University Of Washington Public Health Implementation of Disaster Discussion
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Please answer discussion board question and response to at least two of classmates' Posts. Please see the attachment below.

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Public Health Implementation of Disaster Discussion Board Question. Varney and Hirshon list seven general rationales for providing ED-based public health surveillance. Surveillance is a critical form of communication for public health officials. Choose a real public health outbreak, disaster, or crisis. Provide one example of how any of the concepts described in this paper were actually used to improve public health. Describe the intervention for your classmates. Cite your reference. Classmates’ posts! 1st 10 minutes ago Julia Watson Syndromic Surveillance - Flu COLLAPSE “Syndromic Surveillance describes a dynamic process in collecting real-time or near real-time data on symptom clusters suggestive of biological disease outbreak (Update on Public Health Surveillance, 2006).” The use of syndromic surveillance is to preemptively recognize a cluster of specific symptoms within a community before definitive diagnosis has been made. This pre-recognition allows for size, spread and tempo of an outbreak before it has occurred, allowing for faster response to mitigate the outcomes. The use of syndromic surveillance was originally focused on bioterrorism. However, using this surveillance technique and incorporating Emergency department data can greatly affect the surveillance scope for influenza outbreaks. Traditionally the CDC and WHO would rely on primary care physicians (pcp) or laboratory tests to confirm and track the seasonal and pandemic influenza cases. This data however limits the data of affected population, to individuals and families able to afford a pcp and the laboratory tests to confirm. Additionally, data collected from these sources pose a problem with reporting time, typically open with limited business hours, results “historically lag one to two weeks behind real-world outbreaks (Katherine M. Hiller, 2013).” With the rise of underinsured or uninsured individuals and families accessing the ED as acute care facilities. ED’s are open 24/7 365, allowing for more accurate real-time results and tracking capabilities. Laboratory tests and x-rays are all back within a few hours, allowing for a faster diagnoses and discharge. Additional data that can be extracted from ED information is the ED volume, LPTMS rates, and ambulance dispatch information (Katherine M. Hiller, 2013). References Katherine M. Hiller, L. S. (2013). Syndromic Surveillance for Influenza in the Emergency Department–A Systematic Review. PLOS ONE. Update on Public Health Surveillance. (2006). Emergency Medicine Clinic of N America. Retrieved from https://bblearn.philau.edu/bbcswebdav/courses/19FL-DMM-643-1-2999/Public%20health%20surveillance%20in%20EDs.pdf 2nd 19 minutes ago W10 Abdulrahman Alghamdi COLLAPSE During the 2014 West African Ebola Outbreak, emergency department (ED) -based public health surveillance was one of the strategies that was used to contain the epidemic. Initially, before Ebola was declared as an epidemic, surveillance was only limited to three countries: Liberia, Sierra Leone, and Guinea. However, Integrated Disease Surveillance and Response (IDSR) became a necessity in documenting the 14 priority conditions and diseases associated with the virus. It led to an improvement in quality in terms of data analysis, presentation, and collation by the public health authorities. Therefore it is clear that the implementation of ED-basic health surveillance resulted in improved public health response due Ebola, which was a rapidly developing health emergency not only in West Africa but also in other countries such as Nigeria, the United Kingdom, Spain, Mali, Senegal, Italy, and the United States. Surveillance was made possible by the coordinated response between the Centers for Disease Control and Prevention(CDC), World Health Organization (WHO), nongovernmental organizations, and governments. ED-basic health surveillance enabled district- and national- level staff in the affected countries to identify contacts and cases, as well as train in-country staff. The staff helped in the delivery of essential public health services. Therefore, by helping the overwhelmed data, laboratory, public health, and clinical systems ED-basic health surveillance proved to be effective in improving public health response. Chertow, D. S., Kleine, C., Edwards, J. K., Scaini, R., Giuliani, R., & Sprecher, A. (2014). Ebola virus disease in West Africa—clinical manifestations and management. New England Journal of Medicine, 371(22), 2054-2057. Frieden, T. R., & Damon, I. K. (2015). Ebola in West Africa--CDC's Role in Epidemic Detection, Control, and Prevention. Emerging infectious diseases, 21(11), 1897-905. 3rd 1 hour ago week10 Tariq AlHarbi COLLAPSE Public health surveillance is a necessary perspective of the health field. It helps to identify the sectors in health systems that need to develop. Surveillance systems are used to prepare, execute, and assess public health intervention programs and relay the collected information to decisionmakers. (Varney & Hirshon, 2006). So, one of the most combined methods of improving public health is the use of health surveillance systems to prevent and manage the outbreak of an epidemic. There was an outbreak of Ebola, particularly in West African countries. The public health surveillance systems associated personnel affected to evaluate the spread levels of the epidemic and suggested significant measures to help mitigate its spread. The reasons for active surveillance are pointed at assuring response to an emergency and providing consistent support to contain an epidemic before it spreads and causes adverse public health impacts. Communication systems help us to discuss the health problem. In excellent communication, it is simple to recognize the outbreak as early as possible and try measures that help reduce its spread. For example, the outbreak of Ebola was identified by substantial communication amongst the health personnel in various nations. They trained to recognize the source of the outbreak, and communicate with locals in other nations to establish sanctions that bar people from entering the countries without being screened. Such a measure helped reduce the possible spread as those affected were confined before they could move to other nations. Moreover, it is through effective communication that health personnel from other countries managed to organize and work together towards responding to the outbreak. Acknowledging the fact that it was a public health emergency, working with health personnel from different countries helped in developing effective response and control of the epidemic. References McNamara LA, Schafer IJ, Nolen LD, et al. Ebola Surveillance — Guinea, Liberia, and Sierra Leone. MMWR Suppl 2016;65(Suppl-3):35–43. DOI: http://dx.doi.org/10.15585/mmwr.su6503a6 Varney, S. M., & Hirshon, J. M. (2006). Update on public health surveillance in emergency departments. Emergency Medicine Clinics, 24(4), 1035-1052. 4th 1 day ago Polio Outbreak - W10 Nelly Perez-Melendez COLLAPSE Surveillance systems implementation for public health is essential. These systems are used to prepare, execute, and assess public health intervention programs, relay information to decision-makers, and play an important part in the early detection of health issues (Varney & Hirshon, 2006). The Center for Disease Control and Prevention offers a list of current outbreaks in the United States as well as internationally. As of October 2019, there is an alert for the Polio outbreak in the Philippines, which means that the practice of enhanced precautions is recommended. This outbreak is caused by vaccine-derived poliovirus (VDPV), a sign of low oral polio vaccine coverage in the country (Center of Disease Control, 2019). The Philippines declared the outbreak on September 19, 2019, with two cases confirmed (World Health Organization, 2019). 1. 2. 3. 4. Data collection is still on-going. The World Health Organization (2019) mentioned the following response actions from Public Health: Acute flaccid paralysis (AFP) and environmental surveillance. Field investigation to define the geographic scope. Mass immunization campaigns – reinforced recommendation for all children. WHO, the Global Polio Eradication Initiative (GPEI) and other organizations, are supporting the Department of Health and local health authorities to investigate and support the efforts to enhance surveillance, strengthen routine immunization, communicate risk to the public and implement outbreak response. On May 14, 2019, the Emergency Committee agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC); countries affected are required to declare the emergency at a National level. As we can see with this outbreak, some of the rationales mentioned by Varney and Hirshon (2006) are covered. Improved communication and collaboration for early detection, as well as sharing of information, is critical locally and internationally to prevent the spread of the virus to those with no immunization, especially children. Also, alerting travelers of these outbreaks helps to take appropriate actions to reduce the risks of exposure when traveling from the place of the outbreak and vice-versa. This improves the public health response to what could become a rapidly developing public health emergency (Varney & Hirshon, 2006). Finally, the surveillance of this outbreak includes the environmental aspect due to the nature of the virus, improving their ability to correlate events (Varney & Hirshon, 2006). References: Center of Disease Control and Prevention. (2019). Polio in the Philippines. Retrieved from https://wwwnc.cdc.gov/travel/notices/alert/polio-philippines. Varney, S. M., Hirshon, J. M. (2006). Update on public health surveillance in emergency department. Emergency Medicine Clinics of North America, 24(4), 1035-1052. Doi:10.1016/j.emc.2006.06.004 World Health Organization. (2019). Statement of the twenty-first IHR emergency committee regarding the international spread of poliovirus. Retrieved from https://www.who.int/news-room/detail/29-052019-statement-of-the-twenty-first-ihr-emergency-committee 5th 1 hour ago Abdulaziz Almania Week 10 discussion COLLAPSE Public health surveillance is an important aspect that gives us a solid idea about the health system, community health, and disease outbreaks. The surveillance prosses rely on collecting and analyzing data from multiple resources such as EDs, hospitals admissions, and pharmaceutical sales (Varney & Hirshon, 2006). Since the EDs count as one of the busiest health departments, it is essential that the public health department conducts surveillance actions in the EDs for ensuring the community health and detecting diseases outbreaks. According to the Varney & Hirshon article, there are seven relations in developing EDbased surveillance. These relations will promote public health and will raise public security in case of a disease outbreak (Varney & Hirshon, 2006). We will discuss one of these relations, which applied in the current MERS-CoV outbreak in Saudi Arabia, which is improving the and evaluation documentation in the ED visits During the current MERS-CoV outbreak in Saudi Arabia, many things changed in evaluating and documenting patients who visit the EDs in the country. The patients’ evaluation method for patients who had any respiratory or flu symptoms used to be making the patient wait in the waiting area with a face mask on his face if his case is not severe. After the outbreak, any patient who presents to the ED with respiratory, flu-like symptoms, and/or fever will send to the respiratory unite for evaluation, which usually outside the ED before he enters the ED (Ministry of Health, 2015). Besides, a nasal swap will be taken by a healthcare professional when the patient meets specific criteria (Ministry of Health, 2015). The Ministry of Health (MOH) in Saudi Arabia named three hospitals to be the MERSCoV treating and specializing centers in the country (MOH, 2014). All these hospitals are equipped with massive isolation and ICU rooms. The reason for naming these hospitals is to improve the documentation and tracking of the MERS-CoV information and the outbreak progress countrywide. Furthermore, the MOH in Saudi Arabia was able to connect ten family members and a healthcare personal to a secondary MERS-CoV infection due to contacting with an infected person (WHO,2018). This action shows us how the documentation prosses improved during this outbreak. From my personal experience in Saudi Arabia, when we worked with patients who are suspected to have MERS-CoV, we were obligated to transport the patient to a designated hospital for case documentation purpose. Also, we were compelled to present for MERS-CoV unite to be tested as a safety measures ensure our safety. References Varney, S. M., & Hirshon, J. M. (2006). Update on public health surveillance in emergency departments. Retrieved from https://bblearn.philau.edu/bbcswebdav/courses/19FL-DMM643-1-2-999/Public health surveillance in EDs.pdf. Ministry of Health. (26 April 2014). Three Medical Centers Allocated for Coronavirus in Riyadh, Jeddah and the Eastern RegionRetrieved from https://www.moh.gov.sa/en/CCC/News/Pages/news-2014-04-26-001.aspx Ministry of Health. (June 2015). Infection Prevention and Control Guidelines for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection Retrieved from https://www.moh.gov.sa/en/Documents/2015%20update.pdf World Health Organization. (Augest 2018). WHO MERS Global Summary and Assessment of Risk Retrieved from https://www.who.int/csr/disease/coronavirus_infections/riskassessment-august-2018.pdf Emerg Med Clin N Am 24 (2006) 1035–1052 Update on Public Health Surveillance in Emergency Departments Shawn M. Varney, Lt Col, USAF, MCa,*, Jon Mark Hirshon, MD, MPHb,c a 59 MDW/MCED, 2200 Bergquist Drive, Suite 1, Lackland AFB, TX 78236-5500, USA b Division of Emergency Medicine, Department of Emergency Medicine and Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA c The Charles McC. Mathias, Jr. National Study Center for Trauma and EMS, University of Maryland School of Medicine, 701 West Pratt Street, Fifth Floor, Baltimore, MD 21201, USA The systematic collection and analysis of health data are important actions required to help understand the health needs of a population. When it is done to investigate a problem to contribute to generalizable knowledge, it is defined as research [1]. If these activities are done through the collection of health data in an ongoing manner to influence the health of the public, it can be considered public health surveillance. Considering that in 2003 there were an estimated 113.9 million emergency department (ED) visits nationwide [2], EDs are an ideal location to collect de-identified information on the acute health needs and patterns of the population of the United States. The systematic collection of data from multiple EDs can also serve as a barometer of the overall status of the US health system. While there are a number of logistical and infrastructural barriers that can impede the development of surveillance systems, the potential benefits from these systems are significant. The ability to analyze data; distribute results; and influence policy, funding, and patients’ behavior are important outgrowths of public health surveillance in emergency departments. * Corresponding author. Department of Emergency Medicine, 59 MDW/MCED, 2200 Bergquist Drive, Suite 1, Lackland AFB, TX 78236-5500. E-mail address: shawn.varney@lackland.af.mil (S.M. Varney). 0733-8627/06/$ - see front matter ! 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.emc.2006.06.004 emed.theclinics.com 1036 VARNEY & HIRSHON What is public health surveillance? Definition of surveillance The Centers for Disease Control and Prevention (CDC) has defined public health surveillance as ‘‘the ongoing systematic collection, analysis and interpretation of health data essential to the planning, implementation and evaluation of public health practices, closely integrated with the timely dissemination of these data to those who need to know. The final link in the surveillance chain is the application of these data to prevention and control’’ [3]. Surveillance systems are used to prepare, execute, and assess public health intervention programs and relay the acquired information to decision makers. In the present age of heightened security awareness and threats of bioterrorism, surveillance systems play an additional role in the early detection of health use anomalies. Through the rapid recognition of multiple patients with similar symptoms suggestive of an atypical or biologic agent, alerts are triggered so that public health professionals are notified of a potential threat. Surveillance system components Surveillance systems may range from rudimentary to complexdie, from manual collection and documentation on sheets of paper to automated realtime data delivery. The steps required for a public health surveillance system include data acquisition on a periodic and ongoing basis, timely data collation and analysis, and the application of these data by the proper public health professionals. The basic components of a surveillance system include equipment, personnel, and the required resources for the personnel to analyze the data, communicate promptly and effectively, and maintain the system adequately. The ability to amass and analyze large amounts of information has markedly improved with the advent of current computer technology. Therefore, essential equipment for an ED-based public health surveillance system now includes a robust computerized database system with appropriate Internet and networking capabilities, along with sophisticated software to analyze data for areas of interest. The potential applications of data and the requirements for interoperability with collaborators, such as regional, state, or national systems, dictate the necessary degree of complexity. Fundamental personnel consist of individuals responsible for (1) data collection, (2) information analysis, and (3) timely response to material collected. Thus, many partners are involved, including health care providers in physicians’ offices and EDs and public health professionals in local, state, and federal agencies, as well as laboratory workers, researchers, academicians, and information technology (IT) experts. The ability to maintain multidirectional communication flow among these team members is critical for a functional system. UPDATE ON PUBLIC HEALTH SURVEILLANCE IN THE ED 1037 Required additional resources include financial, institutional, and IT (encompassing communication, data management, and data analysis). To be effective, surveillance system development requires full endorsement and involvement from interested public health, political, and private leaders in many fields. Data sources may include standardized clinical databases from hospitals, doctors’ offices, EDs, pharmacies, telephone health lines, and others. The integration of these databases into a cohesive system requires significant time and effort to garner support of critical partners and to make the system fully operational. Definition of syndromic surveillance Syndromic surveillance describes a dynamic process of collecting real-time or near real-time data on symptom clusters suggestive of a biological disease outbreak. Ideally, these diseases will be detected early in the processdbefore the definitive diagnosisdto enable a rapid response and mitigate adverse outcomes [4,5]. Syndromic surveillance systems have secondary objectives including determining the size, spread, and tempo of an outbreak, or even providing reassurance that an outbreak has not occurred [4]. Initially, syndromic su ...
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Running head: DISCUSSION POST AND REPLIES

Discussion Post and Replies
Student’s Name
Institutional Affiliation

1

DISCUSSION POST AND REPLIES

2

Cholera outbreak in Saudi Arabia
Public health surveillance plays a significant role in health. It provides us with an insight
into disease outbreaks, community health, health system, disasters, as well as the crisis in the
community. Notably, the surveillance process focuses on data collection and analysis from
various resources, including pharmaceutical sales, hospital admission records, and EDs. There is
a need for public health centers to exercise surveillance actions to ensure quick detection of
disease outbreaks.
In 2017, Saudi Arabia reported five cases of cholera outbreak (Weill et al., 2019). As of
now, one claim related to cholera has been reported. The region bordering Yemen is a cholera
outbreak that has reportedly killed the most sensitive area since close to two thousand people.
Therefore, enhanc...

MrMark (17227)
UC Berkeley

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