Examining COVID-19 response among local governments through the political market framework.

The coronavirus disease 2019 (COVID-19) pandemic has brought to the forefront the importance of a local government's role during public health emergencies. While cities around the world have led the pandemic response in their communities by extending public health services, providing socioeconomic assistance to constituents and aiding small businesses and jurisdictions in the United States have had varying degrees of success in managing the crisis. As such, this study employs the political market framework to explore the impact of supply-side determinants (form of government, preparedness capabilities, and federal aid) and demand-side determinants (population, socioeconomic factors, and political affiliation) on a local government's COVID-19 response. Given the lack of attention, the emergency management literature has paid on government form, exploring the impact of council-manager vs mayor-council systems on COVID-19 response has been this study's primary focus. Using a logistic regression and survey data across Florida and Pennsylvania local governments, this study finds government form significant for COVID-19 response. Following our findings, local governments with a council-manager form were more likely to adopt public health and socioeconomic strategies in response to the pandemic than were those with other forms. Furthermore, having emergency management plans, receiving public assistance from Federal Emergency Management Agency, community characteristics like the percent of teens and non-White residents, and political affiliation also had a significant impact on the likelihood of response strategies being adopted.

A comprehensive and healthcare equity promoting response by a civil society-public partnership to COVID-19 in Chiapas, Mexico.

Following the first COVID-19 case in Chiapas, Mexico in March 2020, the non-governmental organisation Compañeros En Salud (CES) and the state's Ministry of Health (MOH) decided to join forces to respond to the global pandemic. The collaboration was built over 8 years of partnership to bring healthcare to underserved populations in the Sierra Madre region. The response consisted of a comprehensive SARS-CoV-2 infection prevention and control programme, which included prevention through communication campaigns to combat misinformation and stigma related to COVID-19, contact tracing of suspected and confirmed COVID-19 cases and their contacts, outpatient and inpatient care for patients with respiratory symptoms, and CES-MOH collaboration on anti-COVID-19 immunisation campaigns. In this article, we describe these interventions and their principal outcomes, as well as reflect on notable pitfalls identified during the collaboration, and we suggest a series of recommendations to prevent and mitigate their occurrence. As with many cities and towns across the globe, the poor preparedness of the local health system for a pandemic and pandemic response led to the collapse of the medical supply chain, the saturation of public medical facilities and the exhaustion of healthcare personnel, which had to be overcome through adaptation, collaboration and innovation. For our programme in particular, the lack of a formal definition of roles and clear lines of communication between CES and the MOH; thoughtful planning, monitoring and evaluation and active engagement of the communities served in the design and implementation of health interventions affected the outcomes of our efforts.

Public Health Law Modernization 2.0: Rebalancing Public Health Powers And Individual Liberty In The Age Of COVID-19.

Public health emergency powers laws in the US underwent a profound stress test during the COVID-19 pandemic. Designed with bioterrorism in mind, they struggled to meet the challenges of a multiyear pandemic. Public health legal powers in the US are both too limited, in that they don't clearly permit officials to implement measures necessary to combat epidemics, and too broad, in that their accountability mechanisms fall short of public expectations. Recently, some courts and state legislatures have cut deeply into emergency powers, jeopardizing future emergency response. Instead of this curtailment of essential powers, the states and Congress should modernize emergency powers laws to balance powers and individual rights in more productive ways. In this analysis we propose reforms including meaningful legislative checks on executive power, stronger substantive standards for executive orders, mechanisms for public and legislative input, and clearer authority to issue orders affecting groups of people.

Explaining the role and responsibilities of the National Anti-Coronavirus Headquarters in prevention and emergency response to pandemics in the workplace: a qualitative study on COVID-19 experience in Iran.

BACKGROUND: In recent years, the Coronavirus disease 2019 (COVID-19) have greatly affected the safety of life and the economy. Taking rapid measures to reduce these problems requires effective and efficient decisions by various departments and headquarters in a country. The purpose of this study was to investigate the role and responsibilities of the National Anti-Corona Headquarters (NACH) in the workplace during the pandemic. METHODS: This study was a qualitative study conducted using a triangulation approach. Data were obtained through semi-structured interviews with 18 participants with a purposive sampling technique as well as the review of related documents and records in response to the COVID-19 pandemic. The inductive and deductive approach was used for the content analysis of data in the Plan-Do-Check-Act (PDCA) model of the ISO45001 management system. RESULTS: Based on the results, four themes (plan, do, check, and act) were considered as the main domains. Subthemes include understanding the needs and expectations of interested parties; specific policy-making for organizations/workplaces; leadership and organizational commitment; addressing risks and opportunities; providing resources; competence of individuals and organizations; awareness; communication; information documentation; emergency response; monitoring, analyze, and evaluate performance; management review; non-compliance and corrective action; and improvement in pandemic control. CONCLUSION: To ensure the effectiveness and efficiency of organizations to deal with pandemics, the NACH must implement these responsibilities and play a pivotal role in responding to pandemics and using the participation of other government agencies and society. The findings of this study can be useful from national to local levels.

Integrating the global health perspective in schools of public health: lessons learned from the Covid-19 pandemic.

This essay discusses the need for schools of public health to convene to implement the practice of public health teaching and research by training health leaders, generating knowledge, and providing health and social services that contribute to the well-being of the community. Since their inception, the academic, research and service programs of some schools have been designed to serve as partners and allies of governments and the health sector in general. Part of their role has been to identify health risks to communities, design strategies to address major problems affecting health, create databases for assessment and intervention in conditions affecting the health of communities, as well as advise government authorities and other social sectors in health education efforts and preventive approaches. These programs have also been an essential part of the design, evaluation and implementation of organizational models of health services and institutional and community clinical care, in addition to integrate public health and health services in the development of unique models at the national level. Likewise, these have extended the scope of actions and services to other state agencies, companies and private health sector organizations, which benefit directly from the experience of the schools of public health. The academic, research and service programs have also strengthened the professional competencies of graduates of the academic programs, who occupy essential decision-making positions.

Analysis of government agencies and stakeholders' twitter communications during the first surge of COVID-19 in Brazil.

BACKGROUND: Official authorities are in charge of communicating with the public in a consistent and coherent manner. The impact of social media on managing the coronavirus 2019 (COVID-19) pandemic potentially influenced social behavior in Brazil. OBJECTIVE: Using Twitter, this study analyzes communications about the COVID-19 pandemic from official agencies of the Brazilian government and key public sector decision-makers. METHOD: We captured public Twitter messages about COVID-19 exchanged between authorities at the federal, state, and municipal levels of government. These messages were further classified into guidance and information messages or disinformation messages. Finally, through analysis of tweets and their frequency, we evidenced the level of information generated by the three levels of government. RESULTS: Our analyses show an underestimation of the magnitude of the pandemic by Brazilian government authorities. None of the spheres of government anticipated the imminent health crisis, did not issue good recommendations and guidelines, and did not take preventive actions. CONCLUSION: The lack of governmental actions and adequate guidance in Brazil has led to an explosive increase in infected people and deaths. Surprisingly, this was not due to technical or structural reasons. It resulted from conflicting communication strategies implemented by the federal, state, and municipal governments in attempts to minimize the effects of COVID-19 on their local health structures.

India's speedy vaccine approvals come under fire.

Critics say regulatory agency lacks key capabilities and independence.

Information Opacity in Biopharmaceutical Innovation Through the Lens of COVID-19.

The COVID-19 pandemic has revealed myriad and complex challenges for our national health care system spanning preparedness, response, access, costs, infrastructure, coordination, and medical innovation. These challenges implicate federal, state, and local agencies and actors, as well as international collaborative bodies. One constant throughout the pandemic has been the pressing need for safe and effective diagnostics, prophylactic vaccines, and drug treatments to counter the virus.1 Inarguably, significant problems with the multi-faceted system of drug and vaccine innovation and regulation manifested long before the COVID-19 pandemic.2 The pandemic, however, has laid bare the inextricable connections among federal funding, patents, product review and approval mechanisms, and the eventual medical products and resulting costs.

Tackling Challenging Data Integrity Topics in 2020: Update on Good Clinical Practice Perspectives from the US FDA and MHRA UK.

With the globalization of clinical trials, regulators have increased collaboration to evaluate the adequacy of clinical trial conduct and to optimize regulatory oversight. The 2020 joint Good Clinical Practice (GCP) symposium of the US Food and Drug Administration and the UK Medicines and Healthcare products Regulatory Agency provided the agencies' perspectives on the challenges in ensuring data quality in novel clinical trial designs and the importance of the management and documentation of protocol deviations, sponsor oversight of clinical trials, and use of electronic source data, including electronic health records. This paper summarizes considerations of both agencies on these topics, along with case examples. This paper touches upon considerations when using real-world data to support regulatory decisions. It also discusses the impact of the coronavirus disease 2019 (COVID-19) pandemic on clinical trial conduct and underscores the importance of well-designed, resilient, and adaptable systems for GCP compliance and data integrity.