scholarly journals What is the best control strategy for multiple infectious disease outbreaks?

2006 ◽  
Vol 274 (1611) ◽  
pp. 833-837 ◽  
Author(s):  
Andreas Handel ◽  
Ira M Longini ◽  
Rustom Antia
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Control Strategy ◽  
Disease Outbreaks ◽  
Effective Control ◽  
School Closures ◽  
Infectious Disease Outbreaks ◽  
Intervention Measures ◽  
Travel Restrictions ◽  
Public Health Goal

Effective control of infectious disease outbreaks is an important public health goal. In a number of recent studies, it has been shown how different intervention measures like travel restrictions, school closures, treatment and prophylaxis might allow us to control outbreaks of diseases, such as SARS, pandemic influenza and others. In these studies, control of a single outbreak is considered. It is, however, not clear how one should handle a situation where multiple outbreaks are likely to occur. Here, we identify the best control strategy for such a situation. We further discuss ways in which such a strategy can be implemented to achieve additional public health objectives.

scholarly journals The impact of unplanned school closure on children’s social contact: Rapid evidence review

2020 ◽  
Author(s):  
Samantha Brooks ◽  
Louise Smith ◽  
Rebecca Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Relevant Literature ◽  
Disease Outbreaks ◽  
Social Contact ◽  
School Closure ◽  
School Closures ◽  
Infectious Disease Outbreaks ◽  
Spread Of Infection ◽  
The Impact

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective. ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted. Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact. ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

scholarly journals The impact of unplanned school closure on children’s social contact: Rapid evidence review

2020 ◽  
Author(s):  
Samantha K. Brooks ◽  
Louise E. Smith ◽  
Rebecca K. Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Relevant Literature ◽  
Disease Outbreaks ◽  
Social Contact ◽  
School Closure ◽  
School Closures ◽  
Infectious Disease Outbreaks ◽  
Spread Of Infection ◽  
The Impact

AbstractBackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective.ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted.Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact.ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

scholarly journals The impact of unplanned school closure on children’s social contact: rapid evidence review

2020 ◽  
Vol 25 (13) ◽  
Author(s):  
Samantha K Brooks ◽  
Louise E Smith ◽  
Rebecca K Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Disease Outbreaks ◽  
Social Contact ◽  
School Closure ◽  
School Closures ◽  
Infectious Disease Outbreaks ◽  
Evidence Review ◽  
Spread Of Infection ◽  
The Impact

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited. Aim This review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures. Methods In February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted. Results A total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact. Conclusion Evidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

scholarly journals What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer B. Nuzzo ◽  
Diane Meyer ◽  
Michael Snyder ◽  
Sanjana J. Ravi ◽  
Ana Lapascu ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health System ◽  
Natural Hazards ◽  
Health Systems ◽  
Scoping Review ◽  
Disease Outbreaks ◽  
World Health ◽  
Infectious Disease Outbreaks ◽  
System Resilience

Abstract Background The 2014–2016 Ebola outbreak was a wake-up call regarding the critical importance of resilient health systems. Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Important work has been done to describe the general attributes of a health system resilient to these crises, and the next step will be to identify the specific capacities that health systems need to develop and maintain to achieve resiliency. Methods We conducted a scoping review of the literature to identify recurring themes and capacities needed for health system resiliency to infectious disease outbreaks and natural hazards and any existing implementation frameworks that highlight these capacities. We also sought to identify the overlap of the identified themes and capacities with those highlighted in the World Health Organization’s Joint External Evaluation. Sources of evidence included PubMed, Web of Science, OAIster, and the websites of relevant major public health organizations. Results We identified 16 themes of health system resilience, including: the need to develop plans for altered standards of care during emergencies, the need to develop plans for post-event recovery, and a commitment to quality improvement. Most of the literature described the general attributes of a resilient health system; no implementation frameworks were identified that could translate these elements into specific capacities that health system actors can employ to improve resilience to outbreaks and natural hazards in a variety of settings. Conclusions An implementation-oriented health system resilience framework could help translate the important components of a health system identified in this review into specific capacities that actors in the health system could work to develop to improve resilience to public health crises. However, there remains a need to further refine the concept of resilience so that health systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

scholarly journals Ethics of instantaneous contact tracing using mobile phone apps in the control of the COVID-19 pandemic

2020 ◽  
Vol 46 (7) ◽  
pp. 427-431 ◽  
Author(s):  
Michael J Parker ◽  
Christophe Fraser ◽  
Lucie Abeler-Dörner ◽  
David Bonsall
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Mobile Phone ◽  
Public Health Practice ◽  
Disease Outbreaks ◽  
Contact Tracing ◽  
Mobile Phone Data ◽  
Public Health Response ◽  
Infectious Disease Outbreaks ◽  
Ethical Implications

In this paper we discuss ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks and epidemics. However, the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this problem, many countries around the world have deployed or are developing mobile phone apps capable of supporting instantaneous contact tracing. Informed by the on-going mapping of ‘proximity events’ these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for ‘intelligent physical distancing’ in such contexts raises a number of important ethical questions. In our paper, we outline some ethical considerations that need to be addressed in any deployment of this kind of approach as part of a multidimensional public health response. We also, briefly, explore the implications for its use in future infectious disease outbreaks.

scholarly journals Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

2019 ◽  
Vol 374 (1776) ◽  
pp. 20180431 ◽  
Author(s):  
Robin N. Thompson ◽  
Oliver W. Morgan ◽  
Katri Jalava
Keyword(s):  
Infectious Disease ◽  
Disease Outbreaks ◽  
Decision Makers ◽  
World Health ◽  
Theme Issue ◽  
Public Health Decision ◽  
Infectious Disease Outbreaks ◽  
Travel Restrictions ◽  
Health Decision ◽  
Health Organization

The World Health Organization considers an Ebola outbreak to have ended once 42 days have passed since the last possible exposure to a confirmed case. Benefits of a quick end-of-outbreak declaration, such as reductions in trade/travel restrictions, must be balanced against the chance of flare-ups from undetected residual cases. We show how epidemiological modelling can be used to estimate the surveillance level required for decision-makers to be confident that an outbreak is over. Results from a simple model characterizing an Ebola outbreak suggest that a surveillance sensitivity (i.e. case reporting percentage) of 79% is necessary for 95% confidence that an outbreak is over after 42 days without symptomatic cases. With weaker surveillance, unrecognized transmission may still occur: if the surveillance sensitivity is only 40%, then 62 days must be waited for 95% certainty. By quantifying the certainty in end-of-outbreak declarations, public health decision-makers can plan and communicate more effectively.This article is part of the theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control’. This issue is linked with the earlier theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes’.

scholarly journals Facemask shortage and the coronavirus disease (COVID-19) outbreak: Reflection on public health measures

2020 ◽  
Author(s):  
Huailiang Wu ◽  
Jian Huang ◽  
Casper J. P. Zhang ◽  
Zonglin He ◽  
Wai-Kit Ming
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Disease Outbreaks ◽  
Wuhan City ◽  
Medical Resources ◽  
Infectious Disease Outbreaks ◽  
Health Measures ◽  
Global Pandemic ◽  
Novel Coronavirus ◽  
Effective Public Health

AbstractBackgroundA novel coronavirus disease (COVID-19) outbreak due to SARS-CoV-2 infection occurred in China in late-December 2019. Facemask wearing is considered as one of the most cost-effective and important measures to prevent the transmission of SARS-CoV-2, but it became a social concern due to the recent global facemask shortage. China is the major facemask producer in the world, contributing to 50% of global production. However, even full productivity (20 million facemasks per day) does not seem to meet the need of a population of 1.4 billion in China.MethodsPolicy review using government websites and shortage analysis using mathematical modelling based on data obtained from the National Health Commission (NHC), the Ministry of Industry and Information Technology (MIIT), the Center for Disease Control and Prevention (CDC) of the People’s Republic of China, and Wuhan Bureau of Statistics.FindingsSupplies of facemasks in the whole of China would have been sufficient for both healthcare workers and the general population if the COVID-19 outbreak only occurred in Wuhan city or Hubei province. However, if the outbreak occurred in the whole of China, facemask supplies in China could last for 5 days if under the existing public health measures and a shortage of 853 million facemasks is expected by 30 Apr 2020. Assuming a gradually decreased import volume, we estimated that dramatic increase in productivity (42.7 times of the usual level) is needed to mitigate the facemask crisis by the end of April.InterpretationIn light of the COVID-19 outbreak in China, a shortage of facemasks and other medical resources can considerably compromise the efficacy of public health measures. Effective public health measures should also consider the adequacy and affordability of medical resources. Global collaboration should be strengthened to prevent the development of a global pandemic from a regional epidemic via easing the medical resources crisis in the affected countries.Research in contextEvidence before this studyWe searched PubMed and Web of Science for articles in English, between 1 Jan 1980, and 1 Jan 2020, using the search terms 1) (infection OR infectious disease* OR outbreaks) AND (modelling); and 2) (mask* OR facemask* OR medical resource*) AND (infection OR infectious disease* OR outbreaks). Most relevant studies identified were performed to predict diseases spread and to determine the original infection source of previous epidemics like SARS and H7N9. However, few studies focused on the medical resources crisis during the outbreaks.Added value of this studyTo the best of our knowledge, this is the first study to investigate the facemask shortage during the novel coronavirus pneumonia (COVID-19) outbreak in China. We have summarized in detail the management strategies implemented by the Chinese governments during the outbreaks. By considering three scenarios for the outbreak development, we simulated the facemasks availability from late-December 2019 to late-April 2020 and estimated the duration of sufficient facemask supplies. Our findings showed that if the COVID-19 outbreak occurred only in Wuhan city or Hubei province, facemask shortage would not appear with the existing public health measures. However, if the outbreak occurred in the whole of China, a shortage of facemask could be substantial assuming no alternative public health measures.Implications of all the available evidenceOur findings provide insight into the public health measures to confront medical resources crisis during infectious disease outbreaks. Effective public health measures should consider the adequacy and affordability of existing medical resources. Governments across the world should revisit their emergency plans for controlling infectious disease outbreaks by taking into account the supply of and demand for the medical resource. Global collaboration should be strengthened to prevent the development of a global pandemic from a regional epidemic via easing the medical resources crisis in the affected countries.

scholarly journals If long-term suppression is not possible, how do we minimize mortality for COVID-19 and other emerging infectious disease outbreaks?

2020 ◽  
Author(s):  
Andreas Handel ◽  
Joel C. Miller ◽  
Yang Ge ◽  
Isaac Chun-Hai Fung
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Care ◽  
Health Care System ◽  
Disease Outbreaks ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Infectious Disease Outbreaks ◽  
Long Time

As COVID-19 continues to spread, public health interventions are crucial to minimize its impact. The most desirable goal is to drive the pathogen quickly to extinction. This generally involves applying interventions as strongly as possible, which worked for SARS, but so far has failed for COVID-19. If fast eradication is not achievable, the next best goal is to delay the spread and minimize cases and burden on the health care system until suitable drugs or vaccines are available. This suppression approach also calls for strong interventions, potentially applied for a long time.

scholarly journals To what extent does evidence support decision making during infectious disease outbreaks? A scoping literature review

2020 ◽  
Vol 16 (3) ◽  
pp. 453-475 ◽  
Author(s):  
Andreea Salajan ◽  
Svetla Tsolova ◽  
Massimo Ciotti ◽  
Jonathan E. Suk
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Decision Making ◽  
Disease Outbreaks ◽  
Decision Makers ◽  
Expert Advice ◽  
Scientific Uncertainty ◽  
Infectious Disease Outbreaks ◽  
Decision Making Processes

Background:Infectious disease outbreaks require decision makers to make rapid decisions under time pressure and situations of scientific uncertainty, and yet the role of evidence usage in these contexts is poorly understood. Aims and objectives:To define and contextualise the role of scientific evidence in the governance of infectious disease outbreaks and to identify recommendations for overcoming common barriers to evidence-informed decision making. Methods:A scoping review and an expert workshop to provide additional input into recommendations on enhancing evidence uptake during infectious disease outbreaks taking place in European settings. Findings:Forty-nine records reporting on multiple decision-making processes during infectious disease outbreaks of the past ten years were included in the study. Decision makers prioritise expert advice, epidemiological data and mathematical modelling data for risk characterisation and management, but tend to be challenged by scientific uncertainties, which allow for conflicting interpretations of evidence and for public criticism and contestation of decision-making processes. There are concrete opportunities for optimising evidence usage to improve public health policy and practice through investment in decision-making competencies, relationship building, and promoting transparent decision-making processes. Discussion and conclusions:It is not necessarily a disregard of evidence that puts a strain on decision making in health crises, but rather competing interests and the lack of clear, unambiguous and rapidly available evidence for risk characterisation and effectiveness of response measures.The relationship between science and public health decision making is relatively understudied but is deserving of greater attention, so as to ensure that the pursuit of evidence for decision making does not challenge timely and effective crisis management.

Use and effectiveness of mHealth technologies in tracking the spread of infectious disease outbreaks and their implications for the COVID-19 pandemic: a systematic review protocol (Preprint)

2020 ◽  
Author(s):  
Madison Milne-Ives ◽  
Simon Rowland ◽  
Alison McGregor ◽  
J Edward Fitzgerald ◽  
Edward Meinert
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Systematic Review ◽  
Public Health Practice ◽  
Disease Outbreaks ◽  
Digital Technologies ◽  
World Health ◽  
Health Practice ◽  
Public Health Response ◽  
Infectious Disease Outbreaks

BACKGROUND The World Health Organisation (WHO) defines mHealth as medical and public health practice supported by mobile devices. A number of mHealth devices, primarily apps designed to support contact tracing, have been utilised as part of the public health response to the Covid-19 pandemic. The value of mHealth devices in augmenting public health practice is however yet to be defined. OBJECTIVE The study aims to address three research questions: (1) What digital technologies are being used to track the symptoms and spread of infectious disease outbreaks and what strategies do they use to do so? (2) How effective and cost-effective are digital technologies at tracking the spread of infectious disease outbreaks and what are their strengths and limitations? (3) What are the user perspectives on the usability and effectiveness of these technologies? METHODS The PICOS template and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) will be followed for this systematic review. The review will be composed of a literature search, article selection, data extraction, quality appraisal, data analysis, and a discussion of the implications of the data for the current COVID-19 pandemic. RESULTS N/A CONCLUSIONS This systematic review will summarise the available evidence for use of mHealth devices for tracking the spread of infectious disease outbreaks. These results are potentially valuable for informing public health policy during infectious disease outbreaks such as the current Covid-19 pandemic.

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