Room
Paternot salle n° 30 ( à côté de l'auditoire PATERNOT )
Theme
Covid / inequities - Consequences of Covid-19: new insights
Chair
Yolanda Müller
Title
Effective communication between and among public health institutions: a qualitative study
Name
Maddalena Fiordelli
Affiliation
Institute of Public Health, Università della Svizzera italiana
Abstract
The Swiss Health System inherits peculiarities of a federal state. The provision of healthcare is quick and the proximity of services ideal, however external evaluations underscore a highly fragmented environment prone to error due to lack of transparency and fragmentation. A public health emergency poses issues at different levels and demands coordination between and within public health institutions. Effective communication becomes crucial. In this context, the first two waves of COVID-19 posed challenges in communication that hindered the response to the crisis. This paper examines the communication difficulties encountered by public health institutions in Switzerland during the pandemic and identifies barriers and facilitators to an effective communication.We collected opinions and experiences of Swiss public health institutions’ representatives between January and July 2021. Qualitative online semi-structured interviews lasted on average 40 minutes, were carried out in the official language of the institutional representative, and later transcribed verbatim and translated into English. An inductive thematic analysis of the transcripts was carried out by the first author. Constant comparison with co-authors ensured consistency of the analysis procedure.
We interviewed 6 key players from federal institutions, and eighteen representatives of twelve cantons. Facilitators to an effective communication within institutions were flexibility, presence or reinforcement of resources dedicated to communication, development of new processes, coordination, and experiential knowledge. Coordination, clear processes, active listening, mediation, and a good network emerged as facilitators for communication between different institutions. Barriers were somewhat symmetrical to facilitators, and encompassed tension between roles, responsibilities not well defined, and lack of resources. In addition to that, communication between institutions was also threatened by discrepancies among cantons and at different governmental levels, between confederation and cantons.
Clear communication protocols, the establishment of centralized communication structures, and increased efforts to facilitate communication between different cultural groups are recommended. Continuous communication training and the inclusion of diverse perspectives could improve the effectiveness of communication within and between public health institutions in Switzerland and beyond.
Title
Frailty, multimorbidity and their association with health service utilization during Covid-19 pandemic in Southern
Switzerland: a one-year follow-up study
Name
Miao Jiang
Affiliation
Institute of Public Health, USI
Abstract
Methods: We used data from the Corona Immunitas Ticino (CIT) study collected between September 2020 and September 2021. We built a Frailty Index (FI) based on 30 health deficits, and grouped participants into robust, pre-frail and frail. We defined multimorbidity as the presence of two or more self-reported, clinically diagnosed chronic diseases. We used logistic and generalized linear models adjusted for age, gender, smoking status and education level.
Results: We included 660 older adults (≥65 years) with complete data (78% of the CIT sample). Of these, 10.3% were frail, 41.5% were robust, and 26.7% reported at least two chronic diseases. In mutually adjusted logistic models, compared with robust and non-multimorbid participants respectively, frail ones were 2.3 times (p=0.011), and multimorbid participants were 1.7 times (p=0.012) more likely to access health care services due to non-Covid related acute conditions. In the general linear model, FI as a continuous variable was associated with a higher number of health services visits (r=2.35, p=0.013).
Conclusion: During Covid-19 outbreaks in southern Switzerland both frailty and multimorbidity continued to predict health service utilization due to non-Covid related health conditions, which might have contributed to increase infection risk in older adults irrespective of preventive measures.
Title
People’s perceptions of information gathering during the COVID-19 pandemic
Name
Bettina Zimmermann
Affiliation
University of Bern, Multidisciplinary Center for Infectious Diseases, Institute of Philosophy
Abstract
The WHO-proclaimed “infodemic”, referring to the vast amount of partially confusing and contradicting information about the COVID-19 pandemic, illustrates new kinds of challenges in a digitized era where everybody has constant access to information and can share content easily via social media. This contribution presents people’s perceptions of gathering information during the COVID-19 pandemic. More specifically, it assesses people’s changing information needs, what sources people trusted and why, and how these developed as the pandemic progressed. Drawing from a series of qualitative interviews held in April 2020 (T1), October 2020 (T2), and October 2021 (T3) with residents of German-speaking Switzerland, this study is part of the pan-European Solidarity in Times of a Pandemic (SolPan) research consortium. Findings focus on Switzerland but will be contrasted with people’s perceptions in other European countries. While in T1, many participants had high information needs and broadly trusted traditional media, the governments in Switzerland, and scientific experts, T2 was characterized by increasing fatigue and information overload as well as the advent of louder conspiracy theories in participants’ social environment. In T3, many participants accommodated the flood of information and uncertainty through heuristics and described a polarization of what sources to trust particularly in the context of COVID-19 vaccination. These findings contribute to a more in-depth, qualitative understanding of how people perceive information gathering during crises when a change in everybody’s behavior is required and where scientific evidence is progressing rapidly. These exceptional circumstances allow a discussion about how scientific uncertainty and new scientific knowledge should be portrayed to lay people to promote behavior that promotes individual as well as population health.Title
Institutional health communication during Covid-19 in Switzerland: lessons learned to manage infodemics
Name
Maddalena Fiordelli
Affiliation
University of Lucerne
Abstract
The proposed workshop will examine institutional communication in navigating the Covid-19 pandemic in Switzerland. It will be based on three contributions that highlight the importance of consistent, transparent and audience-oriented messages in maintaining public trust and mitigating panic in contexts characterized by infodemics.First contribution: Staying ahead of the curve: A qualitative study about challenges to effective public institutional communication during the Covid-19 pandemic in Switzerland.
The study aimed to identify the challenges of institutional communication with the public during the pandemic. In-depth interviews with representatives from key Swiss health institutions showed that rigid organizational structures and limited trust in institutions, as well as mis/disinformation, were among the main challenges. Timeliness, flexibility, and partnerships with the media were crucial to success.
Second contribution: Nurturing a dialogue with the population: A cross sectional study on public perceptions of institutional health communication during pandemic in Switzerland
The study aimed to understand factors associated with the acceptance of public health measures (PHM) during the pandemic. In January 2022, we surveyed the Swiss population. Measures covered information-seeking, attitudes, and beliefs towards PHM, and trust in institutions. 2’587 individuals composed the sample. Swiss residents generally accepted the different PHM, but some factors explain a stronger acceptance. While nurturing a two-way dialogue with the population, institutions should target communication for age and culture, improve risk communication, ground messages on scientific evidence, and ensure mass media presence.
Third contribution: Communication is part of the treatment: A qualitative study about communication challenges faced by hospitals during the COVID-19 pandemic in Switzerland
The study aimed to identify the main communication challenges, and ways to address them, encountered by Swiss hospitals during the pandemic. In-depth interviews with representatives from key hospitals showed the difficulties in defining their role in the communication landscape, especially considering the urgency of providing care and support to an enormous number of urgencies. At the beginning and for many months, hospitals had to deal unclarity and lack of evidence, and to readjust communication from one day to the other both to patients and their families, and to the public.
Title
COVID-19: a new role for sentinel surveillance?
Name
Mirjam Mäusezahl
Affiliation
BAG
Abstract
In Switzerland, the sentinel surveillance system Sentinella, covering consultations in primary care, is one of the pillars of the surveillance of transmissible diseases. Its main purpose is to provide data on the incidence of very frequent infections, not, or only partially, captured by the mandatory declaration system. Among others, Sentinella is used to monitor the annual seasonal influenza outbreaks, with sentinel physicians reporting consultations due to influenza-like-illness episodes.The COVID-19 pandemic led to substantial societal measures, which impacted not only the circulation of respiratory viruses usually captured by Sentinella such as influenza, but also the healthcare-seeking behavior of the Swiss population, with the widescale deployment of test and vaccination structures outside primary care practices. In addition, automated electronic interfaces allowed to capture systematic laboratory notifications in an unprecedented scale.
In this evolving pandemic context, the Sentinella system had to adapt and redefine its role and surveillance objectives. In particular, Sentinella surveillance of suspected COVID cases was implemented, by adapting already existing surveillance of influenza-like-illnesses according to information needs during the different phases of the pandemic. Furthermore, the number of samples originating from Sentinella patients that were tested at the National reference center for influenza was doubled, and the list of viruses the samples were tested for expanded to 11 respiratory viruses. Additionally, questionnaires addressed to the sentinel physicians recorded, among others, trends in shortages of protective material, physicians’ workload, COVID-related teleconsultations, and later long COVID.
This workshop will include three main presentations. First, the BAG will present the main adaptations of COVID-19 surveillance, within Sentinella as well as the other surveillance pillars and new elements deployed over the course of the pandemic, and summarize its main results. Second, we will present data about long COVID collected by Sentinella physicians. Third, we will present simulations based different outbreak scenarios to understand the power and limitations of different surveillance systems.
Based on these experiences and on feedback from the participants, the discussion will address expectations and added value that participants see in Sentinella, especially in comparison with other systems such as mandatory declarations, wastewater monitoring or hospital surveillance. In this post-pandemic phase, drawing on lessons learned during COVID-19 can help shape new options for the future of both endemic and pandemic surveillance.