All levels of government are authorized to apply coronavirus disease 2019 (COVID-19) protection measures; however, they must consider how and when to ease lockdown restrictions to limit long-term societal harm and societal instability. Leaders that use a well-considered framework with an incremental approach will be able to gradually restart society while simultaneously maintaining the public health benefits achieved through lockdown measures. Economically vulnerable populations cannot endure long-term lockdown, and most countries lack the ability to maintain a full nationwide relief operation. Decision-makers need to understand this risk and how the Maslow hierarchy of needs and the social determinants of health can guide whole of society policies. Aligning decisions with societal needs will help ensure all segments of society are catered to and met while managing the crisis. This must inform the process of incremental easing of lockdowns to facilitate the resumption of community foundations, such as commerce, education, and employment in a manner that protects those most vulnerable to COVID-19. This study proposes a framework for identifying a path forward. It reflects on baseline requirements, regulations and recommendations, triggers, and implementation. Those desiring a successful recovery from the COVID-19 pandemic need to adopt an evidence-based framework now to ensure community stabilization and sustainability.

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.

The COVID-19 pandemic highlighted the urgent need to strengthen public health systems. In response, the United Nations Disaster Risk Reduction (UNDRR) Public Health System Resilience Scorecard (Scorecard) was applied in workshops across multiple countries. The aim of our research was to explore the workshop findings to develop priority strategies for strengthening public health system resilience. We conducted a workshop from 14 to 16 March 2023, at the UNDRR Global Education and Training Institute in Incheon, Republic of Korea. A sequential modified Delphi method was utilized to develop a set of prioritized resilience strategies. These were drawn from 70 strategies identified from 13 distinct workshops in eight countries. After two surveys, 23 strategies were finalized. Ten received ratings of “High” or “Very High” from 89% of participants. These related to the inclusion of public health risks in emergency plans, integrating multidisciplinary teams into public health, enabling local transport mechanisms, and improving the ability to manage an influx of patients. The Scorecard provides an adaptable framework to identify and prioritize strategies for strengthening public health system resilience. By leveraging this methodology, our study demonstrated how resilience strategies could inform disaster risk reduction funding, policies, and actions.

The increasing complexity and often transboundary scope of complex emergencies are exceeding the capacity of humanitarian logistics systems. The military plays a growing role in supplementing and even leading humanitarian assistance and disaster relief logistics. However, issues relating to military involvement such as sovereignty and cost have refocused the conversation onto capabilities and capacities of commercial logistics providers, who have not been fully engaged and integrated into disaster preparedness, response, and recovery activities. The commercial sector is part of the larger supply chain management system that includes contracting, procurement, storage, and transportation of food, water, medicine, and other supplies, as well as human resources, and necessary machinery and equipment. Military and commercial logistics share many of these elements and tasks daily. The most effective and efficient response combines key elements from humanitarian, military, and commercial logistics systems. Such trilateral cooperation represents the next step in an evolving partnership paradigm that is truly synergistic. We present a Synchronized Disaster Relief Model, as well as multiple examples of how military, commercial, and humanitarian supply chains each bring unique capabilities to disaster relief operations, and how these three supply chains can complement each other in a synergistic manner, through synchronized action.

Mass gatherings and high-density activities, such as sporting events, conventions, and theme parks, are consistently included among highest-risk activities given the increased potential for widespread coronavirus disease 2019 (COVID-19) transmission. A more balanced risk management approach is required because absolute suppression of risk is unrealistic in all facets of life. Contact tracing remains a limiting factor in achieving such a balance. The use of Bluetooth or pairing devices is proposed to address this challenge. This simple approach, when applied in a manner that satisfies privacy and trust concerns, would allow high-risk encounters to be quickly identified, namely those where participants have spent 15 minutes or more within 6 ft of each other per current guidelines. If an attendee later tests positive for COVID-19 and tracing is required, the event organizer can provide a limited list of potential close contacts rather than an exhaustive list of all attendees. Contact tracers can, therefore, limit efforts to this concise group rather than needing to contact thousands of people or conduct mass media communications. Such a system, if institutionalized, supports risk assurance and safety measures for businesses by demonstrating a commitment to staff, customer protection, and ensuring high-risk encounters are logged, reinforcing longer-term societal pandemic resilience.

Objective: The aim of this study was to identify and prioritize strategies for strengthening public health system resilience for pandemics, disasters, and other emergencies using a scorecard approach. Methods: The United Nations Public Health System Resilience Scorecard (Scorecard) was applied across 5 workshops in Slovenia, Turkey, and the United States of America. The workshops focused on participants reviewing and discussing 23 questions/indicators. A Likert type scale was used for scoring with zero being the lowest and 5 the highest. The workshop scores were analyzed and discussed by participants to prioritize areas of need and develop resilience strategies. Data from all workshops were aggregated, analyzed, and interpreted to develop priorities representative of participating locations. Results: Eight themes emerged representing the need for better integration of public health and disaster management systems. These include: assessing community disease burden; embedding long-term recovery groups in emergency systems; exploring mental health care needs; examining ecosystem risks; evaluating reserve funds; identifying what crisis communication strategies worked well; providing non-medical services; and reviewing resilience of existing facilities, alternate care sites, and institutions. Conclusions: The Scorecard is an effective tool for establishing baseline resilience and prioritizing actions. The strategies identified reflect areas in most need for investment to improve public health system resilience.