1
|
Spreco A, Dahlström Ö, Nordvall D, Fagerström C, Blomqvist E, Gustafsson F, Andersson C, Sjödahl R, Eriksson O, Hinkula J, Schön T, Timpka T. Integrated Surveillance of Disparities in Vaccination Coverage and Morbidity during the COVID-19 Pandemic: A Cohort Study in Southeast Sweden. Vaccines (Basel) 2024; 12:763. [PMID: 39066401 PMCID: PMC11281347 DOI: 10.3390/vaccines12070763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
We aimed to use the digital platform maintained by the local health service providers in Southeast Sweden for integrated monitoring of disparities in vaccination and morbidity during the COVID-19 pandemic. The monitoring was performed in the adult population of two counties (n = 657,926) between 1 February 2020 and 15 February 2022. The disparities monitored were relocated (internationally displaced), substance users, and suffering from a psychotic disorder. The outcomes monitored were COVID-19 vaccination, SARS-CoV-2 test results, and hospitalization with COVID-19. Relocated residents displayed an increased likelihood of remaining unvaccinated and a decreased likelihood of testing as well as increased risks of primary SARS-CoV-2 infection and hospitalization compared with the general population. Suffering from a major psychiatric disease was associated with an increased risk of remaining unvaccinated and an increased risk of hospitalization but a decreased risk of SARS-CoV-2 infection. From the digital monitoring, we concluded that the relocated minority received insufficient protection during the pandemic, suggesting the necessity for comprehensive promotion of overall social integration. Persons with major psychiatric diseases underused vaccination, while they benefitted from proactively provided testing, implying a need for active encouragement of vaccination. Further research is warranted on legal and ethical frameworks for digital monitoring in vaccination programs.
Collapse
Affiliation(s)
- Armin Spreco
- Department of Health, Medicine, and Caring Sciences, Linköping University, 58183 Linköping, Sweden; (A.S.); (D.N.); (C.A.)
- Regional Executive Office, Region Östergötland, 58225 Linköping, Sweden;
| | - Örjan Dahlström
- Department of Behavioral Sciences and Learning, Linköping University, 58183 Linköping, Sweden;
| | - Dennis Nordvall
- Department of Health, Medicine, and Caring Sciences, Linköping University, 58183 Linköping, Sweden; (A.S.); (D.N.); (C.A.)
- Qulturum Development Department, Region Jönköping County, 55305 Jönköping, Sweden;
| | | | - Eva Blomqvist
- Department of Computer and Information Science, Linköping University, 58183 Linköping, Sweden;
| | - Fredrik Gustafsson
- Department of Electrical Engineering, Linköping University, 58183 Linköping, Sweden;
| | - Christer Andersson
- Department of Health, Medicine, and Caring Sciences, Linköping University, 58183 Linköping, Sweden; (A.S.); (D.N.); (C.A.)
- Regional Executive Office, Region Östergötland, 58225 Linköping, Sweden;
| | - Rune Sjödahl
- Regional Executive Office, Region Östergötland, 58225 Linköping, Sweden;
- Department of Biomedical and Clinical Sciences, Linköping University, 58183 Linköping, Sweden; (J.H.); (T.S.)
| | - Olle Eriksson
- Qulturum Development Department, Region Jönköping County, 55305 Jönköping, Sweden;
| | - Jorma Hinkula
- Department of Biomedical and Clinical Sciences, Linköping University, 58183 Linköping, Sweden; (J.H.); (T.S.)
| | - Thomas Schön
- Department of Biomedical and Clinical Sciences, Linköping University, 58183 Linköping, Sweden; (J.H.); (T.S.)
- Department of Infectious Diseases, County of Östergötland and Kalmar, Linköping University, 58183 Linköping, Sweden
| | - Toomas Timpka
- Department of Health, Medicine, and Caring Sciences, Linköping University, 58183 Linköping, Sweden; (A.S.); (D.N.); (C.A.)
- Regional Executive Office, Region Östergötland, 58225 Linköping, Sweden;
- Department of Computer and Information Science, Linköping University, 58183 Linköping, Sweden;
| |
Collapse
|
2
|
Faisant M, Vincent N, Hubert B, Le Tertre A. Regional excess mortality in France during COVID-19 pandemic: the first three epidemic periods (March 2020-June 2021). Eur J Public Health 2024; 34:606-612. [PMID: 38390659 PMCID: PMC11161158 DOI: 10.1093/eurpub/ckae032] [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: 02/24/2024] Open
Abstract
BACKGROUND This study aimed to describe the mortality excess during the three first epidemic periods of COVID-19 in all regions of France. METHODS Two complementary approaches were implemented. First, we described the number of death of patients infected with or diagnosed with COVID-19 in health care (HC) and medico-social (MS) institutions. Then, we estimated general all-cause mortality excess (all ages) by comparing the mortality observed with the expected mortality. We used a daily number of death model according to a negative binomial distribution, as a function of the long-term trend in mortality (penalized spline function of time) and its seasonal variation (cyclic spline function). The model provided expected mortality during epidemic periods with a 95% credibility interval. Each region defined three epidemic periods, including the overseas territories. RESULTS The two approaches were consistent in the most affected regions but there are major regional disparities that vary according to the epidemic period. There is an east-west gradient in the relative excess of deaths from all-causes during each epidemic period. The deaths observed in HC and MS institutions alone do not explain the excess (or deficit) of mortality in each region and epidemic period. CONCLUSION An analysis by age group according to the two approaches and a comparison of death specific causes could provide a better understanding of these differences. Electronic death registration system (mortality by medical causes) would allow a rapid mortality related estimation to an emerging pathology like Coronavirus Disease-2019 (COVID-19) but is still insufficient for real-time medical causes of death monitoring.
Collapse
Affiliation(s)
| | | | - Bruno Hubert
- Santé publique France, SpFrance, Saint-Maurice, France
| | | |
Collapse
|
3
|
Hadianfar A, Delavary M, Lavallière M, Nejatian A, Mehrpour O. Identify successful restrictions in suppressing the early outbreak of COVID-19 in Arizona, United States: Interrupted time series analysis. PLoS One 2023; 18:e0291205. [PMID: 38011229 PMCID: PMC10681290 DOI: 10.1371/journal.pone.0291205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/23/2023] [Indexed: 11/29/2023] Open
Abstract
COVID-19 was responsible for many deaths and economic losses around the globe since its first case report. Governments implemented a variety of policies to combat the pandemic in order to protect their citizens and save lives. Early in 2020, the first cases were reported in Arizona State and continued to rise until the discovery of the vaccine in 2021. A variety of strategies and interventions to stop or decelerate the spread of the pandemic has been considered. It is recommended to define which strategy was successful for disease propagation prevention and could be used in further similar situations. This study aimed to evaluate the effect of people's contact interventions strategies which were implemented in Arizona State and their effect on reducing the daily new COVID-19 cases and deaths. Their effect on daily COVID-19 cases and deaths were evaluated using an interrupted time series analysis during the pandemic's first peaks to better understand the onward situation. Canceling the order of staying at home (95% CI, 1718.52 to 6218.79; p<0.001) and expiring large gatherings (95% CI, 1984.99 to 7060.26; p<0.001) on June 30 and August 17, 2020, respectively, had a significant effect on the pandemic, leading to the daily cases to grow rapidly. Moreover, canceling the stay at home orders led to an increase in the number of COVID-19 daily deaths by 67.68 cases (95% CI, 27.96 to 107.40; p<0.001) after about 21 days while prohibiting large gatherings significantly decreased 66.76 (95% CI: 20.56 to 112.96; p = 0.004) the number of daily deaths with about 21 days' lag. The results showed that strategies aimed at reducing people's contact with one another could successfully help fight the pandemic. Findings from this study provide important evidence to support state-level policies that require observance of social distancing by the general public for future pandemics.
Collapse
Affiliation(s)
- Ali Hadianfar
- Student Research Committee, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Milad Delavary
- Department of Health Sciences, Laboratoire BioNR and Centre Intersectoriel en Santé Durable (CISD), Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Martin Lavallière
- Department of Health Sciences, Laboratoire BioNR and Centre Intersectoriel en Santé Durable (CISD), Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Amir Nejatian
- Department of Civil Engineering, Sharif University of Technology, Tehran, Iran
| | - Omid Mehrpour
- Arizona Poison & Drug Information Center, College of Pharmacy, The University of Arizona, Tucson, Arizona, United States of America
- College of Medicine, University of Arizona, Tucson, Arizona, United States of America
| |
Collapse
|
4
|
Altmejd A, Östergren O, Björkegren E, Persson T. Inequality and COVID-19 in Sweden: Relative risks of nine bad life events, by four social gradients, in pandemic vs. prepandemic years. Proc Natl Acad Sci U S A 2023; 120:e2303640120. [PMID: 37943837 PMCID: PMC10655217 DOI: 10.1073/pnas.2303640120] [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: 03/06/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023] Open
Abstract
The COVID-19 pandemic struck societies directly and indirectly, not just challenging population health but disrupting many aspects of life. Different effects of the spreading virus-and the measures to fight it-are reported and discussed in different scientific fora, with hard-to-compare methods and metrics from different traditions. While the pandemic struck some groups more than others, it is difficult to assess the comprehensive impact on social inequalities. This paper gauges social inequalities using individual-level administrative data for Sweden's entire population. We describe and analyze the relative risks for different social groups in four dimensions-gender, education, income, and world region of birth-to experience three types of COVID-19 incidence, as well as six additional negative life outcomes that reflect general health, access to medical care, and economic strain. During the pandemic, the overall population faced severe morbidity and mortality from COVID-19 and saw higher all-cause mortality, income losses and unemployment risks, as well as reduced access to medical care. These burdens fell more heavily on individuals with low income or education and on immigrants. Although these vulnerable groups experienced larger absolute risks of suffering the direct and indirect consequences of the pandemic, the relative risks in pandemic years (2020 and 2021) were conspicuously similar to those in prepandemic years (2016 to 2019).
Collapse
Affiliation(s)
- Adam Altmejd
- Swedish Institute for Social Research, Stockholm University, Stockholm106 91, Sweden
- Department of Finance, Stockholm School of Economics, Stockholm106 91, Sweden
| | - Olof Östergren
- Department of Public Health Sciences, Stockholm University, Stockholm106 91, Sweden
- Aging Research Center, Karolinska Institutet, Stockholm171 77, Sweden
| | | | - Torsten Persson
- Institute for International Economic Studies, Stockholm University, Stockholm106 91, Sweden
- Suntory and Toyota International Centres for Economics and Related Disciplines, London School of Economics, LondonWC2A 2AE, United Kingdom
| |
Collapse
|
5
|
Chen B, Liu Y, Yan B, Wu L, Zhang X. Why were some countries more successful than others in curbing early COVID-19 mortality impact? A cross-country configurational analysis. PLoS One 2023; 18:e0282617. [PMID: 36888633 PMCID: PMC9994757 DOI: 10.1371/journal.pone.0282617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Why was there considerable variation in initial COVID-19 mortality impact across countries? Through a configurational lens, this paper examines which configurations of five conditions-a delayed public-health response, past epidemic experience, proportion of elderly in population, population density, and national income per capita-influence early COVID-19 mortality impact measured by years of life lost (YLL). A fuzzy-set qualitative comparative analysis (fsQCA) of 80 countries identifies four distinctive pathways associated with high YLL rate and four other different pathways leading to low YLL rate. Results suggest that there is no singular "playbook"-a set of policies that countries can follow. Some countries failed differently, whereas others succeeded differently. Countries should take into account their situational contexts to adopt a holistic response strategy to combat any future public-health crisis. Regardless of the country's past epidemic experience and national income levels, a speedy public-health response always works well. For high-income countries with high population density or past epidemic experience, they need to take extra care to protect elderly populations who may otherwise overstretch healthcare capacity.
Collapse
Affiliation(s)
- Bin Chen
- Marxe School of Public and International Affairs, Baruch College & The Graduate Center, The City University of New York, New York, New York, United States of America
| | - Yao Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Bo Yan
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- * E-mail:
| | - Long Wu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xiaomin Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| |
Collapse
|
6
|
Rosengren A, Söderberg M, Lundberg CE, Lindgren M, Santosa A, Edqvist J, Åberg M, Gisslén M, Robertson J, Cronie O, Sattar N, Lagergren J, Brandén M, Björk J, Adiels M. COVID-19 in people aged 18-64 in Sweden in the first year of the pandemic: Key factors for severe disease and death. GLOBAL EPIDEMIOLOGY 2022; 4:100095. [PMID: 36447481 PMCID: PMC9683858 DOI: 10.1016/j.gloepi.2022.100095] [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: 08/06/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Studies on risk factors for severe COVID-19 in people of working age have generally not included non-working persons or established population attributable fractions (PAFs) for occupational and other factors. Objectives We describe the effect of job-related, sociodemographic, and other exposures on the incidence, relative risks and PAFs of severe COVID-19 in individuals aged 18-64. Methods We conducted a registry-based study in Swedish citizens aged 18-64 from 1 January 2020 to 1 February 2021 with respect to COVID-19-related hospitalizations and death. Results Of 6,205,459 persons, 272,043 (7.5%) were registered as infected, 3399 (0.05%) needed intensive care, and 620 (0.01%) died, with an estimated case fatality rate of 0.06% over the last 4-month period when testing was adequate. Non-Nordic origin was associated with a RR for need of intensive care of 3·13, 95%CI 2·91-3·36, and a PAF of 32·2% after adjustment for age, sex, work, region and comorbidities. In a second model with occupation as main exposure, and adjusted for age, sex, region, comorbidities and origin, essential workers had an RR of 1·51, 95%CI, 1·35-1·6, blue-collar workers 1·18, 95%CI 1·06-1·31, school staff 1·21, 95%CI 1·01-1·46, and health and social care workers 1·89, 95%CI 1·67-2·135) compared with people able to work from home, with altogether about 13% of the PAF associated with these occupations. Essential workers and blue-collar workers, but no other job categories had higher risk of death, adjusted RRs of 1·79, 95%CI 1·34-2·38 and 1·37, 95%CI 1·04-1·81, with adjusted PAFs of altogether 9%. Conclusion Among people of working age in Sweden, overall mortality and case fatality were low. Occupations that require physical presence at work were associated with elevated risk of needing intensive care for COVID-19, with 14% cases attributable to this factor, and 9% of deaths.
Collapse
Affiliation(s)
- Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Department of Medicine Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden,Corresponding author at: Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mia Söderberg
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christina E. Lundberg
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Lindgren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Department of Medicine Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden
| | - Ailiana Santosa
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jon Edqvist
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Åberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Regionhälsan, Gothenburg, Sweden
| | - Magnus Gisslén
- Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Josefina Robertson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ottmar Cronie
- Department of Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden
| | - Naveed Sattar
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Sweden,School of Cancer and Pharmaceutical Sciences, King's College London, United Kingdom
| | - Maria Brandén
- Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm University, Stockholm, Sweden,Institute for Analytical Sociology (IAS), Linköping University, Norrköping, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
7
|
Ludvigsson JF. How Sweden approached the COVID-19 pandemic: Summary and commentary on the National Commission Inquiry. Acta Paediatr 2022; 112:19-33. [PMID: 36065136 PMCID: PMC9538368 DOI: 10.1111/apa.16535] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 12/13/2022]
Abstract
AIM Sweden initially chose a different disease prevention and control path during the pandemic than many other European countries. In June 2020, the Swedish Government established a National Commission to examine the management of COVID-19 in Sweden. This paper summarises, and discusses, its findings. METHODS Three reports published by the Commission were analysed. The first focused on the care of older people during the pandemic. The second examined disease and infection transmission and control and health care and public health. The third updated the first two reports and also covered economic aspects, crisis management and public communication. RESULTS By 25 February 2022, when the final report was published, 15 800 individuals, 1.5 per 1000 Swedish inhabitants, had died after COVID-19. The death rates were high in spring 2020, but overall excess mortality in 2020-2021 was +0.79%, which was lower than in many other European countries. The Commission suggested that the voluntary measures that were adopted were appropriate and maintained Swedes' personal freedom during the pandemic. However, more extensive and earlier measures should have been taken, especially during the first wave. CONCLUSION The Swedish COVID-19 Commission felt that earlier and more extensive pandemic action should have been taken, particularly during the first wave.
Collapse
Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of PaediatricsÖrebro University HospitalÖrebroSweden,Department of MedicineColumbia University College of Physicians and SurgeonsNew YorkNew YorkUSA
| |
Collapse
|
8
|
Cortis D, Vella King F. Back to basics: measuring the impact of interventions to limit the spread of COVID-19 in Europe. Arch Public Health 2022; 80:76. [PMID: 35264231 PMCID: PMC8904711 DOI: 10.1186/s13690-022-00830-5] [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: 05/28/2021] [Accepted: 02/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Following the emergence of the COVID-19 pandemic in Europe at the start of 2020, most countries had implemented various measures in an attempt to control the spread of the virus. This study analyses the main non-pharmaceutical interventions and their impact on the rate by which cumulative cases and deaths were growing in Europe during the first wave of this pandemic. Methods The interventions analysed are the school closures, restrictions on travel, cancellation of events, restrictions on gatherings, partial and full lockdowns. Data was collected on the implementation date of these interventions, and the number of daily cases and deaths during the first wave of the pandemic for every country and territory geographically located in Europe. The study uses growth rates to calculate the increase in cumulative cases and deaths in Europe before, during, and after these interventions were implemented. Results The results show that decisions to close schools, cancel events, and restrict travel were taken during the same time period, whereas the decisions for the other interventions were taken when the growth rates were similar. The most effective interventions at lowering the rate by which cumulative cases were increasing were the travel restrictions, school closures, and the partial lockdown, while most effective against cumulative deaths were the partial lockdown, travel restrictions, and full lockdown. Conclusion All the interventions reduced the rate by which cumulative cases and deaths were increasing with the partial lockdowns being the most effective from the other interventions, during the first wave of the pandemic in Europe.
Collapse
Affiliation(s)
- Dominic Cortis
- Department of Insurance, Faculty of Economics, Management and Finance, University of Malta, Msida, Malta.
| | - Fiona Vella King
- Department of Insurance, Faculty of Economics, Management and Finance, University of Malta, Msida, Malta
| |
Collapse
|
9
|
Arnarson BT. How a school holiday led to persistent COVID-19 outbreaks in Europe. Sci Rep 2021; 11:24390. [PMID: 34937860 PMCID: PMC8695576 DOI: 10.1038/s41598-021-03927-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 12/13/2021] [Indexed: 12/13/2022] Open
Abstract
This paper investigates the role of large outbreaks on the persistence of Covid-19 over time. Using data from 650 European regions in 14 countries, I first show that winter school holidays in late February/early March 2020 (weeks 8, 9 and 10) led to large regional outbreaks of Covid-19 in the spring with the spread being 60% and up-to over 90% higher compared to regions with earlier school holidays. While the impact of these initial large outbreaks fades away over the summer months, it systematically reappears from the fall as regions with school holidays in weeks 8, 9 and 10 had 30–70% higher spread. This suggests that following a large outbreak, there is a strong element of underlying (latent) regional persistence of Covid-19. The strong degree of persistence highlights the long-term benefits of effective (initial) containment policies, as once a large outbreak has occurred, Covid-19 persists. This result emphasizes the need for vaccinations against Covid-19 in regions that have recently experienced large outbreaks but are well below herd-immunity, to avoid a new surge of cases.
Collapse
|
10
|
Liang LL, Kao CT, Ho HJ, Wu CY. COVID-19 case doubling time associated with non-pharmaceutical interventions and vaccination: A global experience. J Glob Health 2021; 11:05021. [PMID: 34552726 PMCID: PMC8442574 DOI: 10.7189/jogh.11.05021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Evidence has revealed that nonpharmaceutical interventions (NPIs) were effective in attenuating the spread of COVID-19. However, policymakers have encountered difficulty in identifying the most effective policies under different circumstances. This study investigated the relative effectiveness of different NPIs and vaccination in prolonging COVID-19 case doubling time (DT). Methods The study sample consisted of observations from 137 countries during 1 January 2020 to 13 June 2021. DT was calculated on a daily basis per country. Data were retrieved from the Oxford COVID-19 Government Response Tracker, World Development Indicators, and Worldwide Governance Indicators. To capture policy intervention dynamics, we combined a random-effect growth-curve model with nonstandard interrupted time series analysis. We also evaluated the association of policy measures with DT for different outbreak stages and levels of government effectiveness. Results Vaccine rollouts, workplace closures, and school closures were relatively effective. For each day that these measures were implemented, the DT increased by 1.96% (95% confidence interval (CI) = 0.63 to 3.29; P = 0.004), 1.41% (95% CI = 0.88 to 1.95%; P < 0.001) and 1.38% (95% CI = 0.95 to 1.81%; P < 0.001), respectively. Workplace and school closures were positively associated with DT at all stages; however, the associations weakened in later stages, where vaccine rollouts appeared to be most effective in prolonging DT (95% CI = 1.51% to 3.04%; P < 0.05). For countries with a high level of government effectiveness, most of the containment measures evaluated were effective; vaccine rollouts had the greatest effect size. For countries with medium or low levels of government effectiveness, only the closure of workplaces was consistently associated with prolonged DT. Conclusions The effectiveness of vaccine rollouts outweighed that of NPIs, especially in the later outbreak stages. However, vaccination was not associated with prolonged case DT in countries with lower levels of government effectiveness, probably due to low vaccine coverage. Among the NPIs examined, workplace closures were highly effective across all outbreak stages and levels of government effectiveness. Our findings suggest that mass vaccination is critical to reducing SARS-CoV-2 transmission, especially in countries where NPIs are less effective.
Collapse
Affiliation(s)
- Li-Lin Liang
- Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan.,Research Center for Epidemic Prevention, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chien-Tse Kao
- Austin Hospital, Austin Health, Melbourne, Australia
| | - Hsiu J Ho
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Ying Wu
- Research Center for Epidemic Prevention, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Public Health, China Medical University, Taichung, Taiwan
| |
Collapse
|
11
|
Rosén M, Stenbeck D, Stenbeck M. The one-sided explanations of a multifactorial coronavirus disease. Scand J Public Health 2021; 50:19-21. [PMID: 34240648 DOI: 10.1177/14034948211026540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Short-term interventions to suppress COVID-19 completely dominate the public, political and even the professional discussion on what explains observed differences in mortality and morbidity across countries. This leads to an exaggerated view of what such measures can accomplish. Factors such as housing and social conditions as well as travel patterns are equally important but neglected aspects of the COVID-19 development. A multifactorial disease needs a multivariate analytical approach.
Collapse
Affiliation(s)
- Måns Rosén
- Former Adjunct Professor of Epidemiology and Public Health, Umeå University, Sweden
| | | | - Magnus Stenbeck
- Institute of Environmental Medicine, Karolinska Institutet, Sweden
| |
Collapse
|
12
|
Noureddine FY, Chakkour M, El Roz A, Reda J, Al Sahily R, Assi A, Joma M, Salami H, Hashem SJ, Harb B, Salami A, Ghssein G. The Emergence of SARS-CoV-2 Variant(s) and Its Impact on the Prevalence of COVID-19 Cases in the Nabatieh Region, Lebanon. Med Sci (Basel) 2021; 9:medsci9020040. [PMID: 34199617 PMCID: PMC8293406 DOI: 10.3390/medsci9020040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/12/2021] [Accepted: 05/20/2021] [Indexed: 12/21/2022] Open
Abstract
Background: An outbreak of an unknown respiratory illness caused by a novel coronavirus, SARS-CoV-2, emerged in the city of Wuhan in Hubei Province, China, in December 2019 and was referred to as coronavirus disease-2019 (COVID-19). Soon after, it was declared as a global pandemic by the World Health Organization (WHO) in March 2020. SARS-CoV-2 mainly infects the respiratory tract with different outcomes ranging from asymptomatic infection to severe critical illness leading to death. Different SARS-CoV-2 variants are emerging of which three have raised concerns worldwide due to their high transmissibility among populations. Objective: To study the prevalence of COVID-19 in the region of Nabatieh-South Lebanon during the past year and assess the presence of SARS-CoV-2 variants and their effect on the spread of infection during times of lockdown. Methods: In our study, 37,474 nasopharyngeal swab samples were collected and analyzed for the detection of SARS-CoV-2 virus in suspected patients attending a tertiary health care center in South Lebanon during the period between 16 March 2020 and 21 February 2021. Results: The results demonstrated a variation in the prevalence rates ranging from less than 1% during full lockdown of the country to 8.4% upon easing lockdown restrictions and reaching 27.5% after the holidays and 2021 New Year celebrations. Interestingly, a new variant(s) appeared starting January 2021 with a significant positive association between the prevalence of positive tests and the percentage of the variant(s). Conclusions: Our results indicate that the lockdown implemented by the Lebanese officials was an effective intervention to contain COVID-19 spread. Our study also showed that lifting lockdown measures during the holidays, which allowed indoor crowded gatherings to occur, caused a surge in COVID-19 cases and rise in the mortality rates nationwide. More importantly, we confirmed the presence of a highly transmissible SARS-CoV-2 variant(s) circulating in the Lebanese community from at least January 2021 onwards.
Collapse
Affiliation(s)
- Fatima Y. Noureddine
- Medical Analysis Laboratory, Molecular Genetics Unit, Sheikh Ragheb Harb University Hospital (SRHUH), Nabatieh P.O. Box 1700, Lebanon; (F.Y.N.); (J.R.); (R.A.S.); (A.A.); (M.J.); (H.S.); (S.J.H.)
| | - Mohamed Chakkour
- Department of Biology, Faculty of Arts and Sciences, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon;
| | - Ali El Roz
- Department of Biology, Faculty of Sciences, Lebanese University, Nabatieh P.O. Box 6573/14, Lebanon;
| | - Jana Reda
- Medical Analysis Laboratory, Molecular Genetics Unit, Sheikh Ragheb Harb University Hospital (SRHUH), Nabatieh P.O. Box 1700, Lebanon; (F.Y.N.); (J.R.); (R.A.S.); (A.A.); (M.J.); (H.S.); (S.J.H.)
| | - Reem Al Sahily
- Medical Analysis Laboratory, Molecular Genetics Unit, Sheikh Ragheb Harb University Hospital (SRHUH), Nabatieh P.O. Box 1700, Lebanon; (F.Y.N.); (J.R.); (R.A.S.); (A.A.); (M.J.); (H.S.); (S.J.H.)
| | - Ali Assi
- Medical Analysis Laboratory, Molecular Genetics Unit, Sheikh Ragheb Harb University Hospital (SRHUH), Nabatieh P.O. Box 1700, Lebanon; (F.Y.N.); (J.R.); (R.A.S.); (A.A.); (M.J.); (H.S.); (S.J.H.)
| | - Mohamed Joma
- Medical Analysis Laboratory, Molecular Genetics Unit, Sheikh Ragheb Harb University Hospital (SRHUH), Nabatieh P.O. Box 1700, Lebanon; (F.Y.N.); (J.R.); (R.A.S.); (A.A.); (M.J.); (H.S.); (S.J.H.)
| | - Hassan Salami
- Medical Analysis Laboratory, Molecular Genetics Unit, Sheikh Ragheb Harb University Hospital (SRHUH), Nabatieh P.O. Box 1700, Lebanon; (F.Y.N.); (J.R.); (R.A.S.); (A.A.); (M.J.); (H.S.); (S.J.H.)
| | - Sadek J. Hashem
- Medical Analysis Laboratory, Molecular Genetics Unit, Sheikh Ragheb Harb University Hospital (SRHUH), Nabatieh P.O. Box 1700, Lebanon; (F.Y.N.); (J.R.); (R.A.S.); (A.A.); (M.J.); (H.S.); (S.J.H.)
| | - Batoul Harb
- Medical administration, SRHUH, Nabatieh P.O. Box 1700, Lebanon;
| | - Ali Salami
- Department of Mathematics, Faculty of Sciences, Lebanese University, Nabatieh P.O. Box 6573/14, Lebanon
- Correspondence: (A.S.); (G.G.); Tel.: +961-7-761-980 (A.S. & G.G.)
| | - Ghassan Ghssein
- Medical Analysis Laboratory, Molecular Genetics Unit, Sheikh Ragheb Harb University Hospital (SRHUH), Nabatieh P.O. Box 1700, Lebanon; (F.Y.N.); (J.R.); (R.A.S.); (A.A.); (M.J.); (H.S.); (S.J.H.)
- Department of Biology, Faculty of Sciences, Lebanese University, Nabatieh P.O. Box 6573/14, Lebanon;
- Department of Laboratory Sciences, Faculty of Nursing and Health Sciences, Islamic University of Lebanon, Khalde P.O. Box 30014, Lebanon
- Correspondence: (A.S.); (G.G.); Tel.: +961-7-761-980 (A.S. & G.G.)
| |
Collapse
|