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Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Op-ed
This op-ed discusses the minimal progress that has been made towards understanding the causes and treatment of long COVID. The main crux of the author’s argument is that long COVID is essentially the same condition as post-infectious syndrome or myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). Thus, long COVID is actually not a new condition, but rather something triggered by acute COVID in the same way that many other illnesses can trigger ME/CFS in individuals. ME/CFS itself is not well-understood, but the years of research and patient experiences with the condition could be applied to the body of long COVID research for the advancement of both causes.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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White Paper/Brief
This article discusses the Foundation for Opioid Response Efforts (FORE) distribution of $1.3 million in grants to organizations studying the potential permanent adoption of COVID-19 care access measures to promote health equity in opioid use disorder treatment. The grants aim to investigate the impact of temporary policies, such as virtual care, on access to care and patient outcomes. The studies will explore how relaxed prescribing policies for buprenorphine, telehealth strategies, and other COVID-19 measures have affected patient access and outcomes, particularly among underserved populations. The research will inform evidence-based policies to sustain access to better care beyond the pandemic and address the ongoing opioid crisis.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Case Study
The Massachusetts Executive Office of Elder Affairs (EOEA) oversees programs and services for older adults through the aging service network, and worked closely with the COVID-19 command center during the COVID-19 pandemic. EOEA worked with senior affordable housing providers and advocated for vaccines for older adult populations. They also used their network to disseminate COVID-19 information to older adults, caregivers, and those working directly with older adults.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Peer Review Study
Jimenez and colleagues conducted an online survey in order to examine reluctance to follow prescribed COVID-19 preventive measures, such as social distancing and hand washing. Research is needed to understand factors underlying such reluctance, with the aim of developing targeted health interventions. The authors found that associating COVID-19 with death as a key factor. Five hundred and ninety participants completed surveys in mid-March 2020, which included attitudes toward COVID-19, preventive behavioral intentions, and sociodemographic factors. Associating coronavirus with death negatively predicted intentions to perform preventive behaviors, including social distancing and hand washing. Social distancing and hand washing were used as outcome measures in separate multivariate models. Further, associating COVID-19 with death was not evenly distributed throughout the sample and was related with a number of sociodemographic factors including age, race, and availability of sick leave.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Peer Review Study
A retrospective registry-based chart review examined the various demographic and clinical risk factors associated with COVID-19 severity among patients aged 18-29. The study was done within a metropolitan health care system in Houston, TX. In the cohort of 1,853 young adult patients diagnosed with COVID-19 infection at a hospital encounter, including 226 pregnant women, 1,438 (78%) scored 0 on the Charlson Comorbidity Index, and 833 (45%) were obese (≥30 kg/m2). Within 30 days of their diagnostic encounter, 316 (17%) patients were diagnosed with pneumonia, 148 (8%) received other severe disease diagnoses, and 268 (14%) returned to the hospital after being discharged home. In multivariate logistic regression analyses, increasing age, male gender, Hispanic ethnicity, obesity, asthma history, congestive heart failure, cerebrovascular disease, and diabetes were predictive of severe disease diagnoses within 30 days. Non-Hispanic Black race, obesity, asthma history, myocardial infarction history, and household exposure were predictive of 30-day readmission.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Peer Review Study
Czeisler and colleagues investigated the prevalence of mental health symptoms, including depression, anxiety, and suicidal ideation in late June 2020. To assess mental health, substance use, and suicidal ideation during the pandemic, representative panel surveys were conducted among adults aged ≥18 years across the United States during June 24-30, 2020. Just over 40% of respondents reported at least one adverse mental or behavioral health condition. The percentage of respondents who reported having seriously considered suicide in the 30 days before completing the survey (10.7%) was significantly higher among respondents aged 18-24 years (25.5%), marginalized racial/ethnic groups (Hispanic respondents [18.6%], non-Hispanic black [black] respondents [15.1%]), self-reported unpaid caregivers for adults (30.7%), and essential workers (21.7%). This research directs attention to the need for community-level intervention and prevention efforts, including health communication strategies.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Peer Review Study
Latkin and colleagues conducted a nationally representative survey in May 2020 to examine opinions regarding vaccine hesitancy. The key outcome measure asked: if and when available, would you plan on getting the vaccine. A key set of covariate measures focused on COVID-19 prevention behaviors such as staying away from large groups, wearing a mask when leaving home, and washing hands more frequently. Additional covariates included knowing a close relative or friend who has contracted COVID-19 and how worried are you that you or someone in your family will get infected with COVID-19. Compared to White participants, Black and Hispanic respondents were significantly more likely to report that they did not intend to obtain a COVID-19 vaccine. In addition, compared to those who reported positive vaccine intentions, respondents with negative vaccine intentions were significantly less likely to report that they engaged in the COVID-19 prevention behaviors of wearing masks and social distancing.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Systematic Review/Meta-Analysis
There are widespread concerns that ethnic minorities and migrants may have inadequate access to COVID-19 vaccines. Improving vaccine uptake among these vulnerable groups is important towards controlling the spread of COVID-19 and reducing unnecessary mortality. The data from this systematic review shows that low confidence in COVID-19 vaccines among Black ethnic minorities driven by mistrust and safety concerns led to high vaccine hesitancy in this group. For migrants, convenience factors such as language barriers, fear of deportation, and reduced physical access to COVID-19 vaccines. Building trust, reducing physical barriers and improving communication transparency about vaccine development through healthcare workers, and religious and community leaders can improve access and facilitate uptake of the COVID-19 vaccines among ethnic minority and migrant communities.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study aimed to determine independent community pharmacist preparedness for COVID-19 vaccination and to identify strategies for COVID-19 vaccination implementation in Pennsylvania. Through surveys and focus groups these recommendations emerged: (1) working with community partners to support off-site mass vaccination clinics, (2) leverage partnerships with community organizations and universities to support staffing for vaccination efforts, (3) use an appointment-based immunization model, (4) use existing scheduling tools, text messaging, and automated phone calls for second-dose reminders, and (5) further training and process improvements to support vaccine documentation and transmission to the Pennsylvania Statewide Immunization Information System.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Summary Report/Recommendations
Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals’ long-term physical, socioeconomic, and mental wellbeing. The recommendations presented in this Viewpoint article have been prioritised and agreed upon by the Lancet Commission on COVID-19’s Task Force on Social Protection, Humanitarian Action, and Vulnerable Group experts. This Viewpoint lists recommendations to protect vulnerable populations and reduce health inequities: (1) execute universal health coverage and social protection systems in every country, (2) at the country-level, ensure that governments and parliaments commit to financing and safeguarding health and social services to support universalism and equity, (3) provide digital equity for all, (4) boost care economy and take immediate steps to transform the current model, (5) re-energise relationships between government and civil society actors, and ensure communities, marginalized populations, and gender identities have a central role in decision making.