several priorities outlined have relevance to future infectious diseases outbreaks and epidemics .”
The thought leaders who constructed the whitepaper highlighted three critical research questions in each of these 10 areas and identified the most pressing areas for research , including :
●Understanding the spread of the virus through asymptomatic and pre-symptomatic patients infected with COVID-19 .
●Determining how risk factors impact disease severity , as well as understanding long-term cardiometabolic , respiratory , neurological , and psychological impacts of the virus .
●Developing tools to identify outbreaks more rapidly in hospitals , nursing homes , and other healthcare settings leading to early interventions to curtail outbreaks .
●Improving the understanding of personal protective equipment ( PPE ), including socio-behavioral reasons for not following PPE guidance , as well as the continued need for PPE during and after the pandemic .
“ This research agenda calls for translational studies from laboratory-based basic science research to well-designed , large-scale studies and health outcomes research ,” says Deverick Anderson , MD , MPH , the senior author of the research agenda . “ To undertake this work , funding organizations must make COVID-19 research their highest priority .”
Overall , the whitepaper addresses the following significant issues :
➊ Epidemiology : ●Understand heterogeneity in epidemiology and transmission dynamics of SARS-CoV-2 . ●Define characteristics and impact of asymptomatic / pre-symptomatic patients infected with SARS-CoV-2 .
●Characterize risk factors that lead to severe disease outcomes including age , sex , race with special emphasis on health disparities , socio-economic status , and comorbidities .
➋ Outbreak investigation ●Identify critical interventions required to stop COVID-19 outbreaks ●Determine optimal personnel , expertise , and training required to conduct rapid SARS-CoV-2 and other outbreak investigations ●Identify optimal resources and technology ( reporting tools , software and hardware ) to support outbreak investigations
➌ Surveillance strategies
●Determine optimal and rapid surveillance strategies to accurately define the scale and depth of COVID-19 and its impact on populations , communities , and individuals .
●Identify highest risk populations for targeted interventions based on their age , gender , race , comorbidities , settings , and community spread .
➍ Isolation precaution practices ●Determine when and how to initiate transmission-based isolation precautions for COVID-19 . ●Determine how to optimize management and care delivery while isolation precautions are in place . ●Determine when to discontinue COVID-19 isolation precautions and reinstitute isolation in cases of possible re-infection .
➎ Personal protective equipment ●What is the appropriate level of universal PPE for current pandemic and in the post-pandemic state ?
●What are the socio-behavioral , adaptive , and contextual factors required to improve appropriate PPE use ?
●Are PPE interventions made during the COVID-19 pandemic likely to be effective against other commonly circulating respiratory viruses ?
➏ Environmental contamination and disinfection ●What are the risks associated with environmental contamination with SARS-CoV-2 for HCP and patients ? ●What are optimized methods for identifying environmental contamination with SARS-CoV-2 ? ●Determine the optimal methods for disinfection of healthcare environments .
➐ Drug and medical supply chain shortages ●Define the extent of drug and medical supply chain shortages caused , directly or indirectly , by the COVID-19 pandemic .
●Identify methods to disseminate best practices to optimize patient care in the face of drug and medical supply chain shortages , from local protocols to international policies to help mitigate future shortages .
●Characterize clinical consequences of drug and medical supply chain shortages .
➑ Antimicrobial stewardship ●Identify the impact of changes in health care utilization and delivery on antibiotic prescribing . ●Define epidemiology and risk factors related to bacterial and fungal co-infections in patients with COVID-19 .
●Develop and implement optimal Antimicrobial Stewardship Program ( ASP ) strategies to improve antimicrobial use and patient outcomes while adapting to changing healthcare delivery during COVID-19 .
➒ Healthcare personnel safety / occupational health ●Define risks that increase HCP exposure to and acquisition of SARS-CoV-2 and interventions that can mitigate these risks ●Determine optimized strategies to protect HCP emotional and psychological health ●Determine impact of social and organizational strategies to maintain the health and wellness of HCP
➓ Return to work ●Determine risk of SARS-CoV-2 transmission by returning HCPs to coworkers and patients , by HCP type and setting . ●Determine the optimal criteria and modifications necessary for earliest safe return to work . ●Determine the sociocultural impact of and strategies for successful return-to-work for HCP .
The whitepaper authors note that this research agenda , while a significant tool for shaping the direction of the scientific literature , represents expert opinion at a moment in time during the worst days of the COVID-19 pandemic . They note that priorities may shift as the pandemic evolves and as vaccines and other therapeutics become available .
References :
Metlay JP and Armstrong KA . Clinical Decision Making During the COVID-19 Pandemic . Ann Intern Med . Feb . 2 , 2021 . https :// doi . org / 10.7326 / M20-8179
Mody L , Anderson D , et al . COVID-19 Research Agenda for Healthcare Epidemiology . Infect Control Hosp Epidemiol . Web , Jan . 21 , 2021 .