Health Security最新文献

Healthcare workers (HCWs) at community hospitals, also known as frontline hospitals (FLHs), may encounter patients with possible infectious diseases, including those caused by high-consequence pathogens such as Zaire ebolavirus. We created and piloted a 1-day, in-person, didactic and skills training program to determine the feasibility and acceptability of implementing an educational program to enhance the knowledge and skills needed to respond when a patient with a potential high-consequence pathogen presents to an FLH. The Maryland Department of Health queried all 104 state FLHs to identify their interest in participating in the pilot training program. HCWs from 12 (75%) of the 16 interested FLHs participated in the program before it was interrupted by the COVID-19 pandemic. In addition to pathogen-specific training based on the Identify, Isolate, and Inform framework, we provided skills training in the proper use of personal protective equipment, spill cleanup, and removal of an incapacitated HCW from an isolation area. We conducted a paired pretraining and posttraining knowledge assessment and measured a significant learning gain among 135 participants (2-tailed t test, P<.05). Over 95% of the participants reported that the training was relevant to their daily work and the clinical simulations and reference material were useful and appropriate for their learning level. Findings from this pilot program demonstrated the feasibility and acceptability of a 1-day combined didactic and skills training program focused on high-consequence pathogens. We plan to reengage the original FLHs and add regional FLHs in an updated training effort based on our findings.

The Maryland Primary Care Program is a statewide advanced primary care program that works directly with practices to transform healthcare delivery by managing chronic disease, preventing unnecessary hospital utilization, and integrating with the public health system. The Maryland Primary Care Program has demonstrated how linking the public health system to primary care practices, paired with strategic financial and resource investments in primary care, can enable the delivery of high-value care and reduce acute hospital utilization. Such a system is especially prudent when responding to crises. Throughout the COVID-19 pandemic, the Maryland Primary Care Program was able to capitalize on existing infrastructure to quickly engage primary care in a robust pandemic response. Successes of this relationship included early and consistent communication channels, as well as coordinated resource distribution. In particular, this partnership allowed primary care providers, the most trusted source of healthcare in patients' lives, to directly provide patients with health information and vaccines. Now comprising more than 500 practices, this vaccine program uses data-driven reports to facilitate intentional vaccine outreach. The program has enabled a more equitable vaccine distribution system, resulting in over 400,000 vaccines administered in Maryland counties. The effectiveness of Maryland's integrated response indicates that partnerships between public health and primary care will result in an effective response in future times of crisis.

The COVID-19 pandemic posed unprecedented challenges for frontline healthcare professionals globally. Despite the varied challenges encountered by frontline healthcare professionals, the difficulties faced by public health communication officials in particular has remained an underexplored area of research. This study examined the specific challenges experienced by communication officials during the COVID-19 pandemic in the United States. A qualitative research design was used to conduct in-depth interviews with communication officials working in local health departments (LHDs) in 2022. A total of 14 participants were recruited through purposive sampling, coupled with a data saturation strategy, from LHDs situated in Kansas, Missouri, and Oklahoma. Thematic analysis revealed 3 key themes: (1) main challenges faced by LHDs during the COVID-19 pandemic, (2) challenges related to information dissemination on social media, and (3) burnout experienced by communication officials. This study's findings suggest that communication officials should be provided with the necessary resources and training to effectively handle misinformation, toxic behaviors, and bullying on social media while prioritizing their mental health. In addition, federal, state, and local health agencies should provide timely, clear, and accurate information to address the challenges faced by communication officials in their bid to disseminate information effectively.

Bangladesh faces distinct challenges as a resource-poor country due to the combined effects of the COVID-19 pandemic and simultaneous dengue outbreaks. Older adults are particularly vulnerable to infection and death from COVID-19. While overall health and life expectancy in the general population have improved substantially in Bangladesh, health services for older adults are still lacking. No specialized geriatric units have been established in hospitals, and no home care programs have been established for older adults. COVID-19 mortality rates were highest among older adults ages 61 to 70 years (35%), and 71 to 80 years (20%) in 2022. Although the country's average COVID-19 mortality rate was low at 1.76%, in older adults, it was much higher (55%), accounting for 14,797 deaths, despite that most cases (55%) were recorded in young adults. During the COVID-19 pandemic, Bangladesh also experienced a dengue epidemic. Around 21,193 dengue patients were admitted to hospitals between January 1 and October 8, 2022. Without a well-established and all-encompassing social care program, the indirect socioeconomic burden of COVID-19 continues to fall on older adults. There is an immediate need for robust healthcare and support services, especially for older adults in Bangladesh, which are particularly susceptible to the dual threats posed by the COVID-19 pandemic and the dengue epidemic. Recommendations are made to protect older adults from the devastating effects of the 2 simultaneous epidemics.

The COVID-19 pandemic has highlighted the need for research about communicating with populations who have limited English proficiency in the United States during infectious disease outbreaks. These populations have experienced significantly worse health outcomes during emergencies, including the COVID-19 pandemic, and evidence-based risk communications are critical to protecting their health. To support improved development of emergency communications for these communities, we conducted a scoping review that examined the extent of research available, with an intent to identify which communications topics are covered in the literature and where research gaps exist. Following the JBI framework, with reporting guided by the PRISMA extension for scoping reviews, 6 electronic databases were systematically searched in October 2022. The inclusion criteria for articles selected were: data collected between 2009 and 2022, published in English, and focused on communications pertaining to emergency infectious disease outbreaks (eg, H1N1 influenza, Zika virus, COVID-19) for populations with limited English proficiency. Of 2,049 articles identified through the search, 31 met the inclusion criteria and were selected for review. We identified major limitations in the evidence base: a majority of studies were conducted only among Spanish speakers or during the COVID-19 pandemic, and most used qualitative or nonrandom samples. Most studies documented basic language barriers in communications, but there was little exploration of more nuanced barriers, such as cultural relevance or social context. Ahead of future outbreaks, more research is urgently needed to examine the information landscapes of populations with limited English proficiency, to inform the development of more effective communications strategies from public health institutions and others.