The Wall Street Journal (WSJ) recently provided its audience with a wide-ranging webinar discussion that covered the nation’s ability to address unprecedented Covid19 challenges like proper testing and tracking, social distancing limitations, and a dangerous societal decline in mental health. The WSJ webinar allowed a panel of industry professionals the opportunity to voice their concerns and relay critical information pertaining to appropriate Covid19 response.
To begin our review, Dr. Rajiv J. Shah, president of The Rockefeller Foundation, discussed the critical steps needed to increase availability of rapid Covid-19 tests across the country and shared some keys considerations for future preparedness. Below are four take-aways from Dr. Shah’s input:
- Testing needs to be fast, frequent, and cheap
- The objective is 30.0M tests/week vs. the current 4-4.5M/week
- Testing must be less than $5 per test and provided without cost by Medicare and other insurance plans
- Types of tests – “not all tests are created equal”
- PCR (polymerase chain reaction), a clinical diagnostic assessment, is the most sensitive technique for detection and is considered the gold standard.
- There are different types of screening with high sensitivity that are being developed at low cost with results in minutes, not hours or days. If the screening tests positive, a clinical diagnostic assessment will be used to confirm the result.
- Antibody testing will tell a person if they have had COVID-19 based on resultant antibodies in their system. The long-term effectiveness of these antibodies is not yet fully known.
- Data capture is essential, regardless of where testing might occur – to include future at-home testing.
Dr. Shah stated that optimal testing provides quick intervention, enables contact tracing, breaks the chain of transmission, and provides the basis for quarantining those infected.
The New Normal
With the return to “normal” in healthcare there is a heightened number of plan members seeking high cost medical care and testing for serious health problems that have gone unchecked or worsened during the pandemic. Identifying these individuals through data analysis early enough to improve the success of medical interventions, restore productive living and better control health plan costs is imperative. Webinar panelist and executive director and co-founder of the Centers for Civic Impact, Beth Blauer, shared her perspective on the role of data in predicting and preventing future pandemics:
Shape for the future of data:
- Federal data platforms
- Data standard agreements
- Improved predictive models
- Test and tracking metrics – precise contact tracing
Major data challenges:
- No standardization of data
- Lack of a consistent application of data towards decision making and actions
- example: no testing distinction between PCR, screening, or antibody
- Lack of generational preparation
Ms. Blauer was part of the team that designed and developed the Johns Hopkins Coronavirus Resource Center dashboard that many people access daily to compare and evaluate national and local Covid19 data. Three key domains included in the Resource Center dashboard are:
- Demographics that include race, ethnicity, and age
- Comparison of local case data vs. state data
- Capacity of healthcare system – # of beds, staff, ICU beds, etc.
- Plus, types of insurance, e.g. Medicare, employer provided.
Society’s ability to adapt to the new normal will determine how well Covid19 challenges are addressed. When leaders like Beth Blauer push the healthcare conversation towards innovative and forward-thinking solutions, society is better for it.
Support from Health IT
Health technology is serving a key role in the effort to stabilize a global epidemic for the first time in human history. Digital health services, like telehealth, give patients and doctors a resource to help address Covid19 social distancing limitations. These telehealth interactions mitigate the risk of catastrophic and expensive health events associated with delayed care.
Other reasons for postponed care that are important to address are:
- Loss of insurance
- Healthcare facility safety concerns
- Financial stress
- Scheduling backlogs due to staff reductions
Telehealth is a great resource that helps address the challenge of delayed care. However, since business operations have been reduced and routine health care postponed or ignored altogether, individuals with newly or undiagnosed health conditions may have developed more serious mental / health complications.
Support for Mental Health
With so much uncertainty shrouding society, its encouraging when a major publication like The Wall Street Journal initiates a proactive dialogue on difficult but urgent topics. Speaker Laurie Santos is the professor of Psychology and the Good Life (the most popular course in Yale’s history) and she spoke on how society should reconsider the current approach to mental health. Ms. Santos argues that appropriate Covid19 response and procedures should cater to the complex emotions triggered by the pandemic. Below are some take-aways from Ms. Santos’s position:
- COVID-19 hit the sweet spot of life. Social connection is essential for baseline well-being
- Impact on personal identity:
- Athletes – limited training, schedules cancelled, self-worth challenged
- Students – classes online, dorms with limited personal contact. Social interactions through clubs, societies, Greek system, athletic are all diminished
- Business – lost jobs, loss of status, challenges of having children at home
- “Who am I: employee, parent, caretaker?”
- Crisis of identity
- Short term: how do I cope, can I cope, and am I able to adjust
- Long term: new-found skills/hobbies/approach to life. For many, there is a post traumatic growth that makes one more resilient and confident in crisis
- Mental health well-being solutions
- Identify needed social connection support systems for individuals and groups
- Access to counseling through telehealth options
- Benefit coverage that provides for the necessary access to tools that assuage anxiety and stress during a difficult time
As we conclude our review of the WSJ webinar discussion it becomes clear that Covid19 requires a proactive multi-disciplinary response to properly address the unprecedented logistical and mental health challenges covid19 has introduced to society. Our I Am! nurse advocacy program was created to connect members with nurse professionals who partner with participants by personalizing the coaching experience so that participants feel comfortable, set meaningful, SMART goals and have needed assistance to succeed in achieving the major health goals most important to them.
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APH’s I Am! Nurse Advocacy Program provides only administrative, strategic, and analytical services and functions and does not make medical diagnosis, provide medical advice, or prescribe medical treatments or options.