1
|
Savaskan N, Lampl BMJ, Yavuz M, Tinnemann P. Germany's national public health gets reorganized: A new institute shall take center stage. Health Policy 2024; 145:105084. [PMID: 38824830 DOI: 10.1016/j.healthpol.2024.105084] [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: 03/08/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
In the aftermath of the COVID-19 pandemic, the German federal government recently orchestrated a fundamental change to its public health infrastructure. This reconstruction centers around the founding of a National Institute for Prevention and Education in Medicine (Bundesinstitut für Prävention und Aufklärung in der Medizin, BIPAM) at the cost of two federal institutions, the Robert Koch-Institute (RKI) and the Federal Center for Health Education (Bundeszentrale für gesundheitliche Aufklärung, BzGA). Thus, the Federal Ministry of Health (Bundesministerium für Gesundheit, BMG) plans to dissolve the BzGA and integrate its personnel into the future BIPAM. Further, all RKI research and surveillance activities related to non-communicable diseases, including AI methods development will be transferred into the BIPAM. The RKI responsibilities will solely focus on infectious diseases. According to announced plans of the BMG the primary objective for establishing the BIPAM is to address non-communicable diseases and enhance overall population health. However, the medical specialist training for public health remains non-academic at a state institution. Simultaneously the BMG already replaced two thirds of experts of the permanent commission on vaccination (Ständige Impfkommission, STIKO) and determined new procedures for appointing future expert commissioners. With these changes, Germany embarks on an extraordinary reshuffling of its national public health organizations and responsibilities, by fundamentally separating all issues around non-communicable diseases from those of infectious diseases. Germany's unraveled research tasks of public health authorities however remains unmet. Thus, 2024 marks a pivotal caesura for public health in the modern history of Germany.
Collapse
Affiliation(s)
- Nicolai Savaskan
- Gesundheitsamt Neukölln (Public Health Authority Neukölln), Berlin-Neukölln, Germany.
| | - Benedikt M J Lampl
- Gesundheitsamt Regensburg, Regensburg, Germany; Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg, Germany
| | - Mesut Yavuz
- YES Automation-Process Management Consulting, Nürnberg, Germany
| | - Peter Tinnemann
- Gesundheitsamt Frankfurt am Main, Frankfurt am Main, Germany; Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
2
|
Yavuz M, Savaskan N. A European roadmap to a digital epidemiology in public health system. Front Digit Health 2024; 6:1284426. [PMID: 38707196 PMCID: PMC11066199 DOI: 10.3389/fdgth.2024.1284426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 03/27/2024] [Indexed: 05/07/2024] Open
Affiliation(s)
- Mesut Yavuz
- Process and Organisational Analysis (IT), YES Automation-Process Management Consulting, Nürnberg, Germany
| | - Nicolai Savaskan
- Department of Public Health Neukölln, District Office Neukölln, Berlin, Germany
| |
Collapse
|
3
|
Gilmour S, Sapounas S, Drakopoulos K, Jaillet P, Magiorkinis G, Trichakis N. On the impact of mass screening for SARS-CoV-2 through self-testing in Greece. Front Public Health 2024; 12:1352238. [PMID: 38510354 PMCID: PMC10950936 DOI: 10.3389/fpubh.2024.1352238] [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: 12/07/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Background Screening programs that pre-emptively and routinely test population groups for disease at a massive scale were first implemented during the COVID-19 pandemic in a handful of countries. One of these countries was Greece, which implemented a mass self-testing program during 2021. In contrast to most other non-pharmaceutical interventions (NPIs), mass self-testing programs are particularly attractive for their relatively small financial and social burden, and it is therefore important to understand their effectiveness to inform policy makers and public health officials responding to future pandemics. This study aimed to estimate the number of deaths and hospitalizations averted by the program implemented in Greece and evaluate the impact of several operational decisions. Methods Granular data from the mass self-testing program deployed by the Greek government between April and December 2021 were obtained. The data were used to fit a novel compartmental model that was developed to describe the dynamics of the COVID-19 pandemic in Greece in the presence of self-testing. The fitted model provided estimates on the effectiveness of the program in averting deaths and hospitalizations. Sensitivity analyses were used to evaluate the impact of operational decisions, including the scale of the program, targeting of sub-populations, and sensitivity (i.e., true positive rate) of tests. Results Conservative estimates show that the program reduced the reproduction number by 4%, hospitalizations by 25%, and deaths by 20%, translating into approximately 20,000 averted hospitalizations and 2,000 averted deaths in Greece between April and December 2021. Conclusion Mass self-testing programs are efficient NPIs with minimal social and financial burden; therefore, they are invaluable tools to be considered in pandemic preparedness and response.
Collapse
Affiliation(s)
- Samuel Gilmour
- Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, United States
| | | | - Kimon Drakopoulos
- Department of Data Sciences and Operations, Marshall School of Business, University of Southern California, Los Angeles, CA, United States
| | - Patrick Jaillet
- Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Trichakis
- Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, United States
| |
Collapse
|
4
|
Hao F, Zhang Z, Lau SSS, Chiang SK, Zhou D, Tan W, Tang X, Ho R. The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China. Front Public Health 2024; 11:1319906. [PMID: 38249361 PMCID: PMC10796473 DOI: 10.3389/fpubh.2023.1319906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Background This study aimed to report the prevalence of COVID-19 over-concern and its associated factors after the relaxation of the health-protective measures in China. Methods A team of seven experts in psychiatry and psychology specializing in COVID-19 mental health research from China, Hong Kong, and overseas reached a consensus on the diagnostic criteria for COVID-19 over-concern. Individuals had to meet at least five of the following criteria: (1) at least five physical symptoms; (2) stocking up at least five items related to protecting oneself during the COVID-19 pandemic; (3) obsessive-compulsive symptoms related to the COVID-19 pandemic; (4) illness anxiety related to the COVID-19 pandemic; (5) post-traumatic stress symptoms; (6) depression; (7) anxiety; (8) stress and (9) insomnia. An online survey using snowball sampling collected data on demographics, medical history, views on COVID-19 policies, and symptoms of COVID-19 over-concern. Multivariate linear regression was performed using significant variables from the previous regressions as independent variables against the presence of COVID-19 over-concern as the dependent variable. Breush-Pagan test was used to assess each regression model for heteroskedasticity of residuals. Results 1,332 respondents from 31 regions in China participated in the study for 2 weeks from December 25 to 27, 2022, after major changes in the zero-COVID policy. After canceling measures associated with the dynamic zero-COVID policy, 21.2% of respondents fulfilled the diagnostic criteria for COVID-19 over-concern. Factors significantly associated with COVID-19 over-concern were poor self-rated health status (β = 0.07, p < 0.001), concerns about family members getting COVID-19 (β = 0.06, p < 0.001), perceived usefulness of COVID-19 vaccine (β = 0.03, p = 0.012), impact on incomes, employment and studies (β = 0.045, p < 0.001) and impact on families (β = 0.03, p = 0.01). Conclusion After removing measures associated with the dynamic zero-COVID policy in China, approximately one-fifth of respondents met the diagnostic criteria for COVID-19 over-concern.
Collapse
Affiliation(s)
- Fengyi Hao
- Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
- Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Zhisong Zhang
- Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Sam S. S. Lau
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
- Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
- College of International Education, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
- Institute of Bioresource and Agriculture, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Soon-Kiat Chiang
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dewen Zhou
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wanqiu Tan
- National University of Singapore (Chongqing) Research Institute, Chongqing, China
| | - Xiangdong Tang
- Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| |
Collapse
|