151
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Xue FX, Shen KL. COVID-19 in children and the importance of COVID-19 vaccination. World J Pediatr 2021; 17:462-466. [PMID: 34581958 PMCID: PMC8476974 DOI: 10.1007/s12519-021-00466-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/09/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Feng-Xia Xue
- Department of Respiratory Medicine, Beijing Children's Hospital, China National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Capital Medical University, Beijing, 100045, China
| | - Kun-Ling Shen
- Department of Respiratory Medicine, Beijing Children's Hospital, China National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Capital Medical University, Beijing, 100045, China.
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152
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Labrague LJ, De Los Santos JAA, Falguera CC. Social and emotional loneliness among college students during the COVID-19 pandemic: The predictive role of coping behaviors, social support, and personal resilience. Perspect Psychiatr Care 2021; 57:1578-1584. [PMID: 33410143 DOI: 10.1111/ppc.12721] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To determine the influence of coping behaviors, resilience, and social support on students' emotional and social loneliness during the COVID-19 pandemic. DESIGN AND METHODS A cross-sectional research design was used to gather data from 303 college students from the Central Philippines using four standardized scales through an online survey. FINDINGS Loneliness among students was high during the coronavirus pandemic. Resilience, coping behaviors, and social support were identified as protective factors against loneliness. PRACTICE IMPLICATIONS Interventions directed toward increasing resilience, social support, and coping behaviors may help decrease emotional and social loneliness caused by the mandatory lockdown during the COVID-19 pandemic.
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Affiliation(s)
| | | | - Charlie C Falguera
- School of Health Sciences, University of the Philippines Manila, Manila, Philippines
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153
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Rauscher E, Burns A. Unequal Opportunity Spreaders: Higher COVID-19 Deaths with Later School Closure in the United States. SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2021; 64:831-856. [PMID: 37332490 PMCID: PMC10275350 DOI: 10.1177/07311214211005486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Mixed evidence on the relationship between school closure and COVID-19 prevalence could reflect focus on large-scale levels of geography, limited ability to address endogeneity, and demographic variation. Using county-level Centers for Disease Control and Prevention (CDC) COVID-19 data through June 15, 2020, two matching strategies address potential heterogeneity: nearest geographic neighbor and propensity scores. Within nearest neighboring pairs in different states with different school closure timing, each additional day from a county's first case until state-ordered school closure is related to 1.5 to 2.4 percent higher cumulative COVID-19 deaths per capita (1,227-1,972 deaths for a county with median population and deaths/capita). Results are consistent using propensity score matching, COVID-19 data from two alternative sources, and additional sensitivity analyses. School closure is more strongly related to COVID-19 deaths in counties with a high concentration of Black or poor residents, suggesting schools play an unequal role in transmission and earlier school closure is related to fewer lives lost in disadvantaged counties.
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154
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Maciel ELN, Gomes CC, Almada GL, Medeiros Junior NFD, Cardoso OA, Jabor PM, Reuter T, Andrade VLGD, Bastos WM, Zandonade E. COVID-19 in children, adolescents and young adults: a cross-sectional study in Espírito Santo, Brazil, 2020. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e20201029. [PMID: 34586293 DOI: 10.1590/s1679-49742021000400001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/08/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze self-reported sociodemographic and clinical characteristics among individuals aged 2 to 22 years and possible associations with SARS-CoV-2 infection in Espírito Santo, Brazil. METHODS This was a serial cross-sectional population-based study carried out from May to June 2020. The COVID-19 positivity rate was assessed by serological testing, and associated factors were assessed using Pearson's chi-square test (5% significance level). RESULTS Among 1,693 individuals aged 2 to 22 years, 6.1% tested positive for COVID-19 and, among these, 35.5% did not present any symptoms. Differences were identified between positive and negative cases regarding the number of symptoms (p-value=0.001).Coughing was reported by 40.4% of positive individuals. Only 14.3% sought health care, namely 29.8% among those who tested positive and 13.3% among those who tested negative (p-value=0.001). CONCLUSION The percentage of asymptomatic patients can impact the COVID-19 transmission chain in schools and fuel outbreaks of the disease in schools.
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Affiliation(s)
| | | | | | | | | | | | - Tania Reuter
- Hospital Universitário Cassiano Antônio Moraes, Vitória, ES, Brasil
| | | | | | - Eliana Zandonade
- Universidade Federal do Espírito Santo, Laboratório de Epidemiologia, Vitória, ES, Brasil
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155
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Ahlers MJ, Aralis HJ, Tang WL, Sussman JB, Fonarow GC, Ziaeian B. Non-Pharmaceutical Interventions and COVID-19 Burden in the United States. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.09.26.21264142. [PMID: 34611668 PMCID: PMC8491859 DOI: 10.1101/2021.09.26.21264142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) are mitigation strategies used to reduce the spread of transmissible diseases. The relative effectiveness of specific NPIs remains uncertain. METHODS We used state-level Coronavirus disease 2019 (COVID-19) case and mortality data between January 19, 2020 and March 7, 2021 to model NPI policy effectiveness. Empirically derived breakpoints in case and mortality velocities were used to identify periods of stable, decreasing, or increasing COVID-19 burden. The associations between NPI adoption and subsequent decreases in case or death velocities were estimated using generalized linear models accounting for weekly variability shared across states. State-level NPI policies included: stay at home order, indoor public gathering ban (mild >10 or severe ≤10), indoor restaurant dining ban, and public mask mandate. RESULTS 28,602,830 cases and 511,899 deaths were recorded. The odds of a decrease in COVID-19 case velocity were significantly elevated for stay at home (OR 2.02, 95% CI 1.63-2.52), indoor dining ban (OR 1.62, 95% CI 1.25-2.10), public mask mandate (OR 2.18, 95% CI 1.47-3.23), and severe gathering ban (OR 1.68, 95% CI 1.31-2.16). In mutually adjusted models, odds remained elevated for stay at home (AOR 1.47, 95% CI 1.04-2.07) and public mask mandate (AOR = 2.27, 95% CI 1.51-3.41). Stay at home (OR 2.00, 95% CI 1.53-2.62; AOR 1.89, 95% CI 1.25-2.87) was also associated with greater likelihood of decrease in death velocity in unadjusted and adjusted models. CONCLUSIONS NPIs employed in the U.S. during the COVID-19 pandemic, most significantly stay at home orders, were associated with decreased COVID-19 burden.
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Affiliation(s)
- Michael J Ahlers
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Hilary J Aralis
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Wilson L Tang
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jeremy B Sussman
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Gregg C Fonarow
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Boback Ziaeian
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Division of Cardiology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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156
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Omowale SS, Casas A, Lai YH, Sanders SA, Hill AV, Wallace ML, Rathbun SL, Gary-Webb TL, Burke LE, Davis EM, Mendez DD. Trends in Stress Throughout Pregnancy and Postpartum Period During the COVID-19 Pandemic: Longitudinal Study Using Ecological Momentary Assessment and Data From the Postpartum Mothers Mobile Study. JMIR Ment Health 2021; 8:e30422. [PMID: 34328420 PMCID: PMC8457341 DOI: 10.2196/30422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Stress is associated with adverse birth and postpartum health outcomes. Few studies have longitudinally explored racial differences in maternal stress in a birthing population in the United States during the ongoing COVID-19 pandemic. OBJECTIVE This study aimed to do the following: (1) assess changes in reported stress before, during, and after initial emergency declarations (eg, stay-at-home orders) were in place due to the COVID-19 pandemic, and (2) assess Black-White differences in reported stress in a pregnant and postpartum population from Southwestern Pennsylvania. METHODS We leveraged data from the ongoing Postpartum Mothers Mobile Study (PMOMS), which surveys participants in real time throughout the pregnancy and postpartum periods via ecological momentary assessment (EMA) and smartphone technology. We analyzed data from a subset of PMOMS participants (n=85) who were either Black or White, and who submitted EMA responses regarding stress between November 1, 2019, and August 31, 2020, the time frame of this study. We divided data into four phases based on significant events during the COVID-19 pandemic: "pre" phase (baseline), "early" phase (first case of COVID-19 reported in United States), "during" phase (stay-at-home orders), and "post" phase (stay-at-home orders eased). We assessed mean stress levels at each phase using linear mixed-effects models and post hoc contrasts based on the models. RESULTS Overall mean stress (0=not at all to 4=a lot) during the pre phase was 0.8 for Black and White participants (range for Black participants: 0-3.9; range for White participants: 0-2.8). There was an increase of 0.3 points (t5649=5.2, P<.001) in the during phase as compared with the pre phase, and an increase of 0.2 points (t5649=3.1, P=.002) in the post phase compared with the pre phase (n=85). No difference was found between Black and White participants in the change in mean stress from the pre phase to the during phase (overall change predicted for the regression coefficient=-0.02, P=.87). There was a significant difference between Black and White participants in the change in mean stress from the during phase to the post phase (overall change predicted for the regression coefficient=0.4, P<.001). CONCLUSIONS There was an overall increase in mean stress levels in this subset of pregnant and postpartum participants during the same time as the emergency declarations/stay-at-home orders in the United States. Compared to baseline, mean stress levels remained elevated when stay-at-home orders eased. We found no significant difference in the mean stress levels by race. Given that stress is associated with adverse birth outcomes and postpartum health, stress induced by the ongoing COVID-19 pandemic may have adverse implications for birthing populations in the United States. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/13569.
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Affiliation(s)
- Serwaa S Omowale
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, United States
- Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea Casas
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yu-Hsuan Lai
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sarah A Sanders
- Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ashley V Hill
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, United States
| | - Tiffany L Gary-Webb
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lora E Burke
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Esa M Davis
- Division of Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dara D Mendez
- Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Division of Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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157
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Askarian M, Taghrir MH, Estedlal A, Estedlal T, Tabei SS, Askarian A. Implementing distancing in case of school reopening amid COVID-19 pandemic: Recommendations. EXCLI JOURNAL 2021; 20:1407-1411. [PMID: 34737684 PMCID: PMC8564904 DOI: 10.17179/excli2021-4142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Taghrir
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Estedlal
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Taraneh Estedlal
- Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Sajjad Tabei
- Medical Genetics Centre of Southern Iran, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ardalan Askarian
- Student, College of Arts & Science, University of Saskatchewan, Saskatoon, Canada
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158
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Carella G, Pérez Trufero J, Álvarez M, Mateu J. A Bayesian Spatial Analysis of the Heterogeneity in Human Mobility Changes During the First Wave of the COVID-19 Epidemic in the United States. AM STAT 2021. [DOI: 10.1080/00031305.2021.1965657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Giulia Carella
- CartoDB Inc., New York, NY
- Barcelona Supercomputing Center, Barcelona, Spain
| | | | | | - Jorge Mateu
- Department of Mathematics, University Jaume I, Castellón de la Plana, Spain
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159
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Bhatt NS, Meyer C, Mau LW, Broglie L, Devine S, Choi SW, Auletta J, Phelan R. Return-to-School Practices for Pediatric Hematopoietic Cell Transplantation Recipients during the COVID-19 Pandemic. Transplant Cell Ther 2021; 28:54.e1-54.e4. [PMID: 34543770 PMCID: PMC8447546 DOI: 10.1016/j.jtct.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 10/25/2022]
Abstract
Although organizations such as Centers for Disease Control and Prevention and American Academy of Pediatrics have published guidelines favoring the resumption of in-person schooling during the coronavirus disease 19 (COVID-19) pandemic, there is no specific guidance on hematopoietic cell transplantation (HCT) recipients' safe return to school. We conducted a cross-sectional survey of pediatric HCT physician members of the Pediatric Transplantation and Cellular Therapy Consortium practicing in the United States to describe current return-to-school practices during the COVID-19 pandemic for HCT recipients. A total of 122 respondents (response rate, 30.6%) from 60 transplant centers in 32 US states completed the survey. Most of the respondents (76%) recommended that HCT recipients consider a remote or hybrid school option at this time if possible. If not possible, the respondents recommended a return to in-person school if the patient is at least 12 months post-transplantation or off immune suppression, while taking school safety measures and local COVID-19 cases into account. These results provide valuable guidance for the HCT community, patients, and caregivers on important topics to consider while making return-to-school decisions.
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Affiliation(s)
- Neel S Bhatt
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
| | - Christa Meyer
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Lih-Wen Mau
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Larisa Broglie
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Steven Devine
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Sung Won Choi
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Minnesota
| | - Jeffery Auletta
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Rachel Phelan
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
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160
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Zviedrite N, Hodis JD, Jahan F, Gao H, Uzicanin A. COVID-19-associated school closures and related efforts to sustain education and subsidized meal programs, United States, February 18-June 30, 2020. PLoS One 2021; 16:e0248925. [PMID: 34520475 PMCID: PMC8439454 DOI: 10.1371/journal.pone.0248925] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/06/2021] [Indexed: 01/03/2023] Open
Abstract
Pre-emptive school closures are frontline community mitigation measures recommended by the US Centers for Disease Control and Prevention (CDC) for implementation during severe pandemics. This study describes the spatiotemporal patterns of publicly announced school closures implemented in response to the coronavirus disease 2019 (COVID-19) pandemic and assesses how public K-12 districts adjusted their methods of education delivery and provision of subsidized meals. During February 18–June 30, 2020, we used daily systematic media searches to identify publicly announced COVID-19–related school closures lasting ≥1 day in the United States (US). We also collected statewide school closure policies from state government websites. Data on distance learning and subsidized meal programs were collected from a stratified sample of 600 school districts. The first COVID-19–associated school closure occurred on February 27, 2020 in Washington state. By March 30, 2020, all but one US public school districts were closed, representing the first-ever nearly synchronous nationwide closure of public K-12 schools in the US. Approximately 100,000 public schools were closed for ≥8 weeks because of COVID-19, affecting >50 million K-12 students. Of 600 districts sampled, the vast majority offered distance learning (91.0%) and continued provision of subsidized meal programs (78.8%) during the closures. Despite the sudden and prolonged nature of COVID-19–associated school closures, schools demonstrated flexibility by implementing distance learning and alternate methods to continue subsidized meal programs.
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Affiliation(s)
- Nicole Zviedrite
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Jeffrey D. Hodis
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
| | - Ferdous Jahan
- Kāpili Services, LLC, Atlanta, Georgia, United States of America
| | - Hongjiang Gao
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amra Uzicanin
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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161
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Baccini M, Cereda G. Screening plans for SARS-CoV-2 based on sampling and rotation: An example in a European school setting. PLoS One 2021; 16:e0257099. [PMID: 34506536 PMCID: PMC8432749 DOI: 10.1371/journal.pone.0257099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Screening plans for prevention and containment of SARS-CoV-2 infection should take into account the epidemic context, the fact that undetected infected individuals may transmit the disease and that the infection spreads through outbreaks, creating clusters in the population. In this paper, we compare through simulations the performance of six screening plans based on poorly sensitive individual tests, in detecting infection outbreaks at the level of single classes in a typical European school context. The performance evaluation is done by simulating different epidemic dynamics within the class during the four weeks following the day of the initial infection. The plans have different costs in terms of number of individual tests required for the screening and are based on recurrent evaluations on all students or subgroups of students in rotation. Especially in scenarios where the rate of contagion is high, at an equal cost, testing half of the class in rotation every week appears to be better in terms of sensitivity than testing all students every two weeks. Similarly, testing one-fourth of the students every week is comparable with testing all students every two weeks, despite the first one is a much cheaper strategy. In conclusion, we show that in the presence of natural clusters in the population, testing subgroups of individuals belonging to the same cluster in rotation may have a better performance than testing all the individuals less frequently. The proposed simulations approach can be extended to evaluate more complex screening plans than those presented in the paper.
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Affiliation(s)
- Michela Baccini
- Department of Statistics, Computer Science, Applications (DISIA), University of Florence, Florence, Italy
- * E-mail:
| | - Giulia Cereda
- Department of Statistics, Computer Science, Applications (DISIA), University of Florence, Florence, Italy
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162
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Sams N, Fisher DM, Mata-Greve F, Johnson M, Pullmann MD, Raue PJ, Renn BN, Duffy J, Darnell D, Fillipo IG, Allred R, Huynh K, Friedman E, Areán PA. Understanding Psychological Distress and Protective Factors Amongst Older Adults During the COVID-19 Pandemic. Am J Geriatr Psychiatry 2021; 29:881-894. [PMID: 33867224 PMCID: PMC8491780 DOI: 10.1016/j.jagp.2021.03.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/23/2021] [Accepted: 03/15/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This study examined the emotional distress and loneliness during COVID-19 and the roles of resiliency and activities. DESIGN A cross-sectional national survey. SETTING Amazon Mechanical Turk (mTurk) and Prolific Research Platforms. PARTICIPANTS Five hundred and one U.S. dwelling English-speaking adults 60 years old and older. MEASUREMENTS Participants completed an online survey with the PHQ-9; GAD-7; Short Health Anxiety Inventory; 3-item UCLA Loneliness scale; PROMIS measures of global health, instrumental, and emotional support; 10-item Connor-Davidson Resilience Scale; and COVID-19 needs assessment. RESULTS Across the sample 13% reported moderate depressive symptoms, 9% reported moderate anxiety symptoms, and 26% endorsed being "lonely." The emotionally distressed group endorsed more loneliness, lower resiliency, less physical exercise, and worse physical health. The low Socio-Economic Status group endorsed less loneliness, less likely to engage in physical exercise and worse physical health.The lonely group endorsed less resilience, less physical exercise, and worse physical health. A multiple logistic regression found that resilience, socioeconomic status, and physical health were significant predictors of loneliness, whereas global health was the best predictor of emotional distress. CONCLUSIONS Even after prolonged social distancing, older adults in this study did not report greater psychological distress compared to earlier studies of older adults during COVID-19. Older adults with lower SES, worse physical health, and less resiliency, were more likely to report more loneliness. It is this group that should be the focus of intervention.
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Affiliation(s)
- Nichole Sams
- University of Washington Department of Psychiatry and Behavioral Sciences,University of Washington ALACRITY Center
| | - Dylan M. Fisher
- University of Washington Department of Psychiatry and Behavioral Sciences
| | - Felicia Mata-Greve
- University of Washington Department of Psychiatry and Behavioral Sciences,University of Washington ALACRITY Center
| | - Morgan Johnson
- University of Washington Department of Psychiatry and Behavioral Sciences,University of Washington ALACRITY Center
| | - Michael D. Pullmann
- University of Washington Department of Psychiatry and Behavioral Sciences,University of Washington ALACRITY Center
| | - Patrick J. Raue
- University of Washington ALACRITY Center,University of Washington AIMS Center
| | | | - Jaden Duffy
- University of Washington Department of Psychiatry and Behavioral Sciences,University of Washington ALACRITY Center
| | - Doyanne Darnell
- University of Washington Department of Psychiatry and Behavioral Sciences
| | | | | | | | | | - Patricia A. Areán
- University of Washington Department of Psychiatry and Behavioral Sciences,University of Washington ALACRITY Center,University of Washington AIMS Center
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163
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Reinhart E, Chen DL. Association of Jail Decarceration and Anticontagion Policies With COVID-19 Case Growth Rates in US Counties. JAMA Netw Open 2021; 4:e2123405. [PMID: 34473257 PMCID: PMC8414192 DOI: 10.1001/jamanetworkopen.2021.23405] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Mass incarceration is known to foster infectious disease outbreaks, amplification of infectious diseases in surrounding communities, and exacerbation of health disparities in disproportionately policed communities. To date, however, policy interventions intended to achieve epidemic mitigation in US communities have neglected to account for decarceration as a possible means of protecting public health and safety. OBJECTIVE To evaluate the association of jail decarceration and government anticontagion policies with reductions in the spread of SARS-CoV-2. DESIGN, SETTING, AND PARTICIPANTS This cohort study used county-level data from January to November 2020 to analyze COVID-19 cases, jail populations, and anticontagion policies in a panel regression model to estimate the association of jail decarceration and anticontagion policies with COVID-19 growth rates. A total of 1605 counties with data available on both jail population and COVID-19 cases were included in the analysis. This sample represents approximately 51% of US counties, 72% of the US population, and 60% of the US jail population. EXPOSURES Changes to jail populations and implementation of 10 anticontagion policies: nursing home visitation bans, school closures, mask mandates, prison visitation bans, stay-at-home orders, and closure of nonessential businesses, gyms, bars, movie theaters, and restaurants. MAIN OUTCOMES AND MEASURES Daily COVID-19 case growth rates. RESULTS In the 1605 counties included in this study, the mean (SD) prison population was 283.38 (657.78) individuals, and the mean (SD) population was 315.24 (2151.01) persons per square mile. An estimated 80% reduction in US jail populations, achievable through noncarceral management of nonviolent alleged offenses and in line with average international incarceration rates, would have been associated with a 2.0% (95% CI, 0.8%-3.1%) reduction in daily COVID-19 case growth rates. Jail decarceration was associated with 8 times larger reductions in COVID-19 growth rates in counties with above-median population density (4.6%; 95% CI, 2.2%- 7.1%) relative to those below this median (0.5%; 95% CI, 0.1%-0.9%). Nursing home visitation bans were associated with a 7.3% (95% CI, 5.8%-8.9%) reduction in COVID-19 case growth rates, followed by school closures (4.3%; 95% CI, 2.0%-6.6%), mask mandates (2.5%; 95% CI, 1.7%-3.3%), prison visitation bans (1.2%; 95% CI, 0.2%-2.2%), and stay-at-home orders (0.8%; 95% CI, 0.1%-1.6%). CONCLUSIONS AND RELEVANCE Although many studies have documented that high incarceration rates are associated with communitywide health harms, this study is, to date, the first to show that decarceration is associated with population-level public health benefits. Its findings suggest that, among other anticontagion interventions, large-scale decarceration and changes to pretrial detention policies are likely to be important for improving US public health, biosecurity, and pandemic preparedness.
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Affiliation(s)
- Eric Reinhart
- Data and Evidence for Justice Reform, The World Bank, Washington, DC
- Department of Anthropology, Harvard University, Cambridge, Massachusetts
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois
| | - Daniel L. Chen
- Data and Evidence for Justice Reform, The World Bank, Washington, DC
- Centre National de la Recherche Scientifique, Paris, France
- Toulouse School of Economics, Toulouse, France
- Institute for Advanced Study in Toulouse, Toulouse, France
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164
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Mendez-Brito A, El Bcheraoui C, Pozo-Martin F. Systematic review of empirical studies comparing the effectiveness of non-pharmaceutical interventions against COVID-19. J Infect 2021; 83:281-293. [PMID: 34161818 PMCID: PMC8214911 DOI: 10.1016/j.jinf.2021.06.018] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/14/2021] [Accepted: 06/19/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate which non-pharmaceutical interventions (NPIs) have been more and less effective in controlling the COVID-19 pandemic. METHODS We performed a systematic review of published and unpublished empirical studies, either observational or interventional, analysing the comparative effectiveness of NPIs against the COVID-19 pandemic. We searched Embase/Medline and medRxiv to identify the relevant literature. RESULTS We identified 34 studies. During the first wave of the COVID-19 pandemic, school closing was the most effective NPI, followed by workplace closing, business and venue closing and public event bans. Public information campaigns and mask wearing requirements were also effective in controlling the pandemic while being less disruptive for the population than other NPIs. There was no evidence on the effectiveness of public transport closure, testing and contact tracing strategies and quarantining or isolation of individuals. Early implementation was associated with a higher effectiveness in reducing COVID-19 cases and deaths, while general stringency of the NPIs was not. CONCLUSIONS In this systematic review, we found that school closing, followed by workplace closing, business and venue closing and public event bans were the most effective NPIs in controlling the spread of COVID-19. An early response and a combination of specific social distancing measures are effective at reducing COVID-19 cases and deaths. Continuous monitoring of NPIs effectiveness is needed in order to adapt decision making.
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Affiliation(s)
- Alba Mendez-Brito
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, Berlin 13353, Germany; Institute of Tropical Medicine and International Health, Charité University Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany
| | - Charbel El Bcheraoui
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, Berlin 13353, Germany
| | - Francisco Pozo-Martin
- Evidence-Based Public Health Unit, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, Berlin 13353, Germany.
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165
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Varol T, Crutzen R, Schneider F, Mesters I, Ruiter RA, Kok G, ten Hoor GA. Selection of determinants of students' adherence to COVID-19 guidelines and translation into a brief intervention. Acta Psychol (Amst) 2021; 219:103400. [PMID: 34419688 PMCID: PMC8367745 DOI: 10.1016/j.actpsy.2021.103400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/12/2021] [Accepted: 08/12/2021] [Indexed: 12/24/2022] Open
Abstract
Background When reopening universities in times of COVID-19, students still have to adhere to COVID-19 behavioral guidelines. We explored what behavioral determinants (and underlying beliefs) related to the adherence to guidelines are both relevant and changeable, as input for future interventions. Methods A cross-sectional online survey was conducted (Oct–Nov 2020), identifying behavioral determinants (and underlying beliefs) of university students' adherence to COVID-19-guidelines, including keeping 1.5 m distance, getting tested, and isolating (N = 255). Results Attitude, perceived norm, self-efficacy, and several beliefs (e.g., risk perception beliefs ‘I am not afraid because I am young’ [r = −0.33; p < .001]; attitudinal beliefs, e.g., ‘I feel responsible for telling people to adhere to guidelines’ [r = 0.37; p < .001]; self-efficacy beliefs, e.g., ‘COVID-19-prevention guidelines are difficult to adhere to’ [r = −0.30; p < .001]) were associated with intention to adhere to guidelines, and for those beliefs there was room for improvement, making them suitable as possible intervention targets. Conclusions Students mostly adhere to COVID-19 guidelines, but there is room for improvement. Interventions need to enhance students' adherence behavior by targeting the most relevant determinants as identified in this study. Based on these findings, a small intervention was introduced targeting the determinants of students' adherence to guidelines.
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166
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González Rodríguez P, Pérez-Moneo Agapito B, Albi Rodríguez MS, Aizpurua Galdeano P, Aparicio Rodrigo M, Fernández Rodríguez MM, Esparza Olcina MJ, Ochoa Sangrador C. [COVID-19: Critical appraisal of the evidence]. An Pediatr (Barc) 2021; 95:207.e1-207.e13. [PMID: 38620739 PMCID: PMC8173476 DOI: 10.1016/j.anpedi.2021.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/28/2021] [Indexed: 12/18/2022] Open
Abstract
We present the summary of a critical appraisal document of the available evidence on COVID-19, developed with a clinical practice guide format following GRADE methodology. The document tries to provide answers to a series of structured clinical questions, with an explicit definition of the population, intervention/exposure, comparison and outcome, and a rating of the clinical relevance of the outcome measures. We conducted a systematic review of the literature to answer the questions, grouped into six chapters: epidemiology, clinical practice, diagnosis, treatment, prevention, and vaccination. We assessed the risk of bias of the selected studies with standard instruments (RoB-2, ROBINS-I, QUADAS and Newcastle-Ottawa). We constructed evidence tables and, when necessary and possible, meta-analysis of the of the most relevant outcome measures. We followed the GRADE system to synthesize the evidence, assessing its quality, and, when appropriate, giving recommendations, rated according to the quality of the evidence, the values and preferences, the balance between benefits, risks and costs, equity and feasibility.
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167
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González Rodríguez P, Pérez-Moneo Agapito B, Albi Rodríguez MS, Aizpurua Galdeano P, Aparicio Rodrigo M, Fernández Rodríguez MM, Esparza Olcina MJ, Ochoa Sangrador C. COVID-19: Critical appraisal of the evidence. An Pediatr (Barc) 2021; 95:207.e1-207.e13. [PMID: 34380606 PMCID: PMC8299218 DOI: 10.1016/j.anpede.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/28/2021] [Indexed: 11/19/2022] Open
Abstract
We present the summary of a critical appraisal document of the available evidence on COVID-19, developed with a clinical practice guide format following GRADE methodology. The document tries to provide answers to a series of structured clinical questions, with an explicit definition of the population, intervention / exposure, comparison and outcome, and a rating of the clinical relevance of the outcome measures. We conducted a systematic review of the literature to answer the questions, grouped into six chapters: epidemiology, clinical practice, diagnosis, treatment, prevention, and vaccination. We assessed the risk of bias of the selected studies with standard instruments (RoB-2, ROBINS-I, QUADAS and Newcastle-Ottawa). We constructed evidence tables and, when necessary and possible, meta-analysis of the of the most relevant outcome measures. We followed the GRADE system to synthesise the evidence, assessing its quality, and, when appropriate, giving recommendations, rated according to the quality of the evidence, the values and preferences, the balance between benefits, risks and costs, equity and feasibility.
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168
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Friedrich F, E Garcia LDC, Petry LM, Pieta MP, Carvalho GE, Zocche G, Ongaratto R, Lumertz MS, Brum M, Stein RT, Scotta MC, Jones MH, Pinto LA. Impact of nonpharmacological COVID-19 interventions in hospitalizations for childhood pneumonia in Brazil. Pediatr Pulmonol 2021; 56:2818-2824. [PMID: 34265188 DOI: 10.1002/ppul.25570] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The knowledge about the impact of the nonpharmacological measures to control the COVID-19 pandemic can give insight into ways in which they can also be applied for other respiratory diseases. To assess the impact of containment measures of the COVID-19 pandemic on pneumonia hospitalizations in children from 0 to 14 years of age in Brazil. METHODS Data from hospital admissions for pneumonia were obtained from the Department of Informatics of Brazilian Public Health System database in the period of 2015-2020 and analyzed by macroregions and age groups. To evaluate the effect of containment measures, on the incidence of pneumonia, the absolute reduction and relative reduction were calculated by analyzing the subsets 2015-2019 vs. 2020. RESULTS Comparing the subsets of April-August 2015-2019 vs. April-August 2020 for Brazil (total), there was an significant reduction in the average incidence of hospitalizations, with numbers ranging from -82% [IRR 0.17 (0.14-0.21)] for <4 years (prepandemic 741.8/100,000 vs. pandemic 132.7/100.000), -83% [IRR 0.17 (0.10-0.27)] for 5-9 years (prepandemic 113.6/100,000 vs. pandemic 19.6/100.000), -77% [IRR 0.23 (0.11-0.46)] for 10-14 (prepandemic 42.0/100,000 vs. pandemic 9.8/100.000) and -82% [IRR 0.18 (0.15-0.21)] for all children ≤14 years (prepandemic 897.4/100,000 vs. pandemic 162.1/100.000). CONCLUSION We found a significant decrease in cases of all cause pneumonia in children under 14 years and especially in the age group <9 years during the COVID-19 pandemic, which may be associated with the nonpharmacological measures applied to control the SARS-CoV-2.
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Affiliation(s)
- Frederico Friedrich
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Laura de Castro E Garcia
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Lucas Montiel Petry
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Marina Puerari Pieta
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Gustavo Eggers Carvalho
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Giovani Zocche
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Renata Ongaratto
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Magali Santos Lumertz
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Marcos Brum
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Renato T Stein
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Marcelo C Scotta
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Marcus Herbert Jones
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
| | - Leonardo Araújo Pinto
- Centro Infant, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Avenida Ipiranga 6690, Porto Alegre, Brazil
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169
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Reinbold GW. Effect of Fall 2020 K-12 instruction types on COVID-19 cases, hospital admissions, and deaths in Illinois counties. Am J Infect Control 2021; 49:1146-1151. [PMID: 34052313 PMCID: PMC8159703 DOI: 10.1016/j.ajic.2021.05.011] [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: 03/23/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 12/13/2022]
Abstract
Background One of the most difficult public policy decisions associated with the COVID-19 pandemic has been about how to offer K-12 instruction. We sought to determine whether differences in instruction types at the beginning of the 2020-2021 school year were related to differences in COVID-19 cases, hospitalizations, and deaths in Illinois counties during the first 3 weeks of the school year. Methods We divided Illinois counties into 3 groups based on the instruction type used for a majority of K-12 students at the start of the school year: in-person, hybrid, or online-only. We used synthetic control analysis to match counties between the 3 groups. Results Both majority hybrid and majority online-only counties had significantly fewer new cases than majority in-person counties. There were no significant differences in new cases between majority hybrid counties and majority online-only counties or in new hospital admissions or deaths between any of the 3 county groups. Conclusions This paper adds to the growing scientific consensus that at least some forms of in-person K-12 instruction have not contributed significantly to the spread of the pandemic. However, our results suggest that there may be an important difference between fully in-person instruction and hybrid instruction.
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170
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Simetin IP, Svajda M, Ivanko P, Dimnjakovic J, Belavic A, Istvanovic A, Poljicanin T. COVID-19 incidence, hospitalizations and mortality trends in Croatia and school closures. Public Health 2021; 198:164-170. [PMID: 34461449 PMCID: PMC8328567 DOI: 10.1016/j.puhe.2021.07.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022]
Abstract
Objectives COVID-19 pandemic affected majority of students worldwide because school closures were one of the first and frequently taken measures in tackling epidemic. This study analyzed trends in COVID-19 morbidity and mortality from the beginning of pandemic in Croatia, in relation to schools opening and closing. Study design Retrospective data review. Methods Data on COVID-19 positive patients in Croatia from week 9 of 2020 to week 10 of 2021 in Croatia were analyzed using joinpoint regression. Analysis also included hospitalizations and mortality trends for age groups 26 to 65 and 66+ from week 30 of 2020. Results Schools opened in fall after the summer holidays in week 37. Joinpoint regression analysis revealed a statistically significant increase in cumulative incidence rates of COVID-19 in all age groups until 50th week, except in the 19–25 age group which saw an increase until 49th week. During the period of increase, there were periods of moderate increases and rapid increases in incidence that were present between 39/41 week and 43/44 week in all age groups except in those 0–6 years [from 40th till 43rd week in age groups 7–14 and 15–18, average percentage change (APC) = 87.41, P = 0.035, and APC = 83.47, P = 0.013; from 39th till 43rd in 19–25, APC = 91.90, P = 0.002; from 40th till 44th in 26–65, APC = 74.79, P < 0.001; from 41st till 44th in 66+, APC = 81.95, P = 0.004]. Steeper increase in hospitalizations was seen in 40th week for age groups 26 to 65 (40th to 45th week APC = 34.67, P < 0.001) and 66+ (40th to 45th week APC = 38.76, P < 0.001). Steeper increase in mortality started in 41st week for both age groups 26 to 65 and 66+ (41st to 46th week APC = 59.59, P < 0.001 and 41st to 45th week APC = 70.28, P < 0.001). Schools were closed for winter holidays in week 51. A steep decrease occurred in week 50 for cases and in week 51 for mortality and hospitalizations. There was no significant increase in hospitalizations and mortality after schools were re-opened in week 03 of 2021 (primary schools) and week 07 (secondary schools). Conclusion COVID-19 morbidity and mortality trends in Croatia observed in fall 2020 in Croatia perhaps cannot completely exclude potential association of school opening in all age groups. However, in winter 2021 effect was completely lacking and numbers were independent of schools’ dynamics. The observed inconsistent pattern indicates that there were no association of school openings and COVID-19 morbidity and mortality trends in Croatia and that other factors were leading to increasing and decreasing numbers. This emphasizes the need to consider the introduction of other effective and less harmful measures by stakeholders, or at least to use school closures as a last resort.
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Affiliation(s)
- I P Simetin
- Division for School Medicine, Mental Health and Addiction Prevention, Croatian Institute of Public Health, Rockefeller's Street 7, Zagreb 10 000, Croatia
| | - M Svajda
- Division for Health Informatics and Biostatistics, Croatian Institute of Public Health, Rockefeller's Street 7, Zagreb 10 000, Croatia
| | - P Ivanko
- Division for Health Informatics and Biostatistics, Croatian Institute of Public Health, Rockefeller's Street 7, Zagreb 10 000, Croatia
| | - J Dimnjakovic
- Division for Health Informatics and Biostatistics, Croatian Institute of Public Health, Rockefeller's Street 7, Zagreb 10 000, Croatia.
| | - A Belavic
- Division for School Medicine, Mental Health and Addiction Prevention, Croatian Institute of Public Health, Rockefeller's Street 7, Zagreb 10 000, Croatia
| | - A Istvanovic
- Division for School Medicine, Mental Health and Addiction Prevention, Croatian Institute of Public Health, Rockefeller's Street 7, Zagreb 10 000, Croatia
| | - T Poljicanin
- Division for Health Informatics and Biostatistics, Croatian Institute of Public Health, Rockefeller's Street 7, Zagreb 10 000, Croatia
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España G, Cavany S, Oidtman R, Barbera C, Costello A, Lerch A, Poterek M, Tran Q, Wieler A, Moore S, Perkins TA. Impacts of K-12 school reopening on the COVID-19 epidemic in Indiana, USA. Epidemics 2021; 37:100487. [PMID: 34425301 PMCID: PMC8366048 DOI: 10.1016/j.epidem.2021.100487] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/26/2021] [Accepted: 08/13/2021] [Indexed: 12/21/2022] Open
Abstract
In the United States, schools closed in March 2020 due to COVID-19 and began reopening in August 2020, despite continuing transmission of SARS-CoV-2. In states where in-person instruction resumed at that time, two major unknowns were the capacity at which schools would operate, which depended on the proportion of families opting for remote instruction, and adherence to face-mask requirements in schools, which depended on cooperation from students and enforcement by schools. To determine the impact of these conditions on the statewide burden of COVID-19 in Indiana, we used an agent-based model calibrated to and validated against multiple data types. Using this model, we quantified the burden of COVID-19 on K-12 students, teachers, their families, and the general population under alternative scenarios spanning three levels of school operating capacity (50 %, 75 %, and 100 %) and three levels of face-mask adherence in schools (50 %, 75 %, and 100 %). Under a scenario in which schools operated remotely, we projected 45,579 (95 % CrI: 14,109–132,546) infections and 790 (95 % CrI: 176–1680) deaths statewide between August 24 and December 31. Reopening at 100 % capacity with 50 % face-mask adherence in schools resulted in a proportional increase of 42.9 (95 % CrI: 41.3–44.3) and 9.2 (95 % CrI: 8.9–9.5) times that number of infections and deaths, respectively. In contrast, our results showed that at 50 % capacity with 100 % face-mask adherence, the number of infections and deaths were 22 % (95 % CrI: 16 %–28 %) and 11 % (95 % CrI: 5 %–18 %) higher than the scenario in which schools operated remotely. Within this range of possibilities, we found that high levels of school operating capacity (80–95 %) and intermediate levels of face-mask adherence (40–70 %) resulted in model behavior most consistent with observed data. Together, these results underscore the importance of precautions taken in schools for the benefit of their communities.
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Affiliation(s)
- Guido España
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States.
| | - Sean Cavany
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - Rachel Oidtman
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - Carly Barbera
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - Alan Costello
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - Anita Lerch
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - Marya Poterek
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - Quan Tran
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - Annaliese Wieler
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - Sean Moore
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States
| | - T Alex Perkins
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, United States.
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Walsh S, Chowdhury A, Braithwaite V, Russell S, Birch JM, Ward JL, Waddington C, Brayne C, Bonell C, Viner RM, Mytton OT. Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies. BMJ Open 2021; 11:e053371. [PMID: 34404718 PMCID: PMC8375447 DOI: 10.1136/bmjopen-2021-053371] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/16/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To systematically reivew the observational evidence of the effect of school closures and school reopenings on SARS-CoV-2 community transmission. SETTING Schools (including early years settings, primary schools and secondary schools). INTERVENTION School closures and reopenings. OUTCOME MEASURE Community transmission of SARS-CoV-2 (including any measure of community infections rate, hospital admissions or mortality attributed to COVID-19). METHODS On 7 January 2021, we searched PubMed, Web of Science, Scopus, CINAHL, the WHO Global COVID-19 Research Database, ERIC, the British Education Index, the Australian Education Index and Google, searching title and abstracts for terms related to SARS-CoV-2 AND terms related to schools or non-pharmaceutical interventions (NPIs). We used the Cochrane Risk of Bias In Non-randomised Studies of Interventions tool to evaluate bias. RESULTS We identified 7474 articles, of which 40 were included, with data from 150 countries. Of these, 32 studies assessed school closures and 11 examined reopenings. There was substantial heterogeneity between school closure studies, with half of the studies at lower risk of bias reporting reduced community transmission by up to 60% and half reporting null findings. The majority (n=3 out of 4) of school reopening studies at lower risk of bias reported no associated increases in transmission. CONCLUSIONS School closure studies were at risk of confounding and collinearity from other non-pharmacological interventions implemented around the same time as school closures, and the effectiveness of closures remains uncertain. School reopenings, in areas of low transmission and with appropriate mitigation measures, were generally not accompanied by increasing community transmission. With such varied evidence on effectiveness, and the harmful effects, policymakers should take a measured approach before implementing school closures; and should look to reopen schools in times of low transmission, with appropriate mitigation measures.
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Affiliation(s)
- Sebastian Walsh
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | | | | | - Simon Russell
- Population, Policy & Practice Department, University College London Institute of Child Health, London, UK
| | | | - Joseph L Ward
- Population, Policy & Practice Department, University College London Institute of Child Health, London, UK
| | | | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Chris Bonell
- London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Russell M Viner
- Population, Policy & Practice Department, University College London Institute of Child Health, London, UK
| | - Oliver T Mytton
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Pfefferbaum B. Challenges for Child Mental Health Raised by School Closure and Home Confinement During the COVID-19 Pandemic. Curr Psychiatry Rep 2021; 23:65. [PMID: 34398310 PMCID: PMC8366164 DOI: 10.1007/s11920-021-01279-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW The closure of schools during the COVID-19 pandemic has interrupted the education of children worldwide. This paper reviews the psychological effects of this action on children and the impact on school-based services. RECENT FINDINGS Emerging epidemiologic findings have generated an intense debate about the need for, and potential benefit of, school closure in the context of COVID-19. International research reveals reactions in children that are not typically considered in the disaster literature as well as those that arise in other disasters. School closure also has curtailed the delivery of mental health services commonly offered in schools. The debate about school closure will likely persist depending on local disease conditions and school readiness. Moreover, school closure is a possibility in future epidemics and pandemics and other disasters. The benefit of school closure must be balanced against the risk to children's education and psychosocial development.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, George Lynn Cross Research Professor Emeritus, University of Oklahoma Health Sciences Center, Oklahoma, USA.
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174
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Lurie MN, Frank D, Williams BG. COVID-19 in South Africa: Correcting the record. GLOBAL EPIDEMIOLOGY 2021; 3:100056. [PMID: 34377973 PMCID: PMC8342816 DOI: 10.1016/j.gloepi.2021.100056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/15/2021] [Accepted: 07/23/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Mark N Lurie
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.,University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa
| | | | - Brian G Williams
- South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
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Scarpioni R, Valsania T, Albertazzi V, Blanco V, DeAmicis S, Manini A, Melfa L, Ricardi M, Rocca C, Gandolfi S. Acute kidney injury, a common and severe complication in hospitalized patients during the COVID-19 pandemic. J Nephrol 2021; 34:1019-1024. [PMID: 34146335 PMCID: PMC8214067 DOI: 10.1007/s40620-021-01087-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/01/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Acute respiratory failure (ARF) is the main clinical sign of coronavirus disease-2019 (COVID-19), but little is known about the outcome of acute kidney injury (AKI) associated with ARF. STUDY DESIGN Retrospective cohort study on clinical features of adult patients hospitalized with COVID-19 between March 1st and April 30th, 2020 in the district of Piacenza (Italy). RESULTS Among 1894 hospitalized patients, 1701 affected by COVID-19 underwent at least two serum creatinine evaluations. According to KDIGO definitions, 233 of 1,701 patients (13.7%) developed AKI: 159, 34, and 40 had stage 1, 2 and 3 AKI, respectively. Patients with AKI were older (mean age 73.5 ± 14 years, range 24-95) than those without AKI (72 ± 14 years, range 20-102). In-hospital mortality was high in COVID patients (567/1701 patients, 33%), which almost doubled among AKI patients (132/233 patients, 57%), compared with those without AKI (p < 0.01). Risk factors for AKI included older age, male gender, diabetes and need for ventilation. Fourteen patients with stage 3 AKI underwent renal replacement therapy (RRT). CONCLUSIONS Hospitalized COVID-19 patients with AKI associated with ARF have poor chances of survival. Diagnosing and preventing the progression of renal damage is fundamental in order to delay initiating RRT, especially when resources are limited.
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Affiliation(s)
- Roberto Scarpioni
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy.
| | - Teresa Valsania
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy
| | - Vittorio Albertazzi
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy
| | - Valentina Blanco
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy
| | - Sara DeAmicis
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy
| | - Alessandra Manini
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy
| | - Luigi Melfa
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy
| | - Marco Ricardi
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy
| | - Chiara Rocca
- Department of Nephrology and Dialysis, ASL "Guglielmo da Saliceto" Hospital Piacenza, via Taverna 49, 29121, Piacenza, Italy
| | - Stefano Gandolfi
- Department of Staff, ASL "Guglielmo da Saliceto" Hospital, Piacenza, Italy
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McCarthy C, Bateman MT, Henderson T, Jean R, Evans R. Adoption of telepharmacy within a community health center: A focus on clinical pharmacy services. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Caitlin McCarthy
- Pharmacy Department Henry J. Austin Health Center Trenton New Jersey USA
- Department of Pharmacy Practice and Administration Ernest Mario School of Pharmacy, Rutgers, the State University of New Jersey Piscataway New Jersey USA
| | - M. Thomas Bateman
- Pharmacy Department Henry J. Austin Health Center Trenton New Jersey USA
- Department of Pharmacy Practice and Administration Ernest Mario School of Pharmacy, Rutgers, the State University of New Jersey Piscataway New Jersey USA
| | - Tyler Henderson
- Medical Department Henry J. Austin Health Center Trenton New Jersey USA
| | - Ronald Jean
- Quality Department Henry J. Austin Health Center Trenton New Jersey USA
| | - Rachael Evans
- Medical Department Henry J. Austin Health Center Trenton New Jersey USA
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Theuring S, Thielecke M, van Loon W, Hommes F, Hülso C, von der Haar A, Körner J, Schmidt M, Böhringer F, Mall MA, Rosen A, von Kalle C, Kirchberger V, Kurth T, Seybold J, Mockenhaupt FP. SARS-CoV-2 infection and transmission in school settings during the second COVID-19 wave: a cross-sectional study, Berlin, Germany, November 2020. Euro Surveill 2021; 26. [PMID: 34448448 PMCID: PMC8393892 DOI: 10.2807/1560-7917.es.2021.26.34.2100184] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BackgroundSchool attendance during the COVID-19 pandemic is intensely debated.AimIn November 2020, we assessed SARS-CoV-2 infections and seroreactivity in 24 randomly selected school classes and connected households in Berlin, Germany.MethodsWe collected oro-nasopharyngeal swabs and blood samples, examining SARS-CoV-2 infection and IgG antibodies by RT-PCR and ELISA. Household members self-swabbed. We assessed individual and institutional prevention measures. Classes with SARS-CoV-2 infection and connected households were retested after 1 week.ResultsWe examined 1,119 participants, including 177 primary and 175 secondary school students, 142 staff and 625 household members. SARS-CoV-2 infection occurred in eight classes, affecting each 1-2 individuals. Infection prevalence was 2.7% (95% confidence interval (CI): 1.2-5.0; 9/338), 1.4% (95% CI: 0.2-5.1; 2/140), and 2.3% (95% CI: 1.3-3.8; 14/611) among students, staff and household members. Six of nine infected students were asymptomatic at testing. We detected IgG antibodies in 2.0% (95%CI: 0.8-4.1; 7/347), 1.4% (95% CI: 0.2-5.0; 2/141) and 1.4% (95% CI: 0.6-2.7; 8/576). Prevalence increased with inconsistent facemask-use in school, walking to school, and case-contacts outside school. For three of nine households with infection(s), origin in school seemed possible. After 1 week, no school-related secondary infections appeared in affected classes; the attack rate in connected households was 1.1%.ConclusionSchool attendance under rigorously implemented preventive measures seems reasonable. Balancing risks and benefits of school closures need to consider possible spill-over infection into households. Deeper insight is required into the infection risks due to being a schoolchild vs attending school.
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Affiliation(s)
- Stefanie Theuring
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marlene Thielecke
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Welmoed van Loon
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Franziska Hommes
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Hülso
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Annkathrin von der Haar
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jennifer Körner
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael Schmidt
- German Red Cross Blood Transfusion Service, Frankfurt, Germany
| | - Falko Böhringer
- Labor Berlin - Charité Vivantes Services GmbH, Berlin, Germany
| | - Marcus A Mall
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alexander Rosen
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christof von Kalle
- Clinical Study Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Valerie Kirchberger
- Medical Directorate, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Joachim Seybold
- Medical Directorate, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Newton S, Zollinger B, Freeman J, Moran S, Helfand A, Authelet K, McHarg M, Montano Vargas N, Shesser R, Cohen JS, Cummings DA, Ma Y, Meltzer AC. Factors associated with clinical severity in emergency department patients presenting with symptomatic SARS-CoV-2 infection. J Am Coll Emerg Physicians Open 2021; 2:e12453. [PMID: 34223443 PMCID: PMC8240469 DOI: 10.1002/emp2.12453] [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: 11/09/2020] [Revised: 03/31/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To measure the association of race, ethnicity, comorbidities, and insurance status with need for hospitalization of symptomatic emergency department patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS This study is a cohort study of symptomatic patients presenting to a single emergency department (ED) with laboratory-confirmed SARS-CoV-2 infection from March 7-August 9, 2020. We collected patient-level information regarding demographics, insurance status, comorbidities, level of care, and mortality using a structured chart review. We compared characteristics of patients categorized by (1) home discharge, (2) general hospital ward admission, and (3) intensive care unit (ICU) admission or death within 30 days of the index visit. Univariate and multivariable logistic regression analyses were performed to report odds ratios (OR) and 95% confidence intervals (95% CI) between hospital admission versus ED discharge home and between ICU care versus general hospital ward admission. RESULTS In total, 994 patients who presented to the ED with symptoms were included in the analysis with 551 (55.4%) patients discharged home, 314 (31.6%) patients admitted to the general hospital ward, and 129 (13.0%) admitted to the ICU or dying. Patients requiring admission were more likely to be Black or to have public insurance (Medicaid and/or Medicare). Patients who were admitted to the ICU or dying were more likely aged ≥ 65 years or male. In multivariable logistic regression, old age, public insurance, diabetes, hypertension, obesity, heart failure, and hyperlipidemia were independent predictors of hospital admission. When comparing those who needed ICU care versus general hospital ward admission in univariate logistic regression, patients with Medicaid (OR 2.4, 95% CI 1.2-4.6), Medicare (OR 4.2, 95% CI 2.1-8.4), Medicaid and Medicare (OR 4.3, 95% CI 2.4-7.7), history of chronic obstructive pulmonary disease (OR 2.2, 95% CI 1.2-4.2), hypertension (OR 1.7, 95% CI 1.1-2.7), and heart failure (OR 2.6, 95% CI 1.4-4.7) were more likely to be admitted into the ICU or die; Black (OR 1.1, 95% CI 0.4-2.9) and Hispanic/Latino (OR 1.0, 95% CI 0.6-1.8) patients were less likely to be admitted into the ICU; however, the associations were not statistically significant. In multivariable logistic regression, old age, male sex, public insurance, and heart failure were independent predictors of ICU care/death. CONCLUSION Comorbidities and public insurance are predictors of more severe illness for patients with SARS-CoV-2. This study suggests that the disparities in severity seen in COVID-19 among Black patients may be attributable, in part, to low socioeconomic status and chronic health conditions.
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Affiliation(s)
- Sophia Newton
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Benjamin Zollinger
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Jincong Freeman
- Department of Biostatistics and Bioinformatics, George Washington UniversityMilken Institute School of Public HealthWashingtonDistrict of ColumbiaUSA
| | - Seamus Moran
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Alexandra Helfand
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Kayla Authelet
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Matthew McHarg
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Nataly Montano Vargas
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Robert Shesser
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Joanna S. Cohen
- Division of Emergency MedicineChildren's National Medical CenterWashingtonDistrict of ColumbiaUSA
- School of Medicine and Health SciencesDepartment of Pediatrics, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Derek A.T. Cummings
- Department of Biology and Emerging Pathogens Institute, University of FloridaGainesvilleFloridaUSA
| | - Yan Ma
- Department of Biostatistics and Bioinformatics, George Washington UniversityMilken Institute School of Public HealthWashingtonDistrict of ColumbiaUSA
| | - Andrew C. Meltzer
- School of Medicine and Health SciencesDepartment of Emergency Medicine, The George Washington UniversityWashingtonDistrict of ColumbiaUSA
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Bilinski A, Salomon JA, Giardina J, Ciaranello A, Fitzpatrick MC. Passing the Test: A Model-Based Analysis of Safe School-Reopening Strategies. Ann Intern Med 2021; 174:1090-1100. [PMID: 34097433 PMCID: PMC8252151 DOI: 10.7326/m21-0600] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has induced historic educational disruptions. In April 2021, about 40% of U.S. public school students were not offered full-time in-person education. OBJECTIVE To assess the risk for SARS-CoV-2 transmission in schools. DESIGN An agent-based network model was developed to simulate transmission in elementary and high school communities, including home, school, and interhousehold interactions. SETTING School structure was parametrized to reflect average U.S. classrooms, with elementary schools of 638 students and high schools of 1451 students. Daily local incidence was varied from 1 to 100 cases per 100 000 persons. PARTICIPANTS Students, faculty, staff, and adult household members. INTERVENTION Isolation of symptomatic individuals, quarantine of an infected individual's contacts, reduced class sizes, alternative schedules, staff vaccination, and weekly asymptomatic screening. MEASUREMENTS Transmission was projected among students, staff, and families after a single infection in school and over an 8-week quarter, contingent on local incidence. RESULTS School transmission varies according to student age and local incidence and is substantially reduced with mitigation measures. Nevertheless, when transmission occurs, it may be difficult to detect without regular testing because of the subclinical nature of most children's infections. Teacher vaccination can reduce transmission to staff, and asymptomatic screening improves understanding of local circumstances and reduces transmission. LIMITATION Uncertainty exists about the susceptibility and infectiousness of children, and precision is low regarding the effectiveness of specific countermeasures, particularly with new variants. CONCLUSION With controlled community transmission and moderate mitigation, elementary schools can open safety, but high schools require more intensive mitigation. Asymptomatic screening can facilitate reopening at higher local incidence while minimizing transmission risk. PRIMARY FUNDING SOURCE Centers for Disease Control and Prevention through the Council of State and Territorial Epidemiologists, National Institute of Allergy and Infectious Diseases, National Institute on Drug Abuse, and Facebook.
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Affiliation(s)
- Alyssa Bilinski
- Interfaculty Initiative in Health Policy, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts (A.B.)
| | - Joshua A Salomon
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California (J.A.S.)
| | - John Giardina
- Interfaculty Initiative in Health Policy, Harvard Graduate School of Arts and Sciences, Cambridge, and Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (J.G.)
| | - Andrea Ciaranello
- Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (A.C.)
| | - Meagan C Fitzpatrick
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland (M.C.F.)
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180
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Tan W. School closures were over-weighted against the mitigation of COVID-19 transmission: A literature review on the impact of school closures in the United States. Medicine (Baltimore) 2021; 100:e26709. [PMID: 34397701 PMCID: PMC8322504 DOI: 10.1097/md.0000000000026709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/28/2021] [Accepted: 06/24/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread wildly across the world. In March of 2020, almost all kindergarten through 12th grade (K-12) schools were closed in the United States in an urgent attempt to curb the pandemic in the absence of effective therapeutics or vaccination. Thirteen months since then, schools remain partially closed. Accumulated evidence suggests that children and adolescents are not the primary facilitators of transmission, limiting the restrictive effects of school closures on disease transmission. The negative effects of school closures on K-12 students need to be systematically reviewed. METHODS Following the guideline of Preferred Reporting Items for Systematic Reviews and Meta-analyzes, a comprehensive literature search from PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science regarding school closures and its impact on K-12 students was conducted. The primary outcomes included the impact of school closures on the mitigation of the pandemic and the resulting public health concerns of K-12 students. RESULTS Prolonged school closures possessed negative effects on K-12 students' physical, mental, and social well-being and reduced the number of health and social workers, hindering the reopening of the country. CONCLUSIONS School closures were over-weighted against the mitigation of coronavirus disease 2019 (COVID-19) transmission. A safe reopening of all K-12 schools in the United States should be of top priority.
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181
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Nader IW, Zeilinger EL, Jomar D, Zauchner C. Onset of effects of non-pharmaceutical interventions on COVID-19 infection rates in 176 countries. BMC Public Health 2021; 21:1472. [PMID: 34320982 PMCID: PMC8318058 DOI: 10.1186/s12889-021-11530-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/21/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND During the initial phase of the global COVID-19 outbreak, most countries responded with non-pharmaceutical interventions (NPIs). In this study we investigate the general effectiveness of these NPIs, how long different NPIs need to be in place to take effect, and how long they should be in place for their maximum effect to unfold. METHODS We used global data and a non-parametric machine learning model to estimate the effects of NPIs in relation to how long they have been in place. We applied a random forest model and used accumulated local effect (ALE) plots to derive estimates of the effectiveness of single NPIs in relation to their implementation date. In addition, we used bootstrap samples to investigate the variability in these ALE plots. RESULTS Our results show that closure and regulation of schools was the most important NPI, associated with a pronounced effect about 10 days after implementation. Restrictions of mass gatherings and restrictions and regulations of businesses were found to have a more gradual effect, and social distancing was associated with a delayed effect starting about 18 days after implementation. CONCLUSIONS Our results can inform political decisions regarding the choice of NPIs and how long they need to be in place to take effect.
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Affiliation(s)
- Ingo W Nader
- IT Power Services GmbH, Modecenterstraße 14/3, A-1030, Vienna, Austria
| | - Elisabeth L Zeilinger
- Faculty of Psychology, University of Vienna, Liebiggasse 5, A-1010, Vienna, Austria.
| | - Dana Jomar
- IT Power Services GmbH, Modecenterstraße 14/3, A-1030, Vienna, Austria
| | - Clemens Zauchner
- IT Power Services GmbH, Modecenterstraße 14/3, A-1030, Vienna, Austria
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Digitale JC, Stojanovski K, McCulloch CE, Handley MA. Study Designs to Assess Real-World Interventions to Prevent COVID-19. Front Public Health 2021; 9:657976. [PMID: 34386470 PMCID: PMC8353119 DOI: 10.3389/fpubh.2021.657976] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022] Open
Abstract
Background: In the face of the novel virus SARS-CoV-2, scientists and the public are eager for evidence about what measures are effective at slowing its spread and preventing morbidity and mortality. Other than mathematical modeling, studies thus far evaluating public health and behavioral interventions at scale have largely been observational and ecologic, focusing on aggregate summaries. Conclusions from these studies are susceptible to bias from threats to validity such as unmeasured confounding, concurrent policy changes, and trends over time. We offer recommendations on how to strengthen frequently applied study designs which have been used to understand the impact of interventions to reduce the spread of COVID-19, and suggest implementation-focused, pragmatic designs that, moving forward, could be used to build a robust evidence base for public health practice. Methods: We conducted a literature search of studies that evaluated the effectiveness of non-pharmaceutical interventions and policies to reduce spread, morbidity, and mortality of COVID-19. Our targeted review of the literature aimed to explore strengths and weaknesses of implemented studies, provide recommendations for improvement, and explore alternative real-world study design methods to enhance evidence-based decision-making. Results:Study designs such as pre/post, interrupted time series, and difference-in-differences have been used to evaluate policy effects at the state or country level of a range of interventions, such as shelter-in-place, face mask mandates, and school closures. Key challenges with these designs include the difficulty of disentangling the effects of contemporaneous changes in policy and correctly modeling infectious disease dynamics. Pragmatic study designs such as the SMART (Sequential, Multiple-Assignment Randomized Trial), stepped wedge, and preference designs could be used to evaluate community re-openings such as schools, and other policy changes. Conclusions: As the epidemic progresses, we need to move from post-hoc analyses of available data (appropriate for the beginning of the pandemic) to proactive evaluation to ensure the most rigorous approaches possible to evaluate the impact of COVID-19 prevention interventions. Pragmatic study designs, while requiring initial planning and community buy-in, could offer more robust evidence on what is effective and for whom to combat the global pandemic we face and future policy decisions.
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Affiliation(s)
- Jean C. Digitale
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Kristefer Stojanovski
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Margaret A. Handley
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, United States
- PRISE Center (Partnerships for Research in Implementation Science for Equity), University of California, San Francisco, San Francisco, CA, United States
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183
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Xie S, Wang W, Wang Q, Wang Y, Zeng D. Evaluating Effectiveness of Public Health Intervention Strategies for Mitigating COVID-19 Pandemic. ARXIV 2021:arXiv:2107.09749v1. [PMID: 34312596 PMCID: PMC8312897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global public health challenge. In the United States (US), state governments have implemented various non-pharmaceutical interventions (NPIs), such as physical distance closure (lockdown), stay-at-home order, mandatory facial mask in public in response to the rapid spread of COVID-19. To evaluate the effectiveness of these NPIs, we propose a nested case-control design with propensity score weighting under the quasi-experiment framework to estimate the average intervention effect on disease transmission across states. We further develop a method to test for factors that moderate intervention effect to assist precision public health intervention. Our method takes account of the underlying dynamics of disease transmission and balance state-level pre-intervention characteristics. We prove that our estimator provides causal intervention effect under assumptions. We apply this method to analyze US COVID-19 incidence cases to estimate the effects of six interventions. We show that lockdown has the largest effect on reducing transmission and reopening bars significantly increase transmission. States with a higher percentage of non-white population are at greater risk of increased $R_t$ associated with reopening bars.
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Affiliation(s)
- Shanghong Xie
- Department of Biostatistics, Columbia University, New York, NY, U.S.A
| | - Wenbo Wang
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Qinxia Wang
- Department of Biostatistics, Columbia University, New York, NY, U.S.A
| | - Yuanjia Wang
- Department of Biostatistics, Columbia University, New York, NY, U.S.A
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
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184
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Miron O, Yu KH, Wilf-Miron R, Kohane I, Davidovitch N. COVID-19 infections following physical school reopening. Arch Dis Child 2021; 106:e34. [PMID: 33288536 DOI: 10.1136/archdischild-2020-321018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Oren Miron
- Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Kun-Hsing Yu
- Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Isaac Kohane
- Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Nadav Davidovitch
- Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
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185
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Irfan O, Li J, Tang K, Wang Z, Bhutta ZA. Risk of infection and transmission of SARS-CoV-2 among children and adolescents in households, communities and educational settings: A systematic review and meta-analysis. J Glob Health 2021; 11:05013. [PMID: 34326997 PMCID: PMC8285769 DOI: 10.7189/jogh.11.05013] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is uncertainty with respect to SARS-CoV-2 transmission in children (0-19 years) with controversy on effectiveness of school-closures in controlling the pandemic. It is of equal importance to evaluate the risk of transmission in children who are often asymptomatic or mildly symptomatic carriers that may incidentally transmit SARS-CoV-2 in different settings. We conducted this review to assess transmission and risks for SARS-CoV-2 in children (by age-groups or grades) in community and educational-settings compared to adults. METHODS Data for the review were retrieved from PubMed, EMBASE, Cochrane Library, WHO COVID-19 Database, China National Knowledge Infrastructure (CNKI) Database, WanFang Database, Latin American and Caribbean Health Sciences Literature (LILACS), Google Scholar, and preprints from medRixv and bioRixv) covering a timeline from December 1, 2019 to April 1, 2021. Population-screening, contact-tracing and cohort studies reporting prevalence and transmission of SARS-CoV-2 in children were included. Data were extracted according to PRISMA guidelines. Meta-analyses were performed using Review Manager 5.3. RESULTS Ninety studies were included. Compared to adults, children showed comparable national (risk ratio (RR) = 0.87, 95% confidence interval (CI) = 0.71-1.060 and subnational (RR = 0.81, 95% CI = 0.66-1.01) prevalence in population-screening studies, and lower odds of infection in community/household contact-tracing studies (odds ratio (OR) = 0.62, 95% CI = 0.46-0.84). On disaggregation, adolescents observed comparable risk (OR = 1.22, 95% CI = 0.74-2.04) with adults. In educational-settings, children attending daycare/preschools (OR = 0.53, 95% CI = 0.38-0.72) were observed to be at lower-risk when compared to adults, with odds of infection among primary (OR = 0.85, 95% CI = 0.55-1.31) and high-schoolers (OR = 1.30, 95% CI = 0.71-2.38) comparable to adults. Overall, children and adolescents had lower odds of infection in educational-settings compared to community and household clusters. CONCLUSIONS Children (<10 years) showed lower susceptibility to COVID-19 compared to adults, whereas adolescents in communities and high-schoolers had comparable risk. Risks of infection among children in educational-settings was lower than in communities. Evidence from school-based studies demonstrate it is largely safe for children (<10 years) to be at schools, however older children (10-19 years) might facilitate transmission. Despite this evidence, studies focusing on the effectiveness of mitigation measures in educational settings are urgently needed to support both public health and educational policy-making for school reopening.
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Affiliation(s)
- Omar Irfan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Jiang Li
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Kun Tang
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zhicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Institute for Global Health & Development, the Aga Khan University, Karachi, Pakistan
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186
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Ertem Z, Schechter-Perkins E, Oster E, van den Berg P, Epshtein I, Chaiyakunapruk N, Wilson F, Perenchevich E, Pettey W, Branch-Elliman W, Nelson R. The Impact of School Opening Model on SARS-CoV-2 Community Incidence and Mortality: A Nationwide Cohort Study. RESEARCH SQUARE 2021:rs.3.rs-712725. [PMID: 34282412 PMCID: PMC8288150 DOI: 10.21203/rs.3.rs-712725/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The role that in-person schooling contributes to community incidence of SARS-CoV-2 infections and deaths remains unknown. We conducted an event study evaluating the effect of in-person school on SARS-CoV-2 cases and deaths per 100,000 persons during the 12-weeks following school opening, stratified by US Census region. There was no impact of in-person school opening and COVID-19 deaths. In most regions, COVID-19 incidence rates were not statistically different in counties with in-person versus remote school modes. However, in the South, there was a significant and sustained increase in cases per week among counties that opened for in-person learning versus remote learning, with weekly effects ranging from 7.8 (95% CI: 1.2-14.5) to 18.9 (95% CI: 7.9-29.9) additional cases per 100,000, driven by increases among 0-9 year olds and adults.
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Affiliation(s)
| | | | | | | | | | | | | | - Elli Perenchevich
- Center for Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
| | - Warren Pettey
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System
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187
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Anderson EJ, Campbell JD, Creech CB, Frenck R, Kamidani S, Munoz FM, Nachman S, Spearman P. Warp Speed for Coronavirus Disease 2019 (COVID-19) Vaccines: Why Are Children Stuck in Neutral? Clin Infect Dis 2021; 73:336-340. [PMID: 32945335 PMCID: PMC7543330 DOI: 10.1093/cid/ciaa1425] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Indexed: 01/19/2023] Open
Abstract
While adult clinical trials of coronavirus disease 2019 (COVID-19) vaccines have moved quickly into phase 3 clinical trials, clinical trials have not started in children in the United States. The direct COVID-19 impact upon children is greater than that observed for a number of other pathogens for which we now have effective pediatric vaccines. Additionally, the role of children in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has clearly been underappreciated. Carefully conducted phase 2 clinical trials can adequately address potential COVID-19 vaccine safety concerns. Delaying phase 2 vaccine clinical trials in children will delay our recovery from COVID-19 and unnecessarily prolong its impact upon children's education, health, and emotional well-being, and equitable access to opportunities for development and social success. Given the potential direct and indirect benefits of pediatric vaccination, implementation of phase 2 clinical trials for COVID-19 vaccines should begin now.
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Affiliation(s)
- Evan J Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - James D Campbell
- Department of Pediatrics and Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - C Buddy Creech
- Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Robert Frenck
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,USA
| | - Satoshi Kamidani
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Flor M Munoz
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular Virology and Microbiology, Baylor College of Medicine
, Houston, Texas,
USA
| | - Sharon Nachman
- Department of Pediatrics, The State University of New York (SUNY) Stony Brook; Stony Brook, New York, USA
| | - Paul Spearman
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,USA
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188
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Tatapudi H, Das TK. Impact of school reopening on pandemic spread: A case study using an agent-based model for COVID-19. Infect Dis Model 2021; 6:839-847. [PMID: 34258483 PMCID: PMC8265176 DOI: 10.1016/j.idm.2021.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 02/08/2023] Open
Abstract
This article examines the impact of partial/full reopening of school/college campuses on the spread of a pandemic using COVID-19 as a case study. The study uses an agent-based simulation model that replicates community spread in an urban region of U.S.A. via daily social mixing of susceptible and infected individuals. Data representing population demographics, SARS-CoV-2 epidemiology, and social interventions guides the model's behavior, which is calibrated and validated using data reported by the government. The model indicates a modest but significant increase (8.15%) in the total number of reported cases in the region for a complete (100%) reopening compared to keeping schools and colleges fully virtual. For partial returns of 75% and 50%, the percent increases in the number of reported cases are shown to be small (2.87% and 1.26%, respectively) and statistically insignificant. The AB model also predicts that relaxing the stringency of the school safety protocol for sanitizing, use of mask, social distancing, testing, and quarantining and thus allowing the school transmission coefficient to double may result in a small increase in the number of reported infected cases (2.14%). Hence for pandemic outbreaks from viruses with similar characteristics as for SARS-CoV-2, keeping the schools and colleges open with a modest campus safety protocol and in-person attendance below a certain threshold may be advisable.
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Affiliation(s)
- Hanisha Tatapudi
- Department of Industrial and Management System Engineering, University of South Florida, Tampa, FL, USA
| | - Tapas K. Das
- Department of Industrial and Management System Engineering, University of South Florida, Tampa, FL, USA
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189
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Kickbusch I, Leung GM, Shattock RJ. Learning from crisis: building resilient systems to combat future pandemics. Lancet 2021; 398:e2-e6. [PMID: 34217403 PMCID: PMC8248923 DOI: 10.1016/s0140-6736(21)00665-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Ilona Kickbusch
- Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Gabriel M Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China.
| | - Robin J Shattock
- Department of Infectious Diseases, Imperial College London, London, UK
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190
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Shah H, Khan MSH, Dhurandhar NV, Hegde V. The triumvirate: why hypertension, obesity, and diabetes are risk factors for adverse effects in patients with COVID-19. Acta Diabetol 2021; 58:831-843. [PMID: 33587177 PMCID: PMC7882857 DOI: 10.1007/s00592-020-01636-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/07/2020] [Indexed: 02/06/2023]
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a pandemic. The cellular receptor for SARS-CoV-2 entry is the angiotensin-converting enzyme 2, a membrane-bound homolog of angiotensin-converting enzyme. Henceforth, this has brought the attention of the scientific community to study the interaction between COVID-19 and the renin-angiotensin system (RAS), as well as RAS inhibitors. However, these inhibitors are commonly used to treat hypertension, chronic kidney disorder, and diabetes. Obesity is a known risk factor for heart disease, diabetes, and hypertension, whereas diabetes and hypertension may be indirectly related to each other through the effects of obesity. Furthermore, people with hypertension, obesity, diabetes, and other related complications like cardiovascular and kidney diseases have a higher risk of severe COVID-19 infection than the general population and usually exhibit poor prognosis. This severity could be due to systemic inflammation and compromised immune response and RAS associated with these comorbid conditions. Therefore, there is an urgent need to develop evidence-based treatment methods that do not affect the severity of COVID-19 infection and effectively manage these chronic diseases in people with COVID-19.
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Affiliation(s)
- Harsh Shah
- Obesity and Metabolic Health Laboratory, Department of Nutritional Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX, 79409, USA
| | - Md Shahjalal Hossain Khan
- Obesity and Metabolic Health Laboratory, Department of Nutritional Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX, 79409, USA
| | - Nikhil V Dhurandhar
- Obesity and Metabolic Health Laboratory, Department of Nutritional Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX, 79409, USA
| | - Vijay Hegde
- Obesity and Metabolic Health Laboratory, Department of Nutritional Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX, 79409, USA.
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191
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Zhang H, Yang J, Li Y, Ren G, Mu L, Cai Y, Luo Q, Zhou Y. The Patterns and Predictors of Loneliness for the Chinese Medical Students Since Post-Lockdown to New Normal With COVID-19. Front Public Health 2021; 9:679178. [PMID: 34277545 PMCID: PMC8281249 DOI: 10.3389/fpubh.2021.679178] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/12/2021] [Indexed: 01/19/2023] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19)-related quarantine has had unique psychological challenges for medical students, particularly loneliness. In this study, we demonstrated the patterns and predictors of loneliness in medical students since post-lockdown to new normal with COVID-19. Methods: A convenience sampling method was used in this study. Face-to-face online questionnaires of UCLA Loneliness Scale and psychological characteristics scales were completed by 1,478 participants. Latent profile analysis and multinominal logistic regressions were performed. Results: Three latent profile models were identified in this study: low loneliness (52.3%), interpersonal sensitivity loneliness (3.5%), and high loneliness (44.1%). Sophomore (Est = 1.937; p < 0.05) and junior students (Est = 2.939; p < 0.05), neuroticism (Est = 2.475; p < 0.05), high arousal symptoms (Est = 2.618; p < 0.01), and the quality of support from friends (Est = 2.264; p < 0.05) were the risk factors for high loneliness profile. In addition, sophomore (Est = 2.065; p < 0.05) and junior students (Est = 2.702; p < 0.01), openness (Est = 2.303; p < 0.05), and conscientiousness personality (Est = −2.348; p < 0.05) were the predictors of an interpersonal sensitive loneliness profile. Good peer relationship (Est = −2.266; p < 0.05) and other support (Est = −2.247; p < 0.05) were protective factors for low loneliness profile. Limitations: Participants were selected from one medical university; the generalizability is limited. Conclusions: Timely loneliness-focused interventions should be targeted on the different profiles and predictors of loneliness in medical students.
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Affiliation(s)
- Hui Zhang
- School of Nursing, Harbin Medical University, Harbin, China
| | - Jun Yang
- School of Nursing, Harbin Medical University, Harbin, China
| | - Yuxin Li
- School of Nursing, Harbin Medical University, Harbin, China
| | - Gaoyue Ren
- School of Nursing, Harbin Medical University, Harbin, China
| | - Lina Mu
- School of Nursing, Harbin Medical University, Harbin, China
| | - Yunjiang Cai
- School of Nursing, Harbin Medical University, Harbin, China
| | - Qiusha Luo
- School of Nursing, Harbin Medical University, Harbin, China
| | - Yuqiu Zhou
- School of Nursing, Harbin Medical University, Harbin, China
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192
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Woskie LR, Hennessy J, Espinosa V, Tsai TC, Vispute S, Jacobson BH, Cattuto C, Gauvin L, Tizzoni M, Fabrikant A, Gadepalli K, Boulanger A, Pearce A, Kamath C, Schlosberg A, Stanton C, Bavadekar S, Abueg M, Hogue M, Oplinger A, Chou K, Corrado G, Shekel T, Jha AK, Wellenius GA, Gabrilovich E. Early social distancing policies in Europe, changes in mobility & COVID-19 case trajectories: Insights from Spring 2020. PLoS One 2021; 16:e0253071. [PMID: 34191818 PMCID: PMC8244916 DOI: 10.1371/journal.pone.0253071] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/28/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Social distancing have been widely used to mitigate community spread of SARS-CoV-2. We sought to quantify the impact of COVID-19 social distancing policies across 27 European counties in spring 2020 on population mobility and the subsequent trajectory of disease. METHODS We obtained data on national social distancing policies from the Oxford COVID-19 Government Response Tracker and aggregated and anonymized mobility data from Google. We used a pre-post comparison and two linear mixed-effects models to first assess the relationship between implementation of national policies and observed changes in mobility, and then to assess the relationship between changes in mobility and rates of COVID-19 infections in subsequent weeks. RESULTS Compared to a pre-COVID baseline, Spain saw the largest decrease in aggregate population mobility (~70%), as measured by the time spent away from residence, while Sweden saw the smallest decrease (~20%). The largest declines in mobility were associated with mandatory stay-at-home orders, followed by mandatory workplace closures, school closures, and non-mandatory workplace closures. While mandatory shelter-in-place orders were associated with 16.7% less mobility (95% CI: -23.7% to -9.7%), non-mandatory orders were only associated with an 8.4% decrease (95% CI: -14.9% to -1.8%). Large-gathering bans were associated with the smallest change in mobility compared with other policy types. Changes in mobility were in turn associated with changes in COVID-19 case growth. For example, a 10% decrease in time spent away from places of residence was associated with 11.8% (95% CI: 3.8%, 19.1%) fewer new COVID-19 cases. DISCUSSION This comprehensive evaluation across Europe suggests that mandatory stay-at-home orders and workplace closures had the largest impacts on population mobility and subsequent COVID-19 cases at the onset of the pandemic. With a better understanding of policies' relative performance, countries can more effectively invest in, and target, early nonpharmacological interventions.
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Affiliation(s)
- Liana R. Woskie
- Department of Health Policy, London School of Economics, London, United Kingdom
| | | | | | - Thomas C. Tsai
- Department of Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | | | - Benjamin H. Jacobson
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Ciro Cattuto
- University of Turin, Turin, Italy
- ISI Foundation, Turin, Italy
| | | | | | - Alex Fabrikant
- Google, LLC, Mountain View, CA, United States of America
| | | | - Adam Boulanger
- Google, LLC, Mountain View, CA, United States of America
| | - Adam Pearce
- Google, LLC, Mountain View, CA, United States of America
| | | | | | | | | | - Matthew Abueg
- Google, LLC, Mountain View, CA, United States of America
| | - Michael Hogue
- Google, LLC, Mountain View, CA, United States of America
| | | | - Katherine Chou
- Google, LLC, Mountain View, CA, United States of America
| | - Greg Corrado
- Google, LLC, Mountain View, CA, United States of America
| | - Tomer Shekel
- Google, LLC, Mountain View, CA, United States of America
| | - Ashish K. Jha
- Brown University School of Public Health, Providence, RI, United States of America
| | - Gregory A. Wellenius
- Google, LLC, Mountain View, CA, United States of America
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
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193
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Kaufman BG, Whitaker R, Mahendraratnam N, Hurewitz S, Yi J, Smith VA, McClellan M. State variation in effects of state social distancing policies on COVID-19 cases. BMC Public Health 2021; 21:1239. [PMID: 34182972 PMCID: PMC8237534 DOI: 10.1186/s12889-021-11236-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/08/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) sickened over 20 million residents in the United States (US) by January 2021. Our objective was to describe state variation in the effect of initial social distancing policies and non-essential business (NEB) closure on infection rates early in 2020. METHODS We used an interrupted time series study design to estimate the total effect of all state social distancing orders, including NEB closure, shelter-in-place, and stay-at-home orders, on cumulative COVID-19 cases for each state. Data included the daily number of COVID-19 cases and deaths for all 50 states and Washington, DC from the New York Times database (January 21 to May 7, 2020). We predicted cumulative daily cases and deaths using a generalized linear model with a negative binomial distribution and a log link for two models. RESULTS Social distancing was associated with a 15.4% daily reduction (Relative Risk = 0.846; Confidence Interval [CI] = 0.832, 0.859) in COVID-19 cases. After 3 weeks, social distancing prevented nearly 33 million cases nationwide, with about half (16.5 million) of those prevented cases among residents of the Mid-Atlantic census division (New York, New Jersey, Pennsylvania). Eleven states prevented more than 10,000 cases per 100,000 residents within 3 weeks. CONCLUSIONS The effect of social distancing on the infection rate of COVID-19 in the US varied substantially across states, and effects were largest in states with highest community spread.
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Affiliation(s)
- Brystana G Kaufman
- Margolis Center for Health Policy, Duke University, 230 Science Drive, Durham, NC, 27705, USA.
- Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC, USA.
| | - Rebecca Whitaker
- Margolis Center for Health Policy, Duke University, 230 Science Drive, Durham, NC, 27705, USA
| | - Nirosha Mahendraratnam
- Margolis Center for Health Policy, Duke University, 230 Science Drive, Durham, NC, 27705, USA
| | - Sophie Hurewitz
- Margolis Center for Health Policy, Duke University, 230 Science Drive, Durham, NC, 27705, USA
| | - Jeremy Yi
- Margolis Center for Health Policy, Duke University, 230 Science Drive, Durham, NC, 27705, USA
| | - Valerie A Smith
- Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC, USA
- General Internal Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Mark McClellan
- Margolis Center for Health Policy, Duke University, 230 Science Drive, Durham, NC, 27705, USA
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194
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Yang B, Huang AT, Garcia-Carreras B, Hart WE, Staid A, Hitchings MDT, Lee EC, Howe CJ, Grantz KH, Wesolowksi A, Lemaitre JC, Rattigan S, Moreno C, Borgert BA, Dale C, Quigley N, Cummings A, McLorg A, LoMonaco K, Schlossberg S, Barron-Kraus D, Shrock H, Lessler J, Laird CD, Cummings DAT. Effect of specific non-pharmaceutical intervention policies on SARS-CoV-2 transmission in the counties of the United States. Nat Commun 2021; 12:3560. [PMID: 34117244 PMCID: PMC8195990 DOI: 10.1038/s41467-021-23865-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/14/2021] [Indexed: 12/13/2022] Open
Abstract
Non-pharmaceutical interventions (NPIs) remain the only widely available tool for controlling the ongoing SARS-CoV-2 pandemic. We estimated weekly values of the effective basic reproductive number (Reff) using a mechanistic metapopulation model and associated these with county-level characteristics and NPIs in the United States (US). Interventions that included school and leisure activities closure and nursing home visiting bans were all associated with a median Reff below 1 when combined with either stay at home orders (median Reff 0.97, 95% confidence interval (CI) 0.58-1.39) or face masks (median Reff 0.97, 95% CI 0.58-1.39). While direct causal effects of interventions remain unclear, our results suggest that relaxation of some NPIs will need to be counterbalanced by continuation and/or implementation of others.
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Affiliation(s)
- Bingyi Yang
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Angkana T Huang
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Bernardo Garcia-Carreras
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | | | - Andrea Staid
- Sandia National Laboratories, Albuquerque, NM, USA
| | - Matt D T Hitchings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Elizabeth C Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chanelle J Howe
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kyra H Grantz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amy Wesolowksi
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joseph Chadi Lemaitre
- Department of Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Susan Rattigan
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Carlos Moreno
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Brooke A Borgert
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Celeste Dale
- Department of Biology, University of Florida, Gainesville, FL, USA
| | - Nicole Quigley
- Department of Biology, University of Florida, Gainesville, FL, USA
| | - Andrew Cummings
- Department of Mathematics, Syracuse University, Syracuse, NY, USA
| | - Alizée McLorg
- Department of Public Health, Syracuse University, Syracuse, NY, USA
| | - Kaelene LoMonaco
- Department of Biology, University of Florida, Gainesville, FL, USA
| | | | | | - Harrison Shrock
- Department of Biology, University of Florida, Gainesville, FL, USA
| | - Justin Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Carl D Laird
- Sandia National Laboratories, Albuquerque, NM, USA.
| | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA.
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
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195
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Piraveenan M, Sawleshwarkar S, Walsh M, Zablotska I, Bhattacharyya S, Farooqui HH, Bhatnagar T, Karan A, Murhekar M, Zodpey S, Rao KSM, Pattison P, Zomaya A, Perc M. Optimal governance and implementation of vaccination programmes to contain the COVID-19 pandemic. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210429. [PMID: 34113457 PMCID: PMC8188005 DOI: 10.1098/rsos.210429] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/27/2021] [Indexed: 05/02/2023]
Abstract
Since the recent introduction of several viable vaccines for SARS-CoV-2, vaccination uptake has become the key factor that will determine our success in containing the COVID-19 pandemic. We argue that game theory and social network models should be used to guide decisions pertaining to vaccination programmes for the best possible results. In the months following the introduction of vaccines, their availability and the human resources needed to run the vaccination programmes have been scarce in many countries. Vaccine hesitancy is also being encountered from some sections of the general public. We emphasize that decision-making under uncertainty and imperfect information, and with only conditionally optimal outcomes, is a unique forte of established game-theoretic modelling. Therefore, we can use this approach to obtain the best framework for modelling and simulating vaccination prioritization and uptake that will be readily available to inform important policy decisions for the optimal control of the COVID-19 pandemic.
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Affiliation(s)
- Mahendra Piraveenan
- Complex Systems Research Group, Faculty of Engineering, University of Sydney, New South Wales 2006, Australia
- Charles Perkins Centre, University of Sydney, New South Wales 2006, Australia
| | - Shailendra Sawleshwarkar
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales 2006, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, New South Wales 2006, Australia
- Public Health Foundation of India, Delhi, India
| | - Michael Walsh
- School of Public Health, Faculty of Medicine and Health, University of Sydney, New South Wales 2006, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, New South Wales 2006, Australia
| | - Iryna Zablotska
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales 2006, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, New South Wales 2006, Australia
| | - Samit Bhattacharyya
- Department of Mathematics, School of Natural Sciences, Shiv Nadar University, Uttar Pradesh, India
| | | | | | - Anup Karan
- Public Health Foundation of India, Delhi, India
| | | | | | - K. S. Mallikarjuna Rao
- Industrial Engineering and Operations Research, Indian Institute of Technology Bombay, Mumbai, India
| | - Philippa Pattison
- Office of the Deputy Vice-Chancellor, University of Sydney, New South Wales 2006, Australia
| | - Albert Zomaya
- School of Computer Science, Faculty of Engineering, University of Sydney, New South Wales 2006, Australia
| | - Matjaz Perc
- Faculty of Natural Sciences and Mathematics, University of Maribor, Maribor, Slovenia
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Complexity Science Hub Vienna, Vienna, Austria
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196
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Reyes MSGL, Dee EC, Ho BL. Vaccination in the Philippines: experiences from history and lessons for the future. Hum Vaccin Immunother 2021; 17:1873-1876. [PMID: 33357156 DOI: 10.1080/21645515.2020.1841541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
In anticipation of a potential vaccine for COVID-19, vaccine uptake may be critical in overcoming the pandemic, especially in countries like the Philippines, which has among the highest rates of infection in the region. Looking at the progress of vaccination in the country - its promises, pitfalls, and challenges - may provide insight for public health professionals and the public. The history of vaccination in the Philippines is marked by strong achievements, such as the establishment and growth of a national programme for immunization, and importantly, the eradication of poliomyelitis and maternal and neonatal tetanus. It is also marred by critical challenges which provide a springboard for improvement across all sectors - vaccine stock-outs,strong opposition from certain advocacy groups, and the widely publicized Dengvaxia controversy. Moving forward, with recent surveys having shown that vaccine confidence has begun to improve, these experiences may inform the approaches taken to address vaccine uptake. These lessons from the past highlight the importance of a strong partnership between health leaders and the local community, bearing in mind cultural appropriateness and humility; the engagement of multidisciplinary stakeholders; and the importance of foresight in preparing public health infrastructure for the arrival of a COVID-19 vaccine.
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Affiliation(s)
| | | | - Beverly Lorraine Ho
- Department of Health, Health Promotion and Communication Service, Philippines
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197
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Kleynhans J, Tempia S, McMorrow ML, von Gottberg A, Martinson NA, Kahn K, Moyes J, Mkhencele T, Lebina L, Gómez-Olivé FX, Wafawanaka F, Mathunjwa A, Cohen C. A cross-sectional study measuring contact patterns using diaries in an urban and a rural community in South Africa, 2018. BMC Public Health 2021; 21:1055. [PMID: 34078327 PMCID: PMC8172361 DOI: 10.1186/s12889-021-11136-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/24/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Describing contact patterns is crucial to understanding infectious disease transmission dynamics and guiding targeted transmission mitigation interventions. Data on contact patterns in Africa, especially South Africa, are limited. We measured and compared contact patterns in a rural and urban community, South Africa. We assessed participant and contact characteristics associated with differences in contact rates. METHODS We conducted a cross-sectional study nested in a prospective household cohort study. We interviewed participants to collect information on persons in contact with for one day. We described self-reported contact rates as median number people contacted per day, assessed differences in contact rates based on participant characteristics using quantile regression, and used a Poisson model to assess differences in contact rates based on contact characteristics within age groups. We also calculated cumulative person hours in contact within age groups at different locations. RESULTS We conducted 535 interviews (269 rural, 266 urban), with 17,252 contacts reported. The overall contact rate was 14 (interquartile range (IQR) 9-33) contacts per day. Those ≤18 years had higher contact rates at the rural site (coefficient 17, 95% confidence interval (95%CI) 10-23) compared to the urban site, for those aged 14-18 years (13, 95%CI 3-23) compared to < 7 years. No differences were observed for adults. There was a strong age-based mixing, with age groups interacting more with similar age groups, but also interaction of participants of all ages with adults. Children aged 14-18 years had the highest cumulative person hours in contact (116.3 rural and 76.4 urban). CONCLUSIONS Age played an important role in the number and duration of contact events, with children at the rural site having almost double the contact rate compared to the urban site. These contact rates can be utilized in mathematical models to assess transmission dynamics of infectious diseases in similar communities.
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Affiliation(s)
- Jackie Kleynhans
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Stefano Tempia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
- MassGenics, Duluth, Georgia, USA
| | - Meredith L McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
- United States Public Health Service, Rockville, MD, USA
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil A Martinson
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa
- Johns Hopkins University Center for Tuberculosis Research, Baltimore, MD, USA
- Department of Science and Technology/National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Thulisa Mkhencele
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Limakatso Lebina
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Floidy Wafawanaka
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Azwifarwi Mathunjwa
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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198
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Banholzer N, van Weenen E, Lison A, Cenedese A, Seeliger A, Kratzwald B, Tschernutter D, Salles JP, Bottrighi P, Lehtinen S, Feuerriegel S, Vach W. Estimating the effects of non-pharmaceutical interventions on the number of new infections with COVID-19 during the first epidemic wave. PLoS One 2021; 16:e0252827. [PMID: 34077448 PMCID: PMC8171941 DOI: 10.1371/journal.pone.0252827] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/23/2021] [Indexed: 12/24/2022] Open
Abstract
The novel coronavirus (SARS-CoV-2) has rapidly developed into a global epidemic. To control its spread, countries have implemented non-pharmaceutical interventions (NPIs), such as school closures, bans of small gatherings, or even stay-at-home orders. Here we study the effectiveness of seven NPIs in reducing the number of new infections, which was inferred from the reported cases of COVID-19 using a semi-mechanistic Bayesian hierarchical model. Based on data from the first epidemic wave of n = 20 countries (i.e., the United States, Canada, Australia, the EU-15 countries, Norway, and Switzerland), we estimate the relative reduction in the number of new infections attributed to each NPI. Among the NPIs considered, bans of large gatherings were most effective, followed by venue and school closures, whereas stay-at-home orders and work-from-home orders were least effective. With this retrospective cross-country analysis, we provide estimates regarding the effectiveness of different NPIs during the first epidemic wave.
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Affiliation(s)
- Nicolas Banholzer
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Eva van Weenen
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Adrian Lison
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Alberto Cenedese
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Arne Seeliger
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Bernhard Kratzwald
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Daniel Tschernutter
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Joan Puig Salles
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Pierluigi Bottrighi
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Sonja Lehtinen
- Department of Environmental Systems Science, ETH Zurich, Zurich, Switzerland
| | - Stefan Feuerriegel
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Werner Vach
- Basel Academy for Quality and Research in Medicine, Basel, Switzerland
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
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199
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Zirinsky E, Paintsil E, Oliveira CR. The clinical epidemiology of coronavirus disease 2019 in children and adolescents mirrors the widening gap in healthcare disparities. Curr Opin Pediatr 2021; 33:281-285. [PMID: 33871422 PMCID: PMC8635086 DOI: 10.1097/mop.0000000000001018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has exacerbated the longstanding racial/ethnic health disparities in the USA, with a disproportionately negative effect on children of color. This review summarizes recently published studies that describe the clinical epidemiology and racial/ethnic disparities associated with SARS-CoV-2 in children. RECENT FINDINGS Children with SARS-CoV-2 infections manifest with a wide spectrum of disease. Most are either asymptomatic or mildly symptomatic with fever, gastrointestinal, and/or upper respiratory disease. Some children can progress to develop severe lower respiratory disease or a hyper-inflammatory, Kawasaki-like syndrome leading to cardiovascular shock. Although SARS-CoV-2-related deaths in children are rare, more children died within the first nine months of the pandemic than have died during any influenza season over the last decade.Black and Hispanic children represent less than 41% of the US population but account for three out of every four SARS-CoV-2-related hospitalizations and deaths in the USA. The drivers of these disparities in children are complex and likely a combination of societal, biological, and behavioral influences. SUMMARY This pandemic brought to light longstanding health disparities in historically marginalized populations, and minority children have suffered tremendously. It provides an opportunity to understand how a virus hijacked deep-rooted inequities, address these inequities, and work to prevent this outcome in future pandemics/epidemics.
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Affiliation(s)
- Elissa Zirinsky
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine
| | - Elijah Paintsil
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine
- Department of Pharmacology, Yale University School of Medicine
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Carlos R. Oliveira
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine
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200
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Lin HXJ, Cho S, Meyyur Aravamudan V, Sanda HY, Palraj R, Molton JS, Venkatachalam I. Remdesivir in Coronavirus Disease 2019 (COVID-19) treatment: a review of evidence. Infection 2021; 49:401-410. [PMID: 33389708 PMCID: PMC7778417 DOI: 10.1007/s15010-020-01557-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/16/2020] [Indexed: 01/04/2023]
Abstract
COVID-19 is an infectious disease caused by a novel β-coronavirus, belonging to the same subgenus as the Severe Acute Respiratory Syndrome (SARS) virus. Remdesivir, an investigational broad-spectrum antiviral agent has previously demonstrated in vitro activity against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and in vivo efficacy against other related coronaviruses in animal models. Its safety profile has been tested in a compassionate use setting for patients with COVID-19. The current therapeutic studies demonstrate clinical effectiveness of remdesivir in COVID-19 patients by shortening time to clinical recovery, and hospital stay. In this review, we critically analyze the current evidence of remdesivir against COVID-19 and dissect the aspects over its safety and efficacy. Based on existing data, remdesivir can be regarded as a potential therapeutic agent against COVID-19. Further large-scale, randomized placebo-controlled clinical trials are, however, awaited to validate these findings.
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Affiliation(s)
| | - Sanda Cho
- Department of General Medicine, Warrington and Halton Hospitals NHS Trust, Warrington, UK
| | | | - Hnin Yu Sanda
- Department of Acute Medicine, Queens Hospital, Romford, England, UK
| | - Raj Palraj
- Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, USA
| | - James S Molton
- Department of Infectious Disease, Western Health, Footscray, Australia
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