Epidemic Preparedness Post - fourth edition

What's happening around the world....

1. 2. 3.

The Business Standard:

Flu cases in Japan hit epidemic warning level

The Print:

India-made ‘artificial tears’ linked to superbug outbreak in US FDA restricts imports

BBC:

Bird flu 'spills over' to otters and foxes in UK

Fresh from academia...

The Lancet Global Health

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026 and response

BMJ Global Health

Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis

News from India

The Hindu:

India joins UAE, France for trilateral on clean energy, counterpandemic steps

The Week:

Indian pharma firm recalls eye drops linked to US drugresistant bacteria outbreak: Report

Times of India:

Budget outlay on med insurance up, public health infrastructure down

For more conversations on epidemic preparedness, please join :

Articles from the field:

Applying 7 Principles of clinical governance to enhance epidemic preparedness

Clinical governance is “A system through which organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.” -

Scally and Donaldson

The various hospital committees aim at improving clinical #governance with the definitive goal of creating enabling environment in the hospital for improving the quality of the clinical services being provided to the patient. A well-prepared and equipped hospital can aid in strengthening the response during emergencies and #pandemics.

The critical care committee or #CrticalCare Working group plays vital role in strengthening hospital preparedness and smoothly managing the hospital affairs during emergencies and pandemics. The committee aims at monitoring the critical care services being delivered at the emergency department and ICU. It makes recommendations to the hospital board on issues related to patient management and referral. The committee develops the action plan for achieving the desired results. The committee should include but not be limited to the medical and nursing superintendent, critical care specialist, anaesthetist, surgeon, physician, orthopaedician, public health expert, emergency, ICU and OT in charge

The pillars of clinical governance are applied to the Critical Care Working Group (CCWG) as well. The 7 pillars of clinical governance are:

7

Expected outcomes of the effective Critical Care Working Group (CCWG)

- Effective triage

- Efficient referral

- Enhanced patient safety and satisfaction

- Improved accountability through audits

- Optimum utilization of hospital resources

- Improved interdepartmental coordination

- Availability of SOPs for the procedures e g for admission, discharge, referral etc

- Reduction in hospital-acquired infections, mortality, morbidity and the average length of stay

- Implanting evidence-based interventions

Written by, Dr Saurabh Parmar

Articles from the field:

Is Big Data a Big-help or Big-head in Epidemic Preparedness?

Big Data has the potential to revolutionize public healthcare in low and middle-income countries (LMICs). Despite facing many challenges, such as limited resources and inadequate infrastructure, LMICs are seeing the benefits of utilizing big data to improve healthcare outcomes. Here are a few unique benefits of big data in #epidemicpreparedness, especially for LMICs.

Early detection and surveillance

Big data helps to improve public health surveillance. By analyzing data from various sources, such as electronic health records, social media, and mobile health apps, healthcare professionals can identify trends and patterns that can inform their decision-making and lead to better public health outcomes For example, researchers use social media data to detect an outbreak of epidemic weeks before its official reporting (1) Also, electronic health records analysis will identify outbreaks (2)

Predictive modeling

Machine learning: Machine learning algorithms can be trained on historical data to predict the spread of outbreaks

GIS mapping: Geographic information systems (GIS) mapping helps forecast the spread of outbreaks based on demographics, travel patterns, and other factors For example, researchers in India used machine learning and GIS to predict the spread of COVID-19 (3)

Resource allocation

Big data can also improve resource allocation in public healthcare in LMICs By analyzing data from various sources, healthcare professionals can identify areas with high healthcare needs and allocate resources accordingly

Supply chain optimization: Big data can optimize the supply chain, ensuring that medical supplies and personnel are deployed to areas of high need (4)

Real-time tracking: Big data can be used to track the spread of an outbreak in real-time For example, we can use the lessons learned from COVID-19 tracking in future epidemics (5)

Improving healthcare systems

Quality improvement: By analyzing patient data, healthcare systems can identify areas for improvement and implement quality improvement initiatives For example, researchers are working on big data to improve the quality of care for patients (6)

Precision Public Health: Big data can be used to develop clinical decision support tools, improving the accuracy of diagnoses and personalized treatment plans, popularly called ‘Precision public health ’ For example, by analyzing a patient’s genomic data, healthcare professionals can tailor treatments to their specific needs (7)

Written by, Srinivas Balusu

Articles from the field:

Global Health Security Agenda and its relevance for India

The Global Health Security Agenda (GHSA) is a comprehensive and cooperative effort by countries, international organizations, and stakeholders to improve global health security The GHSA is designed to prevent, detect, and respond to infectious disease outbreaks and other public health emergencies of international concern, such as pandemics. The GHSA is a critical component of global health governance, aimed at protecting the health of populations around the world and reducing the risk of infectious disease outbreaks.

The Global Health Security Agenda (GHSA) has undergone significant evolution over time to respond to the changing landscape of global health security:

Early 2000s: Emergence of SARS, avian influenza, and Ebola outbreaks highlights the need for a coordinated global response to infectious diseases

2014: The GHSA is officially launched with the goal of improving global health security and reducing the risk of infectious disease outbreaks.

2015: GHSA expands to include pandemic preparedness and response in response to the Ebola outbreak in West Africa.

2016: GHSA adopts a new strategic plan with a focus on strengthening health systems, including laboratory networks, and engaging communities in the efforts to prevent and control infectious diseases.

2020: The COVID-19 pandemic highlights the importance of the GHSA and the need for continued investment in health systems and pandemic preparedness

2021: GHSA continues to evolve to respond to the changing landscape of global health security, including the ongoing COVID-19 pandemic and the emergence of new infectious diseases

Over time, the #GHSA has demonstrated its value as a comprehensive and cooperative effort by countries, international organizations, and stakeholders to improve #globalhealthsecurity and reduce the risk of infectious disease outbreaks. The evolution of the GHSA reflects the need for continued adaptation and innovation to meet the challenges of global health security.

In response to the Ebola outbreak in West Africa, the GHSA was expanded to include #pandemicpreparedness and response. The GHSA also recognizes the importance of strengthening health systems, including laboratory networks, and engaging communities in the efforts to prevent and control infectious diseases

The relevance of the GHSA in the current scenario cannot be overstated, as the world continues to face new and emerging infectious diseases, such as #COVID-19. The GHSA provides a framework for countries and international organizations to work together to improve health security and reduce the risk of infectious disease outbreaks.

(continued on next page)

Written by,

Articles from the field:

Global Health Security Agenda and its relevance for India

In India, the GHSA is being implemented through the Integrated Disease Surveillance Programme (IDSP) and the National Centre for Disease Control (NCDC) The IDSP is responsible for monitoring and detecting outbreaks of infectious diseases, while the NCDC is responsible for disease control and prevention India has made significant progress in improving its health security through the GHSA, including strengthening its laboratory network and enhancing its response capacity to infectious diseases.

The way forward for the GHSA in India includes continued investment in health systems, including laboratory networks and health worker training, and increased engagement with communities. Additionally, it is important to strengthen collaboration and coordination between different agencies involved in the implementation of the GHSA, such as the Ministry of Health and Family Welfare, the Ministry of Agriculture and Farmers’ Welfare, and the Ministry of Environment, Forest and Climate Change.

Development partners like USAID, #WorldBank, UNICEF, etc and iNGOs like Jhpiego are also supporting countries in their GHSA vision Jhpiego is actively engaged in strengthening healthcare systems and promoting the development of strong and resilient health systems that can effectively respond to and manage public health threats, including pandemics. This includes providing technical assistance, capacity building, and the implementation of evidence-based interventions in resource-limited settings to prevent, detect, and respond to public health emergencies. In India, Jhpiego is involved in capacity enhancement in critical care, oxygen management, strengthening of laboratory and surveillance investments including molecular testing & genome sequencing capacity, improvement of health infrastructure in critical care, integrated public health laboratories as a part of its contribution to the country’s GHSA vision.

In conclusion, the Global Health Security Agenda is a critical component of global health governance, aimed at improving health security and reducing the risk of infectious disease outbreaks India has made significant progress in implementing the GHSA, and there is a need for continued investment in health systems and increased engagement with communities. By working together, India and the world can create a more secure and healthier future for all.

Written by, Dr Nochiketa Mohanty

Articles from the field:

Use of Geographical Information System (GIS) and Forecasting in Pandemic Preparedness

Geographical Information System (GIS) has traditionally been used in the areas of geography & spatial data analysis to capture, store and display data related to earths’ position; the daily frequent use being in google maps or navigation systems. The use #GIS of is also quite popular at times of election and its results to highlight various constituencies won by a particular party. During COVID times, we all would have looked at newspaper showing India’s map or that of various districts in different color gradients to signify the case burden in a particular area or some points on map showing location of various hospitals or oxygen facilities GIS is hence a powerful tool that has gained importance for its use to support #pandemicpreparedness efforts GIS can be used to map the spread of a disease, identify highrisk areas, and track the effectiveness of containment and mitigation strategies.

By overlaying data on population density, demographics, and healthcare infrastructure, GIS can help public health officials understand the potential impact of an outbreak and target their response efforts. Additionally, GIS can be used to create digital contact tracing systems, which can help identify and isolate individuals who have been exposed to the virus.

Disease #mapping and #forecasting are one of the key components of pandemic preparedness, and GIS plays a critical role in these efforts GIS allows for the #visualization of disease spread over time and space, making it easier to identify patterns and hotspots By analyzing data on factors such as population density, travel patterns, and healthcare infrastructure, GIS can be used to create models that forecast the potential spread of a disease and identify areas that are most at risk.

Additionally, GIS can be used to create #earlywarning systems that can alert authorities to potential outbreaks before they become widespread. Overall, GIS-based disease mapping and forecasting can help to improve pandemic preparedness by providing valuable insights and supporting effective decision-making in the face of a pandemic.

Written by, Priyanka Kharkwal

Articles from the field:

Neglected Tropical Diseases and priority areas to tackle them in South-East Asia

NTDs are a group of parasitic and bacterial infections that affect over 1 billion people globally, primarily in lowincome communities These diseases cause debilitating physical symptoms and can lead to blindness, disfigurement, and even death

In light of NTD Day, it's important to recognize the impact NTDs have on communities and the importance of addressing them as part of our global health and epidemic preparedness efforts. Investing in NTD control not only improves health outcomes, but also helps build resilient health systems that can respond effectively to outbreaks of NTDs and other infectious diseases.

In the context of South-East Asia and India, The World Health Organization (WHO) reports that the South-East Asia Region holds the record for the world's second-highest number of neglected tropical diseases (NTDs) These diseases can be found in all 11 Member States of the Region, with over 938 million people requiring intervention. In 2021, 59% of the global population requiring treatments for lymphatic filariasis (LF) was from this Region, as well as 66.5% of the new cases of leprosy, and 56% of children needing regular deworming against soil-transmitted helminthiases.

Over the years, the countries in the Region made considerable progress India and Maldives were declared yawsfree in 2016 and 2017, respectively The Region introduced a more effective mass drug administration (MDA) regimen with triple drug (IDA) to speed up the elimination of lymphatic filariasis Nepal achieved elimination of trachoma as a public health problem in 2018 and Myanmar followed suit in 2020. By the end of 2020, 98% of implementation units in Bangladesh, India, and Nepal had achieved the epidemiological threshold of elimination of Kala Azar as a public health problem. The Region also reduced visible disability due to leprosy by 40% between 2016 and 2019.

However, due to the COVID-19 pandemic, many initiatives had to be postponed

Community-based activities for NTDs were affected and funds were diverted to pandemic response The region's current focus is on optimizing existing interventions and leveraging new innovations to overcome any last-mile gaps and challenges This includes expanding the roll-out of triple-drug therapy to eliminate LF in the three LF-endemic countries, increasing access to post-exposure prophylaxis for leprosy, and intensified efforts to detect and manage cases of kala-azar. The second priority is sustaining elimination status in the post-validation phase, which requires continued vigilance, avoiding donor fatigue, and investing in post-validation interventions such as surveillance platform integration and accelerating research and development of new tools and strategies.

Written by, Dr Abhishek Thakkar