The Impact of Fast-Food Density on Obesity during the COVID-19 Lockdown in the UK: A Multi-Timepoint Study on British Cohort Data

Poor food environments are considered to trigger obesity and related health complications by restricting the local food options to predominantly low quality, energy-dense foods. This study investigated the impact of the food environment on obesity with a focus on any changes that might have occurred around the COVID lockdown period in the UK when majority of the population relied on food delivery and the local food environments. The proportion of fast-food retailers in the area and the Retail Food Environment Index (RFEI) were calculated for participants of the 1970 British Cohort Study (BCS70) at three timepoints: pre-COVID (2016), the first UK nation-wide lockdown (April–May 2020) and post lockdown (September–October 2020). The association of the food environment and the odds of obesity was estimated through multivariable logistic regression, with adjustments being made for selected socioeconomic variables. A model using the fast-food proportion as the sole predictor estimated that higher fast-food proportion increased the odds of obesity by 2.41 in 2016, 2.89 during the lockdown and 1.34 post lockdown, compared with 1.87, 2.23, and 0.73, respectively, for the same three periods with adjustments being made for select socioeconomic variables. On the other hand, RFEI increased the odds of obesity only slightly at 1.01, 1.02 and 1.03, respectively, with the model with adjustments yielding respective similar values. The fast-food proportion model indicates that proximity to a poor food environment is linked to obesity, especially during the COVID lockdown period, but the impact of a poor-food environment is limited if the RFEI is used as its indicator. The findings will add much needed insights on the UK data and will inform public health planning and policy.

Management of Hand Surgery Services during the Novel Coronavirus Disease 2019 Pandemic.

Introduction The novel coronavirus disease 2019 (COVID-19) pandemic is an international public health emergency. Health systems must plan for the increasing requirements for critical care during the COVID-19 pandemic. The aim of this article is to offer strategies for hand surgeons to planning and implementing their response during the COVID-19 pandemic and in the subsequent phases to preserve health care system functioning. Materials and Methods Assessment of the principles of management related to COVID-19 management to develop pandemic preparedness and response protocols pertinent to patients, health care workers, and health systems. Results Strategies for the reorganizing hand surgery practice and a set of recommendations that should facilitate the process of rescheduling both out-patient service and surgical activities during the COVID-19 and its subsequent phases are suggested. Conclusion During the COVID-19 pandemic, management of patients requiring specialist care for hand conditions should be adapted to limit the risks associated with the virus without jeopardizing outcomes. These expedient recommendations during extraordinary circumstances are a foundation for further discussion on the topic as the COVID-19 pandemic evolves.

Setting up the Largest Mass Vaccination Center in Europe: The One-Physician One-Nurse Protocol.

To manage mass vaccination without impacting medical resources dedicated to care, we proposed a new model of Mass Vaccination Centers (MVC) functioning with minimum attending staffing requirements. The MVC was under the supervision of one medical coordinator, one nurse coordinator, and one operational coordinator. Students provided much of the other clinical support. Healthcare students were involved in medical and pharmaceutical tasks, while non-health students performed administrative and logistical tasks. We conducted a descriptive cross-sectional study to describe data concerning the vaccinated population within the MVC and the number and type of vaccines used. A patient satisfaction questionnaire was collected to determine patient perception of the vaccination experience. From 28 March to 20 October 2021, 501,714 vaccines were administered at the MVC. A mean rate of 2951 ± 1804 doses were injected per day with a staff of 180 ± 95 persons working every day. At peak, 10,095 injections were given in one day. The average time spent in the MVC was 43.2 ± 15 min (time measured between entry and exit of the structure). The average time to be vaccinated was 26 ± 13 min. In total, 4712 patients (1%) responded to the satisfaction survey. The overall satisfaction with the organization of the vaccination was 10 (9-10) out of 10. By using one attending physician and one nurse to supervise a staff of trained students, the MVC of Toulouse optimized staffing to be among the most efficient vaccination centers in Europe.

Evaluation of Risk Perception of COVID-19 Disease: A Community-Based Participatory Study.

OBJECTIVE: How people behave in a crisis depends on their understanding and evaluation of risk and vulnerability. Therefore, this study was conducted to investigate the Iranians' risk perception of coronavirus disease (COVID-19). METHODS: An online survey was applied, which resulted in the collection of information on demographics, the 5 dimensions of risk perception (cognitive, political, social, cultural, and emotional), and trust in the government among the Iranian users of social networks. Data were analyzed by descriptive and analytical tests of SPSS (IBM Corp, Armonk, NY) software, and confirmatory factor analysis of Amos software. RESULTS: A total of 364 persons from 20 provinces completed the questionnaire during February 25 to March 2, 2020. More than 80% of the participants believed that negligence and lack of close supervision of the authorities have led to the spread of COVID-19. The mean (SD) risk perception was 58.77 (± 10.11), indicating the medium level of risk perception of people. The second-order confirmatory factor analysis also indicated that cultural dimension had the highest positive correlation (0.96), emotional dimension had the highest negative correlation (-0.65), and social dimension had the least correlation with the risk perception model (0.08). CONCLUSION: Iranians' risk perception of the COVID-19 outbreak is not optimal, and it seems necessary to improve it.

Geospatial Modeling of Health, Socioeconomic, Demographic, and Environmental Factors with COVID-19 Incidence Rate in Arkansas, US

The COVID-19 pandemic has posed numerous challenges to human society. Previous studies explored multiple factors in virus transmission. Yet, their impacts on COVID-19 are not universal and vary across geographical regions. In this study, we thoroughly quantified the spatiotemporal associations of 49 health, socioeconomic, demographic, and environmental factors with COVID-19 at the county level in Arkansas, US. To identify the associations, we applied the ordinary least squares (OLS) linear regression, spatial lag model (SLM), spatial error model (SEM), and multiscale geographically weighted regression (MGWR) model. To reveal how such associations change across different COVID-19 times, we conducted the analyses for each season (i.e., spring, summer, fall, and winter) from 2020 to 2021. We demonstrate that there are different driving factors along with different COVID-19 variants, and their magnitudes change spatiotemporally. However, our results identify that adult obesity has a positive association with the COVID-19 incidence rate over entire Arkansas, thus confirming that people with obesity are vulnerable to COVID-19. Humidity consistently negatively affects COVID-19 across all seasons, denoting that increasing humidity could reduce the risk of COVID-19 infection. In addition, diabetes shows roles in the spread of both early COVID-19 variants and Delta, while humidity plays roles in the spread of Delta and Omicron. Our study highlights the complexity of how multifactor affect COVID-19 in different seasons and counties in Arkansas. These findings are useful for informing local health planning (e.g., vaccine rollout, mask regulation, and testing/tracing) for the residents in Arkansas.

Global Crisis Leadership for Disease‐Induced Threats: One Health and Urbanisation

The concept of ‘One Health' (OH) has gathered momentum among the public health and animal health communities as an important global policy agenda for drawing together these disciplines to inform urban planning and health security policies. OH research, from a risk governance perspective, is generally concerned with identifying preventative programmes that can minimise the threats posed by diseases at the animal‐human interface (e.g. Corona virus, Ebola, avian influenza, the Q virus, for example). This article, by drawing on examples of disease threats, discusses the multi‐level challenges of establishing OH with a particular focus on urban change. It considers the risks posed by the increasing urbanisation of animal habitats and what this means for achieving OH. The article concludes by discussing why social scientists need to pay greater attention to the concept of OH.

Impact of Institute Closures and Learning Practices on Education in COVID-19 Pandemic: Omnichannel in Education

Community mitigation is crucial and is part of the preparedness plan of public health planning. Education institutions' closures are a non-pharmaceutical intervention often suggested for mitigating pandemics. Education institute closures could play a major role in the delay of community transmission. An audit is led by past examinations that distinguish the viability of school terminations and social removal techniques during a pandemic. The closure was first executed across China and Hong Kong. Data from the SARS pandemic conclude school closure was not an effective method, but trends of influenza show it may be the right precautionary measure. This article not only debates the need for this precautionary measure but also tells the various available platforms, resources, and solutions to continue the learning and growing process for everyone, regardless of their age group. It also highlights the psychological and mental side effects of the closure and social distancing, concluding with its adverse effects on the economy and welfare of the country. © 2022 IEEE.

Expanding Access to Naloxone: A Necessary Step to Curb the Opioid Epidemic.

The COVID-19 Pandemic has exacerbated the already worsening opioid epidemic within the United States. With a continuing increase in opioid overdose deaths, measures are needed to halt the needless number of deaths and begin on a path of recovery to address all the factors that impact the epidemic. The CDC has provided various recommendations to combat the increases in opioid overdose deaths. These recommendations have included expanded distribution and use of naloxone and overdose prevention education as essential services for people most at risk of overdose. While strategies should include the increase in community resources for those with opioid disorder and shifting the perspectives of healthcare to view opioid disorder as a chronic illness that can be treated with medication such as buprenorphine, these methods are not immediate enough to stop the trend in deaths. The United States must take immediate action to expand access to and use of Naloxone for the public and first responders. Naloxone alone cannot address the magnitude of this epidemic, but it is an essential first step in preventing immediate death while a multimodal strategy is enacted to fully protect those most at risk.

Impact of the COVID-19 Pandemic on Canadian Social Connections: A Thematic Analysis

Background On March 11, 2020, the World Health Organization declared COVID-19 a worldwide pandemic. Responses to the pandemic response disrupted Canadian social connections in complex ways;because social connections are determinants of health and well-being, their disruption could adversely affect health and well-being. Moreover, understanding how pandemics and public health responses affect social connections could inform pandemic recovery strategy and public health approaches designed for future pandemics. The purpose of this study is to understand experiences of pandemic impact on social connections over the pandemic. Methods A sample of 343 Canadian adults was recruited through Athabasca University and social media. Participants were predominantly White (81%) and female (88%). After the pandemic onset, participants responded to open-ended questions about the impact of the pandemic on and any changes to social connections at three time points (baseline, and three- and 6 months from study entry). Responses were categorized into epochs by date (April-June 2020 [Spring];July-August 2020 [Summer];September 2020-January 2021 [Fall/Winter]). Qualitative thematic analysis was used to code themes for each epoch. Results Negative impact of the pandemic (37–45%), loss of social connections (32–36%), and alternative means of connection (26–32%) were prominent themes across the epochs. Restrictions to face-to-face connections were largest in spring (9%) and lowest in the Summer (4%). Conversely, participants increasingly reported limited contact or communication into the Fall and Winter (6–12%) as pandemic restrictions in Canada were reinstated. Conclusions The COVID-19 pandemic threatens social connections, with negative impacts that fluctuated with COVID-19 case rates and subsequent pandemic restrictions. These findings could be used to identify targets for social supports during the pandemic recovery, and to adjust public health strategies for future pandemics that minimize impact on social connections.

How Anaesthesiology Helped to Fight the First Wave of the COVID-19 Pandemic in Portugal.

INTRODUCTION: The dissemination of the COVID-19 pandemic in Europe, namely in Portugal, demanded an organizational and clinical reaction from the Portuguese National Health Service. With the unpredictable impact of COVID-19 infected patients redefining hospital logistics, reducing non-priority elective care and extending the hospital capacity for critical care patients made mobilizing a significant part of human resources a priority. We conducted a national survey to monitor the contribution and the role of anaesthesiologists belonging to the 53 Portuguese National Health Service hospitals in the first wave fight against the pandemic. MATERIAL AND METHODS: This prospective cross-sectional observational study used a weekly survey sent to the Directors of the Anaesthesiology Departments of all Portuguese National Health Service hospitals, between the period of 13th April and 21st June 2020. Directors were asked about human resources, hospital logistics, anaesthetic activity and residency programs in their departments as well as contingency plans facing the impact of the pandemic growth in the PNHS. RESULTS: Contingency strategy for all Portuguese National Health Service hospitals planned for a total of 1524 level III critical care beds during the initial phases of the pandemic, an increase of 151% from the existing 607 level III critical care beds in Portugal in January 2020. This re-configuration effort of the Portuguese National Health Service was only possible due to the partial or total suspension of non-urgent elective activity that reached over 90% of these institutions in the first pandemic months (March and April) and the deployment of anaesthesiologists from their normal activities to the treatment of critical care patients. During the peak of the first pandemic wave, 209 anaesthesiology specialists and 170 trainees (22.9% of the total anaesthesiologist's staff in the Portuguese National Health Service) were deployed in critical care. There was an almost complete interruption of the residency program rotation in 70.4% of hospitals with anaesthesiology residents, between March and April 2020. CONCLUSION: During the first pandemic wave there was an effective and fast reorganisation of the Portuguese National Health Service in order to increase level III critical care beds, which might have contributed to the low mortality rates in Portugal. We believe that this could have also been a result of the contribution given by all public anaesthesiology departments.

Introdução: A disseminação da pandemia por COVID-19 na Europa, designadamente em Portugal, exigiu uma resposta clínica e organizativa por parte do Serviço Nacional de Saúde português. Com o imprevisível impacto da COVID-19 nos doentes infectados, foi prioritário redefinir a logística hospitalar, reduzir a prestação de cuidados electivos não prioritários, e estender a capacidade hospitalar ao tratamento do doente crítico, mobilizando uma parte significativa dos recursos humanos. Utilizou-se um inquérito nacional que permitisse monitorizar a contribuição que os anestesiologistas pertencentes aos 53 hospitais do Serviço Nacional de Saúde tiveram no combate à COVID-19 durante a primeira vaga da pandemia. Material e Métodos: Estudo observacional transversal de tipo prospectivo, baseado num inquérito semanal enviado aos directores dos Serviços de Anestesiologia de todos os hospitais do Serviço Nacional de Saúde, entre 13 de abril e 21 de junho de 2020. Foi solicitada informação relativa aos recursos humanos, logística hospitalar, atividade assistencial, programa de formação pós-graduado, assim como plano de contingência face ao crescimento da pandemia. Resultados: O plano de contingência hospitalar nos hospitais do Serviço Nacional de Saúde previu um total de 1524 camas de cuidados intensivos de nível III, o que corresponde a um crescimento de 151% das 607 camas existentes em janeiro de 2020. Esta reconfiguração dos hospitais do Serviço Nacional de Saúde só foi possível devido à suspensão parcial ou total da atividade eletiva não prioritária que afectou mais de 90% das instituições hospitalares nos primeiros meses da pandemia (março e abril), e à mobilização dos anestesiologistas das suas atividades eletivas para o tratamento do doente crítico. Nos piores momentos, esta mobilização envolveu 209 especialistas e 170 internos de especialidade (22,9% do total destes profissionais nos hospitais do Serviço Nacional de Saúde). Por outro lado, registou-se uma interrupção quase total do programa de formação pós-graduada em mais de 70,4% dos hospitais com esta idoneidade formativa, de março a abril de 2020. Conclusão: Durante a primeira vaga da pandemia houve uma rápida reorganização do Serviço Nacional de Saúde que poderá ter contribuído para a baixa taxa de mortalidade em Portugal. Os autores acreditam que para esse resultado poderá ainda ter contribuído a ajuda dada pelos serviços de Anestesiologia do Serviço Nacional de Saúde.

Optimization of a Patient Distribution Framework: Second Wave COVID-19 Preparedness and Challenges in the Amsterdam Region.

To meet surge capacity and to prevent hospitals from being overwhelmed with COVID-19 patients, a regional crisis task force was established during the first pandemic wave to coordinate the even distribution of COVID-19 patients in the Amsterdam region. Based on a preexisting regional management framework for acute care, this task force was led by physicians experienced in managing mass casualty incidents. A collaborative framework consisting of the regional task force, the national task force, and the region's hospital crisis coordinators facilitated intraregional and interregional patient transfers. After hospital admission rates declined following the first COVID-19 wave, a window of opportunity enabled the task forces to create, standardize, and optimize their patient transfer processes before a potential second wave commenced. Improvement was prioritized according to 3 crucial pillars: process standardization, implementation of new strategies, and continuous evaluation of the decision tree. Implementing the novel "fair share" model as a straightforward patient distribution directive supported the regional task force's decisionmaking. Standardization of the digital patient transfer registration process contributed to a uniform, structured system in which every patient transfer was verifiable on intraregional and interregional levels. Furthermore, the regional task force team was optimized and evaluation meetings were standardized. Lines of communication were enhanced, resulting in increased situational awareness among all stakeholders that indirectly provided a safety net and an improved integral framework for managing COVID-19 care capacities. In this article, we describe enhancements to a patient transfer framework that can serve as an exemplary system to meet surge capacity demands during current and future pandemics.

Analysis of the mental health service provision in Qatar: Progressing in community mental health in a Middle East country.

Background: Qatari health planning in the last decade aimed to make the transition from the traditional hospital-based psychiatric care to a community-based care, building an integrated and comprehensive mental health system. The objective of this study was to explore the mental health service provision in Qatar in 2018 and 2022. This time span coincided with two mental health plans (2013-2018 and 2019-2022) and one health plan (2018-2022). Methods: This study followed a healthcare ecosystem approach, including context analysis and the standard description and classification of mental health services. Service provision was studied applying DESDE-LTC system (Description and Evaluation of Services and DirectoriEs-Long Term Care), an internationally validated methodology to assess and describe mental health services. Service data were analyzed along with sociodemographic indicators from public statistics to know the care context. Results: The availability of specialized mental health services increased for adults, although it remained the same for other age groups. The diversity of care and the weight of health-related care over social-related care also remained quite similar. It was noteworthy the development of new services for young adults, migrant workers, and female populations. Conclusion: This was the first time that this service research methodology has been applied in a Middle East country to study its mental healthcare pattern. The analysis of the mental healthcare pattern in the study time period showed the continued progress toward community-based care in Qatar in the framework of three health plans and despite the unexpected COVID-19 world pandemic.

Практики здоровьесбережения пожилых людей после пандемии (на примере сел Республики Карелия)

В статье рассматриваются особенности практик здоровьесбережения пожилых людей, проживающих в сельской местности и перенесших COVID-19. Эмпирической базой исследования выступают полуструктурированные интервью в трех деревнях юго-востока Республики Карелия с проблемами развития инфраструктуры. Выделенные при анализе интервью практики образуют своеобразный континуум – от самолечения до обращения за помощью местного сообщества, соседей, медиков, к которым имелся доступ. В исследовании определены три основные стратегии здоровьесбережения пожилых людей. Названы факторы, влияющие на формирование этих стратегий.Alternate :The article discusses the features of health-saving practices of older people who have suffered COVID‑19 and live in rural areas. The research focuses on everyday practices and their social projections in the context of the life of older people in such areas. The factors influencing the formation of various health-saving strategies of the olders are described. The most dangerous for all health-saving strategies of the older after COVID‑19 are: infrastructural difficulties, problems associated with the development of rural medicine, lacking support, communications in the local community. The researchers focus on the specific experiences of the older people and how they describe in narratives changing practices and requests for medical help or for the help from the local community after the COVID‑19. The empirical basis of the study is semi-structured interviews collected in three villages in the southeast of the Republic of Karelia with an infrastructure deficit and infrastructure development problems. The strategies outlined in the study form a kind of continuum from the transition to self-medication practices and the use of self-medication by older people, which differ depending on what kind of help older people resorted to, starting from the help of the local community and ending with medical care available in rural areas.

Paleofire Data for Public Health Nursing Wildfire Planning: A Planetary Perspective

Public health Is Increasingly threatened by global warming, land use, and changing wildfire patterns that shape vegetation type, structure, and biodiversity and ultimately affect ecosystem services and our society.1 Uncontrolled large wildfires emit greenhouse gases and aerosols that induce direct and indirect climate feedback through radiative forcing in the atmosphere2 and irreversible changes of natural vegetation, thereby further accelerating climate change and associated fire risks.3 Wildfires are also harmful to human health because they create high pollution concentrations of fine particulate matter that are 2.5 micrometers or smaller (PM2.5) and concentrations of coarse particulate matter that are between 2.5 and 10 micrometers in size. When inhaled, particulate matter significantly increases a myriad of health outcomes, including overall mortality, cardiovascular mortality, and emergency department visits for respiratory morbidity, congestive heart failure, chronic obstructive pulmonary disease, and angina.4,5 Between July and October 2020, high PM2.5 concentrations from massive wildfires surrounding a large regional hospital in the western United States were associated with a 6% increase in COVID-19 cases.6 Risks for developing adverse health effects from wildfire smoke are greatest among people who are living with chronic conditions;who are experiencing intergenerational racial, economic, and housing discrimination;and who are facing social inequities from the COVID-19 pandemic.4The unprecedented recent wildfires in the western United States and their ill effects on human health and society, as well as the multiple other threats to people and places brought about by climate change, draw attention to the increasing urgency of developing new public health approaches and long-term adaptation strategies to support future population health. Observational fire data covering the past few decades give valuable information on current wildfire events.1 However, these data hardly capture long-term trends (i.e., centennial to millennial time scales) of wildfires and associated atmospheric emissions that may help to improve future fire models and thereby provide the base to adapt public health systems.3 To understand long-term trends, natural archives preserve fire history on a wide range ofspatial scales in the past beyond the period of observational fire data;examples include polar and highalpine ice cores;lake, peat, and marine sediment cores.3,8,9 Such paleofire records are based on measurements of the gaseous tracers ammonium and nitrate or particulate matter, such as levoglucosan and black carbon, and charcoal that reflect different components of wildfire-induced atmospheric smoke pollution.8,9 These paleofire records have previously identified complex regional interactions of humans, ecosystems, and climate change.3 Submicron-sized (100-500 nm in diameter) black carbon particles from wildfires and fossil fuel during the industrial era (i.e., the past 250 years) measured in ice cores and lake sediments can be used as a direct tracer for the release of harmful PM2.5 to the atmosphere.8,10 Such paleo black carbon records have been established from both polar and high-alpine glaciers on several continents and are recently developed from lake sediments.10 These found significant changes of fire activity in response to climate and human impact and enhanced pollution levels varying both in time and space. With public health nurses being well positioned to understand population health needs, planetary health, and the health consequences of wildfires, public health nurses can improve upon wildfire adaptation planning and essential public health services by understanding historical perspectives from past fires.9,11,13 Paleofire data provide direct estimates of historical atmospheric emissions from past wildfires and associated harmful concentrations of particulate matter over long distances.

In the shadow of freedom of religion and the press

The Korean government's public health responses to the COVID-19 epidemic have achieved a remarkable outcome in terms of the measured number of infected patients and the overall mortality rate. Nonetheless, the public health authority's various mitigation strategies and vaccination efforts have faced several challenges primarily posed by politically motivated Christian fundamentalists and ultraconservative media's distorted news framing in Korea. This paper examines how these conservative forces - both religious and political - have undermined the Korean public health authority's various mitigation efforts and discusses how to address the problems from a public policy point of view. The paper argues that a comprehensive legal reform including the introduction of effective punitive damages in the media market is a necessary minimum to address some of these problems.

Syndemic analysis of the pandemic COVID-19 crisis: a multidisciplinary "Understand-Anticipate - Propose" meta-method.

BACKGROUND: In order to understand the pandemic COVID-19 crisis in a forward-looking way, the French High Council for public health (HCSP) has designed a conceptual scheme for public health planning based on L. Green's model in order to better understand the issues at stake, by identifying dangers and levers for action. The final aim was to establish priorities and guidelines in order to anticipate the collateral consequences of the management of the crisis and be better prepared for the next one. METHOD: A public health conceptual framework PRECEDE-PROCEED adapted to the Covid-19 health crisis was developed using both a graphic (concept map) and analytic (to make the conceptual scheme functional) approaches. Then, a "meta-method" was applied using three distinct cognitive stages: understanding, anticipation and proposals of action. RESULTS: The conceptual framework was broken down into 10 technical sheets covering essential diagnoses and integrating different public health determinants. Each of these was broken down into three cognitive stages, allowing for a diagnosis of understanding, a scenario of anticipation and a strategic analysis of action according to the chronology: understand-anticipate-propose. From these 10 technical sheets, 32 guidelines have been proposed. CONCLUSION: This work is intended to allow reflections on public health approaches to strengthen and anticipate health crisis management and health planning by politic managers working at national or sub-national level.

Risk management and communication plans from SARS to COVID-19 and beyond.

OBJECTIVE: Nowadays, due to globalisation, the likelihood that infectious diseases spread rapidly is extraordinarily high. SARS and COVID-19 are two diseases of the Coronavirus family, which developed in China and then spread internationally, causing global public health emergencies. This study investigates the role that risk management and communication systems played in mitigating these emergencies, to establish how they should be improved in the future. METHODS: A narrative review was carried out to investigate different knowledge domains, such as risk management and communication, risk assessment and indicators, epidemiological and clinical data, diagnostic methods, vaccines, public health and social measures. RESULTS: On one side, risk management systems assess the main data, knowledge, and indicators on epidemiology, diagnostics, and vaccines (science-based); on the other side, they apply public health and social measures (socially-based). Decision-makers, in fact, implement their actions by constantly balancing these two sides (policy-based). CONCLUSIONS: A correct crisis management approach should support the governance of pandemics, by harmonising the actual risks assessed by experts with those perceived by the general population. It should incorporate not only the biological, but even the environmental, social and economic aspects of virus emergencies, towards establishing a suitable framework to deal with possible future pandemics.

Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review.

BACKGROUND: The provision of care to pregnant persons and neonates must continue through pandemics. To maintain quality of care, while minimizing physical contact during the Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV2) pandemic, hospitals and international organizations issued recommendations on maternity and neonatal care delivery and restructuring of clinical and academic services. Early in the pandemic, recommendations relied on expert opinion, and offered a one-size-fits-all set of guidelines. Our aim was to examine these recommendations and provide the rationale and context to guide clinicians, administrators, educators, and researchers, on how to adapt maternity and neonatal services during the pandemic, regardless of jurisdiction. METHOD: Our initial database search used Medical subject headings and free-text search terms related to coronavirus infections, pregnancy and neonatology, and summarized relevant recommendations from international society guidelines. Subsequent targeted searches to December 30, 2020, included relevant publications in general medical and obstetric journals, and updated society recommendations. RESULTS: We identified 846 titles and abstracts, of which 105 English-language publications fulfilled eligibility criteria and were included in our study. A multidisciplinary team representing clinicians from various disciplines, academics, administrators and training program directors critically appraised the literature to collate recommendations by multiple jurisdictions, including a quaternary care Canadian hospital, to provide context and rationale for viable options. INTERPRETATION: There are different schools of thought regarding effective practices in obstetric and neonatal services. Our critical review presents the rationale to effectively modify services, based on the phase of the pandemic, the prevalence of infection in the population, and resource availability.