scholarly journals Toronto’s Health Department in Action: Influenza in 1918 and SARS in 2003

2006 ◽  
Vol 62 (1) ◽  
pp. 56-89 ◽  
Author(s):  
Heather MacDougall
Keyword(s):  
Communicable Disease ◽  
Health Department ◽  
Contact Tracing ◽  
Effective Vaccine ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
The Past ◽  
International Body ◽  
1918 Influenza

Abstract This article compares the Toronto Health Department’s role in controlling the 1918 influenza epidemic with its activities during the SARS outbreak in 2003 and concludes that local health departments are the foundation for successful disease containment, provided that there is effective coordination, communication, and capacity. In 1918, Toronto’s MOH Charles Hastings was the acknowledged leader of efforts to contain the disease, care for the sick, and develop an effective vaccine, because neither a federal health department nor an international body like WHO existed. During the SARS outbreak, Hastings’s successor, Sheela Basrur, discovered that nearly a decade of underfunding and new policy foci such as health promotion had left the department vulnerable when faced with a potential epidemic. Lack of cooperation by provincial and federal authorities added further difficulties to the challenge of organizing contact tracing, quarantine, and isolation for suspected and probable cases and providing information and reassurance to the multi-ethnic population. With growing concern about a flu pandemic, the lessons of the past provide a foundation for future communicable disease control activities.

scholarly journals Covid Fast Fax: A system for real-time triage of Covid-19 case report faxes

2020 ◽  
Author(s):  
Adam Lavertu ◽  
Alison Stribling ◽  
Matt White ◽  
Greg McInnes ◽  
Russ B. Altman ◽  
...  
Keyword(s):  
Case Report ◽  
Real Time ◽  
Communicable Disease ◽  
Case Reports ◽  
Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Brief Training ◽  
Real Time Identification

Abstract The scale and speed of the COVID-19 pandemic has strained many parts of the national healthcare infrastructure, including communicable disease monitoring and prevention. Many local health departments now receive hundreds or thousands of COVID-19 case reports a day. Many arrive via faxed handwritten forms, often intermingled with other faxes sent to a general fax line, making it difficult to rapidly identify the highest priority cases for outreach and monitoring. We present an AI-based system capable of real-time identification and triage of handwritten faxed COVID-19 forms. The system relies on two models: one model to identify which received pages correspond to case report forms, and a second model to extract information from the set of identified case reports. We evaluated the system on a set of 1,224 faxes received by a local health department over a two-week period. For the 88% of faxes of sufficient quality, the system detects COVID-19 reports with high precision, 0.98, and high recall, 0.91. Among all received COVID-19 faxes, the system identifies high priority cases with a specificity of 0.87, a precision of 0.46 and recall of 0.83. Our system can be adapted to new forms, after a brief training period. Covid Fast Fax can support local health departments in their efforts to control the spread of COVID-19 and limit its impact on the community. The tool is freely available.

scholarly journals Viruses without Borders: Deadly Outbreaks of the 21st Century

2019 ◽  
Vol 3 (1) ◽  
Keyword(s):  
21St Century ◽  
Ebola Virus ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Mosquito Vectors ◽  
The Past ◽  
International Borders ◽  
The World ◽  
Health Experts

Rapid trends in globalization, increase in population, and genetic diversity of viruses collectively provide grounds for emergence and reemergence of viral outbreaks that are threats to overall continuum of human development. In addition to human factors, environmental factors such as water, soil, mosquito vectors and animals are also contributing to the outbreaks of viral diseases. In the past two decades, we have witnessed some of the deadly viral epidemics of the 21st century such as the Ebola virus epidemic in West Africa [1], Yellow Fever outbreak in Angola [2], the 2009 flu pandemic [3]. Dengue Fever [4], and Zika outbreak especially in Brazil [5], just a few to mention. From such outbreaks occurring unpredictably around the world, infectious diseases epidemiologists and global health experts acknowledge viruses have now evolved to rapidly cross international borders. In countries where resources of rapid viral detection and prevention programs are indeed limited, these outbreaks have produced devastating consequences not only overwhelming the local health departments’ capacity to confront the epidemics, but also, they have had serious and measurable devastating effects on economy and human productivity [6].

scholarly journals Building Back Better: Local Health Department Engagement and Integration of Health Promotion into Hurricane Harvey Recovery Planning and Implementation

2019 ◽  
Vol 16 (3) ◽  
pp. 299 ◽  
Author(s):  
Mallory Kennedy ◽  
Shannon Gonick ◽  
Hendrika Meischke ◽  
Janelle Rios ◽  
Nicole Errett
Keyword(s):  
Disaster Recovery ◽  
Technical Assistance ◽  
Health Department ◽  
Decision Makers ◽  
Health Impacts ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Recovery Planning ◽  
Resilient Communities

Disaster recovery provides an opportunity to build healthier and more resilient communities. However, opportunities and challenges encountered by local health departments (LHDs) when integrating health considerations into recovery have yet to be explored. Following Hurricane Harvey, 17 local health and emergency management officials from 10 agencies in impacted Texas, USA jurisdictions were interviewed to describe the types and level of LHD engagement in disaster recovery planning and implementation and the extent to which communities leveraged recovery to build healthier, more resilient communities. Interviews were conducted between December 2017 and January 2018 and focused on if and how their communities were incorporating public health considerations into the visioning, planning, implementation, and assessment phases of disaster recovery. Using a combined inductive and deductive approach, we thematically analyzed interview notes and/or transcripts. LHDs reported varied levels of engagement and participation in activities to support their community’s recovery. However, we found that LHDs rarely articulated or informed decision makers about the health impacts of recovery activities undertaken by other sectors. LHDs would benefit from additional resources, support, and technical assistance designed to facilitate working across sectors and building resilience during recovery.

Employer Requirements to Work during Emergency Responses: Key Ethics Considerations

2017 ◽  
Vol 45 (S1) ◽  
pp. 73-76 ◽  
Author(s):  
Lainie Rutkow ◽  
Holly A. Taylor ◽  
Tia Powell
Keyword(s):  
Emergency Preparedness ◽  
Health Workers ◽  
Health Department ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Local Public Health ◽  
Public Health Workers ◽  
Emergency Responses

Local health departments and their employees are at the forefront of emergency preparedness and response. Yet, recent studies have found that some local public health workers are unwilling to report to work in a variety of disaster scenarios. This can greatly compromise a response, as many local health departments need “all hands on deck” to effectively meet increased demands. To address these concerns, local health departments have employed varied policy strategies to ensure that employees do report to work. After describing different approaches taken by local health departments throughout the United States, we briefly identify and explore key ethics considerations that arise for local health departments when employees are required to report to work for emergency responses. We then discuss how these ethics considerations may inform local health department practices intended to promote a robust emergency response.

scholarly journals Evaluating Streetscape Modifications in Los Angeles, California with a Health Lens

2019 ◽  
Vol 17 (1) ◽  
pp. 10-23
Author(s):  
Gabrielle Green ◽  
Lauren N. Gase ◽  
Chandini Singh ◽  
Tony Kuo
Keyword(s):  
Los Angeles ◽  
Built Environment ◽  
Driver Behavior ◽  
Health Department ◽  
Local Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Health Practitioners

Background and Purpose: Despite growing evidence linking health and the built environment, local health departments are often not involved in the evaluation of a streetscape modification project. This paper describes an assessment conducted by a local health department to address this gap by using a health lens to evaluate the installation of painted curb extensions on a commercial corridor in Los Angeles. Methods: The local health department conducted an observational pre-post study of pedestrian and motorist data at both an intersection receiving the painted curb extension and a comparison intersection along the same corridor that had already received the extension. The study also analyzed streetscape features along the corridor related to walkability, to understand the painted curb extension in the context of the broader built environment. Results: The painted curb extension did not appear to significantly impact pedestrian and motorist behavior, though some slight changes were observed. Pedestrians along the corridor generally exhibited safe behavior at intersections, but encountered dangerous driver behavior and built environment barriers, which can discourage walking. Conclusion: This case study demonstrates how health considerations can be integrated into an evaluation of a streetscape modification project, and can provide guidance for other health practitioners developing such evaluation projects in their own jurisdictions.

scholarly journals Indicators to Guide and Monitor Climate Change Adaptation in the US Pacific Northwest

2020 ◽  
Vol 110 (2) ◽  
pp. 180-188
Author(s):  
Annie Doubleday ◽  
Nicole A. Errett ◽  
Kristie L. Ebi ◽  
Jeremy J. Hess
Keyword(s):  
Climate Change ◽  
Pacific Northwest ◽  
Climate Change Adaptation ◽  
Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
The Us ◽  
State And Local ◽  
Context Specific

Objectives. To develop a set of indicators to guide and monitor climate change adaptation in US state and local health departments. Methods. We performed a narrative review of literature on indicators of climate change adaptation and public health service capacity, mapped the findings onto activities grouped by the Centers for Disease Control and Prevention’s Ten Essential Services, and drafted potential indicators to discuss with practitioners. We then refined the indicators after key informant interviews with 17 health department officials in the US Pacific Northwest in fall 2018. Results. Informants identified a need for clarity regarding state and local public health’s role in climate change adaptation, integration of adaptation into existing programs, and strengthening of communication, partnerships, and response capacity to increase resilience. We propose a set of climate change indicators applicable for state and local health departments. Conclusions. With additional context-specific refinement, the proposed indicators can aid agencies in tracking adaptation efforts. The generalizability, robustness, and relevance of the proposed indicators should be explored in other settings with a broader set of stakeholders.

scholarly journals Regional Governance of Syndromic Surveillance for the Texas Gulf Coast

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Wesley McNeely ◽  
Eunice R. Santos ◽  
Biru Yang ◽  
Kiley Allred ◽  
Raouf R. Arafat
Keyword(s):  
Public Health ◽  
Communities Of Practice ◽  
Syndromic Surveillance ◽  
Health Department ◽  
Regional Governance ◽  
Local Health ◽  
Health Departments ◽  
Care Providers ◽  
Local Health Departments ◽  
Syndromic Surveillance System

ObjectiveDescribe and explain the transition of the syndromic surveillanceprogram at the Houston Health Department (HHD) from being alocally managed and aging system to an ESSENCE system governedby a regional Consortium of public health agencies and stakeholdersin the 13-county area of the southeast Texas.IntroductionSyndromic surveillance systems are large and complex technologyprojects that increasingly require large investments of financial andpolitical capital to be sustainable. What was once a minor surveillancetool in the mid-2000s has evolved into a program that is regardedas valuable to public health yet is increasingly difficult to maintainand operate for local health departments. The Houston HealthDepartment installed a syndromic surveillance system (SyS) sixyears before Meaning Use became known to healthcare communities.The system chosen at the time was the Real-time Outbreak DiseaseSurveillance System (RODS) which, at the time and for its purpose,was a suitable platform for syndromic surveillance. During the past13 years however, maintaining, operating, and growing a SyS by alocal health department has become increasingly difficult. Inclusionin Meaningful Use elevated the importance and profile of syndromicsurveillance such that network growth, transparency of operations,ease of data sharing, and cooperation with other state systems inTexas became program imperatives.MethodsWith support from the informatics group at Tarrant County PublicHealth (TCPH) in the form of mentoring, HHD devised a two prongstrategy to re-invigorate the syndromic program. The first was toreplace RODS with ESSENCE from Johns Hopkins Applied PhysicsLaboratory (JH/APL). The second was to strengthen the regionalnetwork by creating a governance structure that included outsideagencies and stakeholders. The product of this second effort wasthe creation of the Syndromic Surveillance Consortium of SoutheastTexas (SSCSeT) on the Communities of Practice model1usingparliamentary procedure2.ResultsAcquiring ESSENCE and forming SSCSeT were necessary stepsfor the continuing operation of the SyS. The Consortium includesmembers from local health jurisdictions, health care providers, healthpolicy advocates, academicians, and data aggregators. Created asa democratic society, SSCSeT wrote its constitution and by-laws,voted in officers, formed working groups and has begun developingpolicies. The Consortium is cooperating with the Texas Departmentof State Health Services (DSHS) as well as TCPH. Having ESSENCEwill ensure the HHD-SyS will conform to standards being developedin the state and provide a robust syndromic platform for the partnersof the Consortium.ConclusionsSyndromic systems operated by local health departments canadapt to regulatory changes by growing their networks and engagingregional stakeholders using the Communities of Practice model.

scholarly journals Automatic Contact Tracing for Outbreak Detection Using Hospital Electronic Medical Record Data

2020 ◽  
Author(s):  
Michael E DeWitt
Keyword(s):  
Local Level ◽  
Outbreak Detection ◽  
Contact Tracing ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Public Health Professionals ◽  
Record Data ◽  
Insight Into ◽  
Adequate Staffing

Contact tracing is a well-known tool for public health professionals to trace and isolate contacts of known infectious persons. During a pandemic contact tracing is critical to ending an outbreak, but the volume of cases makes tracing difficult without adequate staffing tools. Hospitals equipped with electronic medical records can utilize these databases to automatically link cases into possible transmission chains and surface potential new outbreaks. While this automatic contact tracing does not have the richness of contact tracing interviews, it does provide a way for health systems to highlight potential super-spreader events and support their local health departments. Additionally, these data provide insight into how a given infection is spreading locally. These insights can be used to inform policy at the local level.

scholarly journals Training and Incorporating Students in SARS-CoV-2 Case Investigations and Contact Tracing

2020 ◽  
pp. 003335492097466
Author(s):  
Kristen Pogreba Brown ◽  
Erika Austhof ◽  
Ayeisha M. Rosa Hernández ◽  
Caitlyn McFadden ◽  
Kylie Boyd ◽  
...  
Keyword(s):  
Public Health ◽  
Call Center ◽  
Online Survey ◽  
Contact Tracing ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Data Quality Control ◽  
Public Health Response ◽  
Health Response

Objectives In June 2020, Arizona had the fastest-growing number of cases of coronavirus disease 2019 (COVID-19) worldwide. As part of the growing public health response, the University of Arizona Student Aid for Field Epidemiology Response (SAFER) team was able to modify and increase case investigation efforts to assist local health departments. We outline the recommended logistical and management steps to include students in a public health response of this scope. Methods From April 1 through September 1, 2020, the SAFER team identified key components of a successful student team response: volunteer training, management that allows more senior students to manage newer students, adoption of case-management software, and use of an online survey platform for students to conduct interviews consistently and allow for data quality control and management. Results From April 1 through September 1, 2020, SAFER worked with 3 local health departments to complete 1910 COVID-19 case investigations through a virtual call center. A total of 233 volunteers and 46 hourly student workers and staff members were involved. As of September 2020, students were completing >150 interviews per week, including contact-tracing efforts. Practice Implications Developing relationships between applied public health and academic programs can relieve the burden of low-risk, high-volume case investigations at local and state health departments. Furthermore, by establishing a virtual call center, health sciences faculty and students can volunteer remotely during a pandemic with no additional risk of infection.

scholarly journals Assessment of Missing Immunizations and Immunization-Related Barriers among WIC Populations at the Local Level

2007 ◽  
Vol 122 (5) ◽  
pp. 602-606 ◽  
Author(s):  
Tista S. Ghosh ◽  
Jennifer L. Patnaik ◽  
Anne Bennett ◽  
Lynn Trefren ◽  
Richard L. Vogt
Keyword(s):  
Local Level ◽  
Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Childhood Immunization ◽  
Targeted Interventions ◽  
Immunization Status ◽  
Immunization Rates ◽  
Supplemental Nutrition Program

Objective. Low childhood immunization rates have been a challenge in Colorado, an issue that was exacerbated by a diphtheria-tetanus-acellular pertussis (DTaP) vaccine shortage that began in 2001. To combat this shortage, the locally based Tri-County Health Department conducted a study to assess immunization-related barriers among children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk for undervaccination. Methods. This study assessed characteristics and perceptions of WIC mothers in conjunction with their children's immunization status in four clinics. Results. Results indicated poor immunization rates, which improved with assessment and referral. The uninsured were at higher risk for undervaccination. DTaP was the most commonly missing vaccine, and discrepancies existed between the children's perceived and actual immunization status, particularly regarding DTaP. Targeted interventions were initiated as a result of this study. Conclusion. Local health departments should target immunization-related interventions by assessing their own WIC populations to identify unique vaccine-related deficiencies, misperceptions, and high-risk subpopulations.

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