By Dustin Weiller from the Young Talents committee
Talk 01 of the REA Webinar series, titled: “What knowledge, strategies, and practices do we have at hand to respond in a flexible manner to COVID-19?” explored lessons and practices from diverse countries (USA, Israel, and Norway) to share insights and perceptions on how people act and the combination of top-down and bottom-up approaches in response to the COVID-19 pandemic. Speakers for this talk were: Professor David Woods (USA), Professor Bruria Adinin (Israel), and Dr. Ivonne Herrera (Norway).
Professor Woods began the webinar by posing the following question: “What matters when we are in the middle of this evolving pandemic”? To answer this question, Professor Woods focused on the concept of reducing excessive deaths. Professor Woods described excessive deaths as the ratio of fatalities experienced in a particular jurisdiction relative to the best performing jurisdictions. Excessive deaths are the result of a mismatch between capabilities and the overall demand for care, with the key in this pandemic being to reduce the number of excessive deaths. One way to reduce excessive deaths is by ensuring hospitals and healthcare systems build readiness to respond and handle an influx of patients with COVID-19. Professor Woods used the following metaphor to describe expanding readiness: “steering through fog under pressure, except in this pandemic it is multiple vehicles all trying to drive through the fog to get to the goal of reducing excessive deaths”. A further discussion on this metaphor can be found on the REA website.
Professor Adinin’s discussion highlighted two important populations to consider during this crisis and proposed the question of “who is managing the crisis?”. The first population highlighted are the individuals in the public. It was discussed how this population is vital to the solution and achieving community engagement is important to yielding compliance to directed measures such as social distancing or home quarantines. According to Professor Adinin, past research and experience has demonstrated that stoking fear in the public does not enhance compliance, but instead raises the level of denial and thus achieving the opposite of the goal (i.e. less individuals complying with directed measures). As a result, individuals must partner together for this effort to demonstrate solidarity and enhance a feeling of responsibility towards others to achieve preferred compliance rates.
The second population discussed by Professor Adinin are the frontline responders, otherwise referred to as the healthcare workers. One key component regarding healthcare workers, is to gain their trust and grant their access to the decision makers. We should ensure that the healthcare works feel protected and considered within the decisions and policies made to address COVID-19. Finally, Professor Adinin posed the question of “Who is managing the crisis”? In response, Professor Adinin stated that management of this crisis must be done holistically. This means including healthcare administration, national finance administration, national security administration, other stakeholders, and global partners in the management of this crisis to ensure we “bounce forward”.
Dr. Herrera discussed three main points to addressing COVID-19. The first point was to understand the concept of resilience and focus on bouncing forward because in Dr. Herrera’s words: “In this crisis, the world will not be the same, so we cannot bounce back, we are bouncing forward”. Second, Dr. Herrera discussed asking ‘trigger questions’ such as: “What is the capacity? What are the roles? What are the resources? Do we need to change our roles?” and learning what has/is working well and look at where to act. Finally, Dr. Herrera discussed using innovation in industry to support healthcare by offering examples found in Norway. Industries have altered production to create the resources necessary to care for COVID-19. Additionally, hospitals and care systems have taken to social media to identify shortages in their resources and calling for help in obtaining these resources. In many cases, local industries have answered those calls.
In summary, there were many great points and ideas exchanged between the three speakers. However, concepts such as tradeoffs, collaboration, and addressing stress loads on the healthcare system seemed to be main points of discussion. Tradeoffs were discussed as not being morally sound because it requires healthcare professionals to make care decisions based upon the consideration of the availability of resources and the care needs of the patients. This concept bridged into a discussion on the various loads that impact the healthcare system prior to the crisis and now the crisis is only compounding those loads. Finally, the concept of collaboration was frequently discussed and suggested as a pathway forward. Collaboration across nations and across researchers to find effectiveness in care models over time to help determine which approach(es) worked better and how they are implemented. This concept led to this ‘take-home’ quote: “COVID-19 does not recognize barriers or borders … rather than borders between nations, we are trying to build a border between humanity and a virus”.