Highly infectious diseases in the Mediterranean Sea area: Inventory of isolation capabilities and recommendations for appropriate isolation

High-Level Isolation: A Landscape Analysis of Global Capabilities and Opportunities to Advance the Field

High-level isolation units (HLIUs) have been established by countries to provide safe and optimal medical care for patients with high-consequence infectious diseases. We aimed to identify global high-level isolation capabilities and determine gaps and priorities of global HLIUs, using a multiple method approach that included a systematic review of published and gray literature and a review of Joint External Evaluations and Global Health Security Index reports from 112 countries. A follow-up electronic survey was distributed to identified HLIUs. The landscape analysis found 44 previously designated/self-described HLIUs in 19 countries. An additional 33 countries had potential HLIUs; however, there were not enough details on capabilities to determine if they fit the HLIU definition. An electronic survey was distributed to 36 HLIUs to validate landscape analysis findings and to understand challenges, best practices, and priorities for increased networking with a global HLIU cohort; 31 (86%) HLIUs responded. Responses revealed an additional 30 confirmed HLIUs that were not identified in the landscape analysis. To our knowledge, this was the first mapping and the largest ever survey of global HLIUs. Survey findings identified major gaps in visibility of HLIUs: while our landscape analysis initially identified 44 units, the survey unveiled an additional 30 HLIUs that had not been previously identified or confirmed. The lack of formalized regional or global coordinating organizations exacerbates these visibility gaps. The unique characteristics and capabilities of these facilities, coupled with the likelihood these units serve as core components of national health security plans, provides an opportunity for increased connection and networking to advance the field of high-level isolation and address identified gaps in coordination, build an evidence base for HLIU approaches, and inform HLIU definitions and key components.

Infection surveillance measures during the COVID-19 pandemic in Germany

Introduction: To address the question as to which infection surveillance measures are used during the ongoing COVID-19 pandemic in Germany and how they differ from pre-existing approaches. Methods: In accordance with the systematic approach of a scoping review, a literature search was conducted in national and international medical literature databases using a search string. The search in the databases was limited to the period from 01.01.2000 to 15.11.2020 and has been subsequently completed by hand search until 08.03.2021. A hand search, even beyond 15.11.2020, seemed necessary and reasonable, since due to the dynamics of the ongoing COVID-19 pandemic, a large number of articles and regulations are being published very quickly at short notice. Results: The literature search resulted in the following number of hits in the databases listed below: PubMed: 165 articlesCochrane: 1 review and 35 studiesWeb of Science: 217 articlesRobert Koch Institute: 49 articles Thus, a total of 467 hits were identified, with a total of 124 hits being duplicates. From these, 138 articles were considered relevant to the COVID-19 infection surveillance situation in Germany based on established criteria. After reading the full texts, 92 articles and websites were ultimately included in the scoping review. Discussion: Many of the lessons learned from previous outbreaks seem to have been implemented in the infection surveillance measures during the ongoing COVID-19 pandemic in Germany. Most of the changes compared with previous measures were based on technological streamlining of existing procedures and changes and more inclusion of the population in different infection surveillance measures.

Facilities for Centralized Isolation and Quarantine for the Observation and Treatment of Patients with COVID-19

The coronavirus disease 2019 (COVID-19) pandemic increased the burden on many healthcare systems and in the process, exposed the need for medical resources and physical space. While few studies discussed the efficient utilization of medical resources and physical space so far. Therefore, this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases, suspected cases, and close contacts. In China, three types of facilities for centralized isolation (Fangcang shelter hospitals, refitted non-designated hospitals, and quarantine hotels) underwent retrofitting for the treatment and isolation of confirmed and suspected cases. These facilities mitigated the immediate high demand for space. Moreover, in order to minimize infection risks in these facilities, regulators and governmental agencies implemented new designs, management measures, and precautionary measures to minimize infection risk. Other countries and regions could refer to China's experience in optimally allocating social resources in response to the COVID-19 pandemic. As a conclusion, government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response, health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities, a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility, in-depth studies and international collaboration on the centralized isolation policy are encouraged.