Pathways and obstacles to social recovery following the elimination of SARS-CoV-2 from Aotearoa New Zealand: a qualitative cross-sectional study.

BACKGROUND: Many public health experts have claimed that elimination strategies of pandemic response allow 'normal social life' to resume. Recognizing that social connections and feelings of normality are important for public health, this study examines whether, and for whom, that goal is realized, and identifies obstacles that may inhibit its achievement. METHODS: Thematic analysis of narratives obtained via a qualitative cross-sectional survey of a community cohort in Aotearoa | New Zealand. RESULTS: A majority of participants reported that life after elimination was 'more or less the same' as before the pandemic. Some became more social. Nevertheless, a sizeable minority reported being less social, even many months after elimination. Key obstacles to social recovery included fears that the virus was circulating undetected and the enduring impact of lockdowns upon social relationships, personal habits and mental health. Within our sample, old age and underlying health conditions were both associated with a propensity to become less social. CONCLUSIONS: Elimination strategies can successfully allow 'normal social life' to resume. However, this outcome is not guaranteed. People may encounter difficulties with re-establishing social connections in Zero-COVID settings. Measures designed to overcome such obstacles should be an integral part of elimination strategies.

Community healthcare workers' experiences during and after COVID-19 lockdown: A qualitative study from Aotearoa New Zealand.

Shortly after the COVID-19 pandemic reached Aotearoa New Zealand, stringent lockdown measures lasting 7 weeks were introduced to manage community spread of the virus. This paper reports the findings of a qualitative study examining how lockdown measures impacted upon the lives of nurses, midwives and personal care assistants caring for community-based patients during this time. The study involved nationwide surveys and in-depth interviews with 15 registered nurses employed in community settings, two community midwives and five personal care assistants. During the lockdown, nurses, midwives and personal care assistants working in the community showed considerable courage in answering their 'call to duty' by taking on heightened care responsibilities and going 'the extra mile' to help others. They faced significant risks to personal and professional relationships when they were required to take on additional and complex responsibilities for community-based patients. Despite the hypervigilant monitoring of their personal protective equipment (PPE), the need to safeguard family and community members generated considerable stress and anxiety. Many also faced personal isolation and loneliness as a result of lockdown restrictions. Moreover, the negative impacts of experiences during lockdown often continued to be felt once restrictions had been lifted, inflecting life during periods in which community transmission of COVID-19 was not occurring. This article makes five core service delivery and policy recommendations for supporting community-based nurses, midwives and personal care assistants in respiratory disease pandemics: acknowledging the crucial role played by community-based carers and the associated stress and anxiety they endured by championing respect and compassion; demystifying the 'heroism' or 'self-sacrifice' projected onto care workers; the timely provision of adequate protective equipment; improving remuneration, with adequate provision for time off; and regular counselling, peer support groups and education on work-life balance delivered by support workers in recognition of stressors arising from these complex and isolated working conditions.