2.P. Round table: Covid-19 pandemic: the rise or downfall of public health

Abstract   This year, we are celebrating 30 years of the European Public Health Association. But celebrating this after over two years of COVID-19 and the Russian reinvasion of Ukraine, invites us all to reflect on the use, misuse and non-use of public health. Over the years, our approach to public health has evolved. At the start of the 20th century, public health emphasized the inequalities created by the environments in which people lived, including housing, sanitation, and nutrition. By the end of the century, this extended to the political and commercial determinants of health and the concept of planetary health, which would later be encapsulated by the 2016 Vienna Declaration on Public Health. Given this comprehensive approach, supported by a much greater body of knowledge produced by many disciplines, public health should have been in the driver's seat when the world was hit with COVID-19. But it was not. Its expertise was often absent from COVID-19 response teams. Policies were often driven by panic in the face of visions of overwhelmed hospitals. Restrictions on mixing were essential until more was known about this new virus but there were failures to appreciate the impact that these measures would have on those already disadvantaged, many in precarious employment in public-facing jobs and overcrowded accommodation. As a consequence, existing health inequalities deepened. It seemed that much that had been learned over the preceding decades had been forgotten. In this roundtable, we seek to explain why, and what needs to change in order to refocus the centrality of public health on supporting and creating fair societies as a prerequisite for health for all. So, is COVID-19 the downfall or the new rise of public health? In this Round Table, we will discuss the questions as follows. 1. Where was public health during COVID-19? 2. Why were social factors ignored during COVID-19? 3. Why has public health not used/is not using the momentum created by COVID-19? 4. And the main question: How can we create a fair society? Key messages • Public health needs to strengthen its core activities. • Advocacy is a key role for public health. Speakers/Panellists Martin McKee LSHTM, London, UK Natasha Azzopardi Muscat WHO, Msida, Malta Dineke Zeegers Paget EUPHA Klaus D Pluemer Independent Public Health & Health Promotion Consultant, Duesseldorf, Germany Caroline Costongs EuroHealthNet, Brussels, Belgium

In this presentation, Dr Orcutt, will outline the health system responses needed to respond effectively to the health needs of forcibly displaced populations -from initial health assessments to the longer term -and the role that research can play in ensuring evidence-informed policies and practice. She will present the main areas of the WHO's new global research agenda on migration and health and outline how translating evidence into implementation is essential to improve the health of migrants. Dr Hargreaves will discuss the current guidance for EU/EEA countries on public health considerations for newly arrived migrants, with a specific focus on catch-up vaccination delivery across the life course in mobile populations. She will explore current initiatives and best practices to ensure child, adolescent and adult refugees and migrants are included in catch-up planning and delivery for missed vaccines and missed doses and to align them with the host country vaccine schedule.
Abstract citation ID: ckac129.116 Community engagement to co-design and deliver public health interventions in newly arrived migrants Alison Crawshaw will talk about her participatory research that uses design thinking to develop community-based strategies to improve health outcomes in migrant populations. She will summarise the benefits of using community-based approaches and co-designing public health initiatives with affected migrant communities, bringing in lessons learned from a recent project with the Congolese community in London.
Abstract citation ID: ckac129.117 Health care provision to migrants: what did we learn from the Ukraine, Afghan, and Syrian crises?

Apostolos Veizis
A Veizis 1 1 Intersos, Lancet Migration European Hub, Athens, Greece Contact: a.veizis@intersos.gr Dr Veizis was involved in the immediate health care provision to Ukrainian people fleeing to neighbouring countries including Poland and Moldova, as well as health care provision to Syrian people residing in Greece, working for the nongovernmental organisation INTERSOS and previously MSF. He will discuss his experiences to date in terms of immediate and long-term provision to these groups and the role of both NGOs and mainstream health services in meeting the needs of forcibly displaced migrants to Europe.

2.P. Round table: Covid-19 pandemic: the rise or downfall of public health
This year, we are celebrating 30 years of the European Public Health Association. But celebrating this after over two years of COVID-19 and the Russian reinvasion of Ukraine, invites us all to reflect on the use, misuse and non-use of public health. Over the years, our approach to public health has evolved. At the start of the 20th century, public health emphasized the inequalities created by the environments in which people lived, including housing, sanitation, and nutrition. By the end of the century, this extended to the political and commercial determinants of health and the concept of planetary health, which would later be encapsulated by the 2016 Vienna Declaration on Public Health. Given this comprehensive approach, supported by a much greater body of knowledge produced by many disciplines, public health should have been in the driver's seat when the world was hit with COVID-19. But it was not. Its expertise was often absent from COVID-19 response teams. Policies were often driven by panic in the face of visions of overwhelmed hospitals. Restrictions on mixing were essential until more was known about this new virus but there were failures to appreciate the impact that these measures would have on those already disadvantaged, many in precarious employment in public-facing jobs and overcrowded accommodation. As a consequence, existing health inequalities 15th European Public Health Conference 2022 deepened. It seemed that much that had been learned over the preceding decades had been forgotten. In this roundtable, we seek to explain why, and what needs to change in order to refocus the centrality of public health on supporting and creating fair societies as a prerequisite for health for all. So, is COVID-19 the downfall or the new rise of public health? In this Round Table, we will discuss the questions as follows. 1. Where was public health during COVID-19? 2. Why were social factors ignored during COVID-19? 3. Why has public health not used/is not using the momentum created by COVID-19?
All future trends carry uncertainty in them. For example, the COVID-19 pandemic showed great uncertainty about current and future health impacts and how the virus may directly impact our health. Foresight (as a systematic, participatory, future-intelligence-gathering and medium-to-long term vision-building process aimed at enabling present-day decisions and mobilising joint actions) explicitly addresses uncertainty. Doing a foresight study one has to deal with different sources of uncertainty. Next to commonly known statistical uncertainty, foresight studies have to deal with cognitive uncertainty, i.e. uncertainty related to the limited knowledge that we have regarding the complexity of the underlying system or limited knowledge of what future economic growth will be. A better understanding of the location, level, and nature of the cognitive uncertainties helps assess the robustness of future scenarios. In addition to cognitive uncertainty, normative uncertainty are distinguished. This refers to uncertainty related to differences in what we consider a desirable future. Especially in the field of public health people differ on what they consider to be ''good health''. In this workshop, we will focus on the different aspects of uncertainty and how they are considered in existing foresight studies. The workshop will start with an interactive Mentimeter session to better understand how the audience is familiar with foresight and uncertainty. Then, a brief presentation is given as introduction to foresight and a systematic way of accounting for uncertainty, explaining the basic concepts to level understanding of the audience. This is followed by a presentation of a Foresight study (FRESHER) that addresses cognitive uncertainties consistently and systematically. The second foresight study (Dutch PHFS, RVIM) is a good example of how normative uncertainties are considered. Finally, the last presentation (CEG-IST) gives the policy perspective about how policy makers can incorporate uncertainty, as modelled through foresight, into policy evaluation. The workshop will be concluded by a discussion with the three presenters on the lessons learned regarding foresight and uncertainty. Key messages: Foresight studies addressing uncertainty are essential to be better prepared for the future.
Acknowledging different types of uncertainty is needed to support foresight-informed policy making.
Abstract citation ID: ckac129.120 The inseparable relation between foresight and uncertainty This presentation starts with an interactive mentimeter poll to involve the audience. They will be asked several questions about what they find important in dealing with uncertainty in public health foresight studies.

Background:
The future is per definition uncertain. Our knowledge about the future is obviously limited, especially when we look further into the future. Next to limited knowledge, people also have different ideas about what they consider a desirable future. All these aspects of uncertainty play a role when doing a foresight study. One of the challenges when doing a foresight study is to address these uncertainties in a systematic manner.

Methods:
The cognitive uncertainty addresses the lack of knowledge, which can easily be extended to the information that can be inaccurate or unreliable. These cognitive uncertainties can vary widely, and can be classified according to location, level and nature of the uncertainty. Especially in foresight studies with a strong quantitative character, the cognitive uncertainties can be crucial and can form the basis of developing scenarios. Next to the cognitive uncertainties, normative uncertainties can be distinguished which address desirable futures. These represent the obvious differences in norms and values that people have when valuing health. There are several examples of public health foresight studies that include a proper consideration of uncertainties involved.

Conclusions:
Applications of foresight studies in the field of public health are still limited. However, the recent years we see a broadening of initiatives of doing a foresight study, including addressing uncertainty in an more systematic way. Especially in public health, the normative uncertainty might play a rather relevant role.