As COVID-19 spreads across the District and the world, researchers in the Milken Institute School of Public Health are helping spread awareness of how to combat the disease.

Researchers in the school have explored topics ranging from the effects of COVID-19 on displaced populations to sustaining the health care workforce during the pandemic. Researchers said the harmful societal and health effects of COVID-19 drove them to research solutions to various components of the outbreak.

Patricia Pittman, the director of the Fitzhugh Mullan Institute for Health Workforce Equity in the public health school, co-authored an article earlier this month detailing strategies for how to sustain the health care workforce during the pandemic.

Pittman said government officials must ensure providers are prepared to cross state lines to fill gaps in the health care system because medical professionals are disproportionately located in wealthier areas. She said officials should adopt strategies redeploying furloughed and underutilized health professionals, calling on medical students to treat patients and expediting licensing processes to maximize the number of providers available for patient care.

“Unless local, state and federal officials plan for workforce shortfalls, the problem of lack of access could rapidly escalate if and when infection spreads and the demand for care surges,” Pittman said in an email.

She said discussions over ventilator shortages and sharing equipment between hospitals are “meaningless” if hospitals can’t maintain an “adequate” supply of health care workers. Pittman said hospital administrators are laying off and furloughing workers who do not treat patients in intensive care units, which leads health professionals to be underutilized.

“People deliver care, and in the context of the current pandemic, we are seeing a dangerous dichotomy between our public discourse and the practices in many hospitals,” Pittman said. “We call the health workers heroes, and yet health workers often lack access to personal protective equipment and are risking their own and their families’ infection.”

Carlos Santos-Burgoa, a professor of global health, and William Dietz, the director of the Sumner M. Redstone Global Center for Prevention and Wellness, reviewed research on the 2009 H1N1 pandemic and reports of COVID-19 in Italy and China for a letter to the research journal Obesity earlier this month.

Dietz found that obesity could be associated with many chronic illnesses and predisposes patients with respiratory viruses to “severe” illness and higher chances of death.

He said COVID-19 patients who have obesity could experience similar health complications to those who contracted H1N1, and the higher prevalence of adult obesity in Italy relative to China could explain the discrepancy in COVID-19 mortality rates between the two countries.

“For any new disease or illness, medical and public health professionals examine a wide variety of potential associations between existing health conditions in patients and their response to the new disease to determine the appropriate treatment,” Dietz said in an email.

Dietz said research shows that H1N1 patients with obesity experienced potentially fatal difficulties with ventilation, decreases in respiratory function and increases in inflammation. Health care providers should take obesity into consideration when treating coronavirus patients, he said.

“While the effects of COVID-19 on patients with obesity are still being explored, lessons learned from the H1N1 pandemic should be taken seriously by those caring for patients with obesity and particularly patients with severe obesity,” Dietz said.

Ronald Waldman, a professor of global health, co-authored a study late last month outlining the effects of the pandemic on low-income residents and individuals displaced by humanitarian crises and natural disasters.

Waldman said many low-income countries lack the financial and health care resources to enact proposed World Health Organization recommendations – like isolating people with the virus, instituting testing and tracing contacts. He said most low-income countries lack sufficient testing capabilities and adequately trained public health and medical officials to enforce quarantines.

Low-income countries have a per capita gross national income of less than $1,026, according to the World Bank.

Waldman added that instituting a mandatory lockdown could deprive populations living in low-income countries and displaced persons camps access to food and other necessities.

The study concluded that extensive social distancing efforts can only realistically last for weeks at a time in low-income countries without bearing devastating economic effects. The authors instead suggested that officials target disease shielding efforts – like self-isolation – to vulnerable populations.

“We felt an alternate strategy needed to be proposed, even though we agree that WHO was recommending the best strategy,” Waldman said in an email. “But it was what should be done, not necessarily what could be done.”

Waldman said he and his co-authors decided to highlight potential recommendations for curbing the effects of the pandemic in low-income settings because poorer countries will “likely” experience the highest mortality rates from the disease.

“When you look at the health disparities that have become so evident in the U.S., these are multiplied many folds in low-income countries where a much higher proportion of the population will suffer because they lack the means to protect themselves and/or their families and to seek health care,” Waldman said.