Physical distancing implementation, ambient temperature and Covid-19 containment: An observational study in the United States

COVID-19: Post infection implications in different age groups, mechanism, diagnosis, effective prevention, treatment, and recommendations

SARS-CoV-2 is a highly contagious pathogen that predominantly caused the COVID-19 pandemic. The persistent effects of COVID-19 are defined as an inflammatory or host response to the virus that begins four weeks after initial infection and persists for an undetermined length of time. Chronic effects are more harmful than acute ones thus, this review explored the long-term effects of the virus on various human organs, including the pulmonary, cardiovascular, and neurological, reproductive, gastrointestinal, musculoskeletal, endocrine, and lymphoid systems and found that SARS-CoV-2 adversely affects these organs of older adults. Regarding diagnosis, the RT-PCR is a gold standard method of diagnosing COVID-19; however, it requires specialized equipment and personnel for performing assays and a long time for results production. Therefore, to overcome these limitations, artificial intelligence employed in imaging and microfluidics technologies is the most promising in diagnosing COVID-19. Pharmacological and non-pharmacological strategies are the most effective treatment for reducing the persistent impacts of COVID-19 by providing immunity to post-COVID-19 patients by reducing cytokine release syndrome, improving the T cell response, and increasing the circulation of activated natural killer and CD8 T cells in blood and tissues, which ultimately reduces fever, nausea, fatigue, and muscle weakness and pain. Vaccines such as inactivated viral, live attenuated viral, protein subunit, viral vectored, mRNA, DNA, or nanoparticle vaccines significantly reduce the adverse long-term virus effects in post-COVID-19 patients; however, no vaccine was reported to provide lifetime protection against COVID-19; consequently, protective measures such as physical separation, mask use, and hand cleansing are promising strategies. This review provides a comprehensive knowledge of the persistent effects of COVID-19 on people of varying ages, as well as diagnosis, treatment, vaccination, and future preventative measures against the spread of SARS-CoV-2.

Inactivated vaccine effectiveness against symptomatic COVID-19 in Fujian, China during the Omicron BA.2 outbreak

Objective

More than 90% of the Chinese population have completed 2 doses of inactivated COVID-19 vaccines in Mainland China. However, after China government abandoned strict control measures, many breakthrough infections appeared, and vaccine effectiveness against Omicron BA.2 infection was uncertain. This study aims to investigate the real-world effectiveness of widely used inactivated vaccines during the wave of Omicron variants.

Methods

Test-negative case-control study was conducted in this study to analyze the vaccine effectiveness against symptomatic disease caused by the Omicron variant (BA.2) in Fujian, China. Conditional logistic regression was selected to estimate the vaccine effectiveness.

Results

The study found the vaccine effectiveness against symptomatic COVID-19 is 32.46% (95% CI, 8.08% to 50.37%) at 2 to 8 weeks, and 27.05% (95% CI, 1.23% to 46.12%) at 12 to 24 weeks after receiving booster doses of the inactivated vaccine. Notably, the 3-17 years group had higher vaccine effectiveness after 2 doses than the 18-64 years and over 65 years groups who received booster doses.

Conclusion

Inactivated vaccines alone may not offer sufficient protection for all age groups before the summer of 2022. To enhance protection, other types of vaccines or bivalent vaccines should be considered.

Effectiveness of social distancing measures and lockdowns for reducing transmission of COVID-19 in non-healthcare, community-based settings

Social distancing measures (SDMs) are community-level interventions that aim to reduce person-to-person contacts in the community. SDMs were a major part of the responses first to contain, then to mitigate, the spread of SARS-CoV-2 in the community. Common SDMs included limiting the size of gatherings, closing schools and/or workplaces, implementing work-from-home arrangements, or more stringent restrictions such as lockdowns. This systematic review summarized the evidence for the effectiveness of nine SDMs. Almost all of the studies included were observational in nature, which meant that there were intrinsic risks of bias that could have been avoided were conditions randomly assigned to study participants. There were no instances where only one form of SDM had been in place in a particular setting during the study period, making it challenging to estimate the separate effect of each intervention. The more stringent SDMs such as stay-at-home orders, restrictions on mass gatherings and closures were estimated to be most effective at reducing SARS-CoV-2 transmission. Most studies included in this review suggested that combinations of SDMs successfully slowed or even stopped SARS-CoV-2 transmission in the community. However, individual effects and optimal combinations of interventions, as well as the optimal timing for particular measures, require further investigation. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.

Towards building resilient cities to pandemics: A review of COVID-19 literature

With the global prevalence of COVID-19 disease, the concept of urban resilience against pandemics has drawn the attention of a wide range of researchers, urban planners, and policymakers. This study aims to identify the major dimensions and principles of urban resilience to pandemics through a systematic review focused on lessons learned from the COVID-19 pandemic and comparing different perspectives regarding resilient urban environments to such diseases. Based on the findings, the study proposes a conceptual framework and a series of principles of urban resilience to pandemics, consisting of four spatial levels: housing, neighborhoods, city, and the regional and national scales, and three dimensions of pandemic resilience: pandemic-related health requirements, environmental psychological principles, and general resilience principles. The findings show that resilient cities should be able to implement the pandemic-related health requirements, the psychological principles of the environment to reduce the stresses caused by the pandemic, and the general principles of resilience in the smart city context. This framework provides scholars and policymakers with a comprehensive understanding of resilience on different scales and assists them in making better-informed decisions.

Comparative Performance Evaluation of Personal Protective Measures and Antiviral Agents Against SARS-CoV-2 Variants: A Narrative Review

Scientists identified SARS-CoV-2 in December 2019 in Wuhan city of China. Soon after its identification, Covid-19 spreads almost everywhere. The World Health Organization (WHO) declared the Covid-19 outbreak as a pandemic on March 11, 2020. Countries are facing multiple waves due to the different variants of the coronavirus. Personal preventive measures, vaccines, and antiviral drugs are the approaches to control Covid-19. However, these approaches are being implemented in different countries at different levels because of the availability of personal protective measures and antiviral agents. The objective of this study was to evaluate the effectiveness of practicing measures to fight the Covid-19 pandemic. Here we searched relevant literature from PubMed and Scopus using the keywords such as personal protective measures, antiviral agents, and vaccine effectiveness. According to the present findings, protective measures were found comparatively less effective. Nevertheless, these measures can be used to limit the spreading of Covid-19. Antiviral agents can reduce the hospitalization rate and are more effective than personal protective measures. The most effective strategy against Covid-19 is early vaccination or multiple vaccination dose. The respective authorities should ensure equal distribution of vaccines, free availability of antiviral drugs, and personal protective measure in poor and developing countries. We recommend more studies to describe the effectiveness of practicing preventive measures and antiviral agents against recent variants of the coronavirus.

Factors Affecting Perceived Effectiveness of Government Response towards COVID-19 Vaccination in Occidental Mindoro, Philippines

The COVID-19 pandemic has caused several developing countries to fall behind on vaccination at the onset of the pandemic, thus affecting the mobility of easing restrictions and lowering virus transmission. The current study integrated the Protection Motivation Theory (PMT) and extended the Theory of Planned Behavior (TPB) to evaluate factors affecting the perceived effectiveness of government response towards COVID-19 vaccination in Occidental Mindoro. A total of 400 respondents from the municipalities of Occidental Mindoro answered the online questionnaires, which contained 61 questions. This study outlined the relationship between the dependent and independent variables using structural equation modeling (SEM). The results indicated that knowledge of COVID-19 vaccination had significant direct effects on its perceived severity. Subjective standards had significant adverse effects on willingness to follow. In addition, perceived behavioral control was discovered to impact willingness to follow positively. It also showed that perceived government response was significantly affected by adaptive behavior and actual behavior regarding the perceived government response. Meanwhile, it was found that the perceived government response had significant effects on perceived effectiveness. The current study is one of the first to study the factors that affect the perceived effectiveness of government response toward COVID- 19 vaccination.

Policy responsiveness and institutions in a federal system: Analyzing variations in state-level data transparency and equity issues during the COVID-19 pandemic

In the absence of a coherent federal response to COVID-19 in the United States, state governments played a significant role with varying policy responses, including in data collection and reporting. However, while accurate data collection and disaggregation is critically important since it is the basis for mitigation policy measures and to combat health disparities, it has received little scholarly attention. To address this gap, this study employs agency theory to focus on state-level determinants of data transparency practices by examining factors affecting variations in state data collection, reporting, and disaggregation of both overall metrics and race/ethnicity data. Using ordered logistic regression analyses, we find that legislatures, rather than governors, are important institutional actors and that a conservative ideology signal and socio-economic factors help predict data reporting and transparency practices. These results suggest that there is a critical need for standardized data collection protocols, the collection of comprehensive race and ethnicity data, and analyses examining data transparency and reductions in information asymmetries as a pandemic response tool-both in the United States and globally.

Impact analysis of environmental and social factors on early-stage COVID-19 transmission in China by machine learning

As a highly contagious disease, COVID-19 caused a worldwide pandemic and it is still ongoing. However, the infection in China has been successfully controlled although its initial transmission was also nationwide and has caused a serious public health crisis. The analysis on the early-stage COVID-19 transmission in China is worth investigating for its guiding significance on prevention to other countries and regions. In this study, we conducted the experiments from the perspectives of COVID-19 occurrence and intensity. We eliminated unimportant factors from 113 variables and applied four machine learning-based classification and regression models to predict COVID-19 occurrence and intensity, respectively. The influence of each important factor was analysed when applicable. Our optimal model on COVID-19 occurrence prediction presented an accuracy of 91.91% and the best R² of intensity prediction reached 0.778. Linear regression-based model was identified as unable to fit and predict the intensity, and thus only the variable influence on COVID-19 occurrence can be explained. We found that (1) CO VID-19 was more likely to occur in prosperous cities closer to the epicentre and located on higher altitudes, (2) and the occurrence was higher under extreme weather and high minimum relative humidity. (3) Most air pollutants increased the risk of COVID-19 occurrence except NO₂ and O₃, and there existed a lag effect of 6-7 days. (4) NPIs (non-pharmaceutical interventions) did not show apparent effect until two weeks after.

Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis

OBJECTIVE

To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints).

ELIGIBILITY CRITERIA FOR STUDY SELECTION

Observational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.

MAIN OUTCOME MEASURES

The main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality.

DATA SYNTHESIS

DerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran's Q test and the I² metrics, with two tailed P values.

RESULTS

72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a "package of interventions." Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I²=12%), mask wearing (0.47, 0.29 to 0.75, I²=84%), and physical distancing (0.75, 0.59 to 0.95, I²=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively.

CONCLUSIONS

This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020178692.