Project Tech Support2 was a randomized controlled trial that tested three methods of text message delivery for reducing methamphetamine use and HIV risks among MSM. From March 2014 to January 2016, 286 methamphetamine-using MSM were randomized into: (1) interactive text conversations with Peer Health Educators, plus five-times-a-day automated theory-based messages, plus a weekly self-monitoring text-message assessment (TXT-PHE; n = 94); or, (2) the daily automated messages and weekly self-monitoring assessment (TXT-Auto; n = 99); or, (3) weekly self-monitoring assessment only (AO; n = 93). All three conditions demonstrated reductions in methamphetamine use (coef. = - 0.10), sex on methamphetamine (coef. = - 0.09), and condomless anal intercourse (CAI) with casual male partners (coef. = - 0.06). Only participants in TXT-PHE and TEXT-Auto also reduced CAI with main male partners (coef = - 0.19; coef. = - 0.16), and only TEXT-Auto participants reduced CAI with anonymous male partners (coef. = - 0.05). Additionally, both theory-based text-messaging interventions achieved sustained reductions in five of the six outcomes through 9 months. Overall, automated delivery outperformed peer-delivered messaging.

The state of California, in the United States of America, has a population of nearly 40 million people and is the 5th largest economy in the world. During the COVID-19 (Coronavirus Disease) pandemic in 2020-2021, the state experienced a medical surge that stressed its sophisticated healthcare and public health system. During this period, ventilators, oxygen, and other equipment necessary for providing ventilatory support became a scarce resource in many healthcare settings. When demand overwhelms supply, creative solutions are required at all levels of disaster management and healthcare. This paper describes the disaster response by the state of California to mitigate the emergency demands for oxygen delivery resources.

The COVID-19 pandemic caused critical hospital bed and staffing shortages in parts of California for most of 2020 and 2021. Alternate Care Sites (ACS) were established in several regions to alleviate the hospital patient surge and to maximize staffed bed capacity. Over 1900 patients were successfully provided medical care (with physician, nursing, respiratory therapy, oxygen and pharmacy services) in relatively austere settings. This paper examines the challenges faced at these ACS facilities and how adaptations were incorporated according to the changing dynamics of the COVID-19 pandemic to successfully manage higher acuity patients. ACS facilities were one approach to California’s surge of COVID-19 patients despite limited medical supplies and staffing.

The transfer rate for patients from an Alternate Care Site (ACS) back to a hospital may serve as a metric of appropriate patient selection and the ability of an ACS to treat moderate to severely ill patients accepted from overwhelmed healthcare systems. During the coronavirus infectious disease 2019 (COVID-19) pandemic, hospitals worldwide experienced acute surges of patients presenting with acute respiratory failure. An ACS in Imperial County, California was re-established in November 2020 to help decompress two local hospitals experiencing surges of COVID-19 cases. The patients treated often had multiple comorbid illnesses and required a median supplemental oxygen of three liters per minute (LPM) on admission. Numerous interventions were initiated during a two-week period to improve clinical care delivery. The objectives of this retrospective observational study are to evaluate the impact of these clinical and staff interventions at an ACS on the transfer rate and to provide issues to consider for future ACS sites managing COVID-19 patients. The data suggest that continuous, real-time process-improvement interventions helped reduce the transfer rate back to hospitals from 36.7% to 14.5% and that an ACS is a viable option for managing symptomatic COVID-19 positive patients requiring hospital-level care when hospitals are overburdened.

Numerous state, national, and global resources exist for planning and executing mass vaccination campaigns. However, they are disparate and can be complex. The COVID-19 pandemic highlighted the need for clear, easy to use mass vaccination resources. Meanwhile, annual influenza vaccination, as well as outbreaks such as mpox, demonstrates the need for continued emphasis on timely and effective vaccinations to mitigate outbreaks. This pocket guide seeks to combine relevant resources and basic steps for setting up a mass vaccination clinic, utilizing experience from COVID-19 mass vaccination sites.