A Multisectoral Approach to Identify Innovative Solutions to Strengthen Capacity Building for Pandemic Risk Management

Abstract

Purpose: Foodborne outbreaks are ubiquitous around the world. Outbreaks are commonly detected through laboratory genetic testing and investigators analyse food history in search of commonality between cases to find the source of the outbreak. Geospatial information has the potential to direct investigators to the source of an outbreak. To inform the design of surveillance countermeasures, we collected data to approximate how cases would disperse following a foodborne outbreak in a food establishment in malls located in the city centre or at transport hubs within satellite townships or in smaller food establishments within suburban regions in Singapore.Methods & Materials: Socio-demographics, residential and workplace address and time of survey from a cross-sectional survey at randomly selected malls (10 city area, 20 satellite townships) were analysed. Distances between residence and workplace of subjects, site of survey, and pair-wise distances between addresses were used as indicators of potential geographical dispersion. We assessed if subject characteristics, survey timing and site location was associated with distance from survey site using randomintercept multilevel linear regression. We then calculated the centre of minimum distance using all residential address alone, all work address alone and both addresses together.Results: We surveyed 5012 individuals across 30 sites in Singapore (10 city area, 20 satellite townships of which 10 were beside transport hubs and 10 at least 500m away from a transport hub). Multilevel linear regression confirmed that city centre subjects were more dispersed geographically (␤=0.979; p<0.001) than for satellite township subjects far away from a transport hub; also, working subjects were significantly more dispersed (␤=0.049; p=0.004), while those who ate food at the site were less dispersed (␤=-0.057; p<0.001) than those who did not. Residential addresses were able to pinpoint the source of the outbreak to under 500m for sites in satellite townships, while work addresses were able to do the same for city centre sites. Using both addresses together improved overall detection in all sites to about 500m from the simulated source except one site.Conclusion: When all cases are clearly known, residential and work addresses can help to narrow down the likely source of the outbreak.

Addressing public health and security challenges with system dynamics

“…The integrated theme of public health and security was further informed through NUI Galway's role in the project titled Pandemic Risk and Emergency Management (PANDEM) project, funded through the EU Horizon 2020 Secure Societies programme of research and innovation, whose purpose was to identify viable innovative concepts to strengthen capacity building for pandemic risk management in the EU (Duggan, Hayes, Jilani, Wurmel, & Connolly, 2016). A pandemic is defined as an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people (Last, Harris, Thuriaux, & Spasoff, 2001).…”

Moral philosophy, pragmatism, and the larger cause: why “war” metaphors are needed during pandemics

“…Modern wars are fought on multiple fronts using diplomacy, economics, narrative building, and non-state actors. A pandemic needs a multi-sectoral approach (13)(14)(15). The long arc for Covid-19 response demands a win-some lose-some approach to planning.…”