Implementation Science to Respond to the COVID-19 Pandemic

Abstract

The COVID-19 pandemic continues to expand globally, requiring massive public health responses from national and local governments. These bodies have taken heterogeneous approaches to their responses, including when and how to introduce and enforce evidence-based interventions—such as social distancing, hand-washing, personal protective equipment (PPE), and testing. In this commentary, we reflect on opportunities for implementation science to contribute meaningfully to the COVID-19 pandemic response. We reflect backwards on missed opportunities in emergency preparedness planning, using the example of PPE stockpiling and supply management; this planning could have been strengthened through process mapping with consensus-building, microplanning with simulation, and stakeholder engagement. We propose current opportunities for action, focusing on enhancing the adoption, fidelity, and sustainment of hand washing and social distancing; we can combine qualitative data, policy analysis, and dissemination science to inform agile and rapid adjustment to social marketing strategies to enhance their penetration. We look to future opportunities to enhance the integration of new evidence in decision-making, focusing on serologic and virologic testing systems; we can leverage simulation and other systems engineering modeling to identify ideal system structures. Finally, we discuss the ways in which the COVID-19 pandemic challenges implementation science to become more rapid, rigorous, and nimble in its approach, and integrate with public health practice. In summary, we articulate the ways in which implementation science can inform, and be informed by, the COVID-19 pandemic, looking backwards, proposing actions for the moment, and approaches for the future.

Phased Implementation of COVID-19 Vaccination: Rapid Assessment of Policy Adoption, Reach and Effectiveness to Protect the Most Vulnerable in the US

“…Similarly, the model used in this analysis failed to control for factors such as mask use and seasonality due to data availability. The vaccination approach and system will shift when more COVID-19 vaccines, such as viral vector-based vaccines, are approved by the FDA for regular distribution and supplies become more readily available [ 38 ]. Understanding phased vaccination to reach herd immunity and the impact of vaccination on the growth rate of severe cases and mortality at the population level are important.…”

Deliberation, Dissent, and Distrust: Understanding Distinct Drivers of Coronavirus Disease 2019 Vaccine Hesitancy in the United States

“…Results from randomized control trials and real-world evidence demonstrate vaccines are highly efficacious at preventing severe disease and death, reducing transmission, and causing few adverse events [ 1–3 ]. Yet the arrival of new vaccines must confront an old problem: efficacious interventions—even when affordable and available—may have limited uptake despite proven benefit [ 4 , 5 ]. Indeed, a substantial fraction of the American public does not appear immediately interested in receiving a COVID-19 vaccine, which has been referred to as vaccine hesitancy [ 6–8 ].…”

Variation in Community and Ambulance Care Processes for Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

“…[37] The negative changes to EMS processes associated with the pandemic are worrying and suggest that better preparation and prede ned protocols are needed for emergency care systems to operate under resource-scarce crisis situations, including the stockpiling and effective use of PPE. [49] A clear transition from non-crisis to crisis resource allocation coupled with clear public health messaging will likely be bene cial. Additionally, a centralized public EMS system may improve coordination between different stakeholders during the COVID-19 pandemic and reduce OHCA mortality rates.…”