서브메뉴
검색
Pandemic Preparedness and COVID-19: Lessons Learned From National and Subnational Response, What We Can Learn From Existing Preparedness Metrics, and How to Prepare for Novel Threats- [electronic resource]
Pandemic Preparedness and COVID-19: Lessons Learned From National and Subnational Response, What We Can Learn From Existing Preparedness Metrics, and How to Prepare for Novel Threats- [electronic resource]
상세정보
- 자료유형
- 학위논문파일 국외
- 최종처리일시
- 20240214101452
- ISBN
- 9798379910334
- DDC
- 614
- 서명/저자
- Pandemic Preparedness and COVID-19: Lessons Learned From National and Subnational Response, What We Can Learn From Existing Preparedness Metrics, and How to Prepare for Novel Threats - [electronic resource]
- 발행사항
- [S.l.]: : University of Washington., 2023
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2023
- 형태사항
- 1 online resource(169 p.)
- 주기사항
- Source: Dissertations Abstracts International, Volume: 85-01, Section: B.
- 주기사항
- Advisor: Pigott, David M.
- 학위논문주기
- Thesis (Ph.D.)--University of Washington, 2023.
- 사용제한주기
- This item must not be sold to any third party vendors.
- 초록/해제
- 요약The COVID-19 pandemic has been one of the most catastrophic health emergencies of all time, leading to millions of deaths and hundreds of millions of infections worldwide. Yet, a global pandemic impacting all of humanity was not unforeseen, with countless studies articulating the spillover potential of various pathogens into humans and the ability for such viruses to replicate. Similarly, pandemic preparedness frameworks and metrics existed pre-COVID to quantify pandemic risks and vulnerabilities for a given country to emphasize both strong existing capacities as well as areas for improvement for emerging outbreaks and pandemics of international concern.The unprecedented scale of COVID-19 has renewed focus on pandemic preparedness and response. This research aims to understand the drivers of differential COVID-19 outcomes across various countries and within key countries and to quantify how current preparedness indices of immunization measure up against retrospective COVID-19 vaccination uptake. In the first aim, we consider whether existing pandemic preparedness indicators nationally were informative of better COVID-19 outcomes, and investigate what other political, social, health or demographic covariates influenced heterogeneities in COVID-19 across the globe. In the second aim, we focus our analyses subnationally to investigate drivers of within-country heterogeneities, and again investigate whether pre-pandemic preparedness was informative of COVID-19 outcomes, and whether national patterns were persistent subnationally. In the third aim, we build on our findings from the first and second aim that pandemic preparedness composite measures were not predictive of COVID-19 successes, and decompose such metrics to investigate one specific indicator of routine immunization in order to understand whether our measurement of vaccine readiness was truly informative of pandemic vaccine delivery. In the first aim Pandemic preparedness and COVID-19: an exploratory analysis of infection and fatality rates, and contextual factors associated with preparedness in 177 countries, from Jan 1, 2020, to Sept 30, 2021, we used multi-stage log-log regression models to understand drivers of cross-country differences in COVID-19 infections and mortality from January 2020 through September 2021, expanding on previous research looking at COVID-19 outcomes in relation to pandemic preparedness scores. We first controlled for immutable factors including daily seasonality and age profile, and secondly controlled for baseline risk factors like age profile, seasonality, density, and BMI. Following these adjustments, we modeled our standardized COVID-19 infections and infection fatality rates against policy-amenable factors, including pandemic preparedness indicators, health care readiness, and social and political characteristics. We found that the largest drivers of reduced COVID-19 infections were not associated with existing pandemic preparedness metrics, but instead to higher trust in the government and in other people. As trust is an essential driver of effective risk communication and behavioral modification such as vaccine uptake or social distancing, improving trust prior to the next pandemic is essential. In the second aim An exploratory analysis of improved COVID-19 outcomes in subnational locations across two countries: the United States and Brazil, January 2020 through May 2022, we again used multi-stage log-log regression models to understand within-country drivers of COVID-19 outcomes in Brazil and the United States. These two countries were chosen for their high overall COVID-19 burdens, but also for heterogeneous COVID-19 burdens, responses, and high political polarization. This time, our analysis ran from January 2020 through May 2022, and we controlled for daily seasonality and variant prevalence in the first stage, followed by a standardization for baseline risk factors. We again modeled these standardized estimates versus policy-amenable factors, including pandemic preparedness indicators, health care readiness, and social and political characteristics, though many of the covariates from the first chapter were not available at the state-level and either had to be modeled or omitted. Although there were observable differences within these countries, we identified no significant policy-amenable drivers of COVID-19 differences within countries following baseline standardization, though hospital beds per capita were found to be significantly related to higher infections. Trust was not a key driver of COVID-19 outcomes in Brazil and the United States, though the sample sizes of our trust variables were small and had wide confidence intervals. Similarly, modeled pandemic preparedness indicators were not predictive of improved COVID-19 outcomes subnationally. Our research additionally suggests that access to high quality health care is a potential avenue to explore to reduce the burden of disease in future pandemics. Within-country efforts to prepare for the next pandemic may be best focused on improving access to care and reducing existing burdens of comorbidities such as obesity and cancer which drive not only high mortality in general but are exacerbated in pandemics like COVID-19 where undue morbidity and mortality were observed among the chronically ill and elderly, and to improve estimates of trust and pandemic preparedness at. (Abstract shortened by ProQuest).
- 일반주제명
- Public health.
- 일반주제명
- Health care management.
- 일반주제명
- Immunology.
- 키워드
- COVID-19
- 키워드
- Global health
- 키워드
- Vaccination
- 키워드
- Zoonotic disease
- 기타저자
- University of Washington Global Health
- 기본자료저록
- Dissertations Abstracts International. 85-01B.
- 기본자료저록
- Dissertation Abstract International
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
008240612s2023 us |||||||||||||||c||eng d■001000016933891
■00520240214101452
■006m o d
■007cr#unu||||||||
■020 ▼a9798379910334
■035 ▼a(MiAaPQ)AAI30526990
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614
■1001 ▼aFrame, Erin Hulland.
■24510▼aPandemic Preparedness and COVID-19: Lessons Learned From National and Subnational Response, What We Can Learn From Existing Preparedness Metrics, and How to Prepare for Novel Threats▼h[electronic resource]
■260 ▼a[S.l.]:▼bUniversity of Washington. ▼c2023
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2023
■300 ▼a1 online resource(169 p.)
■500 ▼aSource: Dissertations Abstracts International, Volume: 85-01, Section: B.
■500 ▼aAdvisor: Pigott, David M.
■5021 ▼aThesis (Ph.D.)--University of Washington, 2023.
■506 ▼aThis item must not be sold to any third party vendors.
■520 ▼aThe COVID-19 pandemic has been one of the most catastrophic health emergencies of all time, leading to millions of deaths and hundreds of millions of infections worldwide. Yet, a global pandemic impacting all of humanity was not unforeseen, with countless studies articulating the spillover potential of various pathogens into humans and the ability for such viruses to replicate. Similarly, pandemic preparedness frameworks and metrics existed pre-COVID to quantify pandemic risks and vulnerabilities for a given country to emphasize both strong existing capacities as well as areas for improvement for emerging outbreaks and pandemics of international concern.The unprecedented scale of COVID-19 has renewed focus on pandemic preparedness and response. This research aims to understand the drivers of differential COVID-19 outcomes across various countries and within key countries and to quantify how current preparedness indices of immunization measure up against retrospective COVID-19 vaccination uptake. In the first aim, we consider whether existing pandemic preparedness indicators nationally were informative of better COVID-19 outcomes, and investigate what other political, social, health or demographic covariates influenced heterogeneities in COVID-19 across the globe. In the second aim, we focus our analyses subnationally to investigate drivers of within-country heterogeneities, and again investigate whether pre-pandemic preparedness was informative of COVID-19 outcomes, and whether national patterns were persistent subnationally. In the third aim, we build on our findings from the first and second aim that pandemic preparedness composite measures were not predictive of COVID-19 successes, and decompose such metrics to investigate one specific indicator of routine immunization in order to understand whether our measurement of vaccine readiness was truly informative of pandemic vaccine delivery. In the first aim Pandemic preparedness and COVID-19: an exploratory analysis of infection and fatality rates, and contextual factors associated with preparedness in 177 countries, from Jan 1, 2020, to Sept 30, 2021, we used multi-stage log-log regression models to understand drivers of cross-country differences in COVID-19 infections and mortality from January 2020 through September 2021, expanding on previous research looking at COVID-19 outcomes in relation to pandemic preparedness scores. We first controlled for immutable factors including daily seasonality and age profile, and secondly controlled for baseline risk factors like age profile, seasonality, density, and BMI. Following these adjustments, we modeled our standardized COVID-19 infections and infection fatality rates against policy-amenable factors, including pandemic preparedness indicators, health care readiness, and social and political characteristics. We found that the largest drivers of reduced COVID-19 infections were not associated with existing pandemic preparedness metrics, but instead to higher trust in the government and in other people. As trust is an essential driver of effective risk communication and behavioral modification such as vaccine uptake or social distancing, improving trust prior to the next pandemic is essential. In the second aim An exploratory analysis of improved COVID-19 outcomes in subnational locations across two countries: the United States and Brazil, January 2020 through May 2022, we again used multi-stage log-log regression models to understand within-country drivers of COVID-19 outcomes in Brazil and the United States. These two countries were chosen for their high overall COVID-19 burdens, but also for heterogeneous COVID-19 burdens, responses, and high political polarization. This time, our analysis ran from January 2020 through May 2022, and we controlled for daily seasonality and variant prevalence in the first stage, followed by a standardization for baseline risk factors. We again modeled these standardized estimates versus policy-amenable factors, including pandemic preparedness indicators, health care readiness, and social and political characteristics, though many of the covariates from the first chapter were not available at the state-level and either had to be modeled or omitted. Although there were observable differences within these countries, we identified no significant policy-amenable drivers of COVID-19 differences within countries following baseline standardization, though hospital beds per capita were found to be significantly related to higher infections. Trust was not a key driver of COVID-19 outcomes in Brazil and the United States, though the sample sizes of our trust variables were small and had wide confidence intervals. Similarly, modeled pandemic preparedness indicators were not predictive of improved COVID-19 outcomes subnationally. Our research additionally suggests that access to high quality health care is a potential avenue to explore to reduce the burden of disease in future pandemics. Within-country efforts to prepare for the next pandemic may be best focused on improving access to care and reducing existing burdens of comorbidities such as obesity and cancer which drive not only high mortality in general but are exacerbated in pandemics like COVID-19 where undue morbidity and mortality were observed among the chronically ill and elderly, and to improve estimates of trust and pandemic preparedness at. (Abstract shortened by ProQuest).
■590 ▼aSchool code: 0250.
■650 4▼aPublic health.
■650 4▼aHealth care management.
■650 4▼aImmunology.
■653 ▼aCOVID-19
■653 ▼aGlobal health
■653 ▼aInfectious disease
■653 ▼aPandemic preparedness
■653 ▼aVaccination
■653 ▼aZoonotic disease
■690 ▼a0573
■690 ▼a0982
■690 ▼a0769
■71020▼aUniversity of Washington▼bGlobal Health.
■7730 ▼tDissertations Abstracts International▼g85-01B.
■773 ▼tDissertation Abstract International
■790 ▼a0250
■791 ▼aPh.D.
■792 ▼a2023
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T16933891▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
■980 ▼a202402▼f2024
