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Showing papers by "Georgetown University Law Center published in 2020"


Journal ArticleDOI
25 Feb 2020-JAMA
TL;DR: Wu et al. as mentioned in this paper described the current status of 2019-nCoV, assess the response, and offer proposals for bringing the outbreak under control, and proposed a new vaccination strategy.
Abstract: On December 31, 2019, China reported to the World Health Organization (WHO) cases of pneumonia in Wuhan, Hubei Province, China, now designated 2019-nCoV. Mounting cases and deaths pose major public health and governance challenges. China’s imposition of an unprecedented cordon sanitaire (a guarded area preventing anyone from leaving) in Hubei Province has also sparked controversy concerning its implementation and effectiveness. Cases have now spread to 4 continents. We describe the current status of 2019-nCoV, assess the response, and offer proposals for bringing the outbreak under control.

913 citations


Posted Content
TL;DR: The current status of 2019-nCoV, the response, and proposals for bringing the outbreak under control are described and offered.
Abstract: On December 31, 2019, China reported to the World Health Organization (WHO) cases of pneumonia in Wuhan, Hubei Province, China, now designated 2019-nCoV. Mounting cases and deaths pose major public health and governance challenges. China’s imposition of an unprecedented cordon sanitaire (a guarded area preventing anyone from leaving) in Hubei Province has also sparked controversy concerning its implementation and effectiveness. Cases have now spread to 4 continents. We describe the current status of 2019-nCoV, assess the response, and offer proposals for bringing the outbreak under control.

712 citations


Journal ArticleDOI
02 Jun 2020-JAMA
TL;DR: While researchers race to develop vaccines, officials are implementing physical distancing, including orders to stay at home, restricting travel, and closing nonessential businesses to counteract the spread of SARS-CoV-2.
Abstract: The president and all 50 governors have declared health emergencies to combat the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). While researchers race for vaccines, officials are implementing physical distancing, including orders to stay at home, restrict travel, and close non-essential businesses. To limit cross-border spread, a few states have issued mandatory quarantines for interstate travelers. Models suggest physical distancing would have to persist for 3 months to mitigate peak impacts on health systems and could continue on an intermittent basis for 12-18 months. What legal powers do governments have? What is the role of the courts? How can we balance public health with personal and economic rights?

347 citations


Journal ArticleDOI
TL;DR: For example, the authors assesses the associations of age, gender, and level of education with vaccine acceptance, from a random sample of 13,426 participants selected from 19 high COVID-19 burden countries in June 2020.
Abstract: In December 2020, the first COVID-19 vaccines were approved. Despite more than 85 million reported cases and 1.8 million known deaths, millions worldwide say they may not accept it. This study assesses the associations of age, gender, and level of education with vaccine acceptance, from a random sample of 13,426 participants selected from 19 high-COVID-19 burden countries in June 2020. Based on univariable and multivariable logistic regression, several noteworthy trends emerged: women in France, Germany, Russia, and Sweden were significantly more likely to accept a vaccine than men in these countries. Older (≥50) people in Canada, Poland, France, Germany, Sweden, and the UK were significantly more favorably disposed to vaccination than younger respondents, but the reverse trend held in China. Highly educated individuals in Ecuador, France, Germany, India, and the US reported that they will accept a vaccine, but higher education levels were associated with lower vaccination acceptance in Canada, Spain, and the UK. Heterogeneity by demographic factors in the respondents' willingness to accept a vaccine if recommended by employers were substantial when comparing responses from Brazil, Ecuador, France, India, Italy, Mexico, Poland, Russia, South Africa, South Korea, Sweden, and the US. This information should help public health authorities target vaccine promotion messages more effectively.

163 citations




Journal ArticleDOI
16 Jun 2020-JAMA
TL;DR: Although digital surveillance has the distinct advantages of scale and speed, does it confer sufficient public health benefit to justify adoption given privacy concerns?
Abstract: Contact investigations have been a vital public health strategy, most recently in controlling tuberculosis and sexually transmitted infections including HIV. Yet, the sheer scale of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections poses major challenges to contact investigations. Strategies in China, Singapore, South Korea, and Taiwan have supplemented traditional manual approaches with digital surveillance through smartphone applications. The US has not used digital surveillance as a tool, but Google, Apple, the Massachusetts Institute of Technology (MIT), as well as 2 pan-European consortia and a variety of independent efforts are developing Bluetooth smartphone technology to enable rapid notification of users that they have had a close exposure to individuals diagnosed with medically verified coronavirus disease 2019 (COVID-19). How does digital tracking differ from manual tracing? Although digital surveillance has the distinct advantages of scale and speed, does it confer sufficient public health benefit to justify adoption given privacy concerns? How do the design choices of digital contact tracing systems affect public health and privacy?

77 citations



Journal ArticleDOI
TL;DR: The flavor ban in San Francisco City reduced flavored tobacco use overall and prompted quit attempts and reduced consumption, and the effectiveness of the ban was further compromised by the retailers' non-compliance.

58 citations


Posted Content
TL;DR: Here is a proposal for global cooperation to ensure equitable distribution of vaccines and therapies for COViD-19, with a common global interest.
Abstract: Scientists from across the globe are racing to develop effective vaccines and therapeutics for coronavirus disease 2019 (COVID-19). Plans are beginning to emerge for ensuring the equitable worldwide distribution of vaccines and therapeutics resulting from biomedical innovations. Absent broad agreement and buy-in on those plans, governments may prioritize their own populations, resulting in inequitable distribution of medical products both within and among countries. During the 2009 influenza A(H1N1) pandemic, wealthy nations bought virtually all vaccine supplies. Even after the WHO appealed for donations, supplies for low- and middle-income countries (LMICs) were limited. The White House may have already sought exclusive access to a COVID-19 vaccine candidate. European and Asian countries have imposed export controls on personal protective equipment and ventilators, with similar export controls likely to extend to COVID-19 vaccine and therapeutic stocks. The development and widespread distribution of COVID-19 medical treatments are a common global interest. Here we offer a proposal for global cooperation to ensure equitable distribution of vaccines and therapies for COViD-19.

57 citations


Journal ArticleDOI
TL;DR: The impact of legal determinants of health on the COVID-19 pandemic is evident and multilateral legal agreements could be the path back to global health security and justice by re-establishing norms of international solidarity, committing to global equitable vaccine access initiatives, and laying a foundation for a post-pandemic era built on multilateralism and cooperation.

Journal ArticleDOI
TL;DR: Coronavirus disease 2019 (COVID-19) poses an occupational health risk to food system workers including farmers/producers, grocery store workers, emergency food system staff and volunteers, and others.
Abstract: Coronavirus disease 2019 (COVID-19) poses an occupational health risk to food system workers including farmers/producers, grocery store workers, emergency food system staff and volunteers (eg, food pantry workers), and others These food system workers have been pushed to the front-line of this pandemic, providing essential services that support food consumption for all Americans Food system workers are some of the most economically vulnerable populations and are at risk of further financial disparities and contraction of COVID-19 during this pandemic As we continue to grapple with the best strategies to support the food system and mitigate concerns around the spread of COVID-19, appropriate measures must be considered to better protect and support front-line food system workers that safeguard food access for all Americans

Journal ArticleDOI
TL;DR: Following an assessment of underlying determinants of low vaccination rates, an action based on scientific evidence, ethics, and human rights that spans multiple governments, organisations, disciplines, and sectors is offered.
Abstract: Vaccination is one of public health's greatest achievements, responsible for saving billions of lives. Yet, 20% of children worldwide are not fully protected, leading to 1·5 million child deaths annually from vaccine-preventable diseases. Millions more people have severe disabling illnesses, cancers, and disabilities stemming from underimmunisation. Reasons for falling vaccination rates globally include low public trust in vaccines, constraints on affordability or access, and insufficient governmental vaccine investments. Consequently, an emerging crisis in vaccine hesitancy ranges from hyperlocal to national and worldwide. Outbreaks often originate in small, insular communities with low immunisation rates. Local outbreaks can spread rapidly, however, transcending borders. Following an assessment of underlying determinants of low vaccination rates, we offer an action based on scientific evidence, ethics, and human rights that spans multiple governments, organisations, disciplines, and sectors.

Journal ArticleDOI
TL;DR: The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.

Journal ArticleDOI
TL;DR: In Black in Place, Brandi Thompson Summers positions "Blackness 1 as a prized aesthetic along the H Street Corridor" (p.4), a historic district in Washington (DC) as discussed by the authors.
Abstract: In Black in Place, Brandi Thompson Summers positions “Blackness 1 as a prized aesthetic along the H Street Corridor” (p.4), a historic district in Washington (DC). She examines Blackness through th...

Journal ArticleDOI
TL;DR: While it does not appear that certain flavors are associated with a greater propensity to attempt to quit smoking among concurrent users, nontobacco flavors are popular among former smokers who are exclusively vaping.
Abstract: AIMS: This study examined whether nontobacco flavors are more commonly used by vapers (e-cigarette users) compared with tobacco flavor, described which flavors are most popular, and tested whether flavors are associated with: vaping satisfaction relative to smoking, level of enjoyment with vaping, reasons for using e-cigarettes, and making an attempt to quit smoking by smokers. METHODS: This cross-sectional study included 1603 adults from Canada and the United States who vaped at least weekly, and were either current smokers (concurrent users) or former smokers (exclusive vapers). Respondents were categorized into one of seven flavors they used most in the last month: tobacco, tobacco-menthol, unflavored, or one of the nontobacco flavors: menthol/mint, fruit, candy, or "other" (eg, coffee). RESULTS: Vapers use a wide range of flavors, with 63.1% using a nontobacco flavor. The most common flavor categories were fruit (29.4%) and tobacco (28.7%), followed by mint/menthol (14.4%) and candy (13.5%). Vapers using candy (41.0%, p < .0001) or fruit flavors (26.0%, p = .01) found vaping more satisfying (compared with smoking) than vapers using tobacco flavor (15.5%) and rated vaping as very/extremely enjoyable (fruit: 50.9%; candy: 60.9%) than those using tobacco flavor (39.4%). Among concurrent users, those using fruit (74.6%, p = .04) or candy flavors (81.1%, p = .003) were more likely than tobacco flavor users (63.5%) to vape in order to quit smoking. Flavor category was not associated with the likelihood of a quit attempt (p = .46). Among exclusive vapers, tobacco and nontobacco flavors were popular; however, those using tobacco (99.0%) were more likely than those using candy (72.8%, p = .002) or unflavored (42.5%, p = .005) to vape in order to stay quit. CONCLUSIONS: A majority of regular vapers in Canada and the US use nontobacco flavors. Greater satisfaction and enjoyment with vaping are higher among fruit and candy flavor users. While it does not appear that certain flavors are associated with a greater propensity to attempt to quit smoking among concurrent users, nontobacco flavors are popular among former smokers who are exclusively vaping. Future research should determine the likely impact of flavor bans on those who are vaping to quit smoking or to stay quit. IMPLICATIONS: Recent concerns about the attractiveness of e-cigarette flavors among youth have resulted in flavor restrictions in some jurisdictions of the United States and Canada. However, little is known about the possible consequences for current and former smokers if they no longer have access to their preferred flavors. This study shows that a variety of nontobacco flavors, especially fruit, are popular among adult vapers, particularly among those who have quit smoking and are now exclusively vaping. Limiting access to flavors may therefore reduce the appeal of e-cigarettes among adults who are trying to quit smoking or stay quit.

Journal ArticleDOI
TL;DR: The COVID-19 pandemic resonates with moments in which there was broad social support for containment precisely because lockdowns or stay at home orders are, on the surface, remarkably equitable.
Abstract: Although unprecedented in scope and beyond all our life experiences, sweeping social distancing measures are not without historical precedent. Historically, racism, stigma, and discrimination resulted in grossly inequitable application of disease containment measures. But history also provides examples in which broad measures enjoyed remarkable public support. When it comes to COVID-19, blame and division continue to shape containment responses. But the COVID-19 pandemic also resonates with moments in which there was broad social support for containment precisely because lockdowns or stay at home orders are, on the surface, remarkably equitable. Yet even in a context in which a majority of Americans support social distancing, small but coordinated conservative groups are challenging social distancing as a matter of individual rights. In sharp contrast, vulnerable populations, who bear the heaviest burden of disease, have claimed a right to social distancing as a matter of protection.

Journal ArticleDOI
TL;DR: The International Health Regulations (IHR), the multilateral instrument that governs how 196 states and WHO collectively address the global spread of disease, has been largely side-lined in the COVID-19 pandemic as discussed by the authors, and it is time to reimagine the IHR as an instrument that will compel global solidarity and national action against the threat of emerging and reemerging pathogens.

Journal ArticleDOI
15 May 2020-Science
TL;DR: The sharing of public health information, biological samples, and GSD in the still early days of the COVID-19 pandemic is examined, barriers to sharing under the current international legal system are identified, and legal and policy reforms needed to enhance international scientific cooperation are proposed.
Abstract: The coronavirus disease 2019 (COVID-19) pandemic has demonstrated the critical importance and persistent challenges of rapidly sharing public health and scientific information, biological samples, and genetic sequence data (GSD). Sharing these resources is crucial to characterizing the causative agent, understanding its spread, and developing diagnostics, antiviral treatments, and vaccines. But even though these resources are critical for the global health community, there is currently no legal obligation for countries to share physical pathogen samples or associated GSD. To date, researchers have often shared such resources in a spirit of scientific openness. Yet ongoing scientific cooperation has been insufficient (1) despite the scale of the pandemic threat. The lack of a clear legal obligation to share pathogens or associated GSD during a health emergency represents a blind spot in international law and governance, impeding pandemic response and scientific progress. We examine the sharing of public health information, biological samples, and GSD in the still early days of the COVID-19 pandemic, identify barriers to sharing under the current international legal system, and propose legal and policy reforms needed to enhance international scientific cooperation.

Journal ArticleDOI
TL;DR: Pregnant women should receive respectful maternity care in the context of COVID‐19 and not be subject to policies and practices that violate their human rights.


Journal ArticleDOI
TL;DR: This paper examined the case of the Islamic State (IS) in Iraq and Syria and concluded that most of the civilian response to IS rule suggested domination and authoritarian forms of social-contract building.

Journal ArticleDOI
10 Nov 2020-JAMA
TL;DR: The coronavirus pandemic has strained health systems, revealed unconscionable inequalities, and upended international institutions, here are 7 critical lessons.
Abstract: The world is experiencing a once-in-a-lifetime pandemic, causing untold human suffering and death, unraveling of social relationships, and robbing individuals of livelihoods and countries of prosperity. The coronavirus pandemic has strained health systems, revealed unconscionable inequalities, and upended international institutions. Here are 7 critical lessons.

Journal ArticleDOI
16 Jun 2020-JAMA
TL;DR: The crisis now unfolding could also become a historic opportunity to strengthen the WHO, and broad criticism of the organization is unfounded, and is particularly damaging because the pandemic is poised to deeply affect sub-Saharan Africa.
Abstract: From the time China reported a novel coronavirus to the World Health Organization (WHO) on December 31, 2019, it took barely 4 months to become a pandemic, killing hundreds of thousands, and growing daily. It is now clear that the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had been circulating in Wuhan, China, for weeks before China reported it to the WHO, and that authorities hid information. China maintained SARS-CoV-2 was not readily transmissible between humans. The WHO published China’s data, but without independently verifying their accuracy. President Trump subsequently blamed the WHO for its slow and “China-centric” response. On April 14, 2020, he announced a suspension of US voluntary contributions to the agency. Although the WHO was unable to verify the Chinese data, it was proactive, including widely sharing the genomic sequencing of the virus with international scientists. On January 30, 2020, the WHO declared coronavirus disease 2019 (COVID-19) a global health emergency, urging rigorous containment including testing, contract tracing, and quarantine. Broad criticism of the organization is unfounded, and is particularly damaging because the pandemic is poised to deeply affect sub-Saharan Africa. That said, legitimate concerns about the WHO include its reluctance to insist China allow a robust WHO team on the ground and its praising of China’s transparency. The crisis now unfolding could also become a historic opportunity to strengthen the WHO. Reforms must start with recognizing the global public good achieved by the WHO.

Journal ArticleDOI
TL;DR: In this article, the authors explore how labor and employment laws shape workplace technological change and suggest that ensuring a decent future of work may require reforms to guarantee workers a voice in the development and deployment of workplace technologies.
Abstract: This article explores how labor and employment laws shape workplace technological change. It focuses on emerging data-driven technologies such as machine learning, the branch of artificial intelligence that has sparked widespread concern about the future of work. The article argues that labor and employment laws shape employers’ technological choices in two ways. First, those laws help to facilitate technological development by granting employers broad rights to gather workplace data, to develop new technologies using that data, and to implement those technologies into the workplace, typically regardless of workers’ preferences. Second, those laws channel technological development in certain directions, in particular by encouraging companies to use technologies to exert power over workers and therefore cut labor costs. This analysis has policy implications. Among other things, it suggests that ensuring a decent future of work may require reforms to guarantee workers a voice in the development and deployment of workplace technologies.

Journal ArticleDOI
TL;DR: This brief report describes what the authors know about the nature and costs of survivor loneliness and uses the COVID-19 pandemic as a lens through which to review the ways current DV interventions may help alleviate loneliness, and how these might be expanded to enhance survivor wellbeing, immediately and even after a return to “normal.”
Abstract: The COVID-19 pandemic has dramatically highlighted the isolation of domestic violence survivors, triggering media coverage and innovative efforts to reach out to those who are trapped in their homes, facing greater danger from their partners than from the virus. But another harmful aspect of this difficult time has received far less attention: survivors' intensified loneliness. Although loneliness can be catalyzed by isolation, it is a distinct psychological phenomenon that is internal and subjective in nature. Loneliness is not only acutely painful in its own right; it also inflicts a range of long lasting, health-related harms, and heightens survivors' vulnerability to violence, creating a vicious cycle that may continue long after strict stay-at-home and physical distancing policies end. This may be particularly true for marginalized survivors, for whom larger structural inequalities and institutional failures compound the negative impact of loneliness. This brief report describes what we know about the nature and costs of survivor loneliness and uses the COVID-19 pandemic as a lens through which to review the ways current DV interventions may help alleviate loneliness (as distinct from isolation), and how these might be expanded to enhance survivor wellbeing, immediately and even after a return to "normal."

Journal ArticleDOI
TL;DR: An interprofessional panel of medical and legal experts is convened to elucidate the state of medical-legal ACP and begin to identify strategies to improve and align practices within and across professions.

Posted ContentDOI
10 Jan 2020-bioRxiv
TL;DR: It is proposed that a globally-coordinated project could dramatically speed up this process, playing a critical role in tracking the disease impacts of global change and calling for a global effort to transform parasitology and describe as much of global parasite diversity as possible.
Abstract: How many parasites are there on Earth? Here, we use helminth parasites to highlight how little is known about parasite diversity, and how insufficient our current approach will be to describe the full scope of life on Earth. Using the largest database of host-parasite associations and one of the world’s largest parasite collections, we estimate a global total of roughly 100,000 to 350,000 species of helminth endoparasites of vertebrates, of which 85% to 95% are unknown to science. The parasites of amphibians and reptiles remain the most poorly described, but the majority of undescribed species are likely parasites of birds and bony fish. Missing species are disproportionately likely to be smaller parasites of smaller hosts in undersampled countries–species that have mostly been understudied over the last century. At current rates, it would take centuries to comprehensively sample, collect, and name vertebrate helminths. While some have suggested that macroecology can work around existing data limitations, we argue that patterns described from a small, biased sample of diversity aren’t necessarily reliable, especially as host-parasite networks are increasingly altered by global change. In the spirit of moonshots like the Human Genome Project and the Global Virome Project, we propose a global effort to transform parasitology and describe as much of global parasite diversity as possible. Significance Statement Roughly one in ten parasitic worms has been described by taxonomists, while the majority of species remain unknown to science. Data deficiencies are especially severe for some major groups (reptiles and amphibians) and regions (Africa and Southeast Asia). Decades of work have resulted in much larger datasets on host-parasite interactions, but their utility is limited by major data gaps. At current rates, those gaps could take hundreds of years to be filled. We propose that a globally-coordinated project could dramatically speed up this process, playing a critical role in tracking the disease impacts of global change. If successful, it could be a transformative opportunity for multilateral capacity building, and a path towards more equitable research benefit sharing.

Book ChapterDOI
TL;DR: Health-related human rights have evolved dramatically to offer a normative framework for public health, codifying international standards to frame government obligations and facilitate accountability for realising the highest attainable standard of health.
Abstract: Policymakers have come to look to human rights law in framing national health policy and global health governance. Human rights law offers universal frameworks to advance justice in public health, codifying international standards to frame government obligations and facilitate accountability for realising the highest attainable standard of health. Addressing threats to individual dignity as ‘rights violations’ under international law, health-related human rights have evolved dramatically to offer a normative framework for public health.

Journal ArticleDOI
TL;DR: It will be crucial to examine the lessons learned in the COVID-19 response and the reforms required to rebuild global health institutions while maintaining core values of human rights, rule of law, and global solidarity in the face of unprecedented threats.
Abstract: Global health law is essential in responding to the infectious disease threats of a globalizing world, where no single country, or border, can wall off disease. Yet, the Coronavirus Disease (COVID-19) pandemic has tested the essential legal foundations of the global health system. Within weeks, the SARS-CoV-2 coronavirus has circumnavigated the globe, bringing the world to a halt and exposing the fragility of the international legal order. Reflecting on how global health law will emerge in the aftermath of the COVID-19 pandemic, it will be crucial to examine the lessons learned in the COVID-19 response and the reforms required to rebuild global health institutions while maintaining core values of human rights, rule of law, and global solidarity in the face of unprecedented threats.