Epidemic Preparedness Post - Edition 1

What's happening around the world....

France 24:

Largest global bird flu outbreak ‘in history’ shows no sign of slowing

The Quartz:

The WHO declared Uganda’s Ebola epidemic over.

Global Times:

China vows to strengthen technical exchanges and cooperation on epidemic prevention with WHO

Fresh from academia...

Nature Reviews Microbiology

Long COVID: major findings, mechanisms and recommendations

The Lancet

The COVID-19 pandemic in 2023: far from over

News from India

Massive measles outbreak threatens India’s goal to eliminate disease by 2023

ABP Live:

Nature: Monkeypox, Measles, Swine Flu: Infectious Diseases Other Than Covid Kept India On Its Toes In 2022

ET Healthworld:

High arsenic concentration in groundwater in 18 districts of Bihar: Study

For more conversations on epidemic preparedness, please join :

Articles from the field:

Applying Health System view to Epidemiology

Epidemiology is the study of the determinants, occurrence, and distribution of health and disease in a defined population. Whereas the epidemic refers to affecting a large number of individuals within a population, community, or region at the same time with a common infection. The study of epidemiology tells us about the place, person, and time of the spread of disease. But to take it to the implementation level, we need to think through the health system lenses, which comprises man, money, and material to fight the infection. The WHO has provided us with 6 building blocks of the health system to achieve the desired goal. In the context of an epidemic how these blocks are related to types of epidemiology and can help the government in planning preparedness needs to be elaborated here.

Descriptive epidemiology, where the incidence of infections in the context of time, place, and person is studied and understood. This will inform the service delivery, health workforce, and information systems. In terms of service delivery, the type of new treatment, screening and referral would be decided In terms of the health workforce, what type of capacity building, posting, rotation, temporary hiring, and change in the job description is decided? In terms of information systems what type of data and at what frequency, at what level, what analysis to be performed, how to present the data, and to whom the analysis and insight to be shared in decided.

Analytical Epidemiology, is where one can look for possible causative agents through casecontrol and cohort studies. This will inform the service delivery and access to essential medicine. The case definition will guide the human resource at the facility level in the identification of emerging diseases and strengthen the triage process. The case definition will also inform the line of treatment, prompting the opening of access to essential medicines.

Experimental Epidemiology, will guide us in the identification of unusual cases and arrive at the declaration of the epidemic. The case definition is the starting point, which is further clarified by time, place, and person. The control and prevention measures are devised and conveyed to the staff. The information and situation report for the public is developed. In an ongoing mode, the prevention and control measures are evaluated and improved

For epidemic preparedness (#100daysforepidemicpreparedness), one can apply the lens of the health systems to epidemiology to better gain insights into the new and emerging infection and devise an information-based process and protocol for the health personnel.

by, Dr Tukaram Khandade

Articles from the field:

10 Pillars for the strategic preparedness and response plan

10 pillars for the Strategic Preparedness and Response Plan (SPRP) based on the key findings from WHO IAR (Intra-Action Reviews) of COVID-19 response; lessons learnt and recommendations for the south East Asia

The 74th session of the WHO regional committee for the south East Asia recommended ‘further synthesis of the lessons learnt from the COVID-19 response at a regional level’ and the ‘development of a Regional Roadmap to strengthen health security in the Region’. The key recommendations provided by the state member, representative of the partner agencies and the experts in October 2021 are as follows:

· Sustained investment

· Enhanced partnerships and regional support platforms in public health emergency preparedness and response

· PHC-oriented resilient health systems enabled by digital technology and local manufacturing capacities for equitable access to emergency services and products

Two Regional Roadmaps were developed

1. South-East Asia Regional Roadmap for Diagnostic Preparedness, Integrated Laboratory Networking and Genomic Surveillance 2023–2027

2. Regional Strategic Roadmap on Health Security and Health System Resilience for Emergencies 2023–2027

The above is submitted to the 75th Session of the WHO Regional Committee for South-East Asia for its consideration and decision.

As a part of developing the strategic roadmap on Health System Resilience for Emergencies Bangladesh, Bhutan, India, Indonesia, Nepal, Sri Lanka and Thailand reported on the multistakeholder IAR (intra-action review) of COVID-19 response. Gujarat was one of the sates reported on multi-stakeholder IAR from India. The findings and recommendations have important implications for strengthening national health security systems.

To read more about the 10 pillars identified for the Strategic Preparedness and Response Plan (SPRP), please scan the QR code.

by, Dr Saurabh Parmar

Written

Articles from the field:

The Intersection of Epidemic Preparedness and Health Equity

The COVID-19 #pandemic has brought to light the critical intersection between #epidemicpreparedness and health equity. A scientific approach to #publichealth is crucial in addressing the disproportionate impact that the pandemic has had on marginalized and disadvantaged communities. #socialdeterminantsofhealth (SDOH) play a significant role in determining health outcomes and disparities, particularly for these communities. Studies have demonstrated that individuals from lower socioeconomic backgrounds are more likely to contract COVID-19 and experience worse health outcomes For instance, as per the WHO, COVID-19 infection, hospitalization and mortality have been grossly unequal between population groups – driven by inequalities in the social determinants of health Similarly, a study by the Robert Wood Johnson Foundation in the US found that individuals from Black and Latino communities were more likely to be infected with COVID-19 and die from the disease than White individuals.

To address these underlying issues, it is essential to focus on building #resilienthealthsystems that are inclusive and equitable This includes investing in primary healthcare and addressing the social determinants of health, such as poverty and access to healthcare However, data shows that many countries are facing significant challenges in this regard For example, in India, only 37% of the population was covered by any form of health coverage in 2017–2018 and the country has a shortage of healthcare workers, particularly in rural areas This highlights the need for increased investment in primary healthcare and addressing the shortage of healthcare workers to ensure that health services are accessible to all.

Another critical aspect of ensuring health equity is engaging with communities. By working closely with communities, public health professionals can identify and address different groups' unique needs and concerns Community engagement strategies should be evidence-based and tailored to the specific needs and concerns of different communities However, a study by the World Health Organization found that only a few countries have community engagement strategies in place for disease outbreaks This highlights the need for increased community engagement to ensure that public health interventions are tailored to the specific needs and concerns of different communities.

Effective communication is also key to ensuring health equity. This means providing accurate, accessible, and culturally appropriate information to all members of society, regardless of their level of education or language proficiency Clear and accurate communication is essential in building trust and promoting compliance with public health interventions There is a dire need for effective communication in multiple languages to ensure that all members of society have access to accurate information

Finally, it's important to recognize that health equity in the context of epidemic preparedness is a continuous process. This means monitoring and evaluating the impact of public health interventions on marginalized communities and using this information to improve our efforts continuously. A systematic evaluation of the impact of public health interventions on marginalized communities should be conducted, and the results should be used to inform future public health strategies

In conclusion, the COVID-19 pandemic has highlighted the critical intersection between epidemic preparedness and health equity. A scientific approach to public health, which includes addressing social determinants of health, investing in primary healthcare, increasing community engagement and effective communication in multiple languages, and monitoring and evaluating the impact of public health interventions on marginalized communities, is crucial in ensuring that all members of society have an equal opportunity to stay healthy and safe during a pandemic

Epidemic Preparedness Post

Articles from the field:

Capacity Building in Epidemic Preparedness and Management

The recent pandemic has taught us the importance of strengthening public health systems. The capacity built over time helps during emergencies, especially where the response should be quick and targeted.

For capacity building in low- and middle-income countries (LMIC), different models were adopted to improve public health surveillance and epidemiology capacity For example, as soon as the first case of COVID-19 was discovered in Uganda in March 2020, the CDC and Uganda Ministry of Health partners laid the groundwork for combating it by activating already established Uganda's Field Epidemiology Training Program (FETP) in a short amount of time

As part of COVID-19 preparedness and response capabilities, USAID RISE has implemented a hub and spoke model to help improve pandemic preparedness in LMIC countries.

Under the USAID RISE hub and spoke model, a central hub is responsible for coordinating and providing support to a number of smaller spoke locations The hub is typically located at a national or regional level, and is responsible for providing technical assistance, training, and other support to the spoke locations The spoke locations, in turn, are responsible for collecting and reporting data on public health threats, such as outbreaks of infectious diseases

One key advantage of the USAID RISE hub and spoke model is that it allows for more efficient and effective use of resources. By centralizing support and coordination at the hub, it is possible to provide consistent and highquality support to the spoke locations, even in resource-limited settings. This can be particularly important in the context of a pandemic, when the demand for public health resources may be high and the need for timely and accurate data is critical

In India, #Jhpiego is working on augmenting this network with digital learning platforms to promote collaboration and information sharing By bringing together experts from different sectors and locations, the hub and spoke model allows for the exchange of ideas and best practices, helping to improve the overall effectiveness of preparedness.

Please share your experience with other models and suggestions to improve the ecosystem.

Articles from the field:

One Health and Epidemic Preparedness

Did you know this?

To promote collaboration between animal, environmental, plant and public health scientists, on December 19, 2019 the U.S. Senate unanimously passed a bipartisan Senate Resolution 462 (S Res 462) introduced by Senators Dianne Feinstein (Democrat-California) and Martha McSally (Republican-Arizona) designating January 2020 as National One Health Awareness Month in the U.S.

Continuing this initiative, January has been celebrated as National One Health Awareness Month from there on During the month, the public health community in US comes together to discuss about the topics related with #onehealth They #connect with each other, #create One Health related posts and then #educate each other about the topic

I firmly believe that we need cross-disciplinary partnerships and collaborations to tackle complex public health challenges; especially challenges posed by issues at the intersection of human, animal and environmental interface - and one health surely seems promising as a concept/lens through which we can solve these complex issues

With more than 60 % of the pathogens that cause human diseases originating from domestic animals or wildlife (and more than 180 epidemics happening every year), it is much needed that we all are aware of what One Health is and how it can be utilised to prepare for current as well as future #pandemics and #epidemics. Hence, as part of #100daysforepidemicpreparedness, I am sharing a short slide deck on the concept of One Health and how it can be implemented as part of India's preparedness against epidemics and pandemics.

While the One Health concept has become the global norm - and a new #trending concept - for controlling zoonotic diseases, there is no clear definition, shared agenda, or institutional governance In fact, Its ambiguity makes it a "boundary object," in that it allows for interpretation to fit various purposes and facilitates cooperation, in many cases leading to the promotion of human, animal, and environmental health However, it is still not clear if at the implementation level all three of these facets will get equal attention or not.

This gives rise to the question of how One Health should be understood in zoonotic disease control - is it really about improving the health of humans, animals, and the environment equally, or is it ultimately about public health first?

If it is about equal attention to all three facets, how do we maintain equal attention to all three without skewing towards one particular direction?

Articles from the field:

Proactive Epidemic Preparedness and power of communities

One of the most haunting memories I carry is of my parents being down with #COVID19, last to last year, during the peak of the #pandemic They were eerie times when news of death of close and distant friends and families became a routinely phone notification, the pandemic had not just entered the peripheries of circles, but my very home While I was taking care of two adults, doing house chores and somehow maintaining my sanity, help poured in the least expected ways. I have observed and seen, that the spirit of #communityalways takes me by surprise, that how people despite their own misery, can hold space to show up for you. My neighbors regularly sent in hot and piping home cooked food, unknown and overly burdened doctors found time to give free consultation to my parents' reports (without me asking). My friends did daily check in and made plans on next steps if things don't improve as hoped for. That year I realized the transient nature of our worlds, that epidemics and pandemics hold the devastating power of shaking them upside down They can disrupt economies, strain healthcare systems, and cause immense suffering for individuals and families

But while these crises can be overwhelming, they also remind us of the #strength and #resilience of the human spirit, especially the spirit of community. As we've seen time and time again, people come together in the face of adversity to support one another and find ways to overcome even the toughest challenges.

One of the most important things we can do to prepare for future pandemics and epidemics is to be #proactive. This means investing in public #healthinfrastructure, supporting new technologies and treatments, networks and programs, and educating ourselves about how to best protect ourselves and our loved ones

I feel now is not the time to be complacent, you never know if this is the calm before the storm. Let's keep working together to be prepared for the next pandemic or epidemic, and remember the stories of courage, compassion and hope that have emerged in the midst of this crisis. They are a powerful reminder that even in the darkest of times, the human spirit can shine through. When we come together as a community, we can overcome anything.