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Ledesma JR, Papanicolas I, Stoto MA, Chrysanthopoulou SA, Isaac CR, Lurie MN, Nuzzo JB. Pandemic preparedness improves national-level SARS-CoV-2 infection and mortality data completeness: a cross-country ecologic analysis. Popul Health Metr 2024; 22:12. [PMID: 38879515 PMCID: PMC11179302 DOI: 10.1186/s12963-024-00333-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/11/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Heterogeneity in national SARS-CoV-2 infection surveillance capabilities may compromise global enumeration and tracking of COVID-19 cases and deaths and bias analyses of the pandemic's tolls. Taking account of heterogeneity in data completeness may thus help clarify analyses of the relationship between COVID-19 outcomes and standard preparedness measures. METHODS We examined country-level associations of pandemic preparedness capacities inventories, from the Global Health Security (GHS) Index and Joint External Evaluation (JEE), on SARS-CoV-2 infection and COVID-19 death data completion rates adjusted for income. Analyses were stratified by 100, 100-300, 300-500, and 500-700 days after the first reported case in each country. We subsequently reevaluated the relationship of pandemic preparedness on SARS-CoV-2 infection and age-standardized COVID-19 death rates adjusted for cross-country differentials in data completeness during the pre-vaccine era. RESULTS Every 10% increase in the GHS Index was associated with a 14.9% (95% confidence interval 8.34-21.8%) increase in SARS-CoV-2 infection completion rate and a 10.6% (5.91-15.4%) increase in the death completion rate during the entire observation period. Disease prevention (infections: β = 1.08 [1.05-1.10], deaths: β = 1.05 [1.04-1.07]), detection (infections: β = 1.04 [1.01-1.06], deaths: β = 1.03 [1.01-1.05]), response (infections: β = 1.06 [1.00-1.13], deaths: β = 1.05 [1.00-1.10]), health system (infections: β = 1.06 [1.03-1.10], deaths: β = 1.05 [1.03-1.07]), and risk environment (infections: β = 1.27 [1.15-1.41], deaths: β = 1.15 [1.08-1.23]) were associated with both data completeness outcomes. Effect sizes of GHS Index on infection completion (Low income: β = 1.18 [1.04-1.34], Lower Middle income: β = 1.41 [1.16-1.71]) and death completion rates (Low income: β = 1.19 [1.09-1.31], Lower Middle income: β = 1.25 [1.10-1.43]) were largest in LMICs. After adjustment for cross-country differences in data completeness, each 10% increase in the GHS Index was associated with a 13.5% (4.80-21.4%) decrease in SARS-CoV-2 infection rate at 100 days and a 9.10 (1.07-16.5%) decrease at 300 days. For age-standardized COVID-19 death rates, each 10% increase in the GHS Index was with a 15.7% (5.19-25.0%) decrease at 100 days and a 10.3% (- 0.00-19.5%) decrease at 300 days. CONCLUSIONS Results support the pre-pandemic hypothesis that countries with greater pandemic preparedness capacities have larger SARS-CoV-2 infection and mortality data completeness rates and lower COVID-19 disease burdens. More high-quality data of COVID-19 impact based on direct measurement are needed.
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Affiliation(s)
- Jorge R Ledesma
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA.
| | - Irene Papanicolas
- Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
| | - Michael A Stoto
- Department of Health Management and Policy, School of Health, Georgetown University, 3700 Reservoir Road, N.W., Washington, DC, 20057, USA
| | - Stavroula A Chrysanthopoulou
- Department of Biostatistics, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
| | - Christopher R Isaac
- Nuclear Threat Initiative, 1776 Eye Street, NW, Suite 600, Washington, DC, 20006, USA
| | - Mark N Lurie
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
- International Health Institute, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
- Population Studies and Training Center, Brown University, 68 Waterman St., Box 1836, Providence, RI, 02912, USA
| | - Jennifer B Nuzzo
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
- Pandemic Center, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
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Riedel SI, Trecartin S. The COVID-19 Crisis, Religiosity and Spirituality Among Seventh-Day Adventist Older Adults. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:426-443. [PMID: 38593318 DOI: 10.1080/01634372.2024.2338062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/15/2024] [Indexed: 04/11/2024]
Abstract
This study highlights the lived experience of Seventh-day Adventist older adults during the COVID-19 pandemic, while focusing on their religious and spiritual practices during this event. The researchers conducted 10 in-depth qualitative interviews and found participants experienced notable changes in their personal spirituality and practices. Furthermore, findings showed participants categorizing the events of the pandemic in light of their understanding of the Bible. The analysis highlights the all-encompassing influence of spirituality and religiosity upon participants' experience of the world. The findings assist social workers to consider the importance of assessing and integrating older adults' spirituality as means to enhance their well-being.
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Affiliation(s)
- Sarah I Riedel
- School of Social Work, Andrews University, Berrien Springs, USA
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3
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Pagen DM, Hanssen DA, van Loo IH, Brinkhues S, den Heijer CD, Dukers-Muijrers NH, Hoebe CJ. The association between SARS-CoV-2 seroprevalence and cross-border mobility for visiting family or friends among Dutch residents of a Euregional province. Health Policy 2024; 143:105056. [PMID: 38537398 DOI: 10.1016/j.healthpol.2024.105056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/11/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Border measures were implemented in many countries as infection prevention measures to interrupt between-country COVID-19 transmission. Border closings impact border region residents, as their professional and social lives are often intertwined across national borders. We studied whether crossing borders to visit family/friends in neighbouring countries (cross-border mobility) was associated with SARS-CoV-2 seroprevalence in Dutch Euregional residents. METHODS SARS-CoV-2 serostatus (negative/positive) was assessed (pre-vaccination) using laboratory testing to determine previous infection. Visiting Belgian or German family/friends in February-March 2020 was questioned. The association between cross-border mobility and seroprevalence was tested using logistic regression analysis, adjusted for previously identified exposure factors. RESULTS In 9,996 participants, 36.8 % (n = 3,677) reported cross-border family/friends. Of these, one-third (n = 1,306) visited their cross-border family/friends in February-March 2020. Multivariable analyses revealed no positive association between cross-border mobility and seropositivity, for both participants living in a border municipality (ORfamily/friends not visited=0.90 [95 % CI:0.78-1.04], ORfamily/friends visited=0.88 [95 % CI:0.73-1.05]), and for participants not living in a border municipality (ORfamily/friends not visited=0.91 [95 % CI:0.72-1.16], ORfamily/friends visited=0.62 [95 % CI:0.41-0.94]). CONCLUSIONS This study provided no evidence of cross-border mobility as an important exposure factor for SARS-CoV-2. The results of our unique real-world study suggest that cross-border mobility did not substantially contribute to cross-border SARS-CoV-2 transmission in the Netherlands.
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Affiliation(s)
- Demi Me Pagen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands; Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
| | - Daniëlle At Hanssen
- Department of Medical Microbiology, Infectious Diseases and Prevention, Maastricht University Medical Center (MUMC+), Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
| | - Inge Hm van Loo
- Department of Medical Microbiology, Infectious Diseases and Prevention, Maastricht University Medical Center (MUMC+), Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
| | - Stephanie Brinkhues
- Department of Knowledge and Innovation, South Limburg Public Health Service, Heerlen, the Netherlands
| | - Casper Dj den Heijer
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands; Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nicole Htm Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands; Department of Health Promotion, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Christian Jpa Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands; Department of Social Medicine, Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Medical Microbiology, Infectious Diseases and Prevention, Maastricht University Medical Center (MUMC+), Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
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Allahbakhshian Farsani L, Riahinia N, Danesh F, Azimi A. Co-Occurrence Analysis of COVID-19 Publications with an Emphasis on the Global Health Governance (GHG). Adv Biomed Res 2024; 13:10. [PMID: 38525400 PMCID: PMC10958719 DOI: 10.4103/abr.abr_344_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 03/26/2024] Open
Abstract
Background Analyzing co-occurrence is an effective way to monitor the overview of topic spreading. The present study aimed to conduct a co-occurrence analysis of scientific publications related to COVID-19, emphasizing Global Health Governance (GHG). Materials and Methods This applied research with an analytical approach was carried out on all the scientific publications related to COVID-19, emphasizing GHG (51056 records), extracted from PubMed Central on 26/01/2022. The research population consisted of all the scientific publications related to COVID-19, emphasizing GHG (51056 records), extracted from PubMed Central on 26/01/2022. The data were analyzed using BibExcel, UCINET, Excel, and SPSS software, and Spearman's test was used to confirm correlations. Results The co-word network of the thematic area of COVID-19 includes 226 nodes and 7292 edges. COVID-19 and the pandemic formed the most co-word pairs with 2224 connections. The COVID-19* mental health and COVID-19* anxiety, with 1019 and 925 connections, are ranked next, respectively. The term COVID-19 is ranked first with a centrality index of 225. The keywords of pandemic and public health are ranked second and third with the centrality index of 217 and 206, respectively. Conclusion The global approach of studies related to COVID-19 is more inclined to the epidemiological and public health fields. Assuming the GHG, detailed and comprehensive planning should be performed to strengthen these studies and pave the way for international cooperation, determining research requisites, and developing applied research studies.
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Affiliation(s)
- Leili Allahbakhshian Farsani
- Department of Knowledge and Information Science, Faculty of Education and Psychology, Kharazmi University, Tehran, Iran
| | - Nosrat Riahinia
- Department of Knowledge and Information Science, Faculty of Education and Psychology, Kharazmi University, Tehran, Iran
| | - Farshid Danesh
- Information Management Department, Islamic World Science and Technology Monitoring and Citation Institute (ISC), Shiraz, Iran
| | - Ali Azimi
- Department of Knowledge and Information Science, Faculty of Education and Psychology, Kharazmi University, Tehran, Iran
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Honda A, Tamura T, Baba H, Kodoi H, Noda S. How Hospitals Overcame Disruptions in the Early Stages of the COVID-19 Pandemic: A Case Study from Tokyo, Japan. Health Syst Reform 2023; 9:2175415. [PMID: 36803509 DOI: 10.1080/23288604.2023.2175415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
The COVID-19 pandemic has caused serious disruptions to health systems across the world. While the pandemic has not ended, it is important to better understand the resilience of health systems by looking at the response to COVID-19 by hospitals and hospital staff. Part of a multi-country study, this study looks at the first and second waves of the pandemic in Japan and examines disruptions experienced by hospitals because of COVID-19 and the processes through which they overcame those disruptions. A holistic multiple case study design was employed, and two public hospitals were selected for the study. A total of 57 interviews were undertaken with purposively selected participants. A thematic approach was used in the analysis. The study found that in the early stages of the pandemic, faced with a previously unknown infectious disease, to facilitate the delivery of care to COVID-19 patients while also providing limited non-COVID-19 health care services, the case study hospitals undertook absorptive, adaptive, and transformative actions in the areas of hospital governance, human resources, nosocomial infection control, space and infrastructure management, and management of supplies. The process of overcoming the disruptions caused by the pandemic was complex, and the solution to one issue often caused other problems. To inform preparations for future health shocks and promote resilience, it is imperative to further investigate both organizational and broader health system factors that build absorptive, adaptive, and transformative capacity in hospitals.
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Affiliation(s)
- Ayako Honda
- Graduate School of Economics, Hitotsubashi Institute for Advanced Study (HIAS), Hitotsubashi University, Tokyo, Japan
| | - Toyomitsu Tamura
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroko Baba
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruka Kodoi
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.,Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Noda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Chai D, El Mossadeq L, Raymond M, Courtier-Orgogozo V. Recommended distances for physical distancing during COVID-19 pandemics reveal cultural connections between countries. PLoS One 2023; 18:e0289998. [PMID: 38100502 PMCID: PMC10723704 DOI: 10.1371/journal.pone.0289998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
During COVID-19 pandemic several public health measures were implemented by diverse countries to reduce the risk of COVID-19, including social distancing. Here we collected the minimal distance recommended by each country for physical distancing at the onset of the pandemic and aimed to examine whether it had an impact on the outbreak dynamics and how this specific value was chosen. Despite an absence of data on SARS-CoV-2 viral transmission at the beginning of the pandemic, we found that most countries recommended physical distancing with a precise minimal distance, between one meter/three feet and two meters/six feet. 45% of the countries advised one meter/three feet and 49% advised a higher minimal distance. The recommended minimal distance did not show a clear correlation with reproduction rate nor with the number of new cases per million, suggesting that the overall COVID-19 dynamics in each country depended on multiple interacting factors. Interestingly, the recommended minimal distance correlated with several cultural parameters: it was higher in countries with larger interpersonal distance between two interacting individuals in non-epidemic conditions, and it correlated with civil law systems, and with currency. This suggests that countries which share common conceptions such as civil law systems and currency unions tend to adopt the same public health measures.
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Affiliation(s)
- Dongwoo Chai
- Institut Jacques Monod, Université Paris Cité, CNRS, Paris, France
| | | | - Michel Raymond
- ISEM, University Montpellier, CNRS, EPHE, IRD, Montpellier, France
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Sileo FG, Bonvicini L, Mancuso P, Vicentini M, Aguzzoli L, Khalil A, Giorgi Rossi P. COVID-19 incidence in women of reproductive age: a population-based study in Reggio Emilia, northern Italy. BMC Pregnancy Childbirth 2023; 23:726. [PMID: 37833634 PMCID: PMC10576401 DOI: 10.1186/s12884-023-06044-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Despite being at higher risk of severe disease and pregnancy complications, evidence on susceptibility to SARS-CoV-2 infection in pregnancy is still limited. The aim of the study is to compare the likelihood of undergoing a SARS-CoV-2 test and testing positive for COVID-19 in pregnancy and puerperium with that of the general female population of reproductive age. METHODS This is a retrospective population-based cohort study including 117,606 women of reproductive age (March 2020-September 2021) with 6608 (5.6%) women having ≥ 1 pregnancy. Women were linked to the pregnancy registry to be classified as "non-pregnant", "pregnant", and "puerperium"; then, according to the national case-based integrated COVID-19 surveillance system, all women undergoing a SARS-CoV-2 test during the study period were identified. The Incidence Rate Ratio was calculated to compare the likelihood of being tested for SARS-CoV-2 in pregnant, puerperium and non-pregnant women among all women included. The likelihood of having a COVID-19 diagnosis was calculated using two comparators (not-pregnant women and the person-time before/after pregnancy) by means of Cox proportional hazards models, adjusting for age and with the cluster option to control standard error calculation in repeated pregnancies. Only first infection and swabs before the first one positive were included. RESULTS The probability of being tested for SARS-CoV-2 was 4.9 (95% CI: 4.8-5.1) and 3.6 times higher (95%CI: 3.4-3.9) in pregnancy (including spontaneous miscarriages) and in the puerperium, respectively. The Hazard Ratio (HR) of covid-19 diagnosis during pregnancy vs. non-pregnancy was 1.17 (95% CI 1.03-1.33) with similar results when comparing the risk during pregnancy with that of the same women outside pregnancy (puerperium excluded), with an HR of 1.13 (95% CI 0.96-1.33); the excess decreased when excluding the test performed at admission for delivery (HR 1.08 (95%CI 0.90-1.30). In the puerperium, the HR was 0.62 (95% CI 0.41-0.92) comparing women with ≥ 1childbirth with all other women and excluding the first two weeks of puerperium. CONCLUSIONS Women during pregnancy showed a small increase in the risk of infection, compatible with a higher likelihood of being tested. A lower probability of infection during the puerperium was observed during the entire pandemic period, suggesting likely protective behaviors which were effective in reducing their probability of infection.
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Affiliation(s)
- Filomena Giulia Sileo
- Department of Biomedical, Metabolic and Neural Sciences, International Doctorate School in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Via Campi 80, 41125, Modena, Italy
- Prenatal Medicine Unit, Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - Laura Bonvicini
- Epidemiology Unit, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Via Giovanni Amendola 2, 42123, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Via Giovanni Amendola 2, 42123, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Via Giovanni Amendola 2, 42123, Reggio Emilia, Italy
| | - Lorenzo Aguzzoli
- Unit of Obstetrics and Gynecology, Azienda Unità Sanitaria Locale-IRCCS, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Asma Khalil
- Fetal Medicine Unit, St George's Hospital, St George's University of London, Blackshaw Road, TootingLondon, SW17 0QT, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Via Giovanni Amendola 2, 42123, Reggio Emilia, Italy.
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Ridde V, Traverson L, Zinszer K. Hospital Resilience to the COVID-19 Pandemic in Five Countries: A Multiple Case Study. Health Syst Reform 2023; 9:2242112. [PMID: 37652669 DOI: 10.1080/23288604.2023.2242112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 09/02/2023] Open
Abstract
Since the beginning of the pandemic, hospitals have been central to the COVID-19 response, often experiencing severe financial, material, and human constraints. In this special issue, we present some of the findings of the HoSPiCOVID research project. One of its main objectives was to compare hospital responses to the first and second waves of the COVID-19 pandemic in Brazil, Canada, France, Japan, and Mali. Studying and comparing how nine different hospitals coped with the pandemic in terms of preparedness and response allowed us to: 1) identify strengths and weaknesses of their responses, including challenges for hospital professionals; and 2) produce lessons learned, using a systematic approach to reflect and analyze their potential of resilience to the crisis. In the five countries, research teams conducted in-depth qualitative studies focused on nine large hospitals, using observation sessions, semistructured interviews with hospital professionals, and lessons learned workshops. The empirical work was supported by an original analytical framework on hospital resilience and a heuristic tool focused on configurations. The studies demonstrate that the hospitals were able to absorb and/or adapt to the crisis by deploying different coping mechanisms, which often required extensive involvement of hospital professionals. More extended study periods would be needed to assess the sustainability of these coping mechanisms and discern whether they have transformative potential. These international comparisons of hospital resilience, based on studies of contrasting contexts and epidemiological situations, allowed researchers to identify lessons learned to support hospital decision-makers in thinking more deeply about managing future health crises.
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Affiliation(s)
- Valéry Ridde
- Université Paris Cité, IRD, Ceped, Paris, France
- Institut de Santé et Développement (ISED), Université Cheikh Anta Diop, Dakar, Senegal
| | | | - Kate Zinszer
- School of Public Health (ESPUM), Université de Montréal, Montreal, Quebec, Canada
- Public Health Research Centre (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
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9
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Dagenais C, Kielende M, Coulibaly A, Gautier L, David PM, Peiffer-Smadja N, Honda A, de Araújo Oliveira SR, Traverson L, Zinszer K, Ridde V. Lessons Learned from Field Experiences on Hospitals' Resilience to the COVID-19 Pandemic: A Systematic Approach. Health Syst Reform 2023; 9:2231644. [PMID: 37470503 DOI: 10.1080/23288604.2023.2231644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023] Open
Abstract
In this concluding article of the special issue, we examine lessons learned from hospitals' resilience to the COVID-19 pandemic in Brazil, Canada, France, Japan, and Mali. A quality lesson learned (QLL) results from a systematic process of collecting, compiling, and analyzing data derived ideally from sustained effort over the life of a research project and reflecting both positive and negative experiences. To produce QLLs as part of this research project, a guide to their development was drafted. The systematic approach we adopted to formulate quality lessons, while certainly complex, took into account the challenges faced by the different stakeholders involved in the fight against the COVID-19 pandemic. Here we present a comparative analysis of the lessons learned by hospitals and their staff with regard to four common themes that were the subject of empirical analyses: 1) infrastructure reorganization; 2) human resources management; 3) prevention and control of infection risk; and 4) logistics and supply. The lessons learned from the resilience of the hospitals included in this research indicate several factors to consider in preparing for a health crisis: 1) strengthening the coordination and leadership capacities of hospital managers and health authorities; 2) improving communication strategies; 3) strengthening organizational capacity; and 4) adapting resources and strategies, including for procurement and infection risk management.
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Affiliation(s)
- Christian Dagenais
- Department of Psychology, University of Montréal, Pavillon Marie-Victorin, Montréal, Québec, Canada
| | - Muriel Kielende
- School of Public Health, University of Montréal, Montréal, Québec, Canada
| | - Abdourahmane Coulibaly
- Faculty of Medicine and Odontostomatology, IRL 3189 Santé, Environnement, Société, Bamako, Mali
| | - Lara Gautier
- School of Public Health, University of Montréal, Montréal, Québec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | | | - Nathan Peiffer-Smadja
- Service des Maladies Infectieuses et Tropicales, Hôpital Bichat Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, Inserm, IAME, Paris, France
| | - Ayako Honda
- Research Centre for Health Policy and Economics, Hitotsubashi Institute for Advanced Study (HIAS), Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, Japan
| | | | - Lola Traverson
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | - Kate Zinszer
- School of Public Health, Centre de recherche en santé publique, University of Montréal, Montréal, Québec, Canada
| | - Valéry Ridde
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
- Institut de Santé et Développement, Université Cheikh Anta Diop, Dakar, Senegal
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10
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Ash N, Triki N, Waitzberg R. The COVID-19 pandemic posed many dilemmas for policymakers, which sometimes resulted in unprecedented decision-making. Isr J Health Policy Res 2023; 12:13. [PMID: 37072814 PMCID: PMC10112313 DOI: 10.1186/s13584-023-00564-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic evolved through five phases, beginning with 'the great threat', then moving through 'the emergence of variants', 'vaccines euphoria', and 'the disillusionment', and culminating in 'a disease we can live with'. Each phase required a different governance response. With the progress of the pandemic, data were collected, evidence was created, and health technology was developed and disseminated. Policymaking shifted from protecting the population by limiting infections with non-pharmaceutical interventions to controlling the pandemic by prevention of severe disease with vaccines and drugs for those infected. Once the vaccine became available, the state started devolving the responsibility for the individual's health and behavior. MAIN BODY Each phase of the pandemic posed new and unique dilemmas for policymakers, which resulted in unprecedented decision-making. Restrictions to individual's rights such as a lockdown or the 'Green Pass policy' were unimaginable before the pandemic. One of the most striking decisions that the Ministry of Health made was approving the third (booster) vaccine dose in Israel, before it was approved by the FDA or any other country. It was possible to make an informed, evidence-based decision due to the availability of reliable and timely data. Transparent communication with the public probably promoted adherence to the booster dose recommendation. The boosters made an important contribution to public health, even though their uptake was less than the uptake for the initial doses. The decision to approve the booster illustrates seven key lessons from the pandemic: health technology is key; leadership is crucial (both political and professional); a single body should coordinate the actions of all stakeholders involved in the response, and these should collaborate closely; policymakers need to engage the public and win their trust and compliance; data are essential to build a suitable response; and nations and international organizations should collaborate in preparing for and responding to pandemics, because viruses travel without borders. CONCLUSION The COVID-19 pandemic posed many dilemmas for policymakers. The lessons learned from the actions taken to deal with them should be incorporated into preparedness for future challenges.
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Affiliation(s)
- Nachman Ash
- Department of Health Systems Management, Ariel University, Ariel, Israel.
- Ministry of Health, Jerusalem, Israel.
| | - Noa Triki
- Ministry of Health, Jerusalem, Israel
| | - Ruth Waitzberg
- Department of Health Care Management, Faculty of Economics and Management, Technische Universität Berlin, Berlin, Germany
- The Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem, Israel
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Zweigenthal V, Perez G, Wolmarans K, Olckers L. Health Sciences students' experience of COVID-19 case management and contact tracing in Cape Town, South Africa. BMC MEDICAL EDUCATION 2023; 23:238. [PMID: 37046295 PMCID: PMC10092931 DOI: 10.1186/s12909-023-04205-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND COVID-19 has challenged health and higher education systems globally. Managing the epidemic in Cape Town, South Africa (SA), required partnerships with universities and setting up of de novo systems for mass case and contact tracing (C&CT). Health sciences, predominantly medical students, as well as social work and psychology students formed the core of this telephone-based work over the 18 months when SARS-CoV-2 caused severe disease. METHODS This qualitative study aimed to elicit students' motivations for becoming involved in C&CT, their experiences, and recommendations for C&CT and curricula. After Cape Town's first COVID-19 wave, six on-line focus groups comprising 23 students were conducted, and a further four were conducted with 13 students after the second wave. As the researchers were predominantly educators previously involved in undergraduate health sciences education, the study's purpose was to reflect on students' experiences to make educational and health system recommendations. RESULTS Students were largely motivated to mitigate the impact of the epidemic on society and support people affected by COVID-19, as well as hone their professional skills. While these motivations were realised, students also needed to learn new skills - to autonomously work remotely, using novel communication strategies to engage those affected and use virtual groups to connect with colleagues. They managed responsibilities within the healthcare systems that did not always work smoothly, distressed cases who were financially insecure, difficult employers, and language barriers. They were prepared through training, and supported by virtual, yet effective teamwork and debriefing opportunities. Although the work was sometimes physically and emotionally exhausting, students found the work personally meaningful. They embraced public health's role to protect population and individuals' health. CONCLUSION New teaching and learning practices adopted due to Covid-19 lockdowns enabled this digital C&CT project. It facilitated students to become confident, work autonomously and navigate challenges they will encounter as young professionals. The programme demonstrated that novel opportunities for rich student learning, such as in telehealth, can be embedded into public health and clinical functions of health services in contexts such as in SA, deepening partnerships between the health services and universities, to mutual benefit.
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Affiliation(s)
- Virginia Zweigenthal
- School of Public Health, Faculty of Health Sciences, University of Cape Town, Town, South Africa.
| | - Gonda Perez
- School of Public Health, Faculty of Health Sciences, University of Cape Town, Town, South Africa
| | - Karen Wolmarans
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Town, South Africa
| | - Lorna Olckers
- School of Public Health, Faculty of Health Sciences, University of Cape Town, Town, South Africa
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Can COVID-19 response inform future health system reforms? Lessons learned from Finland. Health Policy 2023; 132:104802. [PMID: 37028262 PMCID: PMC10063522 DOI: 10.1016/j.healthpol.2023.104802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023]
Abstract
The COVID-19 pandemic has plagued health systems in an unprecedented way and challenged the traditional ways to respond to epidemics. It has also revealed several vulnerabilities in countries’ health systems and preparedness. In this paper we take the Finnish health system as an example to analyse how pre-COVID-19 preparedness plans, regulations, and health system governance were challenged by the pandemic and what lessons can be learned for the future. Our analysis draws on policy documents, grey literature, published research, and the COVID-19 Health System Response Monitor. The analysis shows how major public health crises often reveal weaknesses in health systems, also in countries which have been ranked highly in terms of crisis preparedness. In Finland, there were apparent regulative and structural problems which challenged the health system response, but in terms of epidemic control, the results appear to be relatively good. The pandemic may have long-term effects on the health system functioning and governance. In January 2023, an extensive health and social services reform has taken place in Finland. The new health system structure needs to be adjusted to take on board the legacy of the pandemic and a new regulatory frame for health security should be considered.
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Psychosocial Predictors and Mediators Relating to the Preventive Behaviors of Hospital Workers During the COVID-19 Pandemic in Turkey. J Occup Environ Med 2023; 65:255-260. [PMID: 36221299 PMCID: PMC9987642 DOI: 10.1097/jom.0000000000002725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The aim is to analyze the relation of psychosocial factors to COVID-19 contraction, vaccination, and preventive health behavior in and outside work. METHODS The questionnaire data from hospital-workers in Turkey is analyzed using independent-samples t-test, logistic regression, linear regression, and mediation analyses. We developed a questionnaire on mask-hygiene-distance measures and also used previously developed scales including the Big Five Personality Questionnaire, Young Schema Questionnaire Short Form 3, Schwartz's Basic Human Values Scale, Short Dark Triad. RESULTS The odds of being infected by COVID-19 increases by self-direction. The odds of being vaccinated increases by age and conformity, and decreases by emotional stability. Education predicts certain preventive behaviors at work negatively and outside work positively. Older age, being a woman, having chronic disease, the self-transcendence and conservation values, agreeableness, and conscientiousness predict more preventive behaviors. The self-enhancement and openness to change values, the Dark Triad, and early maladaptive schemas predict more risky behaviors. CONCLUSIONS Designing prohealth policies requires further elaboration on the relation of psychosocial factors to preventive behaviors.
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Tille F, Van Ginneken E, Winkelmann J, Hernandez-Quevedo C, Falkenbach M, Sagan A, Karanikolos M, Cylus J. Perspective: Lessons from COVID-19 of countries in the European region in light of findings from the health system response monitor. Front Public Health 2023; 10:1058729. [PMID: 36684940 PMCID: PMC9853016 DOI: 10.3389/fpubh.2022.1058729] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/13/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction Decision-makers initially had limited data to inform their policy responses to the COVID-19 pandemic. The research community developed several online databases to track cases, deaths, and hospitalizations; however, a major deficiency was the lack of detailed information on how health systems were responding to the pandemic and how they would need to be transformed going forward. Approach In an effort to fill this information gap, in March 2020, the European Observatory on Health Systems and Policies, the WHO European Regional Office and the European Commission created the COVID-19 Health System Response Monitor (HSRM) to collect and organise up-to-date information on how health systems, mainly in the WHO European Region, were responding to the COVID-19 pandemic. Findings The HSRM analysis and broader Observatory work on COVID-19 shone light on a range of health system challenges and weaknesses and catalogued policy options countries put in place during the pandemic to address these. Countries prioritised policies on investing in public health, supporting the workforce, maintaining financial stability, and strengthening governance in their response to COVID-19. Outlook COVID-19 is likely to continue to impact health systems for the foreseeable future; the ability to cope with this pressure, and other shocks, depends on having good information on what other countries have done so that health systems develop adequate policy options. In support of this, the country information on the COVID-19 HSRM will remain available as a repository to inform decision makers on options for actions and possible measures against COVID-19 and other public health emergencies. Building on its previous work on health systems resilience, the European Observatory on Health Systems and Policies will sustain its focus on analysing key issues related to the recovery from the pandemic and making health systems more resilient. This includes policy knowledge transfer between countries and systematic resilience testing, aiming at contributing to an improved understanding of health system response, recovery, and preparedness. Contribution to the literature in non-technical language The COVID-19 Health System Response Monitor (HSRM) was the first database in the WHO European Region to collect and organise up-to-date information on how health systems were responding to the COVID-19 pandemic. The HSRM provides a repository of policies which can be used to inform decision makers in health and other policy domains on options for action and possible measures against COVID-19 and other public health emergencies. This initiative proved particularly valuable, especially during the early phases of the pandemic, when there was limited information for countries to draw on as they formulated their own policy response to the pandemic. Our perspectives paper highlights some key challenges within health systems that the HSRM was able to identify during the pandemic and considers policy options countries put in place in response. Our research contributes to literature on emergency responses and recovery, health systems performance assessment, particularly health system resilience, and showcases the Observatory experience on how to design such a data collection tool, as well as how to leverage its findings to support cross-country learning.
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Affiliation(s)
- Florian Tille
- European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, United Kingdom
| | - Ewout Van Ginneken
- European Observatory on Health Systems and Policies, Technische Universität Berlin, Berlin, Germany
| | - Juliane Winkelmann
- Department of Healthcare Management, Technische Universität Berlin, Berlin, Germany
- European Observatory on Health Systems and Policies, Brussels, Belgium
| | - Cristina Hernandez-Quevedo
- European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, United Kingdom
| | - Michelle Falkenbach
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY, United States
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anna Sagan
- European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, United Kingdom
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marina Karanikolos
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonathan Cylus
- European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, United Kingdom
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, United Kingdom
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15
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Pagen DME, van Bilsen CJA, Brinkhues S, Moonen CPB, Van Herck M, Konings K, den Heijer CDJ, Mujakovic S, ter Waarbeek HLG, Bouwmeester-Vincken N, Vaes AW, Spruit MA, Hoebe CJPA, Dukers-Muijrers NHTM. Design and recruitment of a large-scale cohort study on prevalence, risk factors and impact evaluation of post-COVID-19 condition and its wider long-term social, mental, and physical health impact: The PRIME post-COVID study. Front Public Health 2022; 10:1032955. [PMID: 36589958 PMCID: PMC9799054 DOI: 10.3389/fpubh.2022.1032955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Background Persistent symptoms, described as long COVID or post-COVID-19 condition, pose a potential public health problem. Here, the design and recruitment of the PRIME post-COVID study is described. PRIME post-COVID is a large-scale population-based observational study that aims to improve understanding of the occurrence, risk factors, social, physical, mental, emotional, and socioeconomic impact of post-COVID-19 condition. Methods An observational open cohort study was set up, with retrospective and prospective assessments on various health-conditions and health-factors (medical, demographic, social, and behavioral) based on a public health COVID-19 test and by self-report (using online questionnaires in Dutch language). Invited for participation were, as recorded in a public health registry, adults (18 years and older) who were tested for COVID-19 and had a valid Polymerase Chain Reaction (PCR) positive or negative test result, and email address. In November 2021, 61,655 individuals were invited by email to participate, these included all eligible adults who tested PCR positive between 1 June 2020 and 1 November 2021, and a sample of adults who tested negative (2:1), comparable in distribution of age, sex, municipality of residence and year-quarter of testing. New recruitment periods are planned as well. Participants are followed over time by regular follow-up measurements. Data are analyzed using the appropriate data-analyses methods. Discussion The PRIME post-COVID study will provide insights into various health-related aspects of post-COVID-19 condition in the context of various stages of the COVID-19 pandemic. Results will inform practical guidance for society, clinical and public health practice for the prevention and care for long-term impact of COVID-19. Trial registration ClinicalTrialsgov identifier NCT05128695.
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Affiliation(s)
- Demi M. E. Pagen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands,Care and Public Health Research Institute (CAPHRI), Department of Social Medicine, Maastricht University, Maastricht, Netherlands,*Correspondence: Demi M. E. Pagen
| | - Céline J. A. van Bilsen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands,Care and Public Health Research Institute (CAPHRI), Department of Social Medicine, Maastricht University, Maastricht, Netherlands
| | - Stephanie Brinkhues
- Department of Knowledge and Innovation, South Limburg Public Health Service, Heerlen, Netherlands
| | - Chrissy P. B. Moonen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands,Care and Public Health Research Institute (CAPHRI), Department of Social Medicine, Maastricht University, Maastricht, Netherlands
| | - Maarten Van Herck
- Department of Research and Education, Ciro, Horn, Netherlands,School of Nutrition and Translational Research in Metabolism (NUTRIM), Department of Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, Netherlands,The Rehabilitation Research Center (REVAL), BIOMED–Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Kevin Konings
- Department of Process and Information Management, Communication and Automation, South Limburg Public Health Service, Heerlen, Netherlands
| | - Casper D. J. den Heijer
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands,Care and Public Health Research Institute (CAPHRI), Department of Social Medicine, Maastricht University, Maastricht, Netherlands
| | - Suhreta Mujakovic
- Department of Process and Information Management, Communication and Automation, South Limburg Public Health Service, Heerlen, Netherlands
| | - Henriëtte L. G. ter Waarbeek
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands
| | | | - Anouk W. Vaes
- Department of Research and Education, Ciro, Horn, Netherlands
| | - Martijn A. Spruit
- Department of Research and Education, Ciro, Horn, Netherlands,School of Nutrition and Translational Research in Metabolism (NUTRIM), Department of Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Christian J. P. A. Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands,Care and Public Health Research Institute (CAPHRI), Department of Social Medicine, Maastricht University, Maastricht, Netherlands,Care and Public Health Research Institute (CAPHRI), Department of Medical Microbiology, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Nicole H. T. M. Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands,Care and Public Health Research Institute (CAPHRI), Department of Health Promotion, Maastricht University, Maastricht, Netherlands
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van der Scheer JW, Ansari A, McLaughlin M, Cox C, Liddell K, Burt J, George J, Kenny R, Cousens R, Leach B, McGowan J, Morley K, Willars J, Dixon-Woods M. Guiding organisational decision-making about COVID-19 asymptomatic testing in workplaces: mixed-method study to inform an ethical framework. BMC Public Health 2022; 22:1747. [PMID: 36109810 PMCID: PMC9476340 DOI: 10.1186/s12889-022-13993-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/08/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Workplace programmes to test staff for asymptomatic COVID-19 infection have become common, but raise a number of ethical challenges. In this article, we report the findings of a consultation that informed the development of an ethical framework for organisational decision-making about such programmes. METHODS We conducted a mixed-method consultation - a survey and semi-structured interviews during November-December 2020 in a UK case study organisation that had introduced asymptomatic testing for all staff working on-site in its buildings. Analysis of closed-ended survey data was conducted descriptively. An analysis approach based on the Framework Method was used for the open-ended survey responses and interview data. The analyses were then integrated to facilitate systematic analysis across themes. Inferences were based on the integrated findings and combined with other inputs (literature review, ethical analysis, legal and public health guidance, expert discussions) to develop an ethical framework. RESULTS The consultation involved 61 staff members from the case study organisation (50 survey respondents and 11 interview participants). There was strong support for the asymptomatic testing programme: 90% of the survey respondents viewed it as helpful or very helpful. Open-ended survey responses and interviews gave insight into participants' concerns, including those relating to goal drift, risk of false negatives, and potential negative impacts for household members and people whose roles lacked contractual and financial stability. Integration of the consultation findings and the other inputs identified the importance of a whole-system approach with appropriate support for the key control measure of isolation following positive tests. The need to build trust in the testing programme, for example through effective communication from leaders, was also emphasised. CONCLUSIONS The consultation, together with other inputs, informed an ethical framework intended to support employers. The framework may support organisational decision-making in areas ranging from design and operation of the programme through to choices about participation. The framework is likely to benefit from further consultation and refinement in new settings.
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Affiliation(s)
- Jan W. van der Scheer
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Akbar Ansari
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Meredith McLaughlin
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
- Homerton College, Hills Rd, Cambridge, CB2 8PH UK
| | - Caitríona Cox
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Kathleen Liddell
- Faculty of Law, The David Williams Building, 10 West Rd, Cambridge, CB3 9DZ UK
| | - Jenni Burt
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Jenny George
- RAND Europe, Westbrook Centre/Milton Rd, Cambridge, CB4 1YG UK
| | - Rebecca Kenny
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Ruth Cousens
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Brandi Leach
- RAND Europe, Westbrook Centre/Milton Rd, Cambridge, CB4 1YG UK
| | - James McGowan
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | | | - Janet Willars
- Department of Health Sciences, University of Leicester, George Davies Centre, University Road, Leicester, LE1 7RH UK
| | - Mary Dixon-Woods
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
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Duckett S. Public Health Management of the COVID-19 Pandemic in Australia: The Role of the Morrison Government. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10400. [PMID: 36012035 PMCID: PMC9407931 DOI: 10.3390/ijerph191610400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 05/24/2023]
Abstract
The Australian Commonwealth government has four health-related responsibilities during the SARS-CoV-2 pandemic: to provide national leadership; to manage external borders; to protect residents of residential aged care facilities; and to approve, procure and roll-out tests and vaccines. State governments are responsible for determining what public health measures are appropriate and implementing them-including managing the border quarantine arrangements and the testing, tracing, and isolation regime-and managing the hospital response. This paper analyses the national government's response to the pandemic and discusses why it has attracted a thesaurus of negative adjectives.
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Affiliation(s)
- Stephen Duckett
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
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The impact of an enhanced health surveillance system for COVID-19 management in Serrana, Brazil. PUBLIC HEALTH IN PRACTICE 2022; 4:100301. [PMID: 35946045 PMCID: PMC9354446 DOI: 10.1016/j.puhip.2022.100301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 01/03/2023] Open
Abstract
Objective To describe the successful implementation of an enhanced public health surveillance system based on early detection, tracing contacts, and patient follow-up and support. Study design A prospective observational cohort study conducted in Serrana, São Paulo State, Brazil. Methods The implementation was based on four axes: increasing the access to SARS-CoV-2 testing; correct swab collection; testing patients with mild symptoms; and patient follow-up. Positivity rate, patient demographic and clinical characteristics, dynamics of disease severity, SARS-CoV-2 genome evolution, and the impact on COVID-19 research were assessed from August 23, 2020 to February 6, 2021 (between epidemiological week 35/2020 and 5/2021, a total of 24 weeks). Results The number of sites collecting rt-PCR for SARS-CoV-2 was increased from one to seven points and staff was trained in the correct use of personal protective equipment and in the swab collection technique. During the study period, 6728 samples were collected from 6155 participants vs. 2770 collections in a similar period before. SARS-CoV-2 RNA was detected in 1758 (26.1%) swabs vs. 1117 (36.7%) before the implementation of the surveillance system (p < 0.001). Positivity rates varied widely between epidemiological weeks 35/2020 and 5/2021 (IQR, 12.8%-31.3%). Out of COVID-19 patients, 91.1% were adults at a median age of 35 years (IQR, 25-50 years), 42.6% were men and 57.4% were women, with a SARS-CoV-2 positivity rate of 28.6% and 24.4% (p < 0.001), respectively. The most common symptoms were headache (72.6%), myalgia (65.0%), and cough (61.7%). Comorbidities were found in 20.8% of patients, the most common being hypertension and diabetes. According to the World Health Organization clinical progression scale, 93.5% of patients had mild disease, 1.6% were hospitalized with moderate disease, 3.2% were hospitalized with severe disease, and 1.4% died. The enhanced surveillance system led to the development of COVID-19 related research. Conclusions The enhanced surveillance system in Serrana improved COVID-19 understanding and management. By integrating community and academic institutions, it was possible to monitor SARS-CoV-2 positive cases and variants, follow the epidemic trend, guide patients, and develop relevant research projects.
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Greer SL, Falkenbach M, Siciliani L, McKee M, Wismar M, Figueras J. From Health in All Policies to Health for All Policies. Lancet Public Health 2022; 7:e718-e720. [PMID: 35907422 PMCID: PMC9330081 DOI: 10.1016/s2468-2667(22)00155-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 12/14/2022]
Abstract
Worldwide responses to the COVID-19 pandemic have shown that it is possible for politicians to come together across departmental boundaries. To this end, in many countries, heads of government and their health ministers work closely with all other ministries, departments, and sectors, including social affairs, internal affairs, foreign affairs, research and education, transport, agriculture, business, and state aid. In this Viewpoint, we ask if and how the Sustainable Development Goals (SDGs) can support intersectoral collaboration to promote health, since governments have already committed to achieving them. We contend that SDGs can do so, ultimately advancing health while offering co-benefits across society.
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Affiliation(s)
- Scott L Greer
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
| | - Michelle Falkenbach
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY, USA,Correspondence to: Dr Michelle Falkenbach, Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA
| | - Luigi Siciliani
- Department of Economics and Related Studies, University of York, York, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthias Wismar
- European Observatory on Health Systems and Policies, Brussels, Belgium
| | - Josep Figueras
- European Observatory on Health Systems and Policies, Brussels, Belgium
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21
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Makhlouf MD. Stemming the Shadow Pandemic: Integrating Sociolegal Services in Contact Tracing and Beyond. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2022; 50:719-725. [PMID: 36883384 PMCID: PMC10009374 DOI: 10.1017/jme.2023.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has shed light on the challenges of complying with public health guidance to isolate or quarantine without access to adequate income, housing, food, and other resources. When people cannot safely isolate or quarantine during an outbreak of infectious disease, a critical public health strategy fails. This article proposes integrating sociolegal needs screening and services into contact tracing as a way to mitigate public health harms and pandemic-related health inequities.
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Affiliation(s)
- Medha D Makhlouf
- PENNSYLVANIA STATE UNIVERSITY, DICKINSON SCHOOL OF LAW, CARLISLE, PA, USA
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