key: cord-0915420-qc3w4yhj authors: Mishra, Anshuman; Basumallick, Srijita; Lu, Albert; Chiu, Helen; Shah, M. Ashraf; Shukla, Yogesh; Tiwari, Ashutosh title: The Healthier Healthcare Management Models for COVID-19 date: 2021-05-29 journal: J Infect Public Health DOI: 10.1016/j.jiph.2021.05.014 sha: 144e2b387675a4bb0ba27f97b2ef9fbcca4a606c doc_id: 915420 cord_uid: qc3w4yhj The worldwide pandemic situation of COVID-19 generates a situation in which healthcare resources such as diagnostic kits, drugs and basic healthcare infrastructure were on shortage throughout the period, along with negative impact on socio-economic system. Standardized public healthcare models were missing in pandemic situation, covering from hospitalized patient care to local resident’s healthcare managements in terms of monitoring, assess to diagnosis and medicines. This exploratory and intervention-based study with the objective of proposing COVID-19 Care Management Model representing comprehensive care of society including patients (COVID-19 and other diseases) and healthy subjects under integrated framework of healthier management model. Shifting policy towards technology-oriented models with well-aligned infrastructure can achieve better outcomes in COVID-19 prevention and care. The planned development of technical healthcare models for prognosis and improved treatment outcomes that take into account not only genomics, proteomics, nanotechnology, materials science perspectives but also the possible contribution of advanced digital technologies is best strategies for early diagnosis and infections control. In view of current pandemic, a Healthier Healthcare Management Model is proposed here as a source of standardized care having technology support, medical consultation, along with public health model of sanitization, distancing and contact less behaviours practices. Effective healthcare managements have been the main driver of healthier society where, positive action at identified research, technology and management segment more specifically public health, patient health, technology selection and political influence has great potential to enhanced the global response to COVID-19. The implementation of such practices will deliver effective diagnosis and control mechanism and make healthier society. The emerging and re-emerging infectious diseases, SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), Ebola, Zika viruses, H1N1 influenza, and chikungunya infections have become a major cause of mortality and morbidity in the world [1] . SARS Co-2 or COVID-19 imposes an unpredictable threat and challenge for the world community and exerts negative impact in terms of economical and public health relevance [2] . Recent viral infection pandemic of COVID-19 has initiated importance of community's knowledge, practices, and people's attitudes during disease outbreaks [3] [4] . COVID-19 viral disease which has become a pandemic in a short time across all the continents has generated a big challenge to adhere public health models. There is big question mark on the current healthcare control practices due to the current worldwide epidemiological scenario. The continued efforts in providing better facilities for healthcare vary from country to country. The current pandemic situation has highlighted several drawbacks of public health practices to associated organizational response and the need of technology-based solutions [5] [6] . The research data of biological, medical, engineering, chemical and physical science can generate enormous information for translational research. Understanding epidemiology, pathogen variations, clinical features, human susceptibility should be prioritised area of science and technology for any prognosis model. Below mentioned area should be preferred based on logical solutions for public healthcare models. This will help to correlate and understand any possibility of low and high severity of the disease. Various databases are available online which can be studied time to time to understand the trend. J o u r n a l P r e -p r o o f 6 WHO, Scopus, PubMed, ICMR, CDC, and several such kind of multidisciplinary resources can be cross checked for making future strategy plan. Important materials were listed to provide awareness of quality public health literature and resources [7] . Role of genomics and proteomics in framing prognosis to treatment contribution was based on such kind of interpretation, analysis, and results extensively. Regional healthcare protection model should be based on regional risk assessment. Reviewing, developing, and establishing effective control strategies through a diversified approach for regional healthcare model to avoid any specific risk extensively is best lead. Understanding of all scientific information is possible due to open resources and access of various knowledge databases. During pandemic, many publishers are making their resources freely and temporarily available [8] . This makes it possible to adopt technological and innovative research at a much faster pace. Data analytics has the potential to understand the mode of transmission and take more decision of protection against any possibility of outbreak. The most important part of protection is to break the chain of transmission. A global increase in antibiotic-resistant bacteria, limited antiviral drugs is a real challenge for the world in terms of facing the emerging bacterial and viral infections, respectively. Recent research progress on COVID-19 treatment has promising success [9] . Effective and appropriate drugs for the treatment of COVID-19 are missing and other disease drugs and combination of drugs have emerged as the best strategy for treatment. Currently several pharmaceuticals are undergoing clinical trials to assess their safety and efficacy, like remdesivir, interferon β-1a, the antiviral combination lopinavir/ritonavir, the antimalarial chloroquine/hydroxychloroquine, and monoclonal antibodies against components of the immune system such as interleukin-6 (IL-6) and IL-4 for effective treatments of the COVID-19 [6, 10] . Study confirmed the decreased rate of disease through vaccines in infectious diseases of viruses (like human immunodeficiency virus (HIV/AIDS), hepatitis C etc.), Bacteria (tuberculosis (TB) and Protozoa (malaria and neglected tropical diseases (NTDs) etc.) are already recognized. COVID-19 substantially increases the risk of death way faster than other infectious diseases. There is a large global effort to develop several vaccines against COVID-19 protection via clinical trials in different phase stages [11] . Furthermore, this number is uncontrolled due to lack of disease mechanism and therefore absence of appropriate drugs and vaccine. J o u r n a l P r e -p r o o f Emerging infectious threats, for several risks required to adopt shared policy for early detection, treatment and control. Study on other infectious pathogens (virus, bacteria and protozoa etc.) and their better control model should be adopted in COVID-19 prognosis model for better response in the event of an outbreak. According to the WHO report on malaria (WHO -2014) [12] , the death of thousands of children, particularly in African countries, is alarming. Understanding the drug functionality is important in treatment. It is interesting that only trans atovaquone is effective as a malarial drug and its cis isomer is not a malarial drug [13] . The malarial drug choro quinine or hydroxychloroquine is being used as a drug for the treatment of COVID-19. It is known that SARS corona virus (out bust in 2002) was exhaustively studied by Nicol and his group and based on their study, they have recommended that SARS can be treated with chloro quinine or better hydroxychloro quinine as was published in 2005 in virology journal [14] . On World Malaria Day 2012, WHO launched a new initiative called T3: Test. Treat. Track. to provide a framework for endemic countries to strengthen malaria control and elimination [15] . Adopting, diagnostic testing, treatment and track of infectious disease, control management programs were launched on regional basis for effective control. Development of effective public health management policy with best medical countermeasures (e.g., vaccines, diagnostics, therapeutics) is helpful for the control of disease incidence. Models predicting severity and mortality of malaria infection lacking on the generalizability as most of these model's due lack of external validation [16] . Overall, malaria and COVID-19 disease research together can give hope for better model of control [14] [15] [16] . Understanding prognosis model from HIV, another deadly disease is important to frame diagnosis model for COVID-19. In HIV, plasma HIV-1 viral load independently and in combination with CD4+ cell count measurements provided powerful prognostic information for progression to AIDS and death in a specific population [17] . Study suggest that universal HIV treatment would most effectively and efficiently reduce the HIV burden and increasing public health benefit [18] . Numerical simulations are conducted in a novel HIV/AIDS epidemic model to understand globally asymptotically level [19] . Understanding severity of diseases by risk groups (low, middle and high) using the nomogram an accurate and favorable prognostic prediction for ART treatment in HIV would be very favorable J o u r n a l P r e -p r o o f to promote the precise prevention and personalized health management in cost-effectiveness [20] . Dynamic HIV transmission models can provide evidence-based guidance on to treat and prevent, as study suggest that better integration of modelling in decision making can be achieved by systematically reporting on the evidence synthesis process, and by quality of data entered into the model [21] . Clinical complications in COVID-19 are one of key features where various symptoms vary between symptomatic to asymptomatic cases. In case of Tuberculosis, a common modeling approach is the compartmental model, which describes a population divided into mutually exclusive health states and uses differential equations to represent the mechanisms of transition between infection, rapid progression, reactivation, and treatment/recovery health states [22] . Understanding disease progression and transmission based on host susceptibility is important aspects of COVID-19, where disease severity can be predicted for control strategies in advanced. A novel mathematical model that distinguishes between susceptibility amongst the population for tuberculosis depending on the genes is useful to investigate the impact of transmission, severity and treatment [23] . Technologies have potential to accelerate the epidemic management extensively and protect from disease burden. Various adaptations in public health models for better healthcare management area must in disease specific pattern. The policy development process of healthcare technologies can be characterized for testing, shared analysis, validation, implementation, and evaluation via participation of diverse stakeholders' groups [24] . The improvement of decision-oriented processes through technology of GIS, Information technology, Computational analytics, mathematical modeling can save lives and decrease the economic loss of public. Pre-information of incidence can help to initiate protection policy in advanced. The aforesaid policy will initiate protection protocol and help extensively against such kind of deadly and highly infectious diseases burden. In recent times, the healthcare sector has moved towards technology-based utilizations for cost effectiveness and better results. Study suggests that economy and policy influence healthcare technology solutions as we wrestle with keeping healthcare quality high and costs low [25] . Healthcare technologies demonstrate quality, easy access, and cost effectiveness on mass community level so change individual budget extensively. The government has to adopt beneficial J o u r n a l P r e -p r o o f policy of patient according to provider benefit, quality, and outreach assessment for national interest. Below mentioned subheadings were prioritised area of science and technology, which may address for better healthcare technologies for COVID-19 pandemic. The disease transmission is one of the big challenges in such kind of infectious diseases. Mathematical programs can predict, segregate, and define most appropriately for virus transmission, possibility of spreading in localized area or in big community through algorithm. Understanding of super-spreaders subjects, population subgroups of high risk and low risk through mathematical science help to run the control and various awareness programs. Study indicates that mathematical models can predict epidemic curve representing the number of infections caused by the virus over time [26] . Another study of numerical simulations demonstrates the suitability of the proposed disease model for the outbreak that occurred in Wuhan, China [27] . Integration of such kind of algorithms in integrated platforms, where just by data inputs, we get the possible forecasting in advance about disease spread. This information will help to launch public awareness programs of preventive measures. The population demography (density, travel mode, market locations etc.) and ecological factors (climate change, agricultural, etc.) are important for the early identification of infectious threats. Accurate monitoring of infectious disease through pathogen biological information should be linked to surveillance tools focused on risk assessment of any sudden outbreaks to control any possible diseases threats [6] . WHO Figure 3 , defined about risk measurement with proposed Corona risk meter, which is able to alert early for major risks and getting chance of infections. Linking human activity to regional disease outbreaks is also important. Because, human behaviours and attitude monitored through epidemic intelligence methods and move towards adopting better public health models of control for sustainable solution. Monitoring precautionary measurements for mask, sanitization, and distancing in community for COVID-19 via technology-based surveillance will alert early for major risks. Contagious diseases have shaped human history and they are with us even in this technological explosion of 21 st century. The crown shaped virus seen under Electron Microscope having nano-J o u r n a l P r e -p r o o f dimensions is so new that many unknowns still remain about the virus, including its origin, its transmission-how easily it spreads, how it invades the body, how immune system responds, and how deadly it is. Since it is going to stay with us as the weather changes, nanotechnologies will have ultimate solutions but till then, aggressive precautionary measures are answers. Scientists have to tackle Covid-19 from many angles while working on a diagnostic device that consists of coated antibodies that bind to a specific viral protein, while second antibody is attached to gold nanoparticles nanoparticles or other nanomaterial, this is how nanotechnology helps in faster diagnosis. Research focused on modeling of infectious disease dynamics and transmission of COVID-19 is important for making hygiene strategies and protect against infectious droplets. Presently, there is an urgent need to focus research on design and evaluation of nanotechnologybased drug delivery systems, pharmacology of delivered drugs and the (patho-) physiology of the host for better results in disease [30] . Perspective study suggests that bio-nanotechnology can manage the COVID-19 in a personalized manner [31] . Kostas Kostarelos shares his views on how the nanoscience community could contribute to fight against COVID-19 through scientific fact [32] . Hopefully, nanoparticles-based vaccine to fight the COVID-19 will be soon available in the market. Medical needs continue to challenge scientists to seek innovative technological solutions, many of which involve increasing the functionality of materials. Most promising opportunities in materials are at the intersection of traditional research fields such as materials science and biology. But scientists across disciplines and students should come forward to find innovative solutions for this beast, which is moving very fast. The advantages of biosensors-based-technology in the biomedical field lie in the short response times and real-time monitoring of biological processes that can help in point-of-care measurements in mass community. There are studies on antibodies, DNA molecules, and enzymes to develop biosensors that use graphene and its derivatives to produce effective biosensors, which can detect pathogens and biomolecules linked to diseases [33] . Recent study shows that dual-functional LSPR biosensor exhibits a high sensitivity toward the selected SARS-CoV-2 sequences with a lower detection limit down to the concentration of 0.22 pM [34] . There is an urgent need of the unique J o u r n a l P r e -p r o o f world-class metal environmental dissolution technology and colloidal metal nanoparticles production technology. From raw materials to nano metal and nano metal oxide production, there is requirement of different kinds of spherical nanoparticle colloidal solutions by using a single production process [35] .Recent development of effective ingredients for anti-covid-19 virus in TPNT is kind of hope for next level utilization of technology in COVID-19 care [35] : These POC biosensors which are made of polydimethylsiloxane (PDMS), papers, flexible materials (textile, film, and carbon nanosheets) have advantages, challenges and future perspectives as they can manage the spread of COVID-19 very fast [37] . The direction of materials science research should be focused mostly towards biosafety materials [38] . Presently, deleterious effects of coronavirus have prompted the development of novel materials to control the disease faster across world. Mass community services are required during pandemic situations where a wealth of new age technologies play effective role. Supportive clinical care along with new age technologies adapted with IoT, Surveillance, Sensors, Cloud support systems, Artificial intelligence, Machine learning, J o u r n a l P r e -p r o o f and Nanotechnology may be the best feasible tools for decision-making under emergency situations [6] . A digital health industry focused on diagnosis, prevention, and management is increasing day by day [39] . This pandemic has triggered an unprecedented demand for digital health technology, which have healthcare solutions such as for population screening, tracking the infection, and designing targeted responses [40] . A series of applications involved through using artificial intelligence in infectious disease field especially in low-income countries [41] . mHospitals technology company is devoted on mass healthcare mission for regional COVID-19 through translational research programs involving artificial intelligence and mobile technology [42] . WHO has received an overwhelming support from healthcare technology organisations to fight the COVID-19 pandemic On 02 April 2020, 30 of the world's leading digital technology experts gathered in a virtual roundtable to help advance WHO's collaborative response to COVID- 19 [39] . Epidemiological modeling can be used as a tool that can be used to mitigate pandemic risk by predicting disease transmission dynamics. The importance of designing a model to address global health challenges can be done through interdisciplinary collaboration among empiricists, policymakers and technology companies to improve the public health decision-making [43] . Successful public health model can be adopted for all infectious disease outbreaks with slight modification and change of strategies based on regional information or nature of disease. Community's knowledge and people's behaviour also impact transmissions during pandemic. So, the best strategy would be to involve common public in the awareness programs. Important public health management (e.g., case tracing, outbreak investigations, social distancing) slows down the rate of outbreak. Identifying strategies to reduce the spread of COVID-19 is important to understand for healthcare professionals with standard training and knowledge [44] . Effective public health policy is helpful in early diagnosis, better prevention and complete treatment with great potential in cost-effective manner. Preventive policies must embrace research and technology at community level to cover healthcare solutions for all the society to influence public policy formation, and their implementation to varying degrees. Therefore, management of public health model may address evidence of efficacy for varied segments with the focus to specific and regional management models. This kind of structured management with integrated technology approaches providing logical and cost-effective solutions is more useful in pandemic crisis [ Figure 4 and Table 1 ]. Below mentioned management categories is useful for effectiveness in healthcare to make it healthier for society. Contact tracing of persons exposed with COVID-19 cases 58 Intensive care management of coronavirus disease 2019 60 Transformational Healthcare Outcomes 62 Propeller sensors track medication 64 Source of knowledge 68 Call for Papers on Management Science in the COVID-19 70 Political and Crisis Communication 72 Politics, trust, and behaviours 73 Economic, social and political issues 74 Policy sciences: initial reactions and perspectives 75 Strong public health policy is devoted to a description of rapid identification and effective control programmes in accordance with specific principles, while carrying a regional perspective. communities. How do we make risk assessment, COVID-19 diagnosis, and control as an integral part of the public health management during pandemic crisis is important to know. on disease modeling based on data of regional micro epidemics provide a framework for dynamic and compartmental transmission model for virus [27] . The approach to fighting the Coronavirus pandemic must also pay special attention to the integration of diagnosis and control approaches in healthcare management, where infected persons are identified and receive care. Policy for public health here includes (a) surveillance and diagnosis, and (b) screening and control mechanism under appropriate public health settings. Diagnostic for community level in the context of the public health system, is important for individuals, who are unaware of their infection. Early screening through diagnosis strategy help to control for those persons whose infections were positive promptly. As some may unknowingly Being screening at community level in pandemic situation is important to make a decision to avoid high risk for COVID-19 infection. If we delay in testing, then there will be chance to have been exposed to COVID-19. Considering, one wants to always negative for COVID-19 infection better to promote earlier testing. The economic costs for public healthcare management matters to deliver healthcare facility for common man. A comprehensive public health approach with lower cost is highly significant in terms of community utility for diagnosis, treatment and control. Presently, technology based healthcare management is found to be effective to reduce cost and deliver services at broad level. During the 2020, there has been a significant global increase in the COVID-19 exposure and transmission. Ensuring timely access to care for patient with COVID-19 infection, management should be focus on COVID-19 risk behaviours, control mechanism, and treatment strategies. Adherence of sensor based technologies in monitoring of patients and healthcare professionals, revolutionaries the healthcare management [64] [65] [66] . The system supported by experts of engineering, biotechnology, medical science, pharma and chemical science professionals working hand-in-hand with technology and healthcare together in order to stay relevant in the present pandemic. In healthcare, technology could transform healthcare systems into cheaper, faster and better solutions covering models which can win the battle for us against COVID-19. COVID-19 diagnosis provides infection information's which help to take type of control strategies early. At community level, early diagnosis forms the basis to care, control and treatment support for persons in need. Recent digital revolution has catalysed the medical healthcare field and generate an intelligent and smart healthcare model for public and community [66, 67] . Embracing emerging technologies and their design and development according to present healthcare requirement in cost effective way should be promoted and supported at the level for effective management in public health. The continuing importance to adopt effective public health policy in COVID-19 is reflected in the present pandemic. There is an association between clinical practices, knowledge, technology improvement, research outputs and treatment delivery based on available information sources on open sources. By adopting several resource centre information's in public healthcare practices one could increase knowledge. Any valuable or related information was, however, comprehensively sourced from valid and authentic point help to avoid any risk in healthcare. Currently, there is urgent need of universal data management system which categorically provides information's under one umbrella in comparative and evaluation mode with valid references. However, present resources are not able to provide systematic data due to complexity and lack of complete structure for all dimensions. Therefore, experiences that the informants sought should adopted by public health policy makers. Table 1 Understanding the innovation and IPR information and translate it in useful product is useful for worldwide community [71] . Overall, political decision based on available epidemiological information influence extensively life of public [72] . Below mentioned categories, signifies importance of information management in this pandemic era. The authenticate list includes treatment information's, drug trials reports of valid organizations. The information available on web resources should have all minor details for effectiveness of therapy in reducing the risk with further contact information's available for counselling and referrals to the services. Valid public health information on treatment helpful for making decisions for the broader community. The current pandemic context shows evidence of the effectiveness of control in reducing the transmission, by using effective preventive mechanism and technologies. For prevention the surveillance and epidemiological data are the most useful information's sources that helps to create more efficient methods for the control of COVID-19 disease. Health professionals providing services in prevention of disease at community level should be mentioned with report in index journal, organization index at national level for validity point of view. Political leadership is main driver of any country's healthcare system. Political action is based on leaders of the government, who impact on appropriate actions on healthcare issues such as COVID-19 pandemic. Political government has the opportunity to develop or improve the public health by policy. As a disease associated with transmission, insufficient diagnosis, inappropriate treatment facility, infectious disease control system etc. in all the contexts ignorance have greater influence on disease incidence. Politics play essential role to deliver better prognosis ideology, as best practice is the determinants of appropriate implementation. Table 1 and references [73] [74] [75] , denotes importance of political impact in public health management. COVID-19 has also severely affected the global economy and financial markets results in income crisis, unemployment, transportation and industries disruptions in many countries [73] . So, governments should be active in their immediate response to protect financial prosperity. closed industry, loss of food sector and schools denotes the socio-economic effects [74] . The policy makers can recommend several options according to international law, regional public health models and based on evidence in epidemic or endemic conditions. Study signifies the importance of trust in government decisions and actions relating to the management of COVID-19 as a major challenge worldwide [75] . Economic, social and political issues raised by the COVID-19 pandemic should be deal with appropriate policies otherwise lack of knowledge will lead to complications [76] . Study explores the ways in which scientific and technical expertise, emotions, and narratives influence policy decisions and shape relationships among citizens, organizations, and governments [77] . Most important, understanding adaptation, policy responses, alterations in networks (locally and globally), and assessing policy success and failure in terms of various aspects of the policy sciences should deserve attention [77] . Research interpretation of improving the translational research findings for clinical practice can be broadened in the directions of effectiveness, cost, new development, and the idea of improvement through socially desirable innovations [78] . Addressing drawbacks of public health models and counterbalance it with advanced healthcare technologies is the best strategy for any pandemic-like situations. The standard interpretation opens the scope of public policy to include technology assessment (identifying deficiencies, benefits, and costs of new developments) [78] . Using genomics and proteomics research for diagnosis, drug, and vaccines and AI, IoT, Electronics and Cloud computing models for preventive methods will be on the same line [6] . Under pandemic condition, healthcare facility demand is high while technological transformation is slow towards structured management and integrated technology environment. Here, we are proposing regional healthcare models based on priority of three primary risks such as transmission possibility, social distancing, and sanitized environment (Figure 1) . Ensuring control of all these three primary risks will stop the spread of COVID-19 extensively. Behaviour decides handling of precautionary measurements, while attitude for top 3 precautionary measurements decides to spread of disease in community. We have mentioned CORONA Risk Meter in Figure 3 , defined about adaptation of three important precautionary measurements to stop the associated risk before infection such as: disease ( Figure 5 ). Additionally, we should understand important signature, message and results of several studies reported varied healthcare management options ( Table 1) . Understanding of varied healthcare models and their study is important because it will help to make strategies under complex and variable risk. Public health management and patient care management should be improved with advanced healthcare technologies and biomedical research data (Table 1) . These varied management studies can be adopted according to risk assessment of COVID-19 and analyse the results of effectiveness at time to time for better decision. Therefore, healthcare management for regional healthcare practices with high rate of success, characterized by lower risk and costeffective treatment should be gained more effectively by technology oriented public healthcare models. All kind of mentioned, adopted, and integrated control models will prevent the spread of the disease more effectively. This manuscript emphasizes more about adaptation of best healthcare management practices based on other disease models, advanced technology, and COVID-19 multidisciplinary research experiences across continents. More specifically, this article presents an overview of the prognosis and preventive challenges that must be addressed in advance to combat pandemic-like condition in proposed structured framework of management. Majorly, identifying several local clinical features and transmission possibility associated with behavioural interventions in an outbreak region should be discussed in management for making preventive model. The effective interventions in a public health model through advance technology can have profound positive consequences for health and socioeconomic status. With a standard healthcare policy and the proper precautions; we can avoid spreading of infectious diseases. Although, healthier healthcare management preparation has to go a long way in order to control the incidence of the disease worldwide and the data presented through this study shall be helpful for stakeholders in framing policies along with research and technology for better public health management. The healthcare service becoming advance due to advent of technology, analytics, artificial intelligence, and clinical information's systems, which deals with high end experts at one side and intellectual customers on other side. The futuristic sustainable model of healthier outcomes heavily relies on novel biomarkers, intelligent therapeutics, and quality care strategies, which again depend on fast transformation of healthcare system through strong policy of technology enabled structured healthcare management. 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