Overcoming COVID-19 Misinformation: Lessons Learned at the Epicentre of the Outbreak in the USA

THE COVID-19 pandemic has highlighted the dire need to foster increased public confidence in mitigation and prevention strategies through more and better health literacy. More than 2 years into the worst public health crisis of the 21st century, we continue to be consumed by the most basic health questions: should I get tested for COVID-19, should I get vaccinated and boosted against COVID-19, and should I wear a mask? In many countries, the tension between personal freedoms and public good helps to fuel a global threat, with continued transmission of severe acute respiratory syndrome coronavirus 2 and its evolving, more infectious variants. This short essay discusses the negative effects of misinformation and disinformation, and shares recommendations based on lessons learned.

Community-Based Workforce for COVID-19 Contact Tracing and Prevention Activities in New York City, July-December 2020

OBJECTIVES

High rates of hospitalization and death disproportionately affected Black, Latino, and Asian residents of New York City at the beginning of the COVID-19 pandemic. To suppress COVID-19 transmission, New York City implemented a workforce of community engagement specialists (CESs) to conduct home-based contact tracing when telephone numbers were lacking or telephone-based efforts were unsuccessful and to disseminate COVID-19 information and sanitary supplies.

MATERIALS AND METHODS

We describe the recruitment, training, and deployment of a multilingual CES workforce with diverse sociodemographic backgrounds during July-December 2020 in New York City. We developed standard operating procedures for infection control and safety measures, procured supplies and means of transportation, and developed protocols and algorithms to efficiently distribute workload.

RESULTS

From July through December 2020, 519 CESs were trained to conduct in-person contact tracing and activities in community settings, including homes, schools, and businesses, where they disseminated educational materials, face masks, hand sanitizer, and home-based specimen collection kits. During the study period, 94 704 records of people with COVID-19 and 61 246 contacts not reached by telephone-based contact tracers were referred to CESs. CESs attempted home visits or telephone calls with 84 230 people with COVID-19 and 49 303 contacts, reaching approximately 55 592 (66%) and 35 005 (71%), respectively. Other CES activities included monitoring recently arrived travelers under quarantine, eliciting contacts at point-of-care testing sites, and advising schools on school-based COVID-19 mitigation strategies.

PRACTICE IMPLICATIONS

This diverse CES workforce allowed for safe, in-person implementation of contact tracing and other prevention services for individuals and communities impacted by COVID-19. This approach prioritized equitable delivery of community-based support services and resources.

In Layman's Terms: The Power and Problem of Science Communication

Improved policies for science communication are needed to ensure scientific progress in coming decades. The COVID-19 pandemic illustrated massive gaps in science communication, ranging from masking and social distancing mandates to vaccination requirements. These obstacles compounded the pandemic's tremendous inherent clinical and public health challenges. Although science made immense progress in understanding the virus and designing infection control solutions, society still remains within the pandemic due to flawed understanding, low responsiveness, and widespread misinformation on behalf of the public. Flawed communication plagues national responses not only to the pandemic, but also other long-standing issues such as climate change or nutrition. This Letter proposes a new protocol and framework for effective science communication, designed to educate experts in evidence-based communication, improve public partnership through relatability and modern relevance, and increase empathy and trustworthiness to increase public cooperation. A defined protocol for science communication can ensure that evolving knowledge can tangibly benefit society.

The emergence and transmission of COVID-19 in European countries, 2019-2020: a comprehensive review of timelines, cases and containment

When it emerged in late 2019, COVID-19 was carried via travelers to Germany, France and Italy, where freedom of movement accelerated its transmission throughout Europe. However, effective non-pharmaceutical interventions introduced by European governments led to containment of the rapid increase in cases within European nations. Electronic searches were performed to obtain the number of confirmed cases, incident rates and non-pharmaceutical government measures for each European country. The spread and impact of non-pharmaceutical interventions throughout Europe were assessed and visualized. Specifically, heatmaps were used to represent the number of confirmed cases and incident rates for each of the countries over time. In addition, maps were created showing the number of confirmed cases and incident rates in Europe on three different dates (15 March, 15 April and 15 May 2020), which allowed us to assess the geographic and temporal patterns of the disease.

Preparing Frontline Hospitals for Dangerous Special Pathogens Beyond Ebola

Frontline hospitals are at the forefront of all travel-related, emerging and reemerging infectious diseases and special pathogens. Yet, the readiness of frontline hospitals and their ability to identify, isolate, and inform on Ebola and other special pathogens is uncertain. This article addresses the resources necessary to support screening for Ebola and other special pathogens and presents the decision-making algorithm for the transport of patients with high-consequence infectious diseases within the New York City Health + Hospitals integrated healthcare delivery network, which includes 10 frontline hospitals and the Region 2 Ebola and Other Special Pathogen Treatment Center.

Pandemic diseases preparedness and response in the age of COVID-19-a symposium report

For years, experts have warned that a global pandemic was only a matter of time. Indeed, over the past two decades, several outbreaks and pandemics, from SARS to Ebola, have tested our ability to respond to a disease threat and provided the opportunity to refine our preparedness systems. However, when a novel coronavirus with human-to-human transmissibility emerged in China in 2019, many of these systems were found lacking. From international disputes over data and resources to individual disagreements over the effectiveness of facemasks, the COVID-19 pandemic has revealed several vulnerabilities. As of early November 2020, the WHO has confirmed over 46 million cases and 1.2 million deaths worldwide. While the world will likely be reeling from the effects of COVID-19 for months, and perhaps years, to come, one key question must be asked, How can we do better next time? This report summarizes views of experts from around the world on how lessons from past pandemics have shaped our current disease preparedness and response efforts, and how the COVID-19 pandemic may offer an opportunity to reinvent public health and healthcare systems to be more robust the next time a major challenge appears.

Operational stresses on New York City Health+Hospitals Health System frontline hospitals during the 2017-18 influenza season

OBJECTIVE

Identify operational lessons to support hospital and health system preparedness and response for sea-sonal and pandemic influenza based on firsthand experiences from the 2017-2018 influenza season.

DESIGN

We conducted semistructured, retrospective interviews with New York City Health+Hospitals (NYCH+H) personnel to gather firsthand experiences from the 2017-2018 influenza season and evaluated stress data across four operational domains reported by NYCH+H hospitals during the 2017-2018 influenza season.

SETTING

Frontline hospitals in the NYCH+H health system during and after the 2017-2018 influenza season.

PARTICIPANTS

Interviews conducted with personnel from 5 NYCH+H frontline hospitals. Operational stress data re-ported by 11 NYCH+H hospitals during the 2017-2018 influenza season.

MAIN OUTCOME MEASURES

Operational challenges and lessons from frontline hospitals responding to severe sea-sonal influenza.

RESULTS

Operational stresses during the 2017-2018 influenza season varied over the influenza season, between facilities, and across operational domains. Patient surge and staff absenteeism pushed some facilities to their limits, and supply shortages highlighted shortcomings in existing procurement systems. Resources tied to pandemic influ-enza were unavailable without a pandemic declaration.

CONCLUSION

Seasonal influenza poses dynamic operational stresses across health systems and cities, potentially causing major impacts outside of declared pandemics. Lessons from NYCH+H can help other hospitals and health systems anticipate operational challenges, but novel solutions are needed to mitigate effects of patient surge and per-sonnel and supply shortages during severe influenza seasons and pandemics. Improved data collection can help health systems better understand operational stresses and challenges across their facilities.

Operational stresses on New York City Health+Hospitals Health System frontline hospitals during the 2017-18 influenza season

OBJECTIVE

Identify operational lessons to support hospital and health system preparedness and response for sea-sonal and pandemic influenza based on firsthand experiences from the 2017-2018 influenza season.

DESIGN

We conducted semistructured, retrospective interviews with New York City Health+Hospitals (NYCH+H) personnel to gather firsthand experiences from the 2017-2018 influenza season and evaluated stress data across four operational domains reported by NYCH+H hospitals during the 2017-2018 influenza season.

SETTING

Frontline hospitals in the NYCH+H health system during and after the 2017-2018 influenza season.

PARTICIPANTS

Interviews conducted with personnel from 5 NYCH+H frontline hospitals. Operational stress data reported by 11 NYCH+H hospitals during the 2017-2018 influenza season.

MAIN OUTCOME MEASURES

Operational challenges and lessons from frontline hospitals responding to severe seasonal influenza.

RESULTS

Operational stresses during the 2017-2018 influenza season varied over the influenza season, between facilities, and across operational domains. Patient surge and staff absenteeism pushed some facilities to their limits, and supply shortages highlighted shortcomings in existing procurement systems. Resources tied to pandemic influ-enza were unavailable without a pandemic declaration.

CONCLUSION

Seasonal influenza poses dynamic operational stresses across health systems and cities, poten-tially causing major impacts outside of declared pandemics. Lessons from NYCH+H can help other hospitals and health systems anticipate operational challenges, but novel solutions are needed to mitigate effects of patient surge and personnel and supply shortages during severe influenza seasons and pandemics. Improved data collection can help health systems better understand operational stresses and challenges across their facilities.

Restricted and Uncontained: Health Considerations in the Event of Loss of Containment During the Restricted Earth Return of Extraterrestrial Samples

The normal scope of an adequate public health response to released biological material is framed by working with biological vectors with known pathogenicity and virulence. Defining the scope of a response to the release of biological material with unknown pathogenicity and virulence enters into a novel and yet to be framed domain. A current case, in which extraterrestrial samples returned from a location such as Mars, which may harbor life as we know it, requires framing a public health response. An unintentional release of biological material with unknown pathogenicity and virulence may occur when biological containment mechanisms in the Earth-returning transport method are lost. This article raises initial public health and healthcare response questions during a return of extraterrestrial samples to Earth, in the event of its release from biological containment mechanisms: How does the public health community prepare for a response when there is release of samples that may contain potential extraterrestrial organisms from a planetary body or hardy terrestrial organisms surviving a round trip? If a mishap occurs during the return of these samples, what considerations need to be made to confine, decontaminate, and collect material in regions around the mishap? How will the public health community work with relevant government organizations to prepare the general public? The unknowns of exposure, potential extraterrestrial pathogenicity, and decontamination approaches underscore gaps in biopreparedness for this novel case from federal to local levels.

A Novel Approach to Infectious Disease Preparedness: Incorporating Investigational Therapeutics and Research Objectives into Full-Scale Exercises

The use of investigational therapeutics in the care of patients with Ebola virus disease was documented in the literature following the 2013-2016 outbreak. In order to access these types of therapeutics, facilities must have processes in place to quickly and efficiently activate study protocols, obtain the medications, and administer them in a timely manner. Testing these procedures in advance of a real-world event is crucial to ensuring successful implementation and execution. Drills and exercises are routinely used as part of the emergency preparedness planning process, as they provide a low-risk environment in which to test plans and procedures. Including research activities in full-scale emergency preparedness exercises is a novel approach that should be considered when creating a comprehensive special pathogen program. One important aspect of creating an agile response program is developing and sustaining strong relationships with key collaborators. Including departments not previously engaged in infectious disease preparedness exercises provides a forum to strengthen these relationships, clarify roles, and identify gaps. This article describes the process used to incorporate research-centric objectives focused on the use of investigational therapeutics for Ebola virus disease into a full-scale exercise, the evaluation process used to measure the identified objectives, and the results of the exercise.