What is the current state of public health system preparedness for infectious disease emergencies? A scoping review

Background The COVID-19 pandemic continues to demonstrate the risks and profound health impacts that result from infectious disease emergencies. Emergency preparedness has been defined as the knowledge, capacity and organizational systems that governments, response and recovery organizations, communities and individuals develop to anticipate, respond to, or recover from emergencies. This scoping review explored recent literature on priority areas and indicators for public health emergency preparedness (PHEP) with a focus on infectious disease emergencies. Methods Using scoping review methodology, a comprehensive search was conducted for indexed and grey literature with a focus on records published from 2017 and 2020 onward, respectively. Records were included if they: a) described PHEP, b) focused on an infectious emergency, and c) were published in an Organization for Economic Co-operation and Development country. An evidence-based all-hazards Resilience Framework for PHEP consisting of 11 elements was used as a reference point to identify additional areas of preparedness that have emerged in recent publications. The findings were summarized thematically. Results The included publications largely aligned with the all-hazards Resilience Framework for PHEP. In particular, the elements related to collaborative networks, community engagement, risk analysis and communication were frequently observed across the publications included in this review. Emergent themes were identified that expand on the Resilience Framework for PHEP. These were related to mitigating inequities, public health capacities (vaccination, laboratory system capacity, infection prevention and control capacity, financial investment in infrastructure, public health legislation, phases of preparedness), scientific capacities (research and evidence-informed decision making, climate and environmental health), and considerations for health system capacity. Conclusions The themes from this review contribute to the evolving understanding of critical public health preparedness actions; however, there was a paucity of recent evidence on PHEP indicators. The themes can expand on the 11 elements outlined in the Resilience Framework for PHEP, specifically relevant to infectious disease emergencies and risks. Further research will be important to validate these findings, and expand understanding of how refinements to PHEP frameworks and indicators can support public health practice. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present work are contained in the manuscript * COVID-19 : Coronavirus Disease 2019 IPAC : Infection Prevention and Control OECD : Organization for Economic Co-operation and Development PHEP : Public health emergency preparedness PHO : Public Health Ontario SARS : Severe acute respiratory syndrome WHO : World Health Organization