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Objectives: We describe our co-design process aimed at supporting the reintegration of essential care partners into long-term care homes during the COVID-19 pandemic. Methods: More specifically, using a co-design process, we describe the pre-design, generative, and evaluative phases of developing a virtual infection prevention and control course for essential care partners at our partnering long-term care home. For the evaluative phase, we also provide an overview of our findings from interviews conducted with essential care partners on the expected barriers and facilitators associated with this virtual course. Results: Results from these interviews indicated that the virtual course was viewed as comprehensive, detailed, engaging, refreshing, and reliable, and that its successful implementation would require appropriate resources and support to ensure its sustainability and sustainment. Findings from this study provide guidance for the post-design phase of our co-design process. Conclusion: Our careful documentation of our co-design process also facilitates its replication for other technological interventions and in different healthcare settings. Limitations of the present study and implications for co-designing in the context of emergent public health emergencies are explored in the discussion. [ABSTRACT FROM AUTHOR]

The article presents the discussion on proposed a comprehensive framework for navigating the ethical dilemmas associated with risk and crisis communication (RCC). Topics include framework emphasizes ethical principles to ensure that risk communication aligns with the fundamental values of effectiveness, autonomy, and fairness; and underscore using RCC to address fear and panic, promoting rational decision-making, and avoiding reputational damage.

The article presents the discussion on small business owner used their changeable-letter sign to wage a public protest against a variety of restrictions implemented during the COVID-19 pandemic. Topics include sign compared the transmission rate at that time in that part of the US to the sometimes-devastating impact of statewide shutdowns on businesses; and effective vaccines were at limiting transmission, or at preventing serious illness and death.

The article presents the discussion on systematic framework for risk and crisis communication in public health emergencies. Topics include UK's experience during COVID-19, which was marked by tensions between the devolved regional governments; and environments reveals a tradeoff between inclusivity and understandability versus effectiveness in risk and crisis communication.

The article focuses on the critical role of human behavior in response to disasters, addressing the adverse effects, such as physical injuries, property damage, and social disruption, and highlighting the increasing frequency of complex events like mass violence, hurricanes, and pandemics. It emphasizes the understanding of panic as a potentially troublesome but uncommon response to disasters and discusses various types of disasters.

The COVID-19 pandemic, particularly from 2020 to mid-2022, debilitated the management of the HIV epidemic in Africa. The multiple effects included well-documented HIV service interruptions, curtailment of HIV prevention programmes, the associated marked increase in both the risk for HIV infection among key populations and vulnerability of sub-populations (e.g. adolescent girls and young women) who are the focus of these programmes and — as importantly but less well-documented — the diverse negative socio-economic effects that accentuate HIV risk and vulnerability generally (e.g. loss of earnings, gender-based violence, stigma, police harassment of people during "lockdowns"). The global biomedical response to COVID-19 was necessary and remarkable for mitigating the bio-physical impacts of the pandemic (e.g. wide-spread surveillance coupled with rapid updates on the epidemiology of infections, rapid development of vaccines and revisions of treatment). However, drawing upon the widespread criticisms of state responses to the socio-economic effects of the COVID-19 pandemic and of "lockdowns" themselves, this article elaborates a core argument within those criticisms, namely that key lessons learnt during the HIV and AIDS and other pandemics were ignored, at least during the early stages of COVID-19. Our critique is that better integration of the social sciences and humanities in responses to pandemics can counter the reflex tendency to uncritically adopt a biomedical paradigm and, more importantly, to enable consideration of the social determinants of health in pandemic responses. At root, we re-assert a key value of 'integrated' interventions, namely the accommodation of context-sensitive considerations in the formulation of strategies, policies, plans and programme designs. [ABSTRACT FROM AUTHOR]

Public Health Emergency Operations Centers (PHEOCs) are the critical units to lead communications, information sharing, and resource mobilisation during national and international health emergencies, and are key components for maintaining global health security. This assessment sought to examine the coordination mechanisms between national and sub-national PHEOCs in Thailand, Cambodia, Lao People's Democratic Republic, and Malaysia (TCLM countries) during the COVID-19 pandemic. Information was collected on PHEOC structures, functions, and cross-border communications in three stages: a literature review of national PHEOC and emergency preparedness capacities; questionnaire responses from stakeholders to describe PHEOC activity at the national level; and meetings with emergency response staff in five border provinces of Thailand to assess communications between sub-national PHEOCs across country borders. The findings showed that each of the countries has demonstrated a commitment to strengthening their national PHEOCs and improving cross-border communication in the face of the COVID-19 pandemic. Strong existing relationships between TCLM countries assisted in activating a coordinated pandemic response, but gaps remain in efficient data sharing, workforce capacity, and the utilisation of consistent communication platforms among countries. Lessons learned from the pandemic can be used to further strengthen countries' preparedness for future health emergencies, in line with International Health Regulations (2005) and regional plans to build health security in the Southeast Asia region. This assessment provides TCLM countries with the opportunity to address weaknesses in national and international PHEOC capacities. It may be used alongside existing guidelines to prepare the region for a stronger response to future global and regional health emergencies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify the factors that affected health profession students' emergency transition during the COVID-19 pandemic and to explore strategies that may help students be better prepared for any future health crises. Participants: This study population included 73 students that were originally enrolled in one online section (n = 49) and one face-to-face section (n = 24) of a healthcare administration course before the transition. Methods: The cross-sectional study was conducted and the anonymous survey data were analyzed using SPSS and a Man-Whitney U test. Results: Of the 73 students, 48 completed the survey, with a response rate of 66% (48/73). There was a statistically significant difference in the perceived COVID-19 impact (z=-3.339, p = 0.001) and difficulty transitioning during the pandemic (3–2.142, p = 0.032) between both groups. The top three hindering factors were stress and anxiety, difficulty focusing on studying at home, and time management due to uncertainty. Conclusions: The study findings suggest strategies that may help students with adequate knowledge and capabilities in managing stress, anxiety, and unprecedented challenges in the future. [ABSTRACT FROM AUTHOR]

The variations in temperature and wind patterns in South Asia impact Pakistan's monsoon season annually. The floods and their consequences have significantly worsened Pakistan's long-standing issue of period poverty, making it difficult for women to acquire menstrual hygiene products, which leads to the rising prevalence of UTIs among them. " Knowledge and Practice of Adolescent Females About Menstruation and Menstruation Hygiene Visiting a Public Healthcare Institute of Quetta, Pakistan." This article, however, highlights the increased risk of urinary tract infections (UTIs) amongst the women of flood-affected communities, a subject that has yet to receive due attention. [Extracted from the article]

The COVID-19 pandemic has elicited a wide range of national responses with an even wider range of outcomes in terms of infections and mortalities. Australia is a rare success story, keeping deaths comparatively low, and infections too, until the Omicron wave. What explains Australia's success? Typical explanations emphasise leaders' choices. We agree, but argue that leaders' choices, and whether these are implemented effectively, is shaped by the legacy of state transformation. Decades of neo-liberal reforms have hollowed out state capacity and confused lines of control and accountability, leaving Australia unprepared for the pandemic. Leaders thus abandoned plans and turned to ad hoc, simple to implement emergency measures - border closures and lockdowns. These averted large-scale outbreaks and deaths, but with diminishing returns as the Delta variant took hold. Conversely, Australia's regulatory state has struggled to deliver more sophisticated policy responses, even when leaders were apparently committed, including an effective quarantine system, crucial for border controls, and vaccination programme, essential for exiting the quagmire of lockdowns and closed borders, leading to a partial return to top-down governing. The Australian experience shows that to avoid a public health catastrophe or more damaging lockdowns in the next pandemic, states must relearn to govern. [ABSTRACT FROM AUTHOR]

The author shares lessons learned from three yeas of the COVID-19 pandemic and its implications for communication and equity. He talks about health inequity, discriminatory policies and unequal distribution of public resources. He discusses the importance of strengthening public health preparedness, the value proposition of strengthening communication systems, the need for inclusive policies, and significance of empathy and compassion to work and personal lives and to making social connections.

The Australian multiple sclerosis (MS) community experienced two recent major crises, widespread bushfires and the COVID 19 pandemic. We aimed to understand the needs of persons with MS during times of crisis. A consumer-directed mixed-method study. We included an online survey, semi-structured interviews, and a workshop with persons with MS, carers, healthcare professionals, and disability advocates. Data were collected via: (1) 176 people completing online surveys to identify crisis concerns and communications, (2) 29 people completing online interviews on bushfire and pandemic impact, and (3) 13 people participating in a crises-priorities workshop. Descriptive data were calculated for survey response, and a general inductive analytical approach was taken with interview and workshop responses. The most significant concerns were bushfire smoke exposure and disease-modifying-medication and susceptibility to COVID-19 (66% and 63% mean concern score, respectively). Interviews indicated crises experiences from the bushfires, and the pandemic overlapped respective of changes in mood and symptom stability. For bushfires, a need for future preparations, and for the pandemic, the benefits of social restrictions, disclosing personal health information and increased care burden were important. Multiple crises challenged the MS community but offered lessons for healthcare in future crises. Continued progress in centralised crisis information, with considered use of telehealth and rural healthcare support, is needed. The MS community showed high concerns for the effect of toxic smoke from the 2019/2020 Australian bushfires and, separately, for the disease-modifying-medication and susceptibility to COVID-19. The MS community placed priority on a crisis management plan for individuals. Reduced social activity due to restrictions was beneficial for MS symptom self-awareness and may help overall fatigue management. Healthcare system preparation must prepare to alleviate increased carer workload at times of crisis. [ABSTRACT FROM AUTHOR]

Background: Health supply chain is crucial for proper functioning of a health system and advancing national and international health security goals. The Coronavirus 2019 pandemic caused major challenges for health supply chain systems in Uganda and globally. Objectives: This study involved literature review to examine how the electronic logistics management information system and related digital systems were harnessed be best support public health emergencies. Methods: We describe how the health supply chain system leveraged the emergency Electronic Logistic Management Information System developed during the Ebola epidemic in 2019 to support the COVID-19 response in Uganda. The findings are based on the analysis of reports, guidelines, and discussions with stakeholders involved in implementing the electronic Management Information System during the COVID-19 response. Lessons and experiences are shared on how the system supported data visibility, use and health commodity management. Results: A web-based emergency Electronic Management Information System was developed to support the supply chain system during preparedness and response to the Ebola Virus. The system facilitated coordination, information management and provided real-time data for planning, decision making, and distribution of commodities during the COVID-19 response. To address any human resource challenges, 863 staff were trained and mentored in the use of the system. The system enabled the Ministry of Health to track the distribution of Medical Counter Measures through the warehouses, eight regional pre-positioning centers, and over 2000 user units in 136 district vaccine stores. In addition, the system provided quality data for the quantification and monitoring of commodities at all levels of care. Over 1800 bulk orders were processed through the system. Real time stock status reports were transmitted from all national, regional, district and health facility levels. Procurement tracking reports, stock gap analysis and partner contribution were all accessible and visible in the system. This supported the Ministry of Health's resource mobilization and coordination efforts. Conclusions: Availability of reliable, quality real-time data are essential for effective decision making during public health emergencies. The emergency Electronic Logistic Management Information Systems supported health authorities to mount coordinated and effective responses to ensure timely availability of commodities and supplies to support the COVID-19 pandemic response. Lessons learnt from the Ebola epidemic response were translated into actions that enabled effective preparedness and response to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Jails in Massachusetts are among the first nationwide to provide correctional populations with medications to treat opioid use disorder (MOUD). The COVID-19 pandemic caused jails to pivot and adapt MOUD programming. We aimed to identify adaptations and barriers to MOUD access that COVID-19 exacerbated or created, and document new elements that staff wish to sustain as COVID-19 recedes. Methods: We conducted semi-structured in-depth interviews and focus groups in 2020–2021 with 29 jail staff who implement MOUD programming in two Massachusetts jails. We conducted qualitative data analysis in Atlas.ti 8 using an inductive approach. Results: Participants shared that access to MOUD among correctional populations is understood by jail staff to be an essential health service. Thus, to facilitate continued access to MOUD, both during incarceration and also at community reentry, jail staff quickly implemented changes in MOUD regulations and dosing protocols and established telehealth capacity. Despite these program adaptations, participants identified how COVID-19 increased health and social needs among correctional populations, reduced availability of community-based healthcare and recovery-supportive services, and introduced new factors that could undermine recovery. Innovations that participants wished to sustain as COVID-19 receded included telehealth capacity, smaller-sized therapeutic groups, and application of a public health approach to treat opioid use disorder among correctional populations. Conclusions: During disruptive events, jails can adapt MOUD programming to ensure access for people living in jail and upon release. Findings identify factors for understanding the outcomes of jail-based MOUD programming during COVID-19 and highlight opportunities to improve service delivery after COVID-19. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted and exacerbated inequities in health for structurally marginalised Canadians. Their location on society's hierarchies constrained their ability to access healthcare and follow recommended health behaviours. The aim of this article is to identify, from the perspective of marginalised populations, factors influencing the acceptance or rejection of COVID-19 countermeasures by structurally marginalised Canadians. Interviews were conducted with Canadians 18 + who identified as Black (n = 8), First Nations, Métis, or Inuit (n = 7) and low-income (<40,000 annual household income) (n = 8) between August and December 2021. Measures were said to impact well-being and interfere with revenue generating activities. Longstanding unfavourable living and environmental conditions as they relate to structural marginalisation was said to fuel anger toward the government and lead to a greater reluctance to accept countermeasures. Participants described concerns about government decisions being made without considering their unique contexts, or knowledge of the experiences of the population for whom these decisions were being made. Effective proactive action from government is important to foster trust with marginalised populations to support acceptance of health information and address growing inequities. Action that demonstrates government competence and commitment to the interests of marginalised populations is critical. [ABSTRACT FROM AUTHOR]

India has the highest global burden of tuberculosis (TB), accounting for a quarter of the worldwide TB disease incidence. Given the magnitude of India's epidemic, TB has enormous economic implications. Indeed, the majority of individuals with TB disease are in their prime years of economic productivity. Absenteeism and employee turnover due to TB have economic ramifications for employers. Furthermore, TB can easily spread in the workplace and compound the economic impact. Employers who fund workplace, community, or national TB initiatives stand to gain directly and also enjoy reputational benefits, which are important in the era of socially conscious investing. Corporate social responsibility laws in India and tax incentives can be leveraged to bring the logistical networks, reach, and innovative spirit of the private sector to bear on India's formidable TB epidemic. In this perspective piece, we explore the economic impacts of TB; opportunities for and benefits from businesses contributing to TB elimination efforts; and strategies to enlist India's corporate sector in the fight against TB. [ABSTRACT FROM AUTHOR]

This article builds four composite characters from the international Zika response to demonstrate each role's position relative to inclusive health communication. I argue that a lack of jurisdictional stasis is at play in decision-making practices about transnational risk communication approaches. During emergency health responses, this lack of jurisdictional stasis functions to maintain the status quo in order for stakeholders to leverage their power in prioritizing local deliberations in transnational public health discourse and decision making. [ABSTRACT FROM AUTHOR]

This commentary reflects on what has been learnt from government and public health responses to COVID-19, suggesting a tension between 'business as usual' forms of public health in the face of crisis, and the possibilities for a step-change towards a 'healthy publics' approach. We set out a range of ways that diverse, multiple publics have been implicated or brought into being during the COVID-19 pandemic, and we argue that these have generally been ignored or erased by agents or agencies of public health, keen to preserve certainty in their messaging and public confidence in their authority. We conclude with five principles for re-organising pandemic responses around a richer, more context-dependent and diverse account of 'the public'. [ABSTRACT FROM AUTHOR]

Emergency logistics is not only a part of emergency management system, but also an important link of disaster relief and disaster reduction. The performance evaluation of emergency logistics capability is the foundation of improving emergency logistics capability. This paper took emergency logistics capability based on COVID-19 region as the research object. Firstly, we analyse the characteristics and influencing factors of public health emergency logistics. Secondly, we construct the evaluation system of public health emergency logistics capability. Thirdly, we establish the evaluation model of emergency logistics capability based on BP neural network. Finally, the evaluation model was applied to COVID-19 events, and the scientific nature and feasibility of the evaluation model were verified. [ABSTRACT FROM AUTHOR]

The U.S. Army and U. S. Army Public Health Center are dedicated to protecting the health, and readiness of Department of the Army Service Members, civilians, and contractors. Despite implementation of health programs, policies and tobacco control interventions, the advent of electronic nicotine delivery systems (ENDS), including electronic cigarettes (e-cigs), represent unregulated and poorly defined systems to supplant or substitute use of conventional nicotine products (e.g., cigarettes and pipe tobacco). E-cigs present unique challenges to healthcare officials vested in preventive medicine. The health impact of an e-cig and vaping on an individual's acute or chronic disease susceptibility, performance and wellness, is fraught with uncertainty. Given the relatively recent emergence of e-cigs, high-quality epidemiological studies, and applied biological research studies are severely lacking. In sparsely available epidemiological studies of short-term cardiovascular and respiratory health outcomes, any attempt at addressing the etiology of acute and chronic health conditions from e-cig use faces incredible challenges. Until relatively recently, this was complicated by an absent national regulatory framework and health agency guidance on the manufacture, distribution, selling and use of e-cigs or similar ENDS devices and their chemical constituents. Two key issues underpin public health concern from e-cig use: 1) continued or emergent nicotine addiction and potential use of these devices for vaping controlled substances; and 2) inadvertent sudden-onset or chronic health effects from inhalational exposure to low levels of complex chemical toxicants from e-cig use and vaping the liquid. Herein, the health impacts from e-cig vaping and research supporting such effects are discussed. [ABSTRACT FROM AUTHOR]

This paper draws upon the notion of slow emergency as a framework to interpret ethnographic and qualitative findings on the challenges faced by Puerto Ricans with chronic conditions and health-sector representatives throughout the island during and after Hurricane María. We conducted participant observation and qualitative interviews with chronic disease patients (n = 20) health care providers and administrators (n = 42), and policy makers (n = 5) from across the island of Puerto Rico in 2018 and 2019. Many Puerto Ricans coping with chronic diseases during and after María experienced bureaucratic red tape as a manifestation of the colonial legacies of disaster management and health care. They describe a precarious existence in perpetual 'application pending' status, waiting for services that were not forthcoming. Drawing on ethnographically informed case examples, we discuss the effects of these bureaucratic barriers on persons with three chronic conditions: renal disease, opioid dependency, and HIV/AIDS. We argue that while emergency management approaches often presume a citizen-subject with autonomous capacity to prepare for presumably transient disasters and envision a 'post-disaster future' beyond the immediate crisis, Puerto Rican voices draw attention to the longer, sustained, slow emergency of colonial governance. [ABSTRACT FROM AUTHOR]

Mental health professionals (MHPs) have roles supporting mitigation, preparation, and recovery in the global climate crisis. This commentary describes initiatives in the Caribbean to address climate-related threats to individuals and communities focussing on the role of MHPs in supporting community-based projects, regional public health disaster responses, and climate research. [ABSTRACT FROM AUTHOR]

This review aims to (i) identify and critique existing methods of community engagement for outbreak preparedness and response in high-income settings, and (ii) understand community members' experiences of community engagement, and their views and concerns towards pandemic planning/response. Following the PRISMA guidelines, a systematic review was conducted by searching Medline, Embase, PubMed, Global Health, CINAHL Plus and Scopus for publications from 2004 to June 2019. Potential literature was screened using explicit inclusion and exclusion criteria. Included studies were appraised using the Critical Appraisal Skills Programme Qualitative Research checklist. Those using deliberative approaches were appraised using additional criteria for judging deliberation quality. Thematic synthesis was then conducted. Primary studies employed participatory research approaches, deliberative forums, interviews/focus groups to engage community members on pandemic planning/response with varying degrees of involvement and methodological rigour. This review indicates such endeavours must take into account instrumental and relational considerations: socioeconomic pressures; agency and capacity; diversity and divergent views; educate, communicate and engage; trust and transparency. Community engagement for pandemic planning/response requires clear methods, processes and who 'community' constitutes. Instrumental and relational considerations must be addressed concurrently in pandemic planning/response to enhance preparedness for public health emergencies. [ABSTRACT FROM AUTHOR]

This article assesses the impact of the HIV and COVID-19 pandemics and debt dynamics on health, HIV and pandemic preparedness and response-related financing in developing countries. Using a novel dataset, we did a cross-national systematic analysis of all data sources available for government expenditures on health, HIV, COVID-19 and debt servicing in selected developing countries. We found an inadequate multilateral response with the ensuing gaps allowing both pandemics to thrive. The G20 Debt Service Suspension Initiative and the Common Framework only covered countries with a third of the global population of people living with HIV. Rising and unsustainable debt levels are limiting the capacity of governments to protect the health of their populations. Government spending is already falling in response to high debt payments. Specifically, debt servicing is crowding out lifesaving investments. In 2020, for every USD 5 available, USD 4 was spent on debt servicing. Only USD 1 was invested in health. This is a binding constraint on countries' efforts to control COVID-19. Even with a gargantuan effort to increase health expenditure, the outlook for health financing remains negative. Fiscal consolidation, with a heavy emphasis on expenditure cuts, is expected to take place across 139 countries in the coming years. These findings suggest that fiscal policymakers should be concerned about the crowding-out and constraining effects of public debt. To this end, pragmatic recommendations are made to treat and cancel debt as a critical policy lever to accelerate the end of the HIV and COVID-19 pandemics in developing countries as a key condition to addressing the growing inequalities and to ensure debt can be a benefit, not a burden. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has placed strain on healthcare systems across the world; however, countries experiencing overlapping crises such as economic or political unrest face immense pressure in ensuring routine healthcare services can continue to operate. Despite being less likely suffer severe disease or die from COVID-19, data suggest women have experienced poorer mental health, higher rates of unemployment, and more social isolation during the pandemic. In general, we know women and girls experience multiple forms of disadvantage in disaster contexts including being more likely to become homeless, work as an unpaid carer, and to experience poverty. Research from previous disaster contexts has demonstrated that women's healthcare services tend to be deprioritised in the emergency response, and reports suggest this has been the case during the COVID-19 pandemic. This paper highlights key priorities for safeguarding women's and girls' health in disaster contexts, especially during the COVID-19 pandemic, by drawing on learning from the multiple crises facing Beirut, including responding to the pandemic, economic collapse, and the Beirut Port Explosion in 2020. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including how issues such as trust in government shape responses to contact tracing, the policy responses to COVID-19 that have exacerbated social divisions and undermined social justice and the ethnic inequalities in exposure to risk among health works in the British National Health Service (NHS).

Many large nations have failed to adequately protect their indigenous populations from COVID-19, a novel disease which has challenged overarching nation-states to develop plans that are politically acceptable to and effective for heterogeneous populations. These failures of the nation-state to adequately protect citizens have endangered indigenous communities but also opened a space for indigenous solidarity, organization, and institution building. The residents of Spiti Valley of Northern India initially attempted to organize against COVID-19 through the secular mechanisms of government in their district. When residents lost trust in their ability to work through official channels, monasteries transcended traditional and contemporary boundaries to cooperate with each other in developing the Committee for Preventive Measures and Sustainable Development (CPMSD). The CPMSD has successfully warded off COVID-19 through a variety of measures, including limiting incoming traffic, quarantine, education, contact tracing, and social distancing. In the process, the Spiti Valley has revitalized traditional structures of governance. Public health practitioners should carefully document how indigenous (and other) communities organize to combat COVID-19. This data – which may reveal practical as opposed to formal networks of authority – may assist current and future public health practitioners to decide how and with whom to invest scarce human resources. [ABSTRACT FROM AUTHOR]

It is easy but mistaken to think that public health emergency measures and social policy can be separated. This paper compares the experiences of Brazil, Germany, India and the United States during their 2020 responses to the COVID-19 pandemic to show that social policies such as unemployment insurance, flat payments and short-time work are crucial to the effectiveness of non-pharmaceutical interventions as well as to their political sustainability. Broadly, public health measures that constrain economic activity will only be effective and sustainable if paired with social policy measures that enable people to comply without sacrificing their livelihoods and economic wellbeing. Tough public health policies and generous social policies taken together proved a success in Germany. Generous social policies uncoupled from strong public health interventions, in Brazil and the US during the summer of 2020, enabled lockdown compliance but failed to halt the pandemic, while tough public health measures without social policy support rapidly collapsed in India. In the COVID-19 and future pandemics, public health theory and practice should recognise the importance of social policy to the immediate effectiveness of public health policy as well as to the long-term social and economic impact of pandemics. [ABSTRACT FROM AUTHOR]

The rate of infectious disease outbreaks has been accelerating over the past two decades, from the SARS epidemic in 2003 to COVID-19 in 2020. Termed by some as the twenty-first century's first pandemic, SARS originated in China and alerted the country to the importance of public health and epidemic response. After SARS, China improved its health infrastructure and reformed its political and legal health governance system. The emergence of COVID-19 from Wuhan in late 2019 put those reforms to the test. This paper analyses China's public health and epidemic response policies from a historical perspective, tracing the evolution of Chinese public health policies after the SARS outbreak in 2003. This paper assesses China's response to COVID-19 and how post-SARS policy reforms, particularly in epidemic response, played out on the ground in Wuhan. What policies worked well? What were the challenges faced? Based on the policy analysis, this paper presents recommendations for how China can improve its epidemic response through strengthened infectious disease surveillance, more transparent political coordination, and expanded public health infrastructure. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has overwhelmed health systems around the globe, and intensified the lethality of social and political inequality. In the United States, where public health departments have been severely defunded, Black, Native, Latinx communities and those experiencing poverty in the country's largest cities are disproportionately infected and disproportionately dying. Based on our collective ethnographic work in three global cities in the U.S. (San Francisco, Los Angeles, and Detroit), we identify how the political geography of racialisation potentiated the COVID-19 crisis, exacerbating the social and economic toll of the pandemic for non-white communities, and undercut the public health response. Our analysis is specific to the current COVID19 crisis in the U.S, however the lessons from these cases are important for understanding and responding to the corrosive political processes that have entrenched inequality in pandemics around the world. [ABSTRACT FROM AUTHOR]

While the COVID-19 pandemic now affects the entire world, countries have had diverse responses. Some responded faster than others, with considerable variations in strategy. After securing border control, primary health care approaches (public health and primary care) attempt to mitigate spread through public education to reduce person-to-person contact (hygiene and physical distancing measures, lockdown procedures), triaging of cases by severity, COVID-19 testing, and contact-tracing. An international survey of primary care experts' perspectives about their country's national responseswas conducted April to early May 2020. This mixed method paper reports on whether they perceived that their country's decision-making and pandemic response was primarily driven by medical facts, economic models, or political ideals; initially intended to develop herd immunity or flatten the curve, and the level of decision-making authority (federal, state, regional). Correlations with country-level death rates and implications of political forces and processes in shaping a country's pandemic response are presented and discussed, informed by our data and by the literature. The intersection of political decision-making, public health/primary care policies and economic strategies is analysed to explore implications of COVID-19's impact on countries with different levels of social and economic development. [ABSTRACT FROM AUTHOR]

The article focuses on the Insights from Blood Products Management for Pre-Crisis Ethical Resource Allocation. Topics discussed include the authors describe a gap in ethical guidance for resource allocation prior to the activation of crisis care and propose "a modified application of utility; and employing equity as the mediating value" as an appropriate ethical framework to guide resource.

The new coronavirus disease, or COVID-19, was first identified in late 2019 and declared as a pandemic by the World Health Organization (WHO) in March 2020. Turkey and Iran have been heavily affected by the outbreak, with over 460,000 and 890,000 cases reported respectively, so far. Even though these two countries have similar political and ideological approaches and are roughly the same size in terms of population density, as well as despite a high number of reported COVID-19 cases, a fast infection spread rate, and mismanagement of the crisis in both countries, Turkey's death toll remained lower when compared to the death toll in Iran. Deploying a comparative case study methodology drawing on an analysis of secondary sources, this study investigates Turkey and Iran's official responses to COVID-19 to further understand authoritarian reactions to large-scale crises and how distinctions between the actions taken by authoritarian regimes might impact crisis management in such contexts. [ABSTRACT FROM AUTHOR]

The use of information technology during the COVID-19 pandemic raises significant questions around the protection of personal data in a disaster. This paper considers how the clear benefits of using and sharing such data in disaster scenarios can be achieved while recognising an individual's right to privacy through examining the experiences of Taiwan and New Zealand. These states represent two successful COVID-19 response strategies which utilised different approaches to the use of technology. In Taiwan, the response made significant use of personal data and information technology. New Zealand, by contrast, has relied upon stringent lockdowns and extreme limits upon personal freedoms. The paper considers the different approaches to data and privacy that underpinned these responses and considers whether New Zealand can learn from the Taiwanese experience in future disaster planning. In doing so, the paper concludes by examining the wider question of when and if the community's expectation of a safe environment should trump the rights of individuals to retain personal data both in the context of pandemics and in other emergency or disaster scenarios. It also raises deeper questions, exposed by the COVID-19 response, about whether our current approach to privacy is sustainable in the digital age. [ABSTRACT FROM AUTHOR]

With the objective of controlling the spread of the coronavirus, the UK has decided to create and, in early May 2020, was live testing a digital contact tracing app, under the direction of NHS X, a joint unit of NHS England and NHS Improvement. In parallel, NHS X has been building the backend datastore, contracting a number of companies. While the second iteration of the app should integrate a more privacy-friendly design, the project has continued to be criticised for its potential to increase government surveillance beyond the pandemic and for purposes other than tracing the spread of the virus. While I share these concerns, I argue that equal attention should be given to the collaboration between NHS X and the private sector because it has the potential to magnify the illegal collection and sharing of data. Systematic enforcement of the General Data Protection Regulation (GDPR) in the private sector would disrupt the current dynamics hidden in plain sight. [ABSTRACT FROM AUTHOR]

The author discusses the rapid overlapping of varying needs and priorities that elicit conflicts in the ethical balance of individual, institutional, and social interests in public health disasters (PHD) such as in the outbreak of the coronavirus disease 2019 (COVID-19). Topics covered include the balancing of priorities in medical triage decision-making, and the inadequacy of a colorblind bioethical approach. Also noted is the need to understand historical vulnerabilities to save human lives.

Four decades after the Alma-Ata Declaration, strengthening primary health care (PHC) remains a priority for health systems, especially in low- and middle-income countries (LMICs). Given the prominence of chronic diseases as a global health issue, PHC must include a wide range of components in order to provide adequate care. To assess PHC preparedness to provide chronic care in Mozambique, Nepal and Peru, we used, as 'tracer conditions', diabetes, hypertension and a country-specific neglected tropical disease with chronic sequelae in each country. By implementing a health system assessment, we collected quantitative and qualitative data from primary and secondary sources, including interviews of key informants at three health-system levels (macro, meso and micro). The World Health Organization's health-system building blocks provided the basis for content analysis. In total, we conducted 227 interviews. Our findings show that the ambitious policies targeting specific diseases lack the support of technical, administrative and financial resources. Data collection systems do not allow the monitoring of individual patients or provide the health system with the information it requires. Patients receive limited disease-specific information. Clinical guidelines and training are either non-existent or not adapted to local contexts. Availability of medicines and diagnostic tests at the PHC level is an issue. Although medicines available through the public health care system are affordable, some essential medicines suffer shortages or are not available to PHC providers. This need, along with a lack of clear referral procedures and available transportation, generates financial issues for individuals and affects access to health care. PHC in these LMICs is not well prepared to provide adequate care for chronic diseases. Improving PHC to attain universal health coverage requires strengthening the identified weaknesses across health-system building blocks. [ABSTRACT FROM AUTHOR]

The administrative accountability system in China has evolved during public health crises. By holding public officials accountable, the system hopes to improve their performance during emergencies. However, Covid-19 exposed an unexpected effect of the system. Instead of incentivizing public officials to take responsibility, it may have discouraged them from making timely, but potentially risky, decisions. Based on a holistic case analysis of the early response in Wuhan city, the authors demonstrate the lessons learnt and a way to improve the system. The case adds to an increasing academic literature on responsible risk-taking behaviours and decisions under uncertainties, extending the academic discussion by providing the critical contextual information for such behaviours and decisions in China. Tolerating decision errors under uncertainty can improve early responses to public health emergencies like Covid-19 in China. This article shows that integrating an error-tolerance mechanism in an evolving accountability system can encourage responsible risk-taking by governmental officials. A well-designed error-tolerance mechanism that distinguishes between errors to tolerate and errors to punish can encourage proactive actions and prevent tardiness under threat of an incoming infectious disease. Readers who can benefit from this study include policy-makers and managers in government, especially those who work in infectious disease prevention and response, emergency management, or any other public services in which decisions under uncertainties are common. [ABSTRACT FROM AUTHOR]

The Biden administration must reevaluate the emergency response doctrine that proved so fragile during the COVID-19 pandemic. During the crisis, the federal government was not the backstop many expected it would be when states were desperately competing with each other for emergency supplies. A chronically underfunded public health system and a presidential administration that did not heed the pandemic plans it had on hand added to the chaotic response. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to an unprecedented global public health crisis, and governments have implemented various responses with varying degrees of effectiveness. South Korea's approach, which has involved minimal lockdown in order to "flatten the curve", and which offers an alternative for many democracies, has attracted much attention. Based on in-depth interviews with public health professionals and policy advisors in government agencies, this article analyses how well South Korea's response to COVID-19 complies with the expectations of good governance, and assesses the strengths and challenges of the Korean model. Our analysis shows that South Korea has been reactive rather than preventive/passive amid waves of clusters such as outbreaks in nightclubs, e-commerce warehouses, schools, hospitals and religious gatherings. The government has used a range of countermeasures, including contact tracing, diagnostic testing, media briefings and text alerts. At the same time, the challenges for the Korean approach have been concerns about privacy, fatigue over emergency alerts and politicisation. [ABSTRACT FROM AUTHOR]

Countering the calls for more centralized public decision-making and unified command-and-control administration, we show how fragmented authority can foster collective action to mount an effective response to the COVID-19 pandemic. To this aim, we use a conceptual framework that integrates emergency management and political economic theory and provide several examples to illustrate how public and private actors in Germany met the challenges of the pandemic with coordinated, cooperative, and collaborative action. The motivational, strategic, and structural solutions we identify in this research offer to scholars and practitioners insight into the design of resilient public health systems. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had enormous effects on health, wellbeing, and economies worldwide. Governments have responded with rapid and sometimes radical public health interventions. As nations grapple with the question of how to regain normality without unnecessarily endangering lives or healthcare systems, some scientists have argued for policies to encourage or compel the use of face coverings in community (non-clinical) settings, despite acknowledged gaps in the evidence base for the effectiveness of such a measure. This commentary has two objectives. First, in the face of strong arguments that face coverings are a commonsense intervention, with negligible downsides, that can only do good, we make the case for caution in changing policy. Many seemingly benign public health interventions have the potential to cause harm, and that harm is often socially differentiated. We present five arguments for caution in policy change. Second, we reflect on the wider implications of the increasingly overt approaches to policy advocacy taken by some scientists. Drawing from the theory of post-normal science, we argue that the science–policy interface in the case of face coverings has taken a surprisingly traditional form, falling short of interdisciplinary integration and failing to incorporate insights of the full range of relevant experts and affected stakeholders. We sketch a vision for an alternative, more mature, relationship between science and society that accepts uncertainty, embraces deliberation, and rises to the challenge of developing knowledge to improve public health. [ABSTRACT FROM AUTHOR]

The influence of social determinants and health communication on Public health emergency preparedness (PHEP) as well as the mediating effect of health communication were investigated with respect to the 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea. Data were collected through a survey six months after the de facto end of the outbreak and a total of 855 subjects completed the surveys and were included in the analysis. The results suggested that the public's preventive (hand hygiene) and avoidance (avoiding hospitals even when sick) behaviors that were frequently practiced during the pandemic were influenced by their social determinants both direct and indirect pathways. Health communication such as information seeking and processing mediated the effect of social determinants on the behaviors and information seeking was found to have the most significant mediating effect on the relationship between the practice of both preventive and avoidance behaviors and social determinants such as education and age. The results of the present study will deepen our understanding of PHEP by identifying key factors that influence the public's behavioral responses as well as providing information to public health emergency management and health risk communication officials to implement strategies necessary in improving PHEP. [ABSTRACT FROM AUTHOR]

With increasing air travel, contagion can spread anywhere in the world within 24 hours. As a result, the potential risk of introduction and spread of infectious disease is on the rise. Recently, we the global spread of the coronavirus disease (COVID-19) showed the potential of a contagion to emerge, spread and effect the health, social and economic life of people globally. Contact tracing represents an important factor in mitigating the global spread of a pandemic. This research in progress paper explores the design and development of a 'contact tracing' application in relation to airline passengers in the event of a biological threat or pandemic. The current paper-based method of contact tracing has many limitations that can lead to delayed identification of at-risk passengers and ultimately increased the spread of contagion. The use of a digital contact tracing application provides a method of rapidly collecting passenger contact information. [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic spreads, concerns are particularly serious in conflict and humanitarian settings. Tackling the pandemic in those countries is challenging due to the fragility of socioeconomic and health systems. Palestine is one of those countries that is facing compounding challenges, instability, fragility, living conditions, poverty, and mobility, all of which are caused by multifactorial etiology. The Pandemic shows triple tragedies; virus (COVID-19 Pandemic), ongoing Israeli occupation (Politics), and Intra-Palestinian divide (Policies). Yet, Palestine's response to the pandemic is outperforming many countries in the region. The early preventative lockdown measures in the West Bank found effective and not overwhelming the already over-stretched health system. While in the Gaza Strip, the response was slow. Prisoners, labours, besieged people, socioeconomic-disadvantaged classes, and refugees were put at additional high risk. Nonetheless, measures taken were unconsolidated in both regions largely due to the political factors. A little collaboration and inter-agency task forces in preparedness and response was observed, and the mechanisms and governance remain ambiguous. A consolidated and evidence-based nation-wide plan is required, whereby state and non-state actors have a clear and transparent exit strategy. A new thinking approach to promote the public health system and evidence-informed policies in Palestine is an urgent national priority. [ABSTRACT FROM AUTHOR]

Background: The Corona Virus Disease-19 (COVID-19) has been declared a pandemic by the World Health Organization (WHO). We state the consolidated and systematic approach for academic medical centres in response to the evolving pandemic outbreaks for sustaining medical education. Discussion: Academic medical centres need to establish a 'COVID-19 response team' in order to make time-sensitive decisions while managing pandemic threats. Major themes of medical education management include leveraging on remote or decentralised modes of medical education delivery, maintaining the integrity of formative and summative assessments while restructuring patient-contact components, and developing action plans for maintenance of essential activities based on pandemic risk alert levels. These core principles must be applied seamlessly across the various fraternities of academic centres: undergraduate education, residency training, continuous professional development and research. Key decisions from the pandemic response teams that help to minimise major disruptions in medical education and to control disease transmissions include: minimising inter-cluster cross contaminations and plans for segregation within and among cohorts; reshuffling academic calendars; postponing or restructuring assessments. Conclusions: While minimising the transmission of the pandemic outbreak within the healthcare establishments is paramount, medical education and research activities cannot come to a standstill each time there is a threat of one. [ABSTRACT FROM AUTHOR]

In the wake of the COVID-19 pandemic, public health authorities in India presented a contradictory picture between their role in assisting the state to mitigate the global crisis and dealing coercively with the needs of its diverse populations. Conventionally, public health is viewed as an evidence-based profession that is above politics. Yet national responses to COVID-19 in India reveal the embeddedness of health and illnesses in the larger politics of the state. Although it is still early to assess the full spectrum of damage caused by lack of central-level planning, this article argues against COVID-19 being viewed as a 'great leveller'. Rather, it suggests that we inhabit somatic societies that regularly employ the vocabulary of pathology/disease to determine social health. Moreover, the Indian experience illustrates how, even during a pandemic, 'social distancing' is not an apolitical notion. It becomes a measure for the state to co-opt scientific interventions of risk mitigation and relay them to people as a metaphor for exclusion: thereby exacerbating deeper structural inequities around which access to health and well-being of the population is organised. [ABSTRACT FROM AUTHOR]

The author reflects on ethical dilemmas in COVID-19 medical care. She talks about the pandemic triage plans developed in the wake of the SARS outbreak in 2003, the phenomenon she observed as a witness to several deliberative democracy exercises concerning pandemic triage held by researchers in Maryland beginning in 2012 that has rarely been documented or discussed, and ethical dilemmas that had not been anticipated in the pandemic.

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by "crisis standards of care," but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. [ABSTRACT FROM AUTHOR]

Insufficient specifications about public health emergency coordination involving government entities have been criticized as a contributing factor in managerial and institutional shortcomings. In response, this study analyzed the coordination plan and actions taken during the 2015 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak in South Korea. Using network data, we found a low congruence between the planned response coordination networks and those carried out. This result was observed for two reasons. First, unrealized or newly emerging relationships among planned actors contributed to the low congruence. Second, the response plan overlooked the role and relationships of several intermediary actors between the local and national actors in the government system. The broad implication is that public health emergency preparedness and response agencies may be cognizant of the neglected areas in drawing the boundaries between—and the relationships of—core and emergent actors in emergency planning. [ABSTRACT FROM AUTHOR]