Policies enacted during COVID-19 came with unintended health benefits: why go back?

OBJECTIVES: To explore the impact of COVID-19 on the implementation of bundled interventions to improve the engagement and retention of Black women in HIV care. METHODS: Pre-implementation interviews conducted between January and April 202 L with 12 demonstration sites implementing bundled interventions for Black women with HIV. Directed content analysis was employed to examine the site interview transcripts. RESULTS: The pandemic intensified barriers to care and harmful social conditions. However, COVID-19 also forced pivots in health care and social service delivery and some of these changes benefited Black women living with HIV. CONCLUSIONS: The continuation of policies that support the material needs of Black women with HIV and ease access to care is critical. Racial capitalism impedes the enactment of these policies and thus threatens public health.

The longitudinal impact of the SARS-CoV-2 pandemic on participants from the Boston Puerto Rican Health Study

Objective to investigate the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on older Hispanic adults. Methods A total of 522 participants (or their family member, if deceased) from the Boston Puerto Rican Health Study were asked whether they had been diagnosed with SARS-CoV-2, across 2 survey phases. In phase 1 (May – Aug 2020, n=497), participants answered survey questions related to SARS-CoV-2 exposure, diagnosis, and transmission and 5 family members reported deaths. In phase 2, participants were again surveyed (January – June 2021;n=420, and 2 family members reported deaths). SARS-CoV-2 diagnosis and/or death apparently from SARS-CoV-2 was self-reported. Results In 2020, 5.2% reported that they had been SARS-CoV-2 positive;by June 2021, a cumulative 11.0% reported having been SARS-CoV-2 positive (including cases and deaths in the first survey). A total of 7 participants (1.3%) reportedly died from SARS-CoV-2. Language acculturation was significantly lower among participants with SARS-CoV-2 (13.7 ± 17.9) vs. without SARS-CoV-2 (20.0 ± 21.4;P = 0.049). Mean length of return to usual health was 28 ± 38 days (range: 0-210 days;median = 15 days). Depressive symptomatology was significantly lower during the pandemic (CES-D score: 13.4 ± 11.6) compared to the same participants pre-pandemic (17.8 ± 11.7;P = 0.001). Compared to the months before the pandemic, 32% (n=135) of participants reported greater communication with friends and family, and 41% (n=172) reported no change. Conclusions Public health models should be personalized to communities, considering their unique structures and cultural beliefs. Social resiliency may be key for future programmatic responses to pandemics to reduce the mental health burden.

Leveraging Community Resources and Local Expertise to Build a Safe Learning Environment for K-12 Students During COVID-19: A Field Experience.

OBJECTIVE: To share the experiences of stakeholders in a school district's response to the COVID-19 pandemic, especially related to supporting the district in the reopening process and sharing key decision points, challenges, facilitators, and overall lessons learned that may be applied to future emergencies. DESIGN: A descriptive study of participants' experience that included (1) a content analysis of policy documents and recommendations that were developed and published by key stakeholders and (2) interviews with stakeholders in the school system that were coded to identify patterns and themes. SETTING: Remote interviews conducted over Zoom. Participants live or work in Brookline, Massachusetts. PARTICIPANTS: Fifteen qualitative interviews were conducted with school committee members, principals, members of school leadership, school nurses, school staff, parents, advisory panel members, and physicians collaborating with the school district. MAIN OUTCOME MEASURES: Whether patterns and themes related to challenges, solutions, and recommendations for future management of public health emergencies in the district could be identified. RESULTS: Challenges experienced during a school district's response included staffing burdens, changing scopes of services, the difficulty of successfully enforcing social distancing, addressing staff and family fears, meeting informational needs, and limited resources. Multiple interviewees shared that they felt there should have been a greater emphasis on mental health in the district's response. Successes of the response included the creation and implementation of a consistent communications system, recruiting volunteers and mobilizing the community to address critical needs, and effective technology expansion and usage in schools. CONCLUSIONS: Leadership and community collaboration were essential to the response to the COVID-19 pandemic in addition to strategies used to enhance coordination and communication and relay information across the community.

Enhanced Telehealth Case Management Plus Emergency Financial Assistance for Homeless-Experienced People Living With HIV During the COVID-19 Pandemic.

Boston Health Care for the Homeless Program, in Boston, Massachusetts, implemented an intensive telehealth case management intervention combined with emergency financial assistance for 270 homeless-experienced people living with HIV (PLWH) to reduce COVID-19 transmission and promote HIV care retention during Boston's first pandemic peak (March 16-May 31, 2020). Our telehealth model successfully maintained prepandemic case management and primary care contact levels, highlighting the importance of such programs in supporting the care engagement of homeless-experienced PLWH and addressing the dual COVID-19 and HIV epidemics.