The alarm goes off! Code blue! Code blue! The code blue team rushes to the scene. The patient is unresponsive. There is no pulse. The leader of the code team looks at the monitor and takes charge. The patient is in ventricular fibrillation (cardiac arrest) and would very well flat-line if prompt action is not taken. The leader gives clear instructions: Start chest compression. Fred, you will handle the defibrillator. Julie, you will be recording. Ben, you will manage the airway.
If you have ever taken the American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) course, you are familiar with this scenario. The course and provider manual emphasizes communication during resuscitation. According to AHA, elements of effective resuscitation team dynamics include clear messages, clear roles and responsibilities, closed-loop communications, knowing one’s limitations, knowledge sharing, constructive intervention, re-evaluation, summarizing, and mutual respect.
The United States has failed to effectively control the COVID -19 pandemic. Currently, over 120,000 Americans are dead from COVID-19, and over 40 million people have lost their jobs.
Different states and even different cities within a state have different ordinances and policies regarding COVID-19. There are widespread conspiracies and falsehoods. Many of the States that have reopened now see a rising number of new cases. Some people are not observing social distancing measures and have refused to wear masks.
In a medical code, life is at stake, and there is no margin for error. All it takes is a few seconds to make a difference. In a pandemic, lives are equally at stake. What can communication during a medical code teach us on how to communicate during a pandemic?
Clear messages. The message on COVID-19 pandemic should be simple and clear; It is real. It is not a conspiracy. It is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). It is mostly spread by respiratory droplets released when a person talks, sneezes or coughs. Social distancing, regular hand washing and use of face masks can curb the spread of the virus.
Clear roles and responsibilities. Several government agencies and officials are responding to the pandemic. It is often confusing who decides what and who is responsible for different aspects of the response. From an individual or family unit to the federal government, every entity should have clear roles and responsibilities.
Closed-loop communications. Press briefings should allow questions by reporters and citizens. Officials should make sure citizens understand the issues surrounding the COVID-19 pandemic. People that are reluctant about wearing masks or socially distance should be free to ask questions and have their concerns addressed.
Knowing one’s limitations. Politicians should acknowledge their limitations as non-scientists. On the other hand, scientists and physicians should acknowledge the fact that SARS-Cov-2 is a novel virus. Our understanding of the virus is limited and evolving. Even though the pandemic is caused by a virus, the response to the virus must come from different experts, including lawmakers and elected officials.
Knowledge sharing. Knowledge on COVID-19 is evolving. Individuals, hospitals, and businesses have different experiential knowledge on the pandemic. Successes and failures should be shared so that others can learn from them.
Constructive intervention. If someone or something is wrong, there should be room for constructive intervention. It is not wrong for someone to remind another to wear a mask in public.
Re-evaluation and summarizing. Since the pandemic started, several drugs have been tested, and many laws have passed. Some of the laws passed at the national level include Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6071), Families First Coronavirus Response Act (H.R.6201), Coronavirus Aid, Relief, and Economic Security Act (H.R. 748), and Paycheck Protection Program and Health Care Enhancement Act (H.R. 266). What has been successful, and what more can be done?
Mutual respect. It is obvious that the COVID-19 pandemic has become political. We can have a lively debate about the response to the pandemic without resorting to name-calling and vitriol. We should respect people that are different from us or have different opinions from ours. Opinions should not be confused with facts.
We still have the opportunity to turn the tide in the fight against the COVID-19 pandemic. We can protect lives and businesses at the same time. To change the storyline on this pandemic, we must communicate like we are in code blue.
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