US Clinicians’ Experiences and Perspectives on Resource Limitation and Patient Care During the COVID-19 Pandemic

Abstract

Key Points Question How have US clinicians planned for and responded to resource limitation during the coronavirus disease 2019 pandemic? Findings This qualitative study included interviews with 61 clinicians across the United States. While institutions planned for an explicit and systematic approach to resource allocation in crisis settings, this approach did not address many challenges encountered by frontline clinicians, leaving them to struggle with what constituted acceptable standards of care and to make difficult allocation decisions. Meaning The findings of this study suggest that expanding the scope of institutional planning to address a broader spectrum of resource limitation may help to support clinicians, promote equity, and optimize care during the pandemic.

Increasing burden of nursing care on the treatment of COVID-19 patients in the ageing society: analyses during the first to the third wave of pandemic in Kyoto City, Japan

“…A recent study has shown that clinicians and clinical teams for COVID-19 patient care had struggled with the complexity of providing high-quality care because of the following di culties: crisis capacity, resource limitation, and multiple unprecedented barriers to care delivery. [6,7] In addition, healthcare workers had a higher prevalence of stress, anxiety, depression, and psychological distress than the general population during the COVID-19 pandemic. [8] We hypothesize that additional burdens of nursing care for elderly patients will reinforce the anxiety and exhaustion of medical staff and healthcare resources in the ageing society such as Japan.…”

The RADx Tech Clinical Studies Core: A Model for Academic Based Clinical Studies

“…Mitigating strategies to reduce propagation of the pandemic centered on wearing masks, social distancing, and timely testing [1] , [2] . However, the United States had insufficient capacity for rapid SARS-CoV-2 testing that would reduce public health risk and elucidate the true burden of infection [3] – [5] . Consequently, the National Institutes of Health (NIH) received an appropriation from Congress in April 2020 to increase the United States capacity to conduct SARS-CoV-2 viral antigen and nucleic acid testing [6] .…”

Ethical obligations for supporting healthcare workers during the COVID-19 pandemic

“…Further, when resources cannot fully meet demand, HCWs may experience moral distress due to rationing decisions. [3] In addition, being confronted with a highly contagious pathogen like the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is also the fear of becoming infected oneself or spreading the infection to one's family (see Table 1). [4] This stress may contribute to physical exhaustion and feelings of fear and anxiety, sleepdisorders and insomnia, or even burnout and depression.…”

“…Physically stressful working conditions and witnessing the suffering and death of large numbers of patients take a toll. Further, when resources cannot fully meet demand, HCWs may experience moral distress due to rationing decisions [ 3 ]. In addition, being confronted with a highly contagious pathogen like the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is also the fear of becoming infected oneself or spreading the infection to one's family (see table 1 ) [ 4 ].…”