Keywords
COVID-19; prepardness and response to pandemic; Iran; qualitative study
Abstract
Background: The role of health systems in the management of disasters including natural hazards like outbreaks and pandemics, is crucial and vital. Healthcare systems which are unprepared to properly deal with crises are much more likely to expose their public health workers and health personnel to harm and will not be able to deliver healthcare provisions in critical situations. This can lead to a drammatic toll of deaths, even in developed countries. The possible occurrence of global crises has prompted the WHO to devise instruments, guidelines and tools to assess the capacity of countries to deal with disasters. Iran’s health system has been hit hardly by the COVID-19 pandemic. In this study, we aimed to assess its preparedness and response to the outbreak.
Methods: The present investigation was designed as a qualitative study. We utilized the “COVID-19 Strategic Preparedness and Response Plan” devised by WHO as a conceptual framework.
Results: The dimension/pillars which scored the highest was national laboratories, followed by surveillance, rapid response teams and case investigations. Risk communication and community engagement was another pillar receiving a high score, followed by infection prevention and control and by country-level coordination, planning and monitoring. The pillar/dimensions receiving the lowest scores were operational support and logistics; case management; and points of entry.
Discussion: The COVID-19 pandemic has represented an unprecedent event that has challenged healthcare systems and facilities worldwide, highlighting their weaknesses and the need for inter-sectoral cooperation and collaboration during the crisis. Analyzing these experiences and capitalizing on them, by strengthening them,will help countries to be more prepared to face opossible future crises.
References
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40. Mounesan L, Eybpoosh S, Haghdoost A, Moradi G, Mostafavi EJIJoM. Is reporting many cases of COVID-19 in Iran due to strength or weakness of Iran’s health system? 2020;12(2):73-6.
41. Kaba M, Kitaw YJTEJoHD. Novel coronavirus (2019-nCoV)–reminiscent of Spanish flu: A challenge to global public health systems. 2020;34(1).
42. Wang F-S, Zhang CJTL. What to do next to control the 2019-nCoV epidemic? 2020;395(10222):391-3.
43. Tuite AR, Bogoch II, Sherbo R, Watts A, Fisman D, Khan KJAoIM. Estimation of coronavirus disease 2019 (COVID-19) burden and potential for international dissemination of infection from Iran. 2020.
44. Spiegel P, Sheik M, Gotway-Crawford C, Salama PJTL. Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps: a retrospective study. 2002;360(9349):1927-34.
45. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation and treatment coronavirus (COVID-19). Statpearls [internet]: StatPearls Publishing; 2020.
46. Raoofi A, Takian A, Sari AA, Olyaeemanesh A, Haghighi H, Aarabi MJAoIM. COVID-19 Pandemic and Comparative Health Policy Learning in Iran. 2020;23(4):220.
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2. Guarner J. Three Emerging Coronaviruses in Two Decades: The Story of SARS, MERS, and Now COVID-19. American Journal of Clinical Pathology. 2020;153(4):420-1.
3. Organization WH. WHO statement on novel coronavirus in thailand. 2020.
4. Organization WH. Coronavirus disease 2019 (COVID-19): situation report, 67. 2020.
5. Committee WE. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (COVID-19). Geneva: WHO, 2020. 2005.
6. Wu Z, McGoogan JMJJ. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. 2020.
7. Cavallo JJ, Donoho DA, Forman HP, editors. Hospital Capacity and Operations in the Coronavirus Disease 2019 (COVID-19) Pandemic—Planning for the Nth Patient. JAMA Health Forum; 2020: American Medical Association.
8. Kandel N, Chungong S, Omaar A, Xing JJTL. Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries. 2020.
9. Legido-Quigley H, Asgari N, Teo YY, Leung GM, Oshitani H, Fukuda K, et al. Are high-performing health systems resilient against the COVID-19 epidemic? 2020;395(10227):848-50.
10. Remuzzi A, Remuzzi GJTL. COVID-19 and Italy: what next? 2020.
11. Kruk ME, Myers M, Varpilah ST, Dahn BT. What is a resilient health system? Lessons from Ebola. Lancet. 2015;385(9980):1910-2.
12. Chowell G, Abdirizak F, Lee S, Lee J, Jung E, Nishiura H, et al. Transmission characteristics of MERS and SARS in the healthcare setting: a comparative study. BMC Med. 2015;13:210.
13. Nuzzo JB, Meyer D, Snyder M, Ravi SJ, Lapascu A, Souleles J, et al. What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review. BMC Public Health. 2019;19(1):1310.
14. Webb GF, Blaser MJ, Zhu H, Ardal S, Wu J. Critical role of nosocomial transmission in the toronto sars outbreak. Math Biosci Eng. 2004;1(1):1-13.
15. Ki M. 2015 MERS outbreak in Korea: hospital-to-hospital transmission. Epidemiol Health. 2015;37:e2015033.
16. Redlener I, Reilly MJ. Lessons from Sandy--preparing health systems for future disasters. N Engl J Med. 2012;367(24):2269-71.
17. Bell E, Tappero JW, Ijaz K, Bartee M, Fernandez J, Burris H, et al. Joint External Evaluation-Development and Scale-Up of Global Multisectoral Health Capacity Evaluation Process. Emerg Infect Dis. 2017;23(13).
18. Baker MG, Fidler DP. Global public health surveillance under new international health regulations. Emerg Infect Dis. 2006;12(7):1058-65.
19. WHO. Coronavirus disease 2019 (COVID-19) Situation Report – 31. 2020.
20. WHO. Coronavirus disease 2019 (COVID-19) Situation Report – 83. 2020.
21. Organization WH. Access the guidance COVID-19 Partners Platform based on Operational Planning Guidance Training modules: Operational Planning Guidelines and COVID-19 Partners Platform. 2020.
22. Organization WH. nCoV outbreak is an emergency of international concern. 2020. 2019.
23. Organization WH. COVID-19: operational guidance for maintaining essential health services during an outbreak: interim guidance, 25 Mar 2020. World Health Organization; 2020.
24. Ardalan A, MASOUMI G, GOUYA MM, Ghafari M, Miadfar J, Sarvar M, et al. Disaster health management: Iran’s progress and challenges. 2009.
25. FARAJ ZSH, PARTOVI PA, MASOURI N, SAFDARI R. Comparative study of natural disaster health information system in USA, Japan and Iran. 2007.
26. Ruan SJTLID. Likelihood of survival of coronavirus disease 2019. 2020.
27. on COVID NC. Daily Situation Report on Coronavirus disease (COVID-19) in Iran; 22 Mar, 2020. Archives of Academic Emergency Medicine. 2020;8(1).
28. Sharifi H, Jahani Y, Mirzazadeh A, Ahmadi Gohari M, Nakhaeizadeh M, Shokoohi M, et al. Estimating the number of COVID-19-related infections, deaths and hospitalizations in Iran under different physical distancing and isolation scenarios: A compartmental mathematical modeling. 2020:2020.04.22.20075440.
29. Mounesan L, Eybpoosh S, Haghdoost A, Moradi G, Mostafavi E. Is reporting many cases of COVID-19 in Iran due to strength or weakness of Iran’s health system?. Iranian Journal of Microbiology. 2020 1 Apr;12(2):73-6.
30. Pasteur Institute of Iran. Creating the capacity to perform 20,000 COVID-19 tests a day in the Iran 2020 [Available from: http://en.pasteur.ac.ir/.
31. Takian A, Raoofi A, Kazempour-Ardebili S. COVID-19 battle during the toughest sanctions against Iran. Lancet. 2020;395(10229):1035-6.
32. Murphy A, Abdi Z, Harirchi I, McKee M, Ahmadnezhad E. Economic sanctions and Iran’s capacity to respond to COVID-19. Lancet Public Health. 2020.
33. santé Omdl. World Health Statistics 2018: Monitoring Health for the SDGs Sustainable Development Goals: World health organization.; 2018.
34. Jeddi FR, Nabovati E, Bigham R, Khajouei RJIjomi. Usability evaluation of a comprehensive national health information system: relationship of quality components to users’ characteristics. 2020;133:104026.
35. Uyeki TM, Bundesmann M, Alhazzani W. Clinical management of critically ill adults with coronavirus disease 2019 (COVID-19). 2020.
36. Shekelle P, Woolf S, Grimshaw JM, Schünemann HJ, Eccles MPJIS. Developing clinical practice guidelines: reviewing, reporting, and publishing guidelines; updating guidelines; and the emerging issues of enhancing guideline implementability and accounting for comorbid conditions in guideline development. 2012;7(1):62.
37. Beggs JC. Applications: disaster communication and community engagement. Disaster Epidemiology: Elsevier; 2018. p. 163-9.
38. Cheung JC-H, Ho LT, Cheng JV, Cham EYK, Lam KNJTLRM. Staff safety during emergency airway management for COVID-19 in Hong Kong. 2020;8(4):e19.
39. Organization WH. Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19): interim guidance, 19 Mar 2020. World Health Organization; 2020.
40. Mounesan L, Eybpoosh S, Haghdoost A, Moradi G, Mostafavi EJIJoM. Is reporting many cases of COVID-19 in Iran due to strength or weakness of Iran’s health system? 2020;12(2):73-6.
41. Kaba M, Kitaw YJTEJoHD. Novel coronavirus (2019-nCoV)–reminiscent of Spanish flu: A challenge to global public health systems. 2020;34(1).
42. Wang F-S, Zhang CJTL. What to do next to control the 2019-nCoV epidemic? 2020;395(10222):391-3.
43. Tuite AR, Bogoch II, Sherbo R, Watts A, Fisman D, Khan KJAoIM. Estimation of coronavirus disease 2019 (COVID-19) burden and potential for international dissemination of infection from Iran. 2020.
44. Spiegel P, Sheik M, Gotway-Crawford C, Salama PJTL. Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps: a retrospective study. 2002;360(9349):1927-34.
45. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation and treatment coronavirus (COVID-19). Statpearls [internet]: StatPearls Publishing; 2020.
46. Raoofi A, Takian A, Sari AA, Olyaeemanesh A, Haghighi H, Aarabi MJAoIM. COVID-19 Pandemic and Comparative Health Policy Learning in Iran. 2020;23(4):220.
47. Gharebaghi R, Heidary FJSMW. COVID-19 and Iran: swimming with hands tied! 2020;150(1516).