Recovery, Renewal, Resilience

Many individuals and families have experienced negative economic impacts from COVID-19 as a result of business closures, job losses and reduced working hours. Globally, governments have introduced financial stimuli through small business loans and furlough schemes, in an effort to mitigate the consequences of financial losses caused by the pandemic. As many stimulus packages are scheduled to end in the coming months, business owners are concerned that they will be unable to continue to pay staff, and employees are concerned that they may be made redundant. Consider:

• The need to quickly increase the capacity of local financial support and advice systems:
  • Partner with and commission community advice services, e.g. Citizens Advice Bureau (CAB)
  • Build capacity and train volunteers to increase the range of specialist and generalist welfare and debt advice that is available
  • Seek support from local businesses that can provide financial and other advice
• Increase community and business awareness of how to access support services:
  • Run information campaigns targeted at groups that need support
  • Bring together sources of good advice from trusted partners into a single location/source to make information easy to find
  • Sign post and onward refer members of the community to services
• Integrate debt and financial advice and budgeting support with forms of direct financial support

Concurrent incidents during the COVID-19 pandemic, such as locus swarms destroying farms in Africa, forest fires devastating the US, flooding in the UK, show us that climate change actions are crucial when considering renewal strategies. Communities that are more vulnerable to natural disasters are disproportionately challenged during a pandemic. Natural climate solutions protect and restore nature, which can help mitigation of (and adaption to) the impacts of climate change, e.g. coastal wetland can defend communities from storm surge and sea level rise, well-managed forests can protect water supplies, reduce wildfire risk and prevent landslides. Consider:

• Raise awareness locally of the value and potential benefits of nature-based solutions for communities in mitigating risks of future natural disasters
• Engage with local businesses as potential sponsors of nature-based solutions
• Establish a volunteering scheme with employees of local businesses to support nature-based initiatives
  • Partner with local voluntary groups and community based organisations to establish community-led conservation efforts
  • Establish a 'plant a tree initiative', to build and enhance local forestry
  • Encourage roof top gardens and balcony gardens - create online gardening tutorials for creating mini urban gardens
• Work with local land owners to identify appropriate actions that support nature-based approaches, e.g. planting marram grass to stabilise sand dunes or peatland restoration

As COVID-19 vaccine delivery programmes gain pace, attention has turned to vaccine hesitancy and the associated challenges to achieving optimal vaccination goals[1]. Public hesitancy has developed as people are anxious and uncertain about the safety and regulation of the vaccine[2]. Vaccination hesitancy has been found to relate to the public perception of risk, connected to two factors:

• The risk of morbidity or mortality
• Elements of an event that cause fear, worry, mistrust or upset to the public[3]

Recent studies have identified three predominant groups that are at higher risk of COVID-19 vaccine refusal, requiring targeted strategies and communications to address their concerns and hesitancy:

• Women aged 30-39[4]
• Low-income groups[5]
• Socioeconomically disadvantaged groups and BAME communities[6]

Potential causes of COVID-19 vaccine hesitancy:

• The speed at which the available COVID-19 vaccines were produced and approved may lead to scepticism or mistrust relating to their benefit, effectiveness and long-term side effects[7]
• Pregnant women were not included in the majority of COVID-19 clinical trials, so there was little data available to evaluate vaccine safety relating to fertility, pregnancy and young children[8]
• Misinformation through social media and the challenges caused by the anti-vaccination movement in developing and communicating scientific expertise and building public trust in the effectiveness of COVID-19 vaccines[9]

Strategies to address vaccine hesitancy

Although the WHO advise that there is no specific reason for risks that would outweigh the benefits for pregnant women in some vaccines[10], the inclusion of pregnant women in COVID-19 therapeutic trials is crucial to ensure the identification of efficacious and safe treatment[11]. The Behavioural Science and Public Health Network[12] and the European Centre for Disease Prevention and Control[13] offer the following recommendations to address COVID-19 vaccine hesitancy:

• Increase trust and confidence in the safety and effectiveness of the COVID-19 vaccine by:
• Clearly communicating its rigorous development and testing process
• Provide details of the COVID-19 development and testing process, highlighting the way in which the same rigour has been applied for previous vaccines
• Train health care workers to respond to hesitant patients, e.g. their common concerns, addressing those concerns
• Design community-level interventions to target high risk vaccine refusal groups by supporting the development of community networks:
• Leverage and support existing channels that have influence on decision making, such as; community and faith leaders of ethnic minority and low-income communities; teachers and youth/sport club leaders who interact with the parents of young children; online communities and networks[14], e.g. Mumsnet
• Establish community educational and promotional activities to inform on the safety and benefits of vaccination (via talks, videos, presentations and discussions)
• Launch advocacy campaigns supported by community members to promote vaccine safety and counter anti-vaccination messages, to mitigate the prevalence of misinformation in BAME communities[15]
• Establish an on-line decision aid for parents
• Use information from trusted health agencies to produce online information and vaccine information pamphlets for pregnant women and new mothers:
• Detail different vaccines in full, relative to their available safety data, to ensure women can make a factually informed decision
• Raise awareness of online information and disseminate pamphlets

References:

[1] https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(20)30016-8/fulltext

[2] https://www.ecdc.europa.eu/sites/portal/files/documents/Catalogue-interventions-vaccine-hesitancy.pdf

[3] https://oxfordmedicine.com/page/measles%20and%20the%20hesitancy%20to%20vaccinate/measles-and-the-hesitancy-to-vaccinate

[4] https://www.smh.com.au/politics/federal/covid-19-vaccine-advertising-campaign-to-target-specific-fears-20210109-p56svi.html

[5] https://www.sciencedirect.com/science/article/pii/S2666776220300120?via%3Dihub

[6] file:///C:/Users/r66633rj/Downloads/COVIDvaccinePaper4.pdf

[7] https://www.ox.ac.uk/news/science-blog/covid-19-vaccine-hesitancy-uk#

[8] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30484-8/fulltext

[9] https://www.bma.org.uk/news-and-opinion/pushing-back-tackling-the-anti-vax-movement

[10] https://www.who.int/news-room/feature-stories/detail/the-moderna-covid-19-mrna-1273-vaccine-what-you-need-to-know

[11] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30484-8/fulltext

[12] https://www.bsphn.org.uk/_data/site/54/pg/675/COVID-19-Vaccination-Reducing-Vaccine-Hesitancy.pdf

[13] https://www.ecdc.europa.eu/sites/portal/files/documents/Catalogue-interventions-vaccine-hesitancy.pdf

[14] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32642-8/fulltext

[15] https://socialcare.blog.gov.uk/2021/01/27/overcoming-vaccine-hesitancy-in-our-diverse-communities/

Vaccination certification for COVID-19, sometimes referred to as immunity/vaccine passports, are being considered by some countries as a strategy to relax the strict measures that have been imposed on society over the last year. The document is designed to certify people as immune to COVID-19 based on vaccination. Consider the ethical issues associated with varying restrictions on individual liberties based on possession of a vaccine certificate. Consider:

• If a vaccination certification programme could cause unequal treatment of individuals by segregating members of society into different tiers of infection risk and contagiousness, for example:
  • Members of groups who live with systemic discrimination and marginalization may face more barriers to accessing particular areas of society or activities if they are not certified as vaccinated
  • Differences in exposure, access to health care and vaccination certification may lead to some groups having higher or lower proportions of vaccine-certified people
• If the application of vaccination certification should only be used with existing precautions and should not prevent non-vaccine certified people from accessing areas or activities, e.g. people who have not received a vaccination certificate should not be prevented from travelling but may be required to take a test/quarantine on arrival as per the existing precautionary measure
• Whether vaccinations certifications should:
  • Impact a person's ability to exercise fundamental rights such as voting, accessing and social care or education
  • Cause an increase in cost or burden for vaccine-certified individuals, e.g. frontline healthcare workers who are vaccination certified should not be expected to manage more work
• If the perceived benefits of vaccine certifications could increase the risk of people increasing their exposure to intentionally become infected and receive a certificate, which poses risks to an increase in community spread and could potentially cause harm to others
• The perceived value of vaccine certificates and counterfeit market activity/certificates
• How to mitigate implementation risks, e.g. certification being managed by certified bodies, results being processed and confirmed by licensed laboratories, and certificates being issued by health authorities
• To protect personal data and minimize breaches of confidentiality, legal and regulatory measures should be put in place to limit the access to data by governmental authorities

We call to establish community resilience as a new local and national resilience capability. This is a major opportunity for us to renew our local resilience by continuing the community action built during the pandemic.

To read this briefing in full, follow the source link below to TMB Issue 30 (p.2-6).

The significant impacts of COVID-19 have created new groups of vulnerable people, such as people on middle-incomes and small businesses owners who have experienced a sudden loss of income and are now financially vulnerable. These new vulnerable groups have not before been targeted for social protection. Consider how other countries have expanded existing systems to support newly vulnerable people, for example:

• Adjust social protection programmes to give flexibility that can adjust to changing public health situations:
  • Directly link social protection measures to region-specific health or lockdown measures, e.g. tie social protection policies to tiers/categories in health responses
  • Establish a trigger system to rapidly adjust social protection measures to affected areas and groups
• Enable vulnerable people to access the assistance they need:
  • Establish a beneficiary database to identify and assess the social protection needs of newly vulnerable people
  • Partner with existing community organisations to identify vulnerable people, develop community-based targeting, and ensure those who become newly vulnerable are not excluded
  • Facilitate vulnerable individuals to self-identify through a registration service, e.g. online application, supported by a means test for verification
  • Expand sources of data to identify and verify intended beneficiaries, e.g. electricity or bank account data, employer’s redundancy data
• Revise legislation surrounding conditionality requirements, e.g. loosening conditionality principles of social protection programmes:
  • Morocco transformed ‘conditional cash transfer’ (CCTs) to ‘labelled cash transfer’ (LTCs) by removing the conditionality of continued school enrolment for cash transfers - resulting in reduced costs of programme implementation and reported increases in school enrolment and participation of children

Prisons are high risk environments as places of close physical proximity[1]. Persistent overcrowding[2], close living spaces, and staff moving in and out, make social distancing and the isolation and management of any contagion difficult to arrange[3]. National strategies to suppress COVID-19 should focus on reducing outbreaks within prisons, recognising that prison health is public health[4]. Coordinating evidence-based approaches to managing outbreaks of COVID-19 in prison settings can address the spread of the virus in potentially vulnerable people inside prisons and to communities where staff live[5].

In March 2020, WHO published interim guidance on how to deal with COVID-19 in prisons through a whole-of-society approach, with comprehensive guidance in the following key areas[6]:

• Preparation - through collaborative working with health and justice sectors, local and national public health authorities, and civil protection agencies; risk assessment and continuous evaluation; action planning to mitigate risks; assessment of essential infectious control supplies such as PPE, environmental sanitation, hand hygiene and disinfection
• Prevention - through implementation of public health guidelines, such as hand hygiene, social distancing and facemasks; monitoring of staff travelling into prisons from affected communities or who have a history of exposure; reviewing continuity and contingency plans to ensure critical functions can be delivered with reduced numbers of personnel
• Training and Education - planned and targeted at healthcare and custodial staff, including basic disease knowledge, hand hygiene practice, respiratory etiquette, the effective use of PPE and environmental prevention measures such as cleaning and disinfection. WHO have developed several online resources and training that can support this[7]
• Control - through robust prevention strategies; diagnostic strategies, including contact tracing, and interventions, including the environmental cleaning of health-care rooms or cells, where the management of a suspected case has taken place

A recent study identified some core challenges in managing infectious disease in prisons[8], such as:

• Overcrowding and a lack of best practice on managing the early release of prisoners
• Prisoners withholding symptoms for fear of stigma, leading to outbreaks
• Limited capacity of staff and resources to facilitate isolation, quarantine, and contact tracing

Addressing overcrowding, including communicating complex policies, such as an amnesty

Governments and judiciaries globally are considering strategies to tackle overcrowding and reduce prison populations through early release and alternative incarceration for vulnerable detainees and low-risk offenders[9]. Although strongly supported by human rights groups[10] and recommended by the UN[11], COVID-19 amnesties in the Ukraine were however rejected by legislators, media, and the public. This highlights that the explanation and communication of complex policies are just as vital as their design[12]. When communicating amnesties, consider:

• Work closely with civil society, particularly NGOs directly engaged with the public, to assess views and perceptions of amnesties, using this information to inform policy design and implementation
• Establish a clear communication strategy to accompany all elements of the process of transitioning incarcerated persons back into society, with a tailored approach to different social and regional groups
• Communicate informed and factual information through government and trusted civil society organisations, explaining the different elements of amnesties and their place in the larger reintegration framework to help the public feel more informed, secure and resilient

Inmate Volunteers

Irish Red Cross inmate volunteers are trained annually in Infection Control as part of the Community Based Health and First Aid Programme[13]. The activities of the inmate volunteers helped to contribute to zero positive cases amongst prisoners across the country for more than six months. Consider supporting a targeted inmate volunteer training programme to aid the management of infectious disease in prisons:

• As part of preparation and contingency planning, train inmate volunteers and staff on infectious disease and contact tracing to support the education of prisoners and custodial staff, and efforts to control transmission
• Train volunteers to support inmates who face mental health challenges/fears of stigma, e.g., distributing information and education packs, and supplementing support from psychologists, teachers, chaplains, and family visitation services, where these lack capacity
• Inmate volunteers can support the establishment of prison communication strategies on COVID-19, e.g. volunteers can write newsletters that can be distributed throughout prisons each week to provide updated information and educational material regarding COVID-19. Newsletters can include services that are available for inmates, and instructions for exercises and other activities that inmates can do while isolating and in quarantine

References:

[1] Redondo, S. et al. (2020) Corrections and Crime in Spain and Portugal during the Covid-19 Pandemic: Impact, Prevention and Lessons for the Future, Victims & Offenders, 15:7-8, 1156 – 1185, doi: 10.1080/15564886.2020. 1827108

[2] https://www.amnesty.org/en/latest/news/2020/12/pakistan-overcrowding-in-pakistans-prisons-is-a-ticking-time-bomb/

[3] Pagano, M. (2020). COVID-19 Risk Management and Screening in the Penitentiary Facilities of the Salerno Province in Southern Italy. International journal of environmental research and public health, 17(21), p.8033.

[4] https://www.unodc.org/documents/middleeastandnorthafrica//2020/COVID19/COVID_19_Egypt_Final.pdf

[5] https://www.psych.ox.ac.uk/news/people-in-prison-must-be-part-of-public-health-response-to-covid-19

[6] https://apps.who.int/iris/bitstream/handle/10665/336525/WHO-EURO-2020-1405-41155-55954-eng.pdf?sequence=1&isAllowed=y

[7] Emerging respiratory viruses, including COVID-19: methods for detection, prevention, response and control [OpenWHO online course]. Geneva: World Health Organization; 2020 (https://openwho.org/courses/introduction-to-ncov)

[8] Beaudry, G., Zhong, S., Whiting, D., Javid, B., Frater, J. and Fazel, S., 2020. Managing outbreaks of highly contagious diseases in prisons: a systematic review. BMJ global health, 5(11), p.e003201 https://gh.bmj.com/content/5/11/e003201

[9] Amnesty International (2020) https://www.amnesty.org/en/latest/news/2020/12/pakistan-overcrowding-in-pakistans-prisons-is-a-ticking-time-bomb/

[10] https://uacrisis.org/uk/amnistiya-ye-realnym-sposobom-borotby-z-poshyrennyam-koronavirusu-u-mistsyah-nesvobody-pravozahysnyky

[11] https://www.unian.info/society/human-rights-un-recommends-ukraine-grant-amnesty-to-certain-convicts-amid-covid-19-pandemic-11155589.html

[12] https://www.chathamhouse.org/2020/11/covid-19-holds-lessons-ukraines-amnesty-policy

[13] https://www.redcross.ie/national-news/irish-red-cross-responds-to-covid19/

Migrants and refugees face a multitude of health and safety challenges that have been intensified by the pandemic, such as: losing employment and income; eviction and homelessness; and lack of access to 'safety net' support. In addition, some countries have temporarily suspended issuing residency permits, leaving people with irregular status in their country of asylum and further impacting their access to employment and social services. To support migrants and refugees, consider:

• Participate in national resettlement programmes (e.g. SRP UK) to guide preparations, ongoing support and integration of migrants and refugees into local communities
• Establish a working group to enable collaborative working between local councils, community groups and related agencies to determine how local authorities can meet legislative requirements of resettlement programmes
• Inform and prepare local communities where migrants and refugees are to be resettled
• Identify registered and unregistered refugee populations in communities
• Conduct risk and vulnerability assessment mapping
• Include migrants and refugees in social protection schemes to support those who have lost income generating opportunities
• How systems will protect migrants and refugees from harm, irrespective of their status, with access to essential health and social care
• Agree that immigration status is not a legitimate basis to deny access to essential public services (e.g. healthcare, vaccination), and communicate this to public services, migrant and refugee populations, and wider groups
• Invest in risk communication and community engagement at local levels to disseminate information in the relevant languages of migrants and refugees
• Partner with humanitarian actors to provide services
• Establish humanitarian service points or 'safe spaces' which are not subject to immigration enforcement activities, where humanitarian actors can provide essential services to vulnerable migrants

The success of the vaccine programme will, in part, depend on how many people accept the vaccine. The prevailing narrative in a country may influence those who are anxious about the vaccine or uncertain about whether they should have it. Often there are vocal groups in support of, and in opposition to, vaccines and those groups are already very active around COVID-19. Governments will be a main facilitator of vaccine programmes so (in collaboration with partners) should consider addressing voices that oppose vaccine programmes. WHO provides guidelines for responding to vaccine deniers, including broad principles for health authority spokespersons on how to behave when confronted. The principles are based on psychological research on persuasion, public health, communication studies, and on WHO risk communication guidelines. The WHO guidelines cover:

• Tactics by vocal vaccine deniers e.g. skew science, shift hypothesis, censor, and attack opposition
• Who is the target for advocating vaccines i.e. the public are your audience, not the vaccine deniers
• The speaker should represent the well-grounded scientific consensus
• Verbal and nonverbal skills, and listening skills
• Do's and don'ts of verbal and nonverbal communication
• Constructing the argument to support vaccination

There have been well-documented breaches of the COVID-19 rules in, for example, workplaces, shops, public spaces. This has caused frustration and resentment, and made front-line staff question their perceived value and sacrifice. Current enforcement of the rules is led by the authorities, but there is potential for the public to report breaches via whistleblowing apps, which may help to target official enforcement activities. Consider:

• The potential to establish a whistleblowing app to collect information from the public on COVID-19 breaches
• Who should initiate and own an app to allow the public to report COVID-19 breaches, including the potential hesitation the public may have to report via Police websites
• Whether reports will be made anonymously by the public
• How to address and mitigate the potential for malicious or bogus reports
• What thresholds need to be met before action is taken
• How to analyse app data to identify patterns and trends of where, when and what breaches occur
• How to report back on subsequent enforcement actions and outcomes to individual whistle-blowers and to the wider public
• The need to increase capacity to engage, explain and encourage compliance by, for example, staff, trained volunteers, neighbourhood watch, local organisations (see COVID Marshals TMB Issue 28 (hyper) January 22nd)
• How to raise public awareness of whistleblowing apps to ensure that a lack of public awareness does not hinder their effectiveness

COVID-19 is thought to spread through shared surface contact which has led to additional cleaning of public transport, public spaces, and other infrastructure. Pedestrian crossings have been targeted for improvement to avoid people having to press buttons and prevent groups of pedestrians forming as they wait to cross. For example, crossings have been reprogrammed to prioritise pedestrians or have been upgraded to touch-less systems to offer a more hygienic alternative to the standard push button. These measures prevent people from potentially contaminating their hands and encourage safe pedestrian behaviour by ensuring that those cautious of waiting near others and touching push buttons don't cross dangerously. Consider:

• Reprogramme traffic lights to prioritise pedestrians instead of road vehicles:
  • Change the traffic light default swap preference from vehicles to pedestrians - to reduce the time spent by groups of pedestrians at crossings
  • Minimise the impact of new measures on increased traffic congestion by using traffic detection technology
• Install touchless technology to replace buttons:
  • Assess pedestrian crossings to determine the number of touchless push buttons required
  • Scope costs from potential suppliers, and assess affordability
  • Partner with other interested authorities to conduct a trial, choosing locations where regular site inspection and user behaviour observation can be carried out
  • Using results from the trial, identify and allocate funding to road and transport authorities to install touch-less buttons
  • Identify the utilisation of pedestrian crossings and develop an installation priority list
  • Include a feedback sound in touchless technology to ensure ease of use for people with vision impairment and other disabilities
  • Raise public awareness by fixing infographic signage to pedestrian crossing poles that provide functionality and instructions

COVID-19 has strained food producers and distributors (e.g. disrupted food supply chains, problematized crop harvesting, impacted logistics and distribution), and this has impacted the amount of food waste created in the supply chain. COVID-19 has also changed household food waste creation by affecting household income, shopping habits and consumption patterns. The implications are broad. For example, the real cost of food has increased for some vulnerable households, who must purchase from supermarkets that will deliver rather than shop at their usual 'cheaper' shops. Food waste has become an important concern for organisations and households, and some countries are taking strong action. Consider:

• Charge businesses and families that waste food (such as in South Korea, where the proportion of recycling food increased from 2% to 95% in 2009)
• Strengthen partnerships between food producers and distributors and local food initiatives
• Develop local agriculture and growing food in and around cities, e.g. Singapore identified unused spaces in its cities to create urban farms to address supply chain issues cause by COVID-19
• Partner with local volunteer initiatives that tackle food poverty and food waste:
  • Ensure voluntary food distribution groups have the necessary equipment to store nutritious food and distribute that to the community
  • Set up community fridges, e.g. local parishes or town halls to support local groups
  • To ensure food that is not fit for consumption is recycled appropriately
  • Support groups in the collection, transportation and redistribution of food
• Educate households on:
  • How to store food safely after purchasing
  • Safe ways to store and re-use leftovers
  • How to correctly recycle food waste
  • Recipes on for using leftover ingredients
  • How to safely donate excess food
  • How to interpret food labels correctly

Graham Bell of AJC Bell Consulting outlines some over-arching principles of organisational resilience which can help organisations to reflect on the pandemic and learn from it to recovery and renew. This briefing offers guidance on beginning the journey to post-pandemic recovery and renewal.

Read this briefing in full by following the source link below to TMB Issue 29 (p.2-7).

There is not yet sufficient global supply of COVID-19 vaccines - echoing the challenges faced at the beginning of the pandemic when there was insufficient PPE. Variation across regions/countries in the availability of vaccine brings the risk of accentuating long-term health inequalities and could entrench wealth inequalities, as some regions/countries are yet to begin their vaccination programme. This could lead to challenging questions for officials and elected leaders on the prioritisation of who receives the vaccine. For example, "Is it right to vaccinate a low-risk person in Country A (that has vaccine) rather than a high risk, front line health worker in Country B (that does not have sufficient vaccine)?" Consider how vaccine distribution plans and priority groups may polarise public opinion on the value of life and risk, including:

• The UN note that a 'me first' approach could prolong the pandemic as well as cause further economic and human suffering
• Changes to vaccination supply plans or redirecting vaccine stock to other regions/countries to manage targets may heighten public discomfort and disturbance
• Creating tier systems for access to vaccines can lead to fracture lines emerging in society, prompting civil disturbances or protests which may also increase transmission and lead to local outbreaks
• Individuals not agreeing with their classification may reject authority and breach guidelines
• Negative publicity for officials in managing change and social order may impact coming elections

Vaccines must be a global public good, which contribute to the equitable protection and promotion of human well-being among all people. At national level, a clear aim for vaccine programmes is essential, e.g. reduce immediate risk to life, in order to inform the identification of priority groups. As sufficient vaccine supply for whole populations will not be immediately available, WHO have provided a Prioritization Roadmap and a Values Framework, to assist with the prioritization of target groups. The WHO guidelines and framework advise to:

• Identify groups that will achieve the vaccine programme aim where there is an immediate risk to life, e.g. Stage 1 Priority Group - Care home residents, staff and volunteers working in care homes; Stage 2 Priority - Frontline health workers and those of 80 years of age and over. Priority groups should be listed and detailed to cover the whole population that is to be vaccinated
• Clearly define groups within priority phases, e.g. workers who are at very high risk of becoming infected and transmitting COVID-19 because they work in, for example, frontline health care, COVID-19 treatment centres, COVID-19 testing laboratories, or have direct contact with COVID-19 infected patients
• Avoid classifying groups as 'essential workers' as a qualifier
• Make priority groups explicit, straightforward, concise and publicly available
• Assess the prioritisation of those who are in high population density settings, e.g. refugees/detention camps, prisons; or who are not recorded in existing systems, e.g. un-registered persons
• Recognise vaccination as a global issue to begin conversations that identify how we will achieve the aim of reducing immediate risk to life globally, through international collaboration

Regional imbalances have created varying levels of economic impact on local economies. Areas that relied heavily on tourism and sport/music events prior to the pandemic are suffering disproportionate levels of unemployment and loss of trade. Consider a targeted local economic recovery strategy to boost tourism post-pandemic in local economies that have been hit hardest:

• Develop new tourism packages and make them appropriate for post-pandemic tourism, e.g. taking into consideration the potential need for social distancing, for vaccination passports to travel, and for meeting expectations of COVID-safe measures that tourists will have
• Recognise the opportunity to renew approaches to local tourism by adopting a community-centred tourism framework:
  • Redefine and reorientate tourism based on the rights and interests of local communities and local people
  • Involve local businesses, tourism boards and the community in developing targeted strategies to rejuvenate local tourism, that are beneficial to the whole community and geographical area
  • Create partnerships with local businesses and the local tourism board to develop a collaborative marketing plan to attract tourism
• Support local businesses in gaining core health and safety certifications by offering advice on how to gain certification and who to go to for auditing and certification awards
• Work with community voluntary groups to gain certifications such as 'Blue Flag Beach/Tidy Towns' to promote environmental and quality standards that will assist in marketing your local area to potential tourists
• Prepare a targeted marketing strategy to promote local areas when tourism returns, which communicates how the health and safety of visitors is central
• Collaborate with national tourism organisations (e.g. Visit Britain) and large holiday companies to promote domestic tourism
• Provide advice and temporary financial support (e.g. moratoriums on council tax) for local businesses directly involved in tourism (e.g. guest houses, to support their short-term financial viability)

Important parts of recovery are mourning the loss of loved ones, and remembering those who have tragically lost their lives through the pandemic. Consider opportunities to memorialise, including:

• Develop a website dedicated to those who have died during the pandemic, allowing families to create obituaries, find a network of support, and help those who may feel alone in their grief
• Hold online memorial services to enable people to come together and remember loved ones
• Build and dedicate a memorial to those who have died, e.g. St Paul's Cathedral will build an inner portico at the North Transept and dedicate it as a physical memorial to those who have died due to COVID-19
• Invite those of all faiths and none to join in remembering loved ones to offer a safe and inclusive space of refuge, solace and hope

To ensure appropriate memorialisation, consider:

• coproduction of memorialisation options with communities
• collaboration with partners that specialise in supporting those who have been affected by bereavement
• whether the memorial is to those who have died, those who have been otherwise affected by the crisis, and/or those who have helped in the response to the crisis

During national lockdowns and tiered restrictions, visitation to public spaces such as parks has increased dramatically. This increased concentration of people in particular areas poses risk of virus transmission from those who are not abiding by COVID rules. Despite their best efforts, Police have limited capacity to respond to breaches of COVID-19 regulations. As a result there are many breaches going unchallenged and reports of a culture of breaches taking hold. Volunteers, namely COVID Marshals or Ambassadors, can create more capacity to engage, explain and encourage compliance and, when combined with a public app to report breaches, can target deployment to breach hot spots. Consider:

• Identify the types of breaches it may be appropriate to deploy COVID Marshals to so they can engage, explain and encourage compliance
• Identify, select, and train people who may be suitable as COVID Marshals (follow ISO22319)
• Identify safe working practices for the COVID Marshals e.g. deployment in pairs
• Using reports from the public to identify public spaces where breaches are likely to occur
• Develop a system to deploy, monitor, support, and debrief COVID Marshals

As hospitality venues prepare for a safe re-opening, technology can support customer safety and rebuild client confidence. For example, the necessity of contactless service delivery has accelerated and motivated the wider adoption of new technologies across hospitality venues. Consider developing an audit and certification process that supports and guides hospitality venues in the adoption of new technology:

• Identify actions that can make hospitality venues more COVID-safe using technology e.g. replace tangible menus with an ordering app, use scannable QR codes, replace room keys with mobile keys, contactless communications using customer-facing technology tools, guest communications via chatbots/messaging platforms, contactless temperature checks at entrances, air quality improvement and ventilation via bipolar ionisation technology
• Use the identified actions to establish a checklist of practices that hospitality venues may be audited against
• Identify the minimum requirement for hospitality venues to be eligible for certification of COVID-safe technology adoption and service provision
• Identify how the hospitality venue protects its customers by using secure platforms
• Use the checklist and minimum requirements as part of an audit process to certify the safety of hospitality venues
• Apply the audit process to hospitality venues
• Use the audit process to identify further actions that hospitality venues can implement to increase their COVID-safety
• Publicise a list of certified hospitality venues
• Provide certified hospitality venues with certificates/logos that they can display in their window and online
• Have a whistleblower procedure for staff and customers to report serious breaches

Conventional campaigning tactics, such as door-to-door visits and town hall meetings to connect and talk to constituents, are not currently possible in many countries due to COVID-19 guidelines and concerns over risk of virus transmission. Clear guidelines that have the agreement of major parties are needed to ensure appropriate electioneering keeps election candidates and voters safe. Consider the need to:

• Develop an agreement between major political parties on the rules they commit to follow to ensure the safety of their election campaigns
• Identify alternative campaigning methods that are appropriate, such as:
  • Increased use of telephone and postal campaigning
  • Online platforms to support webinars and online town hall meetings with candidates to interact with voters
  • Increased involvement of volunteer helpers in constituencies
• Identify campaigning methods that are not appropriate, for example:
  • Driving voters to voting booths
  • In-person public appearances in places where crowds may then gather
• Appoint an arbitrator to advise on the adherence to agreed rules and the appropriateness of campaigning methods
• Consider how positive and negative campaigning may affect public mood at an already stressful time
• Communicate rules to campaign offices well in advance to allow preparation
• Communicate the campaign rules to the public

Schools have an increased need for support during lockdowns to provide children with the resources they need to learn effectively. Many other organisations are also under significant pressure during COVID-19, but some are coping particularly well as customer demand has increased hugely. Such organisations may have the capacity, capability and willingness to support the parents of schoolchildren in their local community. Consider encouraging local organisations and others to:

• Coordinate community activities on behalf of a school, for example, to:
  • Collect unused computers from businesses and the public so they can be reformatted and given to school children to enable them to access online learning support
  • Provide computer training and skills for local parents so they can assist their children, particularly young children
• Offer free printing of schoolwork for parents of school children who do not have printing services at home
• Make servers available to host school content which can be downloaded by parents
• Contribute financially to support schools to pay for new forms of online schooling, new content, and access to privileged services
• Work with schools to support them to build capability, for example, to:
  • Evaluate and learn the technology that is available and how to use this in online learning
  • Convert materials to make them suitable for online learning
  • Remap donated computers to enable them to be distributed to school children
• Provide specialist services to schools, e.g. readers of braille, sign language, adapting written materials into the spoken word, supporting children with disabilities
• Provide COVID-19 hygiene supplies to schools (e.g. facemasks and hand sanitising stations)
• Actively help Head Teachers in their role, for example, to interpret guidance and its application in their schools, and to support networking and mutual aid between schools

As the roll out of the COVID-19 vaccine gains pace, there has been reporting of a rise in criminal activity targeting people who await information about their vaccine. Examples of how fraudsters are exploiting the vaccine launch includes: scam text messages that request personal information such as bank details; fraudsters turning up at peoples' houses posing as National Health Service employees and offering vaccination for immediate payment. Fraud undermines public confidence in official programmes and contribute to a negative narrative around the vaccine programme. Consider public messaging to:

• Use a range of communication channels to build public awareness of fraudsters' tactics to encourage vigilance regarding vaccination communications
• Ensure communications about fraud awareness are available in different languages and different media e.g. to support migrants or support people with disabilities such as via informational videos: https://signhealth.org.uk/resources/coronavirus/
• Publish a list official government and health websites/social media channels that are authorised to provide official information on the vaccine
• Include in fraud communications information on the ways in which people will be invited for an official vaccine, and ways that they will not be invited
• Identify partnering organisations that can distribute messages about vaccine fraud e.g. organisations that run befriending schemes, check-in and chat services, vaccination partners
• Disseminate consistent information to these partnering organisations to advise them of how to provide information about fraud without concerning people about the safety of the vaccine itself

Vaccine programmes will need to source sufficient vaccine, notify recipients of their eligibility, and arrange processes to administer the vaccine. Vaccine wastage, recipient confusion over invitations, and inefficient processes will risk undermining the programme's efficacy. To build early confidence in vaccine programmes:

• Agree the current aim for the vaccine programme e.g. to reduce immediate risk to life
• Identify the priority groups to vaccinate to achieve the current aim
• Identify individual citizens who belong to those priority groups
• Disseminate public information on current priority groups to manage expectations
• Explain to agencies that lobby for their staff to be given higher priority why they are currently prioritised as set out in the priority groups - and explain how this achieves the current aim
• Establish a national register of healthcare staff who are qualified to administer the vaccine -including volunteers and other staff who have been recently trained and approved
• Identify suitable facilities that can act as vaccine centres e.g. doctor surgeries, schools, public buildings, mass vaccine centres
• Identify the demand for vaccine at each vaccine centre (based on estimated throughput) and ensure that sufficient supply is available when it is needed
• Identify how the vaccine will be transported to centres and stored appropriately
• Maintain close communication with each vaccine centre to share information, for example, on:
  • Stock levels, delivery schedules, and projected demand
  • Which patients have received the vaccine
  • Which patients have been refused the vaccine and for what reason
• Track the performance of vaccine centres to analyse programme risks and capacities, for example, implement an inventory management system to reduce vaccine waste such as by tracking expiry dates (continued)
• Consider future aims for later in the vaccine programme and the timing of vaccinating different priority groups to achieve those aims e.g. to re-open non-essential business
• Seek process-related advice from countries that have already established vaccine centres e.g. Germany

COVID-19 has created new uncertainties that challenge the provision of critical support services to vulnerable families and children. Food programmes need to ensure that vulnerable children receive nutritious food, both inside and outside of school. They also need to facilitate access to other support services, and be delivered in ways that maintain the dignity and respect of recipients, their families and communities. Consider the need to:

• Integrate access to sufficient, nutritious food as part of an overarching plan to combat COVID-19, promote healthy societies, and mitigate long-term health issues
• Establish an assurance programme with service level agreements to increase confidence in emergency food provision, create feedback systems, and enable rapid amendment to services
• Provide guidance to parents so they know what services they are entitled to access
• Ensure parents are aware of "wrap-around" services e.g. anti-poverty schemes
• Analyse the impacts of food programmes on children's diets
• Consult parents and community groups about how to build dignity and choice into emergency and ongoing food provision, and develop opportunities for active involvement planning and delivery
• Develop community-based nutrition awareness and home-based cooking training programmes to support parents in providing balanced meals on a low budget
• Strengthen working partnerships with local government agencies, civic groups, voluntary sector, and social arms of corporations to improve implementation of food programmes
• Remove financial barriers to receiving food support and minimize stigma about 'handouts' e.g. by using a 'pay-as-you-feel' system

Research shows that young people experience more long-lasting labour market impacts due to economic crises than adults, including being the first to lose jobs, working fewer hours, taking more time to secure quality income, and wage scarring where earning losses recover slowly. The International Labour Organisation reported that 17% of young people employed before the pandemic had stopped working entirely, and 42% reported reduced incomes. Additionally, it is widely reported that it is becoming increasingly difficult to source workers with the right skills in sectors where job opportunities exist. Consider developing youth employment initiatives, aimed at promoting domestic employment, skills development, capacity building and enabling equal access opportunities for vulnerable youth:

• Assess your own organisation’s operations and capacity to understand where youth employment opportunities may be protected or enhanced:
  • Recognise the contribution of people who joined your organisation as young people in entry-level roles and try to ensure that restructures do not remove roles that provide a talent pipeline into your organisation.
  • Monitor for age in any furlough and redundancy plans to ensure young people in your existing workforce are not disproportionately affected
• Map labour market information of unemployed young people such as knowledge, skills and abilities, with potential sectors of employment, including consideration for the supply and demand aspects of the labour market
  • Establish a working plan with employment services centres to support registration, profiling, referral, temporary work placements and on-the-job training
• Collaborate with local government and private and public organisations to establish sectors in which temporary employment opportunities for young people could be created e.g. public works and infrastructure maintenance (Nepal)
• Align vocational education and training aimed at up-skilling young people with employment initiatives such as apprenticeships and work experience programmes
• Provide youth-targeted wage subsidy programmes to help young people enter, re-enter or remain in the labour market by reducing costs of recruitment, retention and training
• Continue to provide careers advice in schools, colleges and universities to help young people navigate their employment options during COVID. Ensure careers advisors understand the current labour market and options open to young people so that they can provide timely advice

Alexander Kreh, MSc and Prof. Dr. Barbara Juen, University of Innsbruck, discuss stressors and challenges faced by healthcare workers, and presents results of a survey of healthcare personnel and the stressors they experience. The authors conclude by suggesting how organisations can build and maintain personal resilience among their frontline workers during COVID-19.

To read this briefing in full, follow the source link below to TMB Issue 28 (p.2-9).

COVID-19 vaccination rollout is taking place in many countries, with many more planning to implement mass vaccination strategies for in the near future. The widespread nature of the pandemic has meant that huge numbers of people require vaccination, and a result, demand for vaccines currently far outstrips supply in some countries[1]. Fear surrounding COVID-19 has led to criminals utilising black markets to develop and sell fake vaccinations on the dark web[2]. The demands on government vaccination programmes has also promoted the online sale of other fake medicines such as the malaria drug hydroxychloroquine and the steroid dexamethasone[3] as these have been associated with COVID-19 treatment. In other cases, some online vendors were claiming to sell vaccinations or medicines that would have never been shipped to buyers[4],

And in the UK, there were incidents of scammers turning up at people’s doorsteps offering a vaccine for payment, following a spate of fake text messages[5].

Vaccines are a financially lucrative commodity, and while the pharmaceutical industry is prepared with regular audits and vetting of supply chains, minimising human contact, stops and handovers during distribution, and real-time digital devices which measure temperature and location, there are other risks. Some of those at risk include:

• Desperate consumers believing they can purchase the vaccine online
• Hospitals and healthcare facilities that have been hit with a barrage of phishing and ransomware attacks which can try to sell fake vaccines
• Vaccination centres which may be points of vulnerability; one supply chain security expert stated “we need to tell people at the vaccine centres that they carry gold”[6].

The rise in fake vaccines and medications requires approaches that protect people, and infrastructure.

Protecting people

• Widespread information campaigns that advise people not to buy any vaccines online, with particular focus on informing people with pre-existing health conditions or those in certain vaccine priority groups as these groups may feel an urgency to be vaccinated
• Remind people that they should consult their registered doctor about vaccination, and only be vaccinated at an official vaccination point[7] and that NHS England will never ask for bank details, Pin numbers or passwords, when contacting you about a vaccination
• Monitor online chatrooms and forums that may be regularly used by vulnerable groups to scan for attempts to sell fake vaccines and medications
• Set up and regulate certification organisations which undertake due diligence on sources of drugs (e.g. pharmacies) and medications e.g. pharmacychecker.com to create a transparent solution for the public to check the sources of their online medications to ensure their legitimacy and safety
• Work with healthcare professionals to build trust in vaccinations. The spread of fake vaccines may deter people from legitimately being vaccinated

Protecting infrastructure

• Regularly assess cyber security and train staff in recognising and reporting any phishing scams or malware attacks
• Train staff and volunteers administering vaccinations in the safe and careful disposal of empty vaccine vials which could be stolen and used to package fake vaccines that look authentic[8]
• If required, consider security at vaccination centre sites, especially those which have been set up in temporary locations or do not have adequate security systems

References:

[1] https://www.swissinfo.ch/eng/swiss-regulator-warns-of-fake-covid-19-vaccines-online/46279734

[2] https://www.japantimes.co.jp/news/2020/11/27/asia-pacific/covid-19-vaccine-china-black-market/

[3] https://iea.org.uk/will-there-be-a-black-market-in-covid-vaccines/

[4] https://www.ft.com/content/8bfc674e-efe6-4ee0-b860-7fcb5716bed6

[5] https://www.bbc.co.uk/news/uk-england-london-55577426

[6] https://www.ft.com/content/8bfc674e-efe6-4ee0-b860-7fcb5716bed6

[7] https://www.swissinfo.ch/eng/swiss-regulator-warns-of-fake-covid-19-vaccines-online/46279734

[8]https://www.dw.com/en/officials-warn-of-fake-covid-19-vaccines/a-56123830

Across the world there are ambitious targets to vaccinate staff and residents in care homes. However, this will take time and, meanwhile, the pressure on care homes may build as staff become sick and residents need additional support. At critical points, volunteers may be expected to provide additional capacity inside care homes, but this requires preparation and planning e.g. training volunteers in core skills and knowledge to work in such settings. Consider the need to:

• Work with care home professionals to identify appropriate tasks that volunteers may be able to perform with adequate training and supervision
• Design appropriate volunteer training programmes that are proportionate to the risk, including e-learning packages on, for example:
  • Infection prevention and PPE
  • Medication awareness
  • Vaccine administration
  • Assisting care home residents e.g. moving and handling, legislation, risk awareness, first aid
  • Communication with residents
  • Confidentiality, dignity, and respecting individuals
  • Equality and diversity, and person-centred care
  • Health, safety, food hygiene, risk assessments
  • Safe equipment moving and handling
• Train sufficient volunteers so they can be safely deployed inside care homes to relieve staff shortages
• Ensure appropriate supervision is provided to volunteers inside care homes, and appropriate debriefing is offered on completion of shifts
• Vaccinate trained volunteers before they are deployed to care homes
• Capture learning from volunteers for continual improvement
• Consider the Cabinet Office guidance on involving spontaneous volunteers
• Encourage and support suitable volunteers who wish to transition into the paid workforce in the medium term

Developing a succinct plan that details the organisation's overall strategy for recovery and renewal can help ensure the organisation is working towards the same goal and with the same vision. The plan can be developed with partners and disseminated to relevant parties through local networks. An example of this is the Core Cities UK 10 Point Plan to Leave Lockdown - 10 policy initiatives developed for government to work with cities in exiting lockdown. In brief, the plan considers:

• Clear and transparent criteria for entering and exiting lockdown
• Rapid, localised Test and Trace and vaccination
• Adequate business support packages
• Extended furlough and self-employment support
• Sustainable financing of local government
• Winter support packages for vulnerable people
• Safe and secure places to live e.g. ban on landlord evictions and return of the 'Everyone In' campaign to end rough sleeping
• Commitment to dialogue with key stakeholders across locally agreed geographies
• Focused support for education and learning institutions e.g. rapid Test and Trace for all students and staff, reviewing exam timetables
• Increased local enforcement powers to tackle non-compliance

The pace at which some organisations and individuals have been moving during the COVID-19 pandemic has been relentless with many in prolonged ‘crisis mode’[1]. The pace, combined with mounting tensions and ever-present uncertainties have taken their toll on individuals and systems, leading to systems being overwhelmed, burnout and fatigue. For some systems, organisation and individuals, the recent holiday period has led to a pause in the relentless pace of COVID-19. This case study raises questions about whether continuing to work in a crisis response mode throughout 2021 is the best option, whether it is feasible, and which operations can be paused to create capacity in overwhelmed systems in order to create a potentially more sustainable pace and nurture resilience in people.

Gradually, people have begun to familiarise themselves with the notion of a ‘new normal’ in which our behaviours and expectations of the world we live in are adapted and changed[2]. This new normal came quickly and unexpectedly, and had to cement itself into organisations and individuals during an emergency and, as a result, the pace was rapid. But, as time moves on the new normal has to transition into a new business as usual. This is not a return to normalcy pre-pandemic, but rather a strategy of consistency that adopts COVID-19 learning to substantively address identified shortcomings with a view to facilitating systems, organisations and people to function in a sustainable way, despite the ongoing difficulties and disturbances. This requires:

• The identification of processes to pause or reduce
• The reorganisation of priorities and tasks
• The redeployment of resources[3]

Developing a sustainable pace that will take systems, organisations and individuals through the whole of 2021 might be achieved through analysing lessons learnt and undertaking impact assessments – TMB 17 and TMB 18.

These assessments can help systems, organisations and people to:

• Take stock of their current environment, operations and behaviours to consider whether their pace and activities are fit for purpose and sustainable for 2021
• Take the time to draw on expertise from a whole range of other systems, organisations and people to evaluate their situation
• Take the time to make necessary systematic and sustainable changes to the pace of operations to ensure inclusivity and resilience
• Build relationships and resources beyond an organisation or individual to develop partnerships which may help to reduce pressures and develop a more sustainable pace of operating

In turn, this helps to build approaches for 2021 and the future that can protect systems, organisations, and people, built their resilience and align components of the system (that may unnecessarily be running at a different pace) to increase overall efficiency and resilience.

References:

[1] https://www.health.mil/News/Articles/2020/03/26/In-a-COVID-19-world-pace-yourself-to-stay-resilient-and-avoid-burnout

[2] https://theconversation.com/coronavirus-has-led-to-an-explosion-of-new-words-and-phrases-and-that-helps-us-cope-136909

[3] https://www.alliancembs.manchester.ac.uk/media/ambs/content-assets/documents/news/the-manchester-briefing-on-covid-19-b16-wb-20th-july-2020.pdf

In Greater Manchester UK, the Greater Manchester Combined Authority (GMCA) Ageing Hub, Greater Manchester Health and Social Care Partnership, and partners launched the ‘Keeping Well this Winter campaign’ to support older residents in the region. The resources are designed to:

• Encourage conversations about keeping well during winter using a short film produced by older people, a talking tips guide and booklet to provide clear, practical resources containing key messages for staff and volunteers who have any contact with older residents, their friends or families

Resources are also being distributed directly to older residents through printed copies to avoid digital exclusion.

In addition, to support the promotion and dissemination of this information, a communications toolkit has also been designed for partners and includes:

• Leadership messages
• Briefings and networks/forums
• Internal and external electronic/printed newsletters
• Websites and social media accounts

The tips in these resources may be adapted to apply throughout the year and with other vulnerable people.

In recent years urban planning has revolved around principles of shared spaces e.g. shared offices, vehicles, city squares and parks, and available transport to help people travel to urban centres so that they can access goods and services. COVID-19 has required cities to revaluate these in light of radically changed human behaviour that relies on distancing from one another. Spaces therefore need to be thought about differently, not just as the physical spaces we inhabit, but as complex realities that can meet a variety of functions. Consider how social planning can:

• Relieve loneliness and allow for spending time with friends and family in the open air
• Facilitate alternative safe work environments e.g. moving meetings from offices to outdoor spaces
• Renovating urban spaces to meet new multi-functional requirements while considering the need for green space

Consider also, that social planning may require increased investment in infrastructure and services such as:

• Free and reliable WiFi in outdoor spaces to help meet the requirements of spaces as places that can accommodate work
• Localising 'downtown' areas e.g. ensuring every neighbourhood is serviced with essential shops and services to avoid unnecessary travel

Research suggests that the effectiveness of the COVID-19 vaccine will be heavily affected public attitudes about vaccination. For a highly infectious disease, even a vaccine with adequate efficacy, pace, and coverage may be insufficient to tackle population dynamics (e.g. age and population size) that produce high disease prevalence. Consider public messaging to:

• Foster widespread public understanding and enthusiasm for vaccination, while addressing sources of hesitancy for vaccines (generally and for COVID-19)
• Promote vaccine acceptance through culturally-sensitive, evidence-based and local communication
• Promote the continued need for other prevention practices even after a vaccine becomes available as reducing transmission requires a sustained commitment to public health practices
• Ensure that vaccines are understood by all communities, particularly underserved groups for which longstanding disparities in vaccination coverage have been evident

In Palestine, officials invited young people to share ideas that they felt could help address the impacts of COVID-19. This has been supported by successful initiatives such as the establishment of a Youth Committee on the Palestinian Water Authority as a means of helping to develop the sector. Members of the Youth Committee were also involved in the 2020 Palestinian National Development Agenda. The Palestinian government and Youth Committee have built on their learning and expertise in these sectors to provide innovative ways of addressing COVID-19. Consider:

• Placing Youth Committees at the heart of public awareness campaigns about areas they have been involved in e.g. in Palestine, water consumption and management during COVID-19
• Utilise young people in the creation of innovative smart apps, and online information e.g. in Palestine, the "PalWater App", which provides a platform for customers and service providers to communicate. The application also acted as an alarm reporting system where young people could upload live images and their locations to help citizens notify local authorities of real-time issues
• How involving young people in COVID-19 recovery and resilience can help to build integrated and sustainable long-term solutions e.g. in Palestine, the water sector initiative is being replicated with the Palestinian Ministry of Social Development to establish more youth committees at the local level

All areas of peoples' lives have been impacted by COVID-19 in a multitude of different ways. Compassion acknowledges that people may be suffering, and promotes sensitivity about the issues affecting people. Compassion during COVID-19 should acknowledge that while everyone has been impacted, they will have been impacted differently. Recognising these differences will help to build transparency and authenticity within the organisations. Consider how to develop a compassionate organisation through:

• Creating safe spaces where people can air their concerns and views
• Ensure there are processes in place to address legitimate concerns and views
• Regularly check-in with those within the organisation to actively enquire about their wellbeing - reducing the expectation and pressure on people to self-mobilise support mechanisms
• Anticipate needs e.g. be aware of pressures, deadlines and potential for burnout
• Believe people when they say they are struggling and trust that they are doing their best
• Consider being transparent about your own struggles, but be aware of establishing boundaries
• Note that compassion does not lower expectations within the organisation or undermine people's roles and responsibilities. Rather, it creates a healthier organisational environment that can reduce anxiety, fear and shame

Period poverty has increased sharply in the UK since the COVID-19 pandemic. Period poverty is defined as the struggle to pay for basic sanitary products on a monthly basis. Reports from one charity state they have supplied almost six times as many menstrual products compared with before the pandemic started. Around one in five people have experienced period poverty in the UK which has a significant impact on hygiene, health and wellbeing. Period poverty has risen as result of self-isolation, loss of income, and loss of access to services which may have provided free sanitary products. Scotland has become the first country in the world to provide free and universal access to period products, and places a legal duty on local authorities to make period products available for all those who need them. Consider how to:

• Encourage schools, colleges and universities to provide sanitary products for free
• Encourage businesses and places of work to provide sanitary products
• Establish programmes where sanitary products are distributed to low-income households
• Partner with pharmacies to offer free sanitary products to those eligible for free prescriptions
• Raise awareness of trans, non-binary, and genderqueer people's rights to access sanitary products and ensure provision to them

As the COVID-19 pandemic continues on, people around the world have been utilising black markets to purchase negative COVID-19 test results to enable them to travel. False negative COVID test certificates have been sold for around $300 USD. Systems which email test results can be easily bypassed by downloading and doctoring documents e.g. changing the date of the test, name and test result. Consider how to manage and mitigate proliferation of false negative test results:

• In Hawaii, only results from approved testing partners will be accepted, and they must be transmitted digitally, rather than using emails
• Utilising apps that centralize health and lab data and test/vaccination results e.g. CommonPass, trialled by United Airlines and Cathay Pacific Airways

During the pandemic public toilets have been closed with a view to reducing possible sites of COVID-19 transmission. This has resulted in reported increases in open defecation and urination, which could create another public health crisis. Also, the closure of public toilets can negatively impact people's wellbeing and mental health as some people may not feel comfortable using outdoor spaces for fresh air and exercise without knowing there is a public toilet available. Consider guidelines on:

• The safe opening of public toilets in 'BS 45005 Safe working during the COVID-19 pandemic - General guidelines for organizations'
• Revisions of BS 6465 Sanitary installations: Part 1 Code of practice for the design of sanitary facilities and scales of provision of sanitary and associated appliances, and Part 4 Code of practice for the provision of public toilets

Previously, employers in the USA have supported influenza preparedness by providing on-site clinics to administer flu shots for their staff. It may be possible for organisations to use previous arrangements and infrastructure for flu vaccination to support the COVID-19 vaccination programme. If organisations do not have such infrastructure, developing it could help support COVID-19 vaccination programmes and expedite employees return to work. This may be dependent on the type of vaccinations available and requirements for their storage. When a COVID-19 vaccine is widely available and accessible consider:

• Making vaccination a part of worksite wellness programmes whereby staff can be vaccinated at an onsite clinic provided by their employers
• How employers can provide supplementary support in tackling COVID-19 transmission, alongside the vaccine, through educational material on preventative measures e.g. mask wearing, to promote long-term public health compliance

We describe the background, perspective, research design and approach, our work and deliverables and our team. To read this briefing in full, follow the source link below to TMB Issue 27 (p.2-5).

Interface management considers how to streamline communication, monitor progress and mitigate risks when working with multiple contractors, subcontractors, and clients. This is particularly important during COVID-19 where the government may set out its requirements in contracts, but the actual delivery of a service is done through third parties. One example where effective interface management failed was in the outsourcing of a security firm to supervise quarantined travellers in a hotel in Victoria, Australia. The firm were asked to undertake their 'normal' tasks monitoring movement, alongside biohazard containment which required extensive specialised training they did not have - ultimately leading to widespread transmission of COVID-19. Given the number of outsourced services (e.g. in transportation, security, and health), consideration should be given to the new ways in which service delivery and health merge:

• Evaluate what can reasonably be expected from a contractor given their expertise and resources and provide additional training or resources to ensure COVID-safe services are delivered
• Ensure agreements, resources and expectations for COVID-safe provision are discussed and understood by all parties involved in delivering a service e.g. from government to outsourced supply chains
• Evaluate the impacts of performance-based metrics for services against short and long-term risks to delivery and to health
• Consider who is responsible for 'regular risks' (e.g. costs, lateness and cancellations of services etc.) during COVID-19 and who should manage the public health risks -ensure regular updates are communicated amongst all parties to provide an informed approach of regular and COVID risk and where they converge

The Royal Society of Arts (RSA) has published a 'how to' guide that outlines how to organise a citizen’s assembly, to discuss and understand the impacts of COVID-19. A Citizens’ Assembly is a representative group of citizens who are selected at random from the population to learn about, deliberate upon, and make recommendations in relation to a particular issue or set of issues. The RSA has also launched a 'Future change framework' which can work conjointly with a citizen’s assembly to support community conversations about the impact of COVID-19, recovery and renewal, transition to a post-COVID world, and support communities to heal. The framework includes ways to consider:

• How people have responded to Covid-19 and how that can drive positive change
• What communities and individuals have stopped doing, paused, put in place temporarily, and innovative strategies which could be continued
• How to evaluate the next steps and actions for the future for organisations, local communities, teams, or networks

Time is a main barrier to learning lessons and implementing actions from those lessons. However, learning lessons while an event is still unfolding provides contemporaneous thinking to help guide actions. Organisations or all sorts can identify and learn their own lessons, feeding into industry/association calls for learning. Consider:

• Appointing someone to identify lessons during events
• Maintaining an up-to-date log of lessons to capture learning and support institutional memory
• Using the log of lessons dynamically and reflectively to asses performance and guide debriefs
• Coordinating the lessons learned across an area or industry to pool learning for greater effect, to bring the system together to share context specific learning through:
  • Holding workshops and industry seminars
  • Liaising with academic institutions, networks/associations, and business centres
  • Promoting information widely through various medias e.g. online and in print
• Guidance on collating lessons to assess performance and processes for debriefing can be found in TMBs 18 and 22

Recent research in the UK suggests that people are planning to drive more in future than they did before the coronavirus pandemic, despite the fact many people accept human responsibility for the climate crisis. The preference to travel by car is likely the result of people feeling unsafe on public transport as a result of COVID, reduced public transport services, and a lack of trust in services. To encourage tangible action on climate change for recovery and renewal from COVID-19, localised climate policies for transport can consider:

• Limit and reduce measures to increase road capacity as research suggests new road capacity encourages more traffic and increased emissions
• Introducing low emission zones and/or congestion charging areas - the funds from these can be used to subsidise public transport
• Invest in rapid transition to electric vehicles for public services e.g. public transport, waste removal, and for vehicles that are required to be used by council staff (a 'grey fleet' of vehicles used by staff but not owned by the council)
• Build reduce car use into local plans to consider quality walking and cycling routes, and the provision of transport and delivery hubs to enable the use of cargo bikes and similar for deliveries
• Require that all taxis are electric vehicles through licensing regulations

The SDGs, represent the world's agreed economic, social, and environmental targets for 2030, and can act as a common scorecard to ensure there are objective standards for assessing progress. Localising the ambition of the SDGs to develop local economic development strategies can help integrate social and environmental standards within local economic agendas, reduce disparities between regions, generate local business opportunities and jobs, and aim to include all marginalized communities. Consider how the SDG framework can support inclusive and diversified economic growth:

• Integrate SDG targets into on-going budget reviews process, thereby improving resource allocation and performance evaluation
• Examine the link between ongoing public policies, the SDG targets and budget expenditures
• Analyse the official indicators related to budget-planning instruments
• Partner with the private sector to launch impact investment initiatives that address the SDGs, recovery and renewal from COVID-19 and sustainable economic renewal

Organisations must ensure they, their employees, and people who visit their workplace are complying with COVID-19 safety measures e.g. wear a mask, sanitize and maintain social distancing. As time goes on and people become fatigued with regulations, standards may slip. It is the organisation's responsibility to ensure due diligence in identifying risks and mitigating them. This may require increased surveillance of working practices and trained Compliance Officers who specialise in encouraging compliance. Consider that Compliance Officers can:

• Ensure that COVID-19 safe practices in the workplace are updated, communicated, trained, and monitored effectively
• Constantly seek good practices from elsewhere and systematise these to enhance protection of people at work
• Balance legal requirements with response actions to ensure safety comes first
• Be a single, expert point of contact to address issues related to COVID-19 in an organisation
• Constantly evaluate workplace compliance with the regulations and report on breaches

Building on TMB 24 (People) and 25 (Place), this briefing focuses on Renewal through Processes, concerning changes to ways of working, rules, procedures and access to services. To explore this we discuss some of the overarching conditions that influence why renewal through Process may be needed, we consider how Reshaping and Reorganising can assist in assessing performance of Processes for renewal and we present our thinking on a structure way to operationalise Reshaping and Reorganising Processes in the context of COVID-19.

Follow the source link below to read this briefing in full (p.2-5).

A key model (followed by many countries) to help protect jobs, workers and the economy has emphasised job retention through wage subsidies, layoff restrictions, and short-term compensation schemes. In Greece, initial data suggests that job retention was an effective means of reducing large-scale unemployment - and that additional work is needed to create new jobs. This suggest that strategies to protect jobs should also consider proactive policies to enhance employment possibilities for unemployed and otherwise vulnerable workers to avoid long-term chronic unemployment. Consider:

• Investing in training designed for a 'post-COVID-19' labour market e.g. focusing on upskilling in technical and internet-based skills
• Investing in infrastructure in organisations to support new types of jobs and ensure funds are allocated to ensure employees have adequate resources for the job (e.g. hardware and adequate internet access)
• Allocate funding to improve technical systems for effective job search and job matching, alongside relevant skills training for the new job
• Utilise learning from the pandemic about technology adoption and innovation, the digital divide, and the impact this can have on access to employment and ability to undertake work at home or online

Primary health care workers providing care in remote areas have faced challenges during COVID-19 including inaccessibility to locales, poor hospital infrastructure and facilities, and meeting the needs of vulnerable communities. In Australia, remote health services also face challenges in maintaining adequate appointment and retention of healthcare workers. Consider how to protect remote healthcare staff and remote communities, for example:

• Be mindful of competition between remote and metropolitan areas for staff and resources during COVID-19
• Consider the reliance of remote health services' on short-term or fly-in, fly-out/drive-in, drive-out staff, and the increased risk of transmission into remote areas
• Ensure there are adequate point-of-care COVID-19 testing sites in remote communities to avoid unnecessary travel to centralised locations and to reduce delays in test results
• Consider distribution and storage challenges in maintaining adequate stocks of PPE. Remote health service may also benefit from stocks of hygiene products to distribute to community households through remote health services
• Ensure remote health services are meeting regularly with other essential services e.g. police, schools, and hospitals locally and regionally, to develop local plans for concurrent emergencies in isolated areas
• Ensure the availability of an adequate, appropriately trained local workforce, especially for outbreaks in healthcare buildings
• Consider heightened costs for accommodation for remote healthcare workers due to staffing constraints or COVID-related isolation
• Consider staff burnout due to impact of insufficient staff, frequent orientation of new staff, concerns about the clinical and cultural competency of incoming short-term staff and continuity of care

Social distancing and restricted movements are important measures to control transmission of COVID-19. But the efficacy of this may be improved by increased focus on targeted information that focuses on behavioral change. Persistent spikes in COVID-19 cases has promoted debate about the effectiveness of restricted movement as a preventative measure in and of itself. Lessons from Malaysia suggest that increased attention should be paid to communication strategies that focus on:

• Instilling new norms into people's daily lives through consistent and clear messaging from health officials
• Specific risk behaviours, preventive behaviours, illness behaviours, and compliant behaviours associated with cultural values, perceptions, belief, and attitudes
• Feedback from the public to improve and refine the communication process
• Reinforcing desired behavioural changes through continued behavioural change interventions, namely, capacity building, policy implementation and enforcement, resource mobilization and participation of various players including government, nongovernmental organizations, civil society groups and the target population
• Enhanced localized community messaging that is place specific
• Provision of regular, transparent data to the public in easy to understand formats. Do not decrease the level of open, detailed government information
• Targeted communications for specific hotspots such as some places of work (e.g. construction sites in Malaysia where infection spread quickly because of working conditions), and through providing guidance to associations, clubs and schools
• WHO 'Guidelines for Developing Behavioural Change Interventions in the Context of Avian Influenza' has some useful information on developing Behavioural Change Interventions here.