Health system responses to COVID-19

Beyond Containment:Health systems responses to COVID-19 in the OECD

From OECD report:

The main focus of this brief is on the policiesaimed at providing effective care and managing the pressure on health systems. Four key measures health systems are putting in place in response to the epidemic are considered: 1)ensuring access of the vulnerable to diagnostics and treatment; 2)strengthening and optimising health system capacity to respond to the rapid increase in caseloads; 3)how to leverage digital solutions and data to improve surveillance and care; and 4)how to improve R&D for accelerated development of diagnostics, treatments and vaccines

PS: From Francesca Colombo

Economics of pandemics (2)

Mitigating the COVID Economic Crisis: Act Fast and Do Whatever It Takes

Crucial contribution from key economists. A must read.

Outline:

Introduction
Richard Baldwin and Beatrice Weder di Mauro

1 So far, so good:  And now don't be afraid of moral hazard
2 Flattening the pandemic and recession curves
3 Limiting the economic fallout of the coronavirus with large targeted policies
4 Italy, the ECB, and the need to avoid another euro crisis
5 The EU must support the member at the centre of the COVID-19 crisis
6 Helicopter money: The time is now
7 What the stock market tells us about the consequences of COVID-19
8 Ten keys to beating back COVID-19 and the associated economic pandemic
9 Saving China from the coronavirus and economic meltdown: Experiences and lessons
10 China's changing economic priorities and the impact of COVID-19
11 Singapore's policy response to COVID-19
12 The experience of South Korea with COVID-19
13 COVID-19: Europe needs a catastrophe relief plan
14 The COVID-19 bazooka for jobs in Europe
15 The monetary policy package: An analytical framework
16 Bold policies needed to counter the coronavirus recession
17 Europe ís ground zero
18 Economic implications of the COVID-19 crisis for Germany and economic policy measures
19 Finance in the times of COVID-19: What next?
20 How COVID-19 could be like the Global Financial Crisis (or worse)
21 Protecting people now, helping the economy rebound later
22 Policy in the time of coronavirus
23 Containing the economic nationalist virus through global coordination
24 The case for permanent stimulus

Security policies in front of a new molecular vision of life

Pandemics, Pills, and Politics. Governing Global Health Security

The goal of this book in one sentence:

This volume reveals the major challenges involved in securing populations pharmaceutically and explores how governments are designing extensive new medical countermeasure regimes to overcome those challenges. At the heart of this pharmaceutical turn in security policy, I argue, lies something deeper: the rise of a new molecular vision of life that is reshaping the world we live in—including the way we now imagine and practice security.

The author explains the pharmaceutical defenses for a global pandemic, and specially describes the case of Tamiflu.

 The idea of “medical countermeasures” is also fascinating, secondly, because of the terminology it musters. The concept textually embodies the progressive epistemic fusion of the two professional fields of medicine (“medical”) and security (“countermeasures”), attempting to seamlessly blend key vocabularies from both communities into a single notion. Here the term begins to form a fascinating intersection, or bridge, between these two different social fields, giving rise in the process to a fascinating new and interdisciplinary policy space where the respective concerns of pharmaceuticals and security begin to interpenetrate each other, and can also come into direct tension with one another.

The chapter 4 is specially of interest: The Margin Call for Regulatory Agencies and explains what was done in the Tamiflu case.

A cursory review of the FDA approval processes for Tamiflu paints a fairly uneventful picture. In fact, the sequence of events leading up to FDA approval for Tamiflu can be quickly summarized. A month after the Swiss approval, on 27 October 1999, the FDA approved Tamiflu for “the treatment of uncomplicated acute illness due to influenza infection in  adults who have been symptomatic for no more than 2 days” (FDA 1999b). This marketing approval process unfolded rapidly according to the priority review procedure—within six months—following Roche’s initial application for FDA approval on 29 April 1999.

 Again, the case of Tamiflu has been highly instructive. It showed that this new pharmaceutical intervention could only be designed after scientists had first gained a much better understanding of the precise molecular processes involved in viral replication unfolding inside the human body—especially the role played by the influenza virus’s surface proteins such as neuraminidase. Once scientists had understood the vital role played by the neuraminidase and decoded its precise molecular structure, they discovered a “static” site that could form the basis for a new drug target. Scientists could then set about the task of deliberately designing an “artificial” molecule that would bind to that critical site in the neuraminidase and that could inhibit its key role in the process of viral replication. In that sense, our technical ability to develop new pharmaceutical defenses is itself  dependent upon a prior—and deeper—scientific understanding of the life processes unfolding at the scale of the molecular.

The case of covid-19 began without any countermeasure, because molecular knowledge started mid-January once it was sequenced. Nowadays, we can only wait for a successful vaccine and therapy.

Protect yourself and you protect others

PANDEMICS: WHAT EVERYONE NEEDS TO KNOW

Selected messages from a descriptive and useful and concise book by the winner of the Nobel Prize for Medicine, 1996 :

• Our capacity to deal with and live through pandemic situations is continually improving. We should not be fearful, but we should be aware, watchful and prepared. 
• There are steps that we can take to protect ourselves, our families, and our communities, but these need to be thought through ahead of time. Fostering sound personal habits related to cough etiquette, hand/face contact, and hand sanitation is a good place to start.
• As with any form of defense, it takes political will and financial resources (both public and private) to maintain the integrity of national borders (quarantine), support the professionals who serve in the public health field services and laboratories, and fund the research that leads to greater diagnostic

Safeguarding our lives and our livelihoods

Covid-19 Briefing Materials

Great report by McKinsey, for the files. A must read

ePandemic

Digital Health And The Fight Against The COVID-19 Pandemic

Pandemic storytelling

Pandemics, Publics, and Narrative

How people interpret messages to guide action during a pandemic. This is the topic of this book. The effects of storytelling in health communication are crucial and the book starts with the presumed contagion of swine flu by David Cameron.

Our analysis placed engagements with pandemic storytelling across public life in dialogue with the narratives on the enactment of expert advice. This dual approach helped to establish perspectives on how narratives influence publics to take action, or not. We took the view that narrative does not simply mediate pandemic knowledge and advice by helping to structure it intelligibly and meaningfully. We also questioned the idea that narratives persuade in and of themselves in ways that are not very far removed from now discredited notions of linear, hypodermic communications on matters
of health. We adopted the view that media are thoroughly entangled with experience and that pandemic narratives found there help to constitute subjects and the relationships they have with the expert knowledge systems that underpin public health efforts to manage microbial threats

 Unlike states of illness, which depend on determinate biomedical diagnosis and the related transformation of identity and relationality, pandemic experience was most often indeterminate due to the infrequency with which influenza infection is diagnosed in a laboratory and the great variation in influenza symptoms between people, between influenza outbreaks, and even over the course of a particular influenza pandemic.

 Pandemic narratives are placeholders for rich metaphors of life under threat. The metaphorical properties of contagion and immunity give pandemic narratives biopolitical resonance, connecting as they do: political imperatives to do with the production of life; the self defined and protected against the other; the milieu interieur scene for commune with microbial invaders and friends; the tensions implied in proximity and distance; and the coconstruction of narrative and knowledge.

Somebody will have to write a book about current covid-19 pandemic and the title could be: "We are all soldiers against covid". Nothing to add.