Evaluation of Triage System in a Dedicated Covid-19 Hospital.

The global health system faces a substantial burden from the Covid-19 pandemic. To prevent Covid-19 transmission an effective triage system is useful in resource-limited countries like Bangladesh. The purpose of the study was to determine the status of the triage system in a dedicated Covid-19 Hospital. This cross-sectional study was conducted among conveniently selected 150 respondents including 63 doctors, 72 nurses and 15 administrative staff. Data were collected through face-to-face interviews using a pretested semi-structured questionnaire and observation checklist. The collected data were processed and analyzed with the help of SPSS (Version 26.0) and Xcel 2019. The study was conducted at Kurmitola General Hospital, Bangladesh from January 2020 to December 2020. Among study participants, 54.0% of the respondents belonged to the (31-40) age group and 74.0% were female. Half 50.7% of the respondents working duration was (0-4) years. Two-thirds 67.0% of the respondents had training on the triage system. All of the respondents mentioned the presence of a triage system in this hospital but there was no tele-triage. Regarding infrastructure facilities like triage room, sitting facilities with 1-meter distance in waiting area, one-way entrance, and exit, separated ticket counter and washroom, proper hand wash facilities, all were present in this hospital. All of the respondents mentioned the presence of available logistic support for the triage system in this dedicated Covid-19 hospital including a sufficient supply of PPE, thermometer, and pulse oximeter. All doctors and nurses wore PPE. Almost four-fifths 87.30% of the respondents mention that there was no training on donning and doffing procedure of PPE. There was a statistically significant association between training on triage with age group and occupation of the respondents (p<0.05). The ideal working time of healthcare providers was not maintained. There had no facilities of isolated accommodation and health checkups for staff. But RT-PCR for Covid-19 test was done for all staff when he/she returns to normal life after duty. Based on study findings it has been concluded that the infrastructure facilities and logistic supports are sufficient. But staff management has to be improved and the authority should pay special attention to an effective triage system.

An integrated blockchain-enabled multi-channel vaccine supply chain network under hybrid uncertainties.

The recent pandemic caused by COVID-19 is considered an unparalleled disaster in history. Developing a vaccine distribution network can provide valuable support to supply chain managers. Prioritizing the assigned available vaccines is crucial due to the limited supply at the final stage of the vaccine supply chain. In addition, parameter uncertainty is a common occurrence in a real supply chain, and it is essential to address this uncertainty in planning models. On the other hand, blockchain technology, being at the forefront of technological advancements, has the potential to enhance transparency within supply chains. Hence, in this study, we develop a new mathematical model for designing a COVID-19 vaccine supply chain network. In this regard, a multi-channel network model is designed to minimize total cost and maximize transparency with blockchain technology consideration. This addresses the uncertainty in supply, and a scenario-based multi-stage stochastic programming method is presented to handle the inherent uncertainty in multi-period planning horizons. In addition, fuzzy programming is used to face the uncertain price and quality of vaccines. Vaccine assignment is based on two main policies including age and population-based priority. The proposed model and method are validated and tested using a real-world case study of Iran. The optimum design of the COVID-19 vaccine supply chain is determined, and some comprehensive sensitivity analyses are conducted on the proposed model. Generally, results demonstrate that the multi-stage stochastic programming model meaningfully reduces the objective function value compared to the competitor model. Also, the results show that one of the efficient factors in increasing satisfied demand and decreasing shortage is the price of each type of vaccine and its agreement.

Patient flow management in biological events: a scoping review.

INTRODUCTION: Biological Events affect large populations depending on transmission potential and propagation. A recent example of a biological event spreading globally is the COVID-19 pandemic, which has had severe effects on the economy, society, and even politics,in addition to its broad occurrence and fatalities. The aim of this scoping review was to look into patient flow management techniques and approaches used globally in biological incidents. METHODS: The current investigation was conducted based on PRISMA-ScR: Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. All articles released until March 31, 2023, about research question were examined, regardless of the year of publication. The authors searched in databases including Scopus, Web of Science, PubMed, Google scholar search engine, Grey Literature and did hand searching. Papers with lack of the required information and all non-English language publications including those with only English abstracts were excluded. Data extraction checklist has been developed Based on the consensus of authors.the content of the papers based on data extraction, analyzed using content analysis. RESULTS: A total of 19,231 articles were retrieved in this study and after screening, 36 articles were eventually entered for final analysis. Eighty-four subcategories were identified,To facilitate more precise analysis and understanding, factors were categorised into seven categories: patient flow simulation models, risk communication management, integrated ICT system establishment, collaborative interdisciplinary and intersectoral approach, systematic patient management, promotion of health information technology models, modification of triage strategies, and optimal resource and capacity management. CONCLUSION: Patient flow management during biological Events plays a crucial role in maintaining the performance of the healthcare system. When public health-threatening biological incidents occur, due to the high number of patients, it is essential to implement a holistic,and integrated approach from rapid identification to treatment and discharge of patients.

Reach and Engagement With Population Health Management Interventions to Address COVID-19 Among Safety-Net Health Care Systems.

Interventions designed to address COVID-19 needed to be rapidly scaled up to the population level, and to address health equity by reaching historically marginalized populations most affected by the pandemic (e.g., racial/ethnic minorities and rural and low socioeconomic status populations). From February 2021 to June 2022, SCALE-UP Utah used text messaging interventions to reach 107 846 patients from 28 clinics within seven safety-net health care systems. Interventions provided informational and motivational messaging regarding COVID-19 testing and vaccination, and were developed using extensive community partner input. (Am J Public Health. 2024;114(11):1207-1211. https://doi.org/10.2105/AJPH.2024.307770).

Deep learning-derived optimal aviation strategies to control pandemics.

The COVID-19 pandemic affected countries across the globe, demanding drastic public health policies to mitigate the spread of infection, which led to economic crises as a collateral damage. In this work, we investigate the impact of human mobility, described via international commercial flights, on COVID-19 infection dynamics on a global scale. We developed a graph neural network (GNN)-based framework called Dynamic Weighted GraphSAGE (DWSAGE), which operates over spatiotemporal graphs and is well-suited for dynamically changing flight information updated daily. This architecture is designed to be structurally sensitive, capable of learning the relationships between edge features and node features. To gain insights into the influence of air traffic on infection spread, we conducted local sensitivity analysis on our model through perturbation experiments. Our analyses identified Western Europe, the Middle East, and North America as leading regions in fueling the pandemic due to the high volume of air traffic originating or transiting through these areas. We used these observations to propose air traffic reduction strategies that can significantly impact controlling the pandemic with minimal disruption to human mobility. Our work provides a robust deep learning-based tool to study global pandemics and is of key relevance to policymakers for making informed decisions regarding air traffic restrictions during future outbreaks.

Africa aims to avert an mpox pandemic.

Last month, when the world's most populus country, India, reported its first case of the new, highly transmissible clade Ib mpox variant, the challenge of containing the virus was once again evident. Only a few weeks before that in August, the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (Africa CDC) declared mpox a public health emergency in response to its spread in Africa. Since then, cases of clade Ib mpox have been reported in Sweden, Thailand, and Pakistan. Although mpox is not yet a global pandemic, the new variant may tip the scales in that direction if the world does not act quickly to mitigate its spread in Africa.

Responding to COVID-19: an exploration of EU country responses and directions for further research.

BACKGROUND: During COVID-19, scientists advising policymakers were forced to deal with high uncertainty and risks in an environment of unknowns. Evidence on which policies and measures were effective in responding to the pandemic remains underdeveloped to answer the key question 'what worked and why?'. This study aims to provide a basis for studies to go further to answer this critical question, by starting to look efficacy or how countries ensured that health services remained available and what measures were enacted to protect and treat their populations and workers. METHODS: We applied a three-phase sequential mixed methods design. In phase one, we started with a qualitative content analysis of the EU Country Profile reports to retrieve and analyse data on COVID-19 responses taken by 29 countries in the European region. Phase two is the step of data transformation, converting qualitative data into numerical codes that can be statistically analysed, which are then used in a quantitative cross-national comparative analysis that comprises phase three. The quantifying process resulted in a numerical indicator to measure the 'response efficacy' of the 29 countries, which is used in phase three's association of the response measure with country performance indicators that were derived from European Centre for Disease Control (ECDC) COVID-19 case and death rate data. RESULTS: Through comparing the frequency of COVID-19 measures taken, we found that many countries in the European region undertook similar actions but with differing effects. The cross-national analysis revealed an expected relationship: a lower COVID-19 response efficacy appeared to be related to a higher case and death rates. Still, marked variation for countries with similar response efficacy indicators was found, signalling that the combination and sequence of implementation of COVID-19 responses is possibly just as important as their efficacy in terms of which response measures were implemented. CONCLUSIONS: Many European countries employed similar COVID-19 measures but still had a wide variation in their case and death rates. To unravel the question 'what worked and why?', we suggest directions from which more refined research can be designed that will eventually contribute to mitigate the impact of future pandemics and to be better prepared for their economic and human burden.

Meeting Report From "Correlates of Protection for Next Generation Influenza Vaccines: Lessons Learned From the COVID-19 Pandemic".

BACKGROUND: This report summarizes the discussions and conclusions from the "Correlates of Protection for Next Generation Influenza Vaccines: Lessons Learned from the COVID-19 Pandemic" meeting, which took place in Seattle, USA, from March 1, 2023, to March 3, 2023. CONCLUSIONS: Discussions around influenza virus correlates of protection and their use continued from where the discussion had been left off in 2019. While there was not much progress in the influenza field itself, many lessons learned during the coronavirus disease 2019 (COVID-19) pandemic, especially the importance of mucosal immunity, were discussed and can directly be applied to influenza correlates of protection.

Pandemic perspectives from detained youth during COVID-19: Bridging the knowledge gap for future safeguards.

Despite the worsening health disparities among youth in detention during the COVID-19 pandemic, there has been minimal exploration into the pandemic experiences of detained youth and opportunities for pandemic mitigation. This paper analyzes the perspectives of youth in detention on the pandemic, including the effect of the pandemic on their detention experience and their perceptions about COVID-19 vaccination. The study used purposive sampling to recruit 16 participants (aged 14-17 years) from two juvenile detention centers in the urban Midwest. We conducted semi-structured interviews and analyzed verbatim transcripts using a hybrid deductive-inductive approach and thematic analysis. Four themes emerged: 1) personal experience influenced youth perceptions of pandemic severity and risk; 2) distrust and misconceptions contributed to youth vaccine hesitancy or refusal; 3) desired opportunities and parental opinion motivated youth to get the COVID-19 vaccine; and 4) pandemic mitigation strategies negatively impacted youths' detention center experience. Study findings identify opportunities for detention centers to minimize the negative impacts of pandemic mitigation strategies on youth in detention, expand vaccination knowledge and uptake, and build trust to positively impact the health and wellbeing of detained youth currently and during future pandemics.

Advances in the development of new vaccines for tuberculosis and Brazil's role in the effort forward the end TB strategy.

Tuberculosis (TB) continues to be the world's leading killer of infectious diseases. Despite global efforts to gradually reduce the number of annual deaths and the incidence of this disease, the coronavirus disease 19 (COVID-19) pandemic caused decreased in TB detection and affected the prompt treatment TB which led to a setback to the 2019 rates. However, the development and testing of new TB vaccines has not stopped and now presents the possibility of implanting in the next five years a new vaccine that is affordable and might be used in the various key vulnerable populations affected by TB. Then, this assay aimed to discuss the main vaccines developed against TB that shortly could be selected and used worldwide, and additionally, evidence the Brazilian potential candidates' vaccines in developing in Brazil that could be considered among those in level advanced to TB end.

Attitudes and intentions of parents towards the COVID-19 vaccine for their children at a special moment of the pandemic.

Background: This research was conducted following the FDA's approval of the COVID-19 vaccine for children aged 5 to 11. Our study aimed to evaluate parents' intentions regarding vaccinating their children in response to the pandemic situation. This period was crucial for understanding parents' initial reactions to health authority recommendations. Methods: This descriptive cross-sectional study was conducted with 940 parents. The data were obtained using the Personal Information Form, the COVID-19 Anxiety Scale, and the Scale of Attitudes Towards COVID-19 Vaccine. Descriptive data analysis involved calculating frequency, percentage, mean, and standard deviation values. We employed Student's t-test, one-way ANOVA tests for analysis. Additionally, various characteristics were analyzed using the two-way logistic regression method. Results: In the study, 85.1% of the parents reported having received the COVID-19 vaccine themselves. However, only 20% stated they would accept the COVID-19 vaccine for their children. The intention to vaccinate their children was influenced by factors such as the parent's age, level of COVID-19 anxiety, vaccination status, and knowledge about the COVID-19 vaccine. Conclusion: Despite the FDA's declaration, it was determined that more than two-thirds of parents were hesitant about the COVID-19 vaccine for their children.

Occupational exposure protection and perioperative management of sudden infectious diseases from the perspective of COVID-19.

The coronavirus disease (COVID-19) SARS-CoV-2 virus epidemic continues to exhibit a sporadic onset trend due to the continuous variation of the novel coronavirus. However, the psychological impact of the pandemic persists. It is crucial to reflect on our experiences to better prepare for future large-scale infectious diseases. During outbreaks of infectious diseases, patients may still require orthopaedic surgery. It is crucial to prioritize the safety of medical staff and establish procedures to ensure their protection. However, with the implementation of a series of standardized operational protection procedures, orthopaedic surgeons can safely perform their duties without the risk of contracting COVID-19. There is no doubt that the orthopaedic occupational exposure protection process and perioperative management plan for global infectious diseases, such as COVID-19, require a standardized summarization process and a narrative review.

Epidemic and Pandemic Preparedness and Response in a Multi-Hazard Context: COVID-19 Pandemic as a Point of Reference.

Infectious diseases manifesting in the form of epidemics or pandemics do not only cause devastating impacts on public health systems but also disrupt the functioning of the socio-economic structure. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. This study aims to develop a framework that captures key elements and components of epidemic and pandemic preparedness and response systems, focusing on a multi-hazard context. A systematic literature review was used to collect data through peer-reviewed journal articles using three electronic databases, and 17 experts were involved in the validation. Epidemiological surveillance and early detection, risk and vulnerability assessments, preparedness, prediction and decision making, alerts and early warning, preventive strategies, control and mitigation, response, and elimination were identified as key elements associated with epidemic and pandemic preparedness and response systems in a multi-hazard context. All elements appear integrated within three interventional phases: upstream, interface, and downstream. A holistic approach focusing on all interventional phases is required for preparedness and response to pandemics and epidemics to counter their cascading and systemic effects. Further, a paradigm shift in the preparedness for multi-hazards during an epidemic or pandemic is essential due to the multiple challenges posed by concurrent hazards.

Assessing the impact of COVID-19 non-pharmaceutical interventions and relaxation policies on Class B respiratory infectious diseases transmission in China.

This study investigates the incidence of Class B respiratory infectious diseases (RIDs) in China under the Coronavirus disease 2019 (COVID-19) epidemic and examines variations post-epidemic, following the relaxation of non-pharmaceutical interventions (NPIs). Two-stage evaluation was used in our study. In the first stage evaluation, we established counterfactual models for the pre-COVID-19 period to estimate expected incidences of Class B RIDs without the onset of the epidemic. In the second stage evaluation, we constructed seasonal autoregressive integrated moving average intervention (SARIMA-Intervention) models to evaluate the impact on the Class B RIDs after NPIs aimed at COVID-19 pandemic were relaxed. The counterfactual model in the first stage evaluation suggested average annual increases of 10.015%, 78.019%, 70.439%, and 67.799% for tuberculosis, scarlet fever, measles, and pertussis respectively, had the epidemic not occurred. In the second stage evaluation, the total relative reduction in 2023 of tuberculosis, scarlet fever, measles and pertussis were - 35.209%, - 59.184%, - 4.481%, and - 9.943% respectively. The actual incidence declined significantly in the first stage evaluation. However, the results of the second stage evaluation indicated that a rebound occurred in four Class B RIDs after the relaxation of NPIs; all of these showed a negative total relative reduction rate.

Burden changes in notifiable infectious diseases in Taiwan during the COVID-19 pandemic.

Background: This study aimed to assess the impact of the COVID-19 pandemic on the disease burden of Taiwan's notifiable infectious diseases (NIDs). We compared disease burdens between the pandemic and pre-pandemic year of 2020 (with non-pharmaceutical interventions (NPIs)) and 2010 (without NPIs), respectively, to understand the overall pandemic impact on NIDs in Taiwan. Methods: Forty-three national NIDs were analyzed using the Statistics of Communicable Diseases and Surveillance Report by estimating the premature death and disability via different transmission categories, sex, and age groups. The study evaluated the impact of diseases by assessing the years lost due to death (YLLs), the duration of living with disability (YLDs), and the overall disability-adjusted life years (DALYs) by measuring both the severity of the illness and its duration. Results: Taiwan recorded 1,577 (2010) and 1,260 (2020) DALYs per million population and lost 43 NIDs, decreasing 317 DALYs per million population. Tuberculosis, HIV/AIDS and acute hepatitis B/D were the leading causes of DALYs, accounting for 89% (2010) and 77% (2020). Conclusion: Overall, this study provided the first insight of changes in disease burdens in NIDs between pre- and post-COVID-19 based on a nationwide viewpoint for further preventive measures and interventions to be focused on specific diseases by associated health administrations and policies.

Impact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review.

OBJECTIVES: to identify the repercussions of financial toxicity on the lives of adult cancer patients during the COVID-19 pandemic. METHODS: an integrative review was conducted using the PubMed, Web of Science, Scopus, and Embase databases, as well as the Virtual Health Library portal, in March 2023. RESULTS: out of 62 studies found, 13 were included for analysis. The primary repercussions of financial toxicity included difficulties in covering basic expenses such as food, housing, medication, transportation, and internet access; increased anxiety and concerns related to health and financial situations; reduction or absence of income; challenges in obtaining treatment or accessing healthcare services; rising expenses; and telemedicine as a less burdensome alternative. CONCLUSIONS: the pandemic has exacerbated financial toxicity; therefore, healthcare teams must recognize it as an adverse event of oncological treatment and understand its potential to affect various aspects of patients' lives.

Predictors of older adults' health behaviours to prevent COVID-19 transmission: a multilevel analysis.

OBJECTIVES: While older adults showed higher mortality during COVID-19 pandemic, protective behaviours (knowledge regarding coping with COVID-19 symptoms and preventive behaviours) were highlighted to be important to prevent the spread of infection. This study aimed to identify individual and community-level variables influencing deficient knowledge regarding coping with COVID-19 and not-practicing COVID-19 of older adults during the pandemic. DESIGN: This is a secondary analysis of a cross-sectional study using the 2020 Korea Community Health Survey (KCHS). SETTING: 255 community public health centres nationwide, South Korea. METHODS AND ANALYSIS: Using 2020 KCHS data, multilevel logistic regression analysis was conducted on 55 005 adults aged 65 years or older. RESULTS: Older adults who reside alone, as opposed to with their spouse and who lack the support of another individual exhibited insufficient COVID-19 coping-related knowledge (OR: 1.142, p<0.001) and poor preventive behaviours (OR: 1.177, p<0.001). Furthermore, lower municipal social welfare budget levels were associated with worse health behaviours (OR: 0.062, p<0.001). Specifically, older adults living in rural areas were less likely to engage in COVID-19 preventive behaviours compared with those in urban areas (OR: 1.247, p<0.001). Additionally, the effectiveness of mass media as a motivating factor for adopting preventive measures was only significant in rural populations (OR: 0.944, p<0.05). CONCLUSIONS: Both individual-level and community-level approaches are necessary as an initial response during the pandemic. Since elderly people living alone with low socioeconomic status are vulnerable groups with poor health behaviours, it is helpful to provide social support on how to respond to infectious diseases and manage symptoms. In addition, it is important to expand the municipal social welfare budget to promote health equity between regions through appropriate health behaviour education and the strengthening of public medical services.

Connect, collaborate and tailor: a model of community engagement through infographic design during the COVID-19 pandemic.

BACKGROUND: Across the globe, racial and ethnic minorities have been disproportionately affected by COVID-19 with increased risk of infection and burden from disease. Vaccine hesitancy has contributed to variation in vaccine uptake and compromised population-based vaccination programs in many countries. Connect, Collaborate and Tailor (CCT) is a Public Health Agency of Canada funded project to make new connections between public health, healthcare professionals and underserved communities in order to create culturally adapted communication about COVID-19 vaccines. This paper describes the CCT process and outcomes as a community engagement model that identified information gaps and created tailored tools to address misinformation and improve vaccine acceptance. METHODS: Semi-structured interviews with CCT participants were undertaken to evaluate the effectiveness of CCT in identifying and addressing topics of concern to underserved and ethnic minority communities. Interviews also explored CCT participants' experiences of collaboration through the development of new partnerships between ethnic minority communities, public health and academic researchers, and the evolution of co-operation sharing ideas and creating infographics. Thematic analysis was used to produce representative themes. The activities described were aligned with the levels of public engagement described in the IAP2 spectrum (International Association for Public Participation). RESULTS: Analysis of interviews (n = 14) revealed that shared purpose and urgency in responding to the COVID-19 pandemic motivated co-operation among CCT participants. Acknowledgement of past harm, present health, and impact of social inequities on public service access was an essential first step in establishing trust. Creating safe spaces for open dialogue led to successful, iterative cycles of consultation and feedback between participants; a process that not only helped create tailored infographics but also deepened engagement and collaboration. Over time, the infographic material development was increasingly directed by community representatives' commentary on their groups' real-time needs and communication preferences. This feedback noticeably guided the choice, style, and presentation of infographic content while also directing dissemination strategies and vaccine confidence building activities. CONCLUSIONS: The CCT process to create COVID-19 vaccine communication materials led to evolving co-operation between groups who had not routinely worked together before; strong community engagement was a key driver of change. Ensuring a respectful environment for open dialogue and visibly using feedback to create information products provided a foundation for building relationships. Finally, our data indicate participants sought reinforcement of close cooperative ties and continued investment in shared responsibility for community partnership-based public health.