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Degeling C, Leask J, Attwell K, Wood N, Braunack‐Mayer A, Wiley K, Ward P, Carter SM. Public values to guide childhood vaccination mandates: A report on four Australian community juries. Health Expect 2024; 27:e13936. [PMID: 39102740 PMCID: PMC10753634 DOI: 10.1111/hex.13936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 08/07/2024] Open
Abstract
OBJECTIVE Governments use vaccination mandates, of different degrees of coerciveness, to encourage or require childhood vaccination. We elicited the views of well-informed community members on the public acceptability of using childhood vaccination mandates in Australia. METHODS Four community juries were conducted in Canberra, Launceston, Cairns and Melbourne, Australia between 2021 and 2022. We recruited 51 participants from diverse backgrounds, genders and ages through random digit dialling and social media. Two juries were held in metropolitan areas, and two in regional/rural settings. Outcome measures included jury verdicts and reasons in response to structured questions. RESULTS All juries were concerned about collective protection and individual rights but prioritised the former over the latter. A majority in all juries supported mandates but juries disagreed with respect to the appropriate mandate types. All juries endorsed using the least restrictive or coercive means to encourage vaccination (providing incentives or education, e.g.) before imposing penalties such as financial losses and school exclusions. The overriding view was that it is fairer to place a direct burden on parents rather than children and that mandates should be designed to avoid inequitable impacts on less advantaged groups in society. Many jurors found conscientious objection acceptable as a controlled option for resolute refusers, provided that overall vaccination coverage remains high. CONCLUSION This paper gives policymakers access to the reasons that Australians have for supporting or opposing different mandates under conditions of high knowledge, understanding and deliberation regarding policy options. Sustaining high rates of vaccination requires high levels of co-operation between governments, public health actors and the public. Our findings highlight the importance of considering public values in the design and implementation of vaccination mandates. PATIENT AND PUBLIC INVOLVEMENT We sought input from individuals who did and did not vaccinate during the study design. The views and perspectives of nonvaccinating parents were presented in the evidence to juries. We deliberately excluded nonvaccinating individuals from participating, as the divisive and often hostile nature of the topic, and their minority status, made it difficult to ensure they would feel safe as members of the jury without overrepresenting their perspective in the sample. Two related projects engaged directly with these parents.
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Affiliation(s)
- Chris Degeling
- The Faculty of Arts, Social Sciences and Humanities, Australian Centre for Health Engagement, Evidence and ValuesUniversity of WollongongWollongongNew South WalesAustralia
| | - Julie Leask
- Faculty of Medicine and Health, School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Katie Attwell
- School of Social SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Nicholas Wood
- National Centre for Immunisation Research and SurveillanceWestmeadNew South WalesAustralia
| | - Annette Braunack‐Mayer
- The Faculty of Arts, Social Sciences and Humanities, Australian Centre for Health Engagement, Evidence and ValuesUniversity of WollongongWollongongNew South WalesAustralia
| | - Kerrie Wiley
- Faculty of Medicine and Health, School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Paul Ward
- Research Centre for Public Health, Equity and Human FlourishingTorrens University AustraliaAdelaideSouth AustraliaAustralia
| | - Stacy M. Carter
- The Faculty of Arts, Social Sciences and Humanities, Australian Centre for Health Engagement, Evidence and ValuesUniversity of WollongongWollongongNew South WalesAustralia
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AlKnawy B, Kozlakidis Z, Tarkoma S, Bates D, Honkela A, Crooks G, Rhee K, McKillop M. Digital public health leadership in the global fight for health security. BMJ Glob Health 2023; 8:bmjgh-2022-011454. [PMID: 36792230 PMCID: PMC9933676 DOI: 10.1136/bmjgh-2022-011454] [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: 12/05/2022] [Accepted: 02/03/2023] [Indexed: 02/17/2023] Open
Abstract
The COVID-19 pandemic highlighted the need to prioritise mature digital health and data governance at both national and supranational levels to guarantee future health security. The Riyadh Declaration on Digital Health was a call to action to create the infrastructure needed to share effective digital health evidence-based practices and high-quality, real-time data locally and globally to provide actionable information to more health systems and countries. The declaration proposed nine key recommendations for data and digital health that need to be adopted by the global health community to address future pandemics and health threats. Here, we expand on each recommendation and provide an evidence-based roadmap for their implementation. This policy document serves as a resource and toolkit that all stakeholders in digital health and disaster preparedness can follow to develop digital infrastructure and protocols in readiness for future health threats through robust digital public health leadership.
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Affiliation(s)
- Bandar AlKnawy
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Sasu Tarkoma
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - David Bates
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Antti Honkela
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - George Crooks
- Digital Health and Care Innovation Centre, Glasgow, UK
| | - Kyu Rhee
- CVS Health Corp, Woonsocket, Rhode Island, USA
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Meumann EM, Krause VL, Baird R, Currie BJ. Using Genomics to Understand the Epidemiology of Infectious Diseases in the Northern Territory of Australia. Trop Med Infect Dis 2022; 7:tropicalmed7080181. [PMID: 36006273 PMCID: PMC9413455 DOI: 10.3390/tropicalmed7080181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
The Northern Territory (NT) is a geographically remote region of northern and central Australia. Approximately a third of the population are First Nations Australians, many of whom live in remote regions. Due to the physical environment and climate, and scale of social inequity, the rates of many infectious diseases are the highest nationally. Molecular typing and genomic sequencing in research and public health have provided considerable new knowledge on the epidemiology of infectious diseases in the NT. We review the applications of genomic sequencing technology for molecular typing, identification of transmission clusters, phylogenomics, antimicrobial resistance prediction, and pathogen detection. We provide examples where these methodologies have been applied to infectious diseases in the NT and discuss the next steps in public health implementation of this technology.
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Affiliation(s)
- Ella M. Meumann
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
- Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin 0810, Australia
- Correspondence:
| | - Vicki L. Krause
- Northern Territory Centre for Disease Control, Northern Territory Government, Darwin 0810, Australia
| | - Robert Baird
- Territory Pathology, Royal Darwin Hospital, Darwin 0810, Australia
| | - Bart J. Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
- Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin 0810, Australia
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Degeling C, Hall J, Johnson J, Abbas R, Bag S, Gilbert GL. Should Digital Contact Tracing Technologies be used to Control COVID-19? Perspectives from an Australian Public Deliberation. HEALTH CARE ANALYSIS 2021; 30:97-114. [PMID: 34697720 PMCID: PMC8545621 DOI: 10.1007/s10728-021-00441-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
Mobile phone-based applications (apps) can promote faster targeted actions to control COVID-19. However, digital contact tracing systems raise concerns about data security, system effectiveness, and their potential to normalise privacy-invasive surveillance technologies. In the absence of mandates, public uptake depends on the acceptability and perceived legitimacy of using technologies that log interactions between individuals to build public health capacity. We report on six online deliberative workshops convened in New South Wales to consider the appropriateness of using the COVIDSafe app to enhance Australian contact tracing systems. All groups took the position (by majority) that the protections enacted in the app design and supporting legislation were appropriate. This support is contingent on several system attributes including: the voluntariness of the COVIDSafe app; that the system relies on proximity rather than location tracking; and, that data access is restricted to local public health practitioners undertaking contact tracing. Despite sustained scepticism in media coverage, there was an underlying willingness to trust Australian governing institutions such that in principle acceptance of the new contact tracing technology was easy to obtain. However, tensions between the need to prove system effectiveness through operational transparency and requirements for privacy protections could be limiting public uptake. Our study shows that informed citizens are willing to trade their privacy for common goods such as COVID-19 suppression. But low case numbers and cautionary public discourses can make trustworthiness difficult to establish because some will only do so when it can be demonstrated that the benefits justify the costs to individuals.
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Affiliation(s)
- Chris Degeling
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, Wollongong, Australia.
| | - Julie Hall
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, Wollongong, Australia
| | - Jane Johnson
- Department of Philosophy, Macquarie University, Sydney, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| | - Roba Abbas
- Faculty of Business and Law, University of Wollongong, Wollongong, Australia
| | - Shopna Bag
- Western Sydney Local Health District, NSW Health, Sydney, Australia
| | - Gwendolyn L Gilbert
- Sydney Health Ethics, University of Sydney, Sydney, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
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5
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Zhao IY, Ma YX, Yu MWC, Liu J, Dong WN, Pang Q, Lu XQ, Molassiotis A, Holroyd E, Wong CWW. Ethics, Integrity, and Retributions of Digital Detection Surveillance Systems for Infectious Diseases: Systematic Literature Review. J Med Internet Res 2021; 23:e32328. [PMID: 34543228 PMCID: PMC8530254 DOI: 10.2196/32328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 01/27/2023] Open
Abstract
Background The COVID-19 pandemic has increased the importance of the deployment of digital detection surveillance systems to support early warning and monitoring of infectious diseases. These opportunities create a “double-edge sword,” as the ethical governance of such approaches often lags behind technological achievements. Objective The aim was to investigate ethical issues identified from utilizing artificial intelligence–augmented surveillance or early warning systems to monitor and detect common or novel infectious disease outbreaks. Methods In a number of databases, we searched relevant articles that addressed ethical issues of using artificial intelligence, digital surveillance systems, early warning systems, and/or big data analytics technology for detecting, monitoring, or tracing infectious diseases according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and further identified and analyzed them with a theoretical framework. Results This systematic review identified 29 articles presented in 6 major themes clustered under individual, organizational, and societal levels, including awareness of implementing digital surveillance, digital integrity, trust, privacy and confidentiality, civil rights, and governance. While these measures were understandable during a pandemic, the public had concerns about receiving inadequate information; unclear governance frameworks; and lack of privacy protection, data integrity, and autonomy when utilizing infectious disease digital surveillance. The barriers to engagement could widen existing health care disparities or digital divides by underrepresenting vulnerable and at-risk populations, and patients’ highly sensitive data, such as their movements and contacts, could be exposed to outside sources, impinging significantly upon basic human and civil rights. Conclusions Our findings inform ethical considerations for service delivery models for medical practitioners and policymakers involved in the use of digital surveillance for infectious disease spread, and provide a basis for a global governance structure. Trial Registration PROSPERO CRD42021259180; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259180
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Affiliation(s)
- Ivy Y Zhao
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ye Xuan Ma
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Man Wai Cecilia Yu
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jia Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Wei Nan Dong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Qin Pang
- Department of Information Technology, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Xiao Qin Lu
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Alex Molassiotis
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Eleanor Holroyd
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Chi Wai William Wong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Department of Family Medicine and Primary Care, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
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6
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Diallo G, Bordea G. Public Health and Epidemiology Informatics: Recent Research Trends. Yearb Med Inform 2021; 30:280-282. [PMID: 34479398 PMCID: PMC8416213 DOI: 10.1055/s-0041-1726530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To introduce and analyse current trends in Public Health and Epidemiology Informatics. METHODS PubMed search of 2020 literature on public health and epidemiology informatics was conducted and all retrieved references were reviewed by the two section editors. Then, 15 candidate best papers were selected among the 920 references. These papers were then peer-reviewed by the two section editors, two chief editors, and external reviewers, including at least two senior faculty, to allow the Editorial Committee of the 2021 International Medical Informatics Association (IMIA) Yearbook to make an informed decision regarding the selection of the best papers. RESULTS Among the 920 references retrieved from PubMed, four were suggested as best papers and the first three were finally selected. The fourth paper was excluded because of reproducibility issues. The first best paper is a very public health focused paper with health informatics and biostatistics methods applied to stratify patients within a cohort in order to identify those at risk of suicide; the second paper describes the use of a randomized design to test the likely impact of fear-based messages, with and without empowering self-management elements, on patient consultations or antibiotic requests for influenza-like illnesses. The third selected paper evaluates the perception among communities of routine use of Whole Genome Sequencing and Big Data technologies to capture more detailed and specific personal information. CONCLUSIONS The findings from the three studies suggest that using Public Health and Epidemiology Informatics methods could leverage, when combined with Deep Learning, early interventions and appropriate treatments to mitigate suicide risk. Further, they also demonstrate that well informing and empowering patients could help them to be involved more in their care process.
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Affiliation(s)
- Gayo Diallo
- INRIA SISTM, Team ERIAS - INSERM Bordeaux Population Health Research Center, Univ. Bordeaux, Bordeaux, France
| | - Georgeta Bordea
- INRIA SISTM, Team ERIAS - INSERM Bordeaux Population Health Research Center, Univ. Bordeaux, Bordeaux, France.,Team ERIAS - INSERM BPH Research Center & LaBRI UMR 5800, Univ. Bordeaux, Bordeaux, France
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Ferdinand AS, Kelaher M, Lane CR, da Silva AG, Sherry NL, Ballard SA, Andersson P, Hoang T, Denholm JT, Easton M, Howden BP, Williamson DA. An implementation science approach to evaluating pathogen whole genome sequencing in public health. Genome Med 2021; 13:121. [PMID: 34321076 PMCID: PMC8317677 DOI: 10.1186/s13073-021-00934-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 07/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pathogen whole genome sequencing (WGS) is being incorporated into public health surveillance and disease control systems worldwide and has the potential to make significant contributions to infectious disease surveillance, outbreak investigation and infection prevention and control. However, to date, there are limited data regarding (i) the optimal models for integration of genomic data into epidemiological investigations and (ii) how to quantify and evaluate public health impacts resulting from genomic epidemiological investigations. METHODS We developed the Pathogen Genomics in Public HeAlth Surveillance Evaluation (PG-PHASE) Framework to guide examination of the use of WGS in public health surveillance and disease control. We illustrate the use of this framework with three pathogens as case studies: Listeria monocytogenes, Mycobacterium tuberculosis and SARS-CoV-2. RESULTS The framework utilises an adaptable whole-of-system approach towards understanding how interconnected elements in the public health application of pathogen genomics contribute to public health processes and outcomes. The three phases of the PG-PHASE Framework are designed to support understanding of WGS laboratory processes, analysis, reporting and data sharing, and how genomic data are utilised in public health practice across all stages, from the decision to send an isolate or sample for sequencing to the use of sequence data in public health surveillance, investigation and decision-making. Importantly, the phases can be used separately or in conjunction, depending on the need of the evaluator. Subsequent to conducting evaluation underpinned by the framework, avenues may be developed for strategic investment or interventions to improve utilisation of whole genome sequencing. CONCLUSIONS Comprehensive evaluation is critical to support health departments, public health laboratories and other stakeholders to successfully incorporate microbial genomics into public health practice. The PG-PHASE Framework aims to assist public health laboratories, health departments and authorities who are either considering transitioning to whole genome sequencing or intending to assess the integration of WGS in public health practice, including the capacity to detect and respond to outbreaks and associated costs, challenges and facilitators in the utilisation of microbial genomics and public health impacts.
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Affiliation(s)
- Angeline S Ferdinand
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
| | - Margaret Kelaher
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Courtney R Lane
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Anders Gonçalves da Silva
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Norelle L Sherry
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Susan A Ballard
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Patiyan Andersson
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Tuyet Hoang
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Justin T Denholm
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, Australia
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | | | - Benjamin P Howden
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Deborah A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
- Department of Microbiology, Royal Melbourne Hospital, Melbourne, Australia.
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8
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Envisioning a learning surveillance system for tuberculosis. PLoS One 2020; 15:e0243610. [PMID: 33315902 PMCID: PMC7735594 DOI: 10.1371/journal.pone.0243610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/25/2020] [Indexed: 12/25/2022] Open
Abstract
Surveillance is critical for interrupting transmission of global epidemics. Research has highlighted gaps in the surveillance for tuberculosis that range from failure to collect real-time data to lack of standardization of data for informed decision-making at different levels of the health system. Our research aims to advance conceptual and methodological foundations for the development of a learning surveillance system for Tuberculosis, that involves systematic collection, analysis, interpretation, and feedback of outcome-specific data. It would concurrently involve the health care delivery system, public health laboratory, and epidemiologists. For our study, we systemically framed the cyber environment of TB surveillance as an ontology of the learning surveillance system. We validated the ontology by binary coding of dimensions and elements of the ontology with the metadata from an existing surveillance platform—GPMS TB Transportal. Results show GPMS TB Transportal collects a critical range of data for active case investigation and presumptive case screening for identifying and detecting confirmed TB cases. It is therefore targeted at assisting the Active Case Finding program. Building on the results, we demonstrate enhanced surveillance strategies for GPMS that are enumerated as pathways in the ontology. Our analysis reveals the scope for embedding learning surveillance pathways for digital applications in Direct Benefit Transfer, and Drug Resistance Treatment in National TB Elimination Programme in India. We discuss the possibilities of developing the transportal into a multi-level computer-aided decision support system for TB, using the innumerable pathways encapsulated in the ontology.
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9
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Degeling C, Chen G, Gilbert GL, Brookes V, Thai T, Wilson A, Johnson J. Changes in public preferences for technologically enhanced surveillance following the COVID-19 pandemic: a discrete choice experiment. BMJ Open 2020; 10:e041592. [PMID: 33208337 PMCID: PMC7677347 DOI: 10.1136/bmjopen-2020-041592] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/18/2020] [Accepted: 10/29/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES As governments attempt to navigate a path out of COVID-19 restrictions, robust evidence is essential to inform requirements for public acceptance of technologically enhanced communicable disease surveillance systems. We examined the value of core surveillance system attributes to the Australian public, before and during the early stages of the current pandemic. DESIGN A discrete choice experiment was conducted in Australia with a representative group of respondents, before and after the WHO declared COVID-19 a Public Health Emergency of International Concern. We identified and investigated the relative importance of seven attributes associated with technologically enhanced disease surveillance: respect for personal autonomy; privacy/confidentiality; data certainty/confidence; data security; infectious disease mortality prevention; infectious disease morbidity prevention; and attribution of (causal) responsibility. Specifically, we explored how the onset of the COVID-19 outbreak influenced participant responses. SETTING AND PARTICIPANTS 2008 Australians (general public) completed the experiment: 793 before COVID-19 outbreak onset (mean age 45.9 years, 50.2% male) and 1215 after onset (mean age 47.2 years, 49% male). RESULTS All seven attributes significantly influenced respondents' preferences for communicable disease surveillance systems. After onset, participants demonstrated greater preference for a surveillance system that could prevent a higher number of illnesses and deaths, and were less concerned about their personal autonomy. However, they also increased their preference for a system with high data security. CONCLUSIONS Public acceptance of technology-based communicable disease surveillance is situation dependent. During an epidemic, there is likely to be greater tolerance of technologically enhanced disease surveillance systems that result in restrictions on personal activity if such systems can prevent high morbidity and mortality. However, this acceptance of lower personal autonomy comes with an increased requirement to ensure data security. These findings merit further research as the pandemic unfolds and strategies are put in place that enable individuals and societies to live with SARS-CoV-2 endemicity.
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Affiliation(s)
- Chris Degeling
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, Wollongong, New South Wales, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Caufield East, Victoria, Australia
| | - Gwendolyn L Gilbert
- Sydney Health Ethics, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Marie Bashir Institute for Emerging Infectious Disease and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Victoria Brookes
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Thi Thai
- Centre for Health Economics, Monash Business School, Monash University, Caufield East, Victoria, Australia
| | - Andrew Wilson
- Menzies Centre for Health Policy, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Johnson
- Marie Bashir Institute for Emerging Infectious Disease and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
- Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia
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10
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Habersaat KB, Betsch C, Danchin M, Sunstein CR, Böhm R, Falk A, Brewer NT, Omer SB, Scherzer M, Sah S, Fischer EF, Scheel AE, Fancourt D, Kitayama S, Dubé E, Leask J, Dutta M, MacDonald NE, Temkina A, Lieberoth A, Jackson M, Lewandowsky S, Seale H, Fietje N, Schmid P, Gelfand M, Korn L, Eitze S, Felgendreff L, Sprengholz P, Salvi C, Butler R. Ten considerations for effectively managing the COVID-19 transition. Nat Hum Behav 2020; 4:677-687. [PMID: 32581299 DOI: 10.1038/s41562-020-0906-x] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022]
Abstract
Governments around the world have implemented measures to manage the transmission of coronavirus disease 2019 (COVID-19). While the majority of these measures are proving effective, they have a high social and economic cost, and response strategies are being adjusted. The World Health Organization (WHO) recommends that communities should have a voice, be informed and engaged, and participate in this transition phase. We propose ten considerations to support this principle: (1) implement a phased approach to a 'new normal'; (2) balance individual rights with the social good; (3) prioritise people at highest risk of negative consequences; (4) provide special support for healthcare workers and care staff; (5) build, strengthen and maintain trust; (6) enlist existing social norms and foster healthy new norms; (7) increase resilience and self-efficacy; (8) use clear and positive language; (9) anticipate and manage misinformation; and (10) engage with media outlets. The transition phase should also be informed by real-time data according to which governmental responses should be updated.
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Affiliation(s)
| | - Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences, Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Margie Danchin
- The University of Melbourne and Murdoch Children's Research Institute, Royal Children's Hospital, Victoria, Australia
| | | | - Robert Böhm
- Department of Psychology, Department of Economics, and Copenhagen Center for Social Data Science (SODAS), University of Copenhagen, Copenhagen, Denmark
| | - Armin Falk
- University of Bonn and Institute on Behavior and Inequality (BRIQ), Bonn, Germany
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Saad B Omer
- Yale Institute for Global Health, Department of Internal Medicine (Infectious Diseases), Yale School of Medicine, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale School of Nursing, New Haven, CT, USA
| | - Martha Scherzer
- WHO Regional Office for Europe, Insights Unit, Copenhagen, Denmark
| | - Sunita Sah
- Cambridge Judge Business School, Cambridge University, Cambridge, UK
| | - Edward F Fischer
- Department of Anthropology, Vanderbilt University, Nashville, TN, USA
| | - Andrea E Scheel
- WHO Regional Office for Europe, Insights Unit, Copenhagen, Denmark
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
| | - Shinobu Kitayama
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Eve Dubé
- Département d'Anthropologie, Université Laval, Québec City, Québec, Canada
| | - Julie Leask
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mohan Dutta
- Center for Culture-Centered Approach to Research and Evaluation (CARE), Massey University, Aotearoa, New Zealand
| | - Noni E MacDonald
- Department of Paediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anna Temkina
- Department of Sociology, European University of St. Petersburg, St, Petersburg, Russia
| | - Andreas Lieberoth
- Danish School of Education, Interacting Minds Center, Aarhus University, Aarhus, Denmark
| | - Mark Jackson
- Wellcome Centre for Cultures and Environments of Health and WHO Collaborating Centre on Culture and Health, University of Exeter, Exeter, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- University of Western Australia, Perth, Western Australia, Australia
| | - Holly Seale
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Nils Fietje
- WHO Regional Office for Europe, Insights Unit, Copenhagen, Denmark
| | - Philipp Schmid
- Department of Psychology, University of Erfurt, Erfurt, Germany
| | - Michele Gelfand
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Lars Korn
- Center for Empirical Research in Economics and Behavioral Sciences, Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Sarah Eitze
- Center for Empirical Research in Economics and Behavioral Sciences, Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Lisa Felgendreff
- Center for Empirical Research in Economics and Behavioral Sciences, Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Philipp Sprengholz
- Center for Empirical Research in Economics and Behavioral Sciences, Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Cristiana Salvi
- WHO Regional Office for Europe, Insights Unit, Copenhagen, Denmark
| | - Robb Butler
- WHO Regional Office for Europe, Insights Unit, Copenhagen, Denmark
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