Article by Kim M. Simpson, Connect to End COVID-19 Communications Lead.
As each day passes, we move farther and farther away from being dominated by the COVID-19 Pandemic that began in 2020. We view the pandemic in the rear-view mirror. COVID-19 strains continue to morph and circulate, causing illness and death—though far below levels experienced in the early days, months, years, of the pandemic, thanks to life-saving vaccines and increased immunity. Yet questions linger about the long-term impacts of COVID-19 on individuals, families, society, and social workers.
Social workers, like most helping professionals, were called upon during the pandemic to help individuals and families to make informed decisions about COVID-19 vaccines and treatments. As part of a national response to the pandemic, Connect to End COVID-19 is a $3.3 million Centers for Disease Control and Prevention (CDC)-funded initiative to help social workers and their clients to make informed decisions about life-saving vaccines.
Since July of 2021, NASW and the NASW Foundation have partnered in this initiative with the Health Behavior Research and Training Institute at The University of Texas at Austin Steve Hicks School of Social Work. The mission: to provide tools and information in a national communications campaign and, national and state chapter-level training, that collectively promote COVID-19 vaccine confidence and uptake.
Connect to End COVID-19 achievements during the three-year CDC grant include:
- A collaboration between HBRT and NASW Chapters to provide 27 free six-hour MI-SBIRT Trainings that include five complimentary CEUs for social workers. More than 1,000 social workers have been trained and an app was created and launched.
- Seven live 90-minute complimentary webinars hosted by NASW, provided free CEUS, also available for self-study (close to 18,000 people registered and earned nearly 14,000 CEUs).
- Approximately 40 Ambassadors, recruited from NASW Specialty Practice Section (SPS) member ranks, amplified the initiative’s messaging to their audiences; and, three Sister Social Work Organizations engaged in communications campaigns that augmented messaging.
The grant concludes September 29, 2024, but the need continues, on the part of the social work profession, to promote vaccine confidence and to help individuals and families to make decisions about life-saving vaccines.
A Look Back, A Look Ahead: Part Two of a Three-Part Series
In a three-part series, the Connect to End COVID-19 team examines the impact of this initiative, the important role social workers played in the
pandemic, as well as lingering questions around the long-term impacts of COVID-19 and the pandemic. To read Part One, follow this link.
In Part Two of this series, an interview with Barbara Bedney, PhD, MSW—NASW Chief of Programs and Principal Investigator (PI) on this CDC-funded grant, Engaging Social Workers in Boosting COVID-19 Vaccine Uptake.
Why was it important to have social workers ‘at the table’ during the COVID-19 Pandemic—especially within the context of Connect to End COVID-19 / CDC Vaccine Confidence Grant?
I couldn’t agree with Gwen more and will just add a few additional points of my own.
About the skills and frameworks we bring to the table:
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the principles of ‘trauma-informed care’ include safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice, and cultural, historical, and gender issues. In a trauma-intense environment such as natural disasters or pandemics, the implementation of these principles is critical to ensure that individuals, families, and communities receive the services and supports they need and are not re-traumatized during the process.
Based on their knowledge base, skills, frameworks, and relationship-building skills, social workers are uniquely suited to infusing these principles into their work during disasters and to promoting the safety and resilience of individuals, families, and communities during pandemics and other crises. It is critical that we be at the table to ensure that all crisis-related work incorporates these principles. It is similarly critical that social workers be at the table to develop and implement culturally relevant messages to ensure reliable, accurate, and timely information is distributed to populations known to be at high risk for COVID-19 infection and hospitalization.
About special populations, health disparities, and social determinants of health:
African Americans, Latino individuals, and Native Americans in the US have experienced a disproportionate burden of COVID-19-related infections and deaths (Gray et al., 2020). Individuals with disabilities were also disproportionately affected by the hardships of COVID-19 (ACL, 2022) as were immigrant communities (Clark et al., 2020), rural communities, and older adults.
Social workers understand that health disparities—including disparities in social determinants of health such as education, transportation, housing, and employment (such as overcrowded housing and jobs that prevent social distancing); disparities in access to preventive care (including disparities in access to COVID vaccines, testing, and masks); and disparities in access to health care among others—all play a role in the disproportionate impact of COVID-19 and other disasters on minority and vulnerable populations, and we are committed to ensuring that those populations have access to the services and supports they need to promote their health and well-being. It is part of the mission of social work to bring the issues those populations face to the surface and ensure that they are addressed. This is less likely to happen without social workers advocating for these populations and ensuring that their voices and concerns are heard and addressed.
What is the biggest success of Connect to End COVID-19? What are related smaller successes?
Going back to my previous answer, I believe our biggest success is calling attention to the fact that social workers need to be involved in every aspect of public health, from ensuring that public health interventions are designed with a focus on historically underserved and vulnerable populations (and with an understanding of the social determinants of health that put them at risk in the first place), to developing and implementing communication and outreach strategies to reach populations who may be fearful of public health interventions based on past experiences and traumas and those who may become overwhelmed by misinformation and disinformation about vaccines and other health-related measures; to educating ourselves about the different modalities we can use, such as MI-SBIRT, to promote confidence about vaccines and other preventive measures in the clients we serve. The Connect to End COVID-19 project was a multi-level, multi-pronged intervention, and I believe it demonstrated that preventing and ameliorating any such crisis in the future will require that type of intervention in order to successfully have the desired impact.
In addition, the participation of our sister organizations and chapters from across the country demonstrated the reach and capacity that NASW has in being able to mobilize an entire system to address public health issues and crises, a success which, as suggested previously, calls attention to the need for us to be at the table before, during, and after the next crisis or pandemic occurs. I’m not sure I see any ‘smaller’ successes here, but I do also want to call attention to the outstanding team NASW put together to implement this intervention that enabled us to achieve all the successes we have had!
What are lessons learned, within the context of social work, from the COVID-19 Pandemic?
I agree with Gwen and would only add, again, the importance of ongoing communication, relationship-building, and networking before, during, and after disasters such as pandemics. I had a colleague in New York who ran an agency that provided critical support services to those affected by the attacks on 9/11 who used to say “we were there on 9/11 because we were there on 9/10.” That phrase has always stuck with me. Crisis prevention and amelioration starts before a crisis ever occurs, with strong, pre-existing, trusting relationships that can be rapidly mobilized in times of crisis. I think that is a key lesson from this pandemic, and that it is up to social workers to make sure that lesson isn’t lost.
As for communication, I agree with these sentiments from Crawford (2021), who noted that, “COVID-19 has taught us that information-sharing is not always straightforward. Rather, in this time of widespread misinformation and politization of public health, there has been a greater need for identifying reliable sources and correcting misinformation.”
Social workers, as trusted, empathetic, trauma-informed sources of reliable information, are ideally suited to fulfill that need.
What are some of the lessons learned from the CDC Vaccine Confidence Grant?
In addition to what’s already been said, I think part of what we’ve learned is the importance of vaccine confidence itself as a public health intervention, which again highlights the importance of social workers in public health. Our public health institutions could develop the most safe, most accurate, most reliable, least risky vaccine ever produced, but if the people it is designed for don’t have confidence in it, don’t trust it, are fearful of it (and separately, don’t have access to it), they won’t take advantage of it, and it will fail to stop the spread of whatever virus or disease it is designed to prevent.
Doctors, nurses, researchers, academics, etc. all have a critical role to play in the development of vaccines and other public health measures designed to keep us safe; but unless they simultaneously include social workers in the development of outreach strategies and communication
channels designed to promote confidence in those measures, those measures are likely to fail, and we will likely see again the hesitancy, fear, and distrust that has pervaded the COVID-19 pandemic. So, to me, that is one of the urgent lessons learned from our grant—the imperative that social workers be included, from the beginning, in all public health interventions to ensure that those interventions are successfully translated to the public—and to vulnerable populations in particular—in ways that promote confidence and trust.
Of course the corollary to that is that members of those special populations need to be at the table with social workers to ensure that those messages are culturally competent, trauma-informed, and delivered by trusted sources. Our Ambassadors program shows the importance and impact of messages designed and delivered by community members and local leaders, and this is a lesson that should be incorporated into all crisis prevention and remediation efforts.
Did the Pandemic adversely impact the mental Health of social workers and the individuals and families with whom they work?
Absolutely, and on this the research is pretty unequivocal. McCoyd et al. (2023), for example, suggest that “self-reported symptoms of compassion fatigue and secondary traumatic stress, combined with concerns about safety and difficulties connecting clients with needed services, have combined to yield “a perfect storm of frustration and burnout” (McCoyd et al., 2023). In 2021, Holmes found that the prevalence rate of 26.2% of post traumatic stress disorder (PTSD) reported by social workers was five times higher than the national estimates of 5.3% (Kilpatrick et al. 2013) and over three times higher than the 7.6% reported PTSD rates of active duty and Reserve/National Guard personnel deployed to Afghanistan and Iraq with combat exposure (Holmes et al., 2021).
Lack of information in the early days of the pandemic, changing guidelines and safety precautions, overwhelming work schedules, agency closures, difficulties transitioning to telehealth services, fear of being exposed to COIVD-19 and fear of exposing others, lack of access to personal protective equipment, and personal losses associated with the pandemic all while trying to keep others safe have all been cited as sources of stress for social workers—and all need to be studied and addressed to prevent that kind of stress and burnout in future crises and pandemics.
How do we, as a country, begin to deal with the mental health (and other) related impacts of the pandemic?
I think that is a great question. I think for one, we need to recognize the collective trauma that the pandemic has inflicted upon us as a society. According to the American Psychological Association (APA), “we cannot ignore the fact that we have been significantly changed by the loss of more than 1 million Americans as well as the shift in our workplaces, school systems, and culture at large,” and that there is mounting evidence that our society is experiencing the psychological impacts of a collective trauma. While the lockdowns are gone, the aftermath remains. Chronic
illnesses between the ages of 35–44 increased from 48% in 2019 to 58% in 2023. Adults 35–44 also experienced the highest increase in mental health diagnoses—from 31% reported in 2019 to 45% in 2023.”
Once we acknowledge that, we can begin to help each other to recover from what we have collectively experienced, and social workers have an obvious critical role to play here—we can help create safe spaces and re-establish the sense of safety and control many of us lost during the pandemic; we can develop interventions to close the gaps in health and health care and resources the pandemic has tragically highlighted; we can expand our use of telehealth and other new modalities (and existing modalities such as MI-SBIRT) to reach out to new clients; we can continue to advocate for appropriate reimbursement for our profession and the critical mental health services we provide; and we can continue our important role in de-stigmatizing mental health conditions and promoting equal access to mental health services for everyone who can benefit from those services.
Are we ready for another pandemic (or crisis of another nature) in the future? If not, how do we better prepare?
I’d like to think so, but there are some steps I think need to be taken before the next pandemic to ensure that we are as prepared as possible when it happens. These include:
- The inclusion of social workers and social work frameworks into every aspect of public health planning and intervention and disaster preparedness and response
- Addressing the inequities in social determinants of health that promote inequities in the prevalence and impact of pandemics and other disasters
- Continuing to develop and solidify trusting relationships with community members and leaders from vulnerable populations, and having teams of local leaders (Ambassadors) on the ground ready to delivery culturally competent messages as immediately and as frequently as possible
- Relationship building with communities and populations known to be impacted the most by disasters, and planning with them now to avert the harsh consequences of the next disaster
- Building and solidifying partnerships with a wide variety of organizations to build the infrastructure, safety net, and networks necessary for timely responses to disasters
- The incorporation of social workers as first responders on equal footing with doctors, nurses, EMTs, etc.
- The recognition of the importance of self-care, supervision, and peer support in all aspects of disaster preparedness and response
- The development of multi-level, redundant communication channels that can be called upon to deliver effective, timely, accurate messages through as many means as possible
Anything else that you believe is important to mention?
Nothing more to add here to what Gwen said. This project has elevated the social work profession by showing how intricately tied pandemics are to the social determinants of health, and thereby showcasing the vital, successful, and impactful role that social work can and needs to play in preventing and responding to future pandemics and crises. It has been a privilege and an honor to work with the team on project and I look forward to doing my part to ensure that the many lessons learned from your work are incorporated into all future efforts to promote and protect the public good.
References
- Administration for Community Living (2022). Impact of the COVID-19 pandemic on people with disabilities. Research Findings, April, 2022.
- American Psychological Association (2023). Stress in America 2023: A Nation Recovering from Collective Trauma.
- Clark, E., et al (2020). Disproportionate impact of the COVID-19 pandemic on immigrant populations in the United States. PLOS Neglected Tropical Diseases, 14(7).
- Crawford, C.A. (2021). Studying social workers’ roles in natural disaster during a global pandemic: What can we learn? Qualitative Social Work, 20(1-2), 456-462.
- Gray, D. et al (2020). COVID-19 and the other pandemic: Populations made vulnerable by systemic inequity. Nature Reviews: Gastroenterology and Hepatology, 17, 520-522.
- Holmes, M.R., et al (2021). Impact of COVID-19 Pandemic on Posttraumatic stress, grief, burnout, and secondary trauma of social workers in the United States. Clinical Social Work Journal, 49, 495-504.
- McCoyd, J. LM, Curran, L., Candelario, E., Findley, P.A., and Hennessey, K. (2023). Social service providers under COVID-19 duress: Adaptation, burnout, and resilience. Journal of Social Work, 23(1).
_______________________________________________
Stay tuned for Part three of this three-part series in September. Follow this link to Part One in the series: an interview with Gwen Bouie-Haynes, PhD, LMSW—Executive Director, NASW MS Chapter and NASW Alabama Chapter; and, Project Coordinator, Connect to End COVID-19 Special Populations.
Visit Connect to End COVID-19 on the NASW Website to learn more about the initiative.
The Connect to End COVID-19 initiative is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $3.3 million with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.
