Digital Commons Network^™

Estimating R0 From Early Exponential Growth: Parallels Between 1918 Influenza And 2020 Sars-Cov-2 Pandemics, Grant Foster, Bret D. Elderd, Robert L. Richards, Tad Dallas

Faculty Publications

The large spatial scale, geographical overlap, and similarities in transmission mode between the 1918 H1N1 influenza and 2020 SARS-CoV-2 pandemics together provide a novel opportunity to investigate relationships between transmission of two different diseases in the same location. To this end, we use initial exponential growth rates in a Bayesian hierarchical framework to estimate the basic reproductive number, R0, of both disease outbreaks in a common set of 43 cities in the United States. By leveraging multiple epidemic time series across a large spatial area, we are able to better characterize the variation in R0 across the United States. Additionally, …

Estimating R0 From Early Exponential Growth: Parallels Between 1918 Influenza And 2020 Sars-Cov-2 Pandemics, Grant Foster, Bret D. Elderd, Robert L. Richards, Tad Dallas

Faculty Publications

The large spatial scale, geographical overlap, and similarities in transmission mode between the 1918 H1N1 influenza and 2020 SARS-CoV-2 pandemics together provide a novel opportunity to investigate relationships between transmission of two different diseases in the same location. To this end, we use initial exponential growth rates in a Bayesian hierarchical framework to estimate the basic reproductive number, R₀, of both disease outbreaks in a common set of 43 cities in the United States. By leveraging multiple epidemic time series across a large spatial area, we are able to better characterize the variation in R₀ across the …

The Covid-19 Pandemic And Disruptions To Essential Health Services In Kenya: A Retrospective Time-Series Analysis, Helen Kiarie, Marleen Temmerman, Mutono Nyamai, Nzisa Liku, Wangari Thuo, Violet Oramisi, Lilly Nyaga, Janette Karimi, Phidelis Wamalwa, Gladwell Gatheca

Obstetrics and Gynaecology, East Africa

Background: Public health emergencies can disrupt the provision of and access to essential health-care services, exacerbating health crises. We aimed to assess the effect of the COVID-19 pandemic on essential health-care services in Kenya.

Methods: Using county-level data routinely collected from the health information system from health facilities across the country, we used a robust mixed-effect model to examine changes in 17 indicators of essential health services across four periods: the pre-pandemic period (from January, 2018 to February, 2020), two pandemic periods (from March to November 2020, and February to October, 2021), and the period during the COVID-19-associated health-care workers’ …

Exploring The Impact Of Health Worker Strikes On Maternal And Child Health In A Kenyan County, Abdu Mohiddin, Eva Langat, James Orwa, Violet Naanyu, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Studies of the impact of health care workers’ strikes tend to look at facility-level activity rather than populations, with evidence from low and middle-income countries relatively sparse. This study explored the effect of national strikes on maternal and child health. It looked at the impact on health system activity in both public and non-public sectors (e.g. private, faith-based), on health promotion investments like immunisation, and on disease detection like post-partum haemorrhage (PPH). A 100 day doctors’ strike started in December 2016, a 150 day nurses strike from June 2017 and then the clinical officers for 21 days that …

The Need For Sexual Health Clinics, Their Future Role, And Contribution To Public Health, Meena S. Ramchandani, Christopher Bourne, Lindley A. Barbee, Elske Hoornenborg, Preeti Pathela, Stephanie N. Taylor, Henry De Vries

School of Medicine Faculty Publications

Specialised sexual health clinics (SHCs) play an important role in addressing the staggering rates of STIs seen in many high-income nations. Despite increasing healthcare coverage in the US and nationalised health care in some countries, there is a continued need for SHCs to meet the needs of patients and the community, especially for high-priority populations: those at high risk of STI acquisition and/or groups historically marginalised and underserved in the traditional healthcare system. We need to mobilise resources to support a stronger clinical infrastructure in specialised SHCs. This review describes the importance of SHCs, their future role, and some of …

Administrative Data Improves Quality Of Cervical Pre-Cancer Surveillance In Davidson County, Tennessee, United States, Sheelah Blankenship, Manideepthi Pemmaraju, Edward Mitchel, Tiffanie M. Markus, Marie R. Griffin, Jessica L. Castilho

Journal of Health Research

Background: Accurate data are critical for public health surveillance yet can be challenging to ensure. The Tennessee (TN) HPV Vaccine IMPACT Project aims to assess the effectiveness of the human papillomavirus (HPV) vaccine in prevention of cervical cancer and high-grade dysplasia through laboratory reporting of pathology results among Davidson County women. This project assessed feasibility and value of use of administrative sources for improved data quality and completeness of high-grade cervical events in TN HPV-IMPACT between 2013-2017.

Method: We queried three administrative data systems (Hospital Discharge Data System, Ambulatory Surgical Treatment Center, and Tennessee Medicaid [TennCare]) for eligible women with …

A Multicenter Weighted Lottery To Equitably Allocate Scarce Covid-19 Therapeutics, Douglas B. White, Erin K. Mccreary, Chung-Chou H. Chang, Mark Schmidhoffer, J. Ryan Bariola, Naudia N. Jonassaint, Govind C. Persad, Robert D. Truog, Parag A. Pathak, Tayfun Sönmez, M. Utku Unver

Sturm College of Law: Faculty Scholarship

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need. Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oralantiviral Paxlovid.

Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend …

Data Privacy In The Time Of Plague, Cason Schmit, Brian N. Larson, Hye-Chung Kum

Faculty Scholarship

Data privacy is a life-or-death matter for public health. Beginning in late fall 2019, two series of events unfolded, one everyone talked about and one hardly anyone noticed: The greatest world-health crisis in at least 100 years, the COVID-19 pandemic; and the development of the Personal Data Protection Act Committee by the Uniform Law Commissioners (ULC) in the United States. By July 2021, each of these stories had reached a turning point. In the developed, Western world, most people who wanted to receive the vaccine against COVID- 19 could do so. Meanwhile, the ULC adopted the Uniform Personal Data Protection …

Impact Of Biosecurity Measures, Social Pressure And Bullying On Attitudes, Perceptions, And Job Satisfaction Levels Among Healthcare Workers During The Covid-19 Pandemic: A Cross-Sectional Survey, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho-Leon, Geovanny Efraín Alvarado-Villa, Derly Madeleiny Andrade-Molina, Juan Carlos Fernandez-Cadena, Arjola Agolli, Zeynep Yukselen, Miguel Felix, Juan Carlos Gallardo Bastidas

Department of Paediatrics and Child Health

Introduction: The extent and nature of social pressure and bullying towards healthcare workers (HCWs) during the COVID-19 remains unclear. The following study identifies the effect of social pressure and bullying directed towards HCWs when using biosecurity measures during the COVID-19 pandemic; further, the impact on perceptions, attitudes and job satisfaction level is also explored.
Methodology: We conducted a cross-sectional survey-based study among 684 Ecuadorian HCWs. The survey consisted of 38 questions related to the frequency, attitudes, and perceptions of biosecurity measures during the COVID-19 pandemic. Exploratory factor analysis was performed to assess the validity of the questionnaire. Associations between variables …

Diagnostic Accuracy Of Various Immunochromatographic Tests For Ns1 Antigen And Igm Antibodies Detection In Acute Dengue Virus Infection, Mughees Haider, Saira Yousaf, Asifa Zaib, Azza Sarfraz, Zouina Sarfraz, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Introduction: Rapid diagnostic tests (RDTs) were evaluated, in this paper, for their utility as a reliable test, using resource-constrained studies. In most studies, NS1 antigen and immunoglobulin M (IgM)-based immunochromatographic tests (ICTs) were considered for acute phase detection. We aimed to evaluate the diagnostic accuracy of NS1, IgM, and NS1/IgM-based ICTs to detect acute dengue virus (DENV) infection in dengue-endemic regions.
Methods: Studies were electronically identified using the following databases: MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL Plus. Keywords including dengue, rapid diagnostic test, immunochromatography, sensitivity, specificity, and diagnosis were applied across databases. In total, 15 studies were …

Total Prevention: A History Of Schistosomiasis In Japan, Alexander Bay

History Faculty Articles and Research

In Japan, schistosomiasis was endemic in Yamanashi Prefecture and a few other hotspot areas where the Miya’iri snail lived. The parasite’s lifecycle relied on the intermediary Miya’iri snail as well as the human host. Parasite eggs passed into the agrarian environment through untreated night soil used as fertiliser or through the culture of open defecation in rural Japan. Manmade rice fields and irrigation ditches, night soil covered paddies and highly refined growing seasons put people in flooded rice paddies to intensively work the land in the spring and summer. The disease was equally dependent on human intervention in the natural …

Does Public Health Start Within Jails? A New Incentive For Reform Of Wisconsin's Bail System, Mahmood N. Abdellatif

Marquette Law Review

Wisconsin’s Milwaukee and Dane Counties are among many jurisdictions in the country employing modern bail reforms, specifically the Public Safety Assessment (PSA). Most of these jurisdictions adopted the PSA before the advent of the COVID-19 pandemic in the United States, but are increasingly relevant as the virus continues to derail public health measures. Through the intersection of detainees, correctional officers, judicial officials, attorneys, and visitors, millions of Americans filter in and out of correctional facilities on an annual basis. These facilities serve as a microcosm of society and breeding ground for mass infection. The COVID-19 pandemic amplified an existing need …

Managing Human Resources For Surge Capacity In Referral Hospitals Based On Who Hospital Readiness Checklist For Covid-19, Fitri Dinia, Laksono Trisnantoro, Mochamat Helmi

Folia Medica Indonesiana

Highlights: • Managing human resources for surge capacity in three referral hospital at West Kalimantan was evaluated. • Availability, mobilization and recruitment, duties division, and hospital staff welfare are the reasons for referral hospitals in West Kalimantan are not optimal to face surge capacity during the Covid-19 pandemic. • Provincial Health Office role had not been optimal in the HR management at referral hospitals during the Covid-19 pandemic. Abstract: One of the components of effective disaster response management to deal with surge capacity in referral hospitals in West Kalimantan, Indonesia, was to ensure the adequacy of the number of human …

Assessing The Established Competency Categories Of The Biosafety, Infection Prevention, And Public Health Professions: A Guide For Addressing Needed Professional Development Training For The Current And Next Pandemic, Robert J Emery, Scott J Patlovich, Kristin G King, John M Lowe, Janelle Rios

Faculty, Staff and Student Publications

A recent series of widespread infectious disease outbreaks has highlighted commonalities and differences between three key professions that operate on the front lines of response in support of research and/or direct healthcare providers: biosafety, infection prevention, and public health. This assessment, which builds upon previous study by the authors, examines the stated professional competency categories for these three areas, highlighting similarities and differences. This assessment is important as these professions are being drawn together in an operational environment driven by the current pandemic and inevitably future disease outbreaks. Cross-training opportunities for the various professions are proposed.

Effect Of Bovine Lactoferrin On Seroconversion Following Polio Vaccine Administration In Children: Protocol For A Double-Blinded Randomised Controlled Trial, Atif Habib, Sidrah Nausheen, Shanila Nooruddin, Tooba Javed, Tariq Samejo, Amjad Hussain, Suneeta Namdave, Sehrish Amirali, Muhammad Umer, Lumaan Sheikh

Department of Paediatrics and Child Health

Introduction: The oral polio vaccine (OPV) has substantial results in eliminating wild poliovirus and the vaccine of choice in polio eradication. However, the mucosal immunity induced by the OPV is still uncertain. Literature has shown that bovine lactoferrin (BLF) is a safe and useful protein found in cow's milk with extraordinary antimicrobial, antiviral, antiinflammatory and immune-modulatory functions that help children's gut to fight against micro-organisms like poliovirus. However, limited data exist regarding the effect of BLF on polio vaccine immune response. The primary objective is to evaluate the effect of BLF in enhancing mucosal and humoral immunity in children following …

Comparative Laws In Public Health Unmasked, Christine Chasse

University of Miami International and Comparative Law Review

The COVID-19 pandemic lay bare the vulnerabilities of some countries’ public health responses and praise for others. Comparative law review in public health responses may glean lessons for the United States. For example, the United States had not had a pandemic of this magnitude in over a century and was reluctant to institute early masking policies. Meanwhile, the world raced for a COVID-19 vaccine. This begs the question of who will take the vaccine. Will—or can—governments force their citizens to be inoculated? Global comparisons in personal liberty, freedom, bodily autonomy, and how to parent intersect at the right to (or …

The Emergence Of Postcolonial Apologia: A Rhetorical Analysis Of The Chinese Governmental Response To Western Accusation During The Covid-19 Pandemic, Yiqing Ran

Theses - ALL

In my thesis, I examine how the Chinese government developed postcolonial apologia throughout its dispute with the US government over policies related to COVID-19. I focus on the shifting rhetorical strategies used by the Chinese government to defend China from accusations by other nations, especially the US. I determine that the Chinese government's response to the Western accusation during the COVID-19 pandemic progressively shifted from participating in the Western system to questioning Western centralization and adding Chinese interpretations to the existing world order. I argue that China's self-defense strategies altered in light of the changing geopolitical context and became more …

Institute Of Public Health Newsletter- Volume3, Issue2, Institute Of Public Health (Iph)

Institute of Public Health Newsletter (IPHNL) and Other Publications

Volume 3, Issue 2 (May August 2022)

Taking A User-Centered Design Approach To Develop A Data Dashboard For New York State Department Of Health And Implications For Improving The Usability Of Public Data Dashboards / Narrative Competence And Cognitive Mapping As A Culturally Sustaining Pedagogy In The Education Of Emergent Bilinguals, Bahareh Ansari

Legacy Theses & Dissertations (2009 - 2024)

In recent years, the increased availability of public data dashboards provided opportunities to democratize data access by summarizing large amounts of data into accessible snapshots to facilitate educational efforts and encourage evidence-based decision-making. However, many current practices have not reached their full potential because the dashboard design has not accounted for users’ needs and preferences. This dissertation employed the user-centered design framework with three studies. Study 1 investigated the usability problems of existing public health data dashboards through an expert review of existing dashboards on government websites. Study 2 established the requirements of a usable design for public health data …

In The Grip Of Grippe: The 1918 Influenza Pandemic Viewed Through A Cross-Section Of American Society, Carole C. Thomas

All Theses

In 1918, a virulent strain of influenza swept the world, infecting as many as 500 million people and killing at least 50 million, 675,000 of whom were in the United States. Despite the many advances that had been made in science and medicine, even the best medical professionals were helpless against the disease. Lawmakers, too, were limited in what they could do to respond to the emergency, especially as the demands of the First World War remained a priority. Through an examination of the response to the flu in a cross-section of American society– national, state, and local – this …

Hepatitis C Treatment For Substance Users In North Dakota, Janae Arnold

Physician Assistant Scholarly Project Papers

In the 1960’s, the hepatitis C virus (HCV) epidemic began mainly through the transmission of blood transfusions. By the time screening was implemented, millions had already become infected worldwide. After a decade of declining infection rates, a second wave started in the midst of the opioid epidemic in 2010. Prior to 2014 and the application of curative direct-acting antivirals, treatment was expensive, had low efficacy, many side effects, and long treatment durations. Advances in medicine have allowed for HCV elimination with shorter treatment durations, less side effects, and higher treatment rates. Unfortunately, treatment is not offered to all HCV patients …

Religious Freedom Vs. Compelled Vaccination: A Case-Study Of The 2018-2019 Measles Pandemic Or The Law As A Public Health Response, Barbara Pfeffer Billauer Esq.

Catholic University Law Review

Following the recent decision in Roman Catholic Diocese v. Cuomo,^[1] clear guidance regarding the state’s powers to act during a pandemic is wanting. I look here to the 2018–2019 global measles epidemic, with a focus on the New York and Israeli experiences, for that guidance. Measles rates increased dramatically during the 2018–2019 season, both in the United States and globally. This phenomenon reflects a general decline in worldwide vaccination and an increase in vaccine resistance stoked by anti-vax groups. In the United States, the epidemic targeted ultra-Orthodox Jewish communities, as it did in Israel. This Article evaluates the …

Aeromonas Phage Research And The Public Health Impact Of Antibiotics In Aquaculture Workers, Madelyn Merchant

Honors Projects

One of the most common fish diseases in aquaculture is Aeromonas infection. The most common way to treat this infection is through antibiotics. The bacteria in the fish can become antibiotic-resistant and perpetuate the disease. The diseases in fish create a huge financial loss and the industry loses $6 billion per year due to diseases in fish. An alternative to antibiotics is bacteriophage which causes less environmental degradation and is better for human gut flora. In aquaculture there have been examples of aquaculture workers becoming sick from the water in aquaculture ponds as well as from people eating the fish. …

The Effects Of Partisan Framing On Covid-19 Attitudes: Experimental Evidence From Early And Late Pandemic, Amber Wichowsky, Meghan Condon

Political Science: Faculty Publications and Other Works

Political polarization has dominated news coverage of Americans’ responses to the COVID-19 pandemic. In this research note, we report findings from two experimental studies, in which we present respondents with news stories about COVID-19 mitigation measures that emphasize partisan difference or accord. The stories present the same numeric facts about public opinion, but highlight either the partisan gap that existed at the time of the study, or the fact that large majorities of both Republicans and Democrats supported the measures at the time. Results from our first study, conducted late April 2020, show that a media frame drawing attention to …

Spatial And Prediction Models For Addressing Challenges In Pediatric Tuberculosis Control And Care, Kenneth Suranga Gunasekera

Yale Graduate School of Arts and Sciences Dissertations

Tuberculosis (TB) is among the leading causes of global mortality among children <5 years. Each year, over 1 million TB cases occur among children <15 years worldwide, and nearly one quarter of those children die; approximately 80% of those deaths occur among children <5 years. Alleviating the burden of pediatric TB and mortality requires 1) enhanced efforts to prevent transmission to children and 2) treating more children for TB. Targeting resources to children with a known TB exposure has been a cornerstone of the public health response to prevent transmission and detect cases early. Infectious adults must be diagnosed and treated earlier to prevent transmission to their child contacts. Modeling studies suggest that targeting community-level active case-finding to areas with high local transmission intensity may demonstrate population-level reductions in TB incidence. However, obtaining conclusive evidence of concentrated transmission requires access to spatial and genomic data, which is often only available under research conditions in high TB-incidence settings. In chapter 1, I use Bayesian spatial modeling methods to probe routinely collected, age-disaggregated TB notification data to demonstrate that overrepresentation of young child cases co-locate with areas of high local transmission intensity, identified by molecular evidence of transmission from a prospective cohort study in the same setting. This finding suggests that the use of models that leverage widely available notification data should be explored as tools to target case-finding and treatment efforts in high-transmission locations to maximize the direct and indirect benefits of active screening approaches. In chapter 2, I leverage data from a large prevalence survey to investigate a poorly understood form of TB that may frustrate symptom-based active case-finding efforts. Given that modeling estimates suggest that 96% of global childhood mortality due to TB occurs among children not receiving antituberculosis treatment, identifying and treating more cases of pediatric TB provide an opportunity to reduce child mortality. Diagnostic tools for pediatric pulmonary TB are limited by paucibacillary disease in children as well by resource constraints in many high TB-incidence settings. This contributes to poorer treatment outcomes through missed diagnoses and treatment delays. In chapter 3, I describe the analysis of a cohort of children being evaluated for TB from Cape Town, South Africa to demonstrate that a majority of antituberculosis treatment-decisions could be made using clinical evidence alone, without the need for additional diagnostic testing. In chapter 4, I describe the assembly of a large cohort of pediatric TB diagnostic evaluation data sourced from multiple geographically diverse, high TB-incidence settings to develop a prediction model for TB and investigate its validity and generalizability. As part of this work, I describe efforts in partnership with the World Health Organization to operationalize the prediction model as a treatment-decision algorithm to guide the evaluation of children with presumptive pulmonary TB.

Contact Tracing In The Era Of Covid-19: Implementation Of Traditional Strategies In Novel Contexts And Innovative Approaches To Address Existing Barriers, Tyler James Shelby

Yale Graduate School of Arts and Sciences Dissertations

Background: Contact tracing is an evidence-based intervention that became a core component of many COVID-19 response plans throughout the globe. Despite its demonstrated success within other disease contexts, early studies of COVID-19 contact tracing have reported mixed results regarding the effectiveness and impact of contact tracing on ultimate pandemic objectives such as case incidence or mortality. Yet, there remains a knowledge gap regarding contextual factors that influence implementation outcomes of contact tracing that may in turn influence its ultimate impact. The primary objective of this dissertation is to address this knowledge deficit by evaluating an emergency contact tracing program developed …

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and …

Rethinking Public Health Risk Mitigation Strategies: Recognizing The Biosocial Nature Of Covid-19, Grace Savard

CSB and SJU Distinguished Thesis

The SARS-CoV-2 virus has rippled throughout every aspect of society and influenced how we live, breathe, and interact with one another. The purpose of this thesis is to explore the interdisciplinary biosocial impacts of the SARS-CoV-2 virus and the resulting disease, COVID-19. In order to understand the complexities of caregiving during COVID-19, we conducted 75 semi-structured interviews with 55 healthcare providers across 18 states over a span of two years. This research assesses how COVID-19 risk mitigation strategies were designed with the primary intention to stop the spread of the virus rather than account for the longer-term social and biological …

Self-Medication Practices In Medical Students During The Covid-19 Pandemic: A Cross-Sectional Analysis, Farah Yasmin, Muhammad Sohaib Asghar, Unaiza Naeem, Hala Najeeb, Hamza Nauman, Muhammad Nadeem Ahsan, Abdullah Khan Khattak

Medical College Documents

Background and objectives: During the pandemic, the growing influence of social media, accessibility of over-the-counter medications, and fear of contracting the virus may have led to self-medication practices among the general public. Medical students are prone to such practices due to relevant background knowledge, and access to drugs. This study was carried out to determine and analyze the prevalence of self-medication practices among medical students in Pakistan.
Materials and methods: This descriptive, cross-sectional study was conducted online in which the participants were asked about the general demographics, their self-medication practices and the reasons to use. All participants were currently enrolled …

Skill Improvement For Public Health Center Staffs In The Management Of Toxic And Hazardous Materials, Lilik Djuari, Linda Dewanti, Sulistiawati Sulistiawati, Arya Ivan Mahendra, Ahmad Cholifa Fahruddin

Folia Medica Indonesiana

Highlight: • There was an increase in the accumulation of B3 waste in health centers during the COVID-19 pandemic. • The knowledge and skills level of health center staff in medical THM waste management before and after medical THM waste management training were determined. • Medical THM waste management training was increasing the knowledge and skills level of health center staff. Abstract: The generation of medical toxic and hazardous material (THM) waste at public health centers tends to increase during the Covid-19 pandemic. Only 6.89% of the health centers have medical waste management practices that meet the standards. Medical waste …