How do local-level authorities engage in epidemic and pandemic preparedness activities and coordinate with higher levels of government? Survey results from 33 cities
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Abstract
The COVID-19 pandemic suggests that there are opportunities to improve preparedness for infectious disease outbreaks. While much attention has been given to understanding national-level preparedness, relatively little attention has been given to understanding preparedness at the local-level. We, therefore, aim to describe (1) how local governments in urban environments were engaged in epidemic preparedness efforts before the COVID-19 pandemic and (2) how they were coordinating with authorities at higher levels of governance before COVID-19. We developed a survey and distributed it to 50 cities around the world involved in the Partnership for Healthy Cities. The survey included several question formats including free-response, matrices, and multiple-choice questions. RACI matrices, a project management tool that helps explain coordination structures, were used to understand the level of government responsible, accountable, consulted, and informed regarding select preparedness activities. We used descriptive statistics to summarize local-level engagement in preparedness. Local authorities from 33 cities completed the survey. Prior to the COVID-19 pandemic, 20 of the cities had completed infectious disease risk assessments, 10 completed all-hazards risk assessments, 11 completed simulation exercises, 10 completed after-action reviews, 19 developed preparedness and response plans, three reported involvement in their country’s Joint External Evaluation of the International Health Regulations, and eight cities reported involvement in the development of their countries’ National Action Plan for Health Security. RACI matrices revealed various models of epidemic preparedness, with responsibility often shared across levels, and national governments accountable for the most activities, compared to other governance levels. In conclusion, national governments maintain the largest role in epidemic and pandemic preparedness but the role of subnational and local governments is not negligible. Local-level actors engage in a variety of preparedness activities and future efforts should strive to better include these actors in preparedness as a means of bolstering local, national, and global health security.
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SciScore for 10.1101/2022.05.25.22275614: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Ethics Statement: We submitted all study materials to the Georgetown University Institutional Review Board for ethical review.
Consent: As the study was granted exemption, informed consent was not required to be obtained.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources We used Microsoft Excel and STATA v. Microsoft Excelsuggested: (Microsoft Excel, RRID:SCR_016137)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We …SciScore for 10.1101/2022.05.25.22275614: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Ethics Statement: We submitted all study materials to the Georgetown University Institutional Review Board for ethical review.
Consent: As the study was granted exemption, informed consent was not required to be obtained.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources We used Microsoft Excel and STATA v. Microsoft Excelsuggested: (Microsoft Excel, RRID:SCR_016137)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:These mechanisms for collaboration and communication should also be tested using robust simulation exercises that could help identify weaknesses, ambiguities, and bottlenecks [31]. This study and its results suffer from several limitations. First, and most significantly, the results relied on the completion of a survey by one individual. While we attempted to distribute the survey to the local authority who would be most knowledgeable about epidemic and pandemic preparedness in the city, we cannot guarantee that the data captured by responses are completely valid or factual. One person’s knowledge regarding all of the preparedness efforts, activities, and arrangements in their city may be limited. For instance, a majority of survey participants had served in their current professional role for one to four years and may not have been aware of preparedness efforts in their city before this time. Future research may wish to more deeply examine preparedness efforts in specific cities or to validate the results of this study by reviewing the legislation, regulations, and other legal frameworks that provide the foundation for public health preparedness and coordination between levels of government. Additionally, the specific results from each city are unlikely to hold great amounts of external validity. The governance contexts in which participating cities exist vary widely, and it would be inappropriate to generalize results across contexts without examining the specific authoriti...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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