Publications

Language inequities in global health stem from colonial legacies, and global health security is no exception. The International Health Regulations (IHRs), a legally binding framework published by the WHO, lay the foundation for global health security and state the roles and responsibilities States Parties are compelled to follow to improve their capabilities to prevent, detect and respond to potential public health emergencies of international concern.

In response to growing reports of concerning/harassing messages and backlash related to public health work, the Johns Hopkins Bloomberg School of Public Health established the FlagIt report and response system. The system uses a dedicated FlagIt email inbox for faculty and staff to report harassing or concerning messages related to public-facing work and has an autoreply message sharing available institutional resources.

Biomanufacturing practitioners and researchers describe the norms that should govern the growing, global field, to include safety, security, sustainability, and social responsibility. These ‘4S Principles’ should be broadly adopted so that the future of the field may provide the greatest benefits to society.

Among the approximately 2 dozen families of viruses that have the capacity to infect humans, roughly 25% of these families have pandemic potential (Figure 1). Specifically, this capacity is conferred by their ability to be transmitted via the respiratory route.¹ Devising response plans for each of these 6 viral families — Adenoviridae, Coronaviridae, Paramyxoviridae, Picornaviridae, Pneumoviridae, and Orthomyxoviridae — is essential for pandemic preparedness.

How we share in the work of caring for one another during a pandemic is a common thread in the papers comprising this special feature. The collection itself represents another round of retrospection and forward thinking about ways to improve upon readiness and response for a catastrophic health event now that we have lived through the COVID-19 pandemic.

A tool for cross-sectoral prioritization of zoonotic diseases, and mapping of systems for One Health coordination.

Mass-gathering events are a public health challenge and have the potential to amplify the transmission of infectious diseases. During the COVID-19 pandemic, WHO and the Johns Hopkins Center for Health Security (Johns Hopkins University, Baltimore, MD, USA)—a WHO Collaborating Centre for Global Health Security—developed a global database of mass gatherings, which we continue to maintain. The purpose of this database is to monitor the planning and execution of mass-gathering events and to document the uptake of WHO-recommended policies by organisers; for example, the use of a risk-based approach.

At the onset of the COVID-19 pandemic, and to this day, US state, tribal, local, and territorial health departments lacked comprehensive case investigation and contact tracing (CI/CT) guidelines that clearly define the capabilities and capacities of CI/CT programs and how to scale up these programs to respond to outbreaks. This research aims to identify the capabilities and capacities of CI/CT programs and to develop a conceptual framework that represents the relationships between these program components.

Artificial intelligence (AI) systems, including foundation models such as large language models (LLMs), are rapidly becoming more powerful, and governments and industry are racing to better understand the potential benefits and risks of this technology.

The COVID-19 pandemic, while unfortunately notable for immense strain and death throughout the world, has also shown great promise in the development of medical countermeasures. As the global scientific community shifted almost entirely towards vaccines, diagnostics and therapeutics, new trial designs most significantly adaptive platform trials, began to be used with greater speed and broader reach. These designs allowed for deploying and investigating new therapeutics, repurposing currently existing therapeutics and flexibly removing or adding additional medications as data appeared in real-time. Moreover, public–private sector partnering occurred at a level not seen before, contributing greatly to the rapid development and deployment of vaccines.

Never before has the ability to rapidly detect and characterize any pathogen, be it known or novel, been so important to protecting global health. Pathogen agnostic tools, such as next-generation sequencing (NGS), enhance global biological defense and public health by addressing this exact need, but they must be deployed in a proactive manner to reach their full benefit. Using pathogen agnostic tools only during an outbreak is too retroactive and does not allow time for containment, particularly of a novel pathogen. In this commentary, we propose the development of national guidelines for a proactive, pathogen agnostic wastewater surveillance system in the United States with a focus on localities identified for risk of zoonoses and international ports of entry.

Large-scale epidemics in resource-constrained settings disrupt delivery of core health services, such as routine immunization. Rebuilding and strengthening routine immunization programs following epidemics is an essential step toward improving vaccine equity and averting future outbreaks. We performed a comparative case study analysis of routine immunization program recovery in Liberia and Haiti following the 2014-16 West Africa Ebola epidemic and 2010s cholera epidemic, respectively.

The Model State Indoor Air Quality Act (MSIAQA)¹ developed in collaboration with national advisors adopts science-based regulatory standards, such as testing, enhanced air filtration, system maintenance, and ventilation, to advance the public’s health and increase occupant productivity—ensuring that public indoor environments provide healthy air to breathe.

In late December 2019, novel human pneumonia cases were detected in Wuhan City, China. By February 2020, the disease was officially named coronavirus 19 (COVID-19),¹ and on March 11, 2020, the World Health Organization declared COVID-19 a pandemic.² As of March 30, 2022, the total number of deaths in the United States had reached 976,229 with nearly 80 million reported cases.

The COVID-19 pandemic may serve as a prime example of a 21st century public health emergency, an event accelerated and amplified by global interconnectedness, systemic fragility, and public misinformation. However, the United States continues to address this and other threats with distinctly 20th century information tools. This must change. Health emergency preparedness for modern threats requires rapid situational awareness, achieved only through common data elements, enforced information standards, investment in innovation, expert data analysis, and private sector engagement. To protect the health and safety of Americans, we must confront these challenges now and change the narrative of our future responses.

The proliferation of false and misleading health claims poses a major threat to public health. This ongoing “infodemic” has prompted numerous organizations to develop tools and approaches to manage the spread of falsehoods and communicate more effectively in an environment of mistrust and misleading information. However, these tools and approaches have not been systematically characterized, limiting their utility. This analysis provides a characterization of the current ecosystem of infodemic management strategies, allowing public health practitioners, communicators, researchers, and policy makers to gain an understanding of the tools at their disposal.

The COVID-19 pandemic illuminated the lack of resources available to US state and local public health agencies to respond to large-scale health events. Two response activities that were notably underresourced are case investigation and contact tracing (CI/CT), which health agencies routinely employ to control and prevent the transmission of infectious diseases. However, the scale of contact tracing required during the COVID-19 pandemic exceeded available resources, even in high-capacity public health agencies

Improving indoor air quality (IAQ) will diminish routine exposure to airborne diseases,^1,2 limit outbreaks or epidemics,³ and lower risks of noninfectious respiratory conditions like asthma that affect the health of millions each year.⁴ Improving IAQ is also cost-effective. Proper ventilation and filtration in crowded public indoor settings can significantly reduce the costs of illness at a benefit-cost ratio ranging from 3:1 to 100:1,⁵ exceeding similar ratios for most other public health interventions.⁶