From "getting things right" to "getting things right now": Developing COVID-19 guidance under time pressure and...

Area of Science:

• Public Health
• Health Policy
• Evidence-Based Practice

Background:

• The COVID-19 pandemic necessitated urgent guidance for healthcare and containment strategies.
• The rapid onset of the pandemic challenged traditional, rigorous guidance development processes.
• Guidance developers faced pressure to provide timely information, balancing speed with accuracy.

Purpose of the Study:

• To investigate how guidance developers responded to the need for credible COVID-19 guidance.
• To identify challenges and strategies employed in developing public health guidance during a crisis.
• To explore the impact of the pandemic on future guidance development.

Main Methods:

• An exploratory mixed-methods study involving guidance developers.
• A web-based survey distributed to 46 guidance developers.
• Follow-up interviews with five guidance developers to explore findings in depth.

Main Results:

• Conventional guidance methods were often unsuitable for COVID-19, with 80% adopting alternative approaches.
• Two key strategies for credible guidance under uncertainty emerged: enhanced end-user involvement and combined evidence review/recommendation formulation.
• 70% of respondents anticipated changes in future guidance, focusing on balancing rigor and speed.

Conclusions:

• Guidance development must balance scientific rigor with usability, acceptability, and contingency, especially during uncertain times.
• The COVID-19 crisis highlighted the need to explicitly acknowledge scientific uncertainty in guidance.
• Developing adaptive methods for guidance development is crucial for future public health emergencies.