Global Public Health Database Support to Population-Based Management of Pandemics and Global Public Health Crises, Part I: The Concept

Abstract

This two-part article examines the global public health (GPH) information system deficits emerging in the coronavirus disease 2019 (COVID-19) pandemic. It surveys past, missed opportunities for public health (PH) information system and operational improvements, examines current megatrend changes to information management, and describes a new multi-disciplinary model for population-based management (PBM) supported by a GPH Database applicable to pandemics and GPH crises.

Keywords: global public health; pandemics; population-based management; public health; triage.

Figure 1.

Susceptible-Exposed-Infectious-Removed-Vaccinated (SEIRV) Phase One Triage Categorization. Note: For the entire population and phase two triage management of these subpopulation groups during a bioevent. Percentages based on influenza and SARS outbreak data. Reproduced with permission. Abbreviations: ICU, intensive care unit; SARS, severe acute respiratory syndrome.

Figure 2.

Proposed Restructuring of US HHS/CDC Regional Offices to Sponsor PBMTs. Note: Each of the 10 HHS/CDC regional organizations would house and support a PBMT: PBMTs in the US serve one HHS/CDC regional organization. PBMTs gather and share data with the GPH Database. PBMTs would receive data summaries every six weeks, or more if requested. In normal times, the PBMTs would advise the HHS/CDC regional organization and state health facilities on prevention and preparedness issues gleaned from the GPH Database and both CDC and CDC/HHS regional organizations will assist in propagating the GPH Database with needed information. PBMTs would work with the state and local health departments, hospitals, and clinics, among others, to monitor usage and provide preventive data-based information and timely recommendations. During outbreaks, epidemics, and pandemics, data exchange and summary requests would be daily. If the management situation demands the authority and skillsets of the PBMTs, they will fully engage and manage the pandemic with the legal authority they have. PBMTs are housed in the regional HHS/CDC offices. PBMT permanent staff includes Senior PH Official(s), Medical Expertise (usual infectious diseases/tropical medicine), Biostatisticians, and Epidemiologists, all trained as Disaster Cycle Health Crisis Managers or Scientists. PBMTs are additionally served full- or part-time by a multi-disciplinary team made up of sociologist, anthropologists, and attorneys in International Law. MOE Monitors are members of the PBMTs but are independent. Abbreviations: US, United States; HHS, Health and Human Services; CDC, Centers for Disease Control and Prevention; PBMT, population-based management team; GPH, global public health; PH, public health; MOE, measures of effectiveness.

Figure 3.

WHO, CDC, and PBMT Users of the GPH Database. Abbreviations: WHO, World Health Organization; CDC, Centers for Disease Control and Prevention; PBMT, population-based management team; GPH, global public health.