651
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Receptivity of Governmental Communication and Its Effectiveness During COVID-19 Pandemic Emergency in Vietnam: A Qualitative Study. GLOBAL JOURNAL OF FLEXIBLE SYSTEMS MANAGEMENT 2021. [PMCID: PMC8107776 DOI: 10.1007/s40171-021-00269-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Vietnam is considered as one of the countries with the earliest and most effective responses to the outbreak of 2019 novel coronavirus disease (COVID-19), a pandemic with acute respiratory syndrome caused by the new strain of coronavirus (SARS-CoV-2). An important contribution to the overall success is the effectiveness of the governmental communication strategy in achieving the desired cognitive, affective, and behavioral outcomes. Analysis of the qualitative data collected from twelve focus group discussions with a total of 60 participants revealed that due to the government’s communication efforts, Vietnamese people have adequate information/knowledge about the COVID-19 pandemic, and majority of them experience low emotional levels of anxiety, fear, dread, stress, and panic. Moreover, the communication strategy has helped to form both health-promoting and safety-seeking behaviors among the community. Further, the characteristics of an effective communication strategy such as reliable sources of communication, usages of multiple social media channels, and transparent message contents in the form of infographic or video clips are identified.
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652
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Affiliation(s)
- Cameron S Palmer
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia,Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia,Corresponding author
| | - Warwick J Teague
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia,Surgical Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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653
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Houdek P, Koblovský P, Vranka M. The Challenge of Human Psychology to Effective Management of the COVID-19 Pandemic. SOCIETY 2021; 58:131-134. [PMID: 33967360 PMCID: PMC8090512 DOI: 10.1007/s12115-021-00575-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
When it comes to the nature of the COVID-19 pandemic and the effectiveness of measures against the disease, many citizens worldwide do not trust their governments or health authorities. This brief essay discusses several psychological mechanisms which, under certain conditions, lead people to ignore important sources of information and hinder effective management of the epidemic. The paper shows that understanding psychological mechanisms, such as information neglect, cognitive dissonance, psychological reactance, and, in general, the diversity of people's thinking styles, may help leaders design more effective government communications.
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Affiliation(s)
- Petr Houdek
- Faculty of Business Administration, Prague University of Economics and Business, Prague, Czechia
- Faculty of Social Sciences, Charles University, Prague, Czechia
| | - Petr Koblovský
- Faculty of Social Sciences, Charles University, Prague, Czechia
- Center of Behavioral Experiments (CEBEX), Prague, Czechia
- Institute for Behavioral and Economic Studies (INBES), Prague, Czechia
| | - Marek Vranka
- Faculty of Social Sciences, Charles University, Prague, Czechia
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654
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How Schools Affected the COVID-19 Pandemic in Italy: Data Analysis for Lombardy Region, Campania Region, and Emilia Region. FUTURE INTERNET 2021. [DOI: 10.3390/fi13050109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Coronavirus Disease 2019 (COVID-19) is the main discussed topic worldwide in 2020 and at the beginning of the Italian epidemic, scientists tried to understand the virus diffusion and the epidemic curve of positive cases with controversial findings and numbers. Objectives: In this paper, a data analytics study on the diffusion of COVID-19 in Lombardy Region and Campania Region is developed in order to identify the driver that sparked the second wave in Italy. Methods: Starting from all the available official data collected about the diffusion of COVID-19, we analyzed Google mobility data, school data and infection data for two big regions in Italy: Lombardy Region and Campania Region, which adopted two different approaches in opening and closing schools. To reinforce our findings, we also extended the analysis to the Emilia Romagna Region. Results: The paper shows how different policies adopted in school opening/closing may have had an impact on the COVID-19 spread, while other factors related to citizen mobility did not affect the second Italian wave. Conclusions: The paper shows that a clear correlation exists between the school contagion and the subsequent temporal overall contagion in a geographical area. Moreover, it is clear that highly populated provinces have the greatest spread of the virus.
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655
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Brown KA, Soucy JPR, Buchan SA, Sturrock SL, Berry I, Stall NM, Jüni P, Ghasemi A, Gibb N, MacFadden DR, Daneman N. The mobility gap: estimating mobility thresholds required to control SARS-CoV-2 in Canada. CMAJ 2021; 193:E592-E600. [PMID: 33827852 PMCID: PMC8101979 DOI: 10.1503/cmaj.210132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Nonpharmaceutical interventions remain the primary means of controlling severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) until vaccination coverage is sufficient to achieve herd immunity. We used anonymized smartphone mobility measures to quantify the mobility level needed to control SARS-CoV-2 (i.e., mobility threshold), and the difference relative to the observed mobility level (i.e., mobility gap). METHODS We conducted a time-series study of the weekly incidence of SARS-CoV-2 in Canada from Mar. 15, 2020, to Mar. 6, 2021. The outcome was weekly growth rate, defined as the ratio of cases in a given week versus the previous week. We evaluated the effects of average time spent outside the home in the previous 3 weeks using a log-normal regression model, accounting for province, week and mean temperature. We calculated the SARS-CoV-2 mobility threshold and gap. RESULTS Across the 51-week study period, a total of 888 751 people were infected with SARS-CoV-2. Each 10% increase in the mobility gap was associated with a 25% increase in the SARS-CoV-2 weekly case growth rate (ratio 1.25, 95% confidence interval 1.20-1.29). Compared to the prepandemic baseline mobility of 100%, the mobility threshold was highest in the summer (69%; interquartile range [IQR] 67%-70%), and dropped to 54% in winter 2021 (IQR 52%-55%); a mobility gap was present in Canada from July 2020 until the last week of December 2020. INTERPRETATION Mobility strongly and consistently predicts weekly case growth, and low levels of mobility are needed to control SARS-CoV-2 through spring 2021. Mobility measures from anonymized smartphone data can be used to guide provincial and regional loosening and tightening of physical distancing measures.
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Affiliation(s)
- Kevin A Brown
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont.
| | - Jean-Paul R Soucy
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Sarah A Buchan
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Shelby L Sturrock
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Isha Berry
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Nathan M Stall
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Peter Jüni
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Amir Ghasemi
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Nicholas Gibb
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Derek R MacFadden
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont
| | - Nick Daneman
- Public Health Ontario (Brown, Buchan, Daneman); Dalla Lana School of Public Health (Brown, Soucy, Buchan, Sturrock, Berry), and The Institute for Health Policy, Management, and Evaluation (Stall, Jüni, Daneman), University of Toronto; Applied Health Research Centre, St. Michael's Hospital (Jüni); Sinai Health System and the University Health Network (Stall); Women's College Hospital (Stall); Department of Medicine (Stall, Daneman), University of Toronto, Toronto, Ont.; Communications Research Centre Canada (Ghasemi); Public Health Agency of Canada (Gibb); Ottawa Hospital Research Institute (MacFadden), Ottawa, Ont.; Division of Infectious Diseases (Daneman), Sunnybrook Research Institute, Toronto, Ont.
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656
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Gozzi N, Tizzoni M, Chinazzi M, Ferres L, Vespignani A, Perra N. Estimating the effect of social inequalities on the mitigation of COVID-19 across communities in Santiago de Chile. Nat Commun 2021; 12:2429. [PMID: 33893279 PMCID: PMC8065143 DOI: 10.1038/s41467-021-22601-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/18/2021] [Indexed: 12/11/2022] Open
Abstract
We study the spatio-temporal spread of SARS-CoV-2 in Santiago de Chile using anonymized mobile phone data from 1.4 million users, 22% of the whole population in the area, characterizing the effects of non-pharmaceutical interventions (NPIs) on the epidemic dynamics. We integrate these data into a mechanistic epidemic model calibrated on surveillance data. As of August 1, 2020, we estimate a detection rate of 102 cases per 1000 infections (90% CI: [95-112 per 1000]). We show that the introduction of a full lockdown on May 15, 2020, while causing a modest additional decrease in mobility and contacts with respect to previous NPIs, was decisive in bringing the epidemic under control, highlighting the importance of a timely governmental response to COVID-19 outbreaks. We find that the impact of NPIs on individuals' mobility correlates with the Human Development Index of comunas in the city. Indeed, more developed and wealthier areas became more isolated after government interventions and experienced a significantly lower burden of the pandemic. The heterogeneity of COVID-19 impact raises important issues in the implementation of NPIs and highlights the challenges that communities affected by systemic health and social inequalities face adapting their behaviors during an epidemic.
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Affiliation(s)
- Nicolò Gozzi
- Networks and Urban Systems Centre, University of Greenwich, London, UK
| | | | - Matteo Chinazzi
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, USA
| | - Leo Ferres
- Data Science Institute, Universidad del Desarrollo, Santiago, Chile
- Telefónica R&D, Santiago, Chile
| | - Alessandro Vespignani
- ISI Foundation, Turin, Italy
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, USA
| | - Nicola Perra
- Networks and Urban Systems Centre, University of Greenwich, London, UK.
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, USA.
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657
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Payedimarri AB, Concina D, Portinale L, Canonico M, Seys D, Vanhaecht K, Panella M. Prediction Models for Public Health Containment Measures on COVID-19 Using Artificial Intelligence and Machine Learning: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4499. [PMID: 33922693 PMCID: PMC8123005 DOI: 10.3390/ijerph18094499] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 12/02/2022]
Abstract
Artificial Intelligence (AI) and Machine Learning (ML) have expanded their utilization in different fields of medicine. During the SARS-CoV-2 outbreak, AI and ML were also applied for the evaluation and/or implementation of public health interventions aimed to flatten the epidemiological curve. This systematic review aims to evaluate the effectiveness of the use of AI and ML when applied to public health interventions to contain the spread of SARS-CoV-2. Our findings showed that quarantine should be the best strategy for containing COVID-19. Nationwide lockdown also showed positive impact, whereas social distancing should be considered to be effective only in combination with other interventions including the closure of schools and commercial activities and the limitation of public transportation. Our findings also showed that all the interventions should be initiated early in the pandemic and continued for a sustained period. Despite the study limitation, we concluded that AI and ML could be of help for policy makers to define the strategies for containing the COVID-19 pandemic.
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Affiliation(s)
- Anil Babu Payedimarri
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, 28100 Novara, Italy; (D.C.); (M.P.)
| | - Diego Concina
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, 28100 Novara, Italy; (D.C.); (M.P.)
| | - Luigi Portinale
- Department of Science and Technological Innovation (DISIT) Università del Piemonte Orientale, 15121 Alessandria, Italy; (L.P.); (M.C.)
| | - Massimo Canonico
- Department of Science and Technological Innovation (DISIT) Università del Piemonte Orientale, 15121 Alessandria, Italy; (L.P.); (M.C.)
| | - Deborah Seys
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (D.S.); (K.V.)
| | - Kris Vanhaecht
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (D.S.); (K.V.)
- Department of Quality Management, University Hospitals Leuven, University of Leuven, 3000 Leuven, Belgium
| | - Massimiliano Panella
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, 28100 Novara, Italy; (D.C.); (M.P.)
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658
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Petersen JA, Naish C, Ghoneim D, Cabaj JL, Doyle-Baker PK, McCormack GR. Impact of the COVID-19 Pandemic on Physical Activity and Sedentary Behaviour: A Qualitative Study in a Canadian City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4441. [PMID: 33922094 PMCID: PMC8122654 DOI: 10.3390/ijerph18094441] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 12/19/2022]
Abstract
Public health measures introduced to combat the COVID-19 pandemic have impacted the physical activity, health, and well-being of millions of people. This grounded theory study explored how the COVID-19 pandemic has affected physical activity and perceptions of health among adults in a Canadian city (Calgary). Twelve adults (50% females; 20-70 years) were interviewed between June and October (2020) via telephone or videoconferencing. Using a maximum variation strategy, participants with a range of sociodemographic characteristics, physical activity levels, and perceptions of seriousness and anxiety related to COVID-19 were selected. Semi-structured interviews captured participant perceptions of how their physical activity and perceptions of health changed during the pandemic. Using thematic analysis, four themes were identified: (1) Disruption to Daily Routines, (2) Changes in Physical Activity, (3) Balancing Health, and (4) Family Life. Participants experienced different degrees of disruption in their daily routines and physical activity based on their individual circumstances (e.g., pre-pandemic physical activity, family life, and access to resources). Although participants faced challenges in modifying their daily routines and physical activity, many adapted. Some participants reported enhanced feelings of well-being. Public health strategies that encourage physical activity and promote health should be supported as they are needed during pandemics, such as COVID-19.
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Affiliation(s)
- Jennie A. Petersen
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Calli Naish
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
- Department of Communication, Media and Film, Faculty of Arts, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Dalia Ghoneim
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
| | - Jason L. Cabaj
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
- Provincial Population & Public Health, Alberta Health Services, 10301 Southport Lane SW, Calgary, AB T2W 1S7, Canada
| | - Patricia K. Doyle-Baker
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
- School of Planning, Architecture, and Landscape, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Gavin R. McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
- School of Planning, Architecture, and Landscape, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
- Faculty of Sport Sciences, Waseda University, 1-104 Totsukamachi, Shinjuku-ku, Tokyo 169-8050, Japan
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659
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Tang JW, Kwok KO, Loh TP, Lee CK, Heraud JM, Dancer SJ. Can we do better? A guide to pandemics - some Dos and Don'ts for the next one. J Infect 2021; 83:119-145. [PMID: 33894274 PMCID: PMC8061089 DOI: 10.1016/j.jinf.2021.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Julian W Tang
- Respiratory Sciences, University of Leicester, Leicester, UK; Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Shenzhen Research Institute of The Chinese University of Hong Kong, Shenzhen, China
| | - Tze Ping Loh
- Laboratory Medicine, National University Hospital, Singapore
| | - Chun Kiat Lee
- Laboratory Medicine, National University Hospital, Singapore
| | | | - Stephanie J Dancer
- Department of Microbiology, NHS Lanarkshire, and Edinburgh Napier University, UK
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660
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Laydon DJ, Mishra S, Hinsley WR, Samartsidis P, Flaxman S, Gandy A, Ferguson NM, Bhatt S. Modelling the impact of the tier system on SARS-CoV-2 transmission in the UK between the first and second national lockdowns. BMJ Open 2021; 11:e050346. [PMID: 33888533 PMCID: PMC8068949 DOI: 10.1136/bmjopen-2021-050346] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To measure the effects of the tier system on the COVID-19 pandemic in the UK between the first and second national lockdowns, before the emergence of the B.1.1.7 variant of concern. DESIGN This is a modelling study combining estimates of real-time reproduction number Rt (derived from UK case, death and serological survey data) with publicly available data on regional non-pharmaceutical interventions. We fit a Bayesian hierarchical model with latent factors using these quantities to account for broader national trends in addition to subnational effects from tiers. SETTING The UK at lower tier local authority (LTLA) level. 310 LTLAs were included in the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES Reduction in real-time reproduction number Rt . RESULTS Nationally, transmission increased between July and late September, regional differences notwithstanding. Immediately prior to the introduction of the tier system, Rt averaged 1.3 (0.9-1.6) across LTLAs, but declined to an average of 1.1 (0.86-1.42) 2 weeks later. Decline in transmission was not solely attributable to tiers. Tier 1 had negligible effects. Tiers 2 and 3, respectively, reduced transmission by 6% (5%-7%) and 23% (21%-25%). 288 LTLAs (93%) would have begun to suppress their epidemics if every LTLA had gone into tier 3 by the second national lockdown, whereas only 90 (29%) did so in reality. CONCLUSIONS The relatively small effect sizes found in this analysis demonstrate that interventions at least as stringent as tier 3 are required to suppress transmission, especially considering more transmissible variants, at least until effective vaccination is widespread or much greater population immunity has amassed.
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Affiliation(s)
- Daniel J Laydon
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
| | - Swapnil Mishra
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
| | - Wes R Hinsley
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
| | - Pantelis Samartsidis
- MRC Biostatistics Unit, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Seth Flaxman
- Department of Mathematics and Data Science Institute, Imperial College London, London, UK
| | - Axel Gandy
- Department of Mathematics, Imperial College London, London, UK
| | - Neil M Ferguson
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
| | - Samir Bhatt
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
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661
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Stuart RM, Abeysuriya RG, Kerr CC, Mistry D, Klein DJ, Gray RT, Hellard M, Scott N. Role of masks, testing and contact tracing in preventing COVID-19 resurgences: a case study from New South Wales, Australia. BMJ Open 2021; 11:e045941. [PMID: 33879491 PMCID: PMC8061569 DOI: 10.1136/bmjopen-2020-045941] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The early stages of the COVID-19 pandemic illustrated that SARS-CoV-2, the virus that causes the disease, has the potential to spread exponentially. Therefore, as long as a substantial proportion of the population remains susceptible to infection, the potential for new epidemic waves persists even in settings with low numbers of active COVID-19 infections, unless sufficient countermeasures are in place. We aim to quantify vulnerability to resurgences in COVID-19 transmission under variations in the levels of testing, tracing and mask usage. SETTING The Australian state of New South Wales (NSW), a setting with prolonged low transmission, high mobility, non-universal mask usage and a well-functioning test-and-trace system. PARTICIPANTS None (simulation study). RESULTS We find that the relative impact of masks is greatest when testing and tracing rates are lower and vice versa. Scenarios with very high testing rates (90% of people with symptoms, plus 90% of people with a known history of contact with a confirmed case) were estimated to lead to a robustly controlled epidemic. However, across comparable levels of mask uptake and contact tracing, the number of infections over this period was projected to be 2-3 times higher if the testing rate was 80% instead of 90%, 8-12 times higher if the testing rate was 65% or 30-50 times higher with a 50% testing rate. In reality, NSW diagnosed 254 locally acquired cases over this period, an outcome that had a moderate probability in the model (10%-18%) assuming low mask uptake (0%-25%), even in the presence of extremely high testing (90%) and near-perfect community contact tracing (75%-100%), and a considerably higher probability if testing or tracing were at lower levels. CONCLUSIONS Our work suggests that testing, tracing and masks can all be effective means of controlling transmission. A multifaceted strategy that combines all three, alongside continued hygiene and distancing protocols, is likely to be the most robust means of controlling transmission of SARS-CoV-2.
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Affiliation(s)
- Robyn M Stuart
- Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark
- Burnet Institute, Melbourne, Victoria, Australia
| | | | - Cliff C Kerr
- Global Health Division, Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, Washington, USA
- School of Physics, University of Sydney, Sydney, New South Wales, Australia
| | - Dina Mistry
- Global Health Division, Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Dan J Klein
- Global Health Division, Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Richard T Gray
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Margaret Hellard
- Burnet Institute, Melbourne, Victoria, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nick Scott
- Burnet Institute, Melbourne, Victoria, Australia
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662
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Affiliation(s)
- Julian W Tang
- Respiratory Sciences, University of Leicester, Leicester, UK
| | - Linsey C Marr
- Civil and Environmental Engineering, Virginia Tech, USA
| | - Yuguo Li
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China
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663
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Bosslet GT, Pollak M, Jang JH, Roll R, Sperling M, Khan B. The effect of in-person primary and secondary school instruction on county-level SARS-CoV-2 spread in Indiana. Clin Infect Dis 2021; 74:17-23. [PMID: 33846706 PMCID: PMC8083360 DOI: 10.1093/cid/ciab306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To determine the county-level effect of in-person primary and secondary school reopening on daily cases of SARS-CoV-2 in Indiana. Methods This is a county-level population-based study using a panel data regression analysis of the proportion of in-person learning to evaluate an association with community-wide daily new SARS-CoV-2 cases. The study period was July 12-October 6, 2020. We included 73 out of 92 (79.3%) Indiana counties in the analysis, accounting for 85.7% of school corporations and 90.6% of student enrollment statewide. The primary exposure was the proportion of students returning to in-person instruction. The primary outcome was the daily new SARS-CoV-2 cases per 100,000 residents at the county level. Results There is a statistically significant relationship between the proportion of students attending K-12 schools in-person and the county level daily cases of SARS-CoV-2 28 days later. For all ages, the coefficient of interest (β) is estimated at 3.36 (95% CI: 1.91—4.81; p < 0.001). This coefficient represents the effect of a change the proportion of students attending in-person on new daily cases 28 days later. For example, a 10 percentage point increase in K-12 students attending school in-person is associated with a daily increase in SARS-CoV-2 cases in the county equal to 0.336 cases/100,000 residents of all ages. Conclusion In-person primary and secondary school is associated with a statistically significant but proportionally small increase in the spread of SARS-CoV-2 cases.
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Affiliation(s)
- Gabriel T Bosslet
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Micah Pollak
- School of Business and Economics, Indiana University Northwest, Gary, IN, United States
| | - Jeong Hoon Jang
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Rebekah Roll
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Mark Sperling
- School of Education, Indiana University Northwest, Gary, IN, United States
| | - Babar Khan
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.,Regenstrief Institute, Indianapolis, IN, United States
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664
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Migraine during COVID-19: Data from Second Wave Pandemic in an Italian Cohort. Brain Sci 2021; 11:brainsci11040482. [PMID: 33920175 PMCID: PMC8070557 DOI: 10.3390/brainsci11040482] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives: The study aims to assess the impact of the second COVID-19 pandemic wave on migraine characteristics. Methods: This is an observational cross-sectional study conducted on migraine patients previously interviewed during the first Italian pandemic outbreak. A second structured telephone interview was conducted between 20 November 2020 and 18 January 2021. We compared migraine characteristics among T0 (before pandemic), T1 (during the first pandemic phase), and T2 (during the second pandemic phase). Results: Among the 433 patients interviewed during the first pandemic phase, 304 cases were finally considered. One hundred forty-eight patients had a control visit between March 2020 and December 2020, 120 had an in-person visit, 14 by phone, the remainder used telemedicine software provided by the hospital. Frequency of headache, number of symptomatic drugs and headache intensity worsened during T2, compared to T0 and T1, especially in episodic migraine. Headache intensity increased relating to the negative emotional impact of the pandemic. Migraine management during the pandemic did not influence the clinical outcome. Conclusion: The prolongation of the pandemic seems to have a negative impact on migraine evolution. The arousal and negative psychological behavior toward the COVID-19 outbreak seem to worsen migraine.
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665
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Morris AM, Mintz JM. Une stratégie « sans autres vagues » pour la gestion de la COVID-19 au Canada. CMAJ 2021; 193:E502-E504. [PMID: 33824153 PMCID: PMC8049635 DOI: 10.1503/cmaj.202685-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Andrew M Morris
- Département de médecine (Morris), Système de santé Sinai, Réseau universitaire de santé, Université de Toronto, Ont.; École de politique publique (Mintz), Université de Calgary, Alb.
| | - Jack M Mintz
- Département de médecine (Morris), Système de santé Sinai, Réseau universitaire de santé, Université de Toronto, Ont.; École de politique publique (Mintz), Université de Calgary, Alb
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666
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Georgieva I, Lantta T, Lickiewicz J, Pekara J, Wikman S, Loseviča M, Raveesh BN, Mihai A, Lepping P. Perceived Effectiveness, Restrictiveness, and Compliance with Containment Measures against the Covid-19 Pandemic: An International Comparative Study in 11 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3806. [PMID: 33917334 PMCID: PMC8038651 DOI: 10.3390/ijerph18073806] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/29/2021] [Accepted: 04/03/2021] [Indexed: 01/02/2023]
Abstract
National governments took action to delay the transmission of the coronavirus (SARS-CoV-2) by implementing different containment measures. We developed an online survey that included 44 different containment measures. We aimed to assess how effective citizens perceive these measures, which measures are perceived as violation of citizens' personal freedoms, which opinions and demographic factors have an effect on compliance with the measures, and what governments can do to most effectively improve citizens' compliance. The survey was disseminated in 11 countries: UK, Belgium, Netherlands, Bulgaria, Czech Republic, Finland, India, Latvia, Poland, Romania, and Sweden. We acquired 9543 unique responses. Our findings show significant differences across countries in perceived effectiveness, restrictiveness, and compliance. Governments that suffer low levels of trust should put more effort into persuading citizens, especially men, in the effectiveness of the proposed measures. They should provide financial compensation to citizens who have lost their job or income due to the containment measures to improve measure compliance. Policymakers should implement the least restrictive and most effective public health measures first during pandemic emergencies instead of implementing a combination of many restrictive measures, which has the opposite effect on citizens' adherence and undermines human rights.
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Affiliation(s)
- Irina Georgieva
- Department of Cognitive Science and Psychology, New Bulgarian University, 1618 Sofia, Bulgaria
| | - Tella Lantta
- Department of Nursing Science, University of Turku, 20500 Turku, Finland;
| | - Jakub Lickiewicz
- Faculty of Health Sciences, Jagiellonian University Medical College Krakow, 31-008 Kraków, Poland;
| | - Jaroslav Pekara
- Paramedic Department, Medical College in Prague, 121 08 Prague, Czech Republic;
| | - Sofia Wikman
- Department of Criminology, University of Gavle, 80176 Gävle, Sweden;
| | - Marina Loseviča
- Faculty of Medicine, Medical College, Latvian University in Riga, LV-1079 Riga, Latvia;
| | | | - Adriana Mihai
- Clinical Department of Medicine GE Palade University of Medicine, Pharmacy Science and Technology, 540142 Târgu Mureș, Romania;
| | - Peter Lepping
- Centre for Mental Health and Society, Bangor University, Bangor LL57 2DG, UK;
- Mysore Medical College and Research Institute, Karnataka 570001, India
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667
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Bushman M, Worby C, Chang HH, Kraemer MUG, Hanage WP. Transmission of SARS-CoV-2 before and after symptom onset: impact of nonpharmaceutical interventions in China. Eur J Epidemiol 2021; 36:429-439. [PMID: 33881667 PMCID: PMC8058147 DOI: 10.1007/s10654-021-00746-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/27/2021] [Indexed: 02/08/2023]
Abstract
Nonpharmaceutical interventions, such as contact tracing and quarantine, have been the primary means of controlling the spread of SARS-CoV-2; however, it remains uncertain which interventions are most effective at reducing transmission at the population level. Using serial interval data from before and after the rollout of nonpharmaceutical interventions in China, we estimate that the relative frequency of presymptomatic transmission increased from 34% before the rollout to 71% afterward. The shift toward earlier transmission indicates a disproportionate reduction in transmission post-symptom onset. We estimate that, following the rollout of nonpharmaceutical interventions, transmission post-symptom onset was reduced by 82% whereas presymptomatic transmission decreased by only 16%. The observation that only one-third of transmission was presymptomatic at baseline, combined with the finding that NPIs reduced presymptomatic transmission by less than 20%, suggests that the overall impact of NPIs was driven in large part by reductions in transmission following symptom onset. This implies that interventions which limit opportunities for transmission in the later stages of infection, such as contact tracing and isolation, are particularly important for control of SARS-CoV-2. Interventions which specifically reduce opportunities for presymptomatic transmission, such as quarantine of asymptomatic contacts, are likely to have smaller, but non-negligible, effects on overall transmission.
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Affiliation(s)
- Mary Bushman
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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668
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Saxena A, Bouvier PA, Shamsi-Gooshki E, Köhler J, Schwartz LJ. WHO guidance on ethics in outbreaks and the COVID-19 pandemic: a critical appraisal. JOURNAL OF MEDICAL ETHICS 2021; 47:medethics-2020-106959. [PMID: 33789948 PMCID: PMC8025252 DOI: 10.1136/medethics-2020-106959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
In 2016, following pandemic influenza threats and the 2014-2016 Ebola virus disease outbreaks, the WHO developed a guidance document for managing ethical issues in infectious disease outbreaks. In this article, we analyse some ethical issues that have had a predominant role in decision making in response to the current COVID-19 pandemic but were absent or not addressed in the same ways in the 2016 guidance document. A pandemic results in a health crisis and social and political crises both nationally and globally. The ethical implications of these global effects should be properly identified so that appropriate actions can be taken globally and not just in national isolation. Our analysis, which is a starting point to test the broader relevance of the 2016 WHO document that remains the only available guidance document applicable globally, concludes that the WHO guidance should be updated to provide reasoned and thoughtful comprehensive ethics advice for the sound management of the current and future pandemics.
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Affiliation(s)
- Abha Saxena
- Institute Éthique Histoire Humanités, University of Geneva, Geneva, Switzerland
- Independent Bioethics Consultant, Geneva, Switzerland
| | - Paul André Bouvier
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Department of Social Sciences, University of Fribourg, Fribourg, Switzerland
| | - Ehsan Shamsi-Gooshki
- Department of Medical Ethics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Johannes Köhler
- Department of Anesthesiology and Critical Care Medicine, Kantonsspital Münsterlingen, Munsterlingen, Thurgau, Switzerland
| | - Lisa J Schwartz
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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669
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Cruyt E, De Vriendt P, De Letter M, Vlerick P, Calders P, De Pauw R, Oostra K, Rodriguez-Bailón M, Szmalec A, Merchán-Baeza JA, Fernández-Solano AJ, Vidaña-Moya L, Van de Velde D. Meaningful activities during COVID-19 lockdown and association with mental health in Belgian adults. BMC Public Health 2021; 21:622. [PMID: 33785029 PMCID: PMC8009071 DOI: 10.1186/s12889-021-10673-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/22/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The spread of COVID-19 has affected people's daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people's mental health. AIM To identify correlates of adults' mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular. METHODS A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates. RESULTS Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = -.33). Loss of meaningful activities was strongly related to mental health (β = -.36) and explained 9% incremental variance (R2 change = .092, p < .001) above control variables. CONCLUSIONS The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults' mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.
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Affiliation(s)
- Ellen Cruyt
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | - Patricia De Vriendt
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
- Department of Occupational Therapy, Artevelde University College, Ghent, Belgium
- Mental Health Research group, Frailty in Ageing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Miet De Letter
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | - Peter Vlerick
- Faculty of Psychology and Educational Sciences, Department of Work, Organization and Society, Ghent University, Ghent, Belgium
| | - Patrick Calders
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | - Robby De Pauw
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | - Kristine Oostra
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | | | - Arnaud Szmalec
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Jose Antonio Merchán-Baeza
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain
| | - Ana Judit Fernández-Solano
- Department of Occupational Therapy. School of Health Sciences, Catholic University of Murcia, Murcia, Spain
| | - Laura Vidaña-Moya
- Research Group GrEUIT, Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, Terrassa, Spain
| | - Dominique Van de Velde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium.
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670
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Josephson A, Kilic T, Michler JD. Socioeconomic impacts of COVID-19 in low-income countries. Nat Hum Behav 2021; 5:557-565. [PMID: 33785897 DOI: 10.1038/s41562-021-01096-7] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 03/05/2021] [Indexed: 12/21/2022]
Abstract
The emergence of SARS-CoV-2 and attempts to limit its spread have resulted in a contraction of the global economy. Here we document the socioeconomic impacts of the pandemic among households, adults and children in low-income countries. To do so, we rely on longitudinal household survey data from Ethiopia, Malawi, Nigeria and Uganda, originating from pre-COVID-19 face-to-face household surveys plus phone surveys implemented during the pandemic. We estimate that 256 million individuals-77% of the population-live in households that have lost income during the pandemic. Attempts to cope with this loss are exacerbated by food insecurity and an inability to access medicine and staple foods. Finally, we find that student-teacher contact has dropped from a pre-COVID-19 rate of 96% to just 17% among households with school-aged children. These findings can inform decisions by governments and international organizations on measures to mitigate the effects of the COVID-19 pandemic.
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Affiliation(s)
- Anna Josephson
- Department of Agricultural Economics, University of Arizona, Tucson AZ, USA
| | - Talip Kilic
- Development Data Group, World Bank, Washington, DC, USA
| | - Jeffrey D Michler
- Department of Agricultural Economics, University of Arizona, Tucson AZ, USA.
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671
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School opening during the SARS-CoV-2 pandemic: Public acceptance of wearing fabric masks in class. PUBLIC HEALTH IN PRACTICE 2021; 2:100115. [PMID: 33817681 PMCID: PMC8007211 DOI: 10.1016/j.puhip.2021.100115] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/23/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives Policy decisions regarding mask wearing in schools in times of the SARS-CoV-2 pandemic will likely be made despite a lack of scientific data. Public acceptance is therefore an important indicator to inform the communication activities that accompany the introduction of a new policy. The goal was to assess acceptance and relevant target groups for communication activities. Study design Cross-sectional online survey embedded in the regular German COVID-19 monitoring. Methods Besides sociodemographic information, trust in institutions, knowledge about COVID-19 and protective behaviors, as well as risk perceptions, we assessed public acceptance of school-related mask policies of parents and non-parents (total N = 957). Results In the absence of mandatory mask policies in schools in Germany in August 2020, the general agreement with mask wearing in school was low. Those living in bigger cities or communities – where class sizes are usually larger – agreed more with mask wearing in class; those who felt a greater risk, had greater trust in institutions, or felt higher self-efficacy in fighting the outbreak also wanted children to wear a mask in class. Women were more likely than men to disagree with mask wearing in class. Agreement was highest that policies should uniformly apply for all institutions within a state/province and should not be regulated at the school level or federal/country level. Conclusions Implementing mask policies in school will require intense communication. Acceptance of these policies from teachers and pupils should be considered as well. Women seem to be an important target group as they supported mask wearing in class less than men. Women’s roles in controlling infectious diseases in school should therefore receive special attention and support. Parents rather want teachers than children to wear masks. Those living in bigger cities or communities agreed more with masks in class. Women were more likely than men to disagree with mask wearing in class.
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Gurdasani D, Alwan NA, Greenhalgh T, Hyde Z, Johnson L, McKee M, Michie S, Prather KA, Rasmussen SD, Reicher S, Roderick P, Ziauddeen H. School reopening without robust COVID-19 mitigation risks accelerating the pandemic. Lancet 2021; 397:1177-1178. [PMID: 33713595 PMCID: PMC9755467 DOI: 10.1016/s0140-6736(21)00622-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Deepti Gurdasani
- William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK.
| | - Nisreen A Alwan
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK.
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Zoë Hyde
- University of Western Australia, Perth, WA, Australia
| | - Luke Johnson
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Sarah D Rasmussen
- Department of Mathematics, University of Cambridge, Cambridge, UK; Institute for Advanced Study, Princeton University, Princeton, NJ, USA
| | | | - Paul Roderick
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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673
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Davis JT, Chinazzi M, Perra N, Mu K, Piontti APY, Ajelli M, Dean NE, Gioannini C, Litvinova M, Merler S, Rossi L, Sun K, Xiong X, Halloran ME, Longini IM, Viboud C, Vespignani A. Cryptic transmission of SARS-CoV-2 and the first COVID-19 wave in Europe and the United States. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.24.21254199. [PMID: 33791745 PMCID: PMC8010777 DOI: 10.1101/2021.03.24.21254199] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Given the narrowness of the initial testing criteria, the SARS-CoV-2 virus spread through cryptic transmission in January and February, setting the stage for the epidemic wave experienced in March and April, 2020. We use a global metapopulation epidemic model to provide a mechanistic understanding of the global dynamic underlying the establishment of the COVID-19 pandemic in Europe and the United States (US). The model is calibrated on international case introductions at the early stage of the pandemic. We find that widespread community transmission of SARS-CoV-2 was likely in several areas of Europe and the US by January 2020, and estimate that by early March, only 1 - 3 in 100 SARS-CoV-2 infections were detected by surveillance systems. Modeling results indicate international travel as the key driver of the introduction of SARS-CoV-2 with possible importation and transmission events as early as December, 2019. We characterize the resulting heterogeneous spatio-temporal spread of SARS-CoV-2 and the burden of the first COVID-19 wave (February-July 2020). We estimate infection attack rates ranging from 0.78%-15.2% in the US and 0.19%-13.2% in Europe. The spatial modeling of SARS-CoV-2 introductions and spreading provides insights into the design of innovative, model-driven surveillance systems and preparedness plans that have a broader initial capacity and indication for testing.
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Affiliation(s)
- Jessica T. Davis
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA USA
| | - Matteo Chinazzi
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA USA
| | - Nicola Perra
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA USA
- Networks and Urban Systems Centre, University of Greenwich, London, UK
| | - Kunpeng Mu
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA USA
| | - Ana Pastore y Piontti
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA USA
| | - Marco Ajelli
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA USA
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health,, Bloomington, IN, USA
| | - Natalie E. Dean
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, USA
| | | | - Maria Litvinova
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health,, Bloomington, IN, USA
| | | | | | - Kaiyuan Sun
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Xinyue Xiong
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA USA
| | - M. Elizabeth Halloran
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA. USA
| | - Ira M. Longini
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, USA
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Alessandro Vespignani
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA USA
- ISI Foundation, Turin, Italy
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674
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Varella MAC, Luoto S, Soares RBDS, Valentova JV. COVID-19 Pandemic on Fire: Evolved Propensities for Nocturnal Activities as a Liability Against Epidemiological Control. Front Psychol 2021; 12:646711. [PMID: 33828510 PMCID: PMC8019933 DOI: 10.3389/fpsyg.2021.646711] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/19/2021] [Indexed: 12/19/2022] Open
Abstract
Humans have been using fire for hundreds of millennia, creating an ancestral expansion toward the nocturnal niche. The new adaptive challenges faced at night were recurrent enough to amplify existing psychological variation in our species. Night-time is dangerous and mysterious, so it selects for individuals with higher tendencies for paranoia, risk-taking, and sociability (because of security in numbers). During night-time, individuals are generally tired and show decreased self-control and increased impulsive behaviors. The lower visibility during night-time favors the partial concealment of identity and opens more opportunities for disinhibition of self-interested behaviors. Indeed, individuals with an evening-oriented chronotype are more paranoid, risk-taking, extraverted, impulsive, promiscuous, and have higher antisocial personality traits. However, under some circumstances, such as respiratory pandemics, the psychobehavioral traits favored by the nocturnal niche might be counter-productive, increasing contagion rates of a disease that can evade the behavioral immune system because its disease cues are often nonexistent or mild. The eveningness epidemiological liability hypothesis presented here suggests that during the COVID-19 pandemic, the evening-oriented psychobehavioral profile can have collectively harmful consequences: there is a clash of core tendencies between the nocturnal chronotype and the recent viral transmission-mitigating safety guidelines and rules. The pandemic safety protocols disrupt much normal social activity, particularly at night when making new social contacts is desired. The SARS-CoV-2 virus is contagious even in presymptomatic and asymptomatic individuals, which enables it to mostly evade our evolved contagious disease avoidance mechanisms. A growing body of research has indirectly shown that individual traits interfering with social distancing and anti-contagion measures are related to those of the nocturnal chronotype. Indeed, some of the social contexts that have been identified as superspreading events occur at night, such as in restaurants, bars, and nightclubs. Furthermore, nocturnal environmental conditions favor the survival of the SARS-CoV-2 virus much longer than daytime conditions. We compare the eveningness epidemiological liability hypothesis with other factors related to non-compliance with pandemic safety protocols, namely sex, age, and life history. Although there is not yet a direct link between the nocturnal chronotype and non-compliance with pandemic safety protocols, security measures and future empirical research should take this crucial evolutionary mismatch and adaptive metaproblem into account, and focus on how to avoid nocturnal individuals becoming superspreaders, offering secure alternatives for nocturnal social activities.
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Affiliation(s)
| | - Severi Luoto
- English, Drama and Writing Studies, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Rafael Bento da Silva Soares
- Center for Science Communication and Education Studies, Department of Genetics, Evolution, Microbiology, and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil
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675
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Oliver D. David Oliver: The IEA has used covid-19 as another opportunity to brief against the NHS. BMJ 2021; 372:n697. [PMID: 33731443 DOI: 10.1136/bmj.n697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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676
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Ulyte A, Radtke T, Abela IA, Haile SR, Berger C, Huber M, Schanz M, Schwarzmueller M, Trkola A, Fehr J, Puhan MA, Kriemler S. Clustering and longitudinal change in SARS-CoV-2 seroprevalence in school children in the canton of Zurich, Switzerland: prospective cohort study of 55 schools. BMJ 2021; 372:n616. [PMID: 33731327 PMCID: PMC7966948 DOI: 10.1136/bmj.n616] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To examine longitudinal changes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and to determine the clustering of children who were seropositive within school classes in the canton of Zurich, Switzerland from June to November 2020. DESIGN Prospective cohort study. SETTING Switzerland had one of the highest second waves of the SARS-CoV-2 pandemic in Europe in autumn 2020. Keeping schools open provided a moderate to high exposure environment to study SARS-CoV-2 infections. Children from randomly selected schools and classes, stratified by district, were invited for serological testing of SARS-CoV-2. Parents completed questionnaires on sociodemographic and health related questions. PARTICIPANTS 275 classes in 55 schools; 2603 children participated in June-July 2020 and 2552 in October-November 2020 (age range 6-16 years). MAIN OUTCOME MEASURES Serology of SARS-CoV-2 in June-July and October-November 2020, clustering of children who were seropositive within classes, and symptoms in children. RESULTS In June-July, 74 of 2496 children with serological results were seropositive; in October-November, the number had increased to 173 of 2503. Overall SARS-CoV-2 seroprevalence was 2.4% (95% credible interval 1.4% to 3.6%) in the summer and 4.5% (3.2% to 6.0%) in late autumn in children who were not previously seropositive, leading to an estimated 7.8% (6.2% to 9.5%) of children who were ever seropositive. Seroprevalence varied across districts (in the autumn, 1.7-15.0%). No significant differences were found among lower, middle, and upper school levels (children aged 6-9 years, 9-13 years, and 12-16 years, respectively). Among the 2223 children who had serology tests at both testing rounds, 28/70 (40%) who were previously seropositive became seronegative, and 109/2153 (5%) who were previously seronegative became seropositive. Symptoms were reported for 22% of children who were seronegative and 29% of children who were newly seropositive since the summer. Between July and November 2020, the ratio of children diagnosed with SARS-CoV-2 infection to those who were seropositive was 1 to 8. At least one child who was newly seropositive was detected in 47 of 55 schools and in 90 of 275 classes. Among 130 classes with a high participation rate, no children who were seropositive were found in 73 (56%) classes, one or two children were seropositive in 50 (38%) classes, and at least three children were seropositive in 7 (5%) classes. Class level explained 24% and school level 8% of variance in seropositivity in the multilevel logistic regression models. CONCLUSIONS With schools open since August 2020 and some preventive measures in place, clustering of children who were seropositive occurred in only a few classes despite an increase in overall seroprevalence during a period of moderate to high transmission of SARS-CoV-2 in the community. Uncertainty remains as to whether these findings will change with the new variants of SARS-CoV-2 and dynamic levels of community transmission. TRIAL REGISTRATION NCT04448717.
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Affiliation(s)
- Agne Ulyte
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Irene A Abela
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | | | - Michael Huber
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Merle Schanz
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Alexandra Trkola
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
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677
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678
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Wu JT, Leung K, Lam TTY, Ni MY, Wong CKH, Peiris JSM, Leung GM. Nowcasting epidemics of novel pathogens: lessons from COVID-19. Nat Med 2021; 27:388-395. [PMID: 33723452 DOI: 10.1038/s41591-021-01278-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/03/2021] [Indexed: 12/28/2022]
Abstract
Epidemic nowcasting broadly refers to assessing the current state by understanding key pathogenic, epidemiologic, clinical and socio-behavioral characteristics of an ongoing outbreak. Its primary objective is to provide situational awareness and inform decisions on control responses. In the event of large-scale sustained emergencies, such as the COVID-19 pandemic, scientists need to constantly update their aims and analytics with respect to the rapidly evolving emergence of new questions, data and findings in order to synthesize real-time evidence for policy decisions. In this Perspective, we share our views on the functional aims, rationale, data requirements and challenges of nowcasting at different stages of an epidemic, drawing on the ongoing COVID-19 experience. We highlight how recent advances in the computational and laboratory sciences could be harnessed to complement traditional approaches to enhance the scope, timeliness, reliability and utility of epidemic nowcasting.
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Affiliation(s)
- Joseph T Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. .,Laboratory of Data Discovery for Health (D24H), Hong Kong, China.
| | - Kathy Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Laboratory of Data Discovery for Health (D24H), Hong Kong, China
| | - Tommy T Y Lam
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Laboratory of Data Discovery for Health (D24H), Hong Kong, China.,State Key Laboratory of Emerging Infectious Diseases, School of Public Health, The University of Hong Kong, Hong Kong, China.,Joint Institute of Virology (Shantou University and The University of Hong Kong), Guangdong-Hongkong Joint Laboratory of Emerging Infectious Diseases, Shantou University, Shantou, China
| | - Michael Y Ni
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.,Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong, China
| | - Carlos K H Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - J S Malik Peiris
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,HKU-Pasteur Research Pole, The University of Hong Kong, Hong Kong, China
| | - Gabriel M Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Laboratory of Data Discovery for Health (D24H), Hong Kong, China
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679
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Luoto S, Varella MAC. Pandemic Leadership: Sex Differences and Their Evolutionary-Developmental Origins. Front Psychol 2021; 12:633862. [PMID: 33815218 PMCID: PMC8015803 DOI: 10.3389/fpsyg.2021.633862] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/12/2021] [Indexed: 12/30/2022] Open
Abstract
The COVID-19 pandemic has caused a global societal, economic, and social upheaval unseen in living memory. There have been substantial cross-national differences in the kinds of policies implemented by political decision-makers to prevent the spread of the virus, to test the population, and to manage infected patients. Among other factors, these policies vary with politicians' sex: early findings indicate that, on average, female leaders seem more focused on minimizing direct human suffering caused by the SARS-CoV-2 virus, while male leaders implement riskier short-term decisions, possibly aiming to minimize economic disruptions. These sex differences are consistent with broader findings in psychology, reflecting women's stronger empathy, higher pathogen disgust, health concern, care-taking orientation, and dislike for the suffering of other people-as well as men's higher risk-taking, Machiavellianism, psychopathy, narcissism, and focus on financial indicators of success and status. This review article contextualizes sex differences in pandemic leadership in an evolutionary framework. Evolution by natural selection is the only known process in nature that organizes organisms into higher degrees of functional order, or counteracts the unavoidable disorder that would otherwise ensue, and is therefore essential for explaining the origins of human sex differences. Differential sexual selection and parental investment between males and females, together with the sexual differentiation of the mammalian brain, drive sex differences in cognition and behavioral dispositions, underlying men's and women's leadership styles and decision-making during a global pandemic. According to the sexually dimorphic leadership specialization hypothesis, general psychobehavioral sex differences have been exapted during human evolution to create sexually dimorphic leadership styles. They may be facultatively co-opted by societies and/or followers when facing different kinds of ecological and/or sociopolitical threats, such as disease outbreaks or intergroup aggression. Early evidence indicates that against the invisible viral foe that can bring nations to their knees, the strategic circumspection of empathic feminine health "worriers" may bring more effective and humanitarian outcomes than the devil-may-care incaution of masculine risk-taking "warriors".
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Affiliation(s)
- Severi Luoto
- English, Drama and Writing Studies, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
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680
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Soriano-Arandes A, Gatell A, Serrano P, Biosca M, Campillo F, Capdevila R, Fàbrega A, Lobato Z, López N, Moreno AM, Poblet M, Riera-Bosch MT, Rius N, Ruiz M, Sánchez A, Valldepérez C, Vilà M, Pineda V, Lazcano U, Díaz Y, Reyes-Urueña J, Soler-Palacín P. Household SARS-CoV-2 transmission and children: a network prospective study. Clin Infect Dis 2021; 73:e1261-e1269. [PMID: 33709135 PMCID: PMC7989526 DOI: 10.1093/cid/ciab228] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Indexed: 12/16/2022] Open
Abstract
Background The role of children in household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains uncertain. Here, we describe the epidemiological and clinical characteristics of children with COVID-19 in Catalonia (Spain) and investigate the dynamics of household transmission. Methods Prospective, observational, multicenter study performed during summer and school periods (1 July-31 October, 2020), in which epidemiological and clinical features, and viral transmission dynamics were analyzed in COVID-19 patients <16 years. A pediatric index case was established when a child was the first individual infected within a household. Secondary cases were defined when another household member tested positive for SARS-CoV-2 before the child. The secondary attack rate (SAR) was calculated, and logistic regression was used to assess associations between transmission risk factors and SARS-CoV-2 infections. Results The study included 1040 COVID-19 patients <16 years. Almost half (47.2%) were asymptomatic, 10.8% had comorbidities, and 2.6% required hospitalization. No deaths were reported. Viral transmission was common among household members (62.3%). More than 70% (756/1040) of pediatric cases were secondary to an adult, whereas 7.7% (80/1040) were index cases. The SAR was significantly lower in households with COVID-19 pediatric index cases during the school period relative to summer (p=0.02), and when compared to adults (p=0.006). No individual or environmental risk factors associated with the SAR were identified. Conclusions Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission.
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Affiliation(s)
- Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Anna Gatell
- Equip Pediatria Territorial Alt Penedès-Garraf, Barcelona, Spain
| | - Pepe Serrano
- Equip Pediatria Territorial Alt Penedès-Garraf, Barcelona, Spain
| | | | - Ferran Campillo
- Hospital d'Olot i Equip Pediàtric Territorial Garrotxa i Ripollès (EPTGiR), Girona, Spain
| | | | | | | | - Núria López
- Hospital Universitari del Mar, Barcelona, Spain
| | | | - Miriam Poblet
- Equip Territorial Pediàtric Sabadell Nord, Barcelona, Spain
| | | | - Neus Rius
- Hospital Universitari San Joan de Reus, Tarragona, Spain
| | | | | | | | | | - Valentí Pineda
- Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Uxue Lazcano
- Agencia de Qualitat i Avaluació Sanitaria de Catalunya, AQuAS, Generalitat de Catalunya, Barcelona, Spain
| | - Yesika Díaz
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain.,Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Juliana Reyes-Urueña
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Spain
| | - Pere Soler-Palacín
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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681
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Stojanovic J, Boucher VG, Boyle J, Enticott J, Lavoie KL, Bacon SL. COVID-19 Is Not the Flu: Four Graphs From Four Countries. Front Public Health 2021; 9:628479. [PMID: 33777883 PMCID: PMC7987835 DOI: 10.3389/fpubh.2021.628479] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/16/2021] [Indexed: 01/12/2023] Open
Abstract
Background: COVID-19 has caused a global public health emergency. Government mitigation strategies included a series of behavior-based prevention policies that had a likely impact on the spread of other contagious respiratory illnesses, such as seasonal influenza. Our aim was to explore how 2019-2020 influenza tracked onto COVID-19 pandemic and its mitigation methods. Materials and Methods: We linked the WHO FluNet database and COVID-19 confirmed cases (Johns Hopkins University) for four countries across the northern (Canada, the United States) and southern hemispheres (Australia, Brazil) for the period 2016-2020. Graphical presentations of longitudinal data were provided. Results: There was a notable reduction in influenza cases for the 2019-2020 season. Northern hemisphere countries experienced a quicker ending to the 2019-2020 seasonal influenza cases (shortened by 4-7 weeks) and virtually no 2020 fall influenza season. Countries from the southern hemisphere experienced drastically low levels of seasonal influenza, with consistent trends that were approaching zero cases after the introduction of COVID-19 measures. Conclusions: It is likely that the COVID-19 mitigation measures played a notable role in the marked decrease in influenza, with little to no influenza activity in both the northern and southern hemispheres. In spite of this reduction in influenza cases, there was still community spread of COVID-19, highlighting the contagiousness of SARS-CoV-2 compared to influenza. These results, together with the higher mortality rate from SARS-CoV-2 compared to influenza, highlight that COVID-19 is a far greater health threat than influenza.
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Affiliation(s)
- Jovana Stojanovic
- Montreal Behavioral Medicine Centre, Centre integrée universitaire de santé et services sociaux du Nord de l'Ile de Montréal (CIUSSS-NIM), Montreal, QC, Canada
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Vincent G. Boucher
- Montreal Behavioral Medicine Centre, Centre integrée universitaire de santé et services sociaux du Nord de l'Ile de Montréal (CIUSSS-NIM), Montreal, QC, Canada
- Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada
| | - Jacqueline Boyle
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
- Monash Partners Academic Health Science Centre, Clayton, VIC, Australia
| | - Kim L. Lavoie
- Montreal Behavioral Medicine Centre, Centre integrée universitaire de santé et services sociaux du Nord de l'Ile de Montréal (CIUSSS-NIM), Montreal, QC, Canada
- Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada
| | - Simon L. Bacon
- Montreal Behavioral Medicine Centre, Centre integrée universitaire de santé et services sociaux du Nord de l'Ile de Montréal (CIUSSS-NIM), Montreal, QC, Canada
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
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682
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Reperant LA, Osterhaus ADME. COVID-19 vaccination and critical care capacity: Perilous months ahead. Vaccine 2021; 39:2183-2186. [PMID: 33752954 PMCID: PMC7945870 DOI: 10.1016/j.vaccine.2021.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Leslie A Reperant
- Artemis One Health Research Foundation, Molengraaffsingel 10, 2629JD Delft, The Netherlands.
| | - Albert D M E Osterhaus
- Research Center on Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Bünteweg 2, 30559 Hannover, Germany.
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683
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Abstract
Many countries closed schools during the pandemic to contain the spread of SARS-CoV-2. Sweden closed upper-secondary schools, while lower-secondary schools remained open, allowing for an evaluation of school closures. This study analyzes the impact of school closures on the spread of SARS-CoV-2 by comparing groups exposed and not exposed to open schools. We find that exposure to open schools resulted in a small increase in infections among parents. Among teachers, the infection rate doubled, and infections spilled over to their partners. This suggests that keeping lower-secondary schools open had a minor impact on the overall spread of SARS-CoV-2 in society. However, teachers are affected, and measures to protect them could be considered. To reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most countries closed schools, despite uncertainty if school closures are an effective containment measure. At the onset of the pandemic, Swedish upper-secondary schools moved to online instruction, while lower-secondary schools remained open. This allows for a comparison of parents and teachers differently exposed to open and closed schools, but otherwise facing similar conditions. Leveraging rich Swedish register data, we connect all students and teachers in Sweden to their families and study the impact of moving to online instruction on the incidence of SARS-CoV-2 and COVID-19. We find that, among parents, exposure to open rather than closed schools resulted in a small increase in PCR-confirmed infections (odds ratio [OR] 1.17; 95% CI [CI95] 1.03 to 1.32). Among lower-secondary teachers, the infection rate doubled relative to upper-secondary teachers (OR 2.01; CI95 1.52 to 2.67). This spilled over to the partners of lower-secondary teachers, who had a higher infection rate than their upper-secondary counterparts (OR 1.29; CI95 1.00 to 1.67). When analyzing COVID-19 diagnoses from healthcare visits and the incidence of severe health outcomes, results are similar for teachers, but weaker for parents and teachers’ partners. The results for parents indicate that keeping lower-secondary schools open had minor consequences for the overall transmission of SARS-CoV-2 in society. The results for teachers suggest that measures to protect teachers could be considered.
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684
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Chica M, Hernández JM, Bulchand-Gidumal J. A collective risk dilemma for tourism restrictions under the COVID-19 context. Sci Rep 2021; 11:5043. [PMID: 33658596 PMCID: PMC7930199 DOI: 10.1038/s41598-021-84604-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/18/2021] [Indexed: 11/09/2022] Open
Abstract
The current COVID-19 pandemic has impacted millions of people and the global economy. Tourism has been one the most affected economic sectors because of the mobility restrictions established by governments and uncoordinated actions from origin and destination regions. The coordination of restrictions and reopening policies could help control the spread of virus and enhance economies, but this is not an easy endeavor since touristic companies, citizens, and local governments have conflicting interests. We propose an evolutionary game model that reflects a collective risk dilemma behind these decisions. To this aim, we represent regions as players, organized in groups; and consider the perceived risk as a strict lock-down and null economic activity. The costs for regions when restricting their mobility are heterogeneous, given that the dependence on tourism of each region is diverse. Our analysis shows that, for both large populations and the EU NUTS2 case study, the existence of heterogeneous costs enhances global agreements. Furthermore, the decision on how to group regions to maximize the regions' agreement of the population is a relevant issue for decision makers to consider. We find out that a layout of groups based on similar costs of cooperation boosts the regions' agreements and avoid the risk of having a total lock-down and a negligible tourism activity. These findings can guide policy makers to facilitate agreements among regions to maximize the tourism recovery.
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Grants
- A-TIC-284-UGR18 Consejería de Economía, Innovación, Ciencia y Empleo, Junta de Andalucía (Ministry of Economy, Innovation, Science and Employment, Government of Andalucia)
- PGC2018-101216-B-I00 Ministerio de Economía y Competitividad (Ministry of Economy and Competitiveness)
- P18-TP-4475 Consejería de Economía, Innovación, Ciencia y Empleo, Junta de Andalucía (Ministry of Economy, Innovation, Science and Employment, Government of Andalucia)
- COVID-19-04 Universidad de Las Palmas de Gran Canaria (University of Las Palmas de Gran Canaria)
- COVID-19-04 Universidad de Las Palmas de Gran Canaria (University of Las Palmas de Gran Canaria)
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Affiliation(s)
- Manuel Chica
- Andalusian Research Institute DaSCI "Data Science and Computational Intelligence", University of Granada, 18071, Granada, Spain.
- School of Electrical Engineering and Computing, The University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Juan M Hernández
- Department of Quantitative Methods in Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas, 35017, Spain
- TIDES Institute for Sustainable Tourism and Economic Development, University of Las Palmas de Gran Canaria, Las Palmas, 35017, Spain
| | - Jacques Bulchand-Gidumal
- TIDES Institute for Sustainable Tourism and Economic Development, University of Las Palmas de Gran Canaria, Las Palmas, 35017, Spain
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685
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Goo T, Apio C, Heo G, Lee D, Lee JH, Lim J, Han K, Park T. Forecasting of the COVID-19 pandemic situation of Korea. Genomics Inform 2021; 19:e11. [PMID: 33840175 PMCID: PMC8042305 DOI: 10.5808/gi.21028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/20/2022] Open
Abstract
For the novel coronavirus disease 2019 (COVID-19), predictive modeling, in the literature, uses broadly susceptible exposed infected recoverd (SEIR)/SIR, agent-based, curve-fitting models. Governments and legislative bodies rely on insights from prediction models to suggest new policies and to assess the effectiveness of enforced policies. Therefore, access to accurate outbreak prediction models is essential to obtain insights into the likely spread and consequences of infectious diseases. The objective of this study is to predict the future COVID-19 situation of Korea. Here, we employed 5 models for this analysis; SEIR, local linear regression (LLR), negative binomial (NB) regression, segment Poisson, deep-learning based long short-term memory models (LSTM) and tree based gradient boosting machine (GBM). After prediction, model performance comparison was evelauated using relative mean squared errors (RMSE) for two sets of train (January 20, 2020‒December 31, 2020 and January 20, 2020‒January 31, 2021) and testing data (January 1, 2021‒February 28, 2021 and February 1, 2021‒February 28, 2021) . Except for segmented Poisson model, the other models predicted a decline in the daily confirmed cases in the country for the coming future. RMSE values' comparison showed that LLR, GBM, SEIR, NB, and LSTM respectively, performed well in the forecasting of the pandemic situation of the country. A good understanding of the epidemic dynamics would greatly enhance the control and prevention of COVID-19 and other infectious diseases. Therefore, with increasing daily confirmed cases since this year, these results could help in the pandemic response by informing decisions about planning, resource allocation, and decision concerning social distancing policies.
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Affiliation(s)
- Taewan Goo
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 08826, Korea
| | - Catherine Apio
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 08826, Korea
| | - Gyujin Heo
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 08826, Korea
| | - Doeun Lee
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 08826, Korea
| | - Jong Hyeok Lee
- Department of Statistics, Seoul National University, Seoul 08826, Korea
| | - Jisun Lim
- The Research Institute of Basic Sciences, Seoul National University, Seoul 08826, Korea
| | - Kyulhee Han
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 08826, Korea
| | - Taesung Park
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 08826, Korea
- Department of Statistics, Seoul National University, Seoul 08826, Korea
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686
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Mat Dawi N, Namazi H, Hwang HJ, Ismail S, Maresova P, Krejcar O. Attitude Toward Protective Behavior Engagement During COVID-19 Pandemic in Malaysia: The Role of E-government and Social Media. Front Public Health 2021; 9:609716. [PMID: 33732677 PMCID: PMC7956949 DOI: 10.3389/fpubh.2021.609716] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is still evolving and affecting millions of lives. E-government and social media have been used widely during this unprecedented time to spread awareness and educate the public on preventive measures. However, the extent to which the 2 digital platforms bring to improve public health awareness and prevention during a health crisis is unknown. In this study, we examined the influence of e-government and social media on the public's attitude to adopt protective behavior. For this purpose, a Web survey was conducted among 404 Malaysian residents during the Recovery Movement Control Order (RMCO) period in the country. Descriptive and multiple regression analyses were conducted using IBM SPSS software. Social media was chosen by most of the respondents (n = 331 or 81.9%) as the source to get information related to COVID-19. Multiple regression analysis suggests the roles of e-government and social media to be significantly related to people's attitudes to engage in protective behavior. In conclusion, during the COVID-19 outbreak, public health decision makers may use e-government and social media platforms as effective tools to improve public engagement on protective behavior. This, in turn, will help the country to contain the transmission of the virus.
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Affiliation(s)
| | - Hamidreza Namazi
- School of Engineering, Monash University, Selangor, Malaysia.,Center for Basic and Applied Research, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czechia
| | - Ha Jin Hwang
- Sunway University Business School, Sunway University, Selangor, Malaysia
| | - Suriani Ismail
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Petra Maresova
- Department of Economics, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czechia
| | - Ondrej Krejcar
- Center for Basic and Applied Research, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czechia.,Malaysia Japan International Institute of Technology (MJIIT), Universiti Teknologi Malaysia, Kuala Lumpur, Malaysia
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687
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Barman SM, Csernoch L, Sengupta J. Physiological Societies Across the Globe Unite in an Effort to Handle the COVID-19 Pandemic. Physiology (Bethesda) 2021; 36:62-70. [PMID: 33595387 PMCID: PMC7900910 DOI: 10.1152/physiol.00001.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
| | | | - Jayasree Sengupta
- (Retired from) All India Institute of Medical Sciences, New Delhi, India
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688
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Velikova T, Georgiev T. SARS-CoV-2 vaccines and autoimmune diseases amidst the COVID-19 crisis. Rheumatol Int 2021; 41:509-518. [PMID: 33515320 PMCID: PMC7846902 DOI: 10.1007/s00296-021-04792-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/13/2021] [Indexed: 02/05/2023]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic has become challenging even for the most durable healthcare systems. It seems that vaccination, one of the most effective public-health interventions, presents a ray of hope to end the pandemic by achieving herd immunity. In this review, we aimed to cover aspects of the current knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines and vaccine candidates in the light of autoimmune inflammatory diseases (AIIDs) and to analyze their potential in terms of safety and effectiveness in patients with AIIDs. Therefore, a focused narrative review was carried out to predict the possible implications of different types of SARS-CoV-2 vaccines which confer distinct immune mechanisms to establish immune response and protection against COVID-19: whole virus (inactivated or weakened), viral vector (replicating and non-replicating), nucleic acid (RNA, DNA), and protein-based (protein subunit, virus-like particle). Still, there is uncertainty among patients with AIIDs and clinicians about the effectiveness and safety of the new vaccines. There are a variety of approaches towards building a protective immunity against SARS-CoV-2. Only high-quality clinical trials would clarify the underlying immunological mechanisms of the newly implemented vaccines/adjuvants in patients living with AIIDs.
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Affiliation(s)
- Tsvetelina Velikova
- Department of Clinical Immunology, Medical Faculty, University Hospital “Lozenetz”, Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407 Sofia, Bulgaria
| | - Tsvetoslav Georgiev
- First Department of Internal Medicine, Faculty of Medicine, Medical University-Varna, 55 Marin Drinov Str., Varna, 9002 Bulgaria
- Clinic of Rheumatology, University Hospital “St. Marina”, 1 Hristo Smirnenski Blvd., 9010 Varna, Bulgaria
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689
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Skegg D, Gluckman P, Boulton G, Hackmann H, Karim SSA, Piot P, Woopen C. Future scenarios for the COVID-19 pandemic. Lancet 2021; 397:777-778. [PMID: 33607000 PMCID: PMC7906624 DOI: 10.1016/s0140-6736(21)00424-4] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/12/2021] [Indexed: 01/07/2023]
Affiliation(s)
- David Skegg
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Peter Gluckman
- International Science Council, Paris, France; Koi Tū: The Centre for Informed Futures, University of Auckland, Auckland 1142, New Zealand.
| | - Geoffrey Boulton
- International Science Council, Paris, France; Grant Institute, University of Edinburgh, Edinburgh, UK
| | | | - Salim S Abdool Karim
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Peter Piot
- London School of Hygiene & Tropical Medicine, London, UK
| | - Christiane Woopen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
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690
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Triggle CR, Bansal D, Ding H, Islam MM, Farag EABA, Hadi HA, Sultan AA. A Comprehensive Review of Viral Characteristics, Transmission, Pathophysiology, Immune Response, and Management of SARS-CoV-2 and COVID-19 as a Basis for Controlling the Pandemic. Front Immunol 2021; 12:631139. [PMID: 33717166 PMCID: PMC7952616 DOI: 10.3389/fimmu.2021.631139] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/26/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 emerged from China in December 2019 and during 2020 spread to every continent including Antarctica. The coronavirus, SARS-CoV-2, has been identified as the causative pathogen, and its spread has stretched the capacities of healthcare systems and negatively affected the global economy. This review provides an update on the virus, including the genome, the risks associated with the emergence of variants, mode of transmission, immune response, COVID-19 in children and the elderly, and advances made to contain, prevent and manage the disease. Although our knowledge of the mechanics of virus transmission and the immune response has been substantially demystified, concerns over reinfection, susceptibility of the elderly and whether asymptomatic children promote transmission remain unanswered. There are also uncertainties about the pathophysiology of COVID-19 and why there are variations in clinical presentations and why some patients suffer from long lasting symptoms-"the long haulers." To date, there are no significantly effective curative drugs for COVID-19, especially after failure of hydroxychloroquine trials to produce positive results. The RNA polymerase inhibitor, remdesivir, facilitates recovery of severely infected cases but, unlike the anti-inflammatory drug, dexamethasone, does not reduce mortality. However, vaccine development witnessed substantial progress with several being approved in countries around the globe.
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Affiliation(s)
- Chris R. Triggle
- Department of Pharmacology, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Devendra Bansal
- Department of Health Protection & Communicable Diseases Control, Ministry of Public Health, Doha, Qatar
| | - Hong Ding
- Department of Pharmacology, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Md Mazharul Islam
- Department of Animal Resources, Ministry of Municipality and Environment, Doha, Qatar
| | | | - Hamad Abdel Hadi
- Communicable Diseases Centre, Hamad Medical Corporations, Doha, Qatar
| | - Ali A. Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine, Cornell University, Doha, Qatar
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691
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Affiliation(s)
- Sarah J Lewis
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Alasdair P S Munro
- NIHR Southampton Clinical Research Facility and Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Allyson M Pollock
- Institute of Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
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692
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Di Domenico L, Pullano G, Sabbatini CE, Boëlle PY, Colizza V. Modelling safe protocols for reopening schools during the COVID-19 pandemic in France. Nat Commun 2021; 12:1073. [PMID: 33594076 PMCID: PMC7887250 DOI: 10.1038/s41467-021-21249-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 01/13/2021] [Indexed: 12/12/2022] Open
Abstract
As countries in Europe implement strategies to control the COVID-19 pandemic, different options are chosen regarding schools. Through a stochastic age-structured transmission model calibrated to the observed epidemic in Île-de-France in the first wave, we explored scenarios of partial, progressive, or full school reopening. Given the uncertainty on children's role, we found that reopening schools after lockdown may increase COVID-19 cases, yet protocols exist to keep the epidemic controlled. Under a scenario with stable epidemic activity if schools were closed, reopening pre-schools and primary schools would lead to up to 76% [67, 84]% occupation of ICU beds if no other school level reopened, or if middle and high schools reopened later. Immediately reopening all school levels may overwhelm the ICU system. Priority should be given to pre- and primary schools allowing younger children to resume learning and development, whereas full attendance in middle and high schools is not recommended for stable or increasing epidemic activity. Large-scale test and trace is required to keep the epidemic under control. Ex-post assessment shows that progressive reopening of schools, limited attendance, and strong adoption of preventive measures contributed to a decreasing epidemic after lifting the first lockdown.
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Affiliation(s)
- Laura Di Domenico
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Giulia Pullano
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
- Orange Labs, Sociology and Economics of Network and Services (SENSE), Chatillon, France
| | - Chiara E Sabbatini
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France.
- Tokyo Tech World Research Hub Initiative, Institute of Innovative Research, Tokyo Institute of Technology, Tokyo, Japan.
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693
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Smycka J, Levinsky R, Hromadkova E, Soltes M, Slerka J, Tucek V, Trnka J, Smid M, Zajicek M, Diviak T, Neruda R, Vidnerova P, Berec L. Delays, masks, the elderly, and schools: first COVID-19 wave in the Czech Republic. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 33200137 DOI: 10.1101/2020.11.06.20227330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Running across the globe for more than a year, the COVID-19 pandemic keeps demonstrating its strength. Despite a lot of understanding, uncertainty regarding the efficiency of interventions still persists. We developed an age-structured epidemic model parameterized with sociological data for the Czech Republic and found that (1) delaying the spring 2020 lockdown by four days produced twice as many confirmed cases by the end of the lockdown period, (2) personal protective measures such as face masks appear more effective than just a reduction of social contacts, (3) only sheltering the elderly is by no means effective, and (4) leaving schools open is a risky strategy. Despite the onset of vaccination, an evidence-based choice and timing of non-pharmaceutical interventions still remains the most important weapon against the COVID-19 pandemic.
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694
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Dasgupta S, Kassem AM, Sunshine G, Liu T, Rose C, Kang GJ, Silver R, Maddox BLP, Watson C, Howard-Williams M, Gakh M, McCord R, Weber R, Fletcher K, Musial T, Tynan MA, Hulkower R, Moreland A, Pepin D, Landsman L, Brown A, Gilchrist S, Clodfelter C, Williams M, Cramer R, Limeres A, Popoola A, Dugmeoglu S, Shelburne J, Jeong G, Rao CY. Differences in rapid increases in county-level COVID-19 incidence by implementation of statewide closures and mask mandates - United States, June 1-September 30, 2020. Ann Epidemiol 2021; 57:46-53. [PMID: 33596446 PMCID: PMC7882220 DOI: 10.1016/j.annepidem.2021.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVE Community mitigation strategies could help reduce COVID-19 incidence, but there are few studies that explore associations nationally and by urbanicity. In a national county-level analysis, we examined the probability of being identified as a county with rapidly increasing COVID-19 incidence (rapid riser identification) during the summer of 2020 by implementation of mitigation policies prior to the summer, overall and by urbanicity. METHODS We analyzed county-level data on rapid riser identification during June 1-September 30, 2020 and statewide closures and statewide mask mandates starting March 19 (obtained from state government websites). Poisson regression models with robust standard error estimation were used to examine differences in the probability of rapid riser identification by implementation of mitigation policies (P-value< .05); associations were adjusted for county population size. RESULTS Counties in states that closed for 0-59 days were more likely to become a rapid riser county than those that closed for >59 days, particularly in nonmetropolitan areas. The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening (adjusted prevalence ratio = 0.57; 95% confidence intervals = 0.51-0.63); when stratified by urbanicity, associations were more pronounced in nonmetropolitan areas. CONCLUSIONS These results underscore the potential value of community mitigation strategies in limiting the COVID-19 spread, especially in nonmetropolitan areas.
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Affiliation(s)
- Sharoda Dasgupta
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ahmed M Kassem
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gregory Sunshine
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA; Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Tiebin Liu
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Charles Rose
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gloria J Kang
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rachel Silver
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Christina Watson
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mara Howard-Williams
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Maxim Gakh
- University of Nevada, Las Vegas, Las Vegas, NV
| | - Russell McCord
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA; Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Regen Weber
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kelly Fletcher
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Trieste Musial
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael A Tynan
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rachel Hulkower
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA; Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Amanda Moreland
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dawn Pepin
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa Landsman
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Amanda Brown
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Siobhan Gilchrist
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Catherine Clodfelter
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael Williams
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ryan Cramer
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Alexa Limeres
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Adebola Popoola
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sebnem Dugmeoglu
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Julia Shelburne
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gi Jeong
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Carol Y Rao
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA.
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695
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Parino F, Zino L, Porfiri M, Rizzo A. Modelling and predicting the effect of social distancing and travel restrictions on COVID-19 spreading. J R Soc Interface 2021; 18:20200875. [PMID: 33561374 PMCID: PMC8086876 DOI: 10.1098/rsif.2020.0875] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
To date, the only effective means to respond to the spreading of the COVID-19 pandemic are non-pharmaceutical interventions (NPIs), which entail policies to reduce social activity and mobility restrictions. Quantifying their effect is difficult, but it is key to reducing their social and economic consequences. Here, we introduce a meta-population model based on temporal networks, calibrated on the COVID-19 outbreak data in Italy and applied to evaluate the outcomes of these two types of NPIs. Our approach combines the advantages of granular spatial modelling of meta-population models with the ability to realistically describe social contacts via activity-driven networks. We focus on disentangling the impact of these two different types of NPIs: those aiming at reducing individuals' social activity, for instance through lockdowns, and those that enforce mobility restrictions. We provide a valuable framework to assess the effectiveness of different NPIs, varying with respect to their timing and severity. Results suggest that the effects of mobility restrictions largely depend on the possibility of implementing timely NPIs in the early phases of the outbreak, whereas activity reduction policies should be prioritized afterwards.
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Affiliation(s)
- Francesco Parino
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy
| | - Lorenzo Zino
- Faculty of Science and Engineering, University of Groningen, 9747 AG Groningen, The Netherlands
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA.,Center for Urban Science and Progress, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
| | - Alessandro Rizzo
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy.,Office of Innovation, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
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696
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Silva CJ, Cruz C, Torres DFM, Muñuzuri AP, Carballosa A, Area I, Nieto JJ, Fonseca-Pinto R, Passadouro R, Santos ESD, Abreu W, Mira J. Optimal control of the COVID-19 pandemic: controlled sanitary deconfinement in Portugal. Sci Rep 2021; 11:3451. [PMID: 33568716 PMCID: PMC7876047 DOI: 10.1038/s41598-021-83075-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/27/2021] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic has forced policy makers to decree urgent confinements to stop a rapid and massive contagion. However, after that stage, societies are being forced to find an equilibrium between the need to reduce contagion rates and the need to reopen their economies. The experience hitherto lived has provided data on the evolution of the pandemic, in particular the population dynamics as a result of the public health measures enacted. This allows the formulation of forecasting mathematical models to anticipate the consequences of political decisions. Here we propose a model to do so and apply it to the case of Portugal. With a mathematical deterministic model, described by a system of ordinary differential equations, we fit the real evolution of COVID-19 in this country. After identification of the population readiness to follow social restrictions, by analyzing the social media, we incorporate this effect in a version of the model that allow us to check different scenarios. This is realized by considering a Monte Carlo discrete version of the previous model coupled via a complex network. Then, we apply optimal control theory to maximize the number of people returning to "normal life" and minimizing the number of active infected individuals with minimal economical costs while warranting a low level of hospitalizations. This work allows testing various scenarios of pandemic management (closure of sectors of the economy, partial/total compliance with protection measures by citizens, number of beds in intensive care units, etc.), ensuring the responsiveness of the health system, thus being a public health decision support tool.
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Affiliation(s)
- Cristiana J Silva
- Department of Mathematics, Center for Research and Development in Mathematics and Applications (CIDMA), University of Aveiro, 3810-193, Aveiro, Portugal.
| | - Carla Cruz
- Department of Mathematics, Center for Research and Development in Mathematics and Applications (CIDMA), University of Aveiro, 3810-193, Aveiro, Portugal
| | - Delfim F M Torres
- Department of Mathematics, Center for Research and Development in Mathematics and Applications (CIDMA), University of Aveiro, 3810-193, Aveiro, Portugal
| | - Alberto P Muñuzuri
- Department of Physics, Institute CRETUS, Group of Nonlinear Physics, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain
| | - Alejandro Carballosa
- Department of Physics, Institute CRETUS, Group of Nonlinear Physics, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain
| | - Iván Area
- Departamento de Matemática Aplicada II, E. E. Aeronáutica e do Espazo, Campus de Ourense, Universidade de Vigo, 32004, Ourense, Spain
| | - Juan J Nieto
- Instituto de Matemáticas, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain
| | - Rui Fonseca-Pinto
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - Rui Passadouro
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
- ACES Pinhal Litoral-ARS Centro, Leiria, Portugal
| | | | - Wilson Abreu
- School of Nursing and Research Centre "Centre for Health Technology and Services Research/ESEP-CINTESIS", Porto, Portugal
| | - Jorge Mira
- Departamento de Física Aplicada, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain.
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697
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Liu Y, Morgenstern C, Kelly J, Lowe R, Jit M. The impact of non-pharmaceutical interventions on SARS-CoV-2 transmission across 130 countries and territories. BMC Med 2021; 19:40. [PMID: 33541353 PMCID: PMC7861967 DOI: 10.1186/s12916-020-01872-8] [Citation(s) in RCA: 196] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/25/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) are used to reduce transmission of SARS coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19). However, empirical evidence of the effectiveness of specific NPIs has been inconsistent. We assessed the effectiveness of NPIs around internal containment and closure, international travel restrictions, economic measures, and health system actions on SARS-CoV-2 transmission in 130 countries and territories. METHODS We used panel (longitudinal) regression to estimate the effectiveness of 13 categories of NPIs in reducing SARS-CoV-2 transmission using data from January to June 2020. First, we examined the temporal association between NPIs using hierarchical cluster analyses. We then regressed the time-varying reproduction number (Rt) of COVID-19 against different NPIs. We examined different model specifications to account for the temporal lag between NPIs and changes in Rt, levels of NPI intensity, time-varying changes in NPI effect, and variable selection criteria. Results were interpreted taking into account both the range of model specifications and temporal clustering of NPIs. RESULTS There was strong evidence for an association between two NPIs (school closure, internal movement restrictions) and reduced Rt. Another three NPIs (workplace closure, income support, and debt/contract relief) had strong evidence of effectiveness when ignoring their level of intensity, while two NPIs (public events cancellation, restriction on gatherings) had strong evidence of their effectiveness only when evaluating their implementation at maximum capacity (e.g. restrictions on 1000+ people gathering were not effective, restrictions on < 10 people gathering were). Evidence about the effectiveness of the remaining NPIs (stay-at-home requirements, public information campaigns, public transport closure, international travel controls, testing, contact tracing) was inconsistent and inconclusive. We found temporal clustering between many of the NPIs. Effect sizes varied depending on whether or not we included data after peak NPI intensity. CONCLUSION Understanding the impact that specific NPIs have had on SARS-CoV-2 transmission is complicated by temporal clustering, time-dependent variation in effects, and differences in NPI intensity. However, the effectiveness of school closure and internal movement restrictions appears robust across different model specifications, with some evidence that other NPIs may also be effective under particular conditions. This provides empirical evidence for the potential effectiveness of many, although not all, actions policy-makers are taking to respond to the COVID-19 pandemic.
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Affiliation(s)
- Yang Liu
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - James Kelly
- IPM Informed Portfolio Management, London, UK
| | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK.
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698
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699
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Galle A, Semaan A, Huysmans E, Audet C, Asefa A, Delvaux T, Afolabi BB, El Ayadi AM, Benova L. A double-edged sword-telemedicine for maternal care during COVID-19: findings from a global mixed-methods study of healthcare providers. BMJ Glob Health 2021; 6:e004575. [PMID: 33632772 PMCID: PMC7908054 DOI: 10.1136/bmjgh-2020-004575] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/03/2021] [Accepted: 02/10/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has led to a rapid implementation of telemedicine for the provision of maternal and newborn healthcare. The objective of this study was to document the experiences with providing telemedicine for maternal and newborn healthcare during the pandemic among healthcare professionals globally. METHODS The second round of a global online survey of maternal and newborn health professionals was conducted, disseminated in 11 languages. Data were collected between 5 July and 10 September 2020. The questionnaire included questions regarding background, preparedness and response to COVID-19, and experiences with providing telemedicine. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregated by country income level. RESULTS Responses from 1060 maternal and newborn health professionals were analysed. Telemedicine was used by 58% of health professionals and two-fifths of them reported not receiving guidelines on the provision of telemedicine. Key telemedicine practices included online birth preparedness classes, antenatal and postnatal care by video/phone, a COVID-19 helpline and online psychosocial counselling. Challenges reported lack of infrastructure and technological literacy, limited monitoring, financial and language barriers, lack of non-verbal feedback and bonding, and distrust from patients. Telemedicine was considered as an important alternative to in-person consultations. However, health providers emphasised the lower quality of care and risk of increasing the already existing inequalities in access to healthcare. CONCLUSIONS Telemedicine has been applied globally to address disruptions of care provision during the COVID-19 pandemic. However, some crucial aspects of maternal and newborn healthcare seem difficult to deliver by telemedicine. More research regarding the effectiveness, efficacy and quality of telemedicine for maternal healthcare in different contexts is needed before considering long-term adaptations in provision of care away from face-to-face interactions. Clear guidelines for care provision and approaches to minimising socioeconomic and technological inequalities in access to care are urgently needed.
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Affiliation(s)
- Anna Galle
- ICRH, Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Aline Semaan
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Elise Huysmans
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Constance Audet
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Anteneh Asefa
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Therese Delvaux
- Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | | | - Alison Marie El Ayadi
- Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California, USA
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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700
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Velikova T, Georgiev T. SARS-CoV-2 vaccines and autoimmune diseases amidst the COVID-19 crisis. Rheumatol Int 2021. [PMID: 33515320 DOI: 10.1007/s00296‐021‐04792‐9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic has become challenging even for the most durable healthcare systems. It seems that vaccination, one of the most effective public-health interventions, presents a ray of hope to end the pandemic by achieving herd immunity. In this review, we aimed to cover aspects of the current knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines and vaccine candidates in the light of autoimmune inflammatory diseases (AIIDs) and to analyze their potential in terms of safety and effectiveness in patients with AIIDs. Therefore, a focused narrative review was carried out to predict the possible implications of different types of SARS-CoV-2 vaccines which confer distinct immune mechanisms to establish immune response and protection against COVID-19: whole virus (inactivated or weakened), viral vector (replicating and non-replicating), nucleic acid (RNA, DNA), and protein-based (protein subunit, virus-like particle). Still, there is uncertainty among patients with AIIDs and clinicians about the effectiveness and safety of the new vaccines. There are a variety of approaches towards building a protective immunity against SARS-CoV-2. Only high-quality clinical trials would clarify the underlying immunological mechanisms of the newly implemented vaccines/adjuvants in patients living with AIIDs.
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Affiliation(s)
- Tsvetelina Velikova
- Department of Clinical Immunology, Medical Faculty, University Hospital "Lozenetz", Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407, Sofia, Bulgaria
| | - Tsvetoslav Georgiev
- First Department of Internal Medicine, Faculty of Medicine, Medical University-Varna, 55 Marin Drinov Str., Varna, 9002, Bulgaria. .,Clinic of Rheumatology, University Hospital "St. Marina", 1 Hristo Smirnenski Blvd., 9010, Varna, Bulgaria.
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