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Komesaroff PA, Dwyer DE. The Question of the Origins of COVID-19 and the Ends of Science. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:575-583. [PMID: 37697176 PMCID: PMC10942872 DOI: 10.1007/s11673-023-10303-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/31/2023] [Indexed: 09/13/2023]
Abstract
Intense public interest in scientific claims about COVID-19, concerning its origins, modes of spread, evolution, and preventive and therapeutic strategies, has focused attention on the values to which scientists are assumed to be committed and the relationship between science and other public discourses. A much discussed claim, which has stimulated several inquiries and generated far-reaching political and economic consequences, has been that SARS-CoV-2 was deliberately engineered at the Wuhan Institute of Virology and then, either inadvertently or otherwise, released to the public by a laboratory worker. This has been pursued despite a clear refutation, through comprehensive genomic analysis, of the hypothesis that the virus was deliberately engineered and the failure of detailed investigations to identify any evidence in support of a laboratory leak. At the same time a substantial, established body of knowledge about the many factors underlying the emergence of novel zoonotic diseases has been largely ignored-including climate change and other mechanisms of environmental destruction, tourism, patterns of trade, and cultural influences. The existence and conduct of these debates have raised questions about the vulnerability of science to manipulation for political purposes. Scientific discourses are vulnerable because: (i) claims can be made with no more than probabilistic force; (ii) alleged "facts" are always subject to interpretation, which depends on social, ethical, and epistemological assumptions; and (iii) science and scientists are not inherently committed to any single set of values and historically have served diverse, and sometimes perverse, social and political interests. In the face of this complexity, the COVID-19 experience highlights the need for processes of ethical scrutiny of the scientific enterprise and its strategic deployment. To ensure reliability of truth claims and protection from corrupting influences robust ethical discourses are required that are independent of, and at times even contrary to, those of science itself.
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Affiliation(s)
- Paul A Komesaroff
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, 3800, Australia.
| | - Dominic E Dwyer
- New South Wales Health Pathology-ICPMR Westmead, University of Sydney, Westmead Hospital, Westmead, NSW, 2145, Australia
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Gao R, Liu HH. Political stability as a major determinant of the Covid-19 pandemic outcomes. Heliyon 2023; 9:e20617. [PMID: 37860511 PMCID: PMC10582285 DOI: 10.1016/j.heliyon.2023.e20617] [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: 12/30/2022] [Revised: 09/25/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
This paper explores the role of political stability in explaining the cross-country variation of Covid-19 pandemic outcomes. Based on the international evidence, we find that lower pre-Covid-19 levels of political stability are associated with worse Covid-19 pandemic outcomes. Politically unstable countries are more likely to suffered significantly higher morbidity and mortality. Further analysis shows that political stability only matters in countries prepared with requisite medical capacity to deal with health emergencies. We also find that political stability is more crucial in countries with higher poverty rates. Overall, to combat Covid-19 and the subsequential collective threats successfully, the national authorities should pay more attention to maintain political stability.
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Affiliation(s)
- Rui Gao
- School of Economics, Qingdao University, Kedazhi Road, Qingdao, Shandong, 266000, China
| | - Hai-Hong Liu
- School of Infectious Diseases, Qilu Hospital, Wenhuaxi Road, Shandong University, Jinan, Shandong, 250012, China
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DÜZENCİ S, MALAK B. Environmental Ethics and Mental Health during COVID-19. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1076940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
As the cause of the COVID-19 pandemic, climate change, population density, ecological changes, etc. natural phenomena are shown. The physical, chemical, biological, socioeconomic, cultural and psychological effects of COVID-19 have been felt all over the world. COVID-19 negatively affects the environment with an unbalanced increase in medical waste and disposable products, while quarantine and pandemic measures have given an opportunity for nature to renew itself. The causes and consequences of COVID-19 have brought the concepts of environmental health and therefore environmental ethics to the agenda of healthcare professionals. As the environmental ethics attitudes and behaviors of health professionals develop, health professionals will be able to take initiatives to create these attitudes and behaviors in society. Environmental ethics has been evaluated in the context of public health, mostly in the physical health. However, environmental ethics is also very important in terms of community mental health. Living in an unhealthy environment threatens mental health. Because people want to live in a safe environment, every factor that threatens this trust poses a risk for mental health. There is actually literally no way to talk about happiness in an environment where there is no environmental order and nature is deteriorated and polluted. Therefore, we aimed to explain the concepts of environmental health, environmental ethics and mental health during the COVID-19 process. Thus, an important strategy development in the pandemic process can be achieved by enabling the assessment and management of the causes of the COVID-19 pandemic from a broader perspective.
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Zhao Z, Yue Y, Liu X, Li C, Ma W, Liu Q. The patterns and driving forces of dengue invasions in China. Infect Dis Poverty 2023; 12:42. [PMID: 37085941 PMCID: PMC10119823 DOI: 10.1186/s40249-023-01093-0] [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: 02/02/2023] [Accepted: 04/04/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Global connectivity and environmental change pose continuous threats to dengue invasions from worldwide to China. However, the intrinsic relationship on introduction and outbreak risks of dengue driven by the landscape features are still unknown. This study aimed to map the patterns on source-sink relation of dengue cases and assess the driving forces for dengue invasions in China. METHODS We identified the local and imported cases (2006-2020) and assembled the datasets on environmental conditions. The vector auto-regression model was applied to detect the cross-relations of source-sink patterns. We selected the major environmental drivers via the Boruta algorithm to assess the driving forces in dengue outbreak dynamics by applying generalized additive models. We reconstructed the internal connections among imported cases, local cases, and external environmental drivers using the structural equation modeling. RESULTS From 2006 to 2020, 81,652 local dengue cases and 12,701 imported dengue cases in China were reported. The hotspots of dengue introductions and outbreaks were in southeast and southwest China, originating from South and Southeast Asia. Oversea-imported dengue cases, as the Granger-cause, were the initial driver of the dengue dynamic; the suitable local bio-socioecological environment is the fundamental factor for dengue epidemics. The Bio8 [odds ratio (OR) = 2.11, 95% confidence interval (CI): 1.67-2.68], Bio9 (OR = 291.62, 95% CI: 125.63-676.89), Bio15 (OR = 4.15, 95% CI: 3.30-5.24), normalized difference vegetation index in March (OR = 1.27, 95% CI: 1.06-1.51) and July (OR = 1.04, 95% CI: 1.00-1.07), and the imported cases are the major drivers of dengue local transmissions (OR = 4.79, 95% CI: 4.34-5.28). The intermediary effect of an index on population and economic development to local cases via the path of imported cases was detected in the dengue dynamic system. CONCLUSIONS Dengue outbreaks in China are triggered by introductions of imported cases and boosted by landscape features and connectivity. Our research will contribute to developing nature-based solutions for dengue surveillance, mitigation, and control from a socio-ecological perspective based on invasion ecology theories to control and prevent future dengue invasion and localization.
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Affiliation(s)
- Zhe Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
- Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China
- Shandong University Climate Change and Health Center, Jinan, 250012, People's Republic of China
| | - Yujuan Yue
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
- Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China
| | - Xiaobo Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
- Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China
| | - Chuanxi Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China
- Shandong University Climate Change and Health Center, Jinan, 250012, People's Republic of China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China.
- Shandong University Climate Change and Health Center, Jinan, 250012, People's Republic of China.
| | - Qiyong Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China.
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China.
- Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China.
- Shandong University Climate Change and Health Center, Jinan, 250012, People's Republic of China.
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Paula NMD, Pereira W, Giordani RCF. [COVID-19 in the midst of a "perfect storm" in neoliberal capitalism: critical reflections on its impacts in Brazil]. CIENCIA & SAUDE COLETIVA 2023; 28:761-770. [PMID: 36888860 DOI: 10.1590/1413-81232023283.10262022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 09/06/2022] [Indexed: 03/08/2023] Open
Abstract
The impacts of the recent coronavirus pandemic on Brazilian society revealed a scenario that goes beyond a health crisis. This article sets out to present the causes and consequences of a systemic crisis in the neoliberal economic order based on the prominence of markets and social exclusion, while the role of the State - as the guardian of social rights - is neglected. The methodology adopted follows a critical interdisciplinary perspective from the fields of political economy and social sciences, located in socioeconomic reports referred to in this analysis. It is argued that the neoliberal rationale guiding government policies, which is deep rooted in the social environment, has contributed to the increase in structural inequalities in Brazil, thus creating favorable conditions for exacerbating the impacts caused by the pandemic in society, particularly among the most vulnerable social groups.
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Affiliation(s)
- Nilson Maciel de Paula
- Universidade Federal do Paraná. R. Pref. Lothario Meissner 632, Jardim Botânico. 80210-170 Curitiba PR Brasil.
| | - Wellington Pereira
- Universidade Federal do Paraná. R. Pref. Lothario Meissner 632, Jardim Botânico. 80210-170 Curitiba PR Brasil.
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Dubé È, Labbé F, Malo B, Pelletier C. Public health communication during the COVID-19 pandemic: perspectives of communication specialists, healthcare professionals, and community members in Quebec, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:24-33. [PMID: 36131219 PMCID: PMC9491262 DOI: 10.17269/s41997-022-00697-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/06/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Communication during a pandemic is key in ensuring adoption of preventive behaviours and limiting disease transmission. The aim of the study was to explore how communication specialists working in health and governmental institutions and healthcare professionals have communicated about COVID-19, and how different groups of the public have perceived official communications on COVID-19. METHODS We conducted an exploratory qualitative study. Data were collected via individual semi-structured interviews and focus-group discussions. The Crisis and Emergency Risk Communication (CERC) model was used as a theoretical framework to guide data interpretation. RESULTS We interviewed 6 communication specialists and 5 healthcare professionals. Three focus groups were held with 23 participants (8 young adults, 9 Quebecers of Asian ethnicity, and 6 Quebecers who suffered harshly from economic consequences of the pandemic and measures). Although daily press conferences were rapidly implemented in Quebec, participants highlighted several communication challenges, including accuracy and credibility of information in a context of uncertainties and rapidly evolving knowledge. Participants also identified paternalism, stigmatization of some communities, and issues with promoting action and mobilization of some subpopulations as communication challenges. CONCLUSION Our study showed that the six core CERC principles have not all been applied systematically in communication interventions in Quebec. Despite some limitations, messages about COVID-19 risk were clearly and consistently communicated and were generally well understood by most Quebecers.
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Affiliation(s)
- Ève Dubé
- Institut national de santé publique du Québec, Québec, Québec, Canada.
- Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.
| | - Fabienne Labbé
- Institut national de santé publique du Québec, Québec, Québec, Canada
| | - Benjamin Malo
- Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Catherine Pelletier
- Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
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Lal A, Abdalla SM, Chattu VK, Erondu NA, Lee TL, Singh S, Abou-Taleb H, Vega Morales J, Phelan A. Pandemic preparedness and response: exploring the role of universal health coverage within the global health security architecture. Lancet Glob Health 2022; 10:e1675-e1683. [PMID: 36179734 PMCID: PMC9514836 DOI: 10.1016/s2214-109x(22)00341-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/22/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022]
Abstract
In response to the COVID-19 pandemic, several international initiatives have been developed to strengthen and reform the global architecture for pandemic preparedness and response, including proposals for a pandemic treaty, a Pandemic Fund, and mechanisms for equitable access to medical countermeasures. These initiatives seek to make use of crucial lessons gleaned from the ongoing pandemic by addressing gaps in health security and traditional public health functions. However, there has been insufficient consideration of the vital role of universal health coverage in sustainably mitigating outbreaks, and the importance of robust primary health care in equitably and efficiently safeguarding communities from future health threats. The international community should not repeat the mistakes of past health security efforts that ultimately contributed to the rapid spread of the COVID-19 pandemic and disproportionately affected vulnerable and marginalised populations, especially by overlooking the importance of coherent, multisectoral health systems. This Health Policy paper outlines major (although often neglected) gaps in pandemic preparedness and response, which are applicable to broader health emergency preparedness and response efforts, and identifies opportunities to reconceptualise health security by scaling up universal health coverage. We then offer a comprehensive set of recommendations to help inform the development of key pandemic preparedness and response proposals across three themes-governance, financing, and supporting initiatives. By identifying approaches that simultaneously strengthen health systems through global health security and universal health coverage, we aim to provide tangible solutions that equitably meet the needs of all communities while ensuring resilience to future pandemic threats.
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Affiliation(s)
- Arush Lal
- Department of Health Policy, London School of Economics and Political Science, London, UK.
| | - Salma M Abdalla
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Vijay Kumar Chattu
- Center for Interdisciplinary Research, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India,Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India,Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ngozi Adaeze Erondu
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA,Global Health Institute for Disease Elimination, United Arab Emirates Global Health Programme, Chatham House, London, UK
| | - Tsung-Ling Lee
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan
| | - Sudhvir Singh
- Department of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Hala Abou-Taleb
- Health System Governance Team, Department of Universal Health Coverage/Health Systems, Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | | | - Alexandra Phelan
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA,Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA
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Gostin LO. Living in an Age of Pandemics—From COVID-19 to Monkeypox, Polio, and Disease X. JAMA HEALTH FORUM 2022; 3:e224062. [DOI: 10.1001/jamahealthforum.2022.4062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This JAMA Forum discusses pandemic drivers and the lessons learned by health systems during the COVID-19 pandemic, including global cooperation, equity, health communication, and childhood vaccinations, and provides 5 steps toward a more secure future with information on prevention, preparedness, response, recovery, and resilience.
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Affiliation(s)
- Lawrence O. Gostin
- O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC
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Jia F, Wang DD, Li L. Decision analysis of international joint prevention and control of public health emergencies. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2022; 25:1-22. [PMID: 36164470 PMCID: PMC9491675 DOI: 10.1007/s10668-022-02666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
COVID-19 has caused huge losses to countries around the world, and it will not end in a short time. The lack of motivation for international joint prevention and control is one of the important reasons for the global pandemic of COVID-19. How to improve the efforts and level of international joint prevention and control has become an urgent problem to be solved. Considering the long-term and dynamic nature of international joint prevention and control, the differential game method is used to compare and analyze the optimal decisions of countries in the three scenarios of spontaneous governance, external subsidies and internal cost sharing. The results show that the optimal prevention and control efforts of countries are negatively correlated with discount rates, prevention and control cost coefficients, decay rate and risk factors. It is positively correlated with the impact degree of social benefits, the impact degree of prevention and control efforts on the level of joint prevention and control, the distribution ratio of social benefits, and the impact degree of prevention and control level on social benefits. The prevention and control efforts, joint prevention and control level, social benefits and system benefits under spontaneous governance are the lowest and highest under the internal cost sharing. The internal cost sharing will only be carried out when social benefits distribution ratio obtained reach a certain threshold. This study provides decision-making support for the joint prevention and control of countries to defeat COVID-19 under the normalization of the epidemic.
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Affiliation(s)
- Fangju Jia
- School of Business, Wuxi University, Wuxi, 214105 China
- School of Management Science and Engineering, Nanjing University of Information Science & Technology, Nanjing, 210044 China
| | - Dong-dong Wang
- School of Management, Lanzhou University, Lanzhou, 730000 China
| | - Lianshui Li
- School of Management Science and Engineering, Nanjing University of Information Science & Technology, Nanjing, 210044 China
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Woolaston K, Nay Z, Baker ML, Brockett C, Bruce M, Degeling C, Gilbert J, Jackson B, Johnson H, Peel A, Sahibzada S, Oskam C, Hewitt CL. An argument for pandemic risk management using a multidisciplinary One Health approach to governance: an Australian case study. Global Health 2022; 18:73. [PMID: 35883185 PMCID: PMC9321311 DOI: 10.1186/s12992-022-00850-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022] Open
Abstract
The emergence of SARS-CoV-2 and the subsequent COVID-19 pandemic has resulted in significant global impact. However, COVID-19 is just one of several high-impact infectious diseases that emerged from wildlife and are linked to the human relationship with nature. The rate of emergence of new zoonoses (diseases of animal origin) is increasing, driven by human-induced environmental changes that threaten biodiversity on a global scale. This increase is directly linked to environmental drivers including biodiversity loss, climate change and unsustainable resource extraction. Australia is a biodiversity hotspot and is subject to sustained and significant environmental change, increasing the risk of it being a location for pandemic origin. Moreover, the global integration of markets means that consumption trends in Australia contributes to the risk of disease spill-over in our regional neighbours in Asia-Pacific, and beyond. Despite the clear causal link between anthropogenic pressures on the environment and increasing pandemic risks, Australia's response to the COVID-19 pandemic, like most of the world, has centred largely on public health strategies, with a clear focus on reactive management. Yet, the span of expertise and evidence relevant to the governance of pandemic risk management is much wider than public health and epidemiology. It involves animal/wildlife health, biosecurity, conservation sciences, social sciences, behavioural psychology, law, policy and economic analyses to name just a few.The authors are a team of multidisciplinary practitioners and researchers who have worked together to analyse, synthesise, and harmonise the links between pandemic risk management approaches and issues in different disciplines to provide a holistic overview of current practice, and conclude the need for reform in Australia. We discuss the adoption of a comprehensive and interdisciplinary 'One Health' approach to pandemic risk management in Australia. A key goal of the One Health approach is to be proactive in countering threats of emerging infectious diseases and zoonoses through a recognition of the interdependence between human, animal, and environmental health. Developing ways to implement a One Health approach to pandemic prevention would not only reduce the risk of future pandemics emerging in or entering Australia, but also provide a model for prevention strategies around the world.
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Affiliation(s)
- Katie Woolaston
- School of Law, Queensland University of Technology, Brisbane, Australia.
| | - Zoe Nay
- School of Law, Queensland University of Technology, Brisbane, Australia
| | - Michelle L Baker
- CSIRO, Health and Biosecurity Business Unit, Australian Centre for Disease Preparedness, Geelong, Australia
| | - Callum Brockett
- School of Law, Queensland University of Technology, Brisbane, Australia
| | - Mieghan Bruce
- Biosecurity and One Health Research Centre, Harry Butler Institute, Murdoch University, Western Australia, Australia
| | - Chris Degeling
- Australian Centre for Health Engagement Evidence and Values, School of Health and Society, University of Wollongong, New South Wales, Australia
| | - Joshua Gilbert
- Worimi agriculturalist and researcher, Policy Advisor at the Jumbunna Institute for Indigenous Education and Research, University of Technology Sydney, Australia and PhD Candidate at Charles Sturt University, Bathurst, Australia
| | - Bethany Jackson
- Biosecurity and One Health Research Centre, Harry Butler Institute, Murdoch University, Western Australia, Australia
| | - Hope Johnson
- School of Law, Queensland University of Technology, Brisbane, Australia
| | - Alison Peel
- Centre for Planetary Health and Food Security, Griffith University, Brisbane, Australia
| | - Shafi Sahibzada
- Biosecurity and One Health Research Centre, Harry Butler Institute, Murdoch University, Western Australia, Australia
| | - Charlotte Oskam
- Biosecurity and One Health Research Centre, Harry Butler Institute, Murdoch University, Western Australia, Australia
| | - Chad L Hewitt
- Biosecurity and One Health Research Centre, Harry Butler Institute, Murdoch University, Western Australia, Australia
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Singh S, McNab C, Olson RM, Bristol N, Nolan C, Bergstrøm E, Bartos M, Mabuchi S, Panjabi R, Karan A, Abdalla SM, Bonk M, Jamieson M, Werner GK, Nordström A, Legido-Quigley H, Phelan A. How an outbreak became a pandemic: a chronological analysis of crucial junctures and international obligations in the early months of the COVID-19 pandemic. Lancet 2021; 398:2109-2124. [PMID: 34762857 PMCID: PMC8575464 DOI: 10.1016/s0140-6736(21)01897-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/01/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022]
Abstract
Understanding the spread of SARS-CoV-2, how and when evidence emerged, and the timing of local, national, regional, and global responses is essential to establish how an outbreak became a pandemic and to prepare for future health threats. With that aim, the Independent Panel for Pandemic Preparedness and Response has developed a chronology of events, actions, and recommendations, from December, 2019, when the first cases of COVID-19 were identified in China, to the end of March, 2020, by which time the outbreak had spread extensively worldwide and had been characterised as a pandemic. Datapoints are based on two literature reviews, WHO documents and correspondence, submissions to the Panel, and an expert verification process. The retrospective analysis of the chronology shows a dedicated initial response by WHO and some national governments, but also aspects of the response that could have been quicker, including outbreak notifications under the International Health Regulations (IHR), presumption and confirmation of human-to-human transmission of SARS-CoV-2, declaration of a Public Health Emergency of International Concern, and, most importantly, the public health response of many national governments. The chronology also shows that some countries, largely those with previous experience with similar outbreaks, reacted quickly, even ahead of WHO alerts, and were more successful in initially containing the virus. Mapping actions against IHR obligations, the chronology shows where efficiency and accountability could be improved at local, national, and international levels to more quickly alert and contain health threats in the future. In particular, these improvements include necessary reforms to international law and governance for pandemic preparedness and response, including the IHR and a potential framework convention on pandemic preparedness and response.
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Affiliation(s)
- Sudhvir Singh
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Christine McNab
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Rose McKeon Olson
- Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Nellie Bristol
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Cody Nolan
- Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Elin Bergstrøm
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Michael Bartos
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; School of Sociology, Australian National University, Canberra, ACT, Australia
| | - Shunsuke Mabuchi
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Raj Panjabi
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Abraar Karan
- Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Salma M Abdalla
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; Boston University School of Public Health, Boston, MA, USA
| | - Mathias Bonk
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Margaret Jamieson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - George K Werner
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Anders Nordström
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland
| | - Helena Legido-Quigley
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; London School of Hygiene & Tropical Medicine, London, UK; Saw Swee Hock School of Public Health, Singapore
| | - Alexandra Phelan
- The Independent Panel for Pandemic Preparedness and Response, Geneva, Switzerland; Center for Global Health Science & Security, Georgetown University, Washington, DC, USA
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