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This case study describes the experience of the German Permanent Working Group of Competence and Treatment Centers for High Consequence Infectious Diseases, known as STAKOB (Ständiger Arbeitskreis der Kompetenz- und Behandlungszentren für Krankheiten durch hochpathogene Erreger). STAKOB brings together public health authorities (competence centers) and high-level isolation units (treatment centers) to collaborate on the clinical management of high-consequence infectious diseases (HCIDs) and emerging infectious diseases. The network is coordinated by the Robert Koch Institute, Germany's federal public health institute. The main tasks of STAKOB are to strengthen HCID clinical and public health management and increase expert knowledge on HCID and non-HCID emerging infectious diseases in Germany. STAKOB enables the exchange of knowledge and experiences; development of guidelines on infection prevention and control measures, clinical management, and therapy; and support for the World Health Organization and other outbreak responses internationally. The past years have shown how important the STAKOB network is for Germany—not only in providing critical care for HCID cases but also increasing capacity to support public health and clinical management of emerging infectious disease cases. However, maintaining several high-level isolation units in Germany requires a high commitment of financial, material, and human resources. Due to the rarity of HCID and emerging infectious disease events, maintaining the appropriate level of preparedness and ensuring sufficient investments is an ongoing struggle. Nevertheless, it is essential to have a network ready to react to HCID and non-HCID emerging infectious diseases in times of a changing biosecurity and infectious landscape. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Genesis and the prognostic value of olfactory dysfunction (OD) in COVID-19 remain partially described. The objective of our study was to characterize OD during SARS-CoV-2 infection and to examine whether testing of OD may be a useful tool in clinical practice in order to early identify patients with SARS-CoV-2 infection. METHODS: Olfactory function assessment was objectively carried out using the u-Smell-it® test. In a cross-sectional study part, we evaluated this test in a control cohort of SARS-CoV-2 negative tested patients, who attended the University Hospital Frankfurt between May 2021 and March 2022. In a second longitudinal study part, sensitivity and specificity of OD was evaluated as a diagnostic marker of a SARS-CoV-2 infection in Frankfurt am Main, Germany in SARS-CoV-2 infected patients and their close contacts. RESULTS: Among 494 SARS-CoV-2 negative tested patients, OD was detected in 45.7% and was found to be significantly associated with the male gender (p < 0.001), higher age (p < 0.001), cardiovascular and pulmonary comorbidities (p < 0.001; p = 0.03). Among 90 COVID-19 positive patients, OD was found in 65.6% and was significantly associated with male gender and positive smoking status (p = 0.04 each). Prevalence and severity of OD were significantly increased in infections with the Delta variant (B.1.617.2) compared to those with the Omicron variant (BA.1.1.529). Diagnostic sensitivity and specificity of OD for diagnosis of SARS-CoV-2 infection were 69% and 64%, respectively. CONCLUSION: OD is common in COVID-19 negative and positive tested patients with significantly different prevalence rates observed between different variants. Diagnostic accuracy of OD is not high enough to implement olfactory testing as a tool in diagnostic routine to early identify patients with a SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or urban residence was determined by logistic regression analysis. Findings The weighted proportion of participants with access to basic chronic care ranged from 20.6% in Mexico to 47.6% In South Africa. Access rates were unequally distributed and disadvantaged poor people, except in South Africa where primary health care is free to all. Rural residence did not affect access. The proportion with catastrophic out-of-pocket expenditure for the last outpatient visit ranged from 14.5% in China to 54.8% in Ghana. Financial hardship was more common among the poor in most countries but affected all Income groups. Health insurance generally increased access to care but gave insufficient protection against financial hardship. Conclusion No country provided access to basic chronic care for more than half of the participants with chronic illness. The poor were less likely to receive care and more likely to face financial hardship in most countries. However, inequity of access was not fully determined by the level of economic development or insurance coverage. Future health reforms should aim to improve service quality and increase democratic oversight of health care. Objectif Evaluer la couverture sanitaire universelle pour des adultes de 50 ans ou plus, atteints de maladie chronique, en Afrique du Sud, en Chine, dans la Federation de Russie, au Ghana, en Inde et au Mexique. Methodes A partir de l'etude de l'OMS sur le vieillissement et la sante des adultes dans le monde (SAGE), nous avons obtenu des donnees sur 16 631 participants, ages de 50 ans ou plus, chez qui au molns une maladie chronique a ete diagnostiquee. L'acces a des soins chroniques de base et les difficultes financieres ont ete evalues, et des analyses par regression logistique ont permis de determiner (influence d'avoir une assurance maladie et (influence de vivre en milieu rural ou urbain. Resultats La part ponderee des participants beneficiant d'un acces a des soins chroniques de base varie entre 20,6% au Mexique et 47,6% en Afrique du Sud. Les taux d'acces sont inegalement repartis et en defaveur des personnes pauvres, sauf en Afrique du Sud, ou les soins de sante primaires sont gratuits pour tous. Le fait d'habiter en milieu rural n'a pas d'incidence sur cet acces. La proportion des participants ayant du assumer des depenses directes catastrophiques pour leur derniere consultation ambulatoire s'etablit entre 14,5% en Chine et 54,8% au Ghana. Dans la plupart de ces pays, les difficultes financieres sont plus frequentes chez les personnes pauvres, mais elles affectent toutes les tranches de revenus. Les assurances maladie ameliorent generalement (acces aux soins mais offrent une protection insufnsante contre les difficultes financieres. Conclusion Aucun des pays etudies ne permet a plus de la moitie des participants atteints de maladie chronique d'acceder aux soins chroniques de base. Dans la majorite de ces pays, les personnes pauvres sont moins susceptibles de beneficier de soins et plus exposees aux difficultes financieres. Neanmoins, (inegalite en termes d'acces aux soins n'est pas entierement determinee par le niveau de developpement economique ou par la couverture d'assurance. Les reformes a venir des systemes de sante devraient viser a ameliorer la qualite des services et a favoriser une supervision plus democratique des soins de sante. Objetivo Evaluar la cobertura sanitaria universal para adultos de 50 anos o mas con enfermedades cronicas en China, Federacion de Rusia, Ghana, India, Mexico y Sudafrica. Metodos Se obtuvieron datos de 16631 participantes de 50 anos o mas diagnosticados con, al menos, una enfermedad cronica del Estudio de la OMS sobre envejecimiento y salud de los adultos en el mundo. Se evaluaron el acceso a atencion cronica basica y las dificultades economicas y se determino la influencia del seguro sanitario y de la residencia rural o urbana mediante un analisis de regresion logistica. Resultados La proporcion ponderada de participantes con acceso a atencion cronica basica vario desde un 20,6% en Mexico a un 47,6% en Sudafrica. Las tasas de acceso estaban desigualmente distribuidas y la poblacion pobre se encontraba en desventaja, salvo en Sudafrica, donde la atencion sanitaria primaria es gratuita para todo el mundo. La residencia rural no afectaba al acceso. La proporcion de gastos catastroficos directos durante la ultima visita ambulatoria vario desde un 14,5% en China aun 54,8% en Ghana. Las dificultades economicas eran mas comunes entre los pobres en la mayoria de paises, pero afectaron todos los grupos de Ingresos. Por norma general, los seguros sanitarios aumentaron el acceso a la asistencia, pero no ofrecieron la suficiente proteccion frente a las dificultades economicas. Conclusion Ningun pais ofrecia acceso a atencion cronica basica a mas de la mitad de los participantes con enfermedades cronicas. En la mayoria de los paises, los pobres tenian menos posibilidades de recibir asistencia y mas de sufrir dificultades economicas. No obstante, la desigualdad en el acceso no estaba totalmente condicionada por el nivel de desarrollo economico o la cobertura del seguro. Las futuras reformas sanitarias deberian tener como objetivo mejorarla calidad del servido y aumentar la supervision democratica de la atencion sanitaria., Introduction The World Health Assembly in 2005 and the United Nations General Assembly in 2012 called for universal health coverage to reinforce the human right to health. All Member States [...]