Communicating Recommendations in Public Health Emergencies: The Role of Public Health Authorities

Abstract Background Articulation between Civil Protection and Public Health authorities is of paramount importance to control, reduce and prevent threats to the health of the population in situations of crisis or catastrophes. National Civil Protection Authority produces Emergency Plans which describe the role of every stakeholder in emergency situations. Role and importance of Public Health and Public Health Authorities is not always present or well described and known amongst stakeholders. Methods Data was collected from all Districtal Emergency Plans (n = 18). Each document was analysed considering time frame, refences to Public Health and Health Authorities, definition of roles, communication channels, coordination and inclusion of intersectoral communication flow. Quantitative analysis included absolute and relative frequencies and qualitative analysis to all parts related to the terms “Public Health” and “Health Authority”. Each document was reviewed by 2 independent researchers. Results From 18 Districtal Emergency Plans (DEP) analysed, 94,4% (n = 17) had references to Public Health, but none referred the role of Public Health Officers. Only 16,7% referred to Health Authorities, although 94,4% mentioned the law 135/2013, defining the role and attributes of Health Authority. In 72,2%, coordination of Public Health Measures was attributed to the National Medical Emergency Institute. Epidemiological surveillance and Public Health Emergencies were referred in 55,6%, and attributed to the Regional Administration of Health. Conclusions Public Health Authorities and Public Health Medical Officers role in articulation with National Civil Protection Authority in emergency situations lacks severely, with this role being replaced by other entities. This is of great concern regarding management and control of diseases, particularly communicable diseases. Key messages Public Health Authorities lack the necessary involvement in Emergency Plans and emergency situations. Public health measures are coordinated by other entities rather than Public Health Authorities.

Download Full-text

Rational trust in resilient health systems

Health Policy and Planning ◽

10.1093/heapol/czz066 ◽

2019 ◽

Vol 34 (7) ◽

pp. 553-557 ◽

Cited By ~ 4

Author(s):

Sonja Kristine Kittelsen ◽

Vincent Charles Keating

Keyword(s):

Public Health ◽

Health System ◽

Health Systems ◽

The Public ◽

Public Health Emergencies ◽

Health Authorities ◽

Cast Doubt ◽

Public Health Authorities ◽

System Resilience ◽

Relevant Component

AbstractThe 2014–15 Ebola epidemic in West Africa highlighted the significance of trust between the public and public health authorities in the mitigation of health crises. Since the end of the epidemic, there has been a focus amongst scholars and practitioners on building resilient health systems, which many see as an important precondition for successfully combatting future outbreaks. While trust has been acknowledged as a relevant component of health system resilience, we argue for a more sustained theoretical engagement with underlying models of trust in the literature. This article takes a first step in showing the importance of theoretical engagement by focusing on the appeal to rational models of trust in particular in the health system resilience literature, and how currently unconsidered assumptions in this model cast doubt on the effectiveness of strategies to generate trust, and therein resilience, during acute public health emergencies.

Download Full-text

Excess Mortality from COVID-19: Lessons Learned from the Italian Experience

10.20944/preprints202004.0065.v2 ◽

2020 ◽

Cited By ~ 2

Author(s):

Paolo Pasquariello ◽

Saverio Stranges

Keyword(s):

Public Health ◽

Case Fatality Rate ◽

Case Fatality ◽

Lessons Learned ◽

Fatality Rate ◽

Lombardy Region ◽

Italian Experience ◽

Health Authorities ◽

Public Health Authorities

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

Download Full-text

The role of public health authorities, scientific societies and the pharmaceutical industry in planning and conducting intervention trials

Journal of Hypertension ◽

10.1097/00004872-199609002-00023 ◽

1996 ◽

Vol 14 (Supplement 2) ◽

pp. S135-S140

Author(s):

Pieter A. van Zwieten

Keyword(s):

Public Health ◽

Pharmaceutical Industry ◽

Scientific Societies ◽

Health Authorities ◽

Public Health Authorities ◽

Intervention Trials

Download Full-text

Excess Mortality from COVID-19: Lessons Learned from the Italian Experience

10.20944/preprints202004.0065.v1 ◽

2020 ◽

Cited By ~ 4

Author(s):

Paolo Pasquariello ◽

Saverio Stranges

Keyword(s):

Public Health ◽

Case Fatality Rate ◽

Case Fatality ◽

Lessons Learned ◽

Fatality Rate ◽

Lombardy Region ◽

Italian Experience ◽

Health Authorities ◽

Public Health Authorities

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 12.1% as of April 2, 2020, versus a global case fatality rate of 5.2%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

Download Full-text

The Preventive Role of Exercise on the Physiological, Psychological, and Psychophysiological Parameters of Coronavirus 2 (SARS-CoV-2): A Mini Review

Journal of Risk and Financial Management ◽

10.3390/jrfm14100476 ◽

2021 ◽

Vol 14 (10) ◽

pp. 476

Author(s):

Julien S. Baker ◽

Alistair Cole ◽

Dan Tao ◽

Feifei Li ◽

Wei Liang ◽

...

Keyword(s):

Public Health ◽

Physical Activity ◽

Tai Chi ◽

Mental Distress ◽

Moderate Exercise ◽

Health Authorities ◽

The World ◽

Public Health Authorities ◽

Preventive Role

The world has been severely challenged by the Coronavirus Disease (COVID-19) outbreak since the early 2020s. Worldwide, there have been more than 66 million cases of infection and over 3,880,450 deaths caused by this highly contagious disease. All sections of the population including those who are affected, those who are not affected and those who have recovered from this disease, are suffering physiologically, psychologically or psychophysiologically. In this paper we briefly discuss the consequences of COVID-19 on physiological, psychological and psychophysiological vulnerability. We also attempt to provide evidence in support of exercise management as a prevention strategy for improving and minimizing the physiological, psychological and psychophysiological effects of COVID-19. Moderate exercise including walking, yoga and tai-chi to name but a few exercise regimes are critical in preventing COVID-19 and its complications. Governments, public health authorities and the general population should maintain physical activity during the COVID-19 pandemic to prevent additional physical and mental distress.

Download Full-text

Addressing the challenge of bringing evidence in decision-making for public health emergencies: can HTA reach out to preparedness?

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.943 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C de Waure ◽

A Miglietta ◽

C Favaretti

Keyword(s):

Public Health ◽

Comprehensive Evaluation ◽

National Level ◽

Quality Improvement Process ◽

Health Technologies ◽

Public Health Emergencies ◽

Continuous Quality ◽

Health Authorities ◽

Early Interaction

Abstract Background Preparedness is one of the fundamental public health activities as it allows health systems to effectively manage threats. It can be considered a continuous quality improvement process, therefore requiring an assessment both in planning and checking phase. The assessment should consider several aspects spanning contextual factors but also health technologies being used. In order to manage threats, epidemics in particular, several health technologies are generally deployed. Among them, vaccines, antimicrobials, medical devices (i.e. masks), procedures (i.e. quarantine). Indeed, an early and as much as comprehensive evaluation of their value in the mitigation of epidemics' impact is needed. Health Technology Assessment (HTA) could help doing that. It could be also useful to predict the magnitude of the problem and to shed light on alternatives and needs for organizational reengineering. Anyway, what are the actions required to make HTA reaching out preparedness? Results In order to do it, several conditions should be brought about. The first one is the recognition of the importance of HTA in projecting health technologies impacts by health authorities and institutions. The second one is the timeliness of the assessment. In fact, HTA is generally a time and resource consuming approach as it is based on the collection of available evidence and data. Nevertheless, an early interaction with all stakeholders, the availability of flexible computer infrastructures for data collection and the preventive development of impact models might allow developing the assessment in a limited time. Furthermore, having dedicated working teams at supranational/national level could help keep down time and efforts to conduct the assessment. Conclusions Based on available experiences, advances and barriers in the use of HTA for preparedness might be highlighted and actions to strengthen the role of HTA in this field can be recognized.

Download Full-text

Local public health officials and COVID-19: Evidence from China

10.1101/2020.07.18.20156828 ◽

2020 ◽

Author(s):

John Jiang ◽

Maobin Wang

Keyword(s):

Public Health ◽

Health Departments ◽

Local Public Health ◽

Public Health Departments ◽

Public Health Emergencies ◽

Slowing Down ◽

Medical Background ◽

Health Authorities ◽

Public Health Authorities ◽

Public Health Officials

Understanding what contributes to the slowing down of COVID-19 in China is essential for other governments to better deal with the pandemic. Similar to their counterparts in the U.S. and the U.K., local public health authorities in China are responsible for monitoring infectious diseases and organizing the responses to public health emergencies. However they are not typically viewed as essential as China policymakers focus on economic growth. Only 38% of the heads of the public health departments of Chinese cities have a medical background. We find that cities with medical professionals as the head of public health departments had lower infection rates and death rates from COVID-19. The results were significant only at the start of the outbreak. Our results suggest to better combat a pandemic, local public health authorities should be led by competent people who have a medical background.

Download Full-text

Users’ Beliefs Toward Physical Distancing in Facebook Pages of Public Health Authorities During COVID-19 Pandemic in Early 2020

Health Education & Behavior ◽

10.1177/10901981211014428 ◽

2021 ◽

pp. 109019812110144

Author(s):

Soon Guan Tan ◽

Aravind Sesagiri Raamkumar ◽

Hwee Lin Wee

Keyword(s):

Public Health ◽

Health Belief Model ◽

United States Public Health ◽

Health Belief ◽

The United States ◽

Health Authorities ◽

Public Health Authorities ◽

Control And Prevention ◽

Belief Model ◽

The Health Belief Model

This study aims to describe Facebook users’ beliefs toward physical distancing measures implemented during the Coronavirus disease (COVID-19) pandemic using the key constructs of the health belief model. A combination of rule-based filtering and manual classification methods was used to classify user comments on COVID-19 Facebook posts of three public health authorities: Centers for Disease Control and Prevention of the United States, Public Health England, and Ministry of Health, Singapore. A total of 104,304 comments were analyzed for posts published between 1 January, 2020, and 31 March, 2020, along with COVID-19 cases and deaths count data from the three countries. Findings indicate that the perceived benefits of physical distancing measures ( n = 3,463; 3.3%) was three times higher than perceived barriers ( n = 1,062; 1.0%). Perceived susceptibility to COVID-19 ( n = 2,934; 2.8%) was higher compared with perceived severity ( n = 2,081; 2.0%). Although susceptibility aspects of physical distancing were discussed more often at the start of the year, mentions on the benefits of intervention emerged stronger toward the end of the analysis period, highlighting the shift in beliefs. The health belief model is useful for understanding Facebook users’ beliefs at a basic level, and it provides a scope for further improvement.

Download Full-text

Fueling the Covid-19 pandemic: summer school holidays and incidence rates in German districts

Journal of Public Health ◽

10.1093/pubmed/fdab080 ◽

2021 ◽

Author(s):

Thomas Plümper ◽

Eric Neumayer

Keyword(s):

Public Health ◽

Fixed Effects ◽

Summer School ◽

Incidence Rates ◽

Contact Tracing ◽

Robert Koch Institute ◽

Cross Sectional ◽

Holiday Period ◽

Health Authorities ◽

Public Health Authorities

AbstractBackgroundThe Robert-Koch-Institute reports that during the summer holiday period a foreign country is stated as the most likely place of infection for an average of 27 and a maximum of 49% of new SARS-CoV-2 infections in Germany.MethodsCross-sectional study on observational data. In Germany, summer school holidays are coordinated between states and spread out over 13 weeks. Employing a dynamic model with district fixed effects, we analyze the association between these holidays and weekly incidence rates across 401 German districts.ResultsWe find effects of the holiday period of around 45% of the average district incidence rates in Germany during their respective final week of holidays and the 2 weeks after holidays end. Western states tend to experience stronger effects than Eastern states. We also find statistically significant interaction effects of school holidays with per capita taxable income and the share of foreign residents in a district’s population.ConclusionsOur results suggest that changed behavior during the holiday season accelerated the pandemic and made it considerably more difficult for public health authorities to contain the spread of the virus by means of contact tracing. Germany’s public health authorities did not prepare adequately for this acceleration.

Download Full-text