The Biden administration’s booster strategy gets clumsily underway

https://mailchi.mp/72a9d343926a/the-weekly-gist-september-24-2021?e=d1e747d2d8

After a confusing week of mixed messaging and conflicting opinions from the public health officials advising the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC), late Thursday night CDC Director Dr. Rochelle Walensky announced her decision to recommend COVID booster vaccines for adults over 65, residents of long-term care facilities, and those younger than 65 with underlying medical conditions.

Controversially, Dr. Walensky contradicted the CDC’s own Advisory Committee on Immunization Practices (ACIP) by also recommending that people who are at greater risk of COVID exposure due to occupation or institutional setting—including healthcare workers and teachers—receive a booster shot. Earlier Thursday, ACIP members voted down a recommendation to provide boosters to healthcare workers, despite the FDA’s endorsement of that approach earlier in the week.
 
By Friday morning, President Biden announced he would soon get a booster shot himself, urging those eligible to do so, and re-emphasizing the administration’s primary focus on delivering first doses to those still unvaccinated. There will be more to come on boosters: the FDA and CDC guidance only applies to those who received the Pfizer-BioNTech vaccine at least six months ago; boosters for the Moderna and Johnson & Johnson vaccines are still under review.

This week’s saga caps a month of back-and-forth between public health officials, the White House, and the medical community, following Biden’s August promise—considered by many to be premature—that boosters would be broadly available starting September 20th. The inclusion of healthcare workers in the booster campaign is welcome news; we were flummoxed by ACIPs decision to bypass that critical segment, given mounting hospital staffing shortages amid the surging Delta variant.

More broadly, we’re increasingly distressed by the relatively uncoordinated and poorly-managed communication approach of the Biden administration on vaccines—particularly following a campaign in which competence was touted as a key advantage over the previous administration.
 

Is the perception of safety in healthcare settings declining?

https://mailchi.mp/13ef4dd36d77/the-weekly-gist-august-27-2021?e=d1e747d2d8

Improving Patient Safety—Why Data Matters

When COVID volumes waned in the spring and early summer, most health systems “de-escalated” dedicated COVID testing and triage facilities. But with the Delta variant surging across the country, consumers are now once again looking for services like drive-through testing, which is perceived as more convenient and safer.

One physician leader told us patients in the ED are asking why the hospital got rid of the “COVID tent”, which provided a separate pathway for patients with respiratory and other COVID symptoms—and a highly visible signal that the rest of the department was as COVID-free as possible.

Another system is now fielding questions from the media about whether they’ll bring back their dedicated COVID hospital: “We spent a lot of time last year convincing the community that the dedicated hospital was key to safely managing care during the pandemic. Now we’ve got almost as many COVID admissions spread across our hospitals.” 

Over the past year, providers have learned how to safely manage COVID care and prevent spread in healthcare settings—but consumers may perceive the lack of dedicated facilities as a decline in safety. 

Unlike last year, hospitals are full of non-COVID patients, as those who delayed care reemerge. And with the current surge likely to continue into flu season, emergency rooms will only get more crowded, necessitating a new round of communication describing how hospitals are keeping patients safe, and reassuring patients that healthcare settings remain one of the safest places to visit in the community. 

These are the 5 traits that set extraordinary people apart, says former FBI agent—‘but you need the entire set’

What makes someone extraordinary? As a retired FBI agent with more than 40 years of studying human behavior and performance, no question has captivated me more.

Extraordinary people have a wisdom and way of being that inspires and commands respect. They energize you with their wisdom and empathy. You want them to be your friend, neighbor, co-worker, manager, mentor or community leader.

The 5 traits of extraordinary people

Surprisingly, the qualities that make these people stand out aren’t related to their level of education, income or talents (say, in athletics or art or business).

As it turns out, based on thousands of observations, there are five traits that set exceptional individuals apart from everyone else — but you must have the entire set, and not just one or a few.

I call them “The Five Domains of Exceptional People”:

1. Self-mastery

Self-mastery brings out your best in whatever you do through dedication, curiosity and adaptability.

Usain Bolt, the fastest human to ever live, didn’t achieve that status merely through athletic ability. He achieved it through self-mastery: He learned, sacrificed, worked hard and remained diligently focused. Michael Jordan, the greatest basketball player of all time, did the same.

But another side to self-mastery is knowing our emotions, strengths and, more importantly, our weaknesses. By understanding ourselves, we know things like when others should take the lead, when today is not our day or when we need to confront our demons.

Start attaining self-mastery by asking:

  • What areas need attention?
  • What knowledge, training or skills will help me pursue my goals?
  • What can I do now to initiate change?
  • How can I better myself through books, mentors, organizations, video tutorials or online classes?

2. Observation

We’re taught to look, but not to observe. We look to see if we can cross the street safely or what supermarket line is moving the fastest. It’s a passive experience that’s useful, but may not provide complete information.

Observing, on the other hand, is active; it requires effort, but the results are more enlightening. It’s about using all our senses to decode the world in real time for a more informed understanding of our environment and of others.

By working as an FBI agent and as an ethologist, I’ve developed my sensitivity for reading the needs, wants, desires, concerns and preferences of others — all crucial information for understanding and communicating with people.

The most observational people have a skill set that many lack. They instantly know:

  • What they are seeking and whether there may be multiple explanations.
  • How context and/or culture factors in.
  • How they can validate their observations and conclusions.
  • How to prioritize, separating the inconsequential from the essential.

3. Communication

We communicate constantly. Do it right and people will adore you. Do it wrong and you create doubt, indifference, even anger.

Exceptional communication skills elevate the quality of your relationships. It’s not about communicating perfectly, but rather effectively — and that builds trust. Here’s how:

  • Address emotions first. We cannot think or communicate clearly until emotions are dealt with. This is where reading body language is helpful.
  • Build rapport through caring and kindness. It can be verbal or nonverbal: a wave or an outstretched hand to acknowledge or welcome. Mirroring your companion’s gestures goes far.
  • Be prompt. Answering emails and calls promptly shows that you value others. Bad news shouldn’t be delayed, nor should gratitude and affirmation.
  • Listen to validate. Listen not only for what is said, but also in what order and how often certain words are mentioned. Repetition of a topic, for example, can shed light on unresolved or underlying problems.

4. Action

Our actions are the nonverbals that show who we are, what’s important to us and how we feel about others.

You can’t fully master this trait without the previous three: Self-mastery prepares us for possible actions to take based on what’s happening; observation allows us to understand the situation in context so we can act appropriately; communication allows us to give and receive the information and support to act.

Exceptional individuals weigh four major factors when making decisions:

  • Do my actions build trust?
  • Do my actions add value?
  • Do my actions positively influence or inspire?
  • Do my actions benefit others?

5. Psychological Comfort

Psychological comfort is a state where our biological and emotional needs and preferences are met.

It forms the bedrock of our mental and physical health, driving everything from our relationship choices to the brands we buy. We thrive when we have psychological comfort, and it’s especially essential in difficult times.

Since we’re primed to receive psychological comfort, it doesn’t take a grand gesture — it just takes the right one. It could be a calm voice, a kind word, an acknowledgment, a thank you note, a welcoming smile or suggesting a break.

Psychological comfort is where self-mastery, observation, communication and action join forces, helping you recognize and provide what best reduces unwanted emotions like stress, fear or apprehension.

It’s simple: In the 21st century, whoever provides the most psychological comfort wins.

One-third of US adults postponed care during pandemic: reports

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Dive Brief:

  • About 36% of nonelderly adults and 29% of children in the U.S. have delayed or foregone care because of concerns of being exposed to COVID-19 or providers limiting services due to the pandemic, according to new reports from the Urban Institute and Robert Wood Johnson Foundation.
  • Of those who put off care, more than three-quarters had one or more chronic health conditions and one in three said the result of not getting treatment was worsening health or limiting their ability to work and perform regular daily activities, the research based on polling in September showed.
  • However, the types of care being delayed are fairly routine. Among those surveyed, 25% put off dental care, while 21% put off checkups and 16% put off screenings or medical tests.

Dive Insight:

The early days of the pandemic saw widespread halts in non-emergency care, with big hits to provider finances. 

In recent months, health systems have emphasized the services can be provided in hospitals and doctors offices safely as long as certain protocols are followed, and at least some research has backed them up. Groups like the American Hospital Association have launched ad campaigns urging people to return for preventive and routine care as well as emergencies.

But patients are apparently still wary, according to the findings based on surveys of about 4,000 adults conducted in September.

The research shows another facet of the systemic inequities harshly spotlighted by the pandemic. People of color are more likely to put off care than other groups. While 34% of Whites said they put off care, that percentage rose to 40% among Blacks and 36% among Latinos.

Income also played a role, as 37% of those with household incomes at or below 250% of the poverty level put off care, compared to 25% of those with incomes above that threshold.

Putting off care has had an impact industrywide, as the normally robust healthcare sector lost 30,000 jobs in January. Molina Healthcare warned last week that utilization will remain depressed for the foreseeable future.

Younger Americans were also impacted, with nearly 30% of parents saying they delayed at least one type of care for their children, while 16% delayed multiple types of care. As with adults, dental care was the most common procedure that was put off, followed by checkups or other preventative healthcare screenings.

The researchers recommended improving communications among providers and patients.

“Patients must be reassured that providers’ safety precautions follow public health guidelines, and that these precautions effectively prevent transmission in offices, clinics, and hospitals,” they wrote. “More data showing healthcare settings are not common sources of transmission and better communication with the public to promote the importance of seeking needed and routine care are also needed.”