scholarly journals If long-term suppression is not possible, how do we minimize mortality for COVID-19 and other emerging infectious disease outbreaks?

2020 ◽  
Author(s):  
Andreas Handel ◽  
Joel C. Miller ◽  
Yang Ge ◽  
Isaac Chun-Hai Fung
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Care ◽  
Health Care System ◽  
Disease Outbreaks ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Infectious Disease Outbreaks ◽  
Long Time

As COVID-19 continues to spread, public health interventions are crucial to minimize its impact. The most desirable goal is to drive the pathogen quickly to extinction. This generally involves applying interventions as strongly as possible, which worked for SARS, but so far has failed for COVID-19. If fast eradication is not achievable, the next best goal is to delay the spread and minimize cases and burden on the health care system until suitable drugs or vaccines are available. This suppression approach also calls for strong interventions, potentially applied for a long time.

Emotional determinants of public responses to the risk of epidemics and pandemics: a systematic review

2021 ◽  
Author(s):  
Antonis A. Kousoulis ◽  
Mark R. Francis ◽  
Imogen Grant ◽  
Heidi J Larson
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Systematic Review ◽  
Public Health Intervention ◽  
Disease Outbreaks ◽  
Population Level ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Infectious Disease Outbreaks ◽  
Intervention Uptake

Abstract Background Understanding how people’s emotions influence their health decisions and behaviours at a population level is fundamental to designing effective communication strategies and public health interventions for infectious disease outbreaks. This review identifies relevant research to assess the role of emotional determinants and their impact on public responses to the risk of infectious disease outbreaks, specifically in relation to the uptake of public health interventions. Methods A comprehensive systematic review was conducted exploring the differences in public responses by emotion, infection, outcome and region. A basic consensus approach was followed in which emotional stimuli were categorised as being either pleasant or unpleasant, and predisposing people to bivalent behaviour (i.e., approach or withdrawal). All primary research studies published in five global databases between 1988-2019 were eligible for inclusion. Binomial tests (against a test proportion of 0.5 or 50% for each study outcome) were performed using the direction of effect observed in each study, i.e., either favouring or not favouring intervention uptake. Results A total of 75 studies from 28 different nations were eligible for inclusion in the review. A total of 97 correlations were made between 12 emotions, 10 infectious diseases, and the uptake of seven types of public health interventions. Unpleasant emotions were evoked much more often than pleasant following public health risk communications, with fear and anxiety being the most common. Overall, moderate anxiety-related emotions (worry, anxiety, stress, concern) seemed to be much more significant motivators for public action compared to extreme unpleasant emotions (fear, panic, hopelessness, shame), which had a statistically significantly negative effect on the uptake of public health interventions in several cases. Pleasant emotions (empathy, hope) also showed promise as motivators for public health intervention uptake, but more research is needed to corroborate this. Conclusions The results of this review show that the public’s emotional responses to epidemics in the past 30 years have played a clear role in determining how successful the rollout of public health interventions has been. Emotions need to be considered in crisis communications, and these research findings can help inform communications strategies in the evolving context of the COVID-19 pandemic and future infectious disease outbreaks.

scholarly journals A case study of the evaluation of a public health intervention

2006 ◽  
Vol 30 (4) ◽  
pp. 458 ◽  
Author(s):  
Bradley Forssman ◽  
Leena Gupta ◽  
Graham Burgess
Keyword(s):  
Public Health ◽  
Public Health Intervention ◽  
Disease Outbreaks ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Public Health Action ◽  
Infectious Disease Outbreaks ◽  
Evaluation Approach ◽  
South Wales ◽  
Health Action

Large public health interventions to control infectious disease outbreaks are common, but rigorous evaluation to improve the quality and effectiveness of these is rarely undertaken. Following a large community-based clinic to prevent a hepatitis A outbreak, a multifaceted and multidisciplinary evaluation was conducted involving consumers, health professionals and industry partners. The results of this evaluation were used to produce practical operational guidelines for the planning and conduct of future interventions. These guidelines have been distributed to all public health units in New South Wales and may be included in the next edition of the NSW Health notifiable diseases manual. The evaluation approach can be applied to all public health interventions across NSW and Australia to assist in the development of operational guidelines, in order to increase the quality of public health action in outbreak prevention.

scholarly journals An ethical and prudential argument for prioritizing the reduction of parasite-stress in the allocation of health care resources

2012 ◽  
Vol 35 (2) ◽  
pp. 90-91 ◽  
Author(s):  
Russell Powell ◽  
Steve Clarke ◽  
Julian Savulescu
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Care ◽  
Health Resources ◽  
Economic Benefits ◽  
Health Interventions ◽  
Human Populations ◽  
Public Health Interventions ◽  
Ethical Argument ◽  
The Social

AbstractThe link between parasite-stress and complex psychological dispositions implies that the social, political, and economic benefits likely to flow from public health interventions that reduce rates of non-zoonotic infectious disease are far greater than have traditionally been thought. We sketch a prudential and ethical argument for increasing public health resources globally and redistributing these to focus on the alleviation of parasite-stress in human populations.

scholarly journals Epidemic trends, public health response and health system capacity: the Chilean experience in four months of the COVID-19 pandemic

2020 ◽  
Vol 44 ◽  
pp. 1
Author(s):  
Mauricio Canals ◽  
Cristóbal Cuadrado ◽  
Andrea Canals ◽  
Karla Yohannessen ◽  
Luis A. Lefio ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care System ◽  
Health Interventions ◽  
System Capacity ◽  
Reproductive Number ◽  
Public Health Interventions ◽  
Public Health Response ◽  
System P ◽  
Care System

Objectives. To report the surveillance of COVID-19 pandemic in Chile and analyse the response to public health interventions implemented from 3 March to 30 June 2020 and to assess the risks of collapse of the health care system. Methods. We analysed the effective reproductive number, underreporting of cases, burden of critical beds, case fatality ratio and number of diagnostic RT-PCR for SARS-CoV-2. Results. After an accelerated onset, the COVID-19 pandemic seemed to be relatively controlled in Chile (late April 2020), with reproductive numbers close to 1.00. However, at this time, the load of infected patients was high, with an important number of underreported cases; the diagnostic effort was still limited and heterogeneous across regions. After 1 May up to 30 June a marked exponential increase in the number of cases was observed with a peak on June 14. In this last period the occupation of intensive care unit beds increased to saturation level (89% nationally; 95% in the Metropolitan Region). Conclusions. Our findings suggest that the implemented public health interventions have been initially effective in decreasing the spread of the pandemic. Premature decisions to relax these interventions may have resulted in a rebound in cases with a rapid saturation of the health care system.

scholarly journals What methods and challenges for taking account of context when transferring complex interventions?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias
Keyword(s):  
Public Health ◽  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Complex Interventions ◽  
Health Interventions ◽  
Care Providers ◽  
Public Health Interventions ◽  
Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

scholarly journals What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer B. Nuzzo ◽  
Diane Meyer ◽  
Michael Snyder ◽  
Sanjana J. Ravi ◽  
Ana Lapascu ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health System ◽  
Natural Hazards ◽  
Health Systems ◽  
Scoping Review ◽  
Disease Outbreaks ◽  
World Health ◽  
Infectious Disease Outbreaks ◽  
System Resilience

Abstract Background The 2014–2016 Ebola outbreak was a wake-up call regarding the critical importance of resilient health systems. Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Important work has been done to describe the general attributes of a health system resilient to these crises, and the next step will be to identify the specific capacities that health systems need to develop and maintain to achieve resiliency. Methods We conducted a scoping review of the literature to identify recurring themes and capacities needed for health system resiliency to infectious disease outbreaks and natural hazards and any existing implementation frameworks that highlight these capacities. We also sought to identify the overlap of the identified themes and capacities with those highlighted in the World Health Organization’s Joint External Evaluation. Sources of evidence included PubMed, Web of Science, OAIster, and the websites of relevant major public health organizations. Results We identified 16 themes of health system resilience, including: the need to develop plans for altered standards of care during emergencies, the need to develop plans for post-event recovery, and a commitment to quality improvement. Most of the literature described the general attributes of a resilient health system; no implementation frameworks were identified that could translate these elements into specific capacities that health system actors can employ to improve resilience to outbreaks and natural hazards in a variety of settings. Conclusions An implementation-oriented health system resilience framework could help translate the important components of a health system identified in this review into specific capacities that actors in the health system could work to develop to improve resilience to public health crises. However, there remains a need to further refine the concept of resilience so that health systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

scholarly journals Ethics of instantaneous contact tracing using mobile phone apps in the control of the COVID-19 pandemic

2020 ◽  
Vol 46 (7) ◽  
pp. 427-431 ◽  
Author(s):  
Michael J Parker ◽  
Christophe Fraser ◽  
Lucie Abeler-Dörner ◽  
David Bonsall
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Mobile Phone ◽  
Public Health Practice ◽  
Disease Outbreaks ◽  
Contact Tracing ◽  
Mobile Phone Data ◽  
Public Health Response ◽  
Infectious Disease Outbreaks ◽  
Ethical Implications

In this paper we discuss ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks and epidemics. However, the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this problem, many countries around the world have deployed or are developing mobile phone apps capable of supporting instantaneous contact tracing. Informed by the on-going mapping of ‘proximity events’ these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for ‘intelligent physical distancing’ in such contexts raises a number of important ethical questions. In our paper, we outline some ethical considerations that need to be addressed in any deployment of this kind of approach as part of a multidimensional public health response. We also, briefly, explore the implications for its use in future infectious disease outbreaks.

scholarly journals Fistula as a Public Health challenge in Pakistan

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Shamoon Noushad ◽  
Shershah Syed ◽  
Sadaf Ahmed
Keyword(s):  
Public Health ◽  
Obstetric Fistula ◽  
Secondary Data ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Healthcare Facilities ◽  
Public Health Challenge ◽  
Effective Public Health ◽  
The Impact

Aims: To explore the impact of obstetric fistula in the county and to propose effective public health interventions that can help to prevent the condition with a long-term goal of eradicating the condition. Methods: The survey and analysis included secondary data addressing women's experiences of fistula; dynamics and limitationsdetermining women's access to in healthcare facilities for fistula management; and restraintsof health professional as well as health inequities. Results: It was assessed that recently, many hospitals and organizations in the country go on board on intercessions to address the impact of the illness, however, much importance is on pinpointing and discussing the existing cases rather than focusing on public health interventions that can help to prevent and eventually eradicate the condition in Pakistan.

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