The Communicable Diseases Policy Research Group (CDPRG) is a multidisciplinary team within the Department of Global Health & Development in the Faculty of Public Health and Policy at the London School of Hygiene & Tropical Medicine.The Group is based in Bangkok, Thailand, and conducts research across the SE Asia region, and beyond. It provides a focus of expertise on the diverse public health problems associated with communicable disease control internationally and carries out research that is in support of and for policy reform.

Prof Richard Coker with Prof Vonthanak Saphonn, Rector of UHS, Cambodia. He is accepting a Memorandum of Understanding between UHS and LSHTM on behalf of Prof Peter Piot, Director of LSHTM. May 2015. 

Congratulations to Richard Coker who has received a confirmed letter from the Faculty of Public Health, Mahidol University, for his Adjunct Professor position. 

Prof Richard Coker's talk session "Challenges to TB Control: Lessons from the field"at Faculty of Public Health, Mahidol University,  on 24 September 2014

Jointly organised by:

1. Communicable Diseases Policy Research Group (CDPRG), London School of Hygiene and Tropical Medicine (LSHTM)

2. Department of Epidemiology, Faculty of Public Health, Mahidol University 

Video on "Research in Cambodia and Indonesia protects the world from disease threats"

Interview with Dr. James Rudge about his team's research in Cambodia and Indonesia.


Video on "Influenza: Preparing for the next pandemic"

Tom Drake and Prof Richard Coker discuss pandemic influenza mitigation measures as they affect Southeast Asia, a region considered by many to be the front line of any future battle against the disease.

 

News

6 September 2017

Paper entitled "Mapping infectious disease hospital surge threats to lessons learnt in Singapore: a systems analysis and development of a framework to inform how to DECIDE on planning and response strategies" has been published in BMC Health Services Research.

Shweta R. Singh, Richard Coker, Hubertus J-M Vrijhoef, Yee Sin Leo, Angela Chow, Poh Lian Lim,Qinghui Tan, Mark I-Cheng Chen and Zoe Jane-Lara Hildon authored the paper entitled "Mapping infectious disease hospital surge threats to lessons learnt in Singapore: a systems analysis and development of a framework to inform how to DECIDE on planning and response strategies" which has been published in BMC Health Services Research. DOI 10.1186/s12913-017-2552-1.

Abstract

Background: Hospital usage and service demand during an Infectious Dis ease (ID) outbreak can tax the health system in different ways. Herein we conceptualize hospital surge elements, and lessons learnt from such events,to help build appropriately matched responses to future ID surge threats.

Methods: We used the Interpretive Descriptive qualitative approach. Interviews (n = 35) were conducted with governance and public health specialists; hospital based staff; and General Practitioners. Key policy literature in tandem with the interview data were used to iteratively generate a Hospital ID Surge framework. We anchored our narrative account within this framework, which is used to structure our analysis.

Results: A spectrum of surge threats from combinations of capacity (for crowding) and capability (for treatment complexity)demands were identified. Starting with the Pyramid scenario, or an influx of high screening rates flooding Emergency Departments, alongside fewer and manageable admissions; the Reverse-Pyramid occurs when few cases are screened and admitted but those that are, are complex; during a ‘Black’ scenario, the system is overburdened by both crowding and complexity. The Singapore hospital system is highly adapted to crowding, functioning remarkably well at constant near-full capacity in Peacetime and resilient to Endemic surges. We catalogue 26 strategies from lessons learnt relating to staffing,space, supplies and systems, crystalizing institutional memory. The DECIDE model advocates linking these strategies to types of surge threats and offers a step-by-step guide for coordinating outbreak planning and response.

Conclusions: Lack of a shared definition and decision making of surge threats had rendered the procedures somewhat duplicative. This burden was paradoxically exacerbated by a health system that highly prizes planning and forward thinking,but worked largely in silo until an ID crisis hit. Many such lessons can be put into play to further strengthen our current hospital governance and adapted to more diverse settings.

The paper is available online here.