Real-time virtual infection prevention and control assessments in skilled nursing homes, New York, March 2020-A pilot project.

OBJECTIVE: To describe a pilot project infection prevention and control (IPC) assessment conducted in skilled nursing facilities (SNFs) in New York State (NYS) during a pivotal 2-week period when the region became the nation's epicenter for coronavirus disease 2019 (COVID-19). DESIGN: A telephone and video assessment of IPC measures in SNFs at high risk or experiencing COVID-19 activity. PARTICIPANTS: SNFs in 14 New York counties, including New York City. INTERVENTION: A 3-component remote IPC assessment: (1) screening tool; (2) telephone IPC checklist; and (3) COVID-19 video IPC assessment (ie, "COVIDeo"). RESULTS: In total, 92 SNFs completed the IPC screening tool and checklist: 52 (57%) were conducted as part COVID-19 investigations, and 40 (43%) were proactive prevention-based assessments. Among the 40 proactive assessments, 14 (35%) identified suspected or confirmed COVID-19 cases. COVIDeo was performed in 26 (28%) of 92 assessments and provided observations that other tools would have missed: personal protective equipment (PPE) that was not easily accessible, redundant, or improperly donned, doffed, or stored and specific challenges implementing IPC in specialty populations. The IPC assessments took ∼1 hour each and reached an estimated 4 times as many SNFs as on-site visits in a similar time frame. CONCLUSIONS: Remote IPC assessments by telephone and video were timely and feasible methods of assessing the extent to which IPC interventions had been implemented in a vulnerable setting and to disseminate real-time recommendations. Remote assessments are now being implemented across New York State and in various healthcare facility types. Similar methods have been adapted nationally by the Centers for Disease Control and Prevention.

Preparing education for the crises of tomorrow: A framework for adaptability.

The COVID-19 crisis has disrupted learning globally, exacerbating regional and global disparities that predated the pandemic. This rupture presents a unique opportunity to reimagine our educational system in times of both calm and crisis. Drawing on the work of political scientist Kathleen Thelen and economist and philosopher Amartya Sen, this article introduces a Framework for adaptability that outlines examples of flexible and equitable adaptation to change. The authors define adaptability as the ability of educational systems to respond to rapidly changing circumstances while maintaining stability, promoting equality, and expanding substantive freedoms and well-being. The key components of educational adaptability are: (1) cooperation, (2) inclusion, and (3) flexibility. This article describes how adaptability in education might be facilitated at individual, community, state and global levels. The authors call attention to a critical need to collectivise our approach to risk at the level of national governance. They suggest that this can be achieved by coordinating various professional, scientific, corporate, community and governmental stakeholders in order to ensure continuity in educational service provision, promoting lifelong learning and overall workforce participation.

Préparer l'éducation aux crises de demain : un cadre d'adaptabilité ­ La crise de la COVID-19 a perturbé l'apprentissage partout dans le monde, exacerbant les disparités régionales et mondiales antérieures à la pandémie. Cette rupture offre une occasion unique de réinventer notre système d'éducation tant en période de calme que de crise. S'inspirant des travaux de la politologue Kathleen Thelen et de l'économiste et philosophe Amartya Sen, cet article présente un cadre d'adaptabilité qui esquisse quelques exemples d'adaptation flexible et équitable au changement. Les auteurs définissent l'adaptabilité comme la capacité des systèmes d'éducation à répondre à des situations qui évoluent rapidement et en même temps à maintenir la stabilité, à promouvoir l'égalité et à accroître des libertés et un bien-être essentiels. Les éléments clés de l'adaptabilité éducative sont : (1) la coopération, (2) l'inclusion et (3) la flexibilité. Cet article décrit comment l'adaptabilité pourrait être facilitée dans l'éducation aux niveaux des individus, de la communauté, de l'État et du monde. Ses auteurs attirent l'attention sur le besoin crucial de collectiviser notre approche du risque à l'échelle de la gouvernance nationale. Ils indiquent que l'on peut y parvenir en coordonnant différents acteurs professionnels, scientifiques, entrepreneuriaux, communautaires et gouvernementaux afin d'assurer la continuité de l'offre des services éducatifs, de la promotion de l'apprentissage tout au long de la vie et de la participation générale de la main-d'œuvre.