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Hafez S, Ismail SA, Zibwowa Z, Alhamshary N, Elsayed R, Dhaliwal M, Samuels F, Fakoya A. Community interventions for pandemic preparedness: A scoping review of pandemic preparedness lessons from HIV, COVID-19, and other public health emergencies of international concern. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002758. [PMID: 38709792 PMCID: PMC11073720 DOI: 10.1371/journal.pgph.0002758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/06/2024] [Indexed: 05/08/2024]
Abstract
Community action is broadly recognised as central to comprehensive and effective system responses to pandemics. However, there is uncertainty about how and where communities can be best supported to bolster long-term resilience and preparedness. We applied a typology of community interventions (Community Informing, Consulting, Involving, Collaborating or Empowering-or CICICE) to cover the diverse range of interventions identified across the literature and used this to structure a scoping review addressing three linked topics: (i) how CICICE interventions have been understood and applied in the literature on epidemic and pandemic preparedness; (ii) the spectrum of interventions that have been implemented to strengthen CICICE and (iii) what evidence is available on their effectiveness in influencing preparedness for current and future emergencies. We drew on peer-reviewed and grey literature from the HIV (from 2000) and COVID-19 pandemics and recent public health emergencies of international concern (from 2008), identified through systematic searches in MEDLINE, Scopus, the Cochrane Collaboration database, supplemented by keyword-structured searches in GoogleScholar and websites of relevant global health organisations. Following screening and extraction, key themes were identified using a combined inductive/deductive approach. 130 papers met the criteria for inclusion. Interventions for preparedness were identified across the spectrum of CICICE. Most work on COVID-19 focused on informing and consulting rather than capacity building and empowerment. The literature on HIV was more likely to report interventions emphasising human rights perspectives and empowerment. There was little robust evidence on the role of CICICE interventions in building preparedness. Evidence of effect was most robust for multi-component interventions for HIV prevention and control. Much of the reporting focused on intermediate outcomes, including measures of health service utilisation. We put forward a series of recommendations to help address evidence shortfalls, including clarifying definitions, organising and stratifying interventions by several parameters and strengthening evaluation methods for CICICE.
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Affiliation(s)
- Sali Hafez
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sharif A. Ismail
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zandile Zibwowa
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nadin Alhamshary
- The Nuffield Centre for International Health and Development, School of Medicine, The University of Leeds, Leeds, United Kingdom
| | - Reem Elsayed
- The University of Western Cape, Cape Town, South Africa
| | - Mandeep Dhaliwal
- HIV and Health Group, United Nations Development Program, New York, United States of America
| | - Fiona Samuels
- Centre for Public Health and Policy, Queen Mary University of London, London, United Kingdom
| | - Ade Fakoya
- Institute for Global Health, University College London, London, United Kingdom
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Bartoletti M, Bussini L, Bavaro DF, Cento V. What do clinicians mean by epidemics' preparedness. Clin Microbiol Infect 2024; 30:586-591. [PMID: 37327873 DOI: 10.1016/j.cmi.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Infectious disease pandemics and epidemics pose significant global threats, and the risk of emerging infectious diseases has increased because of factors such as international connections, travel, and population density. Despite investments in global health surveillance, much of the world remains unprepared to manage infectious disease threats. OBJECTIVES This review article discusses the general considerations and lessons learned from the COVID-19 pandemic in terms of epidemic preparedness. SOURCES Non-systematic search on PubMed, scientific society websites, and scientific newspapers (performed in April 2023). CONTENT Key factors for preparedness include robust public health infrastructure, adequate allocation of resources, and effective communication between stakeholders. This narrative review emphasizes the need for timely and accurate dissemination of medical knowledge, as well as addressing the challenges of misinformation and infodemics. It also highlights the importance of quick availability of diagnostic tests and vaccines, ensuring equitable access to these technologies. The role of scientific coordination in developing treatment strategies and the safety and mental well-being of healthcare workers are discussed. Lastly, it should be emphasized the need for medical training, multidisciplinary teams, new technologies and artificial intelligence, and the active role of infectious disease physicians in epidemic preparedness efforts. IMPLICATIONS From clinicians' perspective, healthcare authorities play a crucial role in epidemic preparedness even by providing resource management plans, ensuring availability of essential supplies and training, facilitating communication, and improving safe infection management.
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Affiliation(s)
- Michele Bartoletti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Infectious Disease Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
| | - Linda Bussini
- Infectious Disease Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Davide Fiore Bavaro
- Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Valeria Cento
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Microbiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Ozsahin DU, Isa NA, Uzun B, Ozsahin I. Quantifying holistic capacity response and healthcare resilience in tackling COVID-19: Assessment of country capacity by MCDM. PLoS One 2024; 19:e0294625. [PMID: 38578767 PMCID: PMC10997098 DOI: 10.1371/journal.pone.0294625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/31/2023] [Indexed: 04/07/2024] Open
Abstract
The resilience of a country during the COVID-19 pandemic was determined based in whether it was holistically prepared and responsive. This resilience can only be identified through systematic data collection and analysis. Historical evidence-based response indicators have been proven to mitigate pandemics like COVID-19. However, most databases are outdated, requiring updating, derivation, and explicit interpretation to gain insight into the impact of COVID-19. Outdated databases do not show a country's true preparedness and response capacity, therefore, it undermines pandemic threat. This study uses up-to-date evidence-based pandemic indictors to run a cross-country comparative analysis of COVID-19 preparedness, response capacity, and healthcare resilience. PROMETHEE-a multicriteria decision making (MCDM) technique-is used to quantify the strengths (positive) and weaknesses (negative) of each country's COVID-19 responses, with full ranking (net) from best to least responsive. From 22 countries, South Korea obtained the highest net outranking value of 0.1945, indicating that it was the most resilient, while Mexico had the lowest (-0.1428). Although countries were underprepared, there was a robust response to the pandemic, especially in developing countries. This study demonstrates the performance and response capacity of 22 key countries to resist COVID-19, from which other countries can compare their statutory capacity ranking in order to learn/adopt the evidence-based responses of better performing countries to improve their resilience.
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Affiliation(s)
- Dilber Uzun Ozsahin
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Operational Research Center in Healthcare, Near East University, Nicosia/TRNC, Mersin, Turkey
- Department of Biomedical Engineering, Faculty of Engineering, Near East University, Nicosia/TRNC, Mersin, Turkey
| | - Nuhu Abdulhaqq Isa
- Department of Biomedical Engineering, Faculty of Engineering, Near East University, Nicosia/TRNC, Mersin, Turkey
- Department of Biomedical Technology, Nasarawa State College of Health Science and Technology, Keffi, Nasarawa State, Nigeria
| | - Berna Uzun
- Operational Research Center in Healthcare, Near East University, Nicosia/TRNC, Mersin, Turkey
- Department of Statistics, Carlos III University of Madrid, Madrid, Spain
| | - Ilker Ozsahin
- Operational Research Center in Healthcare, Near East University, Nicosia/TRNC, Mersin, Turkey
- Department of Biomedical Engineering, Faculty of Engineering, Near East University, Nicosia/TRNC, Mersin, Turkey
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, New York, United States of America
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Wu C, Zhang H, Zhang Y, Hu M, Lin Y, He J, Li S, Zhang Y, Lang HJ. The biosafety incident response competence scale for clinical nursing staff: a development and validation study. BMC Nurs 2024; 23:180. [PMID: 38486252 PMCID: PMC10941487 DOI: 10.1186/s12912-024-01848-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/05/2024] [Indexed: 03/17/2024] Open
Abstract
AIMS This study was designed to develop a biosafety incident response competence scale and evaluate its validity and reliability among clinical nurses. DESIGN This study employed a sequential approach, comprising four phases: (1) the establishment of a multidimensional conceptual model, (2) the preliminary selection of the items, (3) further exploration and psychometric testing of the items, (4) the application of the scale among clinical nurses. METHODS The biosafety incident response competence conceptual model was developed through literature review and the Delphi method. A total of 1,712 clinical nurses participated in the preliminary items selection, while 1,027 clinical nurses were involved in the further psychometric testing from July 2023 to August 2023. The item analysis, exploratory factor analysis and confirmatory factor analysis were conducted to evaluate the construct validity. Reliability was measured using Cronbach's alpha, split-half reliability, and test-retest reliability, while validity analysis included content validity, structural validity, convergent validity, and discriminant validity. From September to November 2023, we conducted a survey using the established scale with a total of 4338 valid questionnaires collected. T-test and variance analysis was employed to determine potential variations in biosafety incident response competence based on participants characteristics. RESULTS The final scale is composed of 4 factors and 29 items, including monitoring and warning abilities, nursing disposal abilities, biosafety knowledge preparedness, and infection protection abilities. The explanatory variance of the 4 factors was 75.100%. The Cronbach's alpha, split-half reliability and test-retest reliability were 0.974, 0.945 and 0.840 respectively. The Scale-level content validity index was 0.866. The Average Variance Extracted of the 4 factors was larger than 0.5, the Construct Reliability was larger than 0.7, and the Heterotrait-Monotrait ratio were less than 0.9. There were significant differences in the scores of response competence among nurses of different ages, working years, titles, positions, departments, marital status and participation in biosafety training (all P < 0.05). CONCLUSIONS The biosafety incident response competence scale for nurses exhibits satisfactory reliability and validity, making it a valuable tool for assessing clinical nurses' abilities in responding to biosafety incidents.
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Affiliation(s)
- Chao Wu
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Hongli Zhang
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China
- Department of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yinjuan Zhang
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China
- Department of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Mengyi Hu
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China
- Department of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yawei Lin
- 956th Hospital of the Chinese People's Liberation Army, Tibet Xizang, China
| | - Jing He
- Laboratory Department, Yan'an University Affiliated Hospital, Yan'an, Shaanxi, China
| | - Shuwen Li
- Department of Neurosurgery, Tangdu Hospital, No.1 Xinsi Road, Xi'an, 710032, Shaanxi, China.
| | - Yulian Zhang
- Shaanxi Provincial People's Hospital, No.256 Youyi West Road, Xi'an, 710032, Shaanxi, China.
| | - Hong-Juan Lang
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China.
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Heltveit-Olsen SR, Lunde L, Brænd AM, Spehar I, Høye S, Skoglund I, Sundvall PD, Fossum GH, Straand J, Risør MB. Local management of the COVID-19 pandemic in Norway: a longitudinal interview study of municipality chief medical officers. Scand J Prim Health Care 2024; 42:214-224. [PMID: 38214890 PMCID: PMC10851791 DOI: 10.1080/02813432.2023.2301562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/28/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE To explore the experiences and views of Norwegian Municipality Chief Medical Officers (MCMOs) on preparedness, collaboration, and organization during the COVID-19 pandemic to gain insight into local crisis management of value for future pandemic responses. DESIGN Longitudinal qualitative interview study. We conducted semi-structured digital interviews with nine MCMOs working in different municipalities in Norway from September to December 2020. Five MCMOs were re-interviewed from January to April 2021. We used thematic analysis to analyze the data. RESULTS Through the analysis, three major themes were identified in the material; 1) The view of preparedness changed from being low-priority and dormant to the desire to strengthen preparedness as a permanent measure; 2) The nature of the pandemic forced a change in internal and external communication and collaboration for the MCMOs towards direct dialogue, teamwork and digital networking; 3) The pandemic changed the role and position of the MCMO within the municipal organization. Although most MCMOs were given a leading role in the municipal pandemic response, some MCMOs experienced that they were not positioned to fully exercise their intended role. In our material, de-authorization of the MCMO role seemed to coincide with the increasing size and organizational complexity of the municipality. CONCLUSIONS The Norwegian pandemic response and outcome have been regarded as successful internationally. Although the MCMOs managed to implement flexible and quick responses facilitated by teamwork, dialogue, and joint sensemaking, they also identified several challenges and shortcomings of the Norwegian pandemic preparedness requiring organizational and financial changes to sustain future health system resilience.
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Affiliation(s)
- Silje Rebekka Heltveit-Olsen
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lene Lunde
- Department of Public Health Science, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anja Maria Brænd
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ivan Spehar
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
- Institute of Psychology, Oslo New University College, Oslo, Norway
| | - Sigurd Høye
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ingmarie Skoglund
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Sweden
| | - Pär-Daniel Sundvall
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Sweden
| | - Guro Haugen Fossum
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jørund Straand
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Mette Bech Risør
- Department of Public Health, The Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark
- The General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Gómez-Pérez GP, de Graaff AE, Dekker JT, Agyei BB, Dada I, Milimo E, Ommeh MS, Risha P, Rinke de Wit TF, Spieker N. Preparing healthcare facilities in sub-Saharan Africa for future outbreaks: insights from a multi-country digital self-assessment of COVID-19 preparedness. BMC Health Serv Res 2024; 24:254. [PMID: 38413977 PMCID: PMC10900561 DOI: 10.1186/s12913-024-10761-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/20/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Despite previous experience with epidemics, African healthcare systems were inadequately prepared and substantially impacted by the coronavirus disease 2019 (COVID-19) pandemic. Limited information about the level of COVID-19 preparedness of healthcare facilities in Africa hampers policy decision-making to fight future outbreaks in the region, while maintaining essential healthcare services running. METHODS Between May-November 2020, we performed a survey study with SafeCare4Covid - a free digital self-assessment application - to evaluate the COVID-19 preparedness of healthcare facilities in Africa following World Health Organization guidelines. The tool assessed (i) COVID-19-related capabilities with 31 questions; and (ii) availability of essential medical supplies with a 23-supplies checklist. Tailored quality improvement plans were provided after assessments. Information about facilities' location, type, and ownership was also collected. RESULTS Four hundred seventy-one facilities in 11 African countries completed the capability assessment; 412 also completed the supplies checklist. The average capability score on a scale of 0-100 (n=471) was 58.0 (interquartile range 40.0-76.0), and the average supplies score (n=412) was 61.6 (39.0-83.0). Both scores were significantly lower in rural (capability score, mean 53.6 [95%CI:50.3-57.0]/supplies score, 59.1 [55.5-62.8]) versus urban facilities (capability score, 65.2 [61.7-68.7]/supplies score, 70.7 [67.2-74.1]) (P<0.0001 for both comparisons). Likewise, lower scores were found for public versus private clinics, and for primary healthcare centres versus hospitals. Guidelines for triage and isolation, clinical management of COVID-19, staff mental support, and contact tracing forms were largely missing. Handwashing stations were partially equipped in 33% of facilities. The most missing medical supply was COVID-19 specimen collection material (71%), while 43% of facilities did not have N95/FFP2 respirators and 19% lacked medical masks. CONCLUSIONS A large proportion of public and private African facilities providing basic healthcare in rural areas, lacked fundamental COVID-19-related capabilities and life-saving personal protective equipment. Decentralization of epidemic preparedness efforts in these settings is warranted to protect healthcare workers and patients alike in future epidemics. Digital tools are of great value to timely measure and improve epidemic preparedness of healthcare facilities, inform decision-making, create a more stakeholder-broad approach and increase health-system resilience for future disease outbreaks.
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Affiliation(s)
- Gloria P Gómez-Pérez
- PharmAccess Foundation, Amsterdam, The Netherlands.
- Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands.
| | | | | | | | | | | | | | - Peter Risha
- PharmAccess Tanzania, Dar es Salaam, Tanzania
| | - Tobias F Rinke de Wit
- PharmAccess Foundation, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands
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Muhsen K, Cohen D, Glatman-Freedman A, Husseini S, Perlman S, McNeil C. Review of Israel's action and response during the COVID-19 pandemic and tabletop exercise for the evaluation of readiness and resilience-lessons learned 2020-2021. Front Public Health 2024; 11:1308267. [PMID: 38328537 PMCID: PMC10847317 DOI: 10.3389/fpubh.2023.1308267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/28/2023] [Indexed: 02/09/2024] Open
Abstract
Background Reevaluating response plans is essential to ensuring consistent readiness and resilience to the COVID-19 pandemic. The "During Action Review" and Tabletop (DART) methodology provides a retrospective and prospective assessment to inform the adaptive response. Israel introduced COVID-19 vaccinations in December 2020 and was the first country to implement booster vaccination to address waning immunity and surges caused by new variants. We assessed Israel's readiness and resilience related to COVID-19 response while capturing the pre-vaccination and vaccination periods. Methods A DART analysis was conducted between December 2020 and August 2021 among experts involved in the management of the COVID-19 pandemic in Israel. During the retrospective stage, a role-based questionnaire and discussions were undertaken in a participant-led review of the response, focusing on epidemiology and surveillance, risk communication, and vaccines. The prospective stage included tabletop exercises to evaluate short to long-term simulated scenarios. Results Participants emphasized the pivotal role of Israel globally by sharing experiences with the pandemic, and vaccination. Perceived strengths included multi-sectoral collaboration between the Ministry of Health, healthcare providers, academia, military, and others, stretching capacities, expanding laboratory workload, and establishing/maintaining surveillance. The vaccine prioritization plan and strong infrastructure, including computerized databases, enabled real-life assessment of vaccine uptake and impact. Challenges included the need to change case definitions early on and insufficient staffing. Quarantine of patients and contacts was particularly challenging among underprivileged communities. Risk communication approaches need to focus more on creating norms in behavior. Trust issues and limited cooperation were noted, especially among ethnic and religious minorities. To ensure readiness and resiliency, participants recommended establishing a nationally deployed system for bringing in and acting upon feedback from the field, especially concerning risk communication and vaccines. Conclusion Our study appraised strengths and weaknesses of the COVID-19 pandemic response in Israel and led to concrete recommendations for adjusting responses and future similar events. An efficient response comprised multi-sectoral collaboration, policy design, infrastructure, care delivery, and mitigation measures, including vaccines, while risk communication, trust issues, and limited cooperation with minority groups were perceived as areas for action and intervention.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Middle East Consortium on Infectious Disease Surveillance, Jerusalem, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Middle East Consortium on Infectious Disease Surveillance, Jerusalem, Israel
| | - Aharona Glatman-Freedman
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Sari Husseini
- Middle East Consortium on Infectious Disease Surveillance, Jerusalem, Israel
| | - Saritte Perlman
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Debie A, Nigusie A, Gedle D, Khatri RB, Assefa Y. Building a resilient health system for universal health coverage and health security: a systematic review. Glob Health Res Policy 2024; 9:2. [PMID: 38173020 PMCID: PMC10765832 DOI: 10.1186/s41256-023-00340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Resilient health system (RHS) is crucial to achieving universal health coverage (UHC) and health security. However, little is known about strategies towards RHS to improve UHC and health security. This systematic review aims to synthesise the literature to understand approaches to build RHS toward UHC and health security. METHODS A systematic search was conducted including studies published from 01 January 2000 to 31 December 2021. Studies were searched in three databases (PubMed, Embase, and Scopus) using search terms under four domains: resilience, health system, universal health coverage, and health security. We critically appraised articles using Rees and colleagues' quality appraisal checklist to assess the quality of papers. A systematic narrative synthesis was conducted to analyse and synthesise the data using the World Health Organization's health systems building block framework. RESULTS A total of 57 articles were included in the final review. Context-based redistribution of health workers, task-shifting policy, and results-based health financing policy helped to build RHS. High political commitment, community-based response planning, and multi-sectorial collaboration were critical to realising UHC and health security. On the contrary, lack of access, non-responsive, inequitable healthcare services, poor surveillance, weak leadership, and income inequalities were the constraints to achieving UHC and health security. In addition, the lack of basic healthcare infrastructures, inadequately skilled health workforces, absence of clear government policy, lack of clarity of stakeholder roles, and uneven distribution of health facilities and health workers were the challenges to achieving UHC and health security. CONCLUSIONS Advanced healthcare infrastructures and adequate number of healthcare workers are essential to achieving UHC and health security. However, they are not alone adequate to protect the health system from potential failure. Context-specific redistribution of health workers, task-shifting, result-based health financing policies, and integrated and multi-sectoral approaches, based on the principles of primary health care, are necessary for building RHS toward UHC and health security.
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Affiliation(s)
- Ayal Debie
- Departement of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Adane Nigusie
- Departement of Health Education and Behavioral Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Dereje Gedle
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Resham B Khatri
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Yibeltal Assefa
- School of Public Health, The University of Queensland, Brisbane, Australia
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Abu-Ras W, Ashraf AbuLaban A, Talat AlQaisi S, AlQaisi MTH, Decker E. Orphans in Syria and Iraq Juggling Balls: Wars, COVID-19, and the NGO's financial crisis. Int J Qual Stud Health Well-being 2023; 18:2170010. [PMID: 36744740 PMCID: PMC9904298 DOI: 10.1080/17482631.2023.2170010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic's impact varies between and within nations, causing new forms of inequality. Refugee and orphan children in conflicted areas are more likely to suffer due to poverty, vulnerability, and limited access to essential services including reduction in donor funding. This qualitative study is the first to assess the effects of the COVID-19 pandemic and the financial crisis on Iraqi and Syrian orphaned children and their mothers. The Modified Grounded Theory was used for the preliminary analysis to expand the range of themes. This study has identified five major themes: financial crisis, low educational attainment, child labour, mental health issues, violence, and social problems. The impact of COVID-19 children and adolescents' mental health is of great concern. These multiple crises may significantly impact orphan children and adolescents' cognitive, mental health, and physical development. It is critical to address mental health issues during the current crisis and to plan for possible future pandemics and their intersecting outcomes. A Holistic approach requires providers to be aware of their clients' intersecting circumstances and needs using a range of lenses, including the person in the environment, family dynamics, culture, politics, and structural challenges. Offering food, medical supplies, and housing are considered basic needs.
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Affiliation(s)
- Wahiba Abu-Ras
- Adelphi School of Social Work, Garden City, NY, United States,CONTACT Wahiba Abu-Ras Adelphi School of Social Work, One South Avenue Garden City, Garden City, New York11530
| | | | | | | | - Eliza Decker
- MSW Candidate Adelphi School of Social Work, Garden City, NY, United States of America
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Baron R, Hamdiui N, Helms YB, Crutzen R, Götz HM, Stein ML. Evaluating the Added Value of Digital Contact Tracing Support Tools for Citizens: Framework Development. JMIR Res Protoc 2023; 12:e44728. [PMID: 38019583 PMCID: PMC10719815 DOI: 10.2196/44728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic revealed that with high infection rates, health services conducting contact tracing (CT) could become overburdened, leading to limited or incomplete CT. Digital CT support (DCTS) tools are designed to mimic traditional CT, by transferring a part of or all the tasks of CT into the hands of citizens. Besides saving time for health services, these tools may help to increase the number of contacts retrieved during the contact identification process, quantity and quality of contact details, and speed of the contact notification process. The added value of DCTS tools for CT is currently unknown. OBJECTIVE To help determine whether DCTS tools could improve the effectiveness of CT, this study aims to develop a framework for the comprehensive assessment of these tools. METHODS A framework containing evaluation topics, research questions, accompanying study designs, and methods was developed based on consultations with CT experts from municipal public health services and national public health authorities, complemented with scientific literature. RESULTS These efforts resulted in a framework aiming to assist with the assessment of the following aspects of CT: speed; comprehensiveness; effectiveness with regard to contact notification; positive case detection; potential workload reduction of public health professionals; demographics related to adoption and reach; and user experiences of public health professionals, index cases, and contacts. CONCLUSIONS This framework provides guidance for researchers and policy makers in designing their own evaluation studies, the findings of which can help determine how and the extent to which DCTS tools should be implemented as a CT strategy for future infectious disease outbreaks.
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Affiliation(s)
- Ruth Baron
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Nora Hamdiui
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Yannick B Helms
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Hannelore M Götz
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Mart L Stein
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
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11
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Yuan B. The application of policy composite indicators to predicting the health risk and recovery: a global comparative investigation. Public Health 2023; 224:209-214. [PMID: 37852057 DOI: 10.1016/j.puhe.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/18/2023] [Accepted: 09/07/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES There emerges increasing doubt regarding whether the policy composite indicators are applicable to the COVID-19 pandemic. A few early studies demonstrate that the association between some composite indicators of policy preparedness and the risk of COVID-19 is statistically insignificant, and the relation between any composite indicators and recovery process (e.g., vaccination coverage) remains unexplored. To examine the relation between composite indicators and pandemic risk (as well as the vaccination coverage) with robustness, this study applies different policy preparedness indicators by using data from multi-sources. STUDY DESIGN A cross-sectional analysis was performed. METHOD Regression analysis is adopted to examine the relation between four policy preparedness indicators (i.e., [1] International Health Regulations core capacity index, [2] Global Health Security Index, [3] epidemic preparedness index, and [4] World Governance Index) and COVID-19-confirmed cases/death/vaccination coverage at different time points. The linear regression is performed, and the spatial distribution of indicators are illustrated. RESULTS Countries with higher ranking in policy preparedness indexes can experience less severity of pandemic risk (e.g., confirmed cases and mortality) and faster recovery process (e.g., higher vaccination coverage). However, slight disparity in effectiveness exists across different indicators. CONCLUSION Results show that the policy preparedness indicators have predictive value of the confirmed cases, mortality, and vaccination coverage of COVID-19 pandemic, given sufficiently long-time span is observed.
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Affiliation(s)
- B Yuan
- Sun Yat-sen University, West Xingang Rd 135, 510275, Guangzhou, China.
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12
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Shehu N, Okwor T, Dooga J, Wele A, Cihambanya L, Okonkon I, Gadanya M, Sebastine J, Okoro B, Okafor O, Abejegah C, Oragunye D, Olayinka A. Train-the-trainers intervention for national capacity building in infection prevention and control for COVID-19 in Nigeria. Heliyon 2023; 9:e21978. [PMID: 38034678 PMCID: PMC10682610 DOI: 10.1016/j.heliyon.2023.e21978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Background The first case of COVID-19 in Nigeria was reported on February 27, 2020, and over time, spread across the country leading to many healthcare worker infections. The risk of transmission of COVID-19 within healthcare facilities makes it necessary to establish infection prevention and control measures. The World Health Organisation supported the Nigeria Centre for Disease Control to conduct a train-the-trainers workshop on infection prevention and control for key healthcare workers across Nigeria. Aim/Objectives This study aims to describe the process and results of train-the-trainers as an intervention for national capacity building in infection prevention and control for COVID-19 among healthcare workers in Nigeria. Methods Eight-hour sessions were held over three days with face-to-face instruction and practical hands-on experience in April 2020. A total of 61 healthcare workers participated across the six geographic zones of Nigeria: North Central, North East, North West, South West, South East, and South South. The training included slide presentations, case-based scenarios, and practical hands-on sessions with plenary discussions. Pre- and post-test assessments were used to evaluate knowledge of COVID-19, triage, and infection prevention and control among healthcare workers. Finding/Results 69 % (42) of the participants were male 31 % (19) were female, and the majority (67 %) were medical doctors. Others attending were nurses or health administrators. Of the 70 % (26) of the states with existing infection prevention and control structures within the COVID emergency response, only 40 % were functional. The average percentage of pre-test and post-test scores were 60.8 ± 13.4 and 67.8 ± 9 0.3 respectively, showing a statistically significant difference (p > 0.001) in trainee knowledge. Additionally, 70 % of participants evaluated the training workshop as "satisfactory" or higher in training format, relevance for daily clinical work, active participation, learning new concepts, and logistics. Conclusion Nationwide infection prevention and control training is feasible during a national health crisis. Infection prevention and control is cardinal in the containment of epidemic-prone diseases like COVID-19 and is invaluable in the prevention of healthcare-associated infections in healthcare settings.
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Affiliation(s)
- N.Y. Shehu
- West African Center for Emerging Infectious Diseases (WAC-EID), Jos University Teaching Hospital, Nigeria
| | - T. Okwor
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - J. Dooga
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - A.M. Wele
- University of Port Harcourt Teaching Hospital, Nigeria
| | - L. Cihambanya
- World Health Organization AFRO Regional Office, Brazzaville, People’s Republic of Congo
| | | | - M. Gadanya
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - J. Sebastine
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - B. Okoro
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - O. Okafor
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | | | - D. Oragunye
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - A. Olayinka
- World Health Organization AFRO Regional Office, Brazzaville, People’s Republic of Congo
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13
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Chen X, Kunasekaran MP, Hutchinson D, Stone H, Zhang T, Aagerup J, Moa A, MacIntyre CR. Enhanced EPIRISK tool for rapid epidemic risk analysis. Public Health 2023; 224:159-168. [PMID: 37797562 DOI: 10.1016/j.puhe.2023.08.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/31/2023] [Accepted: 08/26/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVES This study aims to create an enhanced EPIRISK tool in order to correctly predict COVID-19 severity in various countries. The original EPIRISK tool was developed in 2018 to predict the epidemic risk and prioritise response. The tool was validated against nine historical outbreaks prior to 2020. However, it rated many high-income countries that had poor performance during the COVID-19 pandemic as having lower epidemic risk. STUDY DESIGN This study was designed to modify EPIRISK by reparameterizing risk factors and validate the enhanced tool against different outbreaks, including COVID-19. METHODS We identified three factors that could be indicators of poor performance witnessed in some high-income countries: leadership, culture and universal health coverage. By adding these parameters to EPIRISK, we created a series of models for the calibration and validation. These were tested against non-COVID outbreaks in nine countries and COVID-19 outbreaks in seven countries to identify the best-fit model. The COVID-19 severity was determined by the global incidence and mortality, which were equally divided into four levels. RESULTS The enhanced EPIRISK tool has 17 parameters, including seven disease-related and 10 country-related factors, with an algorithm developed for risk level classification. It correctly predicted the risk levels of COVID-19 for all seven countries and all nine historical outbreaks. CONCLUSIONS The enhanced EPIRSIK is a multifactorial tool that can be widely used in global infectious disease outbreaks for rapid epidemic risk analysis, assisting first responders, government and public health professionals with early epidemic preparedness and prioritising response to infectious disease outbreaks.
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Affiliation(s)
- X Chen
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - M P Kunasekaran
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - D Hutchinson
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - H Stone
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - T Zhang
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - J Aagerup
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - A Moa
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - C R MacIntyre
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; College of Public Service & Community Solutions, Arizona State University, Tempe, AZ 85004, United States
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14
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Rogers CJ, Cutler B, Bhamidipati K, Ghosh JK. Preparing for the next outbreak: A review of indices measuring outbreak preparedness, vulnerability, and resilience. Prev Med Rep 2023; 35:102282. [PMID: 37333424 PMCID: PMC10264331 DOI: 10.1016/j.pmedr.2023.102282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 06/20/2023] Open
Abstract
The COVID-19 pandemic has highlighted the need for relevant metrics describing the resources and community attributes that affect the impact of communicable disease outbreaks. Such tools can help inform policy, assess change, and identify gaps to potentially reduce the negative outcomes of future outbreaks. The present review was designed to identify available indices to assess communicable disease outbreak preparedness, vulnerability, or resilience, including articles describing an index or scale developed to address disasters or emergencies which could be applied to addressing a future outbreak. This review assesses the landscape of indices available, with a particular focus on tools assessing local-level attributes. This systematic review yielded 59 unique indices applicable to assessing communicable disease outbreaks through the lens of preparedness, vulnerability, or resilience. However, despite the large number of tools identified, only 3 of these indices assessed factors at the local level and were generalizable to different types of outbreaks. Given the influence of local resources and community attributes on a wide range of communicable disease outcomes, there is a need for local-level tools that can be applied broadly to various types of outbreaks. Such tools should assess both current and long-term changes in outbreak preparedness with the intent to identify gaps, inform local-level decision makers, public policy, and future response to current and novel outbreaks.
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Affiliation(s)
- Christopher J Rogers
- Heluna Health 13300 Crossroads Pkwy N #450, City of Industry, CA 91746, United States
- Department of Health Sciences, California State University, Northridge, CA, United States
| | - Blayne Cutler
- Heluna Health 13300 Crossroads Pkwy N #450, City of Industry, CA 91746, United States
| | - Kasturi Bhamidipati
- Heluna Health 13300 Crossroads Pkwy N #450, City of Industry, CA 91746, United States
- Columbia Mailman School of Public Health, New York, United States
| | - Jo Kay Ghosh
- Heluna Health 13300 Crossroads Pkwy N #450, City of Industry, CA 91746, United States
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15
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Tan MZY, Prager G, McClelland A, Dark P. Healthcare resilience: a meta-narrative systematic review and synthesis of reviews. BMJ Open 2023; 13:e072136. [PMID: 37730383 PMCID: PMC10514640 DOI: 10.1136/bmjopen-2023-072136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered 'resilient' have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical capacities. This study aims to explore and synthesise evidence about healthcare resilience and present a unified framework for future resilience-building. DESIGN Systematic review and synthesis of reviews using a meta-narrative approach. SETTING Healthcare organisations and systems. PRIMARY AND SECONDARY OUTCOME MEASURES Definitions, concepts and measures of healthcare resilience. We used thematic analysis across included reviews to summarise evidence on healthcare resilience. RESULTS The main paradigms within healthcare resilience include global health, disaster risk reduction, emergency management, patient safety and public health. Definitions of healthcare resilience recognise various hierarchical levels: individual (micro), facility or organisation (meso), health system (macro) and planetary or international (meta). There has been a shift from a focus on mainly disasters and crises, to an 'all-hazards' approach to resilience. Attempts to measure resilience have met with limited success. We analysed key concepts to build a framework for healthcare resilience containing pre-event, intra-event, post-event and trans-event domains. Alongside, we synthesise a definition which dovetails with our framework. CONCLUSION Resilience increasingly takes an all-hazards approach and a process-oriented perspective. There is increasing recognition of the relational aspects of resilience. Few frameworks incorporate these, and they are difficult to capture within measurement systems. We need to understand how resilience works across hierarchical levels, and how competing priorities may affect overall resilience. Understanding these will underpin interdisciplinary, cross-sectoral and multi-level approaches to healthcare resilience for the future. PROSPERO REGISTRATION NUMBER CRD42022314729.
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Affiliation(s)
- Mark Z Y Tan
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
| | - Gabrielle Prager
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew McClelland
- Alliance Manchester Business School, The University of Manchester, Manchester, UK
| | - Paul Dark
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
- Clinical Research Network, National Institute for Health and Care Research, London, UK
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16
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Wei W, Liu Y, Zhou N, Tian M, Xie L, Watson R, Dai F, Chen Y, Hu W. Constructing an emergency preparedness evaluation index system for public use during major emerging infectious disease outbreaks: a Delphi study. BMC Public Health 2023; 23:1109. [PMID: 37291522 PMCID: PMC10249543 DOI: 10.1186/s12889-023-15980-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND The major emerging infectious diseases (MEIDs) have occurred frequently and become increasingly serious in the world. Sufficient personal emergency preparedness is critical for the general people in efficiently responding to and recovering from MEIDs. Nevertheless, few specific indicators are available for assessing the individual emergency preparedness of the general public during these periods. Therefore, the aim of this study was to construct an index system for comprehensively evaluating the personal emergency preparedness of the public regarding MEIDs. METHODS Based on the global national-level emergency preparedness index framework and a literature review, a preliminary index system was constructed. From June 2022 to September 2022, a panel of 20 experts from nine provinces and municipalities across multiple research areas participated in this Delphi study. They rated the importance of pre-defined indicators using a five-point Likert scale and provided their qualitative comments. According to the feedback of each round of experts, the indicators of the evaluation index system were revised. RESULTS After two rounds of expert consultation the evaluation index system reached a consensus, containing five first-level indicators, cooperating with prevention and control work, improving emergency response capacity, securing supplies and equipment, preparing economic resources, maintaining physical and mental health with affiliated 20 s-level indicators and 53 third-level indicators. The expert authority coefficient of consultation was 0.88 and 0.90. The Kendall's coefficient of concordance of expert consultations was 0.294 and 0.322, respectively. The differences were statistically significant (P < 0.05). CONCLUSION A valid, reliable and scientific evaluation index system was established. This personal emergency preparedness index system, as a precursor form, will further lay the foundation for the formation of an assessment instrument. At the same time, it could provide a reference for future education and training of emergency preparedness for the general public.
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Affiliation(s)
- Wei Wei
- School of Nursing, Southwest Medical University, 1 Xianglin Road, Luzhou, China
| | - Yubei Liu
- School of Nursing, Southwest Medical University, 1 Xianglin Road, Luzhou, China
| | - Na Zhou
- School of Nursing, Southwest Medical University, 1 Xianglin Road, Luzhou, China
| | - Min Tian
- Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Luzhou, China
| | - Longsheng Xie
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Luzhou, China
| | - Roger Watson
- Health and Social Care Faculty, University of Hull, Cottingham Road, Hull, HU6 7RX, USA
| | - Fengling Dai
- Department of Science and Technology, Southwest Medical University, 1 Xianglin Road, Luzhou, China
| | - Yanhua Chen
- School of Nursing, Southwest Medical University, 1 Xianglin Road, Luzhou, China.
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Luzhou, China.
| | - Weili Hu
- School of Nursing, Southwest Medical University, 1 Xianglin Road, Luzhou, China.
- College of Humanities and Management, Southwest Medical University, 1 Xianglin Road, Luzhou, China.
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17
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Can COVID-19 response inform future health system reforms? Lessons learned from Finland. Health Policy 2023; 132:104802. [PMID: 37028262 PMCID: PMC10063522 DOI: 10.1016/j.healthpol.2023.104802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023]
Abstract
The COVID-19 pandemic has plagued health systems in an unprecedented way and challenged the traditional ways to respond to epidemics. It has also revealed several vulnerabilities in countries’ health systems and preparedness. In this paper we take the Finnish health system as an example to analyse how pre-COVID-19 preparedness plans, regulations, and health system governance were challenged by the pandemic and what lessons can be learned for the future. Our analysis draws on policy documents, grey literature, published research, and the COVID-19 Health System Response Monitor. The analysis shows how major public health crises often reveal weaknesses in health systems, also in countries which have been ranked highly in terms of crisis preparedness. In Finland, there were apparent regulative and structural problems which challenged the health system response, but in terms of epidemic control, the results appear to be relatively good. The pandemic may have long-term effects on the health system functioning and governance. In January 2023, an extensive health and social services reform has taken place in Finland. The new health system structure needs to be adjusted to take on board the legacy of the pandemic and a new regulatory frame for health security should be considered.
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18
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MacIntyre CR, Chen X, Kunasekaran M, Quigley A, Lim S, Stone H, Paik HY, Yao L, Heslop D, Wei W, Sarmiento I, Gurdasani D. Artificial intelligence in public health: the potential of epidemic early warning systems. J Int Med Res 2023; 51:3000605231159335. [PMID: 36967669 PMCID: PMC10052500 DOI: 10.1177/03000605231159335] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
The use of artificial intelligence (AI) to generate automated early warnings in epidemic surveillance by harnessing vast open-source data with minimal human intervention has the potential to be both revolutionary and highly sustainable. AI can overcome the challenges faced by weak health systems by detecting epidemic signals much earlier than traditional surveillance. AI-based digital surveillance is an adjunct to-not a replacement of-traditional surveillance and can trigger early investigation, diagnostics and responses at the regional level. This narrative review focuses on the role of AI in epidemic surveillance and summarises several current epidemic intelligence systems including ProMED-mail, HealthMap, Epidemic Intelligence from Open Sources, BlueDot, Metabiota, the Global Biosurveillance Portal, Epitweetr and EPIWATCH. Not all of these systems are AI-based, and some are only accessible to paid users. Most systems have large volumes of unfiltered data; only a few can sort and filter data to provide users with curated intelligence. However, uptake of these systems by public health authorities, who have been slower to embrace AI than their clinical counterparts, is low. The widespread adoption of digital open-source surveillance and AI technology is needed for the prevention of serious epidemics.
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Affiliation(s)
- Chandini Raina MacIntyre
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
- College of Public Service & Community Solutions, Arizona State University, Tempe, United States
| | - Xin Chen
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Ashley Quigley
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Samsung Lim
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
- School of Civil and Environmental Engineering, University of New South Wales, Sydney, Australia
| | - Haley Stone
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Hye-Young Paik
- School of Computer Science and Engineering, Faulty of Engineering, University of New South Wales, Sydney, Australia
| | - Lina Yao
- School of Computer Science and Engineering, Faulty of Engineering, University of New South Wales, Sydney, Australia
| | - David Heslop
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Wenzhao Wei
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Ines Sarmiento
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Deepti Gurdasani
- William Harvey Research Institute, Queen Mary University of London, United Kingdom
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19
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Traore T, Shanks S, Haider N, Ahmed K, Jain V, Rüegg SR, Razavi A, Kock R, Erondu N, Rahman-Shepherd A, Yavlinsky A, Mboera L, Asogun D, McHugh TD, Elton L, Oyebanji O, Okunromade O, Ansumana R, Djingarey MH, Ali Ahmed Y, Diallo AB, Balde T, Talisuna A, Ntoumi F, Zumla A, Heymann D, Socé Fall I, Dar O. How prepared is the world? Identifying weaknesses in existing assessment frameworks for global health security through a One Health approach. Lancet 2023; 401:673-687. [PMID: 36682374 DOI: 10.1016/s0140-6736(22)01589-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023]
Abstract
The COVID-19 pandemic has exposed faults in the way we assess preparedness and response capacities for public health emergencies. Existing frameworks are limited in scope, and do not sufficiently consider complex social, economic, political, regulatory, and ecological factors. One Health, through its focus on the links among humans, animals, and ecosystems, is a valuable approach through which existing assessment frameworks can be analysed and new ways forward proposed. Although in the past few years advances have been made in assessment tools such as the International Health Regulations Joint External Evaluation, a rapid and radical increase in ambition is required. To sufficiently account for the range of complex systems in which health emergencies occur, assessments should consider how problems are defined across stakeholders and the wider sociopolitical environments in which structures and institutions operate. Current frameworks do little to consider anthropogenic factors in disease emergence or address the full array of health security hazards across the social-ecological system. A complex and interdependent set of challenges threaten human, animal, and ecosystem health, and we cannot afford to overlook important contextual factors, or the determinants of these shared threats. Health security assessment frameworks should therefore ensure that the process undertaken to prioritise and build capacity adheres to core One Health principles and that interventions and outcomes are assessed in terms of added value, trade-offs, and cobenefits across human, animal, and environmental health systems.
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Affiliation(s)
- Tieble Traore
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal.
| | - Sarah Shanks
- Institute of Zoology, Zoological Society of London, London, UK
| | - Najmul Haider
- Royal Veterinary College, University of London, London, UK; School of Life Sciences, Keele University, Keele, UK
| | - Kanza Ahmed
- Global Operations, UK Health Security Agency, London, UK
| | - Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Simon R Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ahmed Razavi
- Global Operations, UK Health Security Agency, London, UK
| | - Richard Kock
- Royal Veterinary College, University of London, London, UK
| | - Ngozi Erondu
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
| | | | - Alexei Yavlinsky
- Infectious Disease Informatics, Institute of Health Informatics, University College London, London, UK
| | - Leonard Mboera
- Southern African Centre for Infectious Disease Surveillance Foundation for One Health, Morogoro, Tanzania
| | - Danny Asogun
- Ekpoma and Irrua Specialist Teaching Hospital, Ambrose Alli University, Irrua, Nigeria
| | - Timothy D McHugh
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Linzy Elton
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Oyeronke Oyebanji
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Rashid Ansumana
- School of Community Health Sciences, Niala University, Bo Campus, Bo, Sierra Leone
| | - Mamoudou Harouna Djingarey
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Yahaya Ali Ahmed
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Amadou Bailo Diallo
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - Thierno Balde
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Ambrose Talisuna
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - David Heymann
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Osman Dar
- Global Operations, UK Health Security Agency, London, UK; Global Health Programme, Royal Institute of International Affairs, London, UK
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Kuhlmann E, Lotta G, Fernandez M, Herten-Crabb A, Mac Fehr L, Maple JL, Paina L, Wenham C, Willis K. SDG5 "Gender Equality" and the COVID-19 pandemic: A rapid assessment of health system responses in selected upper-middle and high-income countries. Front Public Health 2023; 11:1078008. [PMID: 36817917 PMCID: PMC9935821 DOI: 10.3389/fpubh.2023.1078008] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction The COVID-19 pandemic disrupted healthcare and societies, exacerbating existing inequalities for women and girls across every sphere. Our study explores health system responses to gender equality goals during the COVID-19 pandemic and inclusion in future policies. Methods We apply a qualitative comparative approach, drawing on secondary sources and expert information; the data was collected from March-July 2022. Australia, Brazil, Germany, the United Kingdom, and the USA were selected, reflecting upper-middle and high-income countries with established public health and gender policies but different types of healthcare systems and epidemiological and geo-political conditions. Three sub-goals of SDG5 were analyzed: maternity care/reproductive health, gender-based violence, and gender equality/women's leadership. Results We found similar trends across countries. Pandemic policies strongly cut into women's health, constrained prevention and support services, and weakened reproductive rights, while essential maternity care services were kept open. Intersecting gender inequalities were reinforced, sexual violence increased and women's leadership was weak. All healthcare systems failed to protect women's health and essential public health targets. Yet there were relevant differences in the responses to increased violence and reproductive rights, ranging from some support measures in Australia to an abortion ban in the US. Conclusions Our study highlights a need for revising pandemic policies through a feminist lens.
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Affiliation(s)
- Ellen Kuhlmann
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany,*Correspondence: Ellen Kuhlmann ✉
| | - Gabriela Lotta
- Department of Public Administration, Getulio Vargas Foundation, São Paulo, Brazil,Center for Metropolitan Studies, São Paulo, Brazil
| | - Michelle Fernandez
- Institute of Political Science, Universidade de Brasília, Brasília, Brazil
| | - Asha Herten-Crabb
- Department of Health Policy, London School of Economics and Political Science (LSE), London, United Kingdom
| | - Leonie Mac Fehr
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Jaimie-Lee Maple
- College of Health and Biomedicine, University of Victoria, Melbourne, VIC, Australia
| | - Ligia Paina
- Johns Hopkins Bloomberg School of Public Health, Boston, MA, United States
| | - Clare Wenham
- Department of Health Policy, London School of Economics and Political Science (LSE), London, United Kingdom
| | - Karen Willis
- College of Health and Biomedicine, University of Victoria, Melbourne, VIC, Australia
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21
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Carlson CJ, Boyce MR, Dunne M, Graeden E, Lin J, Abdellatif YO, Palys MA, Pavez M, Phelan AL, Katz R. The World Health Organization's Disease Outbreak News: A retrospective database. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001083. [PMID: 36962988 PMCID: PMC10021193 DOI: 10.1371/journal.pgph.0001083] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/04/2022] [Indexed: 05/31/2023]
Abstract
The World Health Organization (WHO) notifies the global community about disease outbreaks through the Disease Outbreak News (DON). These online reports tell important stories about both outbreaks themselves and the high-level decision making that governs information sharing during public health emergencies. However, they have been used only minimally in global health scholarship to date. Here, we collate all 2,789 of these reports from their first use through the start of the Covid-19 pandemic (January 1996 to December 2019), and develop an annotated database of the subjective and often inconsistent information they contain. We find that these reports are dominated by a mix of persistent worldwide threats (particularly influenza and cholera) and persistent epidemics (like Ebola virus disease in Africa or MERS-CoV in the Middle East), but also document important periods in history like the anthrax bioterrorist attacks at the turn of the century, the spread of chikungunya and Zika virus to the Americas, or even recent lapses in progress towards polio elimination. We present three simple vignettes that show how researchers can use these data to answer both qualitative and quantitative questions about global outbreak dynamics and public health response. However, we also find that the retrospective value of these reports is visibly limited by inconsistent reporting (e.g., of disease names, case totals, mortality, and actions taken to curtail spread). We conclude that sharing a transparent rubric for which outbreaks are considered reportable, and adopting more standardized formats for sharing epidemiological metadata, might help make the DON more useful to researchers and policymakers.
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Affiliation(s)
- Colin J. Carlson
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, United States of America
- Department of Biology, Georgetown University, Washington, DC, United States of America
| | - Matthew R. Boyce
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
| | - Margaret Dunne
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ellie Graeden
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
| | - Jessica Lin
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
| | - Yasser Omar Abdellatif
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
| | - Max A. Palys
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
| | - Munir Pavez
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
| | - Alexandra L. Phelan
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, United States of America
| | - Rebecca Katz
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, United States of America
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, United States of America
- Edmund A. Walsh School of Foreign Service, Georgetown University, Washington, DC, United States of America
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22
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Siebenhofer A, Scott AM, Avian A, Terebessy A, Mergenthal K, Schaffler-Schaden D, Bachler H, Huter S, Zelko E, Murray A, Guppy M, Piccoliori G, Streit S, Jeitler K, Flamm M. COVI-Prim international: Similarities and discrepancies in the way general practices from seven different countries coped with the COVID-19 pandemic. Front Public Health 2022; 10:1072515. [PMID: 36600939 PMCID: PMC9806865 DOI: 10.3389/fpubh.2022.1072515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives General practitioners (GPs) are frequently patients' first point of contact with the healthcare system and play an important role in identifying, managing and monitoring cases. This study investigated the experiences of GPs from seven different countries in the early phases of the COVID-19 pandemic. Design International cross-sectional online survey. Setting General practitioners from Australia, Austria, Germany, Hungary, Italy, Slovenia and Switzerland. Participants Overall, 1,642 GPs completed the survey. Main outcome measures We focused on how well-prepared GPs were, their self-confidence and concerns, efforts to control the spread of the disease, patient contacts, information flow, testing procedures and protection of staff. Results GPs gave high ratings to their self-confidence (7.3, 95% CI 7.1-7.5) and their efforts to control the spread of the disease (7.2, 95% CI 7.0-7.3). A decrease in the number of patient contacts (5.7, 95% CI 5.4-5.9), the perception of risk (5.3 95% CI 4.9-5.6), the provision of information to GPs (4.9, 95% CI 4.6-5.2), their testing of suspected cases (3.7, 95% CI 3.4-3.9) and their preparedness to face a pandemic (mean: 3.5; 95% CI 3.2-3.7) were rated as moderate. GPs gave low ratings to their ability to protect staff (2.2 95% CI 1.9-2.4). Differences were identified in all dimensions except protection of staff, which was consistently low in all surveyed GPs and countries. Conclusion Although GPs in the different countries were confronted with the same pandemic, its impact on specific aspects differed. This partly reflected differences in health care systems and experience of recent pandemics. However, it also showed that the development of structured care plans in case of future infectious diseases requires the early involvement of primary care representatives.
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Affiliation(s)
- Andrea Siebenhofer
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria,Institute of General Practice, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QL, Australia
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria,*Correspondence: Alexander Avian
| | - András Terebessy
- Department of Public Health-Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Karola Mergenthal
- Institute of General Practice, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
| | - Dagmar Schaffler-Schaden
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Herbert Bachler
- Institute of General Practice, Medical University of Innsbruck, Innsbruck, Austria
| | - Sebastian Huter
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Erika Zelko
- Faculty of Medicine, Johannes Kepler University of Linz, Linz, Austria
| | - Amanda Murray
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QL, Australia
| | - Michelle Guppy
- School of Rural Medicine and New England GP Research Network, University of New England, Armidale, NSW, Australia
| | - Giuliano Piccoliori
- Institute for Special Training in General Medicine, Institute of General Practice, Claudiana Bozen, Bolzano, Italy
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Klaus Jeitler
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria,Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Maria Flamm
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
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Dos S Ribeiro C, van Roode M, Farag E, Nour M, Moustafa A, Ahmed M, Haringhuizen G, Koopmans M, van de Burgwal L. A framework for measuring timeliness in the outbreak response path: lessons learned from the Middle East respiratory syndrome (MERS) epidemic, September 2012 to January 2019. Euro Surveill 2022; 27:2101064. [PMID: 36695460 PMCID: PMC9716647 DOI: 10.2807/1560-7917.es.2022.27.48.2101064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 09/21/2022] [Indexed: 12/03/2022] Open
Abstract
BackgroundEpidemics are a constant threat in the 21st century, particularly disease outbreaks following spillover of an animal virus to humans. Timeliness, a key metric in epidemic response, can be examined to identify critical steps and delays in public health action.AimTo examine timeliness, we analysed the response to the Middle East respiratory syndrome (MERS) epidemic, with a focus on the international and One Health response efforts.MethodsWe performed a historical review of the MERS epidemic between September 2012 and January 2019 in three steps: (i) the construction of a timeline identifying critical events in the global response, (ii) the performance of a critical path analysis to define outbreak milestones and (iii) a time gap analysis to measure timeliness in the execution of these milestones.ResultsWe proposed 14 MERS-specific milestones at different phases of the epidemic, assessing timeliness of the public health response as well as at the animal-human interface, where we identified the most significant delays.ConclusionsWhen comparing timeliness across three coronavirus epidemics, i.e. MERS (2012), SARS (2002) and COVID-19 (2019), we identified clear improvements over time for certain milestones including laboratory confirmation and diagnostics development, while this was not as apparent for others, as the identification of zoonotic hosts. To more efficiently respond to emerging threats, the global health community should widely assess and tackle specific delays in implementing response interventions by addressing challenges in the sharing of information, data and resources, as well as efficiency, quality, transparency and reliability of reporting events.
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Affiliation(s)
- Carolina Dos S Ribeiro
- Vrije Universiteit (VU) Amsterdam, Faculty of Science, Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Amsterdam, the Netherlands
- The Netherlands National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - Martine van Roode
- Erasmus Medical Center (EMC), Viroscience Department, Pandemic and Disaster Preparedness Centre, Rotterdam, the Netherlands
| | | | - Mohamed Nour
- Ministry of Public Health, Department of Public health, Doha, Qatar
| | - Aya Moustafa
- Ministry of Public Health, Department of Public health, Doha, Qatar
| | - Minahil Ahmed
- Ministry of Public Health, Department of Public health, Doha, Qatar
| | - George Haringhuizen
- The Netherlands National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - Marion Koopmans
- Erasmus Medical Center (EMC), Viroscience Department, Pandemic and Disaster Preparedness Centre, Rotterdam, the Netherlands
| | - Linda van de Burgwal
- Vrije Universiteit (VU) Amsterdam, Faculty of Science, Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Amsterdam, the Netherlands
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Suy Lan C, Sok S, Chheang K, Lan DM, Soung V, Divi N, Ly S, Smolinski M. Cambodia national health hotline - Participatory surveillance for early detection and response to disease outbreaks. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 29:100584. [PMID: 36605884 PMCID: PMC9808424 DOI: 10.1016/j.lanwpc.2022.100584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- Channé Suy Lan
- InSTEDD iLab Southeast Asia, Phnom Penh, Cambodia
- Corresponding author.
| | - Samnang Sok
- Communicable Disease Control Department, Ministry of Health, Cambodia
| | | | | | | | | | - Sovann Ly
- Communicable Disease Control Department, Ministry of Health, Cambodia
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25
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Maziar P, Maher A, Alimohammadzadeh K, Jafari M, Hosseini SM. Identifying the preparedness components in COVID-19: Systematic literature review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:385. [PMID: 36618467 PMCID: PMC9818771 DOI: 10.4103/jehp.jehp_28_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/03/2022] [Indexed: 06/17/2023]
Abstract
In 2019, the COVID-19 pandemic posed a major challenge to the world. Since the world is constantly exposed to communicable diseases, comprehensive preparedness of countries is required. Therefore, the present systematic review is aimed at identifying the preparedness components in COVID-19. In this systematic literature review, PubMed, Scopus, Web of Science, ProQuest, Science Direct, Iran Medex, Magiran, and Scientific Information Database were searched from 2019 to 2021 to identify preparedness components in COVID-19. Thematic content analysis method was employed for data analysis. Out of 11,126 journals retrieved from searches, 45 studies were included for data analysis. Based on the findings, the components of COVID-19 preparedness were identified and discussed in three categories: governance with three subcategories of characteristics, responsibilities, and rules and regulations; society with two subcategories of culture and resilience; and services with three subcategories of managed services, advanced technology, and prepared health services. Among these, the governance and its subcategories had the highest frequency in studies. Considering the need to prepare for the next pandemic, countries should create clear and coherent structures and responsibilities for crisis preparedness through legal mechanisms, strengthening the infrastructure of the health system, coordination between organizations through analysis and identification of stakeholders, culture building and attracting social participation, and service management for an effective response.
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Affiliation(s)
- Pooneh Maziar
- Ph.D. Student of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Maher
- Department of Health Policy, Economics and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khalil Alimohammadzadeh
- Department of Health Services Management, North Tehran Branch, Health Economics Policy Research Center, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
| | - Mehrnoosh Jafari
- Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Seyed Mojtaba Hosseini
- Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
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26
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Kabwama SN, Wanyenze RK, Kiwanuka SN, Namale A, Ndejjo R, Monje F, Wang W, Lazenby S, Kizito S, Troeger C, Liu A, Lindgren H, Razaz N, Ssenkusu J, Sambisa W, Bartlein R, Alfvén T. Interventions for Maintenance of Essential Health Service Delivery during the COVID-19 Response in Uganda, between March 2020 and April 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912522. [PMID: 36231823 PMCID: PMC9566395 DOI: 10.3390/ijerph191912522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The COVID-19 pandemic overwhelmed health systems globally and affected the delivery of health services. We conducted a study in Uganda to describe the interventions adopted to maintain the delivery of other health services. METHODS We reviewed documents and interviewed 21 key informants. Thematic analysis was conducted to identify themes using the World Health Organization health system building blocks as a guiding framework. RESULTS Governance strategies included the establishment of coordination committees and the development and dissemination of guidelines. Infrastructure and commodity strategies included the review of drug supply plans and allowing emergency orders. Workforce strategies included the provision of infection prevention and control equipment, recruitment and provision of incentives. Service delivery modifications included the designation of facilities for COVID-19 management, patient self-management, dispensing drugs for longer periods and the leveraging community patient networks to distribute medicines. However, multi-month drug dispensing led to drug stock-outs while community drug distribution was associated with stigma. CONCLUSIONS Health service maintenance during emergencies requires coordination to harness existing health system investments. The essential services continuity committee coordinated efforts to maintain services and should remain a critical element of emergency response. Self-management and leveraging patient networks should address stigma to support service continuity in similar settings and strengthen service delivery beyond the pandemic.
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Affiliation(s)
- Steven Ndugwa Kabwama
- Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala P.O. Box 7062, Uganda
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Rhoda K. Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Suzanne N. Kiwanuka
- Department of Health Policy Planning and Management, School of Public Health, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Alice Namale
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Fred Monje
- School of Public Health, Makerere University, Kampala P.O. Box 7072, Uganda
| | | | | | - Susan Kizito
- School of Public Health, Makerere University, Kampala P.O. Box 7072, Uganda
| | | | - Anne Liu
- Gates Ventures, Kirkland, WA 98033, USA
| | - Helena Lindgren
- Department of Women’s and Children’s Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Neda Razaz
- Department of Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
| | - John Ssenkusu
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala P.O. Box 7072, Uganda
| | | | | | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
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Tran BX, Nguyen LH, Doan LP, Nguyen TT, Vu GT, Do HT, Le HT, Latkin CA, Ho CSH, Ho RCM. Global mapping of epidemic risk assessment toolkits: A scoping review for COVID-19 and future epidemics preparedness implications. PLoS One 2022; 17:e0272037. [PMID: 36149862 PMCID: PMC9506664 DOI: 10.1371/journal.pone.0272037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/13/2022] [Indexed: 11/19/2022] Open
Abstract
Preparedness and responses to infectious disease epidemics and pandemics require the understanding of communities’ and multisectoral systems’ characteristics with regards to diseases transmission and population’s vulnerabilities. This study aimed to summarize measurement profiles of existing risk assessment toolkits to inform COVID-19 control at global and national levels. An online search in different databases and online sources was performed to identify all epidemic risk and vulnerability assessment instruments. Medline/PubMed, Web of Science databases, and websites of public health organizations were used for the searching process. Of 14 toolkits, levels of setting were mostly at the global or nation level. Components such as Governance and Legislation, Financing, Health Service Provision, and Human Resources are key domains in almost all toolkits. Some important issues for disease detection and surveillance, such as laboratory or capacity of the community for disease control, were not adequately addressed in several toolkits. Limited studies were found that validated the toolkits. Only five toolkits were used in COVID-19 studies. This study provides a summary of risk assessment toolkits to inform epidemic responses. We call for global and national efforts in developing more contextualized and responsive epidemic risk assessment scales incorporating specific-disease and -country factors to inform operational decisions making and strengthen countries’ capacities in epidemic responses.
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Affiliation(s)
- Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
- * E-mail:
| | | | - Linh Phuong Doan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Tham Thi Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Giang Thu Vu
- National Centre For Youth Substance Use Research, University of Queensland, Brisbane, Australia
| | - Hoa Thi Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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Nagasivam A, Fryatt R, de Habich M, Johns B. Exploring the relationship between national governance indicators and speed of initial government response to COVID-19 in low- and middle-income countries. PUBLIC HEALTH IN PRACTICE 2022; 4:100309. [PMID: 36061136 PMCID: PMC9420690 DOI: 10.1016/j.puhip.2022.100309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/31/2022] [Accepted: 08/05/2022] [Indexed: 01/03/2023] Open
Abstract
Objectives This study aimed to explore the relationship between national governance and country response to the COVID-19 pandemic in low- and middle-income countries, to support preparedness for the next pandemic. We conducted a statistical analysis of 116 countries, examining the relationship between speed of initial response and measures of national governance. Study design Observational study, with individual countries as the unit of analysis. Methods We used logistic regression to look for associations between quicker initial government response and four national governance indicators: Government Effectiveness, Political Stability and Absence of Violence/Terrorism, Voice and Accountability, and Corruption Perceptions Index. Results A quicker initial government response was associated with countries with higher Government Effectiveness (OR 13.92 95% CI 3.69-52.48, p < 0.001) and lower Political Stability and Absence of Violence/Terrorism (OR 0.23, 95% CI 0.09-0.57, p = 0.002). There was no relationship observed between speed of initial government response and Voice and Accountability or Corruption Perceptions Index. Other factors associated with quicker initial response were small population size, experiencing first COVID-19 case after the pandemic declaration, not having previous experience with SARS-CoV1 or MERS and not being an island nation. Conclusions This study shows that having higher state policy and implementation capacity, and lower political stability was associated with a quicker initial pandemic response. Limitations of this study include the use of crude national level indicators and broad categorisations of countries into quicker and slower responders. Deeper enquiry into the early decision-making processes taken at the national executive level within individual countries may help clarify the observed associations further.
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Affiliation(s)
- Ahimza Nagasivam
- School of Public Health, Health Education England, 4 Stewart House, 32 Russell Square, Bloomsbury, London, WC1B 5DN, UK,Corresponding author.
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Guimarães RM, Moreira MR. How does the context effect of denialism reinforce the oppression of the vulnerable people and negatively determine health? THE LANCET REGIONAL HEALTH - AMERICAS 2022; 12:100270. [PMID: 35529523 PMCID: PMC9069222 DOI: 10.1016/j.lana.2022.100270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Investigating the Effectiveness of Government Public Health Systems against COVID-19 by Hybrid MCDM Approaches. MATHEMATICS 2022. [DOI: 10.3390/math10152678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To elucidate the effectiveness of the containment strategies against the pandemic, a Multi-Criteria Decision Making (MCDM) model is established to evaluate the government’s performance against COVID-19. In this study, the Analytic Hierarchy Process (AHP), Entropy, and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method are used in determining the performance of the public health system. We adopt both subjective and objective weighting methods for a more accurate evaluation. In addition, the evaluation of performance against COVID-19 is conducted in various aspects and divided into different periods. Data Envelopment Analysis (DEA) is applied to evaluate the sustainability of the public health system. Composite scores of the public health system are determined based on the performance and sustainability assessment. The five countries, South Korea, Japan, Germany, Australia, and China are rated with higher composite scores. On the country, the US, Indonesia, Egypt, South Africa, and Brazil receive lower rating scores among the countries for evaluation. This modeling study can provide a practical quantitative justification for developing containment policies and suggestions for improving the public health system in more countries or areas.
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Pandemic Preparedness and Response: A Foldable Tent to Safely Remove Contaminated Dental Aerosols—Clinical Study and Patient Experience. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The D-DART (Droplet and Aerosol Reducing Tent) is a foldable design that can be attached to the dental chair to prevent the spread of contaminated dental aerosols. The objective of this study was to evaluate the ability of the D-DART to reduce spread of aerosols generated during dental treatment. Thirty-two patients (sixteen per group) undergoing deep ultrasonic scaling were recruited and randomly allocated to groups D-DART or Control (no D-DART). After 20 min from the start of the treatment, the clinician’s face shield and dental chair light were swabbed and the viable microbial load was quantified (ATP bioluminescence analysis, blinded operator). Statistical analyses were performed with Tukey’s Honest Test with a level of significance pre-set at 5%. There were significant increases in ATP values obtained from the operator’s face shield and dental chair light for the Control compared with baseline (31.3 ± 8.5 and fold increase). There was no significant change in microbial load when the D-DART was used compared with baseline (1.5 ± 0.4 fold increase). The D-DART contained and prevented the spread of aerosols generated during deep scaling procedures.
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Kachali H, Haavisto I, Leskelä RL, Väljä A, Nuutinen M. Are preparedness indices reflective of pandemic preparedness? A COVID-19 reality check. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 77:103074. [PMID: 35663497 PMCID: PMC9135491 DOI: 10.1016/j.ijdrr.2022.103074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/26/2022] [Accepted: 05/22/2022] [Indexed: 06/15/2023]
Abstract
The paper contributes to the body of knowledge working towards enhancing the understanding of crisis and disaster preparedness and effective response, via the lens of the ongoing global pandemic and responding to the questions: do the current measures for pandemic preparedness reflect preparedness adequately, and what does pandemic preparedness mean? We analysed how the reported cumulative mortality rates, during the spring of 2020 and in the 60 days after the date of a country's first COVID-19 related death, compared to the expected preparedness rank according to the existing global preparedness indices (IHR and GHSI) on a country level. We found, at country level, that the health-related outcomes from the first wave of the pandemic were primarily negatively correlated with the expected preparedness. We contend that our results indicate a need to investigate further development and enhancement of the preparedness indices.
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Winck GR, Raimundo RLG, Fernandes-Ferreira H, Bueno MG, D’Andrea PS, Rocha FL, Cruz GLT, Vilar EM, Brandão M, Cordeiro JLP, Andreazzi CS. Socioecological vulnerability and the risk of zoonotic disease emergence in Brazil. SCIENCE ADVANCES 2022; 8:eabo5774. [PMID: 35767624 PMCID: PMC9242594 DOI: 10.1126/sciadv.abo5774] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/13/2022] [Indexed: 05/25/2023]
Abstract
In developing countries, outbreaks of zoonotic diseases (ZDs) result from intertwined ecological, socioeconomic, and demographic processes that shape conditions for (i) increased contact between vulnerable human population and wildlife in areas undergoing environmental degradation and (ii) the rapid geographic spread of infections across socially vulnerable regions. In Brazil, recent increases in environmental and social vulnerabilities, amplified by economic and political crises, are potential triggers for outbreaks. We discuss Brazilian features that favor outbreaks and show a novel quantitative method for zoonotic risk assessment. Using data on nine ZDs from 2001 to 2019, we found that the most significant causal variables were vegetation cover and city remoteness. Furthermore, 8 of 27 states presented low-level risk of ZD outbreaks. Given the ZD-bushmeat connection, we identified central hunted mammals that should be surveilled to prevent spillover events. The current challenge is to coordinate intersectoral collaboration for effective One Health management in megadiverse countries with high social vulnerability and growing environmental degradation like Brazil.
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Affiliation(s)
- Gisele R. Winck
- Laboratory of Biology and Parasitology of Wild Reservoir Mammals (LABPMR), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rafael L. G. Raimundo
- Graduate Program in Biological Sciences, Federal University of Paraíba (UFPB), João Pessoa, PB, Brazil
- Graduate Program in Ecology and Environmental Monitoring, Federal University of Paraíba (UFPB), Rio Tinto, PB, Brazil
| | - Hugo Fernandes-Ferreira
- Terrestrial Vertebrate Conservation Lab (Converte), State University of Ceará (UECE), Quixadá, CE, Brazil
| | - Marina G. Bueno
- Laboratory of Comparative and Environmental Virology (LVCA), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Paulo S. D’Andrea
- Laboratory of Biology and Parasitology of Wild Reservoir Mammals (LABPMR), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Fabiana L. Rocha
- Graduate Program in Biological Sciences, Federal University of Paraíba (UFPB), João Pessoa, PB, Brazil
- Center for Species Survival Brazil and Conservation Planning Specialist Group, Species Survival Commission (SSC), International Union for Conservation of Nature (IUCN), Foz do Iguaçu, PR, Brazil
| | - Gabriella L. T. Cruz
- Laboratory of Biology and Parasitology of Wild Reservoir Mammals (LABPMR), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Martha Brandão
- Vice Presidency of Production and Innovation in Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - José Luís P. Cordeiro
- Oswaldo Cruz Foundation (Fiocruz), Eusébio, CE, Brazil
- Department of Biology and Centre for Environmental and Marine Studies (CESAM), Aveiro University, Aveiro, Portugal
- International Platform for Science, Technology, and Innovation in Health (PICTIS), Fiocruz and Aveiro, Portugal
| | - Cecilia S. Andreazzi
- Laboratory of Biology and Parasitology of Wild Reservoir Mammals (LABPMR), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
- International Platform for Science, Technology, and Innovation in Health (PICTIS), Fiocruz and Aveiro, Portugal
- Centre for Functional Ecology (CFE), University of Coimbra, Coimbra, Portugal
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Meadows AJ, Oppenheim B, Guerrero J, Ash B, Badker R, Lam CK, Pardee C, Ngoon C, Savage PT, Sridharan V, Madhav NK, Stephenson N. Infectious Disease Underreporting Is Predicted by Country-Level Preparedness, Politics, and Pathogen Severity. Health Secur 2022; 20:331-338. [PMID: 35925788 PMCID: PMC10818036 DOI: 10.1089/hs.2021.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/18/2022] [Accepted: 06/02/2022] [Indexed: 11/12/2022] Open
Abstract
Underreporting of infectious diseases is a pervasive challenge in public health that has emerged as a central issue in characterizing the dynamics of the COVID-19 pandemic. Infectious diseases are underreported for a range of reasons, including mild or asymptomatic infections, weak public health infrastructure, and government censorship. In this study, we investigated factors associated with cross-country and cross-pathogen variation in reporting. We performed a literature search to collect estimates of empirical reporting rates, calculated as the number of cases reported divided by the estimated number of true cases. This literature search yielded a dataset of reporting rates for 32 pathogens, representing 52 countries. We combined epidemiological and social science theory to identify factors specific to pathogens, country health systems, and politics that could influence empirical reporting rates. We performed generalized linear regression to test the relationship between the pathogen- and country-specific factors that we hypothesized could influence reporting rates, and the reporting rate estimates that we collected in our literature search. Pathogen- and country-specific factors were predictive of reporting rates. Deadlier pathogens and sexually transmitted diseases were more likely to be reported. Country epidemic preparedness was positively associated with reporting completeness, while countries with high levels of media bias in favor of incumbent governments were less likely to report infectious disease cases. Underreporting is a complex phenomenon that is driven by factors specific to pathogens, country health systems, and politics. In this study, we identified specific and measurable components of these broader factors that influence pathogen- and country-specific reporting rates and used model selection techniques to build a model that can guide efforts to diagnose, characterize, and reduce underreporting. Furthermore, this model can characterize uncertainty and correct for bias in reported infectious disease statistics, particularly when outbreak-specific empirical estimates of underreporting are unavailable. More precise estimates can inform control policies and improve the accuracy of infectious disease models.
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Affiliation(s)
- Amanda J. Meadows
- Amanda J. Meadows, PhD, is a Data Scientist/Modeler, Metabiota, San Francisco, CA
| | - Ben Oppenheim
- Ben Oppenheim, PhD, MA, MSc, is Vice President of Product, Policy, and Partnerships, Metabiota, San Francisco, CA
| | - Jaclyn Guerrero
- Jaclyn Guerrero, MPH, is an Advisor, Epidemiology Products, Metabiota, San Francisco, CA
| | - Benjamin Ash
- Benjamin Ash, MS, is Manager of NRT Data, Metabiota, San Francisco, CA
| | - Rinette Badker
- Rinette Badker, MSc, is a Senior Epidemic Analyst, Metabiota, San Francisco, CA
| | - Cathine K. Lam
- Cathine K. Lam, ACAS, is a Data Scientist/Actuary, Metabiota, San Francisco, CA
| | - Chris Pardee
- Chris Pardee, MS, is Senior Manager of Data Acquisition, Metabiota, San Francisco, CA
| | - Christopher Ngoon
- Christopher Ngoon, MS, is a Senior Data Analyst, Metabiota, San Francisco, CA
| | - Patrick T. Savage
- Patrick T. Savage is a Data Quality Analyst, Metabiota, San Francisco, CA
| | - Vikram Sridharan
- Vikram Sridharan, MS, is a Senior Data Scientist and Technical Product Manager, Metabiota, San Francisco, CA
| | - Nita K. Madhav
- Nita K. Madhav, MSPH, is Chief Executive Officer, Metabiota, San Francisco, CA
| | - Nicole Stephenson
- Nicole Stephenson, DVM, MPVM, PhD, is Senior Director of Data Science and Modeling, Metabiota, San Francisco, CA
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Hardhantyo M, Djasri H, Nursetyo AA, Yulianti A, Adipradipta BR, Hawley W, Mika J, Praptiningsih CY, Mangiri A, Prasetyowati EB, Brye L. Quality of National Disease Surveillance Reporting before and during COVID-19: A Mixed-Method Study in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052728. [PMID: 35270431 PMCID: PMC8910184 DOI: 10.3390/ijerph19052728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/12/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023]
Abstract
Background: Global COVID-19 outbreaks in early 2020 have burdened health workers, among them surveillance workers who have the responsibility to undertake routine disease surveillance activities. The aim of this study was to describe the quality of the implementation of Indonesia’s Early Warning and Response Alert System (EWARS) for disease surveillance and to measure the burden of disease surveillance reporting quality before and during the COVID-19 epidemic in Indonesia. Methods: A mixed-method approach was used. A total of 38 informants from regional health offices participated in Focus Group Discussion (FGD) and In-Depth Interview (IDI) for informants from Ministry of Health. The FGD and IDI were conducted using online video communication. Yearly completeness and timeliness of reporting of 34 provinces were collected from the application. Qualitative data were analyzed thematically, and quantitative data were analyzed descriptively. Results: Major implementation gaps were found in poorly distributed human resources and regional infrastructure inequity. National reporting from 2017–2019 showed an increasing trend of completeness (55%, 64%, and 75%, respectively) and timeliness (55%, 64%, and 75%, respectively). However, the quality of the reporting dropped to 53% and 34% in 2020 concomitant with the SARS-CoV2 epidemic. Conclusions: Report completeness and timeliness are likely related to regional infrastructure inequity and the COVID-19 epidemic. It is recommended to increase report capacities with an automatic EWARS application linked systems in hospitals and laboratories.
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Affiliation(s)
- Muhammad Hardhantyo
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
- Faculty of Health Science, Universitas Respati Yogyakarta, Yogyakarta 55281, Indonesia
- Correspondence:
| | - Hanevi Djasri
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
| | - Aldilas Achmad Nursetyo
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
| | - Andriani Yulianti
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
| | - Bernadeta Rachela Adipradipta
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
| | - William Hawley
- Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, GA 30329, USA; (W.H.); (J.M.); (C.Y.P.); (A.M.)
| | - Jennifer Mika
- Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, GA 30329, USA; (W.H.); (J.M.); (C.Y.P.); (A.M.)
| | - Catharina Yekti Praptiningsih
- Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, GA 30329, USA; (W.H.); (J.M.); (C.Y.P.); (A.M.)
| | - Amalya Mangiri
- Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, GA 30329, USA; (W.H.); (J.M.); (C.Y.P.); (A.M.)
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Constructing and validating a transferable epidemic risk index in data scarce environments using open data: A case study for dengue in the Philippines. PLoS Negl Trop Dis 2022; 16:e0009262. [PMID: 35120122 PMCID: PMC8849499 DOI: 10.1371/journal.pntd.0009262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 02/16/2022] [Accepted: 12/21/2021] [Indexed: 01/21/2023] Open
Abstract
Epidemics are among the most costly and destructive natural hazards globally. To reduce the impacts of infectious disease outbreaks, the development of a risk index for infectious diseases can be effective, by shifting infectious disease control from emergency response to early detection and prevention. In this study, we introduce a methodology to construct and validate an epidemic risk index using only open data, with a specific focus on scalability. The external validation of our risk index makes use of distance sampling to correct for underreporting of infections, which is often a major source of biases, based on geographical accessibility to health facilities. We apply this methodology to assess the risk of dengue in the Philippines. The results show that the computed dengue risk correlates well with standard epidemiological metrics, i.e. dengue incidence (p = 0.002). Here, dengue risk constitutes of the two dimensions susceptibility and exposure. Susceptibility was particularly associated with dengue incidence (p = 0.048) and dengue case fatality rate (CFR) (p = 0.029). Exposure had lower correlations to dengue incidence (p = 0.193) and CFR (p = 0.162). Highest risk indices were seen in the south of the country, mainly among regions with relatively high susceptibility to dengue outbreaks. Our findings reflect that the modelled epidemic risk index is a strong indication of sub-national dengue disease patterns and has therefore proven suitability for disease risk assessments in the absence of timely epidemiological data. The presented methodology enables the construction of a practical, evidence-based tool to support public health and humanitarian decision-making processes with simple, understandable metrics. The index overcomes the main limitations of existing indices in terms of construction and actionability. Epidemics are among the most costly and destructive natural hazards occurring globally; currently, the response to epidemics is still focused on reaction rather than prevention or preparedness. The development of an epidemic risk index can support identifying high-risk areas and can guide prioritization of preventive action and humanitarian response. While several frameworks for epidemic risk assessment exist, they suffer from several limitations, which resulted in limited uptake by local health actors—such as governments and humanitarian relief workers—in their decision-making processes. In this study, we present a methodology to develop epidemic risk indices, which overcomes the major limitations of previous work: strict data requirements, insufficient geographical granularity, validation against epidemiological data. We take as a case study dengue in the Philippines and develop an epidemic risk index; we correct dengue incidence for underreporting based on accessibility to healthcare and show that it correlates well with the risk index (Pearson correlation coefficient 0.69, p-value 0.002). Our methodology enables the development of disease-specific epidemic risk indices at a sub-national level, even in countries with limited data availability; these indices can guide local actors in programming prevention and response activities. Our findings on the case study show that the epidemic risk index is a strong indicator of sub-national dengue disease patterns and is therefore suitable for disease risk assessments in the absence of timely and complete epidemiological data.
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Resilience and Sustainability of the Water Sector during the COVID-19 Pandemic. SUSTAINABILITY 2022. [DOI: 10.3390/su14031482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic brought unprecedented socio-economic changes, ushering in a “new (ab)normal” way of living and human interaction. The water sector was not spared from the effects of the pandemic, a period in which the sector had to adapt rapidly and continue providing innovative water and sanitation solutions. This study unpacks and interrogates approaches, products, and services adopted by the water sector in response to the unprecedented lockdowns, heralding novel terrains, and fundamental paradigm shifts, both at the community and the workplace. The study highlights the wider societal perspective regarding the water and sanitation challenges that grappled society before, during, after, and beyond the pandemic. The premise is to provide plausible transitional pathways towards a new (ab)normal in adopting new models, as evidenced by the dismantling of the normal way of conducting business at the workplace and human interaction in an era inundated with social media, virtual communication, and disruptive technologies, which have transitioned absolutely everything into a virtual way of life. As such, the novel approaches have fast-tracked a transition into the 4th Industrial Revolution (4IR), with significant trade-offs to traditional business models and human interactions.
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Abdelmagid N, Checchi F, Roberts B. Public and health professional epidemic risk perceptions in countries that are highly vulnerable to epidemics: a systematic review. Infect Dis Poverty 2022; 11:4. [PMID: 34986874 PMCID: PMC8731200 DOI: 10.1186/s40249-021-00927-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/16/2021] [Indexed: 12/23/2022] Open
Abstract
Background Risk communication interventions during epidemics aim to modify risk perceptions to achieve rapid shifts in population health behaviours. Exposure to frequent and often concurrent epidemics may influence how the public and health professionals perceive and respond to epidemic risks. This review aimed to systematically examine the evidence on risk perceptions of epidemic-prone diseases in countries highly vulnerable to epidemics. Methods We conducted a systematic review using PRISMA standards. We included peer-reviewed studies describing or measuring risk perceptions of epidemic-prone diseases among the general adult population or health professionals in 62 countries considered highly vulnerable to epidemics. We searched seven bibliographic databases and applied a four-stage screening and selection process, followed by quality appraisal. We conducted a narrative meta-synthesis and descriptive summary of the evidence, guided by the Social Amplification of Risk Framework. Results Fifty-six studies were eligible for the final review. They were conducted in eighteen countries and addressed thirteen epidemic-prone diseases. Forty-five studies were quantitative, six qualitative and five used mixed methods. Forty-one studies described epidemic risk perceptions in the general public and nineteen among health professionals. Perceived severity of epidemic-prone diseases appeared high across public and health professional populations. However, perceived likelihood of acquiring disease varied from low to moderate to high among the general public, and appeared consistently high amongst health professionals. Other occupational groups with high exposure to specific diseases, such as bushmeat handlers, reported even lower perceived likelihood than the general population. Among health professionals, the safety and effectiveness of the work environment and of the broader health system response influenced perceptions. Among the general population, disease severity, familiarity and controllability of diseases were influential factors. However, the evidence on how epidemic risk perceptions are formed or modified in these populations is limited. Conclusions The evidence affords some insights into patterns of epidemic risk perception and influencing factors, but inadequately explores what underlies perceptions and their variability, particularly among diseases, populations and over time. Approaches to defining and measuring epidemic risk perceptions are relatively underdeveloped. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00927-z.
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Affiliation(s)
- Nada Abdelmagid
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Francesco Checchi
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bayard Roberts
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Neonates and COVID-19: state of the art : Neonatal Sepsis series. Pediatr Res 2022; 91:432-439. [PMID: 34961785 PMCID: PMC8712275 DOI: 10.1038/s41390-021-01875-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/20/2021] [Accepted: 11/05/2021] [Indexed: 12/12/2022]
Abstract
The SARS-CoV-2 pandemic has had a significant impact worldwide, particularly in middle- and low-income countries. While this impact has been well-recognized in certain age groups, the effects, both direct and indirect, on the neonatal population remain largely unknown. There are placental changes associated, though the contributions to maternal and fetal illness have not been fully determined. The rate of premature delivery has increased and SARS-CoV-2 infection is proportionately higher in premature neonates, which appears to be related to premature delivery for maternal reasons rather than an increase in spontaneous preterm labor. There is much room for expansion, including long-term data on outcomes for affected babies. Though uncommon, there has been evidence of adverse events in neonates, including Multisystem Inflammatory Syndrome in Children, associated with COVID-19 (MIS-C). There are recommendations for reduction of viral transmission to neonates, though more research is required to determine the role of passive immunization of the fetus via maternal vaccination. There is now considerable evidence suggesting that the severe visitation restrictions implemented early in the pandemic have negatively impacted the care of the neonate and the experiences of both parents and healthcare professionals alike. Ongoing collaboration is required to determine the full impact, and guidelines for future management. IMPACT: Comprehensive review of current available evidence related to impact of the COVID-19 pandemic on neonates, effects on their health, impact on their quality of care and indirect influences on their clinical course, including comparisons with other age groups. Reference to current evidence for maternal experience of infection and how it impacts the fetus and then neonate. Outline of the need for ongoing research, including specific areas in which there are significant gaps in knowledge.
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40
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Boyce MR, Asprilla MC, van Loenen B, McClelland A, Rojhani A. How do local-level authorities engage in epidemic and pandemic preparedness activities and coordinate with higher levels of government? Survey results from 33 cities. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000650. [PMID: 36962601 PMCID: PMC10022361 DOI: 10.1371/journal.pgph.0000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
The COVID-19 pandemic suggests that there are opportunities to improve preparedness for infectious disease outbreaks. While much attention has been given to understanding national-level preparedness, relatively little attention has been given to understanding preparedness at the local-level. We, therefore, aim to describe (1) how local governments in urban environments were engaged in epidemic preparedness efforts before the COVID-19 pandemic and (2) how they were coordinating with authorities at higher levels of governance before COVID-19. We developed a survey and distributed it to 50 cities around the world involved in the Partnership for Healthy Cities. The survey included several question formats including free-response, matrices, and multiple-choice questions. RACI matrices, a project management tool that helps explain coordination structures, were used to understand the level of government responsible, accountable, consulted, and informed regarding select preparedness activities. We used descriptive statistics to summarize local-level engagement in preparedness. Local authorities from 33 cities completed the survey. Prior to the COVID-19 pandemic, 20 of the cities had completed infectious disease risk assessments, 10 completed all-hazards risk assessments, 11 completed simulation exercises, 10 completed after-action reviews, 19 developed preparedness and response plans, three reported involvement in their country's Joint External Evaluation of the International Health Regulations, and eight cities reported involvement in the development of their countries' National Action Plan for Health Security. RACI matrices revealed various models of epidemic preparedness, with responsibility often shared across levels, and national governments accountable for the most activities, compared to other governance levels. In conclusion, national governments maintain the largest role in epidemic and pandemic preparedness but the role of subnational and local governments is not negligible. Local-level actors engage in a variety of preparedness activities and future efforts should strive to better include these actors in preparedness as a means of bolstering local, national, and global health security.
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Affiliation(s)
- Matthew R Boyce
- Center for Global Health Science & Security, Georgetown University Medical Center, Washington, District of Columbia, United States of America
| | | | - Breanna van Loenen
- Resolve to Save Lives, New York City, New York, United States of America
| | - Amanda McClelland
- Resolve to Save Lives, New York City, New York, United States of America
| | - Ariella Rojhani
- Vital Strategies, New York City, New York, United States of America
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Luo Y, Li M, Tang J, Ren J, Zheng Y, Yu X, Jiang L, Fan D, Chen Y. Design of a Virtual Reality Interactive Training System for Public Health Emergency Preparedness for Major Emerging Infectious Diseases: Theory and Framework. JMIR Serious Games 2021; 9:e29956. [PMID: 34904951 PMCID: PMC8715362 DOI: 10.2196/29956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/14/2021] [Accepted: 09/09/2021] [Indexed: 02/02/2023] Open
Abstract
Background Sufficient public health emergency preparedness (PHEP) is the key factor in effectively responding to and recovering from major emerging infectious diseases (MEIDs). However, in the face of MEIDs, PHEP is insufficient, so it is necessary to improve PHEP. The rapid development of virtual reality and human-computer interaction provides unprecedented opportunities for innovative educational methods. Objective This study designed a virtual reality interactive training system (VRITS) to provide an effective path for improving PHEP in the context of MEIDs so that the public can effectively respond to and recover from MEIDs. Methods This study used interactive narrative, situated learning and human-computer interaction theories as a theoretical framework to guide the design of the system. We used the literature research method and the Delphi method; consulted multidisciplinary experts, such as infectious diseases, disease control, psychology, and public health personnel, to determine the educational content framework; and set up an interdisciplinary team to construct an operating system framework for the VRITS. Results We named the VRITS “People’s War Against Pandemic.” The educational content framework includes 20 knowledge, emotion, and behavior skills in 5 aspects (cooperating with prevention and control work, improving emergency response ability, guaranteeing supplies and equipment, preparing economic resources, and maintaining physical and mental health). The operating system framework includes virtual interactive training, knowledge corner, intelligent evaluation, and community forum modules, and the core module is the virtual interactive training module. In this module, users control virtual characters to move in various scenes, and then identify and analyze the controllability and harmfulness of the evolving pandemic and select the correct prevention and control strategy to avoid infecting themselves and others. Conclusions The development and sharing of the multidisciplinary theoretical framework adopted by People’s War Against Pandemic can help us clarify the design ideas and assumptions of the VRITS; predict training results; understand the ability of training to change emergency knowledge, emergency emotion, and behavioral responses to MEIDs; and promote the development of more effective training systems based on virtual reality.
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Affiliation(s)
- Yue Luo
- School of Nursing, Southwest Medical University, Luzhou City, China
| | - Mei Li
- School of Nursing, Southwest Medical University, Luzhou City, China
| | - Jian Tang
- Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou City, China
| | - JianLan Ren
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China
| | - Yu Zheng
- Department of Rheumatism and Immunology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China
| | - XingLi Yu
- Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou City, China
| | - LinRui Jiang
- Department of Cardiac Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou City, China
| | - DingLin Fan
- School of Nursing, Southwest Medical University, Luzhou City, China
| | - YanHua Chen
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou City, China
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Lytras T, Tsiodras S. Total patient load, regional disparities and in-hospital mortality of intubated COVID-19 patients in Greece, from September 2020 to May 2021. Scand J Public Health 2021; 50:671-675. [PMID: 34903101 DOI: 10.1177/14034948211059968] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIMS While healthcare services have been expanding capacity during the COVID-19 pandemic, quality of care under increasing patient loads has received less attention. We examined in-hospital mortality of intubated COVID-19 patients in Greece, in relation to total intubated patient load, intensive care unit (ICU) availability and hospital region. METHODS Anonymized surveillance data were analyzed from all intubated COVID-19 patients in Greece between 1 September 2020 and 6 May 2021. Poisson regression was used to estimate the hazard of dying as a function of fixed and time-varying covariates. RESULTS Mortality was significantly increased above 400 patients, with an adjusted hazard ratio of 1.25 (95% confidence interval (CI): 1.03-1.51), rising progressively up to 1.57 (95% CI: 1.22-2.02) for 800+ patients. Hospitalization outside an ICU or away from the capital region of Attica were also independently associated with significantly increased mortality. CONCLUSIONS Our results indicate that in-hospital mortality of severely ill COVID-19 patients is adversely affected by high patient load even without exceeding capacity, as well as by regional disparities. This highlights the need for more substantial strengthening of healthcare services, focusing on equity and quality of care besides just expanding capacity.
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Affiliation(s)
- Theodore Lytras
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Sotirios Tsiodras
- National Public Health Organization, Athens, Greece.,4th Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Greece
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Hilhorst D, Mena R. When Covid-19 meets conflict: politics of the pandemic response in fragile and conflict-affected states. DISASTERS 2021; 45 Suppl 1:S174-S194. [PMID: 34553401 PMCID: PMC8653116 DOI: 10.1111/disa.12514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Covid-19 pandemic has magnified existing crises and vulnerabilities, but much remains unknown about how it has affected fragile and conflict-affected settings. This paper builds on the theory that hazards become a disaster in interaction with vulnerability and response policies, yet often lead to renewed disaster risk creation. It is based on seven case studies of countries worldwide that experienced social conflict at the advent of the pandemic, covering the period from March-August 2020. The findings show that authorities instrumentalised Covid-19 to strengthen their control and agendas. Responsibility was assumed for lockdowns, but this was not accompanied by care to mitigate their adverse effects. Social conflict shaped the response, as high levels of mistrust in authorities complicated the implementation of measures, while authorities did not support community-based coping initiatives. Whether Covid-19 will trigger or exacerbate conflict and vulnerabilities depends on pre-existing, country-specific conditions, and how a government and other actors frame the issue and respond.
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Affiliation(s)
- Dorothea Hilhorst
- Professor, International Institute of Social StudiesErasmus University RotterdamThe Netherlands
| | - Rodrigo Mena
- Assistant Professor, International Institute of Social StudiesErasmus University RotterdamThe Netherlands
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Sanitary Aspects of Countering the Spread of COVID-19 in Russia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312456. [PMID: 34886181 PMCID: PMC8657366 DOI: 10.3390/ijerph182312456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022]
Abstract
Due to the conditions that cause the spread of COVID-19, national health systems worldwide are under severe strain. Most countries face similar difficulties such as a lack of medical personnel and equipment and tools for diagnosis and treatment, overrun hospitals, and forced restriction of planned medical care. Public authorities in healthcare take the following measures due to increased pressure: limiting the transmission and spread of the virus (social distancing and quarantine), mobilizing medical personnel, ensuring the availability of diagnostic and treatment tools, and providing a sufficient number of premises, which are not always suitable for the provision of medical care (buildings and structures). To date, the stages of management decision-making to counter coronavirus infection and the risk of COVID-19 transmission at various facilities have not been analyzed. The authors propose a methodology for assessing the COVID-19 transmission risk at various social and transport facilities. A survey of 1325 respondents from Moscow demonstrated the most significant risk factors, such as visitation avoidance, infection risk, and facemask wearing. Risk categories were determined and objects classified according to high, medium, and low-risk levels.
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McClarty L, Lazarus L, Pavlova D, Reza-Paul S, Balakireva O, Kimani J, Tarasova T, Lorway R, Becker ML, McKinnon LR. Socioeconomic Burdens of the COVID-19 Pandemic on LMIC Populations with Increased HIV Vulnerabilities. Curr HIV/AIDS Rep 2021; 19:76-85. [PMID: 34822064 PMCID: PMC8614077 DOI: 10.1007/s11904-021-00591-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
Purpose of Review To review the impact of the COVID-19 pandemic and its public health response on key populations at risk of HIV infection, with a focus on sex workers. Recent Findings Since last year several groups have documented how the COVID-19 pandemic has impacted the livelihoods and health of sex workers. We focus on case studies from Kenya, Ukraine, and India and place these in the broader global context of sex worker communities, drawing on common themes that span geographies. Summary COVID-19-associated lockdowns have significantly disrupted sex work, leading to economic and health challenges for sex workers, ranging from HIV-related services to mental health and exposure to violence. Several adaptations have been undertaken by sex workers and frontline workers, including migration, a move to mobile services, and struggling to find economic supports. Strengthening community-based responses for future pandemics and other shocks is critical to safeguard the health of marginalized populations.
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Affiliation(s)
- Leigh McClarty
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lisa Lazarus
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Daria Pavlova
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
| | - Sushena Reza-Paul
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Ashodaya Samithi, Mysuru, India
| | - Olga Balakireva
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
- Institute for Economics and Forecasting, Ukrainian National Academy of Sciences, Kyiv, Ukraine
| | - Joshua Kimani
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, University of Nairobi, Nairobi, Kenya
| | - Tetiana Tarasova
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
| | - Robert Lorway
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Marissa L Becker
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada
| | - Lyle R McKinnon
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada.
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, University of Nairobi, Nairobi, Kenya.
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.
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Sadeghi B, Cheung RCY, Hanbury M. Using hierarchical clustering analysis to evaluate COVID-19 pandemic preparedness and performance in 180 countries in 2020. BMJ Open 2021; 11:e049844. [PMID: 34753756 PMCID: PMC8578186 DOI: 10.1136/bmjopen-2021-049844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To rank and score 180 countries according to COVID-19 cases and fatality in 2020 and compare the results to existing pandemic vulnerability prediction models and results generated by standard epidemiological scoring techniques. SETTING One hundred and eighty countries' patients with COVID-19 and fatality data representing the healthcare system preparedness and performance in combating the pandemic in 2020. DESIGN Using the retrospective daily COVID-19 data in 2020 broken into 24 half-month periods, we applied unsupervised machine learning techniques, in particular, hierarchical clustering analysis to cluster countries into five groups within each period according to their cumulative COVID-19 fatality per day over the year and cumulative COVID-19 cases per million population per day over the half-month period. We used the average of the period scores to assign countries' final scores for each measure. PRIMARY OUTCOME The primary outcomes are the COVID-19 cases and fatality grades in 2020. RESULTS The United Arab Emirates and the USA with F in COVID-19 cases, achieved A or B in the fatality scores. Belgium and Sweden ranked F in both scores. Although no African country ranked F for COVID-19 cases, several African countries such as Gambia and Liberia had F for fatality scores. More developing countries ranked D and F in fatality than in COVID-19 case rankings. The classic epidemiological measures such as averages and rates have a relatively good correlation with our methodology, but past predictions failed to forecast the COVID-19 countries' preparedness. CONCLUSION COVID-19 fatality can be a good proxy for countries' resources and system's resilience in managing the pandemic. These findings suggest that countries' economic and sociopolitical factors may behave in a more complex way as were believed. To explore these complex epidemiological associations, models can benefit enormously by taking advantage of methods developed in computer science and machine learning.
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Affiliation(s)
| | - Rex C Y Cheung
- Department of Decision Sciences, San Francisco State University, San Francisco, California, USA
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Najeebullah K, Liebig J, Darbro J, Jurdak R, Paini D. Timely surveillance and temporal calibration of disease response against human infectious diseases. PLoS One 2021; 16:e0258332. [PMID: 34662353 PMCID: PMC8523075 DOI: 10.1371/journal.pone.0258332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 09/27/2021] [Indexed: 11/18/2022] Open
Abstract
Background Disease surveillance and response are critical components of epidemic preparedness. The disease response, in most cases, is a set of reactive measures that follow the outcomes of the disease surveillance. Hence, timely surveillance is a prerequisite for an effective response. Methodology/principal findings We apply epidemiological soundness criteria in combination with the Latent Influence Point Process and time-to-event models to construct a disease spread network. The network implicitly quantifies the fertility (whether a case leads to secondary cases) and reproduction (number of secondary cases per infectious case) of the cases as well as the size and generations (of the infection chain) of the outbreaks. We test our approach by applying it to historic dengue case data from Australia. Using the data, we empirically confirm that high morbidity relates positively with delay in disease response. Moreover, we identify what constitutes timely surveillance by applying various thresholds of disease response delay to the network and report their impact on case fertility, reproduction, number of generations and ultimately, outbreak size. We observe that enforcing a response delay threshold of 5 days leads to a large average reduction across all parameters (occurrence 87%, reproduction 83%, outbreak size 80% and outbreak generations 47%), whereas extending the threshold to 10 days, in comparison, significantly limits the effectiveness of the response actions. Lastly, we identify the components of the disease surveillance system that can be calibrated to achieve the identified thresholds. Conclusion We identify practically achievable, timely surveillance thresholds (on temporal scale) that lead to an effective response and identify how they can be satisfied. Our approach can be utilized to provide guidelines on spatially and demographically targeted resource allocation for public awareness campaigns as well as to improve diagnostic abilities and turn-around times for the doctors and laboratories involved.
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Affiliation(s)
- Kamran Najeebullah
- Data61, Commonwealth Scientific and Industrial Research Organisation, Dutton Park, Australia
- * E-mail:
| | - Jessica Liebig
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Dutton Park, Australia
| | - Jonathan Darbro
- Metro North Public Health Unit, Queensland Health, Brisbane, Queensland, Australia
| | - Raja Jurdak
- Department of Computer Science, Queensland University of Technology, Brisbane, Australia
| | - Dean Paini
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Dutton Park, Australia
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Rizvi SA, Umair M, Cheema MA. Clustering of countries for COVID-19 cases based on disease prevalence, health systems and environmental indicators. CHAOS, SOLITONS, AND FRACTALS 2021; 151:111240. [PMID: 34253943 PMCID: PMC8264526 DOI: 10.1016/j.chaos.2021.111240] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/26/2021] [Indexed: 05/24/2023]
Abstract
The coronavirus has a high basic reproduction number ( R 0 ) and has caused the global COVID-19 pandemic. Governments are implementing lockdowns that are leading to economic fallout in many countries. Policy makers can take better decisions if provided with the indicators connected with the disease spread. This study is aimed to cluster the countries using social, economic, health and environmental related metrics affecting the disease spread so as to implement the policies to control the widespread of disease. Thus, countries with similar factors can take proactive steps to fight against the pandemic. The data is acquired for 79 countries and 18 different feature variables (the factors that are associated with COVID-19 spread) are selected. Pearson Product Moment Correlation Analysis is performed between all the feature variables with cumulative death cases and cumulative confirmed cases individually to get an insight of relation of these factors with the spread of COVID-19. Unsupervised k-means algorithm is used and the feature set includes economic, environmental indicators and disease prevalence along with COVID-19 variables. The learning model is able to group the countries into 4 clusters on the basis of relation with all 18 feature variables. We also present an analysis of correlation between the selected feature variables, and COVID-19 confirmed cases and deaths. Prevalence of underlying diseases shows strong correlation with COVID-19 whereas environmental health indicators are weakly correlated with COVID-19.
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Affiliation(s)
- Syeda Amna Rizvi
- Computer Engineering Department, University of Engineering and Technology, Lahore, Pakistan
| | - Muhammad Umair
- Department of Electrical, Electronics & Telecommunication Engineering, New Campus, University of Engineering & Technology, Lahore, Pakistan
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Using Systems Dynamics for Capturing the Multicausality of Factors Affecting Health System Capacity in Latin America while Responding to the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910002. [PMID: 34639304 PMCID: PMC8507654 DOI: 10.3390/ijerph181910002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/05/2021] [Accepted: 09/16/2021] [Indexed: 11/24/2022]
Abstract
Similar interventions to stop the spread of COVID-19 led to different outcomes in Latin American countries. This study aimed to capture the multicausality of factors affecting HS-capacity that could help plan a more effective response, considering health as well as social aspects. A facilitated GMB was constructed by experts and validated with a survey from a wider population. Statistical analyses estimated the impact of the main factors to the HS-capacity and revealed the differences in its mechanisms. The results show a similar four-factor structure in all countries that includes public administration, preparedness, information, and collective self-efficacy. The factors are correlated and have mediating effects with HS-capacity; this is the base for differences among countries. HS-capacity has a strong relation with public administration in Bolivia, while in Nicaragua and Uruguay it is related through preparedness. Nicaragua lacks information as a mediation effect with HS-capacity whereas Bolivia and Uruguay have, respectively, small and large mediation effects with it. These outcomes increase the understanding of the pandemic based on country-specific context and can aid policymaking in low-and middle-income countries by including these factors in future pandemic response models.
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Köster AM, Bludau A, Devcic SK, Scheithauer S, Mardiko AA, Schaumann R. Infection surveillance measures during the COVID-19 pandemic in Germany. GMS HYGIENE AND INFECTION CONTROL 2021; 16:Doc27. [PMID: 34650903 PMCID: PMC8495235 DOI: 10.3205/dgkh000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction: To address the question as to which infection surveillance measures are used during the ongoing COVID-19 pandemic in Germany and how they differ from pre-existing approaches. Methods: In accordance with the systematic approach of a scoping review, a literature search was conducted in national and international medical literature databases using a search string. The search in the databases was limited to the period from 01.01.2000 to 15.11.2020 and has been subsequently completed by hand search until 08.03.2021. A hand search, even beyond 15.11.2020, seemed necessary and reasonable, since due to the dynamics of the ongoing COVID-19 pandemic, a large number of articles and regulations are being published very quickly at short notice. Results: The literature search resulted in the following number of hits in the databases listed below: PubMed: 165 articlesCochrane: 1 review and 35 studiesWeb of Science: 217 articlesRobert Koch Institute: 49 articles Thus, a total of 467 hits were identified, with a total of 124 hits being duplicates. From these, 138 articles were considered relevant to the COVID-19 infection surveillance situation in Germany based on established criteria. After reading the full texts, 92 articles and websites were ultimately included in the scoping review. Discussion: Many of the lessons learned from previous outbreaks seem to have been implemented in the infection surveillance measures during the ongoing COVID-19 pandemic in Germany. Most of the changes compared with previous measures were based on technological streamlining of existing procedures and changes and more inclusion of the population in different infection surveillance measures.
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Affiliation(s)
- Antonia Milena Köster
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Anna Bludau
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Sanja Katharina Devcic
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Simone Scheithauer
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Amelia Aquareta Mardiko
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Reiner Schaumann
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
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