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Liu Y, Yin Y, Ward MP, Li K, Chen Y, Duan M, Wong PPY, Hong J, Huang J, Shi J, Zhou X, Chen X, Xu J, Yuan R, Kong L, Zhang Z. Optimization of Screening Strategies for COVID-19: Scoping Review. JMIR Public Health Surveill 2024; 10:e44349. [PMID: 38412011 PMCID: PMC10933748 DOI: 10.2196/44349] [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: 11/17/2022] [Revised: 06/29/2023] [Accepted: 11/21/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND COVID-19 screening is an effective nonpharmaceutical intervention for identifying infected individuals and interrupting viral transmission. However, questions have been raised regarding its effectiveness in controlling the spread of novel variants and its high socioeconomic costs. Therefore, the optimization of COVID-19 screening strategies has attracted great attention. OBJECTIVE This review aims to summarize the evidence and provide a reference basis for the optimization of screening strategies for the prevention and control of COVID-19. METHODS We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. We conducted a scoping review of the present publications on the optimization of COVID-19 screening strategies. We searched the PubMed, Web of Science, and Elsevier ScienceDirect databases for publications up to December 31, 2022. English publications related to screening and testing strategies for COVID-19 were included. A data-charting form, jointly developed by 2 reviewers, was used for data extraction according to the optimization directions of the screening strategies. RESULTS A total of 2770 unique publications were retrieved from the database search, and 95 abstracts were retained for full-text review. There were 62 studies included in the final review. We summarized the results in 4 major aspects: the screening population (people at various risk conditions such as different regions and occupations; 12/62, 19%), the timing of screening (when the target population is tested before travel or during an outbreak; 12/62, 19%), the frequency of screening (appropriate frequencies for outbreak prevention, outbreak response, or community transmission control; 6/62, 10%), and the screening and detection procedure (the choice of individual or pooled detection and optimization of the pooling approach; 35/62, 56%). CONCLUSIONS This review reveals gaps in the optimization of COVID-19 screening strategies and suggests that a number of factors such as prevalence, screening accuracy, effective allocation of resources, and feasibility of strategies should be carefully considered in the development of future screening strategies.
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Affiliation(s)
- Yuanhua Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yun Yin
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Michael P Ward
- Sydney School of Veterinary Science, The University of Sydney, NSW, Australia
| | - Ke Li
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mengwei Duan
- Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | | | - Jie Hong
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiaqi Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jin Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xuan Zhou
- Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | - Xi Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiayao Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Rui Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Lingcai Kong
- Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | - Zhijie Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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Yao L, Aleya L, Goldman E, Graff JC, Gu W. An alternative approach-combination of lockdown and open in fighting COVID-19 pandemics. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:82611-82614. [PMID: 36229730 PMCID: PMC9560743 DOI: 10.1007/s11356-022-23438-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
As the COVID-19 pandemic enters its third year and the omicron variant becomes dominant, we propose an alternative strategy for dealing with COVID-19, called hybrid lockdown, that is, the combination of lockdown (the centralized and organized lockdown of the high-risk population) and free mobility (normal mobility) of the low-risk population. Such an approach will enable a country or region, especially with a high population density, to achieve significant prevention and control the effects of the COVID-19 pandemic at the least cost.
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Affiliation(s)
- Lan Yao
- Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN, 47306, USA
- Department of Orthopedic Surgery and BME, College of Medicine, University of Tennessee Health Science Center, 956 Court Ave, Memphis, TN, 38163, USA
| | - Lotfi Aleya
- Chrono-Environnement Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, 25030, Besançon Cedex, France
| | - Emanuel Goldman
- Department of Microbiology, Biochemistry & Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - J Carolyn Graff
- Department of Health Promotion and Disease Prevention, College of Nursing, University of Tennessee Health Science Center, Memphis, TN, 38105, USA
| | - Weikuan Gu
- Department of Orthopedic Surgery and BME, College of Medicine, University of Tennessee Health Science Center, 956 Court Ave, Memphis, TN, 38163, USA.
- Research Service, Memphis VA Medical Center, 1030 Jefferson Avenue, Memphis, TN, 38104, USA.
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, 881 Madison Ave, Memphis, TN, 38163, USA.
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Yao L, Aleya L, Howard SC, Cao Y, Wang CY, Day SW, Graff JC, Sun D, Gu W. Variations of COVID-19 mortality are affected by economic disparities across countries. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 832:154770. [PMID: 35341873 PMCID: PMC8949690 DOI: 10.1016/j.scitotenv.2022.154770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND When the COVID-19 case number reaches a maximum in a country, its capacity and management of health system face greatest challenge. METHODS We performed a cross-sectional study on data of turning points for cases and deaths for the first three waves of COVID-19 in countries with more than 5000 cumulative cases, as reported by Worldometers and WHO Coronavirus (COVID-19) Dashboard. We compared the case fatality rates (CFRs) and time lags (in unit of day) between the turning points of cases and deaths among countries in different development stages and potential influence factors. As of May 10, 2021, 106 out of 222 countries or regions (56%) reported more than 5000 cases. Approximately half of them have experienced all the three waves of COVID-19 disease. The average mortality rate at the disease turning point was 0.038 for the first wave, 0.020 for the second wave, and 0.023 for wave 3. In high-income countries, the mortality rates during the first wave are higher than that of the other income levels. However, the mortality rates during the second and third waves of COVID-19 were much lower than those of the first wave, with a significant reduction from 5.7% to 1.7% approximately 70%. At the same time, high-income countries exhibited a 2-fold increase in time lags during the second and the third waves compared to the first wave, suggesting that the periods between the cases and deaths turning point extended. High rates in the first wave in developed countries are associated to multiple factors including transportation, population density, and aging populations. In upper middle- and lower middle-income countries, the decreasing of mortality rates in the second and third waves were subtle or even reversed, with increased mortality during the following waves. In the upper and lower middle-income countries, the time lags were about 50% of the durations observed from high-income countries. INTERPRETATION Economy and medical resources affect the efficiency of COVID-19 mitigation and the clinical outcomes of the patients. The situation is likely to become even worse in the light of these countries' limited ability to combat COVID-19 and prevent severe outcomes or deaths as the new variant transmission becomes dominant.
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Affiliation(s)
- Lan Yao
- Health Outcomes and Policy Research, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Lotfi Aleya
- Chrono-Environnement Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté Université, F-25030 Besançon Cedex, France
| | - Scott C Howard
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - Yanhong Cao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, PR China; Key Laboratory of Etiologic Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618104), 157 Baojian Road, Harbin, Heilongjiang 150081, PR China
| | - Cong-Yi Wang
- The Center for Biomedical Research, Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Sara W Day
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - J Carolyn Graff
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, PR China; Key Laboratory of Etiologic Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618104), 157 Baojian Road, Harbin, Heilongjiang 150081, PR China.
| | - Weikuan Gu
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, USA; Research Service, Memphis VA Medical Center, 1030 Jefferson Avenue, Memphis, TN 38104, USA.
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Yao L, Li M, Wan JY, Howard SC, Bailey JE, Graff JC. Democracy and case fatality rate of COVID-19 at early stage of pandemic: a multicountry study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:8694-8704. [PMID: 34490579 PMCID: PMC8421237 DOI: 10.1007/s11356-021-16250-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/26/2021] [Indexed: 05/14/2023]
Abstract
Many studies have evaluated factors that influence the course of the COVID-19 pandemic in different countries. This multicountry study assessed the influence of democracy and other factors on the case fatality rate of COVID-19 during the early stage of the pandemic. We accessed the World Health Organization, World Bank, and the Democracy Index 2019 databases for data from the 148 countries. Multiple analyses were conducted to examine the association between the Democracy Index and case fatality rate of COVID-19. Within 148 countries, the percentage of the population aged 65 years and above (p = 0.0193), and health expenditure as a percentage of GDP (p = 0.0237) were positively associated with countries' case fatality rates. By contrast, hospital beds per capita helped to reduce the case fatality rates. In particular, the Democracy Index was positively associated with case fatality rates in a subgroup of 47 high-income countries. This study suggests that enhancing the health system with increased hospital beds and healthcare workforce per capita should reduce case fatality rate. The findings suggest that a higher Democracy Index is associated with more deaths from COVID-19 at the early stage of the pandemic, possibly due to the decreased ability of the government.
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Affiliation(s)
- Lan Yao
- Health Outcomes and Policy Research, College of Graduate Health Sciences, University of Tennessee Health Science Center, 750 Adams Ave #1001, Memphis, TN 38163 USA
| | - Minghui Li
- Minghui Li, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163 USA
| | - Jim Y. Wan
- Jim Y. Wan, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163 USA
| | - Scott C. Howard
- Scott C. Howard, College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38163 USA
| | - James E. Bailey
- James E. Bailey, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163 USA
| | - Joyce Carolyn Graff
- College of Nursing, University of Tennessee Health Science Center, 874 Union Avenue, Memphis, TN 38163 USA
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Graphical Trajectory Comparison to Identify Errors in Data of COVID-19: A Cross-Country Analysis. J Pers Med 2021; 11:jpm11100955. [PMID: 34683095 PMCID: PMC8537769 DOI: 10.3390/jpm11100955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
Data from the early stage of a novel infectious disease outbreak provide vital information in risk assessment, prediction, and precise disease management. Since the first reported case of COVID-19, the pattern of the novel coronavirus transmission in Wuhan has become the interest of researchers in epidemiology and public health. To thoroughly map the mechanism of viral spreading, we used the patterns of data at the early onset of COVID-19 from seven countries to estimate the time lag between peak days of cases and deaths. This study compared these data with those of Wuhan and estimated the natural history of disease across the infected population and the time lag. The findings suggest that comparative analyses of data from different regions and countries reveal the differences between peaks of cases and deaths caused by COVID-19 and the incomplete and underestimated cases in Wuhan. Different countries may show different patterns of cases peak days, deaths peak days, and peak periods. Error in the early COVID-19 statistics in Brazil was identified. This study provides sound evidence for policymakers to understand the local circumstances in diagnosing the health of a population and propose precise and timely public health interventions to control and prevent infectious diseases.
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