scholarly journals The MONITOR Ecosystem: A Digital Health Intervention for the Early Detection, Control, Follow-Up, and Management of COVID-19 in Mexico

2020 ◽  
Author(s):  
Miguel Betancourt-Cravioto ◽  
Jorge Falcón-Lezama ◽  
Fernando Rojas-Estrella ◽  
Rodrigo Saucedo-Martínez ◽  
Roberto Tapia-Conyer

In fighting infectious disease outbreaks, a basic epidemiological principle is to detect cases quickly and to isolate each case, to interrupt transmission. This principle has been the cornerstone of the Carso Group (CG) COVID Protocol, a systematic blueprint for the reopening of operations of workplaces in the context of ongoing disease transmission in Mexico. The CG comprises over 50 companies with approximately 180,000 employees engaged in economic activities including telecommunications, retail, construction, banking, mining, and manufacturing, among others. To cope with the COVID-19 pandemic within the CG, the Carlos Slim Foundation designed, developed and implemented MONITOR, a digital health ecosystem comprising a mobile phone application, web portal, and analytics platform, to assess the infection risk of each employee, follow-up their health status, and detect early symptoms of COVID-19. MONITOR provides daily notifications for any suspected cases and activates a COVID-19 testing request and follow-up of results. This intervention helps rapidly identify and isolate suspected cases, as well as follow-up of work and family contacts, to prevent further outbreaks. Use of MONITOR has thus enabled containment of COVID-19 in workplaces and safe return to work. MONITOR is an example of the implementation of public health practices in workplaces and can serve as the basis for larger deployment in population-wide settings.

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer B. Nuzzo ◽  
Diane Meyer ◽  
Michael Snyder ◽  
Sanjana J. Ravi ◽  
Ana Lapascu ◽  
...  

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.


2020 ◽  
Vol 46 (7) ◽  
pp. 427-431 ◽  
Author(s):  
Michael J Parker ◽  
Christophe Fraser ◽  
Lucie Abeler-Dörner ◽  
David Bonsall

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.


2019 ◽  
Vol 47 (S2) ◽  
pp. 55-58
Author(s):  
Tina Batra Hershey

Public health emergencies, including infectious disease outbreaks and natural disasters, are issues faced by every community. To address these threats, it is critical for all jurisdictions to understand how law can be used to enhance public health preparedness, as well as improve coordination and collaboration across jurisdictions. As sovereign entities, Tribal governments have the authority to create their own laws and take the necessary steps to prepare for, respond to, and recover from disasters and emergencies. Legal preparedness is a key component of public health preparedness. This article first explains legal preparedness and Tribal sovereignty and then describes the relationship between Tribal Nations, the US government, and states. Specific Tribal concerns with respect to emergency preparedness and the importance of coordination and collaboration across jurisdictions for emergency preparedness are discussed. Examples of collaborative efforts between Tribal and other governments to enhance legal preparedness are described.


2021 ◽  
Vol 5 (1) ◽  
pp. 7-14
Author(s):  
Luh Putu Kirana Pratiwi ◽  
Ni Made Kencana Maharani

A market is a place where sellers and buyers meet in buying and selling transactions. People's market is atraditional market. The people's market is one of the most obvious indicators of the economic activities of thepeople in an area. The implementation of safety and health in the work environment is not only intended forvisitors but also employees (market managers), suppliers, and traders. This is because people's markets canbe the main route for the spread of infectious disease outbreaks. People's markets have an important positionto provide safe food. Public markets are influenced by the existence of upstream producers (suppliers of freshingredients), suppliers, vendors, consumers, managers, health-related officers, and community leaders. Thehealthy market is one of the structures in the development of the people's market.


Author(s):  
Beverley J. Paterson ◽  
David N. Durrheim

Surveillance evaluations of surveillance systems should provide evidence to improve public health practice. In response to surveillance evaluation findings amongst Pacific Island Countries and Territories that identified a critical need to better equip local public health officials with skills to rapidly appropriately respond to suspected infectious disease outbreaks across the Pacific, the RAPID (Response and Analysis for Pacific Infectious Diseases) project was implemented to strengthen capacity in surveillance, epidemiology and outbreak response. The RAPID project is a notable example of how evidence gathered through a surveillance evaluation can be used to improve public health surveillance practice.


2018 ◽  
Author(s):  
Tobias P. Loka ◽  
Simon H. Tausch ◽  
Bernhard Y. Renard

AbstractThe sequential paradigm of data acquisition and analysis in next-generation sequencing leads to high turnaround times for the generation of interpretable results. We combined a novel real-time read mapping algorithm with fast variant calling to obtain reliable variant calls still during the sequencing process. Thereby, our new algorithm allows for accurate read mapping results for intermediate cycles and supports large reference genomes such as the complete human reference. This enables the combination of real-time read mapping results with complex follow-up analysis. In this study, we showed the accuracy and scalability of our approach by applying real-time read mapping and variant calling to seven publicly available human whole exome sequencing datasets. Thereby, up to 89% of all detected SNPs were already identified after 40 sequencing cycles while showing similar precision as at the end of sequencing. Final results showed similar accuracy to those of conventional post-hoc analysis methods. When compared to standard routines, our live approach enables considerably faster interventions in clinical applications and infectious disease outbreaks. Besides variant calling, our approach can be adapted for a plethora of other mapping-based analyses.


Author(s):  
Huailiang Wu ◽  
Jian Huang ◽  
Casper J. P. Zhang ◽  
Zonglin He ◽  
Wai-Kit Ming

AbstractBackgroundA novel coronavirus disease (COVID-19) outbreak due to SARS-CoV-2 infection occurred in China in late-December 2019. Facemask wearing is considered as one of the most cost-effective and important measures to prevent the transmission of SARS-CoV-2, but it became a social concern due to the recent global facemask shortage. China is the major facemask producer in the world, contributing to 50% of global production. However, even full productivity (20 million facemasks per day) does not seem to meet the need of a population of 1.4 billion in China.MethodsPolicy review using government websites and shortage analysis using mathematical modelling based on data obtained from the National Health Commission (NHC), the Ministry of Industry and Information Technology (MIIT), the Center for Disease Control and Prevention (CDC) of the People’s Republic of China, and Wuhan Bureau of Statistics.FindingsSupplies of facemasks in the whole of China would have been sufficient for both healthcare workers and the general population if the COVID-19 outbreak only occurred in Wuhan city or Hubei province. However, if the outbreak occurred in the whole of China, facemask supplies in China could last for 5 days if under the existing public health measures and a shortage of 853 million facemasks is expected by 30 Apr 2020. Assuming a gradually decreased import volume, we estimated that dramatic increase in productivity (42.7 times of the usual level) is needed to mitigate the facemask crisis by the end of April.InterpretationIn light of the COVID-19 outbreak in China, a shortage of facemasks and other medical resources can considerably compromise the efficacy of public health measures. Effective public health measures should also consider the adequacy and affordability of medical resources. Global collaboration should be strengthened to prevent the development of a global pandemic from a regional epidemic via easing the medical resources crisis in the affected countries.Research in contextEvidence before this studyWe searched PubMed and Web of Science for articles in English, between 1 Jan 1980, and 1 Jan 2020, using the search terms 1) (infection OR infectious disease* OR outbreaks) AND (modelling); and 2) (mask* OR facemask* OR medical resource*) AND (infection OR infectious disease* OR outbreaks). Most relevant studies identified were performed to predict diseases spread and to determine the original infection source of previous epidemics like SARS and H7N9. However, few studies focused on the medical resources crisis during the outbreaks.Added value of this studyTo the best of our knowledge, this is the first study to investigate the facemask shortage during the novel coronavirus pneumonia (COVID-19) outbreak in China. We have summarized in detail the management strategies implemented by the Chinese governments during the outbreaks. By considering three scenarios for the outbreak development, we simulated the facemasks availability from late-December 2019 to late-April 2020 and estimated the duration of sufficient facemask supplies. Our findings showed that if the COVID-19 outbreak occurred only in Wuhan city or Hubei province, facemask shortage would not appear with the existing public health measures. However, if the outbreak occurred in the whole of China, a shortage of facemask could be substantial assuming no alternative public health measures.Implications of all the available evidenceOur findings provide insight into the public health measures to confront medical resources crisis during infectious disease outbreaks. Effective public health measures should consider the adequacy and affordability of existing medical resources. Governments across the world should revisit their emergency plans for controlling infectious disease outbreaks by taking into account the supply of and demand for the medical resource. Global collaboration should be strengthened to prevent the development of a global pandemic from a regional epidemic via easing the medical resources crisis in the affected countries.


Author(s):  
Andreas Handel ◽  
Joel C. Miller ◽  
Yang Ge ◽  
Isaac Chun-Hai Fung

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.


Author(s):  
Pedro A. Villarreal

Abstract The current chapter deals with public health emergencies and their linkages to constitutional law and theory. The ongoing COVID-19 pandemic poses myriad challenges to constitutional regimes around the world. However, it is by no means the first time that public health emergencies have led to questions of constitutionalism. Past instances of disease outbreaks had already highlighted how emergency legal frameworks unfold when facing the challenge of containing their spread. Against this backdrop, the chapter focuses on pre-COVID-19  instances of cross-border epidemics and pandemics, such as A(H1N1) Influenza, Ebola and Zika, and some of their implications for constitutionalism. These examples of infectious disease outbreaks are assessed by resorting to three models-archetypes of constitutional emergencies as a theoretical background. As they show a coupling between the international and national levels, a brief glimpse at applicable international law regimes is put forward. Ultimately, public health emergencies are not taken as a new genus within already existing classifications. Nevertheless, this contribution shows how they do warrant more detailed analysis, given how their technical features put theories related to constitutionalism under extreme conditions to the test. The contribution was initially drafted before the onset of the COVID-19 pandemic in 2020. Thus, it is a mostly retrospective analysis. Nevertheless, insights taken from outbreaks preceding COVID-19 can help build a broader outlook of the puzzle related to how the intertwinement between constitutionalism and public health emergencies can be addressed through a broader perspective not limited to one disease.


Author(s):  
Andreea Salajan ◽  
Svetla Tsolova ◽  
Massimo Ciotti ◽  
Jonathan E. Suk

Background:Infectious disease outbreaks require decision makers to make rapid decisions under time pressure and situations of scientific uncertainty, and yet the role of evidence usage in these contexts is poorly understood. Aims and objectives:To define and contextualise the role of scientific evidence in the governance of infectious disease outbreaks and to identify recommendations for overcoming common barriers to evidence-informed decision making. Methods:A scoping review and an expert workshop to provide additional input into recommendations on enhancing evidence uptake during infectious disease outbreaks taking place in European settings. Findings:Forty-nine records reporting on multiple decision-making processes during infectious disease outbreaks of the past ten years were included in the study. Decision makers prioritise expert advice, epidemiological data and mathematical modelling data for risk characterisation and management, but tend to be challenged by scientific uncertainties, which allow for conflicting interpretations of evidence and for public criticism and contestation of decision-making processes. There are concrete opportunities for optimising evidence usage to improve public health policy and practice through investment in decision-making competencies, relationship building, and promoting transparent decision-making processes. Discussion and conclusions:It is not necessarily a disregard of evidence that puts a strain on decision making in health crises, but rather competing interests and the lack of clear, unambiguous and rapidly available evidence for risk characterisation and effectiveness of response measures.The relationship between science and public health decision making is relatively understudied but is deserving of greater attention, so as to ensure that the pursuit of evidence for decision making does not challenge timely and effective crisis management.


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