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1.
BMJ Open ; 12(11): e062624, 2022 11 22.
Article in English | MEDLINE | ID: covidwho-2152991

ABSTRACT

OBJECTIVES: A systematic review was conducted with the aims of identifying sectors mentioned in the public health emergency preparedness and response (PHEPR) literature and mapping the involvement of those sectors in the seven PHEPR cycle domains. SETTING: A detailed search strategy was conducted in Embase and Scopus, covering the period between 1 January 2005 and 1 January 2020. METHODS: Published articles focusing on preparedness for and/or response to public health emergencies of multiple origins on the European continent were included. The frequency with which predetermined sectors were mentioned when describing collaboration during the preparedness and response cycle was determined. RESULTS: The results show that description of the involvement of sectors in PHEPR in general and collaboration during PHEPR is predominantly confined to a limited number of sectors, namely 'Governmental institutions', 'Human health industry', 'Experts' and 'Civil Society'. Description is also limited to only three domains of the PHEPR cycle, namely 'Risk and crisis management', 'Pre-event preparations and governance' and 'Surveillance'. CONCLUSIONS: Optimal preparedness and response require predefined collaboration with a broader scope of partners than currently seems to be the case based on this literature review. We recommend considering these outcomes when planning multisectoral collaboration during preparedness and response, as well as the need to further operationalise the term 'multisectoral collaboration' during PHEPRs. PROSPERO REGISTRATION NUMBER: PROSPERO with registration number 176 331.


Subject(s)
Civil Defense , Humans , Civil Defense/methods , Public Health/methods
2.
JMIR Public Health Surveill ; 7(9): e31930, 2021 09 17.
Article in English | MEDLINE | ID: covidwho-2141353

ABSTRACT

This report aimed to provide an overview of the epidemiological situation of COVID-19 in Morocco and to review the actions carried out as part of the national response to this pandemic. The methodology adopted was based on literature review, interviews with officials and actors in the field, and remote discussion workshops with a multidisciplinary and multisectoral working group. Morocco took advantage of the capacities already strengthened within the framework of the application of the provisions of the International Health Regulations (IHR) of 2005. A SWOT analysis made it possible to note that an unprecedented political commitment enabled all the necessary means to face the pandemic and carry out all the response activities, including a campaign of relentless communication. Nevertheless, and despite the efforts made, the shortage of human resources, especially those qualified in intensive care and resuscitation, has been the main drawback to be addressed. The main lesson learned is a need to further strengthen national capacities to prepare for and respond to possible public health emergencies and to embark on a process overhaul of the health system, including research into innovative tools to ensure the continuity of the various disease prevention and control activities. In addition, response to a health crisis is not only the responsibility of the health sector but also intersectoral collaboration is needed to guarantee an optimal coordinated fight. Community-oriented approaches in public health have to be strengthened through more participation and involvement of nongovernmental organizations (NGOs) and civil society in operational and strategic planning.


Subject(s)
COVID-19/prevention & control , Public Health/methods , COVID-19/epidemiology , COVID-19 Testing/methods , COVID-19 Testing/standards , Humans , Morocco/epidemiology , Public Health/statistics & numerical data , Quarantine/psychology , Quarantine/standards , Workforce/standards
3.
Viruses ; 14(11)2022 Nov 12.
Article in English | MEDLINE | ID: covidwho-2143712

ABSTRACT

The epidemiology and transmission dynamics of infectious diseases must be understood at the individual and community levels to improve public health decision-making for real-time and integrated community-based control strategies. Herein, we explore the epidemiological characteristics for assessing the impact of public health interventions in the community setting and their applications. Computational statistical methods could advance research on infectious disease epidemiology and accumulate scientific evidence of the potential impacts of pharmaceutical/nonpharmaceutical measures to mitigate or control infectious diseases in the community. Novel public health threats from emerging zoonotic infectious diseases are urgent issues. Given these direct and indirect mitigating impacts at various levels to different infectious diseases and their burdens, we must consider an integrated assessment approach, 'One Health', to understand the dynamics and control of infectious diseases.


Subject(s)
Communicable Diseases, Emerging , Communicable Diseases , Humans , Communicable Diseases/epidemiology , Public Health/methods
4.
Nature ; 611(7935): 332-345, 2022 11.
Article in English | MEDLINE | ID: covidwho-2106424

ABSTRACT

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.


Subject(s)
COVID-19 , Delphi Technique , International Cooperation , Public Health , Humans , COVID-19/economics , COVID-19/epidemiology , COVID-19/prevention & control , Government , Pandemics/economics , Pandemics/prevention & control , Public Health/economics , Public Health/methods , Organizations , COVID-19 Vaccines , Communication , Health Education , Health Policy , Public Opinion
9.
JAMA ; 328(16): 1585-1586, 2022 10 25.
Article in English | MEDLINE | ID: covidwho-2084336

ABSTRACT

This Viewpoint discusses 3 areas in need of progress regarding societal approaches to pandemics and other health threats: a renaissance in public health; robustness of primary health care; and resilience of individuals and communities, with higher levels of trust in government and society.


Subject(s)
Disaster Planning , Pandemics , Public Health , Quality Improvement , Humans , COVID-19/prevention & control , Pandemics/prevention & control , Public Health/methods , Public Health/standards , SARS-CoV-2 , Quality Improvement/standards , Disaster Planning/methods , Disaster Planning/standards
10.
Ethn Dis ; 32(3): 243-256, 2022.
Article in English | MEDLINE | ID: covidwho-2067447

ABSTRACT

Background: Racism persists, underscoring the need to rapidly document the perspectives and experiences of Black, Indigenous and People of Color (BIPOC) groups as well as marginalized populations (eg, formerly incarcerated people) during pandemics. Objective: This methods paper offers a model for using Public Health Critical Race Praxis (PHCRP) and related critical methodologies (ie, feminist and decolonizing methods) to inform the conceptualization, methods, and dissemination of qualitative research undertaken in response to the evolving COVID-19 pandemic. Sample: Using purposive snowball sampling, we identified organizations involved with health equity and social justice advocacy among BIPOC and socially marginalized populations. Focus group participants (N=63) included community members, organizers, activists, and health workers. Design: We conducted topic-specific (eg, reproductive justice) and population-specific (eg, Asian and Pacific Islander) focus groups (N=16 focus groups) in rapid succession using Zoom software. Methods: A self-reflexive, iterative praxis guided theorization, data collection and analysis. We obtained community input on study design, the semi-structured discussion guide, ethical considerations and dissemination. Applying PHCRP, we assessed our assumptions iteratively. We transcribed each interview verbatim, de-identified the data, then used two distinct qualitative techniques to code and analyze them: thematic analysis to identify unifying concepts that recur across focus groups and narrative analysis to keep each participant's story intact. Results: The praxis facilitated relationship-building with partners and supported the iterative assessment of assumptions. Logistical constraints included difficulty ensuring the confidentiality of virtual discussions. Conclusions: These novel approaches provide an effective model for community-engaged qualitative research during a pandemic.


Subject(s)
COVID-19 , Health Equity , Racism , Humans , Pandemics , Public Health/methods , Qualitative Research
11.
Front Public Health ; 10: 906602, 2022.
Article in English | MEDLINE | ID: covidwho-2022938

ABSTRACT

Introduction: The COVID-19 pandemic response has demonstrated the interconnectedness of individuals, organizations, and other entities jointly contributing to the production of community health. This response has involved stakeholders from numerous sectors who have been faced with new decisions, objectives, and constraints. We examined the cross-sector organizational decision landscape that formed in response to the COVID-19 pandemic in North Carolina. Methods: We conducted virtual semi-structured interviews with 44 organizational decision-makers representing nine sectors in North Carolina between October 2020 and January 2021 to understand the decision-making landscape within the first year of the COVID-19 pandemic. In line with a complexity/systems thinking lens, we defined the decision landscape as including decision-maker roles, key decisions, and interrelationships involved in producing community health. We used network mapping and conventional content analysis to analyze transcribed interviews, identifying relationships between stakeholders and synthesizing key themes. Results: Decision-maker roles were characterized by underlying tensions between balancing organizational mission with employee/community health and navigating organizational vs. individual responsibility for reducing transmission. Decision-makers' roles informed their perspectives and goals, which influenced decision outcomes. Key decisions fell into several broad categories, including how to translate public health guidance into practice; when to institute, and subsequently loosen, public health restrictions; and how to address downstream social and economic impacts of public health restrictions. Lastly, given limited and changing information, as well as limited resources and expertise, the COVID-19 response required cross-sector collaboration, which was commonly coordinated by local health departments who had the most connections of all organization types in the resulting network map. Conclusions: By documenting the local, cross-sector decision landscape that formed in response to COVID-19, we illuminate the impacts different organizations may have on information/misinformation, prevention behaviors, and, ultimately, health. Public health researchers and practitioners must understand, and work within, this complex decision landscape when responding to COVID-19 and future community health challenges.


Subject(s)
COVID-19 , COVID-19/epidemiology , Decision Making , Humans , North Carolina , Pandemics , Public Health/methods
12.
PLoS One ; 17(9): e0273906, 2022.
Article in English | MEDLINE | ID: covidwho-2009710

ABSTRACT

Preventive and modeling approaches to address the COVID-19 pandemic have been primarily based on the age or occupation, and often disregard the importance of heterogeneity in population contact structure and individual connectivity. To address this gap, we developed models based on Erdos-Rényi and a power law degree distribution that first incorporate the role of heterogeneity and connectivity and then can be expanded to make assumptions about demographic characteristics. Results demonstrate that variations in the number of connections of individuals within a population modify the impact of public health interventions such as lockdown or vaccination approaches. We conclude that the most effective strategy will vary depending on the underlying contact structure of individuals within a population and on timing of the interventions.


Subject(s)
COVID-19 , COVID-19/prevention & control , Communicable Disease Control/methods , Humans , Pandemics/prevention & control , Public Health/methods , Vaccination
13.
J Public Health Manag Pract ; 28(5 Suppl 5): S263-S270, 2022.
Article in English | MEDLINE | ID: covidwho-1961249

ABSTRACT

CONTEXT: The Region V Public Health Training Center (RVPHTC) serves the public health workforce in Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. An important tool in priority-setting workforce development is the training needs assessment (TNA), which is vital to identifying and addressing the capacity-building needs of the public health workforce. PROGRAM: In 2021, we conducted semistructured qualitative interviews with key partners in the local, state, and tribal health workforce. IMPLEMENTATION: Findings reflect the results of 23 interviews administered from March to May 2021. Questions solicited in-depth input related to key training gaps identified in our 2020 quantitative TNA; the impact of COVID-19 on the public health workforce; general needs, including preferred training modalities; needs by audience type; and the current capacity for public health agencies to support student development. EVALUATION: Key training needs of the public health workforce identified by the 2021 TNA include the strategic skills domains of (1) resource management; (2) change management; (3) justice, equity, diversity, and inclusion; and (4) effective communication. The first 3 domains were also noted as having the greatest training need in our 2020 quantitative TNA of local health department leadership. DISCUSSION: The COVID-19 pandemic highlighted the need for training in effective communication in new ways and the continued need for training support in the skill domains prioritized in the 2020 assessment. Findings demonstrate the need for capacity building around crosscutting skills and the intersection of strategic skill domains if the field is to be prepared for future threats to public health.


Subject(s)
COVID-19 , Public Health , COVID-19/epidemiology , Health Workforce , Humans , Needs Assessment , Pandemics , Public Health/methods
14.
Int J Environ Res Public Health ; 19(13)2022 06 29.
Article in English | MEDLINE | ID: covidwho-1934054

ABSTRACT

Public health departments are on the frontlines of protecting vulnerable groups and working to eliminate health disparities through prevention interventions, disease surveillance and community education. Exploration of the roles national, state and local health departments (LHDs) play in advancing climate change planning and actions to protect public health is a developing arena of research. This paper presents insights from local public health departments in California, USA on how they addressed the barriers to climate adaptation planning with support from the California Department of Public Health's Office of Health Equity Climate Change and Health Equity Section (OHE), which administers the California Building Resilience Against Climate Effects Project (CalBRACE). With support from the U.S. Centers for Disease Control and Prevention (CDC) Climate-Ready States and Cities Initiative (CRSCI), CalBRACE initiated an adaptation project to seed climate planning and actions in county health departments. In this study, we compared the barriers and strategies of twenty-two urban and rural LHDs and explored potential options for climate change adaptation in the public health framework. Using key informant interviews and document reviews, the results showed how engagement with CalBRACE's Local Health Department Partnership on Climate Change influenced the county departments' ability to overcome barriers to adaptation through the diversification of funding sources, the leveraging strategic collaborations, extensive public education and communication campaigns, and the development of political capital and champions. The lessons learned and recommendations from this research may provide pathways and practices for national, state and local level health departments to collaborate in developing protocols and integrating systems to respond to health-related climate change impacts, adaptation and implementation.


Subject(s)
Climate Change , Health Equity , Centers for Disease Control and Prevention, U.S. , Humans , Local Government , Public Health/methods , Regional Health Planning , United States
15.
BMC Public Health ; 22(1): 1063, 2022 05 28.
Article in English | MEDLINE | ID: covidwho-1933128

ABSTRACT

BACKGROUND: Intersecting opioid overdose, COVID-19, and systemic racism epidemics have brought unprecedented challenges to the addiction treatment and recovery workforce. From 2017 to 2020, the New England Addiction Technology Transfer Center (ATTC) collected data in real-time on the training and technical assistance (TA) requested and attended by the front-line workforce. This article synthesizes practice-based evidence on the types of TA requests, topics of TA, attendance numbers, and socio-demographics of TA attendees over a 3-year period spanning an unprecedented public health syndemic. METHODS: We assessed TA events hosted by the New England ATTC using SAMHSA's Performance Accountability and Reporting System post-event survey data from 2017 to 2020. Events were coded by common themes to identify the most frequently requested training types/topics and most frequently attended training events. We also evaluated change in training topics and attendee demographics over the three-year timeline. RESULTS: A total of 258 ATTC events reaching 10,143 participants were analyzed. The number of TA events and attendance numbers surged in the 2019-2020 fiscal year as TA events shifted to fully virtual during the COVID-19 pandemic. The absolute number of opioid-related events increased, but the relative proportion remained stable over time. The relative proportions of events and attendance rates focused on evidence-based practice and health equity both increased over the 3-year period, with the largest increase after the onset of the pandemic and the murder of George Floyd. As events shifted to virtual, events were attended by providers with a broader range of educational backgrounds. CONCLUSIONS: Results of the current analysis indicate that the demand for TA increased during the pandemic, with a prioritization of TA focused on evidence-based practice and health equity. The practice-based evidence generated from the New England ATTC may help other training and TA centers to anticipate and nimbly respond to the needs of the workforce in the face of the intersecting epidemics.


Subject(s)
COVID-19 , Substance-Related Disorders , COVID-19/epidemiology , Humans , Pandemics , Public Health/methods , Substance-Related Disorders/epidemiology , Substance-Related Disorders/therapy , Workforce
16.
J Biomed Inform ; 132: 104142, 2022 08.
Article in English | MEDLINE | ID: covidwho-1926610

ABSTRACT

OBJECTIVE: Sentiment analysis is an important method for understanding emotions and opinions expressed through social media exchanges. Little work has been done to evaluate the performance of existing sentiment analysis tools on social media datasets, particularly those related to health, healthcare, or public health. This study aims to address the gap. MATERIAL AND METHODS: We evaluated 11 commonly used sentiment analysis tools on five health-related social media datasets curated in previously published studies. These datasets include Human Papillomavirus Vaccine, Health Care Reform, COVID-19 Masking, Vitals.com Physician Reviews, and the Breast Cancer Forum from MedHelp.org. For comparison, we also analyzed two non-health datasets based on movie reviews and generic tweets. We conducted a qualitative error analysis on the social media posts that were incorrectly classified by all tools. RESULTS: The existing sentiment analysis tools performed poorly with an average weighted F1 score below 0.6. The inter-tool agreement was also low; the average Fleiss Kappa score is 0.066. The qualitative error analysis identified two major causes for misclassification: (1) correct sentiment but on wrong subject(s) and (2) failure to properly interpret inexplicit/indirect sentiment expressions. DISCUSSION AND CONCLUSION: The performance of the existing sentiment analysis tools is insufficient to generate accurate sentiment classification results. The low inter-tool agreement suggests that the conclusion of a study could be entirely driven by the idiosyncrasies of the tool selected, rather than by the data. This is very concerning especially if the results may be used to inform important policy decisions such as mask or vaccination mandates.


Subject(s)
COVID-19 , Social Media , Emotions , Humans , Public Health/methods , Sentiment Analysis
17.
J Public Health Manag Pract ; 28(4): 393-398, 2022.
Article in English | MEDLINE | ID: covidwho-1922427

ABSTRACT

CONTEXT: The Foundational Public Health Services (FPHS) include a core set of activities that every health department should be able to provide in order to ensure that each resident has access to foundational services that protect and preserve health. Estimates of the public health workforce necessary to provide the FPHS are needed. OBJECTIVE: This study assessed the potential use of an FPHS calculator to assess health department workforce needs. DESIGN AND SETTING: Qualitative interviews were conducted via Zoom in December 2020-January 2021. PARTICIPANTS: Seventeen state and local public health leaders. MAIN OUTCOME MEASURES: Qualitative insights into the potential use of an FPHS calculator. RESULTS: Almost all participants expressed that a reliable estimate would help them justify requests for new staff and that a calculator based on the FPHS would help organizations to critically assess whether they are meeting the needs of their communities and the core expectations of public health. Although participants expected that a tool to calculate full-time equivalent needs by the FPHS would be helpful, some participants expressed concerns in regard to using the tool, given ongoing workforce issues such as recruitment challenges, hiring freezes, and funding restrictions. An anticipated positive consequence of using this tool was that it may lead to cross-training the workforce and result in more diverse expertise and skills among existing workers. The other unintended consequences were that an FPHS calculator would require a substantial amount of time assessing the current FPHS efforts of existing staff and the results of the FPHS gap estimate could become the bar rather than the minimum needed. CONCLUSIONS: The current public and political focus on public health infrastructure as a result of the COVID-19 pandemic has created a window of opportunity to create change. An FPHS-based staffing tool may help transform public health and initiate a new era.


Subject(s)
COVID-19 , Public Health , Health Services , Health Workforce , Humans , Pandemics , Public Health/methods , Workforce
18.
Prev Chronic Dis ; 19: E35, 2022 06 30.
Article in English | MEDLINE | ID: covidwho-1912044

ABSTRACT

INTRODUCTION: Public-facing maps of COVID-19 cases, hospital admissions, and deaths are commonly displayed at the state, county, and zip code levels, and low case counts are suppressed to protect confidentiality. Public health authorities are tasked with case identification, contact tracing, and canvasing for educational purposes during a pandemic. Given limited resources, authorities would benefit from the ability to tailor their efforts to a particular neighborhood or congregate living facility. METHODS: We describe the methods of building a real-time visualization of patients with COVID-19-positive tests, which facilitates timely public health response to the pandemic. We developed an interactive street-level visualization that shows new cases developing over time and resolving after 14 days of infection. Our source data included patient demographics (ie, age, race and ethnicity, and sex), street address of residence, respiratory test results, and date of test. RESULTS: We used colored dots to represent infections. The resulting animation shows where new cases developed in the region and how patterns changed over the course of the pandemic. Users can enlarge specific areas of the map and see street-level detail on residential location of each case and can select from demographic overlays and contour mapping options to see high-level patterns and associations with demographics and chronic disease prevalence as they emerge. CONCLUSIONS: Before the development of this tool, local public health departments in our region did not have a means to map cases of disease to the street level and gain real-time insights into the underlying population where hotspots had developed. For privacy reasons, this tool is password-protected and not available to the public. We expect this tool to prove useful to public health departments as they navigate not only COVID-19 pandemic outcomes but also other public health threats, including chronic diseases and communicable disease outbreaks.


Subject(s)
COVID-19/epidemiology , Pandemics , Public Health/methods , Chronic Disease/epidemiology , Contact Tracing/methods , Demography/methods , Disease Outbreaks/statistics & numerical data , Hospitalization , Humans , Public Health/statistics & numerical data
19.
J Public Health Manag Pract ; 28(4 Suppl 4): S122-S129, 2022.
Article in English | MEDLINE | ID: covidwho-1865015

ABSTRACT

CONTEXT: Underfunding of the governmental public health system in the United States has been a problem for many years, and the COVID-19 pandemic revealed the significant gaps in public health infrastructure that have resulted from this inadequate funding. PROGRAM: The states of Ohio, Oregon, and Washington received funding in 2016 to define, measure, and advocate for the foundational public health services (FPHS) delivered by the governmental public health system. They have taken unique but related approaches to strengthening work in the areas of categorical public health programs and the underlying infrastructure and capabilities that support the programmatic work. IMPLEMENTATION: All 3 states conducted assessments of gaps and funding needs that have allowed them to advocate for, and receive, limited resources for the governmental public health system. These resources were used to strengthen the public health system in ways that assisted with pandemic response. The pandemic also provided many opportunities for the states to demonstrate the importance of the foundational capabilities (assessment, communications, partnership development, policy, leadership, quality improvement, emergency response planning) and public health infrastructure in the areas of information technology and laboratory capacity. These opportunities allowed states to make progress in obtaining funding for FPHS. CONCLUSION: While heavily focused on the program area of communicable disease control, the pandemic response highlighted the importance of having a robust public health infrastructure that is well supported in the areas of foundational capabilities. Substantial infrastructure investments will allow health departments to close gaps in health inequities; contribute to the significant work needed postpandemic in the areas of chronic disease, behavioral health, climate change, and social determinants of health; and be better prepared for future emergencies.


Subject(s)
COVID-19 , COVID-19/epidemiology , Communicable Disease Control , Health Services , Humans , Pandemics , Public Health/methods , United States/epidemiology
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