PH 600 Assignment 11

Assignment #11 (50 points)

PH 600

Directions: For your final assignment, you will work through a series of questions based on Appendix B of your Birkhead textbook (p. 369-413). All responses must use full sentences (not bullet points). There is no word minimum or maximum for responses- use as much space as needed to fully respond to each question.

1. The 2017 Pandemic Influenza Plan (Table 1; p. 372) describes seven domains for action by public health and its partners when responding to a pandemic. For each of the seven domains, describe a specific activity related to that domain that a health department should take (or did take) to respond to the COVID-19 pandemic. (7 points)

Domain	Health Department Activity in Response to COVID-19
Surveillance, epidemiology, and laboratory activities	Health departments implemented extensive testing and contact tracing programs to track the spread of COVID-19, identify hotspots, and monitor variants of concern.
Community mitigation measures	State and local health departments enforced lockdowns, mandated the use of face masks, and imposed social distancing measures to reduce transmission in public spaces and businesses.
Medical countermeasures	The rapid distribution of vaccines through state-managed vaccination clinics and collaborations with healthcare providers helped mitigate the impact of the pandemic.
Healthcare system preparedness and response activities	Health departments worked with hospitals to increase ICU capacity, distribute ventilators, and manage resource allocation during the height of the pandemic when hospitals were overwhelmed.
Communications and public outreach	Public health authorities disseminated daily updates through press conferences and social media to keep the public informed of new developments, guidelines, and case numbers.
Scientific infrastructure and preparedness	Investments were made in genomic sequencing to monitor the virus’s evolution and potential mutations, enabling a more informed public health response to emerging variants.
Domestic and international response policy, incident management, and global partnerships and capacity building	Coordination with the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) enabled a unified approach to managing the pandemic on both national and global levels.

 

2. Read through the section on the origins and course of the first four months of the COVID-19 pandemic (p. 374-376). Discuss at least two specific factors or actions that contributed to the rapid global spread of COVID-19. How could these factors have been handled differently to slow the spread during these crucial first months? (6 points)

Two major factors contributed to the rapid global spread of COVID-19:

Global Travel: The unrestricted movement of individuals across borders during the early stages of the outbreak allowed the virus to spread from the initial epicenter in Wuhan, China, to countries worldwide (Birkhead et al., 2022). Early travel restrictions could have slowed this spread.

Delayed Response by Governments: Many governments, including the United States, initially downplayed the severity of the pandemic, resulting in delayed lockdowns and inadequate testing capabilities. If governments had responded more swiftly with restrictions and ramped up testing, the virus’s spread could have been slowed (Birkhead et al., 2022).

These factors could have been addressed by implementing stricter travel restrictions and earlier nationwide lockdowns combined with widespread testing to contain the virus’s spread in the early months.

3. As discussed on p. 377, the CDC uses the case definition for COVID-19 prepared by the Council of State and Territorial Epidemiologists (CSTE). This definition includes both clinical criteria (important for identifying a probable case) and laboratory criteria (important for identifying a confirmed case). What are the advantages and disadvantages of having both clinical and laboratory criteria for a disease like COVID-19? (6 points)

Advantages: Combining clinical and laboratory criteria provides a more robust approach to identifying cases. Clinical symptoms can help identify probable cases in resource-limited areas, while laboratory tests confirm infection, leading to more accurate diagnoses.

Disadvantages: Relying on laboratory criteria can delay diagnosis in regions with limited testing capacity (Birkhead et al., 2022). This can hinder timely intervention and isolation measures. Additionally, clinical criteria alone may result in misdiagnosis due to overlapping symptoms with other respiratory illnesses.

4. Review Figure 6 on p. 383 regarding COVID-19 associated deaths. (4 points)
   1. Discuss the difference between a probable death, a confirmed death, and an excess death.

Probable Death: A death where COVID-19 is suspected based on symptoms or other clinical criteria, but laboratory confirmation is lacking.

Confirmed Death: A death that has been verified through a positive COVID-19 test (Romanova et al., 2021).

Excess Death: The number of deaths during a given period that exceeds the expected number of deaths based on historical trends.

1. Name at least one advantage and one disadvantage to having these three different mortality classifications.

Advantage: Multiple mortality classifications allow public health officials to gain a clearer understanding of the pandemic’s true impact, including indirect effects like overwhelmed healthcare systems.

Disadvantage: Differing definitions can lead to inconsistencies in reporting across jurisdictions, making it difficult to compare data accurately.

5. On p. 385, inequities related to COVID-19 are discussed. For each of the social determinants of health, give a specific example of how this determinant could be linked to increased likelihood of COVID-19 infection, severity, death, or related secondary consequences such as unemployment or eviction. (10 points)

 

Social Determinant of Health	Connection to COVID-19 Risk/Consequences
Economic stability	Low-income workers were more likely to work in jobs that could not be performed remotely, increasing their exposure to the virus (Birkhead et al., 2022). Additionally, economic instability led to higher rates of unemployment and eviction, further exacerbating the pandemic’s effects.
Education access and quality	People with lower educational attainment may have less access to reliable health information, which could lead to delays in seeking care or adhering to preventive measures.
Healthcare access and quality	Individuals without health insurance or access to healthcare were less likely to receive timely testing or treatment, leading to higher rates of severe illness and death.
Neighborhood and built environment	Overcrowded living conditions, common in underserved communities, make it difficult for individuals to practice social distancing or isolate themselves when infected, contributing to higher transmission rates (Birkhead et al., 2022).
Social and community context	Marginalized communities often experience higher levels of mistrust in healthcare systems, which may have led to lower vaccine uptake and adherence to public health guidelines.

 

6. Review Table 5 on p. 392-393 regarding the federal legislation passed in the first few months of the pandemic. When all the legislation is taken together, which three provisions do you think made the most significant impact on our country’s public health response? Elaborate on your choices. (6 points)

Emergency Paid Sick Leave: This provision allowed workers to take time off if they were infected or exposed to COVID-19 without fear of losing their jobs or income, helping to reduce workplace transmission (Birkhead et al., 2022).

Expanded Unemployment Benefits: Unemployment benefits provided financial relief to those who lost their jobs during the pandemic, preventing a further decline in poverty and supporting public health by allowing people to stay home.

Paycheck Protection Program (PPP): This program helped small businesses stay afloat, ensuring they could retain employees and contribute to economic recovery without sacrificing public health (Birkhead et al., 2022).

7. 394-395 discuss actions taken by state governments in response to the pandemic. On March 14, 2020, Mississippi Governor Reeves declared a state of emergency in the state. Review the press release, emergency declaration, and media broadcast- all available here. What types of provisions are discussed? Given what you know now, do you think this action did enough to reduce the initial spread of disease in the state? (5 points)

Governor Reeves’ state of emergency declaration enabled Mississippi to access federal resources, implement quarantine measures, and offer public health directives like mask mandates. However, the lack of early enforcement of more stringent measures such as widespread testing, contact tracing, and stay-at-home orders likely contributed to the state’s higher infection rates in the initial phase of the pandemic (Birkhead et al., 2022). Given the current understanding of COVID-19’s transmission, stricter and earlier interventions might have been more effective in curbing the virus’s spread.

8. Read the section on risk communication on p. 401, and then review the CDC’s CERC Manual on Messages and Audiences. Drawing from the information covered in this manual chapter, discuss three specific ways that health communication could have been improved during the COVID-19 pandemic. (6 points)

Consistent Messaging: Conflicting messages from federal and state authorities caused public confusion. A unified communication strategy that ensured consistency across all levels of government would have built public trust and adherence to guidelines.

Tailored Messaging for Different Audiences: Health communications could have been adapted to address different demographic groups’ specific concerns, such as communities with limited English proficiency or rural areas with limited healthcare access.

Transparency and Clarity: Being transparent about the evolving nature of scientific knowledge and admitting when guidance is needed to change would have improved public understanding and trust in health recommendations.

References

Birkhead, G. S., Pirani, S., & Morrow, C. B. (2022). Turnock’s Public Health: What it is and how it works (7th ed.). Jones & Bartlett Learning.

Romanova, E. S., Vasilyev, V. V., Startseva, G., Karev, V., Rybakova, M. G., & Platonov, P. G. (2021). Cause of death based on systematic post‐mortem studies in patients with positive SARS‐CoV‐2 tissue PCR during the COVID‐19 pandemic. Journal of Internal Medicine, 290(3), 655–665. https://doi.org/10.1111/joim.13300

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Assignment #11 (50 points)

PH 600

Directions: For your final assignment, you will work through a series of questions based on Appendix B of your Birkhead textbook (p. 369-413). All responses must use full sentences (not bullet points). There is no word minimum or maximum for responses- use as much space as needed to fully respond to each question.

1. The 2017 Pandemic Influenza Plan (Table 1; p. 372) describes seven domains for action by public health and its partners when responding to a pandemic. For each of the seven domains, describe a specific activity related to that domain that a health department should take (or did take) to respond to the COVID-19 pandemic. (7 points)

Domain	Health Department Activity in Response to COVID-19
Surveillance, epidemiology, and laboratory activities
Community mitigation measures
Medical countermeasures
Healthcare system preparedness and response activities
Communications and public outreach
Scientific infrastructure and preparedness
Domestic and international response policy, incident management, and global partnerships and capacity building

 

2. Read through the section on the origins and course of the first four months of the COVID-19 pandemic (p. 374-376). Discuss at least two specific factors or actions that contributed to the rapid global spread of COVID-19. How could these factors have been handled differently to slow the spread during these crucial first months? (6 points)

 

3. As discussed on p. 377, the CDC uses the case definition for COVID-19 prepared by the Council of State and Territorial Epidemiologists (CSTE). This definition includes both clinical criteria (important for identifying a probable case) and laboratory criteria (important for identifying a confirmed case). What are the advantages and disadvantages of having both clinical and laboratory criteria for a disease like COVID-19? (6 points)
   

   PH 600 Assignment 11

 

4. Review Figure 6 on p. 383 regarding COVID-19 associated deaths. (4 points)
   1. Discuss the difference between a probable death, a confirmed death, and an excess death.
   2. Name at least one advantage and one disadvantage to having these three different mortality classifications.

 

5. On p. 385, inequities related to COVID-19 are discussed. For each of the social determinants of health, give a specific example of how this determinant could be linked to increased likelihood of COVID-19 infection, severity, death, or related secondary consequences such as unemployment or eviction. (10 points)

Social Determinant of Health	Connection to COVID-19 Risk/Consequences
Economic stability
Education access and quality
Healthcare access and quality
Neighborhood and built environment
Social and community context

 

6. Review Table 5 on p. 392-393 regarding the federal legislation passed in the first few months of the pandemic. When all the legislation is taken together, which three provisions do you think made the most significant impact on our country’s public health response? Elaborate on your choices. (6 points)

 

7. 394-395 discuss actions taken by state governments in response to the pandemic. On March 14, 2020, Mississippi Governor Reeves declared a state of emergency in the state. Review the press release, emergency declaration, and media broadcast- all available here. What types of provisions are discussed? Given what you know now, do you think this action did enough to reduce the initial spread of disease in the state? (5 points)

 

8. Read the section on risk communication on p. 401, and then review the CDC’s CERC Manual on Messages and Audiences. Drawing from the information covered in this manual chapter, discuss three specific ways that health communication could have been improved during the COVID-19 pandemic. (6 points)