The Application of a Hospital Medical Surge Preparedness Index to Assess National Pandemic and Other Mass Casualty Readiness.

EXECUTIVE SUMMARY: This article describes the use and findings of the Hospital Medical Surge Preparedness Index (HMSPI) tool to improve the understanding of hospitals' ability to respond to mass casualty events such as the COVID-19 pandemic. For this investigation, data from the U.S. Census Bureau, the Dartmouth Atlas Project, and the 2005 to 2014 annual surveys of the American Hospital Association (AHA) were analyzed. The HMSPI tool uses variables from the AHA survey and the other two sources to allow facility, county, and referral area index calculations. Using the three data sets, the HMSPI also allows for an index calculation for per capita ratios and by political (state or county) boundaries. In this use case, the results demonstrated increases in county and state HMSPI scores through the period of analysis; however, no statistically significant difference was found in HMSPI scores between 2013 and 2014. The HMSPI builds on the limited scientific foundation of medical surge preparedness and could serve as an objective and standardized measure to assess the nation's medical readiness for crises such as the COVID-19 pandemic and other large-scale emergencies such as mass shootings. Future studies are encouraged to refine the score, assess the validity of the HMSPI, and evaluate its relevance in response to future legislative and executive policies that affect preparedness measures.

Health Anxiety versus Economic Anxiety Surrounding COVID-19:An analysis of psychological distress in the early stages of the pandemic

Background This paper evaluates the evolution of health-related and economic-related anxiety surrounding COVID-19 in the early stages of the pandemic. Methods We merged two waves of data from a national survey administered first in late March 2020 (T1) and then a month later in late April/early May 2020 (T2). A moderated mediation model was estimated to predict changes in psychological distress. Results Health-related anxiety and economic-related anxiety surrounding COVID-19 both predict psychological distress. Levels of distress were significantly higher at T2 compared to T1. Over this time period, anxieties evolved away from fear of the virus itself and toward its impact on the economy. Moreover, economic-related anxiety is especially pronounced for men. Limitations Our measure of psychological distress is not a diagnostic instrument, although it meets diagnostic criteria. Moreover, the data do not necessarily provide unbiased population estimates. Conclusions The sources of psychological distress associated with COVID-19 shifted away from early anxieties of physiological infection and toward an emerging fear of joblessness stemming from the economic anxiety of the lockdown. This research suggests that employed individuals, and especially men, may be at risk of psychological distress related to economic anxiety.

Psychological Distress and Coronavirus Fears During the Initial Phase of the COVID-19 Pandemic in the United States

INTRODUCTION: The COVID-19 pandemic is a significant health and economic crisis around the world. The U.S. saw a rapid escalation in laboratory-confirmed cases of COVID-19 and related deaths in March, 2020. The financial consequences of a virtual economic shutdown to curb the spread of the coronavirus are widespread and debilitating, with over 30 million Americans (about 20% of the labor force) filing for unemployment benefits since mid-March. During these unprecedented times, it is important to understand the impact of the COVID-19 pandemic on psychological distress and overall fear associated with the virus. DATA: To gain an understanding of the overall levels and predictors of psychological distress experienced in the first month of the COVID-19 pandemic in the U.S., a survey was administered online to over 2,000 individuals residing in the country. The survey instrument was administered between March 22-26, 2020, during which time the country was suffering through a period of exponential growth in COVID-19 cases and fatalities. It was administered via MTurk, a popular crowdsourcing platform increasingly used by social scientists to procure large samples over a brief period of time. A short, valid screening instrument to measure psychological distress in individuals, the Kessler 10 scale was developed in the U.S. in the 1990s as an easy-to-administer symptom assessment. The first dependent variable is the respondents' summated Kessler 10 score. The second dependent variable is a 7-category measure of how afraid the subject is about the novel coronavirus. The final dependent variable is also a 7-category scale, this time measuring self-reported likelihood of contracting the coronavirus. A variety of socio-demographic variables and health status were collected to analyze factors associated with psychological distress and mental health. METHODS: Ordinary Least Squares (OLS) multiple regression was employed to analyze these data. RESULTS: We find that protective factors against psychological distress include age, gender (male), and physical health. Factors exacerbating psychological distress include Hispanic ethnicity and a previous mental illness diagnosis. Similar factors are significantly related to fear of the virus and self-assessed likelihood of contracting it. DISCUSSION: The COVID-19 pandemic is associated with high levels of psychological distress in the U.S. The Kessler 10 mean value in our sample is 21.12, which falls in the likely to experience mild mental illness category, yet is considerably higher compared to one of the largest and earliest benchmark studies validating the scale. Psychological distress is one element of overall mental health status that could be influenced by the COVID-10 pandemic. Other mental health conditions such as depression, anxiety, and substance use disorders could also be affected by the pandemic. We encourage researchers to examine these and other mental health disorders in future research on the COVID-19 pandemic. CONCLUSION: The relatively high mean score (21.12) for psychological distress during early stages of the pandemic suggests government officials, policy-makers, and public health advocates should act quickly to address emerging mental health problems.