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4.
Nat Med ; 27(3): 396-400, 2021 03.
Article in English | MEDLINE | ID: covidwho-1319038

ABSTRACT

Fourteen months into the SARS-CoV-2 pandemic, we identify key lessons in the global and national responses to the pandemic. The World Health Organization has played a pivotal technical, normative and coordinating role, but has been constrained by its lack of authority over sovereign member states. Many governments also mistakenly attempted to manage COVID-19 like influenza, resulting in repeated lockdowns, high excess morbidity and mortality, and poor economic recovery. Despite the incredible speed of the development and approval of effective and safe vaccines, the emergence of new SARS-CoV-2 variants means that all countries will have to rely on a globally coordinated public health effort for several years to defeat this pandemic.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control , Global Health , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/trends , Global Health/history , Global Health/trends , Government , History, 21st Century , Humans , Pandemics/history , Public Health/history , Public Health/methods , Public Health/trends , Public Health Administration/methods , Public Health Administration/standards , Public Health Administration/trends , SARS-CoV-2/physiology
5.
J Public Health Policy ; 42(2): 211-221, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1258617

ABSTRACT

In order to effectively control spread of coronavirus 2019 (COVID-19), it is essential that jurisdictions have the capacity to rapidly trace close contacts of each and every case. Best practice guidance on how to implement such programs is urgently needed. We describe the early experience in the City and County of San Francisco (CCSF), where the City's Department of Health expanded contact tracing capability in anticipation of changes in San Francisco's 'shelter in place' order between April and June 2020. Important prerequisites to successful scale-up included a rapid expansion of the COVID-19 response workforce, expansion of testing capability, and other containment resources. San Francisco's scale-up offers a model for how other jurisdictions can rapidly mobilize a workforce. We underscore the importance of an efficient digital case management system, effective training, and expansion of supportive service programs for those in quarantine or isolation, and metrics to ensure continuous performance improvement.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Contact Tracing/methods , Public Health Administration/methods , COVID-19/diagnosis , COVID-19 Testing/statistics & numerical data , Data Management/organization & administration , Efficiency, Organizational , Humans , Pandemics , Quarantine/psychology , SARS-CoV-2 , San Francisco/epidemiology , Social Work/organization & administration
10.
Epidemiol Prev ; 44(5-6 Suppl 2): 33-41, 2020.
Article in Italian | MEDLINE | ID: covidwho-1068122

ABSTRACT

BACKGROUND: the ability to implement effective preventive and control measures is rooted in public health surveillance to promptly identify and isolate contagious patients. OBJECTIVES: to describe some organizational aspects and resources involved in the control of COVID-19 pandemic. DESIGN: observational cross sectional study. SETTING AND PARTICIPANTS: a survey of methods and tools adopted by the competent service (Prevention department) in the Local public health units (LHU) of the regional Health services has been performed in May 2020. The survey collected data related to activities carried out during the month of April 2020 on the surveillance system for collection of suspected cases, their virological ascertainment, the isolation procedures and contact-tracing activities by means of an online questionnaire filled in by the public health structure of the regional health system. A convenience sample of Prevention departments was recruited. RESULTS: in 44 Prevention departments of 14 Regions/Autonomous Provinces (caring for 40% of the population residing in Italy), different services were swiftly engaged in pandemic response. Reports of suspected cases were about 3 times the number of confirmed cases in the same month. Local reporting form was used in 46% of the LHUs while a regional form was available in 42% of the Departments (in 9/14 Regions). In one fourth the forms were not always used and 2% had no forms for the reporting of suspected cases. Data were recorded in 52% of LHUs on local databases, while in 20% a regional database (in 7 Regions) had been created. A proportion of 11% did not record the data for further elaboration. The virological assessment with nasopharyngeal swabs out of the hospital setting was carried out on the average in 7 points in each LHU (median 5) and the average daily capacity was 350 (71 per 100,000) swabs. The rate of subjects newly tested during the month of April was of 893 per 100,000 new people. Data collected at the swabbing were recorded on a regional platform in 17 LHUs (39%) of 8 Regions. In 7% LHUs only positive specimens were recorded electronically. Local files were used in 27% LHUs. The interview with confirmed cases was carried out with a local questionnaire in 52% LHUs, while 14% stated that a standardized form was not used. The data collected about cases were recorded on a regional IT platform in 30% Departments (in 8 Regions) and in 41% data were registered only locally. For each confirmed case in April, a median of 4 contacts were identified. Only 13 (30%) Departments in 9 Regions have registered contact data on a regional database. Ten Departments (23%) have only hard copies, while 56% recorded data on local databases. About 5 health professionals for 100,000 resident population were involved in each LHU in each of the following activities as receiving reports of suspected cases, swabs collection, interviews of cases and contact identifications. CONCLUSIONS: the pandemic required rapidly a great organizational effort and great flexibility to increase response capacity, which now must be strengthened and maintained. Several different tools (forms and electronic files) have been developed in each LHU and used for the same surveillance operational processes with a loss in local efficiency. The inhomogeneous data collection and recording is an obstacle for further analyses and risk identifications and is a missed opportunity for the advancement of our knowledge on pandemic epidemiology analysis. In Italy, updating the pandemic response plans is the priority, at national, regional and local level, and the occasion to fill the gaps and to improve surveillance systems to the interruption of COVID-19 transmission.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/organization & administration , Pandemics/prevention & control , Public Health Administration/methods , SARS-CoV-2/isolation & purification , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing/statistics & numerical data , Communicable Disease Control/methods , Contact Tracing , Cross-Sectional Studies , Electronic Health Records , Forms and Records Control , Geography, Medical , Health Care Surveys , Humans , Italy/epidemiology , Nasopharynx/virology , Population Surveillance
12.
J Clin Microbiol ; 58(8)2020 Jul 23.
Article in English | MEDLINE | ID: covidwho-999210

ABSTRACT

An outbreak of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) began in Wuhan, Hubei, China, in December 2019 and spread rapidly worldwide. The response by the Alberta Precision Laboratories, Public Health Laboratory (ProvLab), AB, Canada, included the development and implementation of nucleic acid detection-based assays and dynamic changes in testing protocols for the identification of cases as the epidemic curve increased exponentially. This rapid response was essential to slow down and contain transmission and provide valuable time to the local health authorities to prepare appropriate response strategies. As of May 24, 2020, 236,077 specimens were tested, with 6,475 (2.74%) positives detected in the province of Alberta, Canada. Several commercial assays are now available; however, the response from commercial vendors to develop and market validated tests is a time-consuming process. In addition, the massive global demand made it difficult to secure a reliable commercial supply of testing kits and reagents. A public health laboratory serves a unique and important role in the delivery of health care. One of its functions is to anticipate and prepare for novel emerging pathogens with a plan for pandemic preparedness. Here, we outline the response that involved the development and deployment of testing methodologies that evolved as SARS-CoV-2 spread worldwide, the challenges encountered, and mitigation strategies. We also provide insight into the organizational structure of how a public health response is coordinated in Alberta, Canada, and its benefits.


Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Diagnostic Services/organization & administration , Molecular Diagnostic Techniques/methods , Pneumonia, Viral/diagnosis , Public Health Administration/methods , Alberta , COVID-19 , COVID-19 Testing , Humans , Pandemics , SARS-CoV-2
13.
East Mediterr Health J ; 26(12): 1570-1575, 2020 Dec 09.
Article in English | MEDLINE | ID: covidwho-995096

ABSTRACT

BACKGROUND: During the 2019 Hajj, the Ministry of Health in Saudi Arabia implemented for the first time a health early warning system for rapid detection and response to health threats. AIMS: This study aimed to describe the early warning findings at the Hajj to highlight the pattern of health risks and the potential benefits of the disease surveillance system. METHODS: Using syndromic surveillance and event-based surveillance data, the health early warning system generated automated alarms for public health events, triggered alerts for rapid epidemiological investigations and facilitated the monitoring of health events. RESULTS: During the deployment period (4 July-31 August 2019), a total of 121 automated alarms were generated, of which 2 events (heat-related illnesses and injuries/trauma) were confirmed by the response teams. CONCLUSION: The surveillance system potentially improved the timeliness and situational awareness for health events, including non-infectious threats. In the context of the current COVID-19 pandemic, a health early warning system could enhance case detection and facilitate monitoring of the disease geographical spread and the effectiveness of control measures.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/organization & administration , Disease Outbreaks/prevention & control , Islam , Public Health Administration/methods , Public Health Surveillance/methods , Crowding , Health Planning/organization & administration , Humans , Mass Behavior , Mediterranean Region/epidemiology , Pandemics , SARS-CoV-2 , Saudi Arabia/epidemiology , Sentinel Surveillance , Travel
16.
Healthc Q ; 23(3): 15-23, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-948241

ABSTRACT

The East Toronto Health Partners (ETHP) include more than 50 organizations working collaboratively to create an integrated system of care in the east end of Toronto. This existing partnership proved invaluable as a platform for a rapid, coordinated local response to the COVID-19 pandemic. Months after the first wave of the pandemic began, with the daily numbers of COVID-19 cases finally starting to decline, leaders from ETHP provided preliminary reflections on two critical questions: (1) How were existing integration efforts leveraged to mobilize a response during the COVID-19 crisis? and (2) How can the response to the initial wave of COVID-19 be leveraged to further accelerate integration and better address subsequent waves and system improvements once the pandemic abates?


Subject(s)
COVID-19/therapy , Community Participation , Delivery of Health Care, Integrated/organization & administration , Delivery of Health Care/organization & administration , Health Policy , COVID-19/epidemiology , COVID-19/mortality , Community Participation/methods , Decision Making, Organizational , Delivery of Health Care/methods , Delivery of Health Care, Integrated/methods , Global Health , Humans , Ontario , Organizational Innovation , Primary Health Care/organization & administration , Public Health Administration/methods , Resource Allocation/methods , Resource Allocation/organization & administration
17.
Bioessays ; 42(12): e2000178, 2020 12.
Article in English | MEDLINE | ID: covidwho-841979

ABSTRACT

The 2019 coronavirus (COVID-19), also known as SARS-CoV-2, is highly pathogenic and virulent, and it spreads very quickly through human-to-human contact. In response to the growing number of cases, governments across the spectrum of affected countries have adopted different strategies in implementing control measures, in a hope to reduce the number of new cases. However, 5 months after the first confirmed case, countries like the United States of America (US) seems to be heading towards a trajectory that indicates a health care crisis. This is in stark contrast to the downward trajectory in Europe, China, and elsewhere in Asia, where the number of new cases has seen a decline ahead of an anticipated second wave. A data-driven approach reveals three key strategies in tackling COVID-19. Our work here has definitively evaluated these strategies and serves as a warning to the US, and more importantly, a guide for tackling future pandemics. Also see the video abstract here https://youtu.be/gPkCi2_7tWo.


Subject(s)
COVID-19/epidemiology , Infection Control/organization & administration , Infection Control/trends , Pandemics , Asia/epidemiology , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19 Testing/methods , COVID-19 Testing/standards , COVID-19 Testing/trends , Demography/trends , Economic Recession , Employment/organization & administration , Employment/standards , Employment/trends , Europe/epidemiology , History, 21st Century , Humans , Infection Control/methods , Infection Control/standards , Public Health Administration/methods , Public Health Administration/standards , Public Health Administration/trends , SARS-CoV-2/physiology , Travel-Related Illness , United States/epidemiology
19.
Environ Microbiol ; 22(11): 4527-4531, 2020 11.
Article in English | MEDLINE | ID: covidwho-807515

ABSTRACT

Imposition of restrictions on civil liberties in response to epi/pandemic crises provokes collateral health, economic and social crises. Moreover, as a result of the societal distress engendered, they become less effective over time, reflected in reducing acceptability, public protests, lack of compliance and civil disobedience, as evidenced by current events in some countries. There is an urgent need to evolve new containment strategies that minimize civil liberty restrictions. This requires strategic economic policies to invest in what might be termed pandemic containment innovation, particularly in the development of new means of reducing virus concentrations in closed spaces, and of precision exclusion of virus transmitters from public assemblies. Such innovations and their implementation will in turn create significant employment and boost economies. And, because such investments aim at increasing the resilience of society, healthcare and the economy to pandemics (and indeed outbreaks of respiratory infections in general), they are particularly sustainable.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Civil Rights , Public Health Administration/methods , SARS-CoV-2 , Adolescent , Adult , COVID-19/economics , Child , Child, Preschool , Communicable Disease Control/economics , Communicable Disease Control/methods , Global Health/economics , Humans , Young Adult
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