COVID-19 in a rural health system in New York - case series and an approach to management

Kedar, Eyal; Scott, Regina; Soule, Daniel; Lovelett, Carly; Tower, Kyle; Broughal, Kylie; Jaremczuk, Daniel; Mohaddes, Sara; Rainey-Spence, Imre; Atkinson, Timothy

doi:10.22605/rrh6464

Cited by 5 publications

(7 citation statements)

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“…11 Primary healthcare professionals are recommended to be vaccine ambassadors; being trusted sources of factual vaccine information, they can instil confidence in communities, provide credible and trustworthy health information, and discuss fears and safety concerns. 12 In the USA, rural generalist medical professionals were identified as critical to the rural COVID-19 response, 7 were driven by altruism, and were willing to work long hours in the absence of specialists. Additionally, researchers in New Zealand suggested that rural general practices were more adaptive and better able to cope with changed conditions during the COVID-19 pandemic in comparison to urban practices due to their ability to operate in a resource constrained environment.…”

Section: Discussionmentioning

confidence: 99%

“…6 In the USA, rural models of care were developed for vaccination administration and COVID-19 treatment, demonstrating this can be effectively managed by rural health teams and systems. 7 This growing body of research provides important learnings for policy makers for planning a ○ Australia had very high vaccination rates and very low COVID-19 case numbers and deaths in comparison with other countries. 2 Nationally, 42 598 706 COVID-19 vaccine doses had been administered, with 94.4% of people aged over 16 years old having at least one dose and 91.4% being fully vaccinated (defined as having two doses of approved COVID-19 vaccine).…”

Section: Introductionmentioning

confidence: 99%

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The contribution of rural primary health care to the coronavirus (COVID-19) vaccination program

McIntosh¹,

Hyett

2023

Aust. Health Rev.

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Objective The coronavirus disease 2019 (COVID-19) vaccination response in primary health care provides important learnings for strengthening health systems and preparing for surge response. The aim of this study was to examine the contributions of service providers to the COVID-19 vaccination program in Victoria, Australia, to gain insight into the role of primary health care during surge response and determine if this differs with rurality. Methods A descriptive quantitative study design using existing COVID-19 vaccination data extracted from the Australian Immunisation Record via the Department of Health and Aged Care, Health Data Portal, de-identified for primary health networks, was used. Vaccination administrations were categorised by provider type for the first year of the Australian COVID-19 vaccination program in Victoria, Australia from February 2021 to December 2021. Descriptive analyses describe the total and proportional vaccinations administered by provider type and patient rurality. Results Overall, primary care providers delivered half (50.58%) of total vaccinations for the population, and the number and proportion of vaccinations increased with patient rurality. The largest difference was observed in remote communities where 70.15% of COVID-19 vaccinations were administered by primary care providers. Primary care providers administered fewer COVID-19 vaccines in regional centres at 42.70%, compared to 46.45% administered by state government (and 10.85% administered by other). Conclusion The contribution of primary health care to the COVID-19 vaccine program highlights the importance of rural primary care providers and settings, primarily general practice, to the delivery of population health interventions in rural communities especially during times of crisis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The contribution of rural primary health care to the coronavirus (COVID-19) vaccination program

McIntosh¹,

Hyett

2023

Aust. Health Rev.

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“…These findings parallel accounts of rural “collaboration and creativity” from the United States, where small communities mobilized the resources available to them, building local capacity to respond to the COVID‐19 crisis. 19 , 20 …”

Section: Discussionmentioning

confidence: 99%

Exploring rural doctors’ early experiences of coping with the emerging COVID‐19 pandemic

Couper

Walters

Williams

et al. 2022

The Journal of Rural Health

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Purpose To understand how rural doctors (physicians) responded to the emerging COVID‐19 pandemic and their strategies for coping. Methods Early in the pandemic doctors (physicians) who practise rural and remote medicine were invited to participate through existing rural doctors’ networks. Thirteen semi‐structured interviews were conducted with rural doctors from 11 countries. Interviews were transcribed verbatim and coded using NVivo. A thematic analysis was used to identify common ideas and narratives. Findings Participants’ accounts described highly adaptable and resourceful responses to address the crisis. Rapid changes to organizational and clinical practices were implemented, at a time of uncertainty, anxiety, and fear, and with limited information and resources. Strong relationships and commitment to their colleagues and communities were integral to shaping and sustaining these doctors’ responses. We identified five common themes underpinning rural doctors’ shared experiences: (1) caring for patients in a context of uncertainty, fear, and anxiety; (2) practical solutions through improvising and being resourceful; (3) gaining community trust and cooperation; (4) adapting to unrelenting pressures; and (5) reaffirming commitments. These themes are discussed in relation to the Lazarus and Folkman stress and coping model. Conclusions With limited resources and support, these rural doctors’ practical responses to the COVID‐19 crisis underscore strong problem‐focused coping strategies and shared commitments to their communities, patients, and colleagues. They drew support from sharing experiences with peers (emotion‐focused coping) and finding positive meanings in their experiences (meaning‐based coping). The psychosocial impact on rural doctors working at the limits of their adaptive resources is an ongoing concern.

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“…Rural hospital and primary care services for COVID-19. Rural hospitals, in many cases led by generalists, provided essential health care for mild and moderate cases of COVID-19, taking pressure off higher-level facilities [111][112][113][114]. They faced challenges in operating at the margins at a time when communication channels were disrupted, and support from higher levels was variable, often with limited understanding of the rural hospital context [112].…”

Section: Role Of Digital Technologymentioning

confidence: 99%

COVID-19 preparedness and response in rural and remote areas: A scoping review

Dudley,

Couper,

Kannangarage

et al. 2023

PLOS Glob Public Health

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This scoping review used the Arksey and O’Malley approach to explore COVID-19 preparedness and response in rural and remote areas to identify lessons to inform future health preparedness and response planning. A search of scientific and grey literature for rural COVID-19 preparedness and responses identified 5 668 articles published between 2019 and early 2022. A total of 293 articles were included, of which 160 (54.5%) were from high income countries and 106 (36.2%) from middle income countries. Studies focused mostly on the Maintenance of Essential Health Services (63; 21.5%), Surveillance, epidemiological investigation, contact tracing and adjustment of public health and social measures (60; 20.5%), Coordination and Planning (32; 10.9%); Case Management (30; 10.2%), Social Determinants of Health (29; 10%) and Risk Communication (22; 7.5%). Rural health systems were less prepared and national COVID-19 responses were often not adequately tailored to rural areas. Promising COVID-19 responses involved local leaders and communities, were collaborative and multisectoral, and engaged local cultures. Non-pharmaceutical interventions were applied less, support for access to water and sanitation at scale was weak, and more targeted approaches to the isolation of cases and quarantine of contacts were preferable to blanket lockdowns. Rural pharmacists, community health workers and agricultural extension workers assisted in overcoming shortages of health professionals. Vaccination coverage was hindered by weaker rural health systems. Digital technology enabled better coordination, communication, and access to health services, yet for some was inaccessible. Rural livelihoods and food security were affected through disruptions to local labour markets, farm produce markets and input supply chains. Important lessons include the need for rural proofing national health preparedness and response and optimizing synergies between top-down planning with localised planning and coordination. Equity-oriented rural health systems strengthening and action on rural social determinants is essential to better prepare for and respond to future outbreaks.

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COVID-19 in a rural health system in New York - case series and an approach to management

Cited by 5 publications

References 0 publications

The contribution of rural primary health care to the coronavirus (COVID-19) vaccination program

The contribution of rural primary health care to the coronavirus (COVID-19) vaccination program

Exploring rural doctors’ early experiences of coping with the emerging COVID‐19 pandemic

COVID-19 preparedness and response in rural and remote areas: A scoping review

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