Global Health Event Research Articles

Adapting to change: Clalit's response to the COVID-19 pandemic

The COVID-19 pandemic is the most significant global health event of the past century. The profound and unexpected changes that it brought about have forced healthcare organizations to make far-reaching adjustments to accommodate the new reality. With the outbreak of the pandemic in Israel and the understanding of its consequences, Clalit Health Services (Clalit), the largest healthcare organization in Israel, rapidly mobilized in order to provide the best response possible from the perspective of both its patients and its employees. In the short term, four designated workgroups were established just days into the pandemic. Their task was to prepare operational work plans to achieve the following goals: providing the best possible treatment for COVID patients; maintaining the level of care for non-COVID patients; protecting healthcare personnel without compromising their competence and level of functioning; and beginning the process of post-crisis planning. In the context of the long term, and with the understanding that the changes in healthcare brought about by the COVID-19 pandemic would be long-lasting and irreversible, and would act as a catalyst in Clalit’s preparations for the future, Clalit has carried out the called-for modifications in its organizational strategy. This was based on the need to shift service and treatment foci from the hospitals to the community and the patient’s home and his cellular device, by means of strengthening Clalit’s strategic abilities to become more proactive, more digital and more home-based. In this article, we present a survey of Clalit’s preparations for the new reality in the short and medium terms, as well as the leveraging of insights gained during the first wave of the pandemic, with goal of revising Clalit’s long-term strategic plan. We conclude and point out the organizational abilities required for optimal response to future large-scale emergencies: The ability to quickly identify the need for change, respond quickly while harnessing the various parts of the organization in order to provide an agile and adaptive response, and facilitate long-term planning activity in parallel to providing an operational response in the short and medium terms.

The experiences of frontline nurses in Wuhan: A qualitative analysis of nurse online diaries during the COVID-19 pandemic.

Aims and objectiveTo explore the experiences of frontline nurses through analyzing nurse online diaries during the pandemic.BackgroundOver 42,600 healthcare professionals took care of patients with COVID‐19 in Wuhan in the initial months between 23 January 2020 and 8 April 2020. Many used to write online diaries on Sina Microblog and still wrote about their experiences in the front line on this site. However, there has been little research on frontline nurses' experiences in the initial months of the pandemic through analyzing their narratives.DesignA qualitative descriptive design.MethodsA qualitative content analysis was used to analyze online diaries written by frontline nurses in Wuhan. A total of 205 entries in online diaries were collected from 12 frontline nurses, as accessible to those who subscribed to Sina Microblog social media site, between 23 January 2020 and 8 April 2020. NVivo12 was used to help analyze the data, and COREQ reporting guidelines were also used in this study.ResultsTwo themes were identified: constructing a better self and constructing a strong support network. A better self was constructed in describing positive emotions, commitment to care, pride and achievements, and whole‐person growth. A strong support network was constructed through social support via different sources and gaining self‐support via narrating their personal experiences in diaries.ConclusionsFrontline nurses demonstrated personal growth, psychological well‐being, and professionalism in the process of constructing a better self and a strong support network.Relevance to clinical practiceThe findings indicate that frontline nurses can use narratives as debriefing opportunities and a way of gaining self‐support. We suggest that online communities of professional support be used as an essential platform for sharing narratives and gaining a more comprehensive understanding of frontline nurses in the COVID‐19 pandemic and other global public health events.

The Pathogenic Features of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Possible Mechanisms for Immune Evasion?

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a newly emerging, highly transmitted and pathogenic coronavirus that has caused global public health events and economic crises. As of March 4, 2021, more than 100 million people have been infected, more than 2 million deaths have been reported worldwide, and the numbers are continuing to rise. To date, a specific drug for this lethal virus has not been developed to date, and very little is currently known about the immune evasion mechanisms of SARS-CoV-2. The aim of this review was to summarize and sort dozens of published studies on PubMed to explore the pathogenic features of SARS-CoV-2, as well as the possible immune escape mechanisms of this virus.

Outbreak, epidemic, pandemic: The politics of global health events. A review of Sara E. Davies' Containing Contagion.

Outbreak, epidemic, pandemic: The politics of global health events. A review of Sara E. Davies' <i>Containing Contagion</i>.

Progress in research on cytokine storm

Infectious disease is a kind of disease that can be transmitted between humans and animals. Respiratory infectious diseases are more likely to cause outbreaks through droplet transmission. Coronavirus has repeatedly caused global public health events. Initial symptoms of the infected patients were mild, and the onset of the disease was hidden, but some patients suddenly get worse in a short time, and eventually died due to multiple organ failure. Studies have found that cytokine storms caused by patients' excessive immune response was one of the important causes of death in the infected patients.

To stop the next pandemic, we need to unravel the origins of COVID-19

We find ourselves ten months into one of the most catastrophic global health events of our lifetime and, disturbingly, we still do not know how it began. What’s even more troubling is that despite the critical importance of this question, efforts to investigate the origins of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and of the associated disease, coronavirus disease 2019 (COVID-19), have become mired in politics, poorly supported assumptions and assertions, and incomplete information. To avoid or mitigate the dire consequences of this and future pandemics (here, people in PPE bury a victim in Delhi, India in June), unraveling the origins of SARS-CoV-2 and COVID-19 will be essential—even though a definitive answer may be elusive, and an objective analysis means broaching some uncomfortable possibilities. Image credit: Shutterstock/PradeepGaurs. SARS-CoV-2 is a betacoronavirus whose apparent closest relatives, RaTG13 and RmYN02, are reported to have been collected from bats in 2013 and 2019, respectively, in Yunnan Province, China (1). COVID-19 was first reported in December 2019 more than 1,000 miles away in Wuhan City, Hubei Province, China. Beyond these facts, the “origin story” is missing many key details, including a plausible and suitably detailed recent evolutionary history of the virus, the identity and provenance of its most recent ancestors, and surprisingly, the place, time, and mechanism of transmission of the first human infection. Even though a definitive answer may not be forthcoming, and even though an objective analysis requires addressing some uncomfortable possibilities, it is crucial that we pursue this question. Preventing the next pandemic depends on understanding the origins of this one. There are several potential origin scenarios. First, SARS-CoV-2 may … [↵][1]1Email: relman{at}stanford.edu. [1]: #xref-corresp-1-1

Elevated cardiac biomarkers may be effective prognostic predictors for patients with COVID-19: A multicenter, observational study.

PurposeThe coronavirus disease 19 (COVID-19) has become a global health event. Cardiac biomarkers like creatine kinase isoenzyme (CK-MB), myoglobin, and high-sensitivity troponin T were usually elevated in early stages. This study aimed to investigate whether the elevated cardiac biomarkers could become effective prognostic predictors for COVID-19 patients.MethodsThe present study involved 357 COVID-19 patients. The potential predictors for two study outcomes (in-hospital death and recovery status) in 28 days were selected by LASSO regression analysis. Prognostic values of cardiac biomarkers selected were evaluated using the receiver operating characteristic curve (ROC) and the area under ROC (AUC).ResultsAfter 28-day follow-up, overall 357 patients were divided into death group (n = 25) and survival group (n = 332), or non-recovery group (n = 43) and recovery group (n = 314). The LASSO regression analysis showed elevated CK-MB and myoglobin were independent risk predictors for in-hospital death, and CK-MB and myoglobin were also independent risk predictors for non-recovery. The AUC of CK-MB and myoglobin for in-hospital death were 0.862 (95%CL: 0.804–0.920, p < 0.001) and 0.838 respectively (95%CL: 0.729–0.947, p < 0.001). The AUC of CK-MB and myoglobin for non-recovery were 0.839 (95%CL: 0.786–0.892, p < 0.001) and 0.841 (95%CL: 0.765–0.918, p < 0.001) respectively. We also found AUC of combined use of CK-MB and myoglobin for in-hospital death and non-recovery were 0.883 (95CL: 0.813–0.952, p < 0.001), and 0.873 (95%CL: 0.817–0.930, p < 0.001) respectively.ConclusionsIn patients with COVID-19, elevated CK-MB and myoglobin on admission may be effective predictors for adverse outcomes, and combined use of CK-MB and myoglobin had a better performance for prediction.

#UNMASKEDSELFIESINSOLIDARITY: FROM SELF&lt;IE&gt; CARE TO COLLECTIVE CARE—AFFECTIVE ARTIVISM, NETWORKED BELONGING AND MOBILE MEDIA PARTICIPATORY ART.

Contemporary mobile media affords new insights into the social, critical, cultural and creative practice methods. With the continual rise of social practice in art which sees the “social” and “experience” as the medium, smartphones have become an increasingly important device for information dissemination, collective dialogue and poetic expression. This paper considers these insights through the lively and multivalent discussion of participatory art project entitled $2 (2020) as case study. It is situated within the community of **** University international students, local students, staff and friends during the recent outbreak of the coronavirus in Wuhan, China, a global health event that has had significant socio-cultural, economic, and political impacts. It employs one of the most pervasive barometers of popular culture today, the selfie. Moving through related topics such as facial recognition and digital parenting, the $2 team recognise that now more than ever, we need transformative work to engage in collective care. In essence, this project has created an affective listening network to make the unheard heard, to voice personal concerns, and to show empathy for the broader community affected by this global health crisis. $2 openly supports international students caught in the crossfire of strict new travel restrictions imposed by the Government. We critically reflect on how art is a socially transformative process, through its messages of care alongside messages from Chinese students suffering anxiety and isolation, waiting for the travel bans to be lifted, a tempering of the stigma and racism accompanying the coronavirus event here in $2 .

The National Library of Medicine Global Health Events web archive, coronavirus disease (COVID-19) pandemic collecting.

Since January 30, 2020, when the World Health Organization declared the SARS CoV-2 disease (COVID-19) to be a public health emergency of international concern, the National Library of Medicine's (NLM's) Web Collecting and Archiving Working Group has been collecting a broad range of web-based content about the emerging pandemic for preservation in an Internet archive. Like NLM's other Global Health Events web collections, this content will have enduring value as a multifaceted historical record for future study and understanding of this event. This article describes the scope of the COVID-19 project; some of the content captured from websites, blogs, and social media; collecting criteria and methods; and related COVID-19 collecting efforts by other groups. The growing collection—2,500 items as of June 30, 2020—chronicles the many facets of the pandemic: epidemiology; vaccine and drug research; disease control measures and resistance to them; effects of the pandemic on health care institutions and workers, education, commerce, and many aspects of social life; effects for especially vulnerable groups; role of health disparities in infection and mortality; and recognition of racism as a public health emergency.

Public Perceptions and Attitudes Toward COVID-19 Nonpharmaceutical Interventions Across Six Countries: A Topic Modeling Analysis of Twitter Data.

BackgroundNonpharmaceutical interventions (NPIs) (such as wearing masks and social distancing) have been implemented by governments around the world to slow the spread of COVID-19. To promote public adherence to these regimes, governments need to understand the public perceptions and attitudes toward NPI regimes and the factors that influence them. Twitter data offer a means to capture these insights.ObjectiveThe objective of this study is to identify tweets about COVID-19 NPIs in six countries and compare the trends in public perceptions and attitudes toward NPIs across these countries. The aim is to identify factors that influenced public perceptions and attitudes about NPI regimes during the early phases of the COVID-19 pandemic.MethodsWe analyzed 777,869 English language tweets about COVID-19 NPIs in six countries (Australia, Canada, New Zealand, Ireland, the United Kingdom, and the United States). The relationship between tweet frequencies and case numbers was assessed using a Pearson correlation analysis. Topic modeling was used to isolate tweets about NPIs. A comparative analysis of NPIs between countries was conducted.ResultsThe proportion of NPI-related topics, relative to all topics, varied between countries. The New Zealand data set displayed the greatest attention to NPIs, and the US data set showed the lowest. The relationship between tweet frequencies and case numbers was statistically significant only for Australia (r=0.837, P<.001) and New Zealand (r=0.747, P<.001). Topic modeling produced 131 topics related to one of 22 NPIs, grouped into seven NPI categories: Personal Protection (n=15), Social Distancing (n=9), Testing and Tracing (n=10), Gathering Restrictions (n=18), Lockdown (n=42), Travel Restrictions (n=14), and Workplace Closures (n=23). While less restrictive NPIs gained widespread support, more restrictive NPIs were perceived differently across countries. Four characteristics of these regimes were seen to influence public adherence to NPIs: timeliness of implementation, NPI campaign strategies, inconsistent information, and enforcement strategies.ConclusionsTwitter offers a means to obtain timely feedback about the public response to COVID-19 NPI regimes. Insights gained from this analysis can support government decision making, implementation, and communication strategies about NPI regimes, as well as encourage further discussion about the management of NPI programs for global health events, such as the COVID-19 pandemic.

How to Internationalize Medical Education using Concepts in Internationalization of Higher Education.

This article was migrated. The article was marked as recommended. Internationalization of higher education is a well-researched area with a long history. At a time of increasing globalization, particularly in light of recent global health events, the internationalization of medical education may play an important role in medical school teaching - increasing future medical collaboration and building a global medical community. Internationalization of medical education is a less researched discipline and often limited to areas of Global Health. It is typically not part of the standard medical curriculum. While internationalization of medical education has overlapping themes with Global Health education, it has a much wider scope (i.e., preparation of global citizen physicians, international employability, collaboration, cultural and international understanding). Lessons learned from concepts in internationalization of higher education can aid in the realization of internationalization of medical education programs and establish IoME as a distinct area of educational research. This paper suggests elements to consider when implementing programs in internationalization of medical education. Guided by the analysis of an existing program in internationalization of medical education, important components are highlighted from the perspective of concepts found in internationalization of higher education. Several elements that are important features in internationalization of higher education are emphasized - institutional partnerships, goal setting, variety of internationalization at home concepts, international classroom features, multi-directional student mobility, and sustainability. The authors aim to shed light on the area of internationalization of medical education, widen its scope from Global Health education, and introduce it as a field of study for educational research. Adapting models and concepts of international higher education can help with establishing this field.

Using Experiential Simulation-Based Learning to Increase Engagement in Global Health Education: an Evaluation of Self-reported Participant Experience.

Simulations aim to supplement historic teacher-centric methods by facilitating experiential, self-guided learning and the application of students' knowledge in a controlled environment. The objective of our study is to describe the methodology of developing and facilitating simulations, and to assess their effectiveness as an educational tool for global health training. We describe the methodology used by Global Health Sim between October 2016 and March 2019 to design and facilitate simulations for participants at the high school through graduate school levels, and at conferences and online. Using a mixed-methods evaluation design, we assessed self-reported quantitative measures of content knowledge before and after participating in the simulation and different aspects of the simulation experience. We also conducted a qualitative thematic analysis of the experience and lessons learned as reported by evaluation respondents. We conducted a total of 20 simulations on six unique topics for 213 evaluation respondents. Self-reported knowledge of the topic increased an average of 3.3 points on a 10-point scale (4.1-7.4) and the seven aspects of the experience were rated highly (3-5 points on a 5-point Likert scale). Thematic analysis revealed an increased understanding of the complexity of global health problems and strategies for effectively responding to issues in a multidisciplinary manner. Respondents valued the opportunity to learn about the complexities of responding to global health events, which confirmed that simulations can be utilized as teaching tools for students and professionals. Further research is required to assess the long-term educational impact of simulations in global health.

The Novel Coronavirus COVID-19 Outbreak: Global Implications for Antimicrobial Resistance.

We are in the midst of the novel coronavirus (COVID-19) pandemic, the most significant global health event since Spanish influenza in the early 20th century. Increasingly draconian measures are being implemented worldwide to try to slow the spread of the virus. Antimicrobial resistance (AMR) has been cited as the most significant threat to the global health and global economy in recent years, but is now likely to be eclipsed by COVID-19 for some time. However, the emergence of COVID-19 also presents some important consequences for the development of AMR. This piece will highlight how managing the COVID-19 crisis could impact AMR in the clinic, beyond the clinic in the community, in the environment and in relation to public awareness. When civilization emerges from the other side of this global health emergency, efforts should be made to understand these potential effects on AMR, the other significant, and constant global health issue of our time. In the Clinic Healthcare systems around the world are under increasingly immense pressure. This is leading to several changes in practice that may have impacts on, or relevance to, AMR. For example, the UK government have published several documents relating to COVID-19 management in clinical settings. In the guidance for primary care, it is recommended that any room that has been used for a patient with a suspected SARS-CoV-2 (the causative agent of COVID-19) infection should remain closed and ventilation switched off until full sterilization has taken place (HM Government, 2020a). With regards to infection prevention and control procedure, additional measures are recommended regarding transmission prevention. These include precautions around direct contact with potentially contaminated surfaces, droplets and aerosols (HM Government, 2020b). These may not become routine management options within clinical settings following the COVID-19 pandemic, however, many of these practices may also reduce dissemination of AMR bacteria at a local and global scale. In particular, extra vigilance around hygiene and additional sterilization procedures may reduce the spread of AMR bacteria. It would be interesting to gather data on the prevalence of AMR infections before and after the outbreak to determine if this is the case. Comparison of whole genome sequences of clinical pathogens before, during and after the pandemic is one potential technique that could elucidate changes in carriage of AMR mechanisms circulating in clinical settings. Databases such as BacWGSTdb (Ruan and Feng, 2016) could also be used to track outbreaks of key AMR pathogens to the species, clonal complex or isolate level. With regards to COVID-19 patients contracting secondary bacterial infections, there are very few data so far. However, 1 to 10% of patients have been reported to contract secondary bacterial infections in two separate studies (Lai et al., 2020). This in comparison to infection with pandemic H1N1, where around 12–19% of hospitalized patients with pneumonia developed secondary bacterial infections (Kim, 2020). Given current data it is not possible to predict whether the cases of secondary bacterial infection following development of COVID-19 will increase or decrease overtime. Clinical microbiologists, as well as radiologists, will be key for making these distinctions (Kim, 2020). However, despite the relatively low confirmation of secondary bacterial infections, there have been comparatively more reports of antibiotic usage when treating COVID-19 patients (Lai et al., 2020), including up to 45% of patients receiving antibiotic treatment (Xu et al., 2020). This is even though the World Health Organization recommended against the use of antibiotics during COVID-19 treatment (Cascella et al., 2020). It has also been suggested that certain antibiotics, such as tecioplanin (a glycopeptide antibiotic) could be used as an antiviral after exhibiting activity against coronaviruses (amongst others) previously (Baron et al., 2020). However, great caution should be used given that inappropriate use or overuse of antibiotics is known to be a significant driver of the emergence of AMR. This is why significant focus on AMR revolves around reducing inappropriate or overuse of antibiotics (NICE, 2018). Countries which have made progress in this area may face less AMR secondary bacterial infections than countries that have experienced limited success in reducing antibiotic consumption. Again, it would be interesting to analyse this data, when available. The second reason use of antibiotics should be considered very carefully is that it may lead the public to assume that all antibiotics are suitable for treatment of viral infections (see “Public Awareness,” below).

A COVID-19 conference at AIDS 2020: Virtual

A COVID-19 conference at AIDS 2020: Virtual

Global Medicine, Parasites, and Tasmania.

Until the 1970s, infectious disease training in most medical schools was limited to those diseases common in the area of instruction. Those wishing to explore a more globalised curriculum were encouraged to undertake specialist postgraduate training at schools or institutes of tropical medicine. However, the increase in global trade and travel from the 1970s onward led to dramatic changes in the likelihood of returning travellers and new immigrants presenting with tropical infections in temperate regions. Furthermore, population growth and the changing relationships between animals, the environment, and man in agriculture accentuated the importance of a wider understanding of emerging infectious diseases, zoonotic diseases and parasitic infections. These epidemiological facts were not adequately reflected in the medical literature or medical curriculum at the time. The orientation on tropical infections needed specialised attention, including instruction on diagnosis and treatment of such infections. We describe key global health events and how the changing field of global medicine, from the 1970s to early 2000, impacted on medical education and research. We describe the impact of global health changes in the Tasmanian context, a temperate island state of Australia. We retrospectively analysed data of patients diagnosed with parasites and present a list of endemic and non-endemic parasites reported during this period. Finally, we reflect on the new approaches to the changing needs of global health and challenges that medical programmes, learners and educators face today.

Long-distance effects of epidemics: Assessing the link between the 2014 West Africa Ebola outbreak and U.S. exports and employment.

Although the economic consequences of epidemic outbreaks to affected areas are often well documented, little is known about how these might carry over into the economies of unaffected regions. In the absence of direct pathogen transmission, global trade is one mechanism through which geographically distant epidemics could reverberate to unaffected countries. This study explores the link between global public health events and U.S. economic outcomes by evaluating the role of the 2014 West Africa Ebola outbreak in U.S. exports and exports‐supported U.S. jobs, 2005–2016. Estimates were obtained using difference‐in‐differences models where sub‐Saharan Africa countries were assigned to treatment and comparison groups based on their Ebola transmission status, with controls for observed and unobserved time‐variant factors that may independently influence trends in trade. Multiple model specification checks were performed to ensure analytic robustness. The year of peak transmission, 2014, was estimated to result in $1.08 billion relative reduction in U.S. merchandise exports to Ebola‐affected countries, whereas estimated losses in exports‐supported U.S. jobs exceeded 1,200 in 2014 and 11,000 in 2015. These findings suggest that remote disruptions in health security might play a role in U.S. economic indicators, demonstrating the interconnectedness between global health and aspects of the global economy and informing the relevance of health security efforts.

The CNO US Healthcare Immersion Program, Part 1: A Transformational Leadership Model.

As a result of recent global health events, US health care leaders are strengthening international relationships to share best practices, health research, and support of workforce capacity. The Institute for Healthcare Improvement, the National Academies of Sciences, Engineering, and Medicine, the American Nurses Credentialing Center, and the Joint Commission International have all committed to expanding their vision and mission to improve health and health care globally. To support excellence in international health care delivery, the authors embarked on a Chief Nursing Officer (CNO) US Healthcare Immersion Program. The purpose of the program is to introduce the US nursing leadership competences to China CNO colleagues in preparation for their future role with health care reform.

Ilona Kickbusch: global health reformer

Ilona Kickbusch: global health reformer

Business as Usual: A Lack of Institutional Innovation in Global Health Governance Comment on "Global Health Governance Challenges 2016 – Are We Ready?"

There were once again high expectations that a major global health event - the Ebola virus outbreak of 2014-2015 - would trigger meaningfully World Health Organization (WHO) reform and strengthen global health governance (GHG). Rather than a "turning point," however, the global community has gone back to business as usual. This has occurred against a backdrop of worldwide political turmoil, characterised by a growing rejection of existing political leaders and state-centric institutions. Debates about GHG so far have given insufficient attention to the need for institutional innovation. This entails rethinking the traditional bureaucratic model of postwar intergovernmental organizations which is disconnected from the transboundary, fast-paced nature of today’s globalizing world.

Introduction: Ebola and International Relations

The outbreak of Ebola Virus Disease (EVD) that gripped Liberia, Guinea and Sierra Leone through much of 2014 and 2015 was an enormous and in many ways unprecedented health emergency. Yet the outbreak was not only a global health event – it was also a global political event. In this introduction to the special issue we discuss the contribution that International Relations scholarship can make to analysing and understanding the Ebola outbreak and the global response to it. We group our comments around four key themes: (1) allocating responsibility in a diffuse global health governance system; (2) the causes and effects of Ebola being perceived as a global crisis; (3) the downsides of a security-driven approach to global health emergencies; and (4) issues of inequality both between and within countries, including those around gender, resources and power.