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The Health Systems Response Monitor (HSRM) was established in March 2020 at the beginning of the COVID-19 pandemic to collect and organize up-to-date information on how 50 countries in the WHO European Region and Canada are responding to the crisis. The HSRM uses a structured template, focusing primarily on the responses of health systems but also capturing wider public health initiatives. The HSRM is a joint undertaking of the WHO Regional Office for Europe, the European Observatory on Health Systems and Policies, and the European Commission. The HSRM builds on the Health Systems and Policy Network of the European Observatory, which brings together an international group of high-profile institutions from Europe and beyond with high academic standing in health systems and policy analysis. The content collected on the HSRM platform has been used to enhance cross country learnings through topical snapshots, papers, webinars and more. At the end of 2020, the European Observatory initiated a Health Policy Special Issue (SI) based on the work of the HSRM containing both thematic policy papers and full comparative descriptions and analysis of country responses. Overall, work from the HSRM aims to provide coherent and comprehensive insight on lessons learned from the COVID-19 response so far to support policymakers for future waves or in case of future pandemics. This workshop aims to provide the audience with an overview of the COVID-19 HSRM and the insights gleaned from the SI. An introductory overview will briefly introduce the COVID-19 HSRM and the SI. The first presentation will compare provider payment adjustments across 20 countries. The second presentation will focus on how countries planned services for potential surge capacity, managed care provision, and maintained routine services in both hospital and outpatient settings during the first wave of the pandemic. The third presentation will zoom in on experiences in primary health care. The last presentation will feature one of the country comparison papers from social health insurance countries. The workshop will conclude with an audience discussion about the lessons learned from the COVID-19 HSRM, and future opportunities for research using the HSRM. Key messages: The COVID-19 Health System Response Monitor has tracked the progression of health policies throughout the pandemic and captures particularly policy relevant aspects. Both thematic and cross-country comparisons can illuminate how health systems have responded to the COVID-19 pandemic and provide lessons for future waves and pandemics. [ABSTRACT FROM AUTHOR]

Background: High rates of vaccination are worldwide required to establish a herd immunity stopping the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. Methods: A systematic literature search was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Multiple databases were searched, namely PubMed and Web of Science, on February 24th, 2021 using a set of developed keywords. Inclusion criteria included the study to be 1) conducted in English; 2) investigated attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; 3) utilized validated measurements techniques; 4) have the full text paper available and 5) be peer-reviewed prior to final publication. The Newcastle Ottawa (NOS) scale for cross sectional studies was used to assess the quality of the studies. Results: 73 studies were included in qualitative synthesis. Overall, vaccine acceptance rates ranged from 23.6% in Kuwait to 94.3% in Malaysia and Nepal. A variety of different factors contributed to increased hesitancy, some of which included having negative perception of vaccine efficacy, safety, convenience and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, less educated, with lower income, with no insurance, living in the rural area and self-identified as a racial/ethnic minority. Conclusions: Vaccine hesitancy rates against COVID-19 vaccine ranged widely among across different populations. Identifying the factors that interplay and result in high hesitancy rates among a population can allow formulating a directed intervention to increase their vaccination uptake rates. Key messages: • It is necessary to understand the factors that contribute to the COVID-19 vaccine hesitancy. • It is important to inform policy-makers and formulate direct intervention measures that will successfully handle the pandemic. [ABSTRACT FROM AUTHOR]

Background In 2019, WHO classified vaccine hesitancy as one of the top 10 threats to global health. Vaccination is an area of excellence in nursing that has gained a new focus and has become a challenge in the provision of care and in the management field. Vaccine hesitation raises questions about mandatory vaccination, individual versus collective freedom that are highlighted in the current context due to the emergence of new vaccines. In this paper, we want to analyze and update knowledge about vaccines hesitancy from an ethical and bioethical perspective. Methods A combination of literature reviews on vaccine refusal/hesitancy, ethics and COVID-19 vaccine confidence, accessed on SciELO and PubMed databases and analysis of documents from General Directorate of Health and Ordem dos Enfermeiros (National Nurses Association). Results Vaccination programs aim is a collective protection. The desirable effects at individual level do not have the same ethical value at collective level, leading to cost-benefit imbalances. Moral conflicts between the individual and the collective, cost-benefit imbalances and the insufficiency of bioethics principles, lead us to the use of other moral values and principles, such as responsibility, solidarity and social justice, as a tool for ethical reflection problems related to COVID-19 vaccines. Conclusions There are no perfect solutions to ethical dilemmas and some optimal solutions could depend the context. In a pandemic situation, one of the most relevant ethical issues is the herd immunity since it leaves public health at risk. Equity and the principle of justice in vaccination campaign are shown daily in the nursing profession. [ABSTRACT FROM AUTHOR]

Background: This evidence summary synthesised the evidence relating to pharmacological and non-pharmacological interventions in the community to prevent COVID-19/progression to severe disease. An additional aim was to identify potentially modifiable lifestyle factors associated with reduced risk of infection/progression to severe disease. Methods: A systematic search of published peer-reviewed articles and non-peer-reviewed pre-prints was undertaken from 1 January 2020 to 19 April 2021; no language restrictions were applied. All potentially eligible papers were exported to Covidence. Titles/abstracts and full texts were single screened for relevance. Data extraction and quality appraisal of included studies was completed by a single reviewer and checked by a second. Results: In total, 50 studies, three randomised controlled trials (RCTs), one non-RCT and 46 cohort studies were included. The four included controlled trials tested variations of the pharmacological intervention, ivermectin. While these controlled trials reported a protective effect for ivermectin use, these trials were of poor quality and had serious risk of bias. Across 46 cohort studies, the modifiable lifestyle risk factors identified were obesity, smoking, vitamin D status, physical activity, alcohol consumption and processed meat consumption. These studies reported mixed results in terms of the association between modifiable lifestyle risk factors and poor COVID-19 outcomes. Conclusions: At the time of writing there is no high quality evidence of benefit to support pharmacological interventions to prevent COVID-19. Although there were mixed results for the risk factors identified, maintenance of healthy weight, smoking cessation, engaging in physical activity and moderation of alcohol and processed meat consumption are likely to be beneficial to health and should continue to be encouraged. [ABSTRACT FROM AUTHOR]