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Aims: Suicide is a leading cause of death for young people, and rates in Australia are increasing. The Australian city of Melbourne faced the toughest COVID-19 pandemic lockdown restrictions worldwide, which had a major impact on youth mental health. This study aimed to provide a snapshot into the mental health and suicide-related thoughts and behaviours of Australian Adolescents from Melbourne post the lockdowns. Method(s): Participants were 932 young people (Age M = 15.5, 53% female) recruited from high schools in Melbourne, Australia as part of a larger RCT. Participants completed measures of suicidal ideation (SIDAS) and behaviour (recent attempts and current plans), and depressive symptoms (PHQ-9). Result(s): Preliminary results indicate that 28% of participants experienced some level of suicidal ideation with 7% reporting severe suicidal ideation. Suicide attempts in the sample in the last 12 months (13%) and current plans (3%) were less common but still prevalent. In terms of depressive symptoms, the breakdown in the sample was 5% severe, 8% moderately severe, 18% moderate, 25% mild and 43% none to minimal with 1% not reporting. Data related to particular risk factors (e.g., years since the pandemic, gender, school etc.) along with implications for practice and policy will be presented at the conference. Conclusion(s): This study sheds light on the mental health and suiciderelated thoughts and behaviours of school-attending young people following COVID-19-related lockdowns in Australia. The high levels of suicidality and poor mental health in the cohort point to a need for targeted interventions and support for this group.
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Background: The SARS-CoV-2 pandemic has had an unprecedented impact on healthcare systems, and cancer patients were amongst the most vulnerable. CONTACT is a national multidisciplinary study assessing the impact of the SARS-CoV-2 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC). Method(s): A novel, mixed prospective and retrospective design, with retrospective case identification of both cohorts, and trainee-performed data collection. The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID cohort (07/01/ 2019-03/03/2019) were compared to a cohort diagnosed during the first wave of SARS-CoV-2 in the UK ('COVID' cohort, 16/03/2020-10/05/ 2020), with 12-month follow-up. Result(s): Among 984 patients (pre-COVID: N=483, COVID: N=501), across 96 hospitals, the COVID cohort were less likely to receive staging investigations other than CT scan (148/501, 29.5% vs 180/486, 37.2%;p=0.01). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (42/77, 54.5% vs 72/94, 76.6%, p=0.001) and increase in the proportion recommended neoadjuvant therapy (35/77, 45.5% vs 22/94, 23.4%, p=0.002). Among patients within a non-curative pathway, fewer patients were recommended (201/424, 47.4% vs 223/389, 57.3%, p=0.004) or received palliative therapy (87/424, 20.5% vs 103/389, 26.5%, p=0.045). Ultimately, fewer patients in the COVID cohort underwent resection surgery (29/501, 6.4% vs 45/483, 9.3%, OR 0.64, 95%CI: 0.37- 0.97, p=0.036), whilst more patients received no treatment whatsoever (347/ 501, 69.3% vs 286/483, 59.2% p=0.009). There was no difference in median survival between the COVID and pre-COVID cohorts, (105 days, IQR: 86-124 vs 130 days, IQR: 108-157, p=0.093). Conclusion(s): The CONTACT study confirms alarming reduction in the staging and treatment provided to patients with PDAC diagnosed during the SARS-CoV-2 pandemic. Restoration of cancer services to pre-pandemic standards must be urgently addressed.
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Background: Despite vaccines being attributed to the eradication of smallpox and prevention of many possibly fatal diseases, public confidence in vaccines has been on the decline, and the COVID-19 pandemic has further increased the vaccination gap across the world. A study done by the Michigan Care Improvement Registry compared age-recommended vaccination rates for patients from the years of 2016-2019 and the year 2020. The study showed that in the 16-month age cohort, children obtaining measles vaccine coverage declined from 76.1% in May 2019 to 70.9% in May 2020. An analysis by Scientific American showed only 44.7% of the number of vaccines administered in March 2019 were administered in March 2020 in the state of Texas. Methods: The Quality Improvement sector of the Health Technology department at the UT Health Science Center approved the project and collected data across UT Health primary pediatric care clinics in Harris County. The data points included all the pediatric appointments of patients who were eligible for the MMR 1 and 2 vaccines in 2019 and 2020. The data displayed which eligible patients for the MMR 1 and 2 vaccines received the vaccine at their appointment. The data was analyzed for overall trends of Harris County, and then subdivided by patient racial groups. Results: From 2019 to 2020, the MMR1 vaccination rate decreased from 52.15% to 43.55%, and the MMR2 vaccination rate decreased from 55.70% to 45.57%. Combining years 2019 and 2020, the percentage of eligible patients who did not receive the MMR1 vaccine consisted of 28.04% Caucasian, 22.05% African American, 17.11% Hispanic, Latino, or Latin American, 1.34% Asian or Pacific Islander, and 31.46% Other. The percentage of eligible patients in 2019 and 2020 who did not receive the MMR2 vaccine consisted of 28.05% Caucasian, 16.25% African American, 21.76% Hispanic, Latino, or Latin American, 1.75% Asian or Pacific Islander, and 32.18% Other. The demographic labeled “other” consisted of not answered and not specified patients. Conclusion: Overall, there was a clear decline in the rate of MMR vaccinations to eligible patients from 2019 to 2020. This indicates that the COVID-19 pandemic is potentially playing an even greater role in public health than previously thought due to increasing the possibility of a measles epidemic occurring in Harris County. Stratifying the data by race demonstrated which demographics were more prone to vaccination gaps. Patients who selected not answered/not specified and Caucasian patients were the most likely to experience a gap in vaccine administration leading to an increased chance of measles outbreaks in these groups of patients. This is valuable knowledge for providers to be aware of which groups are more predisposed to vaccine gaps, so the healthcare team can help close the gap through a targeted approach of care.
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The COVID-19 pandemic has exposed fault-lines in the organization of personal support work, including low wages, part-time employment, and risky working condition, despite its essential nature in long-term care (LTC). This is, in part, because personal support work has long-existed on the fringes of what is considered health work, thereby precluding its status as a health profession. In this perspective paper, we explore how the pandemic may contribute to the semi-professionalization of personal support work based on the provision of LTC by personal support workers (PSWs) working in LTC facilities in Ontario, Canada. We first characterize personal support work to illustrate its current organization based on the logics of work control. We then speculate how the pandemic may shift control and map speculated changes onto existing checklists of professionalism and semi-professionalism in health work. We propose the pandemic will shift control away from existing market and hierarchical controls. At most, personal support work may undergo changes that are more characteristic of semi-professional control (semi-professionalism), char-acterized by the formation of a PSW registry that may improve role clarity, provide market shelter, and standardize wages. We do not believe this shift in control will solve all organizational problems that the pandemic has exposed, and continued market and hierarchical controls may be necessary. This perspective may provide insights for other high-income settings, where the pandemic has exposed similar fault-lines in the organization of personal support work in LTC. © 2021 The Author(s).
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Introduction: Facial protective equipment (FPE) is a critical barrier to COVID-19 transmission, but compliance with FPE recommendations has historically been low, even amongst health care workers. This study analyzes factors influencing home care worker FPE compliance during the COVID-19 pandemic. Materials and Methods: Nurses and PSWs employed by VHA Home HealthCare (N=199) completed an online survey adapted from a Facial Protection Questionnaire used in previous studies from January 27 – February 10, 2021. Descriptive statistics, tests of significance, and logistic regression were conducted for each variable separated by FPE compliance. Results: This study found higher rates of FPE compliance (71%) than previously reported. Regression results suggest that participants who were not always FPE compliant (29%) were significantly more likely to have lower perceived FPE efficacy, lower knowledge of recommended FPE use, lower perception of risk at work, and higher personal barriers for face shields. Fogging of glasses or face shields from wearing a mask (74%) or face shield (71%) increased job difficulty for many participants. Conclusions: Policies and initiatives addressing perceived FPE efficacy, knowledge of recommended FPE use, perception of at-work risk, and personal barriers to FPE would be expected to significantly affect FPE compliance in the home care sector. Additionally, interventions that reduce visibility issues while wearing FPE would decrease personal barriers to FPE use.
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Introduction: Personal support workers (PSWs) are considered the backbone of homecare however their working conditions remain precarious and unregulated suggesting increased vulnerability in the face of a pandemic. The purpose of this study is to better understand the experiences of PSWs working in homecare during the COVID-19 pandemic. Methods: This qualitative descriptive study used a social constructivist approach to understand the experiences of Toronto-based PSWs working at a local homecare agency during the COVID-19 pandemic. Semi-structured virtual interviews were conducted. All transcribed interviews were coded and analyzed using the DEPICT framework. Results: 19 interviews were completed. PSWs shared a strong belief in duty to work during a health crisis and responsibility to support their vulnerable clients despite feeling vulnerable themselves to transmission and infection;the weight of pandemic anxiety was felt daily and intensely for most. PSWs described existing system challenges exacerbated by the pandemic that tested the limits of their motivations to work, emotional wellbeing and perception of organizational support. Conclusions: The COVID-19 pandemic contributed to increased occupational stress among PSWs. Longstanding system-level issues coupled with increased emotional labour has positioned this workforce at- risk for burnout indicating that health human resource issues may persist if unaddressed. Homecare organizations can implement strategies that promote and protect the mental wellbeing of PSWs while aggressively lobbying for system changes such as higher wages and better labour protections.
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In May 2020, the New York City (NYC) Mayor’s Office of Climate Resiliency (MOCR) began convening bi-weekly discussions, called the Rapid Research and Assessment (RRA) Series, between City staff and external experts in science, policy, design, engineering, communications, and planning. The goal was to rapidly develop authoritative, actionable information to help integrate resiliency into the City’s COVID response efforts. The situation in NYC is not uncommon. Extreme events often require government officials, practitioners, and citizens to call upon multiple forms of scientific and technical assistance from rapid data collection to expert elicitation, each spanning more or less involved engagement. We compare the RRA to similar rapid assessment efforts and reflect on the nature of the RRA and similar efforts to exchange and co-produce knowledge. The RRA took up topics on social cohesion, risk communication, resilient and healthy buildings, and engagement, in many cases strengthening confidence in what was already known but also refining the existing knowledge in ways that can be helpful as the pandemic unfolds. Researchers also learned from each other ways to be supportive of the City of New York and MOCR in the future. The RRA network will continue to deepen, continue to co-produce actionable climate knowledge, and continue to value organizational sensemaking as a usable climate service, particularly in highly uncertain times. Given the complex, rare, and, in many cases, unfamiliar context of COVID-19, we argue that organizational sensemaking is a usable climate service.