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2.
J Public Health Manag Pract ; 28(6): 650-656, 2022.
Article in English | MEDLINE | ID: covidwho-2018358

ABSTRACT

Telehealth is the use of electronic information and telecommunication technologies to provide care when the patient and the provider are not in the same room at the same time. Telehealth accounted for less than 1% of all Medicare Fee-for-Service outpatient visits in the United States in 2019 but grew to account for 46% of all visits in April 2020. Changes in reimbursement and licensure policies during the COVID-19 pandemic appeared to greatly facilitate this increased use. Telehealth will continue to account for a substantial portion of care provided in the United States and globally. A better understanding of telehealth approaches and their evidence base by public health practitioners may help improve their ability to collaborate with health care organizations to improve population health. The article summarizes the Centers for Disease Control and Prevention's (CDC's) approach to understanding the evidence base for telehealth in public health practice, possible applications for telehealth in public health practice, and CDC's use of telehealth to improve population health.


Subject(s)
COVID-19 , Telemedicine , Aged , COVID-19/epidemiology , Humans , Medicare , Pandemics , Public Health Practice , United States/epidemiology
3.
Food Environ Virol ; 14(4): 410-416, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1990792

ABSTRACT

This study aimed to develop a framework for combining community wastewater surveillance with state clinical surveillance for the confirmation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants within the community and to provide recommendations on how to expand on such research and apply the findings in public health responses. Wastewater samples were collected weekly from 17 geographically resolved locations in Louisville/Jefferson County, Kentucky (USA), from February 10 to December 13, 2021. Genomic surveillance and quantitative reverse transcription PCR (RT-qPCR) platforms were used to screen for SARS-CoV-2 in wastewater, and state clinical surveillance was used for confirmation. The study results highlighted an increased epidemiological value of combining community wastewater genomic surveillance and RT-qPCR with conventional case-auditing methods. The spatial scale and temporal frequency of wastewater sampling provided promising sensitivity and specificity for gaining public health screening insights about SARS-CoV-2 emergence, seeding, and spread in communities. Improved national surveillance systems are needed against future pathogens and variants, and wastewater-based genomic surveillance exhibits great potential when coupled with clinical testing. This paper presents evidence that complementary wastewater and clinical testing are cost-effectively enhanced when used in combination, as they provide a strong tool for a joint public health framework. Future pathogens of interest may be examined in either a targeted fashion or using a more global approach where all pathogens are monitored. This study has also provided novel insights developed from evidence-based public health practices.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , SARS-CoV-2/genetics , Waste Water , COVID-19/epidemiology , Wastewater-Based Epidemiological Monitoring , Genomics , Public Health Practice
4.
J Public Health Manag Pract ; 28(Suppl 1): S27-S37, 2022.
Article in English | MEDLINE | ID: covidwho-1931964

ABSTRACT

This article outlines a pathway for public health departments and practitioners to incorporate law into their efforts to advance equity in health outcomes. We assert that examining and applying law can accelerate public health efforts to mitigate structural and systemic inequities, including racism. Recent events such as the COVID-19 pandemic and the community impacts of policing have brought into sharp relief the inequities faced by many populations. These stark and explosive examples arise out of long-standing, persistent, and sometimes hidden structural and systemic inequities that are difficult to trace because they are embedded in laws and accompanying policies and practices. We emphasize this point with a case study involving a small, majority Black community in semirural Appalachia that spent almost 50 years attempting to gain access to the local public water system, despite being surrounded by water lines. We suggest that public health practitioners have a role to play in addressing these kinds of public health problems, which are so clearly tied to the ways laws and policies are developed and executed. We further suggest that public health practitioners, invoking the 10 Essential Public Health Services, can employ law as a tool to increase their capacity to craft and implement evidence-based interventions.


Subject(s)
COVID-19 , Health Equity , Racism , Humans , Pandemics , Public Health , Public Health Practice , SARS-CoV-2
5.
Sci Rep ; 12(1): 3600, 2022 03 04.
Article in English | MEDLINE | ID: covidwho-1730314

ABSTRACT

Public health emergency decisions are explored to ensure the emergency response measures in an environment where various emergencies occur frequently. An emergency decision is essentially a multi-criteria risk decision-making problem. The feasibility of applying prospect theory to emergency decisions is analyzed, and how psychological behaviors of decision-makers impact decision-making results are quantified. On this basis, the cognitive process of public health emergencies is investigated based on the rough set theory. A Decision Rule Extraction Algorithm (denoted as A-DRE) that considers attribute costs is proposed, which is then applied for attribute reduction and rule extraction on emergency datasets. In this way, decision-makers can obtain reduced decision table attributes quickly. Considering that emergency decisions require the participation of multiple departments, a framework is constructed to solve multi-department emergency decisions. The technical characteristics of the blockchain are in line with the requirements of decentralization and multi-party participation in emergency management. The core framework of the public health emergency management system-plan, legal system, mechanism, and system can play an important role. When [Formula: see text], the classification accuracy under the K-Nearest Neighbor (KNN) classifier reaches 73.5%. When [Formula: see text], the classification accuracy under the Support Vector Machines (SVM) classifier reaches 86.4%. It can effectively improve China's public health emergency management system and improve the efficiency of emergency management. By taking Coronavirus Disease 2019 (COVID-19) as an example, the weight and prospect value functions of different decision-maker attributes are constructed based on prospect theory. The optimal rescue plan is finally determined. A-DRE can consider the cost of each attribute in the decision table and the ability to classify it correctly; moreover, it can reduce the attributes and extract the rules on the COVID-19 dataset, suitable for decision-makers' situation face once an emergency occurs. The emergency decision approach based on rough set attribute reduction and prospect theory can acquire practical decision-making rules while considering the different risk preferences of decision-makers facing different decision-making results, which is significant for the rapid development of public health emergency assistance and disaster relief.


Subject(s)
Blockchain , COVID-19/epidemiology , Decision Making, Organizational , Emergencies , Public Health Practice , Algorithms , COVID-19/virology , Humans , SARS-CoV-2/isolation & purification , Support Vector Machine
7.
Sci Rep ; 12(1): 2627, 2022 02 16.
Article in English | MEDLINE | ID: covidwho-1692539

ABSTRACT

This study aimed to evaluate the effectiveness of wireless emergency alerts (WEAs) on social distancing policy. The Republic of Korea has been providing information to the public through WEAs using mobile phones. This study used five data sets: WEA messages, news articles including the keyword "COVID-19," the number of confirmed COVID-19 patients, public foot traffic data, and the government's social distancing level. The WEAs were classified into two topics-"warning" and "guidance"-using a random forest model. The results of the correlation analysis and further detailed analysis confirmed that the "warning" WEA topic and number of news articles significantly affected public foot traffic. However, the "guidance" topic was not significantly associated with public foot traffic. In general, the Korean government's WEAs were effective at encouraging the public to follow social distance recommendations during the COVID-19 pandemic. In particular, the "warning" WEA topic, by providing information about the relative risk directly concerning the recipients, was significantly more effective than the "guidance" topic.


Subject(s)
COVID-19/prevention & control , Cell Phone , Disease Notification/methods , Physical Distancing , Humans , Mass Media , Public Health Practice , Republic of Korea
9.
Public Health Rep ; 137(2): 213-219, 2022.
Article in English | MEDLINE | ID: covidwho-1643031

ABSTRACT

From May through July 2020, Arizona was a global hotspot for new COVID-19 cases. In response to the surge of cases, local public health departments looked for innovative ways to form external partnerships to address their staffing needs. In collaboration with the Maricopa County Department of Public Health, the Arizona State University Student Outbreak Response Team (SORT) created and implemented a virtual call center to conduct public health case investigations for COVID-19. SORT officially launched a dedicated COVID-19 case investigation program after 3 weeks of program design and training. From June 29 through November 8, 2020, SORT recruited and trained 218 case investigators, completed 5000 case patient interviews, and closed 10 000 cases. Our team also developed process improvements to address disparities in case investigation timeliness. A strong infrastructure designed to accommodate remote case investigations, paired with a large workforce, enabled SORT to provide additional surge capacity for the county's high volume of cases. University-driven multidisciplinary case investigator teams working in partnership with state, tribal, and local public health staff members can be an effective tool for supporting a diverse and growing public health workforce. We discuss the essential design factors involved in building a university program to complement local COVID-19 response efforts, including workflows for case management, volunteer case investigator recruitment and training, secure technology platforms for conducting case investigations remotely, and robust data-tracking procedures for maintaining quality control and timely case reporting.


Subject(s)
COVID-19/epidemiology , Call Centers/organization & administration , Contact Tracing/methods , Disease Outbreaks/prevention & control , Intersectoral Collaboration , Program Development , Program Evaluation , Arizona/epidemiology , Humans , Public Health Practice , SARS-CoV-2 , Students , Universities , Volunteers , Workforce/organization & administration
16.
Am J Public Health ; 112(1): 38-42, 2022 01.
Article in English | MEDLINE | ID: covidwho-1594448

ABSTRACT

We conducted a community seroprevalence survey in Arizona, from September 12 to October 1, 2020, to determine the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used the seroprevalence estimate to predict SARS-CoV-2 infections in the jurisdiction by applying the adjusted seroprevalence to the county's population. The estimated community seroprevalence of SARS-CoV-2 infections was 4.3 times greater (95% confidence interval = 2.2, 7.5) than the number of reported cases. Field surveys with representative sampling provide data that may help fill in gaps in traditional public health reporting. (Am J Public Health. 2022;112(1):38-42. https://doi.org/10.2105/AJPH.2021.306568).


Subject(s)
Antibodies, Viral/blood , COVID-19 Serological Testing , COVID-19/diagnosis , COVID-19/epidemiology , Adolescent , Adult , Aged , Arizona/epidemiology , Child , Family Characteristics , Female , Humans , Male , Middle Aged , Public Health Practice , SARS-CoV-2 , Seroepidemiologic Studies
19.
J Public Health Manag Pract ; 27(5): 492-500, 2021.
Article in English | MEDLINE | ID: covidwho-1501235

ABSTRACT

OBJECTIVES: To examine levels of expenditure and needed investment in public health at the local level in the state of Ohio pre-COVID-19. DESIGN: Using detailed financial reporting from fiscal year (FY) 2018 from Ohio's local health departments (LHDs), we characterize spending by Foundational Public Health Services (FPHS). We also constructed estimates of the gap in public health spending in the state using self-reported gaps in service provision and a microsimulation approach. Data were collected between January and June 2019 and analyzed between June and September 2019. PARTICIPANTS: Eighty-four of the 113 LHDs in the state of Ohio covering a population of almost 9 million Ohioans. RESULTS: In FY2018, Ohio LHDs spent an average of $37 per capita on protecting and promoting the public's health. Approximately one-third of this investment supported the Foundational Areas (communicable disease control; chronic disease and injury prevention; environmental public health; maternal, child, and family health; and access to and linkages with health care). Another third supported the Foundational Capabilities, that is, the crosscutting skills and capacities needed to support all LHD activities. The remaining third supported programs and activities that are responsive to local needs and vary from community to community. To fully meet identified LHD needs in the state pre-COVID-19, Ohio would require an additional annual investment of $20 per capita on top of the current $37 spent per capita, or approximately $240 million for the state. CONCLUSIONS: A better understanding of the cost and value of public health services can educate policy makers so that they can make informed trade-offs when balancing health care, public health, and social services investments. The current environment of COVID-19 may dramatically increase need, making understanding and growing public health investment critical.


Subject(s)
Health Care Costs/statistics & numerical data , Health Services Needs and Demand/economics , Public Health Practice/economics , Public Health/economics , COVID-19/economics , Financing, Government/economics , Humans , Local Government , Ohio
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