Subject(s)
Civil Defense , Communicable Disease Control , Pandemics/prevention & control , Pregnancy Complications, Infectious , Public Health , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/organization & administration , Civil Defense/standards , Climate Change , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/trends , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/prevention & control , Communicable Diseases, Emerging/transmission , Female , Health Services Needs and Demand , Humans , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Public Health/standards , Public Health/trends , SARS-CoV-2 , Travel/trends , Travel-Related IllnessSubject(s)
COVID-19 , Civil Defense , Communicable Disease Control , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/organization & administration , Civil Defense/trends , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/trends , Communication Barriers , Drug Development , Forecasting , Global Health/standards , Global Health/trends , Humans , International Cooperation , Public Health , SARS-CoV-2 , /standards , /trendsSubject(s)
COVID-19/epidemiology , Civil Defense , Health Personnel , Health Services Needs and Demand , Hospitals , Mass Casualty Incidents , Civil Defense/methods , Civil Defense/organization & administration , Health Personnel/ethics , Health Personnel/psychology , Humans , Lebanon , Resilience, Psychological , SARS-CoV-2 , Social ResponsibilitySubject(s)
Ambulatory Care Facilities , COVID-19 , Civil Defense , Communicable Disease Control , Diabetes Complications , Diabetes Mellitus, Type 2 , No-Show Patients , Telemedicine , Age Factors , Ambulatory Care Facilities/organization & administration , Ambulatory Care Facilities/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Cardiotonic Agents/therapeutic use , Civil Defense/organization & administration , Civil Defense/standards , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Diabetes Complications/epidemiology , Diabetes Complications/etiology , Diabetes Complications/therapy , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/therapy , Health Services Accessibility/organization & administration , Humans , Internet Use/statistics & numerical data , Italy/epidemiology , No-Show Patients/psychology , No-Show Patients/statistics & numerical data , Organizational Innovation , Physical Distancing , SARS-CoV-2 , Telemedicine/methods , Telemedicine/standardsSubject(s)
Civil Defense , Communicable Disease Control , Pandemics/prevention & control , Pregnancy Complications, Infectious , Public Health , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/organization & administration , Civil Defense/standards , Climate Change , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/trends , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/prevention & control , Communicable Diseases, Emerging/transmission , Female , Health Services Needs and Demand , Humans , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Public Health/standards , Public Health/trends , SARS-CoV-2 , Travel/trends , Travel-Related IllnessABSTRACT
Failures in preparation and response led to a worsened crisis.
Subject(s)
COVID-19/prevention & control , Preventive Medicine/standards , Civil Defense/organization & administration , Civil Defense/standards , Humans , Preventive Medicine/trends , World Health Organization/organization & administrationABSTRACT
Racially and ethnically diverse and socioeconomically disadvantaged communities have historically been disproportionately affected by disasters and public health emergencies in the United States. The U.S. Department of Health and Human Services' Office of Minority Health established the National Consensus Panel on Emergency Preparedness and Cultural Diversity to provide guidance to agencies and organizations on developing effective strategies to advance emergency preparedness and eliminate disparities among racially and ethnically diverse communities during these crises. Adopting the National Consensus Panel recommendations, the Johns Hopkins Medicine Office of Diversity, Inclusion, and Health Equity; Language Services; and academic-community partnerships used existing health equity resources and expertise to develop an operational framework to support the organization's COVID-19 response and to provide a framework of health equity initiatives for other academic medical centers. This operational framework addressed policies to support health equity patient care and clinical operations, accessible COVID-19 communication, and staff and community support and engagement, which also supported the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. Johns Hopkins Medicine identified expanded recommendations for addressing institutional policy making and capacity building, including unconscious bias training for resource allocation teams and staff training in accurate race, ethnicity, and language data collection, that should be considered in future updates to the National Consensus Panel's recommendations.
Subject(s)
Academic Medical Centers/organization & administration , COVID-19/ethnology , Disasters/prevention & control , Health Equity/standards , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Civil Defense/organization & administration , Consensus , Cultural Diversity , Government Programs/organization & administration , Government Programs/standards , Healthcare Disparities/ethnology , Humans , Minority Groups/statistics & numerical data , Policy Making , Public Health/standards , SARS-CoV-2/genetics , Social Participation , Socioeconomic Factors , United States/epidemiologySubject(s)
Disease Outbreaks , Hospital Administration , COVID-19/epidemiology , COVID-19/therapy , Civil Defense/methods , Civil Defense/organization & administration , Decision Making , Hospice Care/organization & administration , Hospital Administration/methods , Hospital Planning , Humans , PandemicsSubject(s)
COVID-19 , Civil Defense , Communicable Disease Control , Government Agencies , Government Regulation , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/legislation & jurisprudence , Civil Defense/organization & administration , Civil Defense/standards , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Government Agencies/legislation & jurisprudence , Government Agencies/organization & administration , Government Agencies/standards , Humans , Needs Assessment , Public Health Practice/legislation & jurisprudence , Public Health Practice/standards , SARS-CoV-2 , United Kingdom/epidemiologySubject(s)
Civil Defense/organization & administration , Crisis Intervention/organization & administration , Disaster Planning/organization & administration , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division/organization & administration , Behavioral Risk Factor Surveillance System , Emergencies , Humans , Planning Techniques , Public Health/standards , United StatesABSTRACT
BACKGROUND/OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has taken a disproportionate toll on long-term care facility residents and staff. Our objective was to review the empirical evidence on facility characteristics associated with COVID-19 cases and deaths. DESIGN: Systematic review. SETTING: Long-term care facilities (nursing homes and assisted living communities). PARTICIPANTS: Thirty-six empirical studies of factors associated with COVID-19 cases and deaths in long-term care facilities published between January 1, 2020 and June 15, 2021. MEASUREMENTS: Outcomes included the probability of at least one case or death (or other defined threshold); numbers of cases and deaths, measured variably. RESULTS: Larger, more rigorous studies were fairly consistent in their assessment of risk factors for COVID-19 outcomes in long-term care facilities. Larger bed size and location in an area with high COVID-19 prevalence were the strongest and most consistent predictors of facilities having more COVID-19 cases and deaths. Outcomes varied by facility racial composition, differences that were partially explained by facility size and community COVID-19 prevalence. More staff members were associated with a higher probability of any outbreak; however, in facilities with known cases, higher staffing was associated with fewer deaths. Other characteristics, such as Nursing Home Compare 5-star ratings, ownership, and prior infection control citations, did not have consistent associations with COVID-19 outcomes. CONCLUSION: Given the importance of community COVID-19 prevalence and facility size, studies that failed to control for these factors were likely confounded. Better control of community COVID-19 spread would have been critical for mitigating much of the morbidity and mortality long-term care residents and staff experienced during the pandemic. Traditional quality measures such as Nursing Home Compare 5-Star ratings and past deficiencies were not consistent indicators of pandemic preparedness, likely because COVID-19 presented a novel problem requiring extensive adaptation by both long-term care providers and policymakers.
Subject(s)
COVID-19 , Homes for the Aged/organization & administration , Long-Term Care , Nursing Homes/organization & administration , Risk Adjustment , Skilled Nursing Facilities/organization & administration , Aged , COVID-19/mortality , COVID-19/prevention & control , Civil Defense/organization & administration , Humans , Infection Control/methods , Infection Control/standards , Long-Term Care/methods , Long-Term Care/trends , Outcome Assessment, Health Care , SARS-CoV-2Subject(s)
Civil Defense , Communicable Disease Control , Pandemics/prevention & control , Pregnancy Complications, Infectious , Public Health , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/organization & administration , Civil Defense/standards , Climate Change , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/trends , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/prevention & control , Communicable Diseases, Emerging/transmission , Female , Health Services Needs and Demand , Humans , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Public Health/standards , Public Health/trends , SARS-CoV-2 , Travel/trends , Travel-Related IllnessSubject(s)
Aging , COVID-19 , Civil Defense , Community Networks , Frail Elderly , Health Services Research , Preventive Health Services/standards , Rehabilitation Research/standards , Aged , Aging/ethics , Aging/physiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , Civil Defense/organization & administration , Civil Defense/standards , Community Networks/organization & administration , Community Networks/standards , Health Services Research/ethics , Health Services Research/organization & administration , Health Services Research/standards , Humans , Needs Assessment , Patient Selection , Risk Assessment , SARS-CoV-2ABSTRACT
The built environment has been integral to response to the global pandemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In particular, engineering controls to mitigate risk of exposure to SARS-CoV-2 and other newly emergent respiratory pathogens in the future will be important. Anticipating emergence from this pandemic, or at least adaptation given increasing administration of effective vaccines, and the safety of patients, personnel, and others in health care facilities remain the core goals. This article summarizes known risks and highlights prevention strategies for daily care as well as response to emergent infectious diseases and this parapandemic phase.
Subject(s)
COVID-19 , Civil Defense , Health Facilities/trends , Infection Control , Safety Management/organization & administration , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/methods , Civil Defense/organization & administration , Environment, Controlled , Hospital Design and Construction/methods , Humans , Infection Control/methods , Infection Control/organization & administration , SARS-CoV-2ABSTRACT
COVID-19 has infected hundreds of millions of people across the globe. The pandemic has also inflicted serious damages on global and regional governing political structures to a degree meriting a revisit of their own raison d'etre. The global economic fallout is also unprecedented as the flows of goods and people got severely disrupted while lockdowns hit the transport, services and retail industries, among others. We argue that three realities need to be genuinely addressed for building a post COVID-19 order that has to be amply equipped to deal with the next global crisis, as well as the ones on-going for decades. First, there is need to shelf-away the hitherto practiced doctrine that global crises and problems are confronted through local responses. Second, the COVID-19 pandemic has cautioned us on the need to (re)invest in basic, many may consider naïve and simple, public health functions such as sanitation as well as transparent national and global health monitoring. Third, the pandemic is a clear reprimand to discard the mantra that privatization of healthcare delivery system is the solution in favor of viewing health as a public good that needs to be managed and executed by the state and its public sector, be it national, sub-regional or local. It is critical that we learn from such pandemic and advance our societies to become stronger.
Subject(s)
COVID-19 , Civil Defense/organization & administration , Communicable Disease Control , Delivery of Health Care , Global Health , Public Health , COVID-19/economics , COVID-19/epidemiology , COVID-19/prevention & control , Delivery of Health Care/economics , Delivery of Health Care/standards , Delivery of Health Care/trends , Forecasting , Global Health/standards , Global Health/trends , Humans , SARS-CoV-2 , Social Medicine/trendsABSTRACT
Coronavirus disease 2019(COVID-19) has brought great disasters to humanity, and its influence continues to intensify. In response to the public health emergencies, prompt relief supplies are key to reduce the damage. This paper presents a method of emergency medical logistics to quick response to emergency epidemics. The methodology includes two recursive mechanisms: (1) the time-varying forecasting of medical relief demand according to a modified susceptible-exposed-infected- Asymptomatic- recovered (SEIAR) epidemic diffusion model, (2) the relief supplies distribution based on a multi-objective dynamic stochastic programming model. Specially, the distribution model addresses a hypothetical network of emergency medical logistics with considering emergency medical reserve centers (EMRCs), epidemic areas and e-commerce warehousing centers as the rescue points. Numerical studies are conducted. The results show that with the cooperation of different epidemic areas and e-commerce warehousing centers, the total cost is 6% lower than without considering cooperation of different epidemic areas, and 9.7% lower than without considering cooperation of e-commerce warehousing centers. Particularly, the total cost is 20% lower than without considering any cooperation. This study demonstrates the importance of cooperation in epidemic prevention, and provides the government with a new idea of emergency relief supplies dispatching, that the rescue efficiency can be improved by mutual rescue between epidemic areas in public health emergency.
Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/organization & administration , Emergency Medical Services/organization & administration , Pandemics , Public Health/methods , COVID-19/transmission , COVID-19/virology , China/epidemiology , Civil Defense/economics , Emergencies/epidemiology , Emergency Medical Services/economics , Humans , Intersectoral Collaboration , Models, Statistical , SARS-CoV-2/pathogenicity , SARS-CoV-2/physiologySubject(s)
COVID-19 , Civil Defense , Health Services Needs and Demand , Leadership , Ageism/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/organization & administration , Civil Defense/standards , Crew Resource Management, Healthcare/organization & administration , Crew Resource Management, Healthcare/standards , Delivery of Health Care/organization & administration , Health Services Needs and Demand/organization & administration , Health Services Needs and Demand/trends , Humans , SARS-CoV-2 , Social Determinants of Health , United States/epidemiologyABSTRACT
Emergency preparedness is a continuous quality improvement process through which roles and responsibilities are defined to effectively anticipate, respond to, and recover from the impact of emergencies. This process results in documented plans that provide a backbone structure for developing the core capacities to address health threats. Nevertheless, several barriers can impair an effective preparedness planning, as it needs a 360° perspective to address each component according to the best evidence and practice. Preparedness planning shares common principles with health technology assessment (HTA) as both encompass a multidisciplinary and multistakeholder approach, follow an iterative cycle, adopt a 360° perspective on the impact of intervention measures, and conclude with decision-making support. Our "Perspective" illustrates how each HTA domain can address different component(s) of a preparedness plan that can indeed be seen as a container of multiple HTAs, which can then be used to populate the entire plan itself. This approach can allow one to overcome preparedness barriers, providing an independent, systematic, and robust tool to address the components and ensuring a comprehensive evaluation of their value in the mitigation of the impact of emergencies.
Subject(s)
Civil Defense/organization & administration , Disaster Planning/organization & administration , Technology Assessment, Biomedical/organization & administration , Civil Defense/economics , Civil Defense/standards , Disaster Planning/economics , Disaster Planning/standards , Evidence-Based Practice/standards , HumansABSTRACT
COVID-19 has exacted a disproportionate toll on the health of persons living in nursing homes. Healthcare providers and other decision-makers in those settings must refer to multiple evolving sources of guidance to coordinate care delivery in such a way as to minimize the introduction and spread of the causal virus, SARS-CoV-2. It is essential that guidance be presented in an accessible and usable format to facilitate its translation into evidence-based best practice. In this article, we propose the Haddon matrix as a tool well-suited to this task. The Haddon matrix is a conceptual model that organizes influencing factors into pre-event, event, and post-event phases, and into host, agent, and environment domains akin to the components of the epidemiologic triad. The Haddon matrix has previously been applied to topics relevant to the care of older persons, such as fall prevention, as well as to pandemic planning and response. Presented here is a novel application of the Haddon matrix to pandemic response in nursing homes, with practical applications for nursing home decision-makers in their efforts to prevent and contain COVID-19.