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21 January 2022
The overall threat posed by Omicron largely depends on four key questions: (i) how transmissible the variant is; (ii) how well vaccines and prior infection protect against infection, transmission, clinical disease and death; (iii) how virulent the variant is compared to other varian
...
ts; and (iv) how populations understand these dynamics, perceive risk and follow control measures, including public health and social measures (PHSM).
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The WHO health advisory provides guidance to countries on adapting all existing preparedness and response plans and procedures for natural hazards such as cyclones, tropical storms, tornadoes, floods, earthquakes and potential outbreaks of other diseases to their existing COVID-19 strategic prepared
...
ness and response plans. It advises countries to sustain all established public health and social measures to prevent and control COVID-19 while simultaneously preparing for responding to and effectively manage other disaster risks and events. It highlights WHO’s call for local, national, regional and global solidarity to support countries and communities with high levels of vulnerability to natural hazards during the COVID-19 pandemic.
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This document aims to provide public health authorities in European Union and European Economic Area (EU/EEA) countries with guidance for improved preparedness planning taking the lessons that have been identified through various activities in the context of recent public health crises (e.g. COVID-1
...
9 pandemic, mpox multi-country outbreak 2022–23) and translating them to concrete advice. This document, together with the ECDC recommendations on the implementation of public health and social measures (PHSMs) for health emergencies and pandemics published in 2024, form a package of concrete recommendations for preparedness planning for the EU/EEA countries. Lessons learned primarily from the response to the COVID-19 pandemic, but also from the response to the multicountry mpox outbreak in 2022–23, were collected through various activities from Member States, the European Commission, the World Health Organization (WHO) and the WHO Regional Office from Europe. We have then presented these in the form of specific recommendations for planners within each phase of the continuous cycle of preparedness (Anticipation, Response and Recovery), following a prototype structure of a preparedness and response plan. In each section, we have presented a relevant example from a Member State or international organisation to illustrate their practice or attempt to implement lessons after COVID-19 or the mpox outbreak. These examples were identified either through literature review or communication with representatives of the countries within ECDC’s network for Preparedness and Response.
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South Africa reported it fist case of COVID-19 on 5 March 2020. While the first cases were imported, local transmission has led to a rapid increase in the number of cases. As of 21 April 2020, more than 3,400 cases and 58 deaths had been confirmed. On 15 March, President Cyril Ramaphosa declared a n
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ational state of disaster, and the government has since taken several measures to curb the spread of the virus, including closing borders, implementing strict social distancing measures and a 35-day nation-wide lockdown. These measures, along with the global economic shock caused by the pandemic, are expected to generate rising needs requiring an immediate and urgent response. Although South Africa is considered an upper-middle-income country, the amount of disparities—social, economic, and gender—make the country particularly vulnerable during this emergency.
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The COVID-19 pandemic has had an unprecedented impact on health care systems that, in many instances, worsened the already existing assistance gaps. When it comes to Latin America and Central America, this challenge adds to the consequences mass mobilizations have had in recent years, which have exc
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eeded the national capacities to provide prompt assistance and social protection, particularly in the health care field. This pandemic has a direct impact on people on the move since the movement restriction policies and the lockdown and social distancing measures have reduced their ability to insert themselves into economic activities that were already precarious in many cases. Consequently, they have less access to food, housing, medicines and other essential consumer goods, and fewer possibilities of getting to their countries of destinati
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World Psychiatry. 2010 Jun;9(2):67-77.
The main recommendations are presented in relation to: the need for coordinated policies, plans and programmes, the requirement to scale up services for whole populations, the importance of promoting community awareness about mental illness to increase levels
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of help-seeking, the need to establish effective financial and budgetary provisions to directly support services provided in the community. The paper concludes by setting out a series of lessons learned from the accumulated practice of community mental health care to date worldwide, with a particular focus on the social and governmental measures that are required at the national level, the key steps to take in the organization of the local mental health system, lessons learned by professionals and practitioners, and how to most effectively harness the experience of users, families, and other advocates
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Zambia is facing a severe economic crisis marked by high inflation, increasing poverty and a heavy debt burden that is straining both its fiscal stability and progress in health outcomes. By 2020, the country's external debt reached United States dollars (USD) 12.7 billion, representing 108% of the
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country's gross domestic product (GDP). In 2020, Zambia sought assistance through the G20 Common Framework and the International Monetary Fund (IMF) Extended Credit Facility (ECF), securing a USD 1.7 billion loan over 5 years. IMF loans, however, come with austerity measures that prioritise fiscal discipline but could potentially exacerbate social inequalities. These measures, which include increasing consumer taxes on goods and services (value added taxes - VATs), electricity tariffs and fuel prices, disproportionately impact vulnerable populations, raising concerns about their long-term effects on essential services, especially accessible and good quality healthcare services.
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The COVID-19 Law Lab initiative gathers and shares legal documents from over 190 countries across the world to help states establish and implement strong legal frameworks to manage the pandemic. The goal is to ensure that laws protect the health and wellbeing of individuals and communities and that
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they adhere to international human rights standards.
The COVID-19 Law Lab is a database of laws that countries have implemented in response to the pandemic. It includes state of emergency declarations, quarantine measures, disease surveillance, legal measures relating to mask-wearing, social distancing, and access to medication and vaccines. The database will continue to grow as more countries and themes are added.
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interim guidance, 27 May 2021
All countries should increase their level of preparedness, alert and response to identify, manage and care for new cases of COVID-19. Countries should prepare to respond to different public health scenarios, recognizing that there is no one-size-fits-all approach to ma
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naging cases and outbreaks of COVID-19. Each country should assess its risk and rapidly implement the necessary measures at the appropriate scale to reduce both COVID-19 transmission and economic, public and social impacts.
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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the
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y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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Lancet 2021; 398: Series: Heat and Health
Hot weather and heat extremes harm human health, with poverty, ageing, and chronic illnesses as aggravating factors. As the global community contends with even hotter weather in a changing climate, there is a pressing need to better understand the most eff
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ective prevention and response measures, particularly in low-resource settings. In this two-paper series, the physiological, social, and environmental factors that contribute to individual heat vulnerability, and the megatrends affecting future heat-related morbidity and mortality at the population level, are comprehensively reviewed. Solutions to address the physiological heat strain that underlies the negative health effects of heat extremes and hot weather, which can be employed across a range of settings at individual, building, and landscape scales, are presented.
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In Control: A Practical Handbook for Professionals Working in Health Emergencies Internationally RKI
The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin
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gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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Every two minutes, a child under the age of 5 dies from malaria. Under-five children accounted for 67 per cent of all malaria deaths worldwide in 2018. Most of them occurred in sub-Saharan Africa where an estimated 24 million children were infected with its deadliest form. In addition to being the t
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hird-deadliest infectious disease for children, malaria infection and the costs of treatment traps families in a cycle of illness, suffering and poverty.This year’s World Malaria Day is marred by the emergence of the COVID-19 outbreak, which further threatens people’s lives and well-being. Public health officials are taking precautionary and often aggressive measures to limit transmission of this virus, including reductions in social movement, physical distancing, hand-washing and recommending the use of personal protection equipment in high-risk settings. However, while focusing on combating this disease, the world cannot afford to ignore other diseases, such as malaria.
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There is widespread recognition of the growing threat of infectious disease epidemics and pandemics spreading across countries or continents—especially following the recent Ebola and COVID-19 pandemics. Vulnerable groups (including children, older adults, ethnic minorities and other at-risk group
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s) have disproportionately borne the brunt of significant health, social, and economic effects of these epidemics and pandemics, with varying degrees of support received depending on the context. While many argue that communities should or need to play a critical role in supporting and leading preparedness and response efforts, work still needs to be done to engage them effectively. In many instances, modes of engagement with communities—especially by state authorities–have come too late, often as an afterthought are not adequately thought through and have undermined public trust in and support for, disease prevention and control measures
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The WHO continuously reviews available data on SARS-CoV-2 variants of concern. For this version, the global epidemiological
situation of the COVID-19 pandemic as of 21 January 2022 – at a time when the Omicron VOC had been identified in 171
countries across all six WHO Regions and was rapidly re
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placing Delta worldwide – was considered Omicron has a substantial growth advantage, higher secondary attack rates and a higher observed reproduction number than Delta.
There is now significant evidence that immune evasion contributes to the rapid spread of Omicron. Other factors may be a shorter
serial interval (by about 0.8 to 1.2 days compared to Delta) and potential increased intrinsic transmission fitness . There is
growing evidence that with Omicron, there is lower vaccine effectiveness (VE) against infection and symptomatic disease soon after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary series against infection and symptomatic disease for the studied vaccines. Further studies are required to better understand the drivers of transmission and declining incidence in various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of immune evasion, vaccination coverage and level of vaccine-derived and post-infection immunity, levels of social mixing and degree of application of public health and social measures (PHSM).
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One of the principles underpinning the delivery of all essential services and coordination of those services is the “survivor-centered approach”, which places the human rights, needs, and wishes of women and girl survivors at the centre of service delivery.
A key challenge faced by many entit
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ies working to end violence against women is ensuring that survivors’ voices and inputs are incorporated into policies, practices, and procedures on response. Survivors have diverse needs and face different risks. Not all women and girls experience violence in the same way. An effective intervention takes into account the realities of their unique circumstances, addresses individual needs, and reduces the risk for further harm and suffering.
UN Women, together with Global Rights for Women, have developed “Safe consultations with survivors of violence against women and girls”, which is designed to provide practical steps, safety measures, and actions that government agencies, civil society and survivor organizations, and United Nations’ entities can take to incorporate survivors' voices into systemic reform efforts, through safe and meaningful consultations.
This guidance is intended to help policymakers develop survivor-centered programming on ending violence against women and girls that meets the needs of diverse groups of women and girls, including those who are at higher risk of experiencing violence and discrimination. It is applicable to programming across the health, justice and policing, and social services sectors, as well as coordination of these sectors, and will help improve the standard and delivery of essential services for women and girls who have experienced violence.
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The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline
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is available both online and PDF.
**This version of the living guideline (version 5.0) **includes the following seven revised statements for the prevention, identification and management of SARS-CoV-2 infections among health and care workers:
a good practice statement on national and subnational testing strategies;
a good practice statement on passive syndromic surveillance of health and care workers;
a good practice statement on prioritizing health and care workers for SARS-CoV-2 testing;
a good practice statement on protocols for reporting and managing health and care worker exposures;
a good practice statement to limit in-person work of health and care workers with active SARS-CoV-2 infections;
a statement on high-risk exposures and quarantine; and,
a conditional recommendation on the duration of isolation for health and care workers.
Understanding the updated section
Prevention of infections in the health care setting includes a multi-pronged and multi-factorial approach that includes IPC and occupational health and safety measures and adherence to Public Health and Social Measures in the community by the health workforce. The underlying infection prevention and control strategy of this section is the notion that early identification of symptomatic cases, testing and quarantining/isolating health and care workers decreases the risk of nosocomial infection to patients and to other health and care workers.
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The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”.
In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct
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definition were determined and the potential impact of incorrect answers on prevalence estimates from the survey was assessed.
Current wheeze was reported by 13.2% of children. Overall, 83.5% of parents correctly identified “whistling or squeaking” as the definition of wheeze; the proportion was higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio (OR) 3.0), maternal history of asthma (OR 1.5) and maternal education (OR 1.5) were significantly associated with a correct answer, while the converse was found for South Asian ethnicity (OR 0.6), first language not English (OR 0.6) and living in a deprived neighbourhood (OR 0.6).
In summary, the present study showed that misunderstanding could lead to an important bias in assessing the prevalence of wheeze, resulting in an underestimation in children from South Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term wheeze.
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Background paper 9
The Independent Panel for Pandemic Preparedness and Response
May 2021
The social protection landscape for people affected by TB in the WHO South-East Asia Region
