Nourishing nations during pandemics: why prioritize fish diets and aquatic foods in Africa.

The COVID-19 pandemic caught the world unprepared, with containment measures impacting both global supply chains and agri-commodity flows. The public health crisis raised some urgent questions: "how can fish and other aquatic foods and supply chains be prioritized as health-related interventions to avert both a malnutrition crisis and gender inequality?" Furthermore, "what are the integrated responses, investment opportunities, and governance mechanisms to effectively address the pandemic?" As "super foods," diets of fish and aquatic foods provide animal-source protein, omega-3 fatty acids, and micronutrients, including both vitamins and minerals, necessary for both the ill and the healthy. The affordability and accessibility of fish could address food and nutrition security needs under lockdown and border closures, boost immune systems, and increase commodity trade. This analytical piece focuses on the continent of Africa, where malnutrition is pervasive, but also where local aquatic food supplies can be utilised during lockdowns and border closures. The paper provides governance insights on national budget support programs and portfolio restructuring to strengthen local aquatic foods production systems to meet dietary needs. Furthermore, the authors advocate for a coordinated multi-sectoral intervention across several well-being domains in the immediate and medium-term involving various partnerships. These integrated responses will mutually limit the contagion while providing support to functional fish value chains for healthy diets, livelihoods, cross-border trade, and long-term macroeconomic recovery.

Utilising mHealth in the COVID-19 era

1150 Table 1Overview of mean app quality scoresDomain Quality Assessment Subscales Description Mean Rating Score (Standard Deviation) Engagement 3 elements Interesting, appropriately targeted 4.125 (SD 0.182) Functionality 4 elements Performance, usability, navigation, gestural design 4.171 (SD 0.372) Aesthetics 2 elements Layout, visual appeal 4.125 (SD 0.176) Information 3 elements Quality & quantity of information 4.109 (SD 0.172) The overall App quality mean rating was 4.141 (SD 0.27) - RATED GOODThe best-rated domain was functionality (4.171 (SD 0.372)), and the lesser rated domain was information (4.109 (SD 0.172)).In response to the ongoing pandemic, it was also decided to explore the user’s perceptions of how the App assisted in accessing clinical guidelines and supporting the new ways of working introduced as a result of COVID-19.73% of users indicated the App was likely to increase their use of clinical guidelines.70% of users agreed that the mhealth App supported the new ways of working introduced in response to the COVID-19 pandemic.ConclusionsThis project provided a valuable insight into users perception of quality which has informed the further refinement of the App as part of an ongoing PDSA cycle. All domains indicated a quality rating of acceptable and higher. There was a strong indication that the App supported the new ways of working and enhanced access to clinical guidelines and other relevant information.A limitation of this project was its implementation during the acute strain on staff and services due to the COVID-19 pandemic, which may have contributed to the volume of quantitative research responses being smaller than anticipated.References are available on request

Getting Real: The Maryland Healthcare Ethics Committee Network's COVID-19 Working Group Debriefs Lessons Learned.

Responding to a major pandemic and planning for allocation of scarce resources (ASR) under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland's response to COVID-19 and the role of the Maryland Healthcare Ethics Committee Network (MHECN) in bridging gaps in the state's response to prepare health care facilities for potential implementation of ASR plans. Identified "lessons learned" include: Deliberative Democracy Provided a Strong Foundation for Maryland's ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR … And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies.