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1.
Am J Public Health ; 112(3): 417-425, 2022 03.
Article in English | MEDLINE | ID: covidwho-1701797

ABSTRACT

Community-based organizations (CBOs) are integral to achieving the goal of Ending the HIV epidemic (EHE). Their familiarity with and proximity to communities position them to effectively implement strategies necessary to address determinants of health through their formal and informal medical and social services. However, structural inequities have contributed to the demise of many organizations that were instrumental in early responses to the HIV epidemic. We define structural inequities for HIV CBOs as systems in which policies, institutional practices, organizational (mis)representations, and other norms work to produce and maintain inequities that affect CBOs' ability to survive and thrive. In this discussion, we describe the organizational threats to grassroots HIV CBOs and the risks to livelihood and longevity, including examples. The invaluable role of HIV CBOs in EHE and their role in responding to existing and novel infectious diseases like COVID-19 should not be overlooked. Recommendations to promote structural equity are offered. (Am J Public Health. 2022;112(3):417-425. https://doi.org/10.2105/AJPH.2021.306688).


Subject(s)
Community Networks/organization & administration , HIV Infections/epidemiology , Organizations, Nonprofit/organization & administration , Epidemics , Humans , Organizations, Nonprofit/economics
2.
Fam Med Community Health ; 9(4)2021 09.
Article in English | MEDLINE | ID: covidwho-1430202

ABSTRACT

Early in the COVID-19 pandemic-and based on limited data on the novel coronavirus-it was projected that African countries will be ravaged and the health systems overwhelmed. Fortunately, Africa has so far defied these dire predictions. Many factors account for the less dramatic outcome, in particular the local know-how gained through dealing with previous epidemics, such as Ebola, and the early and coordinated political and public health response, applying a combination of containment and mitigation measures. However, these same measures, exacerbated by existing inequalities, have had negative impacts on vulnerable populations, notably women and children. Furthermore, the observed deterioration of access to and provision of essential health services will likely continue and worsen in countries experiencing future waves of COVID-19 and lacking access to vaccines. The impact of the pandemic on health systems may be one of Africa's main COVID-19 challenges and women and children its greatest victims. In this article, we argue that just as learning from previous epidemics and coordinated preparation informed Africa's response to COVID-19, knowledge, innovations and resources from recent implementation research can be leveraged to mitigate the pandemic's effects and inform recovery efforts. As an example, we present the proven model and multifaceted approach of the Innovating for Maternal and Child Health in Africa Initiative and describe how such a model could be readily applied to building the robust and equitable systems needed to tackle future stresses and shocks, such as epidemics, on health systems while maintaining essential routine services.


Subject(s)
COVID-19 , Delivery of Health Care , Health Planning , Pandemics , Africa , Community Networks , Cooperative Behavior , Decision Making , Delivery of Health Care/organization & administration , Health Services Accessibility , Humans , Public Health , SARS-CoV-2
6.
J Health Care Poor Underserved ; 32(3): 1091-1095, 2021.
Article in English | MEDLINE | ID: covidwho-1369547

ABSTRACT

In response to the COVID-19 pandemic, our team adjusted study procedures to support research staff wellbeing. ATN CARES is a community-based, adolescent-focused HIV research program. Our participants and frontline staff alike are predominantly Black or Latinx sexual and gender minorities. Senior researchers and staff collaborated to refine our procedures, anticipating stay-at-home orders in March 2020. Transition to virtual space appeared seamless; however, we did not foresee that staff would have the additional role of providing COVID-19-related informational and emotional support to participants. This and the added strain of working remotely were increasing staff stress and in general negatively affecting staff wellbeing. Leveraging staff interests and skills, staff and senior researchers developed purposeful ways to stay connected and alleviate these strains, including exercise sessions; professional development workshops; motivational messages; and games. These proved beneficial and serve as a reminder that wellbeing of staff-our frontline heroes-is vital to a successful research project.


Subject(s)
COVID-19/epidemiology , Occupational Health , COVID-19/prevention & control , Community Networks , Humans , Pandemics , Physical Distancing
7.
Am J Public Health ; 111(7): 1227-1230, 2021 07.
Article in English | MEDLINE | ID: covidwho-1348403

ABSTRACT

Cook County Health partnered with the Chicago Departments of Public Health and Family & Support Services and several dozen community-based organizations to rapidly establish a temporary medical respite shelter during the spring 2020 COVID-19 peak for individuals experiencing homelessness in Chicago and Cook County, Illinois. This program provided low-barrier isolation housing to medically complex adults until their safe return to congregate settings. We describe strategies used by the health care agency, which is not a Health Resource and Services Administration Health Care for the Homeless grantee, to provide medical services and care coordination.


Subject(s)
COVID-19/rehabilitation , Community Networks/organization & administration , Homeless Persons/statistics & numerical data , Interinstitutional Relations , Social Work/organization & administration , COVID-19/epidemiology , Chicago , Communicable Diseases, Emerging/prevention & control , Humans , Illinois , Interdisciplinary Communication , Public Housing/statistics & numerical data , Vulnerable Populations/statistics & numerical data
8.
PLoS One ; 16(8): e0255644, 2021.
Article in English | MEDLINE | ID: covidwho-1341507

ABSTRACT

OBJECTIVES: In severe COVID-19 pneumonia, the appropriate timing and dosing of corticosteroids (CS) is not known. Patient subgroups for which CS could be more beneficial also need appraisal. The aim of this study was to assess the effect of early CS in COVID-19 pneumonia patients admitted to the ICU on the occurrence of 60-day mortality, ICU-acquired-bloodstream infections(ICU-BSI), and hospital-acquired pneumonia and ventilator-associated pneumonia(HAP-VAP). METHODS: We included patients with COVID-19 pneumonia admitted to 11 ICUs belonging to the French OutcomeReaTM network from January to May 2020. We used survival models with ponderation with inverse probability of treatment weighting (IPTW). RESULTS: The study population comprised 303 patients having a median age of 61.6 (53-70) years of whom 78.8% were male and 58.6% had at least one comorbidity. The median SAPS II was 33 (25-44). Invasive mechanical ventilation was required in 34.8% of the patients. Sixty-six (21.8%) patients were in the Early-C subgroup. Overall, 60-day mortality was 29.4%. The risks of 60-day mortality (IPTWHR = 0.86;95% CI 0.54 to 1.35, p = 0.51), ICU-BSI and HAP-VAP were similar in the two groups. Importantly, early CS treatment was associated with a lower mortality rate in patients aged 60 years or more (IPTWHR, 0.53;95% CI, 0.3-0.93; p = 0.03). In contrast, CS was associated with an increased risk of death in patients younger than 60 years without inflammation on admission (IPTWHR = 5.01;95% CI, 1.05, 23.88; p = 0.04). CONCLUSION: For patients with COVID-19 pneumonia, early CS treatment was not associated with patient survival. Interestingly, inflammation and age can significantly influence the effect of CS.


Subject(s)
Adrenal Cortex Hormones/administration & dosage , COVID-19/drug therapy , COVID-19/mortality , Adult , Aged , COVID-19/therapy , Cohort Studies , Community Networks , Critical Illness/mortality , Critical Illness/therapy , Drug Administration Schedule , Early Medical Intervention/methods , Female , France/epidemiology , Hospital Mortality , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Respiration, Artificial/mortality , Respiration, Artificial/statistics & numerical data , Time Factors , Treatment Outcome
9.
Perspect Public Health ; 141(4): 191-192, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1331918
10.
J Cancer Policy ; 29: 100297, 2021 09.
Article in English | MEDLINE | ID: covidwho-1322196

ABSTRACT

Policymakers everywhere struggle to introduce therapeutic innovation while controlling costs, a particular challenge for the universal Italian National Healthcare System (SSN), which spends only 8.8% of GDP to care for one of the world's oldest populations. Oncology provides a telling example, where innovation has dramatically improved care and survival, transforming cancer into a chronic condition. However, innovation has also increased therapy duration, adverse event management, and service demand. The SSN risks collapse unless centralized cancer planning changes gear, particularly with Covid-19 causing treatment delays, worsening patient prognosis and straining capacity. In view of the 750 billion Euro "Next Generation EU", released by the European Union to relieve Member States hit by the pandemic, the SSN tapped a multidisciplinary research team to identify key strategies for equitable uptake of innovations in treatment and delivery, with emphasis on data-driven technological and managerial advancements - and lessons from Covid-19.


Subject(s)
Delivery of Health Care/organization & administration , Health Planning/organization & administration , Neoplasms/therapy , Community Health Services , Community Networks , Humans , Italy/epidemiology , Primary Health Care , Reimbursement Mechanisms , Telemedicine
11.
J Ambul Care Manage ; 43(3): 183, 2020.
Article in English | MEDLINE | ID: covidwho-1317942
12.
BMC Med ; 19(1): 160, 2021 07 09.
Article in English | MEDLINE | ID: covidwho-1301851

ABSTRACT

BACKGROUND: East Africa is home to 170 million people and prone to frequent outbreaks of viral haemorrhagic fevers and various bacterial diseases. A major challenge is that epidemics mostly happen in remote areas, where infrastructure for Biosecurity Level (BSL) 3/4 laboratory capacity is not available. As samples have to be transported from the outbreak area to the National Public Health Laboratories (NPHL) in the capitals or even flown to international reference centres, diagnosis is significantly delayed and epidemics emerge. MAIN TEXT: The East African Community (EAC), an intergovernmental body of Burundi, Rwanda, Tanzania, Kenya, Uganda, and South Sudan, received 10 million € funding from the German Development Bank (KfW) to establish BSL3/4 capacity in the region. Between 2017 and 2020, the EAC in collaboration with the Bernhard-Nocht-Institute for Tropical Medicine (Germany) and the Partner Countries' Ministries of Health and their respective NPHLs, established a regional network of nine mobile BSL3/4 laboratories. These rapidly deployable laboratories allowed the region to reduce sample turn-around-time (from days to an average of 8h) at the centre of the outbreak and rapidly respond to epidemics. In the present article, the approach for implementing such a regional project is outlined and five major aspects (including recommendations) are described: (i) the overall project coordination activities through the EAC Secretariat and the Partner States, (ii) procurement of equipment, (iii) the established laboratory setup and diagnostic panels, (iv) regional training activities and capacity building of various stakeholders and (v) completed and ongoing field missions. The latter includes an EAC/WHO field simulation exercise that was conducted on the border between Tanzania and Kenya in June 2019, the support in molecular diagnosis during the Tanzanian Dengue outbreak in 2019, the participation in the Ugandan National Ebola response activities in Kisoro district along the Uganda/DRC border in Oct/Nov 2019 and the deployments of the laboratories to assist in SARS-CoV-2 diagnostics throughout the region since early 2020. CONCLUSIONS: The established EAC mobile laboratory network allows accurate and timely diagnosis of BSL3/4 pathogens in all East African countries, important for individual patient management and to effectively contain the spread of epidemic-prone diseases.


Subject(s)
COVID-19/prevention & control , Community Networks , Dengue/epidemiology , Hemorrhagic Fever, Ebola/epidemiology , Laboratories , Mobile Health Units , Burundi/epidemiology , COVID-19/therapy , Dengue/prevention & control , Epidemics , Hemorrhagic Fever, Ebola/prevention & control , Hemorrhagic Fever, Ebola/therapy , Humans , Kenya/epidemiology , Mobile Health Units/economics , Public Health , Rwanda/epidemiology , SARS-CoV-2 , South Sudan/epidemiology , Tanzania/epidemiology , Uganda/epidemiology
14.
Eur J Endocrinol ; 185(2): C1-C7, 2021 Jul 05.
Article in English | MEDLINE | ID: covidwho-1298092

ABSTRACT

Changes that COVID-19 induced in endocrine daily practice as well as the role of endocrine and metabolic comorbidities in COVID-19 outcomes were among the striking features of this last year. The aim of this statement is to illustrate the major characteristics of the response of European endocrinologists to the pandemic including the disclosure of the endocrine phenotype of COVID-19 with diabetes, obesity and hypovitaminosis D playing a key role in this clinical setting with its huge implication for the prevention and management of the disease. The role of the European Society of Endocrinology (ESE) as a reference point of the endocrine community during the pandemic will also be highlighted, including the refocusing of its educational and advocacy activities.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Endocrinologists/organization & administration , Endocrinology/organization & administration , COVID-19/complications , COVID-19/prevention & control , Community Networks/organization & administration , Community Networks/trends , Delivery of Health Care/history , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Endocrine System Diseases/diagnosis , Endocrine System Diseases/epidemiology , Endocrine System Diseases/etiology , Endocrine System Diseases/therapy , Endocrinologists/history , Endocrinologists/trends , Endocrinology/history , Endocrinology/trends , Europe/epidemiology , History, 21st Century , Humans , Pandemics , Phenotype , Physician's Role , Practice Patterns, Physicians'/history , Practice Patterns, Physicians'/organization & administration , Practice Patterns, Physicians'/trends , Societies, Medical/history , Societies, Medical/organization & administration , Societies, Medical/trends , Telemedicine/history , Telemedicine/organization & administration , Telemedicine/trends
15.
Eur J Endocrinol ; 185(2): C1-C7, 2021 Jul 05.
Article in English | MEDLINE | ID: covidwho-1270953

ABSTRACT

Changes that COVID-19 induced in endocrine daily practice as well as the role of endocrine and metabolic comorbidities in COVID-19 outcomes were among the striking features of this last year. The aim of this statement is to illustrate the major characteristics of the response of European endocrinologists to the pandemic including the disclosure of the endocrine phenotype of COVID-19 with diabetes, obesity and hypovitaminosis D playing a key role in this clinical setting with its huge implication for the prevention and management of the disease. The role of the European Society of Endocrinology (ESE) as a reference point of the endocrine community during the pandemic will also be highlighted, including the refocusing of its educational and advocacy activities.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Endocrinologists/organization & administration , Endocrinology/organization & administration , COVID-19/complications , COVID-19/prevention & control , Community Networks/organization & administration , Community Networks/trends , Delivery of Health Care/history , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Endocrine System Diseases/diagnosis , Endocrine System Diseases/epidemiology , Endocrine System Diseases/etiology , Endocrine System Diseases/therapy , Endocrinologists/history , Endocrinologists/trends , Endocrinology/history , Endocrinology/trends , Europe/epidemiology , History, 21st Century , Humans , Pandemics , Phenotype , Physician's Role , Practice Patterns, Physicians'/history , Practice Patterns, Physicians'/organization & administration , Practice Patterns, Physicians'/trends , Societies, Medical/history , Societies, Medical/organization & administration , Societies, Medical/trends , Telemedicine/history , Telemedicine/organization & administration , Telemedicine/trends
16.
JMIR Public Health Surveill ; 7(6): e29528, 2021 06 10.
Article in English | MEDLINE | ID: covidwho-1256281

ABSTRACT

BACKGROUND: COVID-19 testing remains an essential element of a comprehensive strategy for community mitigation. Social media is a popular source of information about health, including COVID-19 and testing information. One of the most popular communication channels used by adolescents and young adults who search for health information is TikTok-an emerging social media platform. OBJECTIVE: The purpose of this study was to describe TikTok videos related to COVID-19 testing. METHODS: The hashtag #covidtesting was searched, and the first 100 videos were included in the study sample. At the time the sample was drawn, these 100 videos garnered more than 50% of the views for all videos cataloged under the hashtag #covidtesting. The content characteristics that were coded included mentions, displays, or suggestions of anxiety, COVID-19 symptoms, quarantine, types of tests, results of test, and disgust/unpleasantness. Additional data that were coded included the number and percentage of views, likes, and comments and the use of music, dance, and humor. RESULTS: The 100 videos garnered more than 103 million views; 111,000 comments; and over 12.8 million likes. Even though only 44 videos mentioned or suggested disgust/unpleasantness and 44 mentioned or suggested anxiety, those that portrayed tests as disgusting/unpleasant garnered over 70% of the total cumulative number of views (73,479,400/103,071,900, 71.29%) and likes (9,354,691/12,872,505, 72.67%), and those that mentioned or suggested anxiety attracted about 60% of the total cumulative number of views (61,423,500/103,071,900, 59.59%) and more than 8 million likes (8,339,598/12,872,505, 64.79%). Independent one-tailed t tests (α=.05) revealed that videos that mentioned or suggested that COVID-19 testing was disgusting/unpleasant were associated with receiving a higher number of views and likes. CONCLUSIONS: Our finding of an association between TikTok videos that mentioned or suggested that COVID-19 tests were disgusting/unpleasant and these videos' propensity to garner views and likes is of concern. There is a need for public health agencies to recognize and address connotations of COVID-19 testing on social media.


Subject(s)
COVID-19/diagnosis , Diagnostic Tests, Routine , Social Media , Adolescent , Community Networks , Humans , SARS-CoV-2 , Video Recording , Young Adult
17.
PLoS Pathog ; 17(6): e1009583, 2021 06.
Article in English | MEDLINE | ID: covidwho-1256050

ABSTRACT

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic reveals a major gap in global biosecurity infrastructure: a lack of publicly available biological samples representative across space, time, and taxonomic diversity. The shortfall, in this case for vertebrates, prevents accurate and rapid identification and monitoring of emerging pathogens and their reservoir host(s) and precludes extended investigation of ecological, evolutionary, and environmental associations that lead to human infection or spillover. Natural history museum biorepositories form the backbone of a critically needed, decentralized, global network for zoonotic pathogen surveillance, yet this infrastructure remains marginally developed, underutilized, underfunded, and disconnected from public health initiatives. Proactive detection and mitigation for emerging infectious diseases (EIDs) requires expanded biodiversity infrastructure and training (particularly in biodiverse and lower income countries) and new communication pipelines that connect biorepositories and biomedical communities. To this end, we highlight a novel adaptation of Project ECHO's virtual community of practice model: Museums and Emerging Pathogens in the Americas (MEPA). MEPA is a virtual network aimed at fostering communication, coordination, and collaborative problem-solving among pathogen researchers, public health officials, and biorepositories in the Americas. MEPA now acts as a model of effective international, interdisciplinary collaboration that can and should be replicated in other biodiversity hotspots. We encourage deposition of wildlife specimens and associated data with public biorepositories, regardless of original collection purpose, and urge biorepositories to embrace new specimen sources, types, and uses to maximize strategic growth and utility for EID research. Taxonomically, geographically, and temporally deep biorepository archives serve as the foundation of a proactive and increasingly predictive approach to zoonotic spillover, risk assessment, and threat mitigation.


Subject(s)
Biological Specimen Banks/organization & administration , Communicable Disease Control , Communicable Diseases, Emerging/prevention & control , Community Networks/organization & administration , Public Health Surveillance/methods , Animals , Animals, Wild , Biodiversity , Biological Specimen Banks/standards , Biological Specimen Banks/supply & distribution , Biological Specimen Banks/trends , COVID-19/epidemiology , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/microbiology , Communicable Diseases, Emerging/virology , Community Networks/standards , Community Networks/supply & distribution , Community Networks/trends , Disaster Planning/methods , Disaster Planning/organization & administration , Disaster Planning/standards , Geography , Global Health/standards , Global Health/trends , Humans , Medical Countermeasures , Pandemics/prevention & control , Public Health , Risk Assessment , SARS-CoV-2/physiology , Zoonoses/epidemiology , Zoonoses/prevention & control
18.
J Sch Health ; 91(7): 584-591, 2021 07.
Article in English | MEDLINE | ID: covidwho-1223522

ABSTRACT

BACKGROUND: In 2014, the Hawaii Department of Education (DOE), the only statewide school system in the United States, predominately enrolled children (keiki) from underserved communities and lacked school nurses or a school health program. Chronic absenteeism due to health concerns was identified as a barrier to academic success. METHODS: The DOE and a public university created Hawaii Keiki: Healthy and Ready to Learn (HK), a program to provide school-based services for 170 Title 1 schools in urban and rural settings and build momentum for statewide collective action. HK has maintained support from public and private entities to address student health. RESULTS: This paper describes 5 years of program development, implementation, and continuing challenges. Most recently in 2020-2021, HK pivoted in the face of school campus closings due to COVID-19 with strategic plans, including telehealth, to move forward in this changed school environment. CONCLUSIONS: The HK program has increased awareness of students' needs and is addressing the imperative to build health services within public schools. The multipronged approach of building awareness of need, providing direct services, educating future care providers, and supporting sound policy development, has an impact that goes beyond any one individual area.


Subject(s)
Child Health/statistics & numerical data , Child Welfare/statistics & numerical data , Community Networks/organization & administration , Health Promotion/organization & administration , School Health Services/organization & administration , Adolescent , COVID-19/prevention & control , Child , Cooperative Behavior , Hawaii , Humans , Program Evaluation
19.
J Racial Ethn Health Disparities ; 8(2): 280-282, 2021 04.
Article in English | MEDLINE | ID: covidwho-1141539

ABSTRACT

With Black and Hispanic communities across the USA experiencing more detrimental negative effects from the COVID-19 pandemic as compared with other demographic groups, the virus has exposed the racial and ethnic disparities in treatment and care that public health experts have been grappling with for years. This paper explains how the systematic collection of racial and ethnic data gleaned from COVID-19 testing in underserved communities can be used to better understand this pandemic and inform measures within our control to prevent the spread of disease in the future.


Subject(s)
African Americans , COVID-19/ethnology , Health Status Disparities , Healthcare Disparities/ethnology , COVID-19/diagnosis , COVID-19 Testing , Communicable Disease Control , Community Health Services , Community Networks , Health Services Accessibility , Humans , Poverty , Poverty Areas , SARS-CoV-2 , United States
20.
Public Health ; 191: 85-90, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1125690

ABSTRACT

The field of bereavement research and care is at a tipping point. The introduction of prolonged grief disorder (PGD) in the International Classification of Diseases (ICD-11) has ignited clinical interest in this new disorder, along with debate over challenges in validating and implementing these new criteria. At the same time, the global COVID-19 pandemic has launched several local and international efforts to provide urgent support and comfort for individuals and communities suffering from grief. Recently, grief experts have called for a collective response to these complicated bereavements and possible increase in PGD due to COVID-19. Here we outline a new European network that aims to unite a community of grief researchers and clinicians to provide accessible, evidence-based support particularly during times of unprecedent crisis. The Bereavement Network Europe (BNE) has been developed with two main aims. Firstly, to develop expert agreed, internationally acceptable guidelines for bereavement care through a three-tiered approach. Secondly, to provide a platform for researchers and clinicians to share knowledge, collaborate, and develop consensus protocols to facilitate the introduction of PGD to diverse stakeholders. This article outlines the current status and aims of the BNE along with the plans for upcoming network initiatives and the three-tiered bereavement care guidelines in response to the COVID-19 pandemic.


Subject(s)
COVID-19 , Community Networks , Delivery of Health Care/organization & administration , Grief , International Classification of Diseases , Bereavement , Europe/epidemiology , Humans , Models, Organizational , Practice Guidelines as Topic
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