Pandemic Response Research Articles

"I think all of us should have […] much better training in ethics." Ethical challenges in policy making during the COVID-19 pandemic: Results from an interview study with Swiss policy makers and scientists.

The COVID-19 pandemic posed many unprecedented challenges to health care systems and public health efforts worldwide. Policy making and science were deeply intertwined, in particular with regard to the justification of health policy measures. In this context, ethical considerations were often at the core of decision-making trade-offs. However, not much is known about the actual ethical challenges encountered by policy makers and scientists involved in policy advice. With this study, we therefore aim to explore the ethical challenges during COVID-19-related political decision-making in Switzerland as perceived by policy makers and scientists involved in policy making. We also explore the role ethics advice had during the pandemic response and what can be learned for future public health crises. We conducted thirteen qualitative expert interviews with policy makers and scientists involved in decision-making on COVID-19 policy responses in Switzerland on the regional and national level. We used inductive content analysis to analyse the interviews. Among the multitude of ethical challenges highlighted, interviewees perceived making trade-offs between the common good vs. the individual good and between economic welfare vs. health of the population, as well as proportionality of the policy measures, and the capacity of the public to accept uncertainty as central. Interviewees had diverging opinions on whether ethical considerations were sufficiently raised and discussed on the Swiss policy level during the COVID-19 pandemic. Among the reasons why ethics was not sufficiently discussed, they mentioned a lack of time in the fast-paced dynamic of the pandemic, ethics as a complex subject area, the interconnectedness between ethics and law, too much focus on few topics (mostly on vaccination-related ethical questions), and power relationships, such as dominance of medical professionals over ethicists. They evaluated ethics support to have been adequately present in the decision-making process, but wished for ethics training, involvement of the public in the discourse and for accompanying communication to build trust among the population for the future. The study provides empirical insights into the ethical considerations of COVID-19 policy making in practice in Switzerland. It can help to develop ethics assistance for future crises and inform ethical health policy and decision-making not only in Switzerland, but also in other countries.

Serving with Values in Challenging Times: Exploring Institutional Leaders' Values Work at Local Level During COVID-19

While existing literature mostly analyzes public leaders' pandemic responses, limited attention has been paid to local government leaders in terms of values work. This study examines the values created and infused by senior managers who serve as institutional leaders in local governments during the COVID-19 pandemic. Focusing on the data collected from the responses of the sample set, the study aims to illuminate the processes of creating and infusing values among senior managers of a metropolitan municipality in Türkiye. For this aim, interviews were conducted with 11 senior managers of this metropolitan municipality. The findings produced within the scope of two propositions firstly reveal three types of value created for, and infused into the organization: personal, organizational, and service-related. Secondly, the study identifies the uniform process devoted to values work among senior managers and reveals that there are no significant differences in the styles of creating and infusing values (i.e., values work) among managers at different levels of local government in challenging times.

Digital skills in social work education: a human rights issue?

ABSTRACT Through a social justice lens, this article explores the growing digitalization of society that created ripe environments for a deepening digital divide that impacts access to the modern digital world for vulnerable populations in the European Union, Spain, and the United States. The COVID-19 pandemic response highlighted the need for and use of digital technology and skills, which brought the digital divide between the world’s regions, countries, and societies to the forefront. This digital divide is defined as the lack of access or adoption of high-speed internet/broadband services. As of 2016, the UN recognized the need to acknowledge internet access as a vehicle to reach other human rights, such as the right to work or access basic education. In today’s post-pandemic society, it has become more evident that the lack of access to the internet hinders access to information, services, and participation in the socio-political landscape. In social work higher education, the increase in the quality of eLearning and digitalization transformed the way teaching and learning happen and the perception of distance learning. Recommendations regarding including digital skills in every aspect of the social work curricula using a human rights framework are included.

Building a Circular Economy for Lithium: Addressing Global Challenges

AbstractAs countries worldwide race toward a green transition, the demand for electric vehicles is surging, and with it comes a growing need for batteries. However, the push for increased domestic mining to secure these materials raises significant concerns about environmental sustainability. Even with stringent regulations, the environmental impact of mining can be profound, posing risks such as biodiversity loss, water pollution, and broader ecological damage. Furthermore, geopolitical tensions could arise as countries whose economic interests are threatened by these initiatives may react adversely. Local communities might also resist mining projects due to concerns over environmental degradation, health risks, and disruptions to their livelihoods. Given the critical importance of metals in the ecological transition, this challenge must be approached with the same urgency and global coordination as a pandemic response. Just as the world mobilized unprecedented resources to tackle COVID‐19, a similarly robust approach is necessary to ensure the availability of critical metals for a sustainable future. This paper suggests potential pathways for academic, technological, and societal advancements within the framework of a circular economy for lithium, aiming to secure a sustainable supply of this essential resource.

Personal Wellbeing Amid Pandemic Response: Impacts of Neighborhood Built Environment, Risk Communication and Health

Abstract Maintaining personal wellbeing is essential for an effective pandemic response due to its multifaceted impacts on various aspects of society. This study aimed to evaluate personal wellbeing during pandemic response and investigate the effects of built environment in neighborhoods, risk communication, and health indicators. A cross-sectional survey design was adopted. A sample with 5458 participants was collected in Hong Kong through a self-administered online survey. Personal Wellbeing Index- Adult (PWI-A) was adopted to measure personal wellbeing. This study indicated a more than 20% decrease in personal wellbeing among Hong Kong residents during the pandemic, particularly impacting future security, personal safety, and living standards. Positive influences on wellbeing included more open spaces, using more traditional information channels, seeking reliable media sources, and confidence in information seeking. Conversely, wellbeing was negatively affected by a higher percentage of public residential areas, using more new information channels, increased social media time, smoking habits and chronic health conditions. These findings provide critical insights into the diverse impacts of the pandemic on individuals and communities. They guide targeted interventions and contribute to building resilience against future crises.

The effect of hybrid classes on extrinsically motivated students

Emerging from the Covid19 pandemic, many higher education institutions rapidly improvised teaching students in a hybrid mode that concurrently combined online and in-person instruction. The varied engagement results from students and staff prompted many institutions to reconsider this hybrid approach (Raes et al., 2020), with opinions of both students and teachers divided on the merits of returning to an in-person classroom. While some studies (Peng & Wei, 2021) noted success at the ‘juggling act’ of supporting both an in-person class and an online class simultaneously, more studies found the emerging technology, split focus, resourcing and unfamiliar instructions to be a disengaging classroom experience (Aagaard et al, 2023). A lack of clear and quantitative evidence has been noted as a key issue with many of the studies of hybrid learning (Raes et al, 2020). The improvised nature of many pandemic teaching responses and the many variables that may confound engagement results, prompts a more considered and deliberate re-examination of hybrid learning which takes into account the motivational needs of students. If a student is motivated to attend a hybrid classroom, their subsequent evaluations of the experience seem likely to be related to their initial motives, expectations and reasons for attending. The lens of Self Determination Theory (SDT) offers a range of insights into the type of motivation felt by students and enables the disambiguation of whether a student is motivated intrinsically or extrinsically (Ryan & Deci, 2017). Intrinsic motivation being characterised by an internal locus of control –arising spontaneously from within. Extrinsic motivation conversely is characterised by an external locus of control – motivation is controlled by outside factors and compulsions that a student feels they ought to follow. Deci and Ryan’s Intrinsic Motivation Inventory (IMI) offers us additional insights into three descriptive sub-types of intrinsic and extrinsic motivation – autonomy, relatedness and mastery. The idea that an unfulfilled need for personal relatedness in some students might relate to levels of student engagement online and in-person was hoped might explain some of variable engagement responses from students. This presentation tells the story of how hundreds of students responded to a synchronous concurrent hybrid classroom intervention across four weeks of an otherwise online subject. Utilising high-quality hybrid learning technology available at the time, the advanced Class.com interface and a well-adapted pedagogy the journey of students with differing motivational needs was explored using the lens of Deci and Ryan’s (2017) IMI. Through regression modelling, network analysis and a broad analysis of associated demographic factors it was found in particular that low ATAR students with extrinsic motivation were more disengaged by the hybrid classroom environment, in comparison to other motivational subgroups. Contrary to expectation, students with a motivational need for relatedness were not found to respond differently to hybrid learning compared with other motivational subgroups. Recommendations for future iterations of synchronous concurrent hybrid classrooms and research are offered.

Interorganizational systems withouthierarchy: immunizationinformation systems.

The 2020-2021 COVID-19 pandemic spurred change across multiple healthcare industries. This study explores how managing vaccination data in the United States of America required cooperation among many different organizations necessitated by an emergency response. We studied how individual states interacted with the federal government to address the need for vaccination-related information during the pandemic. In total, 11 interviews were conducted with individuals responsible for collecting vaccination data and reporting it to the US Federal Government. Seven of those individuals were directors of USA jurisdictional Immunization Information Systems (IIS). Archival data were also combined with the interview responses to inform the analysis and development of guidelines. States across the USA had different ways of tracking and storing immunization data that was heavily influenced by state-level and federal legislation. The lack of a universal patient identifier made cross-state patient identification difficult. Federal requirements for reporting dictated much of how the different state-level entities collected, stored and reported data. This study highlights the importance of data interoperability and data sharing by exploring how a loosely coupled set of entities without direct top-down control or a profit motive can govern data effectively. Our analysis provides greater clarity about the interactions between different stakeholders in a complex system. This study presents primary interviews of 11 individuals, each responsible for tracking and reporting immunization information. Analysis of the data expands existing research on IIS on data sharing, system interoperability and dynamic pandemic responses.

Genomic characteristics, disease outcome and heterologous vaccine effectiveness among cases with SARS CoV-2 infection

BackgroundIn the pursuit of global health security, continuous monitoring of vaccine effectiveness across various viral strains emerges as a crucial imperative. The emergence of SARS-CoV-2 major variants of concern (VOCs), including Alpha, Beta, Delta, and Omicron, has added complexity to the COVID-19 vaccination landscape.ObjectivesTo assess illness severity, evaluate vaccine efficacy across varying doses and types, and determine effectiveness against major VOCs within the population.MethodsThis retrospective cohort study, conducted in Abu Dhabi, United Arab Emirates, focuses on a cohort of 44,073 SARS-CoV-2 positive cases from February 2021 to May 2022, dominated by the Delta and Omicron variants. The study employed a nested case-control design, analyzing hospital admissions for confirmed SARS-CoV-2 infection.ResultsVaccine effectiveness was higher among heterologus-boosted individuals at 87% (95% CI:79%-93%) compared to homologus-boosted individuals at 59% (95% CI: 48%-68%) and fully vaccinated, non-boosted adults at 53% (95% CI: 46%-59%). These findings highlight the importance of heterologous boosting, particularly against rapidly evolving viral variants, offering valuable insights for refining pandemic response strategies.ConclusionThe study underscores the critical need for ongoing assessment and adaptation of vaccination strategies to the evolving viral landscape.

Disability and Vulnerable Groups Inclusion in COVID-19 Policy and Planning in Sub-Sahara African Countries

Background: The COVID-19 pandemic has caused an excess burden of disease in disabled and vulnerable populations. These populations may face an increased risk of contracting COVID-19, greater demand for services and social support, and reduced access to treatment. Despite various national and international efforts towards disability rights and inclusion, substantial gaps exist between disability rights legislation and its implementation. Aims: To assess the inclusion of people with disability and other vulnerable groups in policy and planning documents related to the COVID-19 pandemic response in sub-Sahara Africa. Methods: We conducted content analysis using the EquiFrame policy analysis tool and assessed commitment to 12 vulnerable groups and 21 core human rights in policy and planning documents related to the COVID-19 pandemic. We included documents on general pandemic response, stakeholder engagement, risk communication, and the COVID-19 vaccine from five sub-Saharan African countries, including Nigeria, South Africa, Ethiopia, Kenya, and Zambia. Results: The study highlights the varying degrees to which countries integrate disability, vulnerable groups, and other core human rights concepts into their COVID-19 health policies and planning documents. Only Kenya mentioned disability in their pandemic response plan. However, all countries have explicitly mentioned disability in their stakeholder engagement plans. Except for Kenya, all countries have included disability in their risk communication plans. Notably, South Africa and Zambia demonstrated extensive disability inclusion in their stakeholder engagement and vaccine plan. Thus, these countries have the potential for comprehensive and inclusive health policymaking. In contrast, Nigeria and Ethiopia lag, therefore highlighting areas of improvement across all policy domains. Conclusion: The findings emphasize the critical importance of not only mentioning disability and other vulnerable groups, but also ensuring the depth and quality of this inclusion. While there are positive strides in certain areas, there remains a consistent need for deeper and broader inclusion across all policy domains. Received: 10 September 2024 | Reviewed: 16 October 2024 | Revised: 03 November 2024 | Accepted: 05 November 2024.

Healthcare Analytics in Pandemic Response

Healthcare Analytics in Pandemic Response

Characterization of H5N1 avian influenza virus isolated from bird in Russia with the E627K mutation in the PB2 protein

Currently A(H5Nx) avian influenza viruses are globally widespread and continue to evolve. Since their emergence in 2020 novel highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b reassortant viruses have become predominant in the world and caused multiple infections in mammals. It was shown that some of A(H5N1) viruses mostly isolated from mammals contain an E627K mutation in the PB2 protein which can lead to adaptation of influenza viruses to mammalian cells. In 2023 in Russia we have isolated two highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b viruses from birds one of which contained an E627K mutation in the PB2 protein. This virus had increased virulence in mice. Limited airborne transmission of the virus with the PB2-E627K mutation was observed between ferrets, in which infectious virus was detected in the nasal washings of the three of the twelve recipient ferrets, and clinical symptoms of the disease were observed in one case. Both viruses showed dominant binding to avian-type sialoside receptors, which was most likely the reason for the limited transmissibility. Thus, this study indicates a possible limited increase in the pandemic potential of A(H5N1) 2.3.4.4b viruses and highlights the importance of continuous avian influenza surveillance for pandemic preparedness and response.

Global Emerging Infections Surveillance Program Contributions to Pandemic Preparedness and Response.

Since its establishment in 1997, the US Department of Defense (DoD) Global Emerging Infections Surveillance (GEIS) program has provided support for infectious disease pandemic preparedness and response. The GEIS program has shown the value of having a central hub responsible for coordinating a global network of DoD laboratories that conduct surveillance for militarily relevant infectious disease threats. The program has supported the establishment and maintenance of capabilities for collecting, characterizing, and reporting on major infectious disease events, including the COVID-19 pandemic and mpox outbreak. The GEIS program enables the US government to mitigate infectious disease threats to DoD mission readiness and to effectively respond to pathogens worldwide. Continued investment in maintaining the GEIS program and its network is critical for timely detection and response to future emerging infectious disease threats in various populations within locations where gaps in US government or host-nation surveillance might exist.

The role of economic evaluation in modelling public health and social measures for pandemic policy: a systematic review

BackgroundDynamic transmission models are often used to provide epidemiological guidance for pandemic policy decisions. However, how economic evaluation is typically incorporated into this technique to generate cost-effectiveness estimates of pandemic policy responses has not previously been reviewed.MethodsWe systematically searched the Embase, PubMed and Scopus databases for dynamic epidemiological modelling studies that incorporated economic evaluation of public health and social measures (PHSMs), with no date restrictions, on 7 July 2024.ResultsOf the 2,719 screened studies, 51 met the inclusion criteria. Most studies (n = 42, 82%) modelled SARS-CoV-2. A range of PHSMs were examined, including school closures, testing/screening, social distancing and mask use. Half of the studies utilised an extension of a Susceptible-Exposed-Infectious-Recovered (SEIR) compartmental model. The most common type of economic evaluation was cost-effectiveness analysis (n = 24, 47%), followed by cost-utility analysis (n = 17, 33%) and cost–benefit analysis (n = 17, 33%).ConclusionsEconomic evaluation is infrequently incorporated into dynamic epidemiological modelling studies of PHSMs. The scope of this research should be expanded, given the substantial cost implications of pandemic PHSM policy responses.

A reappraisal of COVID-19 epidemiology after the pandemic: models, data, and interventions

This is a summary of a presentation given in October 2023 at the Academy of Sciences in Bologna. COVID-19 was a major crisis that witnessed massive mobilization of the scientific workforce. Almost a million scientific articles were published on COVID-19 within less than 4 years, most of them of low quality. Several key components of the narrative that prevailed in the pandemic response were misleading and they affected both the credibility of science and public health and the health of billions of people worldwide. Rigorous evidence and a judicious approach to re-evaluating decision-making is needed to revert the tide and regain competence within the scientific community and trust among the general public.

Covid-19 Policy Responses, Digital Health Apps and Data Sharing: Attitudes of Swiss Medical Students

Background: In this paper we present findings from a survey with 256 medical students in Switzerland about their perception of Covid-19 public health measures, their attitude towards digital health apps to respond to the pandemic, and whether the Covid-19 crisis changed their willingness to share their health data in the future for public health research purposes. Results: Results show that most respondents indicated to be somewhat negatively affected by the pandemic, but deemed the public health policy responses to the pandemic in Switzerland as just right or even as slightly too unrestrictive. Most respondents evaluate the use of apps to respond to the pandemic as positive, and 61.7% indicated that they used the contact tracing app and 97.6% the immunity certificate app. The latter was evaluated more positively than the former. They indicated that a better communication about its benefits or the possibility to share health data for research (e.g. by listing Covid-19 symptoms and vaccination status) would improve the contact tracing app. Nearly all respondents indicated that they would share their health data or samples for research purposes in the future. The types of data they would be willing to share are mostly questionnaires about their health status, blood samples and other biological samples, with social media being the least willing to share. Our findings highlight that most respondents believe that their attitude towards sharing data for public health research did not change during or with the Covid-19 pandemic. Conclusions: Recent developments in digital health app use were fuelled by the Covid-19 pandemic and the public – as a central actor – defined social trends with regard to digital health app uptake and willingness to share health data. With this survey we aimed to fill the gap of empirically examining how Swiss medical students – a young, technology- and medicine-inclined subpopulation, perceived the Covid-19 pandemic response, how they evaluate the related use of apps to respond to the pandemic as well as their willingness to share data for health research. The results may shed light on how the Covid-19-related use of technology and health data is changing the health landscape in Switzerland.

The psychology of pandemic policy support: unraveling the complex interplay of personal values and value congruence across 20 European countries

ObjectivesWe explored the roles of personal values and value congruence—the alignment between individual and national values—in predicting public support for pandemic restrictions across 20 European countries. Study designCross-sectional study. MethodsWe analyzed multinational European survey data (N = 34,356) using Schwartz's values theory and person-environment fit theory. Multilevel polynomial regression was employed to assess the linear and curvilinear effects of personal values on policy support. Multilevel Euclidean similarity analysis and response surface analysis were conducted to evaluate the impact of value congruence and delineate nuanced congruence patterns. ResultsFindings revealed that extreme levels of security, conformity, stimulation, hedonism, and achievement values were associated with decreased policy support. Value congruence with security, conformity, and benevolence increased support, while congruence with stimulation, hedonism, and achievement reduced it. High congruence between personal and national social focus values significantly boosted policy support. Extreme mismatches in self-direction values amplified support. Societal power exceeding personal power also increased support. Matched levels of hedonism motivated greater support, while stimulation and achievement value (in)congruence showed little impact. ConclusionsWe highlight the differential effects of personal values and value congruence on public attitudes toward pandemic restrictions. The findings underscore the importance of considering the interplay between individual and societal values when designing and implementing effective pandemic response strategies.

Modeling Population Mobility Flows: A Hybrid Approach Integrating a Gravity Model and Machine Learning

Population mobility between cities significantly affects traffic congestion, disease spread, and societal well-being. As globalization and urbanization accelerate, understanding the dynamics of population mobility becomes increasingly important. Traditional population migration models reveal the factors influencing migration, while machine learning methods provide effective tools for creating data-driven models to handle the nonlinear relationships between origin and destination characteristics and migration. To deepen the understanding of population mobility issues, this study presents GraviGBM, an expandable population mobility simulation model that combines the gravity model with machine learning, significantly enhancing simulation accuracy. By employing SHAPs (SHapley Additive exPlanations), we interpret the modeling results and explore the relationship between urban characteristics and population migration. Additionally, this study includes a case analysis of COVID-19, extending the model’s application during public health emergencies and evaluating the contribution of model variables in this context. The results show that GraviGBM performs exceptionally well in simulating inter-city population migration, with an RMSE of 4.28, far lower than the RMSE of the gravity model (45.32). This research indicates that distance emerged as the primary factor affecting mobility before the pandemic, with economic factors and population also playing significant roles. During the pandemic, distance remained dominant, but the significance of short distances gained importance. Pandemic-related indicators became prominent, while economics, population density, and transportation substantially lost their influence. A city-to-city flow analysis shows that when population sizes are comparable, economic factors prevail, but when economic profiles match, living conditions dictate migration. During the pandemic, residents from hard-hit areas moved to more distant cities, seeking normalcy. This research offers a comprehensive perspective on population mobility, yielding valuable insights for future urban planning, pandemic response, and decision-making processes.

AI-powered pandemic response framework for offshore oil platforms: Ensuring safety during global health crises

AI-powered pandemic response framework for offshore oil platforms: Ensuring safety during global health crises

UK Government COVID-19 response employees' perceptions on working from home: Content analysis of open-ended survey questions.

This study investigates perceptions of homeworking in UK Government response-focused employees that contributed to the COVID-19 pandemic response. A cross-sectional online survey with open-ended questions was conducted. Free-text responses detailing participants perceptions of barriers, facilitators, advantages, and disadvantages were analysed using content analysis. A total of 1,943 free-text responses (from 150 participants) were analysed. There were many conflicting advantages and disadvantages provided by participants, but crudely more positive statements were provided than negative. Flexibility associated with working from home was the most common positive factor, and the isolation and impact on working relationships was the most reported negative factor of working from home. We suggest a 'one size fits all' approach to supporting staff working from home is not fit for purpose due to individual circumstances and contextual factors.

From Pandemic to Heatwave: Digital Strategies for Health Resilience

Abstract Heatwaves threaten public health in the EU, as evidenced by the high heat-related mortality in the summer of 2022. Despite their frequency, European heat-health action plans (HHAPs) largely exclude digital solutions. The COVID-19 pandemic shifted perceptions and use of digital health tools, demonstrating their effectiveness in responding to health crises and providing insights for heatwave management. This work explores the potential of further including digital health interventions into European HHAPs. The objective is to identify adaptable digital strategies to mitigate heatwave health impacts. We started by analyzing WHO’s guidance on the creation of HHAPs, as well as the European Observatory on Health Systems and Policies’ assessment of the four main areas supported by digital health tools during the pandemic. Later, we proposed four main areas where digital health solutions could be efficiently integrated. Each area underwent a rapid literature review to identify digital solutions used during COVID-19, followed by a critical analysis for applicability in heat-health action planning. We identified four areas where the implementation of digital tools should be explored: Communication and Information Dissemination (focusing on raising awareness among vulnerable groups, caregivers, and organizations); Modeling and Forecasting (developing precise forecasts for proactive planning); Health services coordination (among services delivering immediate care during heatwaves); Monitoring and Population Surveillance (implementing strategies to identify and mitigate heat-related risks e.g. among vulnerable populations). Results indicate that digital health solutions from COVID-19 can enhance national HHAPs. Tools for pandemic prevention and response are applicable to extreme weather events. The pandemic’s increased digital usage resulted from policy changes and infrastructure investment - leveraging these advancements could prepare Europe for extreme heat threats. Key messages • Results indicate that digital health solutions from COVID-19 can enhance national HHAPs. Tools for pandemic prevention and response are applicable to extreme weather events. • The pandemic’s increased digital usage resulted from policy changes and infrastructure investment - leveraging these advancements could prepare Europe for extreme heat threats.