COVID-19 illuminated gaps in emergency preparedness and healthcare delivery in the face of a global pandemic. This report from the Lancet Commission identifies strategies for strengthening the multilateral system to address global emergencies such as the COVID-19 pandemic. The report describes a conceptual framework for understanding pandemics; reviews global, regional, and national responses to the COVID-19 pandemic; and provides recommendations for ending the COVID-19 pandemic and preparing for future pandemics.

The COVID-19 pandemic disrupted many aspects of health care. This commentary discusses its impact on patient safety. The authors discuss how the pandemic response dismantled strategies put in place to prevent healthcare-associated infections and falls, and stressors placed on both patients and healthcare workers directed attention away from ongoing safety improvement efforts. They argue that more resilience needs to be built into the system to ensure safety efforts are sustainable in challenging times.

The COVID-19 pandemic has disrupted many aspects of health care delivery and has placed unprecedented pressure on health care workers. This consensus statement, based on input from an international panel of individuals with expertise in health leadership, health care, and public health, outlines 10 imperatives to guide health and public leaders during the post emergency stage of the pandemic. Imperatives addressed in the framework include supporting staff well-being and psychological health, preparing for future emergencies, managing the backlog of delayed care, and the importance of sustaining learning, innovations and collaborations that arose during the pandemic.

Telehealth benefits, barriers, and challenges have become more apparent due to its increased use during the COVID-19 pandemic. This study evaluated 3,828 telehealth examinations (telephone, email) and found that the incidence of serious or minor adverse events was less than 0.50%.  

This article describes the experience of one hospital in eastern Massachusetts implementing rapid response capabilities in an innovative, hybrid acute care-intensive care unit. Health system leadership used failure modes and effect analysis, process mapping, and on-site walkthroughs to identify potential hazards and opportunities for risk mitigation, as well as in situ simulation drills to facilitate team training.

This article describes the use of a broad suspect case criteria for detecting COVID-19 in the emergency department of one large, hospital in Singapore. Both the initial official case criteria and the broadened case definition, which included patients presenting with acute respiratory disease with no alternative etiology and a history of travel or residence in a country with ongoing local transmission were used with the broadened criteria having higher sensitivity. The broader criterion may increase the numbers of suspected positive cases but can help minimize nosocomial ED transmission.

Using a social and behavioral sciences perspective, the authors present insights for aligning behavior with recommendations from experts for managing the COVID-19 pandemic and its impact. Topics include threat perception, leadership, individual and collective interests, science communication, social context, and stress and coping.

Healthcare workers on the frontlines of the COVID-19 pandemic are at risk for adverse psychological impacts. This cross-sectional survey evaluated mental health outcomes affecting healthcare workers treating patients exposed to COVID-19 in China. The 1,257 survey respondents reported symptoms of distress (72%), depression (50%), anxiety (45%) and insomnia (34%). Those engaged directly in the diagnosis, treatment and care of patients with COVID-19 were at greater risk for symptoms of depression (odds ratio [OR]=1.52; 95% CI, 1.11-2.09), anxiety (OR=1.57; 95% CI, 1.22-2.02), insomnia (OR=2.97; 95% CI, 1.92-4.60), and distress (OR=1.60; 95% CI, 1.25-2.04). The authors conclude that special interventions to promote the mental well-being of healthcare workers treating patients with COVID-19 need to be immediately implemented in order to reduce psychological burden.