At the End of Every Pandemic: Beginning a Pandemic Playbook to Respond to the Next

The world was unprepared for COVID-19. Pandemics can unfold quickly; faster than governments can respond, unless they have maintained a realistic pandemic playbook. As the world ahead becomes ever-more complex, such playbook becomes ever-more necessary. This article not only describes the importance of a pandemic playbook but also a system to maintain it. A pandemic playbook both (1) specifies what is needed to respond to a pandemic and (2) provides a lens through which to identify measures that will keep people safe and society secure. The plays in the book are thought-though policies and strategies and corresponding implementation plans. The process of developing a playbook is as important as the product. Any playbook must be fit for purpose in the context of the times in which it is to be used. Above all, it must contain realistic policies and plans that can actually be implemented and can realize their intended effects. Achieving this goal requires (1) repeatedly exercising the playbook so that people know what to do when they need to do it and (2) evaluating results and updating the playbook to keep it relevant and current. Necessarily, to bring ideas alive, this article illustrates them with reference to COVID-19 and earlier pandemics, but it is not intended as a playbook for responding to the next pandemic; nor a postmortem on responses to COVID-19. Instead, it describes actions to take now to be ready when the next global pandemic strikes, so that policy decision-makers will not be lamenting “we should have done that.”

A scoping review of research on the determinants of adherence to social distancing measures during the COVID-19 pandemic

This scoping review focused on answering key questions about the focus, quality and generalisability of the quantitative evidence on the determinants of adherence to social distancing measures in research during the first wave of COVID-19. The review included 84 studies. The majority of included studies were conducted in Western Europe and the USA. Many lacked theoretical input, were at risk for bias, and few were experimental in design. The most commonly coded domains of the TDF in the included studies were 'Environmental Context and Resources' (388 codes across 76 studies), 'Beliefs about Consequences' (34 codes across 21 studies), 'Emotion' (28 codes across 12 studies), and 'Social Influences' (26 codes across 16 studies). The least frequently coded TDF domains included 'Optimism' (not coded), 'Intentions' (coded once), 'Goals' (2 codes across 2 studies), 'Reinforcement' (3 codes across 2 studies), and 'Behavioural Regulation' (3 codes across 3 studies). Examining the focus of the included studies identified a lack of studies on potentially important determinants of adherence such as reinforcement, goal setting and self-monitoring. The quality of the included studies was variable and their generalisablity was threatened by their reliance on convenience samples.

Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview

Healthcare-associated infections (HCAIs) are a major source of morbidity and mortality and are the second most prevalent cause of death. Furthermore, it has been reported that for every one-hundred patients admitted to hospital, seven patients in high-income economies and ten in emerging and low-income economies acquire at least one type of HCAI. Currently, almost all pathogenic microorganisms have developed antimicrobial resistance, and few new antimicrobials are being developed and brought to market. The literature search for this narrative review was performed by searching bibliographic databases (including Google Scholar and PubMed) using the search terms: "Strategies," "Prevention," and "Healthcare-Associated Infections," followed by snowballing references cited by critical articles. We found that although hand hygiene is a centuries-old concept, it is still the primary strategy used around the world to prevent HCAIs. It forms one of a bundle of approaches used to clean and maintain a safe hospital environment and to stop the transmission of contagious and infectious microorganisms, including multidrug-resistant microbes. Finally, antibiotic stewardship also has a crucial role in reducing the impact of HCAIs through conserving currently available antimicrobials.

Empirical "integrated disease management" in Ferrara during the Italian plague (1629-1631)

Plague, a highly infective disease caused by Yersinia pestis (Proteobacteria: Enterobacteriales), ravaged Europe from 1347 over the course of more than 450 years. During the Italian Plague (1629-1631), the disease was rampaging in the entire Northern Italy down to Tuscany, but the city of Ferrara was relatively spared, in spite that the economic activities were maintained with highly affected cities, such as Milan, through the relevant salt commerce. The aim of the study is to evaluate the hygiene rules that were effective in preventing the spread of the plague in Ferrara in 1630, by examining historical documents and reports. According to these documents, a kind of empirical "integrated disease management" was carried out, using remedies including compounds with bactericidal, anti-parasite and repellent activity, and by technical strategies including avoidance of possible plague carriers. The anti-plague remedies and technical strategies used in ancient Ferrara are critically analysed using a multidisciplinary approach (pharmaceutic, medical, epidemiologic and entomological) and compared to current prevention protocols.