PREparadness, REsponse and SySTemic transformation (PRE-RE-SyST): a model for disability-inclusive pandemic responses and systemic disparities reduction derived from a scoping review and thematic analysis

BackgroundPeople with disabilities (PwD) have been facing multiple health, social, and economic disparities during the COVID-19 pandemic, stemming from structural disparities experienced for long time. This paper aims to present the PREparation, RESponse and SySTemic transformation (PRE-RE-SyST): a model for a disability-inclusive pandemic responses and systematic disparities reduction.MethodsScoping review with a thematic analysis was conducted on the literature published up to mid-September 2020, equating to the initial stages of the COVID-19 pandemic. Seven scientific databases and 3 preprint databases were searched to identify empirical or perspective papers addressing health and socio-economic disparities experienced by PwD as well as reporting actions to address them. Snowballing searches and experts’ consultation were also conducted. Two independent reviewers made eligibility decisions and performed data extractions on any action or recommended action to address disparities. A thematic analysis was then used for the model construction, informed by a systems-thinking approach (i.e., the Iceberg Model).Results:From 1027 unique references, 84 were included in the final analysis. The PRE-RE-SyST model articulates a four-level strategic action to: 1) Respond to prevent or reduce disability disparities during a pandemic crisis; 2) Prepare ahead for pandemic and other crises responses; 3) Design systems and policies for a structural disability-inclusiveness; and 4) Transform society’s cultural assumptions about disability. ‘Simple rules’ and literature-based examples on how these strategies can be deployed are provided.Conclusion:The PRE-RE-SyST model articulates main strategies, ‘simple rules’ and possible means whereby public health authorities, policy-makers, and other stakeholders can address disability disparities in pandemic crises, and beyond. Beyond immediate pandemic responses, disability-inclusiveness is needed to develop everyday equity-oriented policies and practices that can transform societies towards greater resiliency, as a whole, to pandemic and other health and social emergencies.

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PREparedness, REsponse and SySTemic transformation (PRE-RE-SyST): a model for disability-inclusive pandemic responses and systemic disparities reduction derived from a scoping review and thematic analysis

International Journal for Equity in Health ◽

10.1186/s12939-021-01526-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Tiago S. Jesus ◽

Sureshkumar Kamalakannan ◽

Sutanuka Bhattacharjya ◽

Yelena Bogdanova ◽

Juan Carlos Arango-Lasprilla ◽

...

Keyword(s):

Thematic Analysis ◽

Scoping Review ◽

Final Analysis ◽

Strategic Action ◽

Economic Disparities ◽

Health Authorities ◽

Systemic Transformation ◽

Simple Rules ◽

Public Health Authorities ◽

Long Time

Abstract Background People with disabilities (PwD) have been facing multiple health, social, and economic disparities during the COVID-19 pandemic, stemming from structural disparities experienced for long time. This paper aims to present the PREparedness, RESponse and SySTemic transformation (PRE-RE-SyST): a model for a disability-inclusive pandemic responses and systematic disparities reduction. Methods Scoping review with a thematic analysis was conducted on the literature published up to mid-September 2020, equating to the initial stages of the COVID-19 pandemic. Seven scientific databases and three preprint databases were searched to identify empirical or perspective papers addressing health and socio-economic disparities experienced by PwD as well as reporting actions to address them. Snowballing searches and experts’ consultation were also conducted. Two independent reviewers made eligibility decisions and performed data extractions on any action or recommended action to address disparities. A thematic analysis was then used for the model construction, informed by a systems-thinking approach (i.e., the Iceberg Model). Results From 1027 unique references, 84 were included in the final analysis. The PRE-RE-SyST model articulates a four-level strategic action to: 1) Respond to prevent or reduce disability disparities during a pandemic crisis; 2) Prepare ahead for pandemic and other crises responses; 3) Design systems and policies for a structural disability-inclusiveness; and 4) Transform society’s cultural assumptions about disability. ‘Simple rules’ and literature-based examples on how these strategies can be deployed are provided. Conclusion The PRE-RE-SyST model articulates main strategies, ‘simple rules’ and possible means whereby public health authorities, policy-makers, and other stakeholders can address disability disparities in pandemic crises, and beyond. Beyond immediate pandemic responses, disability-inclusiveness is needed to develop everyday equity-oriented policies and practices that can transform societies towards greater resiliency, as a whole, to pandemic and other health and social emergencies.

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Users’ Beliefs Toward Physical Distancing in Facebook Pages of Public Health Authorities During COVID-19 Pandemic in Early 2020

Health Education & Behavior ◽

10.1177/10901981211014428 ◽

2021 ◽

pp. 109019812110144

Author(s):

Soon Guan Tan ◽

Aravind Sesagiri Raamkumar ◽

Hwee Lin Wee

Keyword(s):

Public Health ◽

Health Belief Model ◽

United States Public Health ◽

Health Belief ◽

The United States ◽

Health Authorities ◽

Public Health Authorities ◽

Control And Prevention ◽

Belief Model ◽

The Health Belief Model

This study aims to describe Facebook users’ beliefs toward physical distancing measures implemented during the Coronavirus disease (COVID-19) pandemic using the key constructs of the health belief model. A combination of rule-based filtering and manual classification methods was used to classify user comments on COVID-19 Facebook posts of three public health authorities: Centers for Disease Control and Prevention of the United States, Public Health England, and Ministry of Health, Singapore. A total of 104,304 comments were analyzed for posts published between 1 January, 2020, and 31 March, 2020, along with COVID-19 cases and deaths count data from the three countries. Findings indicate that the perceived benefits of physical distancing measures ( n = 3,463; 3.3%) was three times higher than perceived barriers ( n = 1,062; 1.0%). Perceived susceptibility to COVID-19 ( n = 2,934; 2.8%) was higher compared with perceived severity ( n = 2,081; 2.0%). Although susceptibility aspects of physical distancing were discussed more often at the start of the year, mentions on the benefits of intervention emerged stronger toward the end of the analysis period, highlighting the shift in beliefs. The health belief model is useful for understanding Facebook users’ beliefs at a basic level, and it provides a scope for further improvement.

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Fueling the Covid-19 pandemic: summer school holidays and incidence rates in German districts

Journal of Public Health ◽

10.1093/pubmed/fdab080 ◽

2021 ◽

Author(s):

Thomas Plümper ◽

Eric Neumayer

Keyword(s):

Public Health ◽

Fixed Effects ◽

Summer School ◽

Incidence Rates ◽

Contact Tracing ◽

Robert Koch Institute ◽

Cross Sectional ◽

Holiday Period ◽

Health Authorities ◽

Public Health Authorities

AbstractBackgroundThe Robert-Koch-Institute reports that during the summer holiday period a foreign country is stated as the most likely place of infection for an average of 27 and a maximum of 49% of new SARS-CoV-2 infections in Germany.MethodsCross-sectional study on observational data. In Germany, summer school holidays are coordinated between states and spread out over 13 weeks. Employing a dynamic model with district fixed effects, we analyze the association between these holidays and weekly incidence rates across 401 German districts.ResultsWe find effects of the holiday period of around 45% of the average district incidence rates in Germany during their respective final week of holidays and the 2 weeks after holidays end. Western states tend to experience stronger effects than Eastern states. We also find statistically significant interaction effects of school holidays with per capita taxable income and the share of foreign residents in a district’s population.ConclusionsOur results suggest that changed behavior during the holiday season accelerated the pandemic and made it considerably more difficult for public health authorities to contain the spread of the virus by means of contact tracing. Germany’s public health authorities did not prepare adequately for this acceleration.

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EHEC O111:H8 strain and norovirus GII.4 Sydney [P16] causing an outbreak in a daycare center, Brazil, 2019

BMC Microbiology ◽

10.1186/s12866-021-02161-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Liliana Cruz Spano ◽

Caroline Gastaldi Guerrieri ◽

Lays Paula Bondi Volpini ◽

Ricardo Pinto Schuenck ◽

Jaqueline Pegoretti Goulart ◽

...

Keyword(s):

Southeastern Brazil ◽

Viral Pathogens ◽

Daycare Center ◽

Staff Members ◽

Health Authorities ◽

Single Locus Variant ◽

Public Health Authorities ◽

Uremic Syndrome ◽

Norovirus Gii ◽

Relationship Of

Abstract Background This study describes the investigation of an outbreak of diarrhea, hemorrhagic colitis (HC), and hemolytic uremic syndrome (HUS) at a daycare center in southeastern Brazil, involving fourteen children, six staff members, six family members, and one nurse. All bacterial and viral pathogens detected were genetically characterized. Results Two isolates of a strain of enterohemorrhagic Escherichia coli (EHEC) serotype O111:H8 were recovered, one implicated in a case of HUS and the other in a case of uncomplicated diarrhea. These isolates had a clonal relationship of 94% and carried the stx2a and eae virulence genes and the OI-122 pathogenicity island. The EHEC strain was determined to be a single-locus variant of sequence type (ST) 327. EHEC isolates were resistant to ofloxacin, doxycycline, tetracycline, ampicillin, and trimethoprim-sulfamethoxazole and intermediately resistant to levofloxacin and ciprofloxacin. Rotavirus was not detected in any samples, and norovirus was detected in 46.7% (14/30) of the stool samples, three of which were from asymptomatic staff members. The noroviruses were classified as the recombinant GII.4 Sydney [P16] by gene sequencing. Conclusion In this outbreak, it was possible to identify an uncommon stx2a + EHEC O111:H8 strain, and the most recent pandemic norovirus strain GII.4 Sydney [P16]. Our findings reinforce the need for surveillance and diagnosis of multiple enteric pathogens by public health authorities, especially during outbreaks.

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The effect of COVID19 pandemic restrictions on an urban rodent population

Scientific Reports ◽

10.1038/s41598-021-92301-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Miguel A. Bedoya-Pérez ◽

Michael P. Ward ◽

Max Loomes ◽

Iain S. McGregor ◽

Mathew S. Crowther

Keyword(s):

Binary Data ◽

Sampling Interval ◽

Resource Scarcity ◽

Health Authorities ◽

Before And After ◽

Directional Change ◽

Public Health Authorities ◽

Bait Stations ◽

Rodent Populations ◽

The City

AbstractShortly after the enactment of restrictions aimed at limiting the spread of COVID-19, various local government and public health authorities around the world reported an increased sighting of rats. Such reports have yet to be empirically validated. Here we combined data from multi-catch rodent stations (providing data on rodent captures), rodent bait stations (providing data on rodent activity) and residents’ complaints to explore the effects of a six week lockdown period on rodent populations within the City of Sydney, Australia. The sampling interval encompassed October 2019 to July 2020 with lockdown defined as the interval from April 1st to May 15th, 2020. Rodent captures and activity (visits to bait stations) were stable prior to lockdown. Captures showed a rapid increase and then decline during the lockdown, while rodent visits to bait stations declined throughout this period. There were no changes in the frequency of complaints during lockdown relative to before and after lockdown. There was a non-directional change in the geographical distribution of indices of rodent abundance suggesting that rodents redistributed in response to resource scarcity. We hypothesize that lockdown measures initially resulted in increased rodent captures due to sudden shortage of human-derived food resources. Rodent visits to bait stations might not show this pattern due to the nature of the binary data collected, namely the presence or absence of a visit. Relocation of bait stations driven by pest management goals may also have affected the detection of any directional spatial effect. We conclude that the onset of COVID-19 may have disrupted commensal rodent populations, with possible implications for the future management of these ubiquitous urban indicator species.

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Indoor Environmental Quality in Dwellings and Lifestyle Behaviors during the COVID-19 Pandemic: Russian Perspective

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115975 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5975

Author(s):

Vladimir Reshetnikov ◽

Oleg Mitrokhin ◽

Elena Belova ◽

Victor Mikhailovsky ◽

Maria Mikerova ◽

...

Keyword(s):

Public Health ◽

Medical Students ◽

Environmental Quality ◽

Indoor Environmental Quality ◽

Lifestyle Behaviors ◽

Contagious Diseases ◽

Health Authorities ◽

Public Health Authorities ◽

Isolation Index ◽

Novel Coronavirus

The novel coronavirus (COVID-19) outbreak is a public health emergency of international concern, and as a response, public health authorities started enforcing preventive measures like self-isolation and social distancing. The enforcement of isolation has consequences that may affect the lifestyle-related behavior of the general population. Quarantine encompasses a range of strategies that can be used to detain, isolate, or conditionally release individuals or populations infected or exposed to contagious diseases and should be tailored to circumstances. Interestingly, medical students may represent an example of how the COVID-19 pandemic can form new habits and change lifestyle behaviors. We conducted a web-based survey to assess changes in lifestyle-related behavior of self-isolated medical students during the COVID-19 pandemic. Then we analyzed the sanitary-hygienic regulations of the Russian Federation to determine the requirements for healthy buildings. Results showed that during the pandemic, the enforcement of isolation affects medical students’ lifestyle-related behavior and accompanies an increase in non-communicable diseases (NCDs). Indoor environmental quality (IEQ) and healthy buildings are cutting-edge factors in preventing COVID-19 and NCDs. The Russian sanitary-hygienic regulations support improving this factor with suitable requirements for ventilation, sewage, waste management, and disinfection. Herein, assessing isolation is possible through the hygienic self-isolation index.

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Preparedness and response in Portuguese emergency plans - Interaction with public health

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.868 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

G Leiras ◽

A Martins

Keyword(s):

Public Health ◽

Health Authority ◽

Civil Protection ◽

Emergency Plans ◽

Emergency Situations ◽

Health Measures ◽

Health Authorities ◽

Public Health Authorities ◽

Protection Authority

Abstract Background Articulation between Civil Protection and Public Health authorities is of paramount importance to control, reduce and prevent threats to the health of the population in situations of crisis or catastrophes. National Civil Protection Authority produces Emergency Plans which describe the role of every stakeholder in emergency situations. Role and importance of Public Health and Public Health Authorities is not always present or well described and known amongst stakeholders. Methods Data was collected from all Districtal Emergency Plans (n = 18). Each document was analysed considering time frame, refences to Public Health and Health Authorities, definition of roles, communication channels, coordination and inclusion of intersectoral communication flow. Quantitative analysis included absolute and relative frequencies and qualitative analysis to all parts related to the terms “Public Health” and “Health Authority”. Each document was reviewed by 2 independent researchers. Results From 18 Districtal Emergency Plans (DEP) analysed, 94,4% (n = 17) had references to Public Health, but none referred the role of Public Health Officers. Only 16,7% referred to Health Authorities, although 94,4% mentioned the law 135/2013, defining the role and attributes of Health Authority. In 72,2%, coordination of Public Health Measures was attributed to the National Medical Emergency Institute. Epidemiological surveillance and Public Health Emergencies were referred in 55,6%, and attributed to the Regional Administration of Health. Conclusions Public Health Authorities and Public Health Medical Officers role in articulation with National Civil Protection Authority in emergency situations lacks severely, with this role being replaced by other entities. This is of great concern regarding management and control of diseases, particularly communicable diseases. Key messages Public Health Authorities lack the necessary involvement in Emergency Plans and emergency situations. Public health measures are coordinated by other entities rather than Public Health Authorities.

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XarxaSalut, network of municipalities for health, Valencia Region (Spain): policy process evaluation

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.235 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

R Peiró Pérez ◽

E Pérez Sanz ◽

E Legaz Sanchez ◽

J Quiles Izquierdo ◽

Grupo XarxaSalut

Keyword(s):

Process Evaluation ◽

Citizen Participation ◽

Policy Process ◽

Local Level ◽

Common Language ◽

Health Authorities ◽

Open Questions ◽

Economic Support ◽

Public Health Authorities ◽

The Impact

Abstract “XarxaSalut” started in 2017, with the municipalities that have taken the commitment to boost the Promotion of Health (HP) at the local level through community participation, intersectorality and equity perspective. The objective is to present a policy process evaluation (2'5 years) of the implementation of XarxaSalut. Different approaches have been used; a questionnaire addressed to the municipalities at the time of adhesion including data on intersectorality, participation, HP actions and open questions; description of instruments that Regional Public Health Authorities (RPHA) has mobilized and an analysis of barriers and strengths made by the coordination office. In 2017, 17 municipalities were joined, being 197 in February 2020 (70% of the population). 65% are in a process of an organizational change through the intersectoral, decision making and participative working group. 35% are doing analysis of determinants and /or health situation, assets maps and a prioritization of HP actions. The main barriers identified by municipalities are lack of economic and personal resources, and difficulties in achieve citizen participation. The main benefits were the optimization of resources, the exchange of experiences, training, or economic support from the RPHA. Some support instruments develop for RPHA are a collection of guides for community development, funds that the municipalities can apply to support actions related with training, HP action on vulnerable population, on asset maps, participation processes, vulnerable neighborhoods, etc.; Community actions have been included in the “Health Observatory” to give visibility and social support to XarxaSalut. Interdisciplinary training processes with health and municipal professionals have been made in order to develop a common language and strength the competences for HP. Lesson learned: The need to improve coordination and a common language between different types of participants and professionals Key messages The decision makers and professionals in the municipalities understand the impact in health of the policies developed at local level but needs guide and support to deal with it. The coordination between different administrations and primary health at local level and the misunderstandings about health and their determinants are the main aspect to reinforce.

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Patient health engagement model: explaining citizens noncompliance and maladaptive behaviors

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.620 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

G Graffigna ◽

S Barello ◽

L Palamenghi ◽

M Savarese ◽

G Castellini

Keyword(s):

Healthcare Services ◽

Cross Sectional Study ◽

Health Prevention ◽

Prevention Measures ◽

Cross Sectional ◽

Health Authorities ◽

Patient Health ◽

Public Health Authorities ◽

High Level ◽

Restrictive Measures

Abstract Background At the end of February 2020 a new case was diagnosed with COVID-19 in north Italy, suddenly followed by new cases. Italian health authorities decided to enforce restrictive measures. Northern areas of Italy were identified as “red areas” to slow down the epidemic and its impact on the healthcare system. From this perspective, the COVID-19 epidemic in Italy constitutes a testing ground for the assessment of the ability of consumers to cope with this health risk. Methods A cross-sectional study on a representative sample of 1000 Italian citizens was conducted over the period 27 February- 5 March exploring the following hypotheses: 1) less engaged individuals are more concerned for the health emergency and feel more vulnerable; 2) less engaged have higher probability to develop negative attitudes and dysfunctional behaviors. Results only the 16% the interviewees presented a high level of engagement. Lower levels of engagement were measured in the southern parts of Italy (not yet touched by the epidemics at the time of data collection). People with lowers levels of engagement reported higher fears for the contagion and sense of vulnerability. Furthermore, they showed the lower levels of trust in the Public Health Authorities, in medical research and in vaccines. Finally, they appeared more dismissive in their preventive behaviors and more disorganized in the fruition of the healthcare services. Conclusions A psychological analysis of processes of attitudinal and role change in the direction of becoming more engaged in health prevention is worthy in order to forecast potential dysfunctional reactions to restrictive health prevention measures and to orient personalized education initiatives to consumers with different level of engagement. Key messages Profiling based on the levels of health engagement is important in order to plan more effective healthcare measures during epidemics. Targeted educational initiatives should take into account citizens' engagement profiles.

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