Participatory COVID-19 Surveillance Tool in Rural Appalachia: Real-Time Disease Monitoring and Regional Response

IntroductionFew US studies have examined the usefulness of participatory surveillance during the coronavirus disease 2019 (COVID-19) pandemic for enhancing local health response efforts, particularly in rural settings. We report on the development and implementation of an internet-based COVID-19 participatory surveillance tool in rural Appalachia.MethodsA regional collaboration among public health partners culminated in the design and implementation of the COVID-19 Self-Checker, a local online symptom tracker. The tool collected data on participant demographic characteristics and health history. County residents were then invited to take part in an automated daily electronic follow-up to monitor symptom progression, assess barriers to care and testing, and collect data on COVID-19 test results and symptom resolution.ResultsNearly 6500 county residents visited and 1755 residents completed the COVID-19 Self-Checker from April 30 through June 9, 2020. Of the 579 residents who reported severe or mild COVID-19 symptoms, COVID-19 symptoms were primarily reported among women (n = 408, 70.5%), adults with preexisting health conditions (n = 246, 70.5%), adults aged 18-44 (n = 301, 52.0%), and users who reported not having a health care provider (n = 131, 22.6%). Initial findings showed underrepresentation of some racial/ethnic and non–English-speaking groups.Practical ImplicationsThis low-cost internet-based platform provided a flexible means to collect participatory surveillance data on local changes in COVID-19 symptoms and adapt to guidance. Data from this tool can be used to monitor the efficacy of public health response measures at the local level in rural Appalachia.     

Meeting Summary: Global Vaccine and Immunization Research Forum, 2021

The 2021 Global Vaccine and Immunization Research Forum highlighted the considerable advances and recent progress in research and development for vaccines and immunization, critically reviewed lessons learned from COVID-19 vaccine programs, and looked ahead to opportunities for this decade.For COVID-19, decades of investments in basic and translational research, new technology platforms, and vaccines targeting prototype pathogens enabled a rapid, global response. Unprecedented global coordination and partnership have played an essential role in creating and delivering COVID-19 vaccines. More improvement is needed in product attributes such as deliverability, and in equitable access to vaccines.Developments in other priority areas included: the halting of two human immunodeficiency virus vaccine trials due to lack of efficacy in preventing infection; promising efficacy results in Phase 2 trials of two tuberculosis vaccines; pilot implementation of the most advanced malaria vaccine candidate in three countries; trials of human papillomavirus vaccines given in single-dose regimens; and emergency use listing of a novel, oral poliomyelitis type 2 vaccine. More systematic, proactive approaches are being developed for fostering vaccine uptake and demand, aligning on priorities for investment by the public and private sectors, and accelerating policy making.Participants emphasized that addressing endemic disease is intertwined with emergency preparedness and pandemic response, so that advances in one area create opportunities in the other. In this decade, advances made in response to the COVID-19 pandemic should accelerate availability of vaccines for other diseases, contribute to preparedness for future pandemics, and help to achieve impact and equity under Immunization Agenda 2030.     

COVID-19’s impact on primary care and related mitigation strategies: A scoping review

BackgroundThe COVID-19 pandemic has had a substantial impact on primary care throughout Europe and globally.ObjectivesThis review aims to ascertain how the pandemic has impacted primary care service provision/patients and to examine strategies to mitigate these impacts.MethodsThe scoping review framework comprised a six-stage process developed by Arksey and O''Malley. The search process was guided by the Joanna Briggs Institute three-step search strategy and involved searching the PubMed, Embase, Scopus, CINAHL Plus, and Cochrane Library databases. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A thematic analysis approach by Braun and Clarke was used to interpret the findings.ResultsThirty-two studies from 18 countries and six continents were included, 13 reported original research, three were reviews, and 16 were case reports reporting healthcare systems’ experiences of dealing with the pandemic. Emerging themes concerned the COVID-19 pandemic’s impact on primary care service provision and patients, the impact of the rapid transition to telemedicine due to COVID-19 on primary care, and strategies to mitigate the impact of COVID-19 on primary care (i.e. infection prevention and control measures, alternatives/modifications to traditional service delivery or workflow, government policy responses, and education).ConclusionThe COVID-19 pandemic has considerably impacted on primary care at both service and patient levels, and various strategies to mitigate these impacts have been described. Future research examining the pandemic’s ongoing impacts on primary care, as well as strategies to mitigate these impacts, is a priority.     

Responding to pandemics and other disease outbreaks in homeless populations: A review of the literature and content analysis

Considering the recent COVID-19 pandemic, we recognised a lack of synthesis amongst the available literature pertaining to the intersections of homelessness and pandemic response and planning. Therefore, the purpose of this review was to identify relevant peer-reviewed literature in this area to thematically produce evidence-based recommendations that would inform community planning and response amongst homeless populations. Although this review is inspired by the COVID-19 pandemic, our intention was to produce relevant recommendations to for all current and future outbreaks and pandemics more generally. Our search criteria focused on pandemics and rapid-spread illnesses such as contagious respiratory diseases with contact spread and with an emphasis on individuals experiencing homelessness. Content analysis methods were followed to extract and thematically synthesise key information amongst the 223 articles that matched our search criteria between the years of 1984 and 2020. Two reviewers were assigned to the screening process and used Covidence and undertook two rounds of discussion to identify and finalise themes for extraction. This review illustrates that the current breadth of academic literature on homeless populations has thus far focused on tuberculosis (TB) rather than diseases that are more recent and closely related to COVID-19—such as Severe Acute Respiratory Syndrome (SARS) or H1N1. Our thematic content analysis revealed six themes that offer tangible and scalable recommendations which include (1) education and outreach, (2) adapting structure of services, (3) screening and contract tracing, (4) transmission and prevention strategies, (5) shelter protocols and (6) treatment, adherence and vaccination. The breadth and depth of reviews such as these are dependent on the quantity and quality of the available literature. Therefore, the limited existing literature outside of tuberculosis specific to homelessness in this review illustrates a need for more academic research into the intersections of pandemics and homelessness—particularly for evaluations of response and planning. Nonetheless, this review offers timely considerations for pandemic response and planning amongst homeless populations during the current COVID-19 pandemic and can facilitate future research in this area.     

新冠肺炎事件中科技期刊的社会责任及应急响应机制

【目的】 解读新冠肺炎事件中我国科技期刊的抗疫责任、危机应对措施及响应特征,为保障新冠肺炎知识的有效传播,增强科技期刊的突发事件应对能力提供参考。【方法】 通过分析疫情危机中我国科技期刊采取的措施和新冠肺炎文献的刊载数据,研究科技期刊的应急响应机制。【结果】 疫情发生后,科技期刊主要从约稿、审稿和宣传3个方面采取应急响应措施。截至2020年2月27日,共有150种科技期刊以网络首发的形式刊载新冠肺炎文献604篇,涵盖6个研究方向,最高文献下载量达20587次。【结论】 新冠肺炎事件中,我国科技期刊应积极承担起传播相关科学知识的责任,主动作为,发挥出重要的抗疫作用,同时也需要编辑人员进一步加强把关意识,恪守职业道德,提升服务能力。     

One Year of Pandemic Learning Response: Benefits of Massive Online Delivery of the World Health Organization’s Technical Guidance

The World Health Organization (WHO) launched the first web-based learning course on COVID-19 on January 26, 2020, four days before the director general of the WHO declared a public health emergency of international concern. The WHO is expanding access to web-based learning for COVID-19 through its open-learning platform for health emergencies, OpenWHO. Throughout the pandemic, OpenWHO has continued to publish learning offerings based on the WHO’s emerging evidence-based knowledge for managing the COVID-19 pandemic. This study presents the various findings derived from the analysis of the performance of the OpenWHO platform during the pandemic, along with the core benefits of massive web-based learning formats.     

突发公共卫生事件下世界卫生组织推动全球医药产品创新与可及的行动

全球医药产品创新与可及是推动全球健康公平、维护全球卫生安全的重要内容,更是有效防控传染病暴发流行等突发公共卫生事件的关键手段.世界卫生组织(WHO)作为全球最大的政府间卫生组织,在多次抗击突发公共卫生事件中制定了系列政策和行动方案.本文总结了WHO在全球医药产品创新与可及领域所采取的行动,如制定研发蓝图、推动紧急使用清...     

世界卫生组织应对新型冠状病毒肺炎的机制

新型冠状病毒肺炎的大流行是这个时代的全球卫生危机,也是我们目前所面临的最大挑战。在世界范围内,传染病的管理关键在于遵守国际法规,进行国际合作,以追求共同利益和价值。WHO是联合国系统下管理和控制疾病传播的专门性国际组织。本文对WHO应对传染病的防控机制、新型冠状病毒肺炎疫情的应对措施以及努力方向进行综述,以期为全球新型冠状病毒肺炎疫情控制提供参考。     

Experiences of gardening during the early stages of the COVID-19 pandemic

Gardening has the potential to improve health and wellbeing, especially during crises. Using an international survey of gardeners (n = 3743), this study aimed to understand everyday gardening experiences, perspectives and attitudes during early stages of the COVID-19 pandemic in 2020. Our qualitative reflexive thematic and sentiment analyses show that during the first months of the COVID-19 pandemic, gardening seemed to create a safe and positive space where people could socially connect, learn and be creative. Participants had more time to garden during the pandemic, which led to enhanced connections with family members and neighbours, and the ability to spend time in a safe outdoor environment. More time gardening allowed for innovative and new gardening practices that provided enjoyment for many participants. However, our research also highlighted barriers to gardening (e.g. lack of access to garden spaces and materials). Our results illustrate the multiple benefits of gardening apparent during COVID-19 through a lens of the social-ecological model of health.     

新型冠状病毒肺炎实验室诊断技术研究进展

 

2019年12月,湖北省武汉市发现以肺部病变为主的新型冠状病毒感染,2020年2月11日世界卫生组织（WHO）将由新型冠状病毒引发的疾病正式命名为2019冠状病毒病（coronavirus disease 2019,COVID-19）,该病毒称为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。COVID-19短时间内扩散到全国,3月11日WHO宣布COVID-19已构成全球大流行。实验室检测是确诊COVID-19的重要依据,对于该病的治疗和防疫工作至关重要。本文对COVID-19实验室临床诊断技术相关进展进行整理综述。

     

Association of Lifestyle Changes Due to the COVID-19 Pandemic with Nutrient Intake and Physical Activity Levels during Pregnancy in Japan

The coronavirus disease 2019 (COVID-19) pandemic has introduced changes in our lifestyles, such as refraining from unnecessary outings. This study aimed to clarify the association of lifestyle changes due to the COVID-19 pandemic with nutrient intake and physical activity levels during pregnancy in Japan. A cross-sectional study involving 168 healthy pregnant Japanese women was conducted in 2020. Nutrient intake and physical activity levels were assessed using validated self-administered questionnaires. Participants who reported experiencing changes in both dietary habits and physical activity due to the COVID-19 pandemic were classified as the lifestyle-affected group. Analysis of covariance was used. Among primiparas, intake of the following nutrients was significantly higher in the lifestyle-affected group (n = 14) than in the unaffected group (n = 77): protein, potassium, calcium, magnesium, and vitamin B₆. Among multiparas, the intake of dietary fiber and β-carotene were significantly lower in the lifestyle-affected group (n = 13) than in the unaffected group (n = 64). No significant differences in physical activity levels were observed in accordance with the lifestyle changes. These findings suggest that lifestyle changes due to the COVID-19 pandemic have positive effects on nutrient intake during pregnancy in primiparas, whereas in multiparas, these changes have negative effects.     

COVID-19 Surveillance in the Biobank at the Colorado Center for Personalized Medicine: Observational Study

BackgroundCharacterizing the experience and impact of the COVID-19 pandemic among various populations remains challenging due to the limitations inherent in common data sources, such as electronic health records (EHRs) or cross-sectional surveys.ObjectiveThis study aims to describe testing behaviors, symptoms, impact, vaccination status, and case ascertainment during the COVID-19 pandemic using integrated data sources.MethodsIn summer 2020 and 2021, we surveyed participants enrolled in the Biobank at the Colorado Center for Personalized Medicine (CCPM; N=180,599) about their experience with COVID-19. The prevalence of testing, symptoms, and impacts of COVID-19 on employment, family life, and physical and mental health were calculated overall and by demographic categories. Survey respondents who reported receiving a positive COVID-19 test result were considered a “confirmed case” of COVID-19. Using EHRs, we compared COVID-19 case ascertainment and characteristics in EHRs versus the survey. Positive cases were identified in EHRs using the International Statistical Classification of Diseases, 10th revision (ICD-10) diagnosis codes, health care encounter types, and encounter primary diagnoses.ResultsOf the 25,063 (13.9%) survey respondents, 10,661 (42.5%) had been tested for COVID-19, and of those, 1366 (12.8%) tested positive. Nearly half of those tested had symptoms or had been exposed to someone who was infected. Young adults (18-29 years) and Hispanics were more likely to have positive tests compared to older adults and persons of other racial/ethnic groups. Mental health (n=13,688, 54.6%) and family life (n=12,233, 48.8%) were most negatively affected by the pandemic and more so among younger groups and women; negative impacts on employment were more commonly reported among Black respondents. Of the 10,249 individuals who responded to vaccination questions from version 2 of the survey (summer 2021), 9770 (95.3%) had received the vaccine. After integration with EHR data up to the time of the survey completion, 1006 (4%) of the survey respondents had a discordant COVID-19 case status between EHRs and the survey. Using all longitudinal EHR and survey data, we identified 11,472 (6.4%) COVID-19-positive cases among Biobank participants. In comparison to COVID-19 cases identified through the survey, EHR-identified cases were younger and more likely to be Hispanic.ConclusionsWe found that the COVID-19 pandemic has had far-reaching and varying effects among our Biobank participants. Integrated data assets, such as the Biobank at the CCPM, are key resources for population health monitoring in response to public health emergencies, such as the COVID-19 pandemic.     

Pandemics,infodemics and health promotion

The COVID-19 pandemic and the accompanying infodemic are significant public health issues. The COVID-19 infodemic has been prolific from early in the pandemic response, and has continued to escalate during vaccine rollout. COVID-19 is the first pandemic in the social media era, expediting the need for effective measures to manage the high volume of information and misinformation. To address the infodemic, the World Health Organization (WHO) and others have commenced a comprehensive program of work, building capacity, raising awareness and developing new tools and methods. As part of the WHO capacity building effort, they have developed a comprehensive infodemic manager training program. The authors of this paper are Australian alumni from the first two training courses, all authors have health promotion backgrounds. Health Promotion Practitioners are uniquely positioned to build on existing skills, knowledge and reach to develop preventative strategies to help mitigate infodemics. This paper offers our combined perspectives on why the infodemic is a significant health promotion concern and the role we believe Health Promotion Practitioners can play in managing and mitigating the infodemic.     

COVID-19 reveals weak health systems by design: Why we must re-make global health in this historic moment

ABSTRACT

The COVID-19 pandemic demonstrates the critical need to reimagine and repair the broken systems of global health. Specifically, the pandemic demonstrates the hollowness of the global health rhetoric of equity, the weaknesses of a health security-driven global health agenda, and the negative health impacts of power differentials not only globally, but also regionally and locally. This article analyses the effects of these inequities and calls on governments, multilateral agencies, universities, and NGOs to engage in true collaboration and partnership in this historic moment. Before this pandemic spreads further – including in the Global South – with potentially extreme impact, we must work together to rectify the field and practice of global health.     

The Pandemic,Infodemic, and People’s Resilience in India: Viewpoint

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused widespread fear and stress. The pandemic has affected everyone, everywhere, and created systemic inequities, leaving no one behind. In India alone, more than 34,094,373 confirmed COVID-19 cases and 452,454 related deaths have been reported as of October 19, 2021. Around May 2021, the daily number of new COVID-19 cases crossed the 400,000 mark, seriously hampering the health care system. Despite the devastating situation, the public response was seen through their efforts to come forward with innovative ideas for potential ways to combat the pandemic, for instance, dealing with the shortage of oxygen cylinders and hospital bed availability. With increasing COVID-19 vaccination rates since September 2021, along with the diminishing number of daily new cases, the country is conducting preventive and preparatory measures for the third wave. In this article, we propose the pivotal role of public participation and digital solutions to re-establish our society and describe how Sustainable Development Goals (SDGs) can support eHealth initiatives and mitigate infodemics to tackle a postpandemic situation. This viewpoint reflects that the COVID-19 pandemic has featured a need to bring together research findings across disciplines, build greater coherence within the field, and be a driving force for multi-sectoral, cross-disciplinary collaboration. The article also highlights the various needs to develop digital solutions that can be applied to pandemic situations and be reprocessed to focus on other SDGs. Promoting the use of digital health care solutions to implement preventive measures can be enhanced by public empowerment and engagement. Wearable technologies can be efficiently used for remote monitoring or home-based care for patients with chronic conditions. Furthermore, the development and implementation of informational tools can aid the improvement of well-being and dissolve panic-ridden behaviors contributing toward infodemics. Thus, a call to action for an observatory of digital health initiatives on COVID-19 is required to share the main conclusions and lessons learned in terms of resilience, crisis mitigation, and preparedness.     

Health system’s response to the COVID-19 pandemic in conflict settings: Policy reflections from Palestine

ABSTRACT

As the COVID-19 pandemic spreads, concerns are particularly serious in conflict and humanitarian settings. Tackling the pandemic in those countries is challenging due to the fragility of socioeconomic and health systems. Palestine is one of those countries that is facing compounding challenges, instability, fragility, living conditions, poverty, and mobility, all of which are caused by multifactorial etiology. The Pandemic shows triple tragedies; virus (COVID-19 Pandemic), ongoing Israeli occupation (Politics), and Intra-Palestinian divide (Policies). Yet, Palestine’s response to the pandemic is outperforming many countries in the region. The early preventative lockdown measures in the West Bank found effective and not overwhelming the already over-stretched health system. While in the Gaza Strip, the response was slow. Prisoners, labours, besieged people, socioeconomic-disadvantaged classes, and refugees were put at additional high risk. Nonetheless, measures taken were unconsolidated in both regions largely due to the political factors. A little collaboration and inter-agency task forces in preparedness and response was observed, and the mechanisms and governance remain ambiguous. A consolidated and evidence-based nation-wide plan is required, whereby state and non-state actors have a clear and transparent exit strategy. A new thinking approach to promote the public health system and evidence-informed policies in Palestine is an urgent national priority.     

The Anticipated Future of Public Health Services Post COVID-19: Viewpoint

In March 2020, the World Health Organization declared COVID-19 as a global pandemic. The COVID-19 pandemic has affected various public health functions and essential services in different ways and magnitudes. Although all countries have witnessed the effect of COVID-19, the impact differed based on many factors including the integrity and resiliency of the countries’ health systems. This paper presents opinions and expectations of the authors about the anticipated changes in the future of public health at the global, regional, and national levels. The viewpoint is based on the current efforts and challenges that various stakeholders have carried out to control COVID-19 and the contribution from the literature on the future of public health. Numerous agencies and actors are involved in the fight against COVID-19 with variations in their effectiveness. The public health services showed weaknesses in most of the countries, in addition to the lack of adequate curative medicine settings. The pandemic highlighted the need for better governance and stronger and more resilient health systems and capacities. The COVID-19 experience has also emphasized the importance of coordination and collaboration among the countries and stakeholders. The COVID-19 pandemic might lead to a wide discussion to improve international and national approaches to prepare for and respond to similar events in terms of preparedness and response mechanisms and tools. Public health will not be the same as before COVID-19. New health priorities, approaches, and new agendas will be on the table of the global platforms and initiatives. More investment in research and technology to meet the demand for new vaccines and medicines, innovative methods like distance learning and working, more respect and remuneration to health professionals, and normalization of the public health and social measures that were induced during the COVID-19 pandemic are expected to be seen in future.     

Early health system responses to the COVID-19 pandemic in Mediterranean countries: A tale of successes and challenges

This paper conducts a comparative review of the (curative) health systems’ response taken by Cyprus, Greece, Israel, Italy, Malta, Portugal, and Spain during the first six months of the COVID-19 pandemic. Prior to the COVID-19 pandemic, these Mediterranean countries shared similarities in terms of health system resources, which were low compared to the EU/OECD average. We distill key policy insights regarding the governance tools adopted to manage the pandemic, the means to secure sufficient physical infrastructure and workforce capacity and some financing and coverage aspects.We performed a qualitative analysis of the evidence reported to the ‘Health System Response Monitor’ platform of the European Observatory by country experts. We found that governance in the early stages of the pandemic was undertaken centrally in all the Mediterranean countries, even in Italy and Spain where regional authorities usually have autonomy over health matters. Stretched public resources prompted countries to deploy “flexible” intensive care unit capacity and health workforce resources as agile solutions. The private sector was also utilized to expand resources and health workforce capacity, through special public-private partnerships. Countries ensured universal coverage for COVID-19-related services, even for groups not usually entitled to free publicly financed health care, such as undocumented migrants.We conclude that flexibility, speed and adaptive management in health policy responses were key to responding to immediate needs during the COVID-19 pandemic. Financial barriers to accessing care as well as potentially higher mortality rates were avoided in most of the countries during the first wave. Yet it is still early to assess to what extent countries were able to maintain essential services without undermining equitable access to high quality care.