key: cord-1005733-1ickck5e
authors: Greiner, Ashley L; Nguyen, Laura; Shamout, Mays; Krishnan, Sharanya; Stowell, Daniel
title: COVID-19 intra-action reviews: potential for a sustained response plan
date: 2021-03-02
journal: Lancet Glob Health
DOI: 10.1016/s2214-109x(21)00078-4
sha: 381cdd349abf720590573d18ae3e9132093409d2
doc_id: 1005733
cord_uid: 1ickck5e

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However, given that 26 of 33 countries that have already completed an intra-action review are experiencing ongoing SARS-CoV-2 transmission at the time of writing, 3 the retrospective intra-action review process does not sufficiently address ongoing and protracted response planning. Within this context, we advocate for the inclusion of a prospective response examination in the intra-action review process-ie, examining how to sustain response measures to ensure resiliency and plan effectively for the future.

For prospective response planning, we propose additional intra-action review questions that address two thematic areas: first, workforce resiliency, defined as the physical and mental wellbeing of responders; and second, operational resiliency, defined as the ability to deliver crucial ongoing response operations. The US Centers for Disease Control and Prevention has released COVID-19 sustainable response planning guidance for non-US settings, 4 which "aims to identify critical considerations for response leaders developing sustainable and effective COVID-19 response plans. The document defines key factors underlying the monitoring and evaluating of both workforce and operational performance". Additionally, the questions aim to elicit discussion on the strategy for transitioning COVID-19 response-driven operations to public health programmes during a protracted response. This operational resiliency strategy can: "1) distribute the responsibilities and response efforts across the public health system to [alleviate] the demands on the response coordination unit; and 2) ensure long-term sustainability of these operations with early incorporation [in] the public health system." 4 This guidance includes more than 60 This is an Open Access article under the CC BY-NC-ND 4.0 license. agreiner@cdc.gov . We declare no competing interests. The findings and conclusions in this Correspondence are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.

Author manuscript Lancet Glob Health. Author manuscript; available in PMC 2022 May 01. prospective response planning questions aligned with the current WHO COVID-19 strategic preparedness and response plan's nine public health response pillars. 5 As 25 countries are currently planning an intra-action review, we urge countries to focus the review on crucial, immediately implementable activities and to expand the review questions to include workforce and operational resiliency considerations. Including a retrospective review of lessons learned from the response thus far and preparing for an ongoing COVID-19 response through prospective planning are both crucial components to ensure a sustained and effective response strategy. The complementary approach of linking immediate response needs and anticipating future response requirements is crucial for any public health emergency and should be considered in future protracted responses as a standardised approach for intra-action reviews.

The necessity for intra-action reviews during the COVID-19 pandemic

Guidance for conducting a country COVID-19 intra-action review (IAR)

WHO. WHO coronavirus disease (COVID-19) dashboard 2020

COVID-19 sustainable response planningguiding questions for response workforce and operational resiliency considerations in a protracted response

Monitoring and evaluation framework-COVID-19 strategic preparedness and response 2020