Evaluating simulations as preparation for health crises like CoVID-19: Insights on incorporating simulation exercises for effective response

Supporting the nation in crisis: the military health system's role in enhancing public health capacity through public-private partnerships

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic caused significant global disruptions to the healthcare system, which was forced to make rapid changes in healthcare delivery. The pandemic necessitated closer collaboration between the US civilian healthcare sector and the military health system (MHS), resulting in new and strengthened partnerships that can ultimately benefit public health and healthcare for the nation. In this study, we sought to understand the full range of partnerships in which the MHS engaged with the civilian sector during the COVID-19 pandemic and to elicit lessons for the future.

METHODS

We conducted key informant interviews with MHS policymakers and advisers, program managers and providers who were affiliated with the MHS from March 2020 through December 2022. Key themes were derived using thematic analysis and open coding methods.

RESULTS

We conducted 28 interviews between December 2022 and March 2023. During the pandemic, the MHS collaborated with federal and local healthcare authorities and private sector entities through endeavours such as Operation Warp Speed. Lessons and recommendations for future pandemics were also identified, including investment in biosurveillance systems and integration of behavioural and social sciences.

CONCLUSIONS

The MHS rapidly established and fostered key partnerships with the public and private sectors during the COVID-19 pandemic. The pandemic experience showed that while the MHS is a useful resource for the nation, it also benefits from partnering with a variety of organizations, agencies and private companies. Continuing to develop these partnerships will be crucial for coordinated, effective responses to future pandemics.

Artificial intelligence empowering public health education: prospects and challenges

Artificial Intelligence (AI) is revolutionizing public health education through its capacity for intricate analysis of large-scale health datasets and the tailored dissemination of health-related information and interventions. This article conducts a profound exploration into the integration of AI within public health, accentuating its scientific foundations, prospective progress, and practical application scenarios. It underscores the transformative potential of AI in crafting individualized educational programs, developing sophisticated behavioral models, and informing the creation of health policies. The manuscript strives to thoroughly evaluate the extant landscape of AI applications in public health, scrutinizing critical challenges such as the propensity for data bias and the imperative of safeguarding privacy. By dissecting these issues, the article contributes to the conversation on how AI can be harnessed responsibly and effectively, ensuring that its application in public health education is both ethically grounded and equitable. The paper's significance is multifold: it aims to provide a blueprint for policy formulation, offer actionable insights for public health authorities, and catalyze the progression of health interventions toward increasingly sophisticated and precise approaches. Ultimately, this research anticipates fostering an environment where AI not only augments public health education but also does so with a steadfast commitment to the principles of justice and inclusivity, thereby elevating the standard and reach of health education initiatives globally.

Use of virtual reality exercises in disaster preparedness training: A scoping review

Background

The scope and number of disasters have increased over the years. This has called for more robust disaster preparedness training and plans. The use of virtual reality exercises in addition to tabletop exercises is considered a new approach to the preparation of disaster preparedness plans. Virtual reality exercises are being developed to either replace or complement current traditional approaches to disaster preparedness training.

Objectives

To review and summarize the current existing literature regarding the effectiveness, advantages and limitations of using virtual reality exercises in disaster preparedness as a complementary/replacement mechanism for real-time drills and tabletop exercises.

Methods

In this scoping review, we searched PubMed, Cochrane, EMBASE, PLOS, and Google Scholar for research publications involving virtual reality exercises in disaster training from 2008 to 2022 using "AND" and "OR" operators for the keywords "disaster," "preparedness," "virtual reality," and "tabletop." From a total of 333 articles that resulted in our search and were then evaluated by the authors, 55 articles were finally included in this review.

Results

Virtual reality exercises are found to be better in the formulation of disaster preparedness plans compared to tabletop exercises. Virtual reality exercises can be used as the primary means of creating a real-life-like experience in disaster preparedness training and proved at least as better complementary to tabletop exercises. Virtual reality exercises have many advantages over traditional real-life or tabletop exercises and are more cost-effective, but some drawbacks are still identified.

Conclusion

The advantages of virtual reality exercises are remarkable and underline their benefits and uses versus costs. We highly encourage decision-makers and institutions dealing in disaster preparedness to adopt using virtual reality exercises in training for disaster preparedness.

The UK's pandemic preparedness and early response to the COVID-19 pandemic

This article focuses on the UK's pre-COVID 19 pandemic preparedness and its early response to the COVID-19 pandemic (January '20 - March '20). The aim of this article is to explain the high excess mortality the UK experienced compared to many of its international and European peers in the first wave, which is contrary to the country's high ranking in pre-COVID-19 preparedness rankings. The article assesses the various components of pre-COVID-19 pandemic preparedness such as pandemic strategy, exercises, and stockpiles, and it covers government decision making processes on the early response, including questions around post-travel quarantining, test and trace, and mobility restrictions. The article concludes that there were important deficiencies in the UK's pandemic preparedness and early response in the COVID-19 pandemic. These include the centrality of the 'inevitability of spread'-assumption underpinning the UK's pandemic planning pre-COVID, the insufficient implementation of pandemic exercise recommendations, the lack of early and 'live learning' from other countries' experiences, the lack of adoption of public health advice of the World Health Organisation early on, the late implementation of internal mobility restrictions, the lack of timely consideration of alternative early pandemic response models, and fragilities in the SAGE/governmental interplay.

Hospital-Level COVID-19 Preparedness and Crisis Management in Czechia

Objectives: The COVID-19 pandemic exposed the inadequacy of pandemic preparedness mechanisms worldwide. This study gathered comprehensive data from Czech hospitals, identified possible weaknesses in important areas of crisis preparedness, and quantified changes performed to enhance crisis resilience of healthcare facilities. Methods: Drawing on literature review on pandemic preparedness and hospital crisis management and detailed interviews with hospital representatives, a questionnaire was designed and distributed by email among quality managers of all Czech hospitals. Statistical analysis of their responses was conducted using EZR software. Fisher's exact test and Kruskal-Wallis test, with post hoc testing, were used to assess statistical significance. Results: Achieving response rate of 31.9%, responses from 65 hospitals were analysed. New crisis management policies were necessary in 72.3% of responding hospitals. Furthermore, a majority of the respondents changes indicated the need for changes in policies on general pandemic, human resources and infrastructure and material preparedness. Conclusion: The COVID-19 crisis required significant alterations to previously established hospital crisis management protocols and establishment of new ones. The absence of a unified system for crisis preparedness was noted at hospital and national levels.

Public health emergency preparedness for infectious disease emergencies: a scoping review of recent evidence

BACKGROUND

The COVID-19 pandemic continues to demonstrate the risks and profound health impacts that result from infectious disease emergencies. Emergency preparedness has been defined as the knowledge, capacity and organizational systems that governments, response and recovery organizations, communities and individuals develop to anticipate, respond to, or recover from emergencies. This scoping review explored recent literature on priority areas and indicators for public health emergency preparedness (PHEP) with a focus on infectious disease emergencies.

METHODS

Using scoping review methodology, a comprehensive search was conducted for indexed and grey literature with a focus on records published from 2017 to 2020 onward, respectively. Records were included if they: (a) described PHEP, (b) focused on an infectious emergency, and (c) were published in an Organization for Economic Co-operation and Development country. An evidence-based all-hazards Resilience Framework for PHEP consisting of 11 elements was used as a reference point to identify additional areas of preparedness that have emerged in recent publications. The findings were analyzed deductively and summarized thematically.

RESULTS

The included publications largely aligned with the 11 elements of the all-hazards Resilience Framework for PHEP. In particular, the elements related to collaborative networks, community engagement, risk analysis and communication were frequently observed across the publications included in this review. Ten emergent themes were identified that expand on the Resilience Framework for PHEP specific to infectious diseases. Planning to mitigate inequities was a key finding of this review, it was the most frequently identified emergent theme. Additional emergent themes were: research and evidence-informed decision making, building vaccination capacity, building laboratory and diagnostic system capacity, building infection prevention and control capacity, financial investment in infrastructure, health system capacity, climate and environmental health, public health legislation and phases of preparedness.

CONCLUSION

The themes from this review contribute to the evolving understanding of critical public health emergency preparedness actions. The themes expand on the 11 elements outlined in the Resilience Framework for PHEP, specifically relevant to pandemics and infectious disease emergencies. Further research will be important to validate these findings, and expand understanding of how refinements to PHEP frameworks and indicators can support public health practice.

Research Progress and Improvement Ideas of Anti-Epidemic Resilience in China's Urban Communities

In the post-epidemic era, China's urban communities are at the forefront of implementing the whole chain of accurate epidemic prevention and control. However, the uncertainty of COVID-19, the loopholes in community management and people's overly optimistic judgment of the epidemic have led to the frequent rebound of the epidemic and serious consequences. Existing studies have not yet formed a panoramic framework of community anti-epidemic work under the concept of resilience. Therefore, this article first summarizes the current research progress of resilient communities from three perspectives, including ideas and perspectives, theories and frameworks and methods and means, and summarizes the gap of the current research. Then, an innovative idea on the epidemic resilience of urban communities in China is put forward: (1) the evolution mechanism of community anti-epidemic resilience is described through the change law of dynamic networks; (2) the anti-epidemic resilience of urban communities is evaluated or predicted through the measurement criteria; (3) a simulation platform based on Multi-Agent and dynamic Bayesian networks simulates the interactive relationship between "epidemic disturbance-cost constraint--epidemic resilience"; (4) the anti-epidemic strategies are output intelligently to provide community managers with decision-making opinions on community epidemic prevention and control.

Key Influencing Factors and Optimization Strategy of Epidemic Resilience in Urban Communities-A Case Study of Nanjing, China

COVID-19 has posed a significantly severe impact on both people’s lives and the global economic development. Increasing the community epidemic resilience will considerably improve the national public health emergency response capacity from bottom to top. This study identifies the influencing factors of community epidemic resilience through systematic literature review under the 4R framework, then obtains the relationships of influencing factors through Interpretive structural model, and finally assesses the performance of epidemic resilience using PROMETHEE II method through empirical cases in Nanjing, China. The results show that: (1) Eight factors influencing the epidemic resilience of community are identified, and the economic level plays the root role; (2) Community epidemic resilience can be improved from robustness, rapidity, redundancy and resourcefulness aspects; (3) Through the empirical analysis, the epidemic resilience ranking of community can be displayed (Community D > T > S > F); (4) Additionally, the performance and sensitivity analysis of influencing factors in each community can be demonstrated. (5) Finally, four implications are proposed, namely, allocating public resources rationally, significantly increasing the economic level, ensuring the accuracy of information delivery and conducting disaster learning.