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'Containment, delay, mitigation': waiting and care in the time of a pandemic.

ABSTRACT: In this paper we take up three terms - containment, delay, mitigation - that have been used by the UK Government to describe their phased response to the COVID-19 pandemic. Although the terms refer to a political and public health strategy - contain the virus, flatten the peak of the epidemic, mitigate its effects - we offer a psychosocial reading that draws attention to the relation between time and care embedded in each term. We do so to call for the development of a form of care-ful attention under conditions that tend to prompt action rather than reflection, closing down time for thinking. Using Adriana Cavarero's notion of 'horrorism', in which violence is enacted at precisely the point that care is most needed, we discuss the ever-present possibility of failures within acts of care. We argue that dwelling in the temporality of delay can be understood as an act of care if delaying allows us to pay care-ful attention to violence. We then circle back to a point in twentieth-century history - World War II - that was also concerned with an existential threat requiring a response from a whole population. Our purpose is not to invoke a fantasised narrative of 'Blitz spirit', but to suggest that the British psychoanalytic tradition born of that moment offers resources for understanding how to keep thinking while 'under fire' through containing unbearable anxiety and the capacity for violence in the intersubjective space and time between people. In conditions of lockdown and what will be a long and drawn-out 'after life' of COVID-19, this commitment to thinking in and with delay and containment might help to inhabit this time of waiting - waiting that is the management and mitigation of a future threat, but also a time of care in and for the present.

SUBMITTER: Baraitser L

PROVIDER: S-EPMC7361498 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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'Containment, delay, mitigation': waiting and care in the time of a pandemic.

Baraitser Lisa L Salisbury Laura L

Wellcome open research 20200910

In this paper, we take up three terms - containment, delay, mitigation - that have been used by the UK Government to describe their phased response to the COVID-19 pandemic. Although the terms refer to a political and public health strategy - contain the virus, flatten the peak of the epidemic, mitigate its effects - we offer a psychosocial reading that draws attention to the relation between time and care embedded in each term. We do so to call for the development of a form of care-ful attentio ...[more]

PMID: 32704549

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Project description:BackgroundThe time delay between the start of an influenza pandemic and its subsequent initiation in other countries is highly relevant to preparedness planning. We quantify the distribution of this random time in terms of the separate components of this delay, and assess how the delay may be extended by non-pharmaceutical interventions.Methods and findingsThe model constructed for this time delay accounts for: (i) epidemic growth in the source region, (ii) the delay until an infected individual from the source region seeks to travel to an at-risk country, (iii) the chance that infected travelers are detected by screening at exit and entry borders, (iv) the possibility of in-flight transmission, (v) the chance that an infected arrival might not initiate an epidemic, and (vi) the delay until infection in the at-risk country gathers momentum. Efforts that reduce the disease reproduction number in the source region below two and severe travel restrictions are most effective for delaying a local epidemic, and under favourable circumstances, could add several months to the delay. On the other hand, the model predicts that border screening for symptomatic infection, wearing a protective mask during travel, promoting early presentation of cases arising among arriving passengers and moderate reduction in travel volumes increase the delay only by a matter of days or weeks. Elevated in-flight transmission reduces the delay only minimally.ConclusionsThe delay until an epidemic of pandemic strain influenza is imported into an at-risk country is largely determined by the course of the epidemic in the source region and the number of travelers attempting to enter the at-risk country, and is little affected by non-pharmaceutical interventions targeting these travelers. Short of preventing international travel altogether, eradicating a nascent pandemic in the source region appears to be the only reliable method of preventing country-to-country spread of a pandemic strain of influenza.

Project description:Prolonged waiting times and length of stay in Pediatric Emergency Department, are the two of the most challenging patient and clinical outcomes of healthcare institution. These emerged due to various reasons, namely: the use of triaging process and patient flow criteria that eventually lead to bottlenecks and overcrowding in the ED. After realizing the root causes of the prolonged waiting times and length of stay, the KASCH ED instigated a team to study the factors and thereby arrive at a considerable conclusion that will result in an improvement. The quality improvement project was initiated and steps were undertaken to improve the flow, reduce the waiting times, and reduce the overcrowding in Pediatric Emergency Acute Care Unit. The primary cause identified was inadequate team awareness and lack of the ED process flow, thus creating confusion as to where the type of patients based on the triage level will be assessed, managed and treated. Using the Canadian Triage and Acuity Scale (CTAS) as guide in triaging patients, a theory called Pediatric Rapid Assessment and Management (PRAM) was introduced in the Acute Care Unit. This certain model is basically aimed to rapidly assess and managed the patients who were triaged as Level III and Level IV within a period of 30 minutes. Several PDSA cycles were tested and implemented in order to assure that the process fit the criteria and the process flow will be improved. Following the completion of each cycle, significant improvements were noted, such as patients being assessed in Initial Assessment Room on average time less than the target of 15 minutes. In like manner, patients' length of stay on average less than 15 minutes in PRAM bed. The total time for assessment and plan of management is with a target time of less than 30 minutes. The team continuously drive th process and monitored the key performance indicators of the PRAM during the study period and subsequent improvement strategies were likewise implemented.

Project description:MotivationUnder contemporary market conditions in China, the stock index has been volatile and highly reflect trends in the coronavirus pandemic, but rare scientific research has been conducted to model the possible nonlinear relations between the two indicators. Added, on the advent that covid-related news in one time period impacts the stock market in another period, time delay can be an equally good predictor of the stock index but rarely investigated.ObjectivesTo contribute to filling the gaps identified in existing research, this study models relationship between the stock market index and coronavirus pandemic by leveraging volatility in the stock market and covid data through time delay and best degree in a polynomial environment. The resultant optimal time delay and best degree model is used to derive a high-accuracy prediction of stock market index.NoveltyIn line with the possible relations, the novelty of this study is that it proposes, validates and implements polynomial regression with time delay to model nonlinear relationship between the stock index and covid.MethodsThis study utilizes high-frequency data from January 2020 to the first week of July 2022 to model the nonlinear relationship between the stock index, new covid cases and time delay under polynomial regression environment.FindingsThe empirical results show that time delay and new covid cases, when modelled in a polynomial environment with optimal degree and delay, do present better representation of the nonlinear relationship such predictors have with stock index for China. Relative to results from the polynomial regression without delay, the empirical evidence from the model with delay show that an optimal time delay of 17 weeks makes it possible to predict the stock index at high accuracy and record improvements of 16-fold or higher. The representative delay model is used to project for up to 17 weeks for future trends in the stock index.ImplicationThe implication of the findings herein is that the prowess of the time delay polynomial regression is heavily dependent on instability in covid-related time trends and that researchers and decision-makers should consider modeling to cover for the unsteadiness in coronavirus cases to achieve better results.

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'Containment, delay, mitigation': waiting and care in the time of a pandemic.

Publications

'Containment, delay, mitigation': waiting and care in the time of a pandemic.

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