In May 2020, Penn LDI awarded 13 COVID-19 Rapid Response Research Grants, designed to produce policy insights directly relevant to the unfolding pandemic and its broad range of health effects. Thirteen LDI Senior and Associate Fellow principal investigators and twelve co-investigators are involved in the funded projects. Learn about the funded projects and resulting research products below.

Estimating Intervention Effectiveness with Censored Testing


Principal Investigator: Hamsa Bastani, PhD | The Wharton School

A key component for addressing questions related to virus transmission and response effectiveness is an unbiased estimate of the actual number of positive COVID-19 cases. This was a study of potential proxy methods for extrapolating accurate numbers of COVID-19 infections that found Pennsylvania’s actual infection numbers are 60% higher than is being publicly announced. The findings suggest the numbers across the country are likely far higher than currently reported numbers.

Resulting Product:
• Final Video Report

In Whose Best Interest: Nursing Regulation During a Crisis


Principal Investigator: Cynthia Connolly, PhD, RN, FAAN | School of Nursing
Co-Investigators: Patricia D'Antonio, PhD, FAAN, RN; Julie Fairman, PhD, RN, FAAN

Nursing and medical students near the end of their training are being handled in very different ways when it comes to mobilization for clinical work in the current COVID-19 crisis. This study found the pandemic demanded that registered nurses be allowed to practice to the top of their license.

Resulting Product:
Final Video Report

COVID-19 Risk Perception, Knowledge, and Behaviors in 6 States


Principal Investigator: Karen Glanz, PhD, MPH | Perelman School of Medicine and School of Nursing
Co-Investigator: John Holmes, PhD

Despite efforts of public health officials and the media to share current and accurate information about COVID-19, there are many instances of conflicting information and misinformation being disseminated. Researchers, public health experts, and policymakers lack reliable information on a range of epidemiological factors. This study will assess risk perceptions, knowledge, and behaviors related to prevention and response to the pandemic, and the psychological impacts of quarantine and/or diagnosis of COVID-19. 

Safety Net Program Use Among Low-Income Families of Children with Developmental Disabilities During a Pandemic


Principal Investigator: James Guevara, MD, MPH | CHOP and Perelman School of Medicine

Twelve to sixteen percent of young children are estimated to have developmental delays and disabilities. Widespread crises like the COVID-19 pandemic can exert extraordinary strain on families with these children. While government-funded safety net programs assist low-income families, what challenges are these families facing during the coronavirus crisis? This study's goal is to determine changes in the use of, need for, and adjustment to a virtual service delivery model for these safety net programs during the current crisis.

Health System Communication of Novel Pandemic-Era Policies


Principal Investigator: Joanna Hart, MD, MSHP | Perelman School of Medicine

During the current pandemic, inpatient health care facilities must enforce physical distancing, including severe restrictions or elimination of family member presence for admitted patients. While this aims to reduce viral transmission, the presence and manner in which these policies are communicated may influence the public perception of health system support for family-centered care and the alliance between the health system and surrounding community. This study seeks to identify ways to improve this health system communication.

Measuring Pandemic-Related Attitudes and Behaviors in Pennsylvania: A Wave of a Panel Survey


Principal Investigator: Daniel Hopkins, PhD | School of Arts & Sciences

The full extent of the disruption caused by the COVID-19 pandemic across the social and economic life of Pennsylvania and the United States hinges, to a critical extent, on people's behavioral responses to warnings about the virus and the need to adhere to restrictive measures designed to contain and mitigate the contagion. This study of 1,500 Pennsylvania residents found no reduced support for social distancing policies when advocated by elites, and no backlash for a policy described as backed by public health experts.

Resulting Products:
• Final Video & Text Report

Penn Researcher Documents Strong Pennsylvania Support for COVID Restrictions
• Pa. Republicans and Democrats Disagree On Reopening the Economy, but There is a Lot They Do Agree On, Survey Says
• Daniel Hopkins on WHYY Radio Times
• Partisan Polarization and Resistance to Elite Messages: Results from a Survey Experiment on Social Distancing

At the Frontline of the Pandemic in a Resource-Limited Setting: Health Care Providers and Covid-19 in Malawi


Principal Investigator: Iliana Kohler, PhD | School of Arts & Sciences

As COVID-19 continues its spread out of the high- and middle income countries where it is currently concentrated, there are important knowledge gaps essential for health policy responses in lesser resourced areas. This study was aimed at one of those areas—Malawi in southeastern Africa—where there is often no running water in clinics and health centers lack adequate supplies. It found high levels of depression and burnout among clinicians, and declines in the number of patients visiting health facilities, including pregnant women and HIV positive patients.

Resulting Product:
Final Video Report

Multi-State Study of U.S. Nurse Burnout in Minority-Serving and non-Minority-Serving Hospitals, Before and After COVID-19


Principal Investigator: Karen Lasater, PhD, RN | School of Nursing

This study focused on how the COVID-19 pandemic has exacerbated nurse burnout, particularly in minority-serving institutions (MSIs) where the coronavirus burden is falling more heavily. A survey conducted in collaboration with the National Council of State Boards of Nursing found that most hospitals did not meet benchmark patient-to-nurse staffing ratios for medical-surgical or intensive care units. Understaffed hospitals were associated with less job satisfaction among nurses and unfavorable grades for patient safety and quality of care.

Resulting Product:
Chronic Hospital Nurse Understaffing Meets COVID-19: An Observational Study

Understanding the Risk of COVID-19 Exposure Based on a Strategy of Routine Pre-Procedure Screening During a Pandemic


Principal Investigator: Jonathan Tan, MD, MPH, MBI | Perelman School of Medicine
Co-Investigators: Grace Hsu, MD; Allan Simpao, MD, MBI; John Fiadjoe, MD; Clyde Matava, MBCHb, MMed, MHSCJorge Galvezm MD, MBI

Screening for COVID-19 is an essential public health strategy; positive test results facilitate the detection of disease but may lead to a false sense of safety for health care workers. Hospitals may use a negative result to triage limited resources such as personal protective equipment and operating room staff, and eventually use it in the planning of scheduling elective procedures. This work will review COVID-19 screening test literature and quantify the risks of using a COVID-19 screening test negative result to make policy.

Health and Economic Outcomes Among Low-Income Households in India During the COVID-19 Pandemic


Principal Investigator: Harsha Thirumurthy, PhD | Perelman School of Medicine

Focused on the impact of the COVID-19 pandemic in India, this study tracked household well-being and assessed whether temporary or bolstered welfare programs for low-income households adequately protected those households. The work assessed the influence of the COVID pandemic on the HIV epidemic. The conclusions were that the pandemic lowered income by 52%, altered patterns of sexual risk behavior, and produced very high levels of food insecurity.

Resulting Product:
Final Video Report

The Impact of Rapidly Shifting Care Delivery on Inpatient Health Care Utilization, Access, and Quality among Patients with Cirrhosis in the Era of the Coronavirus Pandemic


Principal Investigator: Nadim Mahmud, MD, MS, MPH, MSCE | Perelman School of Medicine
Co-Investigator: Marina Serper, MD, MS

The current pandemic has resulted in massive shifts in health care delivery across the U.S. Many systems have supplanted in-person visits with telemedicine, limited hospital transfers, and set more stringent hospitalization criteria for non-COVID-19 related conditions. This work found dramatic decreases in cirrhosis hospitalizations, with patients having a greater severity of liver disease, shorter length of stay, and more frequent discharges to home rather than to facilities.

Resulting Products:
• Dramatic Nationwide Decline in Cirrhosis Hospitalizations Due to COVID-19
• National Shifts in Outpatient Care for Patients With Cirrhosis
• Declining Cirrhosis Hospitalizations in the Wake of the COVID-19 Pandemic: A National Cohort Study

Answering the Call to Support Family Social Health: Assessing Demand for Child Helpline Inquiries in the Wake of COVID-19


Principal Investigator: Robin Ortiz, MD | Perelman School of Medicine
Co-Investigators: Laura Sinko, PhD, RN, CCST-IRachel Kishton, MDAtheendar Venkataramani, MD, PhDJoanne Wood, MD, MSHP

The combination of isolation, emotional and financial distress, and school closures has led child welfare experts to predict a surge in family violence in the wake of the COVID-19 outbreak. Recent data from Michigan and other state reports show significant decreases of such incidents in March 2020 as social distancing and school closure policies were adopted, compared to 2019. This comparison study of trends in calls and texts to the National Child Abuse Hotline for the same periods concluded that child abuse may be underreported during the pandemic.

Resulting Product:
Final Video Report

Capturing Social Distancing While Immunocompromised: A Photo-Elicitation Study


Principal Investigator: Laura Sinko, PhD, RN, CCST-I | Perelman School of Medicine
Co-Investigator: Raina Merchant, MD, MSHP, FAHA

Photography can provide compelling data showcasing the unique experiences of those at high risk for COVID-19 complications. This survey used patient photography as a pivot for interviews about the individuals' structural changes, and emotional and distress experiences during the pandemic that caused mental health difficulties. The patients were intentionally engaged in wellness strategies. Another goal of the project is to leverage these images to advocate for improved health and welfare supports during periods of quarantine.

Resulting Product:
Final Video Report