Major Infectious Disease Outbreak Research Articles

Exploring hospital resilience protective or risk factors: lessons for future disaster response efforts.

Hospital resilience is essential in responding to disasters, but current research focuses mainly on frameworks and models rather than the protection of resilience and analysis of risk factors during public health emergencies. This study aims to examine the development of resilience in Chinese frontline hospitals during the initial COVID-19 outbreak in 2020, providing insights for future disaster response efforts. We conducted interviews with 26 hospital staff members who were involved in the initial response to the COVID-19 outbreak in China. We used a semi-structured interview approach and employed purposive sampling and snowball sampling techniques. The interview outline was guided by the 'Action Framework' proposed by the World Health Organization (WHO) for responding to infectious disease emergencies. This framework includes dimensions such as command, surveillance, risk communication, medical response, and public health response. We analyzed the collected data using Colaizzi's seven-step data analysis method and the template analysis method. WHO's 'action framework' effectively highlights the factors that contribute to hospital resilience. While medical response, including the availability of materials and facilities, the use of information technology, and the capacity for infectious disease diagnosis and treatment, remains crucial, other important aspects include awareness and beliefs about infections, treatment experience, interdisciplinary collaboration, and more. Additionally, it is essential to establish an intelligent command system, foster trusting partnerships between teams, improve monitoring capabilities for infectious disease agents, enhance risk communication through information synchronization and transparency, strengthen infection control planning, and improve environmental disinfection capabilities for effective public health emergency response. These contradictions significantly impact the enhancement of hospital resilience in dealing with major infectious disease outbreaks. In responding to sudden major infectious diseases, hospitals play a vital role within the healthcare system. Enhancing hospital resilience involves more than just improving treatment capabilities. It also requires effective command coordination at the hospital level, infection control planning, and the deployment of intelligent equipment. Additionally, planning for effective communication and coordination between hospitals, communities, and the national healthcare system can further enhance hospital resilience.

COVID-19 post-pandemic reflections from sub-Saharan Africa: what we know now that we wish we knew then

The commonly heard aphorism about history repeating itself suggests an endless cycle of recurring events. However, George Santayana offered a similar sentiment when he said, "Those who do not learn from history are doomed to repeat it". This emphasises that the responsibility for the recurrence of events lies not with history itself, but with humanity. It underscores that if we desire change, it is our responsibility to initiate it, rather than attributing it to external forces such as fate, luck, or time. With this thought in mind, here we offer a narrative view from sub-Saharan Africa, focusing primarily on our own experiences in Nigeria and Uganda, on what harsh lessons can be learnt from the COVID-19 pandemic regarding emergency preparedness to respond effectively to the next major infectious disease outbreak. Four strategies are suggested, the implementation of which may contribute substantially to safeguarding against an experience similar to the catastrophic public health, social and economic costs borne by African nations during COVID-19 and in its immediate aftermath.

Construction of influencing factors model for public information avoidance behavior in major infectious disease outbreaks based on meta-ethnography

ObjectiveMajor infectious disease outbreaks are highly susceptible to diffuse outbreaks due to their sudden and more widespread nature. Compared to previous outbreaks such as the Spanish flu and SARS in China, COVID-19 has greatly affected the health of citizens and the economic development of countries worldwide, and is representative of major infectious disease outbreaks in many ways. Information avoidance, a common information behaviour during major infectious disease outbreaks, can alleviate the stress caused by information overload as a strategy to reduce negative emotions and maintain optimism. However, it can also bias risk perceptions and avoid content of greater value. Therefore, a deeper understanding of public information behaviour, particularly how and why relevant information is circumvented, places a demand on researchers. MethodsA meta-ethnographic qualitative research methodology was used, and the seven steps of the methodology were strictly followed, including identifying integration themes, defining the connotations of integration themes, reading original studies, identifying relationships between studies, inter-translation between studies, synthetic translation, and presenting integration results. 26 original studies were integrated in a unified research framework, with a macro perspective that integrates consistent as well as complex and even contradictory findings and identifies dominant factors. ConclusionsIdentify demographic factors, information literacy, risk perception, cognitive structure, information quality, information sources, external characteristics of information, and environmental characteristics sub-dimensions around the dimensions of ‘individual’, ‘information’ and ‘environment’. The study also explored the factors under each sub-dimension. The study finally identified three dimensions, nine sub-dimensions and 26 factors, and obtained a more complete theoretical framework to construct a “model of factors influencing public information avoidance behaviour in major infectious disease epidemics”, with a view to providing a theoretical basis and practical reference for relevant departments in guiding public information behaviour and health practices in major infectious disease epidemics.

The analysis of reliability and validity of a competency evaluation model for front-line nursing staff during the outbreak of major infectious diseases.

Outbreaks of major infectious diseases represent a tremendous threat to people's health, safety and property, yet little is known about the competence of front-line caregivers in such situations. To construct a model for evaluating the competency of front-line nursing staff during major infectious disease outbreaks and to test the model's reliability and validity. This was a cross-sectional study that took place between November and December 2021, in Chinese hospitals. The model was constructed through literature reviews, descriptive qualitative research, the Delphi method and the analytic hierarchy process. To evaluate the model's validity and reliability, 550 front-line nurses were selected to complete a questionnaire survey, and six experts were invited to conduct a content validity evaluation. Cronbach's α coefficient was used to test the model's reliability, while an exploratory factor analysis was used to measure the structural validity of the model. The model included 57 items. The Cronbach's α coefficient of the model was 0.983, and the content validity index was 0.958. Six common factors were produced by exploratory factor analysis. The cumulative variance contribution rate was 66.718%. After discussion, the original four dimensions were maintained. The model for evaluating the competency of front-line nursing staff during an outbreak of major infectious diseases has strong reliability and validity and can be used as a tool to assess the competency level of front-line nursing staff. This model can provide a useful reference for care managers to accurately evaluate, train and select caregivers during an epidemic.

HIV policy legacies, pandemic preparedness and policy effort to address COVID-19.

That the world was unprepared for a major infectious disease outbreak is now readily apparent to all credible observers. However, some countries were more prepared than others and we have seen a variety of responses to COVID-19 emerge across nations. While recognizing that the sources of variation in country responses to COVID-19 are many and varied, in this study we seek to examine how policy legacies from national responses to HIV have influenced countries' responses to COVID-19. The aim of this study was to examine whether countries with a more conducive HIV policy environment were better prepared for COVID-19 and have therefore had more preemptive and rights-based responses. Using data from the Oxford Covid-19 Government Response Tracker, we develop measures of country effort to respond to COVID-19 including early containment and closure policies, prevention policies, economic policies, and health system policies. We combine this with data from the HIV Policy Lab and correlate overall and disaggregated country HIV Policy scores with COVID-19 Policy scores. We find that the COVID-19 Containment and Closure Measures Index was negatively correlated with supportive social policies related to HIV in the early stages of the pandemic, but the association did not persist as time went on. The COVID-19 Economic Support Measures had prolonged positive associations with supportive social policies related to HIV and negative association with clinical and treatment policies. Countries with stronger structural responses to HIV have been less inclined towards involuntary measures and more prepared for the social and economic elements of COVID-19 pandemic response.

Based on the time series model and decision tree model, whether wildlife trade should be banned for a long time summary

This article aims to study the main objects, objectives and trade trends of wildlife trade in recent years, as wildlife markets have been identified as the initiators of the outbreak and spread of the new coronavirus in 2020, and to collect and analyze the long-standing ban on wildlife trade. The data is graphed for visual analysis, and the Pearson correlation analysis method is used to analyze the relationship between wildlife trade and major infectious disease outbreak, social and economic impact indicators, and summarize the econom ic and social impact of this long-term ban. Then, the mathematical model we fit, combined with the current situation of the new crown epidemic, to provide effective, forward-looking, sustainable views and policy recommendations.

DETERMINATION OF INDICATORS OF THE DETERIORATION OF THE EPIDEMIOLOGICAL AND EPIZOOTOLOGICAL SITUATIONS

Major outbreaks of infectious diseases have demonstrated the need for new approaches to biosecurity, which include efficient planning and implementation of infection prevention and control measures. This work is not possible without the early determination of relevant indicators. The purpose of the work is the analysis of indicators in determining the deterioration of the epidemiological and epizootological situation. Results. The methodological approaches to the collection of information, the definition of indicators and their evaluation were analyzed. The analysis of the role of indicators in assessing the epidemiological and epizootological situation in terms of diseases was carried out. The main indicators of the deterioration of the epidemiological and epizootological situation for such diseases as coronavirus infection, anthrax, brucellosis, and plague have been identified. Conclusion. The following three general indicators assessing the deterioration of the epidemiological situation were identified: an increase in the incidence, a decrease in the coverage of preventive vaccinations, and the ignition of dormant foci of diseases. To assess the epizootic situation, additional indicators were identified, such as an increase in the incidence in animal population and changes in natural, climatic and soil conditions. Indicators of deterioration of the epidemiological situation may vary depending on the specific disease and its mode of transmission.

Effectiveness of personalized ventilation in reducing airborne infection risk for long-term care facilities

Throughout history, the human population has experienced major outbreaks of infectious diseases. In December 2019 the previously unknown SARS-CoV-2 virus emerged, which had a huge impact globally. Residents of long- term care facilities (LTCFs) showed to be highly susceptible to infection due to their frailty. Respiratory infectious diseases, such as COVID-19, can spread among others via the airborne transmission route. This is caused by sharing the same indoor environment. To reduce the risk of infection via the airborne route, it is important to consider ventilation and other building services system measures, including personalized ventilation (PV). PV has the potential of being a suitable solution for LTCFs, as it could still allow interaction between residents and visitors in the common rooms, which is regarded very important from a mental health perspective. To identify the potential of PV in the context of infection risk, a laboratory experiment was conducted to investigate its effectiveness on the infection risk reduction. The research was performed in a controlled climate chamber. In the experiment a person was mimicked and positioned close to a PV system that provided filtered recirculated air. A particle source maintained a constant particle concentration in the room. The performance of the PV system was measured through the particle concentration near the breathing zone as compared to the room concentration. Several design parameters were investigated. Translating the outcomes to a fictive (equivalent) ventilation rate, the Wells-Riley equation was applied to determine the infection risk. The outcomes indicated that, in this laboratory setting, the PV system can reduce the risk of an infection up to 50%. The performance is affected by the distance of the supply head to the breathing zone, the angle of the supply head, airflows in the room and the location of the particle source. To further optimize the system and allow its application in LTCFs, several aspects still need further attention, such as mobility/placing the person, the breathing pattern of the user and factors influencing the comfort and use.

New insights into the measurement model of a new scale for evaluating restaurant service quality during major infectious disease outbreaks

PurposeConsumers prefer to choose restaurants that value hygiene and safety; therefore, appropriate epidemic prevention measures could restore 30% of lost customers and enhance a restaurant’s reputation during infectious disease outbreaks. Providing customers with safe epidemic prevention service quality is an important mission of the restaurant industry during an epidemic. This study aims to construct an epidemic prevention service quality scale for restaurants (REP-SERV scale).Design/methodology/approachThe REP-SERV scale was constructed through internet big data analytics and qualitative and quantitative research procedures.FindingsA total of 16 key service factors for restaurant epidemic prevention were extracted through internet big data analytics. The REP-SERV scale contained 28 items in six dimensions, including hygiene, empathy, flexible service, support service, personnel management and body temperature and seating arrangement.Practical implicationsThe REP-SERV scale can help many restaurant operators clearly determine the deficiencies and risks of restaurant epidemic prevention services.Originality/valueThe findings can provide references to effectively measure and improve the epidemic prevention service quality in restaurants, thereby providing customers with a comfortable and safe dining environment.

How did general practices organize care during the COVID-19 pandemic: the protocol of the cross-sectional PRICOV-19 study in 38 countries

BackgroundGeneral practitioners (GPs) play a crucial role in the fight against the COVID-19 pandemic as the first point of contact for possibly infected patients and are responsible for short and long-term follow-up care of the majority of COVID-19 patients. Nonetheless, they experience many barriers to fulfilling this role. The PRICOV-19 study investigates how GP practices in 38 countries are organized during the COVID-19 pandemic to guarantee safe, effective, patient-centered, and equitable care. Also, the shift in roles and tasks and the wellbeing of staff members is researched. Finally, PRICOV-19 aims to study the association with practice- and health care system characteristics. It is expected that both characteristics of the GP practice and health care system features are associated with how GP practices can cope with these challenges. This paper describes the protocol of the study.MethodsUsing a cross-sectional design, data are collected through an online questionnaire sent to GP practices in 37 European countries and Israel. The questionnaire is developed in multiple phases, including a pilot study in Belgium. The final version includes 53 items divided into six sections: patient flow (including appointments, triage, and management for routine care); infection prevention; information processing; communication; collaboration and self-care; and practice and participant characteristics. In the countries where data collection is already finished, between 13 and 636 GP practices per country participated in the study. Questionnaire data are linked with OECD and HSMR data regarding national policy responses to the pandemic and analyzed using multilevel models considering the system- and practice-level.DiscussionTo the best of our knowledge, the PRICOV-19 study is the largest and most comprehensive study that examines how GP practices function during the COVID-19 pandemic. Its results can significantly contribute to better preparedness of primary health care systems across Europe for future major outbreaks of infectious diseases.

Incorporating One Health competencies into the medical curriculum: Need of the hour

The manner in which a doctor approach patient care significantly depends on the way in which they were trained during their undergraduation period. The purpose of the current review is to explore the necessity to incorporate One Health competencies in the medical curriculum and devise a framework for the same. An extensive search of all materials related to the topic was carried out on the PubMed search engine and a total of 14 articles were selected based on their suitability with the current review objectives. Keywords used in the search include One Health and medical education in the title alone only. The analysis of the major outbreaks of infectious diseases in the last couple of decades has shown an association with environmental changes. The presence of all these factors has compelled the international welfare agencies and public health authorities to adopt a One Health approach in medical curriculum to integrate humans, animals, and the ecosystem for the containment of these infectious diseases. To ensure that the current crop of medical students who will be joining the health workforce on completion of their training should be trained in different aspects of one health during their undergraduation period. In conclusion, the training of medical students on the One Health approach is an essential aspect of medical training considering the trends of outbreaks of infectious disease outbreaks. It is high time to acknowledge the need and prepare medical students to work as effective members of the interprofessional team and accordingly incorporate One Health competencies into the medical curriculum.

Nursing ethics for prevention and control of major infectious disease outbreaks: Chinese expert consensus

BackgroundMajor infectious disease has become a serious threat to people’s health worldwide. As the world’s largest healthcare workforce and the core forces fighting against the epidemic, nurses are on the frontline of this battle. A number of ethical issues have given rise to numerous concerns that have largely affected nurses in different ways as they respond to the epidemic. In addition, excessive expectations from people can exert undue pressure, which can easily lead to burnout in nurses. MethodsIn this consensus, the expert panel method was used to develop and reach a consensus. The members involved in the formation of the consensus included an expert discussion panel and a consensus writing expert group, a methodologist, and four secretaries. After 16 rounds of online expert consultation and two rounds of expert panel meetings, the writing team analyzed and reviewed the 78 amendments suggested by the experts to develop a consensus on nursing ethics for prevention and control of major infectious disease outbreaks based on the ethical vision of life care. ResultsThis expert consensus focuses on five essential domains: the responsibilities and rights of nurses, the nurse-patient relationship, the doctor-nurse relationship, and the relationship between society and nurses throughout the epidemic. ConclusionsWe hope this consensus can help nurses better understand and respond to the ethical issues and challenges in public health emergencies, and raise reasonable public expectations of the roles and responsibilities of nurses in these situations.

Impact of emergencies on immunization program, risk assessment and response recommendations

Since the founding of the People's Republic of China in 1949, China's vaccination work has been making remarkable achievements. However, under the state of emergency, such as major infectious disease outbreaks, major natural disasters, vaccine-related events, large-scale population entry at the border, vaccination services confront many challenges, and the emergency plan for vaccination services in most areas is still in the exploratory stage. Based on the experience at home and abroad, combined with China's relevant policies, technical guidelines and evidence, this study provides suggestions for vaccination services in aforementioned emergency events, in order to standardize the development and implementation of vaccination services under the state of emergency in China.

The Role of Animal Research in Pandemic Responses.

The significant advances made by the global scientific community during the COVID-19 pandemic, exemplified by the development of multiple SARS-CoV-2 vaccines in less than 1 y, were made possible in part because of animal research. Historically, animals have been used to study the characterization, treatment, and prevention of most of the major infectious disease outbreaks that humans have faced. From the advent of modern 'germ theory' prior to the 1918 Spanish Flu pandemic through the more recent Ebola and Zika virus outbreaks, research that uses animals has revealed or supported key discoveries in disease pathogenesis and therapy development, helping to save lives during crises. Here we summarize the role of animal research in past pandemic and epidemic response efforts, as well as current and future considerations for animal research in the context of infectious disease research.

Emergency Response: A Cross-sectional Study of Core Competencies for Nurses Regarding Major Infectious Disease Outbreaks

IntroductionThe core competencies of nursing personnel have been identified as a main factor affecting nursing effectiveness. This study examined core emergency response competencies of Chinese nursing personnel related to the outbreak of major infectious diseases. MethodsA survey was conducted among 960 nurses working in a tertiary hospital in Shanghai, China. Data were collected on core emergency response competencies of nursing personnel caring for patients with major infectious diseases, measuring overall competency as well as by dimensions of prevention ability, rescue ability, and preparation ability. A t-test and one-way analysis of variance were first analyzed for differences between groups, followed by multiple linear regression to analyze main influencing factors for core emergency response competencies. ResultsThe average score for core emergency response competencies of nursing personnel delivering care to patients with major infectious diseases was 128.05 (SD 22.23) (range 36–180 points); or 71%, which is equivalent to moderate performance. Multiple linear regression analysis demonstrated that the main influencing factors for these nursing personnel were before participation in emergency drills for infectious diseases, current educational background, and working experience in the realm of infectious disease nursing. The final model explained 8.4% of the variance in core emergency response competencies. DiscussionThese findings indicate that it is necessary to strengthen the training of nursing staff with educational background deficits or no prior work or drill experience related to infectious diseases to effectively improve the core emergency response competencies of nursing personnel relative to infectious diseases.

Current recombinant vaccine strategy as a novel approach to prevent Ebola virus diseases: a literature review

Ebola virus has resulted in a devastating hemorrhagic fever epidemic spanning several African countries and leading to thousands of deaths. There have been no vaccines approved or medication strategies toward successful prophylaxis and therapeutics critical until the rVSV-ZEBOV vaccine approved by the US Food and Drug Administration (FDA) in December 2019 as a preventative measure for people aged 18 years old and/or older. Several experimental vaccines are showing some promise. The most advanced vaccine is the clinically tested recombinant vesicular-stomatitis virus (rVSV) which encodes EBOV glycoprotein, widely known as the V920 vaccine candidate. This vaccine induces antibody-producing responses in non-human primate models, and current clinical trials suggest protective efficacy in humans. Although generally well-tolerated, the administration of this vaccine was complicated by occurrences of side effects. The development of vaccine platforms is also challenging, given that Ebola virus diseases have now reached epidemic proportions in some localities. Outcomes in terms of viral persistence after recovery are unknown, and a study explaining the role of adaptive immunity in recovery may be essential to inform effective vaccine design. This review aims to give a basic understanding on the general immunity mechanism elicited by recombinant vector vaccines and the current implementation of this relatively new technology to tackle a major infectious disease outbreak.

Biosecurity Perspectives in Oral and Maxillofacial Radiology in Times of Coronavirus disease (COVID-19): a Literature Review

The aim of this work was to report biosecurity measures in the Oral and Maxillofacial Radiology (OMR) clinic in the current context of COVID-19, based on a literature review. An electronic search for scientific papers was perform ed using PubMed, Embase, Web of Science, and Scopus database. Although the literature related to care in the OMR clinic regarding COVID-19 is still scarce, this unprecedented scenario created by the pandemic generated an urgent need for measures to prevent the transmission of the virus. Dentists are at maximum risk of contagion and, although the practice of OMR generally does not produce aerosols, radiologists and technicians are continually in contact with body fluids, such as saliva. In additio n, imaging exams are often indispensable for emergency or elective dental diagnosis and treatment. Training in infection control practices during major outbreaks of infectious diseases should be quickly reinforced and dental settings have unique characteristics that warrant specific infection control considerations. Some recommendations have been proposed and were discussed, which cover patient flow, equipment handling and environment, radiographic technique and processing, personal protective equipment and preparation and issuance of radiological reports and access to exam results. Due to the COVID-19 pandemic, biosecurity measures in the routine of the OMR clinic are indispensable to enable emergency dental care and the perspectives of returning to elective treatment. Biosecurity measures and staff training at the OMR clinic should be instituted immediately, since imaging exams are an important and often indispensable part of dental diagnosis and treatment.

Key Technologies for Symptom Surveillance System: Enlightenment on the Construction of Multi-trigger Mechanism for Intelligent Early Warning of Infectious Disease

The most prominent feature of symptom surveillance is to pay attention to the collection and use of data from multiple sources, which gives full play to the ability of different data to support early detection of infectious diseases and the detection and early warning of major infectious disease outbreaks. This feature is in line with General Secretary Xi Jinping’s "Establishment of Intelligent Early Warning with Multi-trigger mechanism" . With the construction of new infrastructure such as 5G base stations, data centers, and artificial intelligence, technical support and application scenarios are provided for the construction of an intelligent symptom surveillance system. This paper studies and analyzes the key technologies and applications of existing symptom surveillance systems in China and abroad, and aims to provide theoretical basis and practical reference for reforming and improving the disease surveillance system in China and constructing an intelligent early warning multi-trigger symptom surveillance system.

A variable neighborhood search for the last-mile delivery problem during major infectious disease outbreak.

During major infectious disease outbreak, such as COVID-19, the goods and parcels supply and distribution for the isolated personnel has become a key issue worthy of attention. In this study, we propose a delivery problem that arises in the last-mile delivery during major infectious disease outbreak. The problem is to construct a Hamiltonian tour over a subset of candidate parking nodes, and each customer is assigned to the nearest parking node on the tour to pick up goods or parcels. The aim is to minimize the total cost, including the routing, allocation, and parking costs. We propose three models to formulate the problem, which are node-based, flow-based and bilevel programing formulations. Moreover, we develop a variable neighborhood search algorithm based on the ideas from the bilevel programing formulations to solve the problem. Finally, the proposed algorithm is tested on a set of randomly generated instances, and the results indicate the effectiveness of the proposed approach.

Covid-19 vs. Ebola: Impact on households and small businesses in North Kivu, Democratic Republic of Congo.

In April 2020, the Eastern Democratic Republic of Congo was facing two major infectious disease outbreaks: Covid-19 and Ebola Virus Disease (EVD). We highlight large differences in the socioeconomic impact of these two outbreaks. The data come from a phone survey that we conducted in the period May-July 2020 with 637 households and 363 small firms from a megacity and two rural communes in the province of North Kivu. While 3,470 EVD cases and 2,287 EVD deaths were confirmed since August 2018, self-reported impacts of EVD on revenues, access to food and behavior were limited. In contrast, only 251 Covid-19 cases were reported as of July 22nd but respondents reported sizable effects on livelihoods, especially in the large urban hub, and in part driven by substantial job losses. Our results show that different infectious disease outbreaks can have very different effects, largely unrelated to case numbers of the disease. Moderately lethal but highly transmissible viruses such as Covid-19 can trigger a steep economic downturn, especially in areas with high economic interconnectedness, reflecting both national and international policies to contain the pandemic.