How COVID-19 Changed the Way We Communicate: A Day in the Life of a Public Health Specialist

I received a phone call on 24th February 2020 at 5:00 PM from the director of the Central Public Health Laboratory informing me that we had diagnosed the first two cases of COVID-19 in Oman; within 30 minutes, the news was all over the place. We started asking ourselves a new set of questions, questions we’d never asked ourselves before. I'm now often wondering how much COVID-19 has affected our lives for good or bad, and I am sure many of you are doing the same.

I wish to share my reflections on technology in the context of the pandemic has disrupted my personal and professional life, how we can embrace the opportunities and the positive aspects of it, and how we can be more conscious of its potentially harmful side effects.

I work in the health ministry of Oman headquarters at the Disease Surveillance and Control department. Although we started planning for COVID-19 at the beginning of January 2020 after the news about the emerging illnesses in China, news of the first cases in Oman truly hit home and brought with them different implications and experiences.

On 25th February, I called a meeting for all the concerned departments and experts to discuss our national response plan for COVID-19. We met in person; later in the day, we started to talk to our public health teams in the districts over the phone. In the coming few days cases started to increase, and we began meeting daily with public health personnel over the phone. We also designed an Excel sheet to get the daily epidemiological data from the governorates. A breakthrough happened around the middle of March 2020 when we started using Webex for virtual meetings. We were meeting daily with all the public health experts from all over the country and the panels used to last for 2 to 4 hours. Originally, we discussed every single case, including the process of isolation of patients and quarantine of the contacts; this helped communication as contacts used to move between different governorates. We met every single day, including the weekends and public holidays, for almost seven months until it became once a week. However, we were met with another challenge: getting the data daily before noontime. His Majesty the Sultan established a Supreme Committee to deal with the COVID-19 pandemic in Oman.

The supreme committee and other senior officials requested epidemiological data daily, and usually these requests came in the early morning. This was a nightmare for us because we struggled to get the verified national data before noon and then synthesize it into one report. This challenge led to an opportunity – before the end of April 2020, we managed to develop a web-based surveillance system (Tarassud); the portal is linked with all health institutions, public health departments, and laboratories. This online portal was another breakthrough, and it has allowed us to get instant access to the data in real-time; it also facilitated the work of public health teams for isolation and contact tracing. Later on, the Ministry of Health, in partnership with the private sector, developed an application incorporating Tarassud with a chatbot and geospatial monitoring of cases and contacts (Tarassud+). Tarassud+ eased the burden of public health teams for contact tracing and communication with patients in quarantine by almost 80%. In addition, the use of geospatial technology helped monitor and trace clusters of COVID-19 cases in the community; it has also helped make decisions for a lockdown of specific communities and the whole country. Big data produced at the national level also helped evaluate the effectiveness of different public health and social measures and vaccine strategies implemented by the country.

Technology has also helped countries open their borders for travel using mobile applications that facilitate the monitoring of travelers even before arrival to the country and oblige them to comply with the countries’ requirements for COVID-19 testing, quarantine, and later vaccination. Having virtual meetings has helped dramatically in conducting seminars and training due to the lockdown and for COVID-19 health precautions; this has helped train more staff members expediently, and in a much more efficient and cost-effective manner.

Another subtle development that COVID-19 has accelerated was sharing folders and documents, such as Google documents wherein people could make real-time suggestions or edits directly to the documents without the hassle of transferring them by email. This has expedited the writing of guidelines and policies and has given a feeling of ownership to all contributors. It has facilitated people providing feedback during a virtual meeting that was not there before COVID-19, at least for our team.

Challenges imposed by technology during COVID-19

1. Globalization of knowledge and infodemic – All people got an open-access pass to information about public health and clinical care for COVID-19 and vaccines. Unfortunately, a lot of the data was misleading; we have lost lives because people did not believe in the importance of preventive health measures to protect from COVID-19 or refused to take the vaccine. In addition, many communities and experts were unable to customize the global knowledge to suit their local context.
2. Burnout – Continuous over communication and data overload could have exacerbated the burnout that many people, including me, suffered from. There was a lot of demand put on us to be on top of everything, and we were on call 24 hours, 365 days a year, and the need for urgent instant answers, not to mention the many virtual meetings imposed on us. Compounded, this has led to physical, mental, psychological, and emotional exhaustion leading to burnout. The more people use social media and instant messaging, the more they lose the human touch that they need most during times of isolation. Virtual meetings subsequently became global; people were continuously on demand to participate in different discussions locally and internationally. The majority of international conferences for us were in the evening after working hours and during weekends and holidays. I remember the first time I took annual leave after the onset of COVID-19 was in February 2021, I attended 25 meetings in 3 weeks while on holiday.
3. Technology involved itself in dissolving hierarchical boundaries, which compromised the systematic way work used to be performed. It also exacerbated the burnout of employees, instant messaging applications made employees available and under demand from different levels of leadership; this also brought on chaos and caused frustration among employees.

Still though, I believe that the benefits and opportunities we got from the technological developments in the last two years outweighed the challenges it has imposed. I would like to make some suggestions to build on opportunities brought by technology and how to mitigate some of the challenges.

Tech made it much easier to establish One Health. During COVID-19, we worked with stakeholders from outside the health sector, we shared statistical data with them (no, not individual personal data), and we managed to work together to sail through the pandemic; for example, we worked with the Civil Aviation Authority, Royal Oman Police, Ministry of Transportation and Telecommunication, and Ministry of Tourism to facilitate the opening of the international borders and allow international travel. We created trust, enthusiasm, and a platform for collaboration that we can build on for the future. Another example was a local dengue outbreak in Muscat in 2018; we have established a digital platform for vector surveillance and shared it with the Muscat municipality for vector control activities against Aedes aegypti; this collaboration helped in controlling the outbreak. We are now advocating for the government of Oman to establish a high-level ministerial committee for One Health.

Evolving technology has helped to build better teams and improve training programs in a major way. We managed during COVID-19 to engage with colleagues at the national level; we shared guidelines and policies and discussed them with them openly in virtual meetings; this made teams feel engaged, and they felt the ownership of whatever documents were produced. In addition, virtual training helped make training more standardized, and I assume better quality. I have attended several reputable online training workshops led by international organizations; I don't think I would have been able to participate in one-tenth of them if they were in-person events. Online virtual meetings and training offer the flexibility for people to participate in high-quality conferences and meet colleagues from all over the world to share knowledge and skills.

Going forward, organizational and personal resilience systems need establishing. Technology has destroyed the barriers and boundaries between work and life. I'm afraid we have abused ourselves and our colleagues by contacting them after working hours and during their weekends and holidays; it has been a vicious cycle. Organizations need to set policies and boundaries for the well-being of the individuals. We should actively start working on a systematic way of making resilience of the organizations and individuals a top priority in the planning of recovery post-COVID-19. France and Portugal have passed laws banning employers from contacting their employees after working hours; this may seem extreme, but we should be serious about addressing this issue.

In closing, I tried in this post to reflect on how technology has affected me, especially on a professional level. I invite you to reflect on how technology has changed your professional and personal life. I encourage you to share your ideas with us in the comments and I thank you in advance.

by Seif Al-Abri, ISID Emerging Leader, Oman