COVID-19 Response Roles among CDC International Public Health Emergency Management Fellowship Graduates.

Since 2013, the US Centers for Disease Control and Prevention has offered the Public Health Emergency Management Fellowship to health professionals from around the world. The goal of this program is to build an international workforce to establish public health emergency management programs and operations centers in participating countries. In March 2021, all 141 graduates of the fellowship program were invited to complete a web survey designed to examine their job roles and functions, assess their contributions to their country's COVID-19 response, and identify needs for technical assistance to strengthen national preparedness and response systems. Of 141 fellows, 89 successfully completed the survey. Findings showed that fellowship graduates served key roles in COVID-19 response in many countries, used skills they gained from the fellowship, and desired continuing engagement between the Centers for Disease Control and Prevention and fellowship alumni to strengthen the community of practice for international public health emergency management.

Is Avoidable Hospitalization Experienced Prior to Infection Associated With COVID-19-Related Deaths?

Objectives: This study aimed to determine the effect of the presence or absence of avoidable hospitalization before acquiring coronavirus disease (COVID-19) on COVID-19-related deaths. Methods: This study used the total NHIS-COVID-19 dataset comprising domestic COVID-19 patients, provided by the National Health Insurance Service (NHIS) in South Korea. We conducted logistic regression and double robust estimation (DRE) to confirm the effect of avoidable hospitalization on COVID-19-related deaths. Results: Logistic regression analysis confirmed that the odds ratio (OR) of death due to COVID-19 was high in the group that experienced avoidable hospitalization. DRE analysis showed a higher OR of death due to COVID-19 in the group that experienced avoidable hospitalization compared to the group that did not experience avoidable hospitalization, except in the subgroup aged ≤69 years. Conclusion: The effect of avoidable hospitalization on COVID-19-related deaths was confirmed. Therefore, continued health care, preventive medicine, and public health management are essential for reducing avoidable hospitalizations despite the COVID-19 pandemic. Clinicians need to be informed about the importance of continuous disease management.

Lessons Learned: The Varied Responses of Massachusetts' Local Health Departments During the COVID-19 Pandemic.

CONTEXT: Massachusetts' decentralized public health model holds tightly to its founding principle of home rule and a board of health system established in 1799. Consequently, Massachusetts has more local health departments (n = 351) than any other state. During COVID-19, each health department, steeped in centuries of independence, launched its own response to the pandemic. OBJECTIVES: To analyze local public health resources and responses to COVID-19. DESIGN: Semistructured interviews and a survey gathered quantitative and qualitative information about communities' responses and resources before and during the pandemic. Municipality demographics (American Community Survey) served as a proxy for community health literacy. We tracked the frequency and content of local board of health meetings using minutes and agendas; we rated the quality of COVID-19 communications on town Web sites. SETTING: The first 6 months of the COVID-19 pandemic in Massachusetts: March-August 2020. PARTICIPANTS: Health directors and agents in 10 south-central Massachusetts municipalities, identified as the point of contact by the Academic Public Health Corps. MAIN OUTCOME MEASURES: We measured municipality resources using self-reported budgets, staffing levels, and demographic-based estimates of community health literacy. We identified COVID-19 responses through communities' self-reported efforts, information on town Web sites, and meeting minutes and agendas. RESULTS: Municipalities excelled in communicating with residents, local businesses, and neighboring towns but lacked the staffing and funding for an efficient and coordinated response. On average, municipal budgets ranged from $5 to $16 per capita, and COVID-19 consumed 75% of health department staff time. All respondents noted extreme workload increases. While municipal Web sites received high scores for Accurate Information, other categories (Navigability; Timeliness; Information Present) were less than 50%. CONCLUSIONS: Increased support for regionalization and sustained public health funding would improve local health responses during complex emergencies in states with local public health administration.

Tracking COVID-19 Inequities Across Jurisdictions Represented in the Big Cities Health Coalition (BCHC): The COVID-19 Health Inequities in BCHC Cities Dashboard.

Objectives. To describe the creation of an interactive dashboard to advance the understanding of the COVID-19 pandemic from an equity and urban health perspective across 30 large US cities that are members of the Big Cities Health Coalition (BCHC). Methods. We leveraged the Drexel‒BCHC partnership to define the objectives and audience for the dashboard and developed an equity framework to conceptualize COVID-19 inequities across social groups, neighborhoods, and cities. We compiled data on COVID-19 trends and inequities by race/ethnicity, neighborhood, and city, along with neighborhood- and city-level demographic and socioeconomic characteristics, and built an interactive dashboard and Web platform to allow interactive comparisons of these inequities across cities. Results. We launched the dashboard on January 21, 2021, and conducted several dissemination activities. As of September 2021, the dashboard included data on COVID-19 trends for the 30 cities, on inequities by race/ethnicity in 21 cities, and on inequities by neighborhood in 15 cities. Conclusions. This dashboard allows public health practitioners to contextualize racial/ethnic and spatial inequities in COVID-19 across large US cities, providing valuable insights for policymakers. (Am J Public Health. 2022;112(6):904-912. https://doi.org/10.2105/AJPH.2021.306708).

Bridging global health actors and agendas: the role of national public health institutes.

Global health crises require coordination and collaboration among actors and global health agendas including health security, health promotion, and universal health coverage. This study investigated whether national public health institutes (NPHIs) unify agendas and actors, how this can be achieved, and what factors contribute to success. We conducted semi-structured interviews with 24 public health leaders from 18 countries in six WHO regions between 2019 and 2020. Respondents described how NPHIs bridge agendas reporting five strategies that institutes employ: serving as a trusted scientific advisor; convening actors across and within sectors; prioritizing transdisciplinary approaches; integrating public health infrastructures, and training that builds public health capacity. Findings also revealed five enabling factors critical to success: a strong legal foundation; scientific independence; public trust and legitimacy; networks and partnerships at global, national, and local levels; and stable funding. The Covid-19 pandemic underscores the urgency of securing scientific independence and promoting national institutes' responsiveness to public health challenges.

Nimble, efficient and evolving: the rapid response of the National Collaborating Centres to COVID-19 in Canada. / Agiles, efficients et en évolution : la réponse rapide des Centres de collaboration nationale à la COVID-19 au Canada.

Since December 2019, there has been a global explosion of research on COVID-19. In Canada, the six National Collaborating Centres (NCCs) for Public Health form one of the central pillars supporting evidence-informed decision making by gathering, synthesizing and translating emerging findings. Funded by the Public Health Agency of Canada and located across Canada, the six NCCs promote and support the use of scientific research and other knowledges to strengthen public health practice, programs and policies. This paper offers an overview of the NCCs as an example of public health knowledge mobilization in Canada and showcases the NCCs' contribution to the COVID-19 response while reflecting on the numerous challenges encountered.

The explosion of research on COVID-19 in Canada and around the world called for an improved capacity to support evidence-informed decision making (EIDM). Canada is fostering various mechanisms to achieve this goal; the National Collaborating Centres (NCCs) for Public Health are central to supporting EIDM during the pandemic. The NCCs, a network of networks anchored on six unique knowledge hubs, are well connected to provincial, territorial, local and international partners. In response to COVID-19, the NCCs are making an important contribution to building knowledge, skills and capacity in the public health sector, and to supporting public health professionals in synthesizing and using evidence-informed knowledge in policy and practice.

L'explosion de la recherche menée sur la COVID-19 au Canada et ailleurs dans le monde a nécessité une augmentation de la capacité à soutenir la prise de décisions informées par les données probantes. Parmi les divers mécanismes préconisés par le Canada pour atteindre cet objectif, les Centres de collaboration nationale (CCN) en santé publique jouent un rôle essentiel pendant la pandémie pour soutenir la prise de décisions informées par les données probantes. Les CCN, qui constituent un réseau de réseaux s'appuyant sur six centres de connaissances, ont des liens étroits avec plusieurs partenaires provinciaux, territoriaux, locaux et internationaux. Pour lutter contre la COVID-19, les CCN renforcent de façon significative les connaissances, les compétences et les capacités en santé publique et soutiennent les professionnels en santé publique en synthétisant des connaissances fondées sur des données probantes pour leur intégration aux politiques et aux pratiques.

New York State Local Health Department Preparedness for and Response to the COVID-19 Pandemic: An In-Progress Review.

A mixed-methods approach was taken to describe lessons learned by local health department leaders during the early stages of the COVID-19 pandemic in New York State and to document leaders' assessments of their departments' emergency preparedness capabilities and capacities. Leaders participating in a survey rated the effectiveness of their department's capabilities and capacities in administrative and public health preparedness, epidemiology, and communications on a scale from 1 to 5; those partaking in focus groups answered open-ended questions about the same 4 topics. Subjects rated intragovernmental activities most effective ( = 4.41, SD = 0.83) and reported receiving assistance from other county agencies. They rated level of supplies least effective ( = 3.03, SD = 1.01), describing low supply levels and inequitable distribution of testing materials and personal protective equipment among regions. Local health departments in New York require more state and federal aid to maintain the public health workforce in preparation for future emergencies.

COVID-19 pandemic: an Italian single institution's experience and lessons learned by public health residents' workforce.

Methods: We hereby provide a systematic description of the response actions in which the public health residents' workforce was pivotal, in a large tertiary hospital. Background: The Coronavirus Disease 2019 pandemic has posed incredible challenges to healthcare workers worldwide. The residents have been affected by an almost complete upheaval of the previous setting of activities, with a near total focus on service during the peak of the emergency. In our Institution, residents in public health were extensively involved in leading activities in the management of Coronavirus Disease 2019 pandemic. Results: The key role played by residents in the response to Coronavirus Disease 2019 pandemic is highlighted by the diversity of contributions provided, from cooperation in the rearrangement of hospital paths for continuity of care, to establishing and running new services to support healthcare professionals. Overall, they constituted a workforce that turned essential in governing efficiently such a complex scenario. Conclusions: Despite the difficulties posed by the contingency and the sacrifice of many training activities, Coronavirus Disease 2019 pandemic turned out to be a unique opportunity of learning and measuring one's capabilities and limits in a context of absolute novelty and uncertainty.

Factors Driving Citizen Engagement With Government TikTok Accounts During the COVID-19 Pandemic: Model Development and Analysis.

BACKGROUND: During the COVID-19 pandemic, growth in citizen engagement with social media platforms has enabled public health departments to accelerate and improve health information dissemination, developing transparency and trust between governments and citizens. In light of these benefits, it is imperative to learn the antecedents and underlying mechanisms for this to maintain and enhance engagement. OBJECTIVE: The aim of this study is to determine the factors and influencing mechanisms related to citizen engagement with the TikTok account of the National Health Commission of China during the COVID-19 pandemic. METHODS: Using a web crawler, 355 short videos were collected from the Healthy China account on TikTok (with more than 3 million followers throughout China), covering the period from January 21, 2020, to April 25, 2020. The title and video length, as well as the number of likes, shares, and comments were collected for each video. After classifying them using content analysis, a series of negative binomial regression analyses were completed. RESULTS: Among the 355 videos, 154 (43.4%) related to guidance for clinicians, patients, and ordinary citizens, followed by information concerning the government's handling of the pandemic (n=100, 28.2%), the latest news about COVID-19 (n=61, 17.2%), and appreciation toward frontline emergency services (n=40, 11.3%). Video length, titles, dialogic loop, and content type all influenced the level of citizen engagement. Specifically, video length was negatively associated with the number of likes (incidence rate ratio [IRR]=0.19, P<.001) and comments (IRR=0.39, P<.001). Title length was positively related to the number of shares (IRR=24.25, P=.01), likes (IRR=8.50, P=.03), and comments (IRR=7.85, P=.02). Dialogic loop negatively predicted the number of shares (IRR=0.56, P=.03). In comparison to appreciative information, information about the government's handling of the situation (IRR=5.16, P<.001) and guidelines information (IRR=7.31, P<.001) were positively correlated with the number of shares, while the latest news was negatively related to the number of likes received (IRR=0.46, P=.004). More importantly, the relationship between predictors and citizen engagement was moderated by the emotional valence of video titles. Longer videos with positive titles received a higher number of likes (IRR=21.72, P=.04) and comments (IRR=10.14, P=.047). Furthermore, for short videos related to government handling of the pandemic (IRR=14.48, P=.04) and guidance for stakeholders (IRR=7.59, P=.04), positive titles received a greater number of shares. Videos related to the latest news (IRR=66.69, P=.04) received more likes if the video title displayed higher levels of positive emotion. CONCLUSIONS: During the COVID-19 pandemic, videos were frequently published on government social media platforms. Video length, title, dialogic loop, and content type significantly influenced the level of citizen engagement. These relationships were moderated by the emotional valence of the video's title. Our findings have implications for maintaining and enhancing citizen engagement via government social media.