Securing and supporting human resources
infection, hypertension, illness, chronic disease
HYPERTENSION, RECRUITMENT, TUBERCULOSIS, COVID-19 INFECTION, INFECTION, SEPARATION, TYPE 2 DIABETES, CHRONIC DISEASE
The pandemic progressed in a series of waves and the active use of epidemiological data was a limited tool to predict the timing and duration of future COVID waves. Staff were stood down between waves and had to be re-trained and re-deployed as case incidence increased, with the result that at the peak of each wave there were not enough trained staff to fully realise study enrolment potential.Existing workspaces and shared office zones had to be enlarged to accommodate social distancing and physical barriers were set up between colleagues. Despite infection control measures within the trial and wider measures instituted by the government, staff were susceptible to COVID-19 infection and illness absences compounded staff shortages, particularly during the second wave. Study staff also had competing duties in the pandemic response.Staff recruitment had to be done online and building a cohesive research team from people who had never met in person required innovative approaches, such as online group meetings where insights and issues could be shared. It was important that staff did not feel isolated and unsupported, particularly given the psychological pressure of stress, exhaustion, and separation from family and social support networks resulting from the pandemic response [South Africa is confronted by HIV, tuberculosis, and chronic disease such as type 2 diabetes and hypertension [Training staff amidst the rapidly evolving COVID-19 guidelines was complex, especially for non-clinical team members. The maintenance of a core team of trial staff that worked throughout the study was a key element in ensuring continuity of procedures, rapid pivoting when COVID-19 restrictions changed, and the delivery of high-quality training to peripheral staff. Multi-modal training was delivered remotely and in person, with materials such as presentations, operating procedures, and videos available online. Documentation, monitoring, and evaluation requirements were more demanding during the pandemic, and there were delays in monitoring that were unresolved by remote methods. However, there is scope to further streamline processes and to apply this approach for recruiting and training research teams in more normal circumstances.