Mahshid Abir

The End of the U.S. COVID-19 Public Health Emergency: Q&A with RAND Experts

We asked RAND experts to reflect on the past three years: What were the effects on the United States and around the world, what has changed, what are the most important takeaways, what was done right, and what was done wrong? At the same time, they looked ahead to what might be done to mitigate the health and geopolitical impacts of future pandemics.

An Opportunity to Learn from Our COVID-19 Successes and Failures

COVID-19 showed that the U.S. pandemic response plans of the past were no match for a protracted nationwide health emergency. What lessons were learned that could help the United States effectively protect its population and other vital national interests going forward?

Healthy Nation, Safe Nation: Build Health Security into National Security

The COVID-19 pandemic revealed a need for a more-robust health security paradigm within the broader national security context. But addressing preparedness and response shortfalls for national-level challenges might not be fully possible without first addressing the glaring seams and gaps between the various stakeholder communities.

Earthquake in Turkey, Syria: Insights from RAND Researchers

Thousands of people have been confirmed dead in one the strongest earthquakes to hit Turkey and Syria in the past century. As search-and-rescue missions ended and recovery began, a handful of RAND researchers shared some of their initial thoughts.

Toward 'Smarter' Federal Funding of Public Health Emergencies

The next public health emergency or large-scale disaster may be looming. It may be time to rethink the way federal relief funds are sought and allocated so that aid is more rapidly, accurately, and fairly distributed to hospitals and health systems. This could help ensure patients and communities get the care when and where they need it when crisis hits.

In Search of an Equity Lens: A Physician's Journey

Patient health outcomes, communication with providers, and overall patient satisfaction improve when patients and providers share a similar background. Further, diverse work environments may positively impact health care provider job satisfaction. Increasing diversity in health care work settings is a first important step that could help to increase equity and inclusion in these environments.

Tunisia: Challenges and Successes in COVID-19 Pandemic Response

Tunisia's response to the COVID pandemic has been spotty, though vaccination rates have improved and mortality rates have dropped. When the political instability is factored in, Tunisia's emergence from the pandemic may not be quick.

Jordan: Challenges and Successes in COVID-19 Pandemic Response

Lockdown restrictions that may have contributed to low COVID-19 case numbers in Jordan early in the pandemic resulted in economic stresses and increased psychological distress in the general population. RAND researchers identified challenges faced by Jordanians during the crisis and the country's innovative and equitable response to mitigate them.

Qatar: Challenges and Successes in COVID-19 Pandemic Response

Qatar adopted a spectrum of policies and health measures to contain the spread of COVID-19 and encouraged its innovation ecosystem to play a role in fighting the pandemic. The health sector has gained experience during the pandemic that might inform response to future spikes in demand for health system resources.

Lebanon: Challenges and Successes in COVID-19 Pandemic Response

In Lebanon, COVID-19 infections, hospitalizations, and daily deaths continue to decline. This is an accomplishment worthy of celebration in the midst of hyperinflation, all-time high unemployment, nadir purchasing power, and a health sector on the verge of collapse.

Iran: Challenges and Successes in COVID-19 Pandemic Response

Iran has faced an uphill battle since the first cases of COVID-19 were found in the country. Despite limited resources, Iran has also had its share of successes and innovations in combating the virus.

No Patient Left Behind: Considering Equitable Distribution of Telehealth

The pandemic has revealed telemedicine's potential to improve health care delivery and access. Telemedicine could help reach patients who would normally be excluded or alienated by the traditional structure of the health system.

When It Comes to U.S. Health Systems—Diversity Matters

Health care systems are a powerful and relatively well-resourced stakeholder in the effort to eliminate inequities both among the health workforce and among patient populations. The deliberate practice of increasing diversity within the workplace may have the power to create significant, positive impacts on workplace culture and patient care.

Out of the Ashes: Forging the Post-Pandemic U.S. Health System

With shifting insights, new problems, and exacerbation of old problems revealed by the pandemic, innovative solutions in the U.S. health system are being adopted where rapid change would normally have been rare. There is both an opportunity and a responsibility to assess how these changes are working and where they can improve health, reduce inequity, and save money.

Needed: A Blueprint for a Post-Vaccine World

When a COVID-19 vaccine is developed, many in rich countries may be able to afford it while the poor and uninsured may not. The time to plan for equitable access, financing, intellectual property rights, and global production is now.

Amidst a Pandemic, a Mental Health Crisis May Be Looming

The effects of the COVID-19 pandemic on health care workers' mental health could be significant and may weaken the health care system's ability to resolve the crisis and survive over the long term. Interventions to promote psychological well-being should be implemented now.

Implement Critical Care Surge Strategies Now to Save Lives

As COVID-19 continues to spread, hospitals are bracing for a surge of patients requiring critical care. To meet the demand, U.S. health care facilities may need to fundamentally change the way they allocate space, staff, and equipment.

COVID-19: A Stress Test for a U.S. Health Care System Already Under Stress

There are many things hospitals and health systems could be doing in the coming weeks to best prepare for the advancing novel coronavirus (COVID-19) outbreak. Evaluating their surge response plans will be critical.

Coronavirus Outbreak Intensifies: Q&A with RAND Experts

Cases of the coronavirus have now spread to several dozens of countries, infecting thousands and thousands of people across the globe. With concerns about the disease rising, we asked a group of RAND researchers to answer a wide range of questions about the crisis.

At the Interface of the Health Care System and the Community: Insights from an Academic-Community Partnership in Camden, New Jersey

Asthma is a common and expensive childhood condition that erodes quality of life for kids and families. Researchers sought to identify patient-centered interventions to reduce avoidable asthma-related acute care use and improve outcomes. They found that the solutions lie at the nexus of the health care system and the community.

After School Shootings, Children and Communities Struggle to Heal

School shootings leave wounds that affect students, school staff, families, and communities for years. Building community resilience, implementing evidence-based mental health support early, and providing access for survivors and the community immediately and in the long term could help promote healing and prevent more tragedy.

On Nurse Staffing Ballot Measure, Massachusetts Voters Should Look to Evidence from California

Massachusetts residents will soon vote on the Patient Safety Act, a mandate to increase nurse-to-patient ratios in acute care facilities. Evaluating existing data on the impact of a similar nurse staffing law implemented in California in 2004 may help inform voters as they head to the polls.

Anticipating Harvey's Toll on Health and Health Care

After Hurricane Harvey, challenges to the health of affected communities and the health care systems that serve them are expected to grow. Among the problems are closures of hospitals, pharmacies, and dialysis centers. Lessons from Hurricanes Katrina and Sandy could help relief efforts.

Lessons for First Responders on the Front Lines of Terrorism

Given the persistent risk of terrorist attacks, it is critical to learn from past incidents to prepare for future ones. Medical and nonmedical first responders need more training in basic lifesaving skills. Open communication lines such as a dedicated radio frequency could help responders better coordinate. Disaster drills are also essential.

Need a Doctor Now? Solve the Acute Care Crisis

Many Americans struggle to receive acute care when they need it. The health care system is not focused on meeting unscheduled needs. Reforming acute care delivery will require making it a policy and research priority.

Community Resilience Is Key in the Aftermath of Flint's Lead Water Crisis

For Flint to recover from this latest disaster, it will be critical for the public, private, and nonprofit sectors to invest in and implement strategies to build on existing community resilience and strengthen Flint's ability to bounce back.

Saving Lives After Tragedy

Natural and man-made mass-casualty incidents are a growing threat. Evaluating successes and shortcomings after each crisis can contribute to the design and implementation of robust and resilient response systems and ensure the best possible outcomes for individuals and impacted communities.

Another Nepal Earthquake Makes Disaster Relief Planning Even More Important

Leadership, coordination, communication, and involvement of local stakeholders are critical in order to mount an informed response to natural disasters. Improved disaster management in Nepal could help limit the suffering of impacted communities and help secure a more successful recovery in the long run.

Ebola Shows America Needs Better Disaster Preparedness

Crafting an effective, whole-community strategy to respond to Ebola could stop the spread of the disease now and lay groundwork for responses to future outbreaks and other emergencies. In the long run, this could make public preparedness and resilience valuable assets for the U.S.

One Year Later: Hurricane Sandy's Lessons in Resilience and Recovery

The recovery from Sandy shows once again that how well communities bounce back from disasters depends not just on how they react after a crisis, but on how resilient they have made themselves beforehand. Building community resilience should be part and parcel of disaster preparedness.

Moore Must Be Ready for Psychological Aftermath

Ensuring the availability of needed mental health resources was critical in the immediate aftermath and recovery phase of the 2011 Joplin, Missouri tornado. Authorities in Oklahoma must ensure that such services are in place early so that Moore's residents can begin the long journey to recovery.

From Boston to Oklahoma—Lessons for the Regional Trauma Response System

Three mass-casualty events occurring in three very different settings show that disaster preparedness should not be limited to large cities or “target” areas in the United States. One trait that is common to all such events is the need for coordinated, responsive trauma care for victims.

Medical Records Immune to Tornado in Joplin, Mo.

Across the country, electronic medical records, designed first and foremost to make health care delivery safer and more efficient, are proving valuable when disaster strikes, write Mahshid Abir and Art Kellermann.

Report

Identifying Strategies for Strengthening the Health Care Workforce in the Commonwealth of Virginia

The authors of this report assess shortages in Virginia's health care workforce and identify potential interventions to address them.

Research Brief

Recommendations for Strengthening the Health Care Workforce in the Commonwealth of Virginia

This brief describes potential interventions to boost recruitment and retention in Virginia’s health care workforce and increase its structural efficiency. 

Testimony

Tailoring Disaster and Public Health Emergency Preparedness, Response, and Recovery to the Needs of Older Adults and Disabled Americans

Testimony presented before the U.S. Senate Special Committee on Aging on June 15, 2023.

Report

Strategies for Enhancing Prehospital Outcomes for Cardiac Arrest (EPOC)

The Enhancing Prehospital Outcomes for Cardiac Arrest study sought to identify best practices to address out-of-hospital cardiac arrest events. RAND researchers developed 49 strategies covering all levels of prehospital response.

Report

Key Factors in Designing the Health System–Community Pathways Program for African American/Black Children and Young Adults

This report describes the development of key factors in framework design for the Health System-Community Pathways Program, which aims to increase representation of African American/Black communities in the U.S. health care system workforce.

Report

Pulse-Check: Exploration of Early COVID-19 Pandemic Health Care and Public Health Responses in Select Middle East Nations

This report outlines the results of an exploratory analysis of strategies used by health care systems and public health in response to COVID-19 in five countries -- Iran, Jordan, Lebanon, Qatar, and Tunisia.

Report

Identifying Strategies to Boost COVID-19 Vaccine Acceptance in the United States

This report recommends strategies to help boost COVID-19 vaccine acceptance in the United States in order to reach herd immunity and end the pandemic.

Report

A Comparison of National and International Approaches to COVID-19-Related Measures

The authors evaluate the comparability of commonly used COVID-19 measures within the United States and across countries, and make recommendations for the use and development of measures that would allow for more standardized and valid comparisons.

Report

Health and Social Services in Puerto Rico Before and After Hurricane Maria: Predisaster Conditions, Hurricane Damage, and Themes for Recovery

This overview of health and social services in Puerto Rico includes 31 courses of action to better recover from health crises, build a more resilient system to future disasters, and actively promote health and well-being.

Research Brief

Critical Care Surge Capacity in U.S. Hospitals: Strategies for Responding to the COVID-19 Pandemic

In this brief, the authors present methods for creating critical care surge capacity in hospitals in response to the COVID-19 pandemic and estimate patient capacity, given the number of doctors, nurses, respiratory therapists, ventilators, and beds.

Report

Critical Care Surge Response Strategies for the 2020 COVID-19 Outbreak in the United States

In this report, the authors present strategies for creating critical care surge capacity in hospitals and estimate patient capacity, given the number of available critical care doctors and nurses, respiratory therapists, ventilators, and beds.

Tool

RAND Critical Care Surge Response Tool: An Excel-Based Model for Helping Hospitals Respond to the COVID-19 Crisis

A Microsoft Excel-based tool that allows decisionmakers at all levels -- hospitals, health care systems, states, regions -- responding to the COVID-19 crisis to estimate current critical care capacity and rapidly explore strategies for increasing it.

Journal Article

The Association of Inpatient Occupancy with Hospital-Acquired Clostridium Difficile Infection

These study findings prompt exploration of how hospitals react to occupancy changes and how those care processes translate into hospital-acquired complications in order to inform best practices.

Journal Article

Assessing and Improving Hospital Mass-Casualty Preparedness: A No-Notice Exercise

An exercise developed for hospitals helps them assess and improve their readiness for mass casualty incidents.

Journal Article

An Emergency Medicine-Primary Care Partnership to Improve Rural Population Health: Expanding the Role of Emergency Medicine

Working in partnership, emergency medicine and primary care can address rural populations' most pressing social and medical needs.

Journal Article

Setting Foundations for Developing Disaster Response Metrics 

Review of three natural disasters revealed key categories and specific activities that can be used as an organizational framework to develop standardized disaster response measures and improve future disaster responses.

Journal Article

Cluster Analysis of Acute Care Use Yields Insights for Tailored Pediatric Asthma Interventions

Care patterns for pediatric asthma can help identify differences between types of patients - and possible ways to reduce avoidable hospitalizations.

Journal Article

Using Timely Survey-Based Information Networks to Collect Data on Best Practices for Public Health Emergency Preparedness and Response: Illustrative Case from the American College of Emergency Physicians' Ebola Surveys

Professional associations can use their member networks to collect timely survey data to inform best practices during and immediately after public health emergencies.

Journal Article

Transitions of Care for Stroke Patients Opportunities to Improve Outcomes

This study examines stroke severity, best treatment locations and the associated logistics involved in providing the best care.

Commentary

Intra-Action Report — A Dynamic Tool for Emergency Managers and Policymakers: A Proof of Concept and Illustrative Application to the 2014–2015 Ebola Crisis

Using the Ebola outbreak as an example, the authors introduce a practical proof-of-concept policy analysis tool -- the Intra-Action Report -- that provides a systematic way to capture and communicate progress over the course of an emergency response.

Journal Article

The Impact of a Large-Scale Power Outage on Hemodialysis Center Operations

Comprehensive emergency planning for dialysis centers should include provisions for having backup generators on site, having plans in place for the timely delivery of a generator during a power outage, or having predesignated backup dialysis centers for patients to receive dialysis during emergencies.

Report

The Evolving Role of Emergency Departments in the United States

This report evaluates the evolving role of hospital emergency departments (EDs) in the U.S. health care system. EDs are being increasingly used for complex workups and ED doctors are the principal decisionmakers for half of all hospital admissions.

Research Brief

The Evolving Roles of Emergency Departments

This brief summarizes a RAND analysis of the role of that hospital emergency departments may come to play in either contributing to or reducing the rising costs of health care.

Journal Article

Design of a Model to Predict Surge Capacity Bottlenecks for Burn Mass Casualties at a Large Academic Medical Center

The authors design and test a model to predict surge capacity bottlenecks at a large academic medical center in response to a mass-casualty incident (MCI) involving multiple burn victims.

Journal Article

Electronic Health Records Critical in the Aftermath of Disasters

A fundamental tenet of preparedness for public health emergencies is the reliance on systems that rest on a bedrock of day-to-day use.