Ethical biogovernance in pandemic mandates: a cross-national analysis of healthcare worker vaccination policies

First Confirmed Cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection in the United States, Updated Information on the Epidemiology of MERS-CoV Infection, and Guidance for the Public, Clinicians, and Public Health Authorities—May 2014

Health-care associate transmission of Middle East Respiratory Syndrome Corona virus, MERS-CoV, in the Kingdom of Saudi Arabia

The 21st century has seen several infectious disease outbreaks that have turned into epidemics and pandemics including Severe Acute Respiratory Syndrome (SARS) which began in Asia in 2003 (Poon, Guan, Nicholls, Yuen, & Peiris, 2004), followed by H1N1 that emerged in Mexico and the United States in 2009 (Belongia et al., 2010). Next came the lesser known Middle East Respiratory Syndrome (MERS) originating in Saudi Arabia in 2012 (Assiri et al., 2013), after which the Ebola outbreak in West Africa took place from 2014 to 2016, with a more recent occurrence in the Democratic Republic of Congo from 2018 to 2019 (Malvy, McElroy, de Clerck, Günther, & van Griensven, 2019). To date, the coronavirus (COVID-19) outbreak that started in Wuhan, in the Hubei province of China, in late December 2019 seems to be eclipsing all of these previous infectious diseases in terms of its global reach and impact (Wang, Horby, Hayden, & Gao, 2020). After being declared by the World Health Organization (WHO) as a public health emergency on 30 January 2020 (World Health Organization, 2020c), it was elevated to a pandemic status on 11 March 2020 (World Health Organization, 2020d). As of 28 April 2020, there are more than 2.9 million cases and 202,597 deaths reported worldwide (World Health Organization, 2020b).

Severe Acute Respiratory Syndrome: The Evolution of a New Epidemic

Sisonke: reaching several goals together

Background:Vaccine hesitancy can limit the benefits of available vaccines in halting the spread of COVID-19 pandemic. Previously published studies paid little attention to Arab countries, which has a population of over 440 million. In this study, we present the results of the first large-scale multinational study that measures vaccine hesitancy among Arab-speaking subjects.Methods:An online survey in Arabic was conducted from 14 January 2021 to 29 January 2021. It consisted of 17 questions capturing demographic data, acceptance of COVID-19 vaccine, attitudes toward the need for COVID-19 vaccination and associated health policies, and reasons for vaccination hesitancy. R software v.4.0.2 was used for data analysis and visualization.Results:The survey recruited 36,220 eligible participants (61.1% males, 38.9% females, mean age 32.6 ± 10.8 years) from all the 23 Arab countries and territories (83.4%) and 122 other countries (16.6%). Our analysis shows a significant rate of vaccine hesitancy among Arabs in and outside the Arab region (83% and 81%, respectively). The most cited reasons for hesitancy are concerns about side effects and distrust in health care policies, vaccine expedited production, published studies and vaccine producing companies. We also found that female participants, those who are 30–59 years old, those with no chronic diseases, those with lower level of academic education, and those who do not know the type of vaccine authorized in their countries are more hesitant to receive COVID-19 vaccination. On the other hand, participants who regularly receive the influenza vaccine, health care workers, and those from countries with higher rates of COVID-19 infections showed more vaccination willingness. Interactive representation of our results is posted on our project website at https://mainapp.shinyapps.io/CVHAA.Conclusions:Our results show higher vaccine hesitancy and refusal among Arab subjects, related mainly to distrust and concerns about side effects. Health authorities and Arab scientific community have to transparently address these concerns to improve vaccine acceptance.Funding:This study received no funding.

provide a powerful lift to growth—both in the short and the long term—if they are well aligned with individual country conditions . These include an economy’s level of development, its position in the economic cycle, and its available macroeconomic policy space to support reforms. The larger a country’s output gap, the more it should prioritize structural reforms that will support growth in the short term and the long term—such as product market deregulation and infrastructure investment. Macroeconomic support can help make reforms more effective, by bringing forward long-term gains or alleviating their short-term costs . Where monetary policy is becoming over-burdened, domestic policy coordination can help make macroeconomic support more effective. Fiscal space, where it exists, should be used to offset short-term costs of reforms. And where fiscal constraints are binding, budget-neutral reform packages with positive demand effects should take priority. Some structural reforms can themselves help generate fiscal space. For example, IMF research finds that by boosting output, product market deregulation can help lower the debt-to-GDP ratio over time. Formulating a medium-term plan that clarifies the long-term objectives of fiscal policy can also help increase near-term fiscal space. With nearly all G-20 economies operating at below-potential output, the IMF is recommending measures that both boost near-term growth and raise long-term potential growth. For example: ? In advanced economies, these measures include shifting public spending toward infrastructure investment (Australia, Canada, Germany, United States (US)); promoting product market reforms (Australia, Canada, Germany, Japan, Korea, Italy) and labor market reforms (Canada, Germany, Japan, Korea, United Kingdom (UK), US); and fiscal structural reforms (France, UK, US). Where there is fiscal space, lowering employment protection is also recommended (Korea). ? Recommendations for emerging markets (EMs) focus on raising public investment efficiency ( India, Saudi Arabia, South Africa), labor market reforms (Indonesia, Russia, Saudi Arabia, South Africa, Turkey), and product market reforms (China, Saudi Arabia, South Africa), which would boost investment and productivity within tighter budgetary constraints particularly if barriers to trade and FDI were eased (Brazil, India, Indonesia). Governance (China, South Africa) and other institutional reforms are also crucial. Where policy space is limited, adjusting the composition of fiscal policy can create space to support reforms ( Argentina, India, Mexico, Russia). ? Some commodity-exporting EMs (Brazil, Russia, Saudi Arabia, South Africa) are facing acute challenges, with output significantly below potential and an urgent need to rebuild fiscal buffers. To bolster growth, Fund staff recommends product market and legal reforms to improve the business climate and investment; trade and FDI liberalization to facilitate diversification; and financial deepening to boost credit flows. IMF advice also aims to promote inclusiveness and macroeconomic resilience. The Fund recommends a targeted expansion of social spending toward vulnerable groups (Mexico), social spending for the elderly poor ( Korea), and upgrading social programs for the nonworking poor (US). Recommendations to bolster macrofinancial resilience include expanding the housing supply (UK), resolving the corporate debt overhang (China, Korea), coordinating a national approach to regulating and supervising life insurers (US), and reforming monetary frameworks (Argentina, China).

Since mid-March 2014, the frequency with which cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection have been reported has increased, with the majority of recent cases reported from Saudi Arabia and United Arab Emirates (UAE). In addition, the frequency with which travel-associated MERS cases have been reported and the number of countries that have reported them to the World Health Organization (WHO) have also increased. The first case of MERS in the United States, identified in a traveler recently returned from Saudi Arabia, was reported to CDC by the Indiana State Department of Health on May 1, 2014, and confirmed by CDC on May 2. A second imported case of MERS in the United States, identified in a traveler from Saudi Arabia having no connection with the first case, was reported to CDC by the Florida Department of Health on May 11, 2014. The purpose of this report is to alert clinicians, health officials, and others to increase awareness of the need to consider MERS-CoV infection in persons who have recently traveled from countries in or near the Arabian Peninsula. This report summarizes recent epidemiologic information, provides preliminary descriptions of the cases reported from Indiana and Florida, and updates CDC guidance about patient evaluation, home care and isolation, specimen collection, and travel as of May 13, 2014.

Reconciling breast-feeding and early food introduction guidelines in the prevention and management of food allergy

Racism is a structural determinant of health. While racism in health care services is increasingly well-researched, public health services and public health authorities (PHA) have been neglected as institutional contexts. Yet, PHA play an essential role in protecting and promoting population health at a local and national level. To help fill this research gap, we mapped the academic discourse on racism in PHA with a narrative scoping review. We searched in PubMed, Embase, PsycINFO and CINAHL as well as the reference lists of retrieved publications. We included literature assessing racism in interactions between all stakeholders involved or in the actions (not) taken by PHA, while we excluded literature exclusively focusing on health care facilities. We applied situational analysis (SA) for interpreting the scientific discourse on racism in PHA. Our search yielded 55 publications that include survey and intervention studies as well as opinion pieces. Most of the literature focuses on the US, Australia and New Zealand/Aotearoa. The Tuskegee experiment has been discussed extensively acknowledging the political and historical elements of the racist, inhumane practices and policies in PHA. More recent literature explores anti-racism approaches and how they can facilitate access for racialized, socially multiply stigmatized groups (e.g., screening uptake in racialized queer people). SA also suggests racialized groups may be implicated or silenced groups in racism research surrounding PHA. We show that the literature on racism in PHA is limited, mostly processing historical policies. Studies on how racism affects equitable access to PHA and the associated health inequities are lacking. Positive examples highlight the importance of a) building the services in PHA on anti-racism and equity-driven principles and b) integrating and amplifying the voices of racialized community. Public health research on racism needs to extend the scope from health care services to the under researched public health services and authorities.

Racism is a structural determinant of health. While racism in health care services is increasingly well-researched, public health services and public health authorities (PHA) have been neglected as institutional contexts. Yet, PHA play an essential role in protecting and promoting population health at a local and national level. To help fill this research gap, we mapped the academic discourse on racism in PHA with a narrative scoping review. We searched in PubMed, Embase, PsycINFO and CINAHL as well as the reference lists of retrieved publications. We included literature assessing racism in interactions between all stakeholders involved or in the actions (not) taken by PHA, while we excluded literature exclusively focusing on health care facilities. We applied situational analysis (SA) for interpreting the scientific discourse on racism in PHA. Our search yielded 55 publications that include survey and intervention studies as well as opinion pieces. Most of the literature focuses on the US, Australia and New Zealand/Aotearoa. The Tuskegee experiment has been discussed extensively acknowledging the political and historical elements of the racist, inhumane practices and policies in PHA. More recent literature explores anti-racism approaches and how they can facilitate access for racialized, socially multiply stigmatized groups (e.g., screening uptake in racialized queer people). SA also suggests racialized groups may be implicated or silenced groups in racism research surrounding PHA. We show that the literature on racism in PHA is limited, mostly processing historical policies. Studies on how racism affects equitable access to PHA and the associated health inequities are lacking. Positive examples highlight the importance of a) building the services in PHA on anti-racism and equity-driven principles and b) integrating and amplifying the voices of racialized community. Public health research on racism needs to extend the scope from health care services to the under researched public health services and authorities.

Medical advice for international travelers.

The Segregated Schooling of Blacks in the Southern United States and South Africa

Dans cet article, l'auteur se propose d'analyser les similitudes dans l'education des Afro-americains et sud-africains noirs durant les periodes de segregation et d'Apartheid. La nature de l'oppression en milieu scolaire permet de lier les approches des Etats-Unis et de l'Afrique du Sud en matiere d'education pour les populations visees ainsi que l'usage par les communautes noires, dans ces deux contextes, de l'education comme ascenseur social, permettant de depasser les limites imposees par la segregation. Il est a noter egalement les strategies identiques, dans ces deux environnements, mises en place par les parents, les chefs d'etablissements et les enseignants pour encourager les eleves a depasser le contexte de l'oppression...

BACKGROUND AND OBJECTIVESIn Saudi Arabia (SA), injuries are the second leading cause of death; however, little is known about their frequencies and outcomes. Trauma registries play a major role in measuring the burden on population health. This study aims to describe the population of the only hospital-based trauma registry in the country and highlight challenges and potential opportunities to improve trauma data collection and research in SA.DESIGN AND SETTINGSUsing data between 2001 and 2010, this retrospective study included patients from a large trauma center in Riyadh, SA.PATIENTS AND METHODSA staff nurse utilized a structured checklist to gather information on patients’ demographic, physiologic, anatomic, and outcome variables. Basic descriptive statistics by age group (≤14 vs >14 years) were calculated, and differences were assessed using student t and chi-square tests. In addition, the mechanism of injury and the frequency of missing data were evaluated.RESULTS10 847 patients from the trauma registry were included. Over 9% of all patients died either before or after being treated at the hospital. Patients who were older than 14 years of age (more likely to be male) sustained traffic-related injuries and died in the hospital as compared to patients who were younger than or equal to years of age. Deceased patients were severely injured as measured by injury severity score and Glasgow Coma Scale (P<.001). Overall, the most frequent type of injury was related to traffic (52.0%), followed by falls (23.4%). Missing values were mostly prevalent in traffic-related variables, such as seatbelt use (70.2%).CONCLUSIONThis registry is a key step toward addressing the burden of injuries in SA. Improved injury classification using the International Classification of Disease-external cause codes may improve the quality of the registry and allow comparison with other populations. Most importantly, injury prevention in SA requires further investment in data collection and research to improve outcomes.