has the means to rescue them, a weak centre’s lack of exploitable capacity may induce states to support, and even empower, it in a crisis. This article argues that in providing a contemporaneous stress-test, Covid-19 serves to expose both the pathologies of a strong-centred federation and the surprising resilience of a weak one. It highlights three polity features—powers, decision-making modes and integrity—and charts their political implications during an acute crisis. The article argues that in the EU these features incentivise cooperative ‘polity maintenance’ between polarised states, a feature absent in an American polity marked by rivalry between polarised parties. The article thus challenges notions that the EU’s incompleteness necessarily leads it to dysfunction or that it should strive to emulate established federations.

Creating Comprehensive Crisis Response Systems: An Opportunity to Build on The Promise of 988

The implementation of a national suicide prevention hotline is imminent and will need to be supported by comprehensive crisis systems, which are currently rarely implemented in part due to their cost. In this Commentary paper we identify three core components of a high-functioning, integrated crisis service system. We identified regional crisis call centers, mobile response teams, and crisis receiving and stabilization centers as core components of an integrated crisis service system. We then outline how this approach has been used in Arizona. Building out these systems and sustainable funding models to support these systems is necessary to ensure that 988 implementation lives up to the promise of creating a lifeline to support services for individuals in crisis.

Parent organizations' experiences of the pandemic response in maternity care in thirteen European countries

We surveyed changes to maternity care services in the first 17 months of the COVID-19 pandemic in 13 different European countries, from the perspective of national maternity service (parent) organizations advocating for a human rights approach to maternity services. A qualitative study was conducted in November 2020. An open-question survey was sent to national maternity service (parent) organizations and members of COST Action 18211 in Europe, asking about COVID-19 measures in maternity services (antenatally, intrapartum, postnatally, and overall satisfaction). From the open answers, 16 core issues were extracted. Between February and August 2021, semi-structured interviews with the national representatives of 14 parent member organizations in Europe were conducted, collecting details on overall national situations and changes due to COVID-19 measures. The reported experiences of parent organizations from 13 European countries show wide variations in epidemiological containment measures during the first 17 months of the COVID-19 pandemic. Practices differed between facilities, resulting in emotional disquiet and confusion for parent-patients. Most countries maintained antenatal and postnatal care but restricted psychosocial support (antenatal and birth companions, visitors). Organizations from nine countries reported that women had to wear masks during labor, and all but two countries saw separations of mothers and babies. Most parent organizations described a need for more reliable information for new parents. During the pandemic, non-evidence-based practices were (re-) established in many settings, depriving women and families of many factors which evidence has shown to be essential for a positive birthing experience. Based on the findings, we consider the challenges in maternity services and propose a strategy for future crises.

Role of the Advanced Practice Registered Nurse in Crisis Response

As clinical leaders, advanced practice registered nurses are often called upon to respond to crises. Although frameworks for emergency preparedness and response have been established by the National Organization of Nurse Practitioner Faculties and the International Council of Nurses, the advanced practice registered nurse community is not consistently prepared to participate in crisis response. Merging of the previously established frameworks allows identification of additional opportunities for advanced practice registered nurses to be educated and engaged in emergency preparedness and all-hazards response, including preparation activities, communication, safety and security, incident management, assessment, intervention, and recovery. Additional areas of focus are leadership, ethics, and end-of-life care. Use of the existing frameworks combined with the lessons learned from the COVID-19 response can empower advanced practice registered nurses to improve their readiness to respond to future crises.

Psychosis and psychedelics: Historical entanglements and contemporary contrasts

Experiences of psychedelics and psychosis were deeply entangled in scientific practices in the mid-20th century, from uses of psychedelic drugs that could model psychosis, to detailed phenomenological comparisons of endogenous and drug-induced madness. After the moral panic of the 1960s shut down psychedelic research, however, these two phenomena became disentangled. In the decades following, the science of psychosis transformed, shedding the language of psychoanalysis, and adopting the new scientific veneer of psychiatry. Today, as psychedelic science re-emerges, the research programs surrounding psychosis and psychedelics now stand in stark contrast. Here, I look closely at how these research programs respond to questions related to what is worth measuring, what is worth investigating, and how we ought to respond to these experiences. This comparison reveals radically different assumptions and values that guide each research paradigm and shape clinical practice. While psychedelic research often includes scales that seek to capture experiences of mysticism, meaningfulness, and ego dissolution, research related to psychosis focuses on the measurement of pathological symptoms and functioning. Research into psychosis primarily seeks universal and reductionist causal explanations and interventions, while psychedelic research embraces the importance of set and setting in shaping unique experiences. Responses to psychedelic crisis involve warmth, compassion, and support, while responses to psychotic experiences often involve restraint, seclusion, and weapons. I argue that these differences contain important lessons for psychiatry. However, as psychedelic research struggles to meet regulatory requirements and fit within the paradigm of evidence-based medicine, these differences may quickly dissolve.

Cross-sector decision landscape in response to COVID-19: A qualitative network mapping analysis of North Carolina decision-makers

Introduction

The COVID-19 pandemic response has demonstrated the interconnectedness of individuals, organizations, and other entities jointly contributing to the production of community health. This response has involved stakeholders from numerous sectors who have been faced with new decisions, objectives, and constraints. We examined the cross-sector organizational decision landscape that formed in response to the COVID-19 pandemic in North Carolina.

Methods

We conducted virtual semi-structured interviews with 44 organizational decision-makers representing nine sectors in North Carolina between October 2020 and January 2021 to understand the decision-making landscape within the first year of the COVID-19 pandemic. In line with a complexity/systems thinking lens, we defined the decision landscape as including decision-maker roles, key decisions, and interrelationships involved in producing community health. We used network mapping and conventional content analysis to analyze transcribed interviews, identifying relationships between stakeholders and synthesizing key themes.

Results

Decision-maker roles were characterized by underlying tensions between balancing organizational mission with employee/community health and navigating organizational vs. individual responsibility for reducing transmission. Decision-makers' roles informed their perspectives and goals, which influenced decision outcomes. Key decisions fell into several broad categories, including how to translate public health guidance into practice; when to institute, and subsequently loosen, public health restrictions; and how to address downstream social and economic impacts of public health restrictions. Lastly, given limited and changing information, as well as limited resources and expertise, the COVID-19 response required cross-sector collaboration, which was commonly coordinated by local health departments who had the most connections of all organization types in the resulting network map.

Conclusions

By documenting the local, cross-sector decision landscape that formed in response to COVID-19, we illuminate the impacts different organizations may have on information/misinformation, prevention behaviors, and, ultimately, health. Public health researchers and practitioners must understand, and work within, this complex decision landscape when responding to COVID-19 and future community health challenges.

Religion Protected Mental Health but Constrained Crisis Response During Crucial Early Days of the COVID-19 Pandemic

This study demonstrates that religion protected mental health but constrained support for crisis response during the crucial early days of the COVID-19 pandemic. Data from a national probability-based sample of the U.S. population show that highly religious individuals and evangelicals suffered less distress in March 2020. They were also less likely to see the coronavirus outbreak as a crisis and less likely to support public health restrictions to limit the spread of the virus. The conservative politicization of religion in the United States can help explain why religious Americans (and evangelicals in particular) experienced less distress and were less likely to back public health efforts to contain the virus. We conclude that religion can be a source of comfort and strength in times of crisis, but-at least in the case of the COVID-19 pandemic-it can also undercut efforts to end the root causes of suffering.

In trust we trust: The impact of trust in government on excess mortality during the COVID-19 pandemic

The COVID-19 pandemic has brought forward myriad challenges to public policy, central of which is understanding the different contextual factors that can influence the effectiveness of policy responses across different systems. In this article, we explore how trust in government can influence the ability of COVID-19 policy responses to curb excess mortality during the pandemic. Our findings indicate that stringent policy responses play a central role in curbing excess mortality. They also indicate that such relationship is not only influenced by systematic and structural factors, but also by citizens' trust in government. We leverage our findings to propose a set of recommendations for policymakers on how to enhance crisis policymaking and strengthen the designs of the widely used underlying policy learning processes.

Opportunities to improve behavioral health crisis response: Results of a large urban county's community status assessment

A comprehensive community status assessment of an Ohio urban county's crisis response (CR) system explored the experiences of its behavioral health services' clients and providers to surface themes characterizing the system's responsiveness and identifying opportunities for improvements. Forty-eight focus groups and two online surveys were conducted. Data were analyzed using qualitative content analysis and descriptive statistics. The greatest areas of needed improvement ascertained by this effort are in increased CR system resources, more efficient use of resources, and capacity enhancements in nine areas: the mobile crisis team, CR protocols, psychiatric inpatient and crisis stabilization beds, stabilization admission for eligible persons, stabilization services for in-crisis but admission-ineligible persons, continuity of care, research into child versus adult CR systems, Provider Emergency Support Program, and first responder crisis intervention training. The assessment provides a foundation for the county to identify further opportunities for system scale-up.

Making waves: nurse-led urgent community response

Anyone in England over 18 whose health or wellbeing suddenly deteriorates at home will have access to an urgent community response (UCR) team within 2 hours by April 2022. Community nursing services are providing the core service model to provide these crisis response services. Nurse leads from three UCR accelerator sites (Kirklees, Warrington and Bromley) elaborate on how they are making waves of change for the better, using their clinical skills and building key relationships with other health services. Acutely unwell patients are being seen by practitioners with advanced assessment skills, which keeps eight out of 10 patients at home safe, avoiding hospital admission.

Real-time suicide surveillance supporting policy and practice

Suicide mortality rates are a strong indicator of population mental-health and can be used to determine the efficacy of prevention measures. Monitoring suicide mortality rates in real-time provides an evidence-base to inform targeted interventions in a timely manner and accelerate suicide prevention responses. This paper outlines the importance of real-time suicide surveillance in the context of policy and practice, with a particular focus on public health and humanitarian crises.

A Topic Modeling Analysis of the Crisis Response Stage for COVID-19 Pandemic

After the COVID-19 pandemic occurred in South Korea in 2020, medical institutions have dealt with the epidemiological crisis. The institutions' strategies in response to the crisis were classified into four stages depending on the change of epidemic circumstances. Efficiently responding to the pandemic, close cooperation between the government and medical institutions is essential.

'Let communities do their work': the role of mutual aid and self-help groups in the Covid-19 pandemic response

How to respond quickly, effectively, and sensitively to large-scale crises is debated at length in the aid sector. Institutional focuses on projects and outcomes have led to abundant literature on the efficacy of external interventions, while the actions of individuals and communities to meet their own needs remain under researched. This paper seeks to close the gap by joining global trends and specific case studies to explore the scale, breadth, and characteristics of citizen and community-led responses to the Covid-19 pandemic of 2020-21. Using mixed methods, it argues that mutual aid, self-help, and other spontaneous community measures were vital to the early response to Covid-19 globally. Such endeavours have limitations, however, which can be strengthened with the right national and international support. The paper concludes by calling on authorities and aid actors to widen their understanding of 'first response' and provide meaning ful support to mutual aid and local self-help initiatives now and in the future.

Physician and executive collaboration on rapid development of pandemic needs response to support physicians and medical staff during the COVID-19 pandemic in an academic medical center: a descriptive review

Dialogue on physician well-being was concerning even prior to onset of the COVID-19 pandemic, which introduced additional unprecedented strain on healthcare workers compounded by increased personal and family stress. This paper describes our process for a rapid needs assessment and creation of a pandemic resiliency and well-being support infrastructure for physicians and healthcare staff at an academic medical center. In March 2020, executive leadership from our health system and physician group created a Resiliency and Support Steering Committee (RSSC) for rapid development of a pandemic needs response for our healthcare providers. RSSC identified key priorities: psychological care, medical care, basic care, and communication. A brief pandemic-focused needs survey was designed and distributed to healthcare professionals and targeted efforts focused on initiatives prioritized by respondents. A shared drive database allowed initiatives and outcomes to be communicated in real time. A wellness webpage was rapidly built and disseminated. Psychological support initiatives included proactive and reactive support. Providers were offered rapid access scheduling for primary medical care. Vetted resources were shared for regional grab-and-go food, grocery delivery, laundry services, and childcare. Additional resources included personal protective equipment (PPE) supply chain information, PPE guideline updates and training and access to scrubs/scrub laundering. Our pandemic support will fold into ongoing wellness initiatives that will be tailored and intentionally communicated. Multimodal and intentional communication processes will continue with a focus on enhancing bidirectional platform functionality. Cultural awareness of the importance of mitigating distress and supporting well-being will be prioritized through partnership with frontline members and leadership.

Rebuilding Graduate Medical Education After a Crisis: Perspectives of Medical Residents in the United Arab Emirates

Pandemics create unprecedented public health challenges that require comprehensive and coordinated responses from health care systems and can, thereby, cause substantial and prolonged disruption to residency training. The coronavirus 2019 (COVID-19) pandemic has impacted medical education worldwide. Currently, there is a gap in the literature from the trainee's perspective, and little advice on resuming post-pandemic operations. As internal medicine residents serving on the frontlines of a COVID-19 designated government hospital in the United Arab Emirates, we also faced significant challenges and uncertainties during the pandemic. We are fortunate to have overcome the initial surges and have spent the past 6 months navigating a new reality. We believe that the COVID-19 crisis provides an opportunity for graduate medical education programs worldwide to implement targeted changes that can lead to sustainable improvements in the system. In supporting learning during these times, our residency program has adopted flexible scheduling, focused on frequent and transparent communication, incorporated different strategies to build community and promote psychological wellbeing, and advanced virtual teaching modalities. The aim of this article is to share the strategies that have helped us to move forward in the aftermath of the first phases of the pandemic, whilst we prepare for the uncertainty of the future. We hope that the lessons we have learned can help inform other programs as they react and adapt to the global after-effects of this crisis.

New insights into crisis communication from an “inside” emic perspective during COVID-19

As the COVID-19 pandemic spread across the world, requiring emergency management by health authorities and providers, it created flow-on crises and “crisis contagion” for organizations ranging from international airlines and tourism operators to local businesses, schools, and universities. In addition to the risks directly associated with the health emergency, many organizations were plunged into crisis because of severe restrictions to their operations and income losses. This analysis examines crisis communication in an organization faced with major financial losses, staff redundancies, and disruption. It analyses how these and necessary crisis responses were communicated to stakeholders, using situational crisis communication theory (SCCT), as its analytical framework. While noting alternative perspectives such as crisis and emergency risk communication (CERC) theory, SCCT is identified as the most widely applied theory of crisis communication, and thus warrants ongoing review in an era of media fragmentation, disinformation, and low public trust. Furthermore, this analysis provides a relatively rare “inside” (emic) perspective through ethnography and autoethnography conducted by a senior decision-maker in the organization studied, which expands traditional outside (etic) perspectives and offers new insights into crisis communication.

Essential or not? Knowledge problems and COVID-19 stay-at-home orders

In response to the COVID-19 pandemic, governments around the world issued stay-at-home orders, which required that individuals stay at home unless they were engaging in certain activities. Often these orders would designate certain goods and services as "essential" and would permit individuals engaged in the production, delivery, and purchase of those goods and services to leave their homes to do so. Implicit in these policies, of course, is the assumption that policymakers can know ex ante which goods and services are essential. As proved true while these stay-at-home orders were in effect, essentialness is necessarily subjective and depends on knowledge that is often dispersed, inarticulate, and changes over time. Policymakers, however, do not and often cannot have access to the local knowledge needed to determine ex ante which goods and services are essential, and they lack the feedback mechanisms they would need to adroitly adapt when circumstances change. This paper examines these knowledge problems associated with designating certain goods and services as "essential" when crafting and implementing stay-at-home orders.

Experience of the COVID-19 Pandemic in Rural Odisha, India: Knowledge, Preventative Actions, and Impacts on Daily Life

We conducted 131 semi-structured phone interviews with householders in rural Odisha, India to explore participants’ COVID-19 related knowledge, perceptions, and preventative actions, as well as how the pandemic affected their daily life, economic and food security, and the village-level response. Interviews were conducted with 73 heads of household, 37 primary caregivers, and 21 members of village water and sanitation committees from 43 rural villages in Ganjam and Gajapati districts in Odisha state. The study took place between May–July 2020 throughout various lockdown restrictions and at a time when many migrant workers were returning to their villages and cases were rising. Most respondents could name at least one correct symptom of COVID-19 (75%), but there was lower knowledge about causes of the disease and high-risk groups, and overall COVID-19 knowledge was lowest among caregivers. Respondents reported high compliance with important preventative measures, including staying home as much as possible (94%), social distancing (91%), washing hands frequently (96%), and wearing a facial mask (95%). Additionally, many respondents reported job loss (31%), financial challenges (93%), challenges related to staying home whether as a preventative measure or due to lockdowns (57%), changes in types and/or amount of food consumed (61%), and adverse emotional effects as a result of the pandemic and lockdown. We also provide detailed summaries of qualitative responses to allow for deeper insights into the lived experience of villagers during this pandemic. Although the research revealed high compliance with preventative measures, the pandemic and associated lockdowns also led to many challenges and hardships faced in daily life particularly around job loss, economic security, food security, and emotional wellbeing. The results underscore the vulnerability of marginalized populations to the pandemic and the need for measures that increase resilience to large-scale shocks.

The lie of pandemic pivot and essential work

My emotional responses to this moment include feelings of anger, hope, and déjà vu. Although the scope and scale of this pandemic is unprecedented in our lifetimes, what has been especially hard is not necessarily new - nor entirely unprecedented - and therefore unavoidable. In this essay, I reflect on what was avoidable and call for better response. We must question the seemingly benign (if not optimistic) terms emerging as pandemic discourse, such as "pivot to a new normal" and "essential work," for what they reveal of social injustice and failure to avert future crisis.

ARC: An Open Web-Platform for Request/Supply Matching for a Prioritized and Controlled COVID-19 Response

In 2020 the world was hit by the COVID-19 pandemic putting entire governments and civil societies in crisis mode. Around the globe unprecedented shortages of equipment and qualified personnel were reported in hospitals and diagnostic laboratories. When a crisis is global, supply chains are strained worldwide and external help may not be readily available. In Switzerland, as part of the efforts of the Swiss National COVID-19 Science Task Force, we developed a tailor-made web-based tool where needs and offers for critical laboratory equipment and expertise can be brought together, coordinated, prioritized, and validated. This Academic Resources for COVID-19 (ARC) Platform presents the specialized needs of diagnostic laboratories to academic research groups at universities, allowing the sourcing of said needs from unconventional supply channels, while keeping the entities tasked with coordination of the crisis response in control of each part of the process. An instance of the ARC Platform is operated in Switzerland (arc.epfl.ch) catering to the diagnostic efforts in Switzerland and sourcing from the Swiss academic sector. The underlying technology has been released as open source so that others can adopt the customizable web-platform for need/supply match-making in their own relief efforts, during the COVID-19 pandemic or any future disaster.

Responding to COVID-19: Lessons Learned from a Senior Living and Social Service Organization

This case study analyzes one senior living and social service organization’s coronavirus (COVID-19) crisis response. We conducted interviews with n = 14 department managers to explore the organization’s pivot to remote work and service provision. We used the Pearson and Mitroff Crisis Management Framework to organize themes. A pre-existing culture of teamwork, willingness to adapt and adopt new approaches, and responsiveness to new policies and procedures facilitated the COVID-19 crisis response. However, low levels of digital literacy among staff, decreased job satisfaction due to no face-to-face interaction between care recipient and service provider, and lack of proactive policies for crisis response, which decreased the speed of enacting remote service provision, were obstacles in effective crisis response. Lessons learned from this case study highlight the need for pre-emptive policy creation on remote service provision and work from home policies, as well as training considerations for senior living and social service organizations.

An internal medicine residency's response to the COVID-19 crisis: caring for our residents while caring for our patients

BACKGROUND

In response to the COVID-19 pandemic, internal medicine residencies have had to develop new teaching strategies and attend to wellness concerns. Providing front-line care for patients in a time of widespread crisis while maintaining attention to training has created unprecedented challenges.

OBJECTIVE

Our large community hospital based internal medicine residency sought to develop and evaluate a crisis response to the demands of the COVID-19 pandemic to meet our residents' educational and wellness needs.

METHODS

In March 2020, our residency developed a crisis plan for functioning during the COVID-19 pandemic. A brief survey was sent via email to our 149 residents to obtain their evaluation of how well their needs were being met by this response.

RESULTS

92 (62%) residents completed the survey. 88% indicated their well-being needs were well met. Other components were also rated as successful: effective communication (86%), scheduling/staffing (78%), preparing residents for clinical service (77%), and educational needs (76%).

CONCLUSIONS

Our residency crisis response to the COVID-19 pandemic was favorably evaluated by our residents in meeting their training and well-being needs. In future work we plan to seek longer-term and more objective measures to assess how residents fare during these challenging times, and to use lessons learned to prepare for future crisis situations.

Clinical Pharmacists: An Invaluable Part of the Coronavirus Disease 2019 Frontline Response

Although coronavirus disease 2019 was first identified in December 2019, it rapidly spread and became a global pandemic. The number of patients infected with the novel coronavirus (severe acute respiratory syndrome coronavirus 2) rose rapidly in New York State, placing great stress on healthcare systems. The traditional roles and practices of healthcare providers were dramatically redefined to meet the demand to care for the large number of ill patients. While literature reports on the experiences of many frontline staff, there is a scarcity of reports on the role of clinical pharmacists during this crisis. We report the role of critical care clinical pharmacists at a large academic medical center in New York City during this pandemic. Effective crisis management required clinical pharmacists to employ a wide array of skills and knowledge. Areas included clinical expertise, education, data analysis, health informatics infrastructure, and inventory management in times of surging medication use and manufacturer shortages. Clinical pharmacists fulfilled an essential service during the coronavirus pandemic by working to ensure the best possible outcomes for the patients they served on the frontline.

Changing Grocery Shopping Behaviours Among Chinese Consumers At The Outset Of The COVID-19 Outbreak

This study focuses on the embryonic stages of the COVID-19 pandemic in China, where most people affected opted to abide by the Chinese government's national self-quarantine campaign. This resulted in major disruptions to one of the most common market processes in retail: food retailing. The research adopts the theory of planned behaviour to provide early empirical insights into changes in consumer behaviour related to food purchases during the initial stages of the COVID-19 outbreak in China. Data from the online survey carried out suggest that the outbreak triggered considerable levels of switching behaviours among customers, with farmers' markets losing most of their customers, while local small independent retailers experienced the highest levels of resilience in terms of customer retention. This study suggests avenues for further scholarly research and policy making related to the impact this behaviour may be having around the world on society's more vulnerable groups, particularly the elderly.

Two Sides of a Coin: A Crisis Response Perspective on Tourist Community Participation in a Post-Disaster Environment

This study investigates the attitudes and behavioural intentions of community crisis response and tourism community participation in tourist destinations after the occurrence of a disaster. Further, we built a conceptual model of perceived community participation benefit, community attachment, community resilience, and crisis response and community participation intention and measured it using 556 samples surveyed after the Wenchuan earthquake, China. The results indicated that benefit perception, community attachment, and community resilience have a positive effect on crisis response and community participation. The study further reveals that the local tourism community gradually transforms the negative aspects of terrible disasters into development opportunities. Our case study particularly focuses on the initiative shown by and positive participation of the tourist community in the aforementioned transformation. The study proposes the Attachment, Benefit, and Capability framework of tourist community participation based on the crisis response perspective and expands the boundaries of tourist community participation research. The study has theoretical and practical significance, puts forward relevant countermeasures, and has significant implications.

Specialized disaster behavioral health training: Its connection with response, practice, trauma health, and resilience

This study examined the relationship between having training in key disaster behavioral health (DBH) interventions and trauma health (compassion fatigue, burnout and compassion satisfaction), resilience, the number of crisis responses participated in within the last year, and the frequency of assembling to practice crisis interventions skills. Data was collected from a convenience sample of disaster behavioral health responders (N = 139) attending a training conference in Michigan. Measures included the Professional Quality of Life Scale, the 14-item Resilience Scale, and a demographic questionnaire. Point biserial correlations revealed that having training in large and small group crisis interventions and individual and peer crisis interventions was significantly correlated with higher resilience and lower levels of burnout. Psychological First Aid was not significantly associated with any of the trauma health variables or with resilience. Compassion fatigue and compassion satisfaction were not significantly associated with DBH training. Chi-square tests for independence found no significant association between key DBH training strategies and the number of crisis responses participated in within the past year and the frequency of assembling to practice crisis interventions skills. These findings suggest that completing training in both, large and small group and individual and peer crisis intervention techniques may help to increase resiliency and reduce burnout among disaster behavioral health providers.

Interprofessional collaboration in mental health crisis response systems: a scoping review

Post deinstitutionalization saw the rise of mental health crisis (MHC) response in Canada. First points of contact for individuals in a MHC are often police services or emergency departments. Professionals in these areas may report feeling unprepared, ill equipped, and a lack of confidence to work with clients in crisis. Police indicate that this work is time consuming, demanding, and "not their job". Entry points can exacerbate the crisis given the chaotic, over-stimulating and frightening environment of emergency departments and the perceived threat of police officers. Despite the outcry of support for working more collaboratively, little is known about the impact Interprofessional collaboration (IPC) has in mental health crisis response systems (MHCRS).

PURPOSE

Given this challenge, the aim of this scoping review is to contribute to understanding the current state of knowledge related to IPC in MHCRS.

METHODS

A scoping reviews was conducted to address the research topic.

RESULTS

Review of the literature identified 18 articles for inclusion, 5 experimental or exploratory papers, 7 models of care, and 6 discussion papers. Analysis identified the following themes: Support for interprofessional collaboration, quest for improved care delivery system, merging distinct visions of care, and challenges to interprofessional collaboration. Implications for practice, policy, and research are discussed, as well as issues in the literature related to: Lack of conceptual clarity, absent client perspectives, unequal representation across sectors, and a young and emergent body of literature.

CONCLUSION

Key concepts need better conceptualization, and further empirical research is needed.

IMPLICATIONS FOR REHABILITATION

Conceptualizing mental health crisis (MHC) response as occurring within a system of services, rather than independent sectors, is critical to meeting the needs of clients. Purposefully built in mechanisms to sustain collaboration across care teams and services are required. Merging the distinct, and at times conflicting, visions of care espoused by the diverse sectors involved in MHC response requires deliberate effort.

A winning combination: the 3Cs of business continuity

Contingency planning is a natural part of business life and is used across identified strategic, financial and operational risks. But is it being done well and is it the right approach all of the time? This paper shows how contingency planning forms one layer of a three-line defence termed 'the 3Cs of business continuity': contingency planning; continuity capability; crisis response. Collectively, 'the 3Cs' help organisations deliver a robust response to the risks that can be seen and those that cannot.