scholarly journals Integrated packages of non-pharmaceutical interventions increased public health response efficiency against COVID-19 during the first European wave: evidence from 32 European countries

2020 ◽  
Author(s):  
Andres Garchitorena ◽  
Hugo Gruson ◽  
Bernard Cazelles ◽  
Tommi Karki ◽  
Bertrand Sudre ◽  
...  
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Risk Groups ◽  
Economic Consequences ◽  
European Countries ◽  
Public Health Response ◽  
Incidence Data ◽  
Age Structured ◽  
Pharmaceutical Interventions ◽  
At Home

AbstractIntroductionSince the emergence of SARS-CoV-2, governments have implemented a combination of public health responses based on non-pharmaceutical interventions (NPIs), with significant social and economic consequences. Quantifying the efficiency of different NPIs implemented by European countries to overcome the first epidemic wave could inform preparedness for forthcoming waves.MethodsWe used a dataset compiled by the European Centre for Disease Control (ECDC) on daily COVID-19 incidence, mortality and NPI implementation in 32 European countries. We adapted a capture-recapture method to limit non-reporting bias in incidence data, which we fitted to an age-structured mathematical model coupled with Monte Carlo Markov Chain to quantify the efficiency of 258 public health responses (PHR, a combination of several NPIs) in reducing SARS-Cov-2 transmission rates. From these PHR efficiencies, we used time series analyses to isolate the effect of 13 NPIs at different levels of implementation (fully implemented vs. partially relaxed).ResultsPublic health responses implemented in Europe led to a median decrease in viral transmission of 71%, enough to suppress the epidemic. PHR efficiency was positively associated with the number of NPIs implemented simultaneously. The largest effect among NPIs was observed for stay at home orders targeted at risk groups (β=0.24, 95%CI 0.16-0.32) and teleworking (β=0.23, 95%CI 0.15-0.31), followed by enforced stay at home orders for the general population, closure of non-essential businesses and services, bans on gatherings of 50 individuals or more, and closure of universities. Partial relaxation of most NPIs resulted in lower than average or non-significant changes in response efficiency.ConclusionThis large-scale estimation of NPI and PHR efficiency against SARS-COV-2 transmission in Europe suggests that a combination of NPIs targeting different population groups should be favored to control future epidemic waves.

scholarly journals Public Health Workforce Burnout in the COVID-19 Response in the U.S.

2021 ◽  
Vol 18 (8) ◽  
pp. 4369
Author(s):  
Kahler W. Stone ◽  
Kristina W. Kintziger ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Work Experience ◽  
Large Scale ◽  
Health Workers ◽  
Public Health Workforce ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional ◽  
The U.S

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.

Cross-contamination in molecular laboratories: A challenge to COVID-19 testing in Bangladesh

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Mohammad Jahidur Rahman Khan ◽  
◽  
Selim Reza ◽  
Farzana Mim ◽  
Md Abdullah Rumman ◽  
...  
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Diagnostic Testing ◽  
Diagnostic Errors ◽  
Laboratory Diagnosis ◽  
Cross Contamination ◽  
Rt Pcr ◽  
Public Health Response ◽  
Surveillance Programs ◽  
The Government

Rapid and accurate laboratory diagnosis of SARS-CoV-2 infection is crucial for the management of COVID-19 patients and control of the spread of the virus. At the start of the COVID-19 pandemic, Bangladesh had only one government molecular laboratory where real-time RT-PCR will be performed to diagnose SARS-CoV-2 infection. With the increasing number of suspected cases requiring confirmation diagnostic testing, there was a requirement to quickly expand capacity for large-scale testing. The government of Bangladesh established over 100 molecular laboratories within one year to test COVID-19. To fulfil the requirement for expanded testing, the government was compelled to recruit laboratory employees with inadequate experience, technical knowledge, and skills in molecular assays, particularly in processing specimens, interpreting results, recognizing errors, and troubleshooting. As a result, the risk of diagnostic errors, such as cross-contamination, is increased, as is that the risk of false-positive results, which might risk the patient’s health and undermine the efficacy of public health policies, public health response, surveillance programs, and restrictive measures aimed toward containing the outbreak. This review article aims to explain different sources of crosscontamination in the COVID-19 RT-PCR laboratories and the way to forestall them in efficient and practical ways.

scholarly journals Fall 2021 Resurgence and COVID-19 Seroprevalence in Canada: Modelling waning and boosting COVID-19 immunity in Canada, A Canadian Immunization Research Network Study

2021 ◽  
Author(s):  
David W Dick ◽  
Lauren M Childs ◽  
Zhilan Feng ◽  
Jing Li ◽  
Gergely Rost ◽  
...  
Keyword(s):  
Large Scale ◽  
Severe Disease ◽  
Booster Vaccination ◽  
Late Summer ◽  
Research Network ◽  
Canadian Population ◽  
Waning Immunity ◽  
Age Structured ◽  
Age Structured Model ◽  
Pharmaceutical Interventions

There is a threat of COVID-19 resurgence in Fall 2021 in Canada. To understand the probability and severity of this threat, quantification of the level of immunity/protection of the population is required. We use an age-structured model including infection, vaccination and waning immunity to estimate the distribution of immunity to COVID-19 in the Canadian population. By late Summer 2021, coinciding with the end of the vaccination program, we estimate that 60 - 80% of the Canadian population will have some immunity to COVID-19. Model results show that this level of immunity is not sufficient to stave off a Fall 2021 resurgence. The timing and severity of a resurgence, however, varies in magnitude given multiple factors: relaxation of non-pharmaceutical interventions such as social distancing, the rate of waning immunity, the transmissibility of variants of concern, and the protective characteristics of the vaccines against infection and severe disease. To prevent large-scale resurgence, booster vaccination and/or re-introduction of public health mitigation may be needed.

scholarly journals Changes in Solo and Partnered Sexual Behaviors during the COVID-19 Pandemic: Findings from a U.S. Probability Survey

2020 ◽  
Author(s):  
Devon J. Hensel ◽  
Molly Rosenberg ◽  
Maya Luetke ◽  
Tsung-chieh Fu ◽  
Debby Herbenick
Keyword(s):  
Public Health ◽  
Depressive Symptoms ◽  
Sexual Behaviors ◽  
Multinomial Logistic Regression ◽  
Well Being ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional ◽  
Item Scale ◽  
At Home

AbstractBackgroundResearch demonstrates that pandemics adversely impact sexual and reproductive health (SRH), but few have examined their impact on people’s participation in sex. We examined self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the public health response to COVID-19.MethodsWe conducted an online, nationally representative, cross-sectional survey of U.S. adults (N=1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted multinomial logistic regression to examine past month self-reported changes (decreased, stable or increased) in ten solo and partnered sexual behaviors. Predictor variables included: having children at home, past month depressive symptoms, (ACHA 3-item scale), past month loneliness (UCLA 3-Item Loneliness scale), COVID-19 protection behaviors (adapted 12-item scale), perceived COVID-19 consequences (adapted 10-item scale) and COVID-19 knowledge (adapted 10-item scale).ResultsNearly half of all adults reported some kind of change – most commonly, a decrease – in their sexual behavior in the past month. Having elementary aged children at home, past month depressive symptoms and loneliness and enacting more COVID-19 protective behaviors were associated with both reduced partnered bonding behaviors, such as hugging, cuddling, holding hands and kissing, as well as reduced partnered sexual behaviors, such as oral sex, partnered genital touching and vaginal sex. Greater COVID-19 risk perception and greater COVID-19 knowledge were associated with mixed effects in behavior outcomes.ConclusionsOur data illustrate the very personal ways in which different pandemic-associated factors may create or inhibit opportunities for solo and partnered sex. The centrality of sexuality to health and well-being – even during pandemics – means that a critical piece of public health prevention and management responses should is ensuring that services and resource that support positive sexual decision making remain open and available.

Bioterrorism

2021 ◽  
pp. 287-296
Author(s):  
Peter Katona
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Global Economy ◽  
Large Scale ◽  
Severe Disease ◽  
Public Health Response ◽  
Health Response ◽  
Bioterrorism Agent ◽  
Public Health Surveillance System

History shows us that individuals have used and likely will continue to use biological agents for terrorism purposes. Bioterrorism agents can be easily disseminated, cause severe disease and high mortality rates if cases are not treated properly, and pose significant challenges for management and response. A robust public health surveillance system that includes laboratory (including routine reportable disease surveillance), syndromic, and environmental surveillance is crucial for detection of the release of a bioterrorism agent and the resulting cases. This detection can then set into motion a robust and comprehensive public health response to minimize morbidity and mortality. A large-scale bioterrorism event would be unprecedented, straining and challenging every facet of medical and public health response and would quickly become a global emergency because of both the potential risk of infection and the shock to the global economy. A robust public health and medical workforce is necessary to respond effectively and efficiently to these types of events.

Tracking antimicrobials dispensed during an anthrax attack: A case study from the New Hampshire anthrax exercise

2011 ◽  
Vol 9 (1) ◽  
pp. 65
Author(s):  
Jeanne Tropper, MS, MPH ◽  
Chris Adamski, RN, MSN ◽  
Cynthia Vinion, MEA ◽  
Sanjeeb Sapkota, MBBS, MPH
Keyword(s):  
Public Health ◽  
New Hampshire ◽  
Large Scale ◽  
Performance Metrics ◽  
Automated System ◽  
Rural Setting ◽  
Public Health Services ◽  
Public Health Response ◽  
Health Response

The Countermeasure and Response Administration (CRA) system is a Centers for Disease Control and Prevention informatics application developed to track countermeasures, including medical interventions (eg, vaccinations and pharmaceuticals) and nonmedical interventions (eg, patient isolation, quarantine, and personal protective equipment), administered during a public health response. This case study follows the use of CRA as a supplement to paper-based processes during an exercise in which antimicrobials dispensed to individual exposed persons were captured after a simulated bioterrorist attack of anthrax spores. The exercise was conducted by the New Hampshire Division of Public Health Services on April 14, 2007.Automated systems like CRA can track when medications are dispensed. The data can then be used for performance metrics, statistics, and in locating victims for follow-up study. Given that this case study was limited to a single location in a relatively rural setting, the authors concluded that more study is needed to compare the feasibility of using an automated system rather than paper-based processes for effectively managing a very large-scale urgent public health response.

scholarly journals A simple model to assess Wuhan lock-down effect and region efforts during COVID-19 epidemic in China Mainland

2020 ◽  
Author(s):  
Zheming Yuan ◽  
Yi Xiao ◽  
Zhijun Dai ◽  
Jianjun Huang ◽  
Yuan Chen
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Human Mobility ◽  
Transmission Risk ◽  
Factors Affecting ◽  
The Government ◽  
Lower Transmission ◽  
China Mainland ◽  
Transmission Ability ◽  
At Home

AbstractSince COVID-19 emerged in early December, 2019 in Wuhan and swept across China Mainland, a series of large-scale public health interventions, especially Wuhan lock-down combined with nationwide traffic restrictions and Stay At Home Movement, have been taken by the government to control the epidemic. Based on Baidu Migration data and the confirmed cases data, we identified two key factors affecting the later (e.g February 27, 2020) cumulative confirmed cases in non-Wuhan region (y). One is the sum travelers from Wuhan during January 20 to January 26 (x1), which had higher infected probability but lower transmission ability because the human-to-human transmission risk of COVID-19 was confirmed and announced on January 20. The other is the “seed cases” from Wuhan before January 19, which had higher transmission ability and could be represented with the confirmed cases before January 29 (x2) due to a mean 10-day delay between infection and detection. A simple yet effective regression model then was established as follow: y= 70.0916+0.0054×x1+2.3455×x2 (n = 44, R2 = 0.9330, P<10−7). Even the lock-down date only delay or in advance 3 days, the estimated confirmed cases by February 27 in non-Wuhan region will increase 35.21% or reduce 30.74% - 48.59%. Although the above interventions greatly reduced the human mobility, Wuhan lock-down combined with nationwide traffic restrictions and Stay At Home Movement do have a determining effect on the ongoing spread of COVID-19 across China Mainland. The strategy adopted by China has changed the fast-rising curve of newly diagnosed cases, the international community should learn from lessons of Wuhan and experience from China. Efforts of 29 Provinces and 44 prefecture-level cities against COVID-19 were also assessed preliminarily according to the interpretive model. Big data has played and will continue playing an important role in public health.

scholarly journals 4.C. Round table: Recovering from the COVID-19 Pandemic: Identifying and Acting Upon Lessons Learned

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
Lessons Learned ◽  
European Countries ◽  
Scientific Uncertainty ◽  
Health Practice ◽  
Public Health Response ◽  
The Public ◽  
Health Response ◽  
Wide Range

Abstract   The COVID-19 pandemic has revealed many gaps and vulnerabilities in health systems and pandemic preparedness in European countries. It has also led to innovation and rapid improvements in certain elements of public health practice. One defining characteristic of the COVID-19 pandemic has been the rapid advance of scientific knowledge, accompanied by high degrees of scientific uncertainty. Each phase (or “wave”) of the pandemic has presented unique challenges. This workshop involves public health practitioners from multiple European countries. They will reflect upon some over-arching lessons learned through their experiences in the field, while also alluding to important innovations in public health that should be safeguarded for the future. The panellists will also discuss how lessons learned can be systematically identified and acted upon, through approaches such as after-action reviews (AARs), in order to optimise the public health response to the ongoing COVID-19 pandemic as well as to future ones. The panel discussion format of this workshop adds value to EUPHA 2021 participant through hearing, in a relatively informal format, the experiences from senior staff at national public health agencies from a variety of European countries and contexts. This approach keeps a coherence between speakers will also highlighting the unique challenges posed by specific national contexts. This workshop will also consider how processes such as AARs can be formalised to become routine aspects of public health practice. Particular attention will be paid to challenges and solutions that are similar across national boundaries. During the workshop, the moderator will ensure that the panelists responses are short and succinct. The final 15 minutes will be dedicated to questions from the audience. Speakers/Panelists Flavia Riccardo ISS, Rome, Italy Ute Rexroth RKI, Berlin, Germany Tanya Melillo Directorate of Health Promotion and Disease Prevention, MSIDA, Malta Mario Fafangel National Institute of Public Health, Ljubljana, Slovenia Key messages In order to guide the public health response to the COVID-19 pandemic as well as to future pandemics, it is essential to systematically identify lessons learned as well as innovative good practices. Identifying lessons learned, however, is only a first step as it is essential to develop action plans that are supported and endorsed across a wide range of stakeholders.

scholarly journals Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action

10.2196/18810 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e18810 ◽  
Author(s):  
Robin Ohannessian ◽  
Tu Anh Duong ◽  
Anna Odone
Keyword(s):  
Public Health ◽  
National Health ◽  
Large Scale ◽  
The United States ◽  
Response Strategy ◽  
World Health ◽  
Public Health Response ◽  
Levels Of Care ◽  
Health Response ◽  
Health Organization

On March 11, 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) outbreak as a pandemic, with over 720,000 cases reported in more than 203 countries as of 31 March. The response strategy included early diagnosis, patient isolation, symptomatic monitoring of contacts as well as suspected and confirmed cases, and public health quarantine. In this context, telemedicine, particularly video consultations, has been promoted and scaled up to reduce the risk of transmission, especially in the United Kingdom and the United States of America. Based on a literature review, the first conceptual framework for telemedicine implementation during outbreaks was published in 2015. An updated framework for telemedicine in the COVID-19 pandemic has been defined. This framework could be applied at a large scale to improve the national public health response. Most countries, however, lack a regulatory framework to authorize, integrate, and reimburse telemedicine services, including in emergency and outbreak situations. In this context, Italy does not include telemedicine in the essential levels of care granted to all citizens within the National Health Service, while France authorized, reimbursed, and actively promoted the use of telemedicine. Several challenges remain for the global use and integration of telemedicine into the public health response to COVID-19 and future outbreaks. All stakeholders are encouraged to address the challenges and collaborate to promote the safe and evidence-based use of telemedicine during the current pandemic and future outbreaks. For countries without integrated telemedicine in their national health care system, the COVID-19 pandemic is a call to adopt the necessary regulatory frameworks for supporting wide adoption of telemedicine.

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