The Ukrainian war and the pandemic: the impact on public health and the need for new health digital tools and the next level of intelligence

Authors

DOI:

https://doi.org/10.26641/2307-0404.2023.4.294241

Keywords:

digital health intelligence, social media surveillance, public health genomics, behavior, war, Ukraine, COVID-19

Abstract

Against the background of the war in Ukraine, the COVID-19 pandemic has waned from public consciousness as the threat of the virus to health is outweighed by safety concerns during the war. Pandemic restrictions in the European region are being lifted despite low vaccination rates in Central and Eastern European countries and a lack of effective containment strategies. However, Central and Eastern European countries are influenced most by the flow of refugees from neighboring Ukraine where a triple health crisis occurs: an overloaded health system, an ongoing COVID-19 pandemic, and the war. The aim: to review the progress regarding viral surveillance technologies that use genomics, digital, and informational tools, to find the gap in the literature and formulate policy recommendations for continuing surveillance in the context of permacrisis. Unstructured search was conducted through scientific (PubMed and Google Scholar databases) and grey literature using the keywords. The paper highlights aspects of war-related problems of infectious diseases control in Europe, new challenges in healthcare connected with COVID-19 pandemic and war in Ukraine and provides discussion on the role of innovative surveillance systems in tackling infection outbreaks (with COVID-19 pandemic as an example). The paper overviews perspectives of the implementation of the discussed measures. Future COVID-19 outbreaks and new variants are possible. Complex adaptive system models, new tools, and the next level of health and digital intelligence are needed to provide timely and valuable insights. Combining lessons learned from the COVID-19 pandemic, the threat of war, and the need for continuous outbreaks surveillance, new public health and digital intelligence tools must be designed and implemented at regional, European, and global levels.

References

Goniewicz K, Burkle FM, Horne S, Borowska-Stefańska M, Wiśniewski S, Khorram-Manesh A. The Influence of War and Conflict on Infectious Disease: A Rapid Review of Historical Lessons We Have Yet to Learn. Sustainability. 2021;13(19):1-10. doi: https://doi.org/10.3390/su131910783

Gugushvili A, Mckee M. The COVID-19 pandemic and war. Scand J Public Health. 2022 Feb;50(1):16-8. doi: https://doi.org/10.1177/1403494821993732

Johnson SA. The Cost of War on Public Health: An Exploratory Method for Understanding the Impact of Conflict on Public Health in Sri Lanka. PLOS ONE. 2017 Jan 12;12(1):e0166674. doi: https://doi.org/10.1371/journal.pone.0166674

Sartin JS. Infectious diseases during the Civil War: the triumph of the ‘Third Army’. Clin Infect Dis Off Publ Infect Dis Soc Am. 1993 Apr;16(4):580-4. doi: https://doi.org/10.1093/clind/16.4.580

History of 1918 Flu Pandemic|Pandemic Influenza (Flu)|CDC [Internet]. 2019 [cited 2022 May 21]. Available from: https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm

Martini M, Gazzaniga V, Bragazzi NL, Barberis I. The Spanish Influenza Pandemic: a lesson from history 100 years after 1918. J Prev Med Hyg. 2019 Mar;60(1):E64-7.

Reid AH, Taubenberger JK, Fanning TG. Evidence of an absence: the genetic origins of the 1918 pan-demic influenza virus. Nat Rev Microbiol. 2004 Nov;2(11):909-14. doi: https://doi.org/10.1038/nrmicro1027

Lindskog EE. The effect of war on infant mortality in the Democratic Republic of Congo. BMC Public Health. 2016 Oct 6;16(1):1059. doi: https://doi.org/10.1186/s12889-016-3685-6

Ascherio A, Chase R, Coté T, Dehaes G, Hoskins E, Laaouej J, et al. Effect of the Gulf War on Infant and Child Mortality in Iraq. N Engl J Med. 1992 Sep 24;327(13):931-6. doi: https://doi.org/10.1056/NEJM199209243271306

What the COVID-19 pandemic and the 1918 flu pandemic have in common [Internet]. [cited 2022 Sep 29]. Available from: https://www.medicalnewstoday.com/articles/the-flu-pandemic-of-1918-and-early-conspiracy-theories

Apetrei C. The Conversation. Misinformation is a com¬mon thread between the COVID-19 and HIV/AIDS pandemics – with deadly consequences [Internet]. [cited 2022 Sep 29]. Available from: http://theconversation.com/misinformation-is-a-common-thread-between-the-covid-19-and-hiv-aids-pandemics-with-deadly-consequences-187968

World Health Organization. 5th virtual WHO infodemic management conference meeting report: steps towards measuring the burden of infodemics [Internet]. [cited 2023 Aug 22]. Available from: https://www.who.int/publications-detail-redirect/9789240047174

Health. COVID-19 Is the Worst Pandemic in US History, Now That Deaths Have Surpassed the 1918 Spa-nish Flu [Internet]. [cited 2022 Sep 29]. Available from: https://www.health.com/condition/infectious-diseases/coronavirus/worst-pandemic-us-history-covid-spanish-flu

1918 Pandemic Influenza: Three Waves|Pandemic Influenza (Flu)|CDC [Internet]. 2020 [cited 2023 Feb 22]. Available from: https://www.cdc.gov/flu/pandemic-re¬sources/1918-commemoration/three-waves.htm

World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. [cited 2022 Sep 30]. Available from: https://covid19.who.int/measures

Suk JE, Pharris A, Beauté J, Colzani E, Need-ham H, Kinsman J, et al. Public health considerations for transitioning beyond the acute phase of the COVID-19 pandemic in the EU/EEA. Eurosurveillance. 2022 Apr 28;27(17):2200155. doi: https://doi.org/10.2807/1560-7917.ES.2022.27.17.2200155

Ritchie H, Mathieu E, Rodés-Guirao L, Appel C, Giattino C, Ortiz-Ospina E, et al. Coronavirus Pandemic (COVID-19). Our World Data [Internet]. 2020 Mar 5 [cited 2022 May 21]. Available from: https://ourworldindata.org/covid-vaccinations

Antigenic evolution will lead to new SARS-CoV-2 variants with unpredictable severity | Nature Reviews Microbiology [Internet]. 2022 [cited 2022 May 21]. Avai-lable from: https://www.nature.com/articles/s41579-022-00722-z

Wang CJ, Ng CY, Brook RH. Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing. JAMA. 2020 Apr 14;323(14):1341-2. doi: https://doi.org/10.1001/jama.2020.3151

Cumming J. Going hard and early: Aotearoa New Zealand’s response to Covid-19. Health Econ Policy Law. 2022;17(1):107-19. doi: https://doi.org/10.1017/S174413312100013X

Aiello AE, Renson A, Zivich PN. Social Media- and Internet-Based Disease Surveillance for Public Health. Annu Rev Public Health. 2020 Apr 2;41:101-18. doi: https://doi.org/10.1146/annurev-publhealth-040119-094402

Wilson GM, Ball MJ, Szczesny P, Haymann S, Polyak M, Holmes T, et al. Health Intelligence Atlas: A Core Tool for Public Health Intelligence. Appl Clin Inform. 2021 Aug;12(4):944-53. doi: https://doi.org/10.1055/s-0041-1735973

R Core Team. R: A language and environment for statistical computing [Internet]. Vienna, Austria: R Foun¬dation for Statistical Computing; 2022 [cited 2023 Aug 22]. Available from: https://www.R-project.org/

Spiteri G, Fielding J, Diercke M, Campese C, Enouf V, Gaymard A, et al. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Eurosurveillance. 2020 Mar 5;25(9):2000178. doi: https://doi.org/10.2807/1560-7917.ES.2020.25.9.2000178

Pan American Health Organization, World Health Organization. WHO declares Public Health Emergency on novel coronavirus [Internet]. 2020 [cited 2023 Aug 22]. Available from: https://www.paho.org/en/news/30-1-2020-who-declares-public-health-emergency-novel-coronavirus

Geanta M, Tanwar AS, Lehrach H, Satyamoor-thy K, Brand A. Horizon Scanning: Rise of Planetary Health Genomics and Digital Twins for Pandemic Preparedness. OMICS J Integr Biol. 2022 Feb;26(2):93-100. doi: https://doi.org/10.1089/omi.2021.0062

Wang H, Paulson KR, Pease SA, Watson S, Comfort H, Zheng P, et al. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21. The Lancet. 2022 Apr 16;399(10334):1513-36. doi: https://doi.org/10.1016/S0140-6736(21)02796-3

Lupu D, Tiganasu R. COVID-19 and the effi-ciency of health systems in Europe. Health Econ Rev. 2022 Feb 12;12(1):14. doi: https://doi.org/10.1186/s13561-022-00358-y

PHSM in Response to COVID-19 [Internet]. [cited 2022 Sep 30]. Available from: https://phsm.euro.who.int/

Commission E. The Fall of the Iron Curtain and the beginning of a new chapter in our history [Internet]. Medium. 2020 [cited 2022 Sep 30]. Available from: https://europeancommission.medium.com/the-fall-of-the-iron-curtain-and-the-beginning-of-a-new-chapter-in-our-history-b69105d9a053

Centrul Pentru Inovație in Medicina. Report on Iron Curtain of Vaccination in Europe. Barriers and opportunities for tackling E-W inequalities. Official launch of the Eastern European Vaccination Task Force [Internet]. 2022 [cited 2022 Sep 30]. Available from: https://ino-med.ro/docs/iron-curtain-vaccination-europe-report.pdf

European Commission - European Commission [Internet]. COVID-19: next pandemic phase. [cited 2022 Sep 30]. Available from: https://ec.europa.eu/commission/presscorner/detail/en/ip_22_2646

Netherlands Ministry of Foreign Affairs. Health Care in Ukraine [Internet]. The Netherland Enterprise Agency; 2018 [cited 2022 Sep 30]. Available from: https://www.rvo.nl/sites/default/files/2019/03/Health-Care-in-Ukraine.pdf

“Infodemic” of COVID-19 disinformation bad for Ukrainians health, study for UN finds [Internet]. [cited 2022 Sep 30]. Available from: https://www.unicef.org/ukraine/en/press-releases/infodemic-covid-19-disinformation-bad-ukrainians-health-study-un-finds

Channell-Justice E. COVID-19 in Ukraine: Asses-sing the Government’s Response [Internet]. 2022 [cited 2022 May 21]. Available from: https://huri.harvard.edu/covid-19-ukraine-assessing-governments-response

Holt E. COVID-19 vaccination in Ukraine. Lancet Infect Dis. 2021 Apr 1;21(4):462. doi: https://doi.org/10.1016/S1473-3099(21)00156-0

[On the approval of the Roadmap for the introduction of a vaccine against the acute respiratory disease COVID-19, caused by the SARS-CoV-2 coronavirus, and mass vaccination in response to the COVID-19 pandemic in Ukraine in 2021 – 2022. Order of the Ministry of Health of Ukraine 2020 Dec 24, No. 3018]. [Internet]. 2020 [cited 2023 Aug 22]. Ukrainian. Available from: https://zakon.rada.gov.ua/go/v3018282-20

Ipsos Global Advisor in Ukraine. One year with COVID-19 in Ukraine - what has in Ukrainians’ per-ception. Wave 4. April 2021 [Internet]. 2021 [cited 2023 Aug 22]. Available from: https://www.ipsos.com/sites/default/files/ct/news/documents/2021-04/Ipsos%20COVID%20research%20in%20Ukrai-ne%202021_MarchApr_153-4-ua%20.pdf

ipsos.com [Internet]. Ipsos (unpublished survey), 2022 [cited 2023 Aug 22]. Available from: https://www.ipsos.com/ua-ua

Timonina M. Number of Present Population of Ukraine, as of January 1, 2021 [Internet]. 2021 [cited 2022 May 21]. Available from: https://dataspace.princeton.edu/handle/88435/dsp015t34sn725

Holt E. Ukraine at risk of polio outbreak. The Lancet. 2013 Jun 29;381(9885):2244. doi: https://doi.org/10.1016/S0140-6736(13)61469-5

Ongoing humanitarian crisis in Ukraine. Lancet Haematol. 2022 May 1;9(5):e313. doi: https://doi.org/10.1016/S2352-3026(22)00109-0

Essar MY, Matiashova L, Tsagkaris C, Vlady-chuk V, Head M. Infectious diseases amidst a humani-tarian crisis in Ukraine: A rising concern. Ann Med Surg. 2022 Jun 3;78:103950. doi: https://doi.org/10.1016/j.amsu.2022.103950

Ukraine–European Union relations. Wikipedia [Internet]. 2022 [cited 2022 Sep 29]. Available from: https://en.wikipedia.org/w/index.php?title=Ukraine%E2%80%93European_Union_relations&oldid=1109394166

Kyiv International Institute of Sciology. Press-release: Dynamics of attitude to russian population and emotional background during the war: results of telephone surveying conducted 13-18 May, 2022 [Internet]. [cited 2022 Sep 29]. Available from: https://www.kiis.com.ua/?lang=ukr&cat=reports&id=1112&page=1

Ukraine Refugee Situation [Internet]. [cited 2022 Sep 29]. Available from: https://data.unhcr.org/en/situations/ukraine

Tozzi A, Gesualdo F, D’Ambrosio A, Pandolfi E, Agricola E, Lopalco P. Can Digital Tools Be Used for Improving Immunization Programs? Front Public Health. 2016 Mar 8;4:36. doi: https://doi.org/10.3389/fpubh.2016.00036

Rapidly escalating COVID-19 cases amid reduced virus surveillance forecasts a challenging autumn and winter in the WHO European Region [Internet]. [cited 2022 Sep 30]. Available from: https://www.who.int/europe/news/item/19-07-2022-rapidly-escalating-covid-19-cases-amid-reduced-virus-surveillance-forecasts-a-challenging-autumn-and-winter-in-the-who-european-region

Denmark: the latest coronavirus counts, charts and maps. Reuters [Internet]. [cited 2022 Sep 30]. Availa-ble from: https://graphics.reuters.com/world-coronavirus-tracker-and-maps/countries-and-territories/denmark/

Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020 Apr;5(4):536-44. doi: https://doi.org/10.1038/s41564-020-0695-z

Genome.gov [Internet]. The Cost of Sequencing a Human Genome. [cited 2022 Sep 30]. Available from: https://www.genome.gov/about-genomics/fact-sheets/Sequencing-Human-Genome-cost

European Centre for Disease Prevention and Control. Methods for the detection and characterisation of SARS-CoV-2 variants - second update [Internet]. 2022 [cited 2022 Sep 30]. Available from: https://www.ecdc.europa.eu/en/publications-data/methods-detection-and-characterisation-sars-cov-2-variants-second-update

Obermeyer F, Jankowiak M, Barkas N, Schaffner SF, Pyle JD, Yurkovetskiy L, et al. Analysis of 6.4 million SARS-CoV-2 genomes identifies mutations associated with fitness. Science. 2022 Jun 17;376(6599):1327-32. doi: https://doi.org/10.1126/science.abm1208

World Health Organization. Global genomic sur-veillance strategy for pathogens with pandemic and epidemic potential 2022-2032 [Internet]. [cited 2022 Oct 4]. Available from: https://www.who.int/initiatives/genomic-surveillance-strategy

World Health Organization. Genomic sequencing of SARS-CoV-2: a guide to implementation for maximum impact on public health [Internet]. 2021 [cited 2022 Sep 30]. Available from: https://www.who.int/publications-detail-redirect/9789240018440

European Centre ofr Disease Prevention and Control. SARS-CoV-2 - increased circulation of variants of concern and vaccine rollout in the EU/EEA - 14th update. [Internet]. Stockholm; 2021 [cited 2022 Sep 30]. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/RRA-covid-19-14th-update-15-feb-2021.pdf

Kun Á, Hubai AG, Král A, Mokos J, Mikulecz BÁ, Radványi Á. Do pathogens always evolve to be less virulent? The virulence–transmission trade-off in light of the COVID-19 pandemic. Biol Futura. 2023 Jun 1;74(1):69-80. doi: https://doi.org/10.1007/s42977-023-00159-2

Centrul Pentru Inovație in Medicina. Document de poziție. Supravegherea prin secvențiere genomică a viru¬sului SARS-CoV-2 – propunere de înființare a Centrului Național de Date și Analiză Genomică pentru Sănătatea Publică [Internet]. Centrul Pentru Inovație in Medicina. [cited 2022 Sep 30]. Available from: https://ino-med.ro/docs/¬document-de-pozitie-secventiere-SARS-CoV-2.pdf

Yoo W, Choi DH, Park K. The effects of SNS communication: How expressing and receiving infor-mation predict MERS-preventive behavioral intentions in South Korea. Comput Hum Behav. 2016 Sep;62:34-43. doi: https://doi.org/10.1016/j.chb.2016.03.058

International Organization for Migration [Internet]. New Study Highlights Social Media’s Key Role in COVID-19 Vaccine Uptake for Migrants. 2022 [cited 2022 May 21]. Available from: https://www.iom.int/news/new-study-highlights-social-medias-key-role-covid-19-vaccine-uptake-migrants

Eysenbach G. Infodemiology and Infoveillance: Framework for an Emerging Set of Public Health Infor-matics Methods to Analyze Search, Communication and Publication Behavior on the Internet. J Med Internet Res. 2009 Feb 1;11:e11. doi: https://doi.org/10.2196/jmir.1157

Schweidel DA, Bart Y, Inman JJ, Stephen AT, Libai B, Andrews M, et al. How consumer digital signals are reshaping the customer journey. J Acad Mark Sci [Internet]. 2022 Feb 19 [cited 2022 Sep 30]. Available from: https://doi.org/10.1007/s11747-022-00839-w

Bella A, Flavia R, Napoli C, Giambi C, Del Manso M, Dente MG, et al. Handbook on implementing synd-romic surveillance in migrant reception/detention centres and other refugee settings [Internet]. ECDC. 2016 [cited 2023 Jul 31]. Available from: https://www.ecdc.europa.eu/en/publications-data/handbook-implementing-syndromic-surveillance-migrant-receptiondetention-centres

United Nations [Internet]. National Security and Pandemics. [cited 2023 Aug 22]. Available from: https://www.un.org/en/chronicle/article/national-security-and-pandemics

Downloads

Published

2023-12-22

How to Cite

1.
Geanta M, Cucos B, Boata A, Nuta A, Nuta F, Semenov V. The Ukrainian war and the pandemic: the impact on public health and the need for new health digital tools and the next level of intelligence. Med. perspekt. [Internet]. 2023Dec.22 [cited 2024Nov.21];28(4):207-1. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/294241

Issue

Section

SOCIAL MEDICINE