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Kamalrathne T, Amaratunga D, Haigh R, Kodituwakku L, Rupasinghe C. Epidemic and Pandemic Preparedness and Response in a Multi-Hazard Context: COVID-19 Pandemic as a Point of Reference. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1238. [PMID: 39338121 PMCID: PMC11431425 DOI: 10.3390/ijerph21091238] [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] [Received: 08/01/2024] [Revised: 09/12/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024]
Abstract
Infectious diseases manifesting in the form of epidemics or pandemics do not only cause devastating impacts on public health systems but also disrupt the functioning of the socio-economic structure. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. This study aims to develop a framework that captures key elements and components of epidemic and pandemic preparedness and response systems, focusing on a multi-hazard context. A systematic literature review was used to collect data through peer-reviewed journal articles using three electronic databases, and 17 experts were involved in the validation. Epidemiological surveillance and early detection, risk and vulnerability assessments, preparedness, prediction and decision making, alerts and early warning, preventive strategies, control and mitigation, response, and elimination were identified as key elements associated with epidemic and pandemic preparedness and response systems in a multi-hazard context. All elements appear integrated within three interventional phases: upstream, interface, and downstream. A holistic approach focusing on all interventional phases is required for preparedness and response to pandemics and epidemics to counter their cascading and systemic effects. Further, a paradigm shift in the preparedness for multi-hazards during an epidemic or pandemic is essential due to the multiple challenges posed by concurrent hazards.
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Affiliation(s)
- Thushara Kamalrathne
- Global Disaster Resilience Centre, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK
| | - Dilanthi Amaratunga
- Global Disaster Resilience Centre, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK
| | - Richard Haigh
- Global Disaster Resilience Centre, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK
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2
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d'Onofrio A, Iannelli M, Manfredi P, Marinoschi G. Epidemic control by social distancing and vaccination: Optimal strategies and remarks on the COVID-19 Italian response policy. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2024; 21:6493-6520. [PMID: 39176405 DOI: 10.3934/mbe.2024283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
After the many failures in the control of the COVID-19 pandemic, identifying robust principles of epidemic control will be key in future preparedness. In this work, we propose an optimal control model of an age-of-infection transmission model under a two-phase control regime where social distancing is the only available control tool in the first phase, while the second phase also benefits from the arrival of vaccines. We analyzed the problem by an ad-hoc numerical algorithm under a strong hypothesis implying a high degree of prioritization to the protection of health from the epidemic attack, which we termed the "low attack rate" hypothesis. The outputs of the model were also compared with the data from the Italian COVID-19 experience to provide a crude assessment of the goodness of the enacted interventions prior to the onset of the Omicron variant.
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Affiliation(s)
- Alberto d'Onofrio
- Dipartimento di Matematica, Informatica e Geoscienze, Università di Trieste, Via Alfonso Valerio 12, Edificio H2bis, 34127 Trieste, Italy
| | - Mimmo Iannelli
- Department of Mathematics, University of Trento, Via Sommarive 14, 38123 Trento, Italy
| | - Piero Manfredi
- Dipartimento di Economia e Management, University of Pisa, Via Ridolfi 10, 56124 Pisa, Italy
| | - Gabriela Marinoschi
- Gheorghe Mihoc-Caius Iacob Institute of Mathematical Statistics and Applied Mathematics, Romanian Academy, Bucharest, Romania
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Lee J, Park S, Jang SN, Reyes KA, Garcia F, Canila C, Oraño J, Ballesteros AJ, Muhartini T, Frans S, Marthias T, Putri LP, Mahendradhata Y, De Foo C. Differential impacts of health systems and sociocultural environment on vulnerable populations during the COVID-19 pandemic: lessons from four Asia-Pacific countries. BMC Public Health 2024; 24:1501. [PMID: 38840230 PMCID: PMC11151645 DOI: 10.1186/s12889-024-18949-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND This study aims to evaluate healthcare systems and pandemic responses in relation to marginalized and vulnerable groups, identify populations requiring urgent care, and assess the differential impacts on their health during the pandemic. METHODS Data were collected by the Asia-Pacific Observatory on Health Systems and Policies (APO)-National University of Singapore and APO-International Health Policy Program consortium members: Korea, Indonesia, Philippines, and Singapore. Data were collected through a combination of semi-structured interviews, policy document reviews, and analysis of secondary data. RESULTS Our findings reveal that the pandemic exacerbated existing health disparities, particularly affecting older adults, women, and children. Additionally, the study identified LGBTI individuals, healthcare workers, slum dwellers, and migrant workers as groups that faced particularly severe challenges during the pandemic. LGBTI individuals encountered heightened discrimination and limited access to health services tailored to their needs. Healthcare workers suffered from immense stress and risk due to prolonged exposure to the virus and critical working conditions. Slum dwellers struggled with healthcare access and social distancing due to high population density and inadequate sanitation. Migrant workers were particularly hard hit by high risks of virus transmission and stringent, often discriminatory, isolation measures that compounded their vulnerability. The study highlights the variation in the extent and nature of vulnerabilities, which were influenced by each country's specific social environment and healthcare infrastructure. It was observed that public health interventions often lacked the specificity required to effectively address the needs of all vulnerable groups, suggesting a gap in policy and implementation. CONCLUSIONS The study underscores that vulnerabilities vary greatly depending on the social environment and context of each country, affecting the degree and types of vulnerable groups. It is critical that measures to ensure universal health coverage and equal accessibility to healthcare are specifically designed to address the needs of the most vulnerable. Despite commonalities among groups across different societies, these interventions must be adapted to reflect the unique characteristics of each group within their specific social contexts to effectively mitigate the impact of health disparities.
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Affiliation(s)
- Jakyung Lee
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Hyo-tree nursing home, Incheon, Republic of Korea
| | - Susan Park
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Seoul National University, Seoul, Republic of Korea
| | - Soong-Nang Jang
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea.
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
| | | | - Fernando Garcia
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Carmelita Canila
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Joseph Oraño
- Alliance for Improving Health Outcomes, Quezon City, Philippines
| | | | - Tri Muhartini
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Sandra Frans
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Tiara Marthias
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Likke Prawidya Putri
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Yodi Mahendradhata
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Chuan De Foo
- NUS Saw Swee Hock School of Public Health and National University Health System, Singapore, Singapore
- Duke NUS Graduate Medical School, Singapore, Singapore
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Martignoni MM, Arino J, Hurford A. Is SARS-CoV-2 elimination or mitigation best? Regional and disease characteristics determine the recommended strategy. ROYAL SOCIETY OPEN SCIENCE 2024; 11:240186. [PMID: 39100176 PMCID: PMC11295893 DOI: 10.1098/rsos.240186] [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: 01/31/2023] [Accepted: 05/01/2024] [Indexed: 08/06/2024]
Abstract
Public health responses to the COVID-19 pandemic varied across the world. Some countries (e.g. mainland China, New Zealand and Taiwan) implemented elimination strategies involving strict travel measures and periods of rigorous non-pharmaceutical interventions (NPIs) in the community, aiming to achieve periods with no disease spread; while others (e.g. many European countries and the USA) implemented mitigation strategies involving less strict NPIs for prolonged periods, aiming to limit community spread. Travel measures and community NPIs have high economic and social costs, and there is a need for guidelines that evaluate the appropriateness of an elimination or mitigation strategy in regional contexts. To guide decisions, we identify key criteria and provide indicators and visualizations to help answer each question. Considerations include determining whether disease elimination is: (1) necessary to ensure healthcare provision; (2) feasible from an epidemiological point of view and (3) cost-effective when considering, in particular, the economic costs of travel measures and treating infections. We discuss our recommendations by considering the regional and economic variability of Canadian provinces and territories, and the epidemiological characteristics of different SARS-CoV-2 variants. While elimination may be a preferable strategy for regions with limited healthcare capacity, low travel volumes, and few ports of entry, mitigation may be more feasible in large urban areas with dense infrastructure, strong economies, and with high connectivity to other regions.
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Affiliation(s)
- Maria M. Martignoni
- Department of Mathematics and Statistics, Memorial University of Newfoundland, St. John’s, Canada
- Department of Ecology, Evolution and Behavior, A. Silberman Institute of Life Sciences, Faculty of Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Julien Arino
- Department of Mathematics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amy Hurford
- Department of Mathematics and Statistics, Memorial University of Newfoundland, St. John’s, Canada
- Biology Department and Department of Mathematics and Statistics, Memorial University of Newfoundland, St. John’s, Canada
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Kim J, Jo S, Cho SI. New framework to assess tracing and testing based on South Korea's response to COVID-19. BMC Infect Dis 2024; 24:469. [PMID: 38702610 PMCID: PMC11067276 DOI: 10.1186/s12879-024-09363-4] [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] [Received: 10/07/2023] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
South Korea's remarkable success in controlling the spread of COVID-19 during the pre-Omicron period was based on extensive contact tracing and large-scale testing. Here we suggest a general criterion for tracing and testing based on South Korea's experience, and propose a new framework to assess tracing and testing. We reviewed papers on South Korea's response to COVID-19 to capture its concept of tracing and testing. South Korea expanded its testing capabilities to enable group tracing combined with preemptive testing, and to conduct open testing. According to our proposed model, COVID-19 cases are classified into 4 types: confirmed in quarantine, source known, source unknown, and unidentified. The proportion of the first two case types among confirmed cases is defined as "traced proportion", and used as the indicator of tracing and testing effectiveness. In conclusion, South Korea successfully suppressed COVID-19 transmission by maintaining a high traced proportion (> 60%) using group tracing in conjunction with preemptive testing as a complementary strategy to traditional contact tracing.
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Chen H, Xu T, Mitchell R, Yang H, Zhou Z, Wei X, Wang W. The organization-level and physician-level factors associated with primary care physicians' confidence in pandemic response: A multilevel study in China. PLoS One 2024; 19:e0295570. [PMID: 38421982 PMCID: PMC10903868 DOI: 10.1371/journal.pone.0295570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/23/2023] [Indexed: 03/02/2024] Open
Abstract
Primary care physicians (PCPs) suffered from heavy workloads and health problems during COVID-19 pandemics, and building their confidence in pandemic response has great potential to improve their well-being and work performance. We identified the organizational factors associated with their confidence in pandemic response and proposed potential management levers to guide primary care response for the pandemic. We conducted a cross-sectional survey with 224 PCPs working in 38 community health centers in China. Guided by self-efficacy theory, organization-level factors (organizational structure and organizational culture) and physician-level factors (job skill variety, perceived organizational support, work-family conflict, and professional fulfillment) were selected, and two-level ordinal logit models were built to examine their association with PCPs' confidence in pandemic response. We found that hierarchical culture (OR = 3.51, P<0.05), perceived organizational support (OR = 2.36, P<0.05), job skill variety (OR = 1.86, P<0.05), and professional fulfillment (OR = 2.26, P<0.05) were positively associated with PCPs' confidence in pandemic response. However, the influence of organization structure and work-family conflict seemed limited. The study not only increases our understanding of the influence of organizational context on PCPs' pandemic response confidence, but also points out potential management levers for front-line primary care managers to enhance primary care pandemic response capacity.
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Affiliation(s)
- Haiming Chen
- Zhangjiagang Center for Disease Control and Prevention, Zhangjiagang, Suzhou, China
| | - Tiange Xu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
| | - Rebecca Mitchell
- Health and Wellbeing Research Unit (HoWRU), Macquarie Business School, Macquarie University, Sydney, Australia
| | - Huiyun Yang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Wenhua Wang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Liu M, Shi L, Yang M, Jiao J, Yang J, Ma M, Xie W, Sun G. Ecological comparison of six countries in two waves of COVID-19. Front Public Health 2024; 12:1277457. [PMID: 38481850 PMCID: PMC10933017 DOI: 10.3389/fpubh.2024.1277457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/16/2024] [Indexed: 04/30/2024] Open
Abstract
Objective The purpose of this study is to provide experience and evidence support for countries to deal with similar public health emergencies such as COVID-19 by comparing and analyzing the measures taken by six countries in epidemic prevention and control. Methods This study extracted public data on COVID-19 from the official website of various countries and used ecological comparative research methods to compare the specific situation of indicators such as daily tests per thousand people, stringency index, and total vaccinations per hundred people in countries. Results The cumulative death toll in China, Germany and Australia was significantly lower than that in the United States, South Africa and Italy. Expanding the scale of testing has helped control the spread of the epidemic to some extent. When the epidemic situation is severe, the stringency index increases, and when the epidemic situation tends to ease, the stringency index decreases. Increased vaccination rates, while helping to build an immune barrier, still need to be used in conjunction with non-drug interventions. Conclusion The implementation of non-drug interventions and vaccine measures greatly affected the epidemic prevention and control effect. In responding to public health emergencies such as the COVID-19 epidemic, countries should draw on international experience, closely align with their national conditions, follow the laws of epidemiology, actively take non-drug intervention measures, and vigorously promote vaccine research and development and vaccination.
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Affiliation(s)
- Meiheng Liu
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Manfei Yang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
| | - Jun Jiao
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
| | - Junyan Yang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
| | - Mengyuan Ma
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
| | - Wanzhen Xie
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
| | - Gang Sun
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Pisaneschi G, Tarani M, Di Donato G, Landi A, Laurino M, Manfredi P. Optimal social distancing in epidemic control: cost prioritization, adherence and insights into preparedness principles. Sci Rep 2024; 14:4365. [PMID: 38388727 PMCID: PMC10883963 DOI: 10.1038/s41598-024-54955-4] [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] [Received: 10/12/2023] [Accepted: 02/19/2024] [Indexed: 02/24/2024] Open
Abstract
The COVID-19 pandemic experience has highlighted the importance of developing general control principles to inform future pandemic preparedness based on the tension between the different control options, ranging from elimination to mitigation, and related costs. Similarly, during the COVID-19 pandemic, social distancing has been confirmed to be the critical response tool until vaccines become available. Open-loop optimal control of a transmission model for COVID-19 in one of its most aggressive outbreaks is used to identify the best social distancing policies aimed at balancing the direct epidemiological costs of a threatening epidemic with its indirect (i.e., societal level) costs arising from enduring control measures. In particular, we analyse how optimal social distancing varies according to three key policy factors, namely, the degree of prioritization of indirect costs, the adherence to control measures, and the timeliness of intervention. As the prioritization of indirect costs increases, (i) the corresponding optimal distancing policy suddenly switches from elimination to suppression and, finally, to mitigation; (ii) the "effective" mitigation region-where hospitals' overwhelming is prevented-is dramatically narrow and shows multiple control waves; and (iii) a delicate balance emerges, whereby low adherence and lack of timeliness inevitably force ineffective mitigation as the only accessible policy option. The present results show the importance of open-loop optimal control, which is traditionally absent in public health preparedness, for studying the suppression-mitigation trade-off and supplying robust preparedness guidelines.
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Affiliation(s)
- Giulio Pisaneschi
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Matteo Tarani
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | | | - Alberto Landi
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Marco Laurino
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Piero Manfredi
- Department of Economics and Management, University of Pisa, Pisa, Italy.
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Anzai A, Yamasaki S, Bleichrodt A, Chowell G, Nishida A, Nishiura H. Epidemiological impact of travel enhancement on the inter-prefectural importation dynamics of COVID-19 in Japan, 2020. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:21499-21513. [PMID: 38124607 DOI: 10.3934/mbe.2023951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Mobility restrictions were widely practiced to reduce contact with others and prevent the spatial spread of COVID-19 infection. Using inter-prefectural mobility and epidemiological data, a statistical model was devised to predict the number of imported cases in each Japanese prefecture. The number of imported cases crossing prefectural borders in 2020 was predicted using inter-prefectural mobility rates based on mobile phone data and prevalence estimates in the origin prefectures. The simplistic model was quantified using surveillance data of cases with an inter-prefectural travel history. Subsequently, simulations were carried out to understand how imported cases vary with the mobility rate and prevalence at the origin. Overall, the predicted number of imported cases qualitatively captured the observed number of imported cases over time. Although Hokkaido and Okinawa are the northernmost and the southernmost prefectures, respectively, they were sensitive to differing prevalence rate in Tokyo and Osaka and the mobility rate. Additionally, other prefectures were sensitive to mobility change, assuming that an increment in the mobility rate was seen in all prefectures. Our findings indicate the need to account for the weight of an inter-prefectural mobility network when implementing countermeasures to restrict human movement. If the mobility rates were maintained lower than the observed rates, then the number of imported cases could have been maintained at substantially lower levels than the observed, thus potentially preventing the unnecessary spatial spread of COVID-19 in late 2020.
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Affiliation(s)
- Asami Anzai
- Graduate School of Medicine, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Amanda Bleichrodt
- School of Public Health, Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA
| | - Gerardo Chowell
- School of Public Health, Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- Tokyo Center for Infectious Disease Control and Prevention, Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Nishiura
- Graduate School of Medicine, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto 606-8501, Japan
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Pitsillou E, Yu Y, Beh RC, Liang JJ, Hung A, Karagiannis TC. Chronicling the 3-year evolution of the COVID-19 pandemic: analysis of disease management, characteristics of major variants, and impacts on pathogenicity. Clin Exp Med 2023; 23:3277-3298. [PMID: 37615803 DOI: 10.1007/s10238-023-01168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
Announced on December 31, 2019, the novel coronavirus arising in Wuhan City, Hubei Province resulted in millions of cases and lives lost. Following intense tracking, coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in 2020. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the cause of COVID-19 and the continuous evolution of the virus has given rise to several variants. In this review, a comprehensive analysis of the response to the pandemic over the first three-year period is provided, focusing on disease management, development of vaccines and therapeutics, and identification of variants. The transmissibility and pathogenicity of SARS-CoV-2 variants including Alpha, Beta, Gamma, Delta, and Omicron are compared. The binding characteristics of the SARS-CoV-2 spike protein to the angiotensin-converting enzyme 2 (ACE2) receptor and reproduction numbers are evaluated. The effects of major variants on disease severity, hospitalisation, and case-fatality rates are outlined. In addition to the spike protein, open reading frames mutations are investigated. We also compare the pathogenicity of SARS-CoV-2 with SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV). Overall, this study highlights the strengths and weaknesses of the global response to the pandemic, as well as the importance of prevention and preparedness. Monitoring the evolution of SARS-CoV-2 is critical in identifying and potentially predicting the health outcomes of concerning variants as they emerge. The ultimate goal would be a position in which existing vaccines and therapeutics could be adapted to suit new variants in as close to real-time as possible.
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Affiliation(s)
- Eleni Pitsillou
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia
- School of Science, STEM College, RMIT University, Melbourne, VIC, 3001, Australia
| | - Yiping Yu
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Raymond C Beh
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia
- School of Science, STEM College, RMIT University, Melbourne, VIC, 3001, Australia
| | - Julia J Liang
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia
- School of Science, STEM College, RMIT University, Melbourne, VIC, 3001, Australia
| | - Andrew Hung
- School of Science, STEM College, RMIT University, Melbourne, VIC, 3001, Australia
| | - Tom C Karagiannis
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia.
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia.
- Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia.
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Tradigo G, Das JK, Vizza P, Roy S, Guzzi PH, Veltri P. Strategies and Trends in COVID-19 Vaccination Delivery: What We Learn and What We May Use for the Future. Vaccines (Basel) 2023; 11:1496. [PMID: 37766172 PMCID: PMC10535057 DOI: 10.3390/vaccines11091496] [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: 08/21/2023] [Revised: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Vaccination has been the most effective way to control the outbreak of the COVID-19 pandemic. The numbers and types of vaccines have reached considerable proportions, even if the question of vaccine procedures and frequency still needs to be resolved. We have come to learn the necessity of defining vaccination distribution strategies with regard to COVID-19 that could be used for any future pandemics of similar gravity. In fact, vaccine monitoring implies the existence of a strategy that should be measurable in terms of input and output, based on a mathematical model, including death rates, the spread of infections, symptoms, hospitalization, and so on. This paper addresses the issue of vaccine diffusion and strategies for monitoring the pandemic. It provides a description of the importance and take up of vaccines and the links between procedures and the containment of COVID-19 variants, as well as the long-term effects. Finally, the paper focuses on the global scenario in a world undergoing profound social and political change, with particular attention on current and future health provision. This contribution would represent an example of vaccination experiences, which can be useful in other pandemic or epidemiological contexts.
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Affiliation(s)
- Giuseppe Tradigo
- Department of Computer Science, eCampus University, 22060 Novedrate, Italy;
| | - Jayanta Kumar Das
- Longitudinal Studies Section, Translation Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA;
| | - Patrizia Vizza
- Department of Surgical and Medical Science, Magna Græcia University, 88100 Catanzaro, Italy;
| | - Swarup Roy
- Network Reconstruction & Analysis (NetRA) Lab, Department of Computer Applications, Sikkim University, Gangtok 737102, India;
| | - Pietro Hiram Guzzi
- Department of Surgical and Medical Science, Magna Græcia University, 88100 Catanzaro, Italy;
| | - Pierangelo Veltri
- Department of Computer Science, Modelling, Electronics and Systems, University of Calabria, 87036 Rende, Italy;
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12
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Ochida N, Dupont-Rouzeyrol M, Moury PH, Demaneuf T, Gourinat AC, Mabon S, Jouan M, Cauchemez S, Mangeas M. Evaluating the strategies to control SARS-CoV-2 Delta variant spread in New Caledonia, a zero-COVID country until September 2021. IJID REGIONS 2023; 8:64-70. [PMID: 37583482 PMCID: PMC10423666 DOI: 10.1016/j.ijregi.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 08/17/2023]
Abstract
Objectives New Caledonia, a former zero-COVID country, was confronted with a SARS-CoV-2 Delta variant outbreak in September 2021. We evaluate the relative contribution of vaccination, lockdown, and timing of interventions on healthcare burden. Methods We developed an age-stratified mathematical model of SARS-CoV-2 transmission and vaccination calibrated for New Caledonia and evaluated three alternative scenarios. Results High virus transmission early on was estimated, with R0 equal to 6.6 (95% confidence interval [6.4-6.7]). Lockdown reduced R0 by 73% (95% confidence interval [70-76%]). Easing the lockdown increased transmission (39% reduction of the initial R0); but we did not observe an epidemic rebound. This contrasts with the rebound in hospital admissions (+116% total hospital admissions) that would have been expected in the absence of an intensified vaccination campaign (76,220 people or 34% of the eligible population were first-dose vaccinated during 1 month of lockdown). A 15-day earlier lockdown would have led to a significant reduction in the magnitude of the epidemic (-53% total hospital admissions). Conclusion The success of the response against the Delta variant epidemic in New Caledonia was due to an effective lockdown that provided additional time for people to vaccinate. Earlier lockdown would have greatly mitigated the magnitude of the epidemic.
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Affiliation(s)
- Noé Ochida
- UMR ENTROPIE, IRD, Université de La Réunion, IFREMER, Université de Nouvelle-Calédonie, CNRS, Noumea, New Caledonia
- Research and Expertise Unit on Dengue and Arboviruses, Institut Pasteur of New Caledonia, Pasteur Network, Noumea, New Caledonia
| | - Myrielle Dupont-Rouzeyrol
- Research and Expertise Unit on Dengue and Arboviruses, Institut Pasteur of New Caledonia, Pasteur Network, Noumea, New Caledonia
| | - Pierre-Henri Moury
- Department of Anesthesia and Intensive Care Medicine, Grenoble University Hospital, Grenoble, France
- Research and Expertise Unit of Epidemiology, Institut Pasteur of New Caledonia, Pasteur Network, Noumea, New Caledonia
- Intensive Care Unit, Gaston-Bourret Territorial Hospital Center, Dumbea-Sur-Mer, New Caledonia
| | | | - Ann-Clair Gourinat
- Microbiology Laboratory, Gaston-Bourret Territorial Hospital Center, Dumbea-Sur-Mer, New Caledonia
| | - Sébastien Mabon
- Directorate of Health and Social Affairs, Noumea, New Caledonia
| | - Marc Jouan
- Research and Expertise Unit on Dengue and Arboviruses, Institut Pasteur of New Caledonia, Pasteur Network, Noumea, New Caledonia
- Research and Expertise Unit of Epidemiology, Institut Pasteur of New Caledonia, Pasteur Network, Noumea, New Caledonia
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, UMR2000, CNRS, Paris, France
| | - Morgan Mangeas
- UMR ENTROPIE, IRD, Université de La Réunion, IFREMER, Université de Nouvelle-Calédonie, CNRS, Noumea, New Caledonia
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13
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Ge Y, Wu X, Zhang W, Wang X, Zhang D, Wang J, Liu H, Ren Z, Ruktanonchai NW, Ruktanonchai CW, Cleary E, Yao Y, Wesolowski A, Cummings DAT, Li Z, Tatem AJ, Lai S. Effects of public-health measures for zeroing out different SARS-CoV-2 variants. Nat Commun 2023; 14:5270. [PMID: 37644012 PMCID: PMC10465600 DOI: 10.1038/s41467-023-40940-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
Targeted public health interventions for an emerging epidemic are essential for preventing pandemics. During 2020-2022, China invested significant efforts in strict zero-COVID measures to contain outbreaks of varying scales caused by different SARS-CoV-2 variants. Based on a multi-year empirical dataset containing 131 outbreaks observed in China from April 2020 to May 2022 and simulated scenarios, we ranked the relative intervention effectiveness by their reduction in instantaneous reproduction number. We found that, overall, social distancing measures (38% reduction, 95% prediction interval 31-45%), face masks (30%, 17-42%) and close contact tracing (28%, 24-31%) were most effective. Contact tracing was crucial in containing outbreaks during the initial phases, while social distancing measures became increasingly prominent as the spread persisted. In addition, infections with higher transmissibility and a shorter latent period posed more challenges for these measures. Our findings provide quantitative evidence on the effects of public-health measures for zeroing out emerging contagions in different contexts.
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Affiliation(s)
- Yong Ge
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.
- Key Laboratory of Poyang Lake Wetland and Watershed Research Ministry of Education, Jiangxi Normal University, Nanchang, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China.
| | - Xilin Wu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Wenbin Zhang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Xiaoli Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Die Zhang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Poyang Lake Wetland and Watershed Research Ministry of Education, Jiangxi Normal University, Nanchang, China
| | - Jianghao Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Haiyan Liu
- Marine Data Center, Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, China
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | | | | | - Eimear Cleary
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Yongcheng Yao
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
- School of Mathematics and Statistics, Zhengzhou Normal University, Zhengzhou, China
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Derek A T Cummings
- Department of Biology and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Zhongjie Li
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Andrew J Tatem
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Shengjie Lai
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK.
- Institute for Life Sciences, University of Southampton, Southampton, UK.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
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14
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de Carvalho PVR, Bellas H, Viana J, de Castro Nunes P, Arcuri R, da Silva Fonseca V, Carneiro APM, Jatobá A. Transformative dimensions of resilience and brittleness during health systems' collapse: a case study in Brazil using the Functional Resonance Analysis Method. BMC Health Serv Res 2023; 23:349. [PMID: 37032325 PMCID: PMC10084590 DOI: 10.1186/s12913-023-09301-1] [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: 10/12/2022] [Accepted: 03/17/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND As health systems struggle to tackle the spread of Covid-19, resilience becomes an especially relevant attribute and research topic. More than strength or preparedness, to perform resiliently to emerging shocks, health systems must develop specific abilities that aim to increase their potential to adapt to extraordinary situations while maintaining their regular functioning. Brazil has been one of the most affected countries during the pandemic. In January 2021, the Amazonas state's health system collapsed, especially in the city of Manaus, where acute Covid-19 patients died due to scarcity of medical supplies for respiratory therapy. METHODS This paper explores the case of the health system's collapse in Manaus to uncover the elements that prevented the system from performing resiliently to the pandemic, by carrying out a grounded-based systems analysis of the performance of health authorities in Brazil using the Functional Resonance Analysis Method. The major source of information for this study was the reports from the congressional investigation carried out to unveil the Brazilian response to the pandemic. RESULTS Poor cohesion between the different levels of government disrupted essential functions for managing the pandemic. Moreover, the political agenda interfered in the abilities of the system to monitor, respond, anticipate, and learn, essential aspects of resilient performance. CONCLUSIONS Through a systems analysis approach, this study describes the implicit strategy of "living with Covid-19", and an in-depth view of the measures that hampered the resilience of the Brazilian health system to the spread of Covid-19.
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Affiliation(s)
| | - Hugo Bellas
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jaqueline Viana
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Paula de Castro Nunes
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rodrigo Arcuri
- Programa de Pós-Graduação Em Engenharia de Produção (TPP), Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Valéria da Silva Fonseca
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Alessandro Jatobá
- Centro de Estudos, Estratégicos Antônio Ivo de Carvalho (CEE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
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15
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Adams S, Lancaster K, Rhodes T. Undoing elimination: Modelling Australia's way out of the COVID-19 pandemic. Glob Public Health 2023; 18:2195899. [PMID: 37054450 DOI: 10.1080/17441692.2023.2195899] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
In the middle of 2020, with its borders tightly closed to the rest of the world, Australia almost achieved the local elimination of COVID-19 and subsequently maintained 'COVID-zero' in most parts of the country for the following year. Australia has since faced the relatively unique challenge of deliberately 'undoing' these achievements by progressively easing restrictions and reopening. Exploring the role of mathematical modelling in navigating a course through the pandemic through qualitative interviews with modellers and others working closely with modelling, we argue that each of these two significant phases of Australia's COVID-19 experience can be understood as distinct forms of 'model society'. This refers at once to the society enacted through the governance of risk, and to the visions of societal outcomes - whether to be sought or to be avoided - that are offered up by models. Each of the two model societies came about through a reflexive engagement with risk facilitated by models, and the iterative relationship between the representations of society enacted within models and the possibilities that these representations generate in the material world beyond them.
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Affiliation(s)
- Sophie Adams
- Centre for Social Research in Health, University of New South Wales, Kensington, Sydney, Australia
| | - Kari Lancaster
- Centre for Social Research in Health, University of New South Wales, Kensington, Sydney, Australia
| | - Tim Rhodes
- London School of Hygiene and Tropical Medicine, London, UK
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16
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Basseal JM, Bennett CM, Collignon P, Currie BJ, Durrheim DN, Leask J, McBryde ES, McIntyre P, Russell FM, Smith DW, Sorrell TC, Marais BJ. Key lessons from the COVID-19 public health response in Australia. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 30:100616. [PMID: 36248767 PMCID: PMC9549254 DOI: 10.1016/j.lanwpc.2022.100616] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Australia avoided the worst effects of the COVID-19 pandemic, but still experienced many negative impacts. Reflecting on lessons from Australia's public health response, an Australian expert panel composed of relevant discipline experts identified the following key lessons: 1) movement restrictions were effective, but their implementation requires careful consideration of adverse impacts, 2) disease modelling was valuable, but its limitations should be acknowledged, 3) the absence of timely national data requires re-assessment of national surveillance structures, 4) the utility of advanced pathogen genomics and novel vaccine technology was clearly demonstrated, 5) decision-making that is evidence informed and consultative is essential to maintain trust, 6) major system weaknesses in the residential aged-care sector require fixing, 7) adequate infection prevention and control frameworks are critically important, 8) the interests and needs of young people should not be compromised, 9) epidemics should be recognised as a 'standing threat', 10) regional and global solidarity is important. It should be acknowledged that we were unable to capture all relevant nuances and context specific differences. However, the intent of this review of Australia's public health response is to critically reflect on key lessons learnt and to encourage constructive national discussion in countries across the Western Pacific Region.
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Affiliation(s)
- J M Basseal
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia
| | - C M Bennett
- Institute for Health Transformation, Deakin University, Burwood, Australia
| | - P Collignon
- Medical School, Australian National University and Canberra Hospital, Canberra, Australia
| | - B J Currie
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - D N Durrheim
- Department of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - J Leask
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | - E S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - P McIntyre
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - F M Russell
- Department of Paediatrics, The University of Melbourne and Murdoch Children's Research Institute, Melbourne, Australia
| | - D W Smith
- School of Medicine, University of Western Australia and PathWest Department of Microbiology, Perth, Australia
| | - T C Sorrell
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia
| | - B J Marais
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia
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17
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Magnus MC, Oakley LL, Hansen AV, Örtqvist AK, Petersen TG, Mortensen LH, Bliddal M, Andersen AMN, Stephansson O, Håberg SE. Fetal death after the introduction of COVID-19 mitigation measures in Sweden, Denmark and Norway: a registry-based study. Sci Rep 2022; 12:20625. [PMID: 36450919 PMCID: PMC9709372 DOI: 10.1038/s41598-022-25036-1] [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: 04/30/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
It remains unclear whether the rate of fetal death has changed during the COVID-19 pandemic. We assessed the impact of COVID-19 mitigation measures on fetal death in Sweden (449,347 births), Denmark (290,857 pregnancies) and Norway (261,057 pregnancies) using robust population-based registry data. We used Cox regression to assess the impact of the implementation of pandemic mitigation measures on March 12th, 2020, on miscarriage (fetal loss before gestational week 22) and stillbirth (fetal loss after gestational week 22). A total of 11% of 551,914 pregnancies in Denmark and Norway ended in miscarriage, while the proportion of stillbirths among 937,174 births across the three countries was 0.3%. There was no difference in the risk of fetal death during the year following pandemic mitigation measures. For miscarriage, the combined hazard ratio (HR) for Norway and Denmark was 1.01 (95% CI 0.98, 1.03), and for stillbirth, the combined HR for all three countries was 0.99 (95% CI 0.89, 1.09). We observed a slightly decreased risk of miscarriage during the first 4 months, with an HR of 0.94 (95% CI 0.90, 0.99) after lockdown. In conclusion, the risk of fetal death did not change after the implementation of COVID-19 pandemic mitigation measures in the three Scandinavian countries.
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Affiliation(s)
- Maria C. Magnus
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway
| | - Laura L. Oakley
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway ,grid.8991.90000 0004 0425 469XDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne V. Hansen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark ,grid.437930.a0000 0001 2248 6353Statistics Denmark, Copenhagen, Denmark
| | - Anne K. Örtqvist
- grid.4714.60000 0004 1937 0626Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden ,Department of Obstetrics and Gynaecology, Visby County Hospital, Visby, Sweden
| | - Tanja G. Petersen
- grid.7143.10000 0004 0512 5013Open, Odense University Hospital, Odense, Denmark
| | - Laust H. Mortensen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark ,grid.437930.a0000 0001 2248 6353Statistics Denmark, Copenhagen, Denmark
| | - Mette Bliddal
- grid.10825.3e0000 0001 0728 0170OPEN, University of Southern Denmark, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anne-Marie Nybo Andersen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Olof Stephansson
- grid.4714.60000 0004 1937 0626Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Women’s Health, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Siri E. Håberg
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway
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18
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Foo CD, Verma M, Tan SM, Haldane V, Reyes KA, Garcia F, Canila C, Orano J, Ballesteros AJ, Marthias T, Mahendradhata Y, Tuangratananon T, Rajatanavin N, Poungkantha W, Mai Oanh T, The Due O, Asgari-Jirhandeh N, Tangcharoensathien V, Legido-Quigley H. COVID-19 public health and social measures: a comprehensive picture of six Asian countries. BMJ Glob Health 2022; 7:e009863. [PMID: 36343969 PMCID: PMC9644075 DOI: 10.1136/bmjgh-2022-009863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/15/2022] [Indexed: 11/09/2022] Open
Abstract
The COVID-19 pandemic will not be the last of its kind. As the world charts a way towards an equitable and resilient recovery, Public Health and Social Measures (PHSMs) that were implemented since the beginning of the pandemic need to be made a permanent feature of health systems that can be activated and readily deployed to tackle sudden surges in infections going forward. Although PHSMs aim to blunt the spread of the virus, and in turn protect lives and preserve health system capacity, there are also unintended consequences attributed to them. Importantly, the interactions between PHSMs and their accompanying key indicators that influence the strength and duration of PHSMs are elements that require in-depth exploration. This research employs case studies from six Asian countries, namely Indonesia, Singapore, South Korea, Thailand, the Philippines and Vietnam, to paint a comprehensive picture of PHSMs that protect the lives and livelihoods of populations. Nine typologies of PHSMs that emerged are as follows: (1) physical distancing, (2) border controls, (3) personal protective equipment requirements, (4) transmission monitoring, (5) surge health infrastructure capacity, (6) surge medical supplies, (7) surge human resources, (8) vaccine availability and roll-out and (9) social and economic support measures. The key indicators that influence the strength and duration of PHSMs are as follows: (1) size of community transmission, (2) number of severe cases and mortality, (3) health system capacity, (4) vaccine coverage, (5) fiscal space and (6) technology. Interactions between PHSMs can be synergistic or inhibiting, depending on various contextual factors. Fundamentally, PHSMs do not operate in silos, and a suite of PHSMs that are complementary is required to ensure that lives and livelihoods are safeguarded with an equity lens. For that to be achieved, strong governance structures and community engagement are also required at all levels of the health system.
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Affiliation(s)
- Chuan De Foo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Monica Verma
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - See Mieng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Victoria Haldane
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Katherine Ann Reyes
- School of Public Health, Pamantasan ng Lungsod ng Maynila, Manila, Philippines
- Alliance for Improving Health Outcomes, Quezon, Philippines
| | - Fernando Garcia
- College of Public Health, University of the Philippines, Manila, Philippines
| | - Carmelita Canila
- College of Public Health, University of the Philippines, Manila, Philippines
| | | | | | - Tiara Marthias
- Department of Public Health, Gadjah Mada University Faculty of Medicine Public Health and Nursing, Yogyakarta, Indonesia
- The University of Melbourne Nossal Institute for Global Health, Melbourne, Victoria, Australia
| | - Yodi Mahendradhata
- Department of Public Health, Gadjah Mada University Faculty of Medicine Public Health and Nursing, Yogyakarta, Indonesia
| | | | | | - Warapon Poungkantha
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Tran Mai Oanh
- Health Strategy and Policy Institute, Ministry of Health, Hanoi, Viet Nam
| | - Ong The Due
- Health Strategy and Policy Institute, Ministry of Health, Hanoi, Viet Nam
| | - Nima Asgari-Jirhandeh
- Asia-Pacific Observatory on Health Systems and Policies, World Health Organization, New Delhi, India
| | | | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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19
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Vetrugno G, Sanguinetti M, Murri R, Sali M, Marchetti S, Santangelo R, Fantoni M, Cingolani A, Scoppettuolo G, Di Donato M, Grassi VM, Foti F, Marchese L, De-Giorgio F, Oliva A, Staiti D, De Simone FM, Pascucci D, Cascini F, Pastorino R, Pires Marafon D, Cambieri A, Laurenti P, Boccia S, Ricciardi W, Franceschi F. Effect of Lockdowns on Hospital Staff in a COVID Center: A Retrospective Observational Study. Vaccines (Basel) 2022; 10:1847. [PMID: 36366356 PMCID: PMC9698425 DOI: 10.3390/vaccines10111847] [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: 09/23/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
At the onset of the SARS-CoV-2 pandemic, individual and social measures were strengthened through restrictive non-pharmaceutical interventions, labelled with the term “lockdown”. In Italy, there were two lockdowns (9 March 2020−3 May 2020 and 3 November 2020−27 March 2021). As part of preventive measures, healthcare workers and the administrative staff population of Policlinico A. Gemelli underwent nasopharyngeal swab tests from 1 March 2020 to 9 February 2022, a long time interval that includes the two aforementioned lockdowns. The population included 8958 people from 1 March 2020 to 31 December 2020; 8981 people from 1 January 2021 to 31 December 2021; and 8981 people from 1 January 2022 to 9 February 2022. We then analysed pseudo-anonymized data, using a retrospective observational approach to evaluate the impact of the lockdown on the incidence of SARS-CoV-2 infections within the population. Given the 14 day contagious period, the swab positivity rate (SPR) among the staff decreased significantly at the end of the first lockdown, every day prior to 18 May 2020, by 0.093 (p < 0.0001, CI = (−0.138−−0.047)). After the fourteenth day post the end of the first lockdown (18 May 2020), the SPR increased daily at a rate of 0.024 (p < 0.0001, 95% CI = (0.013−0.034)). In addition, the SPR appeared to increase significantly every day prior to 17 November 2020 by 0.024 (p < 0.0001, CI = (0.013−0.034)). After the fourteenth day post the start of the second lockdown (17 November 2020), the SPR decreased daily at a rate of 0.039 (p < 0.0001, 95% CI = (−0.050−−0.027)). These data demonstrate that, in our Institution, the lockdowns helped to both protect healthcare workers and maintain adequate standards of care for COVID and non-COVID patients for the duration of the state of emergency in Italy.
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Affiliation(s)
- Giuseppe Vetrugno
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maurizio Sanguinetti
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Rita Murri
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Michela Sali
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Simona Marchetti
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Rosaria Santangelo
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Massimo Fantoni
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonella Cingolani
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giancarlo Scoppettuolo
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Michele Di Donato
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Vincenzo M. Grassi
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Federica Foti
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Marchese
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Fabio De-Giorgio
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Oliva
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Domenico Staiti
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Domenico Pascucci
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Fidelia Cascini
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Roberta Pastorino
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Denise Pires Marafon
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Cambieri
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Patrizia Laurenti
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Stefania Boccia
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Walter Ricciardi
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Franceschi
- Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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20
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Mura M, Simon F, Pommier de Santi V, Tangy F, Tournier JN. Role and Limits of COVID-19 Vaccines in the Delicate Transition from Pandemic Mitigation to Endemic Control. Vaccines (Basel) 2022; 10:vaccines10091555. [PMID: 36146633 PMCID: PMC9505741 DOI: 10.3390/vaccines10091555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/30/2022] Open
Abstract
The recent surge of COVID-19 related to the Omicron variant emergence has thrown a harsh light upon epidemic control in the near future. This should lead the scientific and medical community to question the long-term vaccine strategy for SARS-CoV-2 control. We provide here a critical point of view regarding the virological evolution, epidemiological aspects, and immunological drivers for COVID-19 control, including a vaccination strategy. Overall, we need more innovations in vaccine development to reduce the COVID-19 burden long term. The most adequate answer might be better cooperation between universities, biotech and pharmaceutical companies
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Affiliation(s)
- Marie Mura
- Microbiology and Infectious Diseases Department, Institut de Recherche Biomédicale des Armées (IRBA), 91220 Brétigny sur Orge, France
- Innovative Vaccine Laboratory, Institut Pasteur, 75015 Paris, France
| | - Fabrice Simon
- Department of Infectious Diseases and Tropical Medicine, HIA Laveran, 13384 Marseille, France
| | | | - Frédéric Tangy
- Innovative Vaccine Laboratory, Institut Pasteur, 75015 Paris, France
| | - Jean-Nicolas Tournier
- Microbiology and Infectious Diseases Department, Institut de Recherche Biomédicale des Armées (IRBA), 91220 Brétigny sur Orge, France
- Innovative Vaccine Laboratory, Institut Pasteur, 75015 Paris, France
- École du Val-de-Grâce, 75005 Paris, France
- Correspondence:
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21
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Zhang Q, Phang CW, Zhang C. Does the internet help governments contain the COVID-19 pandemic? Multi-country evidence from online human behaviour. GOVERNMENT INFORMATION QUARTERLY 2022; 39:101749. [PMID: 35991759 PMCID: PMC9374504 DOI: 10.1016/j.giq.2022.101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/26/2022] [Accepted: 07/19/2022] [Indexed: 11/04/2022]
Abstract
The effectiveness of social distancing and other public health interventions for containing the COVID-19 pandemic has been demonstrated. However, whether and how Internet use behaviours can lead to enhanced self-protection and reduced transmission when considered in conjunction with behavioural interventions remains unclear. This study investigated the strength of effective Internet behaviours and its interaction with global public health interventions for controlling the COVID-19 pandemic. We conducted an econometric analysis of multisource infection and policy information, Internet behaviour, and meteorological information from worldwide in a 3-month period. People's Internet behaviours may contribute crucially to pandemic containment. Furthermore, they may help enhance the effects of public health interventions, particularly behavioural interventions. We discussed plausible mechanisms through which Internet behaviours reduce epidemic spread independently or in tandem with behavioural interventions. Further investigation into the heterogeneity of the interventions demonstrates Internet behaviour's significance in heightening the effects of difficult-to-implement, primitive crisis orientation, and specific objectives of interventions. Governments should recognise the importance of the Internet and leverage it in managing social crises. Our findings serve as a reference for the formulation of global public health policy. Specifically, the insights provided herein can facilitate the implementation of strategies for containing ongoing secondary outbreaks of COVID-19 or outbreaks of other emergent infectious diseases.
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Affiliation(s)
- Qi Zhang
- Party School of the Chengdu Committee of the Chinese Communist Party, Chengdu 610110, China.,School of Management, Fudan University, Shanghai 200433, China
| | - Chee Wei Phang
- Business School, University of Nottingham Ningbo, Ningbo 315100, China
| | - Cheng Zhang
- School of Management, Fudan University, Shanghai 200433, China
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22
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Hagger MS, Hamilton K. Social cognition theories and behavior change in COVID-19: A conceptual review. Behav Res Ther 2022; 154:104095. [PMID: 35605335 PMCID: PMC9005242 DOI: 10.1016/j.brat.2022.104095] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/31/2022] [Accepted: 04/08/2022] [Indexed: 01/31/2023]
Abstract
The COVID-19 pandemic has had unprecedented health, economic, and social consequences worldwide. Although contact reductions and wearing face coverings have reduced infection rates, and vaccines have reduced illness severity, emergence of new variants of the coronavirus that causes COVID-19, and the shift from pandemic to endemic patterns of infection, highlights the importance of ongoing preventive behavior adherence to manage future outbreaks. Research applying social cognition theories may assist in explaining variance in these behaviors and inform the development of efficacious behavior change interventions to promote adherence. In the present article, we summarize research applying these theories to identify modifiable determinants of COVID-19 preventive behaviors and the mechanisms involved, and their utility in informing interventions. We identify limitations of these applications (e.g., overreliance on correlational data, lack of long-term behavioral follow-up), and suggest how they can be addressed. We demonstrate the virtue of augmenting theories with additional constructs (e.g., moral norms, anticipated regret) and processes (e.g., multiple action phases, automatic processes) to provide comprehensive, parsimonious behavioral explanations. We also outline how the theories contribute to testing mechanisms of action of behavioral interventions. Finally, we recommend future studies applying these theories to inform and test interventions to promote COVID-19 preventive behavior adherence.
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Affiliation(s)
- Martin S Hagger
- Department of Psychological Sciences, University of California, Merced, 5200 N. Lake Rd., Merced, CA, 95343, USA; Health Sciences Research Institute, University of California, Merced, 5200 N. Lake Rd., Merced, CA, 95343, USA; Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, FI-40014, Jyväskylä, Finland; School of Applied Psychology, Griffith University, Mt. Gravatt Campus, 176 Messines Ridge Rd, Mt. Gravatt, QLD, 4122, Australia.
| | - Kyra Hamilton
- Health Sciences Research Institute, University of California, Merced, 5200 N. Lake Rd., Merced, CA, 95343, USA; School of Applied Psychology, Griffith University, Mt. Gravatt Campus, 176 Messines Ridge Rd, Mt. Gravatt, QLD, 4122, Australia; Menzies Health Institute Queensland, Griffith University, G40 Griffith Health Centre, Level 8.86, Gold Coast Campus, QLD, 4222, Australia
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23
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Folkvord F, Peschke L, Ağca YG, van Houten K, Stazi G, Lupiáñez-Villanueva F. Preferences in the willingness to download a Covid tracing app: An experimental study in the Netherlands and Turkey (Preprint). JMIR Form Res 2022; 6:e37891. [PMID: 35867840 PMCID: PMC9337617 DOI: 10.2196/37891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 12/03/2022] Open
Abstract
Background Despite the worldwide growth in using COVID-19 contact tracing apps (CTAs) and the potential benefits for citizens, governments, health care professionals, businesses, and other organizations, only a few studies have examined the factors affecting the levels of willingness to download a CTA. Objective This study aimed to investigate individuals’ preferences in the willingness to download a health app. Methods We conducted an experimental study in 2 countries, the Netherlands (N=62) and Turkey (N=83), using 4 different vignettes (ie, data protection, manufacturer, reward, and gaming models) with different attributes. Participants were randomly assigned to 1 of the conditions within the vignettes. Results The results showed that data protection and gaming elements are factors that influence the willingness to download a COVID-19 CTA. More specifically, we see that data protection is an important factor explaining the willingness to download the app in Turkey, whereas including gaming elements significantly affects the willingness to download the app in the Netherlands. Conclusions COVID-19 CTAs are highly promising to reduce the spread of the virus and make it easier to open up society faster, especially because they can be used quickly and share information rapidly. COVID-19 CTA developers must ensure that their apps satisfactorily and sufficiently address ethical considerations, even in times of crisis. Furthermore, integrating gaming elements in the CTA could enhance the willingness to download the CTA.
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Affiliation(s)
- Frans Folkvord
- Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands
- PredictBy, PredictBy Research, Barcelona, Spain
| | - Lutz Peschke
- Department of Communication and Design, Bilkent University, Ankara, Turkey
| | - Yasemin Gümüş Ağca
- Department of Communication and Design, Bilkent University, Ankara, Turkey
| | | | | | - Francisco Lupiáñez-Villanueva
- PredictBy, PredictBy Research, Barcelona, Spain
- Department of Information and Communication Science, Universitat Oberta de Catalunya, Barcelona, Spain
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24
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Cheong YL, Ghazali SM, Che Ibrahim MKB, Kee CC, Md Iderus NH, Ruslan QB, Gill BS, Lee FCH, Lim KH. Assessing the Spatiotemporal Spread Pattern of the COVID-19 Pandemic in Malaysia. Front Public Health 2022; 10:836358. [PMID: 35309230 PMCID: PMC8931737 DOI: 10.3389/fpubh.2022.836358] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction The unprecedented COVID-19 pandemic has greatly affected human health and socioeconomic backgrounds. This study examined the spatiotemporal spread pattern of the COVID-19 pandemic in Malaysia from the index case to 291,774 cases in 13 months, emphasizing on the spatial autocorrelation of the high-risk cluster events and the spatial scan clustering pattern of transmission. Methodology We obtained the confirmed cases and deaths of COVID-19 in Malaysia from the official GitHub repository of Malaysia's Ministry of Health from January 25, 2020 to February 24, 2021, 1 day before the national vaccination program was initiated. All analyses were based on the daily cumulated cases, which are derived from the sum of retrospective 7 days and the current day for smoothing purposes. We examined the daily global, local spatial autocorrelation and scan statistics of COVID-19 cases at district level using Moran's I and SaTScan™. Results At the initial stage of the outbreak, Moran's I index > 0.5 (p < 0.05) was observed. Local Moran's I depicted the high-high cluster risk expanded from west to east of Malaysia. The cases surged exponentially after September 2020, with the high-high cluster in Sabah, from Kinabatangan on September 1 (cumulative cases = 9,354; Moran's I = 0.34; p < 0.05), to 11 districts on October 19 (cumulative cases = 21,363, Moran's I = 0.52, p < 0.05). The most likely cluster identified from space-time scanning was centered in Jasin, Melaka (RR = 11.93; p < 0.001) which encompassed 36 districts with a radius of 178.8 km, from November 24, 2020 to February 24, 2021, followed by the Sabah cluster. Discussion and Conclusion Both analyses complemented each other in depicting underlying spatiotemporal clustering risk, giving detailed space-time spread information at district level. This daily analysis could be valuable insight into real-time reporting of transmission intensity, and alert for the public to avoid visiting the high-risk areas during the pandemic. The spatiotemporal transmission risk pattern could be used to monitor the spread of the pandemic.
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Affiliation(s)
- Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | | | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nuur Hafizah Md Iderus
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Qistina binti Ruslan
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Balvinder Singh Gill
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Florence Chi Hiong Lee
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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25
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Kontis V, Bennett JE, Parks RM, Rashid T, Pearson-Stuttard J, Asaria P, Zhou B, Guillot M, Mathers CD, Khang YH, McKee M, Ezzati M. Lessons learned and lessons missed: impact of the coronavirus disease 2019 (COVID-19) pandemic on all-cause mortality in 40 industrialised countries and US states prior to mass vaccination. Wellcome Open Res 2022; 6:279. [PMID: 35252592 PMCID: PMC8861471 DOI: 10.12688/wellcomeopenres.17253.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 01/21/2023] Open
Abstract
Background: Industrialised countries had varied responses to the COVID-19 pandemic, which may lead to different death tolls from COVID-19 and other diseases. Methods: We applied an ensemble of 16 Bayesian probabilistic models to vital statistics data to estimate the number of weekly deaths if the pandemic had not occurred for 40 industrialised countries and US states from mid-February 2020 through mid-February 2021. We subtracted these estimates from the actual number of deaths to calculate the impacts of the pandemic on all-cause mortality. Results: Over this year, there were 1,410,300 (95% credible interval 1,267,600-1,579,200) excess deaths in these countries, equivalent to a 15% (14-17) increase, and 141 (127-158) additional deaths per 100,000 people. In Iceland, Australia and New Zealand, mortality was lower than would be expected in the absence of the pandemic, while South Korea and Norway experienced no detectable change. The USA, Czechia, Slovakia and Poland experienced >20% higher mortality. Within the USA, Hawaii experienced no detectable change in mortality and Maine a 5% increase, contrasting with New Jersey, Arizona, Mississippi, Texas, California, Louisiana and New York which experienced >25% higher mortality. Mid-February to the end of May 2020 accounted for over half of excess deaths in Scotland, Spain, England and Wales, Canada, Sweden, Belgium, the Netherlands and Cyprus, whereas mid-September 2020 to mid-February 2021 accounted for >90% of excess deaths in Bulgaria, Croatia, Czechia, Hungary, Latvia, Montenegro, Poland, Slovakia and Slovenia. In USA, excess deaths in the northeast were driven mainly by the first wave, in southern and southwestern states by the summer wave, and in the northern plains by the post-September period. Conclusions: Prior to widespread vaccine-acquired immunity, minimising the overall death toll of the pandemic requires policies and non-pharmaceutical interventions that delay and reduce infections, effective treatments for infected patients, and mechanisms to continue routine health care.
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Affiliation(s)
- Vasilis Kontis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - James E. Bennett
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Robbie M. Parks
- The Earth Institute, Columbia University, New York, NY, USA
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Theo Rashid
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | | | - Perviz Asaria
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Bin Zhou
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Michel Guillot
- Population Studies Center, Department of Sociology, University of Pennsylvania, Philadelphia, PA, USA
- French Institute for Demographic Studies (INED), Paris, France
| | | | - Young-Ho Khang
- Institute of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Majid Ezzati
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana
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26
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McIntyre PB, Aggarwal R, Jani I, Jawad J, Kochhar S, MacDonald N, Madhi SA, Mohsni E, Mulholland K, Neuzil KM, Nohynek H, Olayinka F, Pitisuttithum P, Pollard AJ, Cravioto A. COVID-19 vaccine strategies must focus on severe disease and global equity. Lancet 2022; 399:406-410. [PMID: 34922639 PMCID: PMC8676417 DOI: 10.1016/s0140-6736(21)02835-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 02/04/2023]
Affiliation(s)
- Peter B McIntyre
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ilesh Jani
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | | | - Sonali Kochhar
- Department of Global Health, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA
| | - Noni MacDonald
- Dalhousie Medical School, Dalhousie University, Halifax, NS, Canada
| | - Shabir A Madhi
- South African Medical Research Council Vaccine and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Kim Mulholland
- Department of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Kathleen M Neuzil
- Center for Vaccine Development and Global Health, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Hanna Nohynek
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Folake Olayinka
- STAR Fellows Department, Public Health Institute, Washington DC, USA
| | - Punnee Pitisuttithum
- Department of Clinical Tropical Medicine and the Vaccine Trial Centre, Mahidol University, Nakhon Pathom, Bangkok
| | | | - Alejandro Cravioto
- Department of Public Health, National Autonomous University of Mexico, Mexico City, Mexico
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27
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