Local Healthcare Preparedness and Alert Systems—How to Prevent Future Pandemics?

A special issue of Epidemiologia (ISSN 2673-3986).

Deadline for manuscript submissions: 31 December 2024 | Viewed by 3438

Special Issue Editors


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Guest Editor
Agenzia Regionale Emergenza Urgenza (AREU), Via Campanini 6, 20124 Milan, Italy
Interests: medical education; cardiopulmonary resuscitation; emergency medical service; public health measures; surveillance
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Health Science Department, Public University Navarra, 3100 Pamplona, Spain
2. Epidemiology Division, Public Health Center, 12003 Castelló de la Plana, Spain
Interests: epidemiology; infectious diseases; allergic diseases; outbreaks; coronavirus diseases; salmonellosis and pork product; vitamin D and tuberculosis; cardiovascular and cerebrovascular disease mortality
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

 Dear Colleagues, 

Infectious diseases have become relevant in recent years following the COVID-19 pandemic and the increasing trend of diseases related to antibiotic resistance. COVID-19 had a major impact on the healthcare systems of different countries. However, there is currently a lack of information on the resilience potential of healthcare systems, as it is unclear whether healthcare activities have returned to the same level of efficiency and effectiveness that they had before. Furthermore, it is not fully understood what pro-active alarm systems have been developed in different countries, as well as national or local pandemic plans, recommended by international organisations such as the WHO and OECD.

With this knowledge gap, this Special Issue aims to share updated information on the topic in order to identify three elements that are useful for the entire scientific community. The first one is to highlight the resilience of local healthcare systems, which should hopefully show a return to a level of performance similar to the pre-pandemic phase. The second one is to highlight the infectious diseases alert systems of the different settings in order to share innovative alerting methods. The third and final point is studying the models used and the way in which the different local pandemic plans have been set in order to understand how different healthcare systems have implemented specific plans at the local level.

This Special Issue could also be useful in sharing important information with all the stakeholders in the field of infectious disease prevention and improving the resilience of healthcare systems in the event of future pandemics. Research articles, as well as reviews and expert opinions, are welcome and will be carefully assessed.

Dr. Giuseppe Stirparo
Dr. Alberto Arnedo-Pena
Guest Editors

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Keywords

  • infectious diseases
  • epidemiology
  • COVID-19
  • healthcare systems
  • vaccination
  • surveillance
  • transmission
  • chemical, biological, radiological, and nuclear (CBRN) hazards

 

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Published Papers (3 papers)

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Research

12 pages, 918 KiB  
Article
Underreporting of Cases in the COVID-19 Outbreak of Borriana (Spain) during Mass Gathering Events in March 2020: A Cross-Sectional Study
by Salvador Domènech-Montoliu, Maria Rosario Pac-Sa, Diego Sala-Trull, Alba Del Rio-González, Manuel Sanchéz-Urbano, Paloma Satorres-Martinez, Roser Blasco-Gari, Juan Casanova-Suarez, Maria Gil-Fortuño, Laura López-Diago, Cristina Notari-Rodríguez, Óscar Pérez-Olaso, Maria Angeles Romeu-Garcia, Raquel Ruiz-Puig, Isabel Aleixandre-Gorriz, Carmen Domènech-León and Alberto Arnedo-Pena
Epidemiologia 2024, 5(3), 499-510; https://doi.org/10.3390/epidemiologia5030034 - 9 Aug 2024
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Abstract
Determining the number of cases of an epidemic is the first function of epidemiological surveillance. An important underreporting of cases was observed in many locations during the first wave of the COVID-19 pandemic. To estimate this underreporting in the COVID-19 outbreak of Borriana [...] Read more.
Determining the number of cases of an epidemic is the first function of epidemiological surveillance. An important underreporting of cases was observed in many locations during the first wave of the COVID-19 pandemic. To estimate this underreporting in the COVID-19 outbreak of Borriana (Valencia Community, Spain) in March 2020, a cross-sectional study was performed in June 2020 querying the public health register. Logistic regression models were used. Of a total of 468 symptomatic COVID-19 cases diagnosed in the outbreak through anti-SARS-CoV-2 serology, 36 cases were reported (7.7%), resulting in an underreporting proportion of 92.3% (95% confidence interval [CI], 89.5–94.6%), with 13 unreported cases for every reported case. Only positive SARS-CoV-2 polymerase chain reaction cases were predominantly reported due to a limited testing capacity and following a national protocol. Significant factors associated with underreporting included no medical assistance for COVID-19 disease, with an adjusted odds ratio [aOR] of 10.83 (95% CI 2.49–47.11); no chronic illness, aOR = 2.81 (95% CI 1.28–6.17); middle and lower social classes, aOR = 3.12 (95% CI 1.42–6.85); younger age, aOR = 0.97 (95% CI 0.94–0.99); and a shorter duration of illness, aOR = 0.98 (95% CI 0.97–0.99). To improve the surveillance of future epidemics, new approaches are recommended. Full article
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9 pages, 795 KiB  
Article
Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis
by Francesca Bottega, Erika Kacerik, Gabriele Perotti, Carlo Signorelli and Giuseppe Ristagno
Epidemiologia 2024, 5(3), 362-370; https://doi.org/10.3390/epidemiologia5030026 - 9 Jul 2024
Viewed by 674
Abstract
The COVID-19 pandemic drastically reshaped healthcare in Lombardy, Italy, notably impacting EMS and emergency departments and altering the epidemiology of time-dependent pathologies such as STEMI and OHCA. While previous studies focused on modifications during the pandemic peak, with an increase in the number [...] Read more.
The COVID-19 pandemic drastically reshaped healthcare in Lombardy, Italy, notably impacting EMS and emergency departments and altering the epidemiology of time-dependent pathologies such as STEMI and OHCA. While previous studies focused on modifications during the pandemic peak, with an increase in the number of OHCA diagnoses and a reduction in the number of STEMI, little evidence exists regarding the inter-pandemic phases. We analyzed OHCA and STEMI accesses to the ED in the regional emergency department access register (EUOL) for 2019–2021. The analysis revealed a significant difference in monthly diagnosis averages. For STEMI, the change was statistically significant (F(2, 33) = 4.45, p = 0.02), while it was not for OHCA (F(2, 33) = 0.18, p = 0.83). Despite the monthly decreases, the likelihood of receiving a STEMI diagnosis increased with total accesses, OR 1.40 [95% CI 1.25–1.58, p < 0.0001]. Additionally, there was a significant increase in March 2020 discharge diagnoses for OHCA compared to March 2019, OR 3.35 [95% CI 2.88–3.90, p < 0.0001], corresponding to the first pandemic wave. Therefore, our analysis indicates that the epidemiology of STEMI and OHCA was altered during the COVID-19 pandemic. Full article
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9 pages, 958 KiB  
Article
Italy’s Post-COVID-19 Stroke Network: Has It Returned to Pre-Pandemic Standards?
by Erika Kacerik, Francesca Bottega, Aida Andreassi, Giuseppe Sechi, Alberto Zoli, Marco Botteri, Carlo Signorelli and Nazzareno Fagoni
Epidemiologia 2024, 5(3), 353-361; https://doi.org/10.3390/epidemiologia5030025 - 9 Jul 2024
Cited by 1 | Viewed by 976
Abstract
The COVID-19 pandemic strongly transformed the healthcare system in the Lombardy region (Italy), forcing a rapid reorganization of hospital structures. The emergency medical service (EMS) system and emergency departments (EDs) were among the most affected departments. Several studies have shown a change in [...] Read more.
The COVID-19 pandemic strongly transformed the healthcare system in the Lombardy region (Italy), forcing a rapid reorganization of hospital structures. The emergency medical service (EMS) system and emergency departments (EDs) were among the most affected departments. Several studies have shown a change in the epidemiology of time-dependent pathologies, such as stroke, during the pandemic’s peak. However, there is little scientific evidence regarding the interpandemic phase. The regional register for ED accesses (EUOL) was analyzed, taking into consideration all accesses for stroke and stroke-like syndromes during the years 2019, 2020, and 2021. The analysis shows a significant difference in the average number of diagnoses per month [2092 vs. 1815 vs. 2015, respectively (p < 0.05)] and an increase in the percentage of transports carried out by EMS vehicles to EDs [17% vs. 25% vs. 22%, respectively (p < 0.05)]. The length of stay (LOS) increased for both discharged patients (9.0 vs. 10.1 vs. 11.2 h, respectively; p < 0.005) and hospitalized patients (7.5 vs. 9.7 vs. 10.6 h, respectively; p < 0.005). During the COVID-19 pandemic, the overall number of stroke diagnoses decreased, while the percentage of patients transported to EDs by EMS vehicles increased. Furthermore, an increased processing time in EDs was highlighted. Full article
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