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Su Z, Bentley BL, McDonnell D, Cheshmehzangi A, Ahmad J, Šegalo S, da Veiga CP, Xiang YT. The dangers of having only one pandemic exit strategy. J Infect Public Health 2024; 17:1007-1012. [PMID: 38636311 DOI: 10.1016/j.jiph.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/10/2024] [Accepted: 04/05/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND When it comes to pandemic response, preparation can be the key. Between 2020 and 2024, the fast-paced development of COVID-19-often compounded by pubic policies' failures to reflect the latest reality and the public's divergent reactions to the pandemic and the policies-means that society should prepare for exit strategies that can reflect the reality of the pandemic and the interests of the people. Yet oftentimes societies only have one exit strategy with limited scope. This paper investigates the dangers of having only one pandemic exit strategy for pandemics like COVID-19. METHODS Analyses were based on a review of the literature on COVID-19 exit strategies and our own research. The PubMed literature search focused on two concepts-"COVID-19″ and "exit strategy"-and was limited to peer-reviewed papers published between 2020 and 2024 in English. RESULTS A total of 31 articles were included in the final review. Analyses showed that existing studies on COVID-19 exit strategies often focused on using the modelling method to gauge one exit strategy. Exit strategies were often discussed in the context of implementing, easing, or lifting specific pharmaceutical or non-pharmaceutical interventions. Staged and country-wide coordinated exit strategies were also discussed in the literature, both of which were often deemed as comparatively rigorous options compared to single or stand-alone exit strategies. Drawing on the overall development of COVID-19 and our own research, we presented and discussed the importance of having multiple exit strategies that are considerate of all possible pandemic trajectories, diverse interests of the public, and the communication challenges officials might face in introducing or implementing pandemic policies. CONCLUSION This paper underscored the importance of having multiple exit strategies for societies to prepare for pandemics. The insights of this study can help inform health policies so that they can more comprehensively and compassionately protect the needs and wants of the "public" in public health, particularly in grave times like COVID-19.
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Affiliation(s)
- Zhaohui Su
- School of Public Health, Southeast University, Nanjing 210009, China.
| | - Barry L Bentley
- Cardiff School of Technologies, Cardiff Metropolitan University, Cardiff, UK; Collaboration for the Advancement of Sustainable Medical Innovation, University College London, London, UK.
| | - Dean McDonnell
- Department of Humanities, South East Technological University, R93 V960, Ireland.
| | - Ali Cheshmehzangi
- Network for Education and Research on Peace and Sustainability (NERPS), Hiroshima University, Hiroshima 739-8530, Japan; School of Architecture, Design and Planning, The University of Queensland, Brisbane, 4072, Australia.
| | - Junaid Ahmad
- School of Public Affairs, Zhejiang University, Hangzhou 310027, China.
| | - Sabina Šegalo
- Faculty of Health Studies, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina.
| | - Claudimar Pereira da Veiga
- Fundação Dom Cabral - FDC, Av. Princesa Diana, 760 Alphaville, Lagoa dos Ingleses, Nova Lima, MG 34018-006, Brazil.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Luo W, Liu Z, Ran Y, Li M, Zhou Y, Hou W, Lai S, Li SL, Yin L. Unraveling varying spatiotemporal patterns of dengue and associated exposure-response relationships with environmental variables in Southeast Asian countries before and during COVID-19. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.25.24304825. [PMID: 38585938 PMCID: PMC10996745 DOI: 10.1101/2024.03.25.24304825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
The enforcement of COVID-19 interventions by diverse governmental bodies, coupled with the indirect impact of COVID-19 on short-term environmental changes (e.g. plant shutdowns lead to lower greenhouse gas emissions), influences the dengue vector. This provides a unique opportunity to investigate the impact of COVID-19 on dengue transmission and generate insights to guide more targeted prevention measures. We aim to compare dengue transmission patterns and the exposure-response relationship of environmental variables and dengue incidence in the pre- and during-COVID-19 to identify variations and assess the impact of COVID-19 on dengue transmission. We initially visualized the overall trend of dengue transmission from 2012-2022, then conducted two quantitative analyses to compare dengue transmission pre-COVID-19 (2017-2019) and during-COVID-19 (2020-2022). These analyses included time series analysis to assess dengue seasonality, and a Distributed Lag Non-linear Model (DLNM) to quantify the exposure-response relationship between environmental variables and dengue incidence. We observed that all subregions in Thailand exhibited remarkable synchrony with a similar annual trend except 2021. Cyclic and seasonal patterns of dengue remained consistent pre- and during-COVID-19. Monthly dengue incidence in three countries varied significantly. Singapore witnessed a notable surge during-COVID-19, particularly from May to August, with cases multiplying several times compared to pre-COVID-19, while seasonality of Malaysia weakened. Exposure-response relationships of dengue and environmental variables show varying degrees of change, notably in Northern Thailand, where the peak relative risk for the maximum temperature-dengue relationship rose from about 3 to 17, and the max RR of overall cumulative association 0-3 months of relative humidity increased from around 5 to 55. Our study is the first to compare dengue transmission patterns and their relationship with environmental variables before and during COVID-19, showing that COVID-19 has affected dengue transmission at both the national and regional level, and has altered the exposure-response relationship between dengue and the environment.
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Affiliation(s)
- Wei Luo
- GeoSpatialX Lab, Department of Geography, National University of Singapore, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Zhihao Liu
- School of Geosciences, Yangtze University, Wuhan, China
| | - Yiding Ran
- GeoSpatialX Lab, Department of Geography, National University of Singapore, Singapore, Singapore
| | - Mengqi Li
- Department of Geography, University of Zurich, Zurich, Switzerland
| | - Yuxuan Zhou
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Weitao Hou
- School of Design and the Built Environment, Curtin University, Perth, Australia
| | - Shengjie Lai
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, United Kingdom
| | - Sabrina L Li
- School of Geography, University of Nottingham, Nottingham, United Kingdom
| | - Ling Yin
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Yang L, Yu X, Yang Y, Luo YL, Zhang L. The transmission network and spatial-temporal distributions of COVID-19: A case study in Lanzhou, China. Health Place 2024; 86:103207. [PMID: 38364457 DOI: 10.1016/j.healthplace.2024.103207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/17/2024] [Accepted: 01/28/2024] [Indexed: 02/18/2024]
Abstract
Public emergencies exert substantial adverse effects on the socioeconomic development of cities. Investigating the transmission characteristics of COVID-19 can lead to evidence-based strategies for future pandemic intervention and prevention. Drawing upon primary COVID-19 data collected at both the street level and from individuals with confirmed cases in Lanzhou, China, our study examined the spatial-temporal distribution of the pandemic at a detailed level. First, we constructed transmission networks based on social relationships and spatial behavior to elucidate the actual natural transmission chain of COVID-19. We then analyze key information regarding pandemic spread, such as superspreaders, superspreading places, and peak hours. Furthermore, we constructed a space-time path model to deduce the spatial transmission trajectory of the pandemic while validating it with real activity trajectory data from confirmed cases. Finally, we investigate the impacts of pandemic prevention and control policies. The progression of the pandemic exhibits distinct stages and spatial clustering characteristics. People with complex social relationships and daily life trajectories and places with high pedestrian flow and commercial activity venues are prone to becoming superspreaders and superspreading places. The transmission path of the pandemic showed a pattern of short-distance and adjacent transmission, with most areas not affected. Early-stage control measures effectively disrupt transmission hotspots and impede the spatiotemporal trajectory of pandemic propagation, thereby enhancing the efficacy of prevention and control efforts. These findings elucidate the characteristics and transmission processes underlying pandemics, facilitating targeted and adaptable policy formulation to shape sustainable and resilient cities.
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Affiliation(s)
- Liangjie Yang
- College of Geography and Environmental Science, Northwest Normal University, Lanzhou, 730070, China; Key Laboratory of Resource Environment and Sustainable Development of Oasis, Northwest Normal University, Lanzhou, 730070, China.
| | - Xiao Yu
- College of Geography and Environmental Science, Northwest Normal University, Lanzhou, 730070, China.
| | - Yongchun Yang
- College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730070, China; Key Laboratory of Western China's Environmental Systems, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Ya Ling Luo
- College of Geography and Environmental Science, Northwest Normal University, Lanzhou, 730070, China.
| | - Lingling Zhang
- College of Geography and Environmental Science, Northwest Normal University, Lanzhou, 730070, China.
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Luo W, Liu Q, Zhou Y, Ran Y, Liu Z, Hou W, Pei S, Lai S. Spatiotemporal variations of "triple-demic" outbreaks of respiratory infections in the United States in the post-COVID-19 era. BMC Public Health 2023; 23:2452. [PMID: 38062417 PMCID: PMC10704638 DOI: 10.1186/s12889-023-17406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The US confronted a "triple-demic" of influenza, respiratory syncytial virus (RSV), and COVID-19 in the winter of 2022, leading to increased respiratory infections and a higher demand for medical supplies. It is urgent to analyze these epidemics and their spatial-temporal co-occurrence, identifying hotspots and informing public health strategies. METHODS We employed retrospective and prospective space-time scan statistics to assess the situations of COVID-19, influenza, and RSV in 51 US states from October 2021 to February 2022, and from October 2022 to February 2023, respectively. This enabled monitoring of spatiotemporal variations for each epidemic individually and collectively. RESULTS Compared to winter 2021, COVID-19 cases decreased while influenza and RSV infections significantly increased in winter 2022. We found a high-risk cluster of influenza and COVID-19 (not all three) in winter 2021. In late November 2022, a large high-risk cluster of triple-demic emerged in the central US. The number of states at high risk for multiple epidemics increased from 15 in October 2022 to 21 in January 2023. CONCLUSIONS Our study offers a novel spatiotemporal approach that combines both univariate and multivariate surveillance, as well as retrospective and prospective analyses. This approach offers a more comprehensive and timely understanding of how the co-occurrence of COVID-19, influenza, and RSV impacts various regions within the United States. Our findings assist in tailor-made strategies to mitigate the effects of these respiratory infections.
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Affiliation(s)
- Wei Luo
- GeoSpatialX Lab, Department of Geography, National University of Singapore, 1 Arts Link, #04-32 Block AS2, Singapore, 117570, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Qianhuang Liu
- GeoSpatialX Lab, Department of Geography, National University of Singapore, 1 Arts Link, #04-32 Block AS2, Singapore, 117570, Singapore
| | - Yuxuan Zhou
- Department of Architecture and Civil Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Yiding Ran
- GeoSpatialX Lab, Department of Geography, National University of Singapore, 1 Arts Link, #04-32 Block AS2, Singapore, 117570, Singapore
| | - Zhaoyin Liu
- GeoSpatialX Lab, Department of Geography, National University of Singapore, 1 Arts Link, #04-32 Block AS2, Singapore, 117570, Singapore
| | - Weitao Hou
- Department Of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Shengjie Lai
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK.
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Luo W, Liu Q, Zhou Y, Ran Y, Liu Z, Hou W, Pei S, Lai S. Spatiotemporal Variations of "Triple-demic" Outbreaks of Respiratory Infections in the United States in the Post-COVID-19 Era. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.23.23290387. [PMID: 37293024 PMCID: PMC10246133 DOI: 10.1101/2023.05.23.23290387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objectives The United States confronted a "triple-demic" of influenza, respiratory syncytial virus, and COVID-19 in the winter of 2022, resulting in increased respiratory infections and a higher demand for medical supplies. It is urgent to analyze each epidemic and their co-occurrence in space and time to identify hotspots and provide insights for public health strategy. Methods We used retrospective space-time scan statistics to retrospect the situation of COVID-19, influenza, and RSV in 51 US states from October 2021 to February 2022, and then applied prospective space-time scan statistics to monitor spatiotemporal variations of each individual epidemic, respectively and collectively from October 2022 to February 2023. Results Our analysis indicated that compared to the winter of 2021, COVID-19 cases decreased while influenza and RSV infections increased significantly during the winter of 2022. We revealed that a twin-demic high-risk cluster of influenza and COVID-19 but no triple-demic clusters emerged during the winter of 2021. We further identified a large high-risk cluster of triple-demic in the central US from late November, with COVID-19, influenza, and RSV having relative risks of 1.14, 1.90, and 1.59, respectively. The number of states at high risk for multiple-demic increased from 15 in October 2022 to 21 in January 2023. Conclusion Our study provides a novel spatiotemporal perspective to explore and monitor the transmission patterns of the triple epidemic, which could inform public health authorities' resource allocation to mitigate future outbreaks.
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