[Recent Developments and Future Directions of Oral Healthcare System and Dental Public Health System in China in Light of the Current Global Emergency]

The study is aimed to help promote the development of the oral healthcare system and dental public health system in China and to help achieve the goal of improving the nation's oral health. We herein provided an overview and critical evaluation of recent developments in oral healthcare systems and dental public health systems in China and other countries, and discussed a number of potential directions for the future development of dental public health. The current global public health emergency of the coronavirus disease 2019 (COVID-19) pandemic was also taken into account in our discussions. Thus, to facilitate the accomplishment of the goals of the Healthy China 2030 Program, we suggested the establishment of a community-based, prevention-oriented model for the oral healthcare system and dental public health system. The model we proposed features the integration of oral and general health services, the utilization of technological innovations and big data concerning health, and a forceful promotion of remote dental services focused on prevention and early diagnosis and treatment. Furthermore, under the background of COVID-19 becoming a normal part of people's lives, we should adopt differentiated prevention and protection measures and emergency response preplans appropriate for the actual epidemic situation of a particular region so that clinical services are strengthened while unnecessary wastes of resources are avoided. We should actively explore for alternative approaches to care in the face of special circumstances.

The First Intra-Action Review of Indonesia's Response to the COVID-19 Pandemic, August 2020

The COVID-19 pandemic has had an unprecedented impact on health, society, and the economy globally and in Indonesia. The World Health Organization (WHO) recommended the use of intra-action reviews (IARs) to identify best practices, gaps, and lessons learned to make real-time improvements to the COVID-19 response. The Emergency Committee of the International Health Regulations (2005) has recommended that countries share COVID-19 best practices and lessons learned with peer countries through IARs. Using WHO-established methodology, we conducted the first IAR of Indonesia's COVID-19 response from January through August 2020. The review covered 10 thematic areas (pillars): (1) command and coordination; (2) operational support and logistics; (3) surveillance, rapid response teams, risk assessment, and field investigation; (4) laboratories; (5) case management; (6) infection prevention and control; (7) risk communication and community empowerment; (8) points of entry, international travel, and transportation; (9) large-scale social restrictions; and (10) maintaining essential health services and systems. We held focus group discussions with a variety of stakeholders from a range of government departments, provincial health offices, and nongovernmental organizations. We used the results of the focus group discussions and other key findings from the IAR to formulate recommendations. The IAR identified key areas for improvement at national and subnational levels across all 10 pillars. Priority recommendations included improving multisectoral coordination and monitoring of COVID-19 response plan indicators; strengthening implementation of public health response measures, including case detection, isolation, infection prevention and control, contact tracing, and quarantine; and improving data collection, analysis, and reporting to inform public health risk assessment and response. The IAR is a useful tool for reviewing progress and identifying areas to improve the COVID-19 response in real time and provides a means to share information on areas of need with COVID-19 response partners and contributes to International Health Regulations (2005) core capacity development.

Simulation exercises and after action reviews - analysis of outputs during 2016-2019 to strengthen global health emergency preparedness and response

Background

Under the International Health Regulations (2005) [IHR (2005)] Monitoring and Evaluation Framework, after action reviews (AAR) and simulation exercises (SimEx) are two critical components which measure the functionality of a country’s health emergency preparedness and response under a “real-life” event or simulated situation. The objective of this study was to describe the AAR and SimEx supported by the World Health Organization (WHO) globally in 2016–2019.

Methods

In 2016–2019, WHO supported 63 AAR and 117 SimEx, of which 42 (66.7%) AAR reports and 56 (47.9%) SimEx reports were available. We extracted key information from these reports and created two central databases for AAR and SimEx, respectively. We conducted descriptive analysis and linked the findings according to the 13 IHR (2005) core capacities.

Results

Among the 42 AAR and 56 SimEx available reports, AAR and SimEx were most commonly conducted in the WHO African Region (AAR: n = 32, 76.2%; SimEx: n = 32, 52.5%). The most common public health events reviewed or tested in AAR and SimEx, respectively, were epidemics and pandemics (AAR: n = 38, 90.5%; SimEx: n = 46, 82.1%). For AAR, 10 (76.9%) of the 13 IHR core capacities were reviewed at least once, with no AAR conducted for food safety, chemical events, and radiation emergencies, among the reports available. For SimEx, all 13 (100.0%) IHR capacities were tested at least once. For AAR, the most commonly reviewed IHR core capacities were health services provision (n = 41, 97.6%), risk communication (n = 39, 92.9%), national health emergency framework (n = 39, 92.9%), surveillance (n = 37, 88.1%) and laboratory (n = 35, 83.3%). For SimEx, the most commonly tested IHR core capacity were national health emergency framework (n = 56, 91.1%), followed by risk communication (n = 48, 85.7%), IHR coordination and national IHR focal point functions (n = 45, 80.4%), surveillance (n = 31, 55.4%), and health service provision (n = 29, 51.8%). For AAR, the median timeframe between the end of the event and AAR was 125 days (range = 25–399 days).

Conclusions

WHO has recently published guidance for the planning, execution, and follow-up of AAR and SimEx. Through the guidance and the simplified reporting format provided, we hope to see more countries conduct AAR and SimEx and standardization in their methodology, practice, reporting and follow-up.

Supplementary information

Supplementary information accompanies this paper at 10.1186/s12992-020-00632-w.

[World Health Organization's response mechanisms for COVID-19]

The COVID-19 pandemic is the defining global health crisis and the greatest challenge that we are currently facing. The key to the management of infectious diseases worldwide is to abide by international regulations and conduct international cooperation in pursuit of common interests and values. WHO is the specialized international organization, under the United Nations system, to manage and control the spread of diseases. This study Summecrizes the WHO's response mechanisms for infectious diseases, response measures and the direction of efforts to combat COVID-19, with a view to provide advices for the control of COVID-19 pandemic.

Chinese medical students’ interest in COVID-19 pandemic

BACKGROUND

The outbreak of coronavirus disease 2019 (COVID-19) happened in early December and it has affected China in more ways than one. The societal response to the pandemic restricted medical students to their homes. Although students cannot learn about COVID-19 through clinical practice, they can still pay attention to news of COVID-19 through various channels. Although, as suggested by previous studies, some medical students have already volunteered to serve during the COVID-19 pandemic, the overall willingness of Chinese medical students to volunteer for such has not been systematically examined.

AIM

To study Chinese medical students’ interest in the relevant knowledge on COVID-19 and what roles they want to play in the pandemic.

METHODS

Medical students at Peking Union Medical College were surveyed via a web-based questionnaire to obtain data on the extent of interest in the relevant knowledge on COVID-19, attitude towards volunteerism in the pandemic, and career preference. Logistic regression modeling was used to investigate possible factors that could encourage volunteerism among this group in a pandemic.

RESULTS

A total of 552 medical students responded. Most medical students showed a huge interest in COVID-19. The extent of students’ interest in COVID-19 varied among different student-classes (P < 0.05). Senior students had higher scores than the other two classes. The number of people who were ‘glad to volunteer’ in COVID-19 represented 85.6% of the respondents. What these students expressed willingness to undertake involved direct, indirect, and administrative job activities. Logistic regression analysis identified two factors that negatively influenced volunteering in the pandemic: Student-class and hazards of the voluntary job. Factors that positively influenced volunteering were time to watch COVID-19 news, predictable impact on China, and moral responsibility.

CONCLUSION

More innovative methods can be explored to increase Chinese medical students’ interest in reading about the relevant knowledge on COVID-19 and doing voluntary jobs during the pandemic.

Canada's role in strengthening global health security during the COVID-19 pandemic

The world is confronted by the current pandemic of Corona Virus Disease (COVID-19), which is a wake-up call for all nations irrespective of their development status or geographical location. Since the start of the century we have seen five big infectious outbreaks which proved that epidemics are no more regarded as historic and geographically confined threats. The Canadian government underlined that these infectious disease outbreaks are threats to global health security and disrupt societal wellbeing and development. In this context, the Public Health Agency of Canada is proactive and has shown its preparedness for outbreaks of emerging and epidemic-prone diseases, and in dealing with these pathogens. Even before the declaration of pandemic, Canada has proved its global health leadership by ensuring collective action and multisectoral coordination which still remains a serious challenge especially for low and middle- income countries with existing poor health systems. In this article we discuss how Canada is addressing the global challenges posed by the COVID-19 pandemic through its leadership and practice of global health diplomacy.

Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018

BACKGROUND

Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018.

METHODS

We abstracted data from several sources, including: the WHO African Region's weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counter-checked the different data sources.

DATA ANALYSIS

We used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5-9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports.

RESULTS

Over 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis.

CONCLUSIONS

The frequent and widespread occurrence of epidemics and disasters in Africa is a clarion call for investing in preparedness. While strengthening preparedness should be guided by global frameworks, it is the responsibility of each government to finance country specific needs. We call upon all African countries to establish governance and predictable financing mechanisms for IHR implementation and to build resilient health systems everywhere.

Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018

Background

Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018.

Methods

We abstracted data from several sources, including: the WHO African Region’s weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counter-checked the different data sources.

Data analysis

We used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5–9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports.

Results

Over 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis.

Conclusions

The frequent and widespread occurrence of epidemics and disasters in Africa is a clarion call for investing in preparedness. While strengthening preparedness should be guided by global frameworks, it is the responsibility of each government to finance country specific needs. We call upon all African countries to establish governance and predictable financing mechanisms for IHR implementation and to build resilient health systems everywhere.

The Emergence of Zika Virus as a Global Health Security Threat: A Review and a Consensus Statement of the INDUSEM Joint working Group (JWG)

The Zika virus (ZIKV), first discovered in 1947, has emerged as a global public health threat over the last decade, with the accelerated geographic spread of the virus noted during the last 5 years. The World Health Organization (WHO) predicts that millions of cases of ZIKV are likely to occur in the Americas during the next 12 months. These projections, in conjunction with suspected Zika-associated increase in newborn microcephaly cases, prompted WHO to declare public health emergency of international concern. ZIKV-associated illness is characterized by an incubation period of 3-12 days. Most patients remain asymptomatic (i.e., ~80%) after contracting the virus. When symptomatic, clinical presentation is usually mild and consists of a self-limiting febrile illness that lasts approximately 2-7 days. Among common clinical manifestations are fever, arthralgia, conjunctivitis, myalgia, headache, and maculopapular rash. Hospitalization and complication rates are low, with fatalities being extremely rare. Newborn microcephaly, the most devastating and insidious complication associated with the ZIKV, has been described in the offspring of women who became infected while pregnant. Much remains to be elucidated about the timing of ZIKV infection in the context of the temporal progression of pregnancy, the corresponding in utero fetal development stage(s), and the risk of microcephaly. Without further knowledge of the pathophysiology involved, the true risk of ZIKV to the unborn remains difficult to quantify and remediate. Accurate, portable, and inexpensive point-of-care testing is required to better identify cases and manage the current and future outbreaks of ZIKV, including optimization of preventive approaches and the identification of more effective risk reduction strategies. In addition, much more work needs to be done to produce an effective vaccine. Given the rapid geographic spread of ZIKV in recent years, a coordinated local, regional, and global effort is needed to generate sufficient resources and political traction to effectively halt and contain further expansion of the current outbreak.