Management of the emergency response to the SARS-CoV-2 (COVID-19) outbreak in Stockholm, Sweden, and winter preparations

Abstract

INTRODUCTIONSweden is unique in adopting a ‘no-lockdown’ public health approach to the SARS-CoV-2 (COVID-19) outbreak. There were fears that health services would not be able to care for high numbers of COVID-19 patients. AIMTo describe and review the emergency response of a public primary and community health-care organisation in Stockholm, Sweden, to the demand for care for COVID-19 and non-COVID-19 patients during March–July 2020, and summarise preparations for the months to follow. METHODSThis was a rapid implementation action research case study, which also draws on one author’s experience as Chief Executive Officer and other members’ experience in an emergency management group. RESULTSSweden experienced similar mortality per million population to the UK, despite the different public health strategy used to address the COVID-19 outbreak. The Stockholm-integrated public primary and community health-care service, serving a population of 2.3 million, made many changes quickly. One change included coordinating non-acute private health-care services, following the local government emergency directive to do so. DISCUSSIONIt is possible that the fast and effective response by management and services in primary and community health care reduced infection and hospital demand, which contributed to a lower mortality than otherwise expected. The actions and preparations described for Stockholm’s response may provide ideas for other health-care systems. The partnership research approach between the Karolinska Medical University and the Region Stockholm health-care system used in this project shows that rapid research methods have advantages for both partners in an emergency situation.

The Long-Term Presence of SARS-CoV-2 on Cold-Chain Food Packaging Surfaces Indicates a New COVID-19 Winter Outbreak: A Mini Review

“…Therefore, the management of imported cold-chain foods and its practitioners should be strengthened, and cold-chain food management policies and specific measures should be strictly implemented to promptly detect and isolate those who come into contact with SARS-COV-2 detected in the outer packaging of imported cold-chain foods to avoid the spread of COVID-19. We can prepare for the arrival of winter by developing and strictly enforcing preventive measures and health policies, by going out less, social distancing, wearing masks when going to public places, and maintaining hand hygiene, so that we may avoid new outbreaks of the SARS-CoV-2 epidemic in winter (28)(29)(30).…”

Implementation Science for Managers and Healthcare Organizations Responding to Emergencies

“…The methods section sub-headings correspond to the sub-headings in the results and discussion sections. We give more details about in other publications and in the research protocol for the investigation (Ohrling et al, 2020 ; Øvretveit, 2020a ).…”

“…To achieve the purposes of this article, we reference research methods and data that were collected in the first part of 2020, and published in Ohrling et al, ( 2020 ), to illustrate how we used IS. We refer to other data, not yet fully analyzed, to illustrate, for example, the continuous adaptation of the innovation we are evaluating.…”

“…We do not describe all the details of the methods and findings because the purpose of the article is to show, through this example and our experience, how implementation science (IS) can be used to help implementation and carry out rapid research during a pandemic or evolving emergency. We describe details of the method and findings elsewhere (Ohrling et al, 2020 ; Øvretveit, 2020a ). We then discuss what we learned about applying IS for emergency management implementation and research that others could use, and value of implementation action evaluation to the field of emergency and disaster management.…”

Combining Improvement and Implementation Sciences and Practices for the Post COVID-19 Era

“…The rapid impact research into Stockholm Healthcare response to the pandemic used this approach. 35 This option could be assisted with a searchable improve-mentation database of researchers’ skills, which could also be used by researchers quickly to assemble project teams for preparing or undertaking COVID-19 and other proposals or projects.…”