Research published in BMCPublicHealth describes the critical challenges from the perspective of Culturally and Linguistically Diverse communities that were impacted by communication and engagement efforts during the COVID-19 pandemic.
Before COVID-19, outreach activities with the community were undertaken mainly face to face via caseworkers visiting clients, walk-in appointments/consultations, or group meetings . Social participation was encouraged: “
for a lot of the older community, it’s very one-on-one. We implemented the phone checking service where we were identifying the most vulnerable and providing them support and information Compounding this issue was some COVID-19 resources, as they included “technical jargon”, which may have been confusing for people with low literacy or health literacy levels, even if English was their first language. Government materials were not available across all languages, nor were they always available in simplified English that was “accessible” to communities.There are some communities that are missing the information. If we take the example of the South Sudanese community….
“Stop wasting money on things like ethnic press and TV. Sure, they do a good job and are important to a degree. Still, theree is always going to be a gap that you’re not going to be able to plug unless the community takes ownership and gets them to do the communication themselves to the people they are close to”.
”. Having verbal messages was identified as being critical. In some suburbs, organisations resorted to door-knocking to encourage people to go and get tested. “We’ve had GPs; we even had an orthopaedic surgeon present weekly COVID updates to audiences, getting the accurate advice, wash your hands, keep your distance, do all that, and talk about the specifics in the community.”
“We ran workshops called Speaking COVID. We’ve focused on engaging with the interpreters in workshops…. We did those bi-language group, and we had some content that talked about what does airborne transmission mean and what’s a droplet, what does isolation mean, and does quarantine mean, and all of the terms that became really common in that period and explained those in ways that the interpreters could understand so that they could, in turn, interpret them appropriately for the clients.” .
” . As a solution, it was suggested that education resources be developed from scratch with the targeted communities, which are not only language-specific but also count for the nuances within the community. The videos should include local faces and phrases known in the community”.In other words, you end up with 20 slightly different documents.
the service providers might send them something, Department of Health sends them something, and then their workplace sends something else, so it creates a lot of misunderstanding, but it creates a lot of confusion for the young people” .
In Queensland, we have quite strong regionalism, and people in the region are sometimes sick of being told what to do by Brisbane all the time. The decisions are from Brisbane in an urban area, and they don’t always understand what’s happening Two events were signalled as the triggers for the governments revising their approaches. The first event was the hard lockdown in nine public housing towers in inner Melbourne, Victoria. There were significant delays in preparing and distributing materials about the lockdown in community languages and an absence of interpreters. The second event was the issue regarding the translation of COVID-19 materials and the mix-up in languages, including one document with mixed Farsi and Arabic words.
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Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation - Critical CareBackground Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients. Methods 673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival. Results Most patients were between 50 and 70 years of age. PaO2/FiO2 ratio prior to ECMO was 72 mmHg (IQR: 58–99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41–0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28–1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI | 35 (compared to | 25), absence of renal replacement therapy or major bleeding/thromboembolic events. Conclusions Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival. Trial registration Registered in the German Clinical Trials Re
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