Healthcare Violence and the Potential Promises and Harms of Artificial Intelligence.

ABSTRACT: Currently, the healthcare workplace is one of the most dangerous in the United States. Over a 3-month period in 2022, two nurses were assaulted every hour. Artificial intelligence (AI) has the potential to prevent workplace violence by developing unique patient insights through accessing almost instantly a patient's medical history, past institutional encounters, and possibly even their social media posts. De-escalating dialog can then be formulated, and hot-button topics avoided. AIs can also monitor patients in waiting areas for potential confrontational behavior.Many have concerns implementing AIs in healthcare. AIs are not expected to be 100% accurate, their performance is not compared with a computer but instead measured against humans. However, AIs are outperforming humans in many tasks. They are especially adept at taking standardized examinations, such as Board Exams, the Uniform Bar Exam, and the SAT and Graduate Record Exam. AIs are also performing diagnosis. Initial reports found that newer models have been observed to equal or outperform physicians in diagnostic accuracy and in the conveyance of empathy.In the area of interdiction, AI robots can both navigate and monitor for confrontational and illegal behavior. A human security agent would then be notified to resolve the situation. Our military is fielding autonomous AI robots to counter potential adversaries. For many, this new arms race has grave implications because of the potential of fielding this same security technology in healthcare and other civil settings.The healthcare delivery sector must determine the future roles of AI in relationship to human workers. AIs should only be used to support a human employee. AIs should not be the primary caregiver and a single human should not be monitoring multiple AIs simultaneously. Similar to not being copyrightable, disinformation produced by AIs should not be afforded 'free speech' protections. Any increase in productivity of an AI will equate with a loss of jobs. We need to ask, If all business sectors utilize AIs, will there be enough paid workers for the purchasing of services and products to keep our economy and society a float?

Long COVID's Impact on Patients, Workers, & Society: A review.

The incidence of long COVID in adult survivors of an acute SARS-CoV-2 infection is approximately 11%. Of those afflicted, 26% have difficulty with day-to-day activities. The majority of long COIVD cases occur after mild or asymptomatic acute infection. Children can spread SARS-CoV-2 infections and can also develop long-term neurological, endocrine (type I diabetes), and immunological sequelae. Immunological hypofunction is exemplified by the recent large outbreaks of respiratory syncytial virus and streptococcal infections. Neurological manifestations are associated with anatomical brain damage demonstrated on brain scans and autopsy studies. The prefrontal cortex is particularly susceptible. Common symptoms include brain fog, memory loss, executive dysfunction, and personality changes. The impact on society has been profound. Fewer than half of previously employed adults who develop long COVID are working full-time, and 42% of patients reported food insecurity and 20% reported difficulties paying rent. Vaccination not only helps prevent severe COVID-19, but numerous studies have found beneficial effects in preventing and mitigating long COVID. There is also evidence that vaccination after an acute infection can lessen the symptoms of long COVID. Physical and occupational therapy can also help patients regain function, but the approach must be "low and slow." Too much physical or mental activity can result in post-exertional malaise and set back the recovery process by days or weeks. The complexity of long COVID presentations coupled with rampant organized disinformation, have caused significant segments of the public to ignore sound public health advice. Further research is needed regarding treatment and effective public communication.

Frontline Worker Safety in the Age of COVID-19: A Global Perspective.

The third annual Health Watch USA sm webinar conference assembled 16 speakers from 4 continents who shared information regarding frontline worker safety in the age of COVID-19. The U.S. Bureau of Labor Statistics reported a nearly 4000% increase in workplace illness in 2020 compared with 2019. It is estimated that 2% of the U.S. workforce is not working because of long COVID. In addition, the impact is growing with each surge. After the acute illness, patients are often described as recovered, when in fact many have only survived and are coping with the multisystem impacts of long COVID. Long COVID, including its late cognitive, cardiovascular, embolic, and diabetic complications, disproportionately impacts frontline workers, many of whom are of lower socioeconomic status and represented by ethnic minorities. Natural infection and current vaccines do not provide durable protection for reinfection. Herd immunity is not possible at this time. Although SARS-CoV-2 is unlikely to be eliminated, decreasing spread is imperative to slow the rate of mutations, decrease the number of reinfections, and lower the chances of developing long COVID. The primary mode of spread is through aerosolization. Both routine breathing and talking aerosolizes the virus. With the extremely high infectivity of SARS-CoV-2, it is unlikely that central building ventilation alone will be enough to satisfactorily mitigate spread. Additional safe active air cleaning technology, such as upper-room germicidal UV-C lighting, needs to be deployed. Misinformation and disinformation have inhibited response effectiveness. Examples include downplaying the benefit of well-fitted masks and the risks that COVID-19 and long COVID pose to children, along with believing children cannot spread the disease. The engagement of local community leaders is essential to educate the community and drive social change to accept vaccinations and other public health interventions. Vaccinations and natural immunity alone are unlikely to adequately prevent community spread and do not provide durable protection against the risk of long COVID. Frontline workers must keep their immunity as high as possible and work in settings with clean air, along with wearing N95 masks when they are in contact with the public. Finally, there needs to be a financial safety net for frontline workers and their families in the event of incapacitation or death from COVID-19.

COVID-19 lessons learned: a global perspective.

One June 15, 2021, infectious disease authorities from around the world participated in a joint webinar to share experiences and lessons learned in combatting the COVID-19 pandemic. One of the overriding goals of the conference "COVID-19 Lessons Learned: A Global Perspective" was to provide documentation of worldwide COVID-19 response strategies, in order to combat the plethora of misinformation and conspiracy theories that are being actively disseminated. This misinformation is having a profound negative impact on controlling the pandemic in many countries. Misinformation which was addressed in the conference included challenging the seriousness of COVID-19 infections, a refusal to recognize aerosolization as the major mechanism of spread, a belief that schools can be opened safely without implementation of extensive control strategies, and that masks and vaccines are not effective. A second goal was the identification of common strategies between nations.  Common strategies included the implementation of a range of closures, mask mandates, travel bans and the need for expanded testing. But of utmost importance there was recognition of the need to implement a coordinated national strategy, which is depoliticized and led by scientists.

COVID-19: through the eyes through the front line, an international perspective.

COVID-19 is continuing to ravage the globe. In many Western Countries, the populous has not embraced public health advice which has resulted in a resurgence of the COVID-19 virus. In the United States, there is an absence of a coordinated Federal response. Instead, frontline workers and average citizens are having to cope with extensive mixed messaging regarding mask usage and social distancing from the highest levels of government. This has resulted in the United States not being able to achieve a low level of infection since the pandemic began. In addition, many citizens hold a profound belief that individual freedoms must be preserved, even at the expense of public health; and view the wearing of masks as renouncing this right. These engrained political beliefs can be traced back to the late 1800s. The response of the United States has also been hampered by a highly cost-efficient healthcare system, which does not provide universal care and has a just-in-time supply chain, with far too few supplies in reserve. This efficiency prevented a rapid scaling up of the healthcare response, which resulted in severe deficiencies in available personal protective equipment (PPE) and healthcare staff. To compound issues many healthcare staff are not provided an economic or healthcare safety net. Other frontline workers, such as those who work in transportation and food services, are working under even greater adversities. Many of these workers are from diverse backgrounds, who, along with their families, are at even greater risk for COVID-19. This vulnerable population of frontline workers are faced with a choice of going to work with inadequate PPE or placing food on their families' table. In the United States, official recommendations seem to be ever changing, based more upon supply and test availability, than on science. We must rely on science and learn from the lessons of past pandemics or we will relive, even to a greater degree, the deaths and devastations experienced by our ancestors over 100 years ago.