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PowerPoint Presentation
Steps in the evidence-based public health process (P.E.R.I.E)
Problem
Etiology
Recommendations
Implementations
Evaluation
Adapted from Riegelman R. Evedince based public health and cigarette smoking. Chapter 2. Website: http://samples.jbpub.com/9781284123845/Chapter2.pdf (Accessed 29.01.2022)
The evidence-based public health approach, also known as P.E.R.I.E model, asks five questions to address public health problem. (1) P or the problem. What is the health problem?. (2) E or the etiology. What are the reasons behind the disease cause.(4) I or the implementation. What are the intervention steps needed to reduce the disease burden. (5) E or the evaluation. How good the intervention practices are?
In the following slides, I will be showing COVID-19 pandemic disease based on PERIE model.
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Coronavirus disease 2019 (COVID-19)
Severity
    20% cases severe or critical
Speed & Scale
    Localized outbreak in China (Wuhan) turned into global pandemic.
    Quick spread of disease to all corners of world
Societal and economic disruption
    Shock to health and social care systems
In just a short span of time, a localized outbreak of COVID-19 evolved into a global pandemic . It originated in Wuhan in china and spread quickly to all corners of the world. The World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020. The term pandemic refers to multiple outbreaks of an infectious illness threatening multiple parts of the world at the same time. A report by World Health Organization in 2020 defined three characteristics of COVID-19.
(1)Speed and scale: the disease had spread quickly to all corners of the world, and the explosive spread had overwhelmed even the most resilient health systems. (2) Severity: 20% of cases were said to be severe or critical, with a case fatality rate of over 3%, more severe in older age groups and in those with certain underlying health conditions like heart diseases, Chronic Obstructive Pulmonary disease etc . (3) Societal and economic disruption: The overwhelming nature of the disease sent shock waves to health and social care systems and measures that were taken to control the transmission had broad and deep socio-economic consequences like sudden lockdowns in most countries led to many people losing their jobs.
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Etiology of COVID-19
    Caused by SARS-CoV-2.
    The disease is called coronavirus disease 2019 (COVID-19).
    Symptoms: fever, cough, tiredness, difficulty in breathing, muscle ache, sore throat, headache, nausea.
    Severity: mild to severe. Some have no symptoms but can still spread the virus (asymptomatic transmission). Severe symptoms include shortness of breath and pneumonia.
Covid-19 is caused by SARS-CoV-2 virus also known as coronavirus 2 and the disease is known as coronavirus disease 2019 or COVID-19. Most people who contract the virus will suffer only mild symptoms, such as a cough, a cold, or a high temperature. However, in more severe cases, the infection can cause breathing difficulties and even pneumonia. . We are still learning about how COVID-19 affects people, but those at higher risk include older persons and people with pre-existing medical conditions, including diabetes, heart disease, and lung disease. 
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Risk factors for severe COVID-19 illness (CDC, 2020)
    Age
    Race/ Ethnicity
    Gender
    Some medical conditions e.g., COPD, heart disease, high blood pressure
    Use of certain medications
    Poverty & Crowding
    Certain Occupations like front line workers, essential workers, critical infrastructure workers.
    Pregnancy
The risk of COVID-19 increases with age. People who are older have higher risk of severe illness Race and ethnicity are risk markers for other underlying conditions that affect health, including socioeconomic status, access to health care, and exposure to the virus related to occupation, e.g., frontline, essential, and critical infrastructure workers. People who have existing medical condition have increased risk of illness from COVID-19 e.g., heart diseases, cancer, Chronic Obstructive Pumnoary disease, diabetes, weakened immunity etc.
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Burden of COVID-19
According to the World Health Organization (WHO): COVID-19 cases from January 2020 to January 2022.
Globally (WHO, 2022)
    World Total no. of confirmed COVID-19 cases (morbidity): 364,191,494
    Total no. of deaths due to COVID-19 (mortality): 5,631,457
    Case fatality is 1.5%.
In the United States (WHO, 2022)
     Total no. of confirmed COVID-19 cases (morbidity): 75,481,122
    Total no. of deaths due to COVID-19 (mortality): 906,861
    Case fatality is 1.2%
    
So, how can we describe a health problem? To describe the health problem, we need to know the burden of the disease, the course of the disease and distribution of the disease. The burden of disease is described as occurrence of disability also known as morbidity and death or mortality. As of January 2022, WHO documented COVID-19 cases globally and in United States. Globally, there have been total of 360 million cases of COVID-19 infection, while in United States itself this accounted for 75 million cases. Death cases globally have been 0.5 million while in United States this has been close to 91 thousand. Case fatality has been 1.5% worldwide while for United States this has been 1.2%. Although the symptoms of COVID-19 are more or less similar to common flu that people get every year, however, the case fatality for common flu is only 0.1% compared to that of COVID-19.
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Risk for COVID-19 Infection, Hospitalization, and Death By Age Group (CDC, 2021)
    Rate compared to 18-29 years old    0-4
years    5-17
years    18-29...