Emerging Infectious Disease Preparedness and Response

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Table of Contents

Abstract
Literature Review
Methods
Qualitative Analysis
Conclusion
References

Abstract

Since many new infectious diseases are very dangerous, often fatal, and fraught with epidemics, the problem of combating them and other global severe issues is becoming a priority at the international and national levels (Brencic et al. 2017). Humanity is currently faced with a pandemic of the COVID-19 coronavirus, which has engulfed almost all world countries. Thus, this study aims to determine and analyze how global health can prevent the virus’s development through experience. This systematic review addresses the research question of the preparedness degree and responses of medical institutions worldwide. Research considers the infectious diseases issues and drawbacks, the outbreak of new coronavirus – COVID-19, and public health emergency response. The results of the paper aim to reveal the importance of a multidisciplinary approach and main tasks that need to be addressed, including addressing the issue of combating viruses of various natures and the COVID-19.

Among global problems, there is the threat of the emergence of new infectious diseases and their epidemics, which can be catastrophic for the entire human race. However, it assumed the possibility of new infections due to continuing evolutionary processes and mutation of microorganisms and did not assess the degree of the present danger reliably enough. It seemed that everything would get by with traditional dangerous infections, which are well studied and, to no small extent, defeated. The emergence of new diseases was considered unlikely, and they are not so dangerous, at least not threatening fatal consequences. It is worth recalling that the history of the spread of common long-known infections indicates that epidemics played a huge destructive role in civilization’s life.

New viral infections acquire special significance and danger and represent a severe problem for practical public health. The main reasons for their occurrence, according to leading experts, are a constant change in the genome – a set of genes contained in a single set of chromosomes of a given cell, changes, most often deterioration, in social living conditions and environmental conditions (Luo & Gao, 2020). The new infectious diseases at present can primarily be attributed to the viral hemorrhagic fevers Lassa and Ebola, which manifested themselves mainly at the turn of 1970-1980, and recently humanity has faced the coronavirus pandemic (Luo & Gao, 2020). Their extreme danger is confirmed by the relative speed of spread, the course’s severity, and the high mortality rate.

It is quite promptly required to identify the pathogens against which it is necessary to develop vaccines and antiviral drugs and determine the population contingents in need of vaccination. The main directions of confronting emerging emergency epidemic situations of this type are the rapid and complete diagnosis of the disease and the use of effective vaccines and antiviral drugs – in the case of viral infections – to save people (Brende et al., 2017). It is needed to design vaccines against infectious agents with high genetic heterogeneity and study the genotypes of pathogens on which various drugs’ effectiveness depends (Griffiths, 2019). In some cases, urgent development of vaccines and antiviral medications against pathogens is required that can suddenly and unexpectedly change the structure of a segmented genome (Griffiths, 2019). Consequently, it can lead to pronounced changes in antigenic and biological properties. However, the implementation of this strategy is challenging. At the same time, with the emergence of each new pandemic, it seems that it took into account the previous one’s experience and was at least one step ahead of science’s capabilities.

The struggle to preserve the nation’s health, the issues of medical protection of the country’s population from diseases are complicated by the emergence of new, especially dangerous infections. Because of them, the scale of spontaneously arising epidemic disasters can surpass all the shocks of this plan known to mankind (Sands et al. 2016). Humanity will have to make great efforts to resist them. The study created by Lee et al. (2020) examines the preparedness for emerging epidemic threats. According to Lee et al. (2020, p. 17), “countries prepare in different ways based on their interpretation of disease risks and international agreements such as the International Health Regulations (IHR).” It is necessary to be prepared to use many resources, incur high costs and make significant sacrifices to prevent and, if necessary, eliminate possible large-scale epidemic emergencies. This requires the early development of active prophylactic agents, new vaccines and treatment methods, and strict quarantine methods (Lee et al. (2020, p. 17). It will be necessary to change people’s lifestyles, environmental conditions, and many more cases. Only a focus on this area of national and international efforts can promise humankind a favorable perspective in the fight against this ever-growing and renewed danger.

Literature Review

Infectious Diseases Issues

In recent years, pathogens of previously unknown infectious diseases have been discovered, with which a person has come into contact due to environmental changes and population migration. Besides, it became known that microbes are the cause of some diseases that were previously considered non-infectious. The 21st century is characterized by new viruses, breaking all variability records, claiming over 50 thousand human lives every day. Some of the literature suggests that globalization is changing the parameters of the spread of infectious diseases in human society. Findlater and Bogoch (2018) argue that one of the leading causes of emerging and re-emerging infectious diseases is increased air travel, consequently bringing threats to global health security. A feature of society’s modern development is globalization in all spheres of activity and new challenges to humanity.

The properties and pathogens of contagious diseases themselves are changing rapidly. This is manifested by the rapid development of drug resistance in many microorganisms, ubiquitously, and negatively affecting the morbidity and mortality from tuberculosis, malaria, pneumococcal and staphylococcal infections. Deterioration of the ecological situation and massive psycho-emotional stress lead to a significant increase in the prevalence of immunodeficiency states (Findlater & Bogoch, 2018). The ongoing urbanization process, which leads to substantial changes in society’s social and demographic structure, should also be attributed to globalization’s features.

Climate change has been affecting the spread of natural focal infections. According to Casadevall (2020), the influence of climatic factors on natural focal diseases occurs under the action of other elements of a non-climatic nature – socio-economic, ecological, and demographic. For instance, a significant increase in tick-borne infections characterizes the current epidemiological situation as one of the leading reasons for this growth is climate mitigation and humidification (Bouchard et al., 2019). Global warming is improving the habitat of local mosquitoes that carry arboviruses. This contributes to the formation of new natural foci of mosquito fevers, including West Nile fever. The approaches, the methodology for suppressing the growth of viruses using nanotechnology and metal nanoparticles, fit into the known principles of interaction of biocides and cytostatics with different nature cells (Bouchard et al., 2019). All modern medicine problems are interdisciplinary, applying nanotechnology in medicine; particular hybrid areas have appeared, such as nanomedicine and nanodiagnostics.

There should be the development of reliable, available qualitative, and quantitative methods of testing, diagnosing the type of disease based on knowledge about viruses. Castro-Sánchez et al. (2016) note that one of the main problems is a lack of health literacy, which results in infectious diseases having a high clinical and societal impact. Secondly, Brende et al. (2017) clearly explain that it is needed to create effective vaccines based on learning about the interaction of this type of infection with the body’s healthy cells. For example, there is the Ebola virus outbreak disease in 2013–16, which determined the world’s unpreparedness to detect and respond to epidemic threats (Brende et al., 2017). Moreover, it is crucial to carry out large-scale organizational measures on the federal and regional levels to overcome the viral pandemic, taking into account other countries’ experience and the specifics of a particular country and area. All these problems should be solved in parallel-sequential with the main task of maximizing the health of citizens. The literature reviewed seems to overwhelmingly suggest that united efforts might bring better solutions for emerging infectious diseases.

COVID-19

The emergence of a pandemic in modern conditions is actively promoted by the globalization of the world, the population’s concentration in large cities, and people and goods’ movement across the globe. Modern therapy methods for viral diseases and pharmaceuticals are costly, making them inaccessible for the entire population and requiring subsidies from the state. It is clearly shown in the case of maintaining the health of patients with hepatitis and HIV. For example, according to He et al. ‘s systematic review (2017), the average cost of antiviral therapy for hepatitis C in United States is between the $ 26,000 and $ 95,000. All of the expenses must be taken into account when making decisions to tackle the diseases. The survey, funded by the UK Medical Research Council, collected individual-case data of COVID-19 to establish the virus’s future spread (Verity et al., 2020). Scientists analyzed “the case fatality ratio from individual line-list data on 1334 cases identified outside of mainland China” (Verity et al., 2020, p. 670). Humanity is currently faced a very insidious pandemic of the COVID-19 coronavirus which has engulfed almost all countries.

The COVID-19 pandemic is the current global pandemic of the coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus. The study provided by Li et al. (2020) gives the overall picture and outcomes of the disease (Li et al., 2020). The outbreak was reported in Wuhan, China, in December 2019 (Li et al., 2020). The explosion was declared a public health emergency of international concern by the World Health Organization on January 30, 2020, and a pandemic on March 11 (Li et al., 2020). The COVID-19 epidemic has caused severe socio-economic consequences, including the most significant global recession since the Great Depression and massive famine affecting about 265 million people. For instance, Al-Awadhi et al. (2020) study the question of how the pandemic has affected the stock markets. However, this research provides only the economic side of its drawback without focusing on the medical system.

It postponed or canceled many sporting, religious, political, and cultural events, and widespread supply shortages have been exacerbated by panic buying—reduced emissions of pollutants and greenhouse gases. Pan et al. (2020) elaborate on the position that misinformation about the virus has spread through social media and media. There have been cases of xenophobia and discrimination against the Chinese people and those perceived to be Chinese or regions with high infection rates. Besides, the researches emphasize that the experience gained through combating the disease should be shared to prevent the next outbreaks (Pan et al., 2020). The World Health Organization (WHO) records record levels of COVID-19 infection in the world on an almost daily basis, which indicates an intensification of the pandemic globally (Cruz et al., 2020). Many governments have restricted or banned unnecessary travel to states and regions where the outbreak has occurred. However, in many areas around the world, the virus has reached the national level. This means that many people who are sick are unable to establish when or where they were infected.

The rapidly expanding coronavirus outbreak has affected more than 60 countries and requires urgent action. They are needed to help these countries respond to the spread of disease, prevent it, and reduce morbidity and mortality. The study evolves the various factors and outcomes of COVID-19 that occurred in multiple areas and states. For instance, the research areas are Australia and the European Union (Coyne &; Jennings, 2020; Klonowska &; Bindt, 2020). The literature review also analyzes the American coronavirus response, Pakistan, NATO states, Taiwan, and Singapore (Gottlieb et al., 2020; Suleri, 2020; Tardy, 2020; Galvin et al., 2020; Ahmed et al., 2020). Pakistan could expect 50,000 cases by April 25, according to a federal government report. According to Suleri (2020), by summer 2020, the number remained 13 thousand – almost four times less than expected. Regarding Taiwan’s and Singapore’s politics, US Secretary of Health and Human Services Alex Azar praised their response to the coronavirus pandemic, calling it examples of its transparent, democratic nature (Gottlieb et al., 2020; Galvin et al., 2020; Ahmed et al., 2020). Response measures are most effective as long as the government and private sector action is coordinated and prompt.

Medical Institution Response

There are basic principles for making public health systems resilient in dealing with infectious disease outbreaks. McBryde (2020) elaborates on her position that it is essential to identify new dangerous diseases and its attacks, report suspected and confirmed cases to relevant local, national, regional, and international authorities, and evaluating interventions’ effectiveness. McBryde’s point (2020) is reiterated from an opinion that modeling studies helped analyze COVID-19 dynamics from the epidemic beginning and take needed measures. Furthermore, epidemiological surveillance and registration include training and monitoring epidemiologists, developing epidemiological surveillance standards, and tracking morbidity trends in geographic and temporal aspects.

One of the primary issues in emerging infectious diseases is financing and sponsorship. In health care, the question of whether and to what extent a program or service with external effects should be funded is determined by three conditions (Yamey, G et al. 2017). First, the scale of these consequences, that is, it is not enough to say that such values exist. Second, the degree of co-insurance or co-payment for services included in the initial set (Yamey, G et al. 2017). Finally, it is the fiscal space available to the state, which depends on the second condition

Another question is the necessity of comprehensive contingency planning which involves developing and implementing a contingency plan for significant epidemic outbreaks, forming a team to combat the outbreak and taking countermeasures. Le Turnier et al. (2020) argue that it is essential to identify the team members’ roles and responsibilities and other relevant bodies. Le Turnier et al. (2020) explain that they take action to mobilize resources and organize communication with the population, evaluating the contingency plan’s effectiveness after the end of the epidemic. Concerning united response, analysis of relationships between different organizations and levels of the health system ensure joint coordinated action at local, national, regional, and international levels.

The decrease in the case numbers of COVID-19 is not only the result of development of the epidemiological process but mostly cause of public health measures and social distancing. Chang et al. (2020) suggest that the most important is the healthcare system’s readiness to identify new cases, isolate and treat claims, and identify and track contacts who need to be quarantined remain critical. According to Chang et al. (2020), healthcare professionals and caregivers should wear personal protective equipment and follow standard precautions.

Public Health Emergency Response

Any public health emergency presents new communication challenges that lessons learned can be successfully overcome. Some of the articles reviewed emphasize that one of the main lessons learned from outbreaks of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza A (H1N1), and Ebola – is that is a prerequisite for an effective response to health emergencies (Bradley & Bryan, 2019). The review issued in the Journal of Infection and Public Health focuses on preventing the disease outbreaks by targeting three main groups such as animals, human sentinels for spillover events, and the general human population (Ellwanger et al., 2019). According to Ellwanger et al. (2019, p.314), “human and monetary investments focused on animals, humans, and vectors give rise to powerful strategies for EID prevention.” One of the practical tools in public health response to any threatening event is to inform the public about what is known, what is unknown, and what is being done to gain additional information about the situation, save lives, and minimize adverse consequences.

Effective communication uses community engagement strategies to ensure that they participate in the response and develops acceptable interventions to stop the further spread of the outbreak and ensure that individuals and communities apply protective measures. Another evidence by Palagyi et al. (2019) focuses on the research question of health systems of low- and middle-income countries’ responses to emerging infectious disease outbreaks. Moreover, the Centers for Disease Control and Prevention consider implementing the Public Health Emergency Response is critical for surveillance, case reporting, contact tracing, patient care, and community support to meet any logistical and operational needs (Brencic et al., 2017). Effective implementation of the effective response to health emergencies can minimize social disruption. Thus, it can help maintain employment, the tourism sector, and the economy in addition to protecting health.

Methods

The research question addresses the preparedness and responses of the global healthcare system. The following methodology was used to determine resources on this topic: searching for evidence by broad, general, and main headings and a cited reference method. Moreover, websites, online platforms, and databases such as National University Smart Search, JSTOR, and Google Scholar were drawn into the research. Outside help was not involved; the study was completed independently.

National University Smart Search database was chosen for conducting a comprehensive search. Moreover, to exclude unnecessary results, the publication data filter was set as 2016-2020, and the following keywords were used: ‘new infectious diseases spread, ‘epidemic infectious diseases’, ‘COVID-19 response’, ‘coronavirus preparedness’, ‘coronavirus policy’, ‘healthcare policy’, ‘healthcare preparedness’, ‘healthcare response’, ‘infectious disease’, ‘infectious disease preparedness’, ‘infectious disease response’, ‘pandemic’, ‘coronavirus pandemic’, ‘coronavirus pandemic healthcare’, ‘coronavirus pandemic & healthcare policy’, ‘global health’, ‘COVID-19’, ‘COVID-19 pandemic’, ‘COVID-19 preparedness’, ‘COVID-19 healthcare’, ‘healthcare policy 2020’, ‘pandemic 2020’, ‘global healthcare’.

Google Scholar was used to realizing a general search and choose the Boolean term ‘AND’ and publication data set as 2020. The following keyword was performed: ‘coronavirus pandemic,’ ‘healthcare policy,’ and ‘infectious disease preparedness.’ A main heading search was conducted in JSTOR, using the Boolean terms’ AND’ and ‘OR.’ The following keywords were used in the research: ‘coronavirus pandemic’ OR ‘infectious disease’ AND ‘healthcare policy’ OR ‘infectious disease preparedness’ OR ‘infectious disease response’ OR ‘coronavirus preparedness’ OR ‘coronavirus response.’

Inclusion Criteria

The inclusion criteria for each resource implied the matching to the research question or covering the close details. Besides, the requirements included the following themes: COVID-19, healthcare policy in 2020, global health 2020, emerging infectious disease preparedness, and emerging infectious disease response. The data range of articles and books included 2016 to 2020, as the topic regards the beginning of the 21st century and the present days. The resources are presented by peer-viewed journal articles, online journal articles, World Health Organisation reports, and web pages.

Exclusion Criteria

Exclusion criteria concern a discrepancy of the research question and not covering the related details: COVID economic impact, crisis, world financial crisis, political issues, bilateral relations, coronavirus among pets.

Qualitative Analysis

Qualitative research methods can be used at the stage of getting to know the problem – to obtain a total amount of information for building the primary research. A qualitative approach justifies itself when a systemic, expanded understanding of the object and phenomenon under study is necessary. Specific features of conducting qualitative research are useful for studying the causes of the phenomenon’s origin under review, the internal structure of the topic, and the cause-and-effect correlation between objects and research questions.

Conclusion

The research question concerns the problem of infectious diseases, especially the preparedness and response of global healthcare systems. The paper determines that less economically prosperous countries, where health systems’ quality is considered ineffective, suffers such epidemics. However, the negative consequences are disproportionately large for the most vulnerable population segments, who are the worst prepared to implement measures designed to limit pathogens’ spread. Therefore, it is necessary to determine the transmission of the virus, isolating patients and providing them with medical care in the early stages of the development of the disease, reduce transmission at the community level, and support public participation. Meeting these challenges, countries face different levels of risk and vulnerability to the virus and require extra assistance and levels of financial support; consequently, flexibility and responsiveness will be critical factors.

References

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