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Fumagalli R. Please wear a mask: a systematic case for mask wearing mandates. JOURNAL OF MEDICAL ETHICS 2024; 50:501-510. [PMID: 36810325 PMCID: PMC11228218 DOI: 10.1136/jme-2022-108736] [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: 11/08/2022] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
This paper combines considerations from ethics, medicine and public health policy to articulate and defend a systematic case for mask wearing mandates (MWM). The paper argues for two main claims of general interest in favour of MWM. First, MWM provide a more effective, just and fair way to tackle the ongoing COVID-19 pandemic than policy alternatives such as laissez-faire approaches, mask wearing recommendations and physical distancing measures. And second, the proffered objections against MWM may justify some exemptions for specific categories of individuals, but do not cast doubt on the justifiability of these mandates. Hence, unless some novel decisive objections are put forward against MWM, governments should adopt MWM.
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Affiliation(s)
- Roberto Fumagalli
- Political Economy, King's College London, London, UK
- Philosophy, The London School of Economics and Political Science, London, UK
- Behavioral Ethics Lab, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Greenhalgh T, MacIntyre CR, Baker MG, Bhattacharjee S, Chughtai AA, Fisman D, Kunasekaran M, Kvalsvig A, Lupton D, Oliver M, Tawfiq E, Ungrin M, Vipond J. Masks and respirators for prevention of respiratory infections: a state of the science review. Clin Microbiol Rev 2024; 37:e0012423. [PMID: 38775460 DOI: 10.1128/cmr.00124-23] [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: 06/14/2024] Open
Abstract
SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Shovon Bhattacharjee
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
| | - Abrar A Chughtai
- School of Population Health, University of New South Wales, Sydney, Australia
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Deborah Lupton
- Centre for Social Research in Health and Social Policy Research Centre, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
| | - Matt Oliver
- Professional Standards Advocate, Edmonton, Canada
| | - Essa Tawfiq
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Ungrin
- Faculty of Veterinary Medicine; Department of Biomedical Engineering, Schulich School of Engineering; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joe Vipond
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Pasco R, Fox SJ, Lachmann M, Meyers LA. Effectiveness of interventions to reduce COVID-19 transmission in schools. Epidemics 2024; 47:100762. [PMID: 38489849 DOI: 10.1016/j.epidem.2024.100762] [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: 06/27/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/17/2024] Open
Abstract
School reopenings in 2021 and 2022 coincided with the rapid emergence of new SARS-CoV-2 variants in the United States. In-school mitigation efforts varied, depending on local COVID-19 mandates and resources. Using a stochastic age-stratified agent-based model of SARS-CoV-2 transmission, we estimate the impacts of multiple in-school strategies on both infection rates and absenteeism, relative to a baseline scenario in which only symptomatic cases are tested and positive tests trigger a 10-day isolation of the case and 10-day quarantine of their household and classroom. We find that monthly asymptomatic screening coupled with the 10-day isolation and quarantine period is expected to avert 55.4% of infections while increasing absenteeism by 104.3%. Replacing quarantine with test-to-stay would reduce absenteeism by 66.3% (while hardly impacting infection rates), but would require roughly 10-fold more testing resources. Alternatively, vaccination or mask wearing by 50% of the student body is expected to avert 54.1% or 43.1% of infections while decreasing absenteeism by 34.1% or 27.4%, respectively. Separating students into classrooms based on mask usage is expected to reduce infection risks among those who wear masks (by 23.1%), exacerbate risks among those who do not (by 27.8%), but have little impact on overall risk. A combined strategy of monthly screening, household and classroom quarantine, a 50% vaccination rate, and a 50% masking rate (in mixed classrooms) is expected to avert 81.7% of infections while increasing absenteeism by 90.6%. During future public health emergencies, such analyses can inform the rapid design of resource-constrained strategies that mitigate both public health and educational risks.
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Affiliation(s)
- Remy Pasco
- Integrative Biology, The University of Texas at Austin, Austin, TX,USA
| | - Spencer J Fox
- Department of Epidemiology & Biostatistics, University of Georgia, Athens, GA, USA
| | - Michael Lachmann
- Department of Epidemiology & Biostatistics, University of Georgia, Athens, GA, USA
| | - Lauren Ancel Meyers
- Integrative Biology, The University of Texas at Austin, Austin, TX,USA; Santa Fe Institute, Santa Fe, NM, USA.
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4
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Bartsch SM, Weatherwax C, Martinez MF, Chin KL, Wasserman MR, Singh RD, Heneghan JL, Gussin GM, Scannell SA, White C, Leff B, Huang SS, Lee BY. Cost-effectiveness of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) testing and isolation strategies in nursing homes. Infect Control Hosp Epidemiol 2024; 45:754-761. [PMID: 38356377 PMCID: PMC11102288 DOI: 10.1017/ice.2024.9] [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] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Nursing home residents may be particularly vulnerable to coronavirus disease 2019 (COVID-19). Therefore, a question is when and how often nursing homes should test staff for COVID-19 and how this may change as severe acute respiratory coronavirus virus 2 (SARS-CoV-2) evolves. DESIGN We developed an agent-based model representing a typical nursing home, COVID-19 spread, and its health and economic outcomes to determine the clinical and economic value of various screening and isolation strategies and how it may change under various circumstances. RESULTS Under winter 2023-2024 SARS-CoV-2 omicron variant conditions, symptom-based antigen testing averted 4.5 COVID-19 cases compared to no testing, saving $191 in direct medical costs. Testing implementation costs far outweighed these savings, resulting in net costs of $990 from the Centers for Medicare & Medicaid Services perspective, $1,545 from the third-party payer perspective, and $57,155 from the societal perspective. Testing did not return sufficient positive health effects to make it cost-effective [$50,000 per quality-adjusted life-year (QALY) threshold], but it exceeded this threshold in ≥59% of simulation trials. Testing remained cost-ineffective when routinely testing staff and varying face mask compliance, vaccine efficacy, and booster coverage. However, all antigen testing strategies became cost-effective (≤$31,906 per QALY) or cost saving (saving ≤$18,372) when the severe outcome risk was ≥3 times higher than that of current omicron variants. CONCLUSIONS SARS-CoV-2 testing costs outweighed benefits under winter 2023-2024 conditions; however, testing became cost-effective with increasingly severe clinical outcomes. Cost-effectiveness can change as the epidemic evolves because it depends on clinical severity and other intervention use. Thus, nursing home administrators and policy makers should monitor and evaluate viral virulence and other interventions over time.
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Affiliation(s)
- Sarah M Bartsch
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, New York
| | - Colleen Weatherwax
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, New York
| | - Marie F Martinez
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, New York
| | - Kevin L Chin
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, New York
| | - Michael R Wasserman
- Los Angeles Jewish Home, Reseda, California
- California Association of Long Term Care Medicine, Santa Clarita, California
| | - Raveena D Singh
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California
| | - Jessie L Heneghan
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, New York
| | - Gabrielle M Gussin
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California
| | - Sheryl A Scannell
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, New York
| | - Cameron White
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, New York
| | - Bruce Leff
- Center for Transformative Geriatric Research, Division of Geriatric Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Susan S Huang
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California
| | - Bruce Y Lee
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, New York
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, New York
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Park J, Joo H, Kim D, Mase S, Christensen D, Maskery BA. Cost-effectiveness of mask mandates on subways to prevent SARS-CoV-2 transmission in the United States. PLoS One 2024; 19:e0302199. [PMID: 38748706 PMCID: PMC11095714 DOI: 10.1371/journal.pone.0302199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/30/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Community-based mask wearing has been shown to reduce the transmission of SARS-CoV-2. However, few studies have conducted an economic evaluation of mask mandates, specifically in public transportation settings. This study evaluated the cost-effectiveness of implementing mask mandates for subway passengers in the United States by evaluating its potential to reduce COVID-19 transmission during subway travel. MATERIALS AND METHODS We assessed the health impacts and costs of subway mask mandates compared to mask recommendations based on the number of infections that would occur during subway travel in the U.S. Using a combined box and Wells-Riley infection model, we estimated monthly infections, hospitalizations, and deaths averted under a mask mandate scenario as compared to a mask recommendation scenario. The analysis included costs of implementing mask mandates and COVID-19 treatment from a limited societal perspective. The cost-effectiveness (net cost per averted death) of mandates was estimated for three different periods based on dominant SARS-CoV-2 variants: Alpha, Beta, and Gamma (November 2020 to February 2021); Delta (July to October 2021); and early Omicron (January to March 2022). RESULTS Compared with mask recommendations only, mask mandates were cost-effective across all periods, with costs per averted death less than a threshold of $11.4 million (ranging from cost-saving to $3 million per averted death). Additionally, mask mandates were more cost-effective during the early Omicron period than the other two periods and were cost saving in January 2022. Our findings showed that mandates remained cost-effective when accounting for uncertainties in input parameters (e.g., even if mandates only resulted in small increases in mask usage by subway ridership). CONCLUSIONS The findings highlight the economic value of mask mandates on subways, particularly during high virus transmissibility periods, during the COVID-19 pandemic. This study may inform stakeholders on mask mandate decisions during future outbreaks of novel viral respiratory diseases.
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Affiliation(s)
- Joohyun Park
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Heesoo Joo
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Daniel Kim
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
- Georgia Institute of Technology, H. Milton Stewart School of Industrial and Systems Engineering, Atlanta, Georgia, United States of America
| | - Sundari Mase
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Deborah Christensen
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Brian A. Maskery
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Bartsch SM, Weatherwax C, Wasserman MR, Chin KL, Martinez MF, Velmurugan K, Singh RD, John DC, Heneghan JL, Gussin GM, Scannell SA, Tsintsifas AC, O'Shea KJ, Dibbs AM, Leff B, Huang SS, Lee BY. How the Timing of Annual COVID-19 Vaccination of Nursing Home Residents and Staff Affects Its Value. J Am Med Dir Assoc 2024; 25:639-646.e5. [PMID: 38432644 PMCID: PMC10990766 DOI: 10.1016/j.jamda.2024.02.005] [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: 08/18/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES To evaluate the epidemiologic, clinical, and economic value of an annual nursing home (NH) COVID-19 vaccine campaign and the impact of when vaccination starts. DESIGN Agent-based model representing a typical NH. SETTING AND PARTICIPANTS NH residents and staff. METHODS We used the model representing an NH with 100 residents, its staff, their interactions, COVID-19 spread, and its health and economic outcomes to evaluate the epidemiologic, clinical, and economic value of varying schedules of annual COVID-19 vaccine campaigns. RESULTS Across a range of scenarios with a 60% vaccine efficacy that wanes starting 4 months after protection onset, vaccination was cost saving or cost-effective when initiated in the late summer or early fall. Annual vaccination averted 102 to 105 COVID-19 cases when 30-day vaccination campaigns began between July and October (varying with vaccination start), decreasing to 97 and 85 cases when starting in November and December, respectively. Starting vaccination between July and December saved $3340 to $4363 and $64,375 to $77,548 from the Centers for Medicare & Medicaid Services and societal perspectives, respectively (varying with vaccination start). Vaccination's value did not change when varying the COVID-19 peak between December and February. The ideal vaccine campaign timing was not affected by reducing COVID-19 levels in the community, or varying transmission probability, preexisting immunity, or COVID-19 severity. However, if vaccine efficacy wanes more quickly (over 1 month), earlier vaccination in July resulted in more cases compared with vaccinating later in October. CONCLUSIONS AND IMPLICATIONS Annual vaccination of NH staff and residents averted the most cases when initiated in the late summer through early fall, at least 2 months before the COVID-19 winter peak but remained cost saving or cost-effective when it starts in the same month as the peak. This supports tethering COVID vaccination to seasonal influenza campaigns (typically in September-October) for providing protection against SARS-CoV-2 winter surges in NHs.
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Affiliation(s)
- Sarah M Bartsch
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Colleen Weatherwax
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | | | - Kevin L Chin
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Marie F Martinez
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Kavya Velmurugan
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Raveena D Singh
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Danielle C John
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Pandemic Response Institute, New York City, NY, USA
| | - Jessie L Heneghan
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Gabrielle M Gussin
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Sheryl A Scannell
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Alexandra C Tsintsifas
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Kelly J O'Shea
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Alexis M Dibbs
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Bruce Leff
- Division of Geriatric Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Susan S Huang
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Bruce Y Lee
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA; Pandemic Response Institute, New York City, NY, USA.
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Janse van Rensburg DC, Jansen van Rensburg A, Botha T, Elliott K, Ramagole D, Pillay L, Hendricks S, Eyden D, Arnott C, Stevens DJ. Effects of no mask, a surgical mask and a fabric buff on peripheral oxygenation saturation during moderate intensity exercise: a randomised cross-over study. J Thorac Dis 2024; 16:1854-1865. [PMID: 38617788 PMCID: PMC11009602 DOI: 10.21037/jtd-23-1178] [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: 07/28/2023] [Accepted: 12/15/2023] [Indexed: 04/16/2024]
Abstract
Background Mask-wearing caused significant reductions in coronavirus disease 2019 (COVID-19) transmission. We aimed to determine whether face mask-wearing during exercise caused reductions in peripheral oxygen saturation (SpO2) and whether it affected secondary physiological measures [end-tidal carbon dioxide (EtCO2), respiratory rate (RR), heart rate (HR), expired breath temperature (EBT)]. Subjective measurements included ratings of perceived exertion (RPE), ratings of perceived breathlessness (RPB), and symptomology. Methods A randomised cross-over trial examined no mask (NM), surgical mask (SM) and a buff mask (BM). Thirty participants (30-45 years) cycled at 60% power output for 30 min in three exercise sessions, 24 h apart, within 6 days. Each session recorded all measures at resting baseline (T0), 9 min (T1), 18 min (T2), and 27 min (T3). Dependent statistical tests determined significant differences between masks and time-points. Results SpO2 decreased for SM and BM between T0 compared to T1, T2 and T3 (all P<0.005). BM caused significant reductions at T1 and T2 compared to NM (P<0.001 and P=0.018). Significant changes in EtCO2 and EBT occurred throughout exercise and between exercise stages for all mask conditions (P<0.001). As expected for moderate intensity exercise, RR and HR were significantly higher during exercise compared to T0 (P<0.001). RPB significantly increased for each condition at each time point (P<0.001). RPE was not significant between mask conditions at any exercise stage. Conclusions SM and BM caused a mild but sustained reduction in SpO2 at commencement of exercise, which did not worsen throughout short (<30 min) moderate intensity exercise. Level of perception was similar, suggesting healthy people can wear masks during moderate exercise and activities of daily living.
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Affiliation(s)
| | | | - Tanita Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
| | - Kirsty Elliott
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Dimakatso Ramagole
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Lervasen Pillay
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Shona Hendricks
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Devlin Eyden
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Claire Arnott
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - David James Stevens
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
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Wang CW, de Jong EP, Faure JA, Ellington JL, Chen CHS, Chan CC. Exploring the Barriers and Facilitators of Mask-Wearing Behavior During the COVID-19 Pandemic in Taiwan, the United States, the Netherlands, and Haiti: A Qualitative Study. Disaster Med Public Health Prep 2024; 18:e23. [PMID: 38351541 DOI: 10.1017/dmp.2024.4] [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: 02/16/2024]
Abstract
OBJECTIVE This study explored the barriers and facilitators of mask-wearing behaviors during the pandemic in Taiwan, the United States, the Netherlands, and Haiti. METHODS Face-to-face interviews were conducted in Taiwan and online interviews were conducted with participants in the United States, the Netherlands, and Haiti. RESULTS In general, the habit of wearing a mask before coronavirus disease 2019 (COVID-19) was reported by Taiwanese participants. Additionally, Taiwanese participants perceived that wearing a mask was a social responsibility during the pandemic, suggesting that the collectivistic context might influence mask-wearing behavior. Unlike the Taiwanese population, some people in the United States and the Netherlands were reluctant to wear masks due to perceived restrictions on their freedom. Participants from Haiti mentioned that people who wore masks encountered violence, bullying, and discrimination. The results of this study suggest that political leadership and mask mandates have a strong impact on people's mask-wearing behavior. CONCLUSIONS These findings have valuable implications for the design of diverse behavioral interventions to enhance mask-wearing as part of infectious disease preparedness. Additionally, the findings from these countries offer valuable insights for the development of effective public health interventions to enhance society's resilience during the current pandemic and future infectious disease outbreaks.
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Affiliation(s)
- Chia-Wen Wang
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Lloyd's Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore
| | - Erik Pieter de Jong
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Josemyrne Ashley Faure
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Chi-Hsin Sally Chen
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chang-Chuan Chan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
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9
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Li R, Lu P, Fairley CK, Pagán JA, Hu W, Yang Q, Zhuang G, Shen M, Li Y, Zhang L. Cost-Effectiveness of the Second COVID-19 Booster Vaccination in the USA. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:85-95. [PMID: 37910314 DOI: 10.1007/s40258-023-00844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To assess the cost effectiveness of the second COVID-19 booster vaccination with different age groups. METHODS We developed a decision-analytic Susceptible-Exposed-Infected-Recovered (SEIR)-Markov model by five age groups (0-4 years, 5-11 years 12-17 years, 18-49 years, and 50+ years) and calibrated the model by actual mortality in each age group in the USA. We conducted five scenarios to evaluate the cost effectiveness of the second booster strategy and incremental benefits if the strategy would expand to 18-49 years and 12-17 years, from a health care system perspective. The analysis was reported according to the Consolidated Health Economic Evaluation Reporting Standards 2022 statement. RESULTS Implementing the second booster strategy for those aged ≥ 50 years cost $823 million but reduced direct medical costs by $1166 million, corresponding to a benefit-cost ratio of 1.42. Moreover, the strategy also resulted in a gain of 2596 quality-adjusted life-years (QALYs) during the 180-day evaluation period, indicating it was dominant. Further, vaccinating individuals aged 18-49 years with the second booster would result in an additional gain of $1592 million and 8790 QALYs. Similarly, expanding the vaccination to individuals aged 12-17 years would result in an additional gain of $16 million and 403 QALYs. However, if social interaction between all age groups was severed, vaccination expansion to ages 18-49 and 12-17 years would no longer be dominant but cost effective with an incremental cost-effectiveness ratio (ICER) of $37,572 and $26,705/QALY gained, respectively. CONCLUSION The second booster strategy was likely to be dominant in reducing the disease burden of the COVID-19 pandemic. Expanding the second booster strategy to ages 18-49 and 12-17 years would remain dominant due to their social contacts with the older age group.
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Affiliation(s)
- Rui Li
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Pengyi Lu
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - José A Pagán
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, NY, USA
| | - Wenyi Hu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia
| | - Qianqian Yang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Guihua Zhuang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, 710061, Shaanxi, China
| | - Mingwang Shen
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China.
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, 710061, Shaanxi, China.
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China.
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
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10
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da Silva PG, Hemnani M, Gonçalves J, Rodriguéz E, García-Encina PA, Nascimento MSJ, Sousa SIV, Myrmel M, Mesquita JR. Airborne SARS-CoV-2 is more frequently detected in environments related to children and elderly but likely non-infectious, Norway, 2022. Virol J 2023; 20:275. [PMID: 38001529 PMCID: PMC10675927 DOI: 10.1186/s12985-023-02243-4] [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: 10/26/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
This study investigates the presence of SARS-CoV-2 in indoor and outdoor environments in two cities in Norway between April and May 2022. With the lifting of COVID-19 restrictions in the country and a focus on vaccination, this research aims to shed light on the potential for virus transmission in various settings. Air sampling was conducted in healthcare and non-healthcare facilities, covering locations frequented by individuals across different age groups. The study found that out of 31 air samples, only four showed the presence of SARS-CoV-2 RNA by RT-qPCR, with no viable virus detected after RNAse pre-treatment. These positive samples were primarily associated with environments involving children and the elderly. Notably, sequencing revealed mutations associated with increased infectivity in one of the samples. The results highlight the importance of considering children as potential sources of virus transmission, especially in settings with prolonged indoor exposure. As vaccination coverage increases globally, and with children still representing a substantial unvaccinated population, the study emphasizes the need to re-implement mask-wearing mandates indoors and in public transport to reduce virus transmission. The findings have implications for public health strategies to control COVID-19, particularly in the face of new variants and the potential for increased transmission during the autumn and winter seasons.
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Affiliation(s)
- Priscilla Gomes da Silva
- ICBAS-School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal
- Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- LEPABE-Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Mahima Hemnani
- ICBAS-School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal
- Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - José Gonçalves
- Institute of Sustainable Processes, Valladolid University, Dr. Mergelina s/n, Valladolid, 47011, Spain
| | - Elisa Rodriguéz
- Institute of Sustainable Processes, Valladolid University, Dr. Mergelina s/n, Valladolid, 47011, Spain
| | - Pedro A García-Encina
- Institute of Sustainable Processes, Valladolid University, Dr. Mergelina s/n, Valladolid, 47011, Spain
| | | | - Sofia I V Sousa
- LEPABE-Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Mette Myrmel
- Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - João R Mesquita
- ICBAS-School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal.
- Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, Porto, Portugal.
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
- Virology Unit, Norwegian University of Life Sciences, Ås, Norway.
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11
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Le HHTC, Vien NT, Dang TN, Ware RS, Phung D, Thai PK, Ranganathan S, Vinh NN, Dung PHT, Thanh HN, Dung TTT, Hien TT, Sly PD, Le An P. Wearing masks as a protective measure for children against traffic-related air pollution: A comparison of perceptions between school children and their caregivers in Ho Chi Minh City, Vietnam. Trop Med Int Health 2023; 28:753-762. [PMID: 37615211 PMCID: PMC10946546 DOI: 10.1111/tmi.13923] [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] [Indexed: 08/25/2023]
Abstract
BACKGROUND Traffic-related air pollution (TRAP) problems are unlikely to be solved in the short term, making it imperative to educate children on protective measures to mitigate the negative impact on their health. Children and their caregivers may hold differing views on wearing a face mask as a safeguard against air pollution. While many studies have focused on predicting children's health-protective behaviours against air pollution, few have explored the differences in perceptions between children and their caregivers. OBJECTIVES To examine this, we conducted a study that compared the health beliefs of two generations and evaluated the factors that influence the use of masks by children to reduce air pollution exposure. METHODS The study was conducted in 24 secondary schools and involved 8420 children aged 13-14 and their caregivers. We used a Health Belief Model (HBM)-based instrument containing 17-item self-administered health beliefs questionnaires to gather data. The results were analysed using hierarchical logistic regression to determine the probability of children frequently wearing masks to protect against TRAP. RESULTS Our study showed both children and caregivers recognised that several factors could influence mask-wearing among children: discomfort or difficulty breathing while wearing a mask and forgetting to bring a mask when going outside; perceived threats of the poor quality of air and children's respiratory health problems; and cues to mask use (i.e., seeing most of their friends wearing facemasks and ease of finding masks in local stores). However, only children were significantly concerned with public perception of their appearance while wearing a mask. Females were more likely to wear masks, and caregivers with higher levels of education were more likely to encourage their children to wear masks. Children who commuted to schools by walking, biking, or motorbiking were also more accepting of mask-wearing than those who travelled by car or bus. CONCLUSIONS Children and their caregivers hold different perceptions of wearing masks to protect against air pollution. Children are more susceptible to social judgements regarding their appearance when wearing a mask.
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Affiliation(s)
- Hong H. T. C. Le
- Faculty of MedicineThe University of QueenslandBrisbane CityQueenslandAustralia
- Children's Health and Environment ProgramCentre for Children's Health ResearchBrisbane CityQueenslandAustralia
| | - Nguyen Truong Vien
- Department of Environmental and Occupational HealthPham Ngoc Thach University of MedicineHo Chi Minh CityVietnam
| | - Tran Ngoc Dang
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Robert S. Ware
- Menzies Health Institute QueenslandGriffith UniversityBrisbane CityQueenslandAustralia
| | - Dung Phung
- School of Public HealthThe University of QueenslandBrisbane CityQueenslandAustralia
| | - Phong K. Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandBrisbane CityQueenslandAustralia
| | | | - Nguyen Nhu Vinh
- Centre for the Training of Family Medicine, Faculty of MedicineUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Phan Hoang Thuy Dung
- Grant and Innovation CenterUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Huynh Ngoc Thanh
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Truong Thi Thuy Dung
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - To Thi Hien
- University of Science, Vietnam National UniversityHo Chi Minh CityVietnam
| | - Peter D. Sly
- Children's Health and Environment ProgramCentre for Children's Health ResearchBrisbane CityQueenslandAustralia
| | - Pham Le An
- Centre for the Training of Family Medicine, Faculty of MedicineUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
- Grant and Innovation CenterUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
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12
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Binter J, Pešout O, Pieniak M, Martínez-Molina J, Noon EJ, Stefanczyk MM, Eder SJ. Predictors and motives for mask-wearing behavior and vaccination intention. Sci Rep 2023; 13:10293. [PMID: 37357247 DOI: 10.1038/s41598-023-37072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/15/2023] [Indexed: 06/27/2023] Open
Abstract
Containing a pandemic requires that individuals adhere to measures such as wearing face-masks and getting vaccinated. Therefore, identifying predictors and motives for both behaviors is of importance. Here, we study the decisions made by a cross-national sample in randomized hypothetical scenarios during the COVID-19 pandemic. Our results show that mask-wearing was predicted by empathic tendencies, germ aversion, and higher age, whilst belief in misinformation and presentation of an interaction partner as a family member lowered the safety standards. The main motives associated with taking the mask off included: rationalization, facilitating interaction, and comfort. Vaccination intention was positively predicted by empathy, and negatively predicted by belief in misinformation and higher costs of the vaccine. We found no effect of immunization status of the surrounding social group. The most common motive for vaccination was protection of oneself and others, whereas undecided and anti-vaccine groups reported doubts about the effectiveness and fear of side effects. Together, we identify social and psychological predictors and motives of mask-wearing behavior and vaccination intention. The results highlight the importance of social context for mask-wearing, easy access to vaccines, empathy, and trust in publicly distributed information.
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Affiliation(s)
- Jakub Binter
- Faculty of Social and Economic Studies, Jan Evangelista Purkyně University, Moskevská 54, 400 96, Ústí nad Labem, Czech Republic.
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Prague, Czech Republic.
| | - Ondra Pešout
- Department of Psychology, Jan Evangelista Purkyně University, Ústí nad Labem, Czech Republic
| | - Michał Pieniak
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | | | - Edward J Noon
- Institute of Childhood and Education, Leeds Trinity University, Leeds, UK
| | | | - Stephanie J Eder
- Department of Neurosciences and Developmental Biology, University of Vienna, Djerrassiplatz 1, 1030, Vienna, Austria.
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13
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Li AY, Rawal DP, Chen VV, Hostetler N, Compton SAH, Stewart EK, Ritchie MB, Mitchell DGV. Masking our emotions: Emotion recognition and perceived intensity differ by race and use of medical masks. PLoS One 2023; 18:e0284108. [PMID: 37285323 DOI: 10.1371/journal.pone.0284108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/23/2023] [Indexed: 06/09/2023] Open
Abstract
Although medical masks have played a key role in decreasing the transmission of communicable disease, they simultaneously reduce the availability of nonverbal cues fundamental to social interaction. In the present study, we determined the collective impact of medical masks on emotional expression recognition and perceived intensity as a function of actor race. Participants completed an emotional expression recognition task involving stimuli with or without medical masks. Across six basic emotional facial expressions, medical masks were associated with significantly more emotional expression recognition errors. Overall, the effects associated with race varied depending on the emotion and appearance of masks. Whereas recognition accuracy was higher for White relative to Black actors for anger and sadness, the opposite pattern was observed for disgust. Medical mask-wearing exacerbated actor-race related recognition differences for anger and surprise, but attenuated these differences for fear. Emotional expression intensity ratings were significantly reduced for all emotions except fear, where masks were associated with increased perceived intensity. Masks further increased already higher intensity ratings for anger in Black versus White actors. In contrast, masks eliminated the tendency to give higher intensity ratings for Black versus White sad and happy facial expressions. Overall, our results suggest that the interaction between actor race and mask wearing status with respect to emotional expression judgements is complex, varying by emotion in both direction and degree. We consider the implications of these results particularly in the context of emotionally charged social contexts, such as in conflict, healthcare, and policing.
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Affiliation(s)
- Ashley Y Li
- Brain and Mind Institute, Western Interdisciplinary Research Building, Room 3190, University of Western Ontario, London, Ontario, Canada
| | - Disha P Rawal
- Brain and Mind Institute, Western Interdisciplinary Research Building, Room 3190, University of Western Ontario, London, Ontario, Canada
| | - Vanessa V Chen
- Brain and Mind Institute, Western Interdisciplinary Research Building, Room 3190, University of Western Ontario, London, Ontario, Canada
| | - Nathan Hostetler
- Brain and Mind Institute, Western Interdisciplinary Research Building, Room 3190, University of Western Ontario, London, Ontario, Canada
| | - Shannon A H Compton
- Brain and Mind Institute, Western Interdisciplinary Research Building, Room 3190, University of Western Ontario, London, Ontario, Canada
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Emma K Stewart
- Brain and Mind Institute, Western Interdisciplinary Research Building, Room 3190, University of Western Ontario, London, Ontario, Canada
- Department of Psychology, Faculty of Social Science, University of Western Ontario, London, Ontario, Canada
| | - Mary B Ritchie
- Brain and Mind Institute, Western Interdisciplinary Research Building, Room 3190, University of Western Ontario, London, Ontario, Canada
- Department of Psychology, Faculty of Social Science, University of Western Ontario, London, Ontario, Canada
| | - Derek G V Mitchell
- Brain and Mind Institute, Western Interdisciplinary Research Building, Room 3190, University of Western Ontario, London, Ontario, Canada
- Department of Psychology, Faculty of Social Science, University of Western Ontario, London, Ontario, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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14
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Cimini A, Imperi E, Picano A, Rossi M. Electrospun nanofibers for medical face mask with protection capabilities against viruses: State of the art and perspective for industrial scale-up. APPLIED MATERIALS TODAY 2023; 32:101833. [PMID: 37152683 PMCID: PMC10151159 DOI: 10.1016/j.apmt.2023.101833] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 05/09/2023]
Abstract
Face masks have proven to be a useful protection from airborne viruses and bacteria, especially in the recent years pandemic outbreak when they effectively lowered the risk of infection from Coronavirus disease (COVID-19) or Omicron variants, being recognized as one of the main protective measures adopted by the World Health Organization (WHO). The need for improving the filtering efficiency performance to prevent penetration of fine particulate matter (PM), which can be potential bacteria or virus carriers, has led the research into developing new methods and techniques for face mask fabrication. In this perspective, Electrospinning has shown to be the most efficient technique to get either synthetic or natural polymers-based fibers with size down to the nanoscale providing remarkable performance in terms of both particle filtration and breathability. The aim of this Review is to give further insight into the implementation of electrospun nanofibers for the realization of the next generation of face masks, with functionalized membranes via addiction of active material to the polymer solutions that can give optimal features about antibacterial, antiviral, self-sterilization, and electrical energy storage capabilities. Furthermore, the recent advances regarding the use of renewable materials and green solvent strategies to improve the sustainability of electrospun membranes and to fabricate eco-friendly filters are here discussed, especially in view of the large-scale nanofiber production where traditional membrane manufacturing may result in a high environmental and health risk.
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Affiliation(s)
- A Cimini
- Department of Basic and Applied Sciences for Engineering, University of Rome Sapienza, Rome 00161, Italy
- LABOR s.r.l., Industrial Research Laboratory, Via Giacomo Peroni, 386, Rome, Italy
| | - E Imperi
- LABOR s.r.l., Industrial Research Laboratory, Via Giacomo Peroni, 386, Rome, Italy
| | - A Picano
- LABOR s.r.l., Industrial Research Laboratory, Via Giacomo Peroni, 386, Rome, Italy
| | - M Rossi
- Department of Basic and Applied Sciences for Engineering, University of Rome Sapienza, Rome 00161, Italy
- Research Center for Nanotechnology for Engineering of Sapienza (CNIS), University of Rome Sapienza, Rome 00185, Italy
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15
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Bai Z, Ma Z, Jing L, Li Y, Wang S, Wang BG, Wu Y, Han X. Estimation and sensitivity analysis of a COVID-19 model considering the use of face mask and vaccination. Sci Rep 2023; 13:6434. [PMID: 37081069 PMCID: PMC10116124 DOI: 10.1038/s41598-023-33499-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/13/2023] [Indexed: 04/22/2023] Open
Abstract
To model the COVID-19 infection and develop effective control measures, this paper proposes an SEIR-type epidemic model considering the impact of face-mask wearing and vaccination. Firstly, the effective reproduction number and the threshold conditions are obtained. Secondly, based on the data of South Korea from January 20, 2022 to March 21, 2022, the model parameters are estimated. Finally, a sensitivity analysis and the numerical study are conducted. The results show that the face-mask wearing is associated with [Formula: see text] and [Formula: see text] reductions in the numbers of cumulative cases and newly confirmed cases, respectively, after a period of 60 days, when the face mask wearing rate increases by [Formula: see text]. Furthermore, the vaccination rate is associated with [Formula: see text] and [Formula: see text] reductions in the numbers of cumulative cases and the newly confirmed cases, respectively, after the same period of 60 days when the vaccination rate is increased by [Formula: see text]. A combined measure involving face-mask wearing and vaccination may be more effective and reasonable in preventing and controlling this infection. It is also suggested that disease control departments should strongly recommended the wearing of face masks s as well as vaccination to prevent the unvaccinated people from becoming infected.
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Affiliation(s)
- Zhongtian Bai
- The Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou, 730000, Gansu, People's Republic of China
| | - Zhihui Ma
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
| | - Libaihe Jing
- School of Life Sciences, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yonghong Li
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, People's Republic of China
| | - Shufan Wang
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Bin-Guo Wang
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yan Wu
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Xiaotao Han
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, 730000, Gansu, People's Republic of China
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16
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Zhang X, Fu J, Hua S, Liang H, Zhang ZK. Complexity of Government response to COVID-19 pandemic: a perspective of coupled dynamics on information heterogeneity and epidemic outbreak. NONLINEAR DYNAMICS 2023:1-20. [PMID: 37361005 PMCID: PMC10091349 DOI: 10.1007/s11071-023-08427-5] [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: 09/14/2022] [Accepted: 03/15/2023] [Indexed: 06/28/2023]
Abstract
This study aims at modeling the universal failure in preventing the outbreak of COVID-19 via real-world data from the perspective of complexity and network science. Through formalizing information heterogeneity and government intervention in the coupled dynamics of epidemic and infodemic spreading, first, we find that information heterogeneity and its induced variation in human responses significantly increase the complexity of the government intervention decision. The complexity results in a dilemma between the socially optimal intervention that is risky for the government and the privately optimal intervention that is safer for the government but harmful to the social welfare. Second, via counterfactual analysis against the COVID-19 crisis in Wuhan, 2020, we find that the intervention dilemma becomes even worse if the initial decision time and the decision horizon vary. In the short horizon, both socially and privately optimal interventions agree with each other and require blocking the spread of all COVID-19-related information, leading to a negligible infection ratio 30 days after the initial reporting time. However, if the time horizon is prolonged to 180 days, only the privately optimal intervention requires information blocking, which would induce a catastrophically higher infection ratio than that in the counterfactual world where the socially optimal intervention encourages early-stage information spread. These findings contribute to the literature by revealing the complexity incurred by the coupled infodemic-epidemic dynamics and information heterogeneity to the governmental intervention decision, which also sheds insight into the design of an effective early warning system against the epidemic crisis in the future.
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Affiliation(s)
- Xiaoqi Zhang
- Institute of Economics, Chinese Academy of Social Science, Beijing, China
- National School of Development, Southeast University, Nanjing, China
| | - Jie Fu
- National School of Development, Southeast University, Nanjing, China
| | - Sheng Hua
- National School of Development, Southeast University, Nanjing, China
| | - Han Liang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Zi-Ke Zhang
- College of Media and International Culture, Zhejiang University, Hangzhou, China
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17
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Lee BY, Greene D, Scannell SA, McLaughlin C, Martinez MF, Heneghan JL, Chin KL, Zheng X, Li R, Lindenfeld L, Bartsch SM. The Need for Systems Approaches for Precision Communications in Public Health. JOURNAL OF HEALTH COMMUNICATION 2023; 28:13-24. [PMID: 37390012 PMCID: PMC10373800 DOI: 10.1080/10810730.2023.2220668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
A major challenge in communicating health-related information is the involvement of multiple complex systems from the creation of the information to the sources and channels of dispersion to the information users themselves. To date, public health communications approaches have often not adequately accounted for the complexities of these systems to the degree necessary to have maximum impact. The virality of COVID-19 misinformation and disinformation has brought to light the need to consider these system complexities more extensively. Unaided, it is difficult for humans to see and fully understand complex systems. Luckily, there are a range of systems approaches and methods, such as systems mapping and systems modeling, that can help better elucidate complex systems. Using these methods to better characterize the various systems involved in communicating public health-related information can lead to the development of more tailored, precise, and proactive communications. Proceeding in an iterative manner to help design, implement, and adjust such communications strategies can increase impact and leave less opportunity for misinformation and disinformation to spread.
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Affiliation(s)
- Bruce Y. Lee
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Danielle Greene
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Sheryl A. Scannell
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Christopher McLaughlin
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Marie F. Martinez
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Jessie L. Heneghan
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Kevin L. Chin
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Xia Zheng
- School of Communication & Journalism, Stony Brook University, Stony Brook, NY, USA
- Alan Alda Center for Communicating Science, Stony Brook University, Stony Brook, NY, USA
| | - Ruobing Li
- School of Communication & Journalism, Stony Brook University, Stony Brook, NY, USA
- Alan Alda Center for Communicating Science, Stony Brook University, Stony Brook, NY, USA
| | - Laura Lindenfeld
- School of Communication & Journalism, Stony Brook University, Stony Brook, NY, USA
- Alan Alda Center for Communicating Science, Stony Brook University, Stony Brook, NY, USA
| | - Sarah M. Bartsch
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
- New York City Pandemic Response Institute (PRI), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
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18
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Tjaden AH, Gibbs M, Runyon M, Weintraub WS, Taylor YJ, Edelstein SL. Association between self-reported masking behavior and SARS-CoV-2 infection wanes from Pre-Delta to Omicron-predominant periods - North Carolina COVID-19 Community Research Partnership (NC-CCRP). Am J Infect Control 2023; 51:261-267. [PMID: 36209944 PMCID: PMC9537112 DOI: 10.1016/j.ajic.2022.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Wearing a face mask is a primary public health method to reduce SARS-CoV-2 transmission. METHODS We performed a nested case-control analysis within the North Carolina COVID-19 Community Research Partnership (NC-CCRP) of adults who completed daily surveillance surveys, April 2020 - February 2022. We assessed the association between self-reported mask wearing behavior during nonhousehold interactions and COVID-19 infection during 3 pandemic periods using conditional logistic regression models of risk of infection that were adjusted for demographics, vaccination status, and recent known exposure to COVID-19. RESULTS Among 3,901 cases and 27,813 date-matched controls, there was a significant interaction between mask use and time period (P < .001). Prior to July 2021, the odds of a reported infection were 66% higher (aOR = 1.66, 95% CI = 1.43-1.91) among participants reporting ≥1 day not wearing a mask compared to those who reported no days (1,592 cases, 11,717 controls). During the Delta-predominant period, the results were similar (aOR = 1.53, 95% CI = 1.23-1.89; 659 cases, 4,649 controls). This association was attenuated during the Omicron-predominant period, where odds of an infection was 16% higher (aOR = 1.16, 95% CI = 1.03-1.32; 1,563 cases, 10,960 controls). CONCLUSIONS While the effect of not wearing a mask remains significant, during the Omicron-predominant period we observed a decrease in the association between self-reported mask wearing and risk of SARS-CoV-2 infection.
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Affiliation(s)
- Ashley H. Tjaden
- Biostatistics Center, Milken Institute School of Public Health, George Washington University, Rockville, MD,Address correspondence to Ashley H. Tjaden, COVID-19 Community Research Partnership Coordinating Center, Biostatistics Center, Milken Institute School of Public Health, George Washington University, 6110 Executive Blvd., Suite 750, Rockville, MD 20852, USA
| | - Michael Gibbs
- Department of Emergency Medicine, Atrium Health, Charlotte, NC
| | - Michael Runyon
- Department of Emergency Medicine, Atrium Health, Charlotte, NC
| | | | - Yhenneko J. Taylor
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC
| | - Sharon L. Edelstein
- Biostatistics Center, Milken Institute School of Public Health, George Washington University, Rockville, MD
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19
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Cordero Franco HF, Salinas Martínez AM, Martínez Martínez DL, Santiago Jarquin BR, Guzmán de la Garza FJ. Cessation of Face Mask Use after COVID-19 Vaccination in Patients with Diabetes: Prevalence and Determinants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2768. [PMID: 36833465 PMCID: PMC9956089 DOI: 10.3390/ijerph20042768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Studies on the cessation of face mask use after a COVID-19 vaccine in patients with diabetes are not available, despite their greater predisposition to complications. We estimated the prevalence of cessation of face mask use after receiving the COVID-19 vaccine in patients with diabetes and identified which factor was most strongly associated with non-use. This was a cross-sectional study in patients with diabetes 18-70 years with at least one dose of vaccine against COVID-19 (n = 288). Participants were asked to respond face-to-face to a questionnaire in a primary care center. Descriptive statistics, chi-square tests, and multivariate binary logistic regression were used for analyzing the association between vulnerability, benefits, barriers, self-efficacy, vaccine expectations (independent variables), and cessation of use (dependent variable), controlling for sociodemographic, smoking, medical, vaccine, and COVID-19 history. The prevalence of cessation of face masks was 25.3% (95% CI 20.2, 30.5). Not feeling vulnerable to hospitalization increased the odds of non-use (adjusted OR = 3.3, 95% CI 1.2, 8.6), while perceiving benefits did the opposite (adjusted OR = 0.4, 95% CI 0.2, 0.9). The prevalence was low, and only two factors were associated with the cessation of face mask use after COVID-19 vaccination in patients with type 2 diabetes.
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Affiliation(s)
- Hid Felizardo Cordero Franco
- Epidemiologic and Health Services Research Unit/CIBIN, Mexican Institute of Social Security, Monterrey 64360, Mexico
| | - Ana María Salinas Martínez
- Epidemiologic and Health Services Research Unit/CIBIN, Mexican Institute of Social Security, Monterrey 64360, Mexico
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey 64460, Mexico
| | - Diana Laura Martínez Martínez
- Vice-Rectory of Health Sciences, University of Monterrey, San Pedro Garza García 66238, Mexico
- Family Medicine Clinic No. 26, Mexican Institute of Social Security, Monterrey 64360, Mexico
| | | | - Francisco Javier Guzmán de la Garza
- Epidemiologic and Health Services Research Unit/CIBIN, Mexican Institute of Social Security, Monterrey 64360, Mexico
- School of Medicine, Autonomous University of Nuevo Leon, Monterrey 64460, Mexico
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20
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Kim S, Oh J, Tak S. Association between face covering policies and the incidence of coronavirus disease 2019 in European countries. Osong Public Health Res Perspect 2023; 14:31-39. [PMID: 36944343 DOI: 10.24171/j.phrp.2022.0287] [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: 10/25/2022] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This study was conducted to determine the impact of the strengthening or relaxation of face covering mandates on the subsequent national case incidence of coronavirus disease 2019 (COVID-19) in Europe as the full vaccination rate was increasing. METHODS European countries in which case incidence increased for 3 consecutive weeks were monitored and analyzed using COVID-19 incidence data shared by the World Health Organization (WHO). The epidemic trend of COVID-19 in Europe was compared with that of countries elsewhere in the world based on WHO weekly epidemiological reports from June 20 to October 30, 2021. In addition, this study provided insight into the impact of government mask mandates on COVID-19 incidence in Europe by measuring the index scores of those facial covering policies before and after mandate relaxation or strengthening. The effects of the vaccination rate and the speed of vaccination on COVID-19 incidence were also analyzed. RESULTS The incidence of COVID-19 after the relaxation of face covering mandates was significantly higher than before relaxation. However, no significant difference was observed in vaccination rate between countries with increased and decreased incidence. Instead, rapid vaccination delayed the resurgence in incidence. CONCLUSIONS The findings suggest that face covering policies in conjunction with rapid vaccination efforts are essential to help mitigate the spread of COVID-19.
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Affiliation(s)
- Sookhyun Kim
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jiyoung Oh
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sangwoo Tak
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
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21
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An Old Acquaintance: Could Adenoviruses Be Our Next Pandemic Threat? Viruses 2023; 15:v15020330. [PMID: 36851544 PMCID: PMC9966032 DOI: 10.3390/v15020330] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Human adenoviruses (HAdV) are one of the most important pathogens detected in acute respiratory diseases in pediatrics and immunocompromised patients. In 1953, Wallace Rowe described it for the first time in oropharyngeal lymphatic tissue. To date, more than 110 types of HAdV have been described, with different cellular tropisms. They can cause respiratory and gastrointestinal symptoms, even urinary tract inflammation, although most infections are asymptomatic. However, there is a population at risk that can develop serious and even lethal conditions. These viruses have a double-stranded DNA genome, 25-48 kbp, 90 nm in diameter, without a mantle, are stable in the environment, and resistant to fat-soluble detergents. Currently the diagnosis is made with lateral flow immunochromatography or molecular biology through a polymerase chain reaction. This review aimed to highlight the HAdV variability and the pandemic potential that a HAdV3 and 7 recombinant could have considering the aggressive outbreaks produced in health facilities. Herein, we described the characteristics of HAdV, from the infection to treatment, vaccine development, and the evaluation of the social determinants of health associated with HAdV, suggesting the necessary measures for future sanitary control to prevent disasters such as the SARS-CoV-2 pandemic, with an emphasis on the use of recombinant AdV vaccines to control other potential pandemics.
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22
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Utami AM, Rendrayani F, Khoiry QA, Noviyanti D, Suwantika AA, Postma MJ, Zakiyah N. Economic evaluation of COVID-19 vaccination: A systematic review. J Glob Health 2023; 13:06001. [PMID: 36637810 PMCID: PMC9838689 DOI: 10.7189/jogh.13.06001] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Safe and effective vaccination is considered to be the most critical strategy to fight coronavirus disease 2019 (COVID-19), leading to individual and herd immunity protection. We aimed to systematically review the economic evaluation of COVID-19 vaccination globally. Methods We performed a systematic search to identify relevant studies in two major databases (MEDLINE/PubMed and EBSCO) published until September 8, 2022. After deduplication, two researchers independently screened the study titles and abstracts according to pre-determined inclusion and exclusion criteria. The remaining full-text studies were assessed for eligibility. We assessed their quality of reporting using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist and summarized and narratively presented the results. Results We identified 25 studies that assessed the economic evaluation of COVID-19 vaccination worldwide by considering several input parameters, including vaccine cost, vaccine efficacy, utility value, and the size of the targeted population. All studies suggested that COVID-19 vaccination was a cost-effective or cost-saving intervention for mitigating coronavirus transmission and its effect in many countries within certain conditions. Most studies reported vaccine efficacy values ranging from 65% to 75%. Conclusions Given the favorable cost-effectiveness profile of COVID-19 vaccines and disparities in affordability across countries, considering prioritization has become paramount. This review provides comprehensive insights into the economic evaluation of COVID-19 vaccination that will be useful to policymakers, particularly in highlighting preventive measures and preparedness plans for the next possible pandemic.
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Affiliation(s)
- Auliasari Meita Utami
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Farida Rendrayani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Qisty Aulia Khoiry
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Dita Noviyanti
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Auliya A Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia,Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | - Maarten J Postma
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia,Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, the Netherlands
| | - Neily Zakiyah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia,Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
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23
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Tjaden AH, Edelstein SL, Ahmed N, Calamari L, Dantuluri KL, Gibbs M, Hinkelman A, Mongraw‐Chaffin M, Sanders JW, Saydah S, Plumb ID. Association between COVID-19 and consistent mask wearing during contact with others outside the household-A nested case-control analysis, November 2020-October 2021. Influenza Other Respir Viruses 2023; 17:e13080. [PMID: 36606308 PMCID: PMC9835433 DOI: 10.1111/irv.13080] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Face masks have been recommended to reduce SARS-CoV-2 transmission. However, evidence of the individual benefit of face masks remains limited, including by vaccination status. METHODS As part of the COVID-19 Community Research Partnership cohort study, we performed a nested case-control analysis to assess the association between self-reported consistent mask use during contact with others outside the household and subsequent odds of symptomatic SARS-CoV-2 infection (COVID-19) during November 2020-October 2021. Using conditional logistic regression, we compared 359 case-participants to 3544 control-participants who were matched by date, adjusting for enrollment site, age group, sex, race/ethnicity, urban/rural county classification, and healthcare worker occupation. RESULTS COVID-19 was associated with not consistently wearing a mask (adjusted odds ratio [aOR] 1.49; 95% confidence interval [CI] [1.14, 1.95]). Compared with persons ≥14 days after mRNA vaccination who also reported always wearing a mask, COVID-19 was associated with being unvaccinated (aOR 5.94; 95% CI [3.04, 11.62]), not wearing a mask (aOR 1.62; 95% CI [1.07, 2.47]), or both unvaccinated and not wearing a mask (aOR 9.07; 95% CI [4.81, 17.09]). CONCLUSIONS Our findings indicate that consistent mask wearing can complement vaccination to reduce the risk of COVID-19.
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Affiliation(s)
- Ashley H. Tjaden
- Milken Institute School of Public Health, Biostatistics CenterGeorge Washington UniversityRockvilleMarylandUSA
| | - Sharon L. Edelstein
- Milken Institute School of Public Health, Biostatistics CenterGeorge Washington UniversityRockvilleMarylandUSA
| | - Naheed Ahmed
- Department of Population HealthNYU Grossman School of MedicineNew York CityNew YorkUSA
| | - Lydia Calamari
- Carolinas Medical CenterAtrium HealthCharlotteNorth CarolinaUSA
| | - Keerti L. Dantuluri
- Department of Pediatrics (Infectious Diseases)Levine Children's Hospital, Atrium HealthCharlotteNorth CarolinaUSA
| | - Michael Gibbs
- Carolinas Medical CenterAtrium HealthCharlotteNorth CarolinaUSA
| | - Amy Hinkelman
- Campbell University School of Osteopathic MedicineLillingtonNorth CarolinaUSA
| | - Morgana Mongraw‐Chaffin
- Department of Epidemiology and PreventionWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - John W. Sanders
- Section on Cardiovascular Medicine, Department of MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Sharon Saydah
- U.S. Centers for Disease Control and Prevention COVID‐19 ResponseAtlantaGeorgiaUSA
| | - Ian D. Plumb
- U.S. Centers for Disease Control and Prevention COVID‐19 ResponseAtlantaGeorgiaUSA
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24
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Dash HR, Arora M, Khatoon S. Evaluation of face masks as a valuable forensic DNA evidence in the post-COVID era. Int J Legal Med 2023; 137:311-317. [PMID: 36609509 PMCID: PMC9822694 DOI: 10.1007/s00414-023-02945-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023]
Abstract
After the onset of COVID-19 pandemic, a sharp surge in the usage of the face-masks throughout the globe has been observed. Pre-experiment survey of 252 individuals indicated a higher use of cotton-make masks (41%), followed by N-95 make (31%), and surgical disposable masks (26%). It was also further revealed that a higher fraction of individuals wear a face-mask more than 3 times (37%) before its disposal. In order to assess the potential usability of different mask types as forensic DNA evidence, a study was conducted on 50 healthy individuals. DNA content of different fractions such as the portion of mask covering the mouth region and the ear-piece showed a good source of host DNA. Though no statistically significant difference (P < 0.05) was found in the DNA quantity obtained from different face mask types, an increasing trend was obtained in the order: cloth make type (7.031 ± 0.31 ng), N-95 make (4.711 ± 0.15 ng), and surgical disposable type (2.17 ± 0.13 ng). The time of wearing of a face-mask showed a positive correlation with the yield of DNA irrespective of the face-mask type used. Samples retrieved from both the portions covering the mouth area and the ear-piece showed a good source of genomic DNA yielding an average of 4.82 ± 0.11 ng and 4.44 ± 0.10 ng of DNA, respectively. Irrespective of the face-mask types, number of reuse, and the portion of the mask, 66.66-96.11% of samples showed a complete autosomal STR DNA profile. This suggests that if a face-mask is found at the crime scene, it should be collected and preserved as a potential source of DNA evidence for routine forensic DNA analysis.
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Affiliation(s)
- Hirak Ranjan Dash
- School of Forensic Science, National Forensic Sciences University, Delhi Campus, Institutional Area, Rohini, New Delhi, India, 110085.
| | - Mansi Arora
- School of Forensic Science, National Forensic Sciences University, Delhi Campus, Institutional Area, Rohini, New Delhi India 110085
| | - Subia Khatoon
- School of Forensic Science, National Forensic Sciences University, Delhi Campus, Institutional Area, Rohini, New Delhi India 110085
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25
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Ireri AM, Mwangi CN, Arhin V, Oigo M, Mugo S, Munanu RN. Development and initial validation of the attitudes toward face mask use scale (ATFMUS). Heliyon 2022; 8:e12349. [PMID: 36619417 PMCID: PMC9813729 DOI: 10.1016/j.heliyon.2022.e12349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/14/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Despite availability of instruments for measuring attitudes towards mask use, the psychometric properties of many available instruments are not adequately established which limits their research usefulness across contexts. In three studies, we developed the Attitudes Towards Face Mask Use Scale (ATFMUS) in three phases: item generation, scale development, and scale evaluation. Phase one and two were addressed in study 1 while phase three was addressed in studies 2 and 3. In Study 1, a combined online and pen-and-paper sample of 174 (78% university students) completed a questionnaire with 19 items regarding attitudes towards face mask use derived from theory, previous research, and experience. Responses were subjected to item reduction analysis, exploratory factor analysis and reliability analysis. In Study 2, a student sample of 674 (70.5% high school) completed the new scale together with measures of COVID-19 related anxiety and obsession, personality, affect, social media use, and social desirability. Data from the ATFMUS were analyzed using confirmatory factor analysis and pertinent revisions done. The ATFMUS was then validated using correlation analyses, measurement invariance analyses, and known-group comparisons. In study 3, two samples of university students from Ghana (n = 242) and Kenya (n = 199) were involved in testing the cross-country invariance of the ATFMUS. The results reveal that the 5-item ATFMUS is a reliable and valid scale for assessing attitudes towards face mask use. Invariance analysis revealed that the ATFMUS is fair to use across participants of different age, level of education, and countries. The scale is also sensitive to participants' actual use of face masks as well as their beliefs about COVID-19 and efficacy of the facemasks. This study offers a foundation for further psychometric evaluation of the ATFMUS.
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Affiliation(s)
- Anthony Muriithi Ireri
- Department of Educational Psychology, Kenyatta University, Nairobi, Kenya,Corresponding author.
| | | | - Vera Arhin
- College of Distance Education, University of Cape Coast, Cape Coast, Ghana
| | - Martha Oigo
- Department of Educational Psychology, Kenyatta University, Nairobi, Kenya,Placement and Career Services Department, United States International University of Africa, Nairobi, Kenya
| | - Stephen Mugo
- Department of Educational Psychology, Kenyatta University, Nairobi, Kenya
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Valenzuela-Fernández A, Cabrera-Rodriguez R, Ciuffreda L, Perez-Yanes S, Estevez-Herrera J, González-Montelongo R, Alcoba-Florez J, Trujillo-González R, García-Martínez de Artola D, Gil-Campesino H, Díez-Gil O, Lorenzo-Salazar JM, Flores C, Garcia-Luis J. Nanomaterials to combat SARS-CoV-2: Strategies to prevent, diagnose and treat COVID-19. Front Bioeng Biotechnol 2022; 10:1052436. [PMID: 36507266 PMCID: PMC9732709 DOI: 10.3389/fbioe.2022.1052436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the associated coronavirus disease 2019 (COVID-19), which severely affect the respiratory system and several organs and tissues, and may lead to death, have shown how science can respond when challenged by a global emergency, offering as a response a myriad of rapid technological developments. Development of vaccines at lightning speed is one of them. SARS-CoV-2 outbreaks have stressed healthcare systems, questioning patients care by using standard non-adapted therapies and diagnostic tools. In this scenario, nanotechnology has offered new tools, techniques and opportunities for prevention, for rapid, accurate and sensitive diagnosis and treatment of COVID-19. In this review, we focus on the nanotechnological applications and nano-based materials (i.e., personal protective equipment) to combat SARS-CoV-2 transmission, infection, organ damage and for the development of new tools for virosurveillance, diagnose and immune protection by mRNA and other nano-based vaccines. All the nano-based developed tools have allowed a historical, unprecedented, real time epidemiological surveillance and diagnosis of SARS-CoV-2 infection, at community and international levels. The nano-based technology has help to predict and detect how this Sarbecovirus is mutating and the severity of the associated COVID-19 disease, thereby assisting the administration and public health services to make decisions and measures for preparedness against the emerging variants of SARS-CoV-2 and severe or lethal COVID-19.
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Affiliation(s)
- Agustín Valenzuela-Fernández
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Romina Cabrera-Rodriguez
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Laura Ciuffreda
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Silvia Perez-Yanes
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Judith Estevez-Herrera
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | | | - Julia Alcoba-Florez
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Rodrigo Trujillo-González
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- Departamento de Análisis Matemático, Facultad de Ciencias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Helena Gil-Campesino
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Oscar Díez-Gil
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - José M. Lorenzo-Salazar
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
| | - Carlos Flores
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, University of Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Jonay Garcia-Luis
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
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Kılıç C, Yıldız Mİ, Emekli E, Gülşen G, Alp A. Psychological factors responsible for low adherence to mask-wearing measures during the COVID-19 pandemic. BJPsych Open 2022; 8:e203. [PMID: 36416230 PMCID: PMC9744457 DOI: 10.1192/bjo.2022.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to >6 million deaths. Anti-mask movements may decrease the effects of preventive measures. Psychological factors that may be related to anti-mask behaviour are not well researched. AIMS This study aims to determine the psychological correlates of anti-mask attitudes and behaviour in an online general population sample, focusing on the possible role of claustrophobia. METHOD Data on attitudes and behaviour toward mask-wearing were collected from an online sample of 3709 people. Predictors of both anti-mask attitudes and behaviour were assessed with linear and logistic regression analyses. RESULTS Few people (3.3%) were overtly opposed to mask-wearing; mask opposition was more common in men than women. Predictors of negative attitude toward mask-wearing and low adherence to mask-related measures were similar and included male gender, lower education, lower income, being employed, having had COVID-19 and lower COVID-19-related anxiety. Psychopathology measures did not show a prediction, whereas claustrophobia had a significant prediction that was over and above those of other predictors. Avoidance behaviour had similar predictors, except for higher COVID-19-related anxiety. CONCLUSIONS Although low adherence to mask-wearing during the pandemic was not related to having a mental disorder, it may partly be caused by psychological factors. Those who had a negative attitude also reported lower adherence behaviour, and were characterised by being male, having lower education, being employed and having lower COVID-19-related anxiety; claustrophobia was a strong predictor of attitude. Understanding psychological factors responsible for low adherence may help to decrease morbidity and mortality in future pandemics.
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Affiliation(s)
- Cengiz Kılıç
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Turkey; and Stress Assessment and Research Centre, Hacettepe University, Turkey
| | - M İrem Yıldız
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Turkey; and Stress Assessment and Research Centre, Hacettepe University, Turkey
| | - Esra Emekli
- Department of Psychiatry, Faculty of Medicine, Baskent University, Turkey
| | - Gülhan Gülşen
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Turkey
| | - Anıl Alp
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Turkey
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Padilla-Rivas GR, Delgado-Gallegos JL, Garza-Treviño G, Galan-Huerta KA, G-Buentello Z, Roacho-Pérez JA, Santoyo-Suarez MG, Franco-Villareal H, Leyva-Lopez A, Estrada-Rodriguez AE, Moreno-Cuevas JE, Ramos-Jimenez J, Rivas-Estrilla AM, Garza-Treviño EN, Islas JF. Association between mortality and cardiovascular diseases in the vulnerable Mexican population: A cross-sectional retrospective study of the COVID-19 pandemic. Front Public Health 2022; 10:1008565. [PMID: 36438268 PMCID: PMC9686003 DOI: 10.3389/fpubh.2022.1008565] [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: 08/02/2022] [Accepted: 09/22/2022] [Indexed: 11/12/2022] Open
Abstract
Cardiovascular diseases (CVDs) continue to be the leading cause of death worldwide. Over the past couple of years and with the surge of the COVID-19 pandemic, mortality from CVDs has been slightly overshadowed by those due to COVID-19, although it was during the peak of the pandemic. In the present study, patients with CVDs (CVDs; n = 41,883) were analyzed to determine which comorbidities had the largest impact on overall patient mortality due to their association with both diseases (n = 3,637). Obesity, hypertension, and diabetes worsen health in patients diagnosed positive for COVID-19. Hence, they were included in the overview of all patients with CVD. Our findings showed that 1,697 deaths were attributable to diabetes (p < 0.001) and 987 deaths to obesity (p < 0.001). Lastly, 2,499 deaths were attributable to hypertension (p < 0.001). Using logistic regression modeling, we found that diabetes (OR: 1.744, p < 0.001) and hypertension (OR: 2.179, p < 0.001) significantly affected the mortality rate of patients. Hence, having a CVD diagnosis, with hypertension and/or diabetes, seems to increase the likelihood of complications, leading to death in patients diagnosed positive for COVID-19.
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Affiliation(s)
- Gerardo R. Padilla-Rivas
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Juan Luis Delgado-Gallegos
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Gerardo Garza-Treviño
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Kame A. Galan-Huerta
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Zuca G-Buentello
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Jorge A. Roacho-Pérez
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Michelle Giovana Santoyo-Suarez
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | | | - Ahidée Leyva-Lopez
- Centro de Investigación en Salud Poblacional Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | | | - Jorge E. Moreno-Cuevas
- Departamento de Ciencias Básicas, Universidad de Monterrey, San Pedro Garza García, México
| | - Javier Ramos-Jimenez
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Ana M. Rivas-Estrilla
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Elsa N. Garza-Treviño
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Jose Francisco Islas
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
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29
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Sebastian S, Alphi S, Anjali PH. Maintaining guard: A mixed method study on adherence to preventive behavior in the wake of COVID vaccination from Kerala. DENTISTRY AND MEDICAL RESEARCH 2022. [DOI: 10.4103/dmr.dmr_32_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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