scholarly journals Health, housing, and ‘direct threats’ during a pandemic

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Jennifer K Wagner

Abstract The COVID-19 pandemic brought into stark relief the intimate nexus between health and housing. This extraordinary infectious disease outbreak combined with the astounding lack of a clear, coordinated, prompt, and effective public health response in the U.S. created conditions and introduced practical challenges that left many disoriented-not only health care providers but also housing providers. Innumerable issues are worth examination, such as implications of moratoria on evictions and foreclosures, force majeure contract clauses, insurability of pandemic-related damages and disruptions, holdover tenancies and delayed occupancies, and possible abatement of rent or homeowner/condominium association dues in light of closed common facilities (such as fitness areas) or reduced benefits to be enjoyed with residential property; however, this article focuses on fair housing law and the ``direct threat'' exemption; finds it unlikely that COVID-19 is a disability, likely that the ``direct threat'' defense is available, and both determinations to be case-specific inquiries dependent upon rapidly-changing scientific understanding of this disease. By highlighting adequate housing as a human right for which the government has primary responsibility for ensuring its achievement, this article underscores the importance of finding a holistic solution to public health and housing problems before the next public health emergency arises.

2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )


Author(s):  
Silvia Logar ◽  
Maggie Leese

Abstract Childhood detention represents an integral part of the public health response to the COVID-19 emergency. Prison conditions in Italy put detained minors at grave risk of contracting sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To date (29 April 2020), the Italian penitentiary system is housing 161 minors (147 males), most of them in pre-trial custody, as well as 50 children <3 y of age residing with their mothers in detention. Furthermore, the government reported 5265 unaccompanied minor migrants, mainly from Gambia and Egypt. The fundamental approach to be followed in childhood detention during COVID-19 is prevention of the introduction of infectious agents into detention facilities, limiting the spread within the prison and reducing the possibility of spread from the prison to the outside community. This appears challenging in countries like Italy with intense SARS-CoV-2 transmission. The current COVID-19 pandemic shows the need to provide a comprehensive childhood protection agenda, as the provision of healthcare for people in prisons and other places of detention is a state responsibility.


Author(s):  
Marcia Cruz-Correa ◽  
Elba C. Díaz-Toro ◽  
Jorge L. Falcón ◽  
Enid J. García-Rivera ◽  
Humberto M. Guiot ◽  
...  

Alliances between the government and academic communities can be a key component of the public health response to an emergency such as the coronavirus disease 2019 (COVID-19) pandemic. The Governor of Puerto Rico designated the Puerto Rico Medical Task Force (MTF) COVID-19 to provide direct guidance and evaluation of the government response to the epidemic in Puerto Rico. Several work groups were formed within the MTF to create protocols and provide evidence-based recommendations on different public health aspects. The collaboration between the academia and the government enhanced the Puerto Rican public health response and contributed to the reduction seen in the contagion curve. Healthcare services and hospitals have not reached their maximum patient care capacity and the death toll has been controlled. Incorporating a national MTF with members of the academia into the government structure was beneficial during the COVID-19 response in Puerto Rico. A similar strategy could serve as a model for other states or territories and countries in similar scenarios.


Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1175
Author(s):  
Ramalingam Shanmugam ◽  
Lawrence Fulton ◽  
Zo Ramamonjiarivelo ◽  
José Betancourt ◽  
Brad Beauvais ◽  
...  

COVID-19 (otherwise known as coronavirus disease 2019) is a life-threatening pandemic that has been combatted in various ways by the government, public health officials, and health care providers. These interventions have been met with varying levels of success. Ultimately, we question if the preventive efforts have reduced COVID-19 deaths in the United States. To address this question, we analyze data pertaining to COVID-19 deaths drawn from the Centers for Disease Control and Prevention (CDC). For this purpose, we employ incidence rate restricted Poisson (IRRP) as an underlying analysis methodology and evaluate all preventive efforts utilized to attempt to reduce COVID-19 deaths. Interpretations of analytic results and graphical visualizations are used to emphasize our various findings. Much needed modifications of the public health policies with respect to dealing with any future pandemics are compiled, critically assessed, and discussed.


2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Rene Borroto ◽  
Bill Williamson ◽  
Patrick Pitcher ◽  
Lance Ballester ◽  
Wendy Smith ◽  
...  

ObjectiveDescribe how the Georgia Department of Public Health (DPH) usessyndromic surveillance to initiate review by District Epidemiologists(DEs) to events that may warrant a public health response (1).IntroductionDPH uses its State Electronic Notifiable Disease SurveillanceSystem (SendSS) Syndromic Surveillance (SS) Module to collect,analyze and display results of emergency department patient chiefcomplaint data from hospitals throughout Georgia.MethodsDPH prepares a daily SS report, based upon the analysis ofdaily visits to 112 Emergency Department (EDs). The visits areclassified in 33 syndromes. Queries of chief complaint and dischargediagnosis are done using the internal query capability of SendSS-SSand programming in SAS/BASE. Charting of the absolute countsor percentage of ED visits by syndromes is done using the internalcharting capability of SendSS-SS. A daily SS report includes thefollowing sections:Statewide Emergency Department Visitsby Priority Syndromes(Bioterrorism, BloodyRespiratory,FeverRespiratory, FeverChest, FeverFluAdmit, FeverFluDeaths,VeryIll, andPoxRashFever, Botulism, Poison, BloodyDiarrhea,BloodyVomit, FeverGI, ILI, FeverFlu, RashFever, Diarrhea,Vomit).Statewide Flag Analysis: Is intended to detect statewideflags, by using theChartscapability in SendSS SS.Possible caseswith presumptive diagnosis of potentially notifiable diseases: Isintended to provide early-warning to the DEs of possible cases thatare reportable to public health immediately or within 7 days usingqueries in the Chief Complaint and Preliminary Diagnosis fields ofSendSS-SS.Possible clusters of illness: Since any cluster of illnessmust be reported immediately to DPH, this analysis is aimed atquerying and identifying possible clusters of patients with similarsymptoms (2).Possible travel-related illness: Is intended to identifypatients with symptoms and recent travel history.Other events ofinterest: Exposures to ill patients in institutional settings (e.g. chiefcomplaint indicates that other children in the daycare have similarsymptoms).Trend Analysis: Weekly analysis of seasonality andtrends of 14 syndromes. Finally, specific events are notified to andreviewed by the 18 DEs, who follow up by contacting the InfectionPreventionists of the hospitals to identify the patients using medicalrecords or other hospital-specific identification numbers and followup on the laboratory test results.ResultsSince 05/15/2016, 12 travel-related illnesses, 29 vaccine-preventable diseases, 14 clusters, and 3 chemical exposures havebeen notified to DEs. For instance, a cluster of chickenpox in childrenwas identified after the DE contacted the Infection Preventionist ofa hospital, who provided the DE with the laboratory results and thephysician notes about the symptoms of the patients. These actionshave resulted in earlier awareness of single cases or cluster of illness,prompt reporting of notifiable diseases, and successful interactionbetween DEs and health care providers. In addition, SS continues totrack the onset, peak, and decline of seasonal illnesses.ConclusionsThe implementation of SS in the State of Georgia is helping withthe timely detection and early responses to disease events and couldprove useful in reducing the disease burden caused by a bioterroristattack.


10.2196/19054 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19054 ◽  
Author(s):  
Patrick Sean Sullivan ◽  
Charles Sailey ◽  
Jodie Lynn Guest ◽  
Jeannette Guarner ◽  
Colleen Kelley ◽  
...  

Background The response in the United States to the coronavirus disease (COVID-19) pandemic has been hampered by a lack of aggressive testing for the infection. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cornerstone of an effective public health response. However, efforts to test have been hampered by limited reagents, limitations in the availability of swabs used for the collection of nasopharyngeal swab (NPS) specimens, limitations in personal protective equipment (PPE) for health care providers collecting the NPS specimens, and limitations in viral transport media for transporting the specimens. Therefore, more flexible options for screening for SARS-CoV-2 RNA and serologic responses are critical to inform clinical and public health responses. Objective We aim to document the ability of patients to self-collect sufficient specimens for SARS-CoV-2 viral detection and serology. Methods Patient self-collection of samples will be done with observation by a health care provider during a telemedicine session. Participants will be mailed a specimen collection kit, engage in a telehealth session with a provider through a HIPPA (Health Insurance Portability and Accountability Act of 1996)-compliant video meeting, and collect specimens while being observed by the provider. Providers will record whether they are confident in the suitability of the specimen for laboratory testing that would inform clinical decision making. We will objectively assess the sufficiency of biological material in the mailed-in specimens. Results The protocol was approved by the Emory University Institutional Review Board (IRB) on March 30, 2020 (Protocol number 371). To date, we have enrolled 159 participants. Conclusions Defining a conceptual framework for assessing the sufficiency of patient-collected samples for the detection of SARS-CoV-2 RNA and serologic responses to infection is critical for facilitating public health responses and providing PPE-sparing options to increase testing. Validation of alternative methods of specimen collection should include objective measures of the sufficiency of specimens for testing. A strong evidence base for diversifying testing modalities will improve tools to guide public health responses to the COVID-19 pandemic.


2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Stanley Kofi Alor Alor

Abstract There is no single public health response to COVID-19 worldwide. Every country has to adapt a response to contain the pandemic considering the health system capacity, the health of the economy, infrastructure and human right to avoid mistakes of other countries in the COVID-19 fight. There are basically two main approaches to the response so far. These are the mitigation and lockdown, test and treat approaches. Ghana has confirmed 152 cases with 5 deaths and adapted a hybrid kind of approach considering the context.


2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Alan Siniscalchi ◽  
Charlie Ishikawa

This project reviewed approaches used by public health agencies for alerting health care providers and enhancing surveillance systems to identify the presence of novel respiratory disease and to characterize their recent experience in searching for globally emerging viruses. Public health agencies continue to endeavor to develop and maintain cost-effective disease surveillance systems to better understand the burden of illness, especially newly emerging disease, within their jurisdiction. The importance of maintaining sufficient infrastructure and the trained personnel needed to operate these surveillance systems for optimal disease detection and public health response readiness cannot be understated.


Author(s):  
Patrick Sean Sullivan ◽  
Charles Sailey ◽  
Jodie Lynn Guest ◽  
Jeannette Guarner ◽  
Colleen Kelley ◽  
...  

BACKGROUND The response in the United States to the coronavirus disease (COVID-19) pandemic has been hampered by a lack of aggressive testing for the infection. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cornerstone of an effective public health response. However, efforts to test have been hampered by limited reagents, limitations in the availability of swabs used for the collection of nasopharyngeal swab (NPS) specimens, limitations in personal protective equipment (PPE) for health care providers collecting the NPS specimens, and limitations in viral transport media for transporting the specimens. Therefore, more flexible options for screening for SARS-CoV-2 RNA and serologic responses are critical to inform clinical and public health responses. OBJECTIVE We aim to document the ability of patients to self-collect sufficient specimens for SARS-CoV-2 viral detection and serology. METHODS Patient self-collection of samples will be done with observation by a health care provider during a telemedicine session. Participants will be mailed a specimen collection kit, engage in a telehealth session with a provider through a HIPPA (Health Insurance Portability and Accountability Act of 1996)-compliant video meeting, and collect specimens while being observed by the provider. Providers will record whether they are confident in the suitability of the specimen for laboratory testing that would inform clinical decision making. We will objectively assess the sufficiency of biological material in the mailed-in specimens. RESULTS The protocol was approved by the Emory University Institutional Review Board (IRB) on March 30, 2020 (Protocol number 371). To date, we have enrolled 159 participants. CONCLUSIONS Defining a conceptual framework for assessing the sufficiency of patient-collected samples for the detection of SARS-CoV-2 RNA and serologic responses to infection is critical for facilitating public health responses and providing PPE-sparing options to increase testing. Validation of alternative methods of specimen collection should include objective measures of the sufficiency of specimens for testing. A strong evidence base for diversifying testing modalities will improve tools to guide public health responses to the COVID-19 pandemic.


SURG Journal ◽  
2011 ◽  
Vol 4 (2) ◽  
pp. 12-20
Author(s):  
Thomas William Piggott

Alcohol abuse is attributed to four percent of the global burden of disease and associated with over 60 medical conditions. This burden is borne disproportionately by the indigenous peoples of our world. Two such indigenous populations, albeit far from one another, who are suffering from alcohol abuse are the San in Botswana and the First Nations in Canada. Both marginalised populations have high rates of alcohol abuse; however, there is a clear need for more research into the epidemiology. The public health response to alcohol abuse in indigenous populations is at a different stage in Canada and Botswana. In Canada, alcohol abuse among the First Nations has been on the agenda of public health since the release of the Indian Relations Paper in 1975. In Botswana, alcohol abuse among the San has yet to be recognized– the government response has been blind to ethnicity. This paper examines the similarities and differences between alcohol abuse issues, providing evidence that increased collaboration would lead to benefits for both populations. Neither side, those responsible for the public health of the San or First Nations, has an impeccable record – both sides could learn much from the successes and failures of the other, and other indigenous populations suffering from alcohol abuse globally.


Sign in / Sign up

Export Citation Format

Share Document