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

Author(s):  
Adam Lavertu ◽  
Alison Stribling ◽  
Matt White ◽  
Greg McInnes ◽  
Russ B. Altman ◽  
...  

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.

2006 ◽  
Vol 62 (1) ◽  
pp. 56-89 ◽  
Author(s):  
Heather MacDougall

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.


Author(s):  
Mallory Kennedy ◽  
Shannon Gonick ◽  
Hendrika Meischke ◽  
Janelle Rios ◽  
Nicole Errett

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.


2017 ◽  
Vol 45 (S1) ◽  
pp. 73-76 ◽  
Author(s):  
Lainie Rutkow ◽  
Holly A. Taylor ◽  
Tia Powell

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.


2019 ◽  
Vol 17 (1) ◽  
pp. 10-23
Author(s):  
Gabrielle Green ◽  
Lauren N. Gase ◽  
Chandini Singh ◽  
Tony Kuo

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.


2020 ◽  
Vol 110 (2) ◽  
pp. 180-188
Author(s):  
Annie Doubleday ◽  
Nicole A. Errett ◽  
Kristie L. Ebi ◽  
Jeremy J. Hess

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.


2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Wesley McNeely ◽  
Eunice R. Santos ◽  
Biru Yang ◽  
Kiley Allred ◽  
Raouf R. Arafat

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.


2007 ◽  
Vol 122 (5) ◽  
pp. 602-606 ◽  
Author(s):  
Tista S. Ghosh ◽  
Jennifer L. Patnaik ◽  
Anne Bennett ◽  
Lynn Trefren ◽  
Richard L. Vogt

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.


2017 ◽  
Vol 132 (4) ◽  
pp. 443-447 ◽  
Author(s):  
Rebecca J. Morey ◽  
Melissa G. Collier ◽  
Noele P. Nelson

When food handlers become ill with hepatitis A virus (HAV) infection, state and local health departments must assess the risk of HAV transmission through prepared food and recommend or provide postexposure prophylaxis (PEP) for those at risk for HAV infection. Providing PEP (eg, hepatitis A [HepA] vaccine or immunoglobulin), however, is costly. To describe the burden of these responses on state and local health departments, we determined the number of public health responses to HAV infections among food handlers by reviewing public internet sources of media articles. We then contacted each health department to collect data on whether PEP was recommended to food handlers or restaurant patrons, the number of PEP doses given, the number of HepA vaccine or immunoglobulin doses given as PEP, and the mean number of health department person-hours required for the response. Of 32 public health responses identified from Twitter, HealthMap, and Google alerts from January 1, 2012, to December 31, 2014, a total of 27 (84%) recommended PEP for other food handlers or restaurant patrons or both. Per public health response, the mean cost per dose of the HepA vaccine or immunoglobulin was $34 139; the mean personnel cost per response was $7329; and the total mean cost of each response was $41 468. PEP is expensive. Less aggressive approaches to PEP, such as limiting PEP to fellow food handlers in nonoutbreak situations, should be considered in the postvaccination era. HepA vaccine for PEP provides long-term immunity and can be used when immunoglobulin is unavailable or cannot be administered within 14 days of exposure to HAV.


1952 ◽  
Vol 15 (5) ◽  
pp. 233-237
Author(s):  
Ralph L. Tarbett

The California Conference of Local Health Officers of a 1950 meeting requested the State Health Department to make a study of the effect of food handler training in a restaurant sanitation program. The Conference had previously gone on record as favoring education and inspection as desirable parts of a food sanitation program. This request, coupled with the questions passed by several sanitation directors of local health departments, “Will food handler training schools substantially improve sanitation in our restaurants?” caused the State Department of Public Health to enter upon these studies. Previous to the start of these studies, institutes on promoting and conducting food handler training programs had been held throughout the State. Guides which outlined the food handler courses had been distributed and widely accepted by local departments interested in food handler training. Consultants from the A.P.H.A., U.S.P.H.S., University of California School of Public Health, and Department of Public Health planned the methods, forms, and technique to be used in making this study. Field surveys of restaurants would be used as a base for measurements, State restaurant inspection personnel were used on the survey team. Each restaurant is given a numerical grade based on 100: 37 points for physical plant and 63 points for operational items. A rating is given the community using the U.S.P.H.S. method of scoring. Several types of communities were surveyed: (1) Those not having and not anticipating a food handler training program, (2) those not having, but developing a food handler training program, and (3) those having had a stable program for several years. This is developing a picture of the various types of communities. It is impossible to draw positive conclusions as to the value of food handler training on the basis of our studies up to the present time. However, it does appear, from the information thus far accumulated in a number of communities in the State of California, that food handler training does pay substantial dividends. These dividends appear to be in improved restaurant sanitation, better working relations between the restaurant industry and the local health department, and an increased public interest in and support for the program. Much of the criticism thrown at Health Departments regarding Food Sanitation is the lack of uniformity in recommended practices and legal interpretations of laws. These studies, we believe, in addition to measuring the value of food handler training courses, are also tending to standardize practices and legal interpretations and develop closer relationships between the State and local health departments.


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