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Machhi J, Shahjin F, Das S, Patel M, Abdelmoaty MM, Cohen JD, Singh PA, Baldi A, Bajwa N, Kumar R, Vora LK, Patel TA, Oleynikov MD, Soni D, Yeapuri P, Mukadam I, Chakraborty R, Saksena CG, Herskovitz J, Hasan M, Oupicky D, Das S, Donnelly RF, Hettie KS, Chang L, Gendelman HE, Kevadiya BD. Nanocarrier vaccines for SARS-CoV-2. Adv Drug Deliv Rev 2021; 171:215-239. [PMID: 33428995 PMCID: PMC7794055 DOI: 10.1016/j.addr.2021.01.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/18/2020] [Accepted: 01/01/2021] [Indexed: 02/07/2023]
Abstract
The SARS-CoV-2 global pandemic has seen rapid spread, disease morbidities and death associated with substantive social, economic and societal impacts. Treatments rely on re-purposed antivirals and immune modulatory agents focusing on attenuating the acute respiratory distress syndrome. No curative therapies exist. Vaccines remain the best hope for disease control and the principal global effort to end the pandemic. Herein, we summarize those developments with a focus on the role played by nanocarrier delivery.
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Affiliation(s)
- Jatin Machhi
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Farah Shahjin
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Srijanee Das
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Milankumar Patel
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Mai Mohamed Abdelmoaty
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, NE 68198, USA; Therapeutic Chemistry Department, Pharmaceutical and Drug Industries Research Division, National Research Centre, Giza, Egypt
| | - Jacob D Cohen
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Preet Amol Singh
- Department of Pharmaceutical Sciences & Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Ashish Baldi
- Department of Pharmaceutical Sciences & Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Neha Bajwa
- Department of Pharmaceutical Sciences & Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Raj Kumar
- Center for Drug Delivery and Nanomedicine, Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Lalit K Vora
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom
| | - Tapan A Patel
- Department of Biological Sciences, P. D. Patel Institute of Applied Sciences (PDPIAS), Charotar University of Science and Technology (CHARUSAT), Changa, Anand 388421, Gujarat, India
| | - Maxim D Oleynikov
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Dhruvkumar Soni
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, NE 68198, USA
| | - Pravin Yeapuri
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Insiya Mukadam
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, NE 68198, USA
| | - Rajashree Chakraborty
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Caroline G Saksena
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Jonathan Herskovitz
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
| | - Mahmudul Hasan
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, NE 68198, USA
| | - David Oupicky
- Center for Drug Delivery and Nanomedicine, Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Suvarthi Das
- Department of Medicine, Stanford Medical School, Stanford University, Palo Alto, CA 94304, USA
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom
| | - Kenneth S Hettie
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology, Department of Otolaryngology - Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA
| | - Linda Chang
- Departments of Diagnostic Radiology & Nuclear Medicine, and Neurology, University of Maryland, School of Medicine, Baltimore, MD 21201, USA
| | - Howard E Gendelman
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA; Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, NE 68198, USA; Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, NE 68198, USA.
| | - Bhavesh D Kevadiya
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, NE 68198, USA
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Mobility and COVID-19 mortality across Scandinavia: A modeling study. Travel Med Infect Dis 2021; 41:102039. [PMID: 33785456 PMCID: PMC7999697 DOI: 10.1016/j.tmaid.2021.102039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 02/08/2023]
Abstract
Background In response to COVID-19, the Swedish government imposed few travel and mobility restrictions. This contrasted with its Scandinavian neighbours which implemented stringent restrictions. The influence these different approaches had on mobility, and thus on COVID-19 mortality was investigated. Methods Datasets indicating restriction severity and community mobility were examined; Google's ‘Community Movement Reports' (CMR) show activity at key location categories; the Oxford COVID-19 Government Response Tracker collates legislative restrictions into a ‘Stringency Index’ (SI). Results CMR mobility categories were negatively correlated with COVID-19 mortality. The strongest correlations were obtained by negatively time lagging mortality data, suggesting restrictions had a delayed influence. During the ‘first wave’ a model using SI (AIC 632.87) proved favorable to one using contemporaneous CMR data and SI (AIC 1193.84), or lagged CMR data and SI (AIC 642.35). Validation using ‘second wave’ data confirmed this; the model using SI solely again being optimal (RMSE: 0.2486 vs. 0.522 and 104.62). Cross-country differences were apparent in all models; Swedish data, independent of SI and CMR, proved significant throughout. There was a significant association for Sweden and the death number across models. Conclusion SI may provide a broader, more accurate, representation of changes in movement in response to COVID-19 restrictions.
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[Public health services in the COVID-19 pandemic: strategies and practices in selected European neighbouring countries]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:472-480. [PMID: 33748867 PMCID: PMC7982271 DOI: 10.1007/s00103-021-03295-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/12/2021] [Indexed: 10/26/2022]
Abstract
The challenges posed by the COVID-19 pandemic face different institutional structures and traditions of action in the European health systems. This article uses the example of the public health services in Sweden, France and Austria to address the question of the similarities and differences in the measures taken to combat the pandemic (status: November 2020).Among the countries presented in this article, Austria is the least affected by the pandemic and France is the most affected. In all analysed health systems there is a tension between national and regional responsibilities. France's healthcare system is particularly centralized, while Sweden's is strongly regional and municipal. Governments in the nation states are striving to obtain pandemic containment powers independent of parliamentary decisions. Sweden differs from Austria and France in that its pandemic containment strategy is based primarily on recommendations and appeals rather than directives and bans. The sequences of action during the pandemic and, apart from Sweden, the instruments used to contain the pandemic are similar. The course of the pandemic and the measures taken in Austria and France show clear parallels with those in Germany. The protection of particularly vulnerable groups has not been sufficiently successful in all countries and remains a challenge to be met.
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Perceptions of Urban Green Areas during the Social Distancing Period for COVID-19 Containment in Italy. HORTICULTURAE 2021. [DOI: 10.3390/horticulturae7030055] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The scientific community recognizes that urban green areas play an important role in supporting human wellbeing. Green spaces are used differently by citizens accordingly to their age, gender, education, or lifestyle. During the coronavirus disease (COVID-19) pandemic period in 2020, public green areas were closed due to the limitations imposed by social distancing in Italy and people were forced to stay at home. The aim of this research was to investigate the importance of public green areas in the life of the population in relation to the limits imposed during the first lockdown in Italy. A participatory approach was used, and an online questionnaire focused on people’s perceptions about the public attendance in green areas and their main uses pre-, during, and post-COVID-19 emergency period was administrated randomly to the adult population. The questions focused on the habit, frequency, and duration of park visits and about the individual perceptions and feelings about the green areas close (maximum 200 m distance) to their residences. A total of 3286 responses were obtained and analyzed at national and regional levels (Piemonte). In order to have a general national overview, a basic descriptive statistic was applied using all answers, elaborated in the form of percentages. At the regional level, questions were selected and compared to determine if answers were in related. Statistical analyses with chi-square tests and correspondence analyses were performed. The results indicated that the social distancing period for COVID-19 containment in Italy influenced perceptions about urban green areas. The importance of having outdoor green spaces was highlighted and an increase in interest about urban green areas was observed. Future planning strategies will have to consider the need of designing urban green areas for having more livable cities.
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van Zyl LE. Social Study Resources and Social Wellbeing Before and During the Intelligent COVID-19 Lockdown in The Netherlands. SOCIAL INDICATORS RESEARCH 2021; 157:393-415. [PMID: 33758461 PMCID: PMC7970806 DOI: 10.1007/s11205-021-02654-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
The first intelligent COVID-19 lockdown resulted in radical changes within the tertiary educational system within the Netherlands. These changes posed new challenges for university students and many social welfare agencies have warned that it could have adverse effects on the social wellbeing (SWB) of university students. Students may lack the necessary social study-related resources (peer- and lecturer support) (SSR) necessary to aid them in coping with the new demands that the lockdown may bring. As such, the present study aimed to investigate the trajectory patterns, rate of change and longitudinal associations between SSR and SWB of 175 Dutch students before and during the COVID-19 lockdown. A piecewise latent growth modelling approach was employed to sample students' experiences over three months. Participants to complete a battery of psychometric assessments for five weeks before the COVID-19 lockdown was implemented, followed by two directly after and a month follow-up. The results were paradoxical and contradicting to initial expectations. Where SSR showed a linear rate of decline before- and significant growth trajectory during the lockdown, SWB remained moderate and stable. Further, initial levels and growth trajectories between SSR and SWB were only associated before the lockdown.
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Affiliation(s)
- Llewellyn Ellardus van Zyl
- Department of Industrial Engineering, University of Eindhoven, Eindhoven, The Netherlands
- Optentia Research Focus Area, North-West University (VTC), Vanderbijlpark, South Africa
- Department of Human Resource Management, University of Twente, Enschede, The Netherlands
- Department of Social Psychology, Institute for Psychology, Goethe University, Frankfurt am Main, Germany
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56
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Rumpler R, Venkataraman S, Göransson P. Noise measurements as a proxy to evaluating the response to recommendations in times of crisis: An update analysis of the transition to the second wave of the CoViD-19 pandemic in Central Stockholm, Sweden. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:1838. [PMID: 33765773 PMCID: PMC8023269 DOI: 10.1121/10.0003778] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/21/2021] [Accepted: 02/24/2021] [Indexed: 05/23/2023]
Abstract
Sweden stands out among the other European countries by the degree of restrictive measures taken towards handling the 2019 coronavirus outbreak, associated with the CoViD-19 pandemic. While several governments have imposed a nationwide total or partial lockdown to slow down the spread of the virus, the Swedish government has opted for a recommendation-based approach together with a few imposed restrictions. In a previous contribution by the authors, the impact of the Swedish strategy was observed through the monitored variation of the city noise levels during a period associated with the so-called "first wave" of the pandemic in Stockholm. A very strong impact of these recommendations was shown on the evolution of the noise levels in central Stockholm. This highlighted the potential of acoustic sensor networks both for enforcement of regulation and monitoring of the effectiveness of their implementation. The present contribution presents a follow-up to this urban noise monitoring in central Stockholm, Sweden, for the period leading to the so-called "second wave" of the pandemic in Europe. Both the evolution of adherence to the recommendations and the impact of the recurrence of cases combined with reinforced recommendations are observed through the evolution of the measured noise levels. While the measurements show a gradual lower level of compliance, in particular, past the summer break, these also show again a rapid response to the reinforced recommendations issued by the authorities in mid-fall of 2020. These observations thus confirm the potential associated with detailed urban noise monitoring, for instance here acting as a proxy to evaluating the response to recommendations or restrictions in times of crisis.
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Affiliation(s)
- Romain Rumpler
- The Marcus Wallenberg Laboratory for Sound and Vibration Research (MWL), Department of Engineering Mechanics, KTH Royal Institute of Technology, SE-100 44, Stockholm, Sweden
| | - Siddharth Venkataraman
- The Marcus Wallenberg Laboratory for Sound and Vibration Research (MWL), Department of Engineering Mechanics, KTH Royal Institute of Technology, SE-100 44, Stockholm, Sweden
| | - Peter Göransson
- The Marcus Wallenberg Laboratory for Sound and Vibration Research (MWL), Department of Engineering Mechanics, KTH Royal Institute of Technology, SE-100 44, Stockholm, Sweden
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Díaz-Castro L, Cabello-Rangel H, Hoffman K. The Impact of Health Policies and Sociodemographic Factors on Doubling Time of the COVID-19 Pandemic in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052354. [PMID: 33670888 PMCID: PMC7967756 DOI: 10.3390/ijerph18052354] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 11/16/2022]
Abstract
Background. The doubling time is the best indicator of the course of the current COVID-19 pandemic. The aim of the present investigation was to determine the impact of policies and several sociodemographic factors on the COVID-19 doubling time in Mexico. Methods. A retrospective longitudinal study was carried out across March–August, 2020. Policies issued by each of the 32 Mexican states during each week of this period were classified according to the University of Oxford Coronavirus Government Response Tracker (OxCGRT), and the doubling time of COVID-19 cases was calculated. Additionally, variables such as population size and density, poverty and mobility were included. A panel data model was applied to measure the effect of these variables on doubling time. Results. States with larger population sizes issued a larger number of policies. Delay in the issuance of policies was associated with accelerated propagation. The policy index (coefficient 0.60, p < 0.01) and the income per capita (coefficient 3.36, p < 0.01) had a positive effect on doubling time; by contrast, the population density (coefficient −0.012, p < 0.05), the mobility in parks (coefficient −1.10, p < 0.01) and the residential mobility (coefficient −4.14, p < 0.01) had a negative effect. Conclusions. Health policies had an effect on slowing the pandemic’s propagation, but population density and mobility played a fundamental role. Therefore, it is necessary to implement policies that consider these variables.
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Affiliation(s)
- Lina Díaz-Castro
- Direction of Epidemiological and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
- Correspondence:
| | - Héctor Cabello-Rangel
- Diagnostic Auxiliary Division, Psychiatric Hospital Fray Bernardino Álvarez, Mexico City 14000, Mexico;
| | - Kurt Hoffman
- Research Center in Animal Reproduction, Autonomous University of Tlaxcala, Tlaxcala 90000, Mexico;
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Panneer S, Kantamaneni K, Pushparaj RRB, Shekhar S, Bhat L, Rice L. Multistakeholder Participation in Disaster Management-The Case of the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:203. [PMID: 33668669 PMCID: PMC7918841 DOI: 10.3390/healthcare9020203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 12/23/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is affecting society's health, economy, environment and development. COVID-19 has claimed many lives across the globe and severely impacted the livelihood of a considerable section of the world's population. We are still in the process of finding optimal and effective solutions to control the pandemic and minimise its negative impacts. In the process of developing effective strategies to combat COVID-19, different countries have adapted diverse policies, strategies and activities and yet there are no universal or comprehensive solutions to the problem. In this context, this paper brings out a conceptual model of multistakeholder participation governance as an effective model to fight against COVID-19. Accordingly, the current study conducted a scientific review by examining multi-stakeholder disaster response strategies, particularly in relation to COVID-19. The study then presents a conceptual framework for multistakeholder participation governance as one of the effective models to fight against COVID-19. Subsequently, the article offers strategies for rebuilding the economy and healthcare system through multi-stakeholder participation, and gives policy directions/decisions based on evidence to save lives and protect livelihoods. The current study also provides evidence about multidimensional approaches and multi-diplomatic mechanisms during the COVID-19 crisis, in order to examine dimensions of multi-stakeholder participation in disaster management and to document innovative, collaborative strategic directions across the globe. The current research findings highlight the need for global collaboration by working together to put an end to this pandemic situation through the application of a Multi-Stakeholder Spatial Decision Support System (MS-SDSS).
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Affiliation(s)
- Sigamani Panneer
- Department of Social Work, School of Social Sciences and Humanities and Centre for Happiness, Central University of Tamil Nadu, Thiruvarur, Tamilnadu 610005, India;
| | - Komali Kantamaneni
- Faculty of Creative Industries, Architecture and Engineering, Solent University, Southampton SO14 0YN, UK
- Department of Civil, Environmental & Geomatic Engineering, Chadwick Building, University College London (UCL), Gower St, London WC1E 6BT, UK
| | - Robert Ramesh Babu Pushparaj
- Research Scholar, Department of Social Work, Central University of Tamil Nadu, Thiruvarur, Tamilnadu 610005, India;
| | - Sulochana Shekhar
- Department of Geography, School of Earth Sciences, Central University of Tamil Nadu, Thiruvarur, Tamilnadu 610005, India;
| | - Lekha Bhat
- Department of Epidemiology & Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, Tamilnadu 610005, India;
| | - Louis Rice
- Centre for Architecture and Built Environment Research, University of the West of England, Bristol BS16 1QY, UK;
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Baral S, Chandler R, Prieto RG, Gupta S, Mishra S, Kulldorff M. Leveraging epidemiological principles to evaluate Sweden's COVID-19 response. Ann Epidemiol 2021; 54:21-26. [PMID: 33242596 PMCID: PMC7682427 DOI: 10.1016/j.annepidem.2020.11.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/09/2020] [Accepted: 11/14/2020] [Indexed: 12/21/2022]
Abstract
In the response to COVID-19, countries have implemented response strategies along a continuum of population- and venue-level specificity ranging from suppression to mitigation strategies. Suppression strategies generally include population-wide shelter-in-place mandates or lockdowns, closure of nonessential physical venues, travel bans, testing and contact tracing, and quarantines. Sweden followed a mitigation strategy focused on risk-tailored approaches to mitigate specific acquisition risks among the elderly, minimizing the disruption to education and the delivery of other health care services, and recommendations for social distancing to minimize the disease burden. To date, Sweden has reported higher case counts and attributable mortality than other Scandinavian countries and lower than other Northern European countries. However, there are several limitations with comparison given heterogeneity in testing strategies, suspected and confirmed case definitions, and assessment of attributable mortality. The decisions in Sweden also reflect social priorities such as equity being a foundational principle of Swedish social systems. Consistently, in-person education for those aged less than 16 years continued throughout. Notably, the mitigation strategy did not eliminate the inequitable impacts of COVID-19 cases and mortality in Sweden with higher-exposure and generally lower-income occupations being associated with higher risks intersecting with these communities often residing in more dense multigenerational households. From January 1 to November 15, there has been a 1.8% increase in all-cause mortality in 2020 compared with the average of 2015-2019, representing an excess of 14.3 deaths per 100,000 population. However, the final assessment of excess deaths in Sweden in 2020 including stratification by age and integration of secular trends can only be calculated in the coming years. In response to increasing cases in the fall of 2020, Sweden has continued to leverage business-oriented regulations and public-oriented guidelines for social distancing rather than police-enforced mandates. Ultimately, pandemics present no winners. Countries have implemented a range of different COVID-19 prevention and mitigation strategies responsive to their own priorities and legal systems including equity and the balancing of competing health priorities. Given these varied approaches, countries that pursued elimination, suppression, or mitigation strategies can collaboratively learn from both successes and challenges of the different strategies to inform COVID-19 and future pandemic responses.
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Affiliation(s)
- Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD.
| | | | - Ruth Gil Prieto
- Department of Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - Sunetra Gupta
- Department of Zoology, University of Oxford, Oxford, UK
| | - Sharmistha Mishra
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Martin Kulldorff
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Harvard Medical School, Boston, MA
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Ludvigsson JF. The first eight months of Sweden's COVID-19 strategy and the key actions and actors that were involved. Acta Paediatr 2020; 109:2459-2471. [PMID: 32951258 PMCID: PMC7537539 DOI: 10.1111/apa.15582] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/24/2022]
Abstract
Aim COVID‐19 has affected millions of people worldwide. This paper reviews the Swedish pandemic response. Methods A narrative review was carried out and a timeline constructed. Results By September 1, 2020, 0.8% of Swedish residents had tested positive for the virus and 0.06% of the population had died, which was higher than neighbouring Nordic countries, but lower than some European countries with general lockdowns. The main actors were the Public Health Agency, the National Board of Health and Welfare, the Civil Contingencies Agency and the Government. County councils and regions implemented policies, in conjunction with the Department of Education and county administrative boards. Sweden's response was less invasive than many other countries, with no general lockdown. It focused on mitigation: slowing, but not stopping, the pandemic. Physical distancing was recommended in public spaces, but mandatory in bars, restaurants and at events. Visits to nursing facilities were banned. Kindergartens and schools for children up to 16 stayed open, but closed for older children for three months. There were no enforced quarantines for infected households or geographical regions, and facemasks were not recommended outside health care. Conclusion Sweden chose a different pandemic strategy to its peer nations. This paper examines the first eight months.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Paediatrics Orebro University Hospital Orebro Sweden
- Division of Epidemiology and Public Health School of Medicine University of Nottingham UK
- Department of Medicine Columbia University College of Physicians and Surgeons New York NY USA
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61
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Genie MG, Loría-Rebolledo LE, Paranjothy S, Powell D, Ryan M, Sakowsky RA, Watson V. Understanding public preferences and trade-offs for government responses during a pandemic: a protocol for a discrete choice experiment in the UK. BMJ Open 2020; 10:e043477. [PMID: 33444217 PMCID: PMC7682450 DOI: 10.1136/bmjopen-2020-043477] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Social distancing and lockdown measures are among the main government responses to the COVID-19 pandemic. These measures aim to limit the COVID-19 infection rate and reduce the mortality rate of COVID-19. Given we are likely to see local lockdowns until a treatment or vaccine for COVID-19 is available, and their effectiveness depends on public acceptability, it is important to understand public preference for government responses. METHODS AND ANALYSIS Using a discrete choice experiment (DCE), this study will investigate the public's preferences for pandemic responses in the UK. Attributes (and levels) are based on: (1) lockdown measures described in policy documents; (2) literature on preferences for lockdown measures and (3) a social media analysis. Attributes include: lockdown type; lockdown length; postponement of usual non-urgent medical care; number of excess deaths; number of infections; impact on household spending and job losses. We will prepilot the DCE using virtual think aloud interviews with respondents recruited via Facebook. We will collect preference data using an online survey of 4000 individuals from across the four UK countries (1000 per country). We will estimate the relative importance of the attributes, and the trade-offs individuals are willing to make between attributes. We will test if respondents' preferences differ based on moral attitudes (using the Moral Foundation Questionnaire), socioeconomic circumstances (age, education, economic insecurity, health status), country of residence and experience of COVID-19. ETHICS AND DISSEMINATION The University of Aberdeen's College Ethics Research Board (CERB) has approved the study (reference: CERB/2020/6/1974). We will seek CERB approval for major changes from the developmental and pilot work. Peer-reviewed papers will be submitted, and results will be presented at public health and health economic conferences nationally and internationally. A lay summary will be published on the Health Economics Research Unit blog.
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Affiliation(s)
- Mesfin G Genie
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | | | | | - Daniel Powell
- Health Psychology, University of Aberdeen, Aberdeen, UK
| | - Mandy Ryan
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Verity Watson
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
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Valeriani G, Sarajlic Vukovic I, Lindegaard T, Felizia R, Mollica R, Andersson G. Addressing Healthcare Gaps in Sweden during the COVID-19 Outbreak: On Community Outreach and Empowering Ethnic Minority Groups in a Digitalized Context. Healthcare (Basel) 2020; 8:E445. [PMID: 33139619 PMCID: PMC7712425 DOI: 10.3390/healthcare8040445] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 01/12/2023] Open
Abstract
Since its early stages, the COVID-19 pandemic has interacted with existing divides by ethnicity and socioeconomic statuses, exacerbating further inequalities in high-income countries. The Swedish public health strategy, built on mutual trust between the government and the society and giving the responsibility to the individual, has been criticized for not applying a dedicated and more diverse strategy for most disadvantaged migrants in dealing with the pandemic. In order to mitigate the unequal burden on the marginalized members of society, increasing efforts have been addressed to digital health technologies. Despite the strong potential of providing collective public health benefits, especially in a highly digitalized context as Sweden, need for a stronger cooperation between the public health authorities and migrant community leaders, representatives of migrant associations, religious leaders and other influencers of disadvantaged groups has emerged. Suggestions are presented on more culturally congruent, patient-centered health care services aimed to empower people to participate in a more effective public health response to the COVID-19 crisis.
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Affiliation(s)
- Giuseppe Valeriani
- Refugee Health Centre, Ostergotland County Council, 601 82 Norrköping, Sweden;
| | - Iris Sarajlic Vukovic
- Department for Affective Disorders, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden;
| | - Tomas Lindegaard
- Department of Behavioural Sciences and Learning, Linköping University, 581 83 Linköping, Sweden; (T.L.); (G.A.)
| | - Roberto Felizia
- Refugee Health Centre, Ostergotland County Council, 601 82 Norrköping, Sweden;
| | - Richard Mollica
- Harvard Program in Refugee Trauma, Massachusetts General Hospital, Harvard Medical School, Cambridge, MA 02115, USA;
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, 581 83 Linköping, Sweden; (T.L.); (G.A.)
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Elisabeth M, Maneesh PS, Michael S. Refugees in Sweden During the Covid-19 Pandemic-The Need for a New Perspective on Health and Integration. Front Public Health 2020; 8:574334. [PMID: 33194974 PMCID: PMC7604301 DOI: 10.3389/fpubh.2020.574334] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/07/2020] [Indexed: 11/13/2022] Open
Abstract
Refugees are already a vulnerable group in society and are in a stressful situation due to their often uncertain legal status in seeking asylum and integration in the new society after migration. Refugees are, in general, at greater risk of poor health outcomes when contracting Covid-19, exacerbated by poor living conditions and difficulties in accessing healthcare. The longer-term social consequences of the pandemic also disproportionately impact refugees, including social isolation, unemployment, and difficulties to obtain correct health information. The aim of this paper is to review the social and health consequences that Covid-19 has brought to the refugees residing in Sweden. This needs to be emphasized in order to mitigate against these likely consequences and improve the overall well-being among such a highly vulnerable group in society. As Covid-19 demonstrates, human health needs to be understood holistically, meaning that the vulnerability of any individuals, or even nations, is a vulnerability for the whole population requiring urgent action.
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Affiliation(s)
- Mangrio Elisabeth
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.,Malmö Institute for Studies of Migration, Diversity and Welfare (MIM), Malmö University, Malmö, Sweden
| | | | - Strange Michael
- Malmö Institute for Studies of Migration, Diversity and Welfare (MIM), Malmö University, Malmö, Sweden.,Global Political Studies, Malmö University, Malmö, Sweden
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