Will #COVID19 generate #global #preparedness? (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Will COVID-19 generate global preparedness?

Kathryn H Jacobsen

Published: March 18, 2020 | DOI: https://doi.org/10.1016/S0140-6736(20)30559-6


In The Lancet, Nirmal Kandel and colleagues1 report their analysis using an operational readiness index to summarise countries’ national performance across 18 indicators of preparedness to prevent, detect, and respond to an outbreak of a novel infectious disease. The authors’ analysis shows that only 104 (57%) of 182 countries had the functional capacity to perform crucial activities at national and subnational levels. 32 (18%) countries had low readiness and would require external resources to control an emerging infectious disease event. Kandel and colleagues’ conclusions are similar to those of the Global Health Security Index2  and previous assessments from WHO.3



I declare no competing interests.

Keywords: COVID-19; SARS-CoV-2; Pandemic Preparedness.


#Health #security capacities in the context of #COVID19 #outbreak: an analysis of #IHR annual #report data from 182 countries (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries

Nirmal Kandel, MPH, Stella Chungong, MPH, Abbas Omaar, MSc, Jun Xing, MPH

Published: March 18, 2020 | DOI: https://doi.org/10.1016/S0140-6736(20)30553-5




Public health measures to prevent, detect, and respond to events are essential to control public health risks, including infectious disease outbreaks, as highlighted in the International Health Regulations (IHR). In light of the outbreak of 2019 novel coronavirus disease (COVID-19), we aimed to review existing health security capacities against public health risks and events.


We used 18 indicators from the IHR State Party Annual Reporting (SPAR) tool and associated data from national SPAR reports to develop five indices: (1) prevent, (2) detect, (3) respond, (4) enabling function, and (5) operational readiness. We used SPAR 2018 data for all of the indicators and categorised countries into five levels across the indices, in which level 1 indicated the lowest level of national capacity and level 5 the highest. We also analysed data at the regional level (using the six geographical WHO regions).


Of 182 countries, 52 (28%) had prevent capacities at levels 1 or 2, and 60 (33%) had response capacities at levels 1 or 2. 81 (45%) countries had prevent capacities and 78 (43%) had response capacities at levels 4 or 5, indicating that these countries were operationally ready. 138 (76%) countries scored more highly in the detect index than in the other indices. 44 (24%) countries did not have an effective enabling function for public health risks and events, including infectious disease outbreaks (7 [4%] at level 1 and 37 [20%] at level 2). 102 (56%) countries had level 4 or level 5 enabling function capacities in place. 32 (18%) countries had low readiness (2 [1%] at level 1 and 30 [17%] at level 2), and 104 (57%) countries were operationally ready to prevent, detect, and control an outbreak of a novel infectious disease (66 [36%] at level 4 and 38 [21%] at level 5).


Countries vary widely in terms of their capacity to prevent, detect, and respond to outbreaks. Half of all countries analysed have strong operational readiness capacities in place, which suggests that an effective response to potential health emergencies could be enabled, including to COVID-19. Findings from local risk assessments are needed to fully understand national readiness capacities in relation to COVID-19. Capacity building and collaboration between countries are needed to strengthen global readiness for outbreak control.



Keywords: SARS-CoV-2; COVID-19; Pandemic preparedness.


How will #country-based #mitigation measures influence the course of the #COVID19 #epidemic? (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

How will country-based mitigation measures influence the course of the COVID-19 epidemic?

Roy M Anderson, Hans Heesterbeek, Don Klinkenberg, T Déirdre Hollingsworth

Published: March 09, 2020 / DOI: https://doi.org/10.1016/S0140-6736(20)30567-5


Governments will not be able to minimise both deaths from coronavirus disease 2019 (COVID-19) and the economic impact of viral spread. Keeping mortality as low as possible will be the highest priority for individuals; hence governments must put in place measures to ameliorate the inevitable economic downturn. In our view, COVID-19 has developed into a pandemic, with small chains of transmission in many countries and large chains resulting in extensive spread in a few countries, such as Italy, Iran, South Korea, and Japan. 1 Most countries are likely to have spread of COVID-19, at least in the early stages, before any mitigation measures have an impact.

Keywords: COVID-19; SARS-COV-2.


Are high-performing #health #systems resilient against the #COVID19 #epidemic? (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Are high-performing health systems resilient against the COVID-19 epidemic?

Helena Legido-Quigley, Nima Asgari, Yik Ying Teo, Gabriel M Leung, Hitoshi Oshitani, Keiji Fukuda, Alex R Cook, Li Yang Hsu, Kenji Shibuya, David Heymann

Published: March 06, 2020 / DOI: https://doi.org/10.1016/S0140-6736(20)30551-1


As of March 5, 2020, there has been sustained local transmission of coronavirus disease 2019 (COVID-19) in Hong Kong, Singapore, and Japan.1 Containment strategies seem to have prevented smaller transmission chains from amplifying into widespread community transmission. The health systems in these locations have generally been able to adapt,2,  3 but their resilience could be affected if the COVID-19 epidemic continues for many more months and increasing numbers of people require services. We outline some of the core dimensions of these resilient health systems4 and their responses to the COVID-19 epidemic.



GML is an expert adviser to the Hong Kong Special Administrative Region and Chinese Governments and served as a member of the WHO-China Joint Mission on COVID-19. HO is a temporary adviser for the COVID-19 response team of the Japanese Government. We declare no other competing interests. The authors alone are responsible for the views expressed in this Comment and they do not necessarily represent the decisions or policies of WHO.

Keywords: COVID-19; SARS-CoV-2; Pandemic preparedness.


Responding to #health #emergencies in the Eastern #Mediterranean #region in times of #conflict (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Responding to health emergencies in the Eastern Mediterranean region in times of conflict

Richard Brennan, Rana Hajjeh, Ahmed Al-Mandhari

Published: March 02, 2020 / DOI: https://doi.org/10.1016/S0140-6736(20)30069-6


WHO’s Eastern Mediterranean region (EMR) is facing emergencies on a scale that is perhaps unprecedented in its history. There is armed conflict in 12 of the region’s 22 countries.1, 2 The region’s 680 million people3 represent 9% of the global population, yet the EMR is home to 43% of those who need humanitarian assistance4  and is the source of 64% of the world’s refugees.5 The health effects of these crises are immense. Direct health consequences include trauma-related deaths and disability, gender-based violence, and mental disorders. Disruption of health systems contributes to increased morbidity and mortality from infectious diseases, malnutrition, obstetric complications, and non-communicable diseases (NCDs). Health indicators in the EMR are among the worst in the world.6



AA-M is WHO Regional Director for the Eastern Mediterranean. We declare no other competing interests.

Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps, content, and institutional affiliations.

Keywords: Society; Poverty; Wars; COVID-19; Pandemic preparedness.


#Clinician #perceptions of respiratory #infection #risk; a rationale for research into #mask use in routine practice (Infect Dis Health, abstract)

[Source: Infection, Disease and Health, full page: (LINK). Abstract, edited.]

Infection, Disease & Health / Volume 24, Issue 3, August 2019, Pages 169-176 / Discussion paper

Clinician perceptions of respiratory infection risk; a rationale for research into mask use in routine practice

Ruth Barratt a,b,c, Ramon Z. Shaban b,d,e, Gwendoline L. Gilbert a,b

{a} Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; {b} Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW 2050, Australia; {c} The Westmead Clinical School, University of Sydney, NSW 2145, Australia; {d} Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW 2050, Australia; {e} Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW 2145, Australia

Received 6 December 2018, Revised 29 January 2019, Accepted 30 January 2019, Available online 21 February 2019.

DOI: https://doi.org/10.1016/j.idh.2019.01.003



  • Emerging and remerging infectious diseases continue to pose a threat to human health and global security.
    Outbreaks of respiratory infection result in human and economic costs including staff illness and wider societal disruption.
  • Clinicians’ use of personal protective equipment is critical to reducing the risk of transmission of infectious disease.
  • Training in the use of PPE should take account of clinicians’ and patients’ perceptions of risk.
  • Individual and societal responsibility towards infection prevention may influence clinicians’ use of protective masks.



Outbreaks of emerging and re-emerging infectious diseases are global threats to society. Planning for, and responses to, such events must include healthcare and other measures based on current evidence. An important area of infection prevention and control (IPC) is the optimal use of personal protective equipment (PPE) by healthcare workers (HCWs), including masks for protection against respiratory pathogens. Appropriate mask use during routine care is a forerunner to best practice in the event of an outbreak. However, little is known about the influences on decisions and behaviours of HCWs with respect to protective mask use when providing routine care. In this paper we argue that there is a need for more research to provide a better understanding of the decision-making and risk-taking behaviours of HCWs in respect of their use of masks for infectious disease prevention. Our argument is based on the ongoing threat of emerging infectious diseases; a need to strengthen workforce capability, capacity and education; the financial costs of healthcare and outbreaks; and the importance of social responsibility and supportive legislation in planning for global security. Future research should examine HCWs’ practices and constructs of risk to provide new information to inform policy and pandemic planning.

Keywords: Infectious diseases: protective mask – Pandemic planning – Risk taking – Behaviour – Outbreaks

Keywords: PPE; HCWs.


#Scientists are sprinting to outpace the novel #coronavirus (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Scientists are sprinting to outpace the novel coronavirus

Tedros Adhanom Ghebreyesus, Soumya Swaminathan

Published: February 24, 2020 / DOI: https://doi.org/10.1016/S0140-6736(20)30420-7


The number of people with novel coronavirus disease 2019 (COVID-19) has risen above 75 000 globally, over 99% of whom are in China, with more than 900 cases in 25 other countries as of Feb 20, 2020.1,  2 Science, however, is stepping up to the challenge. Consider the example of Africa’s efforts to scale up its capacity to detect any cases of infection. On Feb 3, 2020, the only African countries with laboratories that could test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were South Africa and Senegal. This scarce capacity was a major concern for a continent bracing for possible infections. Just a fortnight later, WHO had sent testing kits to 27 countries on the continent, which are already being used.3



TAG is the Director-General of WHO. SS is Chief Scientist at WHO. We declare no other competing interests.

Keywords: COVID-19; SARS-CoV-2; Pandemic preparedness.