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Tahir MA, Khan MA, Ikram A, Chaudhry TH, Amir A, Tahir M, Haq IU, Zaki SA, Salam A, Wali S, Munir W, Salman M. Coordination strategies and concept of operations implemented during activation of public health emergency operations center for COVID-19 response in Pakistan. Sci Rep 2023; 13:18831. [PMID: 37914904 PMCID: PMC10620167 DOI: 10.1038/s41598-023-46234-5] [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: 03/28/2023] [Accepted: 10/30/2023] [Indexed: 11/03/2023] Open
Abstract
Public health emergency management systems encountered difficulties in developing countries, especially in Pakistan. The COVID-19 pandemic was extremely challenging for different agencies/departments in Pakistan. Health emergency management depends on a well-established public health emergency operations center that could generate a coordinated response to emergencies. We conducted an assessment of public health emergency response coordination implemented during the COVID-19 at strategic level. This was mix-method qualitative study. Primary data was collected by using a structured questionnaire, and secondary data was collected by desk review. The agencies engaged in pandemic response at the national level in Pakistan were included in the assessment. The overall score of the emergency response coordination system during COVID-19 was 49% for all agencies. We found that agencies faced challenges in leadership, legislation, and financing issues during the pandemic response (44%). None of the agencies had a fully developed framework for joint planning and response system for health emergencies. Roles and responsibilities attached to designated agencies in response were relatively clear (55%) for most of the agencies. Effective public health emergency response is based on multi-departmental coordination, resource mobilization, and clear roles for each agency. Pakistan must proactively address these challenges for pandemic response in future.
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Affiliation(s)
- Majid Ali Tahir
- CDC, National Institutes of Health, Islamabad, Pakistan.
- Department of Public Health and Nutrition, University of Haripur, Haripur, KP, Pakistan.
| | - Mumtaz Ali Khan
- Center for Disease Control, National Institutes of Health, Islamabad, Pakistan
| | - Aamer Ikram
- Center for Disease Control, National Institutes of Health, Islamabad, Pakistan
| | | | - Afreenish Amir
- Center for Disease Control, National Institutes of Health, Islamabad, Pakistan
| | | | - Ijaz Ul Haq
- Department of Public Health and Nutrition, University of Haripur, Haripur, KP, Pakistan.
| | - Shahbaz Ahmed Zaki
- Department of Public Health and Nutrition, University of Haripur, Haripur, KP, Pakistan
| | - Arslan Salam
- Center for Disease Control, National Institutes of Health, Islamabad, Pakistan
| | - Sidra Wali
- Center for Disease Control, National Institutes of Health, Islamabad, Pakistan
| | | | - Muhammad Salman
- Center for Disease Control, National Institutes of Health, Islamabad, Pakistan
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Schumacher L, Senhaji S, Gartner BA, Carrez L, Dupuis A, Bonnabry P, Widmer N. Full-scale simulations to improve disaster preparedness in hospital pharmacies. BMC Health Serv Res 2022; 22:853. [PMID: 35780151 PMCID: PMC9250711 DOI: 10.1186/s12913-022-08230-9] [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: 09/20/2021] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Assess whether full-scale simulation exercises improved hospital pharmacies’ disaster preparedness. Methods Swiss hospital pharmacies performed successive full-scale simulation exercises at least four months apart. An interprofessional team created two scenarios, each representing credible regional-scale disasters involving approximately fifty casualties (a major road accident and a terrorist attack). Four exercise assessors used appraisal forms to evaluate participants’ actions and responses during the simulation (rating them using five-point Likert scales). Results Four hospital pharmacies performed two full-scale simulation exercises each. Differences between exercises one and two were observed. On average, the four hospitals accomplished 69% ± 6% of the actions expected of them during exercise one. The mean rate of expected actions accomplished increased to 84% ± 7% (p < 0.005) during exercise two. Moreover, the average quality of actions improved from 3.0/5 to 3.6/5 (p = 0.01), and the time required to gather a crisis management team drastically decreased between simulations (from 23 to 5 min). The main challenges were communication (reformulation) and crisis management. Simulation exercise number one resulted in three hospital pharmacies creating disaster action plans and the fourth improving its already existing plan. Conclusion This study highlighted the value of carrying out full-scale disaster simulations for hospital pharmacies as they improved overall institutional preparedness and increased staff awareness. The number of expected actions accomplished increased significantly. In the future, large-scale studies and concept dissemination are warranted.
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Affiliation(s)
- Laurence Schumacher
- Specialised Centre for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.,Pharmacy of the Eastern Vaud Hospitals, Rennaz, Switzerland
| | - Salim Senhaji
- Pharmacy, Geneva University Hospitals, Geneva, Switzerland
| | | | - Laurent Carrez
- Service of Pharmacy, Lausanne University Hospital, Lausanne, Switzerland
| | - Arnaud Dupuis
- Surgery Department, Geneva University Hospitals, Geneva, Switzerland.,Specialised Centre for War and Disaster Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Pascal Bonnabry
- Specialised Centre for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.,Pharmacy, Geneva University Hospitals, Geneva, Switzerland
| | - Nicolas Widmer
- Specialised Centre for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland. .,Pharmacy of the Eastern Vaud Hospitals, Rennaz, Switzerland.
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de Vries DH, Kinsman J, Cremers AL, Angrén J, Ciotti M, Tsolova S, Wiltshire E, Takacs J. Public health preparedness and response synergies between institutional authorities and the community: a qualitative case study of emerging tick-borne diseases in Spain and the Netherlands. BMC Public Health 2021; 21:1882. [PMID: 34663298 PMCID: PMC8524986 DOI: 10.1186/s12889-021-11925-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Communities affected by infectious disease outbreaks are increasingly recognised as partners with a significant role to play during public health emergencies. This paper reports on a qualitative case study of the interactions between affected communities and public health institutions prior to, during, and after two emerging tick-borne disease events in 2016: Crimean-Congo Haemorrhagic Fever in Spain, and Tick-Borne Encephalitis in the Netherlands. The aim of the paper is to identify pre-existing and emergent synergies between communities and authorities, and to highlight areas where synergies could be facilitated and enhanced in future outbreaks. METHODS Documentary material provided background for a set of semi-structured interviews with experts working in both health and relevant non-health official institutions (13 and 21 individuals respectively in Spain and the Netherlands), and focus group discussions with representatives of affected communities (15 and 10 individuals respectively). Data from all sources were combined and analysed thematically, initially independently for each country and then for both countries together. RESULTS Strong synergies were identified in tick surveillance activities in both countries, and the value of pre-existing networks of interest groups for preparedness and response activities was recognised. However, authorities also noted that there were hard-to-reach and potentially vulnerable groups, such as hikers, foreign tourists, and volunteers working in green areas. While the general population received preventive information about the two events, risk communication or other community engagement efforts were not seen as necessary specifically for these sub-groups. Post-event evaluations of community engagement activities during the two events were limited, so lessons learned were not well documented. CONCLUSIONS A set of good practices emerged from this study, that could be applied in these and other settings. They included the potential value of conducting stakeholder analyses of community actors with a stake in tick-borne or other zoonotic diseases; of utilising pre-existing stakeholder networks for information dissemination; and of monitoring community perceptions of any public health incident, including through social media. Efforts in the two countries to build on the community engagement activities that are already in place could contribute to better preparedness planning and more efficient and timely responses in future outbreaks.
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Affiliation(s)
| | - John Kinsman
- European Centre for Disease prevention and Control (ECDC), Solna, Sweden
| | | | - John Angrén
- The Swedish Civil Contingencies Agency, Karlstad, Sweden
| | - Massimo Ciotti
- European Centre for Disease prevention and Control (ECDC), Solna, Sweden
| | - Svetla Tsolova
- European Centre for Disease prevention and Control (ECDC), Solna, Sweden
| | - Emma Wiltshire
- European Centre for Disease prevention and Control (ECDC), Solna, Sweden
| | - Judit Takacs
- Centre for Social Sciences, Hungarian Academy of Sciences Centre of Excellence, Budapest, Hungary
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Winter F, Schoneberg C, Wolf A, Bauer BU, Prüfer TL, Fischer SF, Gerdes U, Runge M, Ganter M, Campe A. Concept of an Active Surveillance System for Q Fever in German Small Ruminants-Conflicts Between Best Practices and Feasibility. Front Vet Sci 2021; 8:623786. [PMID: 33644150 PMCID: PMC7902497 DOI: 10.3389/fvets.2021.623786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022] Open
Abstract
Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii. Inhalation of contaminated dust particles or aerosols originating from animals (esp. small ruminants) is the main source of human infection. Hence, an active early warning system for Q fever in German small ruminant livestock was conceptualized to prevent human infections. First, we describe the best practice for establishing this system before evaluating its feasibility, as the combination of both evokes conflicts. Vaginal swabs from all husbandry systems with a focus on reproductive females should pooled and investigated by PCR to detect C. burnetii-shedding animals. Multistage risk-based sampling shall be carried out at the flock level and within-flock level. At the flock level, all flocks that are at risk to transmit the pathogen to the public must be sampled. At the within-flock level, all primi- and multiparous females after lambing must be tested in order to increase the probability of identifying a positive herd. Sampling should be performed during the main lambing period and before migration in residential areas. Furthermore, individual animals should be tested before migration or exhibition to ensure a negative status. If a flock tests positive in at least one individual sample, then flock-specific preventive measures should be implemented. This approach implies huge financial costs (sample testing, action/control measures). Hence, taking the step to develop more feasible and affordable preventive measures, e.g., vaccinating small ruminant flocks, should replace testing wherever justifiable.
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Affiliation(s)
- Fenja Winter
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover Foundation, Hanover, Germany
| | - Clara Schoneberg
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover Foundation, Hanover, Germany
| | - Annika Wolf
- Clinic for Swine, Small Ruminants and Forensic Medicine, University of Veterinary Medicine Hannover Foundation, Hanover, Germany
| | - Benjamin U Bauer
- Clinic for Swine, Small Ruminants and Forensic Medicine, University of Veterinary Medicine Hannover Foundation, Hanover, Germany
| | - T Louise Prüfer
- Lower Saxony State Office for Consumer Protection and Food Safety - Food and Veterinary Institute Braunschweig/Hannover, Hanover, Germany
| | - Silke F Fischer
- National Consulting Laboratory for Coxiella burnetii, State Health Office Baden-Württemberg, Stuttgart, Germany
| | - Ursula Gerdes
- Animal Disease Fund of Lower Saxony, Public Law Institution, Hanover, Germany
| | - Martin Runge
- Lower Saxony State Office for Consumer Protection and Food Safety - Food and Veterinary Institute Braunschweig/Hannover, Hanover, Germany
| | - Martin Ganter
- Clinic for Swine, Small Ruminants and Forensic Medicine, University of Veterinary Medicine Hannover Foundation, Hanover, Germany
| | - Amely Campe
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover Foundation, Hanover, Germany
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