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In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise-i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention-has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are not always justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions.

ABSTRACT Objective Methods Results Conclusion A competency training index system was designed in public health emergencies for community nurses. The purpose of this approach is to provide community nurses with guidelines for standardized training programs on how to respond to public health emergencies.Through semi‐structured interviews, a literature review, and team discussion, the first draft of competency training index system in public health emergencies for community nurses was formed. The Delphi method was used for two rounds of expert consultation to screen, modify and determine indicators. Finally, the analytic hierarchy process was utilized to calculate the weights of indicators at all levels.A total of 15 expert consultants were included. The effective recovery rate of the two rounds of expert consultation questionnaire was 100%, the expert authority coefficient was 0.880, 0.887, and the Kendall coordination coefficient was 0.172 and 0.171 (p < 0.001). Expert opinions have determined that the final revised competency index system in public health emergencies for community nurses training consists of 2 primary indicators, 10 secondary indicators, and 46 tertiary indicators.The study has developed a competency training index system in public health emergencies for community nurses. This system can serve as a foundation for standardized training in community health service institutions. It is characterized by its high demand, scientific approach, reliability, and rationality. [ABSTRACT FROM AUTHOR]

The threat of the emergence of potential pandemics in the future has been looming ever since the world witnessed the worst-ever public health catastrophe following the coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The COVID-19 pandemic affected billions of people killing millions of people throughout the world. Now, we have been noticing an alarming rise in the cases of mpox disease caused by Mpox virus (MPXV). Although discovered in 1958, mpox was largely confined to monkeys before causing the first human infection in 1970. The MPXV is demonstrating a complex transmission behavior as noted by its discovery first in Denmark in monkeys imported from Singapore (Asia) and later spreading to humans causing repeated re-emergence. The virus was confined to the African nations including the Democratic Republic of Congo (DRC) before reemerging in the United States of America in 2003 affecting several people who had a history of contact with animals. Following scattered reports from endemic regions, the virus appears to have remerged after approximately two decades in 2022 involving the United States of America (USA) and European countries. The virus has been spreading across the globe as evidenced by its discovery in 60 countries in 2022 to more than 120 countries in the current year. It is therefore essential to improve the understanding of the MPXV, its epidemiology, pathogenicity and virulence, clinical features, and control and preventive measures and increase preparedness to efficiently tackle any future public health emergency. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic was a public health emergency (PHE) of unprecedented magnitude and impact. It provided the possibility to investigate the Dutch citizens' understanding and perception of the actors involved in the Dutch pandemic response as a PHE unfolded. Methods: Three focus groups (FGs) were held with 16 Dutch citizens in June 2020. Citizens were recruited using the Dutch Health Care Consumer Panel. During the FGs, participants were asked to fill in a table with actors they thought were involved in the management of the COVID‐19 pandemic. They also received information on actors involved in Dutch outbreak responses. Then, the actors named and omitted by the participants were discussed. Results: An analysis of the FGs suggests that the Dutch citizens participating in the study were not fully aware of the scope of actors involved in the Dutch COVID‐19 pandemic response. Some participants would have appreciated more information on the actors involved. This would help them have an informed opinion of the actors involved in the decision‐making process, and accept non‐pharmaceutical interventions implemented. Lastly, most participants recognised that they played a role in limiting the spread of the COVID‐19 pandemic. Yet, very few spontaneously mentioned themselves as actors within the COVID‐19 pandemic response. Conclusion: This study suggests that early in the COVID‐19 pandemic, the Dutch citizens participating in this study's FG did not have a complete understanding of the scope of actors involved in the Dutch COVID‐19 pandemic response, or the potential role of the citizen. Future research can build on these results to explore the citizen's perception of their role during PHEs of another origin, as well as other geographical and historical contexts. Patient or Public Contribution: The public participated in the focus groups and received a non‐expert report summarising the outcomes of the focus groups. [ABSTRACT FROM AUTHOR]

South African research ethics committees (RECs) faced significant challenges during the COVID-19 pandemic. Research ethics committees needed to find a balance between careful consideration of scientific validity and ethical merit of protocols, and review with the urgency normally associated with public health emergency research. We aimed to explore the views of South African RECs on their pandemic preparedness and response during COVID-19. We conducted in-depth interviews with 21 participants from RECs that were actively involved in the review of COVID-19 related research, at seven academic institutions across South Africa. Interviews were conducted remotely using an in-depth interview guide that included questions regarding REC preparedness and response to COVID-19. Interviews were conducted until data saturation, and audio-recordings were transcribed verbatim and coded. An inductive approach to thematic analysis was used to organise data into themes and sub-themes. This study focused on three main themes: coping during COVID-19, building REC capacity during pandemic times and a consistently cautious approach to mutual recognition of REC reviews. Despite an initial sense of unpreparedness, RECs were able to adapt and maintain careful ethical oversight of both COVID and non-COVID research, and the rigour of REC reviews. Several important lessons for preparedness and response to future pandemics were identified, including heightened awareness of publication, funding and political pressures, the importance of regular training for RECs and researchers, and strategies to enhance moral resilience of REC members. Incremental steps are needed to build trust and authentic partnerships among RECs in inter-pandemic times, to facilitate collaboration during future public health emergencies. [ABSTRACT FROM AUTHOR]

Objective: The objective is to characterize the impact of COVID-19 on major healthcare for diabetes, including hospitalization, emergency department (ED) visits and primary care visits in Alberta, Canada. Methods: Participants from Alberta's Tomorrow Project (ATP) with pre-existing diabetes prior to 1 April 2018 were included and followed up to 31 March 2021. A time-segmented regression model was used to characterize the impact of COVID-19 on healthcare utilization after adjusting for seasonality, socio-demographic factors, lifestyle behaviors and comorbidity profile of patients. Results: Among 6099 participants (53.5% females, age at diagnosis 56.1 ± 9.9 y), the overall rate of hospitalization, ED visits and primary care visits was 151.5, 525.9 and 8826.9 per 1000 person-year during the COVID-19 pandemic (up to 31 March 2021), which means they reduced by 12% and 22% and increased by 6%, compared to pre-pandemic rates, respectively. Specifically, the first COVID-19 state of emergency (first wave of the outbreak) was associated with reduced rates of hospitalization, ED visits and primary care visits, by 79.4% (95% CI: 61.3–89.0%), 93.2% (95% CI: 74.6–98.2%) and 65.7% (95% CI: 47.3–77.7%), respectively. During the second state of emergency, healthcare utilization continued to decrease; however, a rebound (increase) of ED visits was observed during the period when the public health state of emergency was relaxed. Conclusion: The declared COVID-19 states of emergency had a negative impact on healthcare utilization for people with diabetes, especially for hospital and ED services, which suggests the importance of enhancing the capacity of these two healthcare sectors during future COVID-19-like public health emergencies. [ABSTRACT FROM AUTHOR]

Mengze Li,1,&ast; Qiannan Jia,1,&ast; Tifei Yuan,2 Lin Zhang,3 Huizhong Wang,1 Jamie Ward,4 Yinchuan Jin,1 Qun Yang1 1Department of Military Medical Psychology, Air Force Medical University, Chinese People’s Liberation Army (PLA), Xi’an, People’s Republic of China; 2Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 3Outpatient Department, 986th Hospital Affiliated to Air Force Medical University, Xi’an, People’s Republic of China; 4School of Psychology, University of Sussex, Brighton, UK&ast;These authors contributed equally to this workCorrespondence: Qun Yang; Yinchuan Jin, Email yangqun1125@hotmail.com; jyc_fmmu@163.comBackground: Public health emergencies pose threats to mental health, and cognitive emotional regulation can be a crucial coping strategy. This study explored the relationship between cognitive emotion regulation strategies and mental health among university students during the COVID-19 pandemic using network analysis.Methods: 1100 university students completed questionnaires assessing depression, anxiety, somatization, and cognitive emotion regulation strategies. Network analysis was conducted to identify network structures and bridge symptoms.Results: (1) In the depression network, the strongest edge is D1 (Little interest)-D2 (Feeling down), while D2 emerged as the node with the highest centrality. C1 (Self-blame), C8 (Catastrophizing), D6 (Feeling bad), and D9 (Suicide) are bridge symptoms. (2) In the anxiety network, A2 (Uncontrollable worrying)-A3 (Worrying too much) were identified as the strongest edge, and A2 exhibiting the highest centrality. C1 (Self-blame), C8 (Catastrophizing), and A6 (Easy annoyance) are bridge symptoms. (3) In the somatization network, the strongest edge is S14 (Fatigue)-S15 (Sleep disturbances) and S9 (Palpitations) exhibited the highest centrality. C1 (Self-blame), C3 (Rumination), C8 (Catastrophizing), S9 (Palpitations), and S14 (Fatigue) are bridge symptoms.Conclusion: Self-blame and catastrophizing are important bridge symptoms for cognitive emotion regulation strategies and mental health networks, so cognitive behavioral therapy, focusing on self-blame and catastrophizing as intervention targets, could most effectively improve mental health during public health emergencies.Keywords: cognitive emotion regulation, mental health, network analysis, public health emergency, COVID-19

Abstract Background Evidence suggests that PTSD symptoms following public health emergencies are influenced by many factors. The aim of this study was to investigate the relationship between perceived social support and Post-traumatic stress disorder symptoms and to explore the chain-mediated role of resilience and positive coping style, among medical staff in Hubei Province, China, during a public health emergency. Methods Convenience sampling was used to select medical staff from two general hospitals in Hubei Province in July 2022 for this study. A total of 2,751 medical staff were included in the study. Multidimensional Scale of Perceived Social Support, 10- itemConnor- Davidson resilience scale, Simplified Coping Style Questionnaire and The Post-traumatic stress disorder Checklist for DSM-5 were used to assess the levels of perceived social support, resilience, coping style and Post-traumatic stress disorder symptoms of medical staff two years after the public health emergency. Statistical descriptions were conducted using SPSS, and a structural equation model was established using AMOS to analyze the chain-mediated roles of resilience and positive coping style between perceived social support and Post-traumatic stress disorder symptoms. Results Structural equation modeling results showed a standardized total effect of perceived social support on Post-traumatic stress disorder symptoms of -0.416 (95%CI [-0.456, -0.374], P

The aim of the work was to conduct a comparative analysis of the existing national legal framework against the provisions of the International Health Regulations (IHR) (2005). The main issues of harmonization of the existing documentation in accordance with modern international requirements have been identified. A number of gaps and inconsistencies in the legislative acts that do not fully comply with the requirements of international legal acts recognized by the Republic of Tajikistan are revealed. Proposals for optimization and improvement of the national legal framework and regulatory documents, as well as for adaptation to the requirements of the IHR (2005) are presented.

The 2022 mpox outbreak presented a familiar challenge to clinical laboratories. Accordingly, our institution was able to swiftly implement in-house mpox testing to meet the imminent diagnostic needs of the public health emergency. While the FDA authorized laboratory-developed tests (LDTs) for lesion specimens, however, it restricted the testing of rectal swabs despite mounting evidence of its clinical utility. Notably, within the short timeframe when rectal testing was available, we identified a high-risk patient without apparent lesions who tested monkeypox-positive only by our in-house rectal swab assay. In order for our institution to continue testing non-lesion samples, The FDA required a separate Emergency Use Authorization (EUA) application that demanded additional resource-costly validation studies despite utilizing the same testing platform as lesion samples. Here, we provide a brief review of the history, current status, and legal scope surrounding LDT validations, with an in-depth comparison of the technical requirements by CLIA, CAP and the FDA. Importantly, we provide our experience with the mpox EUA submission process to serve as context for the challenges that may be imposed by the new FDA regulations. We hope that our experience will offer a valuable perspective that promotes constructive discourse towards addressing the imperative to offer high-quality laboratory diagnostics without compromising on the need of the medical laboratory community to provide effective patient care.

The United States Centers for Disease Control and Prevention (CDC) Laboratory Response Network for Chemical Threats (LRN-C) is a network of more than 50 primarily local public health laboratories covering all states and regions of the United States. It is managed by the CDC and is responsible for collecting, shipping, and analyzing clinical specimens from large-scale and local chemical threat events. The U.S. CDC Chemical Threat Laboratory Response Network establishes a hierarchical network framework, standard specimen collection, packaging, and transport procedures, laboratory testing methods, and related support facilities to achieve rapid collection, shipment, and laboratory analysis of large numbers of specimens following large-scale chemical threat events and to provide local laboratory response capabilities for chemical threat and public health services. The framework design, capability requirements, and event response workflow of the CDC Chemical Threat Laboratory Response Network in the United States provide a reference for the establishment of relevant domestic network laboratories.

Objective To establish and improve the emergency recruitment strategy of voluntary blood donors under public health emergencies in Shenzhen and verify its effectiveness. Methods Blood donor recruitment strategies under routine, emergency and combined situation were developed. The blood collection data from 2017 to 2019 before the outbreak of COVID-19 pandemic was used as the control group, and those from 2020 to 2022 after the outbreak was used as the experimental group, and the feasibility and effectiveness of this emergency recruitment strategy was confirmed through statistical analysis of key indicators of blood collection and supply. Results Through the application of the emergency recruitment strategy for blood donors in Shenzhen under public health emergencies, statistical analysis of the experimental group and the control group showed a year-on-year increase of 14.11%(73 647.25/521 855.5) in whole blood collection, 42.33%(28 891.47/68 250.95) in platelet collection, 0.33%(529/161 033) in first-time donors, 33.25%(3 154/9 487) in repeated donors and 16.78%(32 585/194 149) in the number of 400 mL donors. The inventory of various types of red blood cell maintained between 6-18 days. After the implementation of the emergency recruitment strategy the blood donation population has shown characteristics as younger age, localization, increased repeated donation and a higher proportion of donors with college education or above. Conclusion The emergency recruitment strategy of blood donors under public health emergencies is feasible and effective, which can quickly and efficiently improve the blood recruitment ability.

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has halted the progress of India made towards the ambition of achieving Tuberculosis (TB)-free status by 2025. Steps taken to control the disease have affected many national health programs, including those for TB. Aim: To understand the delays in diagnosing and initiating therapy among TB patients receiving Antitubercular Therapy (ATT) during the early COVID-19 pandemic period. Materials and Methods: This was a cross-sectional study conducted in the Sonepat District of Haryana state, India. The study was conducted among 20% of the total Nikshay Portal-notified TB patients who received treatment from the public sector in the second and third quarters of 2020. Data was collected using a pretested semistructured schedule consisting of variables related to demography, past medical history, symptoms leading to TB diagnosis, place of diagnosis, time between symptom onset and diagnosis, duration taken for initiating therapy, and reasons for delays. The Chi-square test and Fisher's exact test were used to test the significance of the differences. A p-value

Abstract Background Decision fatigue is a new concept in the field of psychology and refers to a state of fatigue alongside impaired cognitive processing and emotional regulation ability. Previous studies have confirmed that nurses are prone to decision fatigue, and nurses who experience decision fatigue may implement nursing measures that are inconsistent with clinical evidence, thus affecting patients’ benefits. COVID-19, as a large-scale global public health emergency, increased the workload and burden of nurses and aggravated decision fatigue. However, the factors leading to decision fatigue among nurses have not yet been identified. Methods This study is guided by interpretative phenomenology. During the epidemic period of COVID-19: From November 2022 to February 2023, a one-to-one, semi-structured in-depth interview was conducted among nurses with decision fatigue experience who were participating in front-line work in Jilin Province using homogenous sampling. The interview recordings and related data were transcribed into text within 24 h, and data analysis was assisted by NVivo 12.0 software. Results After a total of 14 front-line nurses were analyzed in this study, The thematic level reaches saturation, the findings present a persuasive and coherent narrative, and the study is terminated, and finally extracted and formed three core themes: “Cognition, influence and attitude of decision fatigue”, “Approaching factors of decision fatigue” and “Avoidant factors of decision fatigue”. Conclusion This study confirmed that decision fatigue was widespread in the work of front-line nurses, affecting the physical and psychological health of nurses, the quality of nursing work, the degree of benefit of patients and the clinical outcome. However, nursing staff do not know enough about decision fatigue, so the popularization and research of decision fatigue should be strengthened. Improve the attention of medical institutions, nursing managers and nursing staff.Some suggestions are put forward for the intervention of decision fatigue through personnel, task, tool and technology, organization and environment.

ObjectiveTo identify the key issues in emergency response to public health emergencies in the Yangtze River Delta region, and to provide a basis for the formulation of relevant policies.MethodLiterature on emergency response to public health emergencies in the Yangtze River Delta region was systematically reviewed and collected, and 18 main problems were identified after collecting and organizing the problems. A questionnaire survey and cluster analysis were used to identify the key issues.ResultsThe study of 18 major problems revealed that "insufficient reserve of emergency medical supplies", "insufficient financial investment to meet the needs of emergency response", "lack of a sound mechanism for the deployment of supplies, resulting in the untimely deployment of materials", were the key issues of emergency response to public health emergencies in the Yangtze River Delta region.ConclusionFuture development of the emergency response system in the Yangtze River Delta region should focus on accelerating the integration process of the Yangtze River Delta, establishing and improving information systems, optimizing the material storage and deployment network, prioritizing the fund investment and utilization mechanism, and improving the effectiveness of public health emergency response.

ObjectiveTo identify and clarify the key issues faced by tertiary hospitals in responding to public health emergencies.MethodsA literature review index system was constructed, and key issues were identified using hierarchical analysis.ResultsAfter a systematic literature review, 20 types of problems faced by tertiary hospitals in responding to public health emergencies were identified. Three key issues were ultimately identified by prioritizing the issues that needed to be addressed.ConclusionThe key issues of tertiary hospitals in responding to public health emergencies are concentrated in the areas of emergency response capabilities and competencies of medical staff, the number of emergency response personnel, and the standardization and specificity of training and drills. Tertiary hospitals should focus on these issues in developing public health emergency response systems to improve the effectiveness of their emergency response.

Abstract Introduction COVID-19 has demonstrated the importance of competent staff with expertise in public health emergency preparedness and response in the civil aviation system. The civil aviation system is a critical sentinel and checkpoint to prevent imported cases and slow the spread of communicable diseases. Understanding the current competencies of staff to deal with public health emergencies will help government agencies develop targeted training and evidence-based policies to improve their public health preparedness and response capabilities. Methods This cross-sectional pilot study was conducted from November 2022 to October 2023, involving 118 staff members from various positions within China’s civil aviation system. A 59-item questionnaire was translated and developed according to a competency profile. Data were collected using the self-report questionnaire to measure the workforce’s self-perceptions of knowledge and skills associated with public health emergency proficiency, categorized into (1) general competency, (2) preparedness competency, (3) response competency, and (4) recovery competency. KMO & Bartlett test and Cronbach’s α reliability analysis were used to test the reliability and validity of the questionnaire. Descriptive statistics, independent sample T-test, ANOVA, and linear regression models were performed to analyze the competencies. Results A total of 107 staff members from the aviation system were surveyed in this study. The KMO & Bartlett test, (KMO = 0.919, P

Under the governance of public health emergencies, taking 4R crisis management as the perspective of dynamic governance process,combined with rural field research and interviews, we directly face the shortcomings exposed in the grass-roots health emergency governance practice:weak crisis reduction capacity, weak risk awareness, and deviation of emergency plans from the actual situation;limited crisis preparedness, imbalance between supply and demand of emergency manpower and materials, and inefficient distribution of emergency materials;limited crisis response capacity, delayed response of the emergency department, and insufficient refinement of emergency management; Crisis recovery capacity is belittling, insufficient big-picture view of recovery after the incident, and lack of systematic summarisation and communication of experience. Proposed optimization suggestions for the governance capacity of rural grassroots governments in sudden public health emergencies: update the concept, strengthen the risk awareness and crisis learning ability of grass-roots officials and citizens;sink resources, optimise the resource guarantee system for rural areas to cope with public health emergencies;optimise the system, build a public crisis management pattern in which diversified main bodies participate together;innovate the mechanism, and improve the emergency disposal mechanism of “up and down linkage, horizontal synergy” emergency response mechanism. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has halted the progress of India made towards the ambition of achieving Tuberculosis (TB)-free status by 2025. Steps taken to control the disease have affected many national health programs, including those for TB. Aim: To understand the delays in diagnosing and initiating therapy among TB patients receiving Antitubercular Therapy (ATT) during the early COVID-19 pandemic period. Materials and Methods: This was a cross-sectional study conducted in the Sonepat District of Haryana state, India. The study was conducted among 20% of the total Nikshay Portal-notified TB patients who received treatment from the public sector in the second and third quarters of 2020. Data was collected using a pretested semistructured schedule consisting of variables related to demography, past medical history, symptoms leading to TB diagnosis, place of diagnosis, time between symptom onset and diagnosis, duration taken for initiating therapy, and reasons for delays. The Chi-square test and Fisher's exact test were used to test the significance of the differences. A p-value <0.05 was considered significant. Results: 'Diagnostic Time delay' was observed among 86 (35.1%) of the participants, with a 30-day median delay. 'ATT initiation delays' were observed in 51 (20.8%) with a four-day median delay, and 23 (8.6%) of patients reported at least one episode of treatment interruption. 'Being diagnosed for other diseases' 70 (28.6%) and 'ignoring symptoms' 28 (11.4%) constituted the major reasons for 'Diagnostic time delay'. The non availability of drugs 11 (47.8%) and discomfort with drugs 07 (30.4%) were the major reasons for treatment interruption. Conclusion: Ignorance of symptoms and suspicion of other diseases constituted diagnostic delays, and therapy initiations were prolonged more during the pandemic period. [ABSTRACT FROM AUTHOR]

Urban management and planning during public health emergencies, such as the COVID-19 pandemic, are critical. This article examines hospital site selection in Yinzhou, Ningbo, China, using geographical data analysis. It evaluates travel costs and referral patterns between hospitals and community health facilities to establish a sustainable hierarchical diagnosis and treatment system. The results reveal that existing medical facilities, particularly in rural areas, are inadequate during public health emergencies. The article proposes considering total transportation costs in allocating the sites of new hospitals and suggests adopting a 'permanent + temporary' facility planning approach to ease financial burdens. Addressing these issues can mitigate the inequitable distribution of urban and rural medical resources. This article was published open access under a CC BY licence: https://creativecommons.org/licenses/by/4.0/. [ABSTRACT FROM AUTHOR]

Background: Decision fatigue is a new concept in the field of psychology and refers to a state of fatigue alongside impaired cognitive processing and emotional regulation ability. Previous studies have confirmed that nurses are prone to decision fatigue, and nurses who experience decision fatigue may implement nursing measures that are inconsistent with clinical evidence, thus affecting patients' benefits. COVID-19, as a large-scale global public health emergency, increased the workload and burden of nurses and aggravated decision fatigue. However, the factors leading to decision fatigue among nurses have not yet been identified. Methods: This study is guided by interpretative phenomenology. During the epidemic period of COVID-19: From November 2022 to February 2023, a one-to-one, semi-structured in-depth interview was conducted among nurses with decision fatigue experience who were participating in front-line work in Jilin Province using homogenous sampling. The interview recordings and related data were transcribed into text within 24 h, and data analysis was assisted by NVivo 12.0 software. Results: After a total of 14 front-line nurses were analyzed in this study, The thematic level reaches saturation, the findings present a persuasive and coherent narrative, and the study is terminated, and finally extracted and formed three core themes: "Cognition, influence and attitude of decision fatigue", "Approaching factors of decision fatigue" and "Avoidant factors of decision fatigue". Conclusion: This study confirmed that decision fatigue was widespread in the work of front-line nurses, affecting the physical and psychological health of nurses, the quality of nursing work, the degree of benefit of patients and the clinical outcome. However, nursing staff do not know enough about decision fatigue, so the popularization and research of decision fatigue should be strengthened. Improve the attention of medical institutions, nursing managers and nursing staff.Some suggestions are put forward for the intervention of decision fatigue through personnel, task, tool and technology, organization and environment. [ABSTRACT FROM AUTHOR]

"Postmodern society" theory deconstructs the rational foundation of modern theory and presents the general characteristics of decentralization, deauthorization, and deorganization, which advocates the principles of difference and tolerance, negotiation and participation. During the social transition period, people encountered more complicated conflicts and apparent mindset changes from the characteristics of randomness, fluidity, risk, knowledge, variability, individuality and information presented by the "postmodern society", this paper examines people's confidence, calm, and rationality as well as changes in social mentality such as uneasiness and confusion under public health emergencies. To form a positive social mentality, it is necessary to strengthen the awareness of coping with social risks, guiding social mentality, recognizing collective memory, and optimizing system design to cultivate the excellent traditional Chinese culture, and to guide the development of positive social mentality with the core values of socialism. At the same time, it is necessary to reform the governance mechanism of public health emergencies to enhance the ability to handle these situations. We also recommend constructing a positive social psychological counseling system and increasing the positive collective memory of public health emergencies. [ABSTRACT FROM AUTHOR]

Objective To characterize the epidemiological features of public health emergencies that occurred in Changping District of Beijing City in recent years, to provide scientific support for promoting prevention and control levels and strengthening response capability on such episodes. Methods Public health emergencies and related information reported in Changping District (January 2006 to December 2023) were obtained from the National Public Health Emergency Reporting and Management System. A descriptive epidemiological analysis was conducted on factors such as event level, type, and temporal and spatial distribution in the emergency episodes. Results From 2006 to 2023, a total of 1 219 public health emergencies were reported in Changping District (an annual average of 68 incidents), involving 2,097 cases (an annual average of 117 cases), showing an overall decreasing trend in the annual number of incidents. The emergencies were mainly classified as general level (Class IV, 31 incidents, all infectious disease events) and unclassified events (1 183 incidents, including 1 141 non-occupational carbon monoxide poisoning episodes and 34 infectious disease episodes); there were no major level (Class III), significant level (Class II), or particularly significant level (Class I) public health emergencies. Non-occupational carbon monoxide poisoning accounted for the highest proportion of public health emergencies, occurring predominantly in winter months (November to March), with incidents mainly occurring in households (1 091, 95.62%). Infectious disease emergencies mainly emerged in February and summer months (June to August), with incidents mainly occurring in households (42 cases, 60.00%) and schools (25 cases, 35.71%), involving diseases such as cholera, chickenpox, type A influenza (H1N1), and novel coronavirus infection. Meanwhile, the emergencies were mostly located in the streets/towns with higher population density and larger numbers of floating populations, such as Huilongguan Street, Dongxiaokou Street, Beiqijia Street, and Shahe Town. The median reporting time for public health emergencies in Changping District during 2006-2023 was 0.29 days, with a positive correlation between the discovery-to-reporting time and the duration of infectious disease outbreaks (rs=0.429, P<0.01). Conclusions Non-occupational carbon monoxide poisoning and infectious disease outbreaks are the major causes as well as priorities of public health emergencies in Changping District. The urban-rural fringe areas are high-risk and key areas for the management of such emergencies. For public health emergencies caused by cholera, chicken pox, novel coronavirus infection, and other infectious diseases, comprehensive measures such as strengthening epidemic monitoring, expanding vaccination coverage, and improving handling capacity should be taken to enhance the response capability and raise the prevention and control level on such emergencies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, a significant public health emergency, has underscored the criticality of jobs–housing proximity. Static statistical research, however, struggles to uncover the mechanisms underlying jobs–housing balance, providing limited guidance for urban management. This paper adopts the concept of jobs–housing dynamic balance, analyzing the trends in jobs–housing balance in the metropolitan development area of Wuhan in the early and later period of the pandemic from the perspective of individual jobs–housing migration. Using mobile phone signaling data, we identified a stable population of 161,698 residents in June 2019, June 2021, and June 2023, and calculated jobs–housing synchronization and migration impact indices across seven regions. The study finds the following: (1) there is a pronounced misalignment of jobs–housing in the new cities of Wuhan's suburbs, with clear asynchronous in-migration and out-migration; (2) COVID-19 initially led to a unidirectional exodus of the local population for job purposes, significantly contributing to regional jobs–housing imbalance, followed by a partial rebound in the later stages; and (3) the stability of jobs–housing balance in suburban new cities lacking policy support and comprehensive urban functions is worse, primarily due to insufficient employment resilience and the out-migration of the employed population. This paper puts forward a set of recommendations for the sustainable development of suburban new cities. It offers insights into the theoretical advancement of jobs–housing balance and the dynamic, refined transformation of urban studies, enhancing urban managers' understanding of human–place interactions and new city construction. [ABSTRACT FROM AUTHOR]

Vaccination is the key to interrupting the transmission of viruses, reducing public health losses, and improving the efficiency of public health emergency management. The implementation of vaccination requires communication between the government and the public, and the participation of multiple subjects. Strengthening the coordination of multiple subjects in the process of vaccination can improve the vaccination rate and broaden its scope. Therefore, from the perspective of inter-organizational interaction, a public health emergency vaccination game model based on health management departments, vaccinologists, and the public was constructed in this study. With the objective of improving the effectiveness of vaccination, the influential factors in a public health emergency vaccination game system and game subjects' strategy selection were explored using a numerical simulation analysis. The research results showed that the range of vaccination, the diversification of vaccination information release, the level of emergency coordination between health management departments and vaccinologists, and the public's awareness of emergency protection can all effectively promote vaccination. Among them, the effects of vaccination range (δ) and the diversification of vaccination information release (φ) on game subjects' strategy selection fluctuated, but did not affect the overall trend. Both the level of emergency collaboration (θ) and public safety awareness (ε) can enhance the initiative of game subjects to participate in vaccination. When the stable strategy combination formed by the game system are positive promotion strategy, active guidance strategy and active vaccination strategy, the convergence rate of health management departments and vaccinologists to form a stable strategy is greater than that of the public. Further, the implications of promoting the effective implementation of vaccination are put forward via improving the vaccination strategy, strengthening vaccination collaboration, mobilizing the enthusiasm of vaccinologists, and enhancing the initiative of the public. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 has demonstrated the importance of competent staff with expertise in public health emergency preparedness and response in the civil aviation system. The civil aviation system is a critical sentinel and checkpoint to prevent imported cases and slow the spread of communicable diseases. Understanding the current competencies of staff to deal with public health emergencies will help government agencies develop targeted training and evidence-based policies to improve their public health preparedness and response capabilities. Methods: This cross-sectional pilot study was conducted from November 2022 to October 2023, involving 118 staff members from various positions within China's civil aviation system. A 59-item questionnaire was translated and developed according to a competency profile. Data were collected using the self-report questionnaire to measure the workforce's self-perceptions of knowledge and skills associated with public health emergency proficiency, categorized into (1) general competency, (2) preparedness competency, (3) response competency, and (4) recovery competency. KMO & Bartlett test and Cronbach's α reliability analysis were used to test the reliability and validity of the questionnaire. Descriptive statistics, independent sample T-test, ANOVA, and linear regression models were performed to analyze the competencies. Results: A total of 107 staff members from the aviation system were surveyed in this study. The KMO & Bartlett test, (KMO = 0.919, P < 0.001) and Cronbach's α coefficients (α = 0.985) for this questionnaire were acceptable. The results suggested that respondents scored a mean of 6.48 out of 9 for the single question. However, the staff needed to acquire more knowledge in investigating epidemic information (5.92) and case managing (5.91) in the response stage. Overall, males scored higher (409.05 ± 81.39) than females (367.99 ± 84.97), with scores in the medical department (445.67 ± 72.01) higher than management (387.00 ± 70.87) and general department (362.32 ± 86.93). Additionally, those with completely subjective evaluation (425.79 ± 88.10) scored higher than the general group (374.39 ± 79.91). To predict the total score, female medical workers were more likely to have lower scores (β = -34.5, P = 0.041). Compared with those in the medical department, the management workers (β = -65.54, P = 0.008) and general workers (β = -78.06, P < 0.001) were associated with a lower total score. Conclusions: There was still a gap between the public health emergency competencies of the civil aviation system and the demand. Staff in China's civil aviation systems demonstrated overall competence in public health emergency preparedness and response. However, there was a need to enhance the accumulation of practical experience. Implementing effective training programs for public health emergencies was recommended to mitigate knowledge gaps. Meanwhile, regular training evaluations were also recommended to give comprehensive feedback on the value of the training programs. [ABSTRACT FROM AUTHOR]

Context: Coronavirus disease 2019 (COVID-19) is the greatest global health catastrophe of the century, with its vaccine hesitancy compounding the woes. Relevant stakeholders, including pharmacy students (whose education was disrupted) are important bulwarks against these catastrophes, but their COVID-19-related information are scarce. Aims: We assessed COVID-19 knowledge, its vaccine uptake intentions, and the influence of personality traits among pharmacy undergraduates in a Nigerian university. Settings and Design: This was a post-lockdown cross sectional study conducted at the Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto. Subjects and Methods: A 61-item questionnaire was used to collect data among pharmacy undergraduates who attended Usmanu Danfodiyo University, Sokoto, Nigeria, in May 2021. Statistical Analysis Used: Summary statistics– mean (±standard deviation), range, frequency, proportion; inferential statistics– Chi square statistics, binary logistic regression. Results: The response rate was 88% (168/191). The average COVID-19 knowledge score, the frequency of acceptance, and hesitancy to take COVID-19 vaccine among study participants were 42.9% (95% confidence interval [CI] = 42.1–43.7), 39.1% (95% CI = 37.3%–41.8%), and 61.9% (95% CI = 58.0%–64.2%), respectively. In addition, of the 168 study participants, 73 (43.5%) considered themselves to have high self-esteem, 67 (39.9%) were highly extroverted, 91 (54.2%) highly privately self-conscious, 96 (57.1%) highly publicly self-conscious, and 60 (35.7%) highly self-restrained, with 57 (34.0%) not believing in the existence of COVID-19. COVID-19 knowledge varied significantly by level of study (F [2,165] = 5.539; P = 0.005; η2 = 0.06). Similarly, those with high self-esteem were twice as knowledgeable regarding COVID-19 as those with low self-esteem (odds ratio [OR]: 2.02; 95% CI: 1.08–3.78; P = 0.03) with gleaning COVID-19-related information from social media platforms predicting COVID-19 vaccine hesitancy (CVH) (OR: 0.37; 95% CI: 0.16–0.85; P = 0.02). Conclusions: The observed suboptimal COVID-19 knowledge was associated with participants' low level of self-esteem, and the prevalent CVH was associated with obtaining COVID-19-related information from social media platform. [ABSTRACT FROM AUTHOR]

Objectives This study aims to evaluate the changes in human mobility during a public health emergency.Methods Employing detailed spatiotemporal big data on human mobility from China and the USA, we constructed three mobility indices: Mobility change index, distance change index, and volatility change index. We investigated the mobility characteristics within China's Guangdong-Hong Kong-Macau Greater Bay Area (GBA) and the United States' San Francisco Bay Area (SBA) during the epidemic. The singular value decomposition (SVD) algorithm was applied to identified underlying structures and patterns of mobility in these regions.Results The results show that: (1) The GBA outperformed the SBA in terms of human mobility control with a greater decline in movement volumes, smoother volatility in daily movement and shorter average travel distances during the pandemic. (2) Human mobility patterns in the GBA were influenced by both the Chinese Spring Festival holiday and public health policies, from which the daily travel patterns, returning home travel characteristics and returning-to-work characteristics were identified. Human mobility patterns in the SBA show strong regularity (including daily travel characteristics, weekday travel characteristics and weekend travel characteristics), and public health policies do not have profound impacts.Conclusions We quantify the changes in human mobility patterns under different epidemic control measures in two Bay Areas of China and the United States, which is essential to assess and identify intervention effectiveness. It also provides important evidences and references for various infectious disease control in the future. [ABSTRACT FROM AUTHOR]

ObjectivePublic health emergencies pose a serious challenge to the ability of medical personnel to respond. We aimed to establish a scientific and effective resilience capability assessment scale for grassroots medical workers and explore the way to improve resilience.Research designDeveloped a resilience ability assessment scale and applied it on the medical personnel who worked in community health service centers for more than 1 year. Related indicators were identified through literature review and the Delphi method. The established scale was given weight using the attribute analytic hierarchy process, and the evaluation model was built through the grey correlation analysis.Principal findingsA three-level indicator scale was established, which included three first-level indicators [professional quality (weight 0.346), psychological capital (weight 0.614), and emergency attitude (weight 0.040)]. The second-level indicators had 13 contents and were further subdivided into 46 three-level indicators. The overall resilience ability assessment score of 347 medical workers in Guangzhou was only 0.787. However, steady scientific-exercise habits and relative training can help improve their public health emergency resilience ability (p

ABSTRACT Introduction The COVID‐19 pandemic was a public health emergency (PHE) of unprecedented magnitude and impact. It provided the possibility to investigate the Dutch citizens' understanding and perception of the actors involved in the Dutch pandemic response as a PHE unfolded. Methods Three focus groups (FGs) were held with 16 Dutch citizens in June 2020. Citizens were recruited using the Dutch Health Care Consumer Panel. During the FGs, participants were asked to fill in a table with actors they thought were involved in the management of the COVID‐19 pandemic. They also received information on actors involved in Dutch outbreak responses. Then, the actors named and omitted by the participants were discussed. Results An analysis of the FGs suggests that the Dutch citizens participating in the study were not fully aware of the scope of actors involved in the Dutch COVID‐19 pandemic response. Some participants would have appreciated more information on the actors involved. This would help them have an informed opinion of the actors involved in the decision‐making process, and accept non‐pharmaceutical interventions implemented. Lastly, most participants recognised that they played a role in limiting the spread of the COVID‐19 pandemic. Yet, very few spontaneously mentioned themselves as actors within the COVID‐19 pandemic response. Conclusion This study suggests that early in the COVID‐19 pandemic, the Dutch citizens participating in this study's FG did not have a complete understanding of the scope of actors involved in the Dutch COVID‐19 pandemic response, or the potential role of the citizen. Future research can build on these results to explore the citizen's perception of their role during PHEs of another origin, as well as other geographical and historical contexts. Patient or Public Contribution The public participated in the focus groups and received a non‐expert report summarising the outcomes of the focus groups.

At the beginning of the COVID-19 pandemic, an ad hoc organisational framework was established between academic, local government and community partners to implement the “Sentinella – Identify, Trace and Prevent” screening programme in Verona, north-east Italy. Between September 2020 and May 2021, key populations not covered by any screening policies at the local and national level were screened for SARS-CoV-2. Target populations were: older adult residents (males >65 years and females >75 years), bus and taxi drivers, social workers, supermarket employees, hospital cleaning and catering staff, researchers working in the local hospitals, students, and people experiencing homelessness (PEH). Five dedicated swab clinics, home testing facilities, and one mobile clinic were activated to collect nasopharyngeal swabs. Molecular analysis was performed for all the subjects; an antigen-rapid diagnostic test (Ag-RDT) was also implemented as a point-of-care test for PEH. Medical follow-up, psychological support, and quarantine facilities were organised for subjects who tested positive for SARS-CoV-2. Overall, 2075 subjects participated in the surveillance programme. Amongst these, 1,572 were residents/workers, whilst 503 were PEH. A total of 127 (6.2%) participants tested positive for SARS-CoV-2. Sixty-nine were residents, 58 PEH. The incidence rate was 4 per 10.000 person/day (95% CI 3.1–5.0). The highest prevalence and incidence rates were found amongst supermarket employees (9.7% and 8.5 per 10.000 person/day, 95% CI 3.81–18.86, respectively), followed by hospital cleaning staff (8.1%, 7.6 per 10.000 person/day, CI 95% 4.9–11.7). Regarding PEH, the prevalence of SARS-CoV-2 was 11.5%. All PEH identified as positive were isolated in dedicated shelter facilities. Amongst the 69 residents/workers who were quarantined, 53 were reached for initial psychological support for assessing the presence of any psychological distress or psychiatric pathology. Amongst the subjects evaluated, 10 (18.9%) presented clinically significant psychological discomfort and accessed the stepped-care psychological intervention. The community partnerships played a pivotal role in optimising early case detection. Promotion of testing helped to prevent and contain more efficiently potential clusters through strategic planning, especially for PEH. Insights from the study highlight the importance of community partnerships in public health emergencies, particularly in the context of highly transmissible diseases pathways.

Abstract Background The COVID-19 pandemic forced governments, multilateral public health organisations and research institutions to undertake research quickly to inform their responses to the pandemic. Most COVID-19-related studies required swift approval, creating ethical and practical challenges for regulatory authorities and researchers. In this paper, we examine the landscape of ethics review processes in Africa during public health emergencies (PHEs). Methods We searched four electronic databases (Web of Science, PUBMED, MEDLINE Complete, and CINAHL) to identify articles describing ethics review processes during public health emergencies and/or pandemics. We selected and reviewed those articles that were focused on Africa. We charted the data from the retrieved articles including the authors and year of publication, title, country and disease(s) reference, broad areas of (ethical) consideration, paper type, and approach. Results Of an initial 4536 records retrieved, we screened the titles and abstracts of 1491 articles, and identified 72 articles for full review. Nine articles were selected for inclusion. Of these nine articles, five referenced West African countries including Liberia, Guinea and Sierra Leone, and experiences linked to the Ebola virus disease. Two articles focused on South Africa and Kenya, while the other two articles discussed more general experiences and pitfalls of ethics review during PHEs in Africa more broadly. We found no articles published on ethics review processes in Africa before the 2014 Ebola outbreak, and only a few before the COVID-19 outbreak. Although guidelines on protocol review and approval processes for PHEs were more frequently discussed after the 2014 Ebola outbreak, these did not focus on Africa specifically. Conclusions There is a gap in the literature about ethics review processes and preparedness within Africa during PHEs. This paper underscores the importance of these processes to inform practices that facilitate timely, context-relevant research that adequately recognises and reinforces human dignity within the quest to advance scientific knowledge about diseases. This is important to improve fast responses to PHEs, reduce mortality and morbidity, and enhance the quality of care before, during, and after pandemics.

Abstract Background Public health emergencies are characterized by uncertainty, rapid transmission, a large number of cases, a high rate of critical illness, and a high case fatality rate. The intensive care unit (ICU) is the “last line of defense” for saving lives. And ICU resources play a critical role in the treatment of critical illness and combating public health emergencies. Objective This study estimates the demand for ICU healthcare resources based on an accurate prediction of the surge in the number of critically ill patients in the short term. The aim is to provide hospitals with a basis for scientific decision-making, to improve rescue efficiency, and to avoid excessive costs due to overly large resource reserves. Methods A demand forecasting method for ICU healthcare resources is proposed based on the number of current confirmed cases. The number of current confirmed cases is estimated using a bilateral long-short-term memory and genetic algorithm support vector regression (BILSTM-GASVR) combined prediction model. Based on this, this paper constructs demand forecasting models for ICU healthcare workers and healthcare material resources to more accurately understand the patterns of changes in the demand for ICU healthcare resources and more precisely meet the treatment needs of critically ill patients. Results Data on the number of COVID-19-infected cases in Shanghai between January 20, 2020, and September 24, 2022, is used to perform a numerical example analysis. Compared to individual prediction models (GASVR, LSTM, BILSTM and Informer), the combined prediction model BILSTM-GASVR produced results that are closer to the real values. The demand forecasting results for ICU healthcare resources showed that the first (ICU human resources) and third (medical equipment resources) categories did not require replenishment during the early stages but experienced a lag in replenishment when shortages occurred during the peak period. The second category (drug resources) is consumed rapidly in the early stages and required earlier replenishment, but replenishment is timelier compared to the first and third categories. However, replenishment is needed throughout the course of the epidemic. Conclusion The first category of resources (human resources) requires long-term planning and the deployment of emergency expansion measures. The second category of resources (drugs) is suitable for the combination of dynamic physical reserves in healthcare institutions with the production capacity reserves of corporations. The third category of resources (medical equipment) is more dependent on the physical reserves in healthcare institutions, but care must be taken to strike a balance between normalcy and emergencies.

With the onset of the COVID-19 pandemic in early 2020, several countries suspended or restricted mass gathering (MG) events to mitigate the risk of superspreading events. Prohibiting MGs aimed to lessen the likelihood of highly infectious persons coming into close contact with many others. Now that the world has opened its doors wide and removed most of precautionary measures, many questions arise. In this review, we aimed to summarize the current evidence regarding the policies and regulations that were implemented for the safe return of MG events. Besides, we highlighted the impact of the return of MG events during 2021 on the trajectory of COVID-19 spread. Canceling MG events can carry religious, societal, economic, and public negative consequences necessitating the safe return of these events. The experience with the COVID-19 pandemic was the foundation for the recommendations for the safe conduction of MG events during the pandemic by international public health bodies. When policymakers adequately applied precautionary measures and strategic approaches, we witnessed the safe holding of huge MG events without aggravating the COVID-19 situation or increasing the number of new cases beyond the capacity and readiness of the national healthcare system.

Although all walks of life are paying less attention to COVID-19, the spread of COVID-19 has never stopped. As an infectious disease, its transmission speed is closely related to the atmosphere environment, particularly the temperature (T) and PM2.5 concentrations. However, How T and PM2.5 concentrations are related to the spread of SARS-CoV-2 and how much their cumulative lag effect differ across cities is unclear. To identify the characteristics of cumulative lag effects of environmental exposure under city differences, this study used a generalized additive model to investigate the associations between T/PM2.5 concentrations and the daily number of new confirmed COVID-19 cases (NNCC) during the outbreak period in the second half of 2021 in Shaoxing, Shijiazhuang, and Dalian. The results showed that except for PM2.5 concentrations in Shaoxing, the NNCC in the three cities generally increased with the unit increase of T and PM2.5 concentrations. In addition, the cumulative lag effects of T/PM2.5 concentrations on NNCC in the three cities reached a peak at lag 26/25, lag 10/26, and lag 18/13 days, respectively, indicating that the response of NNCC to T and PM2.5 concentrations varies among different regions. Therefore, combining local meteorological and air quality conditions to adopt responsive measures is an important way to prevent and control the spread of SARS-CoV-2.

SARS-CoV-2, the cause of the COVID-19 pandemic, has introduced a challenging era characterized by the persistent emergence of subvariants. Even after the World Health Organization announced the end of the pandemic, the virus continues to evolve, posing significant challenges to public health responses. This comprehensive review examines the multifaceted impacts of these subvariants, emphasizing their significance across diverse dimensions. SARS-CoV-2 has genetic variability, especially at the spike protein region, which has given rise to Variants of Concern, including Beta, Delta, Gamma, Alpha, and the highly mutable Omicron, which differently exhibit varying levels of immune evasion, disease severity, and transmissibility. Subvariants within the Omicron lineage, including BA.1, BA.2, BA.3, and others, further complicate the landscape with distinct genetic signatures and varying infectivity levels. The impacts extend to diagnostic techniques, treatment strategies, and vaccine effectiveness, underscoring the need for a comprehensive public health response emphasizing preventive measures, genomic surveillance, and vaccination campaigns. Sustaining these interventions is critical, necessitating long-term strategies considering socio-political factors, community involvement, continuous adaptation of healthcare approaches, robust monitoring, and sustainable public health interventions to effectively combat the virus's ever-changing landscape. [ABSTRACT FROM AUTHOR]

May 11, 2023, marked the end of the federal COVID-19 Public Health Emergency (PHE). During the PHE, regulatory flexibilities allowed telehealth to more effectively connect physicians providing care and patients seeking it. This paper discusses the implications of the end of the PHE on telehealth coverage, payment, reimbursement, and licensure, and exposes inconsistencies and inequities in extant state regulations. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic forced governments, multilateral public health organisations and research institutions to undertake research quickly to inform their responses to the pandemic. Most COVID-19-related studies required swift approval, creating ethical and practical challenges for regulatory authorities and researchers. In this paper, we examine the landscape of ethics review processes in Africa during public health emergencies (PHEs). Methods: We searched four electronic databases (Web of Science, PUBMED, MEDLINE Complete, and CINAHL) to identify articles describing ethics review processes during public health emergencies and/or pandemics. We selected and reviewed those articles that were focused on Africa. We charted the data from the retrieved articles including the authors and year of publication, title, country and disease(s) reference, broad areas of (ethical) consideration, paper type, and approach. Results: Of an initial 4536 records retrieved, we screened the titles and abstracts of 1491 articles, and identified 72 articles for full review. Nine articles were selected for inclusion. Of these nine articles, five referenced West African countries including Liberia, Guinea and Sierra Leone, and experiences linked to the Ebola virus disease. Two articles focused on South Africa and Kenya, while the other two articles discussed more general experiences and pitfalls of ethics review during PHEs in Africa more broadly. We found no articles published on ethics review processes in Africa before the 2014 Ebola outbreak, and only a few before the COVID-19 outbreak. Although guidelines on protocol review and approval processes for PHEs were more frequently discussed after the 2014 Ebola outbreak, these did not focus on Africa specifically. Conclusions: There is a gap in the literature about ethics review processes and preparedness within Africa during PHEs. This paper underscores the importance of these processes to inform practices that facilitate timely, context-relevant research that adequately recognises and reinforces human dignity within the quest to advance scientific knowledge about diseases. This is important to improve fast responses to PHEs, reduce mortality and morbidity, and enhance the quality of care before, during, and after pandemics. [ABSTRACT FROM AUTHOR]