LearnIT2teach: Teacher training and online learning for newcomers in times of crises

How teachers creatively adopted and adapted to the effects of the COVID-19 outbreak is at the heart of the findings presented in this chapter. With the support of the Avenue-LearnIT2teach project, English Second Language (ESL) teachers in Canada enabled the rapid response of many Language Instruction for Newcomers to Canada (LINC) programs to site closures, resulting in an unprecedented uptake of online learning (OL) in a matter of weeks. The project rapidly changed course to support LINC teachers to adopt blended learning (BL) courseware and adapt teaching practices to the new OL reality. This chapter discusses the impact of the project's efforts to meet the surge in demand in teacher training and learner courseware for these online immigrant settlement and language learning programs. The project's rapid response to onsite LINC program closures during the COVID-19 crisis is reviewed. As a result of the disruptions to in-person program delivery, the focus of the project has shifted from blended learning (BL) to online learning (OL) by adapting its formal and informal professional development (PD) offerings. Findings with respect to the surge in demand for teacher training, course development, and mentoring are presented. Feedback from teachers on the "front lines" further illustrates teachers' OL uptake. The chapter also addresses the impact of formal and informal PD provided by a committed team of mentors as well as the importance of teacher presence in online program delivery. Implications and recommendations with respect to rapid responses in situations of crises conclude the chapter. © Springer Nature Switzerland AG 2021. All rights reserved.

Beyond the Exscalate4CoV Project: LIGATE and REMEDI4ALL Projects

In the last 2 years, the SARS-CoV-2 (COVID-19) pandemic demonstrated that rapid response to outbreaks with readily effective treatments represents a primary health and societal priority. At the same time, we became conscious that technological resources are often not used in the most efficient manner. The LIGATE and REpurposing MEDIcines For All (REMEDI4ALL) projects started on the large-scale mobilization efforts of the EXaSCale smArt pLatform Against paThogEns (Exscalate4Cov) project with the aim to apply cutting-edge technologies in drug discovery, sustain the fight against future pandemics, and promote the everyday fight against rare diseases. In particular, the LIGATE project, using the drug-discovery platform Exscalate, intends to boost the virtual screening of drug campaigns at an extreme scale in terms of performance and streamline the drug-development process. The aim of the REMEDI4ALL project is to collect sciQ1entific expertise and innovative technology platforms for the repurposing of medicines to treat rare diseases or other pathologic conditions with no current therapy. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

A Participatory Archives Approach to Fostering Connectivity, Increasing Empathy, and Building Resilience during the COVID-19 Pandemic

This paper explores two pandemic-era projects conducted by the Museum and Archives of North Vancouver (MONOVA) using a participatory archives framework during the COVID-19 pandemic. #NorthVanStories, a rapid-respond social media collecting project, ran from May to September 2020 and received over 200 submissions. #NorthVanStories–Living Histories, a digital video oral history project, ran from summer 2020 to fall 2021 and produced five videos with seven storytellers from diverse and vulnerable communities. This paper discusses the power of collaborative documenting, storytelling, and memory-making to foster connectivity, increase empathy, and build resilience. It highlights the benefits of working collaboratively with organizations and communities;successful approaches to planning and outreach activities;the importance of flexibility and sustainability when working with communities in times of crisis;and how to ensure the future relevance of archives by being responsive to contemporary events and community interests. © 2023 by the author.

DNN and Model Combined Passive Localization and Social Distancing with Partial Inertial Aiding

At the outbreak of COVID-19, researchers worldwide are seeking approaches to containing this disease. It is necessary to monitor social distance in enclosed public areas, such as subways or shopping malls. Passive localization, such as surveillance cameras, is a natural candidate for this issue, which is meaningful for rapid response to finding the infected suspect. However, the latest surveillance camera system is rotatable, even movable. And it is impossible for professionals to regularly calibrate the extrinsic parameters in a large-scale application, like COVID-19 suspect monitoring. We propose an inertial-aided passive localization method using surveillance camera for social distance measurement without the necessity to obtain extrinsic parameters. Moreover, the hardware modification cost of the off-the-shelf commercial camera is low, which suits the immediate application. The method uses SGBM (Semi-Global Block Matching) for 3D reconstruction and combines YOLOv3 and Gaussian Mixture Model (GMM) clustering algorithm to extract pedestrian point clouds in real time. Combining the 2D DNN-based and model-based methods makes a better balance between the computational load and the detection accuracy than end-to-end 3D DNN-based method. The inertial sensor provides an extra observation for the coordinate transformation from the camera frame into the world ground frame. Results show we can get a decimeter-level social distancing accuracy under noisy background and foreground environments at a low cost, which is promising for urgent COVID-19 public area monitoring. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Remote Operations and Digital Transformation: A Solution for Business Continuity During Covid-19 Pandemic

Mubadala Petroleum conducts a fast-paced drilling program in the Gulf of Thailand, where rapid response resolutions are often required. This paper demonstrates the Remote Operation (RO) approach, which is an integrated approach comprised of people, software, network, and technology to transform operations, and moves analytical activities to safer office-based environments (Figure 1). The approach provides a high level of performance, leveraging global domain expertise, real-time collaboration, data visualization techniques, and intelligent planning within the restrictive context of the COVID-19 pandemic. Copyright © 2022, Offshore Technology Conference.

Comparing the control of COVID-19 epidemic before and after the implementation of rapid response program in southeast of Iran

Objective(s): Organizing the rapid response team is one of the strategic mechanisms that have been used to control the COVID-19 epidemic. This study aimed to compare the COVID-19 epidemic control before and after the implementation of rapid response program in southeast Iran. Methods: This cross-sectional study was carried out in Sistan and Baluchestan province in summer of 2021. The rapid response team has been settled in the region for 3 weeks since 3 July, and rapid response program including mass vaccination with a community-based approach has been implemented in catchment populations of three universities of medical sciences including Zaheadn, Iranshahr and Zabon. Data were collected from June 5, until September 23, 2021 and analyzed using descriptive statistics in Excel software. Results: During the study period, a total of 2,514,911 people were admitted and 2,125,389 people (84.5%) were discharged. 58,441 (2.3%) of the cases were hospitalized. The total number of tests taken during the study period was 310,741 (111,978 tests per million population). This rate decreased about 15% after the implementation (36% versus 21.7%). The total number of positive death cases was estimated at 0.9 per 1000 population. After the implementation, the mean number of hospitalized cases (59 patients per day), the mean difference of positive laboratory cases (400 cases per day), and the mean difference in the number of deaths (confirmed cases) decreased to eight cases per day. Conclusion: The findings showed that the implementation of rapid response program with community-based approach in was successful in controlling the COVID-19 epidemic. © 2023, Iranian Institute for Health Sciences Research. All rights reserved.

Structural Elements and Requirements in Forming Prehospital Health Response Teams in Response to Chemical, Biological, Radiation, and Nuclear Incidents (CBRN), a Comparative Review Study.

One of the important indicators of increasing the capacity of the health system and the chances of survival of patients and injured immediately after chemical, biological, radiation and nuclear (CBRN) accidents is rapid access to medical services. Establishing prehospital health response teams is one of the main strategies to improve the capacity and ability to respond to unusual events. The aim of this study was to investigate the factors influencing the formation of rapid response teams in the field of health in response to chemical, biological, radiation and nuclear accidents (CBRN EDMRT). In this study, the comparative review method was used. The study period was from November 1, 2021 to March 2022. Forming and deploying rapid health response teams based on an extensive multi-step search and keywords in multiple databases such as PubMed, CINHAL, Blackwell, Iranmedex, SID, Cochrane Database of Systematic Reviews, Google Scholar, Scopus Also, the websites of the Ministry of Health and the responsible organizations in different countries and the proposed structure were done by international institutions and sites. After accessing the resources and documents, the process of analysis and comparison of different team structures was performed. After the initial search, the structure and required elements of their teams were extracted. According to published articles and texts, 10 teams from the International Atomic Energy Agency (IAEA), the US Centers for Disease Control and Prevention (CDC), the US Department of Homeland Security, and the North Atlantic Treaty Organization (NATO), Australia, the British Public Health Organization, and the Japanese Red Cross were compared. Team requirements, population distribution, type of accident, level of team activity and training, equipment required by the team after the accident, according to which, each country/organization should consider the above factors to design and establish the structure of CBRN EDMRT to take. A study should be conducted to design a comprehensive and evidence-based structure.

Contemporary Collecting in a Pandemic: Challenges and Solutions for Documenting the COVID-19 Pandemic in Memory Organizations

This paper draws on a survey of contemporary collecting projects aiming to document the COVID-19 pandemic in museums and other memory organizations. The survey focused on European memory organizations and investigated the practices they adopted in collecting, accessioning, recording, preserving, and displaying material and immaterial witnesses of the pandemic. This paper presents the results of the survey, with a particular attention on the challenges faced by these projects in relation to born-digital objects. It discusses how organizations were able to quickly launch initiatives aimed at collecting memories of the pandemic, drawing on different collection methods, adapting to the circumstances, and using a proactive attitude to reach out to different communities. The paper highlights the solutions adopted to ensure legal compliance in these projects and discusses the need for ethical considerations in relation to the collection of traumatic memories. It suggests that these collecting projects are likely to face significant challenges in the subsequent processing of this material-due to its volume and the need for new digital curation and preservation workflows. Therefore, the paper argues that these projects could also lead to a renewed attention and collaboration across the heritage sector on issues of digital curation and preservation.

[Recommendations for the management of long Covid]. / Les recommandations de prise en charge du Covid long.

As we enter the eighth wave of pandemic Covid-19 infection, the disabling persistence of certain symptoms after this viral infection, often trivial with the latest variants, is still a concern. The most effective treatment of these prolonged symptoms after Covid remains a rapid diagnosis, even if it is primarily of elimination, followed by comprehensive, multidisciplinary, specialized management and early but individualized self-help exercises.

Local response in health emergencies: key considerations for COVID-19 in informal urban settlements.

This paper highlights the major challenges and considerations for addressing COVID-19 in informal settlements. It discusses what is known about vulnerabilities and how to support local protective action. There is heightened concern about informal urban settlements because of the combination of population density and inadequate access to water and sanitation, which makes standard advice about social distancing and washing hands implausible. There are further challenges to do with the lack of reliable data and the social, political and economic contexts in each setting that will influence vulnerability and possibilities for action. The potential health impacts of COVID-19 are immense in informal settlements, but if control measures are poorly executed these could also have deep negative impacts. Public health interventions must be balanced with social and economic interventions, especially in relation to the informal economy upon which many poor urban residents depend. Local residents, leaders and community-based groups must be engaged and resourced to develop locally appropriate control strategies, in partnership with local governments and authorities. Historically, informal settlements and their residents have been stigmatized, blamed, and subjected to rules and regulations that are unaffordable or unfeasible to adhere to. Responses to COVID-19 should not repeat these mistakes. Priorities for enabling effective control measures include: collaborating with local residents who have unsurpassed knowledge of relevant spatial and social infrastructures, strengthening coordination with local governments, and investing in improved data for monitoring the response in informal settlements.

Assessing the agile approach to critical infrastructure in the light of primary research

Critical infrastructures have received increasing attention in recent years. One of the main reasons for this over the past two years or so has been the pandemic of the coronavirus and its aftermath, which has required stability but also rapid response and effective management of change to ensure smooth operations. The agile approach, which has its origins in software development, offers precisely these benefits when applied. © 2022 IEEE.

COVID-19 Warning System

The current pandemic has compelled everyone, at all levels, to make a quick and difficult reversal. Our lives are significantly influenced and altered, particularly in terms of how we behave and connect in various facets of our professional and personal life. For example, whilst the peak of the pandemic’s first wave in Europe, people delayed seeking medical help out of fear of becoming infected, a fear that has yet to be completely dispelled. We are still in the midst of the pandemic, unsure when or how it will end. The paradigm is also horribly, extremely attention-grabbing when it comes to research projects within the framework of this scientific journal. The creation of research project processes can take a lengthy period in some cases. For example, it is usual for a project’s look to take two months (or more) to develop, then six months (or more) to review, and finally two or three years to complete once authorised. The direct benefit to society is not always apparent. Sometimes, the outcomes are “just” intermediate stages (little steps) that will be adopted or modified (complemented) into something directly beneficial to society in the future. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Use of mobile medical teams to fill critical gaps in health service delivery in complex humanitarian settings, 2017-2020: a case study of South Sudan.

The vulnerable populations in the protracted humanitarian crisis in South Sudan are faced with constrained access to health services and frequent disease outbreaks. Here, we describe the experiences of emergency mobile medical teams (eMMT) assembled by the World Health Organization (WHO) South Sudan to respond to public health emergencies. Interventions: the eMMTs, multidisciplinary teams based at national, state and county levels, are rapidly deployed to conduct rapid assessments, outbreak investigations, and initiate public health response during acute emergencies. The eMMTs were deployed to locations affected by flooding, conflicts, famine, and disease outbreaks. We reviewed records of deployment reports, outreach and campaign registers, and analyzed the key achievements of the eMMTs for 2017 through 2020. Achievements: the eMMTs investigated disease outbreaks including cholera, measles, Rift Valley fever and coronavirus disease (COVID-19) in 13 counties, conducted mobile outreaches in emergency locations in 38 counties (320,988 consultations conducted), trained 550 healthcare workers including rapid response teams, and supported reactive measles vaccination campaigns in seven counties [148,726, (72-125%) under-5-year-old children vaccinated] and reactive oral cholera vaccination campaigns in four counties (355,790 vaccinated). The eMMT is relevant in humanitarian settings and can reduce excess morbidity and mortality and fill gaps that routine health facilities and health partners could not bridge. However, the scope of the services offered needs to be broadened to include mental and psychosocial care and a strategy for ensuring continuity of vaccination services and management of chronic conditions after the mobile outreach is instituted.

Study of the Deep Processes of COVID-19 in Russia: Finding Ways to Identify Preventive Measures.

The novel coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on all areas of human life. Since the risk of biological threats will persist in the future, it is very important to ensure mobilization readiness for a prompt response to the possible emergence of epidemics of infectious diseases. Therefore, from both a theoretical and practical standpoint, it is currently necessary to conduct a thorough examination of the COVID-19 epidemic. The goal of this research is to investigate the underlying processes that led to the COVID-19 pandemic in Russia and to identify ways to improve preventive measures and ensure mobilization readiness for a quick response to potential COVID-19-like pandemics. This research will analyze the daily dynamics of the number of infection cases and the number of new lethal cases of COVID-19. We analyzed the daily number of new cases of COVID-19 infection N(d), the daily number of new lethal cases L(d), their percentage ratio L(d)/N(d) 100% in Russia for 2 years of the pandemic (from the beginning of the pandemic to 23 March 2022), the rate of increase and decrease of these indicators (dN(d)/dd and dL(d)/dd), as well as their spectra created on the basis of wavelet analysis. Wavelet analysis of the deep structure of the N(d) and L(d) wavelet spectra made it possible to identify the presence of internal cycles, the study of which makes it possible to predict the presence of days with the maximum number of infections and new deaths in a pandemic similar to COVID-19 and outline ways and methods for improving preventive measures and measures to ensure mobilization readiness for a rapid response to the potential emergence of pandemics similar to COVID-19.

IMPACT OF EDUCATIONAL ACTIVITIES, DEDICATED RAPID RESPONSE TEAMS, AND QUALITY CASE REVIEWS ON IN-HOSPITAL CARDIAC ARREST

SESSION TITLE: Lifelong Learning in Critical Care SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: Physiological instability occurs several hours prior to in-hospital cardiac arrest. Delays in early intervention is associated with an increase in morbidity, mortality and the incidence of in-hospital cardiac arrest [1]. Improving health care quality through the deployment of a rapid response team was recommended in 2004 by the Institute for Healthcare Improvement through the ‘100,000 Lives Campaign’ [2]. METHODS: Cleveland Clinic Fairview Hospital, one of the largest academic centers of the Cleveland Clinic Health Care System, appointed a dedicated daytime Rapid Response Registered Nurse in 2016, and in 2017 the above coverage was expanded to the night and week-end shifts. In 2019 a dedicated Internal Medicine Residents team took the lead of the Rapid Response and Code Blue team. Starting in 2017 monthly unannounced Rapid Response and Code Blue educational simulation cases were implemented, and in 2020 a dedicated simulation Lab provided immersive leaning experience to healthcare practitioners. In 2018 a centralized Code Blue event ion by the Quality Data Registry begun and in 2020 monthly events review helped improve the quality of cardiopulmonary resuscitation with valuable feedback provided to caregivers. Also, in 2020 the Cleveland Clinic Health Care System Resuscitation Operations Council was formed, where representatives from each hospital shared experience and quality initiatives. The above helped with the standardization of care across the 21 hospitals of the Cleveland Clinic Enterprise. RESULTS: Across five years of quality initiatives and consolidation of our rapid response response team from 2016 to 2021, the number of Rapid Responses increased by 104 % from 704 events in 2015 to 1438 in 2021. At the same time, the number of Code Blue events decreased by 56.5% from 283 in 2015 to 123 in 2021 and the number on non-critical care medical and surgical units decreased by 48.9% from 45 to 23 cases per year. The above was seen despite a significant increase in the hospital patient census, and the Coronavirus Infectious Disease 19 Pandemic where Fairview Hospital served as a tertiary referral center for all North Central and North Western Ohio. These results confirm prior published data on the subject where not only a focused rapid response team but also educational, simulation and case review activities are all associated with a reduced incidence of unexpected cardiac arrest [3-9]. CONCLUSIONS: A dedicated Rapid Response and Code Blue team, Simulation in education, and frequent quality review of cardiac arrest cases are all strategies that reduce the incidence of in hospital cardiac arrest. Future research is needed to highlight the impact of each of those quality and educational initiatives on outcomes and performance. CLINICAL IMPLICATIONS: Educational Activities, Dedicated Rapid Response Team and Quality Case Reviews decreases the incidence of In-Hospital Cardiac Arrest. DISCLOSURES: No relevant relationships by Francois Abi Fadel No relevant relationships by Lauren Crosby no disclosure on file for Megan Edwards;no disclosure on file for June McMahan;no disclosure on file for Patrick Murphy;No relevant relationships by Kelly Orlosky No relevant relationships by Anoosha Tauquir

TRAINING THE LEADER: EFFECTIVENESS OF A SIMULATION AND CLINICAL SKILLS-BASED CURRICULUM ON RESIDENT COMFORT LEVEL AS CODE LEADERS

SESSION TITLE: Trainees: Mental Well-Being and Performance SESSION TYPE: Original Investigations PRESENTED ON: 10/16/22 10:30 am - 11:30 am PURPOSE: With the COVID-19 pandemic and hospital surges, our institution’s house staff was responsible for a significantly increased volume of critically ill patients while balancing residency training. In August 2020, a needs assessment survey was distributed among categorical Internal Medicine (IM) and Internal Medicine/Pediatrics (Med-Peds) residents. The results indicated low comfort levels in the evaluation of decompensating patients and in leading rapid response teams (RRTs). A grassroots initiative was started by two residents and a resuscitation nursing coordinator to address this need. Here, we describe the design and implementation of a resident-led simulation and clinical skills-based curriculum aimed at improving residents’ comfort in leading RRTs. METHODS: From August to September 2021, 56 senior level IM and Med-Peds residents attended a three-hour resuscitation workshop. A mixed educational format with high fidelity simulations, hands-on skills and small group debriefing discussions was implemented. Five scenarios were developed from retrospective hospital-wide RRT data;ventricular tachycardia (VT), supraventricular tachycardia (SVT), ventricular fibrillation, symptomatic bradycardia, and respiratory distress. Skills training included defibrillator use, transcutaneous pacing, adenosine administration, intraosseous line placement and low- and high-flow oxygen delivery devices. Participants were asked to complete a pre- and post-workshop questionnaire. The survey consisted of 7 questions about their comfort level on a 5-point Likert scale. A two-sample t-test was used to assess for difference in mean scores. RESULTS: Residents’ comfort level scores improved significantly in the following: from 3.49 to 4.36 (P< 0.0001) in the initial evaluation of an RRT patient, from 3.14 to 3.84 (P= 0.0026) in regard to thinking quickly during an emergency, and from 2.88 to 4.00 (P< 0.0001) in leading a RRT. There was also a global increase in comfort level scores with the scenarios: “VT” (P=0.0003), “SVT” (P< 0.0001), “symptomatic bradycardia” (P< 0.0001), and “respiratory distress” (P= 0.0324). CONCLUSIONS: Residents’ comfort levels as code leaders encountering various RRT scenarios significantly improved after our three-hour high-fidelity simulation and clinical skills workshop. CLINICAL IMPLICATIONS: Despite the challenges of COVID-19 group gathering restrictions and hospital surges, this training course became a well-received educational project to improve the effectiveness of resident-led RRTs. In response to its success, a pilot two-year curriculum involving more diverse RRT scenarios is currently being launched. The curriculum includes three workshop sessions per year for a multidisciplinary team of residents, pharmacy residents, and nurses aimed at improving code leader effectiveness and teamwork dynamics. DISCLOSURES: No relevant relationships by Tanja Barac No relevant relationships by Christie Brillante No relevant relationships by Lily Cheng No relevant relationships by Paul Cooper no disclosure on file for Cristina Diaz Pabon;No relevant relationships by Shaveta Khosla

Agility as a Driver of Digital Transformation - a Literature Review

Agility has become increasingly relevant in research and practice in recent years. Originating from software development, it is now progressively applied beyond this field. This agile scaling enables companies to harness the benefits of a flexible and rapid response to change. Widespread digitalisation, increasing complexity and dynamic competitive conditions require companies to demonstrate flexibility and speed of response to drive a digital transformation (DT) towards a digital business. In the wake of the COVID-19 pandemic, many companies have been confronted with DT. Against this background, this paper aims to derive from previous research how companies can benefit from agile project management and agile scaling in DT. For this purpose, a structured literature review was conducted on four scholarly databases, 225 articles were found and reduced to 28 relevant articles through a methodical approach. The review revealed that agility is defined as a driver of DT. Starting from agile digitalisation projects, agility can be carried into the organization and thus support DT. Nevertheless, while the connections between pandemic and DT and between agility and DT are already the subject of research, the two fields have not been linked in the analysed articles. The findings synthesize the current state of knowledge and suggest first agile approaches to framing DT in the context of the pandemic. Future research efforts are needed to provide companies with measures for dealing with the “new normal”. © 2022, IFIP International Federation for Information Processing.

Health system response to COVID-19 and efforts to maintain essential health services in selected primary health care units in Ethiopia: A qualitative study

Introduction/ Background: The COVID-19 pandemic has brought multifaceted impact including on health systems. In Ethiopia limited data is available how the response to the pandemic is shaping at sub-national level. This study explored the response to COVID-19 at subnational level and its impact on essential health services. Methods: We conducted a qualitative study using key informant interviews. A total of 59 health leaders across Ethiopia's 10 regions and 2 administrative cities were purposively selected. Data were collected using a semi-structured interview guide in October 2020. Transcripts were coded, categorized and thematic analysis was conducted. Twenty-four experts with graduate level training conducted the interviews and supervised the data collection. The respondents included regional and zonal managers, directors and health workers at primary health facilities. Results: Local government took the lead in responding to COVID-19 by organizing multisectoral committees. Health officials organized incident management teams. The management reassigned the health workforce to COVID-19 surveillance and case management and took other measures. Training was prioritized for members of rapid response teams, laboratory technicians, clinicians assigned to treatment centers and health extension workers. Personal protective equipment was difficult to obtain at the beginning of the pandemic. Rapid response teams conducted case investigation, contact tracing, and sample collection. Essential health services declined in the first few months of the pandemic, affecting maternal and child health, HIV/AIDS, and tuberculosis services. Impact: There is a need to learn from the multisectoral actions that were effective at beginning of the SARS-COV-2 pandemic. it also underscores multisectoral actions are critical for minimizing the impact of pandemics such as COVID-19. In addition, investing to build resilient health systems at grassroots is a priority issue. Conclusion: Multisectoral support was intensive at beginning and helped in directing human, material, and financial resources toward the response. But the intensity of the response faded away and essential services suffered in the first few months of the pandemic.

Tunisian first COVID-19 Intra-Action Review, March-July 2021

Introduction/ Background: The objective of the Intra-Action Review (IAR) was to review the Tunisian COVID-19 national preparedness and response best practices and challenges to adjust the response to the crisis and impact of COVID-19 pandemic on health systems. Methods: RIA is an interactive and structured methodology, developed by WHO to identify best practices and challenges in a response to an ongoing crisis. The first RIA on COVID-19 response in Tunisia was carried out, under the Tunisian Ministry of Health in cooperation with the German Biological Safety Program and the Biosecurity Cooperation Project in Tunisia, from March 30 to July 1, 2021. Four pillars of the Covid-19 response were selected for review: coordination, laboratory, points of entry, and logistic support. Results: The RIA identified 24 best practices, 23 challenges and 23 recommendations to improve the current response by adopting appropriate actions for immediate, mid and long-term implementation. The best practices include: availability of a prevention, preparedness, response and resilience plan (2P2R), an Early Warning, Alert and Response System (EWARS);regular weekly teleconference “EPICOV”;trained Rapid Response Teams (RRTs), Field epidemiologist and laboratory staff, decentralization of SARS-CoV-2 testing;and an efficient stock management system. The most important challenges were leadership and coordination mechanism, legal framework, human resources, and genomic-sequencing surveillance capacity. Impact: The RIA was an opportunity to analyze the operational capacity of the Tunisian health system to respond to the pandemic in collaboration with other relevant sectors. The results of the RIA will serve to adjust the national response to Covid-19. Conclusion: The recommendations target a legal framework, a quality assurance management system and an Integrated Disease Surveillance and Response (IDRS) system. The RIA recommended also to enhance coordination within and between pillars;and mobilize funds to support 2P2R, EWARS, IDRS and human resources and provide a basis for future joint activities.