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Review Articles
Scrutiny of COVID-19 response strategies among severely affected European nations
Shine Stephen, Alwin Issac, Rakesh Vadakkethil Radhakrishnan, Jaison Jacob, VR Vijay, Sam Jose, SM Azhar, Anoop S. Nair, Nadiya Krishnan, Rakesh Sharma, Manju Dhandapani
Osong Public Health Res Perspect. 2021;12(4):203-214.   Published online July 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0068
  • 6,242 View
  • 109 Download
  • 3 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Although the health care systems in Europe are considered the global benchmark, European nations were severely affected by the coronavirus disease 2019 (COVID-19) pandemic. This manuscript aimed to examine the strategies implemented to combat the COVID-19 pandemic by France, the United Kingdom, Spain, Italy, Germany, and Russia and their outcomes in terms of the number of cases, testing, and deaths. This is the first review of its kind that extensively analyzes the preparedness, mitigation, and response strategies against the COVID-19 pandemic adopted by these nations. This paper further suggests a strategic preparedness model for future pandemics. From the analysis, we found that a decentralized approach, prompt decision-making and timely execution, coordination between local health authorities, and public participation in the implementation of strategies could substantially reduce the case fatality rate. Nations with a high percentage of gross domestic product invested in the health sector, as well as more nurses, physicians, hospital beds, intensive care unit beds, and ventilators, better managed the pandemic. Instead, nations that postponed their pandemic response by delaying tracking, tracing, testing, quarantine, and lockdown were badly affected. The lessons learned from the present pandemic could be used as a guide to prepare for further pandemics.
COVID-19: Weighing the Endeavors of Nations, with Time to Event Analysis
Shine Stephen, Alwin Issac, Jaison Jacob, VR Vijay, Rakesh Vadakkethil Radhakrishnan, Nadiya Krishnan
Osong Public Health Res Perspect. 2020;11(4):149-157.   Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.02
  • 3,445 View
  • 93 Download
  • 8 Citations
AbstractAbstract PDF

The cataclysmic COVID-19 pandemic erupted silently causing colossal impact worldwide, the repercussions of which indicated a lackadaisical vigilance in preparation for such a pandemic. This review assessed the measures taken by nations to contain this pandemic. A literature review was conducted using Medline, Google Scholar, Science Direct, Scopus, and WHO website. There were 8 nations (selected from the GHS index list) appraised for containment strategies. This was achieved by using mortality rate (per million) as the primary endpoint. The nations which were proactive, initiated scientific strategies earlier with rigor, appeared to have succeeded in containing the pandemic, although it is still too early to arbitrate a verdict. The so called “pandemic war” mandates international, interdisciplinary, and interdepartmental collaboration. Furthermore, building trust and confidence between the government and the public, having transparent communication, information sharing, use of advanced research-technology, and plentiful resources are required in the fight against COVID-19.

Original Articles
Assessment of Intensive Vaccination and Antiviral Treatment in 2009 Influenza Pandemic in Korea
Chaeshin Chu, Sunmi Lee
Osong Public Health Res Perspect. 2015;6(1):47-51.   Published online February 28, 2015
DOI: https://doi.org/10.1016/j.phrp.2014.11.007
  • 1,312 View
  • 15 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
We characterized and assessed public health measures, including intensive vaccination and antiviral treatment, implemented during the 2009 influenza pandemic in the Republic of Korea.
Methods
A mathematical model for the 2009 influenza pandemic is formulated. The transmission rate, the vaccination rate, the antiviral treatment rate, and the hospitalized rate are estimated using the least-squares method for the 2009 data of the incidence curves of the infected, vaccinated, treated, and hospitalized.
Results
The cumulative number of infected cases has reduced significantly following the implementation of the intensive vaccination and antiviral treatment. In particular, the intensive vaccination was the most critical factor that prevented severe outbreak.
Conclusion
We have found that the total infected proportion would increase by approximately six times under the half of vaccination rates.
Assessment of the Intensive Countermeasures in the 2009 Pandemic Influenza in Korea
Jin Hyuk Choi, Yunhwan Kim, Seoyun Choe, Sunmi Lee
Osong Public Health Res Perspect. 2014;5(2):101-107.   Published online April 30, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.03.003
  • 1,400 View
  • 16 Download
AbstractAbstract PDF
Objectives
It is critical to implement effective multiple countermeasures to mitigate or retain the spread of pandemic influenza. We propose a mathematical pandemic influenza model to assess the effectiveness of multiple countermeasures implemented in 2009.
Methods
Age-specific parameters, including the transmission rate, the proportion of asymptomatic individuals, the vaccination rate, the social distancing rate, and the antiviral treatment rate are estimated using the least-square method calibrated to the incidence data.
Results
The multiple interventions (intensive vaccination, social distancing, antivrial treatment) were successfully implemented resulting in the dramatic reduction in the total number of incidence.
Conclusion
The model output is sensitive to age-specific parameters and this leads to the fact that a more elaborate age group model should be developed and extensive further studies must be followed.
Brief Report
Public Health Crisis Preparedness and Response in Korea
Hye-Young Lee, Mi-Na Oh, Yong-Shik Park, Chaeshin Chu, Tae-Jong Son
Osong Public Health Res Perspect. 2013;4(5):278-284.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.008
  • 1,495 View
  • 17 Download
  • 20 Citations
AbstractAbstract PDF
Since the 2006 Pandemic Influenza Preparedness and Response Plan according to the World Health Organization’s recommendation, the Republic of Korea has prepared and periodically evaluated the plan to respond to various public health crises including pandemic influenza. Korea has stockpiled 13,000,000 doses of antiviral drugs covering 26% of the Korean population and runs 519 isolated beds in 16 medical institutions. The division of public health crisis response in Korea Centers for Disease Control and Prevention are in charge of responding to public health crises caused by emerging infectious diseases including severe acute respiratory syndrome, avian influenza human infection, and pandemic influenza. Its job description includes preparing for emerging infectious diseases, securing medical resources during a crisis, activating the emergency response during the crisis, and fortification of capabilities of public health personnel. It could evolve into a comprehensive national agency to deal with public health crisis based on the experience of previous national emerging infectious diseases.
Original Article
Evaluation of the Effectiveness of Pandemic Influenza A(H1N1) 2009 Vaccine Based on an Outbreak Investigation During the 2010–2011 Season in Korean Military Camps
Kyo-Hyun Kim, Yoon Gu Choi, Hyun-Bae Yoon, Jung-Woo Lee, Hyun-Wook Kim, Chaeshin Chu, Young-Joon Park
Osong Public Health Res Perspect. 2013;4(4):209-214.   Published online August 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.07.002
  • 1,429 View
  • 15 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
In December 2010, there was an outbreak of acute febrile respiratory disease in many Korean military camps that were not geographically related. A laboratory analysis confirmed a number of these cases to be infected by the pandemic influenza A(H1N1) 2009 (H1N1pdm09) virus. Because mass vaccination against H1N1pdm09 was implemented at the infected military camps eleven months ago, the outbreak areas in which both vaccinated and nonvaccinated individuals were well mixed, gave us an opportunity to evaluate the effectiveness of H1N1pdm09 vaccine through a retrospective cohort study design.
Methods
A self-administered questionnaire was distributed to the three military camps in which the outbreak occurred for case detection, determination of vaccination status, and characterization of other risk factors. The overall response rate was 86.8% (395/455). Case was defined as fever (≥38 °C) with cough or sore throat, influenza-like illness (ILI), and vaccination status verified by vaccination registry. Crude vaccine effectiveness (VE) was calculated as “1 − attack rate in vaccinated individuals/attack rate in nonvaccinated individuals”, and adjusted VE was calculated as “1 – odds ratio” using logistic regression adjusted for potential confounding factor. A number of ILI definitions were used to test the robustness of the result.
Results
The attack rate of ILI was 12.8% in register-verified vaccinated individuals and 24.0% in nonvaccinated individuals. The crude VE was thus calculated to be 46.8% [95% confidence interval (CI): 14.5–66.9]. The adjusted VE rate was 46.8% (95% CI: –9.4 to 74.1). Various combinations of ILI symptoms also showed similar VE rates.
Conclusion
We evaluated the effectiveness of H1N1pdm09 vaccine in the 2010–2011 season in an outbreak setting. Although the result was not sensitive to any analytical method used and ILI case definition, the magnitude of effectiveness was lower than estimated in the 2009–2010 season.
Articles
Sensitivity Analysis of the Parameters of Korea’s Pandemic Influenza Preparedness Plan
Chaeshin Chu, Junehawk Lee, Dong Hoon Choi, Seung-Ki Youn, Jong-Koo Lee
Osong Public Health Res Perspect. 2011;2(3):210-215.   Published online December 31, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.11.048
  • 1,476 View
  • 16 Download
  • 10 Citations
AbstractAbstract PDF
Objectives
Our aim was to evaluate Korea’s Pandemic Influenza Preparedness Plan.
Methods
We conducted a sensitivity analysis on the expected number of outpatients and hospital bed occupancy, with 1,000,000 parameter combinations, in a situation of pandemic influenza, using the mathematical simulation program InfluSim.
Results
Given the available resources in Korea, antiviral treatment and social distancing must be combined to reduce the number of outpatients and hospitalizations sufficiently; any single intervention is not enough. The antiviral stockpile of 4–6% is sufficient for the expected eligible number of cases to be treated. However, the eligible number assumed (30% for severe cases and 26% for extremely severe cases) is very low compared to the corresponding number in European countries, where up to 90% of the population are assumed to be eligible for antiviral treatment.
Conclusions
A combination of antiviral treatment and social distancing can mitigate a pandemic, but will only bring it under control for the most optimistic parameter combinations.

PHRP : Osong Public Health and Research Perspectives