Operationalizing Public Health Skills to Resource Poor Settings: Is This the Achilles Heel in the Ebola Epidemic Campaign?

2014 ◽  
Vol 9 (1) ◽  
pp. 44-46 ◽  
Author(s):  
Frederick M. Burkle
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Standards Of Care ◽  
Public Health Preparedness ◽  
Skill Sets ◽  
Public Health Emergencies ◽  
Resource Poor ◽  
Competency Based ◽  
Medical Teams ◽  
Disease Epidemics

AbstractSustainable approaches to crises, especially non-trauma-related public health emergencies, are severely lacking. At present, the Ebola crisis is defining the operational public health skill sets for infectious disease epidemics that are not widely known or appreciated. Indigenous and foreign medical teams will need to adapt to build competency-based curriculum and standards of care for the future that concentrate on public health emergencies. Only by adjusting and adapting specific operational public health skill sets to resource poor environments will it be possible to provide sustainable prevention and preparedness initiatives that work well across cultures and borders.(Diaster Med Public Health Preparedness. 2014;0:1-3)

Preparedness 3.0: Addressing the Future

2015 ◽  
Vol 9 (6) ◽  
pp. 728-729 ◽  
Author(s):  
Georges C. Benjamin
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Social Media ◽  
Infectious Diseases ◽  
Extreme Weather ◽  
Common Occurrence ◽  
Public Health Preparedness ◽  
Public Health Emergencies ◽  
State Sponsorship ◽  
The Future

ABSTRACTThe last 14 years has taught us that that we are facing a new reality; a reality in which public health emergencies are a common occurrence. Today, we live in a world with dangerous people without state sponsorship who are an enormous threat to our safety; one where emerging and reemerging infectious diseases are waiting to break out; a world where the benefits of globalization in trade, transportation, and social media brings threats to our communities faster and with a greater risk than ever before. Even climate change has entered into the preparedness equation, bringing with it the forces of nature in the form of extreme weather and its complications. (Disaster Med Public Health Preparedness. 2015;9:728–729)

Altered Standards of Care During an Influenza Pandemic: Identifying Ethical, Legal, and Practical Principles to Guide Decision Making

2009 ◽  
Vol 3 (S2) ◽  
pp. S132-S140 ◽  
Author(s):  
Donna Levin ◽  
Rebecca Orfaly Cadigan ◽  
Paul D. Biddinger ◽  
Suzanne Condon ◽  
Howard K. Koh ◽  
...  
Keyword(s):  
Public Health ◽  
Planning Process ◽  
Influenza Pandemic ◽  
State Level ◽  
Mass Casualty ◽  
Standards Of Care ◽  
Public Health Preparedness ◽  
Community Stakeholders ◽  
Mass Casualty Events ◽  
Public Health Officials

ABSTRACTAlthough widespread support favors prospective planning for altered standards of care during mass casualty events, the literature includes few, if any, accounts of groups that have formally addressed the overarching policy considerations at the state level. We describe the planning process undertaken by public health officials in the Commonwealth of Massachusetts, along with community and academic partners, to explore the issues surrounding altered standards of care in the event of pandemic influenza. Throughout 2006, the Massachusetts Department of Public Health and the Harvard School of Public Health Center for Public Health Preparedness jointly convened a working group comprising ethicists, lawyers, clinicians, and local and state public health officials to consider issues such as allocation of antiviral medications, prioritization of critical care, and state seizure of private assets. Community stakeholders were also engaged in the process through facilitated discussion of case scenarios focused on these and other issues. The objective of this initiative was to establish a framework and some fundamental principles that would subsequently guide the process of establishing specific altered standards of care protocols. The group collectively identified 4 goals and 7 principles to guide the equitable allocation of limited resources and establishment of altered standards of care protocols. Reviewing and analyzing this process to date may serve as a resource for other states. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S132–S140)

An Industrial Accident

2020 ◽  
pp. 175-180
Author(s):  
Chadd K. Kraus
Keyword(s):  
Public Health ◽  
Emergency Physician ◽  
Standard Of Care ◽  
Professional Autonomy ◽  
Standards Of Care ◽  
Emergency Physicians ◽  
Scarce Resources ◽  
Public Health Emergencies ◽  
Public Health Functions ◽  
Critical Public Health

Emergency physicians and emergency departments serve critical public health functions at all times and particularly during public health emergencies or disasters. Public health emergencies and disasters transform standards of care into crisis standards of care. In addition to traditional tenets of bioethics, during events requiring crisis standards of care, the emergency physician faces the dilemmas of balancing responsibilities of how to allocate scarce resources to individual patients with obligations to the community and with personal and professional autonomy. Crisis standards of care permit emergency physicians to allocate scarce resources to provide necessary treatments to patients most likely to benefit. In crisis standard-of-care situations, emergency physicians must adhere to ethical and professional norms. The emergency physician should focus on how to best use the available resources with the recognition that not all patients might be able to be treated.

scholarly journals Collaborating with Sovereign Tribal Nations to Legally Prepare for Public Health Emergencies

2019 ◽  
Vol 47 (S2) ◽  
pp. 55-58
Author(s):  
Tina Batra Hershey
Keyword(s):  
Public Health ◽  
Emergency Preparedness ◽  
Disease Outbreaks ◽  
Public Health Preparedness ◽  
Infectious Disease Outbreaks ◽  
Public Health Emergencies ◽  
Us Government ◽  
Tribal Governments ◽  
Tribal Nations ◽  
Coordination And Collaboration

Public health emergencies, including infectious disease outbreaks and natural disasters, are issues faced by every community. To address these threats, it is critical for all jurisdictions to understand how law can be used to enhance public health preparedness, as well as improve coordination and collaboration across jurisdictions. As sovereign entities, Tribal governments have the authority to create their own laws and take the necessary steps to prepare for, respond to, and recover from disasters and emergencies. Legal preparedness is a key component of public health preparedness. This article first explains legal preparedness and Tribal sovereignty and then describes the relationship between Tribal Nations, the US government, and states. Specific Tribal concerns with respect to emergency preparedness and the importance of coordination and collaboration across jurisdictions for emergency preparedness are discussed. Examples of collaborative efforts between Tribal and other governments to enhance legal preparedness are described.

Implications of the Emergency Medical Treatment and Labor Act (EMTALA) During Public Health Emergencies and on Alternate Sites of Care

2009 ◽  
Vol 3 (S2) ◽  
pp. S172-S175 ◽  
Author(s):  
Andrew R. Roszak ◽  
Frances R. Jensen ◽  
Richard E. Wild ◽  
Kevin Yeskey ◽  
Michael T. Handrigan
Keyword(s):  
Public Health ◽  
Medical Treatment ◽  
H1n1 Virus ◽  
The Novel ◽  
Community Centers ◽  
Public Health Preparedness ◽  
Innovative Strategies ◽  
Public Health Emergencies ◽  
Emergency Medical ◽  
Alternative Sites

ABSTRACTHospitals throughout the country are using innovative strategies to accommodate the surge of patients brought on by the novel H1N1 virus. One strategy has been to help decompress the amount of patients seeking care within emergency departments by using alternate sites of care, such as tents, parking lots, and community centers as triage, staging, and screening areas. As at any other time an individual presents on hospital property, hospitals and providers must be mindful of the requirements of the Emergency Medical Treatment and Labor Act. In this article we review the act and its implications during public health emergencies, with a particular focus on its implications on alternative sites of care. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S172–S175)

Impact of Tabletop Exercises on Participants’ Knowledge of and Confidence in Legal Authorities for Infectious Disease Emergencies

2009 ◽  
Vol 3 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Elena Savoia ◽  
Paul D. Biddinger ◽  
Priscilla Fox ◽  
Donna E. Levin ◽  
Lisa Stone ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
The State ◽  
System Level ◽  
Legal Issue ◽  
Fisher Exact Test ◽  
Public Health Preparedness ◽  
Level Of Confidence ◽  
Policies And Procedures ◽  
The Impact

ABSTRACTObjective: Legal preparedness is a critical component of comprehensive public health preparedness for public health emergencies. The scope of this study was to assess the usefulness of combining didactic sessions with a tabletop exercise as educational tools in legal preparedness, to assess the impact of the exercise on the participants’ level of confidence about the legal preparedness of a public health system, and to identify legal issue areas in need of further improvement.Methods: The exercise scenario and the pre- and postexercise evaluation were designed to assess knowledge gained and level of confidence in declaration of emergencies, isolation and quarantine, restrictions (including curfew) on the movement of people, closure of public places, and mass prophylaxis, and to identify legal preparedness areas most in need of further improvement at the system level. Fisher exact test and paired t test were performed to compare pre- and postexercise results.Results: Our analysis shows that a combination of didactic teaching and experiential learning through a tabletop exercise regarding legal preparedness for infectious disease emergencies can be effective in both imparting perceived knowledge to participants and gathering information about sufficiency of authorities and existence of gaps.Conclusions: The exercise provided a valuable forum to judge the adequacy of legal authorities, policies, and procedures for dealing with pandemic influenza at the state and local levels in Massachusetts. In general, participants were more confident about the availability and sufficiency of legal authorities than they were about policies and procedures for implementing them. Participants were also more likely to report the need for improvement in authorities, policies, and procedures in the private sector and at the local level than at the state level. (Disaster Med Public Health Preparedness. 2009;3:104–110)

scholarly journals Health Risks of Selected Mass Gatherings in the Philippines in 2015 and Implications for Public Health Preparedness

2018 ◽  
Vol 52 (2) ◽  
Author(s):  
Ronald P. Law
Keyword(s):  
Public Health ◽  
Health Risks ◽  
The Philippines ◽  
Noncommunicable Diseases ◽  
Public Health Preparedness ◽  
Mass Gatherings ◽  
Department Of Health ◽  
Important Health ◽  
Medical Teams ◽  
Public Health Strategies

Background. Mass gatherings (MG) are events that draw together a large number of people in one or several occasions happening in single or multiple places for a definite period of time. These can lead to different public health risks through exposure to infectious diseases, trauma, and environmental factors. The Philippine Department of Health (DOH) in 2015 participated in special planned events that constituted mass gatherings namely the AsiaPacific Economic Cooperation (APEC) meetings, the Black Nazarene procession, and the Papal Visit. Objective. The study aimed to describe the different health risks arising from the three (3) identified mass gathering events in the Philippines in 2015 and relate them to public health preparedness. Methods. This was a descriptive study of the health risks arising from the MG events. Sources of data were reports submitted by deployed medical teams to the Operations Center (Opcen) that closely monitored the MG. Results. The study found infectious causes, trauma, temperature-related conditions, and noncommunicable diseases to be the important categories of health risks in the specified mass gatherings. These validated the common health risk categories observed in previously well-studied mass gatherings. Conclusion. The study highlighted important health risks and factors for consideration in public health preparedness for mass gatherings in terms of appropriate and effective public health strategies that should be established to minimize health risks and reduce health system impacts of mass gatherings.

scholarly journals Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

2020 ◽  
Author(s):  
Irene Mremi ◽  
Janeth George ◽  
Susan F. Rumisha ◽  
Calvin Sindato ◽  
Leonard E.G. Mboera ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Information ◽  
Disease Surveillance ◽  
Sub Saharan Africa ◽  
Health Management Information System ◽  
Support Functions ◽  
Surveillance And Response ◽  
Sub Saharan ◽  
Disease Epidemics

Abstract Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: A search for eligible articles was done through HINARI, PubMed, and advanced Google Scholar databases. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. Using the key search descriptors, 1,809 articles were identified and screened at two stages and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions while 42 studies assessed the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilized and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.

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