Priority setting during the COVID-19 pandemic: going beyond vaccines

Williams, Iestyn; Essue, Beverley M; Nouvet, Élysée; Sandman, Lars; Razavi, S. Donya; Noorulhuda, Mariam; Goold, Susan Dorr; Danis, Marion; Biemba, Godfrey; Abelson, Julia; Kapiriri, Lydia

doi:10.1136/bmjgh-2020-004686

Cited by 20 publications

(21 citation statements)

References 31 publications

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“…of self-reported health data are important to characterize the sequelae of novel infectious diseases and are critical for developing cost-effectiveness estimates for lifesaving interventions, such as vaccines and other potentially important rehabilitation therapies and interventions, including physical therapy, occupational therapy, and services and therapies associated with cognitive and functional decline (9,10). The findings in this report are subject to at least six limitations.…”

Section: Discussionmentioning

confidence: 96%

“…Additional studies have shown that patients recovering from COVID-19 have higher incidences of negative health outcomes, including poorer physical health and functional status, and might need additional clinical support such as tailored physical and mental health rehabilitation services (7,8). These findings have implications for health care systems during and after the COVID-19 pandemic (9). Postacute sequalae associated with COVID-19 have not been comprehensively described, and data from studies of long-term follow-up to provide reliable estimates of the long-term sequelae associated with COVID-19 are still emerging (6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

“…Postacute sequalae associated with COVID-19 have not been comprehensively described, and data from studies of long-term follow-up to provide reliable estimates of the long-term sequelae associated with COVID-19 are still emerging ( 6 – 8 ). Continued assessments of self-reported health data are important to characterize the sequelae of novel infectious diseases and are critical for developing cost-effectiveness estimates for lifesaving interventions, such as vaccines and other potentially important rehabilitation therapies and interventions, including physical therapy, occupational therapy, and services and therapies associated with cognitive and functional decline ( 9 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

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Outcomes Among Patients Referred to Outpatient Rehabilitation Clinics After COVID-19 diagnosis — United States, January 2020–March 2021

Rogers-Brown¹,

Wanga²,

Okoro³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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As of June 30, 2021, 33.5 million persons in the United States had received a diagnosis of . Although most patients infected with SARS-CoV-2, the virus that causes COVID-19, recover within a few weeks, some experience post-COVID-19 conditions. These range from new or returning to ongoing health problems that can continue beyond 4 weeks. Persons who were asymptomatic at the time of infection can also experience post-COVID-19 conditions. Data on post-COVID-19 conditions are emerging and information on rehabilitation needs among persons recovering from COVID-19 is limited. Using data acquired during January 2020-March 2021 from Select Medical* outpatient rehabilitation clinics, CDC compared patient-reported measures of health, physical endurance, and health care use between patients who had recovered from COVID-19 (post-COVID-19 patients) and patients needing rehabilitation because of a current or previous diagnosis of a neoplasm (cancer) who had not experienced COVID-19 (control patients). All patients had been referred to outpatient rehabilitation. Compared with control patients, post-COVID-19 patients had higher age-and sex-adjusted odds of reporting worse physical health (adjusted odds ratio [aOR] = 1.8), pain (aOR = 2.3), and difficulty with physical activities (aOR = 1.6). Post-COVID-19 patients also had worse physical endurance, measured by the 6-minute walk test † (6MWT) (p<0.001) compared with control patients. Among patients referred to outpatient rehabilitation, those recovering from COVID-19 had poorer physical health and functional status than those who had cancer, or were recovering from cancer but not COVID-19. Patients recovering from COVID-19 might need additional clinical support, including tailored physical and mental health rehabilitation services.Data were obtained from electronic health records (EHRs) of patients referred to Select Medical's outpatient rehabilitation clinics during January 2020-March 2021. Epidemiologic, clinical, and functional data from 1,295 post-COVID-19 patients and 2,395 control patients were examined. Post-COVID-19 patients were defined as those who were referred to a Select Medical facility for post-COVID-19 physical rehabilitation.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes Among Patients Referred to Outpatient Rehabilitation Clinics After COVID-19 diagnosis — United States, January 2020–March 2021

Rogers-Brown¹,

Wanga²,

Okoro³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

View full text Add to dashboard Cite

show abstract

“…Background paper 8 to The Independent Panel for Pandemic Preparedness and Response main report on Impact on Essential Health Services summarises the disruptions to essential health services with a deep dive into low-and middle-income country impacts (The Independent Panel for Pandemic Preparedness and Response, 2021b). A rational approach to public sector health spending and decision making during the COVID-19 pandemic based on ethics and equity principles is crucial to ensure that patients not infected by COVID-19 continue to get access to healthcare and that the services they need continue to be resourced (Williams et al, 2021).…”

Section: Indirect Impact Of Covid-19 On Essential Health Servicesmentioning

confidence: 99%

“…Attention has been given on how to prioritise between patient groups for COVID-19 vaccination and how to ensure equity but these decisions must balance the COVID-19 response with the need to invest in other healthcare (Williams et al, 2021). Here principles of good priority setting including evidence-based and transparent decision-making, participation of stakeholders and a focus on the implementation of decisions can be helpful.…”

Section: Protecting Essential Health Services During Rollout Of Covid-19 Toolsmentioning

confidence: 99%

Protecting and Promoting Systems for Essential Health Services During Rollout of COVID-19 Tools

Millington¹

2021

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The COVID-19 pandemic has had a tremendous negative impact on economies of most countries around the world. COVID-19 has disrupted the ability of health systems to deliver on essential health services and has also exposed pre-existing vulnerabilities and inequities in public health systems. According to a key informant survey conducted by WHO, over one year into the COVID-19 pandemic, there still exist substantial disruptions to essential health services. This rapid review examines evidence on successful interventions that could enable adaptive approaches to help manage and respond future pandemics and mitigate the risk of collapse of the public health systems. Countries must use the opportunity provided by the deployment of COVID-19 vaccines to strengthen health services and health systems and find long-lasting solutions for similar future challenges. The review notes that there still exist gaps in preparedness and response to the Covid-19 pandemic. New variants of concern threaten the effectiveness of existing COVID-19 vaccines, vaccine hesitancy slowing rollout, including in Africa, and interrupted and limited supply of COVID-19 tools. More funding is required though to scale up adaptive measures which are working, accelerating new approaches and innovations to improve service delivery. This review also highlights briefly the plight of marginalised social groups, people living with disabilities, women and children during the pandemic. According to estimates by Global Fund, Gavi, Global Financing Facility, access to life-saving health interventions for women, children and adolescents in 36 of the world’s poorest countries has dropped by as much as 25% due to COVID-19. Countries must build on the momentum of health innovations during the COVID-19 crisis to build more resilient health systems that can withstand disruptions by future pandemics.

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Scarcity in COVID‐19 vaccine supplies reduces perceived vaccination priority and increases vaccine hesitancy

Pereira

Fehl

Jiga‐Boy

et al. 2021

Psychology and Marketing

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In two experimental studies, we tested the effect of COVID‐19 vaccine scarcity on vaccine hesitancy. Based on extensive scarcity literature, we initially predicted that high (vs. low) scarcity would increase demand for vaccines, operationalized as one's willingness to receive a vaccine. Contrary to this prediction, Study 1 showed that scarcity of vaccines reduced participants’ sense of priority which, in turn, also reduced their vaccination intentions. Trust in doctors moderated the effect of perceived vaccination priority on vaccination intentions such that for individuals with high trust in doctors, reduced perceived priority did not reduce their vaccination intentions as much. Study 2 replicated these effects with a more general population sample, which included at‐risk individuals for COVID‐19 complications. At‐risk participants (vs. low‐risk) had higher perceived vaccination priority, but describing vaccine doses as scarce reduced vaccination intentions similarly across both groups. Moreover, Study 2 demonstrated that compassion for others is a boundary condition of the effect of vaccine scarcity on vaccination intentions. For participants with high compassion, scarcity reduces willingness to receive a vaccine; for participants with low compassion, scarcity increases their willingness to be vaccinated. Our results suggest that health policymakers need to deemphasize the scarcity of vaccines to increase vaccine acceptance.

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Priority setting during the COVID-19 pandemic: going beyond vaccines

Cited by 20 publications

References 31 publications

Outcomes Among Patients Referred to Outpatient Rehabilitation Clinics After COVID-19 diagnosis — United States, January 2020–March 2021

Outcomes Among Patients Referred to Outpatient Rehabilitation Clinics After COVID-19 diagnosis — United States, January 2020–March 2021

Protecting and Promoting Systems for Essential Health Services During Rollout of COVID-19 Tools

Scarcity in COVID‐19 vaccine supplies reduces perceived vaccination priority and increases vaccine hesitancy

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