'Crisis decision making at the speed of COVID-19' - Bay Area public health officials share their experience with shelter-in-place order

November 24, 2020

November 24, 2020 - In mid-March, public health officials across the San Francisco area issued the first U.S. regional shelter-in-place order in response to the emerging COVID-19 pandemic. A "field report" on the crisis decision-making approach followed in that effective early response is featured in a special COVID-19 supplement to the Journal of Public Health Management and Practice. The journal is published in the Lippincott portfolio by Wolters Kluwer.

"With the benefit of hindsight and reflection, we recount our story through the lens of public health legal authority, meta-leadership, and decision intelligence," according to the new article, authored by Tomás J. Aragón, MD, DrPH, of the San Francisco Department of Public Health along with local health officers (LHOs) from six other Bay Area jurisdictions. Their paper appears as part of a JPHMP supplement titled "COVID-19 and Public Health: Looking Back, Moving Forward."

On March 15, 2020, LHOs in Alameda, Contra Costa, Marin, San Francisco, San Mateo, and Santa Clara Counties and the City of Berkeley issued legal orders for 6.7 million residents to shelter-in-place to prevent the spread of SARS-CoV-2. Within days, other regions issued similar orders. Studies have confirmed that early shelter-in-place orders prevented many COVID-19 cases, hospitalizations, and deaths across the United States.

But even in a crisis, outcomes can't determine whether a decision was good or bad. "The quality of a decision depends only on the quality of the decision-making process at the time the decision was made," Dr. Aragón and coauthors write. They review key elements of good crisis decision making during complex public health emergencies: The Bay Area LHOs hope their experience will draw attention to the elements of crisis decision making - throughout the pandemic and in preparing for future public health emergencies. "Decision intelligence provides practical tools to improve crisis decision making," Dr. Aragon and coauthors conclude. "We hope that with experimentation and practice, public health officials will improve their routine team decisions, and thereby be capable and ready to make better decisions in new crisis situations."
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The supplement presents 18 original research papers and commentaries, focusing on the early phases of the public health response to COVID-19. In an introduction, guest editors Chrissie Juliano, MPP; Michael Fraser, PhD, CAE; and Brian C. Castrucci, DrPH, MA; write: "The knowledge shared in this supplement can be instantly applied to the current public health response to COVID-19 and to help protect the health of all Americans."

The supplement is sponsored by the de Beaumont Foundation, the Association of State and Territorial Health Officials, and the Big Cities Health Coalition.

Click here to read "Crisis Decision-Making at the Speed of COVID-19: Field Report on Issuing the First Regional Shelter-in-Place Orders in the United States."

DOI: 10.1097/PHH.0000000000001292

About Journal of Public Health Management and Practice

Journal of Public Health Management and Practice publishes articles which focus on evidence-based public health practice and research. The journal is a bi-monthly peer-reviewed publication guided by a multidisciplinary editorial board of administrators, practitioners, and scientists. Journal of Public Health Management and Practice publishes in a wide range of population health topics including research to practice; emergency preparedness; bioterrorism; infectious disease surveillance; environmental health; community health assessment; chronic disease prevention and health promotion; and academic-practice linkages.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2019 annual revenues of €4.6 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students with advanced clinical decision support, learning and research and clinical intelligence. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

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