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Mathematical modelling of (re)emerging infectious respiratory diseases among humans poses multiple challenges for modellers, which can arise as a result of limited data and surveillance, uncertainty in the natural history of the disease, as well as public health and individual responses to outbreaks. Here, we propose a COVID-19-inspired health state diagram (HSD) to serve as a foundational framework for conceptualising the modelling process for (re)emerging respiratory diseases, and public health responses, in the early stages of their emergence. The HSD aims to serve as a starting point for reflection on the structure and parameterisation of a transmission model to assess the impact of the (re)emerging disease and the capacity of public health interventions to control transmission. We also explore the adaptability of the HSD to different (re)emerging diseases using the characteristics of three respiratory diseases of historical public health importance. We outline key questions to contemplate when applying and adapting this HSD to (re)emerging infectious diseases and provide reflections on adapting the framework for public health-related interventions. [ABSTRACT FROM AUTHOR]

The Africa Centers for Disease Control and Prevention declared mpox a Public Health Emergency of Continental Security (PHECS) in Africa. African public health systems have moved to mobilize a response against a backdrop of inherent significant challenges. With this commentary, we discuss how lessons from past public health emergencies, particularly COVID-19 and Ebola outbreaks, have prepared the region for improved disease surveillance, rapid response strategies, and effective public health communication and how these lessons can be applied to the mpox response, emphasizing the importance of strong healthcare infrastructure, effective data sharing, community engagement, targeted interventions, and robust contact tracing. Additionally, addressing misinformation and building public trust are crucial for controlling the spread of any disease. By leveraging these strategies, African countries can enhance their response to mpox. This includes improving diagnostic capabilities, strengthening cross-border collaborations, and prioritizing vaccination campaigns where needed. Ultimately, by applying the hard-earned lessons from the COVID-19 pandemic and Ebola outbreak, the East Africa region can better address the challenges posed by mpox and safeguard public health. [ABSTRACT FROM AUTHOR]

In recent years, the world has witnessed the emergence and rapid spread of socially dangerous diseases, highlighting the critical need for robust ethical and legal frameworks within national biosecurity systems. This article discusses the ethical considerations and legal aspects surrounding the prevention and control of these diseases in order to devise effective strategies for their containment and mitigation. Drawing on a comprehensive review of literature, this study explores how societal norms, individual rights, and public health imperatives intersect within the context of biosecurity measures. It underscores the significance of ethical considerations to ensure fair and equitable access to preventive measures, diagnostics, treatments, and vaccines. Additionally, legal frameworks play a pivotal role in enabling the implementation of necessary interventions during disease outbreaks, such as quarantine measures, contact tracing, and the establishment of efficient surveillance systems. This study analyzes the national biological security measures in Azerbaijan and compares them to other countries to identify strategies for preserving and controlling the transmission of public health threats. The research aims to provide insights into the effectiveness of Azerbaijan's current biological security policies and highlight areas for improvement. The study includes a comprehensive review of relevant literature on biosecurity measures of Azerbaijan. The findings of this study will contribute to the global understanding of biological security practices and inform recommendations for enhancing Azerbaijan's preparedness in managing public health threats. Finally, the article emphasizes the need for international cooperation and harmonization of ethical and legal standards in addressing the global spread of socially dangerous diseases. It highlights the significance of sharing best practices and lessons learned to strengthen preparedness and response capacities across nations, facilitating a more coordinated and effective approach to prevent and control disease outbreaks. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) crisis has brought many appropriate changes in the behavior of the people in India. It posed deleterious effects on nearly every industry and business sector and pharmaceutical industry is no exception. Medical representatives were facing challenges in contacting health-care providers and other concerned individuals for sales efforts during the pandemic affecting their work behaviors and outputs. Therefore, it is highly important that MRs have adequate knowledge about the COVID-19 appropriate behaviors (CABs). Aims and Objectives: The objective of our study was to assess the perception of COVID-19 appropriate behaviors (CAB), among medical representatives. Materials and Methods: The study was conducted during lockdown for a period of 3 months from May to July 2021. After obtaining Institutional approval using the CAB, published by the Ministry of Health and Family Welfare, a questionnaire was designed and along with the consent form was sent to Medical Representatives to collect the information on CAB. Data from all consented voluntary participants using self-administered Google forms were collected. The data collected were reversibly coded and confidentiality of participants was maintained. Results: A total of 88 number of medical representatives (n = 88) participated in the study. Of these, 96.50% were males and all were <50 years. Graduated participants constituted 96.6% (n = 85). Only 67.10% perceived it as a serious disease. Greeting without physical contact was practiced by 57 (64.7%), Namaste, by 56 (63.3%). Avoiding touching hands, nose, and mouth was considered very important by 68.9%. Covering nose and mouth when you cough or sneeze with handkerchief was considered important for 96.6%. Avoiding touching eyes, nose, and mouth was considered "not important at all" and slightly important by 2.2% and 5.6%, respectively. Discourage and avoiding crowd was thought as not important at all by 3.4% and slightly important by 2.3%. Conclusion: The medical representatives are well informed about COVID-19 disease and it is spread but only 2/3rd of the participants regarded COVID-19 as a serious condition and practiced various CABs to prevent infection spread. They considered national news and doctors as the main source of information. [ABSTRACT FROM AUTHOR]

Abstract Mathematical modelling of (re)emerging infectious respiratory diseases among humans poses multiple challenges for modellers, which can arise as a result of limited data and surveillance, uncertainty in the natural history of the disease, as well as public health and individual responses to outbreaks. Here, we propose a COVID-19-inspired health state diagram (HSD) to serve as a foundational framework for conceptualising the modelling process for (re)emerging respiratory diseases, and public health responses, in the early stages of their emergence. The HSD aims to serve as a starting point for reflection on the structure and parameterisation of a transmission model to assess the impact of the (re)emerging disease and the capacity of public health interventions to control transmission. We also explore the adaptability of the HSD to different (re)emerging diseases using the characteristics of three respiratory diseases of historical public health importance. We outline key questions to contemplate when applying and adapting this HSD to (re)emerging infectious diseases and provide reflections on adapting the framework for public health-related interventions.

Introduction: The difference between an epidemic and a pandemic is not the severity of the disease, but the degree of its spread. Pandemics, unlike epidemics, cut across international borders. In this article, the moral challenges of societies during the occurrence of pandemic diseases (such as Covid-19, Sars, etc.) have been investigated. Material and Methods: Conceptual analysis method is used in this article. Related keywords were used in the search of materials and 44 articles were collected from Sciencedirect, Pubmed, Proquest and Elsevier databases and their examples were used according to the purpose. Conclusion: In this study, ethical challenges are divided into three categories: challenges related to sharing facilities, challenges related to providing or not providing medical services, and the challenge of how to react when faced with a controversial and possibly unethical situation. Then these challenges were examined from the perspective of ethical theories. The result of the analysis indicated that the philosophies of utilitarianism, virtuism, and truth-orientedness are not suitable for reasoning, justifying, and acting in difficult situations during pandemics. The philosophy of Justicialism, deontologism, and truth-orientedness are better, and with the help of a combination of the three mentioned theories, a model can be presented for three types of difficult situations in pandemic diseases.

To prevent the transmission of fatal pathogenic microorganisms, a comprehensive strategy is needed that includes public health interventions and research projects. An effective approach is to improve surveillance systems in order to rapidly identify and address epidemics, enabling swift isolation and treatment of sick persons. In addition, practices such as regular handwashing and adherence to established food safety regulations can aid in minimizing the transfer of harmful microorganisms. Research endeavors should prioritize the development of novel vaccines and antimicrobial therapies to counteract the emergence of new infections. Moreover, the implementation of stringent infection control measures in healthcare settings can effectively prevent nosocomial infections and restrict the transmission of these lethal microorganisms. Through the integration of proactive public health actions and state-of-the-art research developments, we can successfully avert the spread of fatal pathogens and safeguard global health security. [ABSTRACT FROM AUTHOR]

The purpose of the study was to analyse the quality of vaccination among the population and to evaluate strategies that contribute to reducing the prevalence of infectious diseases, the number of complications, and the severity of disease. The study also examined pathogens that pose a global threat to the population, which have high risks of outbreaks due to global changes in climatic conditions. The development of vaccines capable of preventing or eliminating an infectious disease, reducing the severity of the disease and the rate of hospitalisation has been studied. In addition, the issue of the causes of low vaccination coverage in Kyrgyzstan, Albania, Bulgaria, and Latvia has been investigated. It was found that diseases that have a geographical distribution in certain climatic zones have a risk of zone expansion due to global climate warming and changes in the habitat of the pathogen or its vectors to other regions. Global health systems are constantly working to create new vaccines and modernise old ones. Despite this, there are many reasons why vaccination coverage is not reaching the target values. These reasons include the availability of vaccines to the public, the level of knowledge of medical personnel and the trust of doctors in vaccination, the level of education of the population and the availability of information about the vaccine, commitment to vaccination in patients, and trust in international medical health systems. This means that low vaccination coverage can lead to a decrease in collective immunity, the occurrence of outbreaks of infectious diseases, and an increase in the burden on the health care system. Therefore, the main strategy for immunisation of the population is to eliminate the causes of low vaccination coverage, take measures to inform the population about vaccines, and increase people's confidence in health systems. [ABSTRACT FROM AUTHOR]

The evolutionary dynamics of viruses, particularly exemplified by SARS-CoV-2 during the ongoing COVID-19 pandemic, underscore the intricate interplay between genetics, host adaptation, and viral spread. This paper delves into the genetic evolution of SARS-CoV-2, emphasizing the implications of viral variants on global health. Initially emerging from the Wuhan-Hu-1 lineage, SARS-CoV-2 rapidly diversified into numerous variants, each characterized by distinct mutations in the spike protein and other genomic regions. Notable variants such as B.1.1.7 (α), B.1.351 (β), P.1 (γ), B.1.617.2 (δ), and the Omicron variant have garnered significant attention due to their heightened transmissibility and immune evasion capabilities. In particular, the Omicron variant has presented a myriad of subvariants, raising concerns about its potential impact on public health. Despite the emergence of numerous variants, the vast majority have exhibited limited expansion capabilities and have not posed significant threats akin to early pandemic strains. Continued genomic surveillance is imperative to identify emerging variants of concern promptly. While genetic adaptation is intrinsic to viral evolution, effective public health responses must be grounded in empirical evidence to navigate the evolving landscape of the pandemic with resilience and precision.

Introduction: The COVID-19 pandemic had devastating effects on health systems globally. Emerging infectious diseases and pandemics will persist as a global health threat and preparedness for an evidence based response becomes challenging for decision makers. Epidemiological modeling can and has supported decision-making throughout pandemics. This study provides an update of the review “Publicly available software tools for decision-makers during an emergent epidemic—Systematic evaluation of utility and usability”1. Research question: What epidemiological modeling tools for decision-makers are open-sourced available for the usage in emerging epidemics or pandemics and how useful and user-friendly are these tools? Methods: A scoping review was conducted. We identified relevant studies through a search of peer-reviewed (Medline Ovid, Embase Ovid, PubMed, Cochrane) and gray literature databases, search engines such as Google, searches through stakeholder websites as well as expert consultations. Results: Of the 66 identified epidemiological modeling tools, 29 were included and qualitatively assessed using five-point-rating scales. The tools showed a good baseline of user-friendliness with variations in assessed components, features and utility. Room for improvement was found, specifically the capability to incorporate external data sources, detailed population descriptions, and geographic resolution. Discussion: Development efforts should prioritize clear communication of uncertainties and expert review processes. Trainings for specific tools should be considered. Conclusion: Tool usage can enhance decision-making when adapted to the user's needs and purpose. They should be consulted critically rather than followed blindly.

Background: This paper discusses the critical importance of epidemic preparedness and innovations in digital health care by examining the transformative impact on speech-language pathology (SLP) services in a specialist outpatient child and adolescent service (CAMHS). Method: This retrospective review analyzes referral data from three periods: pre-pandemic (15 March 2019–14 March 2020), pandemic (15 March 2020–14 March 2021), and post-pandemic (15 March 2021–14 March 2022). Statistical analyses assess trends in referrals and diagnoses during these periods. Feedback was also obtained from Parents of children who received virtual consultations during the pandemic. Results: The results reveal an increase in the demand for SLP services during and after the pandemic, with a surge in referrals (increased from 9.7 to 12.9% when compared pre-pandemic to post-pandemic periods; Chi-Square value 3.33, P = 0.068) for children with social communication challenges and autism spectrum disorder. Phone and video consultations were effectively adopted. Feedback from families shows a positive response (69%–98% of participants responded as strongly agreed and agreed on various items listed in feedback form specifically designed in line with the service objectives) to telehealth interventions, with many parents finding virtual consultations effective and helpful. Conclusions: The study emphasizes the importance of telehealth SLP services in meeting the increasing demand for mental health interventions among children and adolescents. It suggests integrating telehealth into clinical practice beyond the pandemic and highlights the need for long-term evaluation and addressing potential barriers to access. [ABSTRACT FROM AUTHOR]

Social media (SM) based surveillance systems, combined with machine learning (ML) and deep learning (DL) techniques, have shown potential for early detection of epidemic outbreaks. This review discusses the current state of SM-based surveillance methods for early epidemic outbreaks and the role of ML and DL in enhancing their performance. Since, every year, a large amount of data related to epidemic outbreaks, particularly Twitter data is generated by SM. This paper outlines the theme of SM analysis for tracking health-related issues and detecting epidemic outbreaks in SM, along with the ML and DL techniques that have been configured for the detection of epidemic outbreaks. DL has emerged as a promising ML technique that adapts multiple layers of representations or features of the data and yields state-of-the-art extrapolation results. In recent years, along with the success of ML and DL in many other application domains, both ML and DL are also popularly used in SM analysis. This paper aims to provide an overview of epidemic outbreaks in SM and then outlines a comprehensive analysis of ML and DL approaches and their existing applications in SM analysis. Finally, this review serves the purpose of offering suggestions, ideas, and proposals, along with highlighting the ongoing challenges in the field of early outbreak detection that still need to be addressed. [ABSTRACT FROM AUTHOR]

The evolutionary dynamics of viruses, particularly exemplified by SARS-CoV-2 during the ongoing COVID-19 pandemic, underscore the intricate interplay between genetics, host adaptation, and viral spread. This paper delves into the genetic evolution of SARS-CoV-2, emphasizing the implications of viral variants on global health. Initially emerging from the Wuhan-Hu-1 lineage, SARS-CoV-2 rapidly diversified into numerous variants, each characterized by distinct mutations in the spike protein and other genomic regions. Notable variants such as B.1.1.7 (α), B.1.351 (β), P.1 (γ), B.1.617.2 (δ), and the Omicron variant have garnered significant attention due to their heightened transmissibility and immune evasion capabilities. In particular, the Omicron variant has presented a myriad of subvariants, raising concerns about its potential impact on public health. Despite the emergence of numerous variants, the vast majority have exhibited limited expansion capabilities and have not posed significant threats akin to early pandemic strains. Continued genomic surveillance is imperative to identify emerging variants of concern promptly. While genetic adaptation is intrinsic to viral evolution, effective public health responses must be grounded in empirical evidence to navigate the evolving landscape of the pandemic with resilience and precision. [ABSTRACT FROM AUTHOR]

• Machine learning and artificial intelligence can harness copious open-source data. • This can be utilised to generate valid early warning signals of emerging epidemics. • Signals can trigger earlier outbreak investigation, control and vaccine development. • AI and ML will likely enhance rather than replace traditional surveillance. • We describe the EPIWATCH system as an example of an open-source intelligence system. Vast quantities of open-source data from news reports, social media and other sources can be harnessed using artificial intelligence and machine learning, and utilised to generate valid early warning signals of emerging epidemics. Early warning signals from open-source data are not a replacement for traditional, validated disease surveillance, but provide a trigger for earlier investigation and diagnostics. This may yield earlier pathogen characterisation and genomic data, which can enable earlier vaccine development or deployment of vaccines. Early warning also provides a more feasible prospect of stamping out epidemics before they spread. There are several of such systems currently, but they are not used widely in public health practice, and only some are publicly available. Routine and widespread use of open-source intelligence, as well as training and capacity building in digital surveillance, will improve pandemic preparedness and early response capability. [ABSTRACT FROM AUTHOR]

Increased dependency on the forest has resulted in rapid transformation of forest landscapes; this has been identified in the extensive literature as a significant mechanism for the spread of several zoonotic diseases, including the Ebola and COVID-19 viruses. Empirical evidence suggests the need for active management of forest resource access as a holistic path towards curbing spillovers, placing forest management institutions at the epicentre of regulating forest resource use and preventing zoonotic spillovers. Yet, there is scant evidence on the pattern of institutional change in the context of health shocks in many parts of sub-Saharan Africa. This validates the need for context-specific evidence on the perceptions of forest users regarding the triggers of spillovers around forest-based communities and how forest management institutions respond to such shocks. As a contribution, we draw on descriptive statistics and narratives to: (a) analyze the perceptions of forest users regarding the triggers of covariate health-related stocks such as Ebola and COVID-19, (b) characterize forest-related institutional influence on forest management and (c) compare institutional response approaches towards the Ebola virus disease and the COVID-19 pandemic. The study employed a random sampling of 135 households, focus group discussions (n = 4), and expert interviews (n = 8) to generate relevant empirical data. The findings indicate that forest users identify the consumption of bushmeat and human-wildlife contact as the primary triggers of Ebola and COVID-19. Also, the COVID-19 and Ebola virus induced forest management institutional response, which assumed similar patterns. However, the degree of change largely depended on the scale and impact of the shock; COVID-19 induced more institutional responses than Ebola. The study establishes uniformity in the pattern of forest management institutional response to health shocks, providing relevant policy insights for forest settings during health shock events.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a viral pathogen that quickly became a global pandemic in the winter of 2020-2021. In response, governments issued social distancing orders to minimize transmission by reducing community contacts. We tested the efficacy of this social distancing at the state level during the first 2 months of the pandemic in the United States. We utilized data on daily SARS-CoV-2 case numbers and human community mobility (anonymized, aggregated cell phone location data stratified into six categories used as an index of social distancing), the date of government-issued social distancing orders, demographics, urbanization and public transportation. We implemented cross-correlation to identify lag times between declines in mobility and SARS-CoV-2 cases. Incorporating state-specific lag times, we tested for associations between case counts and mobility metrics using Bayesian multilevel models. Decreased mobility around grocery stores/pharmacies, retail/recreation locations, transit stations and workplaces was correlated with decreases in SARS-CoV-2 cases with significant lag times of ≥21 days. Social distancing orders were associated with fewer cumulative SARS-CoV-2 cases when they were put in place earlier. Community mobility had already started declining prior to most social distancing orders, especially the more restrictive orders implemented later in the pandemic. Social distancing is an important tool that has been implemented throughout the pandemic to decrease SARS-CoV-2 transmission, although with significant social and economic impacts. Our results suggest that declines in cases were observed several weeks subsequent to implementation of social distancing measures, and that implementing social distancing earlier could potentially minimize the duration of time these policies need to be in effect. Our findings can inform ongoing management of this pandemic and other emerging infectious disease outbreaks by identifying areas where reductions in mobility are associated with reduced disease transmission, and the expected time frame between behavioural changes and measurable population outcomes.

Abstract Background Recent pandemics have had far-reaching effects on the world’s largest economies and amplified the need to estimate the full extent and range of socioeconomic impacts of infectious diseases outbreaks on multi-sectoral industries. This systematic review aims to evaluate the socioeconomic impacts of airborne and droplet-borne infectious diseases outbreaks on industries. Methods A structured, systematic review was performed according to the PRISMA guidelines. Databases of PubMed, Scopus, Web of Science, IDEAS/REPEC, OSHLINE, HSELINE, and NIOSHTIC-2 were reviewed. Study quality appraisal was performed using the Table of Evidence Levels from Cincinnati Children’s Hospital Medical Center, Joanna Briggs Institute tools, Mixed Methods Appraisal Tool, and Center of Evidence Based Management case study critical appraisal checklist. Quantitative analysis was not attempted due to the heterogeneity of included studies. A qualitative synthesis of primary studies examining socioeconomic impact of airborne and droplet-borne infectious diseases outbreaks in any industry was performed and a framework based on empirical findings was conceptualized. Results A total of 55 studies conducted from 1984 to 2021 were included, reporting on 46,813,038 participants working in multiple industries across the globe. The quality of articles were good. On the whole, direct socioeconomic impacts of Coronavirus Disease 2019, influenza, influenza A (H1N1), Severe Acute Respiratory Syndrome, tuberculosis and norovirus outbreaks include increased morbidity, mortality, and health costs. This had then led to indirect impacts including social impacts such as employment crises and reduced workforce size as well as economic impacts such as demand shock, supply chain disruptions, increased supply and production cost, service and business disruptions, and financial and Gross Domestic Product loss, attributable to productivity losses from illnesses as well as national policy responses to contain the diseases. Conclusions Evidence suggests that airborne and droplet-borne infectious diseases have inflicted severe socioeconomic costs on regional and global industries. Further research is needed to better understand their long-term socioeconomic impacts to support improved industry preparedness and response capacity for outbreaks. Public and private stakeholders at local, national, and international levels must join forces to ensure informed systems and sector-specific cost-sharing strategies for optimal global health and economic security.

The Africa Centers for Disease Control and Prevention declared mpox a Public Health Emergency of Continental Security (PHECS) in Africa. African public health systems have moved to mobilize a response against a backdrop of inherent significant challenges. With this commentary, we discuss how lessons from past public health emergencies, particularly COVID-19 and Ebola outbreaks, have prepared the region for improved disease surveillance, rapid response strategies, and effective public health communication and how these lessons can be applied to the mpox response, emphasizing the importance of strong healthcare infrastructure, effective data sharing, community engagement, targeted interventions, and robust contact tracing. Additionally, addressing misinformation and building public trust are crucial for controlling the spread of any disease. By leveraging these strategies, African countries can enhance their response to mpox. This includes improving diagnostic capabilities, strengthening cross-border collaborations, and prioritizing vaccination campaigns where needed. Ultimately, by applying the hard-earned lessons from the COVID-19 pandemic and Ebola outbreak, the East Africa region can better address the challenges posed by mpox and safeguard public health.

We share the experience of research laboratories in the Eastern Mediterranean Region (EMR) that contributed to preparedness and response to highly pathogenic avian influenza (HPAI), Middle‐East respiratory syndrome coronavirus (MERS‐CoV), and coronavirus disease (COVID‐19). Research groups in the region were pivotal in identifying, characterizing the pathogens and describing their evolution, distribution, transmission routes, and the immunological profile of exposed populations. They demonstrated the capacity to develop and test antivirals and potential vaccines. The EMR experience is a model of how national systems can work with researchers to improve regional preparedness and response to future epidemics and pandemics. [ABSTRACT FROM AUTHOR]

Background: Recent pandemics have had far-reaching effects on the world's largest economies and amplified the need to estimate the full extent and range of socioeconomic impacts of infectious diseases outbreaks on multi-sectoral industries. This systematic review aims to evaluate the socioeconomic impacts of airborne and droplet-borne infectious diseases outbreaks on industries. Methods: A structured, systematic review was performed according to the PRISMA guidelines. Databases of PubMed, Scopus, Web of Science, IDEAS/REPEC, OSHLINE, HSELINE, and NIOSHTIC-2 were reviewed. Study quality appraisal was performed using the Table of Evidence Levels from Cincinnati Children's Hospital Medical Center, Joanna Briggs Institute tools, Mixed Methods Appraisal Tool, and Center of Evidence Based Management case study critical appraisal checklist. Quantitative analysis was not attempted due to the heterogeneity of included studies. A qualitative synthesis of primary studies examining socioeconomic impact of airborne and droplet-borne infectious diseases outbreaks in any industry was performed and a framework based on empirical findings was conceptualized. Results: A total of 55 studies conducted from 1984 to 2021 were included, reporting on 46,813,038 participants working in multiple industries across the globe. The quality of articles were good. On the whole, direct socioeconomic impacts of Coronavirus Disease 2019, influenza, influenza A (H1N1), Severe Acute Respiratory Syndrome, tuberculosis and norovirus outbreaks include increased morbidity, mortality, and health costs. This had then led to indirect impacts including social impacts such as employment crises and reduced workforce size as well as economic impacts such as demand shock, supply chain disruptions, increased supply and production cost, service and business disruptions, and financial and Gross Domestic Product loss, attributable to productivity losses from illnesses as well as national policy responses to contain the diseases. Conclusions: Evidence suggests that airborne and droplet-borne infectious diseases have inflicted severe socioeconomic costs on regional and global industries. Further research is needed to better understand their long-term socioeconomic impacts to support improved industry preparedness and response capacity for outbreaks. Public and private stakeholders at local, national, and international levels must join forces to ensure informed systems and sector-specific cost-sharing strategies for optimal global health and economic security. [ABSTRACT FROM AUTHOR]

In the year 2020, Hong Kong experienced four COVID-19 epidemic waves. The present study aimed to examine the transition of sleep disturbances and explore its associated factors across the later three epidemic waves. Among the 1138 respondents who participated in an online survey at the second wave (T1, April 2020), 338 and 378 participants also completed a follow-up at the third (T2, August 2020) and fourth waves (T3, December 2020), respectively. Participants completed the Insomnia Severity Index and an investigator-designed questionnaire regarding potential factors associated with sleep change such as perceived risk of being infected, economic stress, and confidence in the government and health care professional. Sample of this study were mainly female (67.7%), married (50.3%), young adults (54.2%) with tertiary education (81.6%). Maintaining normal sleep was the most prevalent trajectory of sleep of all three waves (50.5%), followed by persistent insomnia (17.2%) and remitted insomnia (9.0%). Besides female, older-age and lower education level, the results showed that increment in worry about family being infected (adjusted risk ratio, RR = 1.28), perceived interference of daily lives (adjusted RR = 1.19), and economic distress (adjusted RR = 1.24) were significantly associated with the development of clinical insomnia during the three epidemic waves. These factors were also associated with worsening of other sleep parameters. Insomnia being persistent across the three waves of COVID-19 outbreaks was common. Increasing economic distress, daily interference, and worry about family members being infected were associated with an increasing risk of clinical insomnia across the three COVID-19 outbreaks. [ABSTRACT FROM AUTHOR]

The focus of this paper is on COVID-19, the December 2019 dated respiratory epidemic or infection that has ravaged most, if not all, of the world's 253 "countries" (consisting of 194 independent nation-states, 55 dependent-states, Antarctica, and 3 other territories). Readers of this paper should be aware of at least three facts. First, as of January 2022, the submission date of this paper, COVID-19 continues to impact the world, although to a much lesser extent, given the protection afforded by the mRNA vaccines, the boosters, and the antiviral medications (e.g., oseltamivir, penciclovir, acyclovir, Paxlovid, etc.). Second, the paper should be regarded as being inconclusive in both its outlook and its list of references; it provides, at best, an intermediary account of the continuing COVID-19 pandemic. Third, like the Spanish Flu of 1918, it is speculated that the COVID-19 pandemic will not endure beyond three years and will conclude as an endemic problem by, hopefully, early 2023. Therefore, the paper is partitioned into three sections which, respectively, address the infection's three phases: epidemic (initial infection), pandemic (worldwide infection) and endemic (pervasive but nonlife-threatening infection) phases. The lessons learned from the range of decisions made throughout the COVID-19 phases should help to inform and better prepare the world for future pathogens and deadly diseases. [ABSTRACT FROM AUTHOR]

Ongoing COVID-19 studies pay little attention to the risk or protective factors related to psychological stress. This study aims to estimate the prevalence of anxiety, depression and insomnia during the initial phase of the COVID-19 outbreak, and explore factors that might be associated with these outcomes. A population-based cross-sectional survey was conducted using snowball-sampling strategy. Participants from 18 years or older filled out an anonymous online questionnaire. A total of 4527 citizens filled out the questionnaire. Prevalence rates were; insomnia 31.8%, anxiety 17.1% and depression 12.5%. Risk factors associated with anxiety, depression and insomnia were being single (OR = 0.75, OR = 0.57, OR = 0.59), unemployed (OR = 0.47, OR = 0.53, OR = 0.73), financial concerns (OR = 1.66, OR = 2.09, OR = 1.80) at risk for complication from COVID-19 (OR = 1.63, OR = 1.68, OR = 1.60), and being generally worried due to the COVID-19 (OR 0 3.06, OR = 1.41, OR = 1.74). Being single, unemployed, at risk of health complications, or having concerns because of financial or other consequences of the pandemic are associated with mental health adversities such as anxiety, depression and insomnia during a pandemic lockdown. [ABSTRACT FROM AUTHOR]

Aims: To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting. Design: Scoping review. Data Sources: A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers' workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty‐five studies met the inclusion criteria. Review Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses Scoping Review checklist. Results: Healthcare workers experience an increase in workload pressures during a pandemic. This included patients requiring more care, undertaking non‐normal work activities, increase in work content including changes to documentation, increase in demand and skills required, an increase in overtime and hours of work per week and higher patient‐to‐nurse ratios. The review also highlighted changes to the work environment and worsened work environments, including staffing shortages. Conclusion: Focused efforts from health organizations to prioritize supportive conditions, policies focused on improved work environments, staffing adequacy and fair and reasonable workloads will enhance retention of the current workforce and future planning for pandemics. Impact: Understanding workload challenges faced by frontline health professionals during the pandemic can improve planning, including policies and procedures, and resource allocation for future pandemic or emergency situations. In addition, extended periods of high workloads can impact staff retention. As many countries return to life after COVID‐19, it is important that healthcare organizations examine staff pressures and identify ways to support staff moving forward. This will be vital for the future sustainability of the workforce. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

An epidemic of clade I mpox in the Democratic Republic of Congo, low population immunity to orthopoxviruses and advances in synthetic biology should be the triggers to raise our level of preparedness for resurgent orthopoxvirus epidemics.

The purpose of studying the issues of ensuring the safe and efficient use of unmanned vehicles in a megalopolis in the context of the spread of infectious diseases using public regulation tools is to develop, based on the application of methods of systemic legal analysis, evidence-based proposals for improving legislation in the interests of using unmanned vehicles in a megalopolis in order to countering the spread of epidemics and pandemics. The lack of results of scientific understanding of the experience of legal support for the functioning of the transport system of the metropolis in the context of epidemics and pandemics, and, in particular, during the period of countering the spread of the coronavirus infection COVID-19, both in foreign countries and in Russia, seems to be an important negative factor that minimizes the potential of using self-driving cars to reduce cross-contamination opportunities in high-density areas, which undoubtedly include metropolitan areas. Background. The ever-increasing threat of the spread of epidemics and pandemics, as well as their consequences, demonstrated, among other things, by the results of the coronavirus infection COVID-19, entails the well-founded attention of practitioners and the interest of scientists in determining the means to counter the threats of the spread of infectious diseases. Of particular importance is the search for such funds to ensure the safety of the population living in certain areas, characterized by the presence of additional factors that lead to a significant increase in the risk of the disease. In particular, we are talking about the situation in megacities characterized by an extremely high population density, which, combined with the presence of developed transport communications, increased passenger traffic, contributes to “cross” infection, the rapid spread of mass infectious diseases. At the same time, as the results of the study show, the use of unmanned vehicles in a metropolis in the interests of monitoring the epidemiological situation in areas with a high level of infection, delivering medicines to patients, etc. ensures minimization of the risk of infection of medical personnel, significantly reduces material costs and time spent on the implementation of such measures. Materials and research methods. The use of methods of comparative legal analysis allowed the authors, based on the results of studying foreign legal sources, analytical data and scientific literature, allowed the authors to assess the applicability of the experience of legal regulation and the organization of the safe use of unmanned vehicles in a metropolis in the context of the emergence and counteraction to the spread of epidemics and pandemics. A formal dogmatic analysis of Russian regulatory legal and individual acts on the issues of ensuring the safe use of unmanned vehicles in an urban agglomeration made it possible to identify gaps and contradictions that minimize the potential for legal impact on the participants in the relations under study. Results. A comprehensive systematic and legal study of scientific sources, norms of international, foreign and Russian legislation, law enforcement practice allowed the authors to formulate proposals for improving the system of legal regulation in order to safely use unmanned vehicles in a metropolis in the event of risks of occurrence and counteracting the spread of epidemics and pandemics. Conclusion. Legalization in Russian public law of the special requirements proposed by the authors for ensuring the use of unmanned vehicles in a metropolis, their network interaction, the legal grounds for admission to operation and the conditions for their safe use to monitor the epidemiological situation, supply the population with medicines and food in the context of the introduction of quarantine measures in urban agglomeration, can contribute to the elimination of identified gaps in administrative regulation.

Introduction: Our goal was to quantify healthcare clinician (HCC) absenteeism in the emergency department (ED) during the coronavirus disease 2019 (COVID-19) surge and to identify potential interventions that may mitigate the number of absences.Methods: This was a retrospective, descriptive record review that included 82 resident physicians, physician assistants, and staff physicians who were scheduled to work more than three clinical shifts during March 2020 in an urban, academic ED that received a high number of coronavirus disease 2019 (COVID-19) patients. Exposure was defined as a healthcare clinician who was not wearing appropriate personal protective equipment (PPE) having contact with a confirmed COVID-19 positive patient in the ED. The main outcome was the number of HCC absences secondary to exposure to or symptoms concerning for COVID-19.Results: During March 2020, of 82 ED HCCs, 28 (34%) required an absence from clinical duties, totaling 152 absentee calendar days (N = 13 women [46%]; N = 15 men [54%]). Median HCC age was 32 years (interquartile range 28-39), and median number of days absent was four (interquartile range 3-7). While 16 (57%) of the total absences were secondary to a known exposure, 12 (43%) were symptomatic without a known exposure. A total of 25 (89%) absent HCCs received COVID-19 testing (N = 5 positive [20%]; N = 20 negative [80%]) with test results returning in 1-10 days. Eleven (39%) symptomatic HCCs had traveled domestically or internationally in the prior 30 days.Conclusion: Emergency departments should anticipate substantial HCC absences during the initial surge of a pandemic. Possible interventions to mitigate absences include early and broad use of PPE, planning for many asymptomatic HCC absences secondary to exposures, prioritizing HCC virus testing, and mandating early travel restrictions.

In relation to the challenging epidemic situation in Russia caused by the spread of novel coronavirus infection, specialists from the Russian NBC Protection Troops were involved in the disinfection of different facilities and equipment in all regions of the country. The aim of this article was to summarize the experience of mobile Decontamination Operational Groups (DOGs) of the NBC Protection Troops in infection prevention and control for COVID-19 in Moscow and Moscow Region. The mobile DOGs for this region were formed on the basis of the Federal State Budgetary Establishment «27 Scientific Centre» of the Ministry of Defence of the Russian Federation. This center possessed vast experience in performing special tasks for ensuring radiation, chemical and biological safety of different objects. The DOGs were formed from highly qualified professionals with relevant experience in scientific research studies in radiation, chemical and biological protection issues. During the period March 30 to June 28, 2020, the mobile DOGs have performed cleaning and disinfection procedures for different objects at more than 120 addresses in Moscow City and Moscow Region. Thus, they have decontaminated 550 thousand sq. m of surfaces, 13491 units of automotive equipment, 67 passenger cars for personnel, 18 IL-76 aircrafts of the Russian Aerospace Forces and supportive machinery. Nevertheless, the experience of DOGs in infection prevention and control for COVID-19 in Moscow and Moscow Region demonstrated the need to improve the NBC protections means and disinfectant solutions. In general, the disinfection measures organized and carried out by the mobile DOGs have demonstrated high efficiency. There have not been a single case of COVID-19 among DOGs personnel throughout the entire period of performing cleaning and disinfection tasks in epidemic foci.

Critical care was established partially in response to a polio epidemic in the 1950s. In the intervening 70 yr, several epidemics and pandemics have placed critical care and allied services under extreme pressure. Pandemics cause wholesale changes to accepted standards of practice, require reallocation and retargeting of resources and goals of care. In addition to clinical acumen, mounting an effective critical care response to a pandemic requires local, national, and international coordination in a diverse array of fields from research collaboration and governance to organisation of critical care networks and applied biomedical ethics in the eventuality of triage situations. This review provides an introduction to an array of topics that pertain to different states of pandemic acuity: interpandemic preparedness, alert, surge activity, recovery and relapse through the literature and experience of recent pandemics including COVID-19, H1N1, Ebola, and SARS. [ABSTRACT FROM AUTHOR]