The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number (R) of SARS-CoV-2: a modelling study across 131 countries

Comparison of SARS-CoV-2 Vaccination Skepticism, Reasons, and Concerns Between Mass Vaccination Centers and General Practices in Germany 2021

Introduction

The reluctance to be vaccinated against COVID-19 has significantly curbed vaccine uptake. Unlike mass vaccination centers, general practitioners (GPs) might be able to address some of the patients' concerns through their long-term doctor-patient relationship. This study compared vaccination reasons, concerns and skepticism about vaccination, and perceived importance of the vaccine and its hypothetical value between vaccination centers and GP practices.

Methods

A survey was distributed (07/2021-10/2021) among newly vaccinated individuals in ten GP practices (n = 364) and two vaccine centers (n = 474).

Results

Participants in vaccine centers stated more prosocial and benefit-oriented reasons for vaccination, whereas participants in GP practices more often stated the GP's recommendation as the reason. Perceived importance of the vaccine in combating the pandemic was rated higher among individuals at vaccine centers and with higher health awareness and self-efficacy. Participants at both types of sites who preferred a GP for vaccination expressed more vaccination skepticism, which was also related to older age, more health risk concerns related to COVID-19 vaccines, and lower perceived importance of the vaccine.

Conclusion

Our results indicate opportunities for framing future vaccination campaigns that include vaccination centers. Additionally, a rapid GP involvement in future mass vaccinations might be crucial for overcoming attitudinal barriers and achieving higher vaccine uptake.

Clinical frailty score as an independent predictor of outcome in COVID-19 hospitalised patients

PURPOSE OF THE STUDY

We explored potential predictive variables associated with outcomes using baseline clinical parameters of 500 hospitalised patients with COVID -19 in a single centre, UK.

METHODS

Retrospective study collecting demographic and clinical characteristics of patients admitted at Southend University Hospital from 20th February to 7th May 2020.

RESULTS

The mean age of the cohort admitted to hospital with Covid-19 was 69.4 and 58% were over 70. Comorbidities were more frequently observed in non-survivors, whose mean Clinical Frailty Scale was significantly higher (5 vs 3) than survivors, p < 0.001. In addition, mean C-reactive protein was significantly higher.

CONCLUSION

Older and frailer patients with high inflammatory markers were at risk of poor outcomes. Integrated frailty and age-based risk stratification is essential, in addition to monitoring saturation /FiO2 ratio (SFR) and inflammatory markers throughout the disease course to allow for early intervention to improve patient outcomes. A frailty-based risk-stratification approach, rather than age may prove more valuable when considering interventions in patients with multiple comorbidities.

Predicting the spread of COVID-19 in Italy using machine learning: Do socio-economic factors matter?

We exploit the provincial variability of COVID-19 cases registered in Italy to select the territorial predictors of the pandemic. Absent an established theoretical diffusion model, we apply machine learning to isolate, among 77 potential predictors, those that minimize the out-of-sample prediction error. We first estimate the model considering cumulative cases registered before the containment measures displayed their effects (i.e. at the peak of the epidemic in March 2020), then cases registered between the peak date and when containment measures were relaxed in early June. In the first estimate, the results highlight the dominance of factors related to the intensity and interactions of economic activities. In the second, the relevance of these variables is highly reduced, suggesting mitigation of the pandemic following the lockdown of the economy. Finally, by considering cases at onset of the "second wave", we confirm that the territorial distribution of the epidemic is associated with economic factors.