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Martínez MJ, Cotten M, Phan MVT, Becker K, Espasa M, Leegaard TM, Lisby G, Schneider UV, Casals-Pascual C. Viral epidemic preparedness: a perspective from five clinical microbiology laboratories in Europe. Clin Microbiol Infect 2024; 30:582-585. [PMID: 37119988 DOI: 10.1016/j.cmi.2023.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 04/16/2023] [Accepted: 04/22/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Pandemic preparedness is critical to respond effectively to existing and emerging/new viral pathogens. Important lessons have been learned during the last pandemic at various levels. This revision discusses some of the major challenges and potential ways to address them in the likely event of future pandemics. OBJECTIVES To identify critical points of readiness that may help us accelerate the response to future pandemics from a clinical microbiology laboratory perspective with a focus on viral diagnostics and genomic sequencing. The potential areas of improvement identified are discussed from the sample collection to information reporting. SOURCES Microbiologists and researchers from five countries reflect on challenges encountered during the COVID-19 pandemic, review published literature on prior and current pandemics, and suggest potential solutions in preparation for future outbreaks. CONTENT Major challenges identified in the pre-analytic and post-analytic phases from sample collection to result reporting are discussed. From the perspective of clinical microbiology laboratories, the preparedness for a new pandemic should focus on zoonotic viruses. Laboratory readiness for scalability is critical and should include elements related to material procurement, training personnel, specific funding programmes, and regulatory issues to rapidly implement "in-house" tests. Laboratories across various countries should establish (or re-use) operational networks to communicate to respond effectively, ensuring the presence of agile circuits with full traceability of samples. IMPLICATIONS Laboratory preparedness is paramount to respond effectively to emerging and re-emerging viral infections and to limit the clinical and societal impact of new potential pandemics. Agile and fully traceable methods for sample collection to report are the cornerstone of a successful response. Expert group communication and early involvement of information technology personnel are critical for preparedness. A specific budget for pandemic preparedness should be ring-fenced and added to the national health budgets.
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Affiliation(s)
- Miguel Julián Martínez
- Department of Clinical Microbiology, CDB, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain; Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Matthew Cotten
- London School of Hygiene and Tropical Medicine, London, UK; MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - My V T Phan
- London School of Hygiene and Tropical Medicine, London, UK
| | - Karsten Becker
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Mateu Espasa
- Department of Clinical Microbiology, UDIAT, Hospital Universitari Parc Taulí, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Truls M Leegaard
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway; Division of Medicine and Laboratory Sciences, University of Oslo, Oslo, Norway
| | - Gorm Lisby
- Department of Clinical Microbiology, University of Copenhagen Hvidovre Hospital, Hvidovre, Denmark
| | - Uffe Vest Schneider
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Climent Casals-Pascual
- Department of Clinical Microbiology, CDB, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain; Institute for Global Health (ISGlobal), Barcelona, Spain.
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Pericàs JM. Pandemic preparedness beyond COVID-19: what we know, what we do, and what we do not. Clin Microbiol Infect 2024; 30:574-575. [PMID: 38461941 DOI: 10.1016/j.cmi.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Juan M Pericàs
- Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital and Vall d'Hebron Institute for Research, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network of Biomedical Research Centers in Liver and Digestive Diseases (CIBERehd), Madrid, Spain; Infectious Disease Service, Hospital Clínic de Barcelona, Barcelona, Spain; Johns Hopkins University-Pompeu Fabra University Public Policy Center, Barcelona, Spain.
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Fox F, Hayes J, Whelan B, Casey D, Connolly M. Key Factors Impacting a Medical Ventilator Supply Chain During the COVID- 19 Pandemic: Lessons for Pandemic Preparedness. Disaster Med Public Health Prep 2024; 18:e65. [PMID: 38606429 DOI: 10.1017/dmp.2024.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
OBJECTIVES Future pandemics may cause more severe respiratory illness in younger age groups than COVID-19, requiring many more mechanical ventilators. This publication synthesizes the experiences of diverse contributors to Medtronic's mechanical ventilator supply chain during the pandemic, serving as a record of what worked and what didn't, while identifying key factors affecting production ramp-up in this healthcare crisis. METHOD In-depth, one-on-one interviews (n = 17) were held with key Medtronic personnel and suppliers. Template analysis was used, and interview content was analyzed for signals, initiatives, actions, and outcomes, as well as influencing forces. RESULTS Key findings revealed many factors limiting ventilator production ramp-up. Supply chain strengths and weaknesses were identified. Political factors played a role in allocating ventilators and also supported production. Commercial considerations were not priority, but economic awareness was essential to support suppliers. Workers were motivated and flexible. Component shortages, space, production processes, and logistics were challenges. Legally based pressures were reported e.g., import and export restrictions. CONCLUSION Crisis response alone is not enough; preparation is essential. Coordinated international strategies are more effective than individual country responses. Supply chain resilience based on visibility and flexibility is key. This research can help public health planners and the medical device industry prepare for future healthcare crises.
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Affiliation(s)
- Frank Fox
- University of Galway, Global Health, School of Health Sciences, Galway, Ireland
| | - Jessica Hayes
- University of Galway, Global Health, School of Health Sciences, Galway, Ireland
| | - Barbara Whelan
- University of Galway, School of Nursing and Midwifery, Galway, Ireland
| | - Dympna Casey
- University of Galway, School of Nursing and Midwifery, Galway, Ireland
| | - Máire Connolly
- University of Galway, Global Health, School of Health Sciences, Galway, Ireland
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de Grooth HJ, Parienti JJ. Surrogate Endpoints in Pandemic Preparedness. J Infect Dis 2024; 229:1244-1245. [PMID: 38323636 DOI: 10.1093/infdis/jiae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/06/2024] [Indexed: 02/08/2024] Open
Affiliation(s)
- Harm-Jan de Grooth
- Department of Intensive Care Medicine, University Medical Center Utrecht, The Netherlands
| | - Jean-Jacques Parienti
- Department of Clinical Research and Biostatistics, Caen University Hospital and Caen Normandy University
- Inserm U1311 DYNAMICURE, Caen Normandy University, Caen, France
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Sorensen J, Kadowaki L, Kervin L, Hamilton C, Berndt A, Dhadda S, Irfan A, Leong E, Mithani A. Quality improvement collaborative approach to COVID-19 pandemic preparedness in long-term care homes: a mixed-methods implementation study. BMJ Open Qual 2024; 13:e002589. [PMID: 38589056 PMCID: PMC11015329 DOI: 10.1136/bmjoq-2023-002589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND The devastating impact of the COVID-19 pandemic on long-term care (LTC) homes underscores the importance of effective pandemic preparedness and response. This mixed-methods, implementation science study investigated how a virtual-based quality improvement (QI) collaborative approach can improve uptake of pandemic-related promising practices and shared learning across six LTC homes in British Columbia, Canada in 2021 during the COVID-19 pandemic health emergency. METHODS QI teams consisting of residents, family/informal caregivers, care providers and leadership in LTC homes are supported by QI facilitation and shared learning through virtual communication platforms. QI projects address gaps in outbreak preparation, prevention and response; planning for care; staffing; and family presence. Thematically analysed semi-structured qualitative interviews and a validated questionnaire on organisational readiness investigated participants' perceptions of challenges, success factors and benefits of participating in the virtual QI collaborative approach. RESULTS Nine themes were identified through interview analysis, including two related to challenges (ie, making time for QI and hands tied by external forces), four regarding factors for successes (ie, team buy-in, working together as a team, bringing together diverse perspectives and facilitators keep us on track) and three on the benefits of the QI collaborative approach (ie, seeing improvements, staff empowerment and appetite for change). Continuous QI facilitation and coaching for QI teams was feasible and sustainable virtually via video conferencing (Zoom). The QI team members showed limited engagement on the virtual communication platform (Slack), which was predominantly used by the implementation science team and QI facilitators to coordinate the study and QI projects, respectively. CONCLUSIONS The virtual-based QI collaborative approach to pandemic preparedness supported LTC homes to rapidly and successfully form multidisciplinary QI teams, learn about QI methods and conduct timely QI projects to implement promising practice for improved COVID-19 pandemic response.
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Affiliation(s)
- Janice Sorensen
- Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
| | - Laura Kadowaki
- Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
- Simon Fraser University Gerontology Research Centre, Vancouver, British Columbia, Canada
| | - Lucy Kervin
- Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
- Simon Fraser University Gerontology Research Centre, Vancouver, British Columbia, Canada
| | - Clayon Hamilton
- Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Annette Berndt
- Long-Term Care and Assisted Living Research Partners Group, Fraser Health Authority, Surrey, British Columbia, Canada
| | - Simran Dhadda
- Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
| | - Abeera Irfan
- Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
| | - Emma Leong
- Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
| | - Akber Mithani
- Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
- Department of Psychiatry, The University of British Columbia, Vancouver, British Columbia, Canada
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Aguilera B, Donya RS, Vélez CM, Kapiriri L, Abelson J, Nouvet E, Danis M, Goold S, Williams I, Noorulhuda M. Stakeholder participation in the COVID-19 pandemic preparedness and response plans: A synthesis of findings from 70 countries. Health Policy 2024; 142:105013. [PMID: 38401332 DOI: 10.1016/j.healthpol.2024.105013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/26/2024]
Abstract
Stakeholder participation is a key component of a fair and equitable priority-setting in health. The COVID-19 pandemic highlighted the need for fair and equitable priority setting, and hence, stakeholder participation. To date, there is limited literature on stakeholder participation in the development of the pandemic plans (including the priority setting plans) that were rapidly developed during the pandemic. Drawing on a global study of national COVID-19 preparedness and response plans, we present a secondary analysis of COVID-19 national plans from 70 countries from the six WHO regions, focusing on stakeholder participation. We found that most plans were prepared by the Ministry of Health and acknowledged WHO guidance, however less than half mentioned that additional stakeholders were involved. Few plans described a strategy for stakeholder participation and/or accounted for public participation in the plan preparation. However, diverse stakeholders (including multiple governmental, non-governmental, and international organizations) were proposed to participate in the implementation of the plans. Overall, there was a lack of transparency about who participated in decision-making and limited evidence of meaningful participation of the community, including marginalized groups. The critical relevance of stakeholder participation in priority setting requires that governments develop strategies for meaningful participation of diverse stakeholders during pandemics such as COVID-19, and in routine healthcare priority setting.
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Affiliation(s)
- Bernardo Aguilera
- Facultad de Medicina y Ciencia, Universidad San Sebastian, Providencia, Santiago, Chile
| | - Razavi S Donya
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M4, Canada
| | - Claudia-Marcela Vélez
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, KTH-226, Hamilton, Ontario L8S 4M4, Canada; Faculty of Medicine, University of Antioquia, Cra 51d #62-29, Medellín, Antioquia, Colombia
| | - Lydia Kapiriri
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, KTH-226, Hamilton, Ontario L8S 4M4, Canada.
| | - Julia Abelson
- Health Policy Program, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M4, Canada
| | - Elysee Nouvet
- School of Health Studies, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | - Marion Danis
- Section on Ethics and Health Policy, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Susan Goold
- Internal Medicine and Health Management and Policy, Center for Bioethics and Social Sciences in Medicine, University of Michigan, 2800 Plymouth Road, Bldg. 14, G016, Ann Arbor, MI 48109-2800, USA
| | - Ieystn Williams
- School of Social Policy, HSMC, Park House, University of Birmingham, Edgbaston, Birmingham B15 2RT, UK
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Kilmarx PH, Goraleski KA, Khan E, Lindo JF, Saravia NG. Building Research Capacity in Low- and Middle-Income Countries and Pandemic Preparedness: Lessons Learned and Future Directions. Am J Trop Med Hyg 2024; 110:417-420. [PMID: 38266289 PMCID: PMC10919184 DOI: 10.4269/ajtmh.23-0675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024] Open
Abstract
Research capacity is a critical component of pandemic preparedness, as highlighted by the challenges faced during the Ebola outbreak in West Africa. Recent global initiatives, such as the Research & Development Task Force of the Global Health Security Agenda and the World Health Assembly's resolution on strengthening clinical trials, emphasize the need for robust research capabilities. This Perspective discusses the experiences of leaders in infectious disease research and capacity building in low- and middle-income countries, focusing on Colombia, Jamaica, and Pakistan. These case studies underscore the importance of collaborative efforts, interdisciplinary training, and global partnerships in pandemic response. The experiences highlight the necessity for rapid pathogen identification, capacity for genomic sequencing, and proactive engagement with policymakers. Challenges faced, including the shortage of trained staff and reliance on imported reagents, emphasize the ongoing need for building research capacity.
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Affiliation(s)
- Peter H. Kilmarx
- Fogarty International Center, U.S. National Institutes of Health, Bethesda, Maryland
| | | | - Erum Khan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - John F. Lindo
- Department of Microbiology, University of the West Indies, Kingston, Jamaica
| | - Nancy Gore Saravia
- Centro Internacional de Entrenamiento e Investigaciones Medicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
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Czerniewska A, Sharkey A, Portela A, Drapkin S, Mustafa S. National COVID-19 preparedness and response plans: a global review from the perspective of services for maternal, newborn, child and adolescent health and older people. BMJ Glob Health 2024; 9:e013711. [PMID: 38442984 PMCID: PMC10928728 DOI: 10.1136/bmjgh-2023-013711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/05/2023] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Infectious disease outbreaks have historically led to widespread disruptions in routine essential health services. Disruptions due to COVID-19 responses led to excess deaths, including among women and children. This review builds on earlier reviews of essential health services in national COVID-19 response and preparedness plans, focusing specifically on maternal, newborn, child, adolescent and ageing health (MNCAAH) in the context of renewed global emphasis on monitoring, recovering and strengthening these services. METHODS Using Google searches, we identified publicly available COVID-19 response and preparedness plans authored by a national government body or Public Health Institute from any country, territory and/or area, published between January 2020 and December 2022. We assessed whether each plan considered maintenance of MNCAAH services with related activities, costing or monitoring plans, and whether these considerations were integrated into the national incident management system for COVID-19. RESULTS We identified plans from 110 countries, representing 56% of our sample, in 10 languages. Most plans came from low-income and middle-income countries. Three quarters of dated documents were published between February and April 2020. 22% of plans referenced the impact of COVID-19 on MNCAAH, but only 13% included a planned activity for monitoring or mitigating this impact and less than 5% included relevant indicators, costing or integration of services in the incident management system. CONCLUSION We propose that unless content specifically related to the services and needs of these populations is integrated, these services will suffer in a future disruptive event. The COVID-19 response demonstrated the need for an interdisciplinary response to address the unforeseen impacts that arose, yet plans continue to have a narrow focus and a generic approach which may be limiting.
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Affiliation(s)
| | - Alyssa Sharkey
- School of Public and International Affairs, Princeton University, Princeton, New Jersey, USA
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | | | - Saqif Mustafa
- Integrated Health Services, World Health Organization, Geneve, Switzerland
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Williams I, Kapiriri L, Vélez CM, Aguilera B, Danis M, Essue B, Goold S, Noorulhuda M, Nouvet E, Razavi D, Sandman L. How did European countries set health priorities in response to the COVID-19 threat? A comparative document analysis of 24 pandemic preparedness plans across the EURO region. Health Policy 2024; 141:104998. [PMID: 38295675 DOI: 10.1016/j.healthpol.2024.104998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/21/2023] [Accepted: 01/15/2024] [Indexed: 02/26/2024]
Abstract
The COVID-19 pandemic has forced governments across the world to consider how to prioritise the allocation of scarce resources. There are many tools and frameworks that have been designed to assist with the challenges of priority setting in health care. The purpose of this study was to examine the extent to which formal priority setting was evident in the pandemic plans produced by countries in the World Health Organisation's EURO region, during the first wave of the COVID-19 pandemic. This compliments analysis of similar plans produced in other regions of the world. Twenty four pandemic preparedness plans were obtained that had been published between March and September 2020. For data extraction, we applied a framework for identifying and assessing the elements of good priority setting to each plan, before conducting comparative analysis across the sample. Our findings suggest that while some pre-requisites for effective priority setting were present in many cases - including political commitment and a recognition of the need for allocation decisions - many other hallmarks were less evident, such as explicit ethical criteria, decision making frameworks, and engagement processes. This study provides a unique insight into the role of priority setting in the European response to the onset of the COVID-19 pandemic.
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Affiliation(s)
- Iestyn Williams
- Health Services Management Centre, University of Birmingham Park house, 40 Edgbaston Park Rd Birmingham, B15 2RT, UK.
| | - Lydia Kapiriri
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, ON, L8S 4M4, Canada
| | - Claudia-Marcela Vélez
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, ON, L8S 4M4, Canada
| | - Bernardo Aguilera
- Faculty of Medicine and Science at the Universidad San Sebastian, Providencia, Santiago de Chile, Región Metropolitana, Chile
| | - Marion Danis
- Department of Bioethics, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20812, USA
| | - Beverley Essue
- Centre for Global Health Research, St. Michael's Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada
| | - Susan Goold
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 2800 Plymouth Road Building 14, G016, Ann Arbor, MI 48109, USA
| | - Mariam Noorulhuda
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, ON, L8S 4M4, Canada
| | - Elysee Nouvet
- School of Health Studies, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
| | - Donya Razavi
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, ON, L8S 4M4, Canada
| | - Lars Sandman
- National Centre for Priorities in Health, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
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Brüssow H. Pandemic preparedness: On the efficacy of non-pharmaceutical interventions in COVID-19 and about approaches to predict future pandemic viruses. Microb Biotechnol 2024; 17:e14431. [PMID: 38465466 PMCID: PMC10926049 DOI: 10.1111/1751-7915.14431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/15/2024] [Indexed: 03/12/2024] Open
Abstract
With three major viral pandemics over the last 100 years, namely the Spanish flu, AIDS and COVID-19 each claiming many millions of lives, pandemic preparedness has become an important issue for public health. The economic, social and political consequences of the upheaval caused by such pandemics also represent a major challenge for governments with respect to sustainable development goals. The field of pandemic preparedness is vast and the current article can only address selected aspects. The article looks first backwards and addresses the question of the efficacy of non-pharmaceutical interventions (NPI) on the trajectory of the COVID-19 pandemic. The article looks then forward by asking to what extent viral candidates for future pandemics can be predicted by virome analyses from metagenome and transcriptome sequencing, by focusing on the virome from specific animal species and using ecological and epidemiological data about spillover viral infections in veterinary and human medicine. As a comprehensive overview on pandemic preparedness is beyond the capacity of a single reviewer, only selected topics will be discussed using recent key scientific publications. Since COVID-19 has not run its course, a computational program able to predict the future evolution of SARS-CoV-2 is mentioned that could assist proactive mRNA vaccine developments against possible future variants of concern. Ending the COVID-19 epidemic necessitates mucosal vaccines that can suppress the transmission of SARS-CoV-2 and therefore this article closes by discussing a promising and versatile protein nanoparticle experimental vaccine approach for inhalation that does not depend on needles nor a cold chain for distribution.
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Affiliation(s)
- Harald Brüssow
- Laboratory of Gene Technology, Department of BiosystemsKU LeuvenLeuvenBelgium
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Rakeman-Cagno JL, Persing DH, Loeffelholz MJ. Maintaining point of care testing capacity and pandemic preparedness in the post-COVID-19 era. Expert Rev Mol Diagn 2024; 24:147-151. [PMID: 37724428 DOI: 10.1080/14737159.2023.2260743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Testing at the point of care (we also refer to the 'point of need'), with rapid, actionable results reported to the patient and provider within hours can impact the individual as well as public health. Faster testing is good for patients and public health outcomes during 'peace time' (outside of the pandemic setting). AREAS COVERED Testing at the point of need was important during the COVID-19 pandemic to meet testing capacity demands, providing actionable results, and for providing testing within communities to increase access for all populations. Resources were acquired and built up dramatically during the pandemic as part of the response. With the end of the COVID-19 public health emergency and transition back to 'peace time' some testing sites have successfully shifted to using this capacity for testing for other critical needs, like sexually transmitted infection (STI) testing, and response to other seasonal diseases and for outbreak response. EXPERT OPINION The increased testing capacity added to handle unprecedented testing volume during the COVID-19 pandemic can be repurposed for other critical infectious diseases during 'peace time' (post-COVID-19 pandemic). This maintains testing capacity for the next pandemic.
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Affiliation(s)
| | - David H Persing
- Department Pathology, Stanford University, Palo Alto, CA, USA
- Scientific Affairs, Cepheid, Sunnyvale, CA, USA
| | - Michael J Loeffelholz
- Department Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Scientific Affairs, Cepheid, Sunnyvale, CA, USA
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McOwen H, Wasserheit JN, Rabinowitz P. US Academic and NGO Engagement in Pandemic Preparedness and Response. Health Secur 2024; 22:167-171. [PMID: 38394310 DOI: 10.1089/hs.2023.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Affiliation(s)
- Helene McOwen
- Helene L. McOwen, MPH, is a Research Coordinator, Division of Allergy and Infectious Diseases; at the University of Washington, Seattle, WA
| | - Judith N Wasserheit
- Judith N. Wasserheit, MD, MPH, is a Professor, Departments of Global Health, Medicine and Epidemiology; at the University of Washington, Seattle, WA
- Judith N. Wasserheit is Co-Directors, UW Alliance for Pandemic Preparedness, University of Washington, Seattle, WA
| | - Peter Rabinowitz
- Peter M. Rabinowitz, MD, MPH, is a Professor, Departments of Environmental and Occupational Health Sciences, Family Medicine, and Global Health, and Director, University of Washington Center for One Health Research; at the University of Washington, Seattle, WA
- Peter M. Rabinowitz is Co-Directors, UW Alliance for Pandemic Preparedness, University of Washington, Seattle, WA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Chen Y, Ingram C, Downey V, Roe M, Sripaiboonkij P, Buckley CM, Alvarez E, Perrotta C, Buggy C. Pandemic preparedness from the perspective of Occupational Health professionals. Occup Med (Lond) 2024; 74:93-98. [PMID: 38085666 PMCID: PMC10875927 DOI: 10.1093/occmed/kqad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Prior to any infectious disease emergence as a public health concern, early occupational preparedness is crucial for protecting employees from novel pathogens- coronavirus disease 2019 (COVID-19) is no different. AIMS This study ascertains how occupational safety and health (OSH)/Human Resource (HR) professionals in the Republic of Ireland had managed to prepare their workplaces prior to the advent of COVID-19. METHODS As part of a larger COVID-19 workplace study, online focus groups were conducted with OSH/HR professionals. Collected data were transcribed verbatim and entered into NVivo for thematic analysis incorporating intercoder reliability testing. RESULTS Fifteen focus groups were conducted with OSH/HR professionals (n = 60) from various occupational settings. Three levels of organizational preparedness were identified: 'early awareness and preparation'; 'unaware and not ready' and 'aware, but not ready'. Most organizations were aware of the COVID-19 severity, but not fully prepared for the pandemic, especially stand-alone enterprises that may not have sufficient resources to cope with an unanticipated crisis. The experiences shared by OSH professionals illustrate their agility in applying risk management and control skills to unanticipated public/occupational health crises that arise. CONCLUSIONS General pandemic preparedness such as the availability of work-from-home policies, emergency scenario planning and prior experience in workplace outbreaks of infectious diseases were helpful for workplace-associated COVID-19 prevention. This is the first study conducted with OSH/HR professionals in Ireland regarding COVID-19 preparedness in workplaces, which provides valuable insights into research literature, as well as empirical experience for the preparation of future public health emergencies.
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Affiliation(s)
- Y Chen
- Applied Aviation Science Department, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USA
| | - C Ingram
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - V Downey
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - M Roe
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - P Sripaiboonkij
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Centre for Safety and Health at Work, University College Dublin, Dublin, Ireland
| | - C M Buckley
- Health Service Executive, Dublin, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - E Alvarez
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| | - C Perrotta
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - C Buggy
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Centre for Safety and Health at Work, University College Dublin, Dublin, Ireland
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15
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Song P, Adeloye D, Acharya Y, Bojude DA, Ali S, Alibudbud R, Bastien S, Becerra-Posada F, Berecki M, Bodomo A, Borrescio-Higa F, Buchtova M, Campbell H, Chan KY, Cheema S, Chopra M, Cipta DA, Castro LD, Ganasegeran K, Gebre T, Glasnović A, Graham CJ, Igwesi-Chidobe C, Iversen PO, Jadoon B, Lanza G, Macdonald C, Park C, Islam MM, Mshelia S, Nair H, Ng ZX, Htay MNN, Akinyemi KO, Parisi M, Patel S, Peprah P, Polasek O, Riha R, Rotarou ES, Sacks E, Sharov K, Stankov S, Supriyatiningsih W, Sutan R, Tomlinson M, Tsai AC, Tsimpida D, Vento S, Glasnović JV, Vokey LB, Wang L, Wazny K, Xu J, Yoshida S, Zhang Y, Cao J, Zhu Y, Sheikh A, Rudan I. Setting research priorities for global pandemic preparedness: An international consensus and comparison with ChatGPT's output. J Glob Health 2024; 14:04054. [PMID: 38386716 PMCID: PMC10869134 DOI: 10.7189/jogh.14.04054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Background In this priority-setting exercise, we sought to identify leading research priorities needed for strengthening future pandemic preparedness and response across countries. Methods The International Society of Global Health (ISoGH) used the Child Health and Nutrition Research Initiative (CHNRI) method to identify research priorities for future pandemic preparedness. Eighty experts in global health, translational and clinical research identified 163 research ideas, of which 42 experts then scored based on five pre-defined criteria. We calculated intermediate criterion-specific scores and overall research priority scores from the mean of individual scores for each research idea. We used a bootstrap (n = 1000) to compute the 95% confidence intervals. Results Key priorities included strengthening health systems, rapid vaccine and treatment production, improving international cooperation, and enhancing surveillance efficiency. Other priorities included learning from the coronavirus disease 2019 (COVID-19) pandemic, managing supply chains, identifying planning gaps, and promoting equitable interventions. We compared this CHNRI-based outcome with the 14 research priorities generated and ranked by ChatGPT, encountering both striking similarities and clear differences. Conclusions Priority setting processes based on human crowdsourcing - such as the CHNRI method - and the output provided by ChatGPT are both valuable, as they complement and strengthen each other. The priorities identified by ChatGPT were more grounded in theory, while those identified by CHNRI were guided by recent practical experiences. Addressing these priorities, along with improvements in health planning, equitable community-based interventions, and the capacity of primary health care, is vital for better pandemic preparedness and response in many settings.
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Affiliation(s)
- Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, China
| | - Davies Adeloye
- School of Health & Life Sciences, Teesside University, UK
| | - Yubraj Acharya
- Department of Health Policy and Administration, The Pennsylvania State University, USA
| | | | - Sajjad Ali
- Department of Medicine, Ziauddin Medical University, Karachi, Pakistan
| | - Rowalt Alibudbud
- Department of Sociology and Behavioral Sciences, De La Salle University, Manila, Philippines
| | | | | | | | | | | | - Marie Buchtova
- Olomouc University Social Health Institute, Palacký University, Olomouc, Czechia
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Kit Yee Chan
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
- School of Social Sciences, Monash University, Australia
| | | | | | | | - Lina Diaz Castro
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | - Teshome Gebre
- The Task force for Global Health, Addis Ababa, Ethiopia
| | - Anton Glasnović
- Croatian Institute for Brain Research, Zagreb University School of Medicine, Zagreb, Croatia
| | - Christopher J Graham
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | | | - Bismeen Jadoon
- Egyptian Representative, Committee of Fellows of Obstetrics and Gynaecology, Oxford, UK, and Royal Berkshire Hospital, NHS, UK
| | - Giuseppe Lanza
- Oasi Research Institute-IRCCS, Troina, Italy
- University of Catania, Italy
| | - Calum Macdonald
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Chulwoo Park
- Department of Public Health and Recreation, San José State University, San Jose, California, USA
| | | | | | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Zhi Xiang Ng
- School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Mila Nu Nu Htay
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
| | | | | | - Smruti Patel
- Editor, Journal of Global Health Reports, Washington, USA
| | - Prince Peprah
- Social Policy Research Centre/Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Ozren Polasek
- Croatian Science Foundation, Zagreb, Croatia
- Algebra University College, Zagreb, Croatia
| | - Renata Riha
- Royal Infirmary of Edinburgh, University of Edinburgh, UK
| | | | - Emma Sacks
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Konstantin Sharov
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, Russia
| | | | | | - Rosnah Sutan
- Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | | | | | - Dialechti Tsimpida
- Department of Public Health, Policy and Systems, The University of Liverpool, UK
| | | | | | - Laura B Vokey
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Liang Wang
- Guangdong Provincial People’s Hospital, Guangzhou, China
| | - Kerri Wazny
- Children's Investment Fund Foundation, London, UK
| | - Jingyi Xu
- School of Health Humanities, Peking University, Beijing, China
| | | | | | - Jin Cao
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, China
| | - Yajie Zhu
- School of Information Science and Technology, Hangzhou Normal University, Hangzhou, China
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, UK
| | - Igor Rudan
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
- Croatian Science Foundation, Zagreb, Croatia
| | - International Society of Global Health (ISoGH)
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, China
- School of Health & Life Sciences, Teesside University, UK
- Department of Health Policy and Administration, The Pennsylvania State University, USA
- Gombe State University, Gombe, Nigeria
- Department of Medicine, Ziauddin Medical University, Karachi, Pakistan
- Department of Sociology and Behavioral Sciences, De La Salle University, Manila, Philippines
- Norwegian University of Life Sciences, Ås, Norway
- Public Health Development Organization, El Paso, USA
- School of Medicine, University of Zagreb, Croatia
- African Studies, University of Vienna, Austria
- Universidad Adolfo Ibañez, Santiago, Chile
- Olomouc University Social Health Institute, Palacký University, Olomouc, Czechia
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
- School of Social Sciences, Monash University, Australia
- Weill Cornell Medicine – Qatar, Doha, Qatar
- The World Bank, Washington, USA
- Universitas Pelita Harapan, Jakarta, Indonesia
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
- Seberang Jaya Hospital, Ministry of Health, Malaysia
- The Task force for Global Health, Addis Ababa, Ethiopia
- Croatian Institute for Brain Research, Zagreb University School of Medicine, Zagreb, Croatia
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- University of Bradford, UK
- University of Nigeria, Enugu Campus, Nigeria
- Department of Nutrition, University of Oslo, Norway
- Egyptian Representative, Committee of Fellows of Obstetrics and Gynaecology, Oxford, UK, and Royal Berkshire Hospital, NHS, UK
- Oasi Research Institute-IRCCS, Troina, Italy
- University of Catania, Italy
- Department of Public Health and Recreation, San José State University, San Jose, California, USA
- University of Dhaka, Bangladesh
- Jos University Teaching Hospital, Nigeria
- School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
- Lagos State University, Ojo, Lagos, Nigeria
- Clemson University, USA
- Editor, Journal of Global Health Reports, Washington, USA
- Social Policy Research Centre/Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Croatian Science Foundation, Zagreb, Croatia
- Algebra University College, Zagreb, Croatia
- Royal Infirmary of Edinburgh, University of Edinburgh, UK
- Universidad San Sebastián, Santiago, Chile
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, Russia
- Pasteur Institute, Novi Sad, Novi Sad, Serbia
- Children and Mother Health Movement Action, Yogyakarta, Indonesia
- Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
- Stellenbosch University, Cape Town, South Africa
- Massachusetts General Hospital, Boston, USA
- Department of Public Health, Policy and Systems, The University of Liverpool, UK
- University of Puthisastra, Phnom Penh, Cambodia
- Department of Hematology, Dubrava University Hospital, Zagreb, Croatia
- Guangdong Provincial People’s Hospital, Guangzhou, China
- Children's Investment Fund Foundation, London, UK
- School of Health Humanities, Peking University, Beijing, China
- World Health Organization, Geneva, Switzerland
- Capital Institute of Pediatrics, Beijing, China
- School of Information Science and Technology, Hangzhou Normal University, Hangzhou, China
- Usher Institute, University of Edinburgh, UK
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16
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Seabra SG, Merca F, Pereira B, Fonseca I, Carvalho AC, Brito V, Alves D, Libin P, Martins MRO, Miranda MNS, Pingarilho M, Pimentel V, Abecasis AB. Serological screening in a large-scale municipal survey in Cascais, Portugal, during the first waves of the COVID-19 pandemic: lessons for future pandemic preparedness efforts. Front Public Health 2024; 12:1326125. [PMID: 38371240 PMCID: PMC10869482 DOI: 10.3389/fpubh.2024.1326125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
Background Serological surveys for SARS-CoV-2 were used early in the COVID-19 pandemic to assess epidemiological scenarios. In the municipality of Cascais (Portugal), serological testing combined with a comprehensive socio-demographic, clinical and behavioral questionnaire was offered to residents between May 2020 and beginning of 2021. In this study, we analyze the factors associated with adherence to this municipal initiative, as well as the sociodemographic profile and chronic diseases clinical correlates associated to seropositivity. We aim to contribute with relevant information for future pandemic preparedness efforts. Methods This was a cross-sectional study with non-probabilistic sampling. Citizens residing in Cascais Municipality went voluntarily to blood collection centers to participate in the serological survey. The proportion of participants, stratified by socio-demographic variables, was compared to the census proportions to identify the groups with lower levels of adherence to the survey. Univariate and multivariate logistic regression were used to identify socio-demographic, clinical and behavioral factors associated with seropositivity. Results From May 2020 to February 2021, 19,608 participants (9.2% of the residents of Cascais) were included in the study. Based on the comparison to census data, groups with lower adherence to this survey were men, the youngest and the oldest age groups, individuals with lower levels of education and unemployed/inactive. Significant predictors of a reactive (positive) serological test were younger age, being employed or a student, and living in larger households. Individuals with chronic diseases generally showed lower seroprevalence. Conclusion The groups with low adherence to this voluntary study, as well as the socio-economic contexts identified as more at risk of viral transmission, may be targeted in future pandemic situations. We also found that the individuals with chronic diseases, perceiving higher risk of serious illness, adopted protective behaviors that limited infection rates, revealing that health education on preventive measures was effective for these patients.
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Affiliation(s)
- Sofia G. Seabra
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Francisco Merca
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
- Artificial Intelligence Research Lab, Vrije Universiteit Brussels (VUB), Pleinlaan 2, Brussel, Belgium
| | - Bernardo Pereira
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Ivo Fonseca
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | | | - Vera Brito
- Câmara Municipal de Cascais, Cascais, Portugal
| | - Daniela Alves
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Pieter Libin
- Artificial Intelligence Research Lab, Vrije Universiteit Brussels (VUB), Pleinlaan 2, Brussel, Belgium
- Interuniversity Institute of Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - M. Rosário O. Martins
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Mafalda N. S. Miranda
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Marta Pingarilho
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Victor Pimentel
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Ana B. Abecasis
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
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Cunningham-Erves J, Davis M, Stewart EC, Alexander L, Moss J, Barre I, Parham I, Mayo-Gamble T, Davis J. COVID-19 risk communication gaps, needs, and strategies related to pandemic preparedness plans among vulnerable, Black American subgroups: A qualitative study. J Natl Med Assoc 2024; 116:45-55. [PMID: 38151424 DOI: 10.1016/j.jnma.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/16/2023] [Accepted: 12/03/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE Improving current and future risk communication plans is critical to mitigate the COVID-19 pandemic and begin to prepare for future pandemics. Minority groups, particularly African Americans, have been limited in engagement to prepare these plans which has been demonstrated to be disadvantageous. We report findings from a qualitative study that describes gaps, needs, and strategies to improve communication among vulnerable, Black American subgroups during the COVID-19 pandemic. METHODS Sixty-two Black Americans in uniquely, vulnerable subgroups participated in qualitative, semi-structured interviews from May to September 2020. Thematic analyses were used to identify themes. RESULTS Participants were 16 essential workers, 16 parents, 15 young adults, and 15 individuals with underlying medical conditions. Emerging themes were: (1) Poor communication and miscommunication fueled fear and confusion; (2) Information sources and channels: How do I choose one?; (3) Communication needs were simple yet complex; (4) All information sources are not trusted information sources; (5) Preferred yet trusted channels and types of information; and (6) Dissemination of COVID Research: Why and How. Subgroups varied in information sources and processes for choosing the source, communication needs, and channels and types of information needed. They shared why they did and did not trust certain sources along with the importance of COVID research dissemination to promote informed decision-making throughout the pandemic. DISCUSSION This study found that Black American subgroups had diverse, yet trusted and non-trusted messages, messengers, and strategies for communication and wanted research results disseminated. We describe multi-level stakeholders and strategies to help improve risk communication for pandemics, and potentially preparedness and health outcomes.
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Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Internal Medicine, Meharry Medical College 1005 Dr. D.B. Todd, Jr., Blvd Nashville, TN 37208, United States of America; Department of Health Policy, Vanderbilt University Medical Center, 2525 West End Ave Suite 700, Nashville, TN 37203. United States of America.
| | - Megan Davis
- School of Medicine, Vanderbilt University Medical Center 1211 Medical Center Drive Nashville, TN, 37232, United States of America
| | - Elizabeth C Stewart
- Department of Internal Medicine, Meharry Medical College 1005 Dr. D.B. Todd, Jr., Blvd Nashville, TN 37208, United States of America
| | - Leah Alexander
- Division of Public Health Practice, Meharry Medical College 1005 Dr. D.B. Todd, Jr., Blvd Nashville, TN 37208, United States of America
| | - Jamal Moss
- School of Medicine, Meharry Medical College 1005 Dr. D.B. Todd, Jr., Blvd Nashville, TN 37208, United States of America
| | - Iman Barre
- School of Medicine, Meharry Medical College 1005 Dr. D.B. Todd, Jr., Blvd Nashville, TN 37208, United States of America
| | - Imari Parham
- School of Medicine, Meharry Medical College 1005 Dr. D.B. Todd, Jr., Blvd Nashville, TN 37208, United States of America
| | - Tilicia Mayo-Gamble
- Jiann-Ping. Hsu College of Public Health, Georgia Southern University 1332 Southern Drive Statesboro, GA, 30458, United States of America
| | - Jamaine Davis
- Department of Biochemistry and Cancer Biology, Meharry Medical College 1005 Dr. D.B. Todd, Jr., Blvd Nashville, TN 37208, United States of America
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Jaegers LA, McAndrew R, Cornelius A, Scott SD, Pridgeon S, El Ghaziri M, Bello JK. COVID-19 Preparedness, Stressors, and Data-Driven Solutions for Healthcare Workers at a Regional Rural-Urban Hospital System: A Longitudinal Total Worker Health ® Study. Workplace Health Saf 2024; 72:30-38. [PMID: 37873624 DOI: 10.1177/21650799231202792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND During the COVID-19 pandemic in the United States, healthcare workers were devastated by the insufficient preparedness to respond to their patients' and personal health needs. A gap exists in resources to prevent or reduce acute and long-term healthcare worker mental illnesses resulting from COVID-19 frontline response. METHODS We performed an exploratory, mixed methods, longitudinal study of healthcare workers at a regional rural-urban hospital system in the Midwest United States during the COVID-19 response (4 timepoints, 2020). Using the Total Worker Health® (TWH) participatory needs assessment approach, self-identified frontline COVID-19 workers participated in a survey including Health-Related Quality of Life, Impact of Event Scale, and a modified version of the American Nursing Association COVID-19 survey; and a hospital timeline tracked system-level activities. FINDINGS Response rate at Timepoint (T)1 was 21.7% (N = 39) and of those, 14 (36%) completed all four surveys. From T1 to T4, the rate of COVID-19 patients steadily increased, staff exceeded the threshold for post-traumatic stress disorder at T1 and T4; staff reported not enough rest or sleep 50% of the month, T1-T4. Helpfulness of family support increased but community support decreased, T1-T4. Concerns with performing new tasks increased; the challenges related to lack of protective equipment and negative media decreased. Workers wanted to be involved in decision-making, desired timely communication, and needed adequate physical, environmental, and psychological supports. CONCLUSIONS/APPLICATIONS FOR PRACTICE Utilization of a TWH® strategy for describing health needs, hospital response, and multi-level staff suggestions to workplace health solutions during the COVID-19 pandemic identified evidence-based health promotion interventions in a hospital system.
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Affiliation(s)
- Lisa A Jaegers
- Department of Occupational Science and Occupational Therapy, Doisy College of Health Sciences, Saint Louis University
- School of Social Work, College for Public Health and Social Justice, Saint Louis University
| | - Rose McAndrew
- Department of Occupational Science and Occupational Therapy, Doisy College of Health Sciences, Saint Louis University
| | - Andrea Cornelius
- Industrial-Organizational Psychology, Department of Psychology, College of Arts & Sciences, Saint Louis University
| | | | | | | | - Jennifer K Bello
- Department of Family and Community Medicine, School of Medicine, Saint Louis University
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19
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Okubo Y. Lessons learned from the COVID-19 pandemic and future pandemic preparedness for children in Japan. Pediatr Int 2024; 66:e15732. [PMID: 38156531 DOI: 10.1111/ped.15732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 12/30/2023]
Affiliation(s)
- Yusuke Okubo
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
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Brüssow H. Avian influenza virus cross-infections as test case for pandemic preparedness: From epidemiological hazard models to sequence-based early viral warning systems. Microb Biotechnol 2024; 17:e14389. [PMID: 38227348 PMCID: PMC10832514 DOI: 10.1111/1751-7915.14389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/17/2023] [Accepted: 12/06/2023] [Indexed: 01/17/2024] Open
Abstract
Pandemic preparedness starts with an early warning system of viruses with a pandemic potential. Based on information collected in a multitude of surveys, hazard models were developed identifying influenza viruses presenting a pandemic threat. Scores are attributed for 10 viral traits by expert panels which identified avian influenza viruses (AIV) belonging to subtypes H7N9 and H5N1 as representing the greatest pandemic risk. In 2013, more than 100 human cases infected with AIV H7N9 were observed in China. Case fatality rate (CFR) was high (27%), but the human-to-human transmission rate was low and by serological evidence H7N9 did not spread widely. Nevertheless, until 2019 more than 1500 H7N9 patients were identified characterized by a high CFR of 39%. Serology demonstrated that mild infections with H7N9 were widespread. In 2003, more than 400 people experienced AIV H7N7 cross-infection causing mainly conjunctivitis during a large poultry epidemic in The Netherlands. Between 1996 and 2019, a total of 881 human infections with avian H5N1 viruses were documented showing a CFR of 52%. Outbreaks were centred on South East Asia and showed close associations with epizootics in poultry. Mutations predisposing to human cross-infections were identified in the haemagglutinin (HA) and the RNA polymerase subunit PB2 of human H7N9 isolates. Human H5N1 isolates showed mutations in the receptor binding domain of HA and transmission in mammals could be obtained by as few as four additional aa changes introduced experimentally. Researchers have defined viral point mutations in HA, PB2 and the nucleoprotein NP that allowed AIV to cross the species barrier to mammals with respect to receptor recognition, RNA replication and escape from innate immunity respectively. Based on this insight a sequence-based early warning system for AIV preadapted to human transmission could be envisioned. Mink farms and live poultry markets are prime targets for such sequencing efforts.
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Affiliation(s)
- Harald Brüssow
- Division of Animal and Human Health Engineering, Department of BiosystemsKU LeuvenLeuvenBelgium
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Paterson A, Olliaro PL, Rojek A. Addressing stigma in infectious disease outbreaks: a crucial step in pandemic preparedness. Front Public Health 2023; 11:1303679. [PMID: 38186713 PMCID: PMC10768929 DOI: 10.3389/fpubh.2023.1303679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
There is a complex interplay between infectious disease outbreaks and the stigmatization of affected persons and communities. Outbreaks are prone to precipitating stigma due to the fear, uncertainty, moralisation, and abatement of freedoms associated with many infectious diseases. In turn, this stigma hampers outbreak control efforts. Understanding this relationship is crucial to improving coordinated outbreak response. This requires valid and reliable methods for assessing stigma towards and within impacted communities. We propose adopting a cross-outbreak model for developing the necessary assessment tools. A stigma-informed approach must then be integrated into outbreak preparedness and response efforts to safeguard public health and promote inclusivity and compassion in future outbreaks.
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Affiliation(s)
- Amy Paterson
- Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Piero L. Olliaro
- Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
| | - Amanda Rojek
- Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
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22
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Michenka P, Marx D. Hospital-Level COVID-19 Preparedness and Crisis Management in Czechia. Int J Public Health 2023; 68:1606398. [PMID: 38155687 PMCID: PMC10752954 DOI: 10.3389/ijph.2023.1606398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Objectives: The COVID-19 pandemic exposed the inadequacy of pandemic preparedness mechanisms worldwide. This study gathered comprehensive data from Czech hospitals, identified possible weaknesses in important areas of crisis preparedness, and quantified changes performed to enhance crisis resilience of healthcare facilities. Methods: Drawing on literature review on pandemic preparedness and hospital crisis management and detailed interviews with hospital representatives, a questionnaire was designed and distributed by email among quality managers of all Czech hospitals. Statistical analysis of their responses was conducted using EZR software. Fisher's exact test and Kruskal-Wallis test, with post hoc testing, were used to assess statistical significance. Results: Achieving response rate of 31.9%, responses from 65 hospitals were analysed. New crisis management policies were necessary in 72.3% of responding hospitals. Furthermore, a majority of the respondents changes indicated the need for changes in policies on general pandemic, human resources and infrastructure and material preparedness. Conclusion: The COVID-19 crisis required significant alterations to previously established hospital crisis management protocols and establishment of new ones. The absence of a unified system for crisis preparedness was noted at hospital and national levels.
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Affiliation(s)
- Petr Michenka
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - David Marx
- Department of Public Health, Third Faculty of Medicine, Charles University, Prague, Czechia
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Govender K, King J, Nyamaruze P, Quinlan T. The role of the social sciences and humanities in pandemic preparedness responses: insights gained from COVID-19, HIV and AIDS and related epidemics. Afr J AIDS Res 2023; 22:269-275. [PMID: 38117747 DOI: 10.2989/16085906.2023.2262977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/01/2023] [Indexed: 12/22/2023]
Abstract
The COVID-19 pandemic, particularly from 2020 to mid-2022, debilitated the management of the HIV epidemic in Africa. The multiple effects included well-documented HIV service interruptions, curtailment of HIV prevention programmes, the associated marked increase in both the risk for HIV infection among key populations and vulnerability of sub-populations (e.g. adolescent girls and young women) who are the focus of these programmes and - as importantly but less well-documented - the diverse negative socio-economic effects that accentuate HIV risk and vulnerability generally (e.g. loss of earnings, gender-based violence, stigma, police harassment of people during "lockdowns"). The global biomedical response to COVID-19 was necessary and remarkable for mitigating the bio-physical impacts of the pandemic (e.g. wide-spread surveillance coupled with rapid updates on the epidemiology of infections, rapid development of vaccines and revisions of treatment). However, drawing upon the widespread criticisms of state responses to the socio-economic effects of the COVID-19 pandemic and of "lockdowns" themselves, this article elaborates a core argument within those criticisms, namely that key lessons learnt during the HIV and AIDS and other pandemics were ignored, at least during the early stages of COVID-19. Our critique is that better integration of the social sciences and humanities in responses to pandemics can counter the reflex tendency to uncritically adopt a biomedical paradigm and, more importantly, to enable consideration of the social determinants of health in pandemic responses. At root, we re-assert a key value of 'integrated' interventions, namely the accommodation of context-sensitive considerations in the formulation of strategies, policies, plans and programme designs.
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Affiliation(s)
- Kaymarlin Govender
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | | | - Patrick Nyamaruze
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Tim Quinlan
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
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24
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Upshur R. Meme Science, Pandemic Preparedness, and the Trajectory of Failure. J Bioeth Inq 2023; 20:591-596. [PMID: 37646914 DOI: 10.1007/s11673-023-10275-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/31/2023] [Indexed: 09/01/2023]
Abstract
In this paper I analyse the implications of "flattening" the curve for long-term care residents in the Province of Ontario, Canada during the first wave of the SARS-CoV-2/COVID-19 pandemic. I then question what the role of healthcare systems are in the response to public health emergencies and problematize their status as entities in need of protection. The ethical implications of this are discussed in light of potential challenges raised by climate change.
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Affiliation(s)
- Ross Upshur
- Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
- Senior Scientist, Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.
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Marquez DR, Agnew J, Barnett DJ, Davis MF, Dalton KR. Assessing US Small Animal Veterinary Clinic Adaptations and Their Impacts on Workforce COVID-19 Preparedness and Response. Health Secur 2023; 21:450-458. [PMID: 37971808 PMCID: PMC10777815 DOI: 10.1089/hs.2023.0041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 11/19/2023] Open
Abstract
Veterinary personnel are an essential yet often underappreciated workforce, critical for zoonotic disease prevention and response efforts that impact human health. During the early COVID-19 pandemic, the veterinary workforce supported emergency responses by promoting zoonotic disease risk communication, sharing animal health expertise, and boosting laboratory surge capacity against SARS-CoV-2 in animals and people. However, small animal veterinary workers (SAVWs), similar to healthcare workers, faced organizational challenges in providing clinical care to family pets, including those susceptible to SARS-CoV-2. We analyzed a cross-sectional survey of 1,204 SAVWs in the United States to assess veterinary clinic adaptations and their associations with SAVWs' self-perceived readiness, willingness, and ability to respond to the COVID-19 pandemic as a workforce. SAVWs who worked fewer hours than before the pandemic (ready, OR 0.59; willing, OR 0.66; able, OR 0.52) or used personal protective equipment less frequently for protection in the clinic (ready, OR 0.69; willing, OR 0.69; able, OR 0.64) felt less ready, willing, and able to respond to COVID-19. SAVWs working remotely felt less ready (OR 0.46) but not less willing or able to respond to COVID-19. Lastly, SAVWs with dependents felt less ready (OR 0.67) and able (OR 0.49) to respond to COVID-19 than SAVWs without dependents. Our findings highlight the importance of proactively managing work schedules, having access to personal protective equipment, and addressing caregiving concerns to enhance SAVW preparedness and response outcomes. SAVWs are knowledgeable, motivated personnel who should be integrated into local public health emergency preparedness and response plans, supporting a One Health framework that unites multidisciplinary teams to respond to future zoonotic disease threats.
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Affiliation(s)
- David R. Marquez
- David R. Marquez, DVM, MPH, DACVPM, is a Postdoctoral Fellow, in the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- David Marquez is also a Veterinary Preventive Medicine Officer, US Army Veterinary Corps, Medical Center of Excellence, JBSA Fort Sam Houston, TX
| | - Jacqueline Agnew
- Jacqueline Agnew, MPH, PhD, is a Professor Emeritus, in the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Daniel J. Barnett
- Daniel J. Barnett, MD, MPH, in the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Meghan F. Davis
- Meghan F. Davis, DVM, MPH, PhD, are Associate Professors, in the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kathryn R. Dalton
- Kathryn R. Dalton, DVM, PhD, MPH, is an IRTA Postdoctoral Fellow, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
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Gautier L, Noda S, Chabrol F, David PM, Duhoux A, Hou R, Rosana de Araújo Oliveira S, Traverson L, Zinszer K, Ridde V. Hospital Governance During the COVID-19 Pandemic: A Multiple-Country Case Study. Health Syst Reform 2023; 9:2173551. [PMID: 37253204 DOI: 10.1080/23288604.2023.2173551] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/24/2023] [Indexed: 06/01/2023] Open
Abstract
In response to the disruptions caused by COVID-19, hospitals around the world proactively or reactively developed and/or re-organized their governance structures to manage the COVID-19 response. Hospitals' governance played a crucial role in their ability to reorganize and respond to the pressing needs of their staff. We discuss and compare six hospital cases from four countries on different continents: Brazil, Canada, France, and Japan. Our study examined how governance strategies (e.g., special task forces, communications management tools, etc.) were perceived by hospital staff. Key findings from a total of 177 qualitative interviews with diverse hospital stakeholders were analyzed using three categories drawn from the European Observatory on Health Systems and Policies framework on health systems resilience during the COVID-19 pandemic: 1) delivering a clear and timely COVID-19 response strategy; 2) coordinating effectively within (horizontally) and across (vertically) levels of decision-making; and 3) communicating clearly and transparently with the hospital's diverse stakeholders. Our study gleaned rich accounts for these three categories, highlighting significant variations across settings. These variations were primarily determined by the hospitals' environment prior to the COVID-19 crisis, namely whether there already existed a culture of managerial openness (including spaces for social interactions among hospital staff) and whether preparedness planning and training had been routinely integrated into their activities.
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Affiliation(s)
- Lara Gautier
- School of Public Health, Université de Montréal, Montréal, Quebec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | - Shinichiro Noda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Fanny Chabrol
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | | | - Arnaud Duhoux
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada
| | - Renyou Hou
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | | | - Lola Traverson
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | - Kate Zinszer
- School of Public Health, Université de Montréal, Montréal, Quebec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
| | - Valéry Ridde
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
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Mhlanga-Gunda R, Rusakaniko S, Chinyuku AN, Pswarayi VF, Robinson CS, Kewley S, Van Hout MC. "We sleep 10cm apart so there is no social distancing": COVID-19 preparedness in a Zimbabwean prison complex. Int J Prison Health 2022; 19:157-180. [PMID: 35089667 DOI: 10.1108/ijph-10-2021-0101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Prisons in Africa face unprecedented challenges during Coronavirus disease 2019 (COVID-19). In July 2020, the first prison system case of COVID-19 was notified in Zimbabwe. Subsequently, the Zimbabwe Prisons and Correctional Services released their COVID-19 operational plan. The purpose of the study was to assess preparedness, prevention and control of COVID-19 in selected prisons in Zimbabwe. DESIGN/METHODOLOGY/APPROACH A multi-method situation assessment of COVID-19 preparedness was conducted across three Zimbabwean prisons. The World Health Organization checklist to evaluate preparedness, prevention and control of COVID-19 in prisons was administered to frontline health managers. Information garnered was further explored during site observation and in multi-stakeholder key informant interviews with policymakers, prison health directorate, frontline health-care professionals, officers in charge and non-governmental organizations (n = 26); focus group discussions with correctional officers (n = 18); and male/female prisoners (n = 36). Data was triangulated and analyzed using content thematic analysis. FINDINGS Outdated infrastructure, severe congestion, interrupted water supply and inadequate hygiene and sanitation were conducive to ill-health and spread of disease. Health professionals had been well-trained regarding COVID-19 disease control measures. COVID-19 awareness among prisoners was generally adequate. There was no routine COVID-19 testing in place, beyond thermo scanning. Access to health care was good, but standards were hindered by inadequate medicines and personnel protective equipment supply. Isolation measures were compromised by accommodation capacity issues. Flow of prison entries constituted a transmission risk. Social distancing was impossible during meals and at night. ORIGINALITY/VALUE This unique situation assessment of Zimbabwean prisons' preparedness and approach to tackling COVID-19 acknowledges state and prison efforts to protect prisoners and staff, despite infrastructural constraints and inadequate resourcing from government.
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Affiliation(s)
| | - Simbarashe Rusakaniko
- Global and Public Health Unit, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | | | | | - Stephanie Kewley
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
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