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Rationale: To reduce transmission of SARS-CoV-2, non-pharmaceutical interventions (NPIs), including school closures, hand hygiene, mask mandates, and social distancing, were enforced in Arkansas from 3/2020-2/2021. We hypothesized that the presence of NPIs would correlate with a decrease in asthma exacerbations and viral infections. Methods: Demographic information was collected on subjects with asthma exacerbations or viral infections from 3/2018-5/2022, including age, race, ethnicity, and sex. To evaluate the effects of NPIs, three periods were considered: pre- (03/2018-02/2020), during (03/2020-02/2021), and post- (03/2021-05/2022) NPIs. ANOVA analysis and generalized linear models were performed to determine statistical significance. The stringency of NPIs was evaluated using publicly available data (Oxford Covid-19 Government Response Tracker), which allows for direct comparison of Arkansas NPI status to exacerbation data during the same time periods. Results: 5055 asthma exacerbations (3322 unique subjects) occurred between 3/2018-5/2022. Asthma exacerbations decreased from 3/2020-3/2021 and returned to pre-pandemic numbers by summer 2021 (p<0.0001). Similar downward trends occurred for respiratory syncytial virus (RSV) with out-of-season return in summer 2021 (p<0.0001). Rhinovirus was present throughout NPIs. The mean age of exacerbations decreased by 0.9 years when comparing the during NPIs and after NPIs periods (p = 0.0002). An increase in the proportion of exacerbations was noted for non-black and other/unknown ethnicity subjects during and after NPIs. Conclusions: Fewer asthma exacerbations occurred during the most significant NPI employment period (03/2020-02/2021), and an increase in exacerbations was seen as mitigation strategies were relaxed, which correlated with timing of increasing RSV infections.
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BACKGROUND: Increasingly, climate change policies are emerging across Europe. Policies addressing adaptation (adjusting the effects of climate change on public health) are being implemented after the COVID-19 pandemic. This study aims to identify issues in climate adaptation implementation for public health and understand the health implications from responses after COVID-19. METHODS: Key informant interviews were undertaken with decision makers in international, national, and local governments across 20 European countries (Norway, England, Cyprus, Spain, Ireland, Finland, Lithuania, Belgium, the Netherlands, Sweden, Latvia, Italy, Estonia, Austria, Croatia, France, Germany, Hungary, Denmark, and Scotland). A WHO stakeholder analytical framework was followed for developing the interview themes. Participants were recruited if based in European governments, working in public or environmental health, and involved in climate adaptation policy. Participants were recruited through known networks and geographical coverage was obtained (eight per European region). An interview schedule with key themes (barriers, public health agenda, levers, networks, evidence needs, and COVID-19 recovery) was used. Interviews were conducted online, recorded, transcribed, and analysed through Nvivo. FINDINGS: 32 interviews were completed between June and October, 2021;four international stakeholders, five national-level decision makers, 23 city-level decision makers or network representatives. Most reported inadequate resources for health adaptation implementation (funding, training, and personnel) and the marginal role of health in climate adaptation policy. A key reported challenge was limited departmental cross-collaboration across governance levels, because city-level stakeholders were less aware of the public health role in climate change policy. COVID-19 recovery strategies were not perceived as opportunistic for future adaptation. However, several respondents identified benefits for health system resilience, for example improved emergency planning and disaster management. INTERPRETATION: Across Europe, there is varied progress in the implementation of climate change and health adaptation. Providing appropriate resource, inter-departmental collaboration, knowledge mobilisation, and multi-level governance support will facilitate climate and health policy implementation. Overcoming these barriers and learning from COVID-19 through strengthened emergency planning and responses to climate events can strengthen UK public health system resilience and beyond. FUNDING: This project has received part-funding from the Enhancing Belmont Research Action to support EU policy making on climate change and health project, which is part of the EU's Horizon 2020 research and innovation programme (grant agreement number 101003966). The research was part-funded by the National Institute for Health Research Health Protection Research Unit in Environmental Change and Health at the London School of Hygiene and Tropical Medicine in partnership with Public Health England, the Met Office, and University College London (grant number PHSEZT6210). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or PHE.
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Introduction In recent years, both the EU Commission and the Belmont Forum have funded projects focusing on health and climate change with the aim of expanding research and evidence and improving intersectoral cooperation. The EU-funded ENBEL project is developing tools to streamline climate and health research to support policies and strategies and improve response and resilience. Methods Within ENBEL a stakeholder analysis is being carried out for Europe to identify key decision makers involved in climate change and health adaptation, understand interlinkages and identify areas for action to promote collaboration and uptake. Semi-structured interviews with key institutions and stakeholders at different levels (International, European, national and local) will help identify key evidence needs and research gaps and findings will be used to define knowledge tools and policy briefs to enhance adaptation. Furthermore, current policies on adaptation in Europe and how health issues are addressed, especially taking into account the Next Generation EU (NGEU) funding in support of COVID-19 recovery as well as Green Deal and Climate Action, will be reviewed to ensure ENBEL products fit the EU policy agenda. Conclusions ENBEL offers an opportunity to produce targeted research syntheses for decision makers as well an ensuring health becomes a key aspect in climate change policy decision making. The ENBEL project will engage with key decision makers involved in climate change and health adaptation across Europe, providing knowledge, understanding interlinkages and identifying areas for action to promote climate policies that enhance health benefits.
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The humanitarian sector is being forced to adapt its way of providing aid services;for instance, donors expect to see improvements in efficiency, effectiveness, and data visibility of service delivery. This entails the use of new technologies for collecting data and evidence of the aid sector's needs and proposals for prompt and tangible measurable solutions. The COVID-19 pandemic has shown significant disruption in aid organisations' value chains. The new approach to knowledge transfer (KT) includes the exploitation of the three types of knowledge - tacit, implicit, and explicit knowledge - held by a group of experts, who are being left behind for lack of an inclusive KT management vision. This empirical research also explores the hidden knowledge sources held by the underrepresented female workforce (35%) observed during the COVID- 19 pandemic, as essential to cover the existing knowledge gaps in the aid sector. It verifies whether the underrepresentation of female workforce is related to their low mobility due to carrying multiple roles in their society and family, including the factors causing the disruption of the value chain. The paper assesses whether the pandemic had a positive effect in accelerating the organisation's KT between people and to the field staff, and it finds no relationship between gender difference and the extensive use of contingent workforce to deliver results (X2 [1, N=147] =2.580, p > 0.05). It finds no relationship between the underrepresentation of female workforce and mobility (X2 [1, N=151] =0.041, p > 0.05). It confirms that there is no relationship between an employee's gender and their attitude to rating the use of virtual coaching to delivery knowledge to frontline teams (X2 [1, N=298] =1.212, p > 0.05) yet, it finds a strong relationship between an employee's gender and attitude toward rating the use of AI-based technologies in aid sector (X2 [1, N=581] =14.921, p < 0.001). Finally, it confirms that gender is related to the designation of female workforce to management positions in the aid sector (X2 [1, N=128] =5.010, p<0.05). This paper concludes by providing recommendations for action and for the efficient handling of each of the four knowledge sharing dimensions: Reshaping the contingent workforce;adapting the management of employee mobility;innovating approaches to coaching;and deregulating the use of technology for efficient knowledge transfer between people. © 2020 Academic Conferences and Publishing International Limited. All rights reserved.