public health

Ohio House Passes Bill To Limit Future Public Health Orders

Republicans in the Ohio House have approved a bill that would limit the power and length of public health orders on coronavirus that their fellow Republican, Gov. Mike DeWine, has been issuing through Ohio Department of Health Director Dr. Amy Acton. Statehouse correspondent Karen Kasler reports the bill reflects a split in the GOP on how to restart the economy that could carry over into the future.




public health

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

As of Friday in Texas, you can go to a tanning salon. In Indiana, houses of worship are being allowed to open with no cap on attendance. Places like Pennsylvania are taking a more cautious approach, only starting to ease restrictions in some counties based on the number of COVID-19 cases. By Monday, at least 31 states will have partially reopened after seven weeks of restrictions. The moves come as President Trump pushes for the country to get back to work despite public health experts warning that it's too soon. "The early lesson that was learned, really, we learned from the island of Hokkaido in Japan, where they did a really good job of controlling the initial phase of the outbreak," said Bob Bednarczyk, assistant professor of global health and epidemiology at the Rollins School of Public Health at Emory University in Atlanta. Because of that success, many of the restrictions on the island were lifted. But cases and deaths surged in a second wave of infections. Twenty-six days later




public health

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

As of Friday in Texas, you can go to a tanning salon. In Indiana, houses of worship are being allowed to open with no cap on attendance. Places like Pennsylvania are taking a more cautious approach, only starting to ease restrictions in some counties based on the number of COVID-19 cases. By Monday, at least 31 states will have partially reopened after seven weeks of restrictions. The moves come as President Trump pushes for the country to get back to work despite public health experts warning that it's too soon. "The early lesson that was learned, really, we learned from the island of Hokkaido in Japan, where they did a really good job of controlling the initial phase of the outbreak," said Bob Bednarczyk, assistant professor of global health and epidemiology at the Rollins School of Public Health at Emory University in Atlanta. Because of that success, many of the restrictions on the island were lifted. But cases and deaths surged in a second wave of infections. Twenty-six days later




public health

Columbus Declares Public Health Emergency Freeing Up Extra Safety Measures

The Columbus Board of Health today declared a local public health emergency giving the city extra safety measures to respond to COVID-19 cases. The declaration allows for the quarantine and isolation of individuals with the virus and as a last resort law enforcement involvement for any instances of non-compliance.




public health

Take Note: Penn State Prof. Nita Bharti On Public Health Messaging Around Coronavirus

On this Take Note, we talked about public health messaging, specifically how the U.S. government has communicated about and reacted to the coronavirus outbreak. Also, how dealing with a pandemic is different in a democracy than in an authoritarian country. Our guest was Nita Bharti, an assistant professor of biology and the Lloyd Huck Early Career Professor in the Huck Institutes of the Life Sciences at Penn State. This interview is from the Democracy Works podcast, a collaboration between WPSU and the McCourtney Institute for Democracy at Penn State. TRANSCRIPT: Jenna Spinelle: This is Jenna Spinelle here today with Nita Bharti. Nita, thanks for joining us on Democracy Works. Nita Bharti: It's my pleasure. Thanks Jenna. Spinelle: We are going to talk today in the midst of the corona virus outbreak about the relationship between information, government and the public in the midst of an outbreak. That's a complex topic. We're going to kind of come at it from a couple of different angles




public health

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

As of Friday in Texas, you can go to a tanning salon. In Indiana, houses of worship are being allowed to open with no cap on attendance. Places like Pennsylvania are taking a more cautious approach, only starting to ease restrictions in some counties based on the number of COVID-19 cases. By Monday, at least 31 states will have partially reopened after seven weeks of restrictions. The moves come as President Trump pushes for the country to get back to work despite public health experts warning that it's too soon. "The early lesson that was learned, really, we learned from the island of Hokkaido in Japan, where they did a really good job of controlling the initial phase of the outbreak," said Bob Bednarczyk, assistant professor of global health and epidemiology at the Rollins School of Public Health at Emory University in Atlanta. Because of that success, many of the restrictions on the island were lifted. But cases and deaths surged in a second wave of infections. Twenty-six days later




public health

City Visions: Are sugary drinks a public health hazard?

Last week, researchers at UCSF published a study showing that a ban on sugary drinks at work has significant positive health effects, from a smaller waist size to improved insulin resistance to lower cholesterol.




public health

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

As of Friday in Texas, you can go to a tanning salon. In Indiana, houses of worship are being allowed to open with no cap on attendance. Places like Pennsylvania are taking a more cautious approach, only starting to ease restrictions in some counties based on the number of COVID-19 cases. By Monday, at least 31 states will have partially reopened after seven weeks of restrictions. The moves come as President Trump pushes for the country to get back to work despite public health experts warning that it's too soon. "The early lesson that was learned, really, we learned from the island of Hokkaido in Japan, where they did a really good job of controlling the initial phase of the outbreak," said Bob Bednarczyk, assistant professor of global health and epidemiology at the Rollins School of Public Health at Emory University in Atlanta. Because of that success, many of the restrictions on the island were lifted. But cases and deaths surged in a second wave of infections. Twenty-six days later




public health

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

As of Friday in Texas, you can go to a tanning salon. In Indiana, houses of worship are being allowed to open with no cap on attendance. Places like Pennsylvania are taking a more cautious approach, only starting to ease restrictions in some counties based on the number of COVID-19 cases. By Monday, at least 31 states will have partially reopened after seven weeks of restrictions. The moves come as President Trump pushes for the country to get back to work despite public health experts warning that it's too soon. "The early lesson that was learned, really, we learned from the island of Hokkaido in Japan, where they did a really good job of controlling the initial phase of the outbreak," said Bob Bednarczyk, assistant professor of global health and epidemiology at the Rollins School of Public Health at Emory University in Atlanta. Because of that success, many of the restrictions on the island were lifted. But cases and deaths surged in a second wave of infections. Twenty-six days later




public health

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

As of Friday in Texas, you can go to a tanning salon. In Indiana, houses of worship are being allowed to open with no cap on attendance. Places like Pennsylvania are taking a more cautious approach, only starting to ease restrictions in some counties based on the number of COVID-19 cases. By Monday, at least 31 states will have partially reopened after seven weeks of restrictions. The moves come as President Trump pushes for the country to get back to work despite public health experts warning that it's too soon. "The early lesson that was learned, really, we learned from the island of Hokkaido in Japan, where they did a really good job of controlling the initial phase of the outbreak," said Bob Bednarczyk, assistant professor of global health and epidemiology at the Rollins School of Public Health at Emory University in Atlanta. Because of that success, many of the restrictions on the island were lifted. But cases and deaths surged in a second wave of infections. Twenty-six days later




public health

Public Health Officials Aim To Communicate Better With Minorities

The coronavirus has made the racial divide in health more stark with a catastrophic effect on black America. Public officials seek ways to communicate more effectively with communities of color.




public health

Passing on the family legacies of medicine, public health work and reggae music

Do you have a vocation that's been passed through your family for generations? For Dr Mark Wenitong — the legacy of health work has been passed from his mother, through him and onto his son. And that's not the only family tradition being continued... Reggae music has also been a big part of his family's livelihood.




public health

Man who 'told police he had coronavirus' charged with disobeying public health direction

A Tasmanian man who allegedly left his home without a lawful reason and told police he had coronavirus when he was pulled over is charged with failing to comply with a public health direction.




public health

WA scuppers AFL restart plans, saying it has 'no confidence' players won't jeopardise public health

The WA Government drills down on its decision to reject a home and away AFL season, saying the state's borders "would not and should not" be compromised to accommodate players.




public health

America Doesn’t Have a Public Health System

Dr. Anthony S Fauci, director of the National Institute of Allergy and Infectious Diseases and just...




public health

What’s Missing From the Coronavirus BillThe public health and...



What’s Missing From the Coronavirus Bill

The public health and economic crises we’re experiencing are closely related. They reveal in stark terms the dangerous mythology of trickle-down self-sufficiency and the need for policies that respond to the real needs of people who are or will soon be affected.

But Trump doesn’t seem to understand that. Before agreeing to an actual coronavirus relief bill, his administration was considering more corporate tax cuts, tax cuts targeted to the airlines and hospitality industries, and a temporary payroll tax cut. 

But tax cuts will be useless. They’ll be too slow to stimulate the economy, and won’t reach households and consumers who should be the real targets. And they’ll reward the rich, who don’t spend much of their additional dollars, without getting money into the hands of the poor and middle-class, who do.

Thankfully, Congress has moved forward on some of the most urgent priorities like free coronavirus testing, strengthening unemployment insurance and food security programs. But it doesn’t go far enough.

Instead, Congress must immediately provide an emergency $500 billion to help all Americans protect themselves and their families, and keep the economy going.

The money should be used for:

Coronavirus testing and treatment. Diagnostic tests should be mandatory and universal, and free. And everyone with the virus should have access to treatment and to any future vaccines, regardless of ability to pay.

Guaranteed paid sick leave for ALL employees. The current relief bill does cover paid sick leave for some but has huge carve-outs, exempting all companies with over 500 employees and some small businesses under 50 employees. That exclusion could affect up to 20 million Americans. Without guaranteed paid sick leave and family leave, workers who are sick will not remain home and will end up exposing others.

Extended unemployment insurance. Without it, large numbers of Americans will be furloughed or laid off without adequate income to support themselves and their families. As it is, unemployment insurance reaches a measly 27 percent of the unemployed. 

Extended Medicaid. No one should avoid seeing a doctor because of fears about out-of-control medical bills. Right now, 28 million Americans have no health insurance, and countless more are reluctant to see a doctor because of large deductions or co-payments. Especially in a health emergency, health care should be available to all regardless of ability to pay. 

Immediate one-time payments of $1,500 to every adult and $500 per child, renewable if necessary. Some consumers might spend the money right away to meet rent if they lose their regular paycheck. Others might have stronger balance sheets and spend the money at whatever uncertain date the virus is contained. 

Suspension of the Trump administration’s “public charge” rule that enables federal officials to deny green cards to immigrants who use social safety net programs. Programs like, Medicaid, Food Stamps, Temporary Assistance to Needy Families, and Women Infants and Children are more important than ever.

For the same reason, testing and treatment should be available to undocumented immigrants, without fear of deportation.

Trickle-down economics and trickle-down public health are deeply flawed. Corporate tax cuts won’t save us. The coronavirus doesn’t distinguish between rich and poor. We are in this imminent health and economic emergency together, and our own health and wellbeing are dependent on the health and wellbeing of everyone else. 

Each of us is only as healthy as the least-healthy among us.




public health

Public Health First

Dick Kovacevich, former CEO of Wells Fargo bank, thinks most Americans should return to work in...




public health

EPA Community Grants Available to Protect Public Health and the Environment in New England

BOSTON – The US Environmental Protection Agency (EPA) is making grants available for New England communities to support EPA's goals of reducing environmental risks, protecting human health and improving the quality of life. 




public health

EPA issues summary of recent Safe Drinking Water Act orders to protect public health in Wyoming

DENVER -- The U.S.




public health

Health vs. Wealth? Public Health Policies and the Economy During Covid-19 -- by Zhixian Lin, Christopher M. Meissner

We study the impact of non-pharmaceutical policy interventions (NPIs) like “stay-at-home” orders on the spread of infectious disease. NPIs are associated with slower growth of Covid-19 cases. NPIs “spillover” into other jurisdictions. NPIs are not associated with significantly worse economic outcomes measured by job losses. Job losses have been no higher in US states that implemented “stay-at-home” during the Covid-19 pandemic than in states that did not have “stay-at-home”. All of these results demonstrate that the Covid-19 pandemic is a common economic and public health shock. The tradeoff between the economy and public health today depends strongly on what is happening elsewhere. This underscores the importance of coordinated economic and public health responses.




public health

Immigration detention is a public health hazard

As physicians who work in New York City hospitals, we are witnessing how COVID-19 is ravaging the communities we serve. The only way to slow this pandemic is to stop the transmission of the disease. Yet despite everything we know about how the virus spreads and the unprecedented sacrifices workers have made to slow the spread, Immigration and Customs Enforcement (ICE) continues to endanger the lives of over 40,000 immigrants in more than 200 jails and prisons nationally. Most people in immigration detention have committed no criminal offense and have been deemed by ICE to pose no danger, yet they are held arbitrarily pending disposition of their asylum claims or deportation orders.




public health

Inequality of Fear and Self-Quarantine: Is There a Trade-off between GDP and Public Health? -- by Sangmin Aum, Sang Yoon (Tim) Lee, Yongseok Shin

We construct a quantitative model of an economy hit by an epidemic. People differ by age and skill, and choose occupations and whether to commute to work or work from home, to maximize their income and minimize their fear of infection. Occupations differ by wage, infection risk, and the productivity loss when working from home. By setting the model parameters to replicate the progression of COVID-19 in South Korea and the United Kingdom, we obtain three key results. First, government-imposed lock-downs may not present a clear trade-off between GDP and public health, as commonly believed, even though its immediate effect is to reduce GDP and infections by forcing people to work from home. A premature lifting of the lock-down raises GDP temporarily, but infections rise over the next months to a level at which many people choose to work from home, where they are less productive, driven by the fear of infection. A longer lock-down eventually mitigates the GDP loss as well as flattens the infection curve. Second, if the UK had adopted South Korean policies, its GDP loss and infections would have been substantially smaller both in the short and the long run. This is not because Korea implemented policies sooner, but because aggressive testing and tracking more effectively reduce infections and disrupt the economy less than a blanket lock-down. Finally, low-skill workers and self-employed lose the most from the epidemic and also from the government policies. However, the policy of issuing “visas” to those who have antibodies will disproportionately benefit the low-skilled, by relieving them of the fear of infection and also by allowing them to get back to work.




public health

Advocates, public health experts urge NYC officials to begin ‘social distancing’ measures in response to coronavirus

In a letter, the group noted that past pandemics show large-scale social restrictions that keep people physically separated can make the most difference if done before the illness becomes widespread.




public health

Op-Ed: Yes, the government can restrict your liberty to protect public health

Sorry, liberators. Court rulings have firmly established that public health closures — like our current coronavirus shutdowns — are constitutional.




public health

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

By Monday, at least 31 states will be open or partially open, often in opposition to guidelines from scientists. President Trump has been pushing for the country to get back to work.




public health

Letters to the Editor: Churches don't have a 1st Amendment right to ruin public health

Some of the worst COVID-19 outbreaks have been linked to religious services, and the public's health trumps every other right.




public health

What St. George reopening amid COVID-19 and moving to 'orange' means for public health

With businesses across Utah reopening on May 1, here is what returning to normalcy might mean for the health of St. George residents in the future

       




public health

Skelton: Newsom is relying on public health officials for his coronavirus response. But he has to listen to others too

In the U.S. no one rules absolutely — not even public health officials fighting the coronavirus.




public health

Ottawa Public Health 'concerned' about long-term care homes during COVID-19 pandemic

Medical Officer of Health Dr. Vera Etches says hospital staff are providing support to long-term care homes hardest hit by the COVID-19 pandemic.




public health

Coronavirus: Public Health Emergency or Pandemic – Does Timing Matter?

1 May 2020

Dr Charles Clift

Senior Consulting Fellow, Global Health Programme
The World Health Organization (WHO) has been criticized for delaying its announcements of a public health emergency and a pandemic for COVID-19. But could earlier action have influenced the course of events?

2020-05-01-Tedros-WHO-COVID

WHO director-general Dr Tedros Adhanom Ghebreyesus at the COVID-19 press briefing on March 11, 2020, the day the coronavirus outbreak was classed as a pandemic. Photo by FABRICE COFFRINI/AFP via Getty Images.

The World Health Organization (WHO) declared the spread of COVID-19 to be a Public Health Emergency of International Concern (PHEIC) on January 30 this year and then characterized it as a pandemic on March 11.

Declaring a PHEIC is the highest level of alert that WHO is obliged to declare, and is meant to send a powerful signal to countries of the need for urgent action to combat the spread of the disease, mobilize resources to help low- and middle-income countries in this effort and fund research and development on needed treatments, vaccines and diagnostics. It also obligates countries to share information with WHO.

Once the PHEIC was declared, the virus continued to spread globally, and WHO began to be asked why it had not yet declared the disease a pandemic. But there is no widely accepted definition of a pandemic, generally it is just considered an epidemic which affects many countries globally.

Potentially more deadly

The term has hitherto been applied almost exclusively to new forms of flu, such as H1N1 in 2009 or Spanish flu in 1918, where the lack of population immunity and absence of a vaccine or effective treatments makes the outbreak potentially much more deadly than seasonal flu (which, although global, is not considered a pandemic).

For COVID-19, WHO seemed reluctant to declare a pandemic despite the evidence of global spread. Partly this was because of its influenza origins — WHO’s emergency programme executive director said on March 9 that ‘if this was influenza, we would have called a pandemic ages ago’.

He also expressed concern that the word traditionally meant moving — once there was widespread transmission — from trying to contain the disease by testing, isolating the sick and tracing and quarantining their contacts, to a mitigation approach, implying ‘the disease will spread uncontrolled’.

WHO’s worry was that the world’s reaction to the word pandemic might be there was now nothing to be done to stop its spread, and so countries would effectively give up trying. WHO wanted to send the message that, unlike flu, it could still be pushed back and the spread slowed down.

In announcing the pandemic two days later, WHO’s director-general Dr Tedros Adhanom Ghebreyesus reemphasised this point: ‘We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic’ and that WHO was deeply concerned ‘by the alarming levels of inaction’.

The evidence suggests that the correct message did in fact get through. On March 13, US president Donald Trump declared a national emergency, referring in passing to WHO’s announcement. On March 12, the UK launched its own strategy to combat the disease. And in the week following WHO’s announcements, at least 16 other countries announced lockdowns of varying rigour including Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Hungary, Netherlands, Norway, Poland, Portugal, Serbia, Spain and Switzerland. Italy and Greece had both already instituted lockdowns prior to the WHO pandemic announcement.

It is not possible to say for sure that WHO’s announcement precipitated these measures because, by then, the evidence of the rapid spread was all around for governments to see. It may be that Italy’s dramatic nationwide lockdown on March 9 reverberated around European capitals and elsewhere.

But it is difficult to believe the announcement did not have an effect in stimulating government actions, as was intended by Dr Tedros. Considering the speed with which the virus was spreading from late February, might an earlier pandemic announcement by WHO have stimulated earlier aggressive actions by governments?

Declaring a global health emergency — when appropriate — is a key part of WHO’s role in administering the International Health Regulations (IHR). Significantly, negotiations on revisions to the IHR, which had been ongoing in a desultory fashion in WHO since 1995, were accelerated by the experience of the first serious coronavirus outbreak — SARS — in 2002-2003, leading to their final agreement in 2005.

Under the IHR, WHO’s director-general decides whether to declare an emergency based on a set of criteria and on the advice of an emergency committee. IHR defines an emergency as an ‘extraordinary event that constitutes a public health risk through the international spread of disease and potentially requires a coordinated international response’.

In the case of COVID-19, the committee first met on January 22-23 but were unable to reach consensus on a declaration. Following the director-general’s trip to meet President Xi Jinping in Beijing, the committee reconvened on January 30 and this time advised declaring a PHEIC.

But admittedly, public recognition of what a PHEIC means is extremely low. Only six have ever been declared, with the first being the H1N1 flu outbreak which fizzled out quickly, despite possibly causing 280,000 deaths globally. During the H1N1 outbreak, WHO declared a PHEIC in April 2009 and then a pandemic in June, only to rescind both in August as the outbreak was judged to have transitioned to behave like a seasonal flu.

WHO was criticized afterwards for prematurely declaring a PHEIC and overreacting. This then may have impacted the delay in declaring the Ebola outbreak in West Africa as a PHEIC in 2014, long after it became a major crisis. WHO’s former legal counsel has suggested the PHEIC — and other aspects of the IHR framework — may not be effective in stimulating appropriate actions by governments and needs to be reconsidered.

When the time is right to evaluate lessons about the response, it might be appropriate to consider the relative effectiveness of the PHEIC and pandemic announcements and their optimal timing in stimulating appropriate action by governments. The effectiveness of lockdowns in reducing the overall death toll also needs investigation.




public health

Coronavirus: Public Health Emergency or Pandemic – Does Timing Matter?

1 May 2020

Dr Charles Clift

Senior Consulting Fellow, Global Health Programme
The World Health Organization (WHO) has been criticized for delaying its announcements of a public health emergency and a pandemic for COVID-19. But could earlier action have influenced the course of events?

2020-05-01-Tedros-WHO-COVID

WHO director-general Dr Tedros Adhanom Ghebreyesus at the COVID-19 press briefing on March 11, 2020, the day the coronavirus outbreak was classed as a pandemic. Photo by FABRICE COFFRINI/AFP via Getty Images.

The World Health Organization (WHO) declared the spread of COVID-19 to be a Public Health Emergency of International Concern (PHEIC) on January 30 this year and then characterized it as a pandemic on March 11.

Declaring a PHEIC is the highest level of alert that WHO is obliged to declare, and is meant to send a powerful signal to countries of the need for urgent action to combat the spread of the disease, mobilize resources to help low- and middle-income countries in this effort and fund research and development on needed treatments, vaccines and diagnostics. It also obligates countries to share information with WHO.

Once the PHEIC was declared, the virus continued to spread globally, and WHO began to be asked why it had not yet declared the disease a pandemic. But there is no widely accepted definition of a pandemic, generally it is just considered an epidemic which affects many countries globally.

Potentially more deadly

The term has hitherto been applied almost exclusively to new forms of flu, such as H1N1 in 2009 or Spanish flu in 1918, where the lack of population immunity and absence of a vaccine or effective treatments makes the outbreak potentially much more deadly than seasonal flu (which, although global, is not considered a pandemic).

For COVID-19, WHO seemed reluctant to declare a pandemic despite the evidence of global spread. Partly this was because of its influenza origins — WHO’s emergency programme executive director said on March 9 that ‘if this was influenza, we would have called a pandemic ages ago’.

He also expressed concern that the word traditionally meant moving — once there was widespread transmission — from trying to contain the disease by testing, isolating the sick and tracing and quarantining their contacts, to a mitigation approach, implying ‘the disease will spread uncontrolled’.

WHO’s worry was that the world’s reaction to the word pandemic might be there was now nothing to be done to stop its spread, and so countries would effectively give up trying. WHO wanted to send the message that, unlike flu, it could still be pushed back and the spread slowed down.

In announcing the pandemic two days later, WHO’s director-general Dr Tedros Adhanom Ghebreyesus reemphasised this point: ‘We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic’ and that WHO was deeply concerned ‘by the alarming levels of inaction’.

The evidence suggests that the correct message did in fact get through. On March 13, US president Donald Trump declared a national emergency, referring in passing to WHO’s announcement. On March 12, the UK launched its own strategy to combat the disease. And in the week following WHO’s announcements, at least 16 other countries announced lockdowns of varying rigour including Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Hungary, Netherlands, Norway, Poland, Portugal, Serbia, Spain and Switzerland. Italy and Greece had both already instituted lockdowns prior to the WHO pandemic announcement.

It is not possible to say for sure that WHO’s announcement precipitated these measures because, by then, the evidence of the rapid spread was all around for governments to see. It may be that Italy’s dramatic nationwide lockdown on March 9 reverberated around European capitals and elsewhere.

But it is difficult to believe the announcement did not have an effect in stimulating government actions, as was intended by Dr Tedros. Considering the speed with which the virus was spreading from late February, might an earlier pandemic announcement by WHO have stimulated earlier aggressive actions by governments?

Declaring a global health emergency — when appropriate — is a key part of WHO’s role in administering the International Health Regulations (IHR). Significantly, negotiations on revisions to the IHR, which had been ongoing in a desultory fashion in WHO since 1995, were accelerated by the experience of the first serious coronavirus outbreak — SARS — in 2002-2003, leading to their final agreement in 2005.

Under the IHR, WHO’s director-general decides whether to declare an emergency based on a set of criteria and on the advice of an emergency committee. IHR defines an emergency as an ‘extraordinary event that constitutes a public health risk through the international spread of disease and potentially requires a coordinated international response’.

In the case of COVID-19, the committee first met on January 22-23 but were unable to reach consensus on a declaration. Following the director-general’s trip to meet President Xi Jinping in Beijing, the committee reconvened on January 30 and this time advised declaring a PHEIC.

But admittedly, public recognition of what a PHEIC means is extremely low. Only six have ever been declared, with the first being the H1N1 flu outbreak which fizzled out quickly, despite possibly causing 280,000 deaths globally. During the H1N1 outbreak, WHO declared a PHEIC in April 2009 and then a pandemic in June, only to rescind both in August as the outbreak was judged to have transitioned to behave like a seasonal flu.

WHO was criticized afterwards for prematurely declaring a PHEIC and overreacting. This then may have impacted the delay in declaring the Ebola outbreak in West Africa as a PHEIC in 2014, long after it became a major crisis. WHO’s former legal counsel has suggested the PHEIC — and other aspects of the IHR framework — may not be effective in stimulating appropriate actions by governments and needs to be reconsidered.

When the time is right to evaluate lessons about the response, it might be appropriate to consider the relative effectiveness of the PHEIC and pandemic announcements and their optimal timing in stimulating appropriate action by governments. The effectiveness of lockdowns in reducing the overall death toll also needs investigation.




public health

Coronavirus: Public Health Emergency or Pandemic – Does Timing Matter?

1 May 2020

Dr Charles Clift

Senior Consulting Fellow, Global Health Programme
The World Health Organization (WHO) has been criticized for delaying its announcements of a public health emergency and a pandemic for COVID-19. But could earlier action have influenced the course of events?

2020-05-01-Tedros-WHO-COVID

WHO director-general Dr Tedros Adhanom Ghebreyesus at the COVID-19 press briefing on March 11, 2020, the day the coronavirus outbreak was classed as a pandemic. Photo by FABRICE COFFRINI/AFP via Getty Images.

The World Health Organization (WHO) declared the spread of COVID-19 to be a Public Health Emergency of International Concern (PHEIC) on January 30 this year and then characterized it as a pandemic on March 11.

Declaring a PHEIC is the highest level of alert that WHO is obliged to declare, and is meant to send a powerful signal to countries of the need for urgent action to combat the spread of the disease, mobilize resources to help low- and middle-income countries in this effort and fund research and development on needed treatments, vaccines and diagnostics. It also obligates countries to share information with WHO.

Once the PHEIC was declared, the virus continued to spread globally, and WHO began to be asked why it had not yet declared the disease a pandemic. But there is no widely accepted definition of a pandemic, generally it is just considered an epidemic which affects many countries globally.

Potentially more deadly

The term has hitherto been applied almost exclusively to new forms of flu, such as H1N1 in 2009 or Spanish flu in 1918, where the lack of population immunity and absence of a vaccine or effective treatments makes the outbreak potentially much more deadly than seasonal flu (which, although global, is not considered a pandemic).

For COVID-19, WHO seemed reluctant to declare a pandemic despite the evidence of global spread. Partly this was because of its influenza origins — WHO’s emergency programme executive director said on March 9 that ‘if this was influenza, we would have called a pandemic ages ago’.

He also expressed concern that the word traditionally meant moving — once there was widespread transmission — from trying to contain the disease by testing, isolating the sick and tracing and quarantining their contacts, to a mitigation approach, implying ‘the disease will spread uncontrolled’.

WHO’s worry was that the world’s reaction to the word pandemic might be there was now nothing to be done to stop its spread, and so countries would effectively give up trying. WHO wanted to send the message that, unlike flu, it could still be pushed back and the spread slowed down.

In announcing the pandemic two days later, WHO’s director-general Dr Tedros Adhanom Ghebreyesus reemphasised this point: ‘We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic’ and that WHO was deeply concerned ‘by the alarming levels of inaction’.

The evidence suggests that the correct message did in fact get through. On March 13, US president Donald Trump declared a national emergency, referring in passing to WHO’s announcement. On March 12, the UK launched its own strategy to combat the disease. And in the week following WHO’s announcements, at least 16 other countries announced lockdowns of varying rigour including Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Hungary, Netherlands, Norway, Poland, Portugal, Serbia, Spain and Switzerland. Italy and Greece had both already instituted lockdowns prior to the WHO pandemic announcement.

It is not possible to say for sure that WHO’s announcement precipitated these measures because, by then, the evidence of the rapid spread was all around for governments to see. It may be that Italy’s dramatic nationwide lockdown on March 9 reverberated around European capitals and elsewhere.

But it is difficult to believe the announcement did not have an effect in stimulating government actions, as was intended by Dr Tedros. Considering the speed with which the virus was spreading from late February, might an earlier pandemic announcement by WHO have stimulated earlier aggressive actions by governments?

Declaring a global health emergency — when appropriate — is a key part of WHO’s role in administering the International Health Regulations (IHR). Significantly, negotiations on revisions to the IHR, which had been ongoing in a desultory fashion in WHO since 1995, were accelerated by the experience of the first serious coronavirus outbreak — SARS — in 2002-2003, leading to their final agreement in 2005.

Under the IHR, WHO’s director-general decides whether to declare an emergency based on a set of criteria and on the advice of an emergency committee. IHR defines an emergency as an ‘extraordinary event that constitutes a public health risk through the international spread of disease and potentially requires a coordinated international response’.

In the case of COVID-19, the committee first met on January 22-23 but were unable to reach consensus on a declaration. Following the director-general’s trip to meet President Xi Jinping in Beijing, the committee reconvened on January 30 and this time advised declaring a PHEIC.

But admittedly, public recognition of what a PHEIC means is extremely low. Only six have ever been declared, with the first being the H1N1 flu outbreak which fizzled out quickly, despite possibly causing 280,000 deaths globally. During the H1N1 outbreak, WHO declared a PHEIC in April 2009 and then a pandemic in June, only to rescind both in August as the outbreak was judged to have transitioned to behave like a seasonal flu.

WHO was criticized afterwards for prematurely declaring a PHEIC and overreacting. This then may have impacted the delay in declaring the Ebola outbreak in West Africa as a PHEIC in 2014, long after it became a major crisis. WHO’s former legal counsel has suggested the PHEIC — and other aspects of the IHR framework — may not be effective in stimulating appropriate actions by governments and needs to be reconsidered.

When the time is right to evaluate lessons about the response, it might be appropriate to consider the relative effectiveness of the PHEIC and pandemic announcements and their optimal timing in stimulating appropriate action by governments. The effectiveness of lockdowns in reducing the overall death toll also needs investigation.




public health

CBD News: The World Public Health Nutrition Association (WPHNA) has been declared a Biodiversity Champion by the Executive Secretary of the Convention on Biological Diversity (CBD) in recognition of its important contribution to the implementation of th




public health

CBD News: Montreal/Kolkata, 13 February 2015 - A ground-breaking report on biodiversity and health, launched today at the 14th World Congress on Public Health, in Kolkata, India, shows the significant contribution of biodiversity and ecosystem services t




public health

Public health training in climate change: What are prospective employers thinking?

(Columbia University's Mailman School of Public Health) Researchers found that 92 percent of employers who responded to a survey on climate change and public health reported need for public health professionals with training in climate change will very likely increase in the next 5 to 10 years. While graduates of public health programs who focus on climate change are in demand in the current job market, these positions appear to be just a small proportion of the total number of jobs available in public health.




public health

Coronavirus: Public Health Emergency or Pandemic – Does Timing Matter?

1 May 2020

Dr Charles Clift

Senior Consulting Fellow, Global Health Programme
The World Health Organization (WHO) has been criticized for delaying its announcements of a public health emergency and a pandemic for COVID-19. But could earlier action have influenced the course of events?

2020-05-01-Tedros-WHO-COVID

WHO director-general Dr Tedros Adhanom Ghebreyesus at the COVID-19 press briefing on March 11, 2020, the day the coronavirus outbreak was classed as a pandemic. Photo by FABRICE COFFRINI/AFP via Getty Images.

The World Health Organization (WHO) declared the spread of COVID-19 to be a Public Health Emergency of International Concern (PHEIC) on January 30 this year and then characterized it as a pandemic on March 11.

Declaring a PHEIC is the highest level of alert that WHO is obliged to declare, and is meant to send a powerful signal to countries of the need for urgent action to combat the spread of the disease, mobilize resources to help low- and middle-income countries in this effort and fund research and development on needed treatments, vaccines and diagnostics. It also obligates countries to share information with WHO.

Once the PHEIC was declared, the virus continued to spread globally, and WHO began to be asked why it had not yet declared the disease a pandemic. But there is no widely accepted definition of a pandemic, generally it is just considered an epidemic which affects many countries globally.

Potentially more deadly

The term has hitherto been applied almost exclusively to new forms of flu, such as H1N1 in 2009 or Spanish flu in 1918, where the lack of population immunity and absence of a vaccine or effective treatments makes the outbreak potentially much more deadly than seasonal flu (which, although global, is not considered a pandemic).

For COVID-19, WHO seemed reluctant to declare a pandemic despite the evidence of global spread. Partly this was because of its influenza origins — WHO’s emergency programme executive director said on March 9 that ‘if this was influenza, we would have called a pandemic ages ago’.

He also expressed concern that the word traditionally meant moving — once there was widespread transmission — from trying to contain the disease by testing, isolating the sick and tracing and quarantining their contacts, to a mitigation approach, implying ‘the disease will spread uncontrolled’.

WHO’s worry was that the world’s reaction to the word pandemic might be there was now nothing to be done to stop its spread, and so countries would effectively give up trying. WHO wanted to send the message that, unlike flu, it could still be pushed back and the spread slowed down.

In announcing the pandemic two days later, WHO’s director-general Dr Tedros Adhanom Ghebreyesus reemphasised this point: ‘We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic’ and that WHO was deeply concerned ‘by the alarming levels of inaction’.

The evidence suggests that the correct message did in fact get through. On March 13, US president Donald Trump declared a national emergency, referring in passing to WHO’s announcement. On March 12, the UK launched its own strategy to combat the disease. And in the week following WHO’s announcements, at least 16 other countries announced lockdowns of varying rigour including Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Hungary, Netherlands, Norway, Poland, Portugal, Serbia, Spain and Switzerland. Italy and Greece had both already instituted lockdowns prior to the WHO pandemic announcement.

It is not possible to say for sure that WHO’s announcement precipitated these measures because, by then, the evidence of the rapid spread was all around for governments to see. It may be that Italy’s dramatic nationwide lockdown on March 9 reverberated around European capitals and elsewhere.

But it is difficult to believe the announcement did not have an effect in stimulating government actions, as was intended by Dr Tedros. Considering the speed with which the virus was spreading from late February, might an earlier pandemic announcement by WHO have stimulated earlier aggressive actions by governments?

Declaring a global health emergency — when appropriate — is a key part of WHO’s role in administering the International Health Regulations (IHR). Significantly, negotiations on revisions to the IHR, which had been ongoing in a desultory fashion in WHO since 1995, were accelerated by the experience of the first serious coronavirus outbreak — SARS — in 2002-2003, leading to their final agreement in 2005.

Under the IHR, WHO’s director-general decides whether to declare an emergency based on a set of criteria and on the advice of an emergency committee. IHR defines an emergency as an ‘extraordinary event that constitutes a public health risk through the international spread of disease and potentially requires a coordinated international response’.

In the case of COVID-19, the committee first met on January 22-23 but were unable to reach consensus on a declaration. Following the director-general’s trip to meet President Xi Jinping in Beijing, the committee reconvened on January 30 and this time advised declaring a PHEIC.

But admittedly, public recognition of what a PHEIC means is extremely low. Only six have ever been declared, with the first being the H1N1 flu outbreak which fizzled out quickly, despite possibly causing 280,000 deaths globally. During the H1N1 outbreak, WHO declared a PHEIC in April 2009 and then a pandemic in June, only to rescind both in August as the outbreak was judged to have transitioned to behave like a seasonal flu.

WHO was criticized afterwards for prematurely declaring a PHEIC and overreacting. This then may have impacted the delay in declaring the Ebola outbreak in West Africa as a PHEIC in 2014, long after it became a major crisis. WHO’s former legal counsel has suggested the PHEIC — and other aspects of the IHR framework — may not be effective in stimulating appropriate actions by governments and needs to be reconsidered.

When the time is right to evaluate lessons about the response, it might be appropriate to consider the relative effectiveness of the PHEIC and pandemic announcements and their optimal timing in stimulating appropriate action by governments. The effectiveness of lockdowns in reducing the overall death toll also needs investigation.




public health

Vaping deaths - does this change what we think about public health messages

This week the Trump administration has banned the sale of flavoured vapes in the USA. The reason for that is the sudden rash of cases of pulmonary disease, including deaths, linked to vaping. The mechanism by which vaping may be causing damage to the lungs is as yet unclear, and our understanding is hampered by the heterogeneous nature of the...




public health

The public health response to covid - 19

As part of our response to the covid-19 pandemic, we’re going to be running a series of discussions with experts about some of the big issues arising from the virus. In this one, we’re asking about the public health response to an outbreak - what’s necessary, and is it possible to go to far. Joining us are Martin Mckee - professor of european...




public health

Public Health Vs The Economy

Around the world, as the covid pandemic plays out, and some countries are starting to ease their restrictions, this narrative of the economy and public health being opposing weights on a set of scales keeps returning - they need to be balanced. But before this, a healthy population is very much seen as being supportive of the economy. So is a...




public health

Public health leaders slam Boris Johnson over “sin tax” review plan




public health

Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: population based retrospective cohort study




public health

Undiagnosed NIDDM: Clinical and Public Health Issues

Maureen I Harris
Apr 1, 1993; 16:642-652
Kelly West Lecture 1992




public health

Journal of Public Health Dentistry study finds association between man-made chemical, childhood caries

Circulating levels of perfluorodecanoic acid, a type of perfluoroalkyl acid, may be associated with dental caries in children, according to a study published in the fall 2019 issue of the Journal of Public Health Dentistry.




public health

American Institute of Dental Public Health mentors next generation of service-oriented dentists

Dr. David P. Cappelli, Ph.D., acknowledges that as providers, we don’t often understand difficulties that some patients face to receive needed dental care.




public health

Clinical and Public Health Implications of 2019 Endocrine Society Guidelines for Diagnosis of Diabetes in Older Adults

OBJECTIVE

Screening for diabetes is typically done using hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA1c or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample.

RESEARCH DESIGN AND METHODS

We included 2,236 adults aged ≥65 years without known diabetes from the 2005–2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA1c ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA1c 5.7–6.4% or FPG 100–125 mg/dL); and 2) a standard approach (HbA1c ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA1c cut points (≥7 to ≥9%). OGTT screening costs were estimated using Medicare fee schedules.

RESULTS

Diabetes prevalence was 15.7% (~5.0 million) using the Endocrine Society’s approach and 7.3% (~2.3 million) using the standard approach. Treatment eligibility ranged from 5.4 to 0.06% and 11.8–1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA11c <6.5% and would not be recommended for glucose-lowering treatment. Screening all older adults with prediabetic HbA1c/FPG (~18.3 million) with OGTT could cost between $737 million and $1.7 billion.

CONCLUSIONS

Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits.




public health

Migration &amp; Coronavirus: A Complicated Nexus Between Migration Management and Public Health

This webinar, organized by MPI and the Zolberg Institute on Migration and Mobility at The New School, discussed the state of play around the globe surrounding COVID-19 and examined where migration management and enforcement tools may be useful and where they may be ill-suited to advancing public health goals. 




public health

Migration &amp; Coronavirus: A Complicated Nexus Between Migration Management and Public Health

This webinar, organized by MPI and the Zolberg Institute on Migration and Mobility at The New School, discussed migration policy responses around the globe in response to the COVID-19 pandemic, and examined where migration management and enforcement tools may be useful and where they may be ill-suited to advancing public health goals. 




public health

A digest of the law of Scotland relating to the poor, the public health, and other matters managed by parochial boards / by John Guthrie Smith.

Edinburgh : T. & T. Clark, 1878.




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Mosquitoes, communities, and public health in Texas

9780128145463 (electronic bk.)




public health

Agri-food industry strategies for healthy diets and sustainability : new challenges in nutrition and public health

9780128172261