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Priorities for new syntheses

Priorities for living evidence syntheses about COVID-19 can be accessed here. These priorities are derived from COVID-END’s global horizon-scanning initiative and they are shared – in the form of COVID-END’s global horizon-scanning products – through many COVID-END partners. If you want to receive an email containing hyperlinks to the monthly briefing note in which updated priorities appear, as well as our global spotlights, subscribe here.

The following list reflects the re-ordering of topics by panelists, changes to the wording of topics by panelists, and the addition of new topics by panelists (with these new rows added to the bottom of each part of the list and with a blue row header). Topics for which at least some evidence syntheses are available have a light-green row header, and topics for which we are aware of existing or planned living evidence syntheses have a dark-green row header. Evidence-synthesis teams may wish to take on topics:

  1. that are either not highlighted or are highlighted in blue
  2. review the COVID-END inventory to understand what’s already been done for those that are highlighted in yellow
  3. contact us at covid-end@mcmaster.ca to understand what is being done for those that are highlighted in green.

COVID-END’s global horizon-scanning panel recommends that all evidence-synthesis activities be undertaken with several key considerations in mind, including:

  1. engaging interdisciplinary teams (e.g., laboratory, infection prevention and control, engineering, data modeling, outbreak studies, behavioural and social sciences, equity, science communication, and citizens) alongside methodological experts
  2. committing to:
    1. foreground equity considerations
    2. examine benefits and harms (health outcomes but also economic and social outcomes), citizen experiences, and costs
    3. be attentive to variation in state capacity
  3. committing to explicit cycles or triggers for updating living evidence syntheses (and/or at least to finding a home for an evidence synthesis when an emergent issue becomes long-term or recurring and needs to become a living evidence synthesis).
Rank Prioritized topics from panel
Cross-cutting
1 Optimizing packages of responses (public-health measures, health-system arrangements, and economic and social responses), including combinations of centralized and decentralized approaches, in terms of both their health benefits and their economic and social costs
2 Understanding real-world comparative vaccine effectiveness (in addition to trials data about safety and efficacy), including in relation to variants of concern, and the implications for public-health measures (e.g., vaccine substitution and timing for second dose; changes to infection prevention and control measures; and when herd immunity will be reached) and health-system arrangements (e.g., PPE, cohorting, and HVAC)
*** see health-system arrangements for vaccine roll-out ***
3 Understanding the ‘pipeline’ of SARS-CoV-2 variants, the conditions under which they become ‘variants of concern,’ their transmission characteristics, and their implications for public-health measures (e.g., vaccine choice and sequencing, double masking, quarantine length, and border closures) and for health-system arrangements (e.g., capacity planning, PPE, cohorting, and HVAC systems)
Engaging vulnerable groups in society to develop and customize packages of public-health measures, clinical-management approaches, health-system arrangements, and economic and social responses that are sensitive to equity, diversity and inclusion considerations and that address inequalities in COVID-19 burden
5 Supporting coordination across government sectors and across non-governmental organizations, citizen groups, academia, and others, including ‘non-typical’ stakeholders (both in general and specifically to avoid future cycles of lockdowns and re-openings) and increasing capacity for policy learning across jurisdictions
6 Integrating data systems and monitoring and evaluation mechanisms to support pandemic response
New Capturing lessons learned from this pandemic from the perspective of individual citizens/households in clear and concise ways in order to effectively apply them in future
Public-health measures
1 Supporting adherence to public-health measures, including addressing barriers to adherence (e.g., safe transportation to testing and vaccination sites, paid time off work, and publicly funded isolation facilities), optimizing public messaging about individual- and household-level measures (and using creative formats to convey these messages), and using appropriate behavioural interventions
2 Building rapid-response mechanisms to support interdisciplinary outbreak studies (and addressing litigation and other concerns related to sharing information about outbreaks) and to support timely study appraisals and interpretation (and finding other ways to avoid preprints inappropriately driving action before their quality has been determined
3 Adapting strategies for testing that optimize the use of existing capacity and incorporating neighbourhood-based approaches like sewage testing to identify outbreaks
4 Understanding patterns in and consequences of the greater geographic dispersion of infections, including the role of internal and international migration and of tourism in transmission, and of case fatality rates
Clinical management of COVID-19 and pandemic-related conditions
1 Understanding COVID-19 as a ‘syndemic’ that co-occurs with a range of other communicable and non-communicable diseases that differentially affect population groups, and adjusting supports accordingly
2 Documenting and addressing long-haul symptoms of COVID (also known as ‘long COVID’) among people without severe COVID and/or long-term sequelae of severe COVID
3 Screening for and managing emergent mental health and substance use issues and understanding the links with between substance use and pandemic-related increases in domestic violence and suicide
4 Understanding the protective effects of antibodies (e.g., duration of protection) and the role of auto-antibodies in more severe illness
New Optimizing packages of COVID-19 treatments including drug treatments, respiratory support (including pulse oximetry), and physical interventions such as proning
Health-system arrangements
1 Optimizing vaccine roll-out, including securing and distributing a reliable supply of vaccines and ancillary supplies, allocating vaccines and ancillary supplies equitably, communicating vaccine-allocation plans and the safety and effectiveness of vaccines (and addressing the factors that contribute to vaccine hesitancy in particular population groups), administering vaccines in ways that optimize timely uptake, and surveillance, monitoring and evaluation, and reporting (including the documentation of vaccination status and adverse events)
Restoring non-COVID services after surges (including prioritizing and sequencing service restoration based on risk) and addressing the effects of interrupted care on people with chronic conditions, including those with rare diseases
3 Addressing in an agile way health worker shortages, motivation and wellbeing, including strategies to build resilience, manage burnout, and recruit and retrain staff
4 Leveraging primary care as the foundation for the health-system response to COVID-19
5 Consolidating and optimizing the value achieved through shifts in virtual care (including developing or updating of legal frameworks and policies)
6 Strategic purchasing of supplies and equipment (e.g., personal protective equipment and liquid nitrogen for vaccine storage)
7 Strengthening health-system governance (including by addressing corruption and avoiding the politicization of decision-making processes)
Economic and social responses
1 Financial protection – Enhancing economic security by addressing pandemic-related job losses and adjusting ‘safety nets’ (and keeping in mind differential impacts on women and other vulnerable populations) and enhancing workforce development (in healthcare as well as private businesses)
2 Economic development and growth – Embracing new approaches to public financing that support fairness and equity (especially for women and other vulnerable populations) while avoiding fiscal cliffs (expiring tax cuts and government spending cuts) and debt traps
3 Education - Benefits and risks to students, educators and families arising from school closures, re-openings, changes to operations (e.g., school-year adjustments) and pedagogical innovations (e.g., e-learning) that can support ongoing education
4 Food safety and security – Addressing food supply-chain challenges and food insecurity, including both community-based and nationally led actions
5 Community and social services - Promoting children’s resilience and recovery via social policy
6 Citizenship - Linking citizen and community participation in pandemic planning, policymaking and response with outcomes and capturing innovations in government approaches 
7 Culture and gender – Understanding the additional risks of gender-based and domestic violence arising from restrictions and identifying appropriate ways to address such violence
8 Economic development and growth – Understanding and addressing the impacts of the abrupt shift toward nationalism as a governing strategy for the economy and of the ‘new economy’ imposed on many countries by COVOID-19
9 Climate action – Maximizing the opportunity for synergies between the COVID-19 response and climate action, including exploring a ‘green recovery’
10 Transportation - Safely re-opening the tourism and travel industry and managing the related risks (e.g., through testing protocols) and spill-over effects on other countries (e.g., testing requirements before travel)
New Culture and gender – Confronting pandemic-induced or pandemic-exacerbated racism