The COVID-19 global crisis and corporate social responsibility

In order to gain greater insight into the nature of corporate social responsibility (CSR) during a time of crisis, the study examines the commitment of firms to continue to engage in CSR activity despite financial pressures to divert their slack resources elsewhere. The setting of the study is CSR activity during the perhaps unprecedented global crisis associated with the COVID-19 pandemic. Based on a qualitative research method approach, both a variety of media sources and the relevant academic literature are reviewed in order to identify examples of CSR activity related specifically to COVID-19. The examples are then categorized and situated according to Professor Archie Carroll's well-known CSR Pyramid framework describing the economic, legal, ethical, and philanthropic domains of CSR. As such, this study is the first to extend the rich literature stream utilizing Carroll's CSR Pyramid within the unique context of a global pandemic.

The COVID-19 global crisis and corporate social responsibility

In order to gain greater insight into the nature of corporate social responsibility (CSR) during a time of crisis, the study examines the commitment of firms to continue to engage in CSR activity despite financial pressures to divert their slack resources elsewhere. The setting of the study is CSR activity during the perhaps unprecedented global crisis associated with the COVID-19 pandemic. Based on a qualitative research method approach, both a variety of media sources and the relevant academic literature are reviewed in order to identify examples of CSR activity related specifically to COVID-19. The examples are then categorized and situated according to Professor Archie Carroll's well-known CSR Pyramid framework describing the economic, legal, ethical, and philanthropic domains of CSR. As such, this study is the first to extend the rich literature stream utilizing Carroll's CSR Pyramid within the unique context of a global pandemic.

Ethical decisions during COVID-19: level of moral disengagement and national pride as mediators

COVID-19 created a global crisis of unprecedented comprehensiveness affecting personal and professional lives of individuals worldwide. The pandemic and various governmental guidelines associated with it had numerous consequences for the workplace and the marketplace. In light of the global nature and multiplicity of the consequences of the pandemic, this study examines the impact of individual characteristics of respondents from three countries from various areas of the world: China, Israel, and the USA toward COVID-19 related business ethics decisions in three different spheres: human resources, marketing, and social responsibility. Data from 374 respondents in these three countries indicated that moral disengagement was negatively related to all of the ethical decisions presented, with national pride moderating the above. Possible implications of these findings and future research directions are presented.

Communication During the Pandemic

Aim Since the COVID-19 pandemic facemasks have become compulsory in UK hospitals impacting on the visual and vocal (93%) aspects of communication. This QIP looks at the difference a clear mask made to patients. Method ClearmaskTM was used in place of a surgical mask and patients were asked to rate the difference on a likert scale. 100 patients were seen at two appointments, once with a Clearmask and another with a surgical mask. Dragon voice recognition software was used as a control. Results 95% of patients rated communication better with the clearmask, Patients felt more engaged and were more likely to engage with the clinician. The effect was amplified when English was not the first language. Conclusions Clear facemasks improved communication and allow patients to become more engaged in consults and are more likely to allow information to be divulged to a clinician.

Personal protective equipment training & lived experience for healthcare staff during COVID-19.

Objectives: To describe the lived experience of healthcare staff during the Coronavirus Disease 2019 (COVID-19) pandemic relating to the use of personal protective equipment (PPE) and investigate risks associated with PPE use, error mitigation and acceptability of mindfulness incorporation into PPE practice. Methods: A qualitative human factors' study at two Irish hospitals occurred in late 2020. Data was collected by semi-structured interview and included role description, pre-COVID-19 PPE experience, the impact of COVID-19 on lived experience, risks associated with PPE use, contributory factors to errors, error mitigation strategies and acceptability of incorporating mindfulness into PPE practice. Results: Of 45 participants, 23 of whom were nursing staff (51%), 34 (76%) had previously worn PPE and 25 (56%) used a buddy system. COVID-19 lived experience impacted most on social life/home-work interface (n=36, 80%). Nineteen staff (42%) described mental health impacts. The most cited risk concerned 'knowledge of procedures' (n=18, 40%). Contributory factors to PPE errors included time (n=15, 43%) and staffing pressures (n=10, 29%). Mitigation interventions included training/education (n=12, 40%). The majority (n=35, 78%) supported mindfulness integration into PPE practice. Conclusions: PPE training should address healthcare staff lived experiences and consider incorporation of mindfulness and key organisational factors contributing to safety.

Burden of Respiratory Syncytial Virus (RSV) Infection among Hospitalized Older Adults and Those with Underlying Chronic Obstructive Pulmonary Disease (COPD) or Congestive Heart Failure (CHF)

Background. The burden of Respiratory Syncytial Virus (RSV)-associated hospitalization in adults is incompletely understood. The COVID-19 pandemic has resulted in multiple public health measures (e.g., social distancing, handwashing, masking) to decrease SARS-CoV-2 transmission, which could impact RSV-associated hospitalizations. We sought to compare RSV-associated hospitalizations from 2 pre- and one mid-COVID-19 winter viral respiratory seasons. Methods. We conducted an IRB-approved prospective surveillance at two Atlanta-area hospitals during the winter respiratory viral seasons from Oct 2018-Apr 2021 for adults ≥ 50 years of age admitted with acute respiratory infections (ARI) and adults of any age with COPD or CHF-related admissions. Adults were eligible if they were residents of an 8 county region surrounding Atlanta, Georgia. Those with symptoms > 14 days were excluded. Standard of care test results were included. Asymptomatic adults ≥ 50 years of age were enrolled as controls in Seasons 1 and 2. Nasopharyngeal swabs from cases and controls were tested for RSV using BioFireR FilmArrayR Respiratory Viral Panel (RVP). We compared the demographic features and outcomes of RSV+ cases and controls. Results. RSV was detected in 71/2,728 (2.6%) hospitalized adults with ARI, CHF, or COPD and 4/466 (0.9%) controls. In Season 1, RSV occurred in 5.9% (35/596 patients), in Season 2 3.6% (35/970 patients), but in only 0.09% (1/1,162 patients) in Season 3 (P < 0.001 for both seasons). RSV detection in Season 3 was similar to RSV detection among controls during Seasons 1 and 2 (P=0.6). Median age of cases and controls was 67 years (Table 1). Of cases with RSV 11% were admitted to the ICU and two required mechanical ventilation. The majority of hospitalized patients were discharged home (95.8%) with a median length of hospitalization of three days (IQR 2-7). Conclusion. Over 3 seasons, RSV was detected in 2.6% of adults admitted to the hospital with ARI, CHF or COPD. The rate of RSV dramatically declined during the 2020-21 winter respiratory viral season, likely due to public health measures implemented in response to COVID-19.

Outcomes among Influenza and SARS-CoV-2 Infection in Hospitalized Adults Age ≥ 50 Years and with Underlying Chronic Obstructive Pulmonary Disease (COPD) or Congestive Heart Failure (CHF)

Background. A significant burden of disease exists for adults infected with influenza (flu) and SARS-CoV-2, which causes COVID-19. However, data are limited comparing outcomes between hospitalized adults infected with these viruses. Methods. Over the course of 3 consecutive winter respiratory viral seasons, adults ≥ 50 years of age admitted with acute respiratory tract infections (ARI) and adults of any age with COPD or CHF-related admissions were enrolled from 2 Atlanta area hospitals. For the 2018-19 and 2019-20 seasons, participants were approached in the hospital. If the participant enrolled, nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected and tested using BioFire® FilmArray® respiratory panel. Due to the COVID-19 pandemic in 2020-21 and limitations involving participant contact, only NP standard of care (SOC) swabs were collected. A comprehensive medical chart review was completed for each subject which encompassed data on their hospitalization, past medical history, and vaccination history. Co-infected patients were excluded from the analyses. Results. Of the eligible participants, 118 were flu positive (three RSV-influenza co-infections were excluded) and 527 were COVID-19 positive. Median age was lower for the flu cohort at 62 (IQR 56-71) than those with COVID-19 (67, IQR 59-77) (p < 0.0001). Length of stay (LOS) was shorter in flu-infected patients (median 3 d, IQR 2-6), but was longer for COVID-19 patients (median 5 d, IQR 3-10). ICU admission occurred in 20% of those with flu, and among those admitted to the ICU mechanical ventilation (MV) occurred in 12.5%. ICU admission and MV was significantly higher for those with COVID-19, with 28% of patients admitted to the ICU and 47% of those requiring MV. Among patients with COVID-19, 8.9% died. This was significantly higher than that of flu (3.4%) (p=0.008). Hospital discharge occurred more frequently to a nursing home or LTCF with COVID-19 (10.3%) than with flu (0%) (p< 0.0001). Table 1. Breakdown of age, hospitalization course, and discharge disposition for participants diagnosed with influenza or COVID-19 during hospitalization. Conclusion. COVID-19 resulted in a longer hospital admission, a greater chance of ICU admission and MV as compared to flu. Additionally, COVID-19 participants had a high rate of discharge to a nursing home/LTCF and a significantly higher risk of death. While the clinical course was not as severe as COVID-19, influenza contributed a significant burden.

The Burden of Influenza and Rhinovirus among Hospitalized Adults Post the COVID-19 Pandemic

Background. Acute respiratory tract infections (ARIs) are a significant cause of morbidity in adults. Influenza is associated with about 490,600 hospitalizations and 34,200 deaths in the US in the 2018-2019 season. The burden of rhinovirus among adults hospitalized with ARI is less well known. We compared the burden of influenza and rhinovirus from 2 consecutive winter respiratory viral seasons in hospitalized adults and healthy controls pre-COVID-19 and one season mid-COVID-19 to determine the impact of rhinovirus as a pathogen. Methods. From Oct 2018 to Apr 2021, prospective surveillance of adults ≥50 years old admitted with ARI or COPD/CHF exacerbations at any age was conducted at two Atlanta hospitals. Adults were eligible if they lived within an eightcounty region around Atlanta and if their symptom duration was < 14 days. In the seasons from Oct 2018 to Mar 2020, asymptomatic adults ≥50 years old were enrolled as controls. Standard of care test results were included and those enrolled contributed nasopharyngeal swabs that were tested for respiratory pathogens using BioFire® FilmArray® Respiratory Viral Panel (RVP). Results. During the first two seasons, 1566 hospitalized adults were enrolled. Rhinovirus was detected in 7.5% (118) and influenza was detected in 7.7% (121). Rhinovirus was also detected in 2.2% of 466 healthy adult controls while influenza was detected in 0%. During Season 3, the peak of the COVID-19 pandemic, influenza declined to 0% of ARI hospitalizations. Rhinovirus also declined (p=0.01) but still accounted for 5.1% of all ARIs screened (Figure 1). Rhinovirus was detected at a greater rate in Season 3 than in asymptomatic controls in the first 2 seasons (p=0.008). In the first two seasons, Influenza was detected in 8.6% (24/276) of those admitted to the ICU. Rhinovirus was detected in 6.1% (17/276) of those admitted to the ICU but declined to 3.1% (8/258) in Season 3. Conclusion. Dramatic declines occurred in influenza in adults hospitalized with ARI, CHF, or COPD in Atlanta during the COVID-19 pandemic and with enhanced public health measures. Although rhinovirus declined during the COVID-19 pandemic, it continued to be identified at a rate higher than in historical controls. Additional data are needed to understand the role of rhinovirus in adult ARI, CHF, and COPD exacerbations.

Safe PPE: user needs for an interactive ppe training tool

Introduction: Staff competency and access to PPE training became critical early in the COVID 19 pandemic. This placed demands on infection prevention & control staff when already busy with COVID-19-related tasks. Objectives: To be prepared for the next pandemic, we investigated the role of mindfullness and technology in PPE training. Methods: Human factors research involving three clinical sites (N = 174) consiting of interviews, workshops and participatory codesign sessions. This was extended by interviews with 14 IPC experts from 7 sites in UK and USA. Results: Existing PPE & HH Training: - Addressed the lived experience of using PPE - Variety of training formats e.g. classroom (15%) and in-unit training (85%) - One (1/10) site assessed PPE competency - Four (4/10) sites used a Virtual Learning Environment to track the learner journey - One (1/10) site used a mobile phone based training Performance Shaping Factors: - Training, Fatigue, Distraction, Rushing, Stress, etc. - Changing types of PPE with different quality and fit - Changing PPE guidelines as IPC knowledge evolved Emerging Mobile Learning App Concept & Requirements: - All trainers expressed concerns of low engagement with phonebased training - Online and in-person training must be consistent - Assessment should be carried out on-site, with special-purpose equipment - PPE and Hand Hygiene training should incorporate self-care & mindfulness - Scenario-based training needed to support different clinical roles and needs - Customise training to local guidelines Conclusion: Mindfulness is a protective factor for effective and safe performance. Organisations should consider integrating wellness into IPC training. Technology can support in-person training but it is not a replacement and must be available 24-7. A variety of training access pathways are good but the Learner Journey should be tracked to ensure everyone is trained and skills are maintained over time.

Sterilization of gowns: making the most of a scarce commodity during the COVID-19 pandemic.

Baylor Clinic in Mbabane, Eswatini, convened a crisis meeting to tackle critical shortages of long-sleeved disposable gowns that resulted from COVID-19 pandemic constraints on available personal protective equipment (PPE). A strategy deemed safe, affordable and sustainable was adopted to autoclave and re-use gowns based on a risk-stratified approach. Key objectives were to ensure essential infection control and prevention (ICP) for medical doctors, nurses, and laboratory teams. Administrative, environmental and personal protective measures for ICP were enhanced through regular staff training. This strategy for gown re-use has been invaluable in motivating responsible stewardship and maximization of available gowns during the COVID-19 pandemic.

La Baylor Clinic de Mbabane, Eswatini, a convoqué une réunion de crise pour remédier à la grave pénurie de blouses jetables à manches longues due au manque d'équipements de protection individuelle (PPE) lié à la pandémie de COVID-19. Une stratégie jugée sûre, abordable et durable a été adoptée pour stériliser par autoclave et réutiliser les blouses en prenant appui sur une approche stratifiée des risques. Les objectifs clés étaient de garantir la prévention et le contrôle des infections (ICP) pour les médecins, les infirmiers et les équipes de laboratoire. Les mesures ICP d'ordre administratif, environnemental et de protection individuelle ont été renforcées par le biais de formations régulières du personnel. Cette stratégie de réutilisation des blouses a permis de promouvoir une gestion responsable et de tirer au maximum profit des blouses disponibles pendant la pandémie de COVID-19.