Epidemiological intelligence fusion centers: health security and COVID-19 in the Dominican Republic

ABSTRACT

Research on health security has focused on how many different political, economic, social, and health-related factors affect disease containment within states. However, largely missing from this scholarship is an examination of the role public health intelligence plays in limiting the spread of disease. Thus, this study focuses on the effect epidemiological intelligence fusion centers have on disease prevalence. We conduct a case study analysis of the Dominican Republic’s use of epidemiological intelligence fusion centers during the COVID-19 pandemic and provide policy recommendations for other states to follow.

KEYWORDS:

• Human security
• health security
• epidemiological intelligence
• fusion centers
• COVID-19
• Dominican Republic

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Notes

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2. Sánchez, “How Has the Dominican Republic Achieved One of the Highest Vaccination Rates in the Region?”.

3. Iqbal, “Health and Human Security: the public health impact of violent conflict”.

4. Albert, Baez, and Rutland, “Human Security as Biosecurity: Reconceptualizing national security threats in the time of COVID-19”.

5. Iqbal, “Health and Human Security: the public health impact of violent conflict,” 633.

6. Albert, Baez, and Rutland, “Human Security as Biosecurity: Reconceptualizing national security threats in the time of COVID-19,” 86.

7. Elbe, “pandemics on the radar screen: health security, infectious disease and the medicalisation of insecurity”; Prescott, “SARS: A warning”; Davies, “National Security and Pandemics”; Albert, Baez, and Rutland, “Human Security as Biosecurity: Reconceptualizing national security threats in the time of COVID-19”.

8. Enemark, “Is Pandemic Flu a Security Threat?”.

9. Dinicu, “The Strategic Dimension of the Public Health and National Security”.

10. Šehović, “Towards a New Definition of Health Security: A three-part rationale for the twenty-first century”.

11. World Health Organization, “International Health Regulations (2005),” 1; Šehović, “Towards a New Definition of Health Security: A three-part rationale for the twenty-first century”.

12. Stoeva, “Dimensions of health security – A conceptual analysis”, 3.

13. Kandel et al., “Health Security Capacities in the Context of COVID-19 Outbreak: An analysis of International Health Regulations annual report data from 182 countries”.

14. Davies, “National Security and Pandemics,” 21.

15. Kandel et al., “Health Security Capacities in the Context of COVID-19 Outbreak: An analysis of International Health Regulations annual report data from 182 countries,” 1048.

16. Ibid., 1050.

17. Rodier et al., “Global Public Health Security,” 1447.

18. Price-Smith, Contagion and Chaos: Disease, Ecology, and national Security in the Era of Globalization.

19. Šehović, “Towards a New Definition of Health Security: A three-part rationale for the twenty-first century,” 7-8.

20. Šehović, “Towards a New Definition of Health Security: A three-part rationale for the twenty-first century,” 8.

21. Lentzos, Goodman, and Wilson, “Health Security Intelligence: Engaging Across Disciplines and Sector,” 473.

22. Bernard et al., “Intelligence and Global health: Assessing the role of open source and social media intelligence analysis in infectious disease outbreaks”.

23. Yang, Horneffer, and DiLisio, “Mining Social Media and Web Searches for Disease Detection,” 18.

24. Eysenbach, “Infodemiology: Tracking flu-related searches on the web for syndromic surveillance”.

25. Yang, Horneffer, and DiLisio, “Mining Social Media and Web Searches for Disease Detection,” 18; Eysenbach, “Infodemiology: Tracking flu-related searches on the web for syndromic surveillance”.

26. Baker et al., “A Biodefense Fusion Center to Improve Disease Surveillance and Early Warnings to Enhance National Security”.

27. Bernard et al., “Intelligence and Global health: Assessing the role of open source and social media intelligence analysis in infectious disease outbreaks,” 511-513.

28. Bernard et al., “Intelligence and Global health: Assessing the role of open source and social media intelligence analysis in infectious disease outbreaks,” 513; Yang, Horneffer, and DiLisio, “Mining Social Media and Web Searches for Disease Detection,” 18; Eysenbach, “Infodemiology: Tracking flu-related searches on the web for syndromic surveillance”.

29. Baker et al., “A Biodefense Fusion Center to Improve Disease Surveillance and Early Warnings to Enhance National Security,” 4-6.

30. Bowsher, Milner, and Sullivan, “Medical Intelligence, Security, and Global Health: The foundations of a new health agenda,” 269.

31. Ostergard, “The West Africa Ebola Outbreak (2014-2016): a health intelligence failure?”, 478.

32. See note above 30.

33. Ibid., 269.

34. Bowsher, Milner, and Sullivan, “Medical Intelligence, Security, and Global Health: The foundations of a new health agenda”..

35. Arabshian and Schulzrinne, “A SIP-Based Medical Event Monitoring System”.

36. See note above 34.

37. Rubertone and Brundage, “The Defense Medical Surveillance System and the Department of Defense Serum Repository: Glimpses of the future of public health surveillance,” 1903.

38. See note above 30.

39. See note above 37.

40. Gostin & Wiley, “Governmental public health powers during the COVID-19 pandemic: stay-at-home orders, business closures, and travel restrictions”; Jones, Palumbo, and Brown, “Coronavirus; A visual guide to the economic impact”; Peterson et al., “COVID-19 Travel Restrictions and the International Health Regulations-Call for an open debate on easing of travel restrictions”.

41. Linka et al., “Outbreak Dynamics of COVID-19 in Europe and the Effect of Travel Restrictions”.

42. Cuthbertson, “Coronavirus tracked: How US deaths from COVID-19 compare to other great tragedies”.

43. We are grateful to one of our reviewers for this suggestion.

44. Mihók, “The Role of Medical intelligence in the Process of Defense Strategy Development During the COVID-19 Pandemic”; Gronvall, “the Scientific Response to COVID-19 and Lessons for Security”.

45. Al-Tawfiq et al., “Surveillance for Emerging Respiratory Viruses”; Gillem-Ross and Subbarao, “Emerging Respiratory Viruses: Challenges and vaccine strategies”; Hayden, “Respiratory viral threats”; Price-Smith, Contagion and Chaos: Disease, Ecology, and national Security in the Era of Globalization; Kaufman, Medical Intelligence: A Theater Engagement Tool; Mihók, “The Role of Medical intelligence in the Process of Defense Strategy Development During the COVID-19 Pandemic”; Baker et al., “A Biodefense Fusion Center to Improve Disease Surveillance and Early Warnings to Enhance National Security,”.

46. Mihók, “The Role of Medical intelligence in the Process of Defense Strategy Development During the COVID-19 Pandemic”.

47. Walsh, “Improving Five Eyes” Health Security Intelligence Capabilities: Leadership and governance challenges”.

48. Kaufman, Medical Intelligence: A Theater Engagement Tool.

49. Mihók, “The Role of Medical intelligence in the Process of Defense Strategy Development During the COVID-19 Pandemic,” 50; Walsh, “Improving Five Eyes” Health Security Intelligence Capabilities: Leadership and governance challenges”.

50. Lowenthal, From Policy to Secrets: 8^th Edition.

51. U.S. Department of Defense, “National Center for Medical Intelligence (NCMI)”.

52. U.S. Office of the Director of Naval Intelligence, “Unclassified Summary of Assessment of COVID-19 Origins,” 4.

53. Ibid.

54. Ostergard, “The West Africa Ebola Outbreak (2014-2016): a health intelligence failure?”.

55. Ostergard, “The West Africa Ebola Outbreak (2014-2016): a health intelligence failure?”.

56. Kahana, “Intelligence Against COVID-19: Israeli Case Study”.

57. U.S. Department of Defense, “FM 8-10-8, Medical Intelligence in a Theater of Operations, July 1989”.

58. Clemente, “The Fate of an Orphan: The Hawley Board and the Debates over the Postwar Organization of Medical Intelligence,” 265.

59. Ibid., 266.

60. Clemente, “Guide to the Study of Intelligence,”.

61. Morrissey, “Strategies for the integration of medical and health representation within the law enforcement intelligence fusion centers”.

62. Catano and Gauger, “Information Fusion: Intelligence Centers and Intelligence Analysis,” 19.

63. Monahan and Palmer, “the Emerging Politics of DHS Fusion Centers”.

64. Carter and Carter, “The Intelligence Fusion Process for State, Local, and Tribal Law Enforcement”.

65. See note above 62.

66. Monahan and Palmer, “the Emerging Politics of DHS Fusion Centers,” 618.

67. See note above 64.

68. Lewandowski, Rojek, and Manjarrez, “Using a Fusion Center Model to Manage and Improve Border Security”.

69. See note above 66.

70. See note above 61.

71. Baker et al., “A Biodefense Fusion Center to Improve Disease Surveillance and Early Warnings to Enhance National Security,” 6.

72. Centro de Operaciones de emergencia de la Presidencia de la República Dominicana, “Plan de Contingencia Gran Santo Domingo COVID-19 en Apoyo al Ministerio de Salud”; Decreto 140-20, “Danilo designa a Amado Alejandro Baez como asesor del poder ejecutivo en Salud Publica”; Davis, “The Dominican Republic responds to COVID-19 Locally”; World Health Organization, “Dominican Republic Situation”; Arias and Baez, “pertenecer a este proceso es quizas el principal orgullo de mi vida”.

73. Baez et al., “A Public Value Crisis Model Approach to COVID-19 Outbreak Control in the Dominican Republic”.

74. Kaiser et al., “What is Epidemic Intelligence, and how is it being improved in Europe?”.

75. Ibid.

76. See note above 73.

77. See note above 74.

78. Paulino-Ramirez and Tapia, “Learning from pandemics in the Americas: The Dominican Republic Programmatic Response against a novel coronavirus (COVID-19)”.

79. Castillo 2020.

80. Centro de Operaciones de Emergencia de la Republica Dominicana, “Ministerio de Salud deja funcionando Centro de inteligencia en Salud. Informativos teleantillas”.

81. CDN, “OMS Felicita a Republica Dominicana Por Manejo Pandemia De COVID-19,” para. 3.

82. Paquet et al., “Epidemic Intelligence: A New Framework for Strengthening Disease Surveillance in Europe”.

83. Hatfill, “Rapid Validation of Disease Outbreak Intelligence by Small Independent Verification Teams,” 533.

84. Adly, Adly, and Adly, “Approaches Based on Artificial Intelligence and the Internet of Intelligent Things to Prevent the Spread of COVID-19”; Chatterjee et al. “Internet of Things and Artificial Intelligence in Healthcare During COVID-19 Pandemic – A South American Perspective”.

85. Baez et al., “A Public Value Crisis Model Approach to COVID-19 Outbreak Control in the Dominican Republic,” 14.

86. See note above 73.

87. See note above 78.

88. See note above 81.

89. Moore, Recognizing Public Value.

90. Kavanaugh, “Defining and Creating Value for the Public”.

91. Rollins, “Fusion centers, Issues and options for Congress,” 56.

92. Rollins, “Fusion centers, Issues and options for Congress”.

93. See note above 91.

94. Patel, “Fusion Centers Need More rules, Oversight,” para. 7.

95. Ibid., 6.

96. Walsh, “Building better intelligence frameworks through effective governance”.

97. Ibid.

98. Department of Homeland Security, “Fusion center Logistics and Information”.

99. Medbelle, “Hospital City Ranking”.

100. Baker et al., “A Biodefense Fusion Center to Improve Disease Surveillance and Early Warnings to Enhance National Security,” 6.

101. Stoeva, “Dimensions of health security – A conceptual analysis,” 10.

102. Connable, Military Intelligence Fusion for Complex Operations: A New Paradigm; as cited in Catano and Gauger, Information Fusion: Intelligence Centers and Intelligence Analysis.

103. Pfeifer, Network Fusion Information and Intelligence Sharing for a Networked World.

104. See note above 83.

Additional information

Notes on contributors

Craig Douglas Albert

Craig Douglas Albert, PhD–Dr. Albert is Professor of Political Science and the Graduate Director of the Master of Arts in Intelligence and Security Studies at Augusta University. His areas of concentration include international relations, ethnic conflict, cyberterrorism and cyberwar, political philosophy, and the scholarship of teaching and learning. He is widely published, including articles in the Journal of Political Science Education; Iran and the Caucasus; Politics; East European Politics; Chicago-Kent Law Review; Middle Grades Review; The Journal of International Social Studies; Politics and Religion Journal; Politics & the Life Sciences; Cyber Defense Review; and Journal of Cyber Policy.

Alejandro Amado Baez

Alejandro Amado Baez, MD, MPH, PhD. Dr. Baez is a Professor of Emergency Medicine and Epidemiology at the Medical College of Georgia, where he also serves as Vice Chair of the Department of Emergency Medicine and Director of the Center of Operational Medicine. Dr Baez’s operational and academic work is focused on the intersection of security, government and health. In his role as faculty for the Augusta University Masters in Intelligence and Security Studies he has developed academic efforts that focus on Public Health and Epidemiologic Intelligence. Dr Baez has served as the Public Health Advisor to the Dominican Presidency since 2020 and has a joint appointment with the Universidad Nacional Pedro Henriquez Urena in Dominican Republic.

Lance Hunter

Lance Hunter, PhD, is an Associate Professor of International Relations at Augusta University. His research focuses on the relationship between evolving technology and conflict, how political decisions within countries affect conflicts worldwide, and how terrorist attacks influence politics in democratic countries. His work has appeared in journals such as: Journal of Peace Research, Terrorism and Political Violence, Party Politics, Studies in Conflict and Terrorism, Armed Forces and Society, Conflict, Security and Development, European Political Science, Global Policy, Cyber Defense Review, Journal of Cyber Policy, and World Affairs.

John Heslen

John Heslen, PhD., is an Assistant Professor of Political Science at Augusta University. He is a retired Lieutenant Colonel who served as an intelligence officer in the USAF with assignments to Defense Intelligence Agency, U.S. European Command and National Intelligence University. His areas of expertise include the U.S. Intelligence Community, strategic Cybersecurity and the cognitive aspects of information warfare.

Josh Rutland

Josh Rutland is a master’s student in the Intelligence and Security Studies program at Augusta University. His research focuses on cybersecurity, terrorism, and biosecurity. His work has appeared in journals such as: Politics and the Life Sciences, Politics & Policy, Behavioral Sciences of Terrorism and Political Aggression, Journal of Cyber Policy, and PLOS Global Public Health.