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Guide to the Implementation of the National Electronic Disease Surveillance System (NEDSS) in State Public Health Agencies
"This document is targeted to program managers and surveillance staff in state health agencies who are involved in the implementation of the National Electronic Disease Surveillance System (NEDSS). The target audience includes epidemiologists and other professional staff with varying degrees of computer knowledge and skills. […] The document is divided into three sections. Section I describes NEDSS and the NEDSS architecture. Included in that section is a discussion of what an integrated system is and how the integration of multiple systems can be achieved in different ways. The multiple layers of modern information systems (i.e., user interface, middle layer with business rules, and database) are also discussed. Finally, the NEDSS architecture and its elements are summarized. Section II deals more in detail with NEDSS implementation options for state programs. Fully integrated systems are compared with data warehouses. The option of using CDC-developed NEDSS software is discussed against the alternative of adopting state-developed applications. Some guidance is provided on how to choose the best solution for each state and how many systems should be included in NEDSS. Section III includes a brief description of the resources needed at the state level for the implementation of NEDSS. In addition, connectivity, security, and other important issues (such as confidentiality and legal authority to collect and access surveillance information) are discussed. A section with Frequently Asked Questions (FAQs) and a glossary complete the document."
Council of State and Territorial Epidemiologists
Pezzino, Gianfranco
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Low Dose Interferon, Immune Modulation and Emergency Influenza Prophylaxis
"Warnings have been issued that the avian influenza virus presently killing animals and people in Asia may become the new strain of pandemic flu which could potentially kill millions of people. These warnings have sparked renewed interest in ways to treat or prevent influenza. Clinical observations from thousands of influenza patients in Russia, Ukraine, Bulgaria, China, and Japan claim significant clinical benefits to patients intranasally given low-dose (a few hundred to 10,000 units) interferon during natural outbreaks of influenza. In contrast, in experimental influenza virus challenge studies with human volunteers, those volunteers given 800,000 to 70 million units of interferon by intranasal delivery did not experience a clinical benefit. Data generated using low dose interferon was rejected by Western scientists because of the impure nature of the interferon used in early studies and because the low dose interferon did not seem to make any sense. This review proposes that the subject of low dose interferon for influenza be revisited. Intranasal and oral administration of low-dose interferon deliver interferon to the same receptors in the oral-pharyngeal cavity. Low-dose oral interferon may represent an inexpensive, safe way to modulate the immune system during, or before, influenza infection."
Pathobiologics International
Cummins, Joseph M.; Thompson, Chad G.
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Resource Manual for Seasonal and Pandemic Influenza Testing in Texas
"Both seasonal and pandemic influenza pose a serious threat to the health of the public. Seasonal influenza accounts for over 36,000 deaths in the United States each year. The table below lists estimates for the number of Texans that would be affected by an influenza pandemic. Clinical laboratories typically receive the first specimens for testing during a public health emergency and therefore have an important role in preventing or limiting the impact of a pandemic. This manual is being provided as a resource document to improve understanding of influenza surveillance in Texas and the pandemic influenza testing capabilities of the Texas public health system. In addition, this manual will provide guidance for the over 300 clinical or hospital laboratories in Texas that are involved in influenza diagnosis and pandemic influenza planning efforts." This document includes maps, graphs, charts, and tables to illustrate scientific data.
Texas. Department of State Health Services
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Connecticut Department of Public Health: Avian Flu and Pandemic Flu [website]
This frequently updated webpage contains many documents and links about avian and pandemic flu, including extensive information for healthcare providers.
Connecticut. Department of Public Health
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Who Activities in Avian Influenza and Pandemic Influenza Preparedness, January - May 2006
"From 7-9 November 2005, a meeting on avian influenza and human pandemic influenza was jointly convened by WHO, the Food and Agriculture Organization, the World Organisation for Animal Health, and the World Bank. Participants reached a number of conclusions and agreed on a 12-point action plan. Concerning human health matters, four main opportunities to act were identified: reduce high-risk behaviours associated with human infections; improve the detection, investigation, and reporting of human cases and, in so doing, strengthen the early warning system; contain an emerging pandemic virus; and increase pandemic preparedness. A fifth item - considered by many participants to be the most pressing need for adequate preparedness - concerned world capacity to manufacture sufficient quantities of pandemic vaccines and antiviral drugs, at sufficient speed, and to make these interventions broadly accessible to all countries."
World Health Organization
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Information About Social Distancing
From the Introduction: "Social distancing is a term applied to certain actions that are taken by Public Health officials to stop or slow down the spread of a highly contagious disease. The Health Officer has the legal authority to carry out social distancing measures. Since these measures will have considerable impact on our community, any action to start social distancing measures would be coordinated with local agencies such as cities, police departments and schools, as well as with state and federal partners. The Santa Clara County Public Health Department is the local agency responsible for providing the public with information about social distancing measures. This information is being provided to help you understand what you may be asked to do if the Health Officer puts social distancing measures into practice."
Santa Clara County (Calif.). Public Health Department
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Differential Effects of Intervention Timing on COVID-19 Spread in the United States
From the Document: "Assessing the effects of early non-pharmaceutical interventions on COVID-19 [coronavirus disease 2019] spread in the United States is crucial for understanding and planning future control measures to combat the ongoing pandemic. Here we use county-level observations of reported infections and deaths, in conjunction with human mobility data and a metapopulation transmission model to quantify changes of disease transmission rates in US counties from March 15, 2020 to May 3, 2020. We find significant reductions of the basic reproductive numbers in major metropolitan areas in association with social distancing and other control measures. Counterfactual simulations indicate that, had these same control measures been implemented just 1-2 weeks earlier, a substantial number of cases and deaths could have been averted. Specifically, nationwide, 61.6% [95% CI: 54.6%-67.7%] of reported infections and 55.0% [95% CI: 46.1%-62.2%] of reported deaths as of May 3, 2020 could have been avoided if the same control measures had been implemented just one week earlier. We also examine the effects of delays in re-implementing social distancing following a relaxation of control measures. A longer response time results in a stronger rebound of infections and death. Our findings underscore the importance of early intervention and aggressive response in controlling the COVID-19 pandemic."
Joseph L. Mailman School of Public Health
Pei, Sen; Kandula, Sasikiran; Shaman, Jeffrey
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Safety Guide for the 'New Normal' After COVID-19
From the Webpage: "Protect your children, house, finances and data now that confinement measures are starting to relax. Criminals are still looking for victims."
Europol
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Counties Matter: COVID-19
From the Document: "America's counties are on the front lines of our nation's response to the coronavirus pandemic. During this unprecedented public health emergency and the aftermath of an economic crisis, counties are committed to strong intergovernmental cooperation to mitigate COVID-19 [coronavirus disease 2019] and its far-reaching impacts on America's people and places."
National Association of Counties
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Expected Loss Provisioning Under a Global Pandemic
From the Introduction: "The 2007-09 GFC [Great Financial Crisis] exposed significant shortcomings in the accounting principles that underpinned banks' loan loss provisioning practices. At the time, the accounting standard for loan loss provisioning was based on a so-called incurred loss (IL) model, limiting the ability of banks to recognise loan loss provisions in advance of a loss event. It was also criticised as being procyclical, because a large amount of provisions were recognised only after losses became evident. [...] This paper takes stock of the measures introduced in several jurisdictions to influence how ECL [expected credit losses] methodologies can be applied under the current Covid-19 [coronavirus disease 2019] pandemic. Section 2 compares the key features of incurred and ECL methodologies, while Section 3 summarises the actions taken in the United States and in selected IFRS [International Financial Reporting Standards] jurisdictions that have adopted ECL provisioning frameworks. This section also reviews the cumulative impact of these measures on a bank's financial metrics."
Bank for International Settlements
Zamil, Raihan
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Planning Hospital Needs for Ventilators and Respiratory Therapists in the COVID-19 Crisis
From the Description: "Ideally, no one would have to wait for access to a life-saving device, such as a ventilator. But during the coronavirus disease 2019 (COVID-19) crisis, many hospitals have run short of ventilators -- as well as respiratory therapists (RTs) who are trained to operate them -- while other facilities scramble to prepare for the coming demand surge. Any patient who needs a ventilator might not be able to get one, imperiling their survival. Mathematically, the delay that a patient may experience depends on the number of ventilators at the hospital, the number of patients who need them, and the average time that patients spend on them. COVID-19 increases the arrival rate of ventilator patients at hospitals, and these patients have longer lengths of stay, resulting in the sharp rise in demand for ventilators. Hospitals need to estimate how many ventilators they will need to respond to this crisis, accounting for increased uncertain arrival rates and lengths of stay. At the same time, regional coordinators want to know which hospitals have the greatest need for the next spare ventilator or available capacity for the next ventilator patient. To address the ventilator allocation problem at both of these levels, the authors of this Perspective designed a model that can be used to calculate the number of ventilators and RTs needed to achieve a target wait time -- the average delay for a ventilator experienced by a new patient. The target wait time corresponds with a probability that any wait is experienced: If the average wait is small, most patients would in fact experience no wait at all. At the regional level, planners can use this model to assess needs and allocate patients or resources efficiently across hospitals in order to minimize patient wait time."
RAND Corporation
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Macroeconomic Spillover Effects of the Pandemic on the Global Economy: Appendix
From the Document: "Although some economic dislocation is unavoidable in order to contain the spread of the virus, the overall economic consequences will depend on how quickly economic activity rebounds after confinement measures are repealed. Two economic parameters play a central role in the response to the pandemic: the persistence of output fluctuations within each part of the world and the strength of international spillovers."
Bank for International Settlements
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Using Telebehavioral Health to Increase Access to Care for Rural and Vulnerable Populations Amid COVID-19
From the Document: "There are an estimated 11.4 million adults living with a serious mental illness and 20.3 million people aged 12 or older with a substance use disorder in the United States. Pandemics and infectious disease outbreaks such as COVID-19 [coronavirus disease 2019] can increase fear-induced behaviors and trigger or worsen psychiatric disorders such as depression, anxiety, post-traumatic stress, and substance use. Compounding this burden are the pre-existing disparities that rural and vulnerable populations face, including higher rates of poverty, absent or inadequate health insurance coverage, and limited public transportation options. During this time, it is critical to consider strategies that maintain and expand effective behavioral healthcare services to these already-stressed populations. Federal agencies and states have temporarily expanded access to telehealth services to increase access to care. One strategy that states and territories are leveraging to deliver behavioral health services and reduce health disparities during this pandemic is telebehavioral health, a form of telehealth that utilizes virtual communication technologies to provide mental health and substance use services."
Association of State and Territorial Health Officials (U.S.)
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Managing Risk and Facilitating Trade in the COVID-19 Pandemic
From the Overview: "Maintaining trade flows as much as possible during the COVID-19 [coronavirus disease 2019] pandemic will be crucial in providing access to essential food and medical items and in limiting negative impacts on jobs and poverty. Some countries are closing border crossings and implementing protectionist measures such as restricting exports of critical medical supplies. Although these measures may in the short-term provide some immediate reduction in the spread of the disease, in the medium term they may undermine health protection, as countries lose access to essential products to fight the pandemic. Instead, governments should refrain from introducing new barriers to trade and consider removing import tariffs and other taxes at the border on critical medical equipment and products, including food, to support the health response. Trade facilitation measures can contribute to the response to the crisis by expediting the movement, release, and clearance of goods, including goods in transit. The World Bank Group provides guidance and technical assistance to developing and least developed countries to implement best practices to facilitate the free flow of goods. This note provides initial guidance on measures: [1] to support business continuity and protection of front-line officers, and [2] to facilitate safe cross-border trade, which includes (i) handling of relief/emergency consignments, (ii) enhanced use of risk management, safe processing of risk passengers and (iii) increased internal and external border agency collaboration."
World Bank Group
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Do's and Don'ts of Trade Policy in the Response to COVID-19
From the Overview: "Despite the initial inclination of policy makers to close borders, maintaining trade flows during the COVID-19 [coronavirus disease 2019] pandemic will be crucial. Trade in both goods and services will play a key role in overcoming the pandemic and limiting its impact in the following ways: [1] by providing access to essential medical goods (including material inputs for their production) and services to help contain the pandemic and treat those affected, [2] ensuring access to food throughout the world, [3] providing farmers with necessary inputs (seeds, fertilizers, pesticides, equipment, veterinary products) for the next harvest, [4] by supporting jobs and maintaining economic activity in the face of a global recession. Substantial disruption to regional and global value chains will reduce employment and increase poverty. Trade policies will therefore be an essential instrument in the management of the crisis. Trade policy reforms, such as tariff reductions, can contribute: [1] to reducing the cost and improving the availability of COVID-19 goods and services, [2] to reducing tax and administrative burdens on importers and exporters, [3] to reducing the cost of food and other products heavily consumed by the poor and contributing to the macro-economic measures introduced to limit the negative economic and social impact of the COVID-19 related downturn, [4] to supporting the eventual economic recovery and building resilience to future crises."
World Bank Group
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Investing in the Early Years During COVID-19
From the Document: "Young children need comprehensive nurturing care which includes good health, adequate nutrition, early learning opportunities, responsive caregiving, and safety and security. Severe, lifelong impacts can result from deprivations during the early years if children do not have these critical inputs to ensure optimal child development. The World Bank's Investing in the Early Years framework [...] lays out three pillars to ensure children reach their full potential: i. Children are healthy and well-nourished, especially in the first 1,000 days; ii. Children receive early stimulation and learning opportunities; iii. Children are nurtured and protected from stress. In the following three pages, we set out specific risks that children face under each of these pillars due to the COVID-19 [coronavirus disease 2019] crisis, together with response options, potential platforms and country examples. While health and nutrition are key elements of the COVID-19 emergency response and are more likely to be addressed immediately, empowering parents to provide warm and responsive caregiving and ensuring safety and security of young children and early learning opportunities for young children is essential and risks falling through the cracks."
World Bank Group
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Coronavirus Anxiety Project [website]
From the Purpose: "[The Coronavirus Anxiety Project] is a research team that is studying how fear and anxiety about the coronavirus are affecting mental health and well-being of people around the globe. As of June 1, 2020, we have two mental health screeners of COVID-19 [coronavirus disease 2019] anxiety that have solid reliability and validity support. These instruments are now registered as research tools by the NIH [National Institutes of Health] Public Health Emergency and Disaster Research Response (DR2) Program. [...] The Coronavirus Anxiety Scale (CAS; Lee, 2020) assesses dysfunctional anxiety symptoms associated with the coronavirus. The CAS is currently being translated into many different languages and is being used by over 50 teams of health professionals and researchers from around the world. The newest COVID-19 instrument is the Obsession with COVID-19 Scale (OCS; Lee, 2020), which assesses persistent and disturbed thinking about COVID-19. Our hope is that health professionals and scholars will use these tools to identify people at risk for or suffering from clinically significant anxiety related to the coronavirus."
The Coronavirus Anxiety Project
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Roadmap to Recovery: CNL's Plan for Safe Business Resumption
From the Document: "This too shall pass. Timeless words, spoken in one variant or another, for centuries. While the COVID [coronavirus disease 2019] pandemic has thrown our global community into never-before-seen turbulence for the past few months, it too will draw to a close. When and how exactly this will play out is not known, but it is critical that CNL [Canadian Nuclear Laboratories] is ready when it does. This plan presents our approach towards a careful, thoughtful, and reasonable return to routine operations across CNL. It is guided by our unwavering commitment to the protection of our staff, the safety of our campuses and facilities, and protection of public and the environment; and reflects the advice and guidance of provincial and federal health authorities."
Canadian Nuclear Laboratories
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COVID-19 Employee Health Screening Survey
This document contains information on mandatory employee health survey at the beginning and end of the work shift for employees of Santa Monica Police Department.
Santa Monica (Calif.). Police Department
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[City of Santa Monica: Stay at Home/Safer at Home Warning]
This brochure includes information on administrative citations to enforce Emergency Orders.
Santa Monica (Calif.)
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Rural Test & Trace Toolkit: RT3 [website]
From the Website: "Vashon is a rural island community of 11,000 located in Puget Sound near Seattle, WA. We have no acute care or hospital care. When faced with these challenges, we developed and deployed a testing strategy that allowed our community to launch a successful testing site in less than 3 weeks using local resources, a volunteer workforce and without resources from our county's public health system that was already stretched thin. We believe that by following our blueprint, rural and tribal communities could stand up similar testing in one week using volunteer or professional medical and non-medical staff. Our strategy is founded on three basic principles: 1) that informed patients can self-collect nasal swab specimens for testing; 2) that exposure of volunteer healthcare workers to SARS-CoV2 [severe acute respiratory syndrome coronavirus 2] must be minimized; and 3) PPE [personal protective equipment] use can be minimized during testing by isolating patients and workers from each other throughout the testing process."
VashonBePrepared
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COVID-19 Healthcare Delivery Impacts
From the Document: "The COVID-19 [coronavirus disease 2019] pandemic and the associated community mitigation efforts enacted have altered the delivery of and access to healthcare across the U.S. For example, emergency department (ED) visits are down by an estimated 40% in many communities across the country; many in-person office visits have been either postponed or changed to telehealth visits; elective procedures have been postponed indefinitely; and other forms of healthcare delivery have been changed to accommodate social distancing and community mitigation measures. Community mitigation actions, often driven by government orders and mandates, may lead to a change in demand for traditional healthcare services. This tip sheet can help healthcare system planners prepare to mitigate these potential healthcare delivery impacts."
United States. Technical Resources, Assistance Center and Information Exchange
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Technical Note: COVID-19 and Children Deprived of Their Liberty
From the Introduction: "Experience from previous infectious disease outbreaks indicates that new child protection risks are likely to emerge from the direct effects of COVID-19 [coronavirus disease 2019] as well as from measures to prevent and control its spread. Moreover, existing child protection risks are likely to be exacerbated. Some groups of people are more vulnerable in these circumstances, including, as discussed in this note, children deprived of their liberty, who often have compromised psychosocial, physical and mental health issues, live in crowded or unhygienic conditions and are more vulnerable to abuse and neglect. Lessons learned from previous outbreaks emphasize the need for States to accommodate increased child protection needs when devising and implementing their response plans. Failure to address such needs or delayed implementation of coordinated responses can increase suffering, cause irreparable harm to children and can delay the recovery of whole communities."
Alliance for Child Protection in Humanitarian Action; UNICEF
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Pandemic Influenza Continuity of Operations Annex Template
"This template provides guidance to assist organizations in developing a Pandemic Influenza Continuity of Operations plan or, if the organization already has a continuity plan, a Pandemic Influenza Annex. General guidance and sample information is provided for reference and organizations are encouraged to tailor Pandemic Influenza Continuity plans to meet specific organizational needs and requirements. The template contains all elements of a viable continuity plan and allows organizations to insert information as deemed appropriate."
United States. Federal Emergency Management Agency
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Pandemic Influenza Continuity of Operations (COOP) Lake County Sheriff's Office
From the Introduction: "The Federal Government performs essential functions and services that may be adversely impacted in the event of a natural or man-made disaster. In such events, all government Departments and Agencies should have plans to continue to operate their core missions. Maintaining essential functions and services is a vital element in an organization's ability to continue operations. Continuity of operations for various agencies, businesses, and governmental jurisdictions may be disrupted during a pandemic; therefore, it is important for these entities, in particular, the Lake County Sheriff's Office, to ensure it can execute its essential missions in the event of a threat to its normal continuity of operations. Federal Preparedness Circular (FPC) 65, Federal Executive Branch Continuity of Operations (COOP), provides guidance to Federal Executive Branch Departments and Agencies for use in developing contingency plans and programs for COOP. COOP planning is intended to ensure the performance of Department and Agency essential functions across a wide range of all-hazards emergencies."
Lake County (Ohio). Sheriff's Office
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Thinking Through the Unthinkable - How Help from an Unlikely Source Will Strengthen Capacity and Reduce Terrorist Threats in and Around the Straits of Malacca and Singapore
From the Abstract: "This paper describes how the United States government can help Singapore's Information Fusion Center identify, target, and eliminate or reduce the threat of maritime terrorism in the Straits of Malacca and Singapore (Straits). The geography of the Straits and the volume of shipping trade that passes through its waterways make the Straits a prime target for terrorists, and an ongoing security concern for the Indonesian government. Despite coordination, joint patrols and even local maritime information centers amongst partner nations, there remains much to improve Indonesia's security posture and counter-terrorism capabilities in and around the Straits. Jakarta's concern over the Straits, and its nearby ports, is no different than another mega city that struggles with similar terrorist threats and challenges within its own ports and waterways - New York City. In New York, the agency charged with preventing terrorist attacks is a law enforcement one, the New York City Police Department, whose officers and analysts could share their knowledge, specifically in predictive analytics, to stop terrorist threats in Indonesia's 'back yard'. Such assistance will benefit both parties facing terrorists that plan and operate globally, but strike locally."
Asia-Pacific Center for Security Studies
Carter, Alex
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COVID-19 Pandemic Planning Scenarios
From the Document: "CDC [Centers for Disease Control and Prevention] and the Office of the Assistant Secretary for Preparedness and Response (ASPR) have developed five COVID-19 [coronavirus disease 2019] Pandemic Planning Scenarios that are designed to help inform decisions by modelers and public health officials who utilize mathematical modeling. The planning scenarios are being used by mathematical modelers throughout the Federal government. Models developed using the data provided in the planning scenarios can help evaluate the potential effects of different community mitigation strategies (e.g., social distancing)."
Centers for Disease Control and Prevention (U.S.); United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
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Moral Injury in Healthcare Workers on the Frontlines of the Coronavirus (COVID-19) Outbreak
From the Document: "Moral injury (sometimes referred to as 'moral distress') can occur when someone engages in, fails to prevent, or witnesses acts that conflict with their values or beliefs. Most healthcare workers typically do not experience significant distress from difficult situations at work because of their training and preparation, healthcare cultural norms, messages and behavior of peers and leaders, and acceptance by families and the culture at large. However, in unprecedented contexts, such as a pandemic, some people may have difficulty with unfamiliar and potentially distressing work experiences."
National Center for Post-Traumatic Stress Disorder (U.S.)
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Emotional Well-Being and Coping During COVID-19
From the Document: "These are unprecedented times. We need to work extra hard to manage our emotions well. Expect to have a lot of mixed feelings. Naturally we feel anxiety, and maybe waves of panic, particularly when seeing new headlines. A recent article by stress scientist and Vice Chair of Adult Psychology Elissa Epel, PhD, outlines the psychology behind the COVID-19 [coronavirus disease 2019] panic response and how we can try to make the best of this situation. Our anxiety is helping us cope, bond together from a physical distance, and slow the spread of the virus. So our anxiety - while uncomfortable - is a good thing right now, especially if we manage it well. At the same time, we must effortfully prevent panic contagion and create periods when we can be screen-free and calm, engaging our attention in normal daily activities. Seize opportunities to share lightness and humor. Laughter right now is a relief for all of us!"
University of California, San Francisco
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CDC: Influenza (Flu) [website]
This website from the Centers for Disease Control and Prevention (CDC) provides up to date information related to seasonal and other influenza viruses, including pandemic flu. The website contains a variety of resources and tools including: a Flu Vaccine Finder; flu activity and surveillance maps, information on international flu activities, and information for specific high-risk groups.
Centers for Disease Control and Prevention (U.S.)
