scholarly journals Critical role of ethics in clinical management and public health response to the West Africa Ebola epidemic

2016 ◽  
pp. 55 ◽  
Author(s):  
Morenike Folayan ◽  
Bridget Haire ◽  
Brandon Brown
Keyword(s):  
Public Health ◽  
West Africa ◽  
Clinical Management ◽  
Critical Role ◽  
Public Health Response ◽  
The West ◽  
Health Response

Not your typical “historian”

2018 ◽  
Vol 27 (5) ◽  
pp. 523-533
Author(s):  
Adrienne Lefevre ◽  
Madison Walter-Garcia ◽  
Kimberly Hanson ◽  
Julia Smith-Easley
Keyword(s):  
Public Health ◽  
Lessons Learned ◽  
Incident Management ◽  
Public Health Response ◽  
Content Type ◽  
Incident Command ◽  
Health Community ◽  
Health Response ◽  
Decision Making Processes

Purpose In the incident command system (ICS) structure, response documentation is formally found within the planning section. However, longer term emergency responses have demonstrated the need for a flexible and innovative role that encompasses a variety of activities, including response documentation, communications science, real-time evaluation of major themes, and information management. The paper aims to discuss this issue. Design/methodology/approach This need can be universally met through the functional role of “Historian,” a term specific to ICS, or in the case of public health response, incident management system (IMS). It should be noted that the Historian role discussed is not related to the academic study of history, but to archiving key successes and challenges during a response. Ideally the Historian should be activated at the start of an emergency response and remain active to capture the overall picture of the response, including internal information, such as lessons learned, response activities, and decision-making processes. Findings The Historian compiles details of response activities that inform leadership, donors and external communications products while alleviating pressures on the planning section. The primary, minimum output of an IMS Historian is a response timeline, which notes major internal and external events during a response with emphasis on major themes, lessons learned, and creating a user-friendly interface to display this information (see the list “Abbreviated Example of Hurricane Matthew Response Timeline” in the text). Originality/value In a world with competing priorities and ongoing emergencies, the Historian’s role of archiving details of response efforts can help the international public health community to share lessons learned and contribute to lower morbidity and mortality among those affected by emergencies.

scholarly journals Editorial: Coronavirus Disease (COVID-19): Pathophysiology, Epidemiology, Clinical Management and Public Health Response

2021 ◽  
Vol 9 ◽  
Author(s):  
Denise L. Doolan ◽  
Zisis Kozlakidis ◽  
Zhongheng Zhang ◽  
Slobodan Paessler ◽  
Longxiang Su ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Management ◽  
Public Health Response ◽  
Health Response

New decade, new response: Altering the public health response to toxigenic cutaneous diphtheria

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N C Marshall ◽  
M Baxi ◽  
C MacDonald ◽  
C Sikora ◽  
G J Tyrrell
Keyword(s):  
Public Health ◽  
Respiratory Disease ◽  
Diphtheria Toxin ◽  
Laboratory Testing ◽  
Asymptomatic Carrier ◽  
Public Health Response ◽  
Vaccination Rates ◽  
The Public ◽  
Health Response

Abstract Background Classical diphtheria is a potentially fatal respiratory disease mediated by the diphtheria toxin of Corynebacterium diphtheriae. Due to high vaccination rates against this toxin in Canada, the national incidence of respiratory diphtheria is near zero, and the toxin plays no recognized role in cutaneous diphtheria. Therefore, in this study, we assessed the diagnostic and public health benefits of diphtheria toxin testing and cutaneous diphtheria investigations in a highly vaccinated population. Methods Over the last 10 years, we retrospectively determined: the number of C. diphtheriae isolates identified in the province of Alberta, Canada; the disease state of each individual tested (disease vs asymptomatic carrier); the source (cutaneous vs respiratory); and the number of toxin tests performed. Results In 10 years, zero cases of respiratory diphtheria and three cases of toxigenic cutaneous diphtheria were identified. Despite zero cases of respiratory disease, diphtheria toxin testing significantly increased (p = 0.0001), with 86% of toxin tests performed on cutaneous isolates. Subsequent public health investigations of each case of toxigenic cutaneous diphtheria mandated the collection of 315 total specimens from 92 individuals, revealing low rates of C. diphtheriae colonization among contacts and no further cases. Conclusions This study challenges the value of reflexive diphtheria toxin testing in uncomplicated cutaneous diphtheria among highly vaccinated populations. Cutaneous diphtheria investigations demanded disproportionate public health and laboratory resources and demonstrated a discrepancy between toxin pathophysiology and disease. Therefore, we recommend stewarding diphtheria toxin tests for toxin-mediated disease forms and ensuring adequate vaccination. This approach would spare public health and laboratory resources by customizing responses around the role of the diphtheria toxin in each form of disease. Key messages Investigations for cutaneous diphtheria increased demand for toxin testing in Alberta, Canada, though the toxin plays no role in this form of disease. In populations with high vaccination rates against diphtheria toxoid, cutaneous diphtheria cases do not require additional laboratory testing for the presence of the diphtheria toxin.

scholarly journals Control of COVID-19 in Australia through quarantine: the role of special health accommodation (SHA) in New South Wales, Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Penelope Fotheringham ◽  
Teresa Anderson ◽  
Miranda Shaw ◽  
Joseph Jewitt ◽  
Hannah Storey ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Management ◽  
New South ◽  
Clinical Care ◽  
New South Wales ◽  
Public Health Response ◽  
South Wales ◽  
Health Response ◽  
Returning Travellers ◽  
Special Health

Abstract Background The first COVID-19 cases were diagnosed in Australia on 25 January 2020. Initial epidiemiology showed that the majority of cases were in returned travellers from overseas. One aspect of Public Health response was to introduce compulsory 14 day quarantine for all travellers returning to New South Wales (NSW) by air or sea in Special Health Accommodation (SHA). We aim to outline the establishment of a specialised health quarantine accommodation service in the context of the COVID-19 pandemic, and describe the first month of COVID-19 screening. Methods The SHA was established with a comprehensive governance structure, remote clinical management through Royal Prince Alfred Virtual Hospital (rpavirtual) and site management with health care workers, NSW Police and accommodation staff. Results From 29 March to 29 April 2020, 373 returning travellers were admitted to the SHA from Sydney Airport. 88 (26.1%) of those swabbed were positive for SARS-CoV 2. The day of diagnosis of COVID-19 varied from Day 1 to Day 13, with 63.6% (n = 56) of these in the first week of quarantine. 50% of the people in the SHA were referred to rpavirtual for ongoing clinical management. Seven people required admission to hospital for ongoing clinical care. Conclusion The Public Health response to COVID-19 in Australia included early and increased case detection through testing, tracing of contacts of confirmed cases, social distancing and prohibition of gatherings. In addition to these measures, the introduction of mandated quarantine for travellers to Australia was integral to the successful containment of COVID-19 in NSW and Australia through the prevention of transmission locally and interstate from returning travellers.

scholarly journals Modeling and Controlling Epidemic Outbreaks: The Role of Population Size, Model Heterogeneity and Fast Response in the Case of Measles

Mathematics ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 1892
Author(s):  
Kezban Yagci Sokat ◽  
Benjamin Armbruster
Keyword(s):  
Public Health ◽  
Simulation Models ◽  
Fast Response ◽  
The United States ◽  
Public Health Response ◽  
Health Response ◽  
Detailed Simulation ◽  
Stochastic Simulation Model ◽  
Outbreak Size

Modelers typically use detailed simulation models and vary the fraction vaccinated to study outbreak control. However, there is currently no guidance for modelers on how much detail (i.e., heterogeneity) is necessary and how large a population to simulate. We provide theoretical and numerical guidance for those decisions and also analyze the benefit of a faster public health response through a stochastic simulation model in the case of measles in the United States. Theoretically, we prove that the outbreak size converges as the simulation population increases and that the outbreaks are slightly larger with a heterogeneous community structure. We find that the simulated outbreak size is not sensitive to the size of the simulated population beyond a certain size. We also observe that in case of an outbreak, a faster public health response provides benefits similar to increased vaccination. Insights from this study can inform the control and elimination measures of the ongoing coronavirus disease (COVID-19) as measles has shown to have a similar structure to COVID-19.

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