1
|
Zha W, Ni H, He Y, Kuang W, Zhao J, Fu L, Dai H, Lv Y, Zhou N, Yang X. Modeling outbreaks of COVID-19 in China: The impact of vaccination and other control measures on curbing the epidemic. Hum Vaccin Immunother 2024; 20:2338953. [PMID: 38658178 PMCID: PMC11057632 DOI: 10.1080/21645515.2024.2338953] [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: 01/26/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024] Open
Abstract
This study aims to examine the development trend of COVID-19 in China and propose a model to assess the impacts of various prevention and control measures in combating the COVID-19 pandemic. Using COVID-19 cases reported by the National Health Commission of China from January 2, 2020, to January 2, 2022, we established a Susceptible-Exposed-Infected-Asymptomatic-Quarantined-Vaccinated-Hospitalized-Removed (SEIAQVHR) model to calculate the COVID-19 transmission rate and Rt effective reproduction number, and assess prevention and control measures. Additionally, we built a stochastic model to explore the development of the COVID-19 epidemic. We modeled the incidence trends in five outbreaks between 2020 and 2022. Some important features of the COVID-19 epidemic are mirrored in the estimates based on our SEIAQVHR model. Our model indicates that an infected index case entering the community has a 50%-60% chance to cause a COVID-19 outbreak. Wearing masks and getting vaccinated were the most effective measures among all the prevention and control measures. Specifically targeting asymptomatic individuals had no significant impact on the spread of COVID-19. By adjusting prevention and control parameters, we suggest that increasing the rates of effective vaccination and mask-wearing can significantly reduce COVID-19 cases in China. Our stochastic model analysis provides a useful tool for understanding the COVID-19 epidemic in China.
Collapse
Affiliation(s)
- Wenting Zha
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Han Ni
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Yuxi He
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Wentao Kuang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Jin Zhao
- Changsha Center for Disease Control and Prevention, Changsha, People’s Republic of China
| | - Liuyi Fu
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Haoyun Dai
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Yuan Lv
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Nan Zhou
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Xuewen Yang
- Changsha Center for Disease Control and Prevention, Changsha, People’s Republic of China
| |
Collapse
|
2
|
Cabrera Alvargonzalez JJ, Larrañaga A, Martinez J, Pérez Castro S, Rey Cao S, Daviña Nuñez C, Del Campo Pérez V, Duran Parrondo C, Suarez Luque S, González Alonso E, Silva Tojo AJ, Porteiro J, Regueiro B. Assessment of the Effective Sensitivity of SARS-CoV-2 Sample Pooling Based on a Large-Scale Screening Experience: Retrospective Analysis. JMIR Public Health Surveill 2024; 10:e54503. [PMID: 39316785 DOI: 10.2196/54503] [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: 12/19/2023] [Revised: 05/18/2024] [Accepted: 07/18/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND The development of new large-scale saliva pooling detection strategies can significantly enhance testing capacity and frequency for asymptomatic individuals, which is crucial for containing SARS-CoV-2. OBJECTIVE This study aims to implement and scale-up a SARS-CoV-2 screening method using pooled saliva samples to control the virus in critical areas and assess its effectiveness in detecting asymptomatic infections. METHODS Between August 2020 and February 2022, our laboratory received a total of 928,357 samples. Participants collected at least 1 mL of saliva using a self-sampling kit and registered their samples via a smartphone app. All samples were directly processed using AutoMate 2550 for preanalytical steps and then transferred to Microlab STAR, managed with the HAMILTON Pooling software for pooling. The standard pool preset size was 20 samples but was adjusted to 5 when the prevalence exceeded 2% in any group. Real-time polymerase chain reaction (RT-PCR) was conducted using the Allplex SARS-CoV-2 Assay until July 2021, followed by the Allplex SARS-CoV-2 FluA/FluB/RSV assay for the remainder of the study period. RESULTS Of the 928,357 samples received, 887,926 (95.64%) were fully processed into 56,126 pools. Of these pools, 4863 tested positive, detecting 5720 asymptomatic infections. This allowed for a comprehensive analysis of pooling's impact on RT-PCR sensitivity and false-negative rate (FNR), including data on positive samples per pool (PPP). We defined Ctref as the minimum cycle threshold (Ct) of each data set from a sample or pool and compared these Ctref results from pooled samples with those of the individual tests (ΔCtP). We then examined their deviation from the expected offset due to dilution [ΔΔCtP = ΔCtP - log2]. In this work, the ΔCtP and ΔΔCtP were 2.23 versus 3.33 and -0.89 versus 0.23, respectively, comparing global results with results for pools with 1 positive sample per pool. Therefore, depending on the number of genes used in the test and the size of the pool, we can evaluate the FNR and effective sensitivity (1 - FNR) of the test configuration. In our scenario, with a maximum of 20 samples per pool and 3 target genes, statistical observations indicated an effective sensitivity exceeding 99%. From an economic perspective, the focus is on pooling efficiency, measured by the effective number of persons that can be tested with 1 test, referred to as persons per test (PPT). In this study, the global PPT was 8.66, reflecting savings of over 20 million euros (US $22 million) based on our reagent prices. CONCLUSIONS Our results demonstrate that, as expected, pooling reduces the sensitivity of RT-PCR. However, with the appropriate pool size and the use of multiple target genes, effective sensitivity can remain above 99%. Saliva pooling may be a valuable tool for screening and surveillance in asymptomatic individuals and can aid in controlling SARS-CoV-2 transmission. Further studies are needed to assess the effectiveness of these strategies for SARS-CoV-2 and their application to other microorganisms or biomarkers detected by PCR.
Collapse
Affiliation(s)
- Jorge J Cabrera Alvargonzalez
- Microbiology Department, Complexo Hospitalario Universitario de Vigo, Servicio Galego de Saude, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), Microbiology and Infectology Research Group, Vigo, Spain
| | - Ana Larrañaga
- Centro de Investigación en Tecnologías, Energía y Procesos Industriales, University of Vigo, Lagoas-Marcosende, Vigo, Spain
| | - Javier Martinez
- Applied Mathematics I, Telecommunications Engineering School, University of Vigo, Vigo, Spain
| | - Sonia Pérez Castro
- Microbiology Department, Complexo Hospitalario Universitario de Vigo, Servicio Galego de Saude, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), Microbiology and Infectology Research Group, Vigo, Spain
| | - Sonia Rey Cao
- Microbiology Department, Complexo Hospitalario Universitario de Vigo, Servicio Galego de Saude, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), Microbiology and Infectology Research Group, Vigo, Spain
| | - Carlos Daviña Nuñez
- Galicia Sur Health Research Institute (IIS Galicia Sur), Microbiology and Infectology Research Group, Vigo, Spain
| | - Víctor Del Campo Pérez
- Department of Preventive Medicine and Public Health, Complexo Hospitalario, Universitario de Vigo, Vigo, Spain
| | - Carmen Duran Parrondo
- Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Spain
| | - Silvia Suarez Luque
- Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Spain
| | - Elena González Alonso
- Galicia Sur Health Research Institute (IIS Galicia Sur), Microbiology and Infectology Research Group, Vigo, Spain
| | - Alfredo José Silva Tojo
- Dirección Xeral de Maiores y atención Sociosanitaria, Conselleria de Politica Social e Xuventude, Xunta de Galicia, Santiago de Compostela, Spain
| | - Jacobo Porteiro
- Centro de Investigación en Tecnologías, Energía y Procesos Industriales, University of Vigo, Lagoas-Marcosende, Vigo, Spain
| | - Benito Regueiro
- Microbiology Department, Complexo Hospitalario Universitario de Vigo, Servicio Galego de Saude, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), Microbiology and Infectology Research Group, Vigo, Spain
| |
Collapse
|
3
|
Zhou W, Huang D, Liang Q, Huang T, Wang X, Pei H, Chen S, Liu L, Wei Y, Qin L, Xie Y. Early warning and predicting of COVID-19 using zero-inflated negative binomial regression model and negative binomial regression model. BMC Infect Dis 2024; 24:1006. [PMID: 39300391 DOI: 10.1186/s12879-024-09940-7] [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: 04/24/2024] [Accepted: 09/16/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND It is difficult to detect the outbreak of emergency infectious disease based on the exiting surveillance system. Here we investigate the utility of the Baidu Search Index, an indicator of how large of a keyword is in Baidu's search volume, in the early warning and predicting the epidemic trend of COVID-19. METHODS The daily number of cases and the Baidu Search Index of 8 keywords (weighted by population) from December 1, 2019 to March 15, 2020 were collected and analyzed with times series and Spearman correlation with different time lag. To predict the daily number of COVID-19 cases using the Baidu Search Index, Zero-inflated negative binomial regression was used in phase 1 and negative binomial regression model was used in phase 2 and phase 3 based on the characteristic of independent variable. RESULTS The Baidu Search Index of all keywords in Wuhan was significantly higher than Hubei (excluded Wuhan) and China (excluded Hubei). Before the causative pathogen was identified, the search volume of "Influenza" and "Pneumonia" in Wuhan increased with the number of new onset cases, their correlation coefficient was 0.69 and 0.59, respectively. After the pathogen was public but before COVID-19 was classified as a notifiable disease, the search volume of "SARS", "Pneumonia", "Coronavirus" in all study areas increased with the number of new onset cases with the correlation coefficient was 0.69 ~ 0.89, while "Influenza" changed to negative correlated (rs: -0.56 ~ -0.64). After COVID-19 was closely monitored, the Baidu Search Index of "COVID-19", "Pneumonia", "Coronavirus", "SARS" and "Mask" could predict the epidemic trend with 15 days, 5 days and 6 days lead time, respectively in Wuhan, Hubei (excluded Wuhan) and China (excluded Hubei). The predicted number of cases would increase 1.84 and 4.81 folds, respectively than the actual number of cases in Wuhan and Hubei (excluded Wuhan) from 21 January to 9 February. CONCLUSION The Baidu Search Index could be used in the early warning and predicting the epidemic trend of COVID-19, but the search keywords changed in different period. Considering the time lag from onset to diagnosis, especially in the areas with medical resources shortage, internet search data can be a highly effective supplement of the existing surveillance system.
Collapse
Affiliation(s)
- Wanwan Zhou
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China
| | - Daizheng Huang
- Institute of Life Science, Guangxi Medical University, Nanning, China
| | - Qiuyu Liang
- Department of Health Management, The People's Hospital of Guangxi Zhuang Autonomous Region & Research Center of Health Management, Guangxi Academy of Medical Sciences, Nanning, China
| | - Tengda Huang
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China
| | - Xiaomin Wang
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China
| | - Hengyan Pei
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China
| | - Shiwen Chen
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China
| | - Lu Liu
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China
| | - Yuxia Wei
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China
| | - Litai Qin
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China
| | - Yihong Xie
- Department of Epidemiology and Biostatistics, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, 530021, China.
| |
Collapse
|
4
|
Osei I, Mendy E, van Zandvoort K, Jobe O, Sarwar G, Wutor BM, Flasche S, Mohammed NI, Bruce J, Greenwood B, Mackenzie GA. Directly observed social contact patterns among school children in rural Gambia. Epidemics 2024; 49:100790. [PMID: 39270441 DOI: 10.1016/j.epidem.2024.100790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 09/03/2024] [Accepted: 09/04/2024] [Indexed: 09/15/2024] Open
Abstract
INTRODUCTION School-aged children play a major role in the transmission of many respiratory pathogens due to high rate of close contacts in schools. The validity and accuracy of proxy-reported contact data may be limited, particularly for children when attending school. We observed social contacts within schools and assessed the accuracy of proxy-reported versus observed physical contact data among students in rural Gambia. METHODS We enrolled school children who had also been recruited to a survey of Streptococcus pneumoniae carriage and social contacts. We visited participants at school and observed their contact patterns within and outside the classroom for two hours. We recorded the contact type, gender and approximate age of the contactee, and class size. We calculated age-stratified contact matrices to determine in-school contact patterns. We compared proxy-reported estimated physical contacts for the subset of participants (18 %) randomised to be observed on the same day for which the parent or caregiver reported the school contacts. RESULTS We recorded 3822 contacts for 219 participants from 114 schools. The median number of contacts was 15 (IQR: 11-20). Contact patterns were strongly age-assortative, and mainly involved physical touch (67.5 %). Those aged 5-9 years had the highest mean number of contacts [19.0 (95 %CI: 16.7-21.3)] while the ≥ 15-year age group had fewer contacts [12.8 (95 %CI: 10.9-14.7)]. Forty (18 %) participants had their school-observed contact data collected on the same day as their caregiver reported their estimated physical contacts at school; only 22.5 % had agreement within ±2 contacts between the observed and reported contacts. Fifty-eight percent of proxy-reported contacts were under-estimates. CONCLUSIONS Social contact rates observed among pupils at schools in rural Gambia were high, strongly age-assortative, and physical. Reporting of school contacts by proxies may underestimate the effect of school-age children in modelling studies of transmission of infections. New approaches are needed to quantify contacts within schools.
Collapse
Affiliation(s)
- Isaac Osei
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia; Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Emmanuel Mendy
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
| | - Kevin van Zandvoort
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Olimatou Jobe
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
| | - Golam Sarwar
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
| | - Baleng Mahama Wutor
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
| | - Stefan Flasche
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK; Centre of Global Health, Charite - Universitätsmedizin, Berlin, Germany
| | - Nuredin I Mohammed
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
| | - Jane Bruce
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Brian Greenwood
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Grant A Mackenzie
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia; Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia
| |
Collapse
|
5
|
Shahid N, Raza A, Iqbal S, Ahmed N, Fadhal E, Ceesay B. Stochastic delayed analysis of coronavirus model through efficient computational method. Sci Rep 2024; 14:21170. [PMID: 39256433 PMCID: PMC11387501 DOI: 10.1038/s41598-024-70089-z] [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: 05/09/2024] [Accepted: 08/13/2024] [Indexed: 09/12/2024] Open
Abstract
Stochastic delayed modeling has a significant non-pharmaceutical intervention to control transmission dynamics of infectious diseases and its results are close to the reality of nature. The covid-19 has been controlled globally but there is still a threat and appears in different variants like omicron and SARS-CoV-2 etc. globally. This article, considered pattern a mathematical model based on Susceptible, Infected, and recovered populations with highly nonlinear incidence rates. we studied the dynamics of the coronavirus model; a newly proposed version is a stochastic delayed model that is based on nonlinear stochastic delayed differential equations (SDDEs). Transition probabilities and parametric perturbation methods were used for the construction of the stochastic delayed model. The fundamental properties like positivity, boundedness, existence and uniqueness, and stability results of equilibria of the model with certain conditions of reproduction number are studied regularly. Also, the extinction and persistence of disease are studied with the help of well-known theorems. The numerical methods used to find a visualization of results due to the complexity of stochastic delayed differential equations. Furthermore, for computational analysis, we implemented existing methods in the literature and compared their results with the proposed method like nonstandard finite difference for stochastic delayed model. The proposed method restores all dynamical properties of the model with a free choice of time steps.
Collapse
Affiliation(s)
- Naveed Shahid
- Department of Mathematics and Statistics, The University of Lahore, Lahore, Pakistan
| | - Ali Raza
- Department of Physical Sciences, The University of Chenab, Gujrat, Pakistan
| | - Sana Iqbal
- Department of Mathematics and Statistics, The University of Lahore, Lahore, Pakistan
| | - Nauman Ahmed
- Department of Mathematics and Statistics, The University of Lahore, Lahore, Pakistan
- Department of Computer Science and Mathematics, Lebanese American University, Beirut, Lebanon
| | - Emad Fadhal
- Department of Mathematics and Statistics, College of Science, King Faisal University, P. O. Box 400, 31982, Al-Ahsa, Saudi Arabia.
| | - Baboucarr Ceesay
- Mathematics Unit, The University of The Gambia, Sere Kunda, The Gambia.
| |
Collapse
|
6
|
Muntoni AP, Mazza F, Braunstein A, Catania G, Dall'Asta L. Effectiveness of probabilistic contact tracing in epidemic containment: The role of superspreaders and transmission path reconstruction. PNAS NEXUS 2024; 3:pgae377. [PMID: 39285934 PMCID: PMC11404514 DOI: 10.1093/pnasnexus/pgae377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 08/15/2024] [Indexed: 09/19/2024]
Abstract
The recent COVID-19 pandemic underscores the significance of early stage nonpharmacological intervention strategies. The widespread use of masks and the systematic implementation of contact tracing strategies provide a potentially equally effective and socially less impactful alternative to more conventional approaches, such as large-scale mobility restrictions. However, manual contact tracing faces strong limitations in accessing the network of contacts, and the scalability of currently implemented protocols for smartphone-based digital contact tracing becomes impractical during the rapid expansion phases of the outbreaks, due to the surge in exposure notifications and associated tests. A substantial improvement in digital contact tracing can be obtained through the integration of probabilistic techniques for risk assessment that can more effectively guide the allocation of diagnostic tests. In this study, we first quantitatively analyze the diagnostic and social costs associated with these containment measures based on contact tracing, employing three state-of-the-art models of SARS-CoV-2 spreading. Our results suggest that probabilistic techniques allow for more effective mitigation at a lower cost. Secondly, our findings reveal a remarkable efficacy of probabilistic contact-tracing techniques in performing backward and multistep tracing and capturing superspreading events.
Collapse
Affiliation(s)
- Anna Paola Muntoni
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
- Statistical inference and computational biology, Italian Institute for Genomic Medicine, c/o IRCSS, Candiolo 10060, Italy
| | - Fabio Mazza
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Via Ponzio 34/5, Milano 20133, Italy
| | - Alfredo Braunstein
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
- Statistical inference and computational biology, Italian Institute for Genomic Medicine, c/o IRCSS, Candiolo 10060, Italy
| | - Giovanni Catania
- Departamento de Física Teórica, Universidad Complutense, Madrid 28040, Spain
| | - Luca Dall'Asta
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
- Statistical inference and computational biology, Italian Institute for Genomic Medicine, c/o IRCSS, Candiolo 10060, Italy
- Collegio Carlo Alberto, P.za Arbarello 8, Torino 10122, Italy
| |
Collapse
|
7
|
Chen K, Wei F, Zhang X, Jin H, Wang Z, Zuo Y, Fan K. Epidemiological feature analysis of SVEIR model with control strategy and variant evolution. Infect Dis Model 2024; 9:689-700. [PMID: 38646061 PMCID: PMC11031813 DOI: 10.1016/j.idm.2024.03.005] [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] [Revised: 02/26/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
The complex interactions were performed among non-pharmaceutical interventions, vaccinations, and hosts for all epidemics in mainland China during the spread of COVID-19. Specially, the small-scale epidemic in the city described by SVEIR model was less found in the current studies. The SVEIR model with control was established to analyze the dynamical and epidemiological features of two epidemics in Jinzhou City led by Omicron variants before and after Twenty Measures. In this study, the total population (N) of Jinzhou City was divided into five compartments: the susceptible (S), the vaccinated (V), the exposed (E), the infected (I), and the recovered (R). By surveillance data and the SVEIR model, three methods (maximum likelihood method, exponential growth rate method, next generation matrix method) were governed to estimate basic reproduction number, and the results showed that an increasing tendency of basic reproduction number from Omicron BA.5.2 to Omicron BA.2.12.1. Meanwhile, the effective reproduction number for two epidemics were investigated by surveillance data, and the results showed that Jinzhou wave 1 reached the peak on November 1 and was controlled 7 days later, and that Jinzhou wave 2 reached the peak on November 28 and was controlled 5 days later. Moreover, the impacts of non-pharmaceutical interventions (awareness delay, peak delay, control intensity) were discussed extensively, the variations of infection scales for Omicron variant and EG.5 variant were also discussed. Furthermore, the investigations on peaks and infection scales for two epidemics in dynamic zero-COVID policy were operated by the SVEIR model with control. The investigations on public medical requirements of Jinzhou City and Liaoning Province were analyzed by using SVEIR model without control, which provided a possible perspective on variant evolution in the future.
Collapse
Affiliation(s)
- Kaijing Chen
- School of Mathematics and Statistics, Fuzhou University, Fuzhou, 350116, Fujian, China
| | - Fengying Wei
- School of Mathematics and Statistics, Fuzhou University, Fuzhou, 350116, Fujian, China
- Key Laboratory of Operations Research and Control of Universities in Fujian, Fuzhou University, Fuzhou, 350116, Fujian, China
- Center for Applied Mathematics of Fujian Province, Fuzhou University, Fuzhou, 350116, Fujian, China
| | - Xinyan Zhang
- Jinzhou Center for Disease Control and Prevention, Jinzhou, 121000, Liaoning, China
| | - Hao Jin
- Jinzhou Center for Disease Control and Prevention, Jinzhou, 121000, Liaoning, China
| | - Zuwen Wang
- School of Mathematics and Statistics, Fuzhou University, Fuzhou, 350116, Fujian, China
| | - Yue Zuo
- Jinzhou Center for Disease Control and Prevention, Jinzhou, 121000, Liaoning, China
| | - Kai Fan
- Jinzhou Center for Disease Control and Prevention, Jinzhou, 121000, Liaoning, China
| |
Collapse
|
8
|
Hammond J, Yunis C, Fountaine RJ, Luscan G, Burr AM, Zhang W, Wisemandle W, Soares H, Baniecki ML, Hendrick VM, Kalfov V, Pypstra R, Rusnak JM. Oral Nirmatrelvir-Ritonavir as Postexposure Prophylaxis for Covid-19. N Engl J Med 2024; 391:224-234. [PMID: 39018532 DOI: 10.1056/nejmoa2309002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
BACKGROUND Clinical trials of treatments for coronavirus disease 2019 (Covid-19) have not shown a significant benefit of postexposure prophylaxis. METHODS We conducted a phase 2-3 double-blind trial to assess the efficacy and safety of nirmatrelvir-ritonavir in asymptomatic, rapid antigen test-negative adults who had been exposed to a household contact with Covid-19 within 96 hours before randomization. The participants were randomly assigned in a 1:1:1 ratio to receive nirmatrelvir-ritonavir (300 mg of nirmatrelvir and 100 mg of ritonavir) every 12 hours for 5 days or for 10 days or matching placebo for 5 or 10 days. The primary end point was the development of symptomatic SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, confirmed on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) or rapid antigen testing, through 14 days in participants who had a negative RT-PCR test at baseline. RESULTS A total of 2736 participants were randomly assigned to a trial group - 921 to the 5-day nirmatrelvir-ritonavir group, 917 to the 10-day nirmatrelvir-ritonavir group, and 898 to the placebo group. Symptomatic, confirmed SARS-CoV-2 infection developed by day 14 in 2.6% of the participants in the 5-day nirmatrelvir-ritonavir group, 2.4% of those in the 10-day nirmatrelvir-ritonavir group, and 3.9% of those in the placebo group. In each nirmatrelvir-ritonavir group, the percentage of participants in whom symptomatic, confirmed SARS-CoV-2 infection developed did not differ significantly from that in the placebo group, with risk reductions relative to placebo of 29.8% (95% confidence interval [CI], -16.7 to 57.8; P = 0.17) in the 5-day nirmatrelvir-ritonavir group and 35.5% (95% CI, -11.5 to 62.7; P = 0.12) in the 10-day nirmatrelvir-ritonavir group. The incidence of adverse events was similar across the trial groups, with dysgeusia being the most frequently reported adverse event (in 5.9% and 6.8% of the participants in the 5-day and 10-day nirmatrelvir-ritonavir groups, respectively, and in 0.7% of those in the placebo group). CONCLUSIONS In this placebo-controlled trial, postexposure prophylaxis with nirmatrelvir-ritonavir for 5 or 10 days did not significantly reduce the risk of symptomatic SARS-CoV-2 infection. (Funded by Pfizer; ClinicalTrials.gov number, NCT05047601.).
Collapse
Affiliation(s)
- Jennifer Hammond
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Carla Yunis
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Robert J Fountaine
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Gerald Luscan
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Aimee M Burr
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Wuyan Zhang
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Wayne Wisemandle
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Holly Soares
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Mary Lynn Baniecki
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Victoria M Hendrick
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Veselin Kalfov
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Rienk Pypstra
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - James M Rusnak
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| |
Collapse
|
9
|
Gray P, Eriksson T, Skoglund L, Lagheden C, Hellström C, Pin E, Suomenrinne-Nordvik A, Pimenoff VN, Nilsson P, Dillner J, Lehtinen M. Seroepidemiological assessment of the spread of SARS-CoV-2 among 25 and 28 year-old adult women in Finland between March 2020-June 2022. PLoS One 2024; 19:e0305285. [PMID: 38990856 PMCID: PMC11238966 DOI: 10.1371/journal.pone.0305285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/27/2024] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Serological surveys of the prevalence of SARS-CoV-2 are instrumental to understanding the course of the COVID-19 epidemic. We evaluate the seroprevalence of SARS-CoV-2 among young adult Finnish females residing in 25 communities all over Finland from 2020 until 2022. METHODS Between 1st March 2020 and 30th June 2022, 3589 blood samples were collected from 3583 women born in 1992-95 when aged 25 or 28 years old attending the follow-up of an ongoing population-based trial of cervical screening strategies. The crude and population standardized SARS-CoV-2 seroprevalence was measured using nucleocapsid (induced by infection) and spike wild-type (WT) protein (induced both by infection and by vaccination) antigens over time and stratified by place of residence (inside or outside the Helsinki metropolitan region). RESULTS During 2020 (before vaccinations), spike-WT and nucleocapsid IgG antibodies followed each other closely, at very low levels (<5%). Spike-WT seropositivity increased rapidly concomitant with mass vaccinations in 2021 and reached 96.3% in the 2nd quartile of 2022. Antibodies to nucleocapsid IgG remained relatively infrequent throughput 2020-2021, increasing rapidly in the 1st and 2nd quartiles of 2022 (to 19.7% and 56.6% respectively). The nucleocapsid IgG seropositivity increased more profoundly in participants residing in the Helsinki metropolitan region (4.5%, 8.4% and 43.9% in 2020, 2021 and 2022 respectively) compared to those residing in communities outside the capital region (4.5%, 4.3% and 34.7%). CONCLUSIONS Low SARS-CoV-2 infection-related seroprevalence during 2020-2021 suggest a comparatively successful infection control. Antibodies to the SARS-CoV-2 WT spike protein became extremely common among young women by the end of 2021, in line with the high uptake of SARS-CoV-2 vaccination. Finally, the rapid increase of seroprevalences to the SARS-CoV-2 nucleocapsid protein during the first and second quartile of 2022, imply a high incidence of infections with SARS-CoV-2 variants able to escape vaccine-induced protection.
Collapse
Affiliation(s)
- Penelope Gray
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Lovisa Skoglund
- Division of Affinity Proteomics Department of Protein Science KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Camilla Lagheden
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Ceke Hellström
- Division of Affinity Proteomics Department of Protein Science KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Elisa Pin
- Division of Affinity Proteomics Department of Protein Science KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Anna Suomenrinne-Nordvik
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Tampere University Hospital, Tampere, Finland
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ville N Pimenoff
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biobank Borealis of Northern Finland, University of Oulu, Oulu, Finland
| | - Peter Nilsson
- Division of Affinity Proteomics Department of Protein Science KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Joakim Dillner
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Matti Lehtinen
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
10
|
Broda MD, Borovska P, Kollenda D, Linka M, de Haas N, de Haas S, de Haas B. Estimating the human bottleneck for contact tracing. PNAS NEXUS 2024; 3:pgae283. [PMID: 39076682 PMCID: PMC11285183 DOI: 10.1093/pnasnexus/pgae283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/05/2024] [Indexed: 07/31/2024]
Abstract
The SARS-CoV-2 pandemic has highlighted the importance of contact tracing for epidemiological mitigation. Contact tracing interviews (CTIs) typically rely on episodic memory, which is prone to decline over time. Here, we provide a quantitative estimate of reporting decline for age- and gender-representative samples from the United Kingdom and Germany, emulating >15,000 CTIs. We find that the number of reported contacts declines as a power function of recall delay and is significantly higher for younger subjects and for those who used memory aids, such as a scheduler. We further find that these factors interact with delay: Older subjects and those who made no use of memory aids have steeper decline functions. These findings can inform epidemiological modeling and policies in the context of infectious diseases.
Collapse
Affiliation(s)
- Maximilian D Broda
- Experimental Psychology, Justus Liebig University Giessen, Otto-Behaghel-Str 10F, 35394 Giessen, Germany
- Center for Mind, Brain and Behavior, Universities of Marburg, Giessen and Darmstadt, Hans-Meerwein-Strasse 6, 35032 Marburg, Germany
| | - Petra Borovska
- Experimental Psychology, Justus Liebig University Giessen, Otto-Behaghel-Str 10F, 35394 Giessen, Germany
| | - Diana Kollenda
- Experimental Psychology, Justus Liebig University Giessen, Otto-Behaghel-Str 10F, 35394 Giessen, Germany
| | - Marcel Linka
- Experimental Psychology, Justus Liebig University Giessen, Otto-Behaghel-Str 10F, 35394 Giessen, Germany
| | | | - Samuel de Haas
- Chair for Industrial Organization, Regulation and Antitrust, Department of Economics, Justus Liebig University Giessen, Licher Straße 62, 35394 Giessen, Germany
| | - Benjamin de Haas
- Experimental Psychology, Justus Liebig University Giessen, Otto-Behaghel-Str 10F, 35394 Giessen, Germany
- Center for Mind, Brain and Behavior, Universities of Marburg, Giessen and Darmstadt, Hans-Meerwein-Strasse 6, 35032 Marburg, Germany
| |
Collapse
|
11
|
Middleton C, Larremore DB. Modeling the transmission mitigation impact of testing for infectious diseases. SCIENCE ADVANCES 2024; 10:eadk5108. [PMID: 38875334 PMCID: PMC11177932 DOI: 10.1126/sciadv.adk5108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 05/10/2024] [Indexed: 06/16/2024]
Abstract
A fundamental question of any program focused on the testing and timely diagnosis of a communicable disease is its effectiveness in reducing transmission. Here, we introduce testing effectiveness (TE)-the fraction by which testing and post-diagnosis isolation reduce transmission at the population scale-and a model that incorporates test specifications and usage, within-host pathogen dynamics, and human behaviors to estimate TE. Using TE to guide recommendations, we show that today's rapid diagnostics should be used immediately upon symptom onset to control influenza A and respiratory syncytial virus but delayed by up to two days to control omicron-era severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Furthermore, while rapid tests are superior to reverse transcription quantitative polymerase chain reaction (RT-qPCR) to control founder-strain SARS-CoV-2, omicron-era changes in viral kinetics and rapid test sensitivity cause a reversal, with higher TE for RT-qPCR despite longer turnaround times. Last, we illustrate the model's flexibility by quantifying trade-offs in the use of post-diagnosis testing to shorten isolation times.
Collapse
Affiliation(s)
- Casey Middleton
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
| | - Daniel B. Larremore
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
- Santa Fe Institute, Santa Fe, NM, USA
| |
Collapse
|
12
|
Lee H, Choi H, Lee H, Lee S, Kim C. Uncovering COVID-19 transmission tree: identifying traced and untraced infections in an infection network. Front Public Health 2024; 12:1362823. [PMID: 38887240 PMCID: PMC11180726 DOI: 10.3389/fpubh.2024.1362823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/21/2024] [Indexed: 06/20/2024] Open
Abstract
Introduction This paper presents a comprehensive analysis of COVID-19 transmission dynamics using an infection network derived from epidemiological data in South Korea, covering the period from January 3, 2020, to July 11, 2021. The network illustrates infector-infectee relationships and provides invaluable insights for managing and mitigating the spread of the disease. However, significant missing data hinder conventional analysis of such networks from epidemiological surveillance. Methods To address this challenge, this article suggests a novel approach for categorizing individuals into four distinct groups, based on the classification of their infector or infectee status as either traced or untraced cases among all confirmed cases. The study analyzes the changes in the infection networks among untraced and traced cases across five distinct periods. Results The four types of cases emphasize the impact of various factors, such as the implementation of public health strategies and the emergence of novel COVID-19 variants, which contribute to the propagation of COVID-19 transmission. One of the key findings is the identification of notable transmission patterns in specific age groups, particularly in those aged 20-29, 40-69, and 0-9, based on the four type classifications. Furthermore, we develop a novel real-time indicator to assess the potential for infectious disease transmission more effectively. By analyzing the lengths of connected components, this indicator facilitates improved predictions and enables policymakers to proactively respond, thereby helping to mitigate the effects of the pandemic on global communities. Conclusion This study offers a novel approach to categorizing COVID-19 cases, provides insights into transmission patterns, and introduces a real-time indicator for better assessment and management of the disease transmission, thereby supporting more effective public health interventions.
Collapse
Affiliation(s)
- Hyunwoo Lee
- Department of Mathematics, Kyungpook National University, Daegu, Republic of Korea
- Nonlinear Dynamics and Mathematical Application Center, Kyungpook National University, Daegu, Republic of Korea
| | - Hayoung Choi
- Department of Mathematics, Kyungpook National University, Daegu, Republic of Korea
- Nonlinear Dynamics and Mathematical Application Center, Kyungpook National University, Daegu, Republic of Korea
| | - Hyojung Lee
- Nonlinear Dynamics and Mathematical Application Center, Kyungpook National University, Daegu, Republic of Korea
- Department of Statistics, Kyungpook National University, Daegu, Republic of Korea
| | - Sunmi Lee
- Nonlinear Dynamics and Mathematical Application Center, Kyungpook National University, Daegu, Republic of Korea
- Department of Applied Mathematics, Kyunghee University, Yongin-si, Republic of Korea
| | - Changhoon Kim
- Department of Preventive Medicine, College of Medicine, Pusan National University, Busan, Republic of Korea
- Busan Center for Infectious Disease Control and Prevention, Pusan National University Hospital, Busan, Republic of Korea
| |
Collapse
|
13
|
Runge MC, Shea K, Howerton E, Yan K, Hochheiser H, Rosenstrom E, Probert WJM, Borchering R, Marathe MV, Lewis B, Venkatramanan S, Truelove S, Lessler J, Viboud C. Scenario design for infectious disease projections: Integrating concepts from decision analysis and experimental design. Epidemics 2024; 47:100775. [PMID: 38838462 DOI: 10.1016/j.epidem.2024.100775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 04/04/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024] Open
Abstract
Across many fields, scenario modeling has become an important tool for exploring long-term projections and how they might depend on potential interventions and critical uncertainties, with relevance to both decision makers and scientists. In the past decade, and especially during the COVID-19 pandemic, the field of epidemiology has seen substantial growth in the use of scenario projections. Multiple scenarios are often projected at the same time, allowing important comparisons that can guide the choice of intervention, the prioritization of research topics, or public communication. The design of the scenarios is central to their ability to inform important questions. In this paper, we draw on the fields of decision analysis and statistical design of experiments to propose a framework for scenario design in epidemiology, with relevance also to other fields. We identify six different fundamental purposes for scenario designs (decision making, sensitivity analysis, situational awareness, horizon scanning, forecasting, and value of information) and discuss how those purposes guide the structure of scenarios. We discuss other aspects of the content and process of scenario design, broadly for all settings and specifically for multi-model ensemble projections. As an illustrative case study, we examine the first 17 rounds of scenarios from the U.S. COVID-19 Scenario Modeling Hub, then reflect on future advancements that could improve the design of scenarios in epidemiological settings.
Collapse
Affiliation(s)
- Michael C Runge
- U.S. Geological Survey, Eastern Ecological Science Center at the Patuxent Research Refuge, Laurel, MD, USA.
| | - Katriona Shea
- The Pennsylvania State University, University Park, PA, USA
| | - Emily Howerton
- The Pennsylvania State University, University Park, PA, USA
| | - Katie Yan
- The Pennsylvania State University, University Park, PA, USA
| | | | | | | | | | | | - Bryan Lewis
- University of Virginia, Charlottesville, VA, USA
| | | | | | - Justin Lessler
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cécile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
14
|
Shearer FM, McCaw JM, Ryan GE, Hao T, Tierney NJ, Lydeamore MJ, Wu L, Ward K, Ellis S, Wood J, McVernon J, Golding N. Estimating the impact of test-trace-isolate-quarantine systems on SARS-CoV-2 transmission in Australia. Epidemics 2024; 47:100764. [PMID: 38552550 DOI: 10.1016/j.epidem.2024.100764] [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: 07/02/2023] [Revised: 12/15/2023] [Accepted: 03/14/2024] [Indexed: 06/17/2024] Open
Abstract
BACKGROUND Australian states and territories used test-trace-isolate-quarantine (TTIQ) systems extensively in their response to the COVID-19 pandemic in 2020-2021. We report on an analysis of Australian case data to estimate the impact of test-trace-isolate-quarantine systems on SARS-CoV-2 transmission. METHODS Our analysis uses a novel mathematical modelling framework and detailed surveillance data on COVID-19 cases including dates of infection and dates of isolation. First, we directly translate an empirical distribution of times from infection to isolation into reductions in potential for onward transmission during periods of relatively low caseloads (tens to hundreds of reported cases per day). We then apply a simulation approach, validated against case data, to assess the impact of case-initiated contact tracing on transmission during a period of relatively higher caseloads and system stress (up to thousands of cases per day). RESULTS We estimate that under relatively low caseloads in the state of New South Wales (tens of cases per day), TTIQ contributed to a 54% reduction in transmission. Under higher caseloads in the state of Victoria (hundreds of cases per day), TTIQ contributed to a 42% reduction in transmission. Our results also suggest that case-initiated contact tracing can support timely quarantine in times of system stress (thousands of cases per day). CONCLUSION Contact tracing systems for COVID-19 in Australia were highly effective and adaptable in supporting the national suppression strategy from 2020-21, prior to the emergence of the Omicron variant in November 2021. TTIQ systems were critical to the maintenance of the strong suppression strategy and were more effective when caseloads were (relatively) low.
Collapse
Affiliation(s)
- Freya M Shearer
- Infectious Disease Dynamics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Telethon Kids Institute, Perth, Australia.
| | - James M McCaw
- Infectious Disease Dynamics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
| | - Gerard E Ryan
- Infectious Disease Dynamics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Telethon Kids Institute, Perth, Australia
| | - Tianxiao Hao
- Infectious Disease Dynamics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Telethon Kids Institute, Perth, Australia
| | | | - Michael J Lydeamore
- Department of Econometrics and Business Statistics, Monash University, Melbourne, Australia
| | - Logan Wu
- Walter and Eliza Hall Institute, Melbourne, Australia
| | - Kate Ward
- Public Health Response Branch, NSW Ministry of Health, Australia
| | - Sally Ellis
- Public Health Response Branch, NSW Ministry of Health, Australia
| | - James Wood
- School of Population Health, The University of New South Wales, Sydney, Australia
| | - Jodie McVernon
- Department of Infectious Diseases at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia; Victorian Infectious Diseases Reference Laboratory Epidemiology Unit at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Nick Golding
- Infectious Disease Dynamics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Telethon Kids Institute, Perth, Australia; Curtin University, Perth, Australia.
| |
Collapse
|
15
|
Duval D, Evans B, Sanders A, Hill J, Simbo A, Kavoi T, Lyell I, Simmons Z, Qureshi M, Pearce-Smith N, Arevalo CR, Beck CR, Bindra R, Oliver I. Non-pharmaceutical interventions to reduce COVID-19 transmission in the UK: a rapid mapping review and interactive evidence gap map. J Public Health (Oxf) 2024; 46:e279-e293. [PMID: 38426578 PMCID: PMC11141784 DOI: 10.1093/pubmed/fdae025] [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: 10/16/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) were crucial in the response to the COVID-19 pandemic, although uncertainties about their effectiveness remain. This work aimed to better understand the evidence generated during the pandemic on the effectiveness of NPIs implemented in the UK. METHODS We conducted a rapid mapping review (search date: 1 March 2023) to identify primary studies reporting on the effectiveness of NPIs to reduce COVID-19 transmission. Included studies were displayed in an interactive evidence gap map. RESULTS After removal of duplicates, 11 752 records were screened. Of these, 151 were included, including 100 modelling studies but only 2 randomized controlled trials and 10 longitudinal observational studies.Most studies reported on NPIs to identify and isolate those who are or may become infectious, and on NPIs to reduce the number of contacts. There was an evidence gap for hand and respiratory hygiene, ventilation and cleaning. CONCLUSIONS Our findings show that despite the large number of studies published, there is still a lack of robust evaluations of the NPIs implemented in the UK. There is a need to build evaluation into the design and implementation of public health interventions and policies from the start of any future pandemic or other public health emergency.
Collapse
Affiliation(s)
- D Duval
- Research, Evidence and Knowledge Division, UK Health Security Agency (UKHSA), London E14 5EA, UK
| | - B Evans
- Research, Evidence and Knowledge Division, UK Health Security Agency (UKHSA), London E14 5EA, UK
| | - A Sanders
- Research, Evidence and Knowledge Division, UK Health Security Agency (UKHSA), London E14 5EA, UK
| | - J Hill
- Clinical and Public Health Response Division, UKHSA, London E14 5EA, UK
| | - A Simbo
- Evaluation and Epidemiological Science Division, UKHSA, Colindale NW9 5EQ, UK
| | - T Kavoi
- Cheshire and Merseyside Health Protection Team, UKHSA, Liverpool L3 1DS, UK
| | - I Lyell
- Greater Manchester Health Protection Team, UKHSA, Manchester M1 3BN, UK
| | - Z Simmons
- Research, Evidence and Knowledge Division, UK Health Security Agency (UKHSA), London E14 5EA, UK
| | - M Qureshi
- Clinical and Public Health Response Division, UKHSA, London E14 5EA, UK
| | - N Pearce-Smith
- Research, Evidence and Knowledge Division, UK Health Security Agency (UKHSA), London E14 5EA, UK
| | - C R Arevalo
- Research, Evidence and Knowledge Division, UK Health Security Agency (UKHSA), London E14 5EA, UK
| | - C R Beck
- Evaluation and Epidemiological Science Division, UKHSA, Salisbury SP4 0JG, UK
| | - R Bindra
- Clinical and Public Health Response Division, UKHSA, London E14 5EA, UK
| | - I Oliver
- Director General Science and Research and Chief Scientific Officer, UKHSA, London E14 5EA, UK
| |
Collapse
|
16
|
Velarde-García JF, Ortego-Maté C, Sarabia-Cobo C, Delgado Uria A, Fernández-Peña R. Impact of the Pandemic on Dementia Care and Caregivers: A Qualitative Study. Clin Nurs Res 2024; 33:240-252. [PMID: 38623695 DOI: 10.1177/10547738241246023] [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] [Indexed: 04/17/2024]
Abstract
Physical distancing measures to limit contagion in the COVID-19 pandemic made it difficult to care for older persons with dementia. Non-essential home visits were prevented and family caregivers took over most of their care. The aim of our study was to describe the lived experience of peoples living with dementia caregivers during the pandemic regarding the care provided and the person cared for. A qualitative phenomenological design was used. Participants were recruited using purposeful sampling. Informants were selected from primary healthcare centers, day centers, and a community mental health unit. The study participants comprised 21 caregivers. Semi-structured in-depth interviews by telephone were used, and field notes were collected from the researchers. A thematic analysis was conducted. The criteria used to control trustworthiness were credibility, transferability, dependability, and confirmability. Three main themes and six related sub-themes were identified: (1) care for the person with dementia during the pandemic, including lockdown, associated with difficulties in coping with restrictions, deterioration in health, and the impact of the closure of health and social resources; (2) health and social care provided to people with dementia after the disruptions and the care received from primary care prior to hospital or residential admission; and (3) the caregiver's perspective on the effects of the psycho-emotional impact, and coping strategies adopted in caring. Interventions for people with dementia should be planned in order to prevent the worsening of their health and cognitive status, while also developing programs to prevent stress and alleviate caregiver burden in case of health crises.
Collapse
Affiliation(s)
- Juan Francisco Velarde-García
- Department of Nursing, Red Cross College of Nursing, Universidad Autónoma de Madrid, Spain
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos, Madrid, Spain
- Research Nursing Group of Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Carmen Ortego-Maté
- Faculty of Nursing, Universidad de Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL, Santander, Spain
| | - Carmen Sarabia-Cobo
- Faculty of Nursing, Universidad de Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL, Santander, Spain
| | | | - Rosario Fernández-Peña
- Faculty of Nursing, Universidad de Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL, Santander, Spain
| |
Collapse
|
17
|
Rossetti M, Srisomwat C, Urban M, Rosati G, Maroli G, Yaman Akbay HG, Chailapakul O, Merkoçi A. Unleashing inkjet-printed nanostructured electrodes and battery-free potentiostat for the DNA-based multiplexed detection of SARS-CoV-2 genes. Biosens Bioelectron 2024; 250:116079. [PMID: 38295580 DOI: 10.1016/j.bios.2024.116079] [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: 11/29/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 02/02/2024]
Abstract
Following the global COVID-19 pandemic triggered by SARS-CoV-2, the need for rapid, specific and cost-effective point-of-care diagnostic solutions remains paramount. Even though COVID-19 is no longer a public health emergency, the disease still poses a global threat leading to deaths, and it continues to change with the risk of new variants emerging causing a new surge in cases and deaths. Here, we address the urgent need for rapid, cost-effective and point-of-care diagnostic solutions for SARS-CoV-2. We propose a multiplexed DNA-based sensing platform that utilizes inkjet-printed nanostructured gold electrodes and an inkjet-printed battery-free near-field communication (NFC) potentiostat for the simultaneous quantitative detection of two SARS-CoV-2 genes, the ORF1ab and the N gene. The detection strategy based on the formation of an RNA-DNA sandwich structure leads to a highly specific electrochemical output. The inkjet-printed nanostructured gold electrodes providing a large surface area enable efficient binding and increase the sensitivity. The inkjet-printed battery-free NFC potentiostat enables rapid measurements and real-time data analysis via a smartphone application, making the platform accessible and portable. With the advantages of speed (5 min), simplicity, sensitivity (low pM range, ∼450% signal gain) and cost-effectiveness, the proposed platform is a promising alternative for point-of-care diagnostics and high-throughput analysis that complements the COVID-19 diagnostic toolkit.
Collapse
Affiliation(s)
- Marianna Rossetti
- Catalan Institute of Nanoscience and Nanotechnology, UAB Campus, 08193, Bellaterra, Barcelona, Spain.
| | - Chawin Srisomwat
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Faculty of Science, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Massimo Urban
- Catalan Institute of Nanoscience and Nanotechnology, UAB Campus, 08193, Bellaterra, Barcelona, Spain; Universitat Autònoma de Barcelona, Campus de la UAB, Bellaterra, Barcelona, 08193, Spain
| | - Giulio Rosati
- Catalan Institute of Nanoscience and Nanotechnology, UAB Campus, 08193, Bellaterra, Barcelona, Spain.
| | - Gabriel Maroli
- Catalan Institute of Nanoscience and Nanotechnology, UAB Campus, 08193, Bellaterra, Barcelona, Spain; Universitat Autònoma de Barcelona, Campus de la UAB, Bellaterra, Barcelona, 08193, Spain; Instituto de Investigaciones en Ingeniería Eléctrica Alfredo Desages (IIIE), Universidad Nacional del Sur, CONICET, Avenida Colón 80 Bahía Blanca, Buenos Aires, Argentina
| | - Hatice Gödze Yaman Akbay
- Catalan Institute of Nanoscience and Nanotechnology, UAB Campus, 08193, Bellaterra, Barcelona, Spain
| | - Orawon Chailapakul
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Faculty of Science, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Arben Merkoçi
- Catalan Institute of Nanoscience and Nanotechnology, UAB Campus, 08193, Bellaterra, Barcelona, Spain; ICREA Institució Catalana de Recerca i Estudis Avançats, Passeig Lluís Companys 23, 08010, Barcelona, Spain.
| |
Collapse
|
18
|
Farokhnia Hamedani M, Esmaeili M, Sun Y, Sheybani E, Javidi G. Paving the way for COVID survivors' psychosocial rehabilitation: Mining topics, sentiments, and their trajectories over time from Reddit. Health Informatics J 2024; 30:14604582241240680. [PMID: 38739488 DOI: 10.1177/14604582241240680] [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] [Indexed: 05/16/2024]
Abstract
Objective: This study examined major themes and sentiments and their trajectories and interactions over time using subcategories of Reddit data. The aim was to facilitate decision-making for psychosocial rehabilitation. Materials and Methods: We utilized natural language processing techniques, including topic modeling and sentiment analysis, on a dataset consisting of more than 38,000 topics, comments, and posts collected from a subreddit dedicated to the experiences of people who tested positive for COVID-19. In this longitudinal exploratory analysis, we studied the dynamics between the most dominant topics and subjects' emotional states over an 18-month period. Results: Our findings highlight the evolution of the textual and sentimental status of major topics discussed by COVID survivors over an extended period of time during the pandemic. We particularly studied pre- and post-vaccination eras as a turning point in the timeline of the pandemic. The results show that not only does the relevance of topics change over time, but the emotions attached to them also vary. Major social events, such as the administration of vaccines or enforcement of nationwide policies, are also reflected through the discussions and inquiries of social media users. In particular, the emotional state (i.e., sentiments and polarity of their feelings) of those who have experienced COVID personally. Discussion: Cumulative societal knowledge regarding the COVID-19 pandemic impacts the patterns with which people discuss their experiences, concerns, and opinions. The subjects' emotional state with respect to different topics was also impacted by extraneous factors and events, such as vaccination. Conclusion: By mining major topics, sentiments, and trajectories demonstrated in COVID-19 survivors' interactions on Reddit, this study contributes to the emerging body of scholarship on COVID-19 survivors' mental health outcomes, providing insights into the design of mental health support and rehabilitation services for COVID-19 survivors.
Collapse
Affiliation(s)
- Moez Farokhnia Hamedani
- Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Mostafa Esmaeili
- Muma College of Business, University of South Florida, Tampa, FL, USA
| | - Yao Sun
- College of Science and Liberal Arts, New Jersey Institute of Technology, Newark, NJ, USA
| | - Ehsan Sheybani
- Muma College of Business, University of South Florida, Tampa, FL, USA
| | - Giti Javidi
- Muma College of Business, University of South Florida, Tampa, FL, USA
| |
Collapse
|
19
|
Heidecke J, Fuhrmann J, Barbarossa MV. A mathematical model to assess the effectiveness of test-trace-isolate-and-quarantine under limited capacities. PLoS One 2024; 19:e0299880. [PMID: 38470895 DOI: 10.1371/journal.pone.0299880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Diagnostic testing followed by isolation of identified cases with subsequent tracing and quarantine of close contacts-often referred to as test-trace-isolate-and-quarantine (TTIQ) strategy-is one of the cornerstone measures of infectious disease control. The COVID-19 pandemic has highlighted that an appropriate response to outbreaks of infectious diseases requires a firm understanding of the effectiveness of such containment strategies. To this end, mathematical models provide a promising tool. In this work, we present a delay differential equation model of TTIQ interventions for infectious disease control. Our model incorporates the assumption of limited TTIQ capacities, providing insights into the reduced effectiveness of testing and tracing in high prevalence scenarios. In addition, we account for potential transmission during the early phase of an infection, including presymptomatic transmission, which may be particularly adverse to a TTIQ based control. Our numerical experiments inspired by the early spread of COVID-19 in Germany demonstrate the effectiveness of TTIQ in a scenario where immunity within the population is low and pharmaceutical interventions are absent, which is representative of a typical situation during the (re-)emergence of infectious diseases for which therapeutic drugs or vaccines are not yet available. Stability and sensitivity analyses reveal both disease-dependent and disease-independent factors that impede or enhance the success of TTIQ. Studying the diminishing impact of TTIQ along simulations of an epidemic wave, we highlight consequences for intervention strategies.
Collapse
Affiliation(s)
- Julian Heidecke
- Frankfurt Institute for Advanced Studies, Frankfurt, Germany
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Jan Fuhrmann
- Institute of Applied Mathematics, Heidelberg University, Heidelberg, Germany
| | | |
Collapse
|
20
|
Middleton C, Larremore DB. Modeling the Transmission Mitigation Impact of Testing for Infectious Diseases. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.09.22.23295983. [PMID: 37808825 PMCID: PMC10557819 DOI: 10.1101/2023.09.22.23295983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
A fundamental question of any program focused on the testing and timely diagnosis of a communicable disease is its effectiveness in reducing transmission. Here, we introduce testing effectiveness (TE)-the fraction by which testing and post-diagnosis isolation reduce transmission at the population scale-and a model that incorporates test specifications and usage, within-host pathogen dynamics, and human behaviors to estimate TE. Using TE to guide recommendations, we show that today's rapid diagnostics should be used immediately upon symptom onset to control influenza A and respiratory syncytial virus (RSV), but delayed by up to 2d to control omicron-era SARS-CoV-2. Furthermore, while rapid tests are superior to RT-qPCR for control of founder-strain SARS-CoV-2, omicron-era changes in viral kinetics and rapid test sensitivity cause a reversal, with higher TE for RT-qPCR despite longer turnaround times. Finally, we illustrate the model's flexibility by quantifying tradeoffs in the use of post-diagnosis testing to shorten isolation times.
Collapse
Affiliation(s)
- Casey Middleton
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
| | - Daniel B Larremore
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
- Santa Fe Institute, Santa Fe, NM, USA
| |
Collapse
|
21
|
Leung KY, Metting E, Ebbers W, Veldhuijzen I, Andeweg SP, Luijben G, de Bruin M, Wallinga J, Klinkenberg D. Effectiveness of a COVID-19 contact tracing app in a simulation model with indirect and informal contact tracing. Epidemics 2024; 46:100735. [PMID: 38128242 DOI: 10.1016/j.epidem.2023.100735] [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: 05/15/2023] [Revised: 11/17/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
During the COVID-19 pandemic, contact tracing was used to identify individuals who had been in contact with a confirmed case so that these contacted individuals could be tested and quarantined to prevent further spread of the SARS-CoV-2 virus. Many countries developed mobile apps to find these contacted individuals faster. We evaluate the epidemiological effectiveness of the Dutch app CoronaMelder, where we measure effectiveness as the reduction of the reproduction number R. To this end, we use a simulation model of SARS-CoV-2 spread and contact tracing, informed by data collected during the study period (December 2020 - March 2021) in the Netherlands. We show that the tracing app caused a clear but small reduction of the reproduction number, and the magnitude of the effect was found to be robust in sensitivity analyses. The app could have been more effective if more people had used it, and if notification of contacts could have been done directly by the user and thus reducing the time intervals between symptom onset and reporting of contacts. The model has two innovative aspects: i) it accounts for the clustered nature of social networks and ii) cases can alert their contacts informally without involvement of health authorities or the tracing app.
Collapse
Affiliation(s)
- Ka Yin Leung
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, the Netherlands.
| | - Esther Metting
- University of Groningen, University Medical Center Groningen, Data Science Center in Health, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Primary Care, the Netherlands; University of Groningen, faculty of Economics and Business, Department of Operations, the Netherlands
| | - Wolfgang Ebbers
- Erasmus School of Social and Behavioural Sciences, Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Irene Veldhuijzen
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Stijn P Andeweg
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Guus Luijben
- National Institute for Public Health and the Environment, Centre for Health and Society, Bilthoven, the Netherlands
| | - Marijn de Bruin
- National Institute for Public Health and the Environment, Centre for Health and Society, Bilthoven, the Netherlands; Radboud University Medical Centre, Radboud Institute of Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - Jacco Wallinga
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, the Netherlands; Leiden University Medical Centre, Department of Biomedical Datasciences, Leiden, the Netherlands
| | - Don Klinkenberg
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, the Netherlands
| |
Collapse
|
22
|
Ganguly RK, Chakraborty SK. Plastic waste management during and post Covid19 pandemic: Challenges and strategies towards circular economy. Heliyon 2024; 10:e25613. [PMID: 38370243 PMCID: PMC10869756 DOI: 10.1016/j.heliyon.2024.e25613] [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: 08/03/2023] [Revised: 01/20/2024] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
Global petroleum consumption suffered drastically as lockdowns were put in place to contain the Coronavirus Disease 2019 (COVID-19). As a result, oil costs dropped, making virgin plastics more cost-effective than recycled plastics. The usage of plastic has increased as a result of lifestyle modifications, cost-based incentives, and other factors, further obscuring the issue. The utilization of personal protective equipment (PPE) during the pandemic had resulted in a significant surge in the quantity of plastic waste. The plastic packaging industry achieved a revenue milestone of US$ 909.2 billion in 2021, boosting a compound annual growth rate of 5.5 %. The escalating dependence on plastics imposed additional pressure on waste management systems, which were proven to be ineffective and insufficient in addressing the issue. This situation exacerbated the problem and contributed to environmental pollution. Globally, 40 % of plastic waste ended up in landfills, 25 % was incinerated, 16 % was recycled, and the remaining 19 % infiltrated within the environment. By investing in circular technologies like feedstock recycling and enhancing infrastructural and environmental conditions, it expected to become viable to manage plastic waste flows during such a period of crisis. Investing in valorization strategies that transform plastic waste into value-added goods, such as fuels and building materials, receives a compelling macroeconomic signal when both plastic waste and plastic demand are on the rise. A robust circular economy can be accomplished by finalising the life cycle of plastic waste. The concept of Plastic Waste Footprint (PWF) aims to assess the environmental impact of plastic products throughout their intended usage period. In the midst of the emerging challenges in waste management during and post pandemic period, this research study has been conducted to explore the challenges and strategies associated with plastic waste in the environment.
Collapse
Affiliation(s)
- Ram Kumar Ganguly
- Department of Zoology, Vidyasagar University, Midnapore, 721102, West Bengal, India
| | | |
Collapse
|
23
|
Djuric O, Larosa E, Cassinadri M, Cilloni S, Bisaccia E, Pepe D, Bonvicini L, Vicentini M, Venturelli F, Giorgi Rossi P, Pezzotti P, Mateo Urdiales A, Bedeschi E. Effect of an enhanced public health contact tracing intervention on the secondary transmission of SARS-CoV-2 in educational settings: The four-way decomposition analysis. eLife 2024; 13:e85802. [PMID: 38416129 PMCID: PMC10901504 DOI: 10.7554/elife.85802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
Background The aim of our study was to test the hypothesis that the community contact tracing strategy of testing contacts in households immediately instead of at the end of quarantine had an impact on the transmission of SARS-CoV-2 in schools in Reggio Emilia Province. Methods We analysed surveillance data on notification of COVID-19 cases in schools between 1 September 2020 and 4 April 2021. We have applied a mediation analysis that allows for interaction between the intervention (before/after period) and the mediator. Results Median tracing delay decreased from 7 to 3.1 days and the percentage of the known infection source increased from 34-54.8% (incident rate ratio-IRR 1.61 1.40-1.86). Implementation of prompt contact tracing was associated with a 10% decrease in the number of secondary cases (excess relative risk -0.1 95% CI -0.35-0.15). Knowing the source of infection of the index case led to a decrease in secondary transmission (IRR 0.75 95% CI 0.63-0.91) while the decrease in tracing delay was associated with decreased risk of secondary cases (1/IRR 0.97 95% CI 0.94-1.01 per one day of delay). The direct effect of the intervention accounted for the 29% decrease in the number of secondary cases (excess relative risk -0.29 95%-0.61 to 0.03). Conclusions Prompt contact testing in the community reduces the time of contact tracing and increases the ability to identify the source of infection in school outbreaks. Although there are strong reasons for thinking it is a causal link, observed differences can be also due to differences in the force of infection and to other control measures put in place. Funding This project was carried out with the technical and financial support of the Italian Ministry of Health - CCM 2020 and Ricerca Corrente Annual Program 2023.
Collapse
Affiliation(s)
- Olivera Djuric
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
- Centre for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), University of Modena and Reggio EmiliaModenaItaly
| | - Elisabetta Larosa
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Mariateresa Cassinadri
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Silvia Cilloni
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Eufemia Bisaccia
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Davide Pepe
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Laura Bonvicini
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Francesco Venturelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di SanitàRomeItaly
| | | | - Emanuela Bedeschi
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | | |
Collapse
|
24
|
Zhao W, Wang X, Tang B. The impacts of spatial-temporal heterogeneity of human-to-human contacts on the extinction probability of infectious disease from branching process model. J Theor Biol 2024; 579:111703. [PMID: 38096979 DOI: 10.1016/j.jtbi.2023.111703] [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: 09/06/2023] [Revised: 11/26/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023]
Abstract
In this study, we focus on the impacts of spatial-temporal heterogeneity of human-to-human contacts on the spread of infectious diseases and develop a multi-type branching process model by introducing random human-to-human contact mode into a structured population. We provide the general formulas of the generation size, extinction probability, and basic reproduction number of the proposed branching process model. The result shows that the natural temporal heterogeneity (i.e. random contacts over time) can lead to a higher extinction probability while remains the same basic reproduction number and generation size. This is also numerically verified by choosing the real contact distributions from different circumstances of four countries. In addition, we observe a non-monotonic pattern of the differences, against the transmission probability and the mean contact rate, between the extinction probabilities under the constant and random contact patterns. Given the spatial heterogeneity, we show that it can contribute to the increase of basic reproduction number, but also increase the extinction probability of the infectious disease. This study adds novel insights to the course of the impact of heterogeneity on the transmission dynamics and also provides additional evidence for the limited role of reproduction numbers.
Collapse
Affiliation(s)
- Wuqiong Zhao
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an 710049, PR China.
| | - Xia Wang
- School of Mathematics and Statistics, Shaanxi Normal University, Xi'an 710119, PR China.
| | - Biao Tang
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an 710049, PR China.
| |
Collapse
|
25
|
Lau KY, Kang J, Park M, Leung G, Wu JT, Leung K. Estimating the Epidemic Size of Superspreading Coronavirus Outbreaks in Real Time: Quantitative Study. JMIR Public Health Surveill 2024; 10:e46687. [PMID: 38345850 PMCID: PMC10863650 DOI: 10.2196/46687] [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: 02/21/2023] [Revised: 12/01/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Novel coronaviruses have emerged and caused major epidemics and pandemics in the past 2 decades, including SARS-CoV-1, MERS-CoV, and SARS-CoV-2, which led to the current COVID-19 pandemic. These coronaviruses are marked by their potential to produce disproportionally large transmission clusters from superspreading events (SSEs). As prompt action is crucial to contain and mitigate SSEs, real-time epidemic size estimation could characterize the transmission heterogeneity and inform timely implementation of control measures. OBJECTIVE This study aimed to estimate the epidemic size of SSEs to inform effective surveillance and rapid mitigation responses. METHODS We developed a statistical framework based on back-calculation to estimate the epidemic size of ongoing coronavirus SSEs. We first validated the framework in simulated scenarios with the epidemiological characteristics of SARS, MERS, and COVID-19 SSEs. As case studies, we retrospectively applied the framework to the Amoy Gardens SARS outbreak in Hong Kong in 2003, a series of nosocomial MERS outbreaks in South Korea in 2015, and 2 COVID-19 outbreaks originating from restaurants in Hong Kong in 2020. RESULTS The accuracy and precision of the estimation of epidemic size of SSEs improved with longer observation time; larger SSE size; and more accurate prior information about the epidemiological characteristics, such as the distribution of the incubation period and the distribution of the onset-to-confirmation delay. By retrospectively applying the framework, we found that the 95% credible interval of the estimates contained the true epidemic size after 37% of cases were reported in the Amoy Garden SARS SSE in Hong Kong, 41% to 62% of cases were observed in the 3 nosocomial MERS SSEs in South Korea, and 76% to 86% of cases were confirmed in the 2 COVID-19 SSEs in Hong Kong. CONCLUSIONS Our framework can be readily integrated into coronavirus surveillance systems to enhance situation awareness of ongoing SSEs.
Collapse
Affiliation(s)
- Kitty Y Lau
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, China (Hong Kong)
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China (Hong Kong)
| | - Jian Kang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China (Hong Kong)
| | - Minah Park
- Department of Health Convergence, Ewha Womans University, Seoul, Republic of Korea
| | - Gabriel Leung
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, China (Hong Kong)
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China (Hong Kong)
| | - Joseph T Wu
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, China (Hong Kong)
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China (Hong Kong)
- The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Kathy Leung
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, China (Hong Kong)
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China (Hong Kong)
- The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
26
|
Hoi AG, N’Tcha LK, Duguay C, Accrombessi M, Akinro B, Feng C, Labonté R, Protopopoff N, Akogbeto M, Kulkarni MA. Health systems impacts of the COVID-19 pandemic on malaria control program implementation and malaria burden in Benin: A mixed-method qualitative and mathematical modelling and study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002197. [PMID: 38306342 PMCID: PMC10836704 DOI: 10.1371/journal.pgph.0002197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024]
Abstract
The COVID-19 pandemic has sent ripple effects across health systems and impacted the burden of many other diseases, such as malaria in sub-Saharan Africa. This study takes a mixed method approach to assess the impact of COVID-19 on malaria control programs in three rural communes in Benin. We conducted individual semi-structured interviews with key informants who play important roles in malaria control in Benin at three levels of the health system-national, health zone, and commune. Using a purposive sampling technique, informants were interviewed regarding their roles in malaria control, the impact of the pandemic on their activities, and the mitigation strategies adopted. Relevant themes were identified by content analysis. We then formulated an agent-based model of malaria epidemiology to assess the impacts of treatment disruption on malaria burden. The key informant interviews revealed that essential aspects of malaria control were upheld in Benin due to the close collaboration of public health practitioners and health care providers at all levels of the health system. There were some disruptions to case management services for malaria at the start of the pandemic due to the public avoiding health centers and a brief shortage of malaria treatment that may not be entirely attributable to the pandemic. Results from the agent-based model suggest that duration, severity, and timing of treatment disruption can impact malaria burden in a synergistic manner, though the effects are small given the relatively mild disruptions observed. This study highlights the importance of top-down leadership in health emergencies, as well as the critical role of community health workers in preventing negative health outcomes for their communities. We also showcased the integration of qualitative research and mathematical models-an underappreciated form of mixed methods research that offer immense value in the continued evaluation of rapidly evolving health emergencies.
Collapse
Affiliation(s)
- Amber Gigi Hoi
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Ludovic K. N’Tcha
- Centre de Recherche Entomologique de Cotonou, Cotonou, Benin
- Laboratory of Applied Anthropology and Education for Sustainable Development, University of Abomey-Calavi, Abomey-Calavi, Benin
| | - Claudia Duguay
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Manfred Accrombessi
- Centre de Recherche Entomologique de Cotonou, Cotonou, Benin
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Bruno Akinro
- Centre de Recherche Entomologique de Cotonou, Cotonou, Benin
| | - Cindy Feng
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Ronald Labonté
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | - Martin Akogbeto
- Centre de Recherche Entomologique de Cotonou, Cotonou, Benin
| | - Manisha A. Kulkarni
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| |
Collapse
|
27
|
Dubey S, Verma DK, Kumar M. Severe acute respiratory syndrome Coronavirus-2 GenoAnalyzer and mutagenic anomaly detector using FCMFI and NSCE. Int J Biol Macromol 2024; 258:129051. [PMID: 38159703 DOI: 10.1016/j.ijbiomac.2023.129051] [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: 05/11/2023] [Revised: 11/08/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
In order to deepen our understanding of the virus and help guide the creation of efficient therapies, this study uses artificial intelligence tools to thoroughly explore the genetic sequences of the SARS-CoV-2 virus. The process starts by using the Fuzzy Closure Miner for Frequent Itemsets (FCMFI) on a large corpus of SARS-CoV-2 genomic sequences to reveal hidden patterns, including nucleotides base sequences, repeating motifs, and corresponding interchanges. Then, using the Nucleotide Sequence Comprehension Engine (NSCE) technique, we were able to precisely define the genomic areas for mutation analysis. Structured and unstructured proteins are both strongly impacted by virus mutations, with spike proteins that are linked to the severity of COVID-19 pneumonia being particularly affected. Notably, the Mutagenic Anomaly Detector shows a 65 % efficiency boost in computing genome mutation rates compared to conventional point mutation analysis, while GenoAnalyzer offers a remarkable 93.33 % improvement over existing approaches in recognizing common genomic sequence patterns. These results highlight the potential of FCMFI to reveal complex genomic patterns and significant insights in COVID-19 genetic sequences when combined with mutation analysis. The Mutagenic Anomaly Detector and GenoAnalyzer show promise for revealing hidden genomic patterns and precisely estimating the SARS-CoV-2 mutation rate.
Collapse
Affiliation(s)
- Shivendra Dubey
- Department of Computer Science & Engineering, Jaypee University of Engineering & Technology, Guna, Madhya Pradesh Pin-473226, India.
| | - Dinesh Kumar Verma
- Department of Computer Science & Engineering, Jaypee University of Engineering & Technology, Guna, Madhya Pradesh Pin-473226, India.
| | - Mahesh Kumar
- Department of Computer Science & Engineering, Jaypee University of Engineering & Technology, Guna, Madhya Pradesh Pin-473226, India.
| |
Collapse
|
28
|
Gatov E, Sennik S, Goldfarb A, Gans J, Stein J, Agrawal A, Rosella L. Examining the Relationship Between Workplace Industry and COVID-19 Infection: A Cross-sectional Study of Canada's Largest Rapid Antigen Screening Program. J Occup Environ Med 2024; 66:e68-e76. [PMID: 38151981 DOI: 10.1097/jom.0000000000003028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVES To control virus spread while keeping the economy open, this study aimed to identify individuals at increased risk of COVID-19 transmission in the workplace using rapid antigen screening data. METHODS Among adult participants in a large Canadian rapid antigen screening program (January 2021-March 2022), we examined screening, personal, and workplace characteristics and conducted logistic regressions, adjusted for COVID-19 wave, screening frequency and location, role, age group, and geography. RESULTS Among 145,814 participants across 2707 worksites, 6209 screened positive at least once. Workers in natural resources (odds ratio [OR] = 2.1 [1.73-2.55]), utilities (OR = 1.67 [1.38-2.03]), construction (OR = 1.35 [1.06-1.71]), and transportation/warehousing (OR = 1.32 [1.12-1.56]) had increased odds of screening positive; workers in education/health (OR = 0.62 [0.52-0.73]), leisure/hospitality (OR = 0.71 [0.56-0.90]), and finance (OR = 0.84 [0.71-0.99]) had lesser odds of screening positive, compared with professional/business services. CONCLUSIONS Certain industries involving in-person work in close quarters are associated with elevated COVID-19 transmission. Continued reliance on rapid screening in these sectors is warranted.
Collapse
Affiliation(s)
- Evgenia Gatov
- From the Creative Destruction Lab, Rotman School of Management, University of Toronto, Toronto, Canada (E.G., S.S., A.G., J.G., A.A.); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada (E.G.); Rotman School of Management, University of Toronto, Toronto, Canada (A.G., J.G., A.A.); Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, Canada (J.S.); and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada (L.R.)
| | | | | | | | | | | | | |
Collapse
|
29
|
Nagpal C, Sharma A, Bakhshi S, Malik PS, Gupta H, Mittal C, Gund S, Kumar A, Sharma A, Pushpam D, Khurana S, Pramanik R, Gupta N, Batra A. SMART-ESAS: Smartphone Monitoring and Assessment in Real Time of Edmonton Symptom Assessment System Scores for Patients With Cancer. JCO Glob Oncol 2024; 10:e2300447. [PMID: 38386957 PMCID: PMC10898676 DOI: 10.1200/go.23.00447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE Serial patient-reported outcome (PRO) measurements in clinical practice are associated with a better quality of life and survival. Recording electronic PROs using smartphones is an efficient way to implement this. We aimed to assess the feasibility of the electronically filled Edmonton Symptom Assessment System (e-ESAS) scale in the lower-middle-income country (LMIC) setting. METHODS Baseline clinical features and conventional paper-based ESAS (p-ESAS) were collected in newly diagnosed patients with solid organ tumors. Text message link was sent to these patients for filling e-ESAS. ESAS was categorized into physical, psychological, and total symptom domains. Scores were divided into none to mild (0-3) and moderate to severe (4-10). Intraclass correlation coefficients (ICCs) were used to determine the correlation between p-ESAS and e-ESAS. Multivariable logistic regression was used to identify independent factors affecting symptom burden. RESULTS Of 1,160 participants who filled out p-ESAS, 595 completed both e-ESAS and p-ESAS questionnaires and were included in the final analysis. Moderate to severe physical, psychological, and total symptom scores were seen in 39.8%, 40%, and 39% of participants. Tiredness and anxiety were the most common physical and psychological symptoms, respectively. ICCs between the p-ESAS and e-ESAS varied between 0.75 and 0.9. Total symptom scores were independently predicted by metastatic disease (odds ratio [OR], 1.83; 95% CI, 1.26 to 2.67; P = .001) and a higher level of education (OR, 0.42; 95% CI, 0.25 to 0.72; P = .001). CONCLUSION Paper-based and electronically filled ESASs have good intraobserver reliability across individual symptoms and domain scores in a representative cohort at a tertiary care institute in the LMIC. This may help us incorporate e-ESAS in routine clinical care in the real-world setting with financial, infrastructural, and manpower limitations.
Collapse
Affiliation(s)
- Chitrakshi Nagpal
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Sharma
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhat Singh Malik
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Hardik Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Sneha Gund
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Akash Kumar
- Department of Medical Oncology, National Cancer Institute (NCI), All India Institute of Medical Sciences, Jhajjar, India
| | - Aparna Sharma
- Department of Medical Oncology, National Cancer Institute (NCI), All India Institute of Medical Sciences, Jhajjar, India
| | - Deepam Pushpam
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Sachin Khurana
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Raja Pramanik
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Nishkarsh Gupta
- Department of Onco-anaesthesia and Palliative Medicine, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Batra
- Department of Medical Oncology, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
30
|
Yang B, Lin Y, Xiong W, Liu C, Gao H, Ho F, Zhou J, Zhang R, Wong JY, Cheung JK, Lau EH, Tsang TK, Xiao J, Wong IO, Martín-Sánchez M, Leung GM, Cowling BJ, Wu P. Comparison of control and transmission of COVID-19 across epidemic waves in Hong Kong: an observational study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100969. [PMID: 38076326 PMCID: PMC10700518 DOI: 10.1016/j.lanwpc.2023.100969] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/03/2023] [Accepted: 11/01/2023] [Indexed: 08/04/2024]
Abstract
BACKGROUND Hong Kong contained COVID-19 for two years but experienced a large epidemic of Omicron BA.2 in early 2022 and endemic transmission of Omicron subvariants thereafter. We reflected on pandemic preparedness and responses by assessing COVID-19 transmission and associated disease burden in the context of implementation of various public health and social measures (PHSMs). METHODS We examined the use and impact of pandemic controls in Hong Kong by analysing data on more than 1.7 million confirmed COVID-19 cases and characterizing the temporal changes non-pharmaceutical and pharmaceutical interventions implemented from January 2020 through to 30 December 2022. We estimated the daily effective reproductive number (Rt) to track changes in transmissibility and effectiveness of community-based measures against infection over time. We examined the temporal changes of pharmaceutical interventions, mortality rate and case-fatality risks (CFRs), particularly among older adults. FINDINGS Hong Kong experienced four local epidemic waves predominated by the ancestral strain in 2020 and early 2021 and prevented multiple SARS-CoV-2 variants from spreading in the community before 2022. Strict travel-related, case-based, and community-based measures were increasingly tightened in Hong Kong over the first two years of the pandemic. However, even very stringent measures were unable to contain the spread of Omicron BA.2 in Hong Kong. Despite high overall vaccination uptake (>70% with at least two doses), high mortality was observed during the Omicron BA.2 wave due to lower vaccine coverage (42%) among adults ≥65 years of age. Increases in antiviral usage and vaccination uptake over time through 2022 was associated with decreased case fatality risks. INTERPRETATION Integrated strict measures were able to reduce importation risks and interrupt local transmission to contain COVID-19 transmission and disease burden while awaiting vaccine development and rollout. Increasing coverage of pharmaceutical interventions among high-risk groups reduced infection-related mortality and mitigated the adverse health impact of the pandemic. FUNDING Health and Medical Research Fund.
Collapse
Affiliation(s)
- Bingyi Yang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yun Lin
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Weijia Xiong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Chang Liu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Huizhi Gao
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Faith Ho
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jiayi Zhou
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ru Zhang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jessica Y. Wong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Justin K. Cheung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric H.Y. Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Tim K. Tsang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jingyi Xiao
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Irene O.L. Wong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mario Martín-Sánchez
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Gabriel M. Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Benjamin J. Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Peng Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| |
Collapse
|
31
|
Guisado-Clavero M, Astier-Peña MP, Gómez-Bravo R, Ares-Blanco S. Open data for monitoring COVID-19 in Spain: Descriptive study. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024; 42:80-87. [PMID: 37088686 PMCID: PMC10073586 DOI: 10.1016/j.eimce.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 04/09/2023]
Abstract
BACKGROUND The indicators of the pandemic have been based on the total number of diagnosed cases of COVID-19, the number of people hospitalized or in intensive care units, and deaths from the infection. The aim of this study is to describe the available data on diagnostic tests, health service used for the diagnosis of COVID-19, case detection and monitoring. METHOD Descriptive study with review of official data available on the websites of the Spanish health councils corresponding to 17 Autonomous Communities, 2 Autonomous cities and the Ministry of Health. The variables collected refer to contact tracing, technics for diagnosis, use of health services and follow-up. RESULTS All regions of Spain show data on diagnosed cases of COVID-19 and deaths. Hospitalized cases and intensive care admissions are shown in all regions except the Balearic Islands. Diagnostic tests for COVID-19 have been registered in all regions except Madrid region and Extremadura, with scarcely information on what type of test has been performed (present in 7 CCAA), requesting service and study of contacts. CONCLUSIONS The information available on the official websites of the Health Departments of the different regions of Spain are heterogeneous. Data from the use of health service or workload in Primary Care, Emergency department or Out of hours services are almost non-existent.
Collapse
Affiliation(s)
- Marina Guisado-Clavero
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria del área norte de la Comunidad de Madrid, Madrid, Spain
| | - María Pilar Astier-Peña
- Centro de Salud Univérsitas, Servicio Aragonés de Salud, Zaragoza, Spain; GdT de Seguridad del paciente de semFYC y del GdT de Calidad y Seguridad de WONCA, Zaragoza, Spain
| | - Raquel Gómez-Bravo
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and CognitiveSciences, Faculty of Humanities, Education, and Social Sciences, Universidad de Luxemburgo, Luxembourg, Luxembourg
| | - Sara Ares-Blanco
- Centro de Salud Federica Montseny, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| |
Collapse
|
32
|
Hu X, Hu Z, Xu T, Zhang K, Lu HH, Zhao J, Boerwinkle E, Jin L, Xiong M. Equilibrium points and their stability of COVID-19 in US. Sci Rep 2024; 14:1628. [PMID: 38238368 PMCID: PMC10796349 DOI: 10.1038/s41598-024-51729-w] [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: 09/19/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024] Open
Abstract
This study aims to develop an advanced mathematic model and investigate when and how will the COVID-19 in the US be evolved to endemic. We employed a nonlinear ordinary differential equations-based model to simulate COVID-19 transmission dynamics, factoring in vaccination efforts. Multi-stability analysis was performed on daily new infection data from January 12, 2021 to December 12, 2022 across 50 states in the US. Key indices such as eigenvalues and the basic reproduction number were utilized to evaluate stability and investigate how the pandemic COVD-19 will evolve to endemic in the US. The transmissional, recovery, vaccination rates, vaccination effectiveness, eigenvalues and reproduction numbers ([Formula: see text] and [Formula: see text]) in the endemic equilibrium point were estimated. The stability attractor regions for these parameters were identified and ranked. Our multi-stability analysis revealed that while the endemic equilibrium points in the 50 states remain unstable, there is a significant trend towards stable endemicity in the US. The study's stability analysis, coupled with observed epidemiological waves in the US, suggested that the COVID-19 pandemic may not conclude with the virus's eradication. Nevertheless, the virus is gradually becoming endemic. Effectively strategizing vaccine distribution is pivotal for this transition.
Collapse
Affiliation(s)
- Xiaoxi Hu
- State Key Laboratory of Genetic Engineering and Innovation Center of Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Zixin Hu
- State Key Laboratory of Genetic Engineering and Innovation Center of Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
- Artificial Intelligence Innovation and Incubation Institute, Fudan University, Shanghai, China
| | - Tao Xu
- Department of Epidemiology, University of Florida, Gainesville, FL, 32611, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, 12144, USA
| | | | - Jinying Zhao
- Department of Epidemiology, University of Florida, Gainesville, FL, 32611, USA
| | - Eric Boerwinkle
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Li Jin
- State Key Laboratory of Genetic Engineering and Innovation Center of Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Momiao Xiong
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, P.O. Box 20186, Houston, TX, 77030, USA.
| |
Collapse
|
33
|
Kim YJ, Min J. Advances in nanobiosensors during the COVID-19 pandemic and future perspectives for the post-COVID era. NANO CONVERGENCE 2024; 11:3. [PMID: 38206526 PMCID: PMC10784265 DOI: 10.1186/s40580-023-00410-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024]
Abstract
The unprecedented threat of the highly contagious virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes exponentially increased infections of coronavirus disease 2019 (COVID-19), highlights the weak spots of the current diagnostic toolbox. In the midst of catastrophe, nanobiosensors offer a new opportunity as an alternative tool to fill a gap among molecular tests, rapid antigen tests, and serological tests. Nanobiosensors surpass the potential of antigen tests because of their enhanced sensitivity, thus enabling us to see antigens as stable and easy-to-access targets. During the first three years of the COVID-19 pandemic, a substantial number of studies have reported nanobiosensors for the detection of SARS-CoV-2 antigens. The number of articles on nanobiosensors and SARS-CoV-2 exceeds the amount of nanobiosensor research on detecting previous infectious diseases, from influenza to SARS-CoV and MERS-CoV. This unprecedented publishing pace also implies the significance of SARS-CoV-2 and the present pandemic. In this review, 158 studies reporting nanobiosensors for detecting SARS-CoV-2 antigens are collected to discuss the current challenges of nanobiosensors using the criteria of point-of-care (POC) diagnostics along with COVID-specific issues. These advances and lessons during the pandemic pave the way for preparing for the post-COVID era and potential upcoming infectious diseases.
Collapse
Affiliation(s)
- Young Jun Kim
- School of Integrative Engineering, Chung-Ang University, Heukseok-Dong, Dongjak-Gu, Seoul, 06974, Republic of Korea
| | - Junhong Min
- School of Integrative Engineering, Chung-Ang University, Heukseok-Dong, Dongjak-Gu, Seoul, 06974, Republic of Korea.
| |
Collapse
|
34
|
Webb G, Zhao XE. An Epidemic Model with Infection Age and Vaccination Age Structure. Infect Dis Rep 2024; 16:35-64. [PMID: 38247976 PMCID: PMC10801629 DOI: 10.3390/idr16010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/27/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024] Open
Abstract
A model of epidemic dynamics is developed that incorporates continuous variables for infection age and vaccination age. The model analyzes pre-symptomatic and symptomatic periods of an infected individual in terms of infection age. This property is shown to be of major importance in the severity of the epidemic, when the infectious period of an infected individual precedes the symptomatic period. The model also analyzes the efficacy of vaccination in terms of vaccination age. The immunity to infection of vaccinated individuals varies with vaccination age and is also of major significance in the severity of the epidemic. Application of the model to the 2003 SARS epidemic in Taiwan and the COVID-19 epidemic in New York provides insights into the dynamics of these diseases. It is shown that the SARS outbreak was effectively contained due to the complete overlap of infectious and symptomatic periods, allowing for the timely isolation of affected individuals. In contrast, the pre-symptomatic spread of COVID-19 in New York led to a rapid, uncontrolled epidemic. These findings underscore the critical importance of the pre-symptomatic infectious period and the vaccination strategies in influencing the dynamics of an epidemic.
Collapse
Affiliation(s)
- Glenn Webb
- Department of Mathematics, Vanderbilt University, Nashville, TN 37240, USA
| | - Xinyue Evelyn Zhao
- Department of Mathematics, University of Tennessee, Knoxville, TN 37996, USA
| |
Collapse
|
35
|
Hijano DR, Dennis SR, Hoffman JM, Tang L, Hayden RT, Gaur AH, Hakim H. Employee investigation and contact tracing program in a pediatric cancer hospital to mitigate the spread of COVID-19 among the workforce, patients, and caregivers. Front Public Health 2024; 11:1304072. [PMID: 38259752 PMCID: PMC10801179 DOI: 10.3389/fpubh.2023.1304072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Background Case investigations and contact tracing are essential disease control measures used by health departments. Early in the pandemic, they were seen as a key strategy to stop COVID-19 spread. The CDC urged rapid action to scale up and train a large workforce and collaborate across public and private agencies to halt COVID-19 transmission. Methods We developed a program for case investigation and contact tracing that followed CDC and local health guidelines, compliant with the Occupational Safety and Health Administration (OSHA) regulations and tailored to the needs and resources of our institution. Program staff were trained and assessed for competency before joining the program. Results From March 2020 to May 2021, we performed 838 COVID-19 case investigations, which led to 136 contacts. Most employees reported a known SARS-CoV-2 exposure from the community (n = 435) or household (n = 343). Only seven (5.1%) employees were determined as more likely than not to have SARS-CoV-2 infection related to workplace exposure, and when so, lapses in following the masking recommendations were identified. Between June 2021-February 2022, our program adjusted to the demand of the different waves, particularly omicron, by significantly reducing the amount of data collected. No transmission from employees to patients or caregivers was observed during this period. Conclusion Prompt implementation of case investigation and contact tracing is possible, and it effectively reduces workplace exposures. This approach can be adapted to suit the specific needs and requirements of various healthcare settings, particularly those serving the most vulnerable patient populations.
Collapse
Affiliation(s)
- Diego R. Hijano
- Departments of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, United States
| | - Sandra R. Dennis
- Department of Human Resources, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - James M. Hoffman
- Department of Human Resources, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Li Tang
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Randall T. Hayden
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | | | - Aditya H. Gaur
- Departments of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Hana Hakim
- Office of Quality and Patient Safety, St. Jude Children’s Research Hospital, Memphis, TN, United States
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, United States
| |
Collapse
|
36
|
Liu J, Ouyang N, Mizrahi A, Kornides ML. Social Distancing in the COVID-19 Pandemic: Associated Factors, Health Outcomes, and Implications. FAMILY & COMMUNITY HEALTH 2024; 47:80-94. [PMID: 37681938 DOI: 10.1097/fch.0000000000000367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Social distancing has reemerged as a public health measure for containing the spread of COVID-19. This integrative review aims to analyze the historical use of social distancing, the current application during COVID-19, individual factors that affect social distancing practices, and consequential health outcomes. We analyzed relevant literature from searches conducted on Scopus, PubMed, and PsycINFO. We found that resources, culture, age, gender, and personality are associated with the degree to which people practice social distancing. Furthermore, social distancing changes our lifestyles and behavior and results in multifaceted health outcomes, including decreased physical activity and sunlight exposure, increased weight gain, and impaired sleep quality. On the positive side, social distancing has been linked to reduced crime rates and environmental damage, as well as better social and family ties. Future interventions may be utilized to increase adherence to social distancing practices and to mitigate the negative health effects of social distancing.
Collapse
Affiliation(s)
- Jianghong Liu
- Department of Family and Community Health, School of Nursing (Dr Liu), School of Nursing (Ms Ouyang and Dr Kornides), School of Arts and Sciences (Ms Mizrahi), University of Pennsylvania, Philadelphia; and Yale University, New Haven, Connecticut (Ms Ouyang)
| | | | | | | |
Collapse
|
37
|
Mongin D, Bürgisser N, Courvoisier DS. Time trends and modifiable factors of COVID-19 contact tracing coverage, Geneva, Switzerland, June 2020 to February 2022. Euro Surveill 2024; 29:2300228. [PMID: 38240059 PMCID: PMC10797663 DOI: 10.2807/1560-7917.es.2024.29.3.2300228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/19/2023] [Indexed: 01/22/2024] Open
Abstract
BackgroundContact tracing was one of the central non-pharmaceutical interventions implemented worldwide to control the spread of SARS-CoV-2, but its effectiveness depends on its ability to detect contacts.AimEvaluate the proportion of secondary infections captured by the contact tracing system in Geneva.MethodsWe analysed 166,892 concomitant infections occurring at the same given address from June 2020 until February 2022 using an extensive operational database of SARS-CoV-2 tests in Geneva. We used permutation to compare the total number of secondary infections occurring at the same address with that reported through manual contact tracing.ResultsContact tracing captured on average 41% of secondary infections, varying from 23% during epidemic peaks to 60% during low epidemic activity. People living in wealthy neighbourhoods were less likely to report contacts (odds ratio (OR): 1.6). People living in apartment buildings were also less likely to report contacts than those living in a house (OR: 1.1-3.1) depending on the SARS-CoV-2 variant, the building size and the presence of shops. This under-reporting of contacts in apartment buildings decreased during periods of mandatory wearing of face masks and restrictions on private gatherings.ConclusionContact tracing alone did not detect sufficient secondary infections to reduce the spread of SARS-CoV-2. Campaigns targeting specific populations, such as those in wealthy areas or apartment buildings, could enhance coverage. Additionally, measures like wearing face masks, improving ventilation and implementing restrictions on gatherings should also be considered to reduce infections resulting from interactions that may not be perceived as high risk.
Collapse
Affiliation(s)
- Denis Mongin
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nils Bürgisser
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- General internal medicine division, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | | |
Collapse
|
38
|
Fischl MJ, Young J, Kardos K, Roehler M, Miller T, Wooten M, Holmes N, Gula N, Baglivo M, Steen J, Zelenz N, Joyee AG, Munster V, Weishampel Z, Yinda CK, Rouse KG, Gvozden C, Wever D, Yanez G, Anderson M, Yu S, Bearie B, Young S, Berry JD. Development and Clinical Performance of InteliSwab ® COVID-19 Rapid Test: Evaluation of Antigen Test for the Diagnosis of SARS-CoV-2 and Analytical Sensitivity to Detect Variants of Concern Including Omicron and Subvariants. Viruses 2023; 16:61. [PMID: 38257761 PMCID: PMC10821026 DOI: 10.3390/v16010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Timely detection of SARS-CoV-2 infection with subsequent contact tracing and rapid isolation are considered critical to containing the pandemic, which continues with the emergence of new variants. Hence, there is an ongoing need for reliable point-of-care antigen rapid diagnostic tests (Ag-RDT). This report describes the development, evaluation, and analytical sensitivity of the diagnostic performance of the InteliSwab® COVID-19 Rapid Test. Methods: Samples from 165 symptomatic subjects were tested with InteliSwab® and the results were compared to RT-PCR to determine the antigen test performance. The analytical sensitivity of InteliSwab® for the detection of different variants was assessed by limit of detection (LOD) determination using recombinant nucleocapsid proteins (NPs) and testing with virus isolates. Western immunoblot independently confirmed that each monoclonal Ab is capable of binding to all variants tested thus far. RESULTS The overall positivity rate by RT-PCR was 37% for the 165 symptomatic subjects. Based on RT-PCR results as the reference standard, InteliSwab® showed clinical sensitivity and specificity of 85.2% (95% CI, 74.3-92.0%) and 98.1% (95% CI, 93.3-99.7%), respectively. The overall agreement was 93.3% (Kappa index value 0.85; 95% CI, 0.77-0.74) between RT-PCR and InteliSwab® test results. Furthermore, the evaluation of analytical sensitivity for different SARS-CoV-2 variants by InteliSwab® was comparable in the detection of all the variants tested, including Omicron subvariants, BA.4, BA.5, and BQ.1. CONCLUSIONS Due to the surge of infections caused by different variants from time to time, there is a critical need to evaluate the sensitivity of rapid antigen-detecting tests for new variants. The study findings showed the robust diagnostic performance of InteliSwab® and analytical sensitivity in detecting different SARS-CoV-2 variants, including the Omicron subvariants. With the integrated swab and excellent sensitivity and variant detection, this test has high potential as a point-of-care Ag-RDT in various settings when molecular assays are in limited supply and rapid diagnosis of SARS-CoV-2 is necessary.
Collapse
Affiliation(s)
- Mark J. Fischl
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Janean Young
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Keith Kardos
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Michele Roehler
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Tiffany Miller
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Melinda Wooten
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Natalie Holmes
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Nicole Gula
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Mia Baglivo
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Justin Steen
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Nori Zelenz
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Antony George Joyee
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Vincent Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | - Zack Weishampel
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | - Claude Kwe Yinda
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | | | | | - David Wever
- Cahaba Research Inc., Pelham, AL 35124, USA;
| | - Giralt Yanez
- South Florida Research Organization, Medley, FL 33166, USA;
| | | | - Song Yu
- Cahaba Research Inc., MedHelp Urgent Care, Birmingham, AL 32535, USA;
| | - Brian Bearie
- Urgent Care of Colton, Benchmark Research Group, Colton, CA 92324, USA
| | - Stephen Young
- TriCore Reference Laboratories, Albuquerque, NM 87102, USA;
| | - Jody D. Berry
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| |
Collapse
|
39
|
Liu AB, Lee D, Jalihal AP, Hanage WP, Springer M. Quantitatively assessing early detection strategies for mitigating COVID-19 and future pandemics. Nat Commun 2023; 14:8479. [PMID: 38123536 PMCID: PMC10733317 DOI: 10.1038/s41467-023-44199-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Researchers and policymakers have proposed systems to detect novel pathogens earlier than existing surveillance systems by monitoring samples from hospital patients, wastewater, and air travel, in order to mitigate future pandemics. How much benefit would such systems offer? We developed, empirically validated, and mathematically characterized a quantitative model that simulates disease spread and detection time for any given disease and detection system. We find that hospital monitoring could have detected COVID-19 in Wuhan 0.4 weeks earlier than it was actually discovered, at 2,300 cases (standard error: 76 cases) compared to 3,400 (standard error: 161 cases). Wastewater monitoring would not have accelerated COVID-19 detection in Wuhan, but provides benefit in smaller catchments and for asymptomatic or long-incubation diseases like polio or HIV/AIDS. Air travel monitoring does not accelerate outbreak detection in most scenarios we evaluated. In sum, early detection systems can substantially mitigate some future pandemics, but would not have changed the course of COVID-19.
Collapse
Affiliation(s)
- Andrew Bo Liu
- Department of Systems Biology, Harvard Medical School, Boston, MA, USA.
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
| | - Daniel Lee
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - William P Hanage
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michael Springer
- Department of Systems Biology, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
40
|
Thieme AH, Gertler M, Piening BC, Maechler F, Benzler J, Hartmann C, Heumann P, Seybold J, Kirchberger V, Budach V, Mockenhaupt F, Mittermaier M. Clinical evaluation of a web-based personalized recommendation system with electronic health record interface to optimize healthcare resources during SARS-CoV-2 surges. Sci Rep 2023; 13:22498. [PMID: 38110426 PMCID: PMC10728075 DOI: 10.1038/s41598-023-48325-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 11/24/2023] [Indexed: 12/20/2023] Open
Abstract
During the SARS-CoV-2 pandemic, the German healthcare system faced challenges of efficiently allocating testing resources. To address this, we developed an open-source personalized recommendation system (PRS) called "CovApp". The PRS utilized a questionnaire to estimate the risk of infection, provided personalized recommendations such as testing, self-isolation, or quarantine, and featured QR code data transmission to electronic health records. The PRS served up to 2.5 million monthly users and received 67,000 backlinks from 1800 domains. We clinically evaluated the PRS at the SARS-CoV-2 testing facility at Charité and observed a 21.7% increase in patient throughput per hour and a 22.5% increase in patients per day. Patients using the PRS were twice as likely to belong to the High Risk group eligible for testing (18.6% vs. 8.9%, p < 0.0001), indicating successful compliance with CovApp's recommendations. CovApp served as a digital bridge between the population and medical staff and significantly improved testing efficiency. As an open-source platform, CovApp can be readily customized to address emerging public health crises. Further, given the EHR interface, the app is of great utility for other applications in clinical settings.
Collapse
Affiliation(s)
- Alexander Henry Thieme
- Department of Medicine and Biomedical Data Science, Stanford University, Stanford, CA, 94305, USA.
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- Berlin Institute of Health (BIH), 10178, Berlin, Germany.
| | - Maximilian Gertler
- Charité Centre for Global Health, Institute of International Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Brar Christian Piening
- Institute of Hygiene and Environmental Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friederike Maechler
- Institute of Hygiene and Environmental Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Claudia Hartmann
- Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Peter Heumann
- Department of Clinical Procedures GB-IT, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Joachim Seybold
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Volker Budach
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Frank Mockenhaupt
- Charité Centre for Global Health, Institute of International Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Mirja Mittermaier
- Berlin Institute of Health (BIH), 10178, Berlin, Germany
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|
41
|
Italia M, Della Rossa F, Dercole F. Model-informed health and socio-economic benefits of enhancing global equity and access to Covid-19 vaccines. Sci Rep 2023; 13:21707. [PMID: 38066204 PMCID: PMC10709334 DOI: 10.1038/s41598-023-48465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
We take a model-informed approach to the view that a global equitable access (GEA) to Covid-19 vaccines is the key to bring this pandemic to an end. We show that the equitable redistribution (proportional to population size) of the currently available vaccines is not sufficient to stop the pandemic, whereas a 60% increase in vaccine access (the global share of vaccinated people) would have allowed the current distribution to stop the pandemic in about a year of vaccination, saving millions of people in poor countries. We then investigate the interplay between access to vaccines and their distribution among rich and poor countries, showing that the access increase to stop the pandemic gets minimized at + 32% by the equitable distribution (- 36% in rich countries and + 60% in poor ones). To estimate the socio-economic benefits of a vaccination campaign with enhanced global equity and access (eGEA), we compare calibrated simulations of the current scenario with a hypothetical, vaccination-intensive scenario that assumes high rollouts (shown however by many rich and poor countries during the 2021-2022 vaccination campaign) and an improved equity from the current 2.5:1 to a 2:1 rich/poor-ratio of the population fractions vaccinated per day. Assuming that the corresponding + 130% of vaccine production is made possible by an Intellectual Property waiver, we show that the money saved on vaccines globally by the selected eGEA scenario overcomes the 5-year profit of the rights holders in the current situation. This justifies compensation mechanisms in exchange for the necessary licensing agreements. The good news is that the benefits of this eGEA scenario are still relevant, were we ready to implement it now.
Collapse
Affiliation(s)
- Matteo Italia
- Department of Electronic, Information, and Bioengineering, Politecnico di Milano, Milan, Italy.
| | - Fabio Della Rossa
- Department of Electronic, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Fabio Dercole
- Department of Electronic, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| |
Collapse
|
42
|
Patón M, Acuña JM, Rodríguez J. Evaluation of vaccine rollout strategies for emerging infectious diseases: A model-based approach including protection attitudes. Infect Dis Model 2023; 8:1032-1049. [PMID: 37674584 PMCID: PMC10477745 DOI: 10.1016/j.idm.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 09/08/2023] Open
Abstract
Vaccine allocation strategies become crucial during vaccine shortages, especially in the face of potential outbreaks of new infectious diseases, as witnessed during the COVID-19 pandemic. To address this, a specialized compartmental model is created, which simulates an emerging infectious disease similar to COVID-19. This model divides the population into different age groups and is used to compare various vaccine prioritisation approaches, aiming to minimize the total number of fatalities. The model is an improvement upon previous ones as it incorporates essential behavioural factors and is adapted to account for the protective effects of vaccination against both disease infection and transmission. It takes into account human behaviors such as mask-wearing and social distancing by utilizing specific parameters related to self-protection, awareness levels, and the frequency of daily person-to-person interactions within each age group. Furthermore, a novel method for dynamic vaccine prioritisation was introduced in this study. This approach is model-independent and relies on the dynamic R number. It is the first time such a method has been developed, offering a decision-making approach that is not tied to any specific model. This innovation provides a flexible and adaptable strategy for determining vaccine priorities based on real-time data and the current state of the outbreak. Our findings reveal crucial insights into vaccine allocation strategies. When the daily rollout rates are fast (0.75% or higher) and children are eligible for vaccination, prioritising groups with high daily person-to-person interactions can lead to substantial reductions in total fatalities (up to approximately 40% lower). On the other hand, if rollout rates are slower and overall vaccination coverage is high, focusing on vaccinating elders emerges as the most effective strategy, resulting in up to approximately 10% fewer fatalities. However, the scenario changes significantly when children are not eligible for vaccination, as they constitute a highly interactive population group. In this case, the differences between priority strategies become smaller. With fast daily rollout rates, prioritisation based on interactions achieves only a 7% reduction in total fatalities, while a slower rollout with vaccination of elders first leads to an approximately 11% reduction in fatalities compared to the scenario where children are eligible for vaccination. The impact of behavioural parameters is equally critical. When the self-protection levels exercised by the population are low, it significantly affects the optimal vaccine prioritisation strategy to be followed, making it essential to consider behavioural factors in decision-making.
Collapse
Affiliation(s)
- Mauricio Patón
- Department of Chemical Engineering, College of Engineering, Khalifa University, SAN Campus PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Juan M. Acuña
- Department of Epidemiology and Public Health, College of Medicine. Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Jorge Rodríguez
- Department of Chemical Engineering, College of Engineering, Khalifa University, SAN Campus PO Box 127788, Abu Dhabi, United Arab Emirates
| |
Collapse
|
43
|
Juneau CE, Briand AS, Collazzo P, Siebert U, Pueyo T. Effective contact tracing for COVID-19: A systematic review. GLOBAL EPIDEMIOLOGY 2023; 5:100103. [PMID: 36959868 PMCID: PMC9997056 DOI: 10.1016/j.gloepi.2023.100103] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/19/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Contact tracing is commonly recommended to control outbreaks of COVID-19, but its effectiveness is unclear. Following PRISMA guidelines, we searched four databases using a range of terms related to contact tracing effectiveness for COVID-19. We found 343 papers; 32 were included. All were observational or modelling studies. Observational studies (n = 14) provided consistent, very-low certainty evidence that contact tracing (alone or in combination with other interventions) was associated with better control of COVID-19 (e.g. in Hong Kong, only 1084 cases and four deaths were recorded in the first 4.5 months of the pandemic). Modelling studies (n = 18) provided consistent, high-certainty evidence that under assumptions of prompt and thorough tracing with effective quarantines, contact tracing could stop the spread of COVID-19 (e.g. by reducing the reproduction number from 2.2 to 0.57). A cautious interpretation indicates that to stop the spread of COVID-19, public health practitioners have 2-3 days from the time a new case develops symptoms to isolate the case and quarantine at least 80% of its contacts.
Collapse
Affiliation(s)
- Carl-Etienne Juneau
- Direction régionale de santé publique, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Anne-Sara Briand
- École de santé publique, Université de Montréal, Montréal, Québec, Canada
| | - Pablo Collazzo
- Danube University Krems, Dr. Karl Dorrek-Strasse 30, 3500 Krems, Austria and IEEM Universidad de Montevideo, Lord Ponsonby 2542, 16000 Montevideo, Uruguay
| | - Uwe Siebert
- Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Austria
| | | |
Collapse
|
44
|
Stocks D, Nixon E, Trickey A, Homer M, Brooks-Pollock E. Limited impact of contact tracing in a University setting for COVID-19 due to asymptomatic transmission and social distancing. Epidemics 2023; 45:100716. [PMID: 37690279 DOI: 10.1016/j.epidem.2023.100716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 06/21/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023] Open
Abstract
Contact tracing is an important tool for controlling the spread of infectious diseases, including COVID-19. Here, we investigate the spread of COVID-19 and the effectiveness of contact tracing in a university population, using a data-driven ego-centric network model constructed with social contact data collected during 2020 and similar data collected in 2010. We find that during 2020, university staff and students consistently reported fewer social contacts than in 2010, however those contacts occurred more frequently and were of longer duration. We find that contact tracing in the presence of social distancing is less impactful than without social distancing. By combining multiple data sources, we show that University-aged populations are likely to develop asymptomatic COVID-19 infections. We find that asymptomatic index cases cannot be reliably discovered through contact tracing and consequently transmission in their social network is not significantly reduced through contact tracing. In summary, social distancing restrictions had a large impact on limiting COVID-19 outbreaks in universities; to reduce transmission further contact tracing should be used in conjunction with alternative interventions.
Collapse
Affiliation(s)
- Daniel Stocks
- Department of Engineering Mathematics, University of Bristol, Bristol BS8 1TW, United Kingdom.
| | - Emily Nixon
- School of Biological Sciences, University of Bristol, Bristol BS8 1TQ, United Kingdom; Bristol Veterinary School, University of Bristol, Bristol BS40 5DU, United Kingdom
| | - Adam Trickey
- Population Health Sciences, University of Bristol, Bristol BS8 1TW, United Kingdom
| | - Martin Homer
- Department of Engineering Mathematics, University of Bristol, Bristol BS8 1TW, United Kingdom
| | - Ellen Brooks-Pollock
- Bristol Veterinary School, University of Bristol, Bristol BS40 5DU, United Kingdom
| |
Collapse
|
45
|
Jiang H, Gu Z, Liu H, Huang J, Wang Z, Xiong Y, Tong Y, Yin J, Jiang F, Chen Y, Jiang Q, Zhou Y. Evaluation of phase-adjusted interventions for COVID-19 using an improved SEIR model. Epidemiol Infect 2023; 152:e9. [PMID: 37953743 PMCID: PMC10789923 DOI: 10.1017/s0950268823001796] [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: 06/24/2022] [Revised: 11/29/2022] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
A local COVID-19 outbreak with two community clusters occurred in a large industrial city, Shaoxing, China, in December 2021 after serial interventions were imposed. We aimed to understand the reason by analysing the characteristics of the outbreak and evaluating the effects of phase-adjusted interventions. Publicly available data from 7 December 2021 to 25 January 2022 were collected to analyse the epidemiological characteristics of this outbreak. The incubation period was estimated using Hamiltonian Monte Carlo method. A well-fitted extended susceptible-exposed-infectious-recovered model was used to simulate the impact of different interventions under various combination of scenarios. There were 387 SARS-CoV-2-infected cases identified, and 8.3% of them were initially diagnosed as asymptomatic cases. The estimated incubation period was 5.4 (95% CI 5.2-5.7) days for all patients. Strengthened measures of comprehensive quarantine based on tracing led to less infections and a shorter duration of epidemic. With a same period of incubation, comprehensive quarantine was more effective in containing the transmission than other interventions. Our findings reveal an important role of tracing and comprehensive quarantine in blocking community spread when a cluster occurred. Regions with tense resources can adopt home quarantine as a relatively affordable and low-impact intervention measure compared with centralized quarantine.
Collapse
Affiliation(s)
- Honglin Jiang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Zhouhong Gu
- Fudan University School of Computer Science and Technology, Shanghai, China
| | - Haitong Liu
- School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Junhui Huang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Zhengzhong Wang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Ying Xiong
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Yixin Tong
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Jiangfan Yin
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Feng Jiang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Qingwu Jiang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Yibiao Zhou
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| |
Collapse
|
46
|
Dorabawila V, Maduka D, Barnes V, Ramesh N, Hoefer D. Contact tracing: Characteristics of COVID-19 cases that provided contacts. PLoS One 2023; 18:e0293208. [PMID: 37917769 PMCID: PMC10621982 DOI: 10.1371/journal.pone.0293208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/08/2023] [Indexed: 11/04/2023] Open
Abstract
This cross-sectional study evaluated COVID-19 contact tracing efforts to identify variations in contact tracing outcomes in different population subgroups. Contact tracing was a critical tool to slow the COVID-19 epidemic. A literature gap evaluating contact tracing elicitation exits, particularly on prioritized groups. We analyzed data from COVID-19 cases linking statewide case management, immunization, laboratory testing, and hospitalization databases in New York State (NYS) outside of New York City from February 1 to November 30, 2021. Focus was cases in home-based residential settings (excluding congregate care) and prioritized groups (educational institutions, large households, close quarters, higher-risk persons, hospitalized). The primary outcome was completed interviews that provided a contact. Of the 550,850 cases interviewed during the study period, 316,645 (57.5%) provided at least one contact. Adults aged 18 to 49 years were most likely to provide contacts than those aged 65 years and older (adjusted odds ratio [aOR], 1.42; 95% confidence interval [CI], 1.39-1.45). Compared to unvaccinated cases, boosted individuals (aOR, 1.61; 95% CI, 1.50-1.73) were most likely to provide contacts, followed by persons with only a primary vaccine series (aOR, 1.3; 95%CI, 1.28-1.33) and partially vaccinated (aOR, 1.21; 95%CI, 1.18-1.24). Repeat cases (aOR, 1.07; 95%CI, 1.01-1.14), pregnant persons (aOR, 1.26; 95% CI, 1,19-1.34), those with underlying conditions (aOR 1.22; 95%CI, 1.20-1.23), and those in K-12 settings (aOR 1.55; 95%CI, 1.50-1.61) were more likely to provide contacts. There was no clear association between hospitalized, while zip code level income may (aOR, 1.006; 95%CI, 1.003, 1.009). Persons from larger households were more likely to provide contacts: aOR for two or more persons vs. one person households ranged from 2.49 to 4.7 (95%CI, 2.20-4.78). Our findings indicate success in eliciting contacts from prioritized groups and identify variable contact elicitation outcomes from different population groups. These results may serve as a tool for future contact tracing efforts.
Collapse
Affiliation(s)
- Vajeera Dorabawila
- Bureau of Surveillance and Data Systems, New York State Department of Health, Albany, New York, United States of America
| | - Doris Maduka
- Bureau of Surveillance and Data Systems, New York State Department of Health, Albany, New York, United States of America
| | - Virgile Barnes
- Bureau of Surveillance and Data Systems, New York State Department of Health, Albany, New York, United States of America
| | - Nirmala Ramesh
- Bureau of Surveillance and Data Systems, New York State Department of Health, Albany, New York, United States of America
| | - Dina Hoefer
- Bureau of Surveillance and Data Systems, New York State Department of Health, Albany, New York, United States of America
| |
Collapse
|
47
|
Shang ZZ. Security or severity? A research of COVID-19 pandemic control policy based on nonlinear programming approach. Heliyon 2023; 9:e21080. [PMID: 38027929 PMCID: PMC10661509 DOI: 10.1016/j.heliyon.2023.e21080] [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: 04/04/2023] [Revised: 10/05/2023] [Accepted: 10/15/2023] [Indexed: 12/01/2023] Open
Abstract
The COVID-19 pandemic has caused huge impacts to human health and world's econ-omy. Finding out the balance between social productions and pandemic control becomes crucial. In this paper, we first extend the SIR model by introducing two new status. We calibrate the model by 2022 Shanghai COVID-19 outbreak. The results shows compared to zero-constraint policy, under our control policy, 50 % more life can be saved at the cost of 2.13 % loss of consumptions. Our results also emphasize the importance of the dynamic nature and the timing of control policy, either a static pandemic control or a lagged pandemic control damages badly to people's livelihood and social productions. Counter factual experiments show that compared to the baseline, when a persistent high-strength control is applied, aggregate productions decreases by 57 %; when pandemic control ends too early, the death would rise by 15 %, when pandemic control starts too late, the death rises by 23 % and aggregate productions decreases by 13 %.
Collapse
Affiliation(s)
- Ze Zhong Shang
- China Jiliang University, Faculty of Economics and Management, Xueyuan Street, HangZhou, 310000, Zhejiang, China
| |
Collapse
|
48
|
Okolie A, Müller J, Kretzschmar M. Parameter estimation for contact tracing in graph-based models. J R Soc Interface 2023; 20:20230409. [PMID: 37989228 PMCID: PMC10668870 DOI: 10.1098/rsif.2023.0409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/01/2023] [Indexed: 11/23/2023] Open
Abstract
We adopt a maximum-likelihood framework to estimate parameters of a stochastic susceptible-infected-recovered (SIR) model with contact tracing on a rooted random tree. Given the number of detectees per index case, our estimator allows to determine the degree distribution of the random tree as well as the tracing probability. Since we do not discover all infectees via contact tracing, this estimation is non-trivial. To keep things simple and stable, we develop an approximation suited for realistic situations (contract tracing probability small, or the probability for the detection of index cases small). In this approximation, the only epidemiological parameter entering the estimator is R0. The estimator is tested in a simulation study and is furthermore applied to COVID-19 contact tracing data from India. The simulation study underlines the efficiency of the method. For the empirical COVID-19 data, we compare different degree distributions and perform a sensitivity analysis. We find that particularly a power-law and a negative binomial degree distribution fit the data well and that the tracing probability is rather large. The sensitivity analysis shows no strong dependency of the estimates on the reproduction number. Finally, we discuss the relevance of our findings.
Collapse
Affiliation(s)
- Augustine Okolie
- Center for Mathematical Sciences, Technische Universität München, 85748 Garching, Germany
| | - Johannes Müller
- Center for Mathematical Sciences, Technische Universität München, 85748 Garching, Germany
- Institute for Computational Biology, Helmholtz Center Munich, 85764 Neuherberg, Germany
| | - Mirjam Kretzschmar
- University Medical Center Utrecht, Utrecht University, 3584CX Utrecht, The Netherlands
| |
Collapse
|
49
|
de Meijere G, Castellano C. Limited efficacy of forward contact tracing in epidemics. Phys Rev E 2023; 108:054305. [PMID: 38115421 DOI: 10.1103/physreve.108.054305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/16/2023] [Indexed: 12/21/2023]
Abstract
Infectious diseases that spread silently through asymptomatic or pre-symptomatic infections represent a challenge for policy makers. A traditional way of achieving isolation of silent infectors from the community is through forward contact tracing, aimed at identifying individuals that might have been infected by a known infected person. In this work we investigate how efficient this measure is in preventing a disease from becoming endemic. We introduce an SIS-based compartmental model where symptomatic individuals may self-isolate and trigger a contact tracing process aimed at quarantining asymptomatic infected individuals. Imperfect adherence and delays affect both measures. We derive the epidemic threshold analytically and find that contact tracing alone can only lead to a very limited increase of the threshold. We quantify the effect of imperfect adherence and the impact of incentivizing asymptomatic and symptomatic populations to adhere to isolation. Our analytical results are confirmed by simulations on complex networks and by the numerical analysis of a much more complex model incorporating more realistic in-host disease progression.
Collapse
Affiliation(s)
- Giulia de Meijere
- Gran Sasso Science Institute, Viale F. Crispi 7, 67100 L'Aquila, Italy
- Istituto dei Sistemi Complessi (ISC-CNR), Via dei Taurini 19, I-00185 Roma, Italy
| | - Claudio Castellano
- Istituto dei Sistemi Complessi (ISC-CNR), Via dei Taurini 19, I-00185 Roma, Italy
- Centro Ricerche Enrico Fermi, Piazza del Viminale, 1, I-00184 Rome, Italy
| |
Collapse
|
50
|
Kremer C, Willem L, Boone J, Arrazola de Oñate W, Hammami N, Faes C, Hens N. Key performance indicators of COVID-19 contact tracing in Belgium from September 2020 to December 2021. PLoS One 2023; 18:e0292346. [PMID: 37862313 PMCID: PMC10588862 DOI: 10.1371/journal.pone.0292346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 09/18/2023] [Indexed: 10/22/2023] Open
Abstract
The goal of tracing, testing, and quarantining contacts of infected individuals is to contain the spread of infectious diseases, a strategy widely used during the COVID-19 pandemic. However, limited research exists on the effectiveness of contact tracing, especially with regard to key performance indicators (KPIs), such as the proportion of cases arising from previously identified contacts. In our study, we analyzed contact tracing data from Belgium collected between September 2020 and December 2021 to assess the impact of contact tracing on SARS-CoV-2 transmission and understand its characteristics. Among confirmed cases involved in contact tracing in the Flemish and Brussels-Capital regions, 19.1% were previously identified as close contacts and were aware of prior exposure. These cases, referred to as 'known' to contact tracing operators, reported on average fewer close contacts compared to newly identified individuals (0.80 versus 1.05), resulting in fewer secondary cases (0.23 versus 0.28). Additionally, we calculated the secondary attack rate, representing infections per contact, which was on average lower for the 'known' cases (0.22 versus 0.25) between December 2020 and August 2021. These findings indicate the effectiveness of contact tracing in Belgium in reducing SARS-CoV-2 transmission. Although we were unable to quantify the exact number of prevented cases, our findings emphasize the importance of contact tracing as a public health measure. In addition, contact tracing data provide indications of potential shifts in transmission patterns among different age groups associated with emerging variants of concern and increasing vaccination rates.
Collapse
Affiliation(s)
- Cécile Kremer
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Lander Willem
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Jorden Boone
- KPMG Advisory, Public Sector Practice, Zaventem, Belgium
| | - Wouter Arrazola de Oñate
- Belgian Lung and Tuberculosis Association, Brussels, Belgium
- Flemish Association for Respiratory Health and Tuberculosis, Leuven, Belgium
| | - Naïma Hammami
- Department of Infectious Disease Prevention and Control, Department of Care, Flemish Region, Brussels, Belgium
| | - Christel Faes
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Niel Hens
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| |
Collapse
|