1
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Woodward A, Rivers C. The Role of US Federal Policy in Modernizing Public Health Agency Case Investigation and Contact Tracing Capacities. Health Secur 2024. [PMID: 38635976 DOI: 10.1089/hs.2023.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Affiliation(s)
- Alexandra Woodward
- Alexandra Woodward, DrPH, MPH, is a DrPH Researcher, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Center for Health Security, Baltimore, MD
| | - Caitlin Rivers
- Caitlin Rivers, PhD, is an Assistant Professor, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, and a Senior Scholar, Johns Hopkins Center for Health Security, Baltimore, MD
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2
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Downie DL, Rao P, David-Ferdon C, Courtney S, Lee JS, Kugley S, MacDonald PDM, Barnes K, Fisher S, Andreadis JL, Chaitram J, Mauldin MR, Salerno RM, Schiffer J, Gundlapalli AV. Literature Review of Pathogen Agnostic Molecular Testing of Clinical Specimens From Difficult-to-Diagnose Patients: Implications for Public Health. Health Secur 2024; 22:93-107. [PMID: 38608237 PMCID: PMC11044852 DOI: 10.1089/hs.2023.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 04/14/2024] Open
Abstract
To better identify emerging or reemerging pathogens in patients with difficult-to-diagnose infections, it is important to improve access to advanced molecular testing methods. This is particularly relevant for cases where conventional microbiologic testing has been unable to detect the pathogen and the patient's specimens test negative. To assess the availability and utility of such testing for human clinical specimens, a literature review of published biomedical literature was conducted. From a corpus of more than 4,000 articles, a set of 34 reports was reviewed in detail for data on where the testing was being performed, types of clinical specimens tested, pathogen agnostic techniques and methods used, and results in terms of potential pathogens identified. This review assessed the frequency of advanced molecular testing, such as metagenomic next generation sequencing that has been applied to clinical specimens for supporting clinicians in caring for difficult-to-diagnose patients. Specimen types tested were from cerebrospinal fluid, respiratory secretions, and other body tissues and fluids. Publications included case reports and series, and there were several that involved clinical trials, surveillance studies, research programs, or outbreak situations. Testing identified both known human pathogens (sometimes in new sites) and previously unknown human pathogens. During this review, there were no apparent coordinated efforts identified to develop regional or national reports on emerging or reemerging pathogens. Therefore, development of a coordinated sentinel surveillance system that applies advanced molecular methods to clinical specimens which are negative by conventional microbiological diagnostic testing would provide a foundation for systematic characterization of emerging and underdiagnosed pathogens and contribute to national biodefense strategy goals.
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Affiliation(s)
- Diane L. Downie
- Diane L. Downie, PhD, MPH, is Deputy Associate Director for Science, Office of Readiness and Response; at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Preetika Rao
- Preetika Rao, MPH, is a Health Scientist; at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Corinne David-Ferdon
- Corinne David-Ferdon, PhD, is Associate Director of Science, Office of Public Health Data, Surveillance, and Technology; at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Sean Courtney
- Sean Courtney, PhD, is a Health Scientist, at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Justin S. Lee
- Justin Lee, DVM, PhD, is a Health Scientist, Division of Global Health Protection; at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Shannon Kugley
- Shannon Kugley, MLIS, is a Research Public Health Analyst; in Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
| | - Pia D. M. MacDonald
- Pia D. M. MacDonald, PhD, MPH, is a Senior Infectious Disease Epidemiologist; in Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
| | - Keegan Barnes
- Keegan Barnes is a Public Health Analyst; in Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
| | - Shelby Fisher
- Shelby Fisher, MPH, is an Epidemiologist; in Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
| | - Joanne L. Andreadis
- Joanne L. Andreadis, PhD, is Associate Director for Science, at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Jasmine Chaitram
- Jasmine Chaitram, MPH, is Branch Chief, at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Matthew R. Mauldin
- Matthew R. Mauldin, PhD, is Health Scientists, Office of Readiness and Response; at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Reynolds M. Salerno
- Reynolds M. Salerno, PhD, is Director, Division of Laboratory Systems; at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Jarad Schiffer
- Jarad Schiffer, MS, is Health Scientists, Office of Readiness and Response; at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Adi V. Gundlapalli
- Adi V. Gundlapalli, MD, PhD, is a Senior Advisor, Data Readiness and Response, Office of Public Health Data, Surveillance, and Technology; at the US Centers for Disease Control and Prevention, Atlanta, GA
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3
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McOwen H, Wasserheit JN, Rabinowitz P. US Academic and NGO Engagement in Pandemic Preparedness and Response. Health Secur 2024; 22:167-171. [PMID: 38394310 DOI: 10.1089/hs.2023.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Affiliation(s)
- Helene McOwen
- Helene L. McOwen, MPH, is a Research Coordinator, Division of Allergy and Infectious Diseases; at the University of Washington, Seattle, WA
| | - Judith N Wasserheit
- Judith N. Wasserheit, MD, MPH, is a Professor, Departments of Global Health, Medicine and Epidemiology; at the University of Washington, Seattle, WA
- Judith N. Wasserheit is Co-Directors, UW Alliance for Pandemic Preparedness, University of Washington, Seattle, WA
| | - Peter Rabinowitz
- Peter M. Rabinowitz, MD, MPH, is a Professor, Departments of Environmental and Occupational Health Sciences, Family Medicine, and Global Health, and Director, University of Washington Center for One Health Research; at the University of Washington, Seattle, WA
- Peter M. Rabinowitz is Co-Directors, UW Alliance for Pandemic Preparedness, University of Washington, Seattle, WA
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4
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Lim YB, Popescu S. Exploring List-Based Approaches and Potential Threat Agnostic Applications in US Biodefense and Public Health-Toward a Hybrid Approach. Health Secur 2024; 22:146-155. [PMID: 38546510 DOI: 10.1089/hs.2023.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Affiliation(s)
- Yong-Bee Lim
- Yong-Bee Lim, PhD, is a Visiting Scholar, College of Global Futures, Arizona State University, Tempe, AZ
| | - Saskia Popescu
- Saskia Popescu, PhD, MPH, MA, CIC, is an Assistant Professor, Department of Epidemiology and Public Health, University of Maryland Medical School, Baltimore, MD
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5
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Lancaster MJ, Adalja AA, Warmbrod KL. Introduction to the Special Feature, Part 2: Enabling and Implementing Threat Agnostic Approaches to Biodefense and Public Health. Health Secur 2024; 22:83-84. [PMID: 38635952 DOI: 10.1089/hs.2024.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Affiliation(s)
- Mary J Lancaster
- Mary J. Lancaster, PhD, is a Senior Scientist, National Security Directorate, Pacific Northwest National Laboratory, Richland, WA
| | - Amesh A Adalja
- Amesh A. Adalja, MD, is a Senior Scholar, Johns Hopkins Center for Health Security, Baltimore, MD
| | - Kelsey Lane Warmbrod
- Kelsey Lane Warmbrod, MS, MPH, was a Research Analyst, Global Security, Technology and Policy Group, Pacific Northwest National Laboratory, Richland, WA
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6
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Rubin E, Harvey C, Villatoro A, Dean B. Next Generation Public Health Emergency Readiness: Standardized Tools and a Threat Agnostic Biosurveillance System. Health Secur 2024; 22:140-145. [PMID: 38512475 DOI: 10.1089/hs.2023.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Affiliation(s)
- Elizabeth Rubin
- Elizabeth Rubin, MPH, is an Epidemiologist, in the Emergency Preparedness and Response Division, Los Angeles County Department of Public Health, Los Angeles, CA
| | - Caitlin Harvey
- Caitlin Harvey, MPH, is a Disaster Analyst, in the Emergency Preparedness and Response Division, Los Angeles County Department of Public Health, Los Angeles, CA
| | - Alma Villatoro
- Alma Villatoro, MPH, is a Public Health Analyst, in the Emergency Preparedness and Response Division, Los Angeles County Department of Public Health, Los Angeles, CA
| | - Brandon Dean
- Brandon Dean, MPH, is an Emergency Planner, in the Emergency Preparedness and Response Division, Los Angeles County Department of Public Health, Los Angeles, CA
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7
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Downie DL, Rao P, David-Ferdon C, Courtney S, Lee JS, Quiner C, MacDonald PDM, Barnes K, Fisher S, Andreadis JL, Chaitram J, Mauldin MR, Salerno RM, Schiffer J, Gundlapalli AV. Surveillance for Emerging and Reemerging Pathogens Using Pathogen Agnostic Metagenomic Sequencing in the United States: A Critical Role for Federal Government Agencies. Health Secur 2024; 22:85-92. [PMID: 38574329 PMCID: PMC11044857 DOI: 10.1089/hs.2023.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 04/06/2024] Open
Abstract
The surveillance and identification of emerging, reemerging, and unknown infectious disease pathogens is essential to national public health preparedness and relies on fluidity, coordination, and interconnectivity between public and private pathogen surveillance systems and networks. Developing a national sentinel surveillance network with existing resources and infrastructure could increase efficiency, accelerate the identification of emerging public health threats, and support coordinated intervention strategies that reduce morbidity and mortality. However, implementing and sustaining programs to detect emerging and reemerging pathogens in humans using advanced molecular methods, such as metagenomic sequencing, requires making large investments in testing equipment and developing networks of clinicians, laboratory scientists, and bioinformaticians. In this study, we sought to gain an understanding of how federal government agencies currently support such pathogen agnostic testing of human specimens in the United States. We conducted a landscape analysis of federal agency websites for publicly accessible information on the availability and type of pathogen agnostic testing and details on flow of clinical specimens and data. The website analysis was supplemented by an expert review of results with representatives from the federal agencies. Operating divisions within the US Department of Health and Human Services and the US Department of Veterans Affairs have developed and sustained extensive clinical and research networks to obtain patient specimens and perform metagenomic sequencing. Metagenomic facilities supported by US agencies were not equally geographically distributed across the United States. Although many entities have work dedicated to metagenomics and/or support emerging infectious disease surveillance specimen collection, there was minimal formal collaboration across agencies.
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Affiliation(s)
- Diane L. Downie
- Diane L. Downie, PhD, MPH, is Deputy Associate Director for Science, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Preetika Rao
- Preetika Rao, MPH, is a Health Scientist, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Corinne David-Ferdon
- Corinne David-Ferdon, PhD, is Associate Director of Science, Office of Public Health Data, Surveillance, and Technology, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Sean Courtney
- Sean Courtney, PhD, is a Health Scientist, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Justin S. Lee
- Justin S. Lee, DVM, PhD, is a Health Scientist, Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Claire Quiner
- Claire Quiner, MPH, MCP, is a Research Public Health Analyst, Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
| | - Pia D. M. MacDonald
- Pia D. M. MacDonald, PhD, MPH, is a Senior Infectious Disease Epidemiologist, Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
| | - Keegan Barnes
- Keegan Barnes is a Public Health Analyst, Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
| | - Shelby Fisher
- Shelby Fisher, MPH, is an Epidemiologist, Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
| | - Joanne L. Andreadis
- Joanne L. Andreadis, PhD, is Associate Director for Science, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Jasmine Chaitram
- Jasmine Chaitram, MPH, is Branch Chief, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Matthew R. Mauldin
- Matthew R. Mauldin, PhD, is Health Scientists US Centers for Disease Control and Prevention, Atlanta, GA
| | - Reynolds M. Salerno
- Reynolds M. Salerno, PhD, is Director, Division of Laboratory Systems, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Jarad Schiffer
- Jarad Schiffer, MS, is Health Scientists, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Adi V. Gundlapalli
- Adi V. Gundlapalli, MD, PhD, is a Senior Advisor, Data Readiness and Response, Office of Public Health Data, Surveillance, and Technology, US Centers for Disease Control and Prevention, Atlanta, GA
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8
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Bartlow AW, Middlebrook EA, Dichosa AEK, Kayiwa J, Nassuna CA, Kiggundu G, Fair JM. Ongoing Cooperative Engagement Facilitates Agile Pandemic and Outbreak Response: Lessons Learned Through Cooperative Engagement Between Uganda and the United States. Health Secur 2024. [PMID: 38407830 DOI: 10.1089/hs.2023.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Pathogens threaten human lives and disrupt economies around the world. This has been clearly illustrated by the current COVID-19 pandemic and outbreaks in livestock and food crops. To manage pathogen emergence and spread, cooperative engagement programs develop and strengthen biosafety, biosecurity, and biosurveillance capabilities among local researchers to detect pathogens. In this case study, we describe the efforts of a collaboration between the Los Alamos National Laboratory and the Uganda Virus Research Institute, the primary viral diagnostic laboratory in Uganda, to implement and ensure the sustainability of sequencing for biosurveillance. We describe the process of establishing this capability along with the lessons learned from both sides of the partnership to inform future cooperative engagement efforts in low- and middle-income countries. We found that by strengthening sequencing capabilities at the Uganda Virus Research Institute before the COVID-19 pandemic, the institute was able to successfully sequence SARS-CoV-2 samples and provide data to the scientific community. We highlight the need to strengthen and sustain capabilities through in-country training, collaborative research projects, and trust.
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Affiliation(s)
- Andrew W Bartlow
- Andrew W. Bartlow, PhD, is Scientists, Genomics and Bioanalytics, Los Alamos National Laboratory, Los Alamos, NM
| | - Earl A Middlebrook
- Earl A. Middlebrook, PhD, is Scientists, Genomics and Bioanalytics, Los Alamos National Laboratory, Los Alamos, NM
| | - Armand E K Dichosa
- Armand E. K. Dichosa, PhD, is Scientists, Genomics and Bioanalytics, Los Alamos National Laboratory, Los Alamos, NM
| | - John Kayiwa
- John Kayiwa, PhD, is a Senior Laboratory Manager, Department of Arbovirology, Emerging and Re-emerging Viral Diseases, Uganda Virus Research Institute, Entebbe, Uganda
| | - Charity A Nassuna
- Charity A. Nassuna is Laboratory Technologists, Department of Arbovirology, Emerging and Re-emerging Viral Diseases, Uganda Virus Research Institute, Entebbe, Uganda
| | - Gladys Kiggundu
- Gladys Kiggundu is Laboratory Technologists, Department of Arbovirology, Emerging and Re-emerging Viral Diseases, Uganda Virus Research Institute, Entebbe, Uganda
| | - Jeanne M Fair
- Jeanne M. Fair, PhD, is Scientists, Genomics and Bioanalytics, Los Alamos National Laboratory, Los Alamos, NM
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9
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Awan J, Faherty LJ, Willis HH. Navigating Uncertainty in Public Health Decisionmaking: The Role of a Value of Information Framework in Threat Agnostic Biosurveillance. Health Secur 2024; 22:39-44. [PMID: 38079227 DOI: 10.1089/hs.2023.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- Jalal Awan
- Jalal Awan, MS, MPhil, PhD, is an Energy and Climate Policy Analyst, The Utility Reform Network, Oakland, CA, and an Assistant Policy Researcher, RAND Corporation, Santa Monica, CA
| | - Laura J Faherty
- Laura J. Faherty, MD, MPH, MSHP, is a Physician Policy Researcher, RAND Corporation, and an Attending Physician, Maine Medical Center, Portland, ME
| | - Henry H Willis
- Henry H. Willis, PhD, is a Senior Policy Researcher, RAND Corporation, Pittsburgh, PA
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10
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Adalja AA, Warmbrod KL, Lancaster MJ. Introduction to the Special Feature: Threat Agnostic Approaches to Biodefense and Public Health Are Now a Reality. Health Secur 2024; 22:1-2. [PMID: 38385862 DOI: 10.1089/hs.2024.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- Amesh A Adalja
- Amesh A. Adalja, MD, is a Senior Scholar, Johns Hopkins Center for Health Security, Baltimore, MD
| | - Kelsey Lane Warmbrod
- Kelsey Lane Warmbrod, MS, MPH, was a Research Analyst, Global Security, Technology and Policy Group; Pacific Northwest National Laboratory, Seattle, WA
| | - Mary J Lancaster
- Mary J. Lancaster, PhD, is a Senior Scientist, National Security Directorate; Pacific Northwest National Laboratory, Seattle, WA
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11
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Morton L, Creppage K, Rahman N, Early J, Hartman L, Hydrick A, Kasper M. Challenges and Opportunities in Pathogen Agnostic Sequencing for Public Health Surveillance: Lessons Learned From the Global Emerging Infections Surveillance Program. Health Secur 2024; 22:16-24. [PMID: 38054950 PMCID: PMC10902267 DOI: 10.1089/hs.2023.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Affiliation(s)
- Lindsay Morton
- Lindsay Morton, MPH, MS, is a Senior Molecular Epidemiologist; GEIS Branch, Armed Forces Health Surveillance Division, Defense Health Agency, Silver Spring, MD
| | - Kathleen Creppage
- Kathleen Creppage, DrPH, MPH, is a Scientific Program Manager and Technical Lead; GEIS Branch, Armed Forces Health Surveillance Division, Defense Health Agency, Silver Spring, MD
| | - Nazia Rahman
- Nazia Rahman, MPH, is a Molecular Epidemiologist and Portfolio Manager; GEIS Branch, Armed Forces Health Surveillance Division, Defense Health Agency, Silver Spring, MD
| | - June Early
- June Early, MPH, is Global Emerging Infections Surveillance (GEIS) Deputy Chief; GEIS Branch, Armed Forces Health Surveillance Division, Defense Health Agency, Silver Spring, MD
| | - Laurie Hartman
- Laurie Hartman, MS, is a former Laboratory Support Specialist; GEIS Branch, Armed Forces Health Surveillance Division, Defense Health Agency, Silver Spring, MD
| | - Ashley Hydrick
- Ashley Hydrick, DVM, MPH, is a Major, US Army, and former GEIS Focus Area Chief; GEIS Branch, Armed Forces Health Surveillance Division, Defense Health Agency, Silver Spring, MD
| | - Matthew Kasper
- Matthew Kasper, PhD, is a Commander, US Navy, and GEIS Chief; GEIS Branch, Armed Forces Health Surveillance Division, Defense Health Agency, Silver Spring, MD
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Abstract
The COVID-19 pandemic posed unprecedented challenges for frontline healthcare professionals globally. Despite the varied challenges encountered by frontline healthcare professionals, the difficulties faced by public health communication officials in particular has remained an underexplored area of research. This study examined the specific challenges experienced by communication officials during the COVID-19 pandemic in the United States. A qualitative research design was used to conduct in-depth interviews with communication officials working in local health departments (LHDs) in 2022. A total of 14 participants were recruited through purposive sampling, coupled with a data saturation strategy, from LHDs situated in Kansas, Missouri, and Oklahoma. Thematic analysis revealed 3 key themes: (1) main challenges faced by LHDs during the COVID-19 pandemic, (2) challenges related to information dissemination on social media, and (3) burnout experienced by communication officials. This study's findings suggest that communication officials should be provided with the necessary resources and training to effectively handle misinformation, toxic behaviors, and bullying on social media while prioritizing their mental health. In addition, federal, state, and local health agencies should provide timely, clear, and accurate information to address the challenges faced by communication officials in their bid to disseminate information effectively.
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Affiliation(s)
- Muhammad Ittefaq
- Muhammad Ittefaq, PhD, is an Assistant Professor, School of Communication Studies, James Madison University, Harrisonburg, VA
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13
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Findling MG, Caporello HL, Stein RI, Wade CG, Lubell KM, Briseño L, SteelFisher GK. Communications for US Populations With Limited English Proficiency During Infectious Disease Outbreaks: A Scoping Review. Health Secur 2023; 21:489-499. [PMID: 37889614 DOI: 10.1089/hs.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Abstract
The COVID-19 pandemic has highlighted the need for research about communicating with populations who have limited English proficiency in the United States during infectious disease outbreaks. These populations have experienced significantly worse health outcomes during emergencies, including the COVID-19 pandemic, and evidence-based risk communications are critical to protecting their health. To support improved development of emergency communications for these communities, we conducted a scoping review that examined the extent of research available, with an intent to identify which communications topics are covered in the literature and where research gaps exist. Following the JBI framework, with reporting guided by the PRISMA extension for scoping reviews, 6 electronic databases were systematically searched in October 2022. The inclusion criteria for articles selected were: data collected between 2009 and 2022, published in English, and focused on communications pertaining to emergency infectious disease outbreaks (eg, H1N1 influenza, Zika virus, COVID-19) for populations with limited English proficiency. Of 2,049 articles identified through the search, 31 met the inclusion criteria and were selected for review. We identified major limitations in the evidence base: a majority of studies were conducted only among Spanish speakers or during the COVID-19 pandemic, and most used qualitative or nonrandom samples. Most studies documented basic language barriers in communications, but there was little exploration of more nuanced barriers, such as cultural relevance or social context. Ahead of future outbreaks, more research is urgently needed to examine the information landscapes of populations with limited English proficiency, to inform the development of more effective communications strategies from public health institutions and others.
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Affiliation(s)
- Mary G Findling
- Mary G. Findling, PhD, ScM, is Assistant Director, in the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Hannah L Caporello
- Hannah L. Caporello is Senior Research Projects Manager, in the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Rebekah I Stein
- Rebekah I. Stein is a Research Assistant, in the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Carrie G Wade
- Carrie G. Wade, MLIS, is a Research and Instruction Librarian, Countway Library of Medicine, Harvard Medical School, Boston, MA
| | - Keri M Lubell
- Keri M. Lubell, PhD, is a Behavioral Scientist, at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa Briseño
- Lisa Briseño, MS, is a Senior Health Communication Specialist, at the US Centers for Disease Control and Prevention, Atlanta, GA
| | - Gillian K SteelFisher
- Gillian K. SteelFisher, PhD, MSc, is Principal Research Scientist and Director of Global Polling, in the Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
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14
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Koonin LM. A Missing Link in Public Health Preparedness and Emergency Response: Engaging Private Sector Employers for Pandemic Workplace Policies. Health Secur 2023; 21:473-478. [PMID: 37552815 DOI: 10.1089/hs.2023.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Affiliation(s)
- Lisa M Koonin
- Lisa M. Koonin, DrPH, MN, MPH, is Founder and Principal, Health Preparedness Partners, Atlanta, GA
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15
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Schoch-Spana M. Contagion, Care, and Interdependence in Pandemics. Health Secur 2023; 21:431-432. [PMID: 38108794 DOI: 10.1089/hs.2023.0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Affiliation(s)
- Monica Schoch-Spana
- Monica Schoch-Spana, PhD, is a Senior Scholar, Johns Hopkins Center for Health Security, and a Research Professor, Department of Environmental Health and Engineering; both in the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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16
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Abstract
Stanford Vax Crew, one of the largest medical-student-led vaccination programs in the United States, serves as a case study of a successful community-university partnership that adapted its existing operations to enable COVID-19 vaccine distribution. It offers a model for agile, community-centered vaccination campaigns that harness diverse stakeholder strengths to promote vaccine access and uptake in underserved communities. This case study aims to outline the history and structure of the community-university partnership model developed through Stanford Vax Crew, describe key observations of factors that contributed to the scalability of the model, and provide experience-based recommendations for future community-university collaborations.
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Affiliation(s)
- Mira Cheng
- Mira Cheng are Medical Students, Stanford University School of Medicine, Stanford, CA
| | - Caroline Murtagh
- Caroline Murtagh are Medical Students, Stanford University School of Medicine, Stanford, CA
| | - Bryant Macias
- Bryant Macias is Emergency Relief Program Manager UFW Foundation, Los Angeles, CA
| | | | - Walt Newman
- Walt Newman, MD, was a Family Medicine Physician, University of California San Francisco, San Jose, CA
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17
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Grisham R, Gruber E, Haft HM. Maryland's Integration of Public Health and Primary Care During the COVID-19 Pandemic: Case Study and Lessons Learned. Health Secur 2023; 21:509-514. [PMID: 37856160 DOI: 10.1089/hs.2022.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
The Maryland Primary Care Program is a statewide advanced primary care program that works directly with practices to transform healthcare delivery by managing chronic disease, preventing unnecessary hospital utilization, and integrating with the public health system. The Maryland Primary Care Program has demonstrated how linking the public health system to primary care practices, paired with strategic financial and resource investments in primary care, can enable the delivery of high-value care and reduce acute hospital utilization. Such a system is especially prudent when responding to crises. Throughout the COVID-19 pandemic, the Maryland Primary Care Program was able to capitalize on existing infrastructure to quickly engage primary care in a robust pandemic response. Successes of this relationship included early and consistent communication channels, as well as coordinated resource distribution. In particular, this partnership allowed primary care providers, the most trusted source of healthcare in patients' lives, to directly provide patients with health information and vaccines. Now comprising more than 500 practices, this vaccine program uses data-driven reports to facilitate intentional vaccine outreach. The program has enabled a more equitable vaccine distribution system, resulting in over 400,000 vaccines administered in Maryland counties. The effectiveness of Maryland's integrated response indicates that partnerships between public health and primary care will result in an effective response in future times of crisis.
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Affiliation(s)
- Rachel Grisham
- Rachel Grisham, MSPH, is Policy and External Affairs Lead, the Maryland Primary Care Program, Maryland Department of Health, Baltimore, MD
| | - Emily Gruber
- Emily Gruber, MBA, MPH, is Health Equity Manager; the Maryland Primary Care Program, Maryland Department of Health, Baltimore, MD
| | - Howard M Haft
- Howard M. Haft, MD, MMM, is an Adjunct Professor of Medicine, University of Maryland School of Medicine, Baltimore, MD
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Abstract
Community resilience, a system's ability to maintain its essential functions despite disturbance, is a cornerstone of public health preparedness. However, as currently practiced, community resilience generally focuses on defined neighborhood characteristics to describe factors such as vulnerability or social capital. This ignores the way that residents of some neighborhoods (as "essential workers") were required during the COVID-19 pandemic to sacrifice their wellbeing for the sake of others staying at home in more affluent neighborhoods. Using the global care chain theory, we analyze the way that the resilience of affluent neighborhoods depends on siphoning off the labor of other, less affluent neighborhoods, creating what we call the parasitic nature of resilience. We argue that understanding this neighborhood interdependence-and accounting for its parasitic nature-should be prioritized by public health authorities to prevent unintentional harm in future pandemics. Otherwise, any public health emergency response that relies on this labor (as did the COVID-19 pandemic response) depends on exploitative practices that produce the very disparities the response is trying to address. We explore the theoretical grounding and practical effects of this idea to provide the preparedness enterprise with an initial set of theoretical tools to move from a model of community resilience to one of community renewal. The community renewal model is based on an underlying ethics of care, in which systems are redesigned to become more prosocial during a public health response. We believe this model can more successfully address the tragic inequities in labor and health outcomes that we see during public health emergencies.
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Affiliation(s)
- Mitch H Stripling
- Mitch H. Stripling, MPA, is Director, Pandemic Response Institute, ICAP, Mailman School of Public Health, Columbia University, New York, NY
| | - Jordan Pascoe
- Jordan Pascoe, PhD, MPhil, MA, is a Professor, Department of Philosophy, Manhattan College, Riverdale, NY
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19
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Limaye RJ, Schulz G, Michel AE, Collins ME, Johnson SB. Leveraging a Peer-to-Peer Approach to Mitigate Vaccine Misinformation and Improve Vaccine Communication During a Pandemic: Experiences From the Development of a Massive Open Online Course. Health Secur 2023; 21:467-472. [PMID: 38084962 DOI: 10.1089/hs.2023.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
The COVID-19 pandemic has not only led to massive global mortality and morbidity, but it has also fueled an infodemic of false and misleading information about COVID-19 and vaccines. The spread of misinformation and disinformation on vaccine safety and efficacy has contributed to vaccine hesitancy and distrust of public health institutions and has undermined the public health response to the COVID-19 pandemic. Because communication plays a monumental role in pandemic preparedness, a promising approach to countering the COVID-19 infodemic is empowering peers to serve as trusted messengers to provide accurate information using evidence-based communication approaches. With this in mind, we developed a massive open online course (MOOC) to provide the general public with the knowledge, skills, and resources to effectively navigate potentially contentious vaccine conversations with their peers, with a specific focus on parents. Within the first year of the course launch, 29,000 people had enrolled. Learners appreciated the information related to vaccine development, communication tips and techniques, and identifying and responding to vaccine misinformation. Over 1,000 learners who completed the course participated in an online evaluation survey. To address public distrust in healthcare providers, government, and science, our survey results indicate that peer-to-peer approaches to addressing vaccine hesitancy can empower community members to educate others and promote vaccine acceptance at scale.
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Affiliation(s)
- Rupali Jayant Limaye
- Rupali Jayant Limaye, PhD, is an Associate Professor, Global Disease Epidemiology and Control, in the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Gretchen Schulz
- Gretchen Schulz, MSPH, is a Research Assistant, in the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Alexandra E Michel
- Alexandra E. Michel, MPH, is a Research Associate, International Vaccine Access Center, in the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Megan E Collins
- Megan E. Collins, MD, is an Associate Professor, Department of Ophthalmology, at the Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sara B Johnson
- Sara B. Johnson, MD, is a Professor, Department of Pediatrics, at the Johns Hopkins University School of Medicine, Baltimore, MD
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20
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Morales L. Communicating Expert Insights During the COVID-19 Pandemic. Health Secur 2023; 21:515-520. [PMID: 37862232 DOI: 10.1089/hs.2023.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023] Open
Affiliation(s)
- Lymari Morales
- Lymari Morales, MPP, is Associate Dean for Communications and Marketing, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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21
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Marquez DR, Agnew J, Barnett DJ, Davis MF, Dalton KR. Assessing US Small Animal Veterinary Clinic Adaptations and Their Impacts on Workforce COVID-19 Preparedness and Response. Health Secur 2023; 21:450-458. [PMID: 37971808 PMCID: PMC10777815 DOI: 10.1089/hs.2023.0041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 11/19/2023] Open
Abstract
Veterinary personnel are an essential yet often underappreciated workforce, critical for zoonotic disease prevention and response efforts that impact human health. During the early COVID-19 pandemic, the veterinary workforce supported emergency responses by promoting zoonotic disease risk communication, sharing animal health expertise, and boosting laboratory surge capacity against SARS-CoV-2 in animals and people. However, small animal veterinary workers (SAVWs), similar to healthcare workers, faced organizational challenges in providing clinical care to family pets, including those susceptible to SARS-CoV-2. We analyzed a cross-sectional survey of 1,204 SAVWs in the United States to assess veterinary clinic adaptations and their associations with SAVWs' self-perceived readiness, willingness, and ability to respond to the COVID-19 pandemic as a workforce. SAVWs who worked fewer hours than before the pandemic (ready, OR 0.59; willing, OR 0.66; able, OR 0.52) or used personal protective equipment less frequently for protection in the clinic (ready, OR 0.69; willing, OR 0.69; able, OR 0.64) felt less ready, willing, and able to respond to COVID-19. SAVWs working remotely felt less ready (OR 0.46) but not less willing or able to respond to COVID-19. Lastly, SAVWs with dependents felt less ready (OR 0.67) and able (OR 0.49) to respond to COVID-19 than SAVWs without dependents. Our findings highlight the importance of proactively managing work schedules, having access to personal protective equipment, and addressing caregiving concerns to enhance SAVW preparedness and response outcomes. SAVWs are knowledgeable, motivated personnel who should be integrated into local public health emergency preparedness and response plans, supporting a One Health framework that unites multidisciplinary teams to respond to future zoonotic disease threats.
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Affiliation(s)
- David R. Marquez
- David R. Marquez, DVM, MPH, DACVPM, is a Postdoctoral Fellow, in the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- David Marquez is also a Veterinary Preventive Medicine Officer, US Army Veterinary Corps, Medical Center of Excellence, JBSA Fort Sam Houston, TX
| | - Jacqueline Agnew
- Jacqueline Agnew, MPH, PhD, is a Professor Emeritus, in the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Daniel J. Barnett
- Daniel J. Barnett, MD, MPH, in the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Meghan F. Davis
- Meghan F. Davis, DVM, MPH, PhD, are Associate Professors, in the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kathryn R. Dalton
- Kathryn R. Dalton, DVM, PhD, MPH, is an IRTA Postdoctoral Fellow, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
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22
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Alam MS, Sultana R. Simultaneous COVID-19 Pandemic and Dengue Epidemic: A Double Challenge to Geriatric Health Security in Bangladesh. Health Secur 2023; 21:500-508. [PMID: 37890122 DOI: 10.1089/hs.2021.0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Abstract
Bangladesh faces distinct challenges as a resource-poor country due to the combined effects of the COVID-19 pandemic and simultaneous dengue outbreaks. Older adults are particularly vulnerable to infection and death from COVID-19. While overall health and life expectancy in the general population have improved substantially in Bangladesh, health services for older adults are still lacking. No specialized geriatric units have been established in hospitals, and no home care programs have been established for older adults. COVID-19 mortality rates were highest among older adults ages 61 to 70 years (35%), and 71 to 80 years (20%) in 2022. Although the country's average COVID-19 mortality rate was low at 1.76%, in older adults, it was much higher (55%), accounting for 14,797 deaths, despite that most cases (55%) were recorded in young adults. During the COVID-19 pandemic, Bangladesh also experienced a dengue epidemic. Around 21,193 dengue patients were admitted to hospitals between January 1 and October 8, 2022. Without a well-established and all-encompassing social care program, the indirect socioeconomic burden of COVID-19 continues to fall on older adults. There is an immediate need for robust healthcare and support services, especially for older adults in Bangladesh, which are particularly susceptible to the dual threats posed by the COVID-19 pandemic and the dengue epidemic. Recommendations are made to protect older adults from the devastating effects of the 2 simultaneous epidemics.
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Affiliation(s)
- Md Shafiul Alam
- Md. Shafiul Alam, PhD, is a Professor, Department of Geography and Environmental Studies, University of Rajshahi, Rajshahi, Bangladesh
| | - Rumana Sultana
- Rumana Sultana, PhD, is an Assistant Professor, Department of Environmental Science and Management, Independent University Bangladesh, Dhaka, Bangladesh
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23
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Noelte KC, Kosmos C, McWhorter A. New Challenges, Evolved Approach: The Public Health Response Readiness Framework. Health Secur 2023; 21:S89-S94. [PMID: 37725005 DOI: 10.1089/hs.2023.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Affiliation(s)
- Kate C Noelte
- Kate C. Noelte, MPH, is Deputy Director, Division of State and Local Readiness, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Christine Kosmos
- Christine Kosmos, RN, BSN, MS, is Director, Division of State and Local Readiness, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Amanda McWhorter
- Amanda McWhorter, DrPH, MPH, is Deputy Associate Director, Division of State and Local Readiness, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
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24
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Auerbach J, Chen AT. Strengthening the Partnerships That Promote Health Equity and Social Justice. Health Secur 2023; 21:S42-S46. [PMID: 37565775 PMCID: PMC10818052 DOI: 10.1089/hs.2023.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Affiliation(s)
- John Auerbach
- John Auerbach, MBA, is Senior Vice President, Public Health, ICF, Reston, VA
| | - Alice T. Chen
- Alice T. Chen, MD, is Former Senior Advisor, Made to Save, Civic Nation, Washington, DC
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25
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Powell R, Parker B, Moore M, Xiong T, Evans D, Sidibe T. Importance of Public and Private Partnership Supporting Data Disaggregation to Measure Racial, Sexual Orientation, and Gender Identity Disparities in COVID-19. Health Secur 2023; 21:S35-S41. [PMID: 37733289 DOI: 10.1089/hs.2023.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
The COVID-19 pandemic has exposed shortcomings in the US public health data system infrastructure, including incomplete or disparate processes related to data collection, management, sharing, and analysis. Public health data modernization is critical to ensure health equity is at the core of preparedness and response efforts and policies that prioritize equitable responses to health emergencies. To address the inequitable uptake and distribution of COVID-19 vaccinations in communities most disproportionately impacted by the pandemic, the CDC Foundation's Response Crisis and Preparedness Unit began partnering with community-based organizations in March 2021 to provide education and outreach and facilitate access to vaccines. These organizations engaged with partners and communities to address vaccine-related concerns, develop innovative and culturally appropriate communication strategies, and promote timely vaccination. Two grantees, Out Boulder County in Colorado and the Coalition of Asian American Leaders in Minnesota, experienced issues related to public health data collection standards and practices for COVID-19. Data collection tools often lack the appropriate or necessary demographic variables or level of disaggregation needed to be able to assess prioritization and disparities within racial and ethnic groups and across sexual orientation and gender identity categories. In this case study, both grantee organizations document their experiences, challenges, and strategies to overcome barriers to implementing their projects resulting from a lack of meaningful data. These examples identify inequities and systems-level changes related to data collection and surveillance, and they provide recommendations and lessons learned to improve data surveillance for more equitable public health responses.
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Affiliation(s)
- Rachel Powell
- Rachel Powell, PhD, MPH, is Senior Program Manager, Response, Crisis, and Preparedness Unit, National Foundation for the Centers for Disease Control and Prevention, Atlanta, GA
| | - Bruce Parker
- Bruce Parker, PhD, is Deputy Director, Out Boulder County, Boulder, CO
| | - Mardi Moore
- Mardi Moore is Executive Director, Out Boulder County, Boulder, CO
| | - ThaoMee Xiong
- ThaoMee Xiong, MPA, JD, is Executive and Network Director, The Coalition of Asian American Leaders, St. Paul, MN
| | - Dorothy Evans
- Dorothy Evans MPH, MEd, is Program Manager, Response, Crisis, and Preparedness Unit, National Foundation for the Centers for Disease Control and Prevention, Atlanta, GA
| | - Turquoise Sidibe
- Turquoise Sidibe, MPH, is Associate Vice President of Emergency Response, National Foundation for the Centers for Disease Control and Prevention, Atlanta, GA
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26
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Affiliation(s)
- Eric S Toner
- Eric S. Toner, MD, is a Senior Scholar, Johns Hopkins Center for Health Security, Baltimore, MD
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27
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Burns NV, Vutrano JE, Willman KJ, Johnson MS. Recognizing the Impact of Medical Reserve Corps Volunteers on the COVID-19 Pandemic Response. Health Secur 2023; 21:S60-S71. [PMID: 37676998 DOI: 10.1089/hs.2023.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Affiliation(s)
- Nancy V Burns
- Nancy V. Burns, EMT-B, is Upper Merrimack Valley Medical Reserve Corps Coordinator, Westford Health Department, Westford, MA
| | - June Ellen Vutrano
- June Ellen Vutrano, MS, is Medical Reserve Corps Coordinator-Emergency Preparedness Services Coordinator, Office of Preparedness and Response, Maricopa County Medical Reserve Corps, Maricopa County Department of Public Health, Phoenix, AZ
| | - Kyle J Willman
- Kyle J. Willman, MPH, is an Emergency Preparedness Planner, Maricopa County Medical Reserve Corps, Maricopa County Department of Public Health, Phoenix, AZ
| | - Matthew S Johnson
- Matthew S. Johnson is an MPH Candidate and Intern, Maricopa County Medical Reserve Corps, Maricopa County Department of Public Health, Phoenix, AZ
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28
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Sharma S, Pannu J, Chorlton S, Swett JL, Ecker DJ. Threat Net: A Metagenomic Surveillance Network for Biothreat Detection and Early Warning. Health Secur 2023; 21:347-357. [PMID: 37367195 DOI: 10.1089/hs.2022.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Early detection of novel pathogens can prevent or substantially mitigate biological incidents, including pandemics. Metagenomic next-generation sequencing (mNGS) of symptomatic clinical samples may enable detection early enough to contain outbreaks, limit international spread, and expedite countermeasure development. In this article, we propose a clinical mNGS architecture we call "Threat Net," which focuses on the hospital emergency department as a high-yield surveillance location. We develop a susceptible-exposed-infected-removed (SEIR) simulation model to estimate the effectiveness of Threat Net in detecting novel respiratory pathogen outbreaks. Our analysis serves to quantify the value of routine clinical mNGS for respiratory pandemic detection by estimating the cost and epidemiological effectiveness at differing degrees of hospital coverage across the United States. We estimate that a biological threat detection network such as Threat Net could be deployed across hospitals covering 30% of the population in the United States. Threat Net would cost between $400 million and $800 million annually and have a 95% chance of detecting a novel respiratory pathogen with traits of SARS-CoV-2 after 10 emergency department presentations and 79 infections across the United States. Our analyses suggest that implementing Threat Net could help prevent or substantially mitigate the spread of a respiratory pandemic pathogen in the United States.
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Affiliation(s)
- Siddhanth Sharma
- Siddhanth Sharma, MD MPH, is a Public Health Registrar, Metropolitan Communicable Disease Control, Perth, Australia
| | - Jaspreet Pannu
- Jaspreet Pannu, MD, is a Resident Physician, Department of Medicine, Stanford University School of Medicine, Stanford, CA. Johns Hopkins Center for Health Security, Baltimore, MD
| | - Sam Chorlton
- Sam Chorlton, MD, D(ABMM), is Chief Executive Officer, BugSeq Bioinformatics, Vancouver, Canada
| | - Jacob L Swett
- Jacob L. Swett, DPhil, is Cofounder, altLabs, Inc., Berkeley, CA
| | - David J Ecker
- David J. Ecker, PhD, is Vice President of Strategic Innovation, Ionis Pharmaceuticals, Carlsbad, CA
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29
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Woodward A, Rivers C. Case Investigation and Contact Tracing in US State and Local Public Health Agencies: Sustaining Capacities and Applying Lessons Learned From the COVID-19 Pandemic and 2022 Mpox Outbreak. Health Secur 2023; 21:S8-S16. [PMID: 37615561 PMCID: PMC10818042 DOI: 10.1089/hs.2023.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 08/25/2023] Open
Abstract
The COVID-19 pandemic illuminated the lack of resources available to US state and local public health agencies to respond to large-scale health events. Two response activities that were notably underresourced are case investigation and contact tracing (CI/CT), which health agencies routinely employ to control and prevent the transmission of infectious diseases. However, the scale of contact tracing required during the COVID-19 pandemic exceeded available resources, even in high-capacity public health agencies. For both routine outbreak response and epidemic preparedness, health agencies must have CI/CT program capacities in place prior to the detection of an outbreak to be ready to respond. Our research builds on previous work to identify the baseline CI/CT capacities needed in US state and local public health agencies to respond to any type of outbreak. Fifteen public health officials representing 10 public health agencies and 4 experts in CI/CT were interviewed about various aspects of their CI/CT program during the COVID-19 pandemic. The interviews coincided with the beginning of the 2022 mpox epidemic. Discussions on CI/CT during that response were collected to augment the interviews, where possible. Findings revealed that CI/CT capacities were underresourced prior to and during the pandemic, as well as during the mpox outbreak, even after substantial additional resourcing and efforts to scale up. Moreover, state and local health agencies encountered challenges in pivoting their COVID-19 CI/CT capacities for the mpox response, suggesting that CI/CT programs should either be designed with flexibility in mind, or should allow for specialization based on the pathogen's mode of transmission and the population at risk. Federal, state, and local health agency staff and officials should consider lessons learned from this research to plan for readily scalable and sustainable CI/CT programs to ensure readiness for future outbreaks.
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Affiliation(s)
- Alexandra Woodward
- Alexandra Woodward, DrPH, MPH, is a DrPH Researcher, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Center for Health Security, Baltimore, MD
| | - Caitlin Rivers
- Caitlin Rivers, PhD, is an Assistant Professor, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, and a Senior Scholar, Johns Hopkins Center for Health Security, Baltimore, MD
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30
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Popescu SV, Leach R. Building Sustainable Infection Prevention in the Era of COVID-19. Health Secur 2023; 21:379-383. [PMID: 37289770 DOI: 10.1089/hs.2023.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- Saskia V Popescu
- Saskia V. Popescu, PhD, MPH, MA, CIC, is an Assistant Professor, Department of Epidemiology and Public Health, University of Maryland Medical School, Baltimore, MD
| | - Rebecca Leach
- Rebecca Leach, MPH, RN, BSN, CIC, is System Manager of Infection Prevention, CommonSpirit Health, Phoenix, AZ
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31
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Biesiadecki L, Hess B, Schoch-Spana M. Reimagining Preparedness in the Era of COVID-19. Health Secur 2023; 21:S1-S7. [PMID: 37756213 DOI: 10.1089/hs.2023.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Affiliation(s)
- Laura Biesiadecki
- Laura Biesiadecki, MSPH, is Senior Director for Preparedness, National Association of County and City Health Officials, Washington, DC
| | - Beth Hess
- Beth Hess is a Communications Specialist, National Association of County and City Health Officials, Washington, DC
| | - Monica Schoch-Spana
- Monica Schoch-Spana, PhD, CPH, is a Senior Scholar, Johns Hopkins Center for Health Security, and a Senior Scientist, Department of Environmental Health and Engineering; both at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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32
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Yeh MJ, Lee PH. Ethical Preparedness for Health Policymaking and Implementation During Public Health Emergencies: The Role of Rapid Ethical Assessment. Health Secur 2023; 21:371-378. [PMID: 37552814 DOI: 10.1089/hs.2023.0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Scholars have called for ethical preparedness for public health practice and research to address the challenges of special ethical considerations under time and resource pressure during emergencies like the COVID-19 pandemic. We propose the idea of a rapid ethical assessment (REA) that aims to provide ethical justifications and policy recommendations for a specific public health policy, which is necessary for the ethical legitimacy of health policymaking and implementation. We suggest that an REA task force be established and incorporated into the administrative procedure to perform an REA in the early, middle, and terminal stages of a policy proposed by the health authority and to determine to what extent the tradeoffs between values and priorities required by the policy are ethically acceptable. The REA task force's role is consultative, with the final decisionmaking power and political responsibilities falling on the health authority. The REA task force should adopt 4 substantial ethical principles: utilitarianism, equity, human rights, and solidarity. The REA task force would consist of a multidisciplinary team of experts and a group of representatives from those who would be affected by the proposed policy. The REA task force would operate with a 5-step procedure of (1) convening, (2) investigation, (3) determination, (4) reporting and communication, and (5) decision and reassessment. We use 2 real incidents in Taiwan to demonstrate how the REA task force could work to enhance the ethical acceptance of a policy.
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Affiliation(s)
- Ming-Jui Yeh
- Ming-Jui Yeh, PhD, is Assistant Professors, Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan
| | - Po-Han Lee
- Po-Han Lee, PhD, is Assistant Professors, Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan
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33
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Westbrook G, Hollen H, Naqvi O, Neuwald S, Hann N, Cox G, McFerron P, Wendelboe A, Bratzler DW. Achieving a Healthy Oklahoma: Cross-Sector Cooperation to Improve Public Health Preparedness and Pandemic Response. Health Secur 2023; 21:358-370. [PMID: 37581881 DOI: 10.1089/hs.2022.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
In response to the COVID-19 pandemic, the University of Oklahoma Hudson College of Public Health launched the Achieving a Healthy Oklahoma (AHO) initiative in 2021. The goals of AHO were to assess lessons learned in Oklahoma from COVID-19 and set the foundation for enhanced public-private community collaboration by developing recommendations to prepare for future public health crises and promote health across all major economic sectors. Over 700 stakeholders were engaged in surveys, interviews, workgroup meetings, community listening sessions, and steering committee meetings over 8 months to accomplish these goals. Stakeholders produced 60 sector- and stakeholder-specific policy recommendations to address the major issues uncovered during the initiative. The AHO team then distilled them into 5 recommendations: (1) invest in the future of Oklahoma's health workforce to include critically needed public health professions in Oklahoma's healthcare loan repayment programs; (2) establish contracts between higher education institutions in Oklahoma and state and local health departments to monitor health sector workforce needs and provide training; (3) strengthen the delivery of coordinated public health services within local communities during emergencies and daily operations by dedicating health department roles to coordinate public health projects and services; (4) improve preparedness by coordinating annual emergency management exercises across local and state health departments; and (5) emphasize the efficiency and effectiveness of cross-sector collaborative efforts between public, private, and tribal partners. The AHO initiative serves as an action guide for assessing and improving state-level public health emergency responses and strengthening public health infrastructure. Implementing the recommendations in Oklahoma and assessing and addressing similar needs across the nation are necessary to prepare the United States for future public health emergencies.
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Affiliation(s)
- Gabrielle Westbrook
- Gabrielle Westbrook, MPH, is Operations Manager, Center for Public Health Practice, and an Instructor, Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Health Sciences Center
| | - Heather Hollen
- Heather Hollen, MS, is a Science Writer, Office of the Dean, Hudson College of Public Health, University of Oklahoma Health Sciences Center
| | - Ozair Naqvi
- Ozair Naqvi, MS, is a Graduate Research Assistant, Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center
| | - Sharon Neuwald
- Sharon Neuwald, DrPH, is a Consultant, Center for Public Health Practice, Hudson College of Public Health, University of Oklahoma Health Sciences Center
| | - Neil Hann
- Neil Hann, MPH, CHES, is Chair and Lecturer, Department of Health Promotion Sciences, and Director, Center for Public Health Practice, Hudson College of Public Health, University of Oklahoma Health Sciences Center
| | - Gary Cox
- Gary Cox, JD, is a Professor and Associate Dean for Public Health Practice & Community Partnerships, Center for Public Health Practice Hudson College of Public Health, University of Oklahoma Health Sciences Center
| | - Pat McFerron
- Pat McFerron is President and Owner, Cole Hargrave Snodgrass & Associates, located in Oklahoma City, OK
| | - Aaron Wendelboe
- Aaron Wendelboe, PhD, is a Williams Companies Foundation Presidential Professor and Edward E. and Helen T. Bartlett Chair, Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center
| | - Dale W Bratzler
- Dale W. Bratzler, DO, MPH, is Edith Kinney Gaylord Presidential Professor and Chair, Department of Health Administration and Policy, and Dean, Hudson College of Public Health, University of Oklahoma Health Sciences Center
- Dale W. Bratzler is also a Professor of Medicine, College of Medicine, University of Oklahoma Health Sciences Center
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Hoff C, Combs-Black K, Sorek JD, Elsenboss C, Robinson MM, Robison B. Public Health Emergency Preparedness and Response After COVID-19. Health Secur 2023; 21:S72-S78. [PMID: 37668991 DOI: 10.1089/hs.2023.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Affiliation(s)
- Christopher Hoff
- Christopher Hoff, MPH, is Deputy Director Public Health, DuPage County Health Department, Wheaton, IL
| | - Karla Combs-Black
- Karla Combs-Black, PhD, is Deputy Administrative Health Officer, Kent County Health Department, Grand Rapids, MI
| | - Jennifer D Sorek
- Jennifer D. Sorek, MA, is Emergency Preparedness Manager, Ottawa County Department of Public Health, Holland, MI
| | - Carina Elsenboss
- Carina Elsenboss, MS, is Assistant Division Director, Community Environmental Health, Public Health - Seattle & King County, Seattle, WA
| | - Misty M Robinson
- Misty M. Robinson, MA, is Public Health Preparedness Supervisor, Office of Public Health Preparedness, Southern Nevada Health District, Las Vegas, NV
| | - Benjamin Robison
- Benjamin Robison, MPH, is Health Commissioner, Wood County Health Department, Bowling Green, OH
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Cox H, Gebru Y, Horter L, Palomeque FS, Myers K, Stowell D, Easterling T, de Noguera NS, Medina-Forrester A, Bravo J, Pérez S, Chaparro J, Ekpo LLP, Cranford H, Santibañez S, Valencia D. New York State, New York City, New Jersey, Puerto Rico, and the US Virgin Islands' Health Department Experiences Promoting Health Equity During the Initial COVID-19 Omicron Variant Period, 2021-2022. Health Secur 2023; 21:S25-S34. [PMID: 37590481 PMCID: PMC10818041 DOI: 10.1089/hs.2023.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/23/2023] [Accepted: 06/03/2023] [Indexed: 08/19/2023] Open
Abstract
In this case study, we aim to understand how health departments in 5 US jurisdictions addressed health inequities and implemented strategies to reach populations disproportionately affected by COVID-19 during the initial Omicron variant period. We used qualitative methods to examine health department experiences during the initial Omicron surge, from November 2021 to April 2022, assessing successful interventions, barriers, and lessons learned from efforts to promote health equity. Our findings indicate that government leadership supported prioritizing health equity from the beginning of the pandemic, seeing it as a need and vital part of the response framework. All jurisdictions acknowledged the historical trauma and distrust of the government. Health departments found that collaborating and communicating with trusted community leaders helped mitigate public distrust. Having partnerships, resources, and infrastructure in place before the pandemic facilitated the establishment of equity-focused COVID-19 response activities. Finally, misinformation about COVID-19 was a challenge for all jurisdictions. Addressing the needs of diverse populations involves community-informed decisionmaking, diversity of thought, and delivery measures that are tailored to the community. It is imperative to expand efforts to reduce and eliminate health inequities to ensure that individuals and communities recover equitably from the effects of COVID-19.
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Affiliation(s)
- Heidi Cox
- Heidi Cox, MPH, is a Public Health Analyst; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Yonathan Gebru
- Yonathan Gebru, MPH, is a Public Health Advisor; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Libby Horter
- Libby Horter, MPH, is a Data Manager; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Francisco S. Palomeque
- Francisco S. Palomeque, MPH, is a Health Scientist, Division of State and Local Readiness, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA
| | - Kristopher Myers
- Kristopher Myers, PhD, was a Consultant Data Manager, State, Tribal, Local, and Territorial Support Task Force, CDC, Atlanta, GA. He is currently a Data Manager, Goldbelt, C6, LLC, Chesapeake, VA
| | - Daniel Stowell
- Daniel Stowell, MPH, is a Public Health Analyst, Center for Global Health, CDC, Atlanta, GA
| | - Torian Easterling
- Torian Easterling, MD, PhD, is First Deputy Commissioner and Chief Equity Officer, New York City Department of Health and Mental Hygiene, New York, NY
| | - Nayeli Salazar de Noguera
- Nayeli Salazar de Noguera, PhD, is a Program Management Officer, the New Jersey Department of Health, Trenton, NJ
| | - Amanda Medina-Forrester
- Amanda Medina-Forrester, MPH, is Executive Director of Office of Minority and Multicultural Health; the New Jersey Department of Health, Trenton, NJ
| | - Josely Bravo
- Josely Bravo, MPH, is a COVID-19 Vaccine Equity Official; the Puerto Rico Department of Health, San Juan, PR
| | - Siomara Pérez
- Siomara Pérez, DrPH, is a Project Manager; the Puerto Rico Department of Health, San Juan, PR
| | - Jaikiz Chaparro
- Jaikis Chaparro, MSW, is Director of Health Equity Program; the Puerto Rico Department of Health, San Juan, PR
| | - Lisa La Place Ekpo
- Lisa La Place Ekpo, DrPH, is Epidemiologists, US Virgin Islands Department of Health, Saint Thomas, USVI
| | - Hannah Cranford
- Hannah Cranford, MPH, is Epidemiologists, US Virgin Islands Department of Health, Saint Thomas, USVI
| | - Scott Santibañez
- Scott Santibañez, MD, MPHTM, is Chief Medical Officer and Associate Director for Science; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Diana Valencia
- Diana Valencia, MS, is a Health Scientist; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
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Wolford T, Sutton J, Mangal CN. Laboratory Response to Pandemic Threats: Challenges, Needs, and Solutions. Health Secur 2023; 21:S56-S59. [PMID: 37565776 PMCID: PMC10818051 DOI: 10.1089/hs.2022.0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Affiliation(s)
- Tyler Wolford
- Tyler Wolford, MS, is Manager, Emergency Preparedness and Response, Association of Public Health Laboratories, Silver Spring, MD
| | - Jill Sutton
- Jill Sutton is a Specialist, Emergency Preparedness and Response, Association of Public Health Laboratories, Silver Spring, MD
| | - Chris N. Mangal
- Chris N. Mangal, MPH, is Director, Public Health Preparedness and Response, Association of Public Health Laboratories, Silver Spring, MD
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37
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Pickett AD. Strengths, Weaknesses, and Catharsis: The Role of Information Sharing in Public Health After the COVID-19 Response. Health Secur 2023; 21:S101-S104. [PMID: 37756212 DOI: 10.1089/hs.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Affiliation(s)
- Andrew D Pickett
- Andrew D. Pickett, MS, is Director, Bureau of Emergency Preparedness and Response, Pennsylvania Department of Health, Harrisburg, PA
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38
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Hawkins RM, Ma KY, Pickett AD, Bakker G, Kipp SS, Mihalakos A, Petersen PE. Reimagining Incident Management Systems for Public Health Responses. Health Secur 2023; 21:S95-S100. [PMID: 37733245 DOI: 10.1089/hs.2023.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Affiliation(s)
- Regina M Hawkins
- Regina M. Hawkins, MPH, is an Independent Scholar, Alexandria, VA
| | - Kimberly Y Ma
- Kimberly Y. Ma, MS, is a PhD Student, Biodefense Program, Schar School of Policy and Government, George Mason University, Arlington, VA
| | - Andrew D Pickett
- Andrew D. Pickett, MS, is Director, Bureau of Emergency Preparedness and Response, Pennsylvania Department of Health, Harrisburg, PA
| | - Gerrit Bakker
- Gerrit Bakker, MS, is an Independent Scholar, Philadelphia, PA
| | - Steven S Kipp
- Steven S. Kipp is a Public Health Response Coordinator, Sublette County Public Health, Pinedale WY
| | - Alysia Mihalakos
- Alysia Mihalakos, MPH, is Chief, Center for Emergency Preparedness and Response, Rhode Island Department of Health, Providence, RI
| | - Paul E Petersen
- Paul E. Petersen, PharmD, MPH, CEM, is Director, Emergency Preparedness Program, Communicable and Environmental Diseases and Emergency Preparedness Division, Tennessee Department of Health, Nashville, TN
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Montazeri NX, Sandbrink JB. Innovate and Stockpile: Respiratory Protection for Essential Workers in a Catastrophic Pandemic. Health Secur 2023; 21:266-271. [PMID: 37196202 PMCID: PMC10357109 DOI: 10.1089/hs.2022.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Affiliation(s)
- Nadia X. Montazeri
- Nadia X. Montazeri, MD, is a Research Affiliate, Center for International Security and Cooperation, Stanford University, Stanford, CA
| | - Jonas B. Sandbrink
- Jonas B. Sandbrink is a Doctoral Researcher, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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40
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Koonin LM, Roszak SE, McFeely KM. Building on Success Serving the Nation: Codifying Key Pharmacy Practice Authorities Beyond COVID-19. Health Secur 2023; 21:323-328. [PMID: 37162527 DOI: 10.1089/hs.2023.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Affiliation(s)
- Lisa M Koonin
- Lisa M. Koonin, DrPH, MN, MPH, is Founder and Principal, Health Preparedness Partners, Atlanta, GA
| | - Sara E Roszak
- Sara E. Roszak, DrPH, MPH, is Senior Vice President, Health and Wellness Strategy and Policy, National Association of Chain Drug Stores, Arlington, VA
| | - Kayla M McFeely
- Kayla M. McFeely, PharmD, is Senior Director, Pharmacy Care, Health and Wellness Programs, National Association of Chain Drug Stores, Arlington, VA
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Kirsch TD, Lee CJ, King DB, Adeniji AA, Sethi R, Deussing EC. Validation of Opportunities to Strengthen the National Disaster Medical System: The Military-Civilian NDMS Interoperability Study Quantitative Step. Health Secur 2023; 21:310-318. [PMID: 37294940 PMCID: PMC10357102 DOI: 10.1089/hs.2023.0051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/03/2023] [Accepted: 04/18/2023] [Indexed: 06/11/2023] Open
Abstract
The National Disaster Medical System (NDMS) Pilot Program was authorized by Congress to improve the interoperability, capabilities, and capacity of the NDMS. To develop a roadmap for planning and research, the mixed methods Military-Civilian NDMS Interoperability Study (MCNIS) was conducted in 2020-2021. The initial qualitative phase of the study identified critical themes for improvement: (1) coordination, collaboration, and communication; (2) funding and incentives to increase private sector preparedness; (3) staffing capacity and competencies; (4) clinical and support surge capacity; (5) training, education, and exercises between federal and private sector partners; and (6) metrics, benchmarks, and modeling to track NDMS performance. These qualitative findings were subsequently refined, validated, and prioritized through a quantitative survey. Expert respondents ranked 64 statements based on weaknesses and opportunities identified during the qualitative phase. Data were collected using Likert scales, and multivariate proportions and confidence intervals were estimated to compare and prioritize each statement's level of support. Pairwise tests were conducted for each item-to-item pair to determine statistically significant differences. The survey results corroborated the earlier qualitative findings, with all weaknesses and opportunities ranked as important by a majority of respondents. Survey results also pointed to specific priorities for interventions within the 6 previously identified themes. As with the qualitative study, the survey found that the most common weaknesses and opportunities were related to coordination, collaboration, and communication, especially regarding information technology and planning at the federal and regional levels. These priority interventions are now being developed, implemented, and validated at 5 pilot partner sites.
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Affiliation(s)
- Thomas D. Kirsch
- Thomas D. Kirsch, MD, MPH, is a retired Professor and former Director, the National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences. Bethesda, MD
| | - Clark J. Lee
- Clark J. Lee, JD, MPH, is a Senior Research Associate, the National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences and The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
| | - David B. King
- David B. King, PhD, is a Senior Biostatistician, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
| | - Adeteju A. Adeniji
- Adeteju A. Adeniji, MPH, is a Research Coordinator, the National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences and The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
| | - Reena Sethi
- Reena Sethi, DrPH, MHS, is a Senior Public Health Lead Researcher, National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences and The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
| | - Eric C. Deussing
- Eric C. Deussing, MD, MPH, is an Assistant Professor and National Disaster Medical System Pilot Program Director, the National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD
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Ndiaye SM, Tiembre I, Amani YMR, Zamina BYG, Vroh JBB, Diarrassouba M. Assessment of Suspected COVID-19 Deaths in Nonhealthcare Settings in Côte d'Ivoire, March 11 to July 31, 2020. Health Secur 2023; 21:280-285. [PMID: 37352426 DOI: 10.1089/hs.2022.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
According to hospital records, 5 months after reporting its first case of COVID-19, Côte d'Ivoire reported only 102 deaths. We conducted a community mortality survey in the 13 districts where 95% of COVID-19 cases were reported to assess COVID-19 mortality in nonhealthcare settings. To identify suspected COVID-19 deaths in communities, we used data from social and administrative institutions, such as police and fire departments, funeral homes, and places of worship, whose functions include providing services related to deaths. Our survey identified 54 (17.6%) suspected COVID-19 deaths, which is more than half of the official reported number. Our study showed that in areas with low access to healthcare and poorly functioning death notification and registration systems, community-based data sources could be used to identify suspected COVID-19 deaths outside of the health sector. They can provide early warning data on events, such as an unusual number of community deaths or diseases.
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Affiliation(s)
- Serigne M Ndiaye
- Serigne M. Ndiaye, PhD, is Epidemiologists, Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Isaac Tiembre
- Isaac Tiembre, MD, is a Research Professors, Institut National d'Hygiene Publique, Abidjan, Côte d'Ivoire
| | - Yao Me Raphael Amani
- Yao Me Raphael Amani, MD, MPH, is a Medical Epidemiologist, Institut National d'Hygiene Publique, Abidjan, Côte d'Ivoire
| | - Bi Yourou Guillaume Zamina
- Bi Yourou Guillaume Zamani, PhD, is a Research Associate, Institut National d'Hygiene Publique, Abidjan, Côte d'Ivoire
| | - Joseph Bénié Bi Vroh
- Joseph Bénié Bi Vroh, MD, is a Research Professors, Institut National d'Hygiene Publique, Abidjan, Côte d'Ivoire
| | - Mamadou Diarrassouba
- Mamadou Diarrassouba, MD, MPH, is Epidemiologists, Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, GA
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Tomezsko PJ, Phillipson CW, Walsh ME. Lessons Learned From Limited Overlap of 15 In Vitro COVID-19 Drug Repurposing Screens. Health Secur 2023; 21:249-257. [PMID: 37196212 PMCID: PMC10357111 DOI: 10.1089/hs.2022.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 05/19/2023] Open
Abstract
Drug repurposing can quickly and cost-effectively identify medical countermeasures against pathogens with pandemic potential and could be used as a down-selection method for selecting US Food and Drug Administration-approved drugs to test in clinical trials. We compared results from 15 high-throughput in vitro screening efforts that tested approved and clinically evaluated drugs for activity against SARS-CoV-2 replication. From the 15 studies, 304 drugs were identified as displaying the highest level of confidence from the individual screens. Of those 304 drugs, 30 were identified in 2 or more screens, while only 3 drugs (apilimod, tetrandrine, and salinomycin) were identified in 4 screens. The lack of concordance in high-confidence hits and variations in protocols makes it challenging to use the collective data as down-selection criteria for identifying repurposing candidates to move into a clinical trial.
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Affiliation(s)
- Phillip J. Tomezsko
- Phillip J. Tomezsko, PhD, is Technical Staff, Counter WMD Systems Group, MIT Lincoln Laboratory, Lexington, MA
| | | | - Matthew E. Walsh
- Matthew E. Walsh was Associate Technical Staff, Biological and Chemical Technologies Group, MIT Lincoln Laboratory, Lexington, MA
- Matthew E. Walsh is currently a PhD Student, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Ramadan M, Kheirallah KA, Cegolon L, Bellizzi S. Maintaining Cross-Border Cargo Movements Between Jordan and Saudi Arabia During the COVID-19 Pandemic. Health Secur 2023; 21:319-322. [PMID: 37466656 DOI: 10.1089/hs.2022.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
One of Jordan's essential border crossings, the Al-Omari border crossing, is 1 of 3 land crossings between Jordan and Saudi Arabia and is located 160 km west of the capital city of Amman. Given its economic importance and essential role in the functioning of food supply networks across the region, Jordan undertook evidence-driven actions to keep the border crossing safely open during the initial phase of the COVID-19 pandemic. Cross-border coordination and collaboration, specifically with international contact tracing and case management, have been critical elements of Jordan's response. While several bottlenecks and delays led to documented clusters of infections among truck drivers, this case study illustrates the use of evidence to mitigate disease exposure and spread. Plans to manage public health threats need to consider sustainable strengthened surveillance and laboratory capacities coupled with efficient cross-border communication and coordination plans implemented across multiple sectors engaged in cross-country health.
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Affiliation(s)
- Mohannad Ramadan
- Mohannad Ramadan, MD, MSc, is a Research Assistant, Department of Pharmacology and Public Health, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Khalid A Kheirallah
- Khalid A. Kheirallah, PhD, is an Associate Professor, Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Luca Cegolon
- Luca Cegolon, MD, MSc, DTM&H, PhD, is a Clinical Lecturer in Public Health Medicine, University of Trieste, Department of Medical, Surgical & Health Science, and a Consultant Medical Epidemiologist, Unit of Occupational Medicine, University Health Agency Giuliano-Isontina; both in Trieste, Italy
| | - Saverio Bellizzi
- Saverio Bellizzi, MD, MSc, PhD, is a Consulting Medical Epidemiologist, Sassari, Italy
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Bruns R, Adalja A. Introduction to the Global Catastrophic Biological Risks Special Feature. Health Secur 2023; 21:247-248. [PMID: 37466655 DOI: 10.1089/hs.2023.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Affiliation(s)
- Richard Bruns
- Richard Bruns, PhD, and Amesh Adalja, MD, FIDSA, are Senior Scholars, Johns Hopkins Center for Health Security, Baltimore, MD
| | - Amesh Adalja
- Richard Bruns, PhD, and Amesh Adalja, MD, FIDSA, are Senior Scholars, Johns Hopkins Center for Health Security, Baltimore, MD
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Benedict KL, Brady HW, Newsome AL. Viral Disinfection of Porous Fomites Utilizing a Bacteriophage Model and Chlorine Dioxide Gas. Health Secur 2023; 21:303-309. [PMID: 37289796 DOI: 10.1089/hs.2022.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
The pursuit of disinfecting porous materials or fomites to inactivate viral agents has special challenges. To address these challenges, a highly portable chlorine dioxide (ClO2) gas generation system was used to ascertain the ability of a gaseous preparation to inactivate a viral agent, the MS2 bacteriophage, when associated with potentially porous fomites of cloth, paper towel, and wood. The MS2 bacteriophage is increasingly used as a model to identify means of inactivating infectious viral agents of significance to humans. Studies showed that MS2 bacteriophage can be applied to and subsequently recovered from potential porous fomites such as cloth, paper towel, and wood. Paired with viral plaque assays, this provided a means for assessing the ability of gaseous ClO2 to inactivate bacteriophage associated with the porous materials. Notable results include 100% inactivation of 6 log bacteriophage after overnight exposure to 20 parts per million(ppm) ClO2. Reducing exposure time to 90 minutes and gas ppm to lower concentrations proved to remain effective in bacteriophage elimination in association with porous materials. Stepwise reduction in gas concentration from 76 ppm to 5 ppm consistently resulted in greater than 99.99% to 100% reduction of recoverable bacteriophage. This model suggests the potential of ClO2 gas deployment systems for use in the inactivation of viral agents associated with porous potential fomites. The ClO2 gas could prove especially helpful in disinfecting enclosed areas containing viral contaminated surfaces, rather than manually spraying and wiping them.
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Affiliation(s)
- Kendall L Benedict
- Kendall L. Benedict is a Undergraduate Research Assistants, Department of Biology, Middle Tennessee State University, Murfreesboro, TN
| | - Hunter W Brady
- Hunter W. Brady is a Undergraduate Research Assistants, Department of Biology, Middle Tennessee State University, Murfreesboro, TN
| | - Anthony L Newsome
- Anthony L. Newsome, PhD, is a Professor, Department of Biology, Middle Tennessee State University, Murfreesboro, TN
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Abstract
Alternate care sites (ACSs) are temporary medical locations established in response to events that disrupt or limit the ability of established medical facilities to provide adequate care. As with established medical facilities, ACSs require careful consideration of infection prevention and control (IPC) practices to mitigate risk of nosocomial transmission and occupational exposure. We conducted a rapid systematic review of published literature from the date of inception of each database until the date the search was run (September 2021) on the IPC practices in ACSs. The practices described were categorized using the National Institute of Occupational Safety and Health hierarchy of controls framework, including elimination, substitution, engineering controls, administrative controls, and personal protective equipment. Of 313 articles identified, 55 were included. The majority (n=45, 81.8%) were case reports and described ACSs established in the context of infectious disease outbreaks (n=48, 87.3%), natural disasters (n=5, 9%), and military deployments (n=2, 3.6%). Implementation of engineering and/or administrative control practices predominated, with personal protective equipment emphasized in articles related to infectious disease outbreaks. These findings emphasize both a need for more high-quality research into the best practices for IPC in ACSs and how to incorporate the most effective strategies in these settings in response to future events.
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Affiliation(s)
- Molly L Paras
- Molly L. Paras, MD, is an Assistant Physician, Division of Infectious Diseases, Massachusetts General Hospital, and an Assistant Professor, Harvard Medical School
| | - Eileen F Searle
- Eileen F. Searle, PhD, RN, CCRN, is Director of Funded Projects, Center for Disaster Medicine, Department of Emergency Medicine, Massachusetts General Hospital
| | - Melis Lydston
- Melis Lydston, MLS, is Knowledge Specialist, Treadwell Library, Massachusetts General Hospital
| | - Erica S Shenoy
- Erica S. Shenoy, MD, PhD, is Medical Director, Infection Control, Mass General Brigham; an Associate Professor, Harvard Medical School; and a Physician, Division of Infectious Diseases, Massachusetts General Hospital
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Smith J, Gangadharan D, Hemphill M, Edwin S. Review of Restricted Experiment Requests, Division of Select Agents and Toxins, US Centers for Disease Control and Prevention, 2014-2021. Health Secur 2023. [PMID: 37195716 DOI: 10.1089/hs.2022.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
The US Centers for Disease Control and Prevention Division of Select Agents and Toxins (DSAT) regulates laboratories that possess, use, or transfer select agents and toxins within United States as part of the Federal Select Agent Program. DSAT also mitigates biosafety risks through the review of "restricted experiments," which under the select agent regulations are experiments that pose heightened biosafety risks. In a previous study, we evaluated restricted experimental requests submitted to DSAT for review between 2006 and 2013. The purpose of this study is to provide an updated analysis of requests to conduct potential restricted experiments submitted to DSAT between 2014 and 2021. This article describes the trends and characteristics of the data associated with restricted experimental requests involving select agents and toxins that have an impact on public health and safety (US Department of Health and Human Services agents only) or both public health and safety and animal health or products (overlap agents). From January 2014 to December 2021, DSAT received 113 requests to conduct potential restricted experiments; however, 82% (n=93) of those requests were determined not to meet the regulatory definition of a restricted experiment. Of the 20 requests that met the definition of a restricted experiment, 8 were denied because the experiments had the potential to compromise disease control in humans. DSAT continues to encourage entities to practice due diligence and request a review of research that could potentially meet the regulatory definition of a restricted experiment out of an abundance of caution to protect public health and safety and prevent any potential compliance action.
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Affiliation(s)
- Jacinta Smith
- Jacinta Smith, MS, is a Commander, United States Public Health Service, and a Health Scientist; in the Division of Select Agents and Toxins, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Denise Gangadharan
- Denise Gangadharan, PhD, is Associate Director for Science; in the Division of Select Agents and Toxins, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Mark Hemphill
- Mark Hemphill, MS, was Deputy Director; in the Division of Select Agents and Toxins, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Samuel Edwin
- Samuel Edwin, PhD, is Director; in the Division of Select Agents and Toxins, Office of Readiness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
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Wong B, Andrews N, Hathaway A, Burpee A, Agyemang E, Cooper B, Santibañez S. The Mashpee Wampanoag Tribe COVID-19 Pandemic Response: A Case Study. Health Secur 2023. [PMID: 37184662 DOI: 10.1089/hs.2022.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
During the COVID-19 pandemic, the Mashpee Wampanoag Tribe of southeastern Massachusetts requested US federal government assistance. The tribe collaborated successfully with many partners in response to the COVID-19 pandemic. In this case study, the authors describe the tribe's collaboration with a team from the Centers for Disease Control and Prevention who assisted with epidemiology, case investigation and contact tracing, infection prevention and control, community prevention measures, and vaccination. Collaborative efforts resulted in over 200 public service announcements and videos produced, 55 tribal staff trained, 222 people followed up for contact tracing, 80% of tribal members vaccinated, and 5 COVID-19 response plans written. Deployment response teams learned elements essential to partnering with a Native American tribe. This successful partnership during a rapidly evolving pandemic suggests the US federal government and tribal nations can work together effectively to build response capacity for future infectious disease threats.
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Affiliation(s)
- Betty Wong
- Betty Wong, DHSc, MPH, CHES, is a Health Scientist; on the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Nelson Andrews
- Nelson Andrews Jr, is a Tribal Councilman, Director of the Emergency Management Department, Vice President of Community Development Corporation, and Chairman of the Homeland Security and Emergency Services Committee; in the Mashpee Wampanoag Tribe, Mashpee, MA
| | - Allyssa Hathaway
- Allyssa Hathaway is an Assistant, Emergency Management Department; in the Mashpee Wampanoag Tribe, Mashpee, MA
| | - Adam Burpee
- Adam Burpee is an Emergency Manager, Federal Emergency Management Agency, Argyle, TX
| | - Elfriede Agyemang
- Elfriede Agyemang, MD, PhD, is a Medical Epidemiologist; on the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Barbara Cooper
- Barbara Cooper, MSPH, is a Public Health Advisor; on the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Scott Santibañez
- Scott Santibañez, MD, DMin, MPHTM, is Chief Medical Officer; on the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
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Coccia M. High potential of technology to face new respiratory viruses: mechanical ventilation devices for effective healthcare to next pandemic emergencies. Technol Soc 2023; 73:102233. [PMID: 36993793 PMCID: PMC10028215 DOI: 10.1016/j.techsoc.2023.102233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 05/20/2023]
Abstract
Some countries in the presence of unforeseen Coronavirus Disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have experienced lower total deaths, though higher numbers of COVID-19 related infections. Results here suggest that one of the explanations is the critical role of ventilator technology in clinical health environment to cope with the initial stage of COVID-19 pandemic crisis. Statistical evidence shows that a large number of ventilators or breathing devices in countries (26.76 units per 100,000 inhabitants) is associated with a fatality rate of 1.44% (December 2020), whereas a higher fatality rate given by 2.46% is in nations with lower numbers of ventilator devices (10.38 average units per 100,000 people). These findings suggest that a large number of medical ventilators in clinical setting has a high potential for more efficient healthcare and improves the effective preparedness of crisis management to cope with new respiratory pandemic diseases in society. Hence, a forward-thinking and technology-oriented strategy in healthcare sector, based on investments in high-tech ventilator devices and other new medical technologies, can help clinicians deliver effective care and reduce negative effects of present and future respiratory infectious diseases, in particular when new drugs and appropriate treatments are missing in clinical environment to face unknown respiratory viral agents .
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Affiliation(s)
- Mario Coccia
- CNR -- National Research Council of Italy, Research Area of the National Research Council, Strada delle Cacce, 73-10135, Turin, Italy
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