Lessons Learned from the COVID-19 Pandemic to Improve Diagnosis Proceedings of a Workshop–in Brief (2022) / Chapter Skim
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Lessons Learned from the COVID-19 Pandemic to Improve Diagnosis: Proceedings of a Workshop - in Brief
Lessons Learned from the COVID-19 Pandemic to Improve Diagnosis: Proceedings of a Workshop - in Brief
Pages 1-11
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CHANGING DIAGNOSTIC PARADIGMS DUE TO THE COVID-19 PANDEMIC Eric Rubin, editor-in-chief of the New England Journal of Medicine (NEJM) , commented that infectious disease outbreaks present communications challenges as well as technical challenges.
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But persistent diagnostic challenges remain, he said, including diagnostic availability, particularly in countries with poor infrastructure; diagnostic performance characteristics (i.e., sensitivity and specificity) ; equitable distribution of tests; and the implications of incorporating home testing into the diagnostic process.
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He provided several strategies to address these factors, including enhancing the collection of race and ethnicity data in health care; expanding access to health care; providing equitable testing, contact tracing, and treatment; and elevating community and social service investment. Chau Trinh-Shevrin, professor at NYU Langone Health, further emphasized the impact of the pandemic on health inequities with a zip code map of COVID-19 cases that clearly showed the stark disparities during the first wave of the pandemic in New York City in April 2020, noting The neighborhoods hardest hit were socially disadvantaged and predominantly composed of lower-income racial and ethnic minority populations…with high population density and household size, limited English proficiency, and other social determinants of health disparities.
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To understand the root of the inequities that this community faces, Begay briefly touched upon the complex history of federal health policy including the legal basis for Indigenous communities' right to health care based on multiple treaties, executive orders, court decisions, and numerous other laws and acts (American Indian Policy Review Commission, 1977; ANA, 2022; BIA, 2022) .9 Despite the legal obligation of the United States to provide these services, Indigenous populations face some of the worst health disparities when compared to other racial and ethnic groups, and the pandemic has exacerbated these disparities.
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He called for more innovation to improve clinical devices, as well as access to these technologies, and also pointed to the lack of accuracy and precision in collecting data to understand disparities. Essien emphasized the importance of collecting data on social factors that drive health outcomes "to help ensure that communities are receiving the care that they need." Webb Hooper added that using standardized measures to collect data is critical.
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McKee added that investing in public health and pandemic preparedness is critical. NOVEL DIAGNOSTIC STRATEGIES AND TOOLS THAT EMERGED DURING THE COVID-19 PANDEMIC Rick Bright, senior vice president of pandemic prevention and response at the Rockefeller Foundation, discussed the development and implementation of diagnostic tools outside of the clinical setting.
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William Rodriguez, chief executive officer at FIND,12 focused his comments on the implications for innovative diagnosis in global health emergencies, particularly diagnostic innovations in low- and middle-income countries. He emphasized an equity framework focused on vaccine and testing equity and mitigation of COVID-19's impact, and he noted that the most successful message thus far has been realizing that "no one is safe anywhere until everyone is safe everywhere." While there has been almost 10 years of diagnostic technology innovation and progress compressed into just 2 years, with "unprecedented acceleration in development and availability" of molecular tests, surveillancebased tools, genomics and sequencing tools, and antigen rapid tests in low- and middle-income counties with limited resources, there are still large inequities in global testing, and the world is still slow in detecting the emergence of new variants, he said.
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. BOX 1 SUGGESTIONS FROM INDIVIDUAL WORKSHOP PARTICIPANTS TO ACHIEVE DIAGNOSTIC EXCELLENCE USING LESSONS LEARNED FROM THE COVID-19 PANDEMIC Improving Technology and Care Delivery Innovations • Link diagnostic test results to the delivery of appropriate and timely treatment (Bright)
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. • Collect social determinants of health and demographic data using standardized measures (Webb Hooper)
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. American Indian Policy Review Commission.
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STAFF: Jennifer Lalitha Flaubert, Ruth Cooper, Anesia Wilks, Nikita Varman, and Sharyl Nass, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine SPONSORS: This workshop was supported by the Gordon and Betty Moore Foundation. For additional information regarding the workshop, visit https://www.nationalacademies.org/event/01-14-2022/ lessons-learned-from-the-covid-19-pandemic-to-improve-diagnosis.
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