Public Health Emergency Response Systems Research Articles

Information sharing across institutions: Practices and barriers during public health emergencies in Ethiopia

BackgroundRapid, integrated information exchange between stakeholders is critical for effective emergency preparedness and response. However, many low- and middle-income countries face barriers to seamless data sharing. While information accessibility is recognized as important for evidence-based decision-making and resource allocation in Ethiopia, factors influencing current health information sharing practices among stakeholders involved in public health emergency management programs are unclear. This study aims to examine multi-sectoral stakeholders' perspectives and experiences with health data sharing during emergencies in Ethiopia, to identify opportunities and challenges influencing practices to strengthen the national public health emergency response system. MethodsA mixed-methods study was conducted between June and August 2023, involving a survey of 169 stakeholders actively involved in PHEM programs in Ethiopia as well as 23 in-depth interviews with key informants in senior leadership or advisory roles. The data was analyzed using descriptive statistics in SPSS and thematic analysis of qualitative transcripts. ResultsDuring emergencies, it was observed that data sharing between different entities occurred. Quantitative findings showed the predominant types of health data shared between stakeholders during emergencies included hospital data (109, 64.5 %), clinical case information, and laboratory results. Challenges limiting effective coordination included issues like limited functionality of digital health systems (75, 44 %), incompatible data formats (13, 34 %), and financial constraints (83, 49 %) and and socio-cultural barriers constrain current practices in Ethiopia. Qualitative interviews identified five themes around risk communication and inclusive alert systems. Experts emphasized tailored, multichannel outreach but noted infrastructure gaps and digital divides currently limit poorer communities' engagement. ConclusionWhile collaborative health information exchange during emergencies is recognized as important, systemic, financial, and socio-cultural barriers constrain current practices in Ethiopia. Targeted strategies including capacity building, investment in integrated data infrastructure, economic optimization through innovative financing models, trust-based relationship development, and locally relevant communication channels informed by stakeholder perspectives can optimize information accessibility, coordination, quality, and equity of healthcare services during public health emergencies.

Preparing for Future Pandemics and Public Health Emergencies: An American College of Physicians Policy Position Paper.

The onset of the COVID-19 pandemic revealed significant gaps in the United States' pandemic and public health emergency response system. At the federal level, government responses were undercut by a lack of centralized coordination, inadequately defined responsibilities, and an under-resourced national stockpile. Contradictory and unclear guidance throughout the early months of the pandemic, along with inconsistent funding to public health agencies, also created notable variance in state and local responses. The lack of a coordinated response added pressure to an already overwhelmed health care system, which was forced to resort to rationing care and personal protective equipment, creating moral distress and trauma for health care workers and their patients. Despite these severe shortcomings, the COVID-19 pandemic also highlighted successful policies and approaches, such as Operation Warp Speed, which led to the fastest development and distribution of a vaccine in history. In this position paper, the American College of Physicians (ACP) offers several policy recommendations for enhancing federal, state, and local preparedness for future pandemic and public health emergencies. This policy paper builds on various statements produced by ACP throughout the COVID-19 pandemic, including on the ethical distribution of vaccinations and resources, conditions to resume economic and social activity, and efforts to protect the health and well-being of medical professionals, among others.

Spatial effects of public health laboratory emergency testing institutions under COVID-19 in China

BackgroundThe transmission of 2019 novel coronavirus (COVID-19) has caused global panic in the past three years. Countries have learned an important lesson in the practice of responding to COVID-19 pandemic: timely and accurate diagnosis is critical. As an important technology of virus diagnosis, nucleic acid testing (NAT) is also widely used in the identification of other infectious diseases. However, geographic factors often constrain the provision of public health services such as NAT services, and the spatial nature of their resource allocation is a significant problem.MethodsWe used OLS, OLS-SAR, GWR, GWR-SAR, MGWR, and MGWR-SAR models to identify the determinants of spatial difference and spatial heterogeneity affecting NAT institutions in China.ResultsFirstly, we identify that the distribution of NAT institutions in China shows a clear spatial agglomeration, with an overall trend of increasing distribution from west to east. There is significant spatial heterogeneity in Chinese NAT institutions. Secondly, the MGWR-SAR model results show that city level, population density, number of tertiary hospitals and number of public health emergency outbreaks are important factors influencing the spatial heterogeneity of NAT institutions in China.ConclusionsTherefore, the government should allocate health resources rationally, optimise the spatial layout of testing facilities, and improve the ability to respond to public health emergencies. Meanwhile, third-party testing facilities need to focus on their role in the public health emergency response system as a market force to alleviate the inequitable allocation of health resources between regions. By taking these measures to prepare adequately for possible future public health emergencies.

Retracted: Construction of COVID-19 Epidemic Prevention and Control and Public Health Emergency Response System Based on Discrete Stochastic Mathematical Model.

[This retracts the article DOI: 10.1155/2022/5693293.].

Improving China's public health emergency response based on One Health theory

With the progress of globalization and the improvement of transportation, a public health emergency can spread across country's boundary in a short period of time from its original place to other areas or regions, posing public health threatens. Public health emergencies not only affect human-animal/plant-environmental health, but also have long-term implications for social development, so the public health emergency response has gone beyond general public health and requires an integrated and comprehensive One Health approach. This paper analyzes the problems and shortcomings of China's current public health emergency response system in a view of One Health and put forward the recommendations based on One Health concept on integrality, collaboration, development and sustainability of public health emergency response. These recommendations can be used as reference to further optimize the response system of public health emergencies in China.

Construction of COVID-19 Epidemic Prevention and Control and Public Health Emergency Response System Based on Discrete Stochastic Mathematical Model.

This research was aimed at exploring the construction and evaluation method of the comprehensive emergency response system for public health emergencies under the COVID-19 (coronavirus disease 2019) epidemic situation based on discrete stochastic mathematical model. The response of the Centers for Disease Control and Prevention (CDCP) of Taiyuan city in the COVID-19 epidemic situation was taken as an example. A new discrete stochastic COVID-19 epidemic spread mathematical model which integrated public health intervention and input cases was proposed. The model was parameterized by multisource data, and the impact of different flow patterns on the risk of secondary outbreak was analyzed. The advantages and disadvantages of its emergency system construction were analyzed. Additionally, the improvement measures and suggestions for the existing problems were proposed. Results suggested that there was only one specialized disease prevention and control institution in Taiyuan, and there were only 11 centers for disease prevention and control, accounting for 6.2% (11/177) of the total in Shanxi Province. Through the analysis, it was found that the current public health emergency response system in Taiyuan city had imperfect management coordination mechanism, incomplete plan type, serious shortage of public health personnel, poor information communication efficiency, insufficient early warning efficiency of the epidemic detection system, and weak logistics material security links. Therefore, it was proposed to establish a sound coordination system of emergency health management and vigorously promote the construction of emergency health management institutions. Thus, a public health emergency management system integrating management coordination system, plan system, emergency team building system, material reserve management, and other functions was formed. The application of discrete stochastic mathematical model suggests that intermittent population flow and effective isolation of infected people in transient population can effectively reduce the risk of secondary outbreak. The system analysis here also provides theoretical basis for improving the construction of public health emergency response system in Taiyuan.

COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons?

The first coronavirus disease 2019 (COVID-19) outbreak in Daegu city was overcome by efforts, including; 1) prompt isolation and quarantine action by local government with cooperative help from expert groups and the central government, 2) high-intensity social distancing and active cooperation of citizens, 3) admission of asymptomatic and mild patients in 'residential treatment centers', and 4) use of a telephone scoring system for the allocation of patients, with a mortality rate of 2.5%. A continuous suppression policy with test, tracing, and treatment (3 Ts) was implemented as an active response to the initial outbreaks in Korea. With the introduction of vaccines and therapeutic agents, the COVID-19 crisis had improved. Recently, the omicron variant was responsible for most domestic outbreaks, albeit with a low mortality rate (0.1%). Since the omicron outbreak, a damage mitigation policy has been implemented, focusing on protecting vulnerable groups. In the future, preparation including below are needed; 1) improving the national public health emergency response system, 2) strengthening the crisis response capacity of local governments, 3) cooperation between public healthcare and private healthcare, and 4) establishing a resilient medical response system.

Enlightenment from the COVID-19 Pandemic: The Roles of Environmental Factors in Future Public Health Emergency Response.

The coronavirus disease 2019 (COVID-19) pandemic is challenging the current public health emergency response systems (PHERSs) of many countries. Although environmental factors, such as those influencing the survival of viruses and their transmission between species including humans, play important roles in PHERSs, little attention has been given to these factors. This study describes and elucidates the roles of environmental factors in future PHERSs. To improve countries’ capability to respond to public health emergencies associated with viral infections such as the COVID-19 pandemic, a number of environmental factors should be considered before, during, and after the responses to such emergencies. More specifically, to prevent pandemic outbreaks, we should strengthen environmental and wildlife protection, conduct detailed viral surveillance in animals and hotspots, and improve early-warning systems. During the pandemic, we must study the impacts of environmental factors on viral behaviors, develop control measures to minimize secondary environmental risks, and conduct timely assessments of viral risks and secondary environmental effects with a view to reducing the impacts of the pandemic on human health and on ecosystems. After the pandemic, we should further strengthen surveillance for viruses and the prevention of viral spread, maintain control measures for minimizing secondary environmental risks, develop our capability to scientifically predict pandemics and resurgences, and prepare for the next unexpected resurgence. Meanwhile, we should restore the normal life and production of the public based on the “One Health” concept, that views global human and environmental health as inextricably linked. Our recommendations are essential for improving nations’ capability to respond to global public health emergencies.

Can artificial intelligence enable the government to respond more effectively to major public health emergencies? ——Taking the prevention and control of Covid-19 in China as an example

In recent years, public health emergencies have occurred frequently, posing a serious threat to the regional economy and the safety of people's lives and property. In particular, the outbreak of the COVID-19 novel coronavirus this year has caused serious losses to the global economy. On this basis, this article attempts to use modern advanced artificial intelligence technology and modern social science and technology to provide technical assistance and support for the prevention and control of major public health incidents, in order to improve the Chinese government's public relations capabilities and response to public health emergencies. Ability and level. This article attempts to use 3S technology closely related to artificial intelligence technology to design and establish a public health emergency response system, so as to improve the government's response and decision-making ability to respond to and deal with public health emergencies, and reduce the occurrence of emergencies. The results showed that among the 298 respondents, 145 believed that public health emergencies depend on human-to-human transmission. Most event information is acceptable, while 169 people who rely on mobile phones for information think that most of them are acceptable, and 89 people who rely on TV media for information think that most of them are acceptable. It shows that the use of artificial intelligence technology can effectively solve and prevent the further development of the situation, and at the same time improve the government's ability and level to respond to major public health emergencies, and increase the government's prestige in the eyes of the public.

Digital Contact Tracing Based on a Graph Database Algorithm for Emergency Management During the COVID-19 Epidemic: Case Study.

BackgroundThe COVID-19 epidemic is still spreading globally. Contact tracing is a vital strategy in epidemic emergency management; however, traditional contact tracing faces many limitations in practice. The application of digital technology provides an opportunity for local governments to trace the contacts of individuals with COVID-19 more comprehensively, efficiently, and precisely.ObjectiveOur research aimed to provide new solutions to overcome the limitations of traditional contact tracing by introducing the organizational process, technical process, and main achievements of digital contact tracing in Hainan Province.MethodsA graph database algorithm, which can efficiently process complex relational networks, was applied in Hainan Province; this algorithm relies on a governmental big data platform to analyze multisource COVID-19 epidemic data and build networks of relationships among high-risk infected individuals, the general population, vehicles, and public places to identify and trace contacts. We summarized the organizational and technical process of digital contact tracing in Hainan Province based on interviews and data analyses.ResultsAn integrated emergency management command system and a multi-agency coordination mechanism were formed during the emergency management of the COVID-19 epidemic in Hainan Province. The collection, storage, analysis, and application of multisource epidemic data were realized based on the government’s big data platform using a centralized model. The graph database algorithm is compatible with this platform and can analyze multisource and heterogeneous big data related to the epidemic. These practices were used to quickly and accurately identify and trace 10,871 contacts among hundreds of thousands of epidemic data records; 378 closest contacts and a number of public places with high risk of infection were identified. A confirmed patient was found after quarantine measures were implemented by all contacts.ConclusionsDuring the emergency management of the COVID-19 epidemic, Hainan Province used a graph database algorithm to trace contacts in a centralized model, which can identify infected individuals and high-risk public places more quickly and accurately. This practice can provide support to government agencies to implement precise, agile, and evidence-based emergency management measures and improve the responsiveness of the public health emergency response system. Strengthening data security, improving tracing accuracy, enabling intelligent data collection, and improving data-sharing mechanisms and technologies are directions for optimizing digital contact tracing.

COVID-19 Epidemic and Public Health Measures in China

ObjectivesThe study aims to analyze the status quo of public health emergency measures taken in China in dealing with the spread of new coronavirus pneumonia (COVID-19), and to put forward policy suggestions for system construction and improvement.MethodsAccording to the official data released by the National Health Commission, the epidemic data of infected people from 0:00 on January 24, 2020 to 24:00 on February 23, 2020 were quantitatively analyzed through statistical analysis. We used EXCEL software to draw the overall epidemic trend chart and Statistical Product and Service Solutions (SPSS) to carry out descriptive statistical analysis of mortality and cure rate. We made qualitative analysis on the emergency measures implemented by national administrative departments and provincial governments to work on controlling and monitoring COVID-19 nationwide spread.ResultsThe number of patients diagnosed showed a linear increasing trend, with the slope increasing first and decreasing later. Suspected and new cases showed an inverted V pattern, with the peak occurring on February 8 and 12, respectively. There was a linear increase in the number of deaths and an exponential increase in the number of cures. Over the 31-day study period, the mortality rate fluctuated between 2.0% and 3.4%. The mean cure rate was 10.03%, the minimum value was 1.33%, and the maximum value was 32.05%. The quantitative and qualitative analysis shows that the public health emergency response system constructed in China plays a significant role in controlling the epidemic in a certain period of time.DiscussionThe four-tier emergency management system and the joint prevention mechanism established in China have provided various resources to control the epidemic, but there are still weakness in dealing with the spread of COVID-19. It is suggested to improve and strengthen the emergency management system, public health service system, health legal system, citizen health education, and international exchange and cooperation.

Health Innovation and Commercialization Ecosystems and Public Health Emergency Response Systems

Health Innovation and Commercialization Ecosystems and Public Health Emergency Response Systems

Challenges to the system of reserve medical supplies for public health emergencies: reflections on the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in China.

On December 31, 2019, the Wuhan Municipal Health Commission announced an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), China is now at a critical period in the control of the epidemic. The Chinese Government has been taking a series of rapid, comprehensive, and effective prevention and control measures. As the pandemic has developed, a fact has become apparent: there is a serious dearth of emergency medical supplies, and especially an extreme shortage of personal protective equipment such as masks and medical protective clothing. This is one of the major factors affecting the progress of epidemic prevention and control. Although China has made great efforts to strengthen the ability to quickly respond to public health emergencies since the SARS outbreak in 2003 and it has clarified requirements for emergency supplies through legislation, the emergency reserve supplies program has not been effectively implemented, and there are also deficiencies in the types, quantity, and availability of emergency medical supplies. A sound system of emergency reserve supplies is crucial to the management of public health emergencies. Based on international experiences with pandemic control, the world should emphasize improving the system of emergency reserve medical supplies in the process of establishing and improving public health emergency response systems, and it should promote the establishment of international cooperative programs to jointly deal with public health emergencies of international concern in the future.

Infectious disease outbreak preparedness and response in Nigeria: history, limitations and recommendations for global health policy and practice.

Effective disease outbreak response has historically been a challenging accomplishment for the Nigerian health system due to an array of hurdles not unique to Nigeria but also found in other African nations which share its large size and complexity. However, the efficiency of the response mounted against the Ebola Virus Disease (EVD) outbreak of 2014 proved that indeed, though challenging, proactive and effective outbreak response is not impossible. With over 20 public health emergencies and infectious disease outbreaks between 2016 and 2018 alone, Nigeria is one of only five members of the World Health Organization (WHO) African Region to report five or more public health events per annum. There are many lessons that can be drawn from Nigeria's experience in handling outbreaks of infectious diseases. In this review, we discuss the history of emerging and re-emerging infectious disease outbreaks in Nigeria and explore the response strategies mounted towards each. We also highlight the significant successes and note-worthy limitations, which we have then utilized to proffer policy recommendations to strengthen the Nigerian public health emergency response systems.

Global Health Security Implementation: Expanding the Evidence Base.

Global Health Security Implementation: Expanding the Evidence Base.

Impact of new technologies on stress, attrition and well-being in emergency call centers: the NextGeneration 9\u20131-1 study protocol

BackgroundOur public health emergency response system relies on the “first of the first responders”—the emergency call center workforce that handles the emergency needs of a public in distress. Call centers across the United States have been preparing for the “Next Generation 9-1-1” initiative, which will allow citizens to place 9–1-1 calls using a variety of digital technologies. The impacts of this initiative on a workforce that is already highly stressed is unknown. There is concern that these technology changes will increase stress, reduce job performance, contribute to maladaptive coping strategies, lower employee retention, or change morale in the workplace. Understanding these impacts to inform approaches for mitigating the health and performance risks associated with new technologies is crucial for ensuring the 911 system fulfills its mission of providing optimal emergency response to the public.MethodsOur project is an observational, prospective cohort study framed by the first new technology that will be implemented: text-to-911 calling. Emergency center call takers will be recruited nationwide. Data will be collected by online surveys distributed at each center before text-to-911 implementation; within the first month of implementation; and 6 months after implementation. Primary outcome measures are stress as measured by the Calgary Symptoms of Stress Index, use of sick leave, job performance, and job satisfaction. Primary analyses will use mixed effects regression models and mixed effects logistic regression models to estimate the change in outcome variables associated with text-to-911 implementation. Multiple secondary analyses will examine effects of stress on absenteeism; associations between technology attitudes and stress; effects of implementation on attitudes towards technology; and mitigating effects of job demands, job satisfaction, attitudes towards workplace technology and workplace support on change in stress.DiscussionOur public health dependence on this workforce for our security and safety makes it imperative that the impact of technological changes such as text-to-911 are researched so appropriate intervention efforts to can be developed. Failing to protect our 9–1-1 call takers from predictable health risks would be similar to knowingly exposing field emergency responders to a toxic situation without following OSHA required training and practice standards assuring their protection.

A conceptual framework to measure systems' performance during emergency preparedness exercises.

Large-scale public health emergencies require a sophisticated, coordinated response involving multiple entities to protect health and minimize suffering. However, the rarity of such emergencies presents a barrier to gathering observational data about the effectiveness of the public health response before such events occur. For this reason, public health practitioners increasingly have relied on simulated emergencies, known as “exercises” as proxies to test their emergency capabilities. However, the formal evaluation of performance in these exercises, historically has been inconsistent, and there is little research to describe how data acquired from simulated emergencies actually support conclusions about the quality of the public health emergency response system. Over the past six years, we have designed and evaluated more than seventy public health emergency exercises, collaborating with public health agencies, hospitals and others to test a wide variety of systems and their capabilities. Using the data and experience that we gathered, we have developed a conceptual framework that describes the essential elements necessary to consider when applying performance measurement science to public health emergency exercises. We suggest that this framework may assist practitioners and researchers who wish to better measure performance in exercises and to improve public health emergency preparedness.

EPPM and Willingness to Respond: The Role of Risk and Efficacy Communication in Strengthening Public Health Emergency Response Systems

This study examines the attitudinal impact of an Extended Parallel Process Model (EPPM)-based training curriculum on local public health department (LHD) workers’ willingness to respond to representative public health emergency scenarios. Data are from 71 U.S. LHDs in urban and rural settings across nine states. The study explores changes in response willingness and EPPM threat and efficacy appraisals between randomly assigned control versus intervention health departments, at baseline and 1 week post curriculum, through an EPPM-based survey/resurvey design. Levels of response willingness and emergency response-related attitudes/beliefs are measured. Analyses focus on two scenario categories that have appeared on a U.S. government list of scenarios of significant concern: a weather-related emergency and a radiological “dirty” bomb event (U.S. Department of Homeland Security, 2007). The greatest impact from the training intervention on response willingness was observed among LHD workers who had low levels of EPPM-related threat and efficacy perceptions at baseline. Self-efficacy and response efficacy and response willingness increased in intervention LHDs for both scenarios, with greater response willingness increases observed for the radiological “dirty” bomb terrorism scenario. Findings indicate the importance of building efficacy versus enhancing threat perceptions as a path toward greater response willingness, and suggest the potential applicability of such curricular interventions for boosting emergency response willingness among other cadres of health providers.

Diffusion of new technology, health services and information after a crisis: a focus group study of the Sichuan “5.12” Earthquake

The Sichuan "5.12" Earthquake in 2008 occurred in a relatively underdeveloped area in China. The rainy weather, the mountainous environment and the local languages all posed major challenges to the dissemination of information and services after the disaster. By adopting a communication perspective, this study applies the diffusion of innovations theory to investigate how healthcare professionals diffused health technologies, health information and services during the rescue and relief operation. The authors conducted three focus group sessions with the health professionals who had attended to the rescue and relief work of the Sichuan "5.12" Earthquake in 2008. A range of questions regarding the diffusion of innovations were asked during these sessions. The health professionals used their cell phones to communicate with other healthcare providers, disseminated knowledge of health risks and injuries to affected residents with pamphlets and posters and attended daily meetings at the local government offices. They reported on the shortage of maritime satellite cell phones and large-size tents for medical use, and the absence of fully equipped ambulances. Volunteers, local health professionals and local officials provided health information and services in different ways. However, the diffusion of health information and services was less likely to reach those living next to transportation centers, in remote areas and in disaster areas neglected by the media. New communication devices such as cell phones and the mobile Internet enabled medical professionals to coordinate the rescue and relief work after this major natural disaster, at a time when the country's emergency response system still had plenty of room for improvement. In future, the mobile Internet should be used as a means of collecting bottom-up disaster reports so that the media will not neglect any disaster areas as they did during the Sichuan Earthquake. Rescue relief work would have been substantially easier if medical teams had been equipped with advanced appliances such as maritime satellite cell phones. "Disaster medicine" should be treated as a separate discipline in medical schools and receive more investment. Moreover, a stronger public health emergency response system is needed for more efficient dispatch and coordination.

Information Systems and Health Care XIII: Examining the Critical Requirements, Design Approaches and Evaluation Methods for a Public Health Emergency Response System

Research pertaining to emergency response systems has accelerated over the past few years, particularly since 9/11 events, and more recently due to Hurricane Katrina and concern over a potential of an avian flu pandemic. This study examines the requirements that are the most demanding with respect to software and hardware, and the associated design strategies for a public health emergency response system (ERS) for electronic laboratory diagnostics consultation. In addition, this study illustrates ways to evaluate the design decisions. An important goal of a public health ERS is to improve the communication and notification of lifethreatening diseases and harmful agents. The system under study is called Secure Telecommunications Application Terminal Package or STATPack. STATPack supports distributed laboratories to communicate information and make decisions regarding biosecurity situations. The intent of the system is to help hospital laboratories enhance their preparedness for a bioterrorism event or other public health emergency. The practical nature of this research concerns how an ERS diagnostic and consultation system was designed to alert and support first responders and Subject Matter Experts (SMEs). The academic nature of the research centers on the critical requirements of an ERS and how these unique needs can be met through careful design. Understanding the critical requirements will assist developers to better meet the expectations of the users. Specifically, I conducted a thirteen month study analyzing the requirements, design, and implementation of the system.