Issues and Insights on COVID-19

“During the COVID-19 pandemic, we recognize the need for knowledge to shape behavior, evidence to influence policies, and frameworks to guide decision making. My colleagues at Penn and I offer our insights and experience to help you navigate these times from an informed perspective.”
~ Ezekiel J. Emanuel, MD, PhD

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Ethics, Policy, and COVID-19 is a special production from the faculty and online education team of the Department of Medical Ethics and Health Policy at the University of Pennsylvania. 

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Current Content

COVID-19: Transmissions, Risks, and Reopenings

What have we learned in the several months since COVID-19 was declared a pandemic by the WHO? Zeke Emanuel answers the following questions:

  • How does COVID-19 spread?
  • What risk factors increase exposure of COVID-19 transmission—and what activities have lower or higher risk?
  • What are superspreader events?
  • How can schools and businesses be reopened safely?

Zeke Emanuel is a highly sought-after expert in health care, advising the Obama Administration and the WHO. He is a global voice of knowledge and reason during the pandemic—and a visionary in online education for health care professionals.

COVID-19: Transmissions, Risks, and Reopenings

Posted October 30, 2020

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Related Material

COVID-19 Risk Index (graphic mentioned in the video)

K-12 Relative Risk Index

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COVID-19: Rationing

Topics in this 3-video series include:

  • the nature of the COVID-19 outbreak 
  • the current rationing dilemmas and principles 
  • 6 specific recommendations that arise from applying these principles to the COVID-19 pandemic

Want to earn continuing education for this content? Learn more.

Zeke Emanuel is a highly sought-after expert in health care, advising first the Obama Administration and currently the WHO. He is a global voice of knowledge and reason during the pandemic—and a visionary in online education for health care professionals.

Recorded in late March 2020, posted April 6. 

Related Material

How Can Hospitals Address Scarce Resources During Covid-19? Because So Many People Don't Know, Penn LDI Researcher Julia Lynch Has Created a Guide” by Hoag Levins, Leonard Davis Institute of Health Economics. April 2020

“Most hospitals have general contingency plans for resource allocation in times of medical scarcity — like the current COVID-19 pandemic. But they don't have detailed guidelines for the process of actually making those allocation decisions in a fast moving and often conflicted crisis environment. Penn School of Arts and Sciences political scientist and LDI Senior Fellow Julia Lynch, PhD, has now created those guidelines.”

Medical Ethics post-doc Isabel Perera, PhD, worked with Prof. Lynch to research and write Procedural Guidelines for Scarce Resource Allocation Teams (SRAT) Under COVID-19: Promoting Fairness, Transparency, and Accountability.

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Leadership in a Time of Uncertainty and Change

Starting with the evidence-based statement that during times of uncertainty and change, leaders’ decisions have greater impact, Mike Useem offers expert guidance for leaders today. Topics include: 

  • Personal leadership strategies for making effective decisions
  • How organizational architecture and culture drive strategy
  • Creating a mission-driven plan 
  • The qualities of a complete leader

Michael Useem, PhD, is a Professor of Management and Faculty Director of the Leadership Center and McNulty Leadership Program at the Wharton School. 

Atul Kalanuria, MD, FACP, MHCI, is a neurointensivist at the University of Pennsylvania and an alumnus of the Master of Health Care Innovation at Penn.

Leadership in a Time of Uncertainty and Change

Posted November 10, 2020

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It’s Your Leadership Momentfrom Knowledge@Wharton by Michael Useem, PhD, published March 30.

In this opinion piece published by Knowledge@Wharton, Michael Useem, PhD, addresses:

  • the potential for leadership at all levels 
  • the three most essential leadership actions, with recent examples from various industries and government 
  • a personal checklist for exercising your own leadership.
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COVID-19: A Primary Care Perspective

Primary care physician Aimee Ando reflects on her practice’s shift to telemedicine to provide safe, high-quality, accessible care to their patients during COVID-19—and how their experience may influence future care. 

Family medicine physician Aimee Ando, DO, MHCI, is Associate Medical Director of Practice Transformation and Director of Diversity, Equity, and Inclusion for Penn Medicine.

Jennifer S. Myers, MD, is a Professor of Clinical Medicine at the Perelman School of Medicine and an instructor for the MEHP Online course Transforming Health Care Delivery.

COVID-19 - A Primary Care Perspective

Posted September 29, 2020

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Controlling COVID-19

How do you develop individual habits and build community support for public health, such as wearing masks? This panel conversation, recorded in July 2020, explores that question through a behavioral economics lens, with a focus on college campuses.

This video is an excerpt from a session during the 2020 Master of Health Care Innovation Seminar: Innovating and Leading through Disruption.

Kevin Volpp, MD, PhD—Director of the Center for Health Incentives and Behavioral Economics (CHIBE)—moderates this discussion with the following thought leaders:

  • Alison M. Buttenheim, PhD, MBA, Associate Director of CHIBE
  • Vivian Lee, MD, PhD, MBA, President, Health Platforms, Verily Life Sciences
  • Christina Roberto, PhD, Director of the PEACH Lab
  • Mark Smith, MD, MBA, Clinical Professor of Medicine at UCSF
Controlling COVID-19

Posted September 15, 2020

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Optimizing and Implementing Contact Tracing through Behavioral Economics

Optimizing and Implementing Contact Tracing through Behavioral Economics: Contact tracing is not just about making phone calls” by Rinad S. Beidas, PhD; Alison M. Buttenheim, PhD, MBA; Rachel Feuerstein-Simon, MPH, MPA; Austin S. Kilaru, MD; David A. Asch, MD, MBA; Kevin G. Volpp, MD, PhD; Hannah G. Lawman, PhD; and Carolyn C. Cannuscio, ScD

Published June 23, 2020

The effectiveness of contact tracing on reducing the spread of COVID-19 is influenced by people’s behaviors, such as providing information and complying with isolation and quarantine measures. This NEJM Catalyst article draws on behavioral economics as it addresses both research and practice for the best results.

Authors include MHCI and Professional Development faculty members Kevin G. Volpp, MD, PhD, director of the Center for Health Incentives and Behavioral Economics (CHIBE), and David A. Asch, MD, MBA, executive director of the Penn Medicine Center for Health Care Innovation.

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Reimbursing Hospitals for Covid-19 Readiness

Payment for Staying Empty? Reimbursing Hospitals for Covid-19 Readiness: In areas with few cases, must hospital systems pay for unused added infrastructure and foregone revenue from suspended services?” by Christian Terwiesch, PhD; Kevin B. Mahoney; and Kevin G. Volpp, MD, PhD 

Published June 10, 2020

The authors explore ways through which hospitals could receive payment for surplus capacity created in preparation for a surge of COVID-19 patients.

Authors of this NEJM Catalyst article include MHCI and Professional Development faculty members Christian Terwiesch, PhD, and Kevin Volpp, MD, PhD. They are joined by Penn Medicine CEO Kevin B. Mahoney

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Narrative in an Epidemic

Narrative offers a powerful resource during COVID-19, as demonstrated by exploring poems on the themes diagnosis, pain, vigil, and eulogy written by Raymond Carver, Emily Dickinson, and Thom Gunn.

Bioethicist Lance Wahlert, PhD, teaches in both the Department of Medical Ethics and Health Policy and the English Department.

Narrative in an Epidemic

Posted June 8, 2020

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Queering the Quarantine

How might the legacy of HIV/AIDS resonate with the experience of members of the LGBTQ community now experiencing quarantine due to COVID-19? This video reflection explores this question, as well as discrimination in health prevention, new LGBTQ elderly populations, and more.

Assistant Professor Lance Wahlert, PhD, is a bioethicist, disability studies scholar, and queer studies scholar.

Queering the Quarantine

Posted May 26, 2020

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Community Health Workers: Social First Responders

The Penn Center for Community Health Workers—a national center of excellence focused on improving population health through effective community health worker programs, exemplified by their IMPaCT model—outlines their response to community needs during COVID-19, proposes a solution that employs social first responders, and calls for policy updates in order to scale nationally.

Presenters from the Penn Center for Community Health Workers are Shreya Kangovi, MD, MS, Founding Executive Director; Jill Feldstein, MPA, Chief Operating Officer; and Georgieanna Peirre-Paul, Senior Community Health Worker. 

Community Health Workers: Social First Responders

Posted May 11, 2020

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Related Material

 “COVID-19 Webinar Recording” by Penn Center for Community Health Workers. April 16, 2020.  

 “An Effective Way to Tackle the Social Causes of Poor Health” by Shreya Kangovi. Harvard Business Review, May 13, 2019.  

Don’t Throw Cold Water On Health Care’s Hot Spotters” by Shreya Kangovi and David Grande. Health Affairs blog, February 11, 2020.  

Evidence-Based Community Health Worker Program Addresses Unmet Social Needs And Generates Positive Return on Investment” by Shreya Kangovi, Nandita Mitra, David Grande, Judith A. Long, and David A. Asch. Health Affairs 39, no. 2 (February 1, 2020): 207–13.  

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The Struggle of Dementia Patients and Caregivers

As coronavirus shut down support systems, the struggles of dementia patients and caregivers only get worse | Opinion by Sara Manning Peskin, Allison K. Hoffman, and Jason Karlawish, For The Inquirer

What challenges do caregivers and dementia patients face when support systems are closed due to COVID-19? This Philadelphia Inquirer opinion piece responds by telling the story of one couple, scanning the health care and policy landscapes for solutions, and offering a “stay-at-home survival guide” from the Penn Memory Center. 

Authors from the Penn Memory Center are clinical fellow Sara Manning, MD; research scientist Allison K. Hoffman, JD, also a professor at the University of Pennsylvania Carey Law School; and Jason Karlawish, MD, codirector and professor of medicine. 

Related Material 

The COVID-19 Stay-at-Home Survival Guide for Those Caring for a Loved One with Dementia, Penn Memory Center 

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Research in Emergency Settings

Using a framework of research ethics principles, Dr. Baren examines the challenges of conducting research in the emergency setting. She also outlines Federal regulations that govern conducting research without prospective informed consent.

Jill M. Baren, MD, MBE, FACEP, FAAP is an emergency medicine physician and a national expert on the federal regulations which govern emergency research using an Exception from Informed Consent in clinical trials.

Research in Emergency Settings

Posted May 4, 2020

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Disability, Rationing, and COVID-19

About 1 in 4 American adults lives with some type of disability. How might their conditions influence decisions about COVID-19 care when ventilators, for example, are in great demand and short supply?

Emily A. Largent, JD, PhD, RN, is the Emanuel and Robert Hart Assistant Professor of Medical Ethics and Health Policy at the University of Pennsylvania’s Perelman School of Medicine. 

Disability, Rationing, and COVID-19

Posted April 27, 2020

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Related material

"Ethics of Reallocating Ventilators in the COVID-19 Pandemic" by Andrew Peterson, Emily A. Largent, and Jason Karlawish. BMJ. May 12, 2020.

The Ruderman White Paper on Fair Resource Allocation During the COVID-19 Pandemic by Dominic Sisti, Joseph Stramando, and Hanna Shaul Bar Nissim. Ruderman Family Foundation. April 2020.

Office of Civil Rights (OCR) Bulletin on Civil Rights Laws and HIPAA Flexibilities That Apply During the COVID-19 Emergency,” March 28, 2020

OCR Resolves Civil Rights Complaint Against Pennsylvania After it Revises its Pandemic Health Care Triaging Policies to Protect Against Disability Discrimination,” April 16, 2020

The Way We Ration Ventilators Is Biased” by Harald Schmidt. New York Times. April 15, 2020. 

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Population Health and the Economy

The Intersecting Health Disasters of the Pandemic and Its Economic Meltdown from Penn LDI by Atheendar Venkataramani, MD, PhD, and Rachel Werner, MD, PhD 

Recorded April 17, posted April 27, 2020 

What are the likely long-term population health consequences of the coronavirus-driven economic downturn? Penn’s Leonard Davis Institute of Health Economics (LDI) explores the issue in an Experts at Home video and summary article. 

Atheendar Venkataramani, MD, PhD, is an LDI Senior Fellow and Assistant Professor of Medical Ethics and Health Policy. Rachel Werner, MD, PhD, is LDI’s Executive Director and affiliated faculty with Medical Ethics and Health Policy. 

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Tips for Physical Distancing

Behavioral Science Tips for Physical Distancing for Ideas42 by Harsha Thirumurthy, PhD, and Alison M. Buttenheim, PhD, MBA

Posted April 27, 2020

This 2-page tip sheet offers evidence-based strategies for “how local and national governments and other institutions can use behavioral design to help slow the spread of COVID-19 in communities in low and middle-income countries around the world while facilitating social cohesion and the provision of essential services.”

Harsha Thirumurthy, PhD, and Alison M. Buttenheim, PhD, MBA, are both Associate Professors of Medical Ethics and Health Policy at Penn and Associate Directors at the Center for Health Incentives and Behavioral Economics (CHIBE).

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Implications of COVID-19 for the Field of Bioethics

How might COVID-19 influence the focus of medical ethics? To answer that question, Jonathan D. Moreno, PhD, looks back briefly to the origins of bioethics, identifiesits more recent concerns, and then considers what aspects of life and care during the COVID-19 pandemic are likely to require careful attention in the future.

Jonathan D. Moreno, PhD, bioethicist and professor, recently wrote EverybodyWants to Go to Heaven but Nobody Wants to Die: Bioethics and the Transformation of Health Care in America with Amy Gutmann, President of the University of Pennsylvania.

Implications of COVID-19 for the Field of Bioethics

Posted April 20, 2020

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COVID-19: FDA Drug Regulation

Questions answered in this interview include: 

  • Have any new drugs been approved by the FDA for treatment of COVID-19? 
  • Can existing drugs be used to treat COVID-19? 
  • How can providers and patients access drugs to treat COVID-19? 

Want to earn continuing education for this content? Learn more.

Holly Fernandez Lynch, JD, MBe, is an expert in clinical research ethics and regulation, as well as FDA regulatory policy regarding drugs.

COVID-19: FDA Drug Regulation

Recorded on April 3, posted on April 10, 2020

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Related material

Panic Prescribing’ Untested Coronavirus Treatments: A Danger To Patients Today and Tomorrow” by Holly Fernandez Lynch, Alison Bateman-House, and Arthur L. Caplan. Health Affairs blog. March 31, 2020.

FDA resources:  

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