Health security
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In response to the 2014 Ebola outbreak, the Office of the Assistant Secretary for Preparedness and Response (ASPR) funded the creation of 10 Regional Ebola and Other Special Pathogen Treatment Centers (RESPTCs) across the United States. These high-level isolation units are designed to provide care for patients infected with high-consequence pathogens, such as viral hemorrhagic fevers, in an environment that is safe for patients, staff, the hospital, and surrounding communities. This commentary describes the impact on infection prevention and preparedness that the Johns Hopkins biocontainment unit has on the hospital and health system beyond the unit itself. Training, research projects, and collaborative partnerships conducted by a high-level isolation unit team while the unit is not activated for patient care can enhance infection prevention, multidisciplinary training and innovation, personal protective equipment design and testing, clinical skills, and infection prevention beyond the isolation setting.
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Telephone nurse triage lines, such as the Centers for Disease Control and Prevention's (CDC) Flu on Call®, a national nurse triage line, may help reduce the surge in demand for health care during an influenza pandemic by triaging callers, providing advice about clinical care and information about the pandemic, and providing access to prescription antiviral medication. We developed a Call Volume Projection Tool to estimate national call volume to Flu on Call® during an influenza pandemic. The tool incorporates 2 influenza clinical attack rates (20% and 30%), 4 different levels of pandemic severity, and different initial "seed numbers" of cases (10 or 100), and it allows variation in which week the nurse triage line opens. ⋯ Assuming a 20% clinical attack rate and a case hospitalization rate of 0.8% to 1.5% (1968-like pandemic severity), we estimated the nationwide number of calls during the peak week of the pandemic to range from 1,551,882 to 3,523,902. Assuming a more severe 1957-like pandemic (case hospitalization rate = 1.5% to 3.0%), the national number of calls during the peak week of the pandemic ranged from 2,909,778 to 7,047,804. These results will aid in planning and developing nurse triage lines at both the national and state levels for use during a future influenza pandemic.
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Emerging disease threats like Zika pose a risk to naïve populations. In comparison to chronic diseases, there is scientific uncertainty surrounding emerging diseases because of the lack of medical and public health information available as the threat emerges. Further complicating this are the multiple, diverse channels through which people get information. ⋯ Demographic variation in primary source of information means public health officials should consider alternative channels to reach target groups in an emerging event. Without an understanding of how information has reached people, and who individuals engaged with regarding that information, public health practitioners are missing a key piece of the puzzle to improving public health campaigns during a future event like Zika. This analysis aims to inform the public health community about the message channels the US population uses during an emerging disease event and the most prevalent channels for different demographic groups, who can be targeted with particular messaging.
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In an increasingly globalized world, countries face infectious disease threats and public health emergencies that transcend borders, making health security of paramount importance. Legal frameworks, at both the international and national levels, can empower governments to strengthen public health and preparedness systems to better detect and respond to infectious disease threats and public health emergencies. ⋯ This article uses 3 case studies to describe a role for law in IHR implementation. It highlights the Centers for Disease Control and Prevention's (CDC's) Global Health Security Public Health Law Project and describes how legal mapping data and the resources developed are being used by countries to strengthen health systems and support IHR implementation.
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A One Health approach is critical to strengthening health security at country, regional, and global levels. However, operationally its uptake remains limited. ⋯ This article highlights relevant tools, standards, and guidance to assist countries and institutions in meeting the collective vision articulated at the 2018 Prince Mahidol Award Conference on "Making the World Safe from the Threats of Emerging Infectious Diseases." Taking stock of assessment findings, resources, priorities, and implementation initiatives across human and animal health, environment and disaster risk reduction sectors can help expand participation in global health security, target risk drivers, and form synergies for collective action and shared gains for both emerging and endemic disease challenges. In addition to health security gains, a multisectoral, One Health approach can drive benefits for wider health sector and global development goals.