Author/Authors :
Johnson, Kimberly A. College of Behavioral and Community Science - Department of Mental Health Law and Policy - University of South Florida, Tampa, FL USA , Keough, Carolyn Operation PAR Inc, Clearwater, FL USA , Hills, Holly College of Behavioral and Community Science - Department of Mental Health Law and Policy - University of South Florida, Tampa, FL USA , Vermeer, Wouter Department of Psychiatry and Behavioral Sciences - Feinberg School of Medicine - Northwestern University, Chicago, USA , Lengnick-Hall, Rebecca The Brown School - Washington University in St. Louis, St. Louis, MO USA , McNulty, Moira Department of Medicine - Section of Infectious Diseases - University of Chicago, Chicago, IL USA , McGovern, Mark Center for Behavioral Health Services and Implementation Research - Department of Psychiatry and Behavioral Sciences - Stanford University School of Medicine, Palo Alto, CA USA , Brown, Hendricks Department of Psychiatry and Behavioral Sciences - Feinberg School of Medicine - Northwestern University, Chicago, USA
Abstract :
Background
The COVID-19 pandemic has created a crisis in access to addiction treatment. Programs with residential components have been particularly impacted as they try to keep infection from spreading in facilities and contributing to further community spread of the virus. This crisis highlights the ongoing daily trade-offs that organizations must weigh as they balance the risks and benefits of individual patients with those of the group of patients, staff and the community they serve.
Main body
The COVID-19 pandemic has forced provider organizations to make individual facility level decisions about how to manage patients who are COVID-19 positive while protecting other patients, staff and the community. While guidance documents from federal, state, and trade groups aimed to support such decision making, they often lagged pandemic dynamics, and provided too little detail to translate into front line decision making. In the context of incomplete knowledge to make informed decisions, we present a way to integrate guidelines and local data into the decision process and discuss the ethical dilemmas faced by provider organizations in preventing infections and responding to COVID positive patients or staff.
Conclusion and commentary
Provider organizations need decision support on managing the risk of COVID-19 positive patients in their milieu. While useful, guidance documents may not be capable of providing support with the nuance that local data and simulation modeling may be able to provide.
