By multiple measures, COVID-19 has challenged healthcare providers more than any other public health crisis since the 1918 influenza pandemic. As the coronavirus pandemic enters its second year, many health systems, hospitals, and physician practices remain in crisis mode. A pair of physician leaders at Cincinnati-based UC Health recently spoke with HealthLeaders to discuss how the health system has grappled with COVID-19.

Surveys of more than 2,000 people in May and October 2020 show about a 10% drop in trust of the CDC over that period, with the overall population-level trust in the agency falling to the same lower level of trust long held by Black Americans about the agency.

Much of the burnout discussion has focused on frontline and direct care nursing staff, especially during the COVID-19 pandemic. But chief nursing executives and other nurse leaders operate within the same volatile environments while also managing organizational, disciplinary, and operational stress, according to the study, Nurse Leader Burnout: How to Find Your Joy.

The new report, which was published by Urban Institute researchers with funding from the Robert Wood Johnson Foundation, examines historical trends for flu vaccination that indicate ways to address racial, ethnic, and economic inequities in the rollout of coronavirus vaccines. The report is based on data from the 2016 to 2018 National Health Interview Survey.

The proposed standard would likely require employers to create a company-specific plan to minimize worker exposure to COVID-19. The rule is expected to mandate mask-wearing, social distancing, hand-washing breaks, and communication procedures for workers during outbreaks. The new standard, which many feel is long overdue, is expected to protect the most at-risk workers.

Those performing such “aerosol-generating” procedures, often in an intensive care unit, got the best protective gear even if there wasn’t enough to go around, per Centers for Disease Control and Prevention guidelines. And for anyone else working with COVID patients, until a month ago, a surgical mask was considered sufficient. A new wave of research now shows that several of those procedures were not the most hazardous. Recent studies have determined that a basic cough produces about 20 times more particles than intubation, a procedure one doctor likened to the risk of being next to a nuclear reactor.

In a recent study of COVID-19 patients hospitalized with severe acute respiratory infection, functional impairment was found in 53.8% of patients four months after hospital discharge. Long COVID symptoms include cough, shortness of breath, anxiety and depression, cardiac issues, fatigue, deconditioning, and hair loss.

The incidents range from 335 discarded doses in Lee County, North Carolina, that were damaged in shipping, to nearly 5,000 doses that went to waste in Tennessee in February, prompting additional federal oversight.