Canadian pandemic influenza preparedness: Public health measures strategy

Tracking emergency response actions during COVID-19 leads to development of an innovative public health evaluation tool

SETTING

Early in the pandemic, KFL&A Public Health needed a way to capture, organize, and display COVID-19-related events to be accountable for and evaluate our actions.

INTERVENTION

We used accessible software (Microsoft Office 365 suite, Microsoft PowerBI) to develop a data collection and visualization system. The Canadian Institute for Health Information (CIHI) developed a timeline and categorization approach for provincial and national COVID-related interventions, which was used to develop a regional version for local events using similar categories. We collected and displayed qualitative data alongside epidemiological data that allowed users to display different timelines of actions and outcomes and evaluate our response.

OUTCOMES

In developing the timeline, we took stock of the information and data we wanted to collect, sort, and display locally. Next, we collected information on response actions, case and contact tracing, and staffing changes in a database that we displayed on a timeline. We included CIHI's data set to provide insight into pandemic response across all jurisdictions.

IMPLICATIONS

Our timeline tool has many advantages for public health authorities beyond responding to a rapidly evolving emergency. By collecting information on events as they occur, decisions and actions are documented that may otherwise be overlooked. This enables decision-makers to visualize the impact of public health actions on health outcomes over time. The tool is completely customizable and scalable depending on the project scope and we plan to apply this method to other public health programming. Finally, we include lessons learned from quickly developing these tools in a real-time pandemic setting, both locally at KFL&A Public Health and nationally at CIHI.

Social innovation in health and community-driven engagement as a key strategy for addressing COVID-19 crisis challenges: insights and reflections from the multicultural society of Iran

Background

Social innovation is one of the strategies for appealing to people and encouraging social cooperation and engagement in interventions during crisis periods. In this regard, community engagement is an operative and innovative community health approach for achieving successful health outcomes. There is limited information about the role and operational impact of social innovation on community engagement during the challenges posed by the COVID-19 crisis. In this study, we aim to contribute to the understanding of innovative social strategies to attract social participation in crises such as the COVID-19 pandemic by highlighting the experience of social innovative strategies based on community-driven engagement in Iran.

Methods

This qualitative study was conducted in seven provinces of Iran-Mazandaran, Zanjan, Golestan, Lorestan, Tehran, Kurdistan, and Khuzestan-from 4 September 2021 to 1 March 2022. A sample of Iranians (15-71 years) was selected by purposeful and snowball sampling methods to participate in the study, and 187 semi-structured telephone interviews were conducted. Participants were recruited from three levels of the community: community leaders, healthcare providers, and laypeople. The data collection tool was an interview guide, which was designed based on a review of the literature. The data were analyzed using conventional content analysis. Exploratory analyses were performed to identify social innovative strategies based on community engagement used during the COVID-19 crisis in Iran. The interviews continued until data saturation was reached.

Results

Based on our findings, we distilled innovative strategies into 6 main themes and 37 categories: (1) information giving/sharing, (2) consultation, (3) involvement/collaboration, (4) health education and prevention, (5) empowering, and (6) advocacy. The results revealed that the participants were very driven to engage in the management and control of the COVID-19 crisis, even though they faced significant challenges.

Conclusion

The spread of the COVID-19 pandemic required social- and community-based responses. These reactions increased the possibility of fair access to health services, especially for vulnerable groups and minorities. As with other epidemics, applying the experience of the comprehensive participation of communities played an important and active role in the prevention and control of COVID-19. In this regard, giving and sharing information, consultation, involvement/collaboration, health education/prevention, empowerment, and advocacy are the most important innovative strategies that might encourage the community to perform COVID-19 crisis management and control.

How do economic and public finance statuses affect policy responses during a pandemic? - learning from the COVID-19 first wave

BACKGROUND

In the time of a pandemic, it is typical for public health bodies to collaborate with epidemiologists to design health policies both at national and international levels for controlling the spread. A point largely overlooked in literature is the extent economic capability and public finance status can influence the policy responses of countries during a pandemic situation. This article fills this gap by considering 12 public health and 7 economic measures (i.e., policies) in 200 countries during the COVID-19 first wave, with countries grouped across income categories.

METHODS

We apply statistical analysis, inclusive of regression models, to assess the impact of economic capability and public finance status on policy responses. Multiple open-access datasets are used in this research, and information from the hybrid sources are cumulated as samples. In our analysis, we consider variables including population characteristics (population size, density) and economic and public finance status (GDR, current account balance, government surplus/deficit) further to policy responses across public health and economic measures. Additionally, we consider infection rates across countries and the institution of the measures relative to infection rate.

RESULTS

Results suggest that countries from all income groups have favoured public health measures like school closures and travel bans, and economic measures like influencing interest rates. However, strong economy countries have more adopted technological monitoring than low-income countries. Contrarily, low-income countries have preferred traditional measures like curfew and obligatory mask-wearing. GDP per capita was a statistically significant factor influencing the institution of both public health and economic measures. Government finance statuses like current account balance and surplus/deficit were also significant factors influencing economic measures.

CONCLUSIONS

Overall, the research reveals that, further to biological characteristics, policymakers and epidemiologists can consider the economic and public finance contexts when suggesting health responses to a pandemic. This, in turn, calls for more international cooperation on economic terms further to public health terms.

How did socio-demographic status and personal attributes influence compliance to COVID-19 preventive behaviours during the early outbreak in Japan? Lessons for pandemic management

This study focuses on how socio-demographic status and personal attributes influence self-protective behaviours during a pandemic, with protection behaviours being assessed through three perspectives – social distancing, personal protection behaviour and social responsibility awareness. The research considers a publicly available and recently collected dataset on Japanese citizens during the COVID-19 early outbreak and utilises a data analysis framework combining Classification and Regression Tree (CART), a data mining approach, and regression analysis to gain deep insights. The analysis reveals Socio-demographic attributes – sex, marital family status and having children – as having played an influential role in Japanese citizens' abiding by the COVID-19 protection behaviours. Especially women with children are noted as more conscious than their male counterparts. Work status also appears to have some impact concerning social distancing. Trust in government also appears as a significant factor. The analysis further identifies smoking behaviour as a factor characterising subjective prevention actions with non-smokers or less-frequent smokers being more compliant to the protection behaviours. Overall, the findings imply the need of public policy campaigning to account for variations in protection behaviour due to socio-demographic and personal attributes during pandemics and national emergencies.

A web-based health education module and its impact on the preventive practices of health-care workers during the COVID-19 pandemic

Proper training on the preventive measures against COVID-19 among health-care workers is crucial for mitigating the spread of viral infection. The present study evaluated the efficacy of a brief web-based module on the practice of hand hygiene and respiratory etiquette among respective health-care workers. A comparative study was conducted with a total of 500 participants. A self-reported questionnaire was used for both pre- and post-intervention evaluation. The post-intervention assessment was conducted 1-2 weeks following the intervention. The difference in the practice of hand hygiene and respiratory etiquettes during work hours was recorded. We found that the intervention resulted in an evident difference in the use of alcohol-based hand sanitizer by the participating doctors before examining the patient. Interns showed a much higher propensity to wash their hands for at least 20 s, relative to other health-care workers. The difference between pre- and post-intervention handwashing for >5 times/day was 6.5% in females and 4.5% in males. In short, the study was able to demonstrate that a web-based health education module is an effective tool for the education and promotion of preventative measures in hospital setups, which may ultimately aid in halting the spread of COVID-19 among health-care workers.

Beyond COVID-19: Five commentaries on reimagining governance for future crises and resilience

Several Canadian and international scholars offer commentaries on the implications of the COVID-19 pandemic for governments and public service institutions, and fruitful directions for public administration research and practice. This second suite of commentaries considers the challenges confronting governments as a result of the COVID-19 pandemic and in the decades to come with an increasingly broad lens: the need to understand and rethink the architecture of the state given recent and future challenges awaiting governments; the need to rethink government-civil society relations and policies to deliver services for increasingly diverse citizens and communities; the need for new repertoires and sensibilities on the part of governments for recognizing, anticipating, and engaging on governance risks despite imperfect expert knowledge and public skepticism; how the COVID-19 crisis has caused us to reconceive international and sub-national borders where new "borders" are being drawn; and the need to anticipate a steady stream of crises similar to the COVID-19 pandemic arising from climate change and related challenges, and develop new national and international governance strategies for fostering population and community resilience.

Characterizing early Canadian federal, provincial, territorial and municipal nonpharmaceutical interventions in response to COVID-19: a descriptive analysis

BACKGROUND

Nonpharmaceutical interventions (NPIs) are the primary tools to mitigate early spread of the coronavirus disease 2019 (COVID-19) pandemic; however, such policies are implemented variably at the federal, provincial or territorial, and municipal levels without centralized documentation. We describe the development of the comprehensive open Canadian Non-Pharmaceutical Intervention (CAN-NPI) data set, which identifies and classifies all NPIs implemented in regions across Canada in response to COVID-19, and provides an accompanying description of geographic and temporal heterogeneity.

METHODS

We performed an environmental scan of government websites, news media and verified government social media accounts to identify NPIs implemented in Canada between Jan. 1 and Apr. 19, 2020. The CAN-NPI data set contains information about each intervention's timing, location, type, target population and alignment with a response stringency measure. We conducted descriptive analyses to characterize the temporal and geographic variation in early NPI implementation.

RESULTS

We recorded 2517 NPIs grouped in 63 distinct categories during this period. The median date of NPI implementation in Canada was Mar. 24, 2020. Most jurisdictions heightened the stringency of their response following the World Health Organization's global pandemic declaration on Mar. 11, 2020. However, there was variation among provinces or territories in the timing and stringency of NPI implementation, with 8 out of 13 provinces or territories declaring a state of emergency by Mar. 18, and all by Mar. 22, 2020.

INTERPRETATION

There was substantial geographic and temporal heterogeneity in NPI implementation across Canada, highlighting the importance of a subnational lens in evaluating the COVID-19 pandemic response. Our comprehensive open-access data set will enable researchers to conduct robust interjurisdictional analyses of NPI impact in curtailing COVID-19 transmission.