Elaine Hicks Photo credit: Tulane University

Librarians are bringing their information triage, vetting, and organization skills to bear on the current crisis in new ways. Among them, a group of volunteers are indexing vast volumes of information on COVID-19. 

The effort began with Dr. Lina Moses, an epidemiologist and disease ecologist at Tulane University’s School of Public Health and Tropical Medicine (TUSPHTM), New Orleans. In February, she was deployed by the school to the World Health Organization’s (WHO) Geneva headquarters to help respond to COVID-19, as part of the WHO’s Global Outreach Alert & Response Network (GOARN). GOARN leverages the resources of its 250-plus member organizations—public health agencies, research institutes, and academic institutions such as TUSPHTM—to respond to outbreaks. GOARN-Research was developed to handle the findings of those studying and treating outbreaks in the field.

Together with WHO librarians and graduate students, Moses reviewed daily publication reports on the disease with the goal of distributing the most valuable information to WHO’s operational response teams. However, the volume of information was daunting, and she “needed help curating it and pushing it to the right people so they could develop recommendations for this novel disease and pathogen.”

So she reached out to Elaine Hicks, education, research, and public health librarian at Tulane’s Rudolph Matas Library of the Health Sciences. Hicks was well suited for the task—she had worked at the Cook County Department of Public Health in Illinois from 1996 to 2004, as the country grappled with anthrax attacks, SARS, and West Nile virus. 

“I knew she would understand both the academic and operational aspects of GOARN-Research’s mandate and…could bridge some gaps,” said Moses.

A GRASSROOTS COALITION

Hicks knew she couldn’t do it alone. She created the Librarian Reserve Corps (LRC), modeled after the Medical Reserve Corps, a federal government community response organization, and posted a message asking for volunteers on the Medical Library Association’s (MLA) MEDLIB-L listserv. About 130 librarians from the United States, Canada, Germany, Australia, and Trinidad responded. 

“This is an organically developing organization,” said Hicks. “It has no ownership, no budget, no bureaucratic guidelines. We are simply applying our knowledge skills and experience to assist the research needs of Dr. Moses.”

Nevertheless, LRC is a well-organized, effective team. Four workgroups were formed, and leaders emerged. Stacy Brody, a reference and instructional librarian at Himmelfarb Health Sciences Library at George Washington University, School of Medicine and Health Sciences, Washington, DC; and Sara Loree, a medical librarian at St. Luke’s Health System in Idaho, work directly with WHO and GOARN-Research and oversee the efforts of the volunteer librarians. Brody oversees the Daily Publication List Metadata Enhancement, which adds metadata to the records to make them easier to identify, while Loree oversees the Literature Search Services group, which generates evidence inventories as needed by WHO and GOARN partners; the Rapid Systemic Review Searches group, which conducts searches of bibliographic databases in support of reviews done by WHO and GOARN partners; and the Media/News Outlet Alerts, which makes WHO and GOARN partners aware of media coverage of scientific articles related to COVID-19. Since starting the LRC, Hicks has stepped back, letting Brody and Loree take the lead.

IMPERFECT INFO

Many of the records Moses was dealing with weren’t uniformly indexed, making it difficult to know to whom to distribute them. Said Hicks, “This is a consequence of the infodemic, meaning that there’s more information that can be processed by any established” mechanism.

The type of information made the job difficult, too. Moses said, “Reports, briefs, evaluations are so much of what forms the basis for evidence in outbreaks—because people don’t have time to write it up for peer-review, or it’s not novel or what many call ‘innovative’, or it yielded negative results or it wasn’t the most ideal methodologically. But it’s what we have and desperately need for response. I was never trained on how to access this information, either as a responder or a researcher. So I really depend on librarians.”

A major challenge has been the volume of commentary or opinion pieces. “This is often the case in health emergencies,” explained Moses, “because the people who normally would be collecting this data and publishing and building evidence are too busy responding.”

Jessica Callaway, a clinical research librarian at the Shepherd Center in Atlanta, who leads the day-to-day operations of the Daily Publication List Metadata Enhancement group, noted, “Normally all you want is the peer-reviewed research articles, the double-blind studies.” But, said Callaway, many of these opinion pieces contain valuable case information. When indexing, volunteers are especially careful to distinguish a letter to the editor, for example, from a scholarly article.

“The work of the Librarian Reserve Corps is a testament to the power of librarianship in a time of crisis,” said Dr. Susan Norris, a scientist in the science division of WHO. “The demand for information is more vital than ever now, but making sense of it is harder than ever. The Librarian Reserve Corps’ efforts shine a spotlight on the critical importance of librarianship in support of evidence-based decision-making.”

SERVICE AT SCALE

The task ahead was demanding—the daily publication list started at about eight articles and increased to an average of 400, though there have been as many as 1,100 records on a single day. Each day, librarians peruse an alphabetized list of articles and sign up to index a section. Using Zotero, they enter metadata (such as title, author, and date) and relevant tags. So far 32 volunteers have updated roughly 2,200 records.

Being able to have members of the different groups share information was important, so the MLA volunteered the use of its technology platforms. Said Kate Corcoran, senior director, members and communities, of MLA, “We set up a community for the Librarian Reserve Corps, along with five forums, and have helped to sign up volunteers. The community and forums are visible to volunteers through our website and all forum communications are also received by team members via email.”

The vendor Springshare has also made several of its products freely available. LRC uses LibAnswers to manage requests from WHO and GOARN partner organizations, and relies on LibGuides to produce instructional guides for the volunteer librarians, as well as to share daily publication lists with GOARN. Loree said that LRC may use LibWizard “to share surveys with and collect information from other information providers. By collecting the data in one place, we hope to be able to identify opportunities for partnerships and collaboration.” And LibCRM may prove useful to help manage the many volunteers.

Though it’s been a rigorous time commitment—the librarians have volunteered about 500 hours total, on top of increasingly busy day jobs—they are passionate about the work. “Having the ability to access information when you need it is the literal difference between life and death for some people,” said Callaway.

MAKING AN IMPACT

David Banush, dean of libraries at Tulane’s Howard-Tilton Memorial Library, believes the LRC will help universities understand the value of librarians beyond their traditional mandate. “We work with trusted, reliable sources of info every day and we know where to find them and we know how to distribute them, I think and I hope that will be recognized as the real value by our parent institutions going forward when we start to reflect on the current crisis.”

Volunteer Alicia Livinski, a biomedical librarian at the National Institute of Health and a TUSPHTM graduate, hopes that other academic and public librarians are inspired by the work of the LRC. “There’s an intense need at the local public health and state department level for the same kind of support, if not even more so.” She added, “Local public health departments are so overwhelmed in most states, and if they’re not yet, they will be.”